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Whose fault is it? The laws here must be better than yours, because part of the law is a "duty to help", and no, you can't be sued if you genuinely get something wrong while lending assistance.

The problem with that (and it's a here problem) is that getting involuntary "help" might cost you your job, severely limit your future prospects, and make a general mess out of your life. Which is all to say, we should be really really careful about deciding that someone is a suicide risk. Are you willing to trust your future to an algorithm written for facebook?

This doesn't mean that if you have a friend who obviously needs help then you don't get them help. Plus in the world of mental health, the gap between voluntary seeking of help, and involuntary intervention is huge in consequenses.

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What next - saying that it's okay not to stop a blind person from falling into an open excavation?

A clear and present danger is very far removed from guesses. If I see a person close to committing suicide, I'd try to stop them. Same with your blind guy. Remember though, in the USA, unless you have had some training and certification, either of the two can sue you.

And I just know someone will chime in with the Good Samaritan laws. Not as comprehensive as one might think:

http://www.aaos.org/news/aaosn...

I find it hard to consider lawsuits a miniscule part of the problem, have a look at the following link if you disagree. http://www.aaos.org/news/aaosnow/dec10/advocacy2.asp

I would like to highlight the following part in particular.

In a recent Gallup survey, physicians attributed 34 percent of overall healthcare costs to defensive medicine and 21 percent of their practice to be defensive in nature. Specifically, they estimated that 35 percent of diagnostic tests, 29 percent of lab tests, 19 percent of hospitalizations, 14 percent of prescriptions, and 8 percent of surgeries were performed to avoid lawsuits.

Liability reform has been estimated to result in anywhere from a 5 percent to a 34 percent reduction in medical expenditures by reducing defensive medicine practices, with estimates of savings from $54 billion to $650 billion.

I don't know the details about the Texas case in particular, but the very article that gave these numbers mentions Texas and some of the benefits that occurred from the legislative changes. There are other explanations why it wouldn't make a dent in the rate of inflation other than the overall cost being miniscule. It's possible Texas had another area of cost that grew faster than other states and countered the effect. It's also possible that despite the change, doctors didn't change their practice of defensive medicine. Perhaps out of habit, lack of knowledge of the changes, or the changes being too small. I don't know enough to say.

Your criticism of the fraud claim is much more deserved. The examples I gave were small and tended to focus only on the side of the little guy when fraud can also include things such as doctors, hospitals, and the like making fraudulent charges against insurance. I'm sure there are countless ways fraud occurs I haven't even thought of, much less mentioned. Overall though, the matter is far from a joke. The NPR estimated the cost of fraud in the US system at $60 billion to $600 billion a year. http://motherjones.com/mojo/2009/08/cost-medical-fraud-could-pay-health-care-reform

DSHEA. Essentially, the supplements industry bought off Congress and had them pass a law exempting themselves from FDA regulation of their claims as long as they avoided treating specific conditions and diseases. You can't cure acne but I'm sure you can "promote skin health" or whatever.

What we say here in our corner of the medical IT world: "Medicare uses the carrot-and-stick approach. First, they beat you with a stick. And if that doesn't work, they beat you with a carrot."

If you're too lazy to read the ref above, Plantar Fasciitis is an inflammation of the tendons on the bottom of your feet. Beat the soles of your feet with a 2x4 for about 15 minutes and you'll get an idea of what my feet feel like every day.

Having said all that, I *do* agree that getting up and walking around every now and then definitely helps shake things loose. I'm helping to design a network for a Very Important defense system right now, and when I hit a mental roadblock, a walk out to the parking garage and back will break the logjam about 90% of the time.

Luckily I've been blessed with a geek boss (and his boss, and his boss) who understand this totally, and don't bitch at me for what would appear to many other managers to be screwing off.

My right thumb and ring finger started hurting really badly after I moved my bookshelves. It also hurts down my wrist and forearm when I grasp something heavy with that hand, like a milk jug or big pile of books. I thought I was getting carpal tunnel, but my doctor said I had deQuervain's Tendinitis. She basically said that the only cure was rest. The doctor visit went something like this -

I just love modern medicine!

Over this last summer, the ridiculous amount of typing I was doing caused by ring finger and pinky to go numb. Thinking it was Carpal Tunnel, I went to the doctor, who confirmed to me that Carpal Tunnel is not usually caused by typing.

What she did tell me, however, was that I likely had Ulnar Tunnel Syndrome. Though this is also not caused by typing, it was the resting of my elbow on the desk which applied pressure on the Ulnar Nerve, causing numbness and pain.

Couple this with my career as a professional trombonist, and I had trouble.

The moral of the story is simple - it is not so much how much you type (or perform), it is the position of your hand and arm whilst doing it. Keeping a natural, "open" posture is ultimately the best way to prevent these problems.

I had what was initially diagnosed as possible carpal tunnel syndrome. I'd heard plenty about the standard carpal release operation from people who'd had it. When I run across 3 out of 3 dissatisfied customers (YMMV, of course, this might be your best solution), I decided I'd better look into alternatives REAL fast.

So I googled, and I found something. The something was on the American Academy of Orthopedic Surgeons site, for A new procedure to alleviate carpal tunnel syndrome uses a balloon catheter to stretch and expand the ligament and relieve pressure on the median nerve in the carpal tunnel of the wrist. It also mentioned a 95% customer satisfaction rate.

Well, the chief of Orthopedic Surgery who was examining me was very interested, this was new at the time and new to him as well, and the URL was from a source he was extremely unlikely to dismiss, given that he was probably paying them membership dues.

He referred me to a lab test, an EMG (electromyogram) checking nerve conductivity that showed I did not have carpal tunnel, and when the results came back, sent me to a physical therapist who essentially, taught me how to use my wrists and hands on the keyboard so as to reduce the specific actions that led to the problem. That was 8 years ago, and I've had no problems past minor wrist pain since then, and the use of ice several times and wrist braces once or twice took care of it.

While this did not help me directly other than getting more respect and perhaps better care than I might have otherwise, I'm sure that any patient who the doctor might have considered standard carpal tunnel release surgery for was well served because the doctor knew of a less intrusive alternative.

I think this is how doctor-patient interaction for the common purpose of getting fixed is supposed to work. Use common sense, listen to the doctor, and if you want him to listen to the information you've found, find sources he is unlikely to argue with because he, too regards them as authoritative..

If he suggests alternatives to surgery or medication, LISTEN, this is his field of expertise. He'll probably listen to you if the question is Linux vs OpenBSD.

You've got the time to google, use sources like Medline, etc. ... time a doctor frequently doesn't have. If you're here, you might be even better at using websearch and possibly even searching medical databases than she/he does. You can use this time to give a doctor information he doesn't have time to get. Your common purpose is getting your ass fixed.

If you have a doctor that won't work with you towards this common goal, find another doctor.

You may not feel the pain/strain as your mind is inundated by other, more important datum. Here is a url with simple pictures and descriptions of some integral stretches to prevent RSI and prolong comfort; http://web.mit.edu/atic/www/rsi/RSIMIT/exercise.ht ml.

This is from my own home page:

People who do not have carpal tunnel can get an incredible amount of help out of work with a physical therapist with experience dealing with RSI/CTS supervised by a doctor. Get a medical diagnosis first, preferably involving an electromyogram which can determine definitively whether or not the median nerve is really compressed or not. I had tendinitis a few years ago which was originally diagnosed as CTS, I considered this a wakeup call.

And if you've really screwed the pooch and the doctor is recommending carpal tunnel release surgery, be warned, I've met more than one person who's tried carpal tunnel release... and is not happy with the results, anyone contemplating that procedure should probably check into the balloon release described below first.

"Sunday February 25, 1996 Balloon catheter relieves pressure on median nerve in carpal tunnel"

"A new procedure to alleviate carpal tunnel syndrome uses a balloon catheter to stretch and expand the ligament and relieve pressure on the median nerve in the carpal tunnel of the wrist. This avoids cutting the ligament when conventional therapy is not effective."

"According to a study of 120 patients treated with the new procedure during the past four years, 85 percent had marked clinical improvement in relief of wrist pain and numbness, and 95 percent reported overall satisfaction with the outcome."

American Academy of Orthopedic Surgeons web site carpal balloon release info.

I suffered from carpal tunnel syndrome and now I'm mostly over it. I believe that my recovery is due in equal parts to rotating among three keyboards so that my wrists aren't always in the same position, good typing habits, and practicing the exercises recommended by the America Academy of Orthopaedic Surgeons to prevent injury.

The AAOS page with infos on this is located at:

http://www.aaos.org/wordhtml/press/exerci.htm [aaos.org]

Cheers!

Guess we're going to be needing these after all.

It's a pain in the ass to do them, but your wrists will thank you in five years. Young coders might feel invincible now, but any sort of 40hr+ work week will make quick work of the nerves in your hands and arms no matter how young you are.

Also check out this informative (if cute) prevention handbook.

-Erik

Orthopedist info

I got a bulging disc (L5S1, the lowest one) when I tried to do reverse crunches at the gym after apparent years of poor lower back posture (as my physical therapist explained it). Four things helped over the past few months:

1) Sitting up properly. The proper way is to jut your stomach and the base of your butt out in opposite directions, then back off a bit. This will put your hip bone more in line with your spine.

2) Months of physical therapy which included two things in particular that helped- yogic press-ups and bridges. In a press-up, get on the floor like you are about to do a push-up; but keep your hips on the floor while pushing up fully with your arms until you feel something. It may help to exhale when you're at the top. In a bridge, you get in the classic sit-up position on the floor, feet close together, but instead of sitting up, you push your hips to the sky. Line up your thighs with your back (in mid-air) and then stretch one leg out... if this is working, your hip on that side will droop which means you have some lower-back weakness. Do each side, then lower, repeat about 10 times. You want to get it so that your hips stay rock-solid when you lift a leg.

3) Walking, light exercise (elliptical etc.), and when I was able to take it, ultimate frisbee =) I am no fan of sports but Ultimate is pretty fun and a hell of a workout, as well as a nice way to meet people.

4) A new Aeron office chair for myself =) Kickass investment.

Genetic Predisposition? I don't think so.

Here's some info about CTS.

-Cyc