Today, medications are available for the treatment of most illnesses. Patients are generally made aware of the potential complications and side effects of these drugs. The problems that frequently occur are complicated by the unknown factors, particularly with long-term multi-drug therapies.

No one can dispute the necessity of insulin for the control of diabetes or thyroxin for the treatment of hypothyroidism. At the same time, many conditions can be treated or even prevented, utilizing certain long-term measures or less dangerous therapeutic approaches. Aside from a balanced diet, the utilization of vitamins and supplements and the minimum of one-half hour of vigorous daily exercise, there are therapies available for the treatment of medical problems that can control or cure the pathological process involved, without risk.

This article focuses on a patient who was on a pharmaceutical regimen for the treatment of gout for a period extending over three years. The results were a number of undesirable consequences. The management of this patient clearly illustrates the need for re-evaluation of current medical practice. The drugs utilized were a combination of Allopurinol and Colchicine.

At Meditech over the past several years, we have demonstrated that Low Intensity Laser Therapy can completely resolve the symptoms and physical findings associated with gout. This usually occurs after two to four treatments over consecutive days. Patients may be inconvenienced with regard to travel and time, however this approach obviates all the dangers and complications involved with drug therapies.

Diagnosis

Gout has such a distinct clinical signature that it can generally be diagnosed by history and physical examination alone. Elevated serum urate (7 mg/dL) supports the diagnosis, but is not specific. It should be noted that 30% of patients have a normal serum urate level at the time of their first attack. The diagnosis of gout can be confirmed by histopathological analysis of the aspirated joint fluid, which will clearly demonstrate intracellular monosodium urate crystals. In addition, hypertension and renal insufficiency are typically present.⁴

Treatment

The initial treatment administered is generally directed to relieve the pain. This comprises the use of analgesics, NSAIDs, ice, etc. Drug therapy programs may include Allopurinol (xanthine oxidase inhibitor), Colchicine (microtubule polymerization inhibitor), corticosteroids, hormones or Probeniset (uricosuric). The intended effect is to lower uric acid levels and reduce inflammation in the joints.

Allopurinol is often prescribed to prevent recurrence, reduce the incidence of renal calculi and manage uric acid levels. Administration for an extended period of time may be required before the full effect of the drug is noted. Patients may also be advised to continue taking this medication even if they are asymptomatic. During the first few months, Allopurinol may cause an increase in attacks of gout, secondary to the inflammatory response. Colchicine is therefore often co-prescribed to minimize inflammation.

The potential side effects related to the administration of Allopurinol can be mild to serious.² Skin rashes are common and may be evidence of an allergic reaction. Allopurinol may also cause irritation of the gastro-intestinal tract and produce drowsiness. A series of additional side effects have been reported, including hypersensitivity reactions manifested as hepatitis with symptoms of eosinophilia, dermal lesions, aplastic anemia and vasculitis. Some studies report that hypersensitivity leading to morbidity may be inordinately high in cases with prior liver or renal functional impairment. Gastrointestinal bleeding has also been reported. Discontinuation of Allopurinol is usually recommended to avoid progression of these complications.

Allopurinol is considered to be the drug of choice in treating and preventing gouty arthritis and instances of uric acid accumulation.⁶ Whereas this drug is generally deemed to be safe, hypersensitivity exists, primarily in patients with chronic renal insufficiency.² In these cases, a significant increase in mortality rates has been observed. The mechanisms leading to complications are still under investigation, however there is evidence suggesting that complications may be due to bacterial infection or viral reactivation, such as cytomegalovirus or human herpes virus-6.^{7, 8} A chronic history of renal insufficiency often characterizes a state of immunodeficiency, manifested particularly by impaired T-cell mediated responses with lower than normal levels of CD4+ and CD8+ lymphocytes.

Colchicine is often prescribed in conjunction with Allopurinol as a potent anti-inflammatory. This approach usually limits attacks of gout⁹ which tend to increase for the first few months of Allopurinol administration. Biologically, Colchicine is a mitotic inhibitor, which affects tissues with high rates of cellular division and is lethal to cellular replication in general. Clinically, some therapeutic value can be derived from this drug as a chemotherapy agent and indeed, it may have a role to play in this area. In high doses, it can cause gastrointestinal and renal problems and may even cause paralysis. Colchicine also acts as an immunosuppressant and therefore relieves the pain and discomfort associated with attacks of acute gout. The drug is generally administered to individuals who may be at risk of developing gout and in patients with pre-existing chronic inflammatory conditions such as rheumatoid arthritis. Potential risk factors associated with Colchicine vary from mild to extreme and may elevate morbidity and mortality rates significantly.

The case histories outlined below, demonstrate the potential hazardous complications of a drug therapy programme:

1. A Gutiérrez-Macías et al. reported the case of an 80-year-old male with a history of chronic renal insufficiency, who was given 300 mg Allopurinol per day to control uric acid levels. At initiation of the drug programme the patient was asymptomatic. After six weeks of treatment, he developed loss of muscle strength, anorexia, fever, diarrhoea, jaundice, abdominal pain and dermal lesions, in addition to severe eosinophilia. Essentially, his immune system ceased to function. Immune suppressants (Prednisone) were insufficient to reverse the effects and due to deterioration of liver function, hepatic encephalopathy ensued and the patient expired.¹

2. M. Arakawa et al. describe a 43-year-old man with a history of chronic renal insufficiency who was given an open-ended prescription of Allopurinol (100 mg qd). After the first month of therapy, he began to experience symptoms (malaise, elevated body temperature) and was admitted to hospital. Two weeks later, he had a high fever with skin rashes (erythema multiforme) and a drug reaction was suspected. The administration of Allopurinol ceased immediately but his status continued to deteriorate, resulting in renal failure and virtual destruction of the integumentary system. Extensive blood testing revealed the presence of Cytomegalovirus. Despite blood transfusions and resuscitory efforts the patient died.⁵

It is important to stress that although these cases were are not common, the rate of deterioration was rapid. Individuals with chronic renal or liver insufficiency appear to be most vulnerable to Allopurinol hypersensitivity reactions although the mechanisms responsible for these adverse events remain unclear.

Case Report - Meditech Clinic

A 66-year-old Caucasian male presented for treatment of a pre-gangrenous right lower extremity on September 10, 2008. He had been on daily insulin for several years; he was also taking Allopurinol and Colchicine daily over the past 3 years, for the prevention of gout. While on these medications, he had not had any acute attacks of gout. Over this period of time however, the patient developed renal failure in addition to progressive peripheral arterial occlusive disease involving all extremities in varying degrees. This was accompanied by generalized deterioration both physically and psychologically. At the time of his initial examination, there were several ulcers on the right foot and amputation of the right lower extremity had been suggested. The hands and the left foot were only moderately affected.

Following one treatment with Low Intensity Laser Therapy, symptoms diminished and physical findings improved dramatically. Needless to say, all medications except insulin were stopped. His physical status continues to improve with regular treatment (Bioflex Professional system) at a clinic located close to his home (two hours drive to Meditech).

Discussion
• It is important to categorize this situation with regard to healthcare in general and to initiate changes to alter the management of these types of clinical conditions.
• Medical supervision in this instance was clearly inadequate and the pharmacist who kept filling repeat prescriptions on demand should come under scrutiny.
• Whereas the clinicians at Meditech have not conducted tests with regard to the toxicities of the drugs in question, it has become increasingly clear to us over the years that all pharmaceuticals have side effects which may be highly undesirable.

Conclusions
• The therapeutic approach to gout requires re-evaluation.
• The initial treatment of gout should be directed to the relief of pain.
• This may include analgesics initially, however the long-term strategy should include preventative measures which treat the pathology, rather than modulating symptoms.
• A combination of pharmaceuticals may be effective on a short-term basis; the risks associated with this approach, however, must be carefully considered.
• Hyperuricemia levels may be controlled with medications initially, however the course of treatment should be monitored frequently and medications should not be considered a satisfactory long-term solution.
• Preventative measures including diet, control of diabetes, hypertension and obesity should be stressed as preventative measures.
• Low Intensity Laser Therapy in the treatment of gout is safe, effective and devoid of any complications³ and should therefore be the treatment of choice.
• Sustained good health implies the use of the minimum number of pharmaceuticals essential to the maintenance of good health.

References
1. Gutiérrez-Macías, A et al (2005) Fatal allopurinol hypersensitivity syndrome after treatment of asymptomatic hyperuricaemia
2. Singer JZ et al (1986) The allopurinol hypersensitivity syndrome: unnecessary morbidity and mortality. Arthritis Rheum
3. Soriano F et al (2006) Photobiomodulation of pain and inflammation in microcrystalline arthropathies: experimental and clinical results, Photomedicine and Laser Surgery 24(2):140-50.
4. http://www.emedicine.com/med/topic924.htm
5. Arakawa M et al (2001) Allopurinol hypersensitivity syndrome associated with systemic cytomegalovirus infection and systemic bacteremia, Internal Medicine 40(4):331-5.
6. A Kumar (1996) Allopurinol, erythema multiforme, and renal insufficiency, BMJ 312:173-174.
7. Koike M et al (2008) Viruses may trigger allopurinol hypersensitivity syndrome, NDT Plus 1(4):273-274.
8. Masaki T et al (2003) Human Herpes Virus 6 Encephalitis in Allopurinol-induced Hypersensitivity Syndrome
9. Morris I (2003) Colchicine in acute gout, BMJ 327:1275-1276.

At Meditech, we continue to see an increasing number of these sometimes challenging problems that fail to respond to conventional therapies.

Utilizing the Meditech regimen, we are able to achieve consistent positive results, particularly as our experience in this area increases.

Our treatment approach consists of the following:
• the removal of dressings
• discontinuation of the majority or all pharmaceuticals
• instituting a programme of laser therapy
• saline compresses as indicated

A useful adjunct when available is the hyperbaric chamber.

On this programme, we have developed the ability to heal an extensive variety of wounds in a relatively short period of time.

Our goal is to establish this method of healing more widely.

The 7 cases illustrated in this monograph clearly corroborate the effectiveness of laser therapy, the basic platform in this healing methodology.

CASE #1

Patient#: 5230
Age: 50/F
Diagnosis: Pre-gangrenous foot - Multiple ulcers secondary to Diabetes Mellitus

This diabetic ulcer presented for follow-up several months post-cessation of laser treatment. There has been no recurrence of the ulcer previously treated with the BioFlex System. The patient is asymptomatic, fully functional and the photograph indicates significant remodeling of the soft tissues.

CASE #2

Patient#: 5094
Age: 77/M
Diagnosis: Ulcer - left foot

This patient demonstrates complete healing of an ulcer after 5 treatments administered over the course of 1 week. Etiology is peripheral arterial occlusive disease. At this time, the patient is asymptomatic, walking normally and does not require any medication.

CASE #3

Patient#: 4840
Age: 72/F
Diagnosis: Infected ulcer - secondary to inadequate arterial circulation

This patient lives over 4 hours away from our clinic and is therefore only being treated sporadically with the Home Unit II. Despite the self-administration, healing is progressing slowly and complete epithelization of the ulcer bed should be complete over the next 6 weeks. Notably, the dimensions of the ulcer have been reduced from 111 cm² to 7.87 cm² and there is healing both at the base and the ulcer margins.

CASE #4

Patient#: 3183
Age: 79/M
Diagnosis: Dermal Ulcer - right heel

This patient's ulcer developed while being treated in the hospital for a CVA. Following the conventional therapeutic approach, the ulcer continued to increase in dimension. The patient utilized oral and topical antibiotics and dressing changes on alternate days over several months.

On our wound care program, the wound was left open and antibiotics were discontinued. In addition, laser therapy was instituted along with saline compresses at home. Complete healing has occurred and remodeling is evident post-cessation of laser therapy.

CASE #5

Patient#: 6329
Age: 90/F
Diagnosis: Ulcers - right foot, great & 2nd toes

One can visualize the improvement in the appearance of the foot following 6 treatments. Cyanosis is no longer present and the edema and erythema are minimal. Mobility of the toes has been completely restored and the ulcers demonstrate good peripheral healing.

CASE #6

Patient#: 6198
Age: 58/M
Diagnosis: Peripheral arterial occlusive disease with multiple ulcers - left foot

Patient presented with an extremely inflamed forefoot (diameter 42 cm), discolouration, ulcerations and fissuring in several areas and unable to bear weight. After several treatments diameter reduced to 32 cm, all signs of inflammation have disappeared and patient is able to bear weight without discomfort (note distance between 1st and 2nd toes).

Copyright © 2008 Meditech International Incorporated. ALL RIGHTS RESERVED.

This photograph depicts the foot of a 66-year old diabetic and indicates what can be achieved:

The right forefoot on presentation was cool to the touch, the toes were immobile, cyanotic and no peripheral arterial pulses were present.

The photographs of 9/10/2008 are indicative of his initial status.

Prior to his second treatment on 9/12/2008, the photographs were repeated and significant change had occurred. On the occasion of his second visit, the toes were mobile, the edema and cyanosis had largely disappeared and the patient was relatively pain-free. The foot was no longer in jeopardy.

This case clearly demonstrates the healing potential of Low Intensity Laser Therapy.

The critic in this instance happened to be a physiotherapist, who has been established in practice for thirty years and pointed out that he was extremely proud of his profession and his accomplishments. At the same time, it was apparent that his knowledge of the contents of this material was limited and based on established concepts, which are invariably behind the times.

We are all aware of the axiom, that once a text is published it immediately proceeds to obsolescence. Moreover, original work, where the focus of research must be placed, is generally not published or accepted by the academic community, for many years after the work has been completed.

The reviewer expressed his enthusiasm with regard to other texts he had read in the past, with all of which I am quite familiar. The publications to which referred had compiled a significant database and established a useful library of the current consensus. At the same time, the authors had limited experience in the clinical application of laser therapy and their efforts were largely restricted to the definition of terminologies and established concepts in this field. Whereas this is commendable, it does not advance the frontiers of the technology, nor is it cognizant of the fact that change is occurring at an accelerated pace.

Our publications, in essence, record the evolution and observations of almost twenty years of original work, including the development of the BioFlex series of systems and their highly successful application in the treatment of many thousands of diverse and challenging medical conditions. The results achieved are based on the combination of appropriate synergies, including basic research, innovative engineering and extensive medical knowledge. Only through this process can optimal objectives be obtained.

It is encouraging to note that many of foremost physiotherapists in North America and around the world have integrated Low Intensity Laser Therapy successfully in the scope of their practice. Traditionally, physiotherapists have relied almost exclusively on manual techniques and a variety of established modalities such as ultrasound, interferential current etc., which may preclude researching other potentially more effective solutions. Moreover, as in the health care sector in general, the focus appears to be primarily on the modulation of symptoms, rather than curing the pathology. At a time when medicine is moving into the molecular/cellular age of healing, I believe that the utilization of more productive therapies requires emphasis.

Almost twenty years ago, when I began to explore the Laser Therapy field, educational opportunities were limited. The research available was often documented in foreign languages which were difficult to translate. In the course of my self-education, I consulted many basic researchers, manufacturers and a variety of therapists involved in this relatively novel field of endeavour, all of whom were acknowledged to be the leaders in their particular area of expertise. Upon completion of this process, I arrived at the conclusion that more original and independent thought and work were necessary. While deriving significant benefit from the knowledge of these pioneers, I recognized that departures from the prevailing concepts were indicated and even more important, today I realize that this process needs to be intensified as we move forward.

At Meditech's certification seminars I always state to those attending, "Over the next three days you will be exposed to the history and current understanding of this technology, however our educational programmes are directed to enable you to become a proficient student of this science; hopefully, your views will be flexible and open to change, while the frontiers of the science continue to advance."

At our clinics, at least several times daily, patients will inquire, "Why does my healthcare professional/physician not know about this therapy? Prior to attending here, I have been following many courses of treatment recommended and my condition has continued to deteriorate; yet, after less than three weeks of treatment at your clinic, I no longer require analgesics and am able to carry on with most normal activities."

This question is easy to answer. Medical care today is more focused on delivery systems and control of the mode of treatment, rather than what may be most effective. These sentiments should be a clear indicator that all professions must re-examine their teachings, their knowledge and preconceived concepts - frequently, otherwise, they will fail to adopt more effective therapeutic approaches which may benefit the patient.

- then there is the placebo effect. If a patient can be psychologically induced to believe that something is proceeding that assists in the healing process, whether it is a pleasant sound, the flashing of bright lights or other external influences, a number of patients will obtain temporary relief which may even become permanent. Patients will improve for a few days or even weeks, allowing the body's natural healing processes to continue to move forward. From this it can be safely assumed that a large percentage of all patients, no matter what the injury or the disease, will heal spontaneously without any therapy provided - including the placebo effect.

A number of pathologists in their studies have indicated that with all malignancies a spontaneous remission rate of somewhere between 2-5% is reported, again without any treatment whatsoever. Just imagine, cancer cured by the body's own natural, protective mechanisms. It should also be understood that once chemotherapy or radiation is initiated, the immune system breaks down and is largely destroyed and in many cases this may be more detrimental than the disease itself.

In our society, pharmaceuticals unduly influence all therapeutic approaches. It has been documented by accredited scientific researchers that approximately 80% of all prescriptions written, do more harm than good, not to mention the deleterious unknown effects of the interaction between many medications. Whereas I cannot attest to the accuracy of this comment personally, I always tell patients that the fewer medications they are taking, the better the chance of maintaining good health and obtaining a speedy recovery from illness.

With due respect to the pharmaceutical industry, diabetics cannot survive without insulin, patients suffering from hypothyroidism require thyroxin in order to function normally and many medications are not only useful but essential.

In situations of acute pain, I condone the use of analgesics in sufficient doses until the acute phase has passed. Similarly, I recommend the use of antibiotics, again in adequate doses, if the offending organism can be identified and eradicated using this approach. This does not mean that when a patient has an upper respiratory infection caused by a virus, that this rule should be followed. Indeed, in these instances the use of antibiotics is contraindicated.

Cortisone, probably one of the best medications ever developed, has tremendous value in cases of acute trauma, deficiency states such as Addison's disease and in the treatment of anaphylactic reactions. Its prolonged use is also justified in a number of chronic systemic illnesses. One must also recognize that after several weeks of use, continued ingestion of this drug can be counterproductive. It is important to understand that many medications are best avoided, particularly if one realizes that NSAIDs are the eighth largest cause of death in patients in the USA, a fact that speaks for itself.

The potential problems associated with the extensive use of the "statin" family of drugs as the best protection against coronary artery disease, almost universally prescribed to reverse atherosclerosis should give pause for reflection. The long-range adverse effects of these medications remain in question, despite the research presented to the medical profession by the pharmaceutical industry. Not only should the long-term effects be studied more thoroughly but also the potential adverse effects on the hepatic, renal and other organ systems.

The healthcare dollars diverted to the pharmaceutical therapy approach should definitely be re-evaluated in light of the hardcore negative evidence emerging from an increasing number of sources. We all need to be aware of the political factors, lobbying and the pursuit of material gain in our society and their role in this scenario. Disturbingly, a disproportionate degree of influence of this type of activity has crept into medical education, in the pharmaceutical industry's quest for profit. No one to date has attempted to counter this trend.

The inhalation of a variety of medicines, particularly those prescribed by respirologists, should also be monitored and reassessed. It is my observation that these are being utilized too frequently, again with significant adverse effects. This puts the net benefit to patients under the microscope.

As previously stated, a healthy lifestyle, which can be considered preventative medicine is the best approach to the avoidance of health problems. This incorporates a balanced diet, thirty minutes of vigorous daily exercise in addition to the ingestion of certain minerals, vitamins and supplements on a regular basis, together with the complete avoidance of tobacco and alcohol ingestion in moderation. These tenets form the cornerstone for good health and longevity. Moreover, these measures instituted early in life and continued religiously represent a positive expenditure of energy, much like putting a few dollars into a bank account from the moment you earn remuneration in order to ensure your future economic health.

Diseases, nevertheless, will continue to occur whether conferred by genes, environmental influences and other factors not yet recognized. In many of these situations, Low Intensity Laser Therapy is rapidly establishing its value as the preferred therapeutic approach. Wide dissemination of these facts must be encouraged. All schools involved in the education of healthcare professionals should take note and researchers should increase the scope of their scientific studies. At the same time, clinicians must pursue a more aggressive course integrating this technology into their practice in an effort to help millions of patients immediately in a safe, effective manner and at a low cost.

Numerous features are integrated in these devices. They are completely portable and can therefore be used in transit, on the playing field and in the comfort of your own home. Significantly, they can be used frequently and for more prolonged treatment sessions and utilized on this basis, can approach the healing power of the BioFlex Professional System. Recommended use is one to two times per day for any acute area of pathology; other conditions can be treated sequentially.

Once economics, the time perspective and travel are taken into account, their value is readily apparent. Whereas they are not designed to replace the Professional Systems, in many situations their usefulness is clearly evident, i.e:

• in situations where access to professional care is unavailable
• when treatment with a professional system has been completed and continuing therapy will enhance the treatment outcome
• to ensure a long-range positive result
• for patients traveling long distances to attend a clinic (once symptoms have substantially diminished and where ongoing treatment is desirable to achieve a more advanced level of permanent healing) 
• in instances where continuation of therapy stimulates further progress and prevents regression of the pathology (cartilaginous regeneration of joint surfaces, etc.)
• maintenance of results achieved
• preventative care on a regular basis (i.e. baseball pitchers, golfers, dancers, gymnasts, etc.)

It should be readily apparent that the usefulness of these systems is unlimited. Athletes, arthritis sufferers, patients with chronic back problems, psoriasis and other dermatological problems, once they acquire a system, find that treatment becomes a prerequisite to improved functional levels and often purchase additional systems for other members of their family.

Ideally and particularly with advanced pathologies, such as stenosis of the spine, severe degenerative osteoarthritis, the Professional System’s three-step treatment is optimal. At the same time, in the many instances described, the Home Units I & II, used in a judicious and timely fashion, achieve a more than satisfactory standard of pain-free function.

For optimal effect, the following criteria should be observed:

• whenever possible, the correct diagnoses should be established by a healthcare professional
• frequency of treatment and protocol selections are prescribed in the Clinical User’s Manual, which provides an easy-to-use point of reference
• if progress is slow or plateaus, customization of protocols invariably provides a solution.

The Home Unit I, which utilizes the large surface infrared array, is the “workhorse” of the system. The Home Unit II is similar in design and content, except that it also includes a large surface red array. The latter will heighten the degree of effectiveness in the treatment of superficial lesions and dermatological conditions, either in combination with the infrared array or in stand-alone configuration. In certain deep-seated lesions, combined with the infrared array, it will also enhance cellular regeneration and the healing process.

Generally, the Home Unit I will be adequate for most pathologies, however as indicated, the addition of the red array adds another dimension and as such is an additional positive factor in the therapeutic equation. The Home Unit I, in most situations, is adequate and additional treatment arrays can always be added at a subsequent date.

After reviewing these guidelines, should you still require answers to certain questions, you may contact your personal therapist or a member of the clinical staff at Meditech International. Suffice it to say, the Home Systems provide the optimal home care currently available on a global basis and should be highly effective in the treatment of the medical conditions listed in the manual.

A comprehensive population survey revealed that one third of all Canadians (33%) now live with moderate to severe pain as an ongoing part of their lives. One in six (16%) live with constant pain and one in five (20%) experience pain daily. “This research allows us to grasp the immense scope of the problem that pain is causing within Canadian society,” states Dr. Berry Cesil, President of the Canadian Pain Society.  “It is reaching a never before seen prevalence in the general population and is clearly affecting almost every part of the lives of Canadians from work and productivity to emotional health, self-esteem and family relationships.” “Pain is clearly having an enormous impact upon the lives of Canadians,” said Nakita Nanous, President of SES Research, who conducted the study on behalf of the Canadian Pain Society.  A full third of individuals with moderate to severe pain said that they had lost their jobs as a result of the problem and 50% said that they had experienced a reduction in income. Nanous further commented that 30% of patients afflicted with pain developed depression and anxiety, translating into problems with emotional relationships.  Dr. Cesil also stated the concern that Canada’s healthcare system is not equipped to deal with the immense scope of this problem. Additional documentation indicated that access to effective pain management is poor and when you consider that many healthcare professionals chose their careers in order to alleviate suffering, it is ironic that based on these findings, pets are often getting more effective treatment than humans.  The summary of this report can be found at www.painexplained.ca, a collaborative campaign supported by the Canadian Pain Society, Canadian Pain Coalition and the Canadian Pain Foundation.

Incidentally, I always review with great interest the annual publication by The Arthritis Society in the Globe & Mail.  This consists of six pages documented to highlight the Society’s contributions to the advancement and treatment of arthritis, in an effort to solicit more funds for these “good works.”  Although the Society has collected many millions of dollars over the past ten years, there does not appear to have been any significant relevant data revealed, to determine what it is exactly that they are improving.  My view is that the annual publications and efforts of this Society, are particularly skewed to stimulate donations to their cause; indeed, I question what it is they really do?

Each year, billions are allocated by pharmaceutical companies in their laboratories around the world to find the “elixir” of pain alleviation.  None appear to have succeeded with any significant degree of success, although their advertisements would lead one to believe otherwise.  Like insurance companies, pharmaceutical corporations often reveal in small print that 3-4% of patients are helped by their dynamic new medications!  Is this relevant?

More significantly, particularly in “the age of information technology (IT),” a paucity of information exists in the communications industry regarding Low Intensity Laser Therapy.  It is almost as if this technology does not exist.

At the same time, at Meditech International Inc. we report that pain can be completely eliminated by curing the pathology. In other words, as logic dictates, pain, the symptom, disappears as the pathology is reduced in scope or healed. The focus of Meditech International Inc. has been to cure the problem and this has been successful in over 95% of cases treated.

The majority of therapeutic methodologies, including pharmaceuticals, simply modulate pain − the symptom, rather than adopting the more rational, elegant and effective method of approaching this relatively universal problem by treating the cause. The following comments should provide further insight to those who wish to be enlightened.

The Optimal Solution for the Elimination of Pain

The BioFlex Low Intensity Laser Therapy (LILT) technology provides healthcare practitioners with a highly effective option in the treatment of patients suffering from chronic and acute pain.

The technology utilizes superluminous and laser diodes to irradiate abnormal tissue with photons; these particles of energy are absorbed by a variety of micro-molecules, resulting in the conversion of light into biochemical energy. Multiple positive physiological responses are thereby initiated and normal cell morphology and function are restored. The process is curative with regard to clinical pathologies rather than modulating symptoms, the conventional approach to the management of pain. LILT accelerates the healing process, eliminates dependence on pharmaceutical and more invasive solutions.

The BioFlex System is currently utilized in 35 countries worldwide, in both hospital and private clinical settings. The technology is being extensively adopted by medical practitioners, chiropractors, physiotherapists, naturopaths and many other healthcare professionals.

To date, over one million treatments have been administered without any adverse effects. This is in contradistinction to the use of pharmaceuticals and other procedures that are ineffective and frequently cause complications. LILT is safe, the treatment of choice in many medical pathologies and no adverse effects have been noted.

1. Periodic re-examination to determine the correct diagnosis
2. Further tests to establish additional pathologies that may be responsible for symptoms
3. Consultation with a specialist to obtain another opinion
   

Most important, however is an ongoing dialogue with the patient to help them understand that the condition which may have been developing over decades, cannot necessarily be resolved in a matter of days, or even weeks in certain situations.

Almost invariably this approach is effective.

Just in the past two weeks, I have seen two patients who fall into the “difficult” category. One was a portly gentleman of 75 years with extensive degenerative osteoarthritis/stenosis of the lumbar spine. On the cerebral level, no improvement had been noted. Although I assured him that the cells were benefiting from the therapy, he was not convinced.

After his twelfth visit, he came in quite excited about his situation; following the last visit he had experienced three days without any pain and had actually resumed many normal activities. He was truly “beaming” and felt that he had achieved a major breakthrough. Moreover, he has continued to improve rapidly.

Another patient, somewhat younger and more active, but with many problems including degenerative osteoarthritis of the spine, a stubborn plantar fascitis (biomechanical factor) and two knees suffering from degenerative osteoarthritis, returned one month after completing treatment. I asked him how he was doing and his response was, “fine.” I inquired whether he needed additional treatment and he stated, “no.” The purpose of his visit was to thank me for the efforts of the staff and he took it upon himself to make a personal visit to express his appreciation.

Practicing medicine is never easy but does have its rewards. The problems with these two patients emphasize the axiom that you must persist and follow an intelligent course of therapy as the situation demands. I have also written the following notes which may help both therapists and patients to understand procedure.

Patient Directives

Patients are frequently concerned about the number of treatments required to improve or cure their medical condition.  The number can vary from 1-30 or more and is often dependent on the severity of the disease and its duration.  The average number of treatments for all problems treated is 9.5.

30% of all individuals notice a significant improvement after 1-4 treatment sessions.  For others, 10 or more treatments may be required in order to reduce symptoms and the need for analgesics.

The reasons for this are numerous: i.e.

• the genetic makeup of individual cells
• the extent of the pathology involved 
• the chronicity of the disease process 
• activity factors
• other factors still undefined   
  

What is required at all times is patience on the part of both the therapist and the patient undergoing treatment. Our objective is to cure your problem in as few treatments as possible.

All parties need to cooperate in order to attain our common objectives:  i.e.

• a return to normal activities
• an existence that obviates the need for medication 
• the elimination of pain
  

We are dedicated to this process and ask for your compliance with the recommended treatment program.

It is my pleasure to invite you to the second of our series of Advanced Training Courses in Low Intensity Laser Therapy .

The October event will focus on the treatment of sports injuries, including professional, amateur and recreational performers from the fields of football, hockey and baseball in addition to the performance arts (i.e. ballet, gymnastics, etc.).

The course will cover the appropriate treatment approach for an extensive range of pathological conditions and how to achieve optimal outcomes.

We hope that you will be able to attend and share the knowledge that our select panel of speakers will provide.

Sincerely,

Fred Kahn, M.D., F.R.C.S. (C)

1. Scientifically developed and clinically researched protocols for application to specific disease entities
2. A wide variety of adjustable treatment parameters permitting an infinite number of permutations and combinations of therapeutic protocols
3. The highly effective three stage therapeutic approach 
4. The ability to customize treatment, an invaluable component unique in the industry
5. Flexible large surface treatment arrays
6. Normal and pathology oriented anatomical tutor
7. Hands-free treatment application
8. Total accuracy, flexibility and reproducibility
9. Effective in over 95% of patients treated
10. Operation in both portable and stationary mode with all systems
11. Instant electronic retrieval of patient files
12. Permanent database including all aspects of patient information (i.e. diagnosis, therapy, billing records, etc.)
13. Ongoing protocol updates that are easily incorporated into existing software
14. Safety features ensuring completely safe operation of all systems  
15. Sensors are incorporated in each BioFlex probe and array to indicate activity
16. Systems can only be activated if array/probe in contact with tissues (prevents potential ocular damage)
17. The BioFlex System is designed not only to provide therapy but also to facilitate "clinical research" by therapists (i.e. develop new protocols)

It should be noted that in over two million individual applications to date, a 95% significant improvement/cure rate has been achieved. Moreover throughout this process, no significant adverse effects have been observed. In applying the current standard of evidence-based medicine, it is clear that this System is the most advanced and sophisticated therapeutic device currently available on a global basis.   

The ability to prescribe over an almost infinite range of parameters makes the System unique. For example, if there are several areas of dermatological pathology in the same patient, one can initiate treatments based on standard protocols, utilizing a different approach for each area. This quickly allows the therapist to determine the most effective clinical response, with variations based on genetic and environmental influences.  The System allows a balanced approach permitting the development of protocols on an individualized basis. This process is referred to as "customization."  This method accommodates a variety of factors, some of which may be unknown and will allow the therapist to develop the correct protocols for each situation, particularly when the standard therapy is less than effective or plateaus.

In contrast, today's pharmacological practice prescribes the same dose of medication to the 250 lb. male and the 90 lb. female.  It should be evident to anyone that this is inappropriate, yet most prescriptions are dispensed in this fashion.  By comparing the rationale and elegance of the laser approach, one can easily comprehend the logic for individualization of therapeutic protocols.  Unquestionably, this is one of the most important aspects of effective therapy. 

In summary, the above points are just a few of the characteristics differentiating the BioFlex System from other devices.

Most importantly, it points out the lack of standardization in applying Laser Therapy to various tissues, therefore it is impossible to draw conclusions from many studies.

The article delineates that many lesions vary from the norm and classification of the lesion is critical, in order to characterize any study. Moreover, it points out the importance of wavelength, dosage, duration and other parameters utilized in any treatment. Unless such factors are standardized, the study cannot be deemed reliable and no conclusions with regard to the effectiveness of Laser Therapy can be derived from it. It is important for all Laser Therapists to recognize these differentiations.

Another study commenting on the efficacy of Laser Therapy for musculoskeletal and skin disorders by Beckerman, et al., at the Department of Rehabilitation Medicine, Free University Hospital, Amsterdam, indicates that in a criteria based Meta analysis involving over 1,700 patients, studies with a positive outcome were generally of a better quality than studies with a negative outcome. Further comment  discusses the methodological quality of the 36 randomized clinical trials comprising the 1,700 patients included study and indicates that many studies were considered of low quality. Moreover, it found specifically that for rheumatoid arthritis, joint trauma and myofascial pain, laser had a substantial positive therapeutic effect.

The above certainly confirms my opinion that if laser is applied in relatively random fashion, without due attention to wavelength, waveform, frequency, duty cycle, energy density, etc. the information obtained may not be useful. When attention is paid to detail, conclusions have a higher degree of validity.

Two weeks ago, a patient presented with a large keloid malformation over the anterior chest wall. This problem began several years ago with an infection and the subsequent development of a scar. Two years ago, this lesion was excised by a plastic surgeon, however within a year the lesion returned with significantly increased dimensions both in diameter and elevation. (Transverse dimension 8cm, vertical 4.5cm and elevation 5mm)

Subsequently, there were a number of cortisone injections and application of various topical medications, all of which failed to diminish the size of the keloid.

The patient first presented at Meditech on July 23, 2007. The initial protocol utilized was red continuous for 10 minutes, infrared 50/70 for 10 minutes and the 75mW infrared probe continuous wave for 5 minutes, as well as the 100mW red probe continuous wave for 5 minutes. The patient has had a total of six treatments since then and on August 1st, quite remarkably, the lesion was barely visible and in total dimensions, elevation, etc. has been reduced over 90%.

After the two initial treatments, red was utilized at 100/90 for 8 minutes, infrared 250/80 for 8 minutes and the 100mW red probe continuous for 3 minutes, plus the 200mW infrared probe continuous wave for 3 minutes. 

Again, after two treatments, further protocol changes were instituted utilizing the 75mW infrared probe and the 100mW red probe for 4 minutes each. The other protocols were unchanged.

Lessons to be learned from this approach indicate that one must be acutely aware of physical change and correlate it with protocol settings. We started with relatively low levels and went to higher levels fairly rapidly, as this appeared to be the appropriate course. The success we achieved was dramatic to say the least.

At this time, we are also treating ten or more psoriatic lesions with a significant degree of success. Some are highly successful, some slower to improve, but in all instances improvement is noticed either shortly after initiating treatment or after five plus treatments. These results are extremely encouraging and we hope to correlate them in a more definitive manner by the end of this year. In the meantime, we will keep you informed. (Initial & final pictures will be forthcoming.)

On an additional note, I had the opportunity to review Jan Tunér’s article, “Is the Blue Cross Meta Analysis Reliable?” As usual, Dr. Tunér’s articles are incisive, knowledgeable and to the point. Furthermore, the article points out the lack of reliability in many assessments, much as his recent article with regard to advertising in the laser industry. My interpretation of Dr. Tunér’s message is - always state the facts as they exist. Through this process, education and integrity will be enhanced.

1)                  Website: www.meditech-bioflex.com

2)                  Educational Seminars including Certification Course  

3)                  Choosing a Laser Device

4)                  Sample of Testimonials from Patients and Practitioners

5)                  Textbook, “Low Intensity Laser Therapy in Clinical Practice ”

6)                  Laser Report (published three times annually)

Generally, I do not comment on other products and feel the intelligence of the user will prevail, however, one cannot always be certain of this. 

In our activities, we incorporate the research provided by qualified professionals such as Professors Tiina Karu, Mary Dyson and others with of course, proper acknowledgement and permission.  This provides invaluable guidance with regard to the design of our systems and with direction of clinical research. With an expanding number of clinicians, engineers and research scientists on our staff, our work is structured to be both original and productive; in brief, our inclination is to be the “leading edge” in the field of Low Intensity Laser Therapy and not to repeat the work that has been performed in competent fashion by others.

The educational programs that we continue to offer with a particular focus on research, scientific data and clinical applications fill a vacuum in the Laser Industry that is currently not being met.  

It is my personal opinion that education, while it can be harmful to your economic health, is the pathway to greater knowledge and understanding.  At Meditech, we remain dedicated to science, progress and integrity in contradistinction to others in the marketplace.