A growing number of hospitals are relying on remote ICUs to monitor and evaluate patients virtually, which helps to cope with an unrelenting COVID-19 caseload.
Chronic back pain and sciatica are very common, and increasing in prevalence. The human back does not seem to have been designed for obesity coupled with sedentary habits. I have had both back pain and sciatica . My wife had surgery in an attempt to control her back pain, my son successfully controlled his back pain with medical treatment, and an 87 year old friend recently had successful micro-neurosurgical treatment.
I will summarize these stories and will finish with some generalizations I believe will help those wanting to avoid a lot of misery. The sooner you start the better.
My back pain developed after an ill-advised use of a shovel to get rid of some grass intruding on my asphalt driveway, and caused me to miss work for the only day in 35 years of practice. Sciatica then developed on my left side. I could not sleep flat, and would sit all night in a comfortable chair. A hospital bed helped me outlast the impressive calf pain.
My wife developed severe back pain eventually leading to a “laminectomy and fusion”. Some level of back pain and incapacity plagued her the rest of her life.
My son developed severe sciatica and went to an Orthopedist. After a CAT scan revealed a rupture disc, he was penciled in for surgery. When asking about alternative treatments, the doctor told him, half laughingly, to lose 20% of his body weight and to start swimming. He went on a 30 day, 1000 calorie/day diet and lost 30 lbs. He has been swimming daily for the past 10 years. He has had no more back pain.
My 87 year old friend developed sciatica on his right side, had no luck with PT and pain meds including opioids. Microsurgery by a neurosurgeon successfully removed his ruptured disc, and he has had little or no pain after the first week.
Sciatica at least has a well defined cause: something is irritating that long nerve which starts in the small of the back and travels to its’ destination in the foot. That something is often an extrusion from an intervertebral disc, a cushion between the block-like vertebral bodies.
This herniation can be confirmed by a CAT scan or MRI, and removed by minimally invasive microsurgery. Beyond that model problem, down through spinal stenosis and ending in chronic back pain, the understanding gets progressively more fuzzy, treatment ever more contrived.
Prevention sounds better and better. The most important thing in preventing back pain is to MAINTAIN A NORMAL WEIGHT. Our backs were not designed for vertically compressive forces. The lock-step increasing incidences of obesity and back/sciatic problems support this idea.
REGULAR EXERCISE is very important. Swimming and walking are 2 of the best forms of exercise. Exercises like running on hard surfaces, jumping in volleyball, and weight lifting seem less optimal.
The ABDOMINAL MUSCLES stabilize the spine, and prevent excessive motion. Walking and swimming both exercise and strengthen the abdominals.
Maintaining FLEXIBILITY and RANGE OF MOTION are important. flexibility will help prevent those unplanned, sudden motions from throwing your back out of alignment, or maybe generating a painful muscle tear.
Finally, getting into the habit of BENDING YOUR LEGS and tensing the stabilizing abdominals when you pick up something on the floor is a help.
I question the wisdom of back surgery for back pain alone, especially if accompanied by spinal fusion. Even when there is sciatica, the statistics show that treatment with surgery is no better than medical therapy after 2 years.
The development of microsurgical techniques may give surgery an edge, however. At the risk of cliche, AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE.
From Healthcare IT News (June 12, 2020):
Technology-enabled workflows now enable patients to complete most of the registration formalities prior to the visit, be it a virtual consult or a clinic visit. Registration kiosks in hospital lobbies may soon be enabled with facial recognition software to eliminate the need for touching any surface.
Routine examinations are also going virtual, with many diagnostic procedures now possible through remotely controlled devices. Caregivers are beginning to do their patient rounds through virtual visits. This trend will only grow in the coming years.
A vast and growing array of automated communication tools allows caregivers to use rule-based messaging to push everything from health coaching, post-discharge care instructions, and appointment reminders through IVR, text, SMS, and mobile alerts.
The coronavirus pandemic has overwhelmed hospitals, physicians and the medical community. That’s pushed telemedicine into the hands of providers and patients as the first response for primary care. Telemedicine isn’t new to the medical community, however it hasn’t been embraced due to insurance coverage, mindset and stigma. Here’s how it works and what it means for the future of health care.
The safety and convenience of Telemedicine have been amply illustrated by Covid 19. It’s place in the future of Medicine would seem to be assured.
Once the epidemic is over, however, some sticky details, waved away by fiat during the early days, must be addressed.
Will Payment parity be allowed by the Health insurance companies (And Medicare) be continued? Will cross-border Practice still be allowed by the states. Will more Doctors modernize? Will lawyers (and litigious patients) restrain themselves?
Your heart and your brain are your two most vital organs, and if you enjoy life, they should be a top priority. These amazing structures are tethered to life-giving support by your arteries, just as the new you was tethered by your ubilical cord.
Life is fragile, hanging by a thread, or an artery. over the span of your life, These arteries can become plugged by fatty deposits called plaques. A healthy life style-SLEEP, DIET and EXERCISE– could slow down or prevent this atherosclerosis.
But everybody should know about the symptoms of HEART ATTACK and STROKE (1) and how to respond if the arteries sustaining your heart or brain become blocked.
You should be familiar with the hospitals in your area. How close are they? What are their capabilities? Are they Class 1 for heart attacks and stroke? Do they have a CATH LAB?
SPEED is important. Within minutes of the BLOCKAGE of an ARTERY to your heart or brain, vital cells start to die. The goal is to remove the blockage as soon as possible. CALL 911 as soon as you have heart attack or stroke symptoms. Don’t be afraid of the ER because of Covid, since almost all now use TELEMEDICINE SCREENING to keep infected patients segregated.
Alas, for many people, such PREVENTATIVE MEDICINE requires too much SELF DISCIPLINE AND CONVICTION. America has an epidemic of OBESITY and an avalanche of tasty FAST FOODS provided by a CONSUMER SOCIETY that is ever-attentive to the latest fads and trends.