Jun 222014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

DSCF8138I love A.1. steak sauce.  That concoction of tomatoes, raisin paste, distilled vinegar and a whole host of other spices and herbs. The original sauce upon which A.1. is based, was created in 1824 by Henderson William Brand, a chef to King George IV of the United Kingdom. It’s been a mainstay on my steaks, burgers and even steak fries for years. But on my most recent usage, I came to realize that perhaps many restaurants and end users have been duped.  

I’m not speaking of those who would find it nearly sacrilegious to put A.1. on a fine steak in the first place – but rather, perhaps we’ve all been part of some oversight  on the bottle’s design and how it’s been used by us.  Now that my eyes have been opened, I would put forth the argument that the bottle’s design, whether purposely or not, promotes many tens of millions of ‘over-pours’ from home diners and restaurant patrons – perhaps monthly.

Years ago I recall hearing about a soy sauce manufacturer who was looking for a unique marketing angle to sell more of their product. One day, a slick executive suggested that they keep everything else the same and simply enlarge the hole or holes in the top.  More soy sauce distributed with each pour, increased consumption and voilà – they had increased sales.

The technique is not unheard of.  Henkel changed the dosage of their German dish liquid Pril and enlarged the opening of the bottle.  I won’t deny A.1.’s popularity and the brand is definitely trusted.  Moreover, I’m not accusing Kraft or any of the former owners of foul play.  But why hasn’t Kraft chosen to manufacture the bottle in a far cheaper plastic container, keeping the same shape and adding a squeeze top?  

Other sauces such as Heinz 57 have made the change, and so has Hellman’s with their mayonnaise.  But then again, mayo doesn’t come running out of the large opening when you use it.  Plastic is certainly cheaper to use in packaging than glass, but perhaps the over-pours, an oversight by many of us, is exactly what is keeping the product’s output churning in large volumes.  

Of course, larger volumes lead to more corporate income, better placements on grocery store shelves, and more advantageous pricing relationships with food wholesalers and restauranteurs.  Whether Kraft knows it or not, our over-pours are helping their ‘heavily’ trickled-down product economics.  

Just makes me wonder…and you?

Jun 132014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

 

It’s Sunday, June 15th.  Tomorrow will start the first week in 22 years that I will not be seeing patients for chiropractic care.  There is some sadness to be sure, but at the same time, I’m excited for the challenges of a new career.  My move is into the world of internet technology, where I will be a part of the strategy team for an emerging company in the domain registry space.  Though no longer in practice, I will always remain a Chiropractor in my hands and heart.

In looking back on my chiropractic career, I give credit to my father, who brought me into this profession as a child.  I learned a lot from Dad’s legacy.  I can honestly say that I will not miss Medicare or the commercial health insurance companies one bit.  But I will miss my patients, and the many wonderful times we’ve shared.   Just a few nights ago we shared a terrific evening at the office, where we said our goodbyes.

GoodpicpatientsErinKip20140610_194256

 

 

 

 

goodpic3

 

 

 

 

 

 

 

 

Just a few takeaways I have learned and experienced in practice:

-  Chiropractic is a profession built not upon status, but upon success where medicine failed those in pain.  

-  The power of a chiropractic adjustment is awesome, and at times life-changing. 

-  Chiropractic IS NOT ‘Alternative Medicine’.  It is not a part of the medical profession, nor is it alternative to anything. 

-  As a chiropractor, you need to have a thick skin and not worry about being on par with medicine.  Most people will not call you ‘Doctor’, nor will the masses hold you in the same esteem as a surgeon or specialist.  Selflessness is always better than narcissism, especially in this profession.  

-  Many patients, and unfortunately many family doctors know very little about how to evaluate the health of the spine.  This leads to patients coming in far later for care, so that instead of just pain they also bring in joints that have irreversible damage.

-  If we could MRI patients proactively, so that disc and joint issues could be detected even before pain came, it would help the health of our country tremendously.  It would also decrease back and neck surgeries, as well as joint replacements.

-  Chiropractic is a profession built upon results and referrals.  

My wife Nellie and I came to Richmond in 1996, to begin our new married life.  We walked into this empty space, which had formerly been a popcorn store, and immediately knew that this was going to be the place.  We brought in contractors, and helped to paint the office during the days, and I went door to door to many hundreds of homes in the afternoons and evenings.

In my years of practice, I always held to the mantra that you could never ‘out-give’ yourself or your talents.  I worked hard to educate and to help people learn about chiropractic – and the difference it could make for them and their families.  The time spent helping many thousands of patients will bring me many good thoughts for my remaining years on this planet.

Now I leave what I’ve built to another doctor who will carry on the same tradition of giving for the sake of giving, serving for the sake of serving, and loving for the sake of loving.  That’s chiropractic.  It’s about the people you meet, the experiences you and the patients share, and the ability to use only your hands to effect the body’s inner healing to occur.

With that, I’d like to:

-  Thank God for giving me good hands, and the ability to use them – and my mind properly.

-  Thank my Dad for getting me into chiropractic.  Dad was a pioneer in this profession, when there were still states that didn’t allow for chiropractic licensing. Dad will be missed.

-  Thank my loving wife Nellie for giving me the support I needed to start this practice, and the diligence and persistence she lent during its many years of success.

-  Thanks to all of my staff over the years, and most especially Elaine Larry, who was the most helpful and most loved of all of my staff.  She may work for me, but we call her and her husband dear friends.

I will miss my patients very, very much.  It has been a complete privilege taking care of them.  If practice has taught me anything, it’s taught me that people need to hear the message of chiropractic.  My chiropractic philosophy is a reflection of my personal life experience as a chiropractic patient, provider & educator.  The many miracles that I have witnessed and my passion to see the next generation become less chemical-dependent and avoid surgery have been a daily driving force.

 

With gratitude,

Dr. Stephen Ambrose, DC

May 072014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

nicepicDad1

Dr. Robert S. Ambrose
(1942-2014)

 

This is the first week in 45 years of my life that I am without a father.  A man who I called Dad, who I spoke to as a brother, and who I shared feelings with as a trusted friend.  A powerful sparkle in God’s eye that he allowed to be shared with friends, family and patients.

Many reading this post will not be able to attend the funeral of Robert Ambrose.  I only hope that the words I write and you read will pay this man the due he so richly deserves.  I’ve also included some of his most recent pictures below, which you can click to enlarge and enjoy.

Dad wasn’t perfect, and trying to make him seem perfect would be dishonoring to what he would want me to tell others.  You see, Dad didn’t concern himself with being the best, the richest, or the flashiest.  His passion was to enjoy life, to love his family and to help others. Over these last few days since his sudden and surprising death, my brother Michael and I have gotten to know Dad’s heart and mind in a way better than perhaps a last conversation.

Many of us would presume to understand what God’s plan is for us.  When someone we love or care about is taken away, we sometimes question the “fairness” and the “love” that a just God would have in doing this.  But I believe that events such as the death of a close and loved individual bring clarity and understanding to our lives – if we are to open up our minds and hearts.  What I believe, more now than ever, is that there IS a God, that in being with Him, Dad is finally free from suffering, and that we all will have the opportunity to see Dad once again.

My father’s life tells a story of an only child born to Helen and Stephen Ambrose.  Robert, or “Bobby” as he was known to his parents and closest relatives, was born at St. Vincent’s Hospital in Manhattan, on September 19, 1942.  Dad was a full-blooded Hungarian, who entered his first day of school in Lakewood, N.J. never learning how to speak English.  Dad adapted and eventually thrived in school, making many friends and pursuing sports, such as Varsity Baseball.  He was handsome, proud of his 1958 Pontiac and could ‘cut a fine rug’ on the dance floor.

After Lakewood High School, Dad attended the University of Maryland, studying and eventually gaining a degree in Sociology. Thereafter, against the wishes of his strong-willed and loving mother, Dad chose a career in Chiropractic – a profession that was much maligned by mainstream medicine.  But being on the ‘odd’ or minority side of things wasn’t important to Dad.  He didn’t compromise his values just to be liked.  He was a man who knew that he enjoyed helping people, and that it was within him to be excellent at that.  Dad went on to help many thousands of sick and hurting patients in his more than 41 years of chiropractic practice in central New Jersey.

My mother and father married in 1963 and bore two children, myself and my sister Melissa.  Eventually divorcing, Dad always felt it important to be near his children and to bring as little disruption  to our lives as possible.  So he kept his home chiropractic office, which was connected to my mother’s home – for another 28 years!  Mom and Dad stayed friends because they knew that apart from their differences, that the welfare and comfort of their children came first.  I loved Dad for that.

Eventually Dad remarried to Judy Zager, who had been very successful in real estate.  Dad loved Judy very much, and she bore him a son named Michael in 1984.  In the spring of 1986, Judy was tragically killed in an automobile accident – but my brother Michael survived.  He has gone on to be an accomplished pianist and entrepreneur in the internet domain space.  Dad’s heart was broken, but he stayed strong for his children, raising Michael as a single Dad.  He could have quickly remarried, but Dad wasn’t looking for a helper, he was looking for another heart to love.

That happened for Dad, when in 1997 he married Sande Mule, an accomplished dance school owner and teacher.  Sande brought energy and excitement back into the areas of Dad’s life that had been dimmed for years.  Dad’s passion came back into so many areas of his life, and he was a better man for being with her.  Our hearts go out to Sande in his loss of a dear husband and wonderful companion.

So what else did Dad do?

He was an accomplished sailor, and a proud member of the U.S. Power Squadrons.  He was an avid skier, taking his family on many trips to Vermont, Utah, Pennsylvania and yes, even northern New Jersey.  Dad’s sole baseball devotion was to the New York Yankees.  For football, you could frequently catch Dad regularly jumping out of his recliner, in good times and bad, when watching his beloved New York Giants.

Was Dad the greatest man to ever walk the earth?  Probably not.  But he WAS great.

Was he the most intelligent?  No.  But many times he HAD the right answers.

Was he the most handsome?  Well, a popular line he always threw out was, “Handsomer than the Handsomest!”   I’ll let that stand for now Dad, since you can’t be here to defend yourself.

In closing, Robert Ambrose was a man that we were all better off for knowing and for loving.  Today I am wearing the gold chain and anchor that that sailor wore for so many years, until that fateful night that he had to remove it in the emergency room.  I don’t know if it’s because I’m wearing it now, or the pride of being able to wear it, but I feel like he’s with me just that much more.

Dear God….I miss my Dad.  We all miss him so very much.  Please take good care of him Father.

 

EulogyDadSteveSailing20130715_104141

 

 

 

 

 

 

 

 

 

 

EulogyDadEllenSailing

dadmike

 

Feb 022014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

 

“Did you know that childhood is the only time in our lives when insanity is not only permitted to us, but expected?” 
                                                                                           - Louis de Bernières, Captain Corelli’s Mandolin

 

In many ways, I believe that vintage toys, that is, those more than twenty years old, were the best.  They were less likely to break, didn’t put all of their value on the latest computer technology, and carried a longer time to obsolescence.  After all, we still see Slinky, Etch-A-Sketch and Monopoly on the toy shelves…but do we still purchase Madden 2008 or Halo 2?

So many of the new toys are either mindless, such as many video games, or they seek to make a big point of stimulating an educational need or developmental stage of childhood.  Vintage toys didn’t have an agenda, they weren’t difficult, and didn’t result in passive over-stimulation (staring at the TV screen anyone?)

Perhaps Susan Linn, a doctor of Psychiatry at Harvard Medical School sums it up best, “The best toy is 10% toy and 90% child. We’ve got all these toys embedded with computer chips that talk and sing and play and dance at the press of a button. But what they do is deprive children of the ability to exercise their creativity. The toys that really foster creativity just lie there until they’re transformed by children.”

So I’ve taken a little liberty with this post, in that I hope you are able to identify with some of these items.  Perhaps you had one or more as a kid, and can remember the fun it brought you.  The second half of this is a challenge to your memory.  

As you can see, there are no identifying names, only numbers.  If there are some that you don’t remember but want to know, just email me the number and I’ll give you the name.  Plus, if I’ve missed any important ones that you liked (other than Barbie) , feel free to let me know.

1kennereasybakeoven 2hoppityhop 3Mego2XL 4lunarlauncher

 

 

 

 

 

 

 

???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

6 NFL 1972 electronic football game

 

 

 

 

 

 

 

 

7snoopysnoconemachine

 

8eightball9gumby

 

 

 

10firechief pedal car 11Spirograph12armymen

 

 

 

 

 

 

13 Viewmaster 14ticklemeelmo 15tonkatruckmightyloader

 

 

 

 

 

 

 

16bigwheel 17joybuzzer 18chattycathy dolls

 

 

 

 

 

 

19clackers 20barbie dream house 21stretcharmstrong

 

 

 

 

 

 

 

 

22littlepeoplegarage VLUU L100, M100  / Samsung L100, M100 24wiffleball

 

 

 

 

 

 

 

 

25beaniebaby

26Tinkertoy

27GI JOe

 

 

 

 

 

 

 

 

28buckrogersraygun

29rockemsockemrobots

30oldmaid

 

 

 

 

 

 

 

 

32flatsypatsy

33roller skates with key

34EvelKnievelStuntBike

 

 

 

 

 

 

 

 

35waterrocket

36star trek phaser

37SixMillionDollarMan

 

 

 

 

 

 

 

 

38rayline tracer gun

39shrinkydinks

40SchwinStingRay 1967Fastback3speed

Jan 252014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

midway

The United States has only 5% of the world’s population, but houses an astronomical 25% of the world’s criminals. Theories as to why this exists include a politicized response to urban and drug-related crime in the 1970’s, overspending of state funds, and the privatization of prisons.  Whatever the reasons, it’s clear that we simply have too many prisoners for our prisons to safely hold, and the costs are skyrocketing.

According to a recent report by the U.S. Government Accountability Office (GAO), the Department of Justice’s Bureau of Prisons’ 9.5 percent population growth from 2006 to 2011 well exceeded its rated capacity.  As of the time I am penning this chapter, there is a thirty-nine percent overage in our prison system, which is estimated to grow to near 50% by 2018.

How about this.  At 4,575 prisons, the U.S. quadruples second place Russia at just 1,029.  The total prison population in America is just over 2.2 million, which is the population of Houston – America’s fourth largest city.

The ballooning incarcerated population puts a tremendous strain on rehabilitation efforts, while simultaneously putting inmates and guards in danger.  With double and triple bunking in one cell, the crowding and loss of privacy increases the odds that prisoners will lash out at themselves and guards.

There are cases of those wrongly accused, but the vast majority prisoners ARE guilty of heinous and violent crimes such as murder, rape, sodomy, child molestation, human trafficking, espionage, using weapons of mass destruction, and treason.  These felons and death row inmates constitute the country’s 41,000 prisoners serving a term of life without parole (LWOP).

THE COSTS

Duke University researchers estimate that the death penalty costs taxpayers an additional $2.16 million for each case.  Such cases generally take at least twenty years for appeals to go through the courts system!  Moreover, the state of Kansas found that it costs an average of $740,000 to keep someone in prison for life.

According to a California Corrections study, it costs taxpayers up to 300% more to care for prisoners over the age of fifty-five; this is due to chronic conditions inherent with their failing health.  The cost of housing a thirty-seven-year-old prison inmate is about $49,000 per year.  At age fifty-five, the cost…wait for it… increases to $150,000 per year!  If the inmate lives to age seventy-seven, the state could spend as much as $4 million to keep him in prison for life.

Why are we giving criminals without a chance for parole medical treatment and care?  They are afforded healthcare privileges that many millions of uninsured law-abiding Americans can’t afford and do without.

THE SOLUTION

Let me take you into my world…and a solution called the ‘Pacific Prisons’.  It will ease some of the taxpayer burden, free up more money in state budgets, offer a serious deterrent for committing capital crimes, lighten the load on court dockets, and offers the possibility of completely removing the death penalty from all fifty states.

The Pacific Prisons program begins with the ‘lifers’ and only the lifers taking a permanent vacation away from the United States – never to return.  We are talking about the 41,000 convicted male and female felons who have absolutely no chance of parole, or are on death row.  In total, these individuals (39,770 male and 1,230 female) constitute less than 2 percent of all U.S. prisoners.

Naturally, it would be unfair for us to burden another country with our ‘criminal baggage’, so we’ll have to find a few deserted islands, still under control of the United States.  After some research, I came across just the set of little beauties that will do the trick – Midway Island and Palmyra Atoll.

These islands are considered part of the U.S. Minor Outlying Islands.  They are rarely visited, except by military or scientific personnel, and are both considered wildlife refuges under various federal government agencies, such as Fish and Wildlife and the Department of Agriculture.

midwayMidway Island, having an area of 2.4 square miles, would be the prison for the male convicts.  Its location is in the northern Pacific Ocean, sitting about halfway between North America and China’s mainland.  The island was formerly a convenient refueling stop for transpacific flights, and later served as a critical naval air station during World War Two and the Korean War.

In 1993 the then naval air facility was officially decommissioned by the military.  The island still has twenty miles of roads, nearly five miles of pipelines, and a one-and-a-half mile long runway.

Midway Island is approximately 3,200 miles west of California, 2,200 miles east of Japan, 4,300 miles northeast of Australia and 1,300 miles to Honolulu, Hawaii.  That puts it right about…in the middle of nowhere.

The female LWOP convicts will go to Green Island, greenislandas a part of the Kure Atoll, which is about 58 miles northwest of Midway Island.  From 1960 to 1992, this 200 acre island served as a United States Coast Guard LORAN station, complete with a short coral runway.

So we have two islands, under U.S. control, former military bases, having average temperatures of 72 degrees year-round and both are remote.  There would be plenty of high walls and barbed wire fences built.  No doctors, hospitals, teachers, therapists, books, mail or electricity.  Sundown would really be ‘lights-out’.

Food would be in the form of a mixture of protein powder, grains, nuts, powdered vitamins and minerals.  It would contain all the essential nutrients to sustain life.  There would be no packaging, and its dispersal would be through devices similar to small silos, dropping the food down.  Water would be brought in through desalinization and filtration, thereafter delivered to prisoners through numerous tough-built and protected fountains.

Showers and lavatories would be designed with a minimal opportunity for prisoners to break, touch or make usable any parts.  Technology like what we see outdoors at large events – you get the drift.  Living facilities would not need heat or air conditioning, nor would there be bars.  Just cement rooms mattresses.  Anyway, I’ll leave that up to the engineers and security design teams.

The guards would be well-paid and rotate duty perhaps every three to six months.  They would take an approach of being ‘hands-off’ with the prisoners.  That is, they would sit high atop cement guard posts, outside of the high cement walls.  They would not interact with the prisoners, except to shoot, if needed, during escape attempts.  This means that prisoners would in fact, be forming their own communities and policing themselves.

Some may think, “How cruel.  They’re being treated like animals.  They can kill each other.”  Perhaps they may be right.  But if they commit heinous crimes, who speaks for the cruelty to the victims?  Remember, these are people who will never get parole, or be executed anyway.  They have effectively earned the right to be exiled from U.S. society and perhaps its norms, in exchange for a system where they can live among themselves.

ESCAPE?

These prisoners would essentially have their own private remote island with the nearest major life, according to prevailing trade winds, about 1,600 miles in the Marshall Islands.  These are a set of atolls, themselves divided into 1,156 tiny islands.  If one were to get past the guards, he or she would need to have sailing and navigational skills and build a craft worthy enough to combat the harsh conditions of the raging ocean.

Next, would be the issue of food and water.  Assuming tremendous luck and a true, consistent route, the successful escape would require moving at least 50 miles a day (in the correct direction) for 33 straight days.  Getting enough food and water to last for four weeks (per individual escapee) would be quite a trick.

Plus, any time someone tries to escape, and gets off the island, no one on the island knows if the ‘convict castaway’ made it.  Without feedback, they lose hope and cling to the desire to stay safe, secure, and relatively well-fed on the island.  It’s simple behavioral psychology – man desires to stay alive.  He (or she) will seek whatever means necessary to do so.

Allotting $2 billion for the buildings and say $500 million for guards, food, clothing and sanitation each year, at today’s costs of up to $740,000 per prisoner for life, the Pacific Prisons could instantly save up to $20 billion!  Plus billions more each year.  Let’s remember, this is just on 2% of the entire prison population.

This could also provide a window to remove the death penalty in many, if not all states.   This may offer some solace to who oppose it, but only insomuch as they don’t think about the ‘survival of the fittest’ on the prison island.  But it would save tremendously on taxpayer expense for the majority of these cases needlessly tying up the court system.

And what of deterrence?  The criminals or future criminals who understand that “lifer” crimes will lead them to a self-policing island without three square meals, medical care, and electricity, may think at least twice.  Fear is an excellent motivator.  

Cost savings aside, there is the fact that, with less crime, criminal cases and reduced death sentence appeals, there may be less jobs for prosecutors, police departments and state-appointed attorneys.  I think I can live with that.

Jan 192014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

5373670168_e88553c29bThis is one of my “why hasn’t someone made that yet?” inventions.  It came to me one day when I opened the refrigerator, reached for the one-percent milk, looked at the expiration date, and noticed it was the same day’s date.  

So like any reasonably intelligent person who wants to be sure, I smelled the milk and – yuck…but just for a second. Then it smelled normal!  Hmmm…..

No discoloration, but I couldn’t take the chance.  Plus, I am one of those people who you may call ‘low level-phobic’, as I am inclined to throw away milk or any perishable item on its last quantity-legs, far faster than others.  Does anyone really like to drink the last of the soda?

So what happens when we smell the milk – and it’s a toss-up.  What if you have a cold and can’t do the smell?  Now you really could be out of luck.  

Not to mention, that this printed date on milk has always been a thorn in my mind – errr….side.  Does it mean it’s the “still good” date even after you’ve opened the milk?  Or does it begin from the day it was packaged, even if it stays unopened?  Oh, my mind just swims and swims.  

Here’s a fact.  In the U.S., more than 76 million cases of food-borne illness occur each year.  According to the Food and Drug Administration, such cases have resulted in more than 32,000 hospitalizations and 5,000 deaths.  But in the other corner are those who hate to waste.  Because, studies as far back as 1995 point out that retailers lost nearly 17.4 billion pounds of milk per year because consumers assumed it was spoiled.  

Enter the smart guys.  In 2012, scientists from Tufts University created a sticker made of gold and silk fibers that would stick to a food item and determine its edibleness.  But have you seen it commercially?  Additionally, there is currently a product called The Milk Maid, a quart size milk jug in a glass container that plugs into a ‘smart base’ in your fridge.  I think General Electric is testing it now with consumers.

The smart base of the Milkmaid is able to sense if your milk is spoiled or how soon it will spoil by using pH sensors. Milk, which is made up of nearly 90% water, normally has a pH level of near 6.7.  This makes it slightly acidic.  As the pH level drops, bacteria will make milk sour.  Hence, when it takes a drop, the drinking had better stop!  

So the Milk Maid is neat, to be sure.  But why should people have to buy an aftermarket product when something simpler could suffice?  So here goes…

 

THE INVENTION

This invention solves the problem of having to guess whether milk is fresh or not, and at a far cheaper price.  The technology is made by first making all milk caps transparent, instead of colored.  Next, place a small, circular, adhesive bio-sensor with semi-permeable membrane on the inside of the screw-on milk cap.  The inside layer of the sensor, facing the milk inside the carton, would block liquid, but allow gas molecules from the milk to pass through.  

The outside layer, pressing up against the inside of the plastic cap, would have a paper sensor with reagent, much like a dipstick for a urine test at the doctor’s office. This sensor would pick up an increase in carbon dioxide, a known gas offshoot of spoiling milk.  As the CO2 levels begin to increase, it would hit the reagent on the paper tab and change color. 

Perhaps the paper sensor would be colored white when first purchased, and stay white for as long as the milk is fresh. However, once the milk gives off enough carbon dioxide to be ‘freshness-questionable’, the paper would change from white to red.  Anyone picking up the milk could see the color change through the transparent milk cap.  

STOP!  NOT ANOTHER DROP!

Guess what?  You can bring the same concept for deli meat baggies at the grocery store.  Sure cheese turns blue, but do you really know when the roast beef becomes stale meat?

 

 

 

Jan 122014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

8512557588_f5a4be7b43_oEach year, nearly 90 million Americans are struck with some level of back or neck pain.  Next to the common cold, more people visit doctors for back pain than any other symptomatic condition.  Neck pain alone affects nearly 45% of today’s workers, and is a regular malady for 12% of adults in the U.S.

Though I work largely in the insurance reporting industry, I’m proud to say I’ve also practiced chiropractic over the last twenty years.  During that time, I’ve examined and treated thousands of patients with a variety of health histories and conditions. Spine-related pain, in fact, has many different causes such as muscular, disc, nerve, pathological and congenital.  They each have their own distinct presentation.

Years of selectively sorting such patient findings has delivered a common denominator, which has been greatly overlooked in health provider offices.  I have documented it in nearly one-third of all patient cases. It’s spinal self-manipulation, that is, ‘cracking’ one’s own neck and back regularly.

Have you run into people who do this?  Do you do this?

Extrapolating my findings against the nation’s population, I surmise there are probably millions of teens and adults who regularly pop and twist their necks and backs.  Sometimes it’s done several times a day!  This addictive syndrome, adopted typically in younger years, helps to relieve stress, pain, nervousness, or anxiety. 

You’ve probably seen such individuals putting their hands on their chin and head, slowly twisting and then….snap!   Others roll their neck quickly or overstretch their lower spine to the point at which there is an audible cracking.  I’ve even watched students arching their backs over chairs, in order to obtain temporary stiffness relief.  

Anatomy tells us that our spines are made up of many spinal bones, or vertebra.  The joints of the spine do not have the same amount of motion as do the larger joints, like the shoulders, hips, and knees.  Because the bones of the spine interlock and work jointly, the motion of bending forward or sideways is shared throughout the spinal joints, each moving a little bit and adding to the others. So what’s the big deal here?

Normally, when you turn your neck or twist around, your spinal joints move in what is known as active range of motion.  But when a person forces their spine to go past that range, this commonly leads to overstretching ligaments, which causes the spinal column to become less stable in places.  As a result of the ligaments losing their healthy tension, nearby muscles  compensate to recapture spinal stability, thereby getting tighter and stiffer.  

The increased muscle tension makes the muscle and area around the spine feel tighter. As a result, the individual feels chronic and constant stress or stiffness – so they snap their neck or back over and over again.  It’s a habit that feeds into itself and may be a common contributor to early osteoarthritis in the spine.  

Simply stated, the problem with losing proper tension in the ligaments is that the spine can become hypermobile, or move too much.  According to Dr. Mark Wheaton, a board-certified pain management expert, in his paper, The Ligament Injury Connection to Osteoarthritis, “Disrupting ligaments increases the risk of cartilage injury and arthritis because the joint [ie. Neck/back] is no longer stabilized by the ligament structures”.  Injuries can cause such ligament disruption, but so can the frequent self-manipulation of one’s neck and lower back segments.  

Unlike chiropractic adjustments, in which the patient has his or her joints moved professionally, thereby gaining stability of the joints, the chronic self-manipulator’s habit grows more and more – and the stability lessens and lessens.  It often culminates to a point where the individual can no longer pop their joints because they have so badly overstretched the ligaments and tissues.  Hence, more constant and chronic aches.

This is not a habit easily resolved, because it requires the individual to go through a period of withdrawal, where some nagging pain and stiffness will most likely increase. Self-manipulation is highly addictive, and many people do it without thinking about it.  Proper chiropractic adjustments may offer help, but it is even more important to start strengthening the neck with exercises.  This may allow the muscles to become shorter and stronger, thereby helping to tighten back some of the ligaments.  But the individual DOES have to stop cold turkey for best results.

Cracking one’s knuckles, at least in one study, has shown itself to be a falsity.  I have seen chronic self-manipulators, who having no past injury, show signs of osteoarthritis at a very early age.  Perhaps the spine is different than the knuckles, in that it can move, or become misaligned in many more different directions.  Studies will need to be undertaken, if we are to understand more.  

I have a true passion for helping those, especially when it can stave off larger, future problems.  Having back pain, neck stiffness and osteoarthritis is bad enough for those who acquired it through prior injuries or means they couldn’t control.   In this case, kids and adults are unknowingly inflicting small repetitive stresses, which can possibly become larger problems down the road.  

If you have any questions, please feel free to reach out to me.  My intent is to bring this to national attention.  

Jan 042014
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

110859301_5cc01c7ed5_o

Stay positive, man! 

Forgive and forget. 

Have patience. 

Turn the other cheek. 

Let go and let God. 

Nah…Not this week.  Instead, I’m going to let loose my rant on just a few of the most common things I run into that IRK me.  And while you may find this negative, in fact I find the written release quite cathartic and balancing.  

Now that we are all done talking about our New Years’ resolution and plans for successful execution, let’s move into those things for which we will not allow for our absolution.  I invite you to comment on those things that most frustrate or irk you.  

Be mindful that I will delete any comments from amateur therapists who tell me that it’s wrong to vent or ‘sound negative’.  So c’mon and send me your best!

 

#1 LOUD THUMPING MUSIC IN CARS

How many times have you pulled up to a stoplight and either heard the car next to you or behind cranking up the music to window shattering levels?  You want to ignore it, but the thumping bass permeates through that quarter-inch of skull and stays in here.  Damn…how long does a red light stay red anyway?  

I think that deep down inside, some of us would want to roll down the window and yell, “Turn that crap down!” .  Just the same, our eyes slyly drift to find the culprit, if only for a second.  Instantly, we measure him or her up for their potential response.  Would they open the door and walk over to your window?  Give you the single-finger salute? Drive after you with road rage?  Or perhaps honor your wishes?  

Standing up for the goodness of your ears may be even more difficult with those musical offenders having tinted windows, tattoos or wearing the ‘flat-brimmed baseball cap and sunglasses’ tandem.  Multiple passengers in the ‘rolling-jam-session-mobile’ always makes voicing your displeasure seem that much more impossible too.  

However, I have taken a completely new approach.  When I’m alone in my faithful SUV and run into such characters, I will start moving my head side-to-side, throwing up my shoulders and arms – performing the ‘seat dance of death’. Other times, if I am right next to the thumping, I have been known to put MY window down and turn up my music even louder than the next guys. I feel a little like George Costanza in Seinfeld when he says, “We’re gonna’ take it up another notch.”

The new response has generated zero fights or angry outbursts.  Some thumbs up, several laughs from the young crowd for my new dance moves, a few look-aways too.  God, how I wish I could invent a radio stun-gun to temporarily disable the electronics.  Dammit Jim…I’m a blogger, not an advanced electronics engineer from DARPA or MIT.  

 

#2 THE PERSON WHO STAYS PARKED IN THE SPOT YOU WANT

I don’t know about you, but when I go to my local Starbucks (aka ‘Four-Bucks’) for my morning tea, the parking spaces are always filled.  Ah, I just found someone who has come to their car door, gets in, and…and…

Okay, give them a few seconds to get settled.  Wait!  Why aren’t they putting on their seatbelt? Why are they pulling out their cellphone?  Why aren’t they starting up the car?  They…they aren’t pulling out – they’re settling in!  Breakfast in a parking spot?

And don’t even get me started on people who park improperly, filling up two spaces.

 

#3 PEOPLE WHO ALWAYS TALK ABOUT THEIR KIDS 

I have no problem at all when our friends or acquaintances talk about their kids and accomplishments – for a short time.  However, we have a group of friends that do nothing but tell us about their kids’ great accomplishments every time we have a conversation with them.  Every single time!  

Sometimes, my wife and I get lucky and they ask us about our kids.  But when we answer, they get that look in their eye.  You know the look – when they are working very hard to politely listen to your response.  But really, they are not paying attention.  Instead, they are just biting their lip to tell you all about their kids and one-up you.  

Do you know someone like this?  If you happen to mention your child was potty trained at two years old, they’ll reply that their child was potty trained before he or she could even walk.  If your kid can read at a 4th grade level, their child already has a book deal.  

Is it that these parents are looking to live vicariously through their children’s lives?  Do they have an inferiority complex? Insecurity about their job as parents?  Are they pushing their kids to be too perfect, risking the little ones having future depression or a failure complex?  

You know, I don’t need to be reminded about how incredible your kids accomplishments have been, in order to define them as a child, or you as a parent.  Instead of what school your son got into, how gifted he is, or how many touchdown passes he’s thrown for, perhaps these parents might try bragging about their kindness and good nature. For example, how they have chosen, on their own, to help the elderly neighbor with their lawn, or help dish out hot meals to the homeless. 

I’d sure like to see that on Facebook more often than their SAT scores and perpetual honor roll announcements.  

 

Dec 282013
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

Close up of young couple fighting

I’d like to discuss a new concept to be put forth toward marriage, that is, a social union and legal contract between two spouses.  Though there are many different motives for marriage, including legal, social, sexual, emotional, financial, spiritual, and religious; my focus is based on a new model to improve the likelihood of a marriage being ‘successful’ and life-lasting.

Let’s begin by looking at some important statistics about marriage and America’s middle class, which make up a large portion of our population.  Such numbers provide a strong backdrop toward understanding the far-reaching and devastating social effects of poor marriages, as well as those ending in divorce.

Back in the 1980’s, thirteen percent of children born to moderately-educated mothers were born out of wedlock.   Today, that number has risen to 44 percent – a massive increase of 338 percent!  Moreover, a recent analysis of data from the National Center for Health Statistics, revealed that in the U.S., among women less than thirty years of age, more than half of childbirths— 53 percent—now occur outside of marriage. 

If you believe that it makes no real difference whether children are raised with unmarried or married parents, take a read at an insight granted by Paul Amato, a Penn State sociologist:

“Increasing marital stability to its 1980 level would result in nearly half a million fewer children suspended from school, about 200,000 fewer children engaging in delinquency or violence, a quarter of a million fewer children receiving therapy, about a quarter of a million fewer smokers, about 80,000 fewer children thinking about suicide, and about 28,000 fewer children attempting suicide.”

Marriage and Relationship Education (MRE) programs have been in place since the mid-1970’s, having received public funding at the state and federal level.  The average “dosage” of the past typical MRE program was twelve hours, with most programs having targeted young married couples or engaged couples.

In review of the many studies referencing nearly thirty years of these programs, individuals who had MRE classes or training saw their relationship quality improve by forty to fifty percent. Along with that, communication skills with their spouse or future spouse were seen improving by fifty to sixty percent.  Hence, MRE programs appear to positively affect the first two to three years of marriage, which also happen to be high risk years for divorce.

So why haven’t these programs become more widespread in use? 

The simple fact is that people who are about to enter marriage only think the best thoughts and do not believe that they will be one of the divorce “statistics” down the road. Plus, there are no immediate benefits afforded.

Separately, many religious organizations and churches offer pre-marital classes for their members, emphasizing the moral underpinnings of marriage and the importance of God as a part of it.  However, several important studies on religion and divorce rates were made by George Barna, founder of The Barna Group, a market research firm looking specifically at “the intersection of faith and culture”.  

Barna’s group interviewed nearly 3,800 faith-based couples, including agnostics and atheists.  The results showed that the divorce rates for Christians were not much lower than the national average – and, in many cases, were equal to those of atheists and agnostics!

All of this led me to what I believe could be a new solution – The Marital ‘Rewards’ Program.  

The Rewards Program would start with the understanding that not all people are meant to be married, nor at the time they believe they should be.  The primary purpose of the program would be in discovering potential conflicts, and that couples could see these problems as true deterrents.  From there, the couples would either work through and solve them, set them aside and continue into the marriage with the real possibility of future marital difficulties, or hold off marriage altogether.  

The program would be a 30-day course, non-religious in nature, and consist of questions, group meetings, homework, consulting and tests.  Topics would include some of the most common reasons for divorce, such as:

  • Infidelity
  • Finances
  • Addiction (Smoking, drinking, drugs)
  • Risk-taking
  • Sexual preferences
  • Communication
  • Abuse
  • Child-rearing
  • Cultural differences
  • Boredom/Lack of Interest

All participants who complete the Rewards Program would receive an initial individual benefit of a $1,500 tax credit, for the first taxable year after completion.  If the participants do not pay taxes because of lower or no income, they would receive the money as a yearly payment by the government, to use as they see fit.  For each year they remain married and cohabitate, the benefit would be a $500 tax credit, with an additional $500 tax credit if they would take a yearly 12-hour course.

The prospective couple would also need to receive a minimum of two hours education on divorce, including statistics, state law, what happens during a divorce, child custody, and alimony payments.  Both participants would sign a form stipulating that they understand the nature, possibility, and legal ramifications of divorce.

This program would by no means be mandatory.  However, it would set the precedent for establishing a strong marital and family foundation.  That in itself could help to begin a cycle where strong nuclear families create more successful future generations.  

I welcome your thoughts here.

Dec 212013
 
Share thisShare on LinkedInShare on Google+Share on FacebookTweet about this on Twitter

4385086822_18f837c167_zPerhaps I’m not the only person to think of this.  Such a shame that the idea can’t be patented.  

Perhaps if it ever comes to be, I can look forward to yearly Christmas gifts from radiologists, orthopedists and MRI manufacturers.  (Hint…if you’re ever in Richmond, feel free to take me out for a nice steak dinner!)

In the area of bone and joint health, I have always found it astounding that our health care system has never adopted a proactive view of screening for joint problems. To evaluate joints, especially weights bearing joints such as the spine, knees and hips, regardless of whether an individual has pain or not.

According to researchers, osteoarthritis (OA) is a condition which annually increases health care expenditures by $186 billion. Let’s put this into perspective.  Though there are more than one hundred different types of arthritis, the cost of diagnosing and treating OA and its effects exceeds the combined yearly revenues of Microsoft, McDonald’s, Amazon, Visa, Nike, and EBay.  

The Centers for Disease Control and Prevention (CDC) states that today, 27 million Americans suffer just with OA. To make matters worse, estimates are that by the year 2030 there will be a 248% increase in the number of adults in the U.S. diagnosed with this condition.  

Medical experts concur with the CDC, stating that the increase in OA is due to obesity and longer-living adults.  The latest research forecasts that the demand for knee replacements will increase 674% by year 2030, with hip replacement demand increasing nearly 200% for that same target year.  That will keep a lot of orthopedists well-paid and orthopedic hospitals well-staffed.

Osteoarthritis is a degenerative type of arthritis and a major debilitating disease that causes gradual loss of cartilage, mostly affecting the knees, hips, hands, feet, and spine. It is also known as degenerative joint disease.  If you’ve seen the malformed knuckles of an elderly person or ever had people tell you about their ‘bone spurs’, you know of it. 

The operative (pardon the pun) word here is ‘disease’. Osteoarthritis is not merely an ache and pain condition. Rather, it’s a disease process where the cartilage or spinal discs between bones wears away.  Over time, bone spurs grow in and around the affected joint, much like a weathered door hinge becoming rusted. Beside the pain of arthritis, it affects mobility too.   Primary OA is due to aging and heredity.  Secondary OA is due to prior injuries, surgeries, congenital abnormalities and carrying excess weight.

If you didn’t know about osteoarthritis and its prevalence, now you do.  Let’s move on.

 

THE PROBLEM

The crux of this blog topic centers on a commonly-held notion, shared both by patients and many front-line family doctors.  The same logic that proves true for many common health issues does not stay consistent for joint-related maladies such as OA.  To be more clear…

Organic problems such as diabetes, osteoporosis, cancer, heart disease and high cholesterol often exist when people have no symptoms.  That is to say, one can FEEL GOOD and be diseased and dying.  However, when it comes to joint-related conditions, the understanding is that until one FEELS BAD, they really don’t have a problem.  

Organic conditions are handled proactively through the use of objective, screening tests such as pap smears, blood and urine tests, mammograms, blood pressure checks, bone density tests, and prostate/OBGYN exams. Doctors, patients and health payers buy into the value of these tests.   

In contrast, joint-related conditions, such as OA, are identified when patients come to their doctor complaining of pain and symptoms.  Hence, these patients and their joint conditions are handled reactively through the use of medication, pain management, therapy and surgery.  There is no screening to identify loss of joint health before the pain comes.  

Yet any rheumatologist, orthopedist or chiropractor worth their salt will tell you that the onset of any stiffness or pain will typically occur long after the beginning of the degenerative arthritic process in a joint. Osteoarthritis comes either as a result of either normal aging or from past injury to a joint.

Would one wait until his or her first heart attack to get their blood pressure checked?

Let’s take Mary Smith, a 42-year old saleswoman and mother of two.  She visits her family doctor’s office complaining of neck stiffness and some intermittent tingling in her right hand that she’d had for the last six months. Ms. Smith had not suffered any recent falls, accidents, or lifting injuries.  However, she has had what she felt was ‘stress-related’ upper back stiffness for the last 7-8 years.  For this, she has taken over-the-counter pain medication several times a week to help her feel better.  

On a visit to her family doctor, she is examined and has x-rays taken of her neck.  The x-rays reveal osteoarthritis in the two lowest bones of her neck.  The rest of the neck appears normal.  The doctor tells Mrs. Smith that a little bit of OA is “normal for her age” and provides her with some pain medication. In time her neck pain feels better, so long as she continues her medication, but she still has tingling in the right hand.

Mrs. Smith is referred to an orthopedist.  There, a more extensive history is taken, where she recalls being in a single, severe auto accident when she was 20 years old.  She had been stopped at a streetlight and was subsequently rear-ended by a car going 50 mph.  She was taken to the emergency room and being given pain medication.  Her recollection is that a few weeks later, she felt better and all was seemingly well.  

Upon performing some orthopedic tests, the patient demonstrated increased right hand tingling.  With more specific imaging done for her neck, it was determined that even though she was only 42 years old, Mrs. Smith had the lower neck joints of a ‘normal’ 70-year old woman. This included the diagnosis of two moderately degenerated discs in her lower neck, as well as two bone spurs rubbing against nearby nerve root tissue.  This was determined to be causing both the tingling in her hand, as well as what she always thought to be stress-related neck and upper back pain.

For Mrs. Smith, the auto accident most likely injured the joints of her lower neck to the point where although she felt better, the beginning of OA commenced in those damaged areas.  The time for Mrs. Smith to start making changes in her life would have been perhaps when she was in her mid-twenties, or even when she had her first consistent period of aching in the upper back.  

How many Mary Smiths do we know?  How many times are people diagnosed with OA, after having many years of light pain and stiffness?  How many times do people and doctors dismiss low-level pain as ‘just muscular’ or stress?  Can OA be thwarted or lessened if patients knew of damaged cartilage before they feel their first ache or pain?

 

A SOLUTION

I’d like to see doctors, hospitals and insurance companies embrace regular joint imaging in determining the earliest signs of cartilage degeneration and osteoarthritis. This would be done from non-invasive MRI units millions of times a year. Just like one would have their regular screening tests for heart, blood, urine, etc., they would also go for a screening MRI.  

Such screening would be a proactive measure for people starting at age 30, and perhaps earlier and more frequent for those who had prior-documented joint injuries. In this sense, soft tissue injuries could be better tracked, allowing a greater possibility for people to age in a far healthier manner.  

Is the technology here yet?  Well, it may actually be right around the corner. Let’s start off with a little understanding about cartilage, the way it becomes damaged, and the result of osteoarthritis. 

Cartilage is composed of collagen (a protein) and glycosaminoglycans (GAG), which are carbohydrates. When cartilage begins to degenerate even the slightest bit, there is a measurable loss of GAG seen on a special types of medical radiology, known as gagCEST sodium imaging, done on an MRI machine. The decrease of GAG is seen at even the smallest levels because this software tracks protons shared between GAG and water molecules.

By using MRI imaging with gagCEST software technology, the MRI will now be able to monitor cartilage health of knees, hips, and spines.  If degeneration is detected early, drug therapy may be able to make a long-term difference.  Plus weight management measures and regular targeted strengthening exercises will have best effects.  Most important though – doctors and their patients will be able to know, year in and year out, how the joints are aging.  Hence, a way to monitor joint health.

I know what you’re thinking: patient expense, insurance coverage, long lines at MRI units, etc.  Well devil’s advocates… the water seems warm, so jump right in with your comments at the bottom of this article.  

But for now, let me at least fire off the first salvo, which comes in four parts:

1.  CON.  A lot of people don’t know, but there currently exists a pseudo-monopoly rule, inclusive of MRI units, in 36 states.  MRI facilities are not allowed to be set up for business without first obtaining a Certificate of Need (CON) given by the state.  The process can involve hundreds of thousands of dollars in legal fees, marketing studies, consulting fees and appeals.  Many experts and even the U.S. Department of Justice oppose these state rules, rightly believing CON laws “create barriers to entry for health care providers, prohibit competition and drive up healthcare costs.”

Removing such laws will allow many more MRI centers to be opened.  This will allow appropriate servicing of many individuals needing proactive MRI screening services, apart from current imaging patients. Even if those laws aren’t readily removed, the 14 ‘non-CON’ states will hopefully show success for the other states to consider.

2.  A greater volume of services will drive down cost.  MRI facilities will be far busier, but they will also be getting reimbursed for their work.  Obviously, proactive MRI screening is not going to pay at current MRI reimbursement levels, nor should they need to.  Insurance companies, through the AMA’s CPT code guidelines and reimbursement recommendations, can set fair and equitable screening measures and reimbursement rates.  

For those MRI centers who DON’T want to perform screening services, the free market will allow for those that do. Perhaps there will be just those MRI centers that choose to specialize in screening services, as opposed to other types of imaging done.  The beauty of a free market filling needs.

3. A greater reduction in the amount of future joint replacements and surgeries.  I’m sure orthopedists won’t be happy with this one, but earlier detection, understanding and personal responsibility offers both benefits and detriments – depending on the side one is coming from.  Patients will be healthier, while insurers and self-insured organizations will obviously be happy to reduce their medical costs.  I’m sure joint replacement manufacturers will be sending me my Christmas coal.  

4. More responsibility and better outcomes.  People who learn about their joint problems earlier have time on their side.  Plus, by keeping weight down, avoiding riskier activities, strengthening muscles and joint tissues, they have the best opportunity to prevent OA.  Ask yourself how many heart surgeries have been avoided because of determining one has high cholesterol or blood pressure?  It would naturally stand to reason that knowing of joint problems would yield similar reductions in surgery and better quality of life outcomes.

 

Feel free to comment below, as well as share this with others.