New Office Location We are officially at our new office location at the following address and will be open for the first time at this new location on Monday, June 8th, 2009: Meridian Valley Chiropractic Clinic, PS 13106 S.E. 240th St. Suite 201 Kent, WA 98031 This office is about 1 block west (closer to Kent) of our old location on 240th Street in Kent, and is on the same side of the road. The building is a 2-story structure that has a Windermere sign on the front. We are on the 2nd floor right next to where the elevator is. The sign "Meridian Valley Chiropractic" is on the front of the building facing 240th Street where our suite is located. We will be open the same hours as we were at the old location. Our phone numbers will remain the same: (253) 631-1118, (253) 631-1156 fax If you have any questions, or need directions, please phone or e-mail us! RESEARCH: Chiropractic Adjustments Are Safe and More Effective There is no human experimental evidence that chiropractic adjustments or neck manipulations are causally related to strokes. The claims and statements that have been made and that have been interpreted by plaintiff attorneys and plaintiff experts to contend a link are based largely on anecdotes, case reports, and case controlled studies. A multitude of systematic distortions (biases) may effect the results and conclusions drawn from case-control studies. Other criteria must be used to determine whether a purported association is actually causative because an association does not prove causation. At this point in time due to the rarity with which vertebrobasilar accidents occur within this population, experimental evidence in humans and prospective cohort studies examining the hypothesis that chiropractic adjustments cause stroke - do not exist. In fact, recent research shows no evidence of excess risk of VBA stroke associated with chiropractic care as compared to primary care. Regarding advising on risks - a risk should be disclosed if a reasonable patient in what the doctor knows or should know to be the patient’s position, would be likely to attach significance to the risk or cluster of risks in deciding whether to forego the proposed therapy. Patients and doctors must make this decision based upon appropriate information. Since there is no human experimental evidence that chiropractic adjustments or neck manipulations are causally related to strokes, it is inappropriate to require a doctor to suggest that such a risk exists. Further, chiropractors utilize a number of techniques to address joint dysfunction and vertebral subluxation. Many techniques do not employ the type of manipulation that has been alleged to be a factor in vertebrobasilar accidents. This adds to the inappropriate nature of such a disclosure. The following is a response to research paper posted on a website with a multitude of doctors and other people, likely quackwatchers, jumping at any chance to spread innuendos and rumors about chiropractic. Here is a very, very brief glance at the emerging evidence base: Let's look at alternative conservative methods of care in relationship to "traditional" methods for surgical interventions for lumbar disc herniations: “In our experience, recurrent lumbar disc herniation occurred in more than 10% of patients and was associated with substantial health care costs. Development of novel techniques to prevent recurrent lumbar disc herniation is warranted to decrease the health care costs and morbidity associated with this complication. Prolonged conservative management should be attempted when possible to reduce the health care costs of this complication. Diagnosis and management of recurrent disc herniation were associated with a mean cost of $26,593 per patient, and the mean cost was markedly less for patients responding to conservative treatment ($2,315) compared with those requiring revision surgery ($39,836) (P <0.001). Of 141 primary lumbar discectomies performed at our institution with the patients followed for 1 year, the total cost associated with the management of subsequent recurrent disc herniation was $452,083 ($289,797 per 100 primary discectomies). The mean cost was substantially less in patients responding to conservative therapy compared with those requiring further surgery ($2,315 versus $39,836).” [McGirt MJ, Ambrossi GL, Datoo G, Sciubba DM, Witham TF, Wolinsky JP, Gokaslan ZL, Bydon A. Recurrent disc herniation and long-term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal. Neurosurgery. 2009 Feb;64(2): 338-44.] Looking at cost benefit comparison analysis of conservative care such as chiropractic care: "Comparing self-selected chiropractic patients to self-selected medical patients,.. In 6 of the 8 comorbid conditions studied, the rates were lower in the cohort with chiropractic coverage compared with the group without coverage. The rates of comorbid conditions in self-selected chiropractic patients were lower in all 8 categories compared with self-selected medical patients. They concluded that, the inclusion of a chiropractic benefit in a health plan produces a modest favorable selection processes resulting in a slightly younger patient population with fewer comorbidities. At the level of patient self-selection, chiropractic patients are considerably younger and healthier than comparable medical patients." [Nelson CF, Metz RD, LaBrot TM, Pelletier KR. The selection effects of the inclusion of a chiropractic benefit on the patient population of a managed health care organization. J Manipulative Physiol Ther. 2005 Mar-Apr;28(3):164-9.] And in this study they found: "For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs. This effect was greater on a per-episode basis than on a per-patient basis." [Nelson CF, Metz RD, LaBrot T. Effects of a managed chiropractic benefit on the use of specific diagnostic and therapeutic procedures in the treatment of low back and neck pain. J Manipulative Physiol Ther. 2005 Oct;28(8):564-9.] Ahhh, and the old tried and true, “Chiropractors kill people (neck-snap leading to stroke).” I suppose if you keep saying this enough times all the research that refutes this is supposed to go away. If you are not a quackwatcher then you have been taken in by a masterful scam. THERE WAS NO DIFFERENCE IN PATIENT STROKE INCIDENCE BETWEEN ALLOPATHIC (medical) AND CHIROPRACTIC PATIENTS IN THE FOLLOWING STUDY. If you read this landmark article you will see the issue is that patients with impending strokes are seeing their doctors for head pain and chiropractors commonly treat patients with head pain and headaches. The allopathic physicians are not adjusting patient's neck yet still their patient's also have a similar incidence. The most recent powerful study “Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study,” published in Spine (journal) on chiropractic and stroke by Cassidy et al concluded that, “vertebrobasilar artery (VBA) stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and primary care physician visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke [1].” They found NO “evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care [1].” In a groundbreaking study conducted to determine if vertebral artery dissection (VAD) and stroke are found following chiropractic office visits as part of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. According to the Task Force President Scott Haldeman, DC, MD, PhD, looking at the association between chiropractic office visits and the incidence of vertebral artery strokes: "current research suggests that dissections are probably multifactorial in origin [2]." He continued that "They appear to occur in a person with a genetic predisposition to arterial dissection. They also appear to require a second factor such as viral infection or possibly estrogen. They can then be triggered by a minor head movement, including activities of daily living, an adjustment or an examination of the neck [2]." In another related study they sought to “estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors. The “data were obtained from 28,807 treatment consultations and 50,276 cervical spine manipulations. There were no reports of serious adverse events. They concluded, even though no adverse event occurred in this study, “Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low [3].” While a patient with head and neck pain will not usually chose to do nothing for their discomfort, one of the most common options is usually over the counter pain non-steroidal anti-inflammatories (NSAIDS) . Similarly relating to low back pain, non-steroidal anti- inflammatories (NSAIDS) have not been found any more effective than spinal manipulation for the treatment of neck pain [4]. In fact the research has shown that spinal manipulation is safer by as much as a factor of several hundred times compared to the use of NSAIDS [5]. One concern is that no matter how safe a procedure might be if it offers no discernable benefit then any risk is unwarranted. Manual therapies such as chiropractic have been found to be as effective as NSAIDS [6] and even more cost effective when compared to physiotherapy or general medical care [7]. From the conclusion of a study by Rubinstein et al they found that with chiropractic care, “Adverse events may be common, but are rarely severe in intensity. Most of the patients report recovery, particularly in the long term. Therefore, the benefits of chiropractic care for neck pain seem to outweigh the potential risks [8].” 1. Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008 Feb 15;33(4 Suppl):S176-83. 2. DC Staff. Chiropractic and Stroke Risk: Setting the Record Straight. Dynamic Chiropractic, Sep 24, 2007; 25(20). [http://www.chiroweb.com/archives/25/20/05.html last accessed June 18, 2008] 3. Thiel HW, Bolton JE, Docherty S, Portlock JC. Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey. Spine. 2007; 32(21):2375-2378, 4. Dabbs V, Lauretti WJ, A risk assessment of cervical manipulation vs. NSAIDS for the treatment of neck pain. J Manipulative Physiol Ther 1996;8:530-6. 5. California Division of Workers Compensation Medical Unit (formerly the Industrial Medical Council):http://165.235.90.100/IMC/guidelines.html 6 Hoving JL, Koes BW, de Vet HCW, van der Windt AWM, Assendelft WJJ, van Mameren H, Deville WLJM, Pool JJM, Scholten RJPM, Bouter LM, Manual therapy, physical therapy, or continued care by a general practitioner for patient with neck pain: A randomized controlled trial. Annals of Internal Medicine 2002;136(10): 713-22. 7. Korthals-de B, Ingeborg BC, Hoving JL, van Tulder MW, Rutten-van Molken MPMH, Ader HJ, deVetHCW, Koes BW, Vondeling H, Bouter LM, Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: Economic evaluation alongside a randomized controlled trial, British Medical Journal 2003;326(7395): 911. 8. Rubinstein SM, Leboeuf-Yde C, Knol DL, de Koekkoek TE, Pfeifle CE, van Tulder MW. The Benefits Outweigh the Risks for Patients Undergoing Chiropractic Care for Neck Pain: A Prospective, Multicenter, Cohort Study J Manip Physiological Therapeutics. Jul 2007;30(6): 408-18. Mercury in High Fructose Corn Syrup In the October 2009 issue of the journal "Pediatrics", evidence was found that mercury is used as a preservative in high fructose corn syrup. It is used to enhance the shelf life of high fructose corn syrup, and is even found in products labeled "organic". This study clearly and reliably demonstrated that significant levels of mercury were present in 45% of the samples analyzed. The estimate for potential average daily exposure to mercury from high fructose corn syrup (HFCS) could be as high as 28.4 mcg (this is compared to daily exposure of mercury from dental amalgams of 0.79 to 1.91mcg). Mercury in any form is a very potent neurotoxin (something that kills nerve and brain cells) and is responsible for delayed development and permanent damage to human nervous systems - especially in children and newborns. Other than HFCS, compounds shown to have significant mercury content are Thimerosal (a preservative used in childhood vaccinations) and dental amalgams. Based upon the results of this study, it is highly recommended to avoid any food containing high fructose corn syrup - even if labeled as "organic". This is in addition to numerous studies that have linked high fructose corn syrup to escalating rates of diabetes and obesity in the United States.   Meridian Valley Chiropractic, along with all information provided, is for educational purposes only and is not an attempt to replace the need to seek healthcare services or to provide specific healthcare advice. We strongly encourage users to consult with their chiropractor or other qualified healthcare professionals for personal healthcare attention and answers to personal questions. Meridian Valley Chiropractic 13106 S.E. 240th St., Suite 201 Kent, WA 98031 Michael Hughes, DC E-Mail: mvcc92@gmail.com Phone: 253-631-1118 Fax: 253-631-1156   © 2001-2003 Healthy Practices, Inc. All rights reserved.