DAY 214 - On the Brink of Behind

courtesy of emdot at flickr

my brother’s birthday tomorrow
haven’t gotten to arranging lunch

nephew’s bar results tomorrow
will I remember to call?

Mother’s Day on Sunday
finally asked this morning about what would feel like a gift

Jay’s 60th on Tuesday
not only no card yet,
but damn, have to be at a conference in Sacramento all day

Tom’s wife has cancer
how can I be of help, and when?

who else have I not checked on?
checked in with?
remembered?
are they feeling uncared for by me?

maybe I can let go of the fear of the brink
of falling behind
maybe let go of the worry that others may feel that I don't care
or don't care enough

is there any way we could agree for ever
that I love you
that I will try to respond to you in ways that comfort you
but that if I come up short
it is never that I love you less
rather, that I am over the edge
and beyond behind?

I could use your help
in getting over this fear of falling

DAY 213 - When Friendship is a Problem a Yelp Won’t Help

A post on http://wired.com , dated April 6, 2010, entitled "Yelp Fights Fraud Allegations by Unfiltering Reviews", by Eliot Van Buskirk, contained the following statement from Yelp CEO Jeremy Stoppelman; "review filters take action on all types of suspicious content — both reviews that may have been written by a business owner or a business owner’s friends ...". 

What Stoppelman is talking about is a computer algorithm that Yelp uses to remove reviews that it thinks may be bogus. While his comment is understandable, it may also prove Yelp to be incompatible with small businesses that provide very personalized services.

My wife and I have operated Ventura Chiropractic & Massage since 1983. We truly like, if not love, our patients, and care about their wellbeing. Not too surprisingly, our patients like/love us, and truly care about our wellbeing. Sound anything like friendship? Well, it is!

So, when Stoppelman says that Yelp intentionally filters out (makes invisible) any review that appears to be written by a “business owner’s friends”, that means that virtually all the reviews of our practice have been, and will be removed, because they were, and will clearly appear to be written by our friends.

As of today, May 4, 2011, 17 reviews have been written about our practice, by patients who happen to be friends. Most of them, we met as new patients; they accidentally became friends. One review has been completely erased from the site, 15 have been filtered (made invisible), and one is left visible as though it were the only legitimate review.

Maybe Yelp was not made for us, for our practice, nor for our patients who would wish to share with the world, their experience of our office. It is important to understand that the issue is much bigger than our little office. We are not the only business that is rewarded with friendship as a byproduct of the caring interaction that accompanies the service that we provide.

We are not giving up our friends, but we may have to give up on Yelp.

DAY 211 - Medicare Complexity: Not Just for Old Folks

Wouldn’t it be lovely if it were as simple as to either “keep your hands off Medicare”, or “privatize Medicare”?

If I had to choose one right now, May 2, 2011, I would choose “keep your hands off Medicare”, but I don’t ... have to.

To me, "keep your hands off Medicare" means, leave it as it is; and that just won't work.

Here are the huge problems with “hands off”:
1)    the vast majority of health care practice in America, including Medicare, uses a try-to-fix-it-once-it-is-clearly-broken approach; prevention is a miniscule part of our system,
2)    Medicare, and our health care system (more accurately, a disease care system) overwhelmingly focus on, and financially reward, the managing of symptoms with drugs, surgeries, and procedures; understanding, discussing and dealing with the causes of illness are uncommon for both doctors and patients,
3)    Medicare does not emphasize improving lifestyle choices as the key to improved health, even though medical science has proven it to be the most efficacious and the most cost effective means of achieving health,
4)    Medicare, as it is, and our health care system, are grossly dysfunctional, and are currently contributing to the bankrupting of America.

We, the American people, must begin to take responsibility for our health, and act on it.

Privatization is even worse than "hands off".

While our government bureaucracies are often inefficient, the private health insurance industry, driven first and foremost by the profit motive, has a long and often lurid history, including regular lapses of moral judgment when dealing with subscribers and health care providers.

As many private insurance companies deny care, often illegally, those effected subscribers commonly turn to public hospitals and emergency rooms, where the costs are borne by we, the taxpayers, rather than the insurance company.

Ultimately, in the realms of health and health care, our conditions and fates are interconnected. We will, sink or swim together. This being the case, rather than "keeping our hands off Medicare", we need to put our hands on it, and begin to massage it into a more functional system.

We must start by acknowledging and rewarding what we have long known; that improved self-care is the sine qua non of individual and community health. We must remind our doctors, and teach our citizens about the powerful and necessary daily practices that determine health. We must relearn the values of caring for ourselves and caring for others.

Simple answers just won’t cut it. Let us join hands and begin the work of healing ourselves, and of healing our Nation.

DAY 203 - The Non-Comparison of Private Enterprise to Government

Please excuse the generalizations, which of course, are not true in all cases. I write this with no intent to harm.

Most of us understand the impossibility of comparing apples to oranges. How interesting then, that many folks directly compare work accomplished, and the price tag for projects carried out by a private business and by a governmental agency. One must assume that discussions about whether private or public organizations can best do work, is more emotionally charged than discussions about which fruit is “best”. Why, other than the cognitive disorientation that often accompanies a charged emotional state, would one try to directly compare the efficiency and cost of a governmental project, to that of a private enterprise?

I am neither an economist, nor particularly knowledgeable about governance, but I know enough to know that businesses and democratic governments have different primary goals, operate in different arenas, and function under different constraints.

Businesses focus on making a profit. They are free, to a great extent, to carry out their plans without concern for the public, the environment, or the future; and often do so.

Democratic governments, on the other hand, are committed to the common good, and are responsible to protect the common good in every possible realm.

Seems clear that making a profit, while abiding by some laws, would be child’s play compared to the mind-numbing complexity of trying to productively serve and protect the public good.

Most adults have seen the harm that can be done in the name of profit, even when governments are trying to protect the people, the environment and the future. Some of the greatest profits have been made outside the realm of the common good, in the realm of sweatshops.

Governments are not the most efficient producers, the least expensive, nor are they known for turning a profit. Fortunately, that is not what they were designed for.

 Let us recognize an orange as an orange, an apple as an apple, and let us clearly ask ourselves what we want from our government; a profit, or the common good.

DAY 201 - Magnesium: More Than a Laxative

In 1983, having recently graduated from chiropractic college, I established my practice in Ventura, California. At that time, it had not crossed my mind that I would spend my career looking for, learning about, and teaching patients about simple, powerful, critical, and often underutilized approaches to health. But, a few months of practicing, with therapeutic successes not being what I would have hoped, my search began.

I was looking primarily for keys to health that were inexpensive, or free; and that patients could utilize or  practice on their own, rather than having to pay a doctor or therapist to do it for them.

One of my first finds was the powerful, yet safe and gentle mineral, magnesium.

I am often asked, “Why do you talk so much about magnesium?” It is because magnesium is a critical mineral that affects every part of the body, and because most Americans are deficient in magnesium. Magnesium is so basic to all bodily functions that when a person does not have enough, a wide variety of mild to severe symptoms can occur. Most Americans are getting approximately 200 mg of magnesium from their diet. The RDA (the minimal requirement, not the optimal level) was 400 mg/day. The current DRI is 420 mg/day.

Signs that may indicate magnesium insufficiency include, but are not limited to; back or neck pain, muscle spasms, headache, panic attacks, tiredness, poor sleep, depression, anxiety, tension, nervousness, high blood pressure, kidney stones, gall stones, osteoporosis, breast tenderness, PMS, mitral valve prolapse, constipation.

A few of the most serious diseases that have been linked to magnesium deficiency are heart disease, diabetes, depression, and osteoporosis.

Some of the conditions that are benefited by magnesium are:
menstrual cramps - preeclampsia - back or neck pain - muscle spasms - headache - panic attacks - tiredness - poor sleep - depression - tension - nervousness - high blood pressure - kidney stones - gall stones - osteoporosis - breast tenderness - PMS - mitral valve prolapse - constipation

Not all magnesiums are created equal: Magnesium in nutritional supplements is delivered in a variety of chemical forms, including glycinate, chloride, citrate, oxide, sulfate, aspartate, and others. The most common, least effective, and cheapest form of magnesium is magnesium oxide. It is used in most multivitamins, and tends to cause intestinal gas and diarrhea. Because of the ill effects, manufacturers reduce the amount of magnesium in their supplements to 1/4 of the RDA level; never advising potential buyers of the low potency.

The greatest dangers of supplemental magnesium are: 1) forgetting to take yours, 2) taking an ineffective and/or insufficient amount and thinking that you are protected.

The most effective magnesium I have worked with since 1995 is Mag Glycinate from Metagenics. I have watched hundreds of patients try other forms of magnesium with little or no success or relief. This simple nutrient has markedly improved the lives of many of my patients, often without making any other lifestyle changes. This brand and chemical form of magnesium is only sold in doctor's offices, and can be difficult to find.

Using magnesium glycinate often provides so much relief from musculoskeletal conditions that a patient may not need treatment from a DC or MD.

I recommend 400 mg/day of elemental magnesium in the form of magnesium glycinate. Remember, you need more than the RDA.

Take the test: Take Mag Glycinate as I have recommended (below) for two weeks; consistently. Then stop taking it for two weeks. Repeat this cycle 3 times and keep some notes on how you feel and function on and off of it. Many people clearly feel better on than off. Warning - not feeling better does not prove that you do not need magnesium - there may be too many other health-deterring factors in your life for you to feel the effect of the magnesium.

When and how to take Mag Glycinate: Mag Glycinate is best taken away from food, though many patients report excellent results when taken with food. I suggest that patients take 2 tablets when they wake up in the morning, and 2 when they go to bed. It is fine to take one at a time, four times throughout the day.

Some individuals are gut-sensitive to magnesium. They may experience intestinal gas or loosening of the stool. If this occurs, the dose should be decreased, if need be, by breaking tablets in pieces, until no symptoms occur. Discuss this sensitivity with your doctor for guidance in selecting an appropriate dose. Those who are gut-sensitive are usually those who are most deficient in magnesium.

How to find an effective magnesium, wherever you are in the United States: you can buy SlowMag, or its generic at most any pharmacy, over-the-counter. To achieve the same effects as Mag Glycinate, you will need to take 6 of the SlowMag tablets per day.

Testing for magnesium has historically been done by measuring magnesium in the serum (liquid portion of the blood). However, it has been known for years, and has been published in medical journals that serum magnesium is an extremely inaccurate test. Even so, most doctors still order serum testing. Superior tests include:
RBC magnesium: Red blood cell testing is not the most accurate, but is the most readily available.
Intracellular testing: of cells from the inside of the mouth by means of an electron microscope: see EXA test
Growth assessment: see SpectraCell

Insist on accurate magnesium testing. Your life may depend on it! Cardiologists with whom I have talked are as amazed as I am that most doctors still order inaccurate serum magnesium testing. If you have only had serum magnesium testing, you don’t know anything reliable about your magnesium status. Beware and be in charge of your health.

Epsom salts baths: Epsom salts are the salt of magnesium sulfate. It is best used in a warm to hot bath. Because of the heat, they are not suggested during the first 24-48 hours following acute injuries (sudden onset such as a sprained ankle) in which swelling is present. Epsom salts are highly effective in treating chronic aches and pains, soreness from overuse, and sprains and strains after the acute phase (usually 24-48 hours following injury). Epsom salts can be purchased at large grocery stores and drug stores for $3-4.00 per half gallon. Put ½ gallon of Epsom salts into a hot bath. Soak for 15 minutes.

Epsom salts are not just good for aches and pains. Many people find a soak very relaxing. It can improve sleep and leaves the skin feeling very soft.

If you are using a bath for treatment of significant back pain, be sure to get out of bath while the water is still in the tub. The water will buoy you and assist you in getting out of the tub. If you think you might have trouble getting out, and you don’t want to be left sitting in a cold and empty tub, it is wise to have another person in the house when you take your bath in case you need assistance.

A laxative can be worth its weight in gold. Magnesium is worth so much more!

DAY 200 - Big Really Big Family

Imagine you had a really large family. And imagine that every time you turned around, there was another family need, responsibility or occasion that you felt drawn to respond to. Grampa needs a ride to his chiropractic appointment. Your niece is getting married; shop for gift, pick up tux, rehearsal, bachelorette party, wedding and reception. Aunt Tori is dealing with cancer; send a card, make a call, discuss possibility of a visit, reflect on her life and the meaning of life. Who’s picking up the CSA? And tomorrow is Liel’s birthday .....

Not recognizing and not responding to these family needs has consequences. A simple lack of planning ahead, also has consequences.

In this world, there is no need for anyone to simply imagine; we all do ... have a really large family; humankind. We are members of communities, states, nations, and are citizens of the world. Not recognizing and not responding to these family members has consequences. A simple lack of planning ahead, also has consequences.

My Mom and Dad raised us to know that others in the world were important, but their actions showed me that their real focus and attention was on the wellbeing of our nuclear family. As I grew, raised a family, and got older, I cared about others, but put almost all of my effort into the wellbeing of my own nuclear family.

I am drawn today to think and write about families, the boundaries that we imagine and live, and the allocation of our efforts during our lives, because of a recent, even literal, watershed event. This last Tuesday night, the Ventura City Council voted 6-0 to not annex the North Ventura Avenue area, nor Canada Larga, areas that had been proposed, if not pushed, for development, i.e., building and expansion. In the minds of a number of residents of Ventura and Ventura County, the annexation of North Ventura Avenue or Canada Larga would have been unsustainable, unecological; a clear step on the road to mirroring the sprawl and unlivibility of Los Angeles, here in Ventura County.

But, it was not the minds of the residents that helped to guide the Ventura City Council to this 6-0 vote, it was the actions of these same people who organized, planned, communicated, and came to City Council meetings. These people came out, stood up, and spoke up because they don’t need to read this essay. They already knew their large family, knew the consequences of not responding, and chose to plan ahead.

If you have appetite for a little more, I would highly recommend the following essay in The Ojai Post, by Steve Sprinkel, Ojai organic farmer, really-big family man, and visionary planner-activist for our future. http://tinyurl.com/3awc629

DAY 198 – YELP!!! Reviews Locked Up

Yelp, in my vocabulary, has always meant a sharp cry or bark, usually arising from an animal or human, startled or hurt. Today, in this writing, I use the word both in its common meaning, as I have known it throughout my life, and the modern, referring to an online website dedicated first to reviews of restaurants, and now to reviews of all manner of businesses, including chiropractic practices.

My son, Kenn, recently used www.Yelp.com to find a dentist for himself in New York City. What a success story! The reviews he read lead him to a dentist that provided exactly the care he was looking for.

My son’s experience got me thinking about the power of online reviews for helping folks find just the service they are looking for. It provided me the opportunity to recognize how limited, if not outdated the Yellow Pages are. The Yellow Pages, of course, are mainly a compilation of business owners' own reviews of themselves; possibly not the most helpful. It’s the customer, the client, the patient that we want to hear from.

Thus inspired, I located the Yelp-created shell of an online listing of my chiropractic office, and began to fill it in with information about the practice. The next step was to publicize that we were Yelp-friendly.

Having been in practice for 28 years, and currently serving satisfied new patients each week, I figured there would be a few who would start Yelping "with something to say". And I was right.

Over a period of 4 weeks, reviews trickled in. To date, 12 have been posted. But within a week of the first review being posted, I had my first encounter with the grim filterer. You’ve heard of the grim reaper? That’s old school. The grim filterer is a computer algorithm used by Yelp to try to determine if a review is bogus or legitimate. Apparently there are risks, some deadly, inherent in trying to sort human expressions by computer.

As the reaper, uh filterer, came through on its periodic mission of cleansing, one review was destroyed completely, 8 were banished to a purgatory-like existence called “filtered”, and 3 remain, as of this moment, on the net, easily accessible to those who might be trying to find their perfect chiropractor in Ventura, California.

The “filtered” existence of these reviews is an invisibility, not unlike having been swept under a carpet. The dust can be found by lifting a corner of the carpet. The “filtered” reviews can be seen by going to the bottom left corner of the last visible review and clicking on the grayed-out link “(8 Filtered)”. Presto, the dust, and the suspect reviews.

One can read the remaining 3 reviews of my practice at: http://www.yelp.com/biz/ventura-chiropractic-and-massage-ventura-2 , the “filtered” reviews at: https://biz.yelp.com/r2r/af9pJZ24DSobDPpCPNTtzw/filtered_reviews , and, like I said, you’ll never find the 12th review.

For clarity, each and every one of the 12 reviews that have been written about my practice, Ventura Chiropractic & Massage, are legitimate reviews, written in each case by patients of mine.

Lest a rebellion get underway, I want you to know that I have not been singled out. There are thousands of the sharp-cry-or-bark-usually-arising-from-an-animal-or-human-startled-or-hurt type yelps ricocheting around cyberspace, some resembling profanity, that decry the removal of legitimate complimentary (4-5 star) reviews. Nonetheless, I believe that Yelp.com is committed to benefiting all of us as best it can.

For now, let me say that I support Yelp.com because I believe that Yelp is working on providing a functional network of feedback that can help you and I find better matches in our lives.

Finally, as with individuals in purgatory, I am told that some of the "filtered" reviews may be moved once again into the light, if their creators become "Yelp-established" rather than one-shot, questionable reviewers. There is hope; these reviews may not be on their way to hell.