Archive for April, 2010

Plumber butt, coin slot, crack problems: OK, so this is not technically a back issue…I guess.

Friday, April 30th, 2010

I know this is not really a back issue, but I felt it would be irresponsible for me to not report on it anyway- and technically, it does cover ones’ sacrum.

Finally a product for people wearing low cut jeans who don’t want to display their butt crack for everyone to see. I will rely upon the website to describe this unique and interesting product:

The Backtacular Gluteal Cleft Shield, created by designer Kimberly Brewer, is a stylish cover that prevents any unfortunate butt-crack revelations.

Made of hypo-allergenic denim, and decorated with studs and rhinestones for added bling, the Backtacular Gluteal Cleft Shield is applied directly to the skin, and sits above the waistband protecting the wearer’s modesty and morals like a tiny, fashionable nun.

The BGCS can be bought online from Brewer’s Kimberlily site.

Now all she needs to do to make it really take off is offer a customised version, which instead of rhinestones just features an advert for your plumbing services. She’d be on to a winner.

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I’m gonna order mine today!

Thanks for stopping by, and be well!

-Andy

Matt Dubrow, D.O. presents his ‘One Thing’….For low back pain, stretch!

Friday, April 30th, 2010

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Today, Matt Dubrow, D.O. presents his ‘One Thing.’ His recommendation, to stretch first thing in the morning, is a great one. You are far more likely to injure your back in the morning before you have adequately warmed up, than at any other time during the day. You would be surprised how many people throw their backs out while sitting on the edge of their bed putting on a pair of socks! Thank you again Matt!

I have asked stretching expert Jorden Gold to provide a follow up to this post, and give us his 3 best first-thing-in-the-morning stretches. Look for that post early next week.

Thanks for visiting,

Andy

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Talking medical insurance reform with colleagues, Osteopaths being Osteopaths…

Thursday, April 29th, 2010

Well, today through Saturday I am at the convention of the Pennsylvania Osteopathic Medical Association getting some continuing medical education credits. It is always nice having the chance to catch up with some friends from medical school, internship, and residency and hear about their adventures in practice.

Talk About Insurance Reform…

This year the conversations were particularly interesting in light of the medical insurance reform. Some docs are elated by it, and others are terrified. The interesting thing is that again, I am dealing with a whole lot of folks who just spew back the talking points that their respective sides feed them. To date, I am the only physician I know who has actually taken the time to read the bill.

Do I like all of it? No- of course not. It would be impossible to create a bill which would ultimately satisfy everyone. As it stands, I like about 80% of what we got. I think the insurance & pharmaceutical industries got off easy with this legislation- I would have like to have seen accountability for how our premium dollars are being spent- but by and large I think the bill does more good than not, and at least it’s a start.

One of the things I see people focusing on more than any other aspect of the bill is the concept of mandatory health insurance. I don’t have as much as a problem with this as some of my colleagues do, in as much as we are already responsible for purchasing auto insurance- so I don’t see this as being very different. Some opponents say that rationale doesn’t hold up because you can choose not to drive. My response to that is that in most cities there is a federally subsidized mass transit system for those who choose not to drive- or simply cannot afford a car or insurance, so there is a safety net.

Look, I know a lot of you don’t like the idea of the Federal Government getting involved in health insurance, but the alternative would be to hyper-regulate the insurance industry (which has largely chosen to not self-regulate in any meaningful way) and that would not make free-enterprise folks happy either. I don’t know what the correct answer is, but it was interesting to speak with so many people on the front lines, and hear their opinions.

Osteopaths being Osteopaths…

On a slight side note, one of the most discouraging things about this convention was hearing about how many of my fellow Osteopathic physicians have given up Osteopathic Manual Medicine (manipulation) altogether. They all know it works wonderfully- they have other reasons. Many of them site the poor insurance reimbursement, or the commitment of time as reasons for forsaking this fantastic modality.

I became a physician because of my exposure to some wonderful Osteopathic physicians (my father being one of them,) and I had the opportunity to see hands-on medicine at work from a very young age. It saddens me that in this time when Americans are literally clamoring for all sorts of alternative approaches to medicine, that we have this long-tested modality at our disposal, and yet it is fading out of existence. D.O.s should be experiencing a renaissance, but instead are settling for assimilation.

Thankfully, not all of us are going that route. I maintain my commitment to Manual Medicine- and tomorrow’s ‘One Thing’ segment will be by a wonderful friend and physician, Matthew Dubrow, D.O.

I have known Matt for many years. His father was an extraordinary Opthalmologist in the hospital where I did my residency, and Matt is truly gifted at Osteopathic technique. I know his ‘One Thing’ will be a good one!

Thanks for stopping by, and I look forward to catching up with you here tomorrow.

Best,

Andy

Really, what could be more fun than a medical conference??

Really, what could be more fun than a medical conference??

Drug companies showing you the latest pill for whatever ails you.

Drug companies showing you the latest pill for whatever ails you.

When it comes to back pain, make no assumptions, Insurance nightmares

Wednesday, April 28th, 2010

When do you need to consult a physician?

You know the old adage about not assuming things? Well boy is it ever true when it comes to back pain.

The vast majority of back pain is musculoskeletal (originating in the bones & muscles of your back,) but there are some conditions which cause back pain which have little or nothing to do with the back itself. Kidney disease, pancreatic disease, several cancers, and other conditions have back pain as their hallmark symptom.

So what are you supposed to do to help differentiate between run of the mill back pain, and something more insidious? Here are a few pointers, which should only serve as a guideline:

-First of all, if you have back pain (in particular pain which has no clear cause, such as having moved a lot of heavy furniture) which lasts more than 72 hours, go see your physician.

-If your pain is excruciating, don’t wait it out- consult your physician as well.

-If you have ongoing back pain (from arthritis, disc disease- really any idenitfied cause, and the symptoms change in any significant way, for example you suddenly develop sciatica, or other new symptom, consult your physician.

-If you develop incontinence of bowel or bladder, go straight to the ER- do not pass go, do not collect $200. I don’t mean to be glib, but this one is serious, and requires immediate attention. It may seem obvious, but I have had more than one patient who waited several days before telling anyone about this symptom.

-If small movements cause a feeling of ‘electrical shocks’ in your extremities, consult a physician.

These are the big ones which come to mind right now- there are others, but the take home point here is than not all back pain IS back pain, and some is more serious than others. If you have new pain which came from out of nowhere, or you have ongoing pain which has changed in some significant way, you need to be seen by your physician.

Insurance Nightmares…

I am looking for some of your experiences with insurance- particularly those which went less than well. Have you had an insurance nightmare? Please share it with me here- I am preparing a piece on appealing your denial of coverage, based upon a recent horrible experience my family has gone through.

Beautiful sky over Philadelphia last night- Spring is kind of here!

Beautiful sky over Philadelphia last night- Spring is kind of here!

Back Pain & You: When do you become your illness? When do you become you again?

Tuesday, April 27th, 2010

Yesterday, Terri Trespecio did a really nice post on my appearance on her show. In it she made this statement:

“Don’t overidentify with your back pain. There are far more interesting things you and I should be known for.”

I was so happy to read this!

So many people suffering with back & neck pain start to accept their pain as being such a fundamental, unavoidable component of their lives, that it actually starts to become part of their identity- shaping all they do, and influencing their attitudes about just about everything. Now that’s not to say that pain doesn’t or shouldn’t effect your life when you are suffering- that would be unreasonable. What I am concerned about is something more insidious.

I often make a differentiation between a person who is sick, and a sick person. Let me explain…

Assume there are two people with the same physical medical conditions:

The first, a person who is sick, wakes up and says “I am very sick, and it will be really difficult to all of the things I need to do today.”

The second, a sick person, wakes up and says “I am very sick, and I won’t be able to do all of the things I need to do today.”

It is a subtle distinction, but an important one.

When you are in pain- especially if the pain lingers for a while- it can so easy for it to become part of your who you are. You can see why- it’s always there- reminding you of its’ presence.

It is really important to avoid this quagmire, as it changes who you are, and gives the pain more power over you than it should. There are a few things you can do to help:

-Take a few minutes out of the day to reflect on those times when the pain was not so bad.

-Find gratitude for all of the things in your life which may be going well, so you don’t start to believe that nothing is right.

-Even if they are uncomfortable, try to participate in some of the activities you normally would.

-Remind your partner that you are still you, even when you are in pain. Don’t allow them to treat you as though you are fragile. That approach will only worsen matters, and make it harder to get out of this mindset, as you now have a reinforcer.

-Make sure you don’t give up on hobbies and diversions, even if it means modifying your participation in the activity (You may not be able to go horseback riding when you are in pain, but perhaps you could instruct kids on how to ride.)

These are just a few suggestions. It is critical to your overall well being that you not allow yourself to become your back pain.

Thanks for stopping by.

-Andy

My good friend Jorden Gold doing facilitated stretching on former Eagle, Chad Lewis

My good friend Jorden Gold doing facilitated stretching on former Eagle, Chad Lewis

Sharp Rise in Complex Back Surgeries.

Monday, April 26th, 2010

A new study on back surgeries has shown that there has been a significant increase in spinal surgeries between the years of 2002 and 2007. In this study, conducted by physicians at the Oregon Health and Science University in Portland and published in the Journal of the American Medical Association showed that the increase went from 1.3 to 19.9 surgeries per 100,00 medicare patients. Complex surgeries were defined as procedures in which 3 or more vertebrae were fused.

Now they didn’t draw any conclusions from this study, but certainly there are a couple of things we need to consider here.

As spinal surgery is the last option for most patients, what conservative options did they try before surgery? The statistical outcomes for these types of surgeries are still not that great- so surgeons typically don’t perform them unless there is a very good reason.

Are there lifestyle factors which increase the likelihood that we are damaging our spines to the point that surgery is necessary? Does the fact that Americans seem to be less active contribute to this? Is their a correlation to the rate of obesity?

These questions will probably be addressed in another study, but it would be hard to imagine that lifestyle and preventive considerations would not have affected these increases in a significant way. As I said, spinal surgery is a last option for most patients, and I know that there are things we can all do to decrease the likelihood that we will get to that point.

Thanks for tuning in.

-Andy

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Exciting Announcement!

Sunday, April 25th, 2010

I have been invited to become a regular contributor to the new Whole Daily Living blog on Martha Stewart’s Whole Living website. The site will be going live in the next few weeks. I am honored and excited to be able to participate!

Stay tuned here for more information, and a link to the site when it becomes available.

Best, and I look forward to seeing you this week on the blog.

-Andy

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B.T.T.o.D: Back Pain Tips for Students Studying for Finals…

Thursday, April 22nd, 2010

Well, we are fast approaching the end of the school year, and with that comes finals season. Normally, during the rest of the year I don’t see a whole lot of teenagers with back pain, but this time of year I almost always see more high school and college age students who are hurting. As you will hear me say again and again- we simply weren’t designed to sit on our butts all day long. Watch my video tip of the day, then proceed to some other simple tips you can do to help protect yourself (or your kids!) from back pain while studying for finals.

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To prevent yourself from experiencing back pain when studying for hours & hours & hours….

1) As I said in the video, get up periodically (optimally every 45 minutes or so.)

2) Keep yourself hydrated. Avoid the temptation to use energy drinks, as they will actually leave you dehydrated. Water will help you prevent stiffness, and ultimately if you are drinking enough, it will force you to adhere to (1) above.

3) If you are seated at a computer for studying, make sure your monitor is propped up to eye level (old phone books make a great monitor stand,) and your keyboard is at a height which allows you to have a neutral wrist position (with your wrists flat.) If you are using a laptop, and external keyboard can help you to optimize your position, and they are no longer an expensive proposition.

4) Use a book stand rather than holding onto a heavy textbook which will force you into an anatomically compromised position.

5) If your chair does not have one built in, roll up a small towel or t-shirt to use as a lumbar support. Place it into the small of your back.

These few suggestions may go far in preventing you from having to take finals in pain. I hope they help. If you have any other thoughts or suggestions, please share them with us on the blog.

Best,

-Andy

Photo from in the studio during appearance on Martha Stewart Radio Tuesday.

Photo from in the studio during appearance on Martha Stewart Radio Tuesday.

Discussion about lifestyle and back pain with Terri Trespecio, Martha Stewart Radio

Wednesday, April 21st, 2010

Yesterday, I had a great time being interviewed by Terri Trespicio on Martha Stewart Radio. We covered all sorts of different topics on back & neck pain from callers all around the country. I was also the butt of some pretty hardcore ribbing about the tatami mat I sleep on- but I digress. It really was a lot of fun. Terri is a great host, and the callers all had interesting questions and comments. If you missed it, it will be rebroadcast this weekend- check out the Whole Living website for more info.

Following the show, I had the chance to speak with Terri about some of the lifestyle issues which can contribute to back pain. Ironically, Terri had been dealing with some back pain this past week, and was headed to her physician’s office right after the show.

Here’s the clip:

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Thanks for stopping by, and be well!

-Andy

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Great appearance on Martha Stewart Radio.

Tuesday, April 20th, 2010

This is my first post from my iPhone, so I will be brief as typing could be easier. I just came off the air on Martha Stewart radio on Sirius/XM. I was on the ‘Whole Living’ show, hosted by Terri Trespecio. First off, Terri is a great host- you should definitely tune into her show. Second- THANK YOU for all of your great calls & comments to the show.
I will post more on this later- stay tuned!!
-Andy