If I am going to write about everything that’s wrong with the health care system in the United States, I would need to write at least a 2,000-part series, assuming that I stuck with only the major flaws. To keep things simple, I’ll start by examining what our healthcare system does with medical problems that I happen to have. That way you’ll get the perspective of both the doctor and the patient.

Doc Elbows
Let’s start with my bad back. As a young man, I was a pretty good 880-yard runner. In college, one year I was the conference champion. I was also the leadoff 880-runner in the two-mile relay, and one year we won this event at the Drake Relays, one of the most significant college track and field events in the country. At 6’2″ and 180 pounds I was unusually large for a half-miler, but that was just fine with our coach. At these big relay meets, when the gun went off, they started off with 3 teams in each lane. After the first 100 yards or so my coach expected that the other two runners in my lane would be on their ass and I was very good at my job. That’s where I got the nickname “Doc Elbows”.

For many decades after college, I continued to run for fun and exercise. I wasn’t too much into marathons and that sort of torture, but 4-6 mile runs suited me just fine. Over time I gradually noticed that my back would become quite stiff and sore after running. I consulted with several physicians and after a cursory exam, they ordered back x-rays and a lumbar spine MRI scan. I shocked when I looked at these x-rays because of the advanced degenerative disc disease throughout my back. Because this sort of thing runs in our family and I could still run, I didn’t give it much thought at the time.

Call me Gimpy
Then about 12 years ago I developed a sudden foot drop due to pressure on one of the nerves in my lower back. I was told by several physicians that I needed to have emergency surgery performed, or the foot drop might become permanent. I ignored their advice, and my leg gradually returned to normal. At this time, I also noticed more stiffness and soreness in my back, so I looked at the various non-invasive options available for this type of back problem. I came across a book titled “Pain Free” by Pete Egoscue. In his book, he outlines a series of posture-based exercises that are much different than the standard exercises recommended by the medical profession and Physical Therapists. I found his workouts to be quite helpful, and I did them almost every day for over a decade. My back gradually became a little worse over the years, but it didn’t restrict my activities in any significant way.

My Nick Name Changed From “Doc Elbows” to “Double Gainer”
That changed rather abruptly in the spring of 2016. I was walking rapidly down the hospital hallway to respond to an emergency when my lead foot landed in a puddle of water on a waxed tile floor. I flew into the air and came crashing down on my lower back and left hip. My move can best be described as a “double gainer,” and I received scores of 9.8 from all the judges except the Russian judge who gave me a rating of 9.2! At first, I couldn’t move, and the other employees thought I might have become paralyzed. I was finally able to get back on my feet, and although I had a lot of pain in my back, I could walk, so I kept on working. The next morning, I could barely get out of bed so when I went to the hospital, I first visited the ER where x-rays revealed severe degenerative disc disease but no apparent fractures. At this time, I could barely walk so my PCP took me out of work and placed me on Worker’s Compensation where I received a baseline salary until I could return to work.

Playing Russian Roulette with my Health
For the next several months I was evaluated by several back specialists. One wanted to do an epidural steroid injection, but I knew that even when this works, it only provides temporary symptomatic relief. I attended a few Physical Therapy sessions and found them to be unhelpful and a general waste of time. I continued to do my Egoscue exercises, but some days I couldn’t do the whole set because of back pain. I took Advil or ibuprofen for pain, and they seemed to work much better than Tylenol. I refused to take strong narcotics, but my PCP finally talked me into taking low dose tramadol, a very mild narcotic like medication. The Advil/Tramadol worked quite well, and after a few months, I felt like I was ready to go back to work. I was examined by a total of 3 physicians representing my large Boston Healthcare organization, and they all agreed that I was ready to go back to work with some minimal restrictions. For reasons that were unclear to myself and my attorney, my employer never came up with a job that fell within my few restrictions.

While sitting around and waiting, I was evaluated by one of the top back specialists in the Boston area. He ordered another lumbar spine MRI scan and told me the study was “one of the worst that he had ever seen.” My degenerative disc disease was worse than ever, and I had severe dextro-scoliosis of a vertebra in my midback, making my lumbar spine look like a pretzel. The specialist recommended a rigid back brace, but these have only been shown to be helpful in young people where the spine is still growing. These braces can be beneficial for controlling acute pain, but excessive use can lead to atrophy of muscles.

Show me a Scalpel and I’ll Beat Usain Bolt in the 100 Meter Dash!
I was also given a TENS unit, a form of electrical stimulation to help reduce pain but I did not find that this method reduced my back pain. He then suggested that back surgery might be the best option given the severity of my problem. He would need to do 3 separate procedures over a week while I stayed in the hospital. I have been practicing medicine long enough to know that these complex spinal fusions rarely offer much relief and they often leave you worse off than if you never had the surgery. The back surgeon sold both the brace and TENS unit out of his office, and I paid for them out of my own pocket. In the old days this was considered a “conflict of interest” because the doctor was making money off the treatments he was recommending, but today this situation permeates modern medicine.

Back to the Basics
After doing a complete review of the relevant medical literature on chronic back problems, the only treatments that consistently showed positive results was strength training or what is commonly referred to as traditional weightlifting. I found it interesting that this approach was not mentioned once by any of the healthcare providers I had consulted. The skeptic in me suspects that perhaps it’s because they can’t make any money off me if I am doing all the work without their help! I found a personal trainer who worked with me on an aggressive strength-training program, but he charged $90 per hour, and after several sessions, there wasn’t much more he could teach me. I have a full multi-station weight training machine at home, so I started to do several hours of strength-training exercises every other day. After several months I was in better shape than I had been in years. We then went to our home in Greece, and every day I swam for at least 90 minutes in the warm Mediterranean ocean. In the evenings I often went for long walks in the hills overlooking the sea, and over the past few weeks I have tried jogging for short distances, and I have been able to do so without pain.

Grab the Bull by the Horns—Literally!
I have also started learning and listening to my friend Robb Wolf concerning his CrossFit approach to exercise. This popular system involves intense workouts using natural functional movements. I am currently in the process of visiting various CrossFit gyms in the Boston area to find one that fits my needs and personality. Part of the CrossFit philosophy is the benefit of performing these functional exercises in groups where the enthusiasm of others can sometimes pull you through the inevitable physical doldrums that can occur with intense exercise.

With All the Clowns Around, There Must Be a Circus in Town!
Besides the obvious flaw of my healthcare providers failing to point out the benefits of intense exercise for my back problems, how many other ways has this system let me and my back down? Let me count the ways! Not once over the past 20 years have any of my healthcare providers recommended any dietary measures that might help my back. Most back problems are driven by chronic inflammation, and a poor diet is a leading driver of inflammation throughout the body. Not once over the past 20 years have any of my health care providers suggested supplements that might be helpful. Number one on this list is the importance of taking a high-quality omega 3 supplement in a dose high enough to get the AA/EPA ratio between 1 and 3. At this level, the pro-inflammatory omega 6 fatty acids and the anti-inflammatory omega 3 fatty acids are in proper balance. The average American has a ratio of 18, and my recent reading was 1.9 while taking a high dose of OmegaRx, a brand developed by my friend Barry Sears, likely the world’s leading expert concerning fatty acids and health.

Even though the data on the usefulness of supplements like chondroitin sulfate, glucosamine and MSM is relatively sparse, I have taken this combination for over 20 years, and I have no reason to stop now. Of course, I have never even discussed these supplements with my physicians because most of them don’t believe in the benefits of any supplements. It isn’t surprising that they’re always ready and willing to pull out the prescription pad to order a bevy of ineffective and potentially dangerous drugs. That’s why I even hate to refer to this circus full of clowns as a “healthcare system”.

My former employer finally agreed to settle my Worker’s Compensation case. They wrote me a rather large check and sent me on my way. I can now work anywhere, and I recently started working at several large rehab units providing care for older individuals with complex combinations of medical and psychiatric disorders. I love caring for these patients and it feels really good to be back in the saddle again! It also gives me the opportunity to give my patients valuable health information that has been denied to me all these years.

Even though I have yet to find a complete cure for my chronic back problems, my pain is tolerable, my ability to function is better than ever, and my quality of life is outstanding. The only thing I’ve been cured of is my expectation that our healthcare system has something positive to offer me concerning my back problems.