Risks of Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a standard class of drugs. They are used chronically for persistent pain due to osteoarthritis and other musculoskeletal disorders in older adults. Specifically, an estimated 40% of people age 65 and older fill one or more prescriptions for an NSAID each year. Exposing themselves to serious risk. Considering that NSAIDs are also currently available over the counter, it is clear to see that even more significant numbers of older adults expose themselves to NSAIDs in the United States.

NSAID use causes an estimated 41,000 hospitalizations and 3300 deaths each year among older adults.

Some specific ADRs of concern with chronic use of NSAIDs include:

  1. Gastrointestinal (GI)
  2. Renal
  3. Cardiovascular (CV – heart attacks or heart failure) and cerebrovascular (strokes)
  4. Central nervous system (CNS – dementia, cognitive impairment)

Although I only discuss ADRs affecting these four organ systems in this review, it is crucial to recognize that NSAIDs can cause various other adverse effects (e.g., hepatotoxicity (liver damage), cutaneous toxicity).

GI Risks Associated with Chronic NSAID Use

The spectrum of potential NSAID-related GI adverse effects is extensive, ranging from dyspepsia to life-threatening gastric bleeding. A nested case-control study showed that NSAIDs increase the risk of fatal peptic ulcers by nearly fivefold in older adults. Other studies show that the risk of peptic ulcer complications increases by three- to fivefold in older adults using NSAIDs. This risk higher in those taking concomitant systemic corticosteroids and warfarin. In addition, the risk is increased as early as within the first month of treatment and sustains over time. Often, these peptic ulcers are asymptomatic but can lead to significant morbidity and mortality.

Renal Risks Associated with Chronic NSAID Use

Similar to NSAID-related GI adverse effects, NSAID-induced renal dysfunction has a wide spectrum of adverse effects, including decreased glomerular perfusion, decreased glomerular filtration rate, and acute renal failure (ARF). While it is important to recognize that ARF can develop at any point during long-term NSAID therapy, the risk may be highest among those who have recently initiated therapy.

Specifically, in a nested case-control study of older adults, the risk of ARF increases nearly twofold for all NSAIDs within 30 days of initial use/prescribing. This risk is greater in those older adults with pre-existing chronic kidney disease (CKD) and in those who use long half-life NSAIDs.

Cardiovascular/Cerebrovascular (heart attack/stroke) Risks Associated with Chronic NSAID Use

NSAIDs worsen/increase the risk of various CV and cerebrovascular outcomes.

NSAIDs =also cause or exacerbate heart failure (HF) in older adults. Specifically, a cohort study of older adults found that rofecoxib and nonselective NSAIDs (naproxen, ibuprofen, and diclofenac), but not celecoxib were significantly associated with an increased risk of admission for HF as compared to those not taking NSAIDs. Another cohort study found that among patients who had survived their first hospitalization because of HF. Subsequent use of any NSAID (including celecoxib, as well as ibuprofen, diclofenac, naproxen, and other NSAIDs) led to a significantly increased risk of death.

CNS (Central Nervous System) Risks Associated with Chronic NSAID Use

NSAID use is associated with several CNS effects, including aseptic meningitis, psychosis, and cognitive dysfunction. Studies to date have not consistently shown a benefit from chronic NSAID use in reducing the risk of dementia or cognitive impairment. Interestingly, though, several studies have shown that high-dose NSAIDs (i.e., anti-inflammatory doses) may increase the risk of cognitive impairment. In particular, indomethacin appears to cause more CNS effects than other NSAIDs in the elderly.

Conclusion

This review has summarized the potential risks associated with chronic NSAID use in older adults. Including GI, renal, CV/cerebrovascular, and CNS adverse effects. Although I only discuss ADRs affecting these four organ systems in this review, it is important to recognize that NSAIDs can cause various other adverse effects (eg, hepatotoxicity, cutaneous toxicity). Moreover, it is important to note that nonpharmacological approaches (weight reduction, increasing physical activity) may also help patients who are experiencing musculoskeletal pain.

As the aging population rapidly grows over the next few decades, the risks associated with chronic NSAID use will remain a significant public health issue.

 

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Painkillers

Painkillers

Painkillers, are they bad, or are they good? Yes, they are great for masking pain, but do they do anything? Long term use of painkillers can cause many problems. Taking strong painkillers or just regular painkillers frequently for a long time can cause liver and stomach damage. Additionally, it may not even help the underlying problem. Perhaps after this blog, there will be more awareness about the side effects of pain killers.

Overuse of painkillers can lead to both liver and stomach damage. Let’s start with the most common painkillers that we can find over the counter; Paracetamol. The recommended daily allowance of Paracetamol is 4000 mg, which is equivalent to around eight tablets. However, many other medications already consist of Paracetamol in the formula, so this makes it hard to keep track of the amount that the body is intaking. Going over the recommended daily allowance can lead to long term liver damage or even liver death as well. Even if you stick to 4000 mg daily and do not exceed it, the daily or frequent use of this amount of painkillers is detrimental to your health.

Painkillers cont.

Another common painkiller are NSAIDs (Nonsteroidal anti-inflammatory drugs); iburoprofen, asprin and diclofenac are only a few that falls into this category. This category of painkillers can damage the stomach if it taken for long periods. These should only be taken under the recommendation of a GP. NSAIDs interfere with the production of mucus in the stomach. The mucus in the stomach forms a mucosal layer to prevent gastric acid from eroding and damaging the stomach. With a decrease of mucus production in the stomach, it becomes more susceptible to gastric ulcers. Study has shown that even taking NSAIDs just once is enough to cause irritation and inflammation of the stomach.

Finally, painkillers serve a purpose, but do they get to the root of the problem. By masking the pain, you may make the original problem worse. This is because pain is a way for our body that something is not right and should be looked into more thoroughly. If the painkiller covers the pain, we would have no idea that the area is injured or has a problem, and we would continue our activities. This may further aggravate the injury leading it to become a long term problem. Taking painkillers is like temporarily covering a leaky roof rather than repairing the problem. It will always keep coming back, and over time it’ll just get worse and worse.

So it’s up to whether or not you want to fix the problem and for your body to heal from the inside, or just mask the symptoms.

 

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Brain Health

The human brain is the organ that controls everything in our body. It acts as our engine and provides vital messages to different parts of our body to keep everything moving. Just like the engine in our cars, we keep it oiled, regularly serviced and well maintained. But how well do we maintain the health of our brains? There are several ways we can keep our brains well-groomed. This can be done through regular stimulus and healthy nutrition.

Improving the brain with stimulus

Just like other muscles in our body, our brain grows with constant stimulus. When we exercise our brain becomes stronger, smarter and better. We can stimulate our brain through many means such as reading, solving puzzles, playing challenging board games and regular exercise. Study has shown that if we do some sort of physical mental challenge it can help reinforce brain cell connection. This means we are less likely to suffer from mental diseases like Alzheimer’s and dementia.

Physical mental challenges involve your hands, eyes and brains; this means that these activities should not be done on our devices. In fact, research has shown that due to the amount of time we spend on our devices, our concentration span and our ability to recall information has decreased. So as a recommendation, it is good to stimulate our brain for 30 minutes a day. Whether this is reading a book, enjoying a puzzle or playing board games with family and friends.

Diet and mind

Another way to keep our brains well maintained is through a healthy diet. There are some foods that should be avoided if we want to keep our brains well maintained; sugary drinks (eg. fizzy drinks), artificial sweeteners, highly processed foods and alcohol just to name a few. Instead we should be consuming nutrients that are good for the brain such as omega 3, antioxidants, unsaturated fats and magnesium. All of these can be found in natural food sources such as berries, legumes, nuts, seeds (flaxseeds, linseeds, hemp seeds) and vegetables. A healthy diet can help your brain just as much as helping the rest of your body.

In a technological era that we are in right now, we have now lost the ability to concentrate for long periods of time and recall information that we have just read or seen. It is important to keep our brain well-conditioned at all times as this is the master organ of our body. This can be done through regular stimulus and a healthy diet. So please start taking care of your brain and give it what it needs so you can start excelling in your life.

 

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The Importance of Exercise: Cardiovascular Training

In our blog ‘Strength Training’, we talked about the importance of strength training and as a recommendation, 40-60 minutes of strength/weight training every week is needed. These exercises could be from something that we can just do with our body weight such as push ups, plank, squats, pull ups and many more. This week, I would like to explore cardiovascular training and how you can include it into your exercise routine.

Please be aware, when I say we need to do endurance training. We are not going to run a marathon or do a triathlon. We actually include cardio/endurance in our daily lives most of the time; when we walk, do chores at home and even while we are doing our weekly grocery shopping. Cardio training are just exercises that challenge our heart and lungs. As a recommendation, we should be doing around 150 minutes of cardio every week. That comes down to around 20 minutes a day. If you include 2 days of weight training exercises, it makes it 30 minutes a day over 5 days.

Cardiovascular training is just as important as doing weight training. There are many benefits from cardio training; increasing strength of heart muscles, lowering blood cholesterol and many more.

Cardiovascular training helps us build and increase the muscles of the heart just like how weight training help us build muscles. By increasing the strength of our heart muscles there will be less pressure in our cardiovascular system. This is because cardiovascular training can increase the efficiency of transporting oxygen around our body. Due to the increase in strength, it can also increase the stroke volume with each beat, which means that with each beat of the heart more blood will be pumped out. As a result, this can help you lower your blood pressure.

Another benefit of doing cardiovascular training is lowering blood cholesterol levels. There are two types of cholesterols; low density lipoprotein (LDL) and high density lipoprotein (HDL). LDL is known as bad cholesterol because it causes fatty build ups in the arteries which leads to narrowing of arteries. With the arteries narrowing, it is harder for blood to flow through causing an increase in blood pressure. HDL on the other hand is the good cholesterol in our body. HDL absorbs the bad cholesterol in your body and stores them in the liver. The liver then flushes the bad cholesterol out of your system. Cardiovascular training raises HDL in the body which induces the decrease of LDL. As a result, the arteries will be less narrow which will also bring down your blood pressure.

Some people think cardio is really boring but you can make if fun. If doing long walk or jogging isn’t your thing, you can try some high intensity interval training (also known as HIIT), go play a sport you enjoy or even go dancing with someone. The great thing about cardio is that it can be done anywhere, it is also a good opportunity to start a new hobby too!

Now you know the benefits of cardio, go out there and move your body. With this, it wraps up our 3 part series on why we should exercise. I hope now you know the importance of exercise and will take out some time from your busy day to keep your body healthy!

 

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WELLNESS – TOP 5 TIPS ON RAISING HEALTHY CHILDREN

In the next five blogs, I will reveal the top 5 tips on raising the wellness of children!

But first, I want to address an important question.

When it comes to raising healthy children, how would a chiropractor and a medical professional proceed?

There are two significant differences that exist between the ‘chiropractic wellness’ approach and the ‘medical approach’ to health as each sets a different goal and a different course of action.

Firstly the medical profession views the human body as a conglomerate of chemical and mechanical functions so that when a health challenge arises, doctors look specifically at the problem area and take a “we’ve got to fix it” approach. This might be through eradicating germs that they credit with creating disease or through offering drugs or surgery. The focus is to reduce symptoms and to address health issues in a disease-oriented model.

Wellness chiropractors see the body as a whole, acknowledging that the body works together. So that when we compromise, or tax one area of our body, other areas can, in time, become vulnerable.

Most of us are aware that our nervous system controls and coordinates every function of the body. Still, we may not appreciate that there a significant number of stressors that accompany our modern lifestyle, which taxes our spine and nervous system. These lifestyle factors move a body out of balance and threaten our health. Chiropractors ask questions like, “How can we help the body recreate balance and good function?” and “What part of this person’s environment is taxing their health?” Chiropractors take a vitalistic view of the human body, respecting the body’s innate or inner intelligence and adjust the spine to stimulate the body’s natural ability to recreate balance, order, and healing.

While current health issues are addressed, wellness chiropractors are most excited about helping clients become proactive about all facets of their health.

 

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Kids Balance Exercises: Tap and Hop

Introduction

Chiropractic care for your kids can greatly benefit their physical and mental development including improving their balance. Kids Chiropractic care is gentle, precise, and effective. Here’s a tip on how you can help your kids improve their balance with tap and hop.

[embedyt] https://www.youtube.com/watch?v=Sw4rezd3Gw0[/embedyt]

 

Kids Balance Exercises: Tap & Hop

This week’s activities focus on sharpening up your child’s body and brain connection. For this purpose, we will use the movement and stimulating the joints. Helping your child develop better balance and become more aware of their body position in space can improve their capacity to learn!

STEPS for Tap and Hop:

1. Firmly tap your knees three times.
2. Then tap your elbows three times.
3. Then tap your shoulders three times.
4. Crouch down and hop as high as you can.

GOAL: do this 5 times.

 

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Health Advice – How To Live Longer

It seems like every few years we have to unlearn some health advice that experts have come up with.

“Fats are bad… No, they’re good!”

“Carbs are the enemy! No wait, sugars! What’s the difference again?”

You’d think that after all these years of experimentation, documentation and research that they would have the answer by now. Well they have… But it’s no surprise fountain of youth or berry found in some remote location. In fact, the answer is no surprise at all. It’s really quite simple and attainable by the vast majority of people (even those that can’t afford organic bananas).

  1. Sleep well

Ever since we were young we’ve known that sleep is an important part of being healthy and energized throughout the day, but chances are that you’re overestimating the amount of sleep you get! Sleep affects pretty much everything, from your mental state to your digestion, so if you’re doing everything right but still not seeing results, take a closer look at your sleep habits!

  1. Eat better

Ever hear the saying “You are what you eat”? Well there’s some truth to that since the foods you eat literally make up your body. When you’re missing important nutrients, your body is more likely to get damaged or fall ill. Which is why it’s important to ensure that you’re in the habit of getting an adequate amount of carbohydrates (vegetables, rice, quinoa, fruits), protein (tofu, legumes and so on) and healthy fats (nuts and seeds). Bacon, sausages and deli meats are not a part of this list as they are not healthy in any amount and regarded as a Class A carcinogen (cancerous) which is the same level as smoking cigarettes.

  1. Move more

Exercise signals the body to use nutrients and balance blood sugars, build and repair bone and muscle tissue, and circulate blood, nutrients and oxygen throughout your entire body, including your brain! It’s one of the most incredible things you can do for your health. Its not optimal to sit around and watch Netflix all day (although there’s nothing wrong with the occasional binge), we were designed to move. So start moving! Whether it be a leisurely walk around the block or an intense Crossfit session, you’ve got to make it a lifestyle. If you’re looking for a community focused gym that you can get all your needs (cardio, strength, boxing, weights, body weight, running, rowing etc) that’s not full of posers then you should try https://www.priorityfitness.co.nz/.

  1. Stress less

Everyone has their own unique way of getting in the zone and escaping from the world for a little bit. Whether it be painting, meditation, having a coffee with friends or cuddling on the couch with your hubby, always make time for yourself to take it slow and really enjoy life as it comes. It’s easy to get caught in the riptide of the fast paced lifestyle and forget about the little things like personal time and health. So always schedule some YOU time and never forget one of the most powerful medicines of them all – laughter.

These 4 pillars have stuck as health advice clichés for as long as anyone can remember… but they remain so for a reason. Lifestyle habits have a powerful impact on quality of life. Granted, there are many things that we don’t have control over, but we DO have control over our habits. Going over how to make these habits stick will take a whole other article, but you can get started by ditching the mindset of being perfect and starting when you’re “ready”, and instead become PROACTIVE by starting now (no matter how small the step). We’ll visit each of these pillars in future blog posts to make sure you’re on the right track!

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Happy people live longer | When Bobby McFerrin sang his most… | Flickr

 

How To Avoid Burnout (Stay Sane!)

You have experienced a decrease in focus, memory, and clear thoughts. This is a sign of what’s known as mental fatigue or burnout. It can be linked to many things in your life including sleep, stress, and even diet!

The biggest contributor to all this is really at the core of how society runs today with non-stop activities and connectivity. It’s hard to catch a break! And rather than just eliminate everything that you know, why not try to increase your resilience and build some coping strategies to ensure that you can get the most out of what you do.

Structural chiropractors are known for improving the function of the spinal joints and other joints in the body to help your nervous system thrive, but what good is that if your life is under an emotional thunderstorm and mental breakdown? Structural chiropractors look at the whole person and offer lifestyle advice, as well as recognize who requires further investigation by another health care provider.

Here are four burnout resiliency strategies that you can include into your life:

  1. Sleep: aim for 7-9 hours as it seems to be the optimal range for proper recovery of the brain and body. Be sure to check out our blog on how to sleep properly to support the structure of your spine.
  2. Exercise: increasing exercise has been shown to decrease the risk of depression and anxiety. It does this by getting you out of the house and releasing endorphins, which are neurotransmitters that help you feel good and confident. If you’re hesitant about doing exercise on your own – join a class!
  3. Nutrition: reducing the amount of inflammation in your diet can help your reap huge health benefits. Inflammation-inducing foods are unique for each individual and may require form trial and error, but can often be found in processed meats, juice or pop and even gluten. If you really don’t know where to start, speak to a nutritionist.
  4. Meditate: If you flick through some past blogs you’ll see that we’ve started to mention meditation as a positive health strategy quite a bit. And this is with good reason. Meditation is up and coming and many people are now experiencing the benefits of taking the time to step back and relax their mind for a bit as it can produce greater productivity and efficiency later. Even 10 minutes a day can do wonders for your health. It can be in any way you’d like; focusing on the breath, breathing techniques, a stroll outside. Find what works for you and schedule it in!

Summary

At the end of the day, the only person that can help yourself is you. And when you’re feeling foggy, unmotivated, and burnout it can be hard sometimes and it can be a downward spiral. The best way to address that is to make a decision to do something about (these strategies) and the rest will figure itself out as you start to take time and take care of yourself and your mental health. Contact one of our structural chiropractors if you have any questions.

 

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Stress Management – 3 Ways

Mindfulness and stress are on the tips of everyone’s tongue nowadays. Large corporations are investing millions on mindfulness rooms and practices for their employees to reap the benefits and increase productivity. Meditation and stress-reduction taught in school curriculums now, because they also know the effectiveness.

It seems the hustle and bustle of everyday life is getting to our heads. It’s not natural for our circuitry to be firing constantly for so long. So how can we help support this new way of life, or at least reduce the amount of stress that affects us?

Here are our 3 top tips:

  1. Exercise/Yoga: Studies have shown that regular exercise or yoga can decrease stress, pain, and even your risk of injury. Aiming to do either one of these 3-5 times a week is ideal and does wonders to support your mind by increasing blood flow to the brain and having your focus set on something other than a screen for at least half an hour.
  2. Diaphragmatic breathing (or belly breathing): this kind of breathing calms down the nervous system and reduces the noise that goes on by getting you to focus on your breathing. Studies have demonstrated breathing exercises can reduce fatigue and anxiety. To actually benefit from the practice, it must be performed 3-5 times a day for at least 5 minutes.
  3. Meditation: once thought of as a hippie ritual, mindfulness meditation is now common practice used to help people reduce stress, anxiety, chronic pain, headaches and depression. It’s widely accessible as there are many online guides as well as apps that can help guide you through a session and all you need is yourself and a peaceful environment.

Stress is just a part of life and how you choose to manage it is up to you. Keep these tips in mind to take care of your mental health and keep your mind sharp. If you have any questions or would like more tips on stress management, please consult with a health professional.

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Deadlift Foot Placement (Part 1)

Background

There is nothing quite like the feeling of picking up a heavy weight in your hands. As with any movement or exercise in the gym, when repeatedly done incorrectly the deadlift can lead to some issues.

Although the deadlift appears simple, there are a few things you need to pay attention to. The first is foot position. It’s not uncommon for me to see people in the gym deadlifting with their feet in too wide a stance. I’m referring to the conventional deadlift here, not the sumo deadlift where the feet are supposed to be placed in a wide stance.

How and Why

Having your feet too far apart will mean that your knees will cave inward to make room for your arms to grab the bar. This is not good as it will stress the ligaments of the knees, increasing your chance of injury or at the very least, decreasing your power output during the lift.

Exact foot position will vary slightly from person to person but for general consideration, if your stance is too narrow you may struggle to engage the glutes at the top of the lift. If the stance is too wide, as mentioned it will push the knees inward.

A good place to start is with feet hip width apart (please note that this is narrower than shoulder width apart!). With the feet in this position they will be directly beneath the hips, allowing you to grab the bar with your hands shoulder width apart.

Image result for feet hip width apart for deadlift

There are dozens of other things to look out for when deadlifting. But getting your feet in the right place is a good place to start.

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