Wilkerson Chiropractic

05/26/2024

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03/03/2024

It has been a privilege and honor providing you with care over these past 46 years. I am thankful for all of you. I will be retiring from my daily and monthly practice duties soon. Therefore, we have made arrangements to have Dr Teresa Martinez-Baker take over ownership, custodial, and operational management of our patients and the practice at 415 East Ocean Ave. Suite A Lompoc Ca. This will be finalized at the end of this month. She begins treating her patients at our facility on March 4, 2024.

To assure a smooth transition of our patients and to introduce “Dr. T” to whoever I see this month, I will be treating my patients during the month of March 2024. Dr. T will be meeting you and we will be discussing your file, so she will be familiar with you and our approach to your treatment.

Dr. Matinez-Baker has been practicing in Lompoc for many years and has her own Facebook Dr.T's Family Chiropractic & Website. I therefore will be closing this Wilkerson Chiropractic page in the near future.

We will miss you, but it's good to know Amy, a familiar and friendly face will be staying on with Dr. T

Sincerely and God’s Blessings to you all,

Marc F. Wilkerson D.C. & Janis Wilkerson

02/26/2024

Weekly Health Update
Week of: Monday, February 26th, 2024

“Well-arranged time
is the surest mark
of a well-arranged mind.”
~ Isaac Pitman

Health Alert:
Low Vitamin D Linked to Cardiovascular Disease Risk in Young Adults. Among a group of 177 young adults aged 18-25 years, researchers observed that those with lower vitamin D serum concentrations were more likely to exhibit risk factors linked to an elevated risk for cardiovascular disease. The findings suggest that assessing vitamin D status in young adults could signal healthcare providers as to which patients may benefit from additional testing and interventions to reduce their risk for cardiovascular disease in the future.
Journal of Endocrinological Investigation, January 2024

Diet:
Prunes May Benefit Postmenopausal Women. Consuming 50-100 grams of prunes a day can slow bone loss in postmenopausal women by altering proinflammatory cytokine secretion and monocyte activation.
Journal of Nutrition, November 2023

Exercise:
Combined Exercise Intervention Reduces Risk for Serious Events in Liver Cirrhosis Patients. An analysis of data from 11 randomized controlled trials revealed that patients with liver cirrhosis who engage in a fitness program that combines resistance and aerobic training are four times less likely to experience serious events such as portal hypertension, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, liver cancer, jaundice, gastrointestinal bleeding, and coagulopathy.
Journal of Gastroenterology, December 2023

Chiropractic:
Chronic Neck Pain and Forward Head Posture. A systematic review that included 16 studies found that corrective postural exercises and manual therapies are effective interventions for improving pain and disability in patients with chronic neck pain associated with forward head posture. Doctors of chiropractic often use a combination of manual therapies and specific exercises when managing patients with chronic neck pain.
HealthCare (Basil), December 2023

Mental Attitude:
Twin Dementia Diagnosis May Be Risk Factor for Early Death for Sibling. Using data from the Swedish Twin Registry, researchers report that among fraternal twins, if one received a dementia diagnosis, the other twin had a slightly lessened life expectancy compared with fraternal twins in which neither developed dementia. The research team suspects this may be due to unhealthy habits acquired during childhood by both siblings, which may elevate the risk for dementia in one and conditions like heart disease in the other.
Alzheimer's and Dementia, December 2023

Wellness/Prevention:
Toothbrushing Could Be a Life Saver in the Hospital. New research suggests that brushing your teeth at least once a day during a stay in the intensive care unit can reduce the risk for pneumonia infection, leading to a lower mortality risk, shorter stay, and less time spent on a mechanical ventilator.
JAMA Internal Medicine, December 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

02/19/2024

Weekly Health Update
Week of: Monday, February 19th, 2024

“Successful people are simply
those with successful habits.”
~ Brian Tracy

Health Alert:
One-in-Ten Home Colon Cancer Tests Are Unusable. Due to factors including inadequate stool specimens, incomplete labeling, old specimens, and leaking or broken containers, researchers estimate that about 10% of at-home colon cancer tests sent to a lab are unusable. The study highlights the need for improved patient education, test-tracking procedures, and timely follow-up to address breakdowns in the screening process and enhance the effectiveness of at-home screening tests for colon cancer.
Cancer Epidemiology, Biomarkers & Prevention, December 2023

Diet:
New Salt Substitute Formula Can Help Reduce High Blood Pressure.
The National Heart, Lung, and Blood Institute reports that a new salt formulation that is 75% sodium chloride and 25% potassium chloride can relax the walls of the arteries, lowering blood pressure and reducing the risk for hypertension.
National Heart, Lung, and Blood Institute, December 2023

Exercise:
How Exercise Inhibits Fat Infiltration in Muscles... Myosteatosis is a term used to describe the accumulation of fat in skeletal muscles, which can negatively affect physical function and health-related quality of life. In a recent study, researchers observed that exercise increases the expression of the PGC-1alpha gene, which improves mitochondrial fatty acid oxidation, inhibiting the fibro-adipogenic progenitors that drive fat accumulation in muscles.
Journal of Physiology, December 2023

Chiropractic:
Treatment for Cervical Radiculopathy. A systematic review that included eight studies concluded that neural mobilization is an effective treatment option for mobility, pain, disability, and functional activity in patients with cervical radiculopathy. Doctors of chiropractic frequently use neural mobilization as part of a multimodal approach when managing cervical radiculopathy cases.
Journal of the Pakistan Medical Association, September 2023

Mental Attitude:
Fear of Serious Illness Can Shorten Life. Illness anxiety disorder is a chronic mental health condition in which a person excessively worries about having a serious, undiagnosed medical illness, despite having little or no medical evidence to support it. According to a recent study that looked at long-term data concerning more than 45,000 adults found that individuals with illness anxiety disorder were not only more likely to die from circulatory or respiratory diseases during the 24-year study, but they died at younger ages (up to five years) than participants without the mental health condition.
JAMA Psychiatry, December 2023

Wellness/Prevention:
Steps for Healthy Brain Ageing. To reduce the risk for dementia, The University of Connecticut offers the following tips: exercise regularly, eat a heart-healthy diet, manage your blood pressure, protect against head injuries, don’t smoke, avoid excessive alcohol intake, address hearing loss, and keep an active social life.
University of Connecticut, December 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

02/12/2024

Weekly Health Update
Week of: Monday, February 12th, 2024

“Nothing happens
unless first we dream.”
~ Carl Sandburg

Health Alert:
Phthalates May Lower Fertility. Phthalates are a class of chemicals used to increase the durability of many materials, including some cosmetics and plastics. These chemicals are known as endocrine disruptors, which can influence hormone levels in the body. In a recent study that included more than 1,200 women attempting to conceive, researchers observed that those with higher levels of phthalates in their blood were up to 18% less likely to become pregnant.
Environmental Health Perspectives, December 2023

Diet:
Whey Protein May Lower Diabetes Risk. For adults at risk for developing type 2 diabetes, a recent umbrella review that included 13 systematic reviews concluded that taking a daily whey protein supplement “may improve multiple clinical indicators of glucose control, along with triglycerides and blood pressure…”
Current Developments in Nutrition, October 2023

Exercise:
Postpartum Physical Activity Benefits. A review of guidelines from 22 countries found that increased physical activity and/or less sedentary behavior in the postpartum period is associated with the following benefits: weight control/management, a reduced risk for depression, and improved well-being.
Journal of Sport and Health Science, December 2023

Chiropractic:
The Importance of Proper Diagnosis and Treatment. This case study described a patient with anteromedial leg pain that had been diagnosed as shin splints for ten years. Following a review of the patient’s history and chiropractic examination focused on anatomy, biomechanics, and the peripheral nervous system, the patient received a diagnosis of dynamic stenosis of the left L4-5 intervertebral foramen leading to mixed partial mononeuropathy of the L4 spinal nerve, causing pain and hypersensitivity in the anteromedial shin. A treatment plan that included manual therapy targeting the intervertebral foramen resulted in resolution of the patient’s pain and sensory symptoms.
Journal of the Canadian Chiropractic Association, August 2023

Mental Attitude:
Doctors Are Both Excited and Concerned About AI's Role in Medicine. The American Medical Association reports that a survey of their membership revealed about 70% of medical physicians believe artificial intelligence (AI) could enhance workflow efficiency and aid in better patient diagnosis, and roughly half thought it can aid in documentation and reduce red tape associated with prior authorization for insurance coverage. However, about 40% of respondents voiced concern about the impact of AI on patient-doctor interactions and patient privacy.
American Medical Association, December 2023

Wellness/Prevention:
Prospective Dads Should Avoid Alcohol. Texas A&M University researchers note that alcohol can affect s***m quality, reducing the risk for conception and increasing the risk for potential birth defects if pregnancy is achieved. Because these effects can persist during withdrawal, the research team recommends men wishing to become fathers abstain from alcohol for at least three months.
Andrology, December 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

02/05/2024

Weekly Health Update
Week of: Monday, February 5th, 2024

“Good things happen
to those who hustle.”
~ Chuck Noll

Health Alert:
One-in-Fifty Young Kids Is Severely Obese. After falling from 2.1% in 2010 to 1.8% in 2016, the rate of severe obesity among young children in the United States has risen to 2%. The finding is alarming as being overweight early in life often leads to poor lifestyle choices in adolescence and young adulthood that not only increase the risk for chronic disease but also diagnosis at younger ages.
Pediatrics, December 2023

Diet:
Is an Inflammatory Diet Linked to Stroke? Using data from the National Health and Nutrition Examination Survey, researchers report that a pro-inflammatory diet—an eating pattern characterized by a high intake of sugar, polysaturated vegetable oils, trans fats, dairy products, feed lot-raised meat, red meat, processed meat, alcohol, refined grains, and artificial food additives—is associated with up to an 87% elevated risk for stroke.
BMC Public Health, January 2024

Exercise:
Is Exercise Linked to Better Math Scores? Northeastern University researchers note that among 218 grade-school students, those with higher physical fitness scores were more likely to also perform better on arithmetic assessments.
Psychology of Sport and Exercise, January 2024

Chiropractic:
Non-Invasive Interventions for Myofascial Pain Syndrome. Myofascial pain syndrome is a chronic condition characterized by pain and tenderness in specific areas of muscles and the connective tissue surrounding muscles. A systematic review that included 40 studies found that manual therapy, laser therapy, shock wave therapy, and ultrasound therapy are effective, non-invasive treatment options for reducing pain intensity, pressure pain threshold, and pain-related disability in patients with myofascial pain syndrome. These therapies are often utilized by doctors of chiropractic when managing myofascial pain syndrome and other musculoskeletal disorders.
International Journal of Surgery, November 2023

Mental Attitude:
Mood Disorders Common Among Caregivers of Stroke Survivors.
Questionnaires completed by 301 caregivers of stroke patients revealed that between 17% and 28% of such individuals experienced high levels of psychological distress, including anxiety, depression, and post-traumatic stress disorder. The findings highlight the necessity for strong support systems for family members caring for stroke survivors.
Neurology, December 2023

Wellness/Prevention:
How to Tackle Dandruff. The American Academy of Dermatology notes that dandruff isn't a sign of poor hygiene and can have myriad causes such as oily skin, improper hair care habits, and certain medical conditions. Before consulting a professional, the Academy recommends the following for mild cases: use a specially formulated shampoo for persistent dandruff that contains ingredients such as zinc pyrithione, salicylic acid, sulfur, selenium sulfide, ketoconazole, or coal tar; if one shampoo proves ineffective, alternate between shampoos with different active ingredients; and try changing the frequency in which you wash your hair.
American Academy of Dermatology, December 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

02/01/2024

Sharing an article for joint pain relief

Snapping Hip Syndrome

While chronic hip pain can affect individuals of all ages and activity levels, 30-40% of those who have a history of playing sports and 12-15% of adults over age 60 may develop the condition. Although hip pain can result in a variety of diagnoses, a common form is coxa saltans, or snapping hip syndrome (SHS). This variety of hip pain is characterized by an audible or palpable snap of the hip joint, which can occur on one side or both hips, be painful or painless, and may not always have an obvious or knowable cause.

The snapping noise is due to the iliopsoas (hip flexor tendon) or the iliotibial (IT) band located on the side of the leg. When the iliopsoas is involved, this is referred to as the “internal type” of SHS, which is reproduced by extending and internally rotating the hip and moving into flexion and external rotation where the snap is reproduced as it rides over the femoral head. When the IT band is involved (referred as the “external type”), the snapping is due to the tendon sliding over the greater trochanter when the hip is moved from extension to flexion. Both types are referred to as extra-articular in nature as the cause is beyond the hip joint itself. There are also intra-articular causes of SHS from pathologies such as from loose bodies, torn labrum, and/or fracture. Intra-articular cases are generally more serious in nature and may require more aggressive treatment. To complicate matters, intra- and extra- articular SHS can co-occur, especially with the iliopsoas variant of SHS.

A comprehensive literature review found that people who frequently engage in activities that require hip movements at extreme rotations are more likely to develop symptomatic SHS—especially young gymnasts and ballet dancers. Due to the size and growth of the pelvis during development, young women are also at elevated SHS risk. Additionally, avid exercisers and obese/overweight individuals may both develop hypertrophy and inflammation of the psoas muscle and areas of the internal hip including the iliopsoas bursa, iliopsoas muscle, and other local structures, which can also increase their risk for snapping hip syndrome.

Thankfully, outside of pathologies that require immediate pharmaceutical or surgical intervention, most SHS cases respond to conservative management approaches, which includes chiropractic care. If you’re experiencing hip pain or discomfort with movement that’s creating a snapping noise, your chiropractor will assess your mobility, palpate around the entire region, assess your range of motion (spinal, pelvic, hip) and your gait, as well as perform provocative tests such as the FADIR test (flex, adduct, and internal rotation of the hip) to determine what type (or types) of SHS you have so that they can create an initial treatment plan. A multimodal treatment approach may include manual therapies and physiotherapies provided in the office in conjunction with activity modifications and specific exercises.

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

02/01/2024

Sharing an article for carpal tunnel pain relief

Pronator Tunnel Syndrome Vs. Carpal Tunnel Syndrome

The median nerve originates from nerve roots (specifically C5-T1) that exit the cervical spine and then merge together in the brachial plexus in the neck and shoulder region traveling down the arm, through the wrist, and into the hand. Compression or restriction of the mobility of the median nerve anywhere along its course can result in the symptoms commonly associated with carpal tunnel syndrome (CTS), including numbness, tingling, pain, and weakness in the thumb and index, middle, and the thumb-side of the ring finger. So how do doctors of chiropractic differentiate between CTS where the median nerve is compressed at the wrist and another peripheral neuropathy like pronator tunnel syndrome (PTS) in which compression occurs as the nerve passes through the forearm, just below the elbow?

When a patient seeks care for suspected CTS, they’ll first complete a history. This information will direct the course of their chiropractor’s examination to best identify what is generating the patient’s symptoms. Classically, PTS will also include symptoms that start near the elbow (aching, numbness) due to activities that require repetitive elbow flexion and forearm/hand rotations (called supination and pronation) with firm gripping. However, there are presentations of CTS in which pain can be referred into the forearm and even above the elbow. One way your doctor of chiropractic can differentiate PTS from CTS is to apply compression over the pronator teres muscle for 30 seconds. If PTS is present, then this activity can reproduce paresthesia (numb/tingling) into the forearm, hand, and fingers, whereas this may not have the same result in cases of CTS.

Of note, CTS and PTS can co-occur together or along with compression of the median nerve at the neck or shoulder, which may only be identified following a thorough examination. To highlight the importance of properly identifying PTS and CTS, two separate studies have found that PTS is misdiagnosed between 32% and 49% of the time. Failure to address PTS can result in inappropriate treatment at the wrist, including unsuccessful surgical decompression.

Conservative chiropractic treatment for CTS and PTS will typically involve a multimodal approach using manual therapies, physiotherapy modalities, nutrition recommendations, nocturnal splinting, activity modification, and at-home exercises to reduce inflammation and restore the mobility of the median nerve as it travels from the neck to the hand. Because issues like hypothyroidism, diabetes, obesity, autoimmune diseases, and other systemic/chronic conditions can contribute to CTS and PTS, co-management with an allied healthcare provider may be required to achieve a satisfactory result. As with other musculoskeletal conditions, both CTS and PTS are easier to manage with conservative, non-surgical treatment approaches—including chiropractic care—earlier in the course of the disorder, so don’t delay treatment until either (or both) conditions become severe. In the most advanced cases, surgical intervention may be the only option available to a patient.

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

01/29/2024

Weekly Health Update
Week of: Monday, January 29th, 2024

“The only durable sense of success
is if you've followed your calling.”
~ Jim Harrison

Health Alert:
Sleep Apnea Linked to Heart Disease. Following an analysis of data concerning more than 500,000 adults, researchers report that individuals with a history of sleep apnea have a 35% increased risk for coronary artery disease.
MedRxiv, November 2023

Diet:
Can Broccoli Sprouts Protect Against IBD? In a recent experiment, researchers found that mice with inflammatory bowel disease (IBD) given a supplement of broccoli sprouts along with their normal diet experienced more mild disease symptoms and developed a healthier gut bacteria population.
mSystems, November 2023

Exercise:
Fitness Can Help Mitigate Anxiety-Related Low Back Pain Risk. Past research has identified anxiety as a risk factor for low back pain. According to a recent study that included more than 13,000 adults, researchers observed that those with self-reported anxiety and high cardiorespiratory fitness levels are nearly four times less likely to develop low back pain in the following five years than those with anxiety and low fitness.
Journal of Sports Science, June 2023

Chiropractic:
Hamstring Tightness Linked to Neck and Low Back Pain. Examinations of 104 adults under 40 years of age revealed that nearly three-quarters of those with either chronic neck or low back pain reported tight hamstrings in one or both legs. The authors note that hamstring tightness can affect the biomechanics of the spine, increasing the risk for disorders such as low back pain and neck pain.
Journal of Pakistan Medical Association, August 2023

Mental Attitude:
Biological Age May Affect Risk and Dementia. Using data from the UK Biobank study, researchers report that individuals whose blood lipid levels, blood pressure, and pulmonary function resemble those of someone more than five years older than them are 40% more likely to develop vascular dementia or stroke than their peers with a biological age closer to their actual age.
Journal of Neurology, Neurosurgery and Psychiatry, November 2023

Wellness/Prevention:
Pill-Sized Device Can Track Breathing and Heart Rate. Scientists from the Massachusetts Institute of Technology have developed a “technopill” that when swallowed, can monitor an individual’s breathing and cardiac function with high accuracy until it’s excreted a few days later. It’s hoped such a device can provide doctors with a non-invasive tool for collecting real-time information on patient health.
Cell Press, November 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

01/23/2024

Weekly Health Update
Week of: Monday, January 22nd, 2024

“Let us not look back in anger,
nor forward in fear,
but around in awareness.”
~ James Thurber

Health Alert:
Most Americans Unaware of Harmful PFAS. Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are chemicals used to imbue heat-, oil-, stain-, grease-, and water-resistant properties to products such as food containers, clothes, and furniture that can persist in the environment and body for an extended period of time. Past research suggests that higher PFAS exposure is linked to several poor outcomes including fertilities issues, developmental challenges, and some cancers. A survey of 1,100 American adults revealed that 45% had never heard of PFAS, 32% had heard the term but didn’t know what they are, and 97% did not believe their drinking water contains any.
PLOS One, November 2023

Diet:
Parents Less Likely to Buy Children Sugary Drinks If... The Rudd Center for Food Policy and Health reports that if the contents of beverages marketed for kids are clearly noted on the front of the package, then parents will be less likely to purchase sugary drinks for their children.
Public Health Nutrition, November 2023

Exercise:
Weekend Workouts Are a Viable Option. According to a recent study, achieving 150 minutes of moderate-intensity (or 75 minutes of vigorous-intensity) physical activity during the weekend is as effective at reducing the risk for early death and cardiovascular events as spreading the same amount of exercise over the full week.
Mayo Clinic, November 2023

Chiropractic:
Poor Ergonomics Linked to More than 100 Million Low Back Pain Cases Annually. An analysis of global datasets suggests that poor work ergonomics may contribute to more than 126 million cases of low back pain each year, leading to $216.1 billion in productivity losses and $47 billion in healthcare costs.
Scandinavian Journal of Work, Environment & Health, October 2023

Mental Attitude:
Cognitive Impairments and Osteoporosis. A meta-analysis that pooled data from ten studies found that patients with cognitive impairment—Alzheimer’s disease especially—have a 50% increased risk for developing osteoporosis.
BMC Geriatrics, December 2023

Wellness/Prevention:
Special Toothpaste May Help Curb Peanut Allergy. Researchers are currently testing a new toothpaste that contains peanut proteins intended to desensitize patients with a peanut allergy, without triggering systemic reactions in the process. The toothpaste is current undergoing testing for approval by the Food and Drug Administration in the United States.
American College of Allergy, Asthma and Immunology, November 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

01/17/2024

Weekly Health Update
Week of: Monday, January 15th, 2024

“The way to get started
is to quit talking
and begin doing.”
~ Walt Disney

Health Alert:
Syphilis Cases in Newborns Have Jumped Dramatically in Recent Years. The Centers for Disease Control and Prevention (CDC) reports that more than 3,700 babies in the United States were born with syphilis in 2022, a ten-fold increase from 2012. The CDC notes that timely testing and treatment during pregnancy can prevent 90% of congenital syphilis cases, underscoring the need for improved public outreach and screening.
Centers for Disease Control and Prevention, November 2023

Diet:
Cutting Glutamate May Reduce Odds for Post-Brain Injury Mood Disorders. For patients recovering from traumatic brain injury (TBI), a recent study found that reducing glutamate intake may reduce the risk for post-TBI depression and other mood disorders. Some common dietary sources of glutamate include soy products and processed food products and additives, including MSG.
Nutrients, November 2023

Exercise:
Adding Brain Games along with Tai Chi May Provide Greater Benefits to Seniors. Past research has shown that tai chi interventions can lead to better cognitive and physical health outcomes among older adults, and now a new study has demonstrated that combining tai chi with cognitive challenges may lead to even greater benefits. It’s hoped this new hybrid intervention can reduce the risk for falls among seniors, which can help them remain independent longer into old age.
Annals of Internal Medicine, October 2023

Chiropractic:
Nearly a Third of Adults Have Shoulder Pain. Among a group of 1,128 middle-aged adults, 31.4% reported experiencing shoulder pain within the previous month. Further analysis revealed that those whose work activities included physical or heavy manual labor were 66% more likely to have shoulder pain. Doctors of chiropractic frequently treat patients with shoulder pain using a multimodal approach that combines manual therapies and specific exercises.
Chiropractic & Manual Therapies, November 2023

Mental Attitude:
Brain Injury Linked to Later Heart Risks. Using the Taiwan's National Health Insurance Research Database, researchers report that men with a history of traumatic brain injury (TBI) have a 14% increased risk for heart failure. Additionally, women under age 50 with a history of TBI have a 32% elevated risk for coronary heart disease.
PLoS One, December 2023

Wellness/Prevention:
Shark Healing Ability May Help Humans. Researchers from the Karolinska Institute in Stockholm and the Marine Biological Laboratory note that shark skin has exceptional wound healing abilities, which may lead to the creation of novel wound-healing treatments inspired by shark skin properties.
International Journal of Molecular Sciences, November 2023

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.