I wanted to share this with all of you. Please pass it along to friends and family! This was prepared by a friend who really understands the battle of receiving an accurate diagnosis and the all too-common story of receiving incomplete testing and therefore not a complete picture. 


Read below, or better yet, click the link below for the handout!
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Did you know:  thyroid disorder may present itself with 300+ symptoms!  

Thyroid disease is often misdiagnosed.

 

The TSH test alone is NOT the gold standard for detecting thyroid disorder.

 

All of these Tests are required to check thyroid function:

§    T4 (Thyroxine)  – Inactive form of thyroid hormone.  T4 is a storage hormone and requires iodine to convert to T3, the usable form of the hormone. 

§    T3 (Triiodothyronine) - Active form of thyroid hormone.  Every cell in our body has receptors for this thyroid hormone.

§    TSH (Thyroid Stimulating Hormone) – Hormone released by the pituitary gland.  Stimulates the thyroid gland to release hormone.  The TSH value rarely correlates to how a patient feels!

§    Reverse T3 (rT3)- The inactive form of T3 that doesn’t get used by the body.  A high rT3 is indicative of inflammation in the body caused by stressors. 

§    Thyroid antibodies (TPO AB, TgAb -TSI for Graves’ Disease)- Presence determines autoimmunity. 

 

Be sure to insist your doctor run ALL of these tests.  If not, find another doctor that will!

 

Other important tests to monitor when diagnosed with thyroid disorder:

§  Iron (4 tests: Ferritin, % Saturation, TIBC and serum (or total) iron)

§  Cortisol salvia test (only) (for adrenal issues)

§  Sex hormones

§  B12 & folate, Vitamin D3 (25-hydroxyvitamin D)

§  Magnesium and Potassium, & Calcium, Sodium, Glucose, etc.

§  MTHFR gene: if you have high levels of mercury, or iron, or B12 and family history of cancer, heart disease or stroke.

 
Prescription hormones:

  • T4-only: Synthroid, Levoxyl, Levothyroxine, etc
  • T3 medications: Armour, Naturethroid, Westhroid-P, etc.
 

T4-only hormones are often prescribed by physicians and often leave patients sick and tired because many people have trouble converting the T4 to T3 or have inflammatory issues in the body and too much gets converted to rT3.  Also, the laboratory reference ranges are too broad and those that know how to treat thyroid disease use a much narrower range.  It is important to find a physician that will treat you based upon your symptoms, not just your lab values!

 

Signs that T4-only meds are NOT working for you include:

Low/high blood pressure, high cholesterol, depression, anxiety, weight issues, lingering fatigue, deficiencies in B12, vitamin D, magnesium, iron. Digestive issues, adrenal and hormone issues, being cold, heart palpitations, PMS, fertility issues, etc.  The list is very long!

 

Did you know:

 The majority of thyroid disorders are due to Hashimoto’s Thyroiditis, an autoimmune ds.

Many don’t know this because their doctors either do not order the antibody test or do not tell them they have autoimmune disease.  BUT, if you have autoimmune disease, it is IMPORTANT to treat the immune system and change your diet (gluten-free at minimum) and lifestyle as well so that you don’t develop additional autoimmune diseases.  Celiac disease & Hashimoto’s are often linked.

 

Did you know:

Fibromyalgia is also contributed to low T3; undertreated or untreated thyroid disease.  Most doctors will say there is no known cause or treatment and that it can only be managed.  They may also say it is an emotional or psychiatric problem! Not true!

References:  

§   Stop the Thyroid Madness (website and book, author Janine Bowthorpe)

§   Why do I still Have Thyroid Symptoms? Datis Kharrazian

§   www.thyroidchange.org

 

Prepared by: Angela Michalski, amichalski4@wi.rr.com



 
 
Written by Susan Voss. Edited by Dr. Therese Miller, DC.

What is it and why does it happen? 

Iliotibial Band Syndrome is due to inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg. The IT band begins at the hip (iliac crest) and extends to the outer side of the lower leg (fibula) just below the knee joint.  The band functions in coordination with several of the thigh and hip muscles to provide stability to the outside of the knee joint, which is where the irritation usually occurs.  Irritation can also occur at the hip or cause hip "bursitis" as well. 
 
Iliotibial band syndrome is an overuse injury most common in runners and bicyclists.  Runners can develop ITBS when making mistakes in their training or with poor mechanics.  Roads are banked to allow for  water runoff.  If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. Running too many hills can also inflame the IT band.  Bicyclists may develop ITBS if they have improper posture on their bike and most commonly if they "toe in" when they pedal.  This increases the angle of the IT band as it crosses the knee, increasing the risk of inflammation.
 
What are the symptoms of ITBS? 

Pain on the outer side of the knee is the most common symptom but pain on the outside of the hip is also common.  There may initially be a sensation of stinging or needle-like pricks that are most often ignored. Some people may feel a snapping or notice a popping sound at the knee, and there may be some swelling.  Occasionally the pain may radiate along the IT band on outer side of the thigh between the knee and
hip.
 
How is ITBS treated? 

Initial treatment for ITBS includes rest, ice cup, compression and elevation; in addition to determining the underlying cause of the irritation. Depending on each individual case, any number of techniques may be helpful including ART, Graston, Kinesiotape, Trigger Point Dry Needling, Class IV Cold Laser Therapy, or many others.  Anti-inflammatory ointments can help to reduce inflammation.  
 
After the acute phase has subsided, focus should be on correcting muscle imbalances or improper mechanics which caused the inflammation to begin  with; this is different in each case. Treatment may include flexibility, stretching, and mobility or strengthening as well as gait retraining, bike adjustments or addressing other movement patterns. 
  
An important step in recovery is to evaluate the underlying cause of the problem. ITBS often becomes a chronic concern because steps are never taken to change and address why the irritation and inflammation actually occurs. 

Finally, patience is required for optimal results in healing ITBS. Whether it is waiting for mechanics changes to develop or simply returning to activity too soon-these common mistakes delay healing.  Listen to your body so you can return to and enjoy the sport you love!
 
 
Did you see our article posted January 30th:

"The Location of Pain isn't Always the Problem."

Be sure to read further on an analogy about how compensations can lead to much larger problems!
 
 
If there is a medical emergency, obviously an ambulance is called and the athlete is taken to the hospital for further evaluation and treatment. Concussions can cause emergenecy situations immediately after the injury or even hours later, and it is very important to recognize these signs and get the athlete the appropriate medical attention quickly.


There is significant debate in treatment options for non-emergency treatments. The one item that is agreed upon is rest. Rest may include lack of participation in sports, or in severe cases may even involve using earphones to control noise, dark rooms to reduce eye strain and rest from mental activities such as studying or working.

One up and coming technique is Active Release Technique or A.R.T. This specific soft-tissue based technique can help increase blood flow and oxygenation to the area treated as well as reduce spasm, tightness and even scar tissue. The premise behind this technique and concussion is several nerves exiting the spine in the neck have a direct connection to the dura (the fibrous covering around the brain). By reducing any compression or irritation on these nerves as well as increasing circulation and nutrients, athletes may be given a chance at faster healing and fewer lasting symptoms. While there are no published research articles currently on this topic, there are multiple case studies as well as anecdotal reports of improvement in symptoms that are awaiting publication.

Chiropractic Manipulation or Adjusting is another method that may have merit in treating concussion. Again, further research is needed in this area. Manipulation is used to help control or alter the nervous system, which is obviously affected by concussion.  Although there are reasons adjusting is contraindicated, the examination both pre-season as well as post-concussion would determine if manipulation is safe to perform. Manipulation can then be used as a very safe and effective way to calm down the overstimulated nervous system and speed up healing of the central nervous system from a concussion. Most adjusting would address the upper cervical spine where the nerves exiting the spine are directly connected to the dura and where some very important neurological structures rest just in front of the spine, and are therefore easily stimulated.

Stay tuned for another article specifically following the treatment of a young athlete and his treatment for concussion. 
 
 
The first concern when any athlete is suspected of concussion is to rule out the really serious that could be deadly or constitutes an emergency. Once this is done, evaluation can begin. There are several areas to evaluate: symptoms (what the patient reports), memory and ability to process information, and signs (what the healthcare provider can identify).

Symptoms: The patient is asked to describe their symptoms (which do not always begin immediately after the injury).

Memory/Cognitive: There are a variety of tests. Asking the patient to count backwards, recite well-known facts, remember items that will be asked approximately 5 minutes later are all common aspects of this portion of the exam.

Signs: This is often a major area of focus because these items cannot be altered or "faked." Many athletes are anxious to return to the game, and this portion of the exam gives a clear answer to some of the damage that may be present. There are 12 cranial nerves inside the skull as well as nerves that exit the spinal cord that can be tested for changes in their function. Changes in pupil size, ability to smell or hear, tracking of your eyes with movement, changes in sensation in particular areas or strength in certain muscles can be indicators of changes in your central nervous system.

These three areas will be tested at rest. If these areas are all normal under resting conditions, retesting under "exacerbation" or after performing challenging athletic tasks is used to further identify problems. For football, the athletes are likely asked to sprint 25-50 yards, perform jumping jacks, pushups, squats, etc to elevate the heart rate then are retested immediately. 

Based on the findings at rest and/or during activity, we can determine the degree of injury. Treatment is based and later, monitored, by these tests. 

Stay tuned for the next post on Treatment Options. 

 
 
Concussion itself is defined as a "mild traumatic brain injury" and its symptoms typically last fewer than 24 hours. It is important to realize that the head does not have to "hit" anything and there does not have to be a large force to cause a concussion. Our bodies are designed to absorb forces front-back better than any other direction, so a hit from the side or a jarring from an angle may be enough even under low forces.

The severity of a concussion and the severity of the after-effect are determined by a number of factors including the severity and length of the symptoms, previous history of head injuries, and severity of past injuries. The big concerns aside from initial complications are Post-Concussion Syndrome and Second Impact Syndrome.1

Post-Concussion Syndrome is a condition that causes significant aftermath following a concussion. These can range from personality and emotional changes (changes in anger, temperament, etc) to reduced response time, headaches, chronic pain, fatigue and a host of other problems. In many cases post-concussion Syndrome is short-lived but it may be a permanent change. These changes can quite literally be life-altering and must be taken seriously and treated properly.

Second-Impact Syndrome is a condition that can be deadly and is still not fully understood. First described in 1984, it involves a second head injury (typically prior to complete healing of the first). The brain swells and bleeds more severely than expected. There is a large hole in the base of the skull that the brainstem travels through on its way to becoming the spinal cord; as the pressure increases around the brain from the swelling the brain can actually be deformed and pushed through this hole. This is known as herniation and can be deadly. While still controversial, growing evidence supports higher risk with concussions that are not managed fully. This is the primary reason concussions are gaining so much more attention.

Stay tuned for the next post on Concussion Evaluation....
 
 
Everywhere we look these days, you hear about concussions. As the Packers ended regular season this past week, there are prime examples! Alex Greene and Josh Sitton returned from concussion; earlier this season, it was TJ Lange, Johnny White, Jerel Worthy, and Terrel Manning. 6 players so far in the season have missed practice and many have missed games all for something that years ago didn't receive much attention. So what is the big deal? How are they evaluated? What treatment options are available? How is an athlete evaluated for return to play? Stay tuned for the next several posts to help you better understand why Concussions are such a big deal, how it is evaluated and how they are treated. 

 
 
aka 5 Pet Peeves of Every Healthcare Provider

1.       SPILL THE BEANS ALREADY.

Picture the last time you were in a waiting room and they were "running behind." You often blame it on "overbooking" but did you know the number one reason providers run behind is because of their patients? Have you ever noticed the first thing a doctor asks when they walk into the room is typically: "How are things going? Has anything changed?" This is on purpose. New pain, changes in pain, or new conditions require more time (and sometimes an exam) to determine their cause. Your appointment is scheduled for a specific amount of time before the next patient. Your provider plans their best of use of every time from the second they walk into that room. If you leave that new condition to the end you leave us with a variety of unpleasant choices: push our other patients back and run behind our schedule (who likes sitting in a waiting room?), rush through and possibly miss something, or put it off to the next visit (who wants to spend an extra visit and/or be sent out while still in pain?)

2.       DIDN'T MOM EVER TELL YOU SECRETS AREN'T NICE?

Did you know that GI symptoms (diarrhea, gas, constipation, etc) may be related to some forms of arthritis? Did you know that changes in bowel or  bladder habits with a low back injury is a sign of a very, very serious medical emergency? There are hundreds of other examples. While you may feel embarrassed about talking about your bowel movements, you shouldn't- trust me....we've heard it all! You may not think they are related, and maybe they aren't- but you are always better to tell your provider absolutely EVERYTHING and let us decide if it's relevant- that's why we went to so much school!

3.       THIS IS NOT BURGER KING, YOU DON'T GET IT YOUR WAY (Sorry!)

We LOVE it when our patients want to get involved in their care and you're on board with your treatment plan. We LOVE to see patients excited about their health. That being said, it can be a struggle when a patient walks in and says: "this is what I have and this is what I need." You may be completely right, and it helps to have that input- nobody knows your body as well as you do; but keep an open mind. The entire goal of seeing a provider is to capitalize on their expertise and get back to health as quickly as possible. When a provider incorporates other techniques or options into your treatment plan, don't take it as if they weren't listening. You're provider is usually looking out for your best interest and not all techniques/options are right for all people.  It's called a doctor-patient relationship for a reason....and you should absolutely be involved in your care. If you aren't comfortable with a technique or have questions- speak up!!! We'd rather answer questions and make sure you understand why we are doing what we are doing than have you go home frustrated!

4.       JUST BECAUSE YOUR NEIGHBOR HAD IT DOESN'T MEAN YOU DO TOO.

We've all done it. Bob next door has a low back injury with leg pain, he says: "It's sciatica." Several days later you awake with leg pain. It must be sciatica too. Except for the fact that our leg pain is in a completely different area and doesn't involve the sciatic nerve at all. The best guideline is to seek care if you are in pain, regardless of what your neighbor has. Maybe Bob's "sciatica" got better without treatment; what if your case requires early care and you put it off? It's easy to miss something or over-diagnose just because of what is going on around us. 

5.       WEB MD DOES NOT ACTUALLY HAVE A MEDICAL DEGREE.

While the internet is a thriving source of information and WebMD or mayoclinic.com can have some good information about conditions, it's not exactly a replacement for professional medical advice and care. Treatments are much less effective when conditions are improperly diagnosed and many treatments may actually make the problem worse. In addition, most conditions become harder to treat and will require more treatment (either more aggressive or more frequent= more expensive!) the longer they are allowed to fester. Heaven-forbid something more serious is underlying your pain- the sooner it is diagnosed and treated, the better the outcome. Period. A proper diagnosis is the #1 battle, so don't risk losing the war! 

 
 
I'm already seeing patients fighting colds and immune systems firing up. There are obvious ways to help fight off those pesky winter bugs- from washing your hands thoroughly and regularly to disinfectant sprays and hand sanitizers. But so many people forget about the most important steps! Sleep exercise, diet, and even Chiropractic Adjustments all play a role in the health of your immune system!

SLEEP- While adequate sleep is obvious, we all get caught up in busy daily life. Make sleep a priority. You should feel well-rested when you awake. Sleep allows your body to replenish immune and blood cells.

DIET- This becomes a little more detailed.  Your immune system relies heavily on the nutrients you put into your system daily; deep fried chicken, fast food lunches and ice cream don't exactly pack a punch in the nutrients your body needs! To keep it very basic, your body especially needs vitamin C, vitamin A, Zinc, and Selenium. The best foods to stock up on are leafy-green veggies, and a variety of bright colored fruits and veggies. The more variety you can get from fruits and especially vegetables the better nutrient variety you get. Make it a goal, one big salad every day is a great place to start! A high-quality multivitamin to supplement what you don't get is also a big help, but don't rely fully on this. Your body will more readily absorb and use nutrients from food before a supplement. So use it as it was meant- as a supplement!

EXERCISE- Again, this is very detailed. High-intensity workouts, training for sporting competitions, or "weekend-warrior" workouts actually make your body more susceptible to infection until you have recovered. So be careful, during a competition season is the time you need to be most diligent with all of your preventative steps! Regular and moderate intensity exercise, however boost the immune systems surveillance and response to invaders. As with typical exercise recommendations, change your type of workout every 4-6 weeks. As your body adapts to your workouts, so does your immune system!

CHIROPRACTIC ADJUSTMENTS- This is often an overlooked step. While your immune system has two "sides," one side is heavily controlled by your nervous system. The nerves which carry the information to up regulate your immune response sit just in front of the spinal column and/or exit the spinal column to get into the periphery. Chiropractic manipulations influence and affect the nervous- hence being such a safe and powerful tool! This is no exception. By normalizing the nervous system information and stimulating specific areas of the nervous system we can actually increase your body's immune response.

While this article touches on the very basics of steps you can take to help prevent getting sick, catching a cold isn't always completely avoidable. Stay tuned to the best recommendations when the sniffles do hit! For more information on the details of how the immune system works, also read THE IMMUNE SYSTEM: DEMYSTIFIED. 

 
 
I apologize it has been so long since I have written. I plan to begin posting more regularly again on a variety of topics- if you have anything in particular in mind, please send the request to my email at: drtmiller@millerswc.com.

As many of you know, the past several months have been full of changes. In an effort to better serve our patients and improve our care, you will find many new features in our office and some big changes coming soon. To help keep you up-to-date, here is just a sampling:

We changed our billing procedures. All billing requiring insurance now uses a company called ChiroBill, located right here in southeast Wisconsin. This allows for more timely and accurate billing. Any services which are paid at the time of service are still managed in our office.

You'll see two new faces in the office: Cori just graduated Homestead High School and will be pursuing her college degree in the fall. Susan is a Chiropractic Technician and is continuing her education in the clinical sciences.

We've extended our office hours due to high demand. Over the past several months, we've added 5 additional hours to Mondays, Tuesdays and Thursdays!

We have a new online scheduling system. We've received great feedback from you about the ability to schedule online. This new system is easy to use and allows a realtime look at our available schedules. 

We've upgraded our phone system to better assist your needs. 

And the real big one.......long awaited......we have a NEW LOCATION!!! It's been in the works for a while, and as many of you know we have been searching for the perfect new home. Now we've found it. We will be moving to 3400 S. 103rd St, Suite 300, Greenfield WI 53227. We expect the move to occur in mid-August. Construction is rolling, but as we know more we will keep you up to date!


I'd like to thank all of my patients for their support and understanding as we grow, change, and improve as a company. I know change is hard, but we're trying to make it all for the better!