Showing posts with label rehabilitation. Show all posts
Showing posts with label rehabilitation. Show all posts

19 April 2016

Back Pain Attacks Writers and Readers



Do you love books? Reading them, writing them, anything to do with them?
And have you ever had back pain?

Chances are high that you said yes to both books and back pain. This is a site for mystery lovers, after all, and approximately 84 percent of adults get low back pain at some time in their lives.⁠1 ⁠2 So you and I are not alone.

(Wouldn’t that make a great birthday card? Happy 18th birthday! Party hard, because now you have an 8 out of 10 chance of hurting your back!)

So listen. I’m an emergency doctor who loves books. I decided to tackle this sucker by writing THE EMERGENCY DOCTOR’S GUIDE TO A PAIN-FREE BACK, which releases Thursday, April 21st.

Obligatory disclaimer: I am a doctor, but I’m not your doctor, so you have to go see your own health care  practitioner. All I can do is give you helpful advice on treatment and prevention.

I pored over research articles. I read other books and considered both traditional and integrative approaches, including acupuncture, yoga, and diet. What struck me is that some people want to give advice without anchoring it on research, so I’m proud to say that I included studies written right up until January 2016.

The other thing that struck me was that a lot of fact-based books were super dull, so mine is short, funny, and full of cartoons and pictures because hey, life is short.

Here are three tips for readers and writers:

1. You don’t have to be a book lover to get back pain. Even sitting all the time doesn’t automatically cause back pain⁠ 3, although it does predispose you to other problems (coronary artery disease, diabetes, breast and colon cancer ⁠4…I know! I’m full of good news today!). So try to get up and move throughout your day.

2. After you go see your doctor, you may well get diagnosed with non-specific low back pain. More than 85 percent of the time, we don’t find a particular cause.5 I consider that good news, because you don’t want the herniated disc, fracture, infection, or cancer. You want to get better. Fast. And to do that…

Kathleen can do it. So can you!
3. “Don’t tell me I have to exercise,” groaned more than one writer-friend on Facebook.
Yes, I’ve got triple good news for you. You do have to exercise once you get over your initial agony, or to prevent it in the first place. Exercise and education reduce your risk of a back pain episode by 25 to 40 percent, as shown in a 2016 meta-analysis by Dr. Daniel Steffens and colleagues at the University of Sydney. They considered 21 randomized control trials of 30,850 people.6

There’s no hard evidence on which type or amount of exercise is best. “It seems to matter less exactly what type of exercise you do than that you do it in a regular way,” said Dr. Timothy S. Carey, a physician at the University of North Carolina at Chapel Hill, who co-authored a commentary on the mega-study by Steffens.

So choose exercise that you like, and do it. Cardio, core, strength training, flexibility, and working your upper and lower limbs were all included in that mega-study.

Since we’re all busy, I developed a three-pronged exercise program where you can even work on your strength and flexibility in bed, at work, and while watching TV. My program is meant to be accessible to everyone. Look at my friend Kathleen. She’s a senior citizen, and she’s hitting it hard. With my book!

Click cover to preorder e-book now for a special price of $5.99 (regular price $9.99).
Direct Amazon.com link here.
Bottom line: most of us will get back pain sooner or later. As someone who loves words, you’re already at at advantage to prevent it through education. Keep reading and start moving, and you'll save your energy for more fun stuff like cat detectives and hard-bitten thrillers.


1 Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine. 1987; 12:264.
2 Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine. 1998; 23:1860.
3 Chen SM, Liu MF, Cook J et al. Sedentary lifestyle as a risk factor for low back pain: a systematic review. International Archives of Occupational and Environmental Health. 2009 Jul, 82(7): 797-806
4 Lee I, Shiroma EJ, Lobelo F et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 380(9838): 219-229
5 Deyo RA, Weinstein JN. Low back pain. N Engl J Med 2001;344: 363-70
6 Steffens D, Maher CG, Pereira LS, et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 2016 Jan 11:1-10. doi: 10.1001/jamainternmed.2015.7431. 

31 July 2014

The Road to Damascus


by Eve Fisher

Every once in a while there's a high profile parole hearing, where everyone gets geared up on one side or the other.  (And yes, we just had one up my way.) They're usually murder cases, sometimes horrific.  There is press coverage, rehashing the crime in all its gory details.  The family (usually) protests vociferously to any parole.  The character witnesses for the prisoner are generally considered either bleeding hearts and/or easily gulled and/or sincere but mistaken. And usually the prisoner is not released.  Contrary to the television world, I would say that 90% of all violent offenders do not get released their first time up for parole, or second, or third.  And many violent offenders do not and perhaps will never get released.

This may not be a bad thing:  Charles Manson leaps to mind.  He is currently 80 years old, still residing in Corcoran State Prison in California, and that's fine with me.  The members of his "family" who participated in the Tate-LaBianca Murders (mostly tried in 1970, one in 1971) were:

  • Susan Atkins - 17 parole hearings, all denied; 22 years old going in; died at 61 in prison.
  • Patricia Krenwinkle - 13 parole hearings, all denied; 23 years old going in; currently 67 years old.
  • Tex Watson - 14 parole hearings, all denied; 25 years old going in; currently 69 years old.
  • Leslie Van Houten - 19 parole hearings, all denied; 19 years old going in; currently 65 years old.

Everyone agrees that they were manipulated by Manson; that he masterminded the horrible murders; that they were under the influence of drugs.  All had/have, over their 40+ years in prison, claimed to become born-again Christians, and/or worked with AA, NA, and other organizations, and/or transformed.  It is extremely doubtful that any of them will ever be paroled.  The crimes were too horrific (although no more horrific than others that have been committed against less famous people) and received too much publicity.

Okay.  So what about these cases?
  • A 16 year old tried as an adult, convicted, and sentenced to life without parole for shooting a taxi driver in cold blood in order to get the taxi and use it to flee from the scene of a robbery the kid had just committed.
  • An 18 year old Native American killed another man in a drunken brawl and was sentenced to life without parole because "he would never be a decent member of society."
  • Any of the many "three strikes and you're out" life convictions for committing three felonies.

What if they clean up their act, sober up, get saved, whatever, study, work hard, participate in AA, NA, and other organizations, and/or were transformed in various ways?  Two questions:
  1. Is there really such a thing as repentance and transformation?
  2. Does it matter?
First one:  Can people really repent, change, transform? You would think, given the title above, that everyone who claims to be Christian would say yes.  However, after years working in the judicial system, I can tell you that most people don't believe it, at least not for certain crimes and certainly not for others.  Why?  Well, here are a few options:
  1. They've - we've - all been taken one too many times; we've all been screwed big time and haven't gotten over it.
  2. They can't imagine another person's life, much less that life actually changing.  How can someone, anyone, think/feel/act differently than me without being dangerously crazy, and in need of serious treatment and/or incarceration? (Well, that's what fiction is for, to explain it.)
  3. Life is much easier when you maintain the "once a ___, always a ___" attitude.
But okay, say we do believe that people change.  Comes the second question, does it matter?  In other words, what is punishment really about?  I've read that it's a three-fold concept, incorporating
  1. retribution and/or incapacitation (as in Old Testament/Sharia law); 
  2. deterrence (although there have been studies that prove people aren't deterred by the severity of punishment; certainly in Restoration/ Victorian England, where people were hanged for stealing a handkerchief, there were still plenty of thieves because poverty was so endemic); and 
  3. rehabilitation.
Rehabilitation is the interesting one:  if rehabilitation (i.e., transformation) is the goal, and if people are capable of rehabilitation, does that mean we still execute them and/or keep them incarcerated for life? And if they are rehabilitated/transformed, shouldn't we let them out, to try again, to live again?  Or is rehabilitation, while a sweet dream, an ideal outcome, irrelevant to punishment as a debt that must be paid, using time instead of money?

(Although, speaking of debts, we all know, don't we, that prison is extremely expensive? Which is part of the push towards private prisons which, frankly, scare the hell out of me, because private prisons have quotas for occupancy...  And then there's the whole thing of trying to pry all the costs for our court system out of the accused and arrested - whether or not they are found innocent.  And then there's the infamous case of the woman who died in jail because her children skipped school and someone had to pay the truancy fines and they didn't have the money, so she got to go to the equivalent of debtors' prison in Pennsylvania.)

Look, I believe in rehabilitation.  I believe in transformation.  I am not the same person I was in my teens (thank God).  And yet, I have no answers, just questions.  There are some crimes for which I'd lock people away for life.  But they may not always be the same crimes that someone else would lock a person away for life.

And then there's Saul.  He was guilty, at the very least, of accessory to murder (he held the coats as Stephen got lynched), and he was going to kill as many heretics as he could find.  And then Saul got knocked off his horse on the road to Damascus, and became a believer overnight, blinded and restored to sight by a miracle.  He eventually had to leave Damascus - in the middle of the night - and went to Jerusalem, with a new name - Paul - but that didn't fool anybody. The disciples didn't want anything to do with him, because they didn't believe that he had changed.  It was a big risk. They took some convincing.  So do we. So do I.  The question is, when is the risk worth taking? Is it worth taking? How do we know?