The Fieldstone Farm Therapeutic Riding Center

The Fieldstone Farm 

Therapeutic Riding Center

Last week I had the distinct pleasure of being shown the Fieldstone Farm, one of our region's most incredible agencies for help and change.   My extraordinary tour was led by the President of the Board and longtime friend, Mr. Tom Rathbone, and the inspired Executive Director, Ms. Lynnette Stuart.

The Fieldstone Farm was created 35 years ago, and offers a unique form of help to those in need- the relationship of people and horses.  This relationship is old enough that we can say with confidence that we as humans evolved together with horses so that we are both who we are in some measure in relation to each other.

With that in mind, riding a horse, being with a horse, being connected to a horse, offers benefits to any person.

And it is for that reason that riding a horse can help people with a wide range of troubles and challenges, in particular those of us with issues in these categories:

• Physical disabilities
• Cognitive disabilities
• Psychosocial disabilities

In each instance, the unique dimension of connection between horse and rider changes the life of the rider, often changing their experience of their challenge, opening up new directions for growth, change, and recovery.

Consider the fact that if you tape a video of a rider while simply sitting on a horse while the horse walks, the rider's spine and limbs fully and automatically replicate the normal motions of walking.  This opens the world of walking to a child or adult with problems that might keep them from experiencing the sensation of walking.  These would include conditions such as severe cerebral palsy, progressive deteriorating conditions such as ALS.

Or, consider the power of the horse, a large animal connecting with the rider, on the rider's own moods and perceptions of self.  The Fieldstone Farm experience has helped large numbers of our community help advance social skills, increase confidence, stabilize moods, relate to other people more effectively.

The Fieldstone Farm has taken the impact of the horse and rider relationship to the world of academics and runs a great high school, Gaitway, that is very successful in finding motivation in students who seem to have lost it all.

The program also has a very vibrant volunteer program that involves formal training and certification.  In 2011, 650 people volunteered over 22,000 hours of time, learning a lot about horses, and people.

This remarkable program has been a great help to many families in our practice over the years, and so I thought it would be helpful for you to hear about the great work being done there.

If you are interested, check out their fascinating website:  www.fieldstonefarmtrc.com

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Beware of the False Pneumonia

Beware of the False Pneumonia

Pneumonia.  

We are seeing a continuing and rather dramatic rise in how often families are told their children have pneumonia, especially in ER's and Urgent Care Centers.

But it turns out that the pneumonia that these centers are talking about is quite different than what most people think pneumonia is.   

For most of history, and in most everyone's mind, pneumonia was a very dangerous illness, caused by potentially very deadly bacteria.  Pneumonia was an illness where bacteria created a lot of pus in the lungs, causing a very rapid decline and significant danger.  

Technically, this is a form of pneumonia called bacterial pneumonia, and when you get this disease, you get very sick, very rapidly, and in its more severe forms, you can get quite a bit sicker every hour.  Some forms of this disease can also be quite dramatic in their recovery, with some people getting so much better on antibiotic that they feel good within hours of starting antibiotic.

This is not the disease that is being diagnosed as pneumonia thousands of times a day in ER's and Urgent Care Centers across the country.  The pneumonia being diagnosed so frequently now is a type of pneumonia, and so technically is not a "false pneumonia," but it often is an illness that really has no relationship whatsoever to bacterial pneumonia.

The illness being called pneumonia, most frequently in children, is really a type of cold, that in the vast majority of circumstances poses no risk to the safety of a child, and will not benefit at all from use of antibiotic.

What is this form pneumonia that is so unrelated to what we have all long thought pneumonia was about?  It is an illness called viral pneumonia.

Viral pneumonia can be very severe, but in the vast majority of cases seen in kids, it really is, as noted above, much much more like a cold than like bacterial pneumonia.   

Bacterial pneumonia in its full form tends to be a very rapidly progressing process where you get seriously ill very rapidly and can get worse every hour.  Left untreated, bacterial pneumonia can be a very dangerous illness.  At its heart, bacterial pneumonia destroys lung tissue and creates a ton of pus in the lungs.

Viral pneumonia, typically, makes you breathe faster and cough a lot, but does not much more than that.  It can also cause fever and feeling lousy, but it tends to make you ill to a certain degree- a certain amount of fever, misery, cough- and then you stay that sick for a few days or weeks, then recover.  There is typically, in the most frequent  mild forms, no progression.  Rather, you just sit there at that level of illness for a long stretch of time.  Viral pneumonias, at their heart, cause swelling and mucus production, some pus, but not nearly as much as with the unrelated illness, bacterial pneumonia.  

And, there is essentially no drug that cures viral pneumonia.  Antibiotics are useless for this disease, since antibiotics only kill bacteria, and there are no bacteria to kill in the illness, viral pneumonia.

Now here is the core source of confusion between these two very different, unrelated diseases, you can't tell the difference between them by looking at a chest X-ray.  The X-ray, CT Scan, and MRI cannot tell the difference between pus and mucus.  Bacterial pneumonia makes pus, viral pneumonia mucus, no imaging scan or X-ray can tell the difference between the two.

This confusion led the nation's two top professional societies on the subject of pneumonia* to make a formal recommendation that a chest X-ray NOT BE DONE ROUTINELY when a child is seen in the ER with a question of pneumonia.  Further, these societies noted that the vast majority of pneumonia in childhood is viral, not bacterial, pneumonia; and, therefore antibiotics should NOT BE PRESCRIBED ROUTINELY, if it clear the illness is more viral in nature.

BOTTOM LINE:

1. The two diseases, bacterial pneumonia and viral pneumonia, are not similar, related, or have anything to do with each other, beyond both affecting the lung.
2.  Bacterial pneumonia can be very dangerous, making you sicker by the hour, and involves production of lots of pus in the lung.
3. Viral pneumonia, in its typical form (note that it too can be very severe, but 99% of the time is not) causes much misery from fever and cough, but tends to hover at a certain level of intensity, not changing dramatically over time, but lingering.
4. In children who are not dangerously ill, that is who do not require oxygen, can breathe fairly easily, the vast majority do not have bacterial pneumonia, they have the other illness, viral pneumonia.
5. Chest X-rays and antibiotics are not useful for mild, viral, pneumonias.  In fact, in their milder forms, the viral pneumonias are more accurately described as bad colds in the lung and not "true" pneumonias.  At least they bear no resemblance or connection to what most of us think of as a real pneumonia- which is the bacterial form.
6. Here is the key point:  more than anything else, the difference is in how sick your child is.  That, far more than a Chest X-ray, will determine if the process is dangerous and bacterial or very safe and viral.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.