The heavy scents of spices waft from ethnic cuisine towards the waterline. Gazing down the paths at the edge of the marina, antique lamps glowing along the tree-lined route, the enticing laughter and soft music reach out to me as I stroll briskly towards you. Awaiting my arrival, your heart pumping in anticipation, patience languishes. The day was sunny and warm, the night breezes crisp, yet inviting me to hurry towards my prize. Active again, investing in heated play, sumptuous, healthy food, attention to me once more. Socially active again because I am taking care of myself, preventively, regularly, finding natural tools to keep me moving. Welcome to living a contemporary, healthy, good nutrition-filled, fit and enjoyable life.

If you want an alternative perspectives on contemporary health, nutrition and fitness, we are here.

The Funalt III Group

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The patient presents with recurrent pain about the outer aspect of the right elbow. He reports that the pain primarily occurs with forceful gripping and occurs with movements of his right upper extremity characterized as repetitive wrist extension and palm upwards rotation of his forearm (supination).

He reports that the symptoms are recurrent, associated primarily with periods of increased racquet sports activity and fitness training. He reports prior use of OTC and prescription NSAIDs, and receiving a number of local steroid injections.

On physical examination his right upper extremity appears normal, without focal redness or swelling. The soft tissue over the lateral epicondyle is mildly swollen and of a softer, fuller texture compared to that on the left. He demonstrates normal active range of motion at the elbow. He reports slight increase in pain over the lateral elbow (epicondyle) with resisted wrist extension and supination, with mildly decreased strength (pain limited) compared to the left.

Assessment

1. Lateral epicondylitis

Considerations

The diagnosis is not particularly challenging or uncommon. Of significance is that the label is only applicable for a limited period. Tendons attaching at the lateral epicondyle that are repeatedly inflamed may degenerate over time, epicondylitis transitioning to epicondylosis. As such, traditional oral anti-inflammatory treatment and local steroid injections will not be effective indefinitely. Moreover, excessive local steroid injections may hasten deterioration of the tissues.

Treatment

1. Educate the patient about the involved musculature, adjacent soft tissue and function.

2. The patient is to attempt to eliminate contributing causal/exacerbating activities as much as is possible.

3. We discussed his workout routine making adjustments to its content.

4. I recommended that he consider purchasing a lighter weight hybrid/composite tennis racquet and decrease backhand stroke frequency.

5. We discussed applying alternating heat, ice, mild friction massage and local electrical stimulation (TENS) to encourage local circulation with limited concurrent analgesic benefit.

6. I recommended twice a day application of a thin layer of topical DMSO overlaid with a balm composed of one or more of the following numerous substances: menthol, aloe, eucalyptus, cayenne, arnica, Emu oil, devil’s claw, c. indica (as allowed in his State); other agents are also applicable.

Presuming that the tissues have not already degenerated significantly and the patient can make appropriate lifestyle changes, I anticipate a positive response to the treatment plan over time. At follow-up we will address additional evaluation and treatment alternatives depending upon case status and how much of the plan he was able to fully engage.

Contact us with questions about this case and other issues of interest.

Humans are composed of approximately 55 to 75 percent water depending upon age, gender and percent body fat. Regular replacement of internal water is critical to our health. As such, one might state that the most important aspect of good healthcare is quality water consumption. When is the last time your favorite politician or clinician discussed water quality as an important issue in relation to your healthcare?

Have you ever gone online trying to assess health insurance products? There is no universal template that all insurers are required to complete to allow head-to-head product comparison. As such, it takes days to make partial comparisons and you are frequently asked a significant number of personal questions. The whole process is very invasive, challenging and inexpedient. Moreover, you are also obliged to independently determine the veracity and reliability of the claims about services provided by the insurer, a monumental task. However, if you are finally able to get insured, its now time to see a physician.

Health care service delivery by very large regional medical groups and service provider panels developed by insurance companies often results in significant losses of medical practice autonomy by individual clinicians. Primary care physicians are those most significantly affected. Practice content, style, setting and numerous other elements are increasingly so impaired that there is an escalating shortage of physicians in many areas of the country. Physician assistants and nurse practitioners are frequently substituted in these understaffed regions because the cost per provider to the systems and insurers is lower and such fits organizational budgets.

Head to head, when all of these practitioners were undergraduates, you can bet that the women and men now functioning as physicians academically outperformed their nursing and physician assistant peers. However, some of our governments, insurers and medical groups pursuing cost-containment will foist upon us the suggestion that there is comparable quality of knowledge, experience and care to be received via all of these clinicians. Moreover, they will use phrases like “as good as” or “delivered with increased sensitivity” while maintaining or increasing premiums and costs of ongoing services. If you do not demand the products and services for which you pay, don’t be surprised if in the future a “health care assistant” reading a computer algorithm supported by an insurance adjuster’s treatment guideline becomes your medical provider.

Additionally, new pharmacists are graduating from schools around the nation. Depending upon their degrees, Masters or Doctorate in Pharmacy, the students have just completed six to eight years of rigorous scientific training in combined undergraduate and graduate studies. A successful pharmacist needs to be knowledgeable in pharmaceutical biochemistry, physiology, computer science, small business management, and the multiple elements of insurance and health delivery systems. However, as health care delivery system models change and local drug stores become satellites of large chains, a greater number of lesser trained pharmacy technicians are being networked with a single regional pharmacist to lower the cost of product delivery.

So, now that you have fought through the maze of health insurance acquisition, I hope that it pays for a physician and pharmacist. Maybe you need to hire an agent.

Patient choice is a permutation of the theory of microeconomics that relates medical service preferences to service demand curves. The link between personal preferences, use of medical services, and the demand curve is one of the most complex relations in economics. Implicitly, economists assume that anything purchased will be consumed, unless the purchase is for integration into production. Of course, most medical care expenditures are not made for production except for those made by medical businesses. Preferences are the desires by each individual for the use of medical services or goods and services.

We can make life easy for our bodies and minds to live and function or we may challenge our bodies by the way we live. A person who is in a state of ease should not be stressed, fatigued, and dysfunctional, in pain, overweight or otherwise often mechanically, physiologically, chemically, or mentally characterized by other than normal status. The prefix “dis” is defined by absence of, opposite of, deprived of, or removed. As such, living with dis-ease/disease is life with a body and/or mind that is absent of, or not in a state of ease.

Memorial Day is experienced reverently and in celebration of the accomplishments of rites of Spring: cleaning, planting, trimming, and sprucing. The sound of steel wool on barbecue grill surfaces, scrubbing up the fire pits, and scaling off the calcium rings in swimming pools will complement the breezes swooshing through new foliage as we prepare for the onset of summer fun, and joy of Memorial Day.

Many of you should likewise prepare your shoulders for the holiday. Its not because the plates of food and the beverages will wear on your musculature, rather you are ill-prepared for water sport fun.

Swimmer’s shoulder is a term used to describe the shoulder symptoms of a competitive swimmer or the overzealous weekend athlete. The pain is similar to that experienced by many athletes playing positions requiring high volume throwing such as pitchers and quarterbacks. While the orientation of the body differs in swimming, the mechanisms of injury are very similar, repetitive wind-up, backward then forwards motions of the shoulder(s) overhead. In swimming, overhead is simply performed in a horizontal position.

Swimming can be even harder on an overzealous weekend sportsman because even between pitches and passes there are periods of rest. Whereas as long as you are moving through the water, your upper extremities, particularly your shoulders are getting a substantial workout. Moreover, swimming requires above average shoulder flexibility and range of motion to be performed well.

The muscle group most frequently injured is commonly referred to as the rotator cuff. The actual component most often offended is the tendon of the supraspinatus muscle as it inserts into the proximal aspect of your arm at the humerus. As such, the injury is known as supraspinatus or rotator cuff tendonitis.

To avoid the injury this spring, start warming up now. Stretching exercises involving reaching your hands forwards, rearwards, away from your sides, up as high as you can reach, “wing-flapping “ motions, and turning circles with your arms along your sides and/or in front of you as you lean forward slightly. There are more muscles, ligaments and cartilage that make up the rotator cuff and complementary elements than just the supraspinatus. You need to prepare all of them for your holiday fun and the summer activities on the way. Stretch your rotator cuff and avoid a Swimmers’ Shoulder injury.

Contact us with questions about this subject or others of interest to you.

A young woman briskly traverses the stairs, downwards to the kitchen. Near the bottom she slips, falling firmly onto her buttocks. She’s more startled than anything, arising and getting on with her day. However, she later notices pain in the right side of her pelvis when her weight is substantially shifted to her right leg and when she sits crossed legged on the floor during stretching. She also notes right gluteal pain when rotating her leg inwards and outwards. She hopes that the symptoms spontaneously resolve soon so as to not interfere with caring for her newborn and her body reshaping program.

Upon visiting her doctor, he finds no problems on x-ray. He informed her that normal hormone induced laxity of pelvic ligaments during late pregnancy, followed by the trauma (fall) resulted in some sacroiliac joint dysfunction. The stability of the joints between the sacrum and pelvic bones is provided by ligaments, no muscles directly support the SI joints.

Some important conservative care include restricted activity (avoid that which aggravates your condition), deep massage if there is an apparent occasional painful locking of the joints, flexibility exercises to engage the soft tissue as it heals. Deep heat and ice application will provide analgesia and promote circulation. You may address pain with oral OTC and prescription medicines, or preferred herbal analgesics. The target tissues are often too deep for topical medicated rubs.

Contact us with specific questions regarding contemporary assessment and management of sacroiliac joint injuries.

Most persons with a sense of quality, contemporary health, nutrition and fitness have a reasonable understanding of good dietary and exercise practices. Moreover, the battle is generally that of taking action versus accepting the fallback mantra of “be satisfied with who you are.” The latter is acceptable only if you have acknowledged that where you are is not where you want/need to be, and the satisfaction is based upon your efforts in transition. If you need a new strategy, you may wish follow these seven free steps to guaranteed weight loss.

If you are not yet convinced, consider the following. The media is still promoting H1N1 vaccination (we have to get rid of the overstock), but the real epidemic in the U.S. is obesity. Affecting more than sixty percent of the population, it will cause far more morbidity and mortality than the flu. It affects all age groups. Moreover, its high prevalence is a measure of our self-deception. If you don’t believe that you are deceiving yourself, then be your own fitness spy.

Get a small notebook and record the following:

1. The time of day you eat and drink anything with calories.

2. Your hunger level (1-10 scale) at the time of your intake.

3. What and how much did you eat and/or drink?

4. Did you apply gravies, toppings, dressings, etc., and what volume?

5. Your mood when you eat and/or drink.

6. Your reason for eating and/or drinking.

7. Describe your exercise for the day.

After recording your consumption activity for approximately three weeks, review it against what you know to be good practices. Make some decisions and develop some strategies to address your findings (mistakes) and start again. Enjoy being a “fitness spy”, and the next thing you’ll be recording is your successful steps to weight loss, guaranteed.

Some diseases are associated with specific, identified, genetic markers. Hence, there is a specialty of medical genetics. Other diseases simply tend to occur in families, thereby the bothersome questions about your family’s medical history.

Just because the disease or health issue occurred in a preceding generation does not mean you are destined to develop the condition. Families also have histories of smoking, alcohol consumption, common nutrition/diet and fitness habits, living and working in proximate locations at similar jobs, and engaging in common pastimes and other behaviors that contribute to undesirable health outcomes. Break historically adverse contributors to health and yield an improved, contemporary health future.

Marketers know that in the U.S., the following are difficult to resist as backdrops to presenting products:

1. Attractive people of the opposite sex.

2. Lush and provocative settings.

3. The expression of aphrodisiac-like outcomes and paths to exciting lives and riches.

As such, these backdrops are pervasive in product promotions. You will never see a slovenly, unattractive, sick addict in withdrawal, in dark, dismal surrounds working as a spokesperson for any product.

Instead, expect a beautiful, handsome, comely, stately, robust, funny, warm, or attractively quirky girl/guy from next door to confidently introduce every product that you don’t need and may even kill you over time. Moreover, they may even offer it for $19.95 plus Shipping & Handling.

Bottom line health advice: If it takes an expensive/sexy ad campaign to sell it to you, you will probably do better without it. Work on good nutrition, exercise, and a healthy lifestyle to get your rise out of life.