August 21, 2000, Newsletter
Hi from Dr. Lamb! www.drlamb.com
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In this issue: Answers to questions sent to Dr. Lamb...
- Boot Camp
- A Major Arthritis Fighter
- Prescription renewals on-line
- Dr. Kovacs - Medical Sleep Studies & Legal site
- TBQ BBQ
- Ask Dr. Lamb
Boot Camp
Some of our readers from the military services have asked about various
injuries experienced during military training.
Military training is not really for the old, as the training is generally very
arduous and somewhat injury provoking. Some of the training, such as Navy Seals screening is so physically demanding that only about a third or even
less of the applicants (who have already been screened by the military)
actually make it through the testing phase.
I have seen some of what the applicants must endure and it is quite gruelling.
However, standard boot camp is no picnic. It too is quite gruelling and many of
the applicants suffer bruises, sprains, strains, cuts, hypothermia,
hypoglycaemia, exercise exhaustion, occasional fractures and mental breakdown.
Many of the service people complain of muscle and tendon injuries such as
hamstring and buttock injuries, Achilles' tears, neck and back pain, joint pain and crepitus (crunching),
headaches and a decrease in their joint range of
motion.
For people undergoing any intense and/or prolonged training, a personal
stretching program should be included, especially in the military, as these
individuals lives may depend upon their ability to run, hide, roll and
fight.
In my opinion, stretching should be done before and after exercise.
The amount of stretching required is dependent upon the inherent flexibility of
the person, the intensity and duration of exercise, the age
of the individual, the muscle mass and the integrity of the spine, limbs, muscles
and nerves.
In general the time stretching should be at least equal to half the time of
the exercise. In some circumstances they should be equal, half before the
exercise and half after the exercise.
The stretching should include (wherever possible) stretching of the neck, back, shoulders,
hips, legs and arms. Exhaling with
the stretch makes a difference and actually enhances the stretch.
Stretching can harm and be painful, so one should progress slowly with intensity
(how hard), duration (10- 45 seconds) and frequency (1-10 repeats) of the
stretch.
Of course, one should seek a professional before beginning any program of
exercise or stretching.
A Major Arthritis Fighter
A few of our readers have asked me about CMO-cis-9, also known as cetyl
myristoleate and it's usage in chronic pain. I first heard about and used
CMO-Cis-9 about four years ago.
CMO-cis-9 was discovered by a researcher at the NIH, or National Institute of
Health. So the story goes….
Harry W. Diehl, who worked for the NIH was frustrated by the fact that a
neighbor nearby suffered from arthritis and no good treatment seemed underway.
So Harry sat down to discover a solution for arthritis.
First he needed some live specimens for research. He was looking for the
typical white mouse on which much of our research is first initiated. He could not
find mice with arthritis and he could not induce arthritis in the mice. Another
researcher from California wrote and asked "if you or anyone else can give
mice arthritis, I want to know about it because mice are 100% immune to
arthritis."
A light went off in Harry's head and he began researching these furry little
beasts. He isolated cetyl myristoleate from the blood of these mice. He
eventually concluded that this compound seems to be one of the key factors in
mice not developing arthritis. CMO is not generally found in humans but aside
from mice, is reported to be found in sperm whales and in beaver prostates.
The exact mechanism is not known but I suspect that CMO-Cis-9 aids in the
re-myelination process (repair of nerve lining) of damaged and compressed spinal
nerves that lead to persistent muscle shortening around a joint that leads to
compression arthritis (a.k.a. osteoarthritis-see my articles on compression
arthritis).
By "repairing" these nerves, the process may be reversed. CMO
chemically is a long-acting fatty acid ester that appears to be similar to the essential fatty acids linoleic acid and alpha-linoleic acid. Essential fatty
acids must be eaten and cannot be manufactured in the body.
Essential fatty acids have frequently been reported to be of some help in the
treatment of chronic pain and arthritis. CMO has been reported to be of help in both osteoarthritis and rheumatoid arthritis.
As a point of interest, this would suggest to me that not only is osteoarthritis
potentially neuropathic (nerve generated) but so too might be rheumatoid
arthritis. The typical dosage of CMO is 12-15 grams per day for one month and
the manufacturer does not report any major adverse side-effects but caution is advised in asthmatics and those who have suffered
severe allergic reactions.
Of course, pregnant and lactating women should not use this product.
It is my suspicion that CMO would be helpful for many pain disorders including
OA, RA, fibromyalgia, myofascial pain, limb numbness and pain and probably many
other pain syndromes.
Interestingly, I successfully treated my brother, who developed severe low back pain with three
herniated disks in February this year, using a combination of IMS, Nerve blocks, inversion therapy, self-stretching,
manipulation, Celebrex and CMO. It seemed that when I added the CMO, he improved
to a new level.
However, there is no panacea for complicated pain syndromes. I have had patients
with no effect or relief with CMO. Every case seems to be a difficult fight for relief. CMO is expensive, however, it may be worth
considering if you are suffering a chronic pain syndrome that has spinal or joint
components to the condition.
Prescription renewals on-line
Now available in Ontario, Canada you are able to request your prescription
renewals from your physician on-line.
YOUR doctor will receive a fax from
your on-line request for a renewal of your prescription. (These are for non-narcotic, non-emergency, standard
prescriptions.) The doctor reviews your request. If they approve -
it is faxed to YOUR pharmacy for you to pick-up.
If the doctor wants to
see you before the renewal, then you will have a call from their office asking you to
come in. What a great way to avoid the delays in making an appointment and the time off work to see the doctor for routine renewals.
The cost of the renewal service is C$30 per request (up to three medications per
request.) If your the doctor asks you to come in for all the medications
requested - you receive a refund of C$15.)
To use this service, you also have to be a member of the Iasis Safeguard health
system that authenticates and protects those using any of the many
Iasis services. The annual cost of this program is
C$25.
For more information, go to www.drugsanddocs.com or contact us at
info@drugsanddocs.com.
If your physician or pharmacy is not on the system, give them this
newsletter or have them contact the
Iasis Corporation at
905-608-2349.
There is no cost to them to join our new service.
TBQ
Now off the topic of pain and on to pleasure!
Like to BBQ? Visit the TBQ website for great BBQ spices and sauces that
can be ordered online. If you are ever in the Detroit area, visit one of
their restaurants in Windsor, Ontario. Great ribs and chicken!
www.tunnel-bar-b-q.com
ASK DR. LAMB
Thanks to all who have sent in questions. I read every question and we try
to pick ones that would be of general interest to cover in the newsletters.
If you have other questions - please write me at-
pain@drlamb.com
The information contained in this newsletter is the opinion of Dr. G. Blair Lamb
M.D. C.C.F.P. and should not be used as personal medical advice.
Everyone is encouraged to see their own healthcare professional to
review what is best for them.
For further details, please visit-
http://www.drlamb.com/legal.htm
Thanks for reading! Visit the website for additional information.
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