

### My Precious Spine and I

A self-care manual for you and your Spine

By

Eugene J. van Wyk MCSP

Smashwords Edition

My Precious Spine and I

Copyright 2013, Eugene van Wyk

Smashwords Edition, License Notes

All rights reserved. This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

Editor – T van Wyk

Graphic Design Concepts - Eugene J. van Wyk

Cartoon Artist - Derrick Nesbit

Photography - Jonathon N. Hansworth

Cover Design – Laura Shinn

Thanks To My Enthusiastic Wife And Right-hand, Tineke, For Editing Assistance.

About the Author

Eugene van Wyk is a British qualified Chartered Physiotherapist. He began work in 1961 at various British and South African Cerebral Palsy Units. In 1965 he commenced general private practice.

Contents

Preface

Introduction

1 My Precious Spine and its Construction and Functions

2 "Why Do I Get Back and NeckAche?

3 My Precious Spine and My Home

4 My Precious Spine and Selection Of Furniture, Fittings and Attachments

5 My Precious Spine and Sleeping

6 My Precious Spine and Sexual Intercourse

7 My Precious Spine and Cleansing My Body

8 My Precious Spine and Being a Mother or Father

9 Your Role as a Domestic Executive

10 My Precious Spine and Shopping, Transport and Storage of Provisions

11 My precious Spine and Cleaning

12 My Precious Spine and Gardening

13 My Precious Spine and My Pets

14 My Precious Spine and Travelling

15 My Precious Spine and Enforced, Prolonged Bed Rest

16 My Precious Spine and Office Work

17 My Precious Spine and Industry

18 My Precious Spine Sport And Recreation

19 My Precious Spine and Injury Prevention

20 My Precious Spine and Remedial Action

21 My Precious Spine and Available Aids

22 My Precious Spine and Exercises

23 My Precious Spine and Footwear

24 My Precious Spine and Maturity

25 My Precious Spine and RETIREMENT

26 Is it True that?

27 My Precious Spine and Moving Home or Business

28 Handy Hints

29 My Precious Spine And Security

30 How can Physiotherapy Services be of Assistance to Me

Alphabetical List of Conditions and Complaints

Biography

PREFACE

This edition, of My Precious Spine And I -- A Self-Care Manual For You And Your Spine, is the next, an enriched, patient request, demand driven, follow-up on my previously published book with the same title.

In this edition, I address many of the Mounting, Present-day Issues, that are Demanding More and More of Our Well-informed Self Preservation Attention. Particularly, on the Socio-economic front, where so many folks have become the Victims of the Down Trending Financial and Retirement Fronts. It might even be That "Your pension scheme has Gone in to 'Liquidation!!'"

Patient Liza farmer's wife Friday February 15, 2008 : "People who don't listen or learn, line themselves up for future problems!"

"The retirement investment consultant may be prepared to experiment with your retirement!" even now, many years later, still so true! Remember that Self-empowerment Knowledge can be everywhere; it can be in people, in fellow workers; friends and family; it can be in books; it can be in libraries; it can even be in computers! You only have to be keen, enthusiastic and pro-active to harvest it!

Apart from not being loved, our greatest fear is to be poor. Particularly, being poor in retirement! For some of us, it's our greatest worry; no one wants to have money worries. Therefore, it is most important, that we get our money life in order.

I've found, that encouraging my patients to become self-empowerment health and investment Knowledge enriched, at an early age, builds up survival endurance. The only limit is our enthusiasm and imagination.

I continue to believe, that one should continue to learn; with the emphasis on health and financial self empowerment. Failing that, you simply, must urgently enlist the help, advice and on-going association, of one or more reputable, health care accredited, and registered, financial and investment advisor or advisors.

Why quality advice and investment experience is important

This is one of the many services, a good and trustworthy qualified and registered financial planner should do for you, if you cannot do it yourself.

In your health and financial life, you are the driver and head coach. It is your important and vital job, to surround yourself, with the best health service providers and financial advisors, that are available to reach the present and future level of health and success, you desire for you, your family or your business.

I cannot overemphasise this: Ideally, you should find a true Financial Planner or Financial Advisor who works on a fee-only basis. This means that he/she will either create a financial plan for you and charge a flat hourly rate, or charge a percentage fee annually, based on the value of the portfolio he/she is managing for you.

These two approaches tend to weed out the inherent conflicts of interest that are typically associated with the traditional commission-based pay of a Financial Advisor or Stockbroker. In a fee-only relationship, the advisor gets paid more, if the clients portfolio increases. It is very important to check the credentials of any professional advisor, before taking them on board and adding them to your team.

Similarly, I think it is important, that people have trustworthy and experienced mentors through their life, because they can get encouraged, in new and different stimulating and enriching directions.

Keep in mind, that you can find many mentors, by simply consulting with books, about any subject of your choice. Just develop a liking for books -- either in paper or electronic format.

With books, you will find there is always that stimulating, mind opening and uplifting debate.

Now you appreciate the nice and rewarding thing, when you start investigating and bringing valuable bits and pieces of information together. You always find, to your horizon-broadening delight, that you know considerably less than you started off with.

To be financially literate, and financially intelligent, means being able to understand the big picture of money.

Cash flow, particularly during retirement, not money, relieves anxiety.

In order to get where you want to go, you need to know where you are. This is the first step to take, control of your present and future life, and spend more time minding your own welfare and business.

Underlying this manuscript is the challenge of fellow citizens back-care awareness empowerment. This book is not an anatomy knowledge book, but a book about behavioural changes.

With reference to my experience-based book: There are books similar to it; reading them too, can only broaden your base of back caring experience.

A number of additional factors, that have been distilled over the years, have now been incorporated in this latest edition.

The material contained herein, is "information only" and should not replace the counsel and advice from your personal physiotherapist. The book is simply an additional key to opening the better quality of life door to even more extended horizons.

These are self-evident principles, perhaps not yet acquired habits. They are guidelines -- safety lighthouses and beacons. We already know many of them. But what's common sense is not necessarily common practice. So let's learn them, re-learn them, until it automatically becomes part of the "software" of our brains. Then teach them -- by example -- to our family, friends, co-workers and to other people. They are natural mechanical rules and laws. We cannot break them. We can only break ourselves, or our backs, against them. We might as well learn and accommodate them, utilise them and be grateful for them. Then it too, empowers us and emancipates us from the drudgery of backache and deprivation of quality of life.

Physiotherapists have intimate knowledge of functional anatomy. They are thus in a good position to determine, by assessment, the need for radiological, surgical or orthopedic intervention in the case of Recent Trauma (particularly sporting injuries).

To be a successful physiotherapist, you almost always have to deliver pain-relief on demand.

In change of habits; there can be pain. In change of either home or country; there can be pain. In staying where you are, there can be even more pain!

Yes, there are changes in the air, but change is not always a bad thing. Therefore, take advantage of the horizons and potentials offered by change; for change of location with pain, offers new stimulating open doors!

Acquire the habits and techniques of successfully decanting physical, as well as relocation pain.

How to read this book

If you want to get the most out of the material in this book, you'll need to really become pro- active. You'll need to re-examine your body- care mindset and habits; preconceived ideas; your future quality of life objectives and goals.

Bear in mind that your sound body is the only "instrument" through which you operate and implement your dreams and objectives in life. Therefore, if you don't get control of your body and mind's health, how can you expect to control and direct the expressions that come through your body and mind?

To acquire the back awareness habits, to integrate them as part of your every-day life, you have to be willing to do three things with the information in this book; learn it, teach it to your family, friends and co-workers; and then do it yourself -- which means, apply it to your life.

Remember, the quality of good health and life cannot be achieved by taking the right shortcut. However, I am convinced that the principles underlying this material, can empower you to minimise the risk of spinal abuse.

"My Precious Spine and I" can be read all at once -- in one _comfortable_ sitting. However, it is structured in such a manner that _individual chapters_ can be read in relation to one's particular needs, at the time in question. Nevertheless, it is preferable to obtain a _holistic overview_ by taking your time to reflect upon the impact and implications of each chapter upon the _quality_ of _your_ spinal-care and life.

When you have read this book, and realise to what _practical_ extent the information contained is of help to you, ask yourself the following: "Who else needs to read this book right now? Which of my family, friends or colleagues' quality of life can I help improve by getting them a copy of this book?"

A staggering 60 to 80 percent of adults suffer back problem every year -- most aged between 16 and 60.

At the lower age group, surely our back care education is lacking the necessary pain and possible future discomfort saving attention.

Internationally, back injury is the largest single cause of long-term sick leave.

Fortunately, only a very low percentage of back pain investigations ultimately result in surgery.

When sustaining a spinal, or any other injury, the key to success is prompt action. The longer it's left unattended, the more frustrating and complicated it gets. After three months, what began as something straightforward, and easy to treat, may have become a chronic problem, often just as painful but more difficult to treat satisfactorily.

It's never too late to get better health ways of living. You can try and reverse a lifetime of bad habits. Regrettably, particularly, when we are young, and very actively involved with competitive sport, we assume that we are indestructible. In later life, we think that any accumulated damage we inflicted on ourselves can be undone when we desperately try to clean up our act.

Fortunately, the heartening conclusion: the body has, given continuous support, an amazing ability to heal itself, provided the damage is not too great. With the rehabilitation to better health program, if you Make enough changes, you'll soon discover you've adopted a new way of quality of life. But you'll never know how much possible further long term damage you can undo if you don't try.

_Promptly_ consulting with your physiotherapist, is the most cost-effective and pain-time reducing path, to a quick and successful resolution, of any treatment-amenable electro-musculo-skeletal trauma conditions.

The manuscript is the harvest of many years of practical international experience; pushed by patient need and pulled by leading edge technological developments and "evolution. I have been continually mining an ever- changing experience and expertise database.

I have a few missions, a few goals.

One of my missions in life is to channel, particularly young kids -- with the emphasis on young girls, to become Investment and Financial literal as soon as possible in life.

My goal is always to help the people I work with, move forward, adapting to their own changing health challenges, and learning to use it as a strength, in their personal and professional lives.

Once one obtains Self-control, you realise it is strength and power!

Why?

My patients are relying upon my empathy, expertise, experience and my ability.

My real motives, for writing this book, if you want to know, is that I didn't ask for this job. I took it on as a personal challenge, to help others in my peer group: back owners, retirees, seniors, and fellow savers just trying to successfully survive.

Further, I hope, with your active assistance, at enthusiastic grass-roots level campaign, to "change the course of international back awareness and care!"

You may well ask, somewhat tinted by a mounting degree of skepticism, how does the plan to distribute one particular back care book, square with the prevailing minimal information about back care Reality education?

Maybe there is no simple way of "changing the world." But, then, for us optimists, maybe there is!

The important part of the story, is that my wife and myself, realised what might happen down the employment and financial track, and dedicated ourselves to study in this health and investment self-empowerment area, more than four decades ago, and now have a lot to share -- and an independence track record, to back up its value. We often tell, particularly the younger patients, that when we were younger, there was a common saying: "How come there is so much month left at the end of the money?" It was funny then. Now, with inflation and the diminishing purchasing power of the currency, it's become: "How come there is so much life left at the end of the money?" This is not the least bit funny; for many older folks, who are not financially prepared for retirement, it's terrifying.

I mean that most of my conservative generation played by the rules; we paid our taxes, saved our nest eggs, and did everything else we were supposed to do for the last 30 or more years. Retirement projections were based on a "conservative" projected investment yield of 6 % vs. inflation of 2 %. Now those numbers have reversed -- yield is 2 % and inflation is 6%.

Many in our generation realised that living within -- and below -- your means, is a good thing when we retired; pay yourself first, and learn to live on the rest.

Savers will always find a way to save; the important key is to get started now, and to persist.

When you run out of money, stop spending.

After all, if a person has enough sense to save and invest for the long term, that person usually has enough sense to take care of his health.

My Valuable Service, is that I make people feel better, maybe more optimistic, important and reliable.

I don't want any of my friends, or readers', to ever say, "Why didn't you warn me?"

Picture yourself and your parents in this now more frequently occurring dilemma: your safe and dependable sources of decent income have been taken away from you. You now have to put the bulk of your life savings at much higher risk, than you are comfortable with, and your day-to-day cost of living is skyrocketing. you are afraid, and very anxious, because you really cannot afford to lose your nest egg. Your parents are no longer working, and they don't have the ability to earn it back if they lose it.

This is a very real financial anxiety, generating pressure, that a lot of elderly people feel.

Is it ever too late to start with a self-empowerment wake-up call?

Certainly not!

That implies a massive self-education process; it might mean joining an investor's empowerment club or group.

Unless you have a lot of money, enough to warrant paying a true expert money manager -- you are going to have to become less passive, and more progressively active as an investor.

Important: Bottom line: self-education is a continuous process.

No one -- maybe other than your heirs -- is more concerned about your life savings than you are.

Stay on top of things, by continually reading, learning, and monitoring your investment skills and investments.

That will equip you to ask the right questions; what are the sources of advice?

Soon you will note that you're only as competent till you meet your level of incompetence.

Today is part of your life's curriculum. Learn as much as you can, and tomorrow will look after itself.

Your Finances

The important question here is not, "Do you have enough money?" Rather, it is, can your funds take care of your life style and it's requirements?

Years of active learning and investigating, has revealed, that to expect a regular monthly, quarterly or yearly, reliable and safe income stream, requires an early disciplined and on-going involvement with our choices of investments.

Has it worked?

Well, fortunately, for us, it is yielding most gratifying results during retirement.

We have also been guided, particularly in the early days, by advisors, who, so it seemed, were really concerned about our future financial safety.

Nevertheless, being very observant, even at that very early phase in our lives, we noted the upmarket luxury vehicles in which the two advisors made their appearances at our home!

Did we take note of that fact? You bet! Indeed we did.

This motivated us to begin learning, how money and investments work. So, more than 40 years ago, we took the necessary steps to become financially literate, by implementing a program of investment self-empowerment. Although, almost nothing is totally certain, the wisdom of international diversification still holds true and rewarding for us!

This morning, a very concerned patient reflected that, "the fear of being retrenched, or dismissed from your job, is now always there!

In view of this, possibility, please take note in chapter 24, where this matter is addressed: Chapter 24: MY PRECIOUS SPINE AND MATURITY

Well, the delightful truth is, there is always another way to do, what you now do for a single person, at one time.

When you're selling hours for bucks, you are experiencing little to no growth: you are completely dependent on yourself. If you get sick or injured, or have a personal problem that keeps you from working a period of time, you can't make any money.

Sad to say, too, you're not getting any younger. Also, there is always the younger and more up-to-date generation, on its way in to the already overcrowded work force.

You can only do what you successfully do for a certain number of years and you're using up more of that valuable time every day.

So whatever you do, don't kill valuable time! Please don't procrastinate!

Of course, we want to set up a recurring, safe and regular income stream from our current business, investments or customers, so we don't have to generate, new investment formulas or events, every few weeks.

This is where it becomes stimulating, interesting, and, self-empowering. Opening new doors and avenues.

Start Focusing on linear income instead of passive income:

By now, you too, will realise that not all income is created equal. Some streams are linear and some are passive.

Linear income, is what you get from a regular paycheck and day to day job. You work for an hour and get paid once for that hour's work, and that's it. The sting in the tail: If you don't turn up to work you don't get paid.

The beauty of Passive income, is that when you work once, but continue to get paid over and over again, from work you're no longer actively doing, you are still getting income.

The way to become wealthy, is having passive income, coming in, whether you go to work or not.

Wouldn't it be nice, exciting and rewarding, to be paid hundreds of times for every hour you work?

Of course, there are choices! That's what happens if you invest in property and top international quality regular income yielding companies.

Initially, you do research and work long hours, save up a deposit and then invest it into a property or any number of selected international companies.

Now your money starts working for you and your family, and keeps giving you sound investment returns "passively" in the form of capital growth and rental returns.

Above all else, it requires an appreciation of "self-engineered wealth." Self-engineered wealth is wealth you create for yourself... without depending on a long list of costly financial advisors.

It also requires that you develop an appreciation of money-talk and capital.

We have also noticed, that "The truly wealthy", never trust all their savings to stocks.

The best thing you can do, for yourself and your family, is to start early and build capital and invest it wisely.

Most people only wake up -- if at all -- to this simple strategy, almost too late!

They are energy takers, not asset makers. They are keen and undisciplined spenders, not savers. They are hefty consumers, not asset producers. They are "being drained from" borrowers, not asset generating lenders. They are the conventional "follow me" thinkers, not the thinking beyond the wall and unconventional thinkers.

In fact, often, sadly, they have also outsourced their common sense, much to their health and financial disadvantage!

When it comes to your money, particularly during retirement, surprises are something you don't need. Avoid surprises, by expanding and knowing your circle of competence, and staying inside it.

Unfortunately, most people are financially and mathematically illiterate, so they don't understand, that the odds are way against big, fast gains in stocks. And that, is why an early understanding of the great power of compounding, the single greatest tool an investor can possess, remains, and is likely to remain, unexploited by the vast majority of investors.

Remember - this is very urgent - and take note: You only get one shot at compounding your wealth over decades.

As all of us are aware, particularly when interacting with aggressive retail therapy, it's not human nature to delay gratification. Nor is it human nature to want to spend time studying self-empowering material to make life easier down the track!

Now, I hope that you will take your first step down the road of self-engineered wealth.

Also, don't forget, that You are also constructing an income stream, that can add to your capital.

Many years ago, we noticed, and took note of, the fact, that, rather than getting another job, the wealthy people know, they have to send their saved money out to work for them.

To put it simply: If you're not making money while you sleep, you'll never become rich.

Napoleon Hill in Think and Grow Rich said, "Anything the mind can conceive and believe, it can achieve" and "When you're ready for a thing, it will make its appearance."

Today, 28 January 2013, I am reading, and certainly enjoying, Peter Male's -- Acquired Tastes, a must to-be-read book for all the particularly young and enthusiastic entrepreneurs, who still wish to acquire the necessary "trimmings" of success, and then, how to possibly squander their newly gained fortunes!

Don't forget, that through the often untapped power of your mind, you possess the ability and capacity to draw to yourself, the things, people, and circumstances, necessary to achieve your dreams and objectives.

Is it, therefore, beyond your imagination and capacity, to see what you can experience by sometimes relocating?

There's a dream keeps returning, like rain to the sea. There's a fire ever burning in the souls of the free. There's a lifetime of learning that it's all been in jest. And at the end of your journey, it's like you never left. Dave Mason

Informed proposed health procedure consent, can be effectively exercised only if the patient possesses enough relevant information, to enable an intelligent procedure or medication choice.

This is Your right to dignity

It is part of your PATIENTS' Rights!

It's never too late to visit your NATIONAL Patients' Rights Charter.

In the long run there is no constituency for bad information. In the short run, all sorts of moneymaking and other groups want to bend the facts their way.

The physiotherapist can guide you, point you in the right direction but certainly cannot travel the road on your behalf.

Helpful information needs to be in jargon-free language and given in informal and pragmatic ways that are separate from, but complement, healthcare intervention. The language gap between patient and health service provider is often kept wider than need be, either by lack of empathy, or occasionally, by the deliberate use of jargon in order to preserve dominance over the uninformed patient.

Some healthcare professionals, who invest their ego into their position, are wary about patients who want to be well-informed. However, the "mystique and mystery of medicine and healthcare", has, to a large extent, evaporated. In particular, thanks to the advent of rapid and relatively "cheap" electronic communication via the Internet. Such progress has drastically scaled down the egos of many healthcare "service providers.

Sometimes, "These health care providers are big-money people with big egos and well-payed careers to protect.

The previously influential and power wheedling gatekeepers of information and knowledge, are becoming less relevant. That voice of authority is now taken away from them!

The investigating information-seeking public is by-passing them.

They avoid practitioners who were taught and brainwashed by conventional, pharmaceutical and surgical-bound clinical conventions.

Sooner or later, to their relief, the chronically pain experiencing patient, will encounter a service provider that did not fit expected conventional healing patterns or standard dogmas.

The pharmaceutical companies created the morphine market; the market that should have no pain.

I'm against annual doctor visits for healthy people. No known scientific evidence, shows "annual physicals" help anything other than fill the pockets of doctors. And, often, some doctors are much too quick to prescribe pills, to fix whatever ails you.

Fortunately, by acquiring the necessary apparatus, you can monitor your own blood pressure.

I have always been of the school that you're better off having the information and trying to use it intelligently and judiciously to your advantage, as opposed to not having it at all.

The only -- and most important -- beneficiary of "open medicine and healthcare" is the patient! You must, however, be wary of jargon -- face-saving tickets such as "arthritis", "fibrositis", "lumbago", "rheumatism", "old age" and "sciatica".

This book is dedicated to you, back-owner, and a potential back-pain sufferer.

The text was compiled and written to enhance the quality of life of my extended family, patients and clients who have been so instrumental in its creation with their positive and questioning input.

This book is spiced with apt and to the point patient quotes.

CONTROL risk by knowledge and understanding.

The tyranny of distance from quality healthcare services is no longer an issue. The power of the printed word -- either on paper or electronically -- is extremely empowering, if only we wish to take advantage of it.

Fortified with knowledge, insight and an appreciation of some of the more frequent strain-disposing factors, you can be in command of the quality and well-being of your spinal column and life.

If "back care" isn't learned, it isn't earned.

Never stop being inquisitive about your health, illness and financial well-being. A culture stifling inquisitiveness is detrimental to a free people. There is growing consumer-led demand for non-drug solutions to health restoration care, under laid by rapidly improving media dissemination of information, pertaining to the adverse side effects, often associated with medication.

The growing awareness of the progressively health-informed public, that they are entitled to play an active part in determining the nature and course of remedial action, to improve their health, has similarly encouraged this trend. The result is that the health-restorative and pain relieving value of non-drug treatment approaches, such as those provided by physiotherapy, have risen in popularity.

There is also growing awareness that treatment by physical means, for trauma and body-abuse "conditions," is the first option! The "prescriptive" practitioners, who do not take cognisance of this public information driven fact, will experience natural attrition of their practises.

To introduce a non-drug healthcare oriented lifestyle, to a drug-eager population, reared on the "advantages" of pain killers, is daunting but growing much easier on account of patient health awareness self-empowerment.

However, there is mounting concern among the more informed members of the public, about the possible impact of the use of pharmaceutical and recreational drugs by people involved with the recent alarming number of gun-related mass killings.

How the public is lead to believe that drugs are the substitute for normal human tragedy-related emotions: consider, in fact, if grief is not a psychological "disorder" but rather a completely normal human response to tragedy and disaster? Look at this tell-tale headline:

"The drug-wielding grief industry rushed to Connecticut to help kids "deal with" the tragedy at Sandy Hook Elementary School.

The professionals will help you and your kids with some self-esteem training assisted by some "little pills."

Consider the possible consequences if mind-numbing, perspective-distorting psychiatric drugs make matters worse by disconnecting the group or individual from reality.

Further, what are the future implications, if the non-caring mass murderer, was a user of reality disconnect psychiatric drugs?

What, if you consider that the hard pushed psychiatry is no substitute for friends, supporting family, and community?

The alarming fact, is that One in 10 Americans are already taking medication for psychiatric disorders.

Sadly, a substantial proportion of the public is more dependent on prescribed drugs for taking care of their problems, and less patient, self-reliant and resilient than before.

It is quite obvious that, financially, the psychiatric industry is booming. Evidently, many instances of violence have been linked to psychiatric drugs.

More and more we are motivated by our health service providers and the pharmaceutical industry, to resort to Comforting Ourselves With Drugs.

How did this happen? And who, or what, is to blame for this?

Is it perhaps due to the possible over psychiatric medication that turned drug-dispensing psychiatry into a growth business.

"The successful financial commodification of fear, pain and grief, also proceeds at leaps and bounds.

Yet, not everyone experiences pain or grieves in the same way.

It is not the "professional" health service providers, or counsellors, that provide the best support for grievers, but rather, understanding, empathetic family, friends, and colleagues!

Imagine the dull world, that left us the well known and loved musical artists, authors, painters and sculptors had they been the victims of the various drugs that are at the order of today?

There would be no outstanding concerts of time honoured people like:

TCHAIKOVSKY, MOZART, SCHUMANN, CHOPIN, SHOSTAKOVICH, BEETHOVEN, LISZT, and many more.

Furthermore, imagine, if these folks had been on any of today's chemical diets?

Let alone the magnificent works that adorn the remarkable art galleries, museums and other art centres of the world.

I leave it to your creative imagination, to build up a possible -- "we are deprived" -- list of names that might have been lost if subjected to the various drugs that are available at present.

Mind numbing drugs would likely have kill their persistence and creativity. And what are they doing to our generation?

I believe they are killing our creativity and determination.

Drug therapies cannot replace ethics, religion, and the support of empathetic, caring family, friends, and community.

Body or Psychic pain, is not always a pathology that must be chemically or pharmaceutically cured.

If your health care service provider, is quick to want to medicate your or a loved one, and you do not feel happy about the possible impact, of mind numbing or character changing drugs, always feel free to get a second or third opinion.

Remember: You are part of an international growing number of folks who are getting more self empowered about both their health and financial status. You certainly are actively interested in your own health; you're not crazy, and you're not alone.

Use your newly acquired self-empowered status, don't be intimidated.

Don't become part of The Homogenisation of the lookalike patient and personality.

Patient and personality homogenisation has become something of an healthcare objective. If it continues, it might turn out that all future people will, more or less, look alike.

These fear generating intimidation regulations, are responsible for the outsourcing and disappearance of the built-in protective gut feeling and common sense that is there to take care of our best interests.

More and more we are motivated by both our lack of taking an active interest in our personal health information, as well as being stimulated by some of our health service providers, and the pharmaceutical industry, to resort to Comforting Ourselves With Drugs.

Is it really true, that they are the masters and we are the submissive slaves, and we are to accept our lot in life?

But the concept of patient empowerment, itself seems to rule out the possibility that well informed patients can work out problems for themselves, without the perceived need for often unnecessary surgery or drugs?

What's urgently needed is a thorough international probing in to the associated effects of prescription medications, on violence.

MANY popular drugs often have very serious side effects. Often, these drugs are prescribed as an answer to the moral problems that all of us have to confront. These drugs don't resolve moral dilemmas; they disguise them and confuse the issue.

Frequently, too, the adverse side effects of the drugs are not pointed out to the patient. This may put them at risk, when involved with handling equipment at work, motor vehicles and many more!

Sadly and regrettably, from an elevated and superior position, often condescendingly, we are being treated like children. Wait, not even that. Often, We are being treated as if we have no insight, say, or even brains at all!

Unchecked, without your informed active partaking in your health direction. The situation can be very serious.

In the end, if the goal is to protect your health and well being, it is time to become proactively involved in your health care self empowerment program, as soon as possible.

The test of the value of a treatment, is not whether it is accepted as orthodox, fashionable or respectable, but whether it works. Each of us must find the "things" that promote his or her own healing.

EVERYTHING we believe is a theory. Are we smart enough to understand the theory of everything? At present know.

The Only thing, any theory has to commend it, is whether it "works or not." Does it help us to get well and to maintain a state of good health? If it does, for us, then it is a very good theory. For many people it is a theory that works since it brings healing without danger. It is a matter of the patient taking more responsibility for their own health, instead of abdicating responsibility to a healthcare expert, who is expected to banish illness through the "magic" of their "prescription forms, Hypodermic syringes or "scalpels. Healing, after all, is an amalgam of science, art, experience and expertise.

Guided by what the patient divulges to the physiotherapist, and the results of any possible and relevant investigations, it is up to the therapist to do the crafting of the appropriate long and short term treatments, to meet the requirements of the patient.

My wish is that this book will provide some of the knowledge and insight necessary for the creation of a more equitable balance between healthcare experts and patients.

Our error is, that frequently-prevailing prejudice or selective ignorance, turns us to drugs and surgery as first alter- natives, instead of waiting until we have exhausted natural, harmless forms of treatment.

Prejudice is a restricting burden that confuses the past, threatens the future and renders the present inaccessible.

At present, there is so much, scary financial, Inflation and patient disinformation, that must be carefully analysed.

We have to reshape the memory of prejudice, status, knowledge, painstakingly and expensively acquired over many years.

Introducing new concepts and treatment forms to established practitioners is threatening for those in a prescription and treatment rut. They are likely to be resistant to replace knowledge, painstakingly and expensively acquired over many years.

Painkillers cure little. Their only function is to shield the underlying problem. Pain is often the "sounding board" for patients' persistent anger, depression, fear, frustration, stress and tension. Often this is the result of "the underlying mechanical cause" of the pain not being addressed "by corrective treatment.

Patient morale is a very important health- restoring factor. Their emotional state can determine how effective the treatment or rehabilitation outcome will be. This too, can prolong the period required for treatment.

What we urgently need, is a long overdue, health and finance self empowerment enthusiasm renaissance.

Anthony: "it's only when he puts his hand in your mouth that he starts making money." Re dentist!

Hope is bleeding away!

"I want to build a structure that can look after me and my family."

Although your body has the capacity to heal itself, physical therapy treatments accelerate this process and help ensure a more complete recovery. The socio- economic and health benefits of commencing early physiotherapy treatment and rehabilitation, are, therefore, overwhelming. Furthermore, the "suffering period" is diminished; the side-effects of drug consumption, too, are reduced.

But most important of all, the patients are actively and constructively involved in their health goal-setting improvement objectives.

All technologies and sciences need to be mastered to harness them for the benefit of mankind.

Persistent pain is like poverty -- debilitating, demoralising, lingering and energy-depriving -- that is, if you don't do something active and positive to alleviate it. Don't let discomfort or pain accumulate. Be kind to your back -- you'll miss it when it's gone.

Preconceived ideas are the locks on the doors, to an enhanced lifestyle, wisdom and a better quality of life.

No single practitioner can escape the judgment of time, which will be rendered upon the actions we take \-- or do not take -- and the advice we give -- or fail to give our patients.

Our effectiveness as healers, rests not only in the acquisition of "imposing" skills and knowledge, but also depends upon our capacity for sincere empathy and compassion, as viewed from our patients' perspective.

When it comes right down to it, those human traits are often more important to the welfare of the patient than the technical dimensions of our skills.

Knowledge and expertise management is important to leverage what we learn, so that we can do the healing job faster and more efficiently in the future.

Treatment is like a recipe -- getting the right "ingredients" together to get the optimal results.

To do my job is immensely rewarding, because often I'm directing and affecting enthusiastic and keen young minds.

"Never deprive someone of hope; it might be all he or she has."

DISCLAIMER: The work included in this publication, is based on currently prevailing leading edge information. It may contain errors, and you shouldn't make any health, investment or other decision, based solely on what you read here. Technology, skills, and information, are moving ahead at an increasing pace. Therefore, always confer with your health care team, your financial and investment team, to keep up to date about the latest available information that will aid, you and your family, on how best to help with your requirements.

What is your Status And Fortune worth without The Support Of a Well Cared For Back?

After all, it's your future, your health, your financial money management, and your very important personal responsibility!!!

INTRODUCTION

"Oh, it hurts so much! Whatever I do, aggravates the pain!"

"I had to give up my job on account of the backache!"

"Backache, seems to drain away my energy, my vitality, my enthusiasm and desire to work!"

"As for sex, well, it's just not on. It's seriously affecting my marriage!"

During my varied career, in various countries, as a practising Chartered Physiotherapist, I have often heard these and similar devastating comments. They portray the pain, frustration, anxiety and fear, of the victims of spinal injury or spine distortions.

To all these patients I owe a great debt. They have, in various thought-provoking and practical ways, been instrumental in the birth of "My Precious Spine and I."

Knowledge and understanding of the spinal column, and its functional environment, are great ways to eradicate fear and anxiety.

I have said enough to indicate that your happiness, health, and joy of life accomplishment, as well as the hope for man's future, lies in understanding the back care Principles.

I have written this book, so that you can understand and use the back care Principles. Science does not have a monopoly on our in-borne curiosity.

Its acceptance and daily application, is up to you.

It is with the _lessons_ of spinal injuries, and spinal distortions, rather than with spinal injuries themselves, that this book is concerned. Spinal care information, based on years of practical experience, is offered without mystifying and confusing medical jargon.

This is about, Evangelising the most important subject. Back Care And Improving Quality Of "Life!

Know and control your nature; know the limitations of your body; do everything in moderation.

Do everything with your whole heart, because you never know what long-term influence it will have.

Spending for _dependence_ , is _much_ more _expensive_ than spending for _preventative independence_. A well-looked after back is a money saver. Particularly so, when one is looking forward to it's _pain-free support_ when _retiring_.

On occasions, particularly when the patient's healing expectations supersede their possible healing or recovery schedule, they want to know "why is my progress so slow."

But it's not all in the mind, we have to tell patients this.

However, we often must first Nurse the patients through their initial pain.

We know that the sensitive and complicated nervous system, is plastic and changes. We also know negative thoughts, feelings, job fears and behaviours will prolong and maintain pain.

Helping people understand the mechanical and physical reasons for their pain, is a vital and important factor to enable them to become proactive, to confront their apprehensions and fears, and to control it.

A policy of dynamic inaction. Fraud; Crime; corruption.

Remember the golden rule: He who has the gold, makes the rules.

"The worst crime of all: being boring!"

Weirdness itself is normal -- and makes us human.

I like to tell patients, that their muscles are one of their most precious assets and that they should be kept in good condition and nurtured and looked after for as long as possible. The important thing to remember about pain, is that once it's gone, it leaves no obvious scars or residual feeling. That is to say, you can't memorise pain, the way you can a favourite song or poem. You can always say: "Oh, it's just bloody awful." But there is no impressive sensation, no actual physical twinge that accompanies saying such a pain recall sympathy inducing thing.

On occasions, it might rather seem like elastic pain.

Daily I listened to pained recounting, by those whose lives had been touched by motor vehicle accidents, violent domestic and theft-related crime, piecing together facts to form a back ground picture of their suffering. Yes, several times, female patients tried to hide the body-evident trauma caused by a violent partner or husband.

I well recall a young lady, suddenly erupting about the facial trauma inflicted by her boy friend. He, incidentally was living in her house at the time. As we released the pressure from a valve, about to blow, she began to relax. And the traumatic detail emerged, piece by piece, until the horrifying picture, inside her memory, was finally on paper.

Sadly, only then did she begin to respond to the required treatment.

By taking the time, to listen to the details of these distraught patient's ordeals, I was discovering descriptions of vicious attackers, that were in conflict with the sketches of suspects, created by the media.

Often, patients open up while they are having treatment -- and the longer I listened, the more detailed the victims' traumatic memories became. It took time, and an empathetic disposition, to get to the real patient's impressions.

And the already overburdened motor vehicle accident investigators, didn't have the time.

I began to take meticulous note of what the patients were "communicating.

Meanwhile, I developed my linguistic and professional diagnostic ability to translate a patient's words and account into a pain-causing image.

It's not that the healing task becomes easier, but that with mounting experience and empathy, our ability to do it becomes better.

It's about using your expertise, to meet ALL a particular patient's needs in your area of expertise and knowledge.

As a health care service provider, you may be handling your patient's present complaints, but that's a small part of their total health picture.

They probably have many other urgent problems, that are eating away at their reserves. As a health care professional, you're doing your patient, a disservice if you don't direct them to the ones that make the most sense for their individual situation.

Sometimes, when dealing with patients who either sustained severe injuries at work or during a motor vehicle accident, we find that There are so many emotions hanging around our necks and competing for attention, that unemotional conversation, is not easy.

The motor vehicle victim, who has a regular well memorised symptom pattern and unchanging pain or discomfort routine, immediately makes himself more vulnerable.

Mrs. Wilson, divorced from a sponging, adulterous husband -- who had affairs between their first and second child; catching him in their bed -- contacted the auctioneer "you must take the bed immediately; or else, I leave it on the street!"

Always Try And Take the Best Possible Care of Yourself and Your Precious Spine.

The back care wish, must be father or mother, to the preventive action.

CHAPTER 1

MY PRECIOUS SPINE AND ITS CONSTRUCTION AND FUNCTIONS

The spinal column, is a very sophisticated, highly developed and efficient mechanical supportive and weight-transferring mechanism. It houses a complex inter-body parts communication system -- the spinal cord. It supports the head, trunk and arms in the erect position.

This most amazing "stable instability" mechanism -- the spinal column -- consists of thirty-three vertebrae, stacked (more or less) one on top of the other. Interspersed between the bony vertebrae, are the relatively flexible and shock-absorbing inter-vertebral disks. An elaborate "tethering and securing" system is in place to secure the mechanical spinal column components in their correct interrelation positions.

It is evident, from observing one's own body that the column has several curves.

The spinal column, is divided into the following sections, commencing from the head end:

The cervical, thoracic and lumbar spine, followed by the sacrum and coccyx.

In my practice, I deal mostly with down to earth, pragmatic people. The following practical analogy of the spinal column, is always of assistance in aiding understanding:

Imagine the spinal column as consisting of a pile of motor car tyres, interspersed by inflated inner tubes.

Now imagine yourself standing inside this column. Extend your arms sideways at shoulder level.

Imagine it so happens that a sleeve-lined hole through the inner tube accommodates your arms at shoulder level.

We call the tyres the vertebrae; the inner tubes the vertebral disks; your trunk the spinal cord and your arms the spinal peripheral nerves.

In this analogy, if for any reason the inner tube at the level of your arms is deflated, your arms will get "pinched" at the points where they extend through the "inter-vertebral spaces."

It is evident, that with such a complex, and frequently totally abused structure, almost endless "things" can go wrong.

Pain is inevitable. Suffering, however, optional.

(For more anatomical information concerning construction of the spinal column, consult a manuscript dealing with anatomy. The local library or the Internet should be of assistance.)

THE CERVICAL SPINE -- (The neck) -- seven vertebrae:

This part of the spine supports and balances the head. It also provides infinite variable mobility to satisfy our visual and hearing requirements.

Because of this very considerable amount of collective mechanical mobility of the cervical spine, it also happens to be particularly vulnerable and "trauma sensitive."

The cervical spine is often "brutalised" by whiplash trauma, inflicted by a motor vehicle accident. This is particularly true, when a vehicle is impacted from the rear. The problem is compounded by the absence of well-designed and constructed head restraints, that form an integral part of the backrest of the car-seat.

THORACIC VERTEBRAE -- between the neck and lower spine -- twelve in number:

These vertebrae, form an integral part of the rib cage. At the back, the ribs articulate with the thoracic vertebrae, enabling the chest movements for breathing to occur.

The thoracic spine is relatively immobile. It is also the area between the shoulder blades, where tension-induced muscular tightness and aching frequently occurs. This is particularly evident, following prolonged knitting, typing, computer or handcraft sessions.

In the event of an impact injury on the front of the chest, a great deal of impact force is transmitted via the ribs to the thoracic spine. The joints between the ribs and thoracic vertebrae frequently get injured when this occurs. Distortion of the thoracic spine and the associated joints can cause impairment of deep breathing.

A tight "band-like" feeling around the chest, or a "heart attack" chest pain, can also originate from the thoracic spine. It is, in the latter case, imperative to seek immediate medical advice and assessment.

LUMBAR VERTEBRAE -- lower back-- five

The lumbar vertebrae have the arduous task of transmitting the weight of the head, upper limbs and trunk -- as well as any weight being carried -- to the pelvis when sitting, standing, walking or running. Here, a greater degree of movement, than at the thoracic spine, is possible. The lumbar spine, particularly at the third, fourth and fifth inter-vertebral spaces, is frequently subjected to lifting-abuse-stresses. Lower back pain, at times affecting internal organs, originates here.

Pain, pins and needles and numbness, affecting one or both legs, can originate from the lumbar spine.

SACRAL VERTEBRAE -- fused to form the sacrum -- five in number:

The sacrum is located between the hipbones and articulates with the lumber vertebrae above.

COCCYX -- usually four rudimentary vertebrae fused together constitute the triangular tailbone:

The coccyx has, attached to it, some of the muscles that move the tail in lower animals. It is usually incapable of wagging in man. It is particularly vulnerable to fracture when falling down stairs or on your behind. In such cases, it usually gives rise to a great deal of pain.

The vertebrae are numbered from the top, cervical -- one to seven, thoracic one to twelve, etc.

Provision is made on either side, between the adjoining vertebrae, for the accommodation of the spinal nerves that communicate with the spinal cord.

My precious spine is a miracle of mechanical, structural and functional engineering. It also houses one of the most sophisticated electro-mechanical communication systems, the spinal cord.

My precious spine is primarily a mechanical structure. It therefore is subservient to the rules and laws governing structural and mechanical engineering. It is evident that a practitioner with a mechanical bent of mind and a functional approach to daily living will stand you in good stead whenever you have spinal problems.

Philosophical Mr. Thornton: "Your back's your bank manager and will determine how well you'll live!"

CHAPTER 2

WHY DO I GET BACK- AND NECK-ACHE?

Compatibility between your spine and the postures you adopt, for the execution of your daily activities must, at all times, be optimal. Distortion of this very important _marriage relationship_ , between your spine and the correct functional posture, adopted during your everyday activities, will soon herald the instigation of _divorce proceedings_ \-- the onset of back- or neck-ache. It is thus important that you shall, at all times, interrelate the protective requirements, of your precious spine with the least abusive functional posture. A good posture, therefore, is mandatory in finding the dynamic range of _functionally_ less _abusive positions_ for the body and spine to assume, when executing a particular activity.

With the exception of spinal birth defects, the majority of back and neck-related aches, are caused by a disregard for the spine and functional- posture-compatibility. This disregard, mainly based on ignorance, is generally caused by a variety of situations and circumstances.

You, no doubt, must have come to the conclusion, that there must be some great force at work against the welfare and interest of your spine and you!

No doubt, you too, must surely hold the view that these great forces are in response to some pecuniary interests!

I shall now name some of the backbreaking forces I have alluded to:

STRUCTURAL ENVIRONMENT:

Does your home and garden _fit_ your body and spine _comfortably_?

OCCUPATIONAL MAL-ADAPTATION OF EQUIPMENT:

Is your desk, drawer and related _equipment_ layout the most advantageous? Is your workbench height relationship correct?

PUBLIC COMPLACENCY:

I have a great affinity for the opinion of the individual. Public tolerance is the commercial counterpart of public complacency.

Do you accept, without voicing your opinion if indicated, the standard and quality of seating offered in your mode of Transportation?

Do you question the backbreaking design of your furniture and household equipment?

You should, however, in conjunction with an architect or draughtsman, pay due attention to the _centre_ around which all your _activities_ occur -- _your precious spine_. Think of the heavy and cumbersome vacuum cleaner that has to be dragged around the home -- not to mention the distorting manoeuvre involved in getting it up and down the stairs.

DISREGARD OF LIFTING AIDS OR LIFTING HELP:

A variety of inexpensive aids exist, minimise lifting and transporting back strains, both at home and at work.

BEDS AND MATTRESSES:

How do you go about selecting the correct bed, the correct mattress? How do you sleep on that mattress? How do you make the bed?

LACK OF SPINAL CARE EDUCATION AT SCHOOL, AND AT HOME:

Inadequate spinal-care education, both at home and at school, is exacerbated by an equal lack of setting spinal care examples. The expense incurred by treating spinal injuries is compounded by the accompanying frustrations and lack of productivity. These considerations alone, excluding the often-accompanying pain and agony, give a spinal-care education program a very high priority rating.

The quality of your sex life, too, is closely related to the state of your lower spine. If your back is sore you may not even want to think about it.

CHAPTER 3

MY PRECIOUS SPINE AND MY HOME.

Your home must accommodate your family -- your wife, your children and yourself comfortably. It must provide adequate space for all members of the household, to indulge their respective pre- occupations and hobbies. Your home should instill a sense of permanence and stability. It should also provide security and safety as well as inducing pride.

A Home Defence Plan

Depending on which part of a country or the world you live, it is prudent to seriously consider establishing a personal and property protection plan.

Of late, more attention has been focused on international political, financial and yes, even food riots.

Self Defence- How to prepare a "total home defence" plan. What you need to know about home invasions

When people are income deprived, as well as work opportunity eluded, the incidence of violently entering your home, is on the traumatic increase.

A man's home is his castle.

The purpose of this discussion is to point out a few basic precautions and facilities available to increase home and personal security.

What you need to know about home invasions

With the online ease of access to almost any part of the world, or any person, it is getting more frequently reported that one's online security and safety is being violated and intruded upon. It is a most desirable and regular practice, to update the internet security systems and walls, that are in place to provide protection to possible online intrusion, to your very personal computer stored information.

In various growing parts of the world, communities live behind security walls or fences.

Furthermore, additional personal home security, with an electronic radio wave link to a security company, is often advisable.

Consult about local security, with both local security service companies and with folks living in the area in which you intend to either rent or buy a property.

Periodically, check the parameter and entrance to your residence state of safety security.

Similarly, in the event of a fire, would it be easy and fast to get out of the building.

Unusual tips for hiding valuables in your home

The only real practical tip in this regard, is not to flaunt your valuables or wealth.

When it comes to defending yourself from being a target of a lawsuit, especially a frivolous one, the lower your wealth profile and the more difficult it is to assess your true net worth, the better off you are.

What about natural disasters and emergencies

More and more frequently natural disasters, by way of floods, hurricanes, earth quakes, fires, and a growing catalogue of life and property destructive events occur.

Here too, as we have recently noted, with most natural disasters, food, water, shelter and safety are at the top of the requirements list.

Not to forget safety and security of personal and identification documents.

I also note, that more and more folks -- including the ladies -- are attending self defence classes to enable them to protect their person and families.

I have had several woman patients report the successful encounters they had with on-street muggers.

Their success -- Preparedness.

When you consider acquiring an already established residence, you must take in to account pre-existing or anticipated health problems.

Prevention of spinal strains and injuries is aided greatly, by the careful selection of a future home.

I have a patient, an ambulance driver, who had to retrieve an unconscious victim from the third floor of an apartment building. In the process, my patient sustained a severe back injury. This prevented him from further duties as an ambulance man.

All this, it transpired, was the result of the apartment dweller's inattentiveness to his own condition.

EASE AND SAFETY OF ACCESS TO RESIDENCE:

Your precious spine resents carrying the day's heavy shopping over a long and cumbersome distance, as does the rest of you. You must pay special attention to the existence of stairs and slippery surfaces.

SPLIT-LEVEL OR MULTI-STOREY HOMES:

Acquiring a split-level or multi-storey home will really get your _back up!_ The use of serving trolleys in the home is automatically penalised. Lugging domestic equipment such as vacuum cleaners and polishers up and down stairs, has little spinal appeal.

GARDEN LEVELS:

Here you must decide whether you have a green thumb, or whether you can afford to let someone else do the backbreaking work for you. If your gardening enthusiasm gets the better of you, then you must look at the accessibility and inclines involved. Can you get to all parts of the garden with a wheelbarrow, garden trolley or lawnmower? Is it a _labour intensive_ garden? Has the area an adequate and dependable water-supply -- or will you, from time to time, being subjected to water restrictions, have to carry water in a bucket? The latter aspect of gardening has a high spinal distortion mortality rate!

LOW MAINTENANCE:

The marked increase in labour costs are reflected in the rapidly expanding "do it yourself" industry. Does your home you are about to acquire threaten to involve you, at an ever-increasing tempo, with its rapid expansion? If the writing is on the wall, both your pocket and your spine will object. Careful consideration will doubtless enhance your appreciation of a low maintenance home.

PRACTICAL CONSIDERATIONS WHEN DESIGNING A HOME:

Conceptualising a home to be constructed can be rather awesome and overwhelming. This is particularly magnified if one has had no previous experience as a homeowner. Whenever you exceed your limits, the ever-present financial ceiling jolts your head -- a painful and somewhat unpleasant experience for your neck.

You should, however, in conjunction with an architect or draughtsman, pay due attention to the centre around which all your activities occur -- "your precious spine". The initial overwhelming awesomeness of planning and designing the project, is soon replaced by a proper perspective.

Keep in mind that many "home-design" computer software programs are available. You can play about with them to get some practical ideas about how to make your home dreams come alive.

"What on earth are your requirements in and around the new home?" When you can answer _this_ question, you gain a clearer focus on how to systematically resolve the "requirements" headache. To aid both you and your spine in the correct direction, you must consider the following:

THE TERRAIN ON WHICH THE HOME IS TO BE ERECTED:

Is the ground level and accessible, or is construction and gardening going to be a _backbreaking_ exercise?

Has the block of land got adequate water drainage? If storm-water drainage is inadequate, guaranteed erosion by storm-water is bound to occur -- yet again causing "undesired spinal strains". Flooding of the home itself poses potential expenses, frustrations and the possible lifting of water-soaked carpets. This preoccupation to being spine-unfriendly, is often vehemently resented by the olfactory sense organs.

This morning Mrs. Watson, an elderly lady, complained that "I can't get my car out of my driveway. I have to back it down a very steep and narrow driveway on to the street. It's my neck and this fractured wrist, you know!"

Mrs. Watson's case illustrates the importance of accessibility to the property. She is now dependent on help -- which, for her, is very frustrating.

GEOGRAPHICAL AND STRUCTURAL LAYOUT OF THE HOME:

Primarily, you must decide whether you require a single floor, a split-level or multi- storey home. Which will be the most _advantageous_ way to locate the home to enable you to use the prevailing climate to your advantage? Do you require solar assistance in the bedrooms and any other area during winter?

How can locating the home aid the _domestic executive_ in her kitchen? Preparing an evening meal, with the sun blazing on you is not particularly welcome on a hot summer's day.

Having decided about the _elevation_ requirements of the residence, you must now determine the nature and number of rooms to be incorporated. Their inter- relationship, too, must be based on time and motion concepts. To minimise carrying the day's shopping, for example, it is advisable to locate the pantry or bulk storage area on the same level near the garage. The size and composition of your family will determine the nature and number of rooms to be incorporated in the design of the home.

Most homes will include some, or all, of the following rooms:

Kitchen, dining-room, pantry, bedrooms -- main and children's, bathroom, lounge, recreation/ family-room, sewing-room, study, workshop -- garage, toilet and patio. Each one of these rooms and areas has its own back saving design requirements. Before considering specifics however, attention must be focused on a few general back-strain-reducing points.

CORRECT HEIGHT OF WORKING LEVELS AND WORKBENCHES:

My precious spine shows its resentment to a prolonged stooping posture, by registering an _ache_ between the shoulder blades, as well as the lower back. You must therefore, guard against this stress _provoking_ folly when designing your home.

_Correct working level heights, for your requirements_ , must be specified on the designer's plans and be adhered to by the builder and cabinet maker.

To calculate the correct working-level height for the kitchen worktop, for example, proceed as follows:

Wear the type of shoe that you normally wear during your domestic activities. Stand tall with arms by your side, fists lightly clenched, thumbs pointing forward. Keep your elbows by your side and bend your forearm about forty (40) degrees, your fists are now slightly in front of you, thumbs pointing forward, and slightly upward. The measurement between the _underside of your clenched fists_ and the _floor_ on which you are standing, is the _correct height_ for your working surface. (The more degrees the elbow is bent, for example fifty (50) degrees, the _higher_ the work-surface will be.)

POWER POINTS, LIGHT SWITCHES AND DOOR HANDLES:

General utility power points must be located at such a level, so as not to force you down on all fours, when connecting domestic appliances, such as a vacuum cleaner.

Accessibility of light switches, must not be beyond the reach of any _miniature_ occupants of the home. It can be distressing for a toddler, not to be able to reach the light- switch or the door-handle of its bedroom.

KITCHEN:

When you work in the kitchen it is your aim to accomplish the task in hand without excessive walking and _bending_. In fact, the kitchen must _fit_ the _domestic executive_ like a well-designed dress. It must enhance both her comfort and self- esteem.

First, you must determine what facilities you wish to have available in the kitchen. This will influence the allocation of space in the layout of the plan. You must, further, decide whether you will require an _interconnecting_ facility between the kitchen and the adjoining dining-room. This can be in the form of a serving hatch or a _split level_ bar-counter. In our household we prefer the bar-counter arrangement, which facilitates ease of serving when entertaining. It also provides some storage space and creates the illusion of spaciousness. Most appreciated, of course, is the _communications facility provided between the breadwinner_ on the one side and the _bread- baker_ on the other!

WHAT APPLIANCES DO YOU REQUIRE IN THE KITCHEN?

Dishwasher; double sink; food-blender and accessories with appropriate storage space; fume extractor; garbage disposal unit; microwave oven; refrigerator and deep- freeze units; stove and oven. Various electrical appliances; can opener, coffee-grinder, coffee-maker, electric knife, electric sharpener, toaster oven, toaster, etc.

WORKING-HEIGHT LEVELS:

Adequate bench-top space is always appreciated. You must make sure that it is at the correct height to please your patient spine. The material, used to cover the work surfaces, should be scratch-resistant and easy to clean.

STORAGE SPACE AND STORAGE REQUIREMENTS:

The use of electrical or mechanical aids in the kitchen, is closely related to the ease of accessibility of the device in question. If, for example, you have to retrieve the food-blender from a cupboard, at floor-level, each time you wish to use it, your natural resentment of difficult manoeuvres may deprive you of its use. However, on the other hand, if the food-blender and its accessories have their own home, you will frequently call upon them to assist you with food preparation.

When designing the layout for drawers and storage space in the kitchen, the golden rule is: _The things you use the most_ must _be nearest at hand_.

STORAGE SPACE PRIORITIES:

Storage spaces and areas, correctly located, are a very prominent _back-saving_ feature. Less frequently used articles can be stored further away from the "correct" position."

Cutlery drawers, with divisions, should be located immediately under the worktop. If a bar-counter is used between the kitchen and the dining-room then these will be located _under_ its lower terrace. Removable, molded and snug-fitting plastic drawer divisions are available. Their use makes cleaning much easier. Drawers, to store the other cooking- utensils, should be located _under_ the cutlery drawers of the workbench. Below these drawers should be the storage-cupboards for larger items.

If storage cupboards are mounted against the walls, above the workbench top, then adequate clearance between the bottom of the wall-mounted cupboards and the top of the workbench is essential. Here, too, care should be taken that the interiors of the wall-mounted cupboards should be deep enough to accommodate the diameter of the dinner-plates, when the doors are closed.

Particular note should be taken, that the front to back measurement of the wall-mounted cupboard, is less than that of the workbench top. This "head space," is most essential, so that it allows for your head when bending forward whilst working at the workbench.

COOKING AREA:

Your spine finds it easier to move heavy pots and pans from the stove, by gently sliding them on to the adjoining work-surface. It is therefore advisable to have the stove and adjoining work-surface at the _same level_.

Fumes carry food-particles that are deposited on cupboard tops, walls, furniture and floors. This is a source of "built-in labour" and your "precious spine" at once registers pangs of resentment! If smoke- or fume-generating appliances are used for preparing food, they should be placed next to the stove, under the "catchment" area of the fume- extractor overhead. These include frying pans, fish fryers, chip makers, waffle irons, toaster ovens and many others. By far the best fume extraction system, is the type incorporating a canopy. The fumes are exhausted via a filter and ducted to the outside of the home. This system may include a variable-speed fan, washable or disposable filter and canopy light.

The eye-level oven, is a back-saver too. It is particularly important that the oven-door should be hinged at the _side_ and not at the _bottom_. In the latter case, the door will flap down, and expose the hot inner side, just waiting to burn your forearm.

WASHING-UP SINK:

A stainless steel double sink -- with an outlet strainer -- is a hygienic time saver. Here, too, stooping for prolonged periods whilst washing the dishes, is back straining. If the top of the sink is at workbench level, the sink should be at a correct functional height.

Your "precious spine" is always grateful, when it hears that you have acquired heavy kitchen appliances, with castors. It is less ruinous on both your spine and the floor to move these appliances for cleaning or repair purposes.

The dishwasher should have its power, as well as the water supply points and drainage facilities, immediately behind and above it. Failing this, it may be necessary to adopt difficult postural contortions, to get at the respective points possibly concealed in a cupboard.

GARBAGE AND WASTE DISPOSAL:

An electric waste-disposal system may be an asset. However the _organic_ gardener will probably resent this idea!

Space must be allocated for the _garbage container_. This must be of lightweight material and not require back-bending to open the lid. The container should be lined with a biodegradable plastic bag. Your "precious spine" will be exuberant with delight when it notices the garbage container is mounted on castors.

FLOOR AND WALL CLADDING:

You spend a lot of time standing or walking in your kitchen. Should this provoke discomfort or backache? Certainly not! Placing your foot on the floor, when walking, amounts to a hammer blow. How can you reduce the _impact_ of this blow, which is transmitted via your leg to your spine? The floor cladding must be pliable, non-absorbent, easy to clean and scratch resistant. Washable wall cladding reduces maintenance and enhances kitchen hygiene.

POWER POINTS AND LIGHTS:

Trailing power cords constitute a very real danger. More so when they are within reach of inquisitive miniature people. Insufficient, or ill-placed power-points, generate frustration in the kitchen. This, in turn, may limit the use of those labour-saving electrical-appliance gifts. You must, therefore, determine in advance, what your power- point and lighting requirements are going to be. You must also determine their exact location.

We find the availability of the following power-outlets very practical:

Bar-counter top _(if interleading to the adjoining room)_ \-- particularly convenient when entertaining for connecting coffee-maker, hot-tray and trolley, etc; can opener; deepfreeze unit; dishwasher; electric kettle or jug; food- processor -- housed in storage cupboard; fume-extractor; microwave oven; computer and communications system; radio; refrigerator; stove -- with eye-level oven if desired; TV; CD/Tape player; waste-disposal unit, etc.

The best light source is the ceiling-mounted energy saving or fluorescent strip lighting. The fume- extractor canopy light is an invaluable aid when cooking on the stove.

WATER-SUPPLY POINTS:

It is obvious that a hot-and-cold water- supply is required at the sink and dishwasher. A central swivel spout, over the sink, provides water-temperature control and is the ideal. Particular care, must be taken to ensure that the tap-heads are out of the path of movement, of the crockery, from one sink to the other. Failing this, chip marks will soon be evident on these precious articles. A practical hint here too, is to fix a short segment of durable rubber or plastic tubing to the end of the spout to make it less "dish-lethal."

Many refrigerators have an ice-making facility incorporated. They, too, require their own water supply.

CHOICE OF APPLIANCES:

I recently had a little middle-aged lady require treatment for a back complaint. "You won't believe this," she reluctantly related, "but I fell into the deepfreeze. Thank heaven, there was somebody else at home, who heard my shouts for help!" It transpired, that this very active little lady attempted to retrieve some frozen food, from a chest-type _deepfreeze_ unit. The movement of her centre of gravity, unceremoniously added her to the contents of the freezer. This ungracious ceremony had, as its heir a rather painful back.

When acquiring kitchen or any other appliances, you must at all times ask, "How much future labour, stresses and strains, maintenance expense, and _elbow grease_ am I buying?" A self-defrosting refrigerator and deepfreeze unit is a welcome labour-saver. This is particularly true in a high humidity climate. The self-cleaning oven is another welcome friend.

There are two approaches to the dishwasher. Loading from the top or from the front. If you decide on the latter type, have it mounted on a trolley to bring it up to a proper loading height. Failing this, you will have to squat down to get to the task in hand.

DINING-ROOM:

The dining-room and kitchen should be adjoining and on the same floor level. This facilitates the use of a back-saving serving-trolley. Here, too, a power-outlet is essential for connecting electrical aids, such as an electric- knife, warming-tray, coffee-maker, etc. An overhead intensity and height-adjustable light can add to the dining atmosphere.

LAUNDRY AND PANTRY:

The laundry must be on the ground-level floor, if at all possible. It must accommodate the washing tub -- at the correct height, the washing-machine -- top-loading; clothes-dryer (incorporating a fluff filter) -- which might require external ducting and which may be wall-mounted to save space; laundry-trolley and basket; broom and cleaning equipment cupboard.

Clothes-dryers, that offer the choice of using either the exhaust air-vent located at the back or either side of the unit, are available. Additionally, a flexible hose can be connected to the exhaust-vent, thus allowing the hot and damp air to be piped to the outside of the building, via a window. A further handy feature, is the ease with which the dryer door- hinge can be fixed to either the right or left side of the front panel.

Eliminating stairs, between the laundry and the clothes-line, makes it possible to use the laundry-trolley, to transport the heavy, wet washing without back-strain. The use of the trolley at the clothes-line, also eliminates the necessity of bending to ground-level each time an article is taken out of the basket to hang it on the line.

The pantry -- bulk storage area -- must be near the garage and on the same level as the garage and kitchen. Transferring supplies from the car to the pantry is thus a less arduous and back-straining task. Here, too, the laundry- trolley may be of enormous assistance.

It is essential that the necessary power and water outlets and drainage facilities should be provided in the laundry.

Adequate pantry shelving is always welcome. Here too, the provision of a double power outlet will never be regretted.

THE BATHROOM:

Spinal related strains and injuries that first reared their nasty heads in the bathroom have taught me a few very valuable and practical lessons.

The elderly Mrs. Rotund attended treatment for her _lumbar_ spine. Her build and appearance reflected her partiality for good food. At about four o'clock, one cold winter's afternoon, she decided to luxuriate in the splendour and comfort of a "warm" bath. She duly and systematically went through the preparatory ritual. She cautiously lowered herself into the tub to avoid rapid and disastrous water displacement. All went much to her delight. With her spirit revitalised and her ablutions completed, Mrs. Rotund decided to extricate her body from the tub.

"I simply could not lift myself," she recalled. There was no handle or grab-rail to hang on to! Do you know, I tried and tried! I strained my arms and back!"

At this juncture -- while easing her pain -- I was processing her misfortunes into some future _preventive_ program. "Well," she continued a little embarrassed. "I began to feel cold. I tried to add hot water -- but you know ..." and she laughed. She was endowed with an abundance of adipose tissue. This, like a very thick curtain, was suspended down her front. Yes, indeed, I could appreciate her voluminous dilemma. "At last," she continued, "I somehow managed to reach the taps. I thought I would burst, but I hung on. I added so much water that the bath began to overflow, but this did not help. So there I sat for a whole hour. My husband, fortunately rescued me."

THE BATHTUB:

When you sit in the bathtub the water taps must be _easily_ at hand. They should be located against the wall, at the side of the tub. The spout should be against the same wall, towards your feet. Locating the spout in this position, against the wall, takes it out of harm's way for tandem bathers.

Grab-handles or rails well secured, to assist with getting out of the bath, are essential. Many have come to great and incapacitating harm as a result of slipping in the bath. A slip-resistant mat, on the floor of the bath, provides security and stability.

SHOWER CUBICLE:

For reasons of burn safety, particularly for children, I prefer a thermostatically controlled supply of water to the showerhead. The latter should be mounted against the wall, enabling the tallest member of the family, to stand under it whilst having a shower. A wall-mounted footrest provides stability when washing the lower extremities. The risk of falling is thus reduced.

The taps for the shower must be located on either one or other sidewall of the cubicle. They must be placed near the entrance to the cubicle. Failing to observe this important point will force the bather to extend the hand under hot running water to regulate the flow. This may cause dangerous burns.

HAND BASIN, TAPS AND VANITY UNIT:

The hand-basin and vanity unit should be at the correct height and easy to clean. A pop-up plug for the basin reduces frustrations resulting from water inadvertently escaping due to accidental dislodging of a conventional stopper. The taps must be easy to manipulate, for both the young and any elderly users.

"I find it so terribly difficult to open the taps," I often hear an elderly lady say.

The use of leverage advantages, when using water-taps, is an enormous help for people experiencing gripping or hand and arm problems. Motion-activated taps, similar to air hand drying units are available. A combined spout, catering for both the hot and cold water, provides better water temperature regulation.

TOWEL-RAILS:

I find that the majority of towel-rails are engaged in a ceaseless battle with my precious spine. The towels invariably slip off and land on the floor. Yet another "victory" for them. I poise my guns with _non-slip_ towel-rails. If they cannot be obtained commercially, then I have them made. A multi-rail unit, provides extended hanging space with improved ventilation. Electrically heated towel-rails, for use in colder climates, are of enormous assistance and comfort.

HEATER AND EXTRACTOR FAN:

Provision of a safe, wall-mounted electric heater does help considerably with winter temperatures. A ceiling-mounted extractor fan reduces bathroom "fog-free". The extractor-fan is best located above the shower- cubicle. The use of an extractor-fan reduces the incidence of algae to a great extent, particularly in high humidity climates.

FLOOR:

The bathroom and shower-cubicle floor should be _slip-resistant_ and easy to clean. A gentle slope towards the centre of the floor, where a drainage hole is provided, greatly aids floor cleaning. A lightweight hosepipe, mounted in the shower-cubicle, eliminates the use of a heavy bucket of water when cleaning the floor.

I do not appreciate "cold comfort." In fact, in our present home, the en-suite dressing and bathroom offers the luxury of a fully carpeted floor.

MIRRORS:

Often the tendency is _not_ to extend the mirror high enough. Your "precious spine" resents this encroachment upon its _correct posture liberty_. Applying makeup, combing hair and shaving, frequently necessitates a spinal distortion stance.

"I was combing my hair, when suddenly, wham! It went!"

The lanky Mrs. Knotneck subsequently had the height of her mirrors rectified.

SHOWER AND BATH-SEATS:

A non-corrosive, lightweight shower-stool can be a valuable aid and source of stability to someone less resistant to gravitational forces. Getting in and out of the bath, when your spine happens to be in the wrong mood, can be a painful exercise. With the aid of a bath-seat, you can indulge in your ablutions in comparative comfort.

SUNKEN BATH:

Although aesthetically pleasing, it calls for the sunken morale of your poor spine. How do you clean _this_ type of bath? To get down on all fours, does not appeal to your spine or your dignity! The answer, of course, is to use a cleaning cloth or similar aid with a long handle.

Many people experience excruciating bruises, bumps and, sometimes, fractures, resulting from falls in the bathroom. By anticipating this problem, you can address it with an innovative designer or architect. This calls for the use of more padded "injury encountering areas" such as taps, spouts, bath and hand basin edges, etc.

TOILETS:

Depending on family requirements and available space, you may incorporate the toilet with the bathroom. A few practical considerations resulting from a conference with your "precious spine".

THE CORRECT SEAT HEIGHT:

To ascertain this, it is best to visit the bathroom accessory store and sit on units of various heights. In this manner, you can determine the most comfortable one.

"I heard this _terrible_ cracking sound ... I was absolutely sure it couldn't be me!! Well, ... I had _no_ tummy pains or cramps. And the next moment ... the whole blinking loo parted from the wall! Well, thank goodness! I was not hurt. You should have seen the mess!" He laughed shyly. "You can imagine my family's very windy comments!"

When you select a wall-mounted unit, you must be certain that it is capable of standing up to the rigours of prolonged use. Dislodgment can play havoc with rather vulnerable parts of your anatomy.

TOILET-ROLL HOLDER:

Architects or home designers, rarely seem to specify the exact location of the toilet-roll holder. More often than not, its accessibility -- at the moment of need -- calls for considerable spinal contortions.

A little practical thinking at the design stage, will avoid any unnecessary distress! If wheelchair access to the toilet is required, this should be borne in mind when determining in which direction the toilet door should open.

BEDROOMS:

You must decide beforehand how many bedrooms will be required. The wishes and demands of the future occupants must be borne in mind. If very young children require a great deal of nocturnal care, inter- connecting bedrooms might be worth considering.

Will the children's bedrooms have to duplicate as study rooms, too?

Spinal-care considerations related to the design of the bedroom and its fittings concerns cupboard and dressing-tables. Here too, as is the case in the kitchen, priority of use determines the layout of the cupboards. The less frequently used articles, must be stored on the _perimeter_ of the _reach-arc_.

Provide adequate storage space at the _bottom_ of the cupboards for heavy articles such as suitcases filled with material to be stored. To hoist these heavy loads to the conventional storage space at the top of the cupboard is, literally, backbreaking. Reserve this space for lightweight articles.

LIGHTWEIGHT STEPLADDER:

Make storage provision in one of the cupboards for the storage of a very handy ally -- a lightweight portable aluminium stepladder. You can, literally, depend on this friend in times of _shortage_. It is always ready and available to aid your "precious spine" to reach aloft.

However, as always, periodically check that the ladder is still safe and stable to use.

A full-length mirror, mounted in one of the cupboard doors, aids the reflective lady of the home.

Scholars spend prolonged periods at their desks. Adequate desk and study space, in their bedrooms, is essential. Correct chair and desk heights must be determined. The correct quality and quantity of lighting, reduces spinal distortions and fatigue of the desk-bound student. A desk-mounted light reduces unnecessary shadows.

LOUNGE:

Here the primary spinal-care consideration, is concerned with the design and layout of a bar-counter and storage facilities. You must make sure that the serving level is at the correct height. Trying to move in a very restricted space behind the bar- counter, is like trying to put a tot in a half-tot measure -- difficult, if not impossible! Here, too, you must allow for functional manoeuvering space.

Barstools of the correct height, that provide adequate seating and back support, are a natural must. A foot-support rail will take the drag out of sitting at the bar-counter.

"The main problem about my painful neck," Mr. Allchurch said, disgustedly, "of course, is that I can't empty my tankard!" To him this state of affairs verged on social catastrophe!

SEWING, RECREATION AND HOBBIES ROOM:

Accessibility and tidiness are the primary requirements of this area. The sewing apparatus must be able to be concealed at the drop of a pin. The design of the sewing-cupboard must provide the correct working-level height when seated in front of it. Storage-space must be available for the necessary needlework-machines, patterns, materials, cotton reels, scissors, needles and associated items.

Provision for a double power outlet must be made at the worktop-level of the needlework cupboard. Many needlework-machines are regulated by a footswitch. To facilitate connecting the cable from the top cupboard compartment to the bottom area, a "flap-up" lid at the back of the working surface is a good idea. On one of the sides of the "flap," a slot is provided to accommodate the footswitch cable. Once the cable is in place, the lid is closed, thus preventing "swallowing" any articles on the work-surface Appropriate and shadow-free lighting is very essential.

A wall-fixed storage-bench accommodates many of the "loose-end" items and toys that find their way to the recreation-room.

GARAGE:

Your "precious spine" appreciates the proximity of the garage to the pantry or main bulk- provisions storage area. Having it on the same level enables you to put the laundry trolley to good use when unloading the day's heavy shopping.

FLOOR:

Here, a floor that is durable and easy to clean is a labour saver. When the concrete floor is laid, and before a vehicle is ever parked on it, apply a durable floor cover paint. The _epoxy_ paint may be coloured or transparent. This protective coating prevents floor "pitting" and stops oil from penetrating the concrete. Thereafter it is very easy to wipe off any oil that might fall on the floor. Vacuuming, followed by mopping, keeps the floor well preserved and fine looking. One must, however, be extremely careful when walking on this painted floor, when it is wet with water -- it can be very slippery!

DOORS:

"It jumped the rail! I pushed and pulled with all my _might_! It just stood there! Defiant! Resolutely refusing to budge!" At this juncture I had _no_ illusions about Mr. Doublebent's loyalty to his garage-door. "Well," he continued, "I _had_ to get my car out, and here I am!"

Several options are available when selecting garage doors. Mr. Doublebent's garage _had_ an overhead rail suspended sliding-door. He has since installed a lightweight, well- balanced, aluminium roll-up door. In fact, to get even with his previous frustrations, he has installed an automatic remote-control device with which he can open and close the door from the comfort of his car.

The tilt and conventional side- hinge-doors, are alternative options. Correctly installed roll-up doors will never overburden your spine!

WORKSHOP:

If you enjoy woodwork. Particularly making wooden toys. You like to feel at home and at ease in your workshop. You must determine, beforehand, what facilities the workbench has to provide. You must decide what it must accommodate and where.

Will you be sitting or standing to do the work? You may prefer to stand on a _duckboard_ which provides the thermal and electrical insulation. Calculating the correct _height_ for the workbench, must take the thickness of the duckboard into account.

STORAGE SPACE:

Ease of accessibility to tools and materials always makes the task of the hobbyist that much more pleasant. The same applies in the workshop.

As all workshop enthusiasts are surely aware, it is so easy to spend an enormous amount of time looking for a specific tool or piece of equipment.

Time spent designing and making tool or equipment- specific storage-cupboards, ultimately saves time and frustration. Your specific interests determine the nature of tools, electrical equipment and materials which will require storage in your workshop.

The basic rule is that the more frequently used tools and materials must be nearest at hand.

POWER POINTS, VENTILATION AND LIGHTING:

Location of the power outlets must coincide with the lay-out plan for the electrical equipment to be used. Power outlets must be at the correct operational height for the equipment you are using.

A comfortable environmental temperature lessens fatigue. This, in turn, enhances operational safety and reduces strains. Provision of air-conditioning, and a heating-system, is a sound investment.

SWIMMING POOL AND CHANGING ROOM:

If there is one task I have little affinity for, it is cleaning the swimming pool. I am delighted to note that there are a substantial body of like-minded pool slaves. However, to succumb to this aversion, reflects negative action. We enjoy our in-ground pool.

Practical experience led me to design a _low maintenance_ shaped pool. The rectangular pool is almost oval-shaped. The water intake and skimmer box are located at the middle of the one side. Two return outlets are located on the same side as the skimmer-box. Each water return jet is directed into an oval end, respectively. This arrangement eliminates "dead areas" so very popular with algae.

Another back-ache-inducing procedure is scrubbing the tiles round the perimeter of the inside of the pool. Here, I find the use of large tiles minimises the crevices, the algae-forming areas. A long-handled, water powered swivel brush makes cleaning the tiles a much less arduous task.

FILTER, AUTOMATIC-CLEANER AND CHLORINATOR:

The location of the filtration unit, in relation to the skimmer-box of the pool, is very important. It is very disturbing to have the noisy pump-motor in the vicinity of the bedrooms. The pump must be on the same level as the _skimmer-box_ intake. Failing this, it becomes necessary to prime the unit each time it is opened to clean the _filter-trap_ at the pump. Apart from the irritation, is added the unnecessary load of carrying a bucket of water, another aggravation for your spine. A well-informed and careful choice of filtration unit will reduce frustrations and backache! _A sand-filter_ , with a rinsing facility, is certainly the least troublesome to operate and maintain. No damage occurs with the "backwash" washing the filter.

A variety of water-powered automatic pool cleaners are on the market. They save both time and back-energy. When selecting an automatic pool-cleaner, it is advisable to "listen" to the particular unit in action. Some designs are rather noisy on account of the mechanical action involved. This noise can be quite disturbing.

When installing the pool, make absolutely sure that the _water-intake_ connection at the skimmer box, is at least fifteen centimeters below the pool water level. Overlooking _this_ , seemingly small detail, may jeopardise the use of the _automatic pool-cleaner_. Whenever it turns windy, I turn the pool cleaner on to collect leaves, dust and grass cuttings that may have got into the pool. Furthermore, very effective leaf- catchers -- installed at the water _return_ inlet -- are available to enhance pool care ease. However, make sure that this unit is well secured, or else it will be inclined to dislodge, causing unnecessary frustration.

Do you have the time and desire to spend, adding chemicals, to keep the pool water in good order? This may involve carrying heavy containers of chemicals and, of course, seeking the aid of a "pool-sitter" when you go on holiday.

Rapid technological advances with pool water-care are in progress. Comprehensive investigation into currently available water-care systems, at the time of pool design and construction, is advisable. A _solar_ blanket will extend the swimming-season and keep the pool clean at the same time. You must select one that is easy to apply and to remove again.

"Well, you see," Mr. Waters complained resentfully, "the pool-cover sprung a leak. It had so much water and dirt on top of it ... I had the battle of my life to get the darn thing off. And then," he added with disgust, "almost all the muck fell into the pool!" Mr. Water's resulting strained wrist provided me with a new patient.

Various swimming-pool-liners are currently in use. Experience has taught me that a fibre-glass or plastic lining, gives fewer algae problems; is less susceptible to cracks; retains water better and is chemically much more economical to maintain.

Wet feet have a habit of carrying dirt into your home. Dripping swimming costumes are an integral part of summertime youngsters. A poolside dressing room will keep the party happy. Here you must provide a shower, clothes hooks, seating, and storage for the accessory pool-equipment. An area for storing gardening equipment is also appropriate at this location. A non-slip pool deck minimises the risks of slipping and the associated traumas.

AIR-CONDITIONING, VENTILATION, THERMAL AND SOUND-INSULATION:

When installing ducted centralised air- conditioning, you must, where possible, make sure the _return air outlets_ and _filters_ will be easily accessible for cleaning purposes. Any _ceiling-mounted_ ducting covers must be easy to remove, clean and replace. Not providing for this can demand prolonged overhead work, resented by both your neck and shoulders.

Thermal ceiling INSULATION:

Doing this at the design stage of your home, avoids crawling in the loft at a later stage. This procedure can be particularly back straining and irritating, when using fiberglass material.

It is equally IMPORTANT to fit a ceiling and insulating material to the garage and workshop areas. In some countries, thermal insulation in the outer walls of the building might also be advantageous. Add to this, where required, double glazing of the windows.

Consideration must also be given to the wide variety of thermal insulating characteristics of the glass to be used in the home.

STRATEGIC LIGHTING:

"Well, I simply didn't see that there was a step. I lost my balance and fell down! Oh, the pain! It was just excruciating!"

Mrs. Pots visited her friends at their home one evening. She fell and fractured her right forearm. To add insult to injury, she was both right-handed and living on her own.

When you design your new home, you must think of the well-being and safety of your family and any visitors. If you settle for a split or multi-storey home, adequate lighting must be provided at the level-changing areas. This also applies to outside and garden steps. A handrail always aids with stability when mounting or descending the stairs.

I have treated so many patients which, _not_ by their own choice, descended stairs "unceremoniously", on their backsides, with lasting DAMAGE to their spinal columns! On enquiry, it often transpired that a _slippery_ step initiated the painful chain of events. Adequate step height and depth, with anti-slip tread, is certainly a back-saver.

FLOOR-COVERING:

Various areas in your home have specific floor-covering requirements. The kitchen, for example, requires a pliable, shock- absorbing, thermal insulating and washable floor cover. It must, in addition, be scratch- resistant.

The garage-floor is very responsive to cleaning when coated with a layer of the appropriate epoxy floor paint. If you decide upon a wooden floor for the home, you should ascertain whether its maintenance is labour- intensive? Pliability under foot lessens stepping _impact_. This, in turn, reduces spinal and general body fatigue.

Reflective Mr. R.D. Smart: "Only now that my back is sore, do I realise that I should use my _hips_ and _knees_ for bending and lifting."

CHAPTER 4

MY PRECIOUS SPINE AND SELECTION OF FURNITURE, FITTINGS AND ATTACHMENTS

"O, however weary I can be -- just sitting on that comfortable sofa -- the support it provides, keeps me alive!"

Particular attention must be paid to the selection of the furniture that you rest your weary body on. Correct, comfortable and adequate support is required for all parts of the body. The lounge chairs must support the thighs and back. Here, you must guard against acquiring chairs that are _too low_.

"You can just imagine my embarrassment," declared the stately Mrs. Knoxford-Jones, "I heaved, huffed and puffed to try and extricate myself from this _ghastly_ low armchair."

Mrs. Knoxford-Jones was attending my practice for treatment of a painful arthritic lumbar spine. Nature, evidently, did not deem this discomfort as being enough. She also had, as fellow travellers, an osteo-arthritic right hip, and very painful left knee.

I can indeed appreciate this very charming and independent lady's embarrassment. She was the victim of an aesthetically pleasing but gravitationally dismaying chair.

Moving furniture about, for cleaning or re- arranging purposes, has brought many "strains" to my practice. When selecting heavy lounge furniture, metal castors that allow it to roll, are a prerequisite. The metal treads roll easier on carpeted floors. In the lounge, the back-straining low chairs are rivalled by the low coffee tables.

An esteemed member of my family is the warming trolley. My wife loads the prepared dishes on to the warming trolley in the kitchen. It will painstakingly wait upon her commands in the dining-room -- no last-minute rush and stresses or strains.

A height-adjustable swivel chair, on castors, is a very practical piece of kitchen furniture. It provides excellent support as well as absorbing the shock when sitting down.

A log fire is a balm to the soul. It is also a focal, and sometimes a vocal - point for family and friends. Select an efficiently designed fireplace, that will provide minimum heat loss and be easy to clean.

A unit with an ash-collecting drawer, removable from outside of the building, is the one of preference. You must, however, confer with local authorities to obtain information concerning air pollution regulations. This might necessitate the use of a gas or electrical heating system in preference to a coal or log fire.

KITCHEN-AIDS LIST:

Your body, particularly its energy resource, always appreciates any task-relieving aids. This is equally true for food preparation in the _kitchen_. Following, is a list of currently available, effort and energy-saving, kitchen-aids:

Portable ringer-timer; coffee-grinder; electric coffee-maker; electric kettle or jug with steam whistle or one that _turns off_ automatically when the water is boiling; milk saver; milkshake machine; Thermos flask or jug; board -- for slicing, beating or rolling on; Ice-fillable glass or plastic rolling-pin.

CLOTHING AND SKIN PROTECTION EQUIPMENT:

Gloves for washing up. Thermally insulated gloves -- for handling hot items; Apron; Hand lotions and creams.

BARBECUE HANDLING TONGS

and a variety of barbecue accessories.

CORKSCREW

\-- counter-lever type.

CUTTING AND SLICING EQUIPMENT:

Bread- slicer; ice-grinder; electric knife; electric can-opener, manual long-handled can opener; poultry scissors; meat saw; fruit knives; cake-slicer and lifter; frozen food knife or saw, electric sharpener, grater.

OTHER APPLIANCES:

Dishwasher; fire extinguisher; food blender or processor -- with attachments; fume extractor; funnels; garbage disposer; garnishing and decorating equipment obtainable from supermarket or specialty store; ice-cream making machine; ice-cream scoop; ironing equipment (i.e. electric steam iron teflon coated; ironing machine; adjustable height ironing board; ironing stool); juicing equipment; garlic press; electrical or manual juice-extractor; measuring cups and spoons, microwave oven with radiation leak detector; nutcracker (thumbscrew type); oven -- at eye-level with door hinged side-ways, to avoid arms being burnt; portable gas barbecue; pots and pans (with teflon coating and thermally insulated handles); sieves; kitchen scales; personal scales; screw-top bottle-top opener; pressure cooker; shopping list \-- pads and pencil.

ELECTRICAL EQUIPMENT:

Electric frying-pan; electric slow-cooker (hotpot); electric grill; refrigerator and deep freeze unit; toaster oven; serving trolley and hot tray; stove -- electric or gas (with stove top guard); toaster; a wok -- electric stir-fry pan.

COCKTAIL BAR OR CABINET:

Bar-spoon; basin -- with hot and cold water supply; coasters; corkscrew counter-lever type; drinks tray; electric blender; glasses; ice bucket; ice crusher or grinder; ice tongs; mixing glass; refrigerator; shaker -- three piece stainless steel, with built-in strainer; stirrers; strainer; straws -- long and short; water jug.

Remember, also, that many articles are available for left-handed people. These include:

Scissors -- various purpose and function designs; knives -- bread knives, grapefruit knives, apple-corer, potato-peeler; cork- extractor and diaper pins.

Some left-handed appliances:

1. Bread knife

2. Grapefruit knife

3. Apple-corer and peeler

4. Vegetable peeler

5. Cork-extractor

6. Nail Scissors

7. Paper Scissors

8. Needlework Scissors

9. Dressmaker's Scissors

10. Diaper Pins.

Mrs. Small, returning to the practice in a flurry, to retrieve a forgotten parcel: "Oh, thank God, deary, it's my husband's remains!" Mr. Small, evidently had been cremated.

CHAPTER 5

MY PRECIOUS SPINE AND SLEEPING

"There's nothing like a good night's comfortable and refreshing sleep!"

You spend a substantial part of your life in bed. During sleep your muscles are relaxed. The alignment of your spinal column is influenced by the design of the mattress, bed-base and pillows.

SELECTING A BED:

The base, on which the mattress rests, must provide _rigid flexibility_. In other words, it must be pliable in relation to the _frame_ of the bed. Longitudinally pliable, _independent_ stability is provided by the individual timber struts. Adequate ventilation for the overlying mattress is essential. _This_ bed-base arrangement caters for that requirement. It is important to guard against obtaining a bed-base that _is counter-sunk_. This means that the mattress will lie in a timber frame. This _frame_ plays havoc with the fingers when making the bed.

SELECTING A MATTRESS:

"I've hardly slept the past two weeks!" the exasperated Mrs. Beaverboard exploded. " _Doctor_ Whitehead told me to put a board on my bed, to sleep on. I did! But the discomfort!" What Dr. Whitehead evidently had in mind, was that Mrs. Beaverboard should put the board _under_ , and not on _top_ of her mattress.

I am assaulted, if not actually insulted, by a bewildering variety of advertisements for mattresses. One thing, at least, they all have in common is prestige for the bank-balance of the manufacturer.

What qualities should you look for when acquiring a new mattress?

ADEQUATE VENTILATION:

Mr. Penny-Whistle was referred to me for treatment of his low-grade chronic bronchitis. He was in his early thirties. Despite medication and physiotherapy treatment, the condition seemed reluctant to part from him.

"What type of mattress do you sleep on?" I enquired.

"Well," he replied thoughtfully, "it's a sponge-rubber mattress."

Further investigation revealed that Mr. Penny-Whistle perspired considerably at night. On turning, the "wet" area, would "chill" on account of the rapid evaporation of the perspiration. An examination of the timber struts below his mattress, showed the presence of excessive moisture. He acquired a good quality innerspring mattress and, with the old mattress, went his chronic low-grade bronchitis. A rubber mattress minimises ventilation to the body areas in contact with it. This is not unlike wearing a plastic jacket.

CORRECT AND ADEQUATE SUPPORT:

Many mattresses cause nocturnal spinal alignment distortion by not meeting the most essential requirement \-- pliability. Your spine appreciates a mattress that is _yielding_ to accommodate your body's _normal contours_.

HOW TO SELECT A SUITABLE MATTRESS:

When the time comes to select a new mattress, make sure that the salesperson is not on a bonus scheme to promote a particular brand name.

When selecting a double bed mattress, you must, of course, be accompanied in this test, by your bed partner!

You must determine what your requirements are -- adequate ventilation and pliability. The best results, when selecting a new mattress, are obtained by _testing_ the various types available. Insist on having the mattress on a rigid base; or the floor, if a base is not available. Remove your shoes and adopt your preferred sleeping posture on the mattress. Make sure there is adequate support for your head as well.

When lying on your side, your shoulder and hip must push slightly into the mattress. Failing this, the overly rigid mattress will force your spine into an abnormal alignment.

BABY'S COT AND CHILDREN'S BEDS:

Informed parents, as a rule, have informed children. Your body care ideas, particularly spinal-care, should commence at the infant stage.

When selecting a baby's cot, it must be the proper height to minimise strain on your back when putting junior to bed or lifting him or her out of it.

When selecting bunk-beds for the children, they must be easy to make and safe for the children to get in and out of.

SELECTING PILLOWS:

Allergic considerations aside, pillows must be comfortable and provide stable support. The pillow must be of even texture. It must not be "lively." A "lively" pillow, is one that is made of _spongy_ material. The head and neck cannot "snuggle" down on this kind of pillow. A feeling of "tension" remains persistent in the neck and shoulder areas.

SLEEPING POSITION:

"My neck is always sore! Oh, and I like sleeping on my stomach."

Mrs. Gripewater had been experiencing persistent headaches, associated with a painful neck. During the course of investigations it transpired that she preferred to sleep on her tummy with _two_ pillows under her head. She had been spending at least _six_ hours each night, with her neck in this most uncomfortable and misaligned position. Advice on the correct sleeping posture, in conjunction with treatment for her neck, ended both the headache and the neck pain.

After you have selected the correct mattress, your main concern is the correct arrangement of the pillows for your sleeping posture.

If you prefer to sleep on your stomach, the pillow should be arranged longitudinally from your shoulders to your hips. Although your neck is _rotated_ in this position, it is _not_ thrust _backwards_ as with using _two_ pillows, under the head.

It would be most awkward to sit or stand with your head cocked to one side during the day. There is no reason why you should be sleeping on your side, in this position.

When lying on your side, the gap between your head and the mattress must be filled in such a manner as to keep your spinal column in a "straight" line. The head, therefore, must not hang down towards the mattress.

The choice of the number of pillows required when sleeping on your back is influenced by the pre- existing curvature of the _thoracic_ spine. If you have very rounded shoulders, with a protruding head, you will have to compensate by using as many pillows as will support your head in comfort.

If you sleep on your side and you have a painful neck, a "butterfly" pillow on top of the ordinary pillow, provides some degree of neck comfort.

HOW SHOULD I GET OUT OF BED?

Often, reluctantly!

The least strenuous way is to lie flat on your back, near the edge of the bed. You then bend both knees, so that the feet rest flat on the mattress. Then, roll on to your side, nearest the edge of the bed. With the knees bent, straighten the _lower_ legs over the edge. At the same time, lift your trunk from the mattress by using the uppermost arm to press on the mattress, in front of your body. In this way, you pivot yourself into a sitting position, with the legs over the side of the bed.

To get to the standing position, draw your feet back a little, place your hands on your knees, lean forward from the hips and press on the knees to straighten up. Using this procedure, coordinated momentum is most helpful.

To sit down, with a sore back, can be most disconcerting. Here, you must proceed as follows: Stand with a dining room-type chair touching the back of your knees. To ease matters, a pillow may be placed on the chair to provide additional seating height. You bend your hips and knees, supporting your trunk \-- via your arms -- on your knees. Through this smoothly coordinated movement, take a seat. A high chair, with armrests, also makes the procedure much easier, providing the much required stability and security.

Perplexed Mrs. Turner: "Why did I have to suffer for two years with relief only two blocks away? At that, relief without pain-killers or drugs!"

CHAPTER 6

MY PRECIOUS SPINE AND SEXUAL INTERCOURSE

"Well, my dear fellow," expostulated the well-matured Mr. Toddy Linklator, "as long as I still can make _contact_ , I'm still _alive_!"

Judging by the condition of his spine, this gentleman had experienced a good number of summers. He was, however, somewhat frustrated. His recently acquired lower back-pain, put a restraint on his sexual life.

Many patients have pertinently commented on the restraining, or abstaining, influence their spinal ache has had on the quality of their sexual intercourse. Comments and observations vary:

"It's difficult," commented the despondent Mr. Bartholomue.

"It's off limits," complained the newly-wed Mrs. Goldstein.

"Since I've had the backache," said the disgruntled Mr. Thuits, "there's been none!"

Mrs. Wigglebottom's reflective comment was: "Nobody seems to be able, or interested to advise one about the best position to aid your back!"

This is one of the dark areas of healthcare. Patients are reluctant to discuss their problems and to ask for advice. Practical advice, whenever it is asked for, is often slow in coming, or totally inadequate. Sexual intercourse, in a relationship, can and should be, an enchanting _tension_ earthing and defusing pleasurable experience. Many practitioners are ill-equipped to offer a viable solution that will satisfy their patients.

It is imperative that you should have a good bed-base and matching fine quality mattress. You must also, retain body fitness. Excessive weight, with associated general muscular weakness, is detrimental to your spine, weight-bearing joints and general health.

You must at all times take good functional and preventive care of your "precious spine". Not only is pain or discomfort emanating from the spine, a source of exhaustion and fatigue, it also is an impediment to satisfactory sexual intercourse.

Keeping the back warm, prior to sexual intercourse, should reduce the pain and improve mobility. A small pillow, under the lower back of the female partner, may prove to be of great comfort if she already has a pre-existing back complaint. Alternatively, she may place a pillow under both knees, thus reducing the strain on the lower back. In the event of the male partner having a pre-existing back problem, the above-mentioned position may be reversed.

"Oh, well! With my back being the way it is -— I've not slept on a bed for eleven years. I sit and sleep in my armchair, mate!" Mr. Grimsby, a very remarkable toxic pessimist, was referred to me for treatment of his _acutely_ sore lumbar-spine. He had acquired this work-related injury, some twelve years earlier, it had through insurance, proved most beneficial.

He was an example and representative of that growing class of patients, who have sustained work or motor-vehicle accident-related injuries, and who appear to derive some gratification by displaying an ever-changing and well memorised pattern of pains and discomfort. He fancied, however, that it might be to his financial benefit, occasionally to diversify the pains and symptoms scenario. This, he also did in a variety of flexible and ingenious ways, to try and perplex and confound the _healthcare_ and _legal service_ providers.

Later, on inquiring about his family, he replied: "Oh, yes, mate, I've a son of seven!" This statement, once more, proves that _no_ hurdle is insurmountable!

It is a question of trial and error as to which position suits the individual concerned.

Young Doris Keys: "I've got _so_ many pains, I feel like an old-age home!"

CHAPTER 7

MY PRECIOUS SPINE AND CLEANSING MY BODY

Cleansing and grooming your body enhances your self-respect and health. Body odours, subtly straining interpersonal relationships, are also kept at bay. Some of my fellow travellers pay scant attention to body cleanliness. "Well, sir," Mr. Grimesbeek reported to me the following day, "those bubble baths you prescribed did my back a _power_ of good!" Subsequent treatment of Mr. Grimesbeek was less demanding on my olfactory nerve-endings.

HAVING A BATH:

When having a bath, your "precious spine" appreciates a non-slip mat on the floor of the tub. This minimises the risk of slipping, with its associated fractures, strains or other injuries. Taps, strategically located within easy reach, are a boon to the back. There is no need to "do the double" when adding water to the bath.

If you have a chronic back problem that does not respond to electro-mechanical treatment and manipulation, the aid of a _non-slip_ bath seat will reduce stresses and strains. Having undressed, take a seat on the bath-seat. Next, lift one leg at a time into the tub, having made sure that the water is at the correct temperature. A _long-handled_ back-scrubber provides cleansing accessibility to all parts of your back.

HAVING A SHOWER:

When your back is really sore, it is less strenuous to have a shower than to have a bath. It is of paramount importance that the shower cubicle floor, should be _slip-resistant_. A wall-mounted shower- head should be high enough not to require bending your neck to wash your hair.

The burn safety of your entire family is best served by a thermostatically controlled water regulation system. This avoids water-temperature changes when water is drawn elsewhere in the home. A sudden and unexpected change in temperature of the water, whilst having a shower, may elicit an evasive jump, particularly painful with a sore back.

A wall-mounted safety-shelf is a convenience on which containers and razors can be stored with safety.

A more mature person may appreciate the aid of a slip-resistant, non-corrosive shower stool.

WASHING YOUR HAIR:

Prolonged and painful stooping is eliminated when you wash your hair under the shower. If, however, circumstances dictate the use of a hand basin, support your trunk on the _far_ side of the basin with one hand by implementing the "third leg option."

If you have your hair washed at the hairdresser, it should be done with your body reclining backwards.

SHAVING:

Here, the best options for your spine, are either the use of an electric shaver, or the "wet" razor. The latter, like washing the hair, is best used under the shower. Again, if you have to use the hand- basin, support your trunk on the _far_ side of the basin, once again the third leg option.

BRUSHING YOUR TEETH:

The use of a glass of water, with which to rinse your mouth, reduces unnecessary bending. Battery-powered toothbrushes, are also available.

DRYING YOURSELF:

"I was just drying my hair and, wham, there she was, this terrible pain in my neck." For a moment I thought Mr. Longpane was referring to some unwarranted female visitor. In fact, he executed the hair drying procedure with excessive vigour.

A powerful, well-insulated hair-dryer or hot air-blower, can assist with the body drying procedure. These handy appliances can extend your "drying reach."

DRESSING YOURSELF:

"Life is _so_ much easier," exclaimed the grateful Mr. Ramrod, "since I have been using the slip-on shoes with the aid of the long-handled shoehorn."

This is true. The furthest members of your body, can be quite taxing on your spine. Aids to dress them are welcome. Door-mounted storage facilities for your shoes are a boon. Your shoes are both easily accessible and tidy.

On the occasions that you use lace-up shoes, first undo the laces. With the aid of the long-handled shoe- horn, place your foot in the shoe. The question, of course, is how easiest to get to the shoe to do it up? Here, with your rather mature spine, the elevation of a stool comes in handy. You place the foot, bearing the shoe, on the stool. Reaching for the lace is now less demanding. Yet another approach to your foot is to lie on your back. In this posture, the leg's centre of gravity is changed in your favour -- thus making it much easier to get at the foot to put on either socks, stockings or shoes.

Dress fashion-designers have a rather sadistic streak. Their creations invariably have zip-fasteners at the back. It is so much easier for your spine when the fasteners are located within easy reach, either at the front or at the side of the garment is by far the best!

"It's so difficult to undo this brassiere" explained Mrs. Love, exasperated. "You'd swear it's _tamperproof_!" This lady had neck and associated shoulder pain. She was greatly helped, during the remedial stage of her complaint, by the acquisition of brassieres with the catch at the front.

A wall or cupboard-door mounted, full length mirror, in conjunction with a mobile full length mirror, provides excellent views when dressing.

"Ignore an injury and you frequently inherit compound interest discomfort." Or put another way, banking traumas for later enhanced pain value withdrawal.

This morning, Edna Shorthorn emphasised the value of the latter quote, when she said: "I was determined this time; I wasn't going to leave it until it was too far gone!"

CHAPTER 8

MY PRECIOUS SPINE AND BEING A MOTHER OR FATHER

"I've had this terrible back every since my eldest son was born," complained the weary Mrs. Slapp. "I've had two more children and now it's just about killing me!"

Ten years ago she embarked upon one of the most demanding careers, parenthood. It is demanding on all our resources, mental, physical and financial. She had intuitive and observational armament to add to her mental resources.

She had limited insight about the physical demands of pregnancy, labour and infant care. She learned many of the practical considerations the hard and, alas, painful way -- by acquiring a back-injury.

PREGNANCY, LABOUR AND BIRTH:

During the later stages of pregnancy, the ligaments that bind the bony components of the pelvis together, become more lax. This provides enhanced relative mobility of the bony components in question, which, in turn, aids and facilitates the process of natural childbirth. Particular care of the spine, during this period, is absolutely essential. Jarring, jolting, lifting heavy weights and falling on your back- side, can cause severe and lasting damage.

In addition, overburdening the structures involved with the excessive gain of weight during pregnancy, is another disadvantage.

KNOWLEDGE AND INSIGHT ALLAYS FEARS:

It is a sound policy to confer with a physiotherapist, for guidance and advice, during pregnancy, labour and birth. The beginnings of disc- protrusions are often laid down by prolonged, severe stretching of the posterior longitudinal ligament, in the lumbar area, by the "nursing mother's position."

Lying on your back, for days without adequate support under the lumbar -- lower back -- spine, endangers the only ligament that holds the discs in place. It is comforting, to rectify this bad posture, by placing a small pillow under the lumbar spine.

You should inform the obstetrician and nursing staff about the state of your back at the time of hospitalisation and labour. With this information at their disposal, due and correct spinal support and care should be forthcoming during the period in bed.

Many minor, and yet irritating, gynecological problems, following childbirth, can be avoided. The _immediate_ implementation of an active muscle restoration program of the pelvic floor muscles, following birth, greatly aids in preventing future troubles. A great deal of "pregnancy back-ache", results from implementing spinal care procedures, too late in the course of the pregnancy.

It is, therefore, absolutely imperative that you should consult your physiotherapist very early during the pregnancy, to obtain backache-saving guidance and advice. The healthcare practitioner responsible for the delivery of the baby has a great responsibility. The responsibility must also extend to care of the mother's spine during delivery. The prospective mother must, therefore, periodically bring her concern for the well-being and safety of her back, to the attention of her practitioner.

SELECTION AND PREPARATION OF BABY's ACCOMMODATION:

Adjoining and inter-leading rooms, provide privacy for both parents and the little newcomer.

It is a valuable time and frustration saver, to acquire baby's furniture and requirements in advance.

In what will junior sleep?

The selected cot must provide security of tenure, stability and ease of access. It should also, preferably, be mounted on castors. The cot should also be at the correct height, to facilitate ease of putting baby to bed or lifting him or her out. The mattress must be even and pliable.

It is of cardinal importance that the waterproof mattress, or the waterproofing material covering it, be covered with natural fibre material. Sleeping on waterproof material, that does not breathe, can cause chronic low-grade bronchitis. Baby perspires, turns over, thus exposing the area to rapid evaporation of perspiration. This causes a rapid local temperature gradient drop. Therefore, it is advisable to make sure that baby's waterproof is covered with a few layers of natural fibers, such as wool or cotton. Better ventilation, for breathing requirements, too, is available through natural fibre material.

BATHING AND DRESSING:

"Leaning over that bed to change the little blighter breaks my back." This remark has often come my way. There is an effective remedy, by using correct bathing and dressing furniture. Baby's bath should be mounted on a trolley of suitable height. It must be self-draining by lowering the drainage pipe into the bath in the bathroom. An appropriate hose, fixed to the bath taps, eliminates the necessity of transporting water, which can become quite heavy, from the tap to baby's bath. The filled bath is then wheeled to junior's room and parked next to the dressing-table.

Dressing baby, is best done at the dressing table. This should be at the correct height for mother's spine. ALL clothing and accessories must be within easy reach, whilst standing at the table. Miniature people take to unexpected mobility at the most inopportune moments. A fall for them, can be very painful and damaging.

A diaper-container, at the bottom of the bath-trolley, makes transport to the washing-machine much easier. On occasions, when baby's diaper has to be changed on a bed, it is more economical on mother's back to kneel next to the bed.

FEEDING:

It is best, for mother's future looks, to breastfeed baby in a sitting position. She may lean slightly backwards, but should have her spine well and comfortably supported. Baby's spine and head, too, must be firmly and comfortably supported during the feeding session.

At an advanced stage, better baby control is provided by a stable high-chair. Mother can now sit alongside baby, on an appropriate stool or chair.

LIFTING AND CARRYING BABY:

An overweight baby or toddler, will add to your lifting and carrying burden. It is also, to baby's long-term health advantage, to acquire the correct eating habits at an early age.

When you lift baby, you must also take good care of his or her spine. Adequate support of the head and neck must be provided in a comfortable manner.

At the comprehension stage of development, baby will begin to imitate the examples set in back-care. Important: This very early stage, is when the cycle of back-care education should begin!

Remember, that the child is father to the man and mother to the woman.

However, due consideration of your own spine, when lifting and carrying the youngster, is imperative. You must, wherever possible, do the lifting with your hips and knees. Keeping the back straight, reduces the risk of sustaining a spinal injury.

When carrying baby, like any other weight, it must be carried close to the body. It is a sound practice to periodically change baby from side to side when carrying him or her. Changing a carrying cot from one hand to another, also reduces one-sided spinal-strains or distortion.

TRANSPORTING BABY:

A split-level or multi-storey home calls for more frequent lifting and carrying of the youngster. Selecting a high baby carriage, or perambulator -- certainly is a back-aid. A collapsible, lightweight push-chair, is easy to transport in the car and is of enormous help on a shopping expedition.

Recently we visited Vienna, Austria. I was most intrigued and impressed to note that, when a baby carriage or wheelchair was to be taken on board the public transport bus, the bus tilted over toward the baby carriage or wheelchair. Once these vehicles had rolled on board, the hydraulic system returned the bus to the normal travel mode. All credit to such advanced consumer convenience thinking.

Maurine Lowe, aged four years, was travelling on the front passenger seat of the family car, unsecured. In transit, the pet dog jumped from the back seat onto her mother's arm. The car swerved into the curb and Maurine was flung against the dashboard. Miraculously, she survived. After a period of four months' unconsciousness, with the appropriate team-care, she recovered completely.

It is not your custom to transport fragile glass unsecured, in a metal Container. Yet, it is staggering realise how many bodies are referred to me for repair. These bodies have, in many instances, not been secured to the metal transport boxes. Adequate safety and securing provisions must be made for both adults and young children travelling in a motor-vehicle.

A carrying cot, covered with a retaining net, and secured to the body of the vehicle, offers baby valuable protection in the event of an accident. Lining the inside of the carry-cot, with a thick layer of shock-absorbing sponge material -- covered with the necessary thickness of natural fibre cloth -- is yet another positive contribution toward baby protection.

A variety of car safety harnesses are available for children. These aids are only an adjunct to travel safety discipline.

"Dad's back is too sore to play with us!" That remark, coming from young Vincent, has the ring of shattered family crystal about it.

Reserved Mr. Scott: "Doctor Bib has got very good bedside manners, I'm told. She's pregnant, of course!"

CHAPTER 9

YOUR ROLE AS A DOMESTIC EXECUTIVE

The corporate domestic executive is a multi-facetted diamond. Hard, durable and glittering, regrettably almost always under-priced! She is, in fact, the spinal-column of the family. Distorting this precious spinal column has far-reaching repercussions for the whole family and its happy and successful evolution!

PREPARING MEALS:

A practically designed, well-appointed and laid-out kitchen is a prerequisite for ease of meal preparation. The working surfaces, too, must be at the correct height. Appliances and aids must be easily accessible.

A castor-mounted kitchen stool reduces the drudgery of standing whilst preparing the meal.

With the aid of the deep freeze unit and microwave oven, it is easy to prepare meals in advance. Multi-meal preparation, part of which is deep-frozen, gradually builds up a convenient emergency stock. Teflon-lined pots and pans reduce irksome scrubbing. A Milk-saver prevents milk from boiling over -- saving yet more unnecessary work!

One of the handiest kitchen aids is the cupboard-mounted bottle top-opener. This device makes "unscrewing" the lids of bottles or glass jars that much easier. Particularly when one has weakness or pain in the hands and wrists.

MAKING THE BEDS:

Your precious spine, when subjected to pain, resents bending to make the beds. The obvious solution to the problem is to acquire height-adjustable back-saver beds. Failing this, go down on your knees and make the bed in a kneeling position. The co-operation of the other members of the family makes bed making a less arduous task.

"Am I not entitled to two pains concurrently?

CHAPTER 10

MY PRECIOUS SPINE AND SHOPPING, TRANSPORT AND STORAGE OF PROVISIONS

This chapter highlights yet a number of other facets of the glittering corporate domestic executive!

Where possible, the home garage must be near, and on the same level as the pantry or bulk storage area. Pliable, lightweight, shock- absorbing shoes reduce walking fatigue whilst shopping. Remember, extended periods of time are spent walking on hard floors whilst out shopping. Plan your shopping expeditions during "off peak" shopping times. In this way you can move faster whilst selecting goods. The standing time at the checkout counter is less and parking is more readily available.

If the domestic executive is allowed the choice of vehicle for performing their various transportation duties, they should choose a car with automatic transmission, power-steering, power- brakes and airconditioning. For your grocery requirements, select a store with ample parking on a level accessible with a shopping cart. You may also wish to utilise a parcel-delivery service from the checkout counter.

If you do not have your own transportation, the existence of a home delivery service may ease your carrying burden.

When loading parcels into the trunk of the car, the lighter parcels -- requiring more reach -- should be stowed first. When loading or unloading luggage from the trunk of the car, lean forward to retrieve the article with one hand, whilst supporting yourself on the fender with the other hand. (The third leg option.)

Once at home, unloading the shopping onto the laundry-trolley, to transport to the pantry or bulk storage area, saves time and effort. The use of a lightweight stepladder, to reach shelves in the pantry, is useful.

Fluid materials constitute a large percentage of the weight of the day's shopping. You should, therefore, have milk and fruit juices delivered to your home, where this service is available. Frozen, concentrated or powdered juices and soups are also weight and space-savers.

The availability of a child-care centre, at the shopping complex, makes the shopping expedition much easier and less frustrating.

CHAPTER 11

MY PRECIOUS SPINE AND CLEANING

Various cleaning aids are available to assist you with the assortment of cleaning duties in and around the home. Injudicious selection of these aids can, however, detract considerably from their back-care assistance value.

SELECTION OF APPLIANCES:

If an appliance causes your body and temperament more harm than good, it is not worth having.

A _rinse_ facility, on the cycle of the dishwashing-machine, enables you to rinse the mealtime dishes. Once a full load is obtained in this manner, proceed with the washing cycle.

CLOTHES WASHING-MACHINE AND TUMBLE- DRYER:

A fully automatic, top-loading washing machine is one of the high-ranking friends of your "precious spine". The wall-mounted tumble-dryer takes care of any emergency clothes drying requirements. It is particularly important, to make sure that the tumble-dryer has a filter system to catch up any fluff.

VACUUM cleaner:

"Whenever I use the vacuum-cleaner, this terrible pain between my shoulder blades comes on. I had the shock of my life. The pain in my chest -- I thought it was a heart attack!" Fortunately, Mrs. Pushfoot-Jones had no heart attack. Her quite similar symptoms were brought on by the necessity of stooping whilst using a very heavy and reluctant vacuum-cleaner. Living in a multi-storey home compounded her problems.

When selecting a vacuum-cleaner, it must be lightweight, mounted on large castors, have a long handle and a large storage capacity. It must be easy to retrieve articles inadvertently sucked up. The trailing type of unit is more convenient to handle. A powerful variable speed (variable suction) motor of at least a thousand watts is advisable to perform the suction.

Recent back straining experience, during flooding of our home, once again, highlighted the value of having a vacuum unit, capable of sucking up water!

A washable filter reduces operational costs. Disposable, bio- degradable catchment bags save a great deal of "dirty work." A long-handled carpet sweeper is a helpful standby to clean small areas of carpet.

It is ironic that many industrial machines should be cheaper and more durable than the Domestic units.

STOVE:

A solid glass-top stove, with a self- cleaning oven, saves much back-strain and elbow grease. An oven-mounted rotisserie offers yet another welcome "cooking alternative."

A canopy-mounted extractor unit, over the stove, eliminates cookery deposits on the kitchen-cupboards and work surfaces. It also helps to keep the home odour-free.

A self-defrosting deep freeze or refrigerator unit, saves valuable cleaning time and does away with frustrating back-bending work.

Ceiling mounted exhaust units in the bath- rooms reduces bathroom mists. This, in turn, provides a clean mirror.

POINTS TO CONSIDER WHEN CLEANING THE FOLLOWING:

FLOORS:

"I've been going down on my hands and knees to clean the carpets!"

False economy prevented Mrs. Martin from acquiring a vacuum-cleaner. The medical expenses incurred in rectifying her back problem had already exceeded the cost of a machine.

The correct tool for the job is always advisable. A long-handled mop or sponge easily cleans washable floors.

The water-powered swivel brush is a good help with cleaning outside walls, windows and concrete or painted areas.

A drainage hole, in the centre of the bathroom and laundry, greatly aids with their cleaning.

BEDROOMS:

"I ricked my neck when trying to clean under the bed."

Heavy furniture, mounted on castors, is more yielding to the demands of your spine. Should the bed, however, refuse to budge, then go down on your knees.

With the aid of an adaptable vacuum- cleaner head, you can reach all areas under the bed. KITCHEN:

Here, too, caster mounted appliances are more amenable to your cleaning demands. The repairman, too, can get behind them without ruining the surface of the floor.

HANGING AND IRONING WASHING:

The laundry-trolley happily carries the heavy wet washing to the washing-line. The pegs are kept in a container fixed to the trolley.

An adjustable height washing-line is the obvious choice to install. Washing-line installers are inclined to install the line too high. You must make sure that it is installed in such a manner that, when it is at its lowest, you can easily reach it to hang the washing. Once the washing is on the line, it is a simple procedure to hoist it the necessary distance from the ground.

Prolonged standing, while doing the ironing, often builds up muscular tension. This is particularly true of the muscles along the upper part of the back and shoulders.

The ironing board or table must be at the correct height.

A stool to sit on, while ironing, reduces tension and fatigue.

A light- weight, non-stick steam iron makes the going that much easier.

If the persistent volume of ironing justifies it, the use of an ironing machine will save much time and energy.

The availability of laundry services, can, of course, be put to good time, energy and back-saving use.

WASHING AND CLEANING THE CAR:

This task results in a great deal of resentment from both your spine and you. If the vehicle is kept in a clean environment, cleaning has to be done less frequently. The use of a hose-pipe avoids carrying heavy buckets of water.

A good quality wash-and-wax liquid requires less elbow grease to get that shine.

Fortunately, modern aerodynamic vehicles have less hand-ruining protrusions and also have a considerably smaller surface area to clean.

You must, however, remember that a variety of cleaning services may be available in your vicinity.

CLEANING OUTSIDE THE HOME:

Raking and sweeping the outdoor areas has little appeal to me. The use of a wider garden broom collects more dust and leaves with one sweep.

Even better, is a garden vacuum cleaner, either electrically or fuel operated. Well-planned water drainage facilities around the outside of the home, make it that much easier to use the hand-held hose-pipe for further washing down purposes.

If back care isn't learned, it isn't earned.

CHAPTER 12

MY PRECIOUS SPINE AND GARDENING

Analytical and systematic planning of the garden is essential. If you design the scale model on graph paper, it eliminates a great deal of backbreaking "trial and error." This allows for planning where heavy materials should be delivered.

You must, of course, consider your present or anticipated future state of health in terms of immediate and future garden labour requirements.

ACCESSIBILITY AND TYPE OF GARDEN:

Mrs. Green attended treatment for her painful wrist.

"Carrying all those rocks," she admitted, "brought on the pain. If only," she continued, "I could get the wheelbarrow where I wanted them!" It is so much easier when all the areas of the garden are accessible with a wheelbarrow or garden trolley.

You must also determine whether it is to be a flower, vegetable or any other type of garden.

AUTOMATION AND ASSISTANCE:

It is time consuming and expensive to dig up an already established garden. An automatic watering system is best planned and installed at the initial stage of the garden design and layout.

It is also important to know whether you will have, or can afford to have, any assistance with the garden layout and maintenance.

When a great deal of initial digging and levelling has to be done, it often is cheaper, and certainly less backbreaking, to utilise the services of a mechanical device. Plant hire services, invariably have the correct machine for the job in question.

SELECTION OF GARDEN MATERIALS:

Once the groundwork is done, you have a large variety of garden materials to choose from.

You can either sow or plant the lawn.

Yet another choice is to buy a ready-grown lawn, having it delivered and laid.

I vividly recall us following the latter route. The hefty rolls of sod were delivered on an extremely hot and very humid day. The scorching backbreaking and under-breath CURSING, while "unrolling" the lawn, is well imprinted on my memory as "something never to be done again!!" Garden edges can be formed by used logs, pre-cast concrete slabs, stones or timber strips.

WHEELBARROW, GARDEN-TROLLEY AND WATER-ROLLER:

The wheelbarrow should be lightweight and durable. The pneumatic wheel must not extend much beyond the front of the tray. Very important leverage principles are at stake when using the wheelbarrow. You must use these leverage advantages to the benefit of your spine and energy resources.

To lift the barrow, bend at your hips and knees. Grip the handles and lift by straightening your hips and knees. In this manner, you reduce the strain on your back.

You must also be wary of obstacles in the path of the wheel while in transit. The obstacles will cause jarring when the wheel hits them. The jarring is then transmitted to your spine at the risk of an injury.

A garden trolley, requiring no lifting to load, is an appreciated aid when moving heavy material or appliances. A similar unit, that is capable of mounting stairs, caters for differences in levels when moving goods.

When in the process of maintaining my garden, I often require a roller. The water-roller is easy to handle for storage purposes. When it is required, simply fill it with the necessary amount of water and commence work.

ADDITIONAL AIDS:

The garden invariably calls for the digging of holes. They may be required for fencing, erecting shelters, planting trees, etc. The post hole digger makes easy work for this task.

A mechanised or tractor-mounted earth auger expedites multiple hole digging with infinite ease.

A mobile granular fertiliser applicator gives even distribution of fertiliser on the lawn, without the need to carry a heavy bucket of fertiliser. However, my experience with the latter device, is that the moisture in the grass causes the granular fertiliser to "clog" the machine.

An automatic fertiliser and pesticide applicator can be incorporated in the irrigation system. The irrigation system, too, can be fitted with moisture detection sensors that will automatically turn the system on and off. Yet more welcome labour and time saving.

Establishing a new garden, is time-consuming, expensive and gratifying, family and friends appreciate your efforts. So, too, do prevailing pests, albeit in a destructive manner.

If you select to use chemical pest control, then the lightweight, portable pressure pump is the applicator to use. Alternatively, if a large area has to be treated, a mix-nozzle, used in conjunction with the hosepipe, reduces the carrying burden.

Lightweight plastic buckets and watering cans are both durable and an advantage when it comes to energy and strain saving.

It can be difficult to bend down to plant seeds. A convenient way to overcome this problem, is to use a "pea-planter."

To make one, take some straight plastic tubing, into which a plastic kitchen- funnel will fit, cut a length that will reach from the ground to just above waist height. You then, "fit" the plastic funnel into one end of the tube. Preheating that end of the tubing in boiling water, will provide a more durable fitting.

Next, take a walking stick, the tip of which is of a larger diameter than the plastic tubing. With the walking stick, make the appropriate depth hole in the prepared garden soil, place the end of the "peaplanter" in it, and drop the seed into the funnel, to commence its journey into the hole in the soil. You then gently close it with your foot. Nature and observant care will take care of the rest.

Long-handled gardening tools and brooms save unnecessary bending.

Kneeling pads and a low gardening stool, greatly assist in getting down to the job.

Climbing peas, beans and annual flowers are a delight to have. Once the crop is harvested, the climbers must be removed. This procedure is expedited by the use of a disposable net for the plants to climb against. You simply undo the net, and all is done at once.

A simple hosepipe storage system keeps the garden tidy whilst protecting the hose.

THE MATURE GARDENER:

"I'm sure it's carrying those heavy buckets of water that dragged on my shoulders!"

A recent prolonged spell of drought, resulted in water restrictions. Enthusiastic gardeners, such as Mrs Kiely, soon displayed the "bucket carrier's syndrome."

The wiser, or more mature gardener, must pay serious attention to the prospect of diminishing agility and body power.

Several possibilities bring gardening within easy reach when, for a variety of reasons, you cannot bend, or must minimise your bending.

VERMICULAPONICS GARDENING:

Soil is heavy to transport, particularly upstairs to the flat of a pot-plant enthusiast. Vermiculite is an inert material, capable of retaining five times its own weight, in water. Your local library offers several excellent books on this particular type of gardening.

NON-DIG GARDEN:

This form of gardening, involves the use of organic material for the growth of the plants. The timber frame beds are built up on the ground surface, thus reducing the amount of bending involved to do the gardening. The nature of this type of garden does away with heavy digging!

TUBS:

Tubs are eminently suited to growing roses, strawberries, shrubs and many other plants. Plant-care is easier and within reach. Plants in tubs may be brought to the display area when flowering, by using the garden-trolley.

Tubs on castors are commercially available.

ELEVATED PLANT BEDS:

It is more economical, to combine the use of durable trestles with a vermiculaponics gardening system. You can either make a timber-bed, lined with plastic sheeting, to contain the vermiculite; or you can use individual plastic bags -- on a gravel base -- on the table.

The latter method provide better plant disease control, as the affected plant unit can be completely removed.

PLANT HOUSES:

The planthouse can be in the form of either a greenhouse or artificial light garden, or a combination of the two.

The plant-house should include a workbench at the correct height. This is a back-saver when transplanting or preparing pots for planting.

A high stool at the workbench, lessens standing fatigue.

The garden-sprayer can be mounted on a tripod or spiked stand. The latter should have a footrest with which it may be thrust into the soil.

"I just love gardening," extolled Mrs. Joyce O'Hurn. "And since I've got the kneeling aid, it's made it so much easier to get up again!"

This elderly arthritic lady was so delighted with the new aid that enabled her to extend her active gardening career.

A block-and-tackle arrangement, used in conjunction with a suitable canvas-sling or net, is of enormous help, with lifting heavy material out of the trunk of the car, or off a trailer. You can then lower the load onto a suitable trolley to transport it to the final destination. The block-and-tackle suspension point must be mounted in such a way that you can drive the vehicle or trailer under it.

The canvas-sling or net is first placed on the floor of the car's trunk, or trailer, depending on which vehicle is to be used. The load is then placed on top of this.

At home, the sling or net is fixed to the block-and-tackle, hoisted, secured, and the vehicle removed. The appropriate trolley is then moved in under the load. The load is gently lowered on to it, and off you go!

A suitable chain block and tackle, with a stable gantry, takes the heaving out of removing the motor, from the engine bay of the vehicle, preparatory to doing repairs on it.

Remember that, your budget allowing, you can always enlist the aid of available gardening and lawn-mowing services.

Chirpy Mrs. Rose: "My neighbours say it's a Venetian blind neck-ache because I'm so nosy!"

CHAPTER 13

MY PRECIOUS SPINE AND MY PETS

Your family pet requires ample attention and care. In return, you have a loyal, affectionate and healthy friend.

PET CARE TABLE:

When your dog requires washing or brushing, and your back does not want to stoop to the occasion, persuade it to get on to the table. Providing a ramp, for the pet to walk on to the pet-care-table, can also assist some of the more mature animals. It might be prudent to provide a water supply and drainage facility, at the pet care table.

When transporting pets in the car, you should make sure that they do not cause accidents by jumping on to the driver's arms, or, for that matter, any other part of the driver's anatomy! The pets, too, should be secured in the vehicle.

Horse riding, has certain associated perils. If you take to this pet-associated sport, it is essential to wear protective headgear while on horseback. Your head can, spinal injuries aside, come to lasting and regrettable disaster when forced to unceremoniously dismount!

Mrs. Cooper has a passion for horses. She loves handling and training them. She periodically has to have remedial treatment for her various spinal and muscular strains.

"Thank heavens," she said gratefully, "you can always get me back in the saddle again!"

Recently an elderly right-handed little lady took her frisky and bulky dog for a walk, with dire consequences. When taking pooch for his walk, she wrapped his leash several times round her wrist. Pooch, motivated by a smaller dog, jerked the little lady off balance. The result of the fall was a dislocated right shoulder with various other bruises and cuts. To add insult to injury, she had recently lost her husband and was living on her own.

When taking your family pet for a walk, hold the leash loosely in your hand, to avoid a similar catastrophe. Fortunately, the little lady in question, has a willing and supportive family!

Mr. J.K. Stone: "The doctor is never wrong. It's the patient who's neurotic!"

"One can handle the back pain, but one cannot always handle the helplessness that goes with it!"

The history of backache, is the history of lack of back-care education!

CHAPTER 14

MY PRECIOUS SPINE AND TRAVELLING

It is essential to sharpen the saw regularly, when renewing and enhancing the greatest resource and asset you have, yourself.

On occasions it is life view enhancing, to elevate oneself out of one's "groove," to observe a wider horizon and life-enriching experience.

A holiday revitalises the physical energy; stimulates and refocuses the mental and social outlook on life.

The first step to take, is to focus on the homecoming, before one leaves the home.

HOLIDAY PRECAUTIONS:

Arriving back at home, after a pleasant holiday, to find "back straining" work to be done, because obvious precautions were not taken, very rapidly abolishes "the good time" memories.

Turn off the water-supply and water-heating system, -- the former will avert flooding the home with its associated hard work and replacement and repairs expenses. A saving on electricity, too, will aid the budget.

Set the system to turn on automatically or ask a friend to turn on the water-heating system in advance of your return.

The obvious property security precautions must be put in place.

Furthermore, it is advisable to check the destination accommodation for ease of access -- steps; elevators; ease of access to public transport.

Travelling takes up a varying amount of your sedentary time. Vehicular designers spend a marginal consideration on the requirements of your spine, whilst sitting in their units. Distorted postures are forced upon your spine during the numerous phases of your association with the transport vehicle.

SELECTING A MOTOR VEHICLE:

"I had a battle to get out of the car," Mr. Street apologised. "This often happens. I think I'll have to change the vehicle!"

The upper part of his trunk, appeared to stand to the left of his pelvis. Backache was acute and disabling.

This tall and well proportioned gentleman acquired a vehicle totally unsuitable for his body frame.

The rather sad, but costly, mistake, made by an 80 year old gentleman, came to my attention a few days ago. He acquired a very expensive, low-flung Continental vehicle. No sooner had he arrived at home, only to realise that it was almost impossible for him to get out of the car. His dismay, one can only guess at!

The ultimate choice of a vehicle is influenced by the utility it has to provide.

The following considerations, however, are important:

\- Is the vehicle to serve as an extension of your office seat? Or will it, in fact, be the office seat?

\- Is it to be a family car, primarily for the use of the domestic executive?

EASE OF ENTRY AND EXIT FROM THE VEHICLE:

A car, that you have to put on like a jacket, is most exasperating to your spine. The seat must be easily accessible.

It is equally as important that it should be easy to get in and out of the vehicle.

The door-opening and steering-wheel-seat relationship must enable you to seat yourself with ease.

SEATING-SUPPORT, SAFETY-HARNESSES, HEAD-AND-NECK RESTRAINTS:

The driver's seat must be in the correct alignment-relationship with the operational foot controls of the vehicle. Misalignment, in some vehicles, forces the driver to sit at a slight angle, in relation to the operating controls. This causes continuous spinal distortion while driving.

The distance of the seat from the controls, must be adjustable. So, too, must the height of the seat and the angle of the backrest.

The lumbar-spine has a curve. A well-contoured seat, will accommodate this curve and provide the required support.

"I stopped at the traffic lights," Mr. Penny-Farthing related. "I heard the squeal of brakes and then, this terrible burning ache in my neck!"

The accident occurred three years ago. Initially, he had the required physiotherapy treatment, and all was well. Three years later, almost to the day, he developed persistent headaches with visual impairment. A well-designed and constructed head restraint would have minimised the severity of the neck injury at the time of the accident.

Constructional safety of the seat, head-restraint and their anchorage to the body of the vehicle, is vitally important. This also applies to the Safety-harnesses, and their securing brackets, and how they are attached to the body of the vehicle.

"I think I got a chill after that long, hot drive," Mr. John Summers observed.

He had been sitting on a plastic seat-cover with no facility for ventilation. Body-heat could not be adequately dissipated. His back became damp. Rapid evaporation occurred when he got out of the car.

Natural fibre material, such as cotton or wool, is preferable for seat upholstery. Such materials, allow aeration of the body-part in contact with them, and are also more comfortable during both winter and summer driving. A good quality sheepskin seat- cover provides excellent and comfortable support and stability.

It is also advisable, when driving on hot days, to wear easy-fitting, comfortable, natural fibre material clothing.

TRANSMISSION, BRAKES AND STEERING:

An automatic transmission system eliminates gear changes, with the associated leg-and-spinal strains. Clutching and declutching, particularly in slow-moving city traffic, often causes marked back, hip and knee pain. Similar advantages are achieved with power- brakes. Power-steering, aids the upper part of your spine and shoulders considerably. Driving becomes less fatiguing and tension does not mount as easily.

ACCESS TO TRUNK OR STORAGE SPACE:

It is more in keeping with the spinal care concept, to select a number of smaller suitcases instead of one large and heavy one when travelling. The use of two smaller suitcases, allows for better weight distribution when carrying them.

"It started," Mr. Trotter said rather sadly, "the day we left home. I placed the luggage in the trunk of the car. I felt something give in my back. But, you know, I thought it would pass off!" He related pensively: "Europe by bus with a sore back, heavy luggage and no help -- it was a pleasure to be home again!"

To carry two suitcases, simply bend your hips and knees, grip the suitcases, take up the tension in your legs and back, and straighten hips and knees, then walk to your destination, putting them down by once more bending hips and knees.

To place the luggage in the trunk of the car, lift one case with one hand, support your body and spine on the fender with the other hand (once again, note the third leg option), and place the case in position.

To unload follow the same procedure by first supporting your body on the fender, gripping the case in the trunk and lifting it out.

It is advisable to acquire a vehicle with a low trunk sill. This reduces the necessity of lifting heavy luggage over a high unit -- yet another back-saver.

SAFETY-HARNESSES:

The safety-harness provided, must be of the three- point anchorage type. This provides a more efficient protective mechanism without the risk of being flopped over a lap-strap in the event of an accident.

In my practice, I have had many patients -- motor-vehicle accident victims -- who sustained quite bad "soft tissue" injuries inflicted by the "cutting action" of the safety-harness.

Surely, better, and therefore less traumatic, restraint forced pressure impact, would be, if the restraining harness-belts were wider. It would increase the "shock absorbing area," thus reducing the "cutting" effect of the harness-belt on the underlying soft tissue.

In fact, I believe that some innovative and pragmatic vehicle- passenger safety-designer will come up with a superior safety-harness design for motor- vehicles.

Safety features must also be provided for the rear-seat passengers as well as for all passengers travelling in buses and microbuses. Fortunately, more and more vehicle manufacturers are forced, by public concern, to provide safer vehicles.

The advent of frontal and side impact airbags, is yet another accident damage reducing feature, as far as vehicle occupants are concerned.

Anti-intrusion bars should be a feature of a well-designed vehicle, thus minimising lateral impact damage to the precious cargo of the vehicle. Not only should human passengers be secured by restraining safety-harnesses while travelling in motor-vehicles. The same should apply to pets and goods transported in the passenger compartment of the vehicle. Unsecured, they can become lethal objects when sudden deceleration occurs. This can happen on forceful braking or during a front-end collision.

Heavy goods transported in the trunk of the vehicle, too, must -- where possible -- be secured to the frame of the unit.

Often victims of motor-vehicle accident suffer severe cuts inflicted by broken glass. This frequently develops into unsightly scar- tissue.

Car-designers, should focus on head injury prevention as well as glass cut prevention.

Vehicle design should not concern itself only with the safety of the occupants. The quality of life of many pedestrians is grossly violated -- if not terminated -- by being knocked over by moving, non-yielding vehicles.

REPLACING A WHEEL:

"Well," Tom Braun said rather sheepishly, "I was in a hurry, so I lifted the car to replace the wheel! Well it was heavier than I thought!"

His strained lumbar spine testified to the latter fact. He was, to my utter surprise, the third patient who had embarked upon such detrimental folly.

You should, when acquiring the vehicle, find out how the jack operates. A drop of oil on the wheel nuts, reduces torsional spinal strains when undoing them.

If you know in advance that, for some reason, you cannot replace the wheel yourself, then a "Please help! Thank you!" portable sign can assist.

This large-lettered, rain-resistant sign should be made in such a way that its base can be clamped with a strong magnet, to the roof of the car. After use, and a great deal of gratitude, it gets replaced in the trunk once more.

It goes without saying that the wheel nuts should be kept together in a container such as the hubcap while changing the wheel. Losing them is awfully frustrating.

Fortunately, with better modern tyre pressure regulation and management, many vehicles now have facilities to handle and make life much easier, with "flat tyre" care!

An extension-light that plugs into the power outlet is most helpful at night. A tube of grease-remover and a roll of paper towels soon have your hands clean and ready to go. You must have the defective wheel repaired as soon as possible. It is also essential to have a periodic check to make sure that the spare-wheel is at the correct pressure.

A variety of aerosol tyre inflators, with sealing compounds, are on the market, as additional emergency aids. Furthermore, preparations are on the market that can be "installed" in all the tires. With this automatic sealing compound "on board," greater ease of mind is assured. Regular inspection of the condition of the tires, is mandatory.

COLOUR, NOISE LEVEL AND STRUCTURAL SAFETY:

Selection of the appropriate colour for your vehicle, indirectly influences the safety and comfort of your "precious spine".

First, the vehicle must be conspicuous, even to the many colour-blind drivers. This also applies to the rear end of the vehicle.

Next, the internal temperature of the vehicle, has a direct relationship to the heat- absorbing or reflecting characteristics of the exterior colour. And will the colour of the vehicle show up dirt easily? If it does, it means an abundant use of elbow grease and bending will be called for!

Excessive levels of travel noise are fatiguing. Tension and headaches frequently result from travel-associated interior vehicular noises. It is a sound policy to pay particular attention to wind-noise levels while in transit.

Does the ventilation and air filtration system, allow comfortable driving with the windows closed?

How much road noise is transmitted to the body of the vehicle? How much engine and transmission noise do you have to contend with?

I look forward to the mandatory provision of passenger-compartment noise-level statistics, for vehicles travelling at one hundred kilometres per hour. A decibel reading value would greatly aid with the selection of a less noise fatiguing new vehicle.

You can always replace your motor car, but you have but one body to serve you the span of a lifetime!

Often a motor-vehicle accident, unites all the petty pains, sustained into one broad mass of aches -- one great pain, one collective body of discomfort, with a vast, financial anticipation animating it.

The structural safety of the design and construction of the vehicle, is of paramount importance! The importance of this point is emphasised, again and again, to me by the numerous road accident victims I have treated. They were lucky! Many others however, had no comment to make -- at the undertaker!

The structural safety around me, when I am on the road, should be the best that I can afford! Will I have adequate protection in the event of a head-on collision? Has the passenger compartment got anti-intrusion bars to minimise side-on collision damage? If the vehicle rolls, will the roof collapse on the passengers?

Well then, who deserves the better car? The worker who commutes to work and back, or the corporate domestic executive, who has to fetch and carry, including providing transport for precious little people?

Statistics have proven, that daytime driving with the headlights on low beam, diminishes head-on collision possibilities significantly. In fact, in some progressive countries, it is mandatory for the lighting system of the vehicle to be turned on automatically when the vehicle ignition is turned on. A small price to save a most valuable asset -- your precious health.

SERVICING AND MAINTENANCE:

If you are an amateur automotive engineer, who indulges in repairing and maintaining the vehicle yourself, consider these factors.

Is the motor easy to work on? Will it be easy to remove and overhaul? Can you remove it singlehandedly, with block-and-tackle?

With an automatic transmission vehicle, it is essential to have jumper cables. With this valuable device, you can "borrow" power, from a fellow motorist, in the event of battery failure of your car.

GETTING IN AND OUT OF THE CAR:

Getting in and out of your vehicle, with a "protesting" back, requires planning and caution.

Open the door as wide as possible.

If you use crutches or a walking stick, to eliminate the pain while walking, place them next to your seat, then stand next to the car, with your back to the seat.

With the door window down, support yourself with one hand on the windowsill and the other on the front door pillar. Bend your hips and knees, lowering your backside into the vehicle. Next, hand-support the other leg into position, while pivoting your backside into position on the seat.

To get out of the car, simply reverse the procedure. However, take care not to lean the crutches or walking stick against the outside of the car. They may -- and probably will \-- slide and fall out of reach.

Directors of public transport companies, particularly those using buses, have a big responsibility towards their crutch-using passengers. The latter usually use both hands to operate the crutches and can, therefore, not use grab-rails stabilise and support themselves in a jerking vehicle. Drivers should be urgently advised to take cognizance of this fact.

CARAVANS AND MOTOR HOMES:

One thing about caravans and motor homes, that many patients have repeatedly told me: "Never lift the damn thing! Use the jockey-wheel, it saves the back!"

"Damn! The battery is flat!"

Solar power-units, to charge the power supplying battery, while parked, are available. These reduce the frustration of starting the vehicle, after a few days.

CYCLING:

Cycling is a most commendable form of transport. It provides pleasant exercise, without polluting the environment.

Brain-injury, as a result of accidents, is very disabling. Adequate head-protection, while cycling, is absolutely essential!

When selecting a bicycle, its road shock absorption capacity must be good. This calls for a thick pneumatic tire and a sprung saddle. Dropped handlebars impose excessive strain on your lower back and neck, and must, therefore, be avoided.

HOLIDAY TRAVEL:

Few things are as disheartening, as experiencing persistent, nagging pains or aches during a holiday. This is particularly true of travel beyond the boundaries of your own country. You have a pleasant hand-and-glove association with the healthcare team taking care of you at home.

In foreign lands, with strange tongues, any physical discomfort seems to be compounded. Add to this a fixed travel schedule -- and you may wish you stayed at home!

How can you aid your precious spine during your globetrotting ventures?

"Travelling light" is the first strain and time saver.

The use of two small suitcases, instead of one heavy and cumbersome one, makes carrying and manoeuvering a much easier task. Wheels are available to fix to the suitcase, thus enabling it to be pulled along. Suitcases, with wheels already attached, are equally labour-saving.

The correct weight distribution in suitcases with wheels, is essential. The heavier articles must be stored over the wheels area. In this way, less weight is placed on your spine when lifting the suitcase.

We enjoy visiting foreign lands. The one lesson that has come home forcefully, is that "having hands free," is most convenient and smooths movement down narrow aircraft aisles. This, of course, is made possible by the use of a well- constructed rucksack or backpack. Further- more, when out on day trips or tours (which might include shopping), once again the backpack is most convenient.

There is no need to lug all the luggage from the airport to the overnight hotel.

When in transit, the left luggage-lockers at the airport accommodate the bulk of your baggage, ready for collection the next day.

A small pillow, in the small of the back, often compensates for the poor design of the aircraft seat. You should, when flying a long distance, periodically get out of the seat to stretch your legs and straighten your spine (See Chapter 22. My precious spine and exercise -- static travel exercises.)

The clothing you wear certainly influences your comfort in flight. It should be easy fitting and have a high content of natural fibre. This enables you to do some static exercises in your seat, without undue discomfort. We find the use of tracksuits, when flying, very comfortable and convenient. One does not feel strapped in by tight garments or belts.

The use of slip-on, easy fitting shoes, too, makes the long distance flight -- with its risk of swollen feet -- much more comfortable.

CONFERENCES:

Conferences, where the mind should be clear, frequently take place in a smoke-laden atmosphere. The participants are accommodated on chairs designed, no doubt, to supplement the income of healthcare practitioners! Nature, let alone your spine, dictates that you should be an active participant during such events. Standing up from time to time, brings about a postural re-alignment, which reduces the effect of prolonged sitting. It also stimulates the circulation, thus helping to clear the brain and promote alertness.

Travelling across the "east -- west" time barrier, results in jet-lag. Disunity of the body's chemistry and electronics, in relation to time, thus occurs. Ignoring this important fact, when scheduling important meetings soon after arrival at your destination, can have far-reaching and totally undesirable consequences.

Attune yourself to your new time-zone, before leaving home, commence three or four days before leaving, to progressively adopt the new "day pattern." Failing this, allow at least three days, following your arrival at your destination, before any scheduled important meeting.

Modern global communications technology, is saving time and reducing the need to travel as frequently. Global satellite "conference" facilities are at hand as time, money and energy savers.

CHAPTER 15

MY PRECIOUS SPINE AND ENFORCED, PROLONGED BED REST

"After being in bed for a week my back became very sore!" Wally Bentwater's practitioner had advised "ten days bed rest" for a knee injury. He should, incidentally, have had immediate, active remedial physiotherapy treatment.

Wally developed marked muscular weakness and the knee complaint did NOT improve either. He spent the time in bed, resting on a "banana-shaped" mattress. This continual postural distortion, caused more damage to his back, although it was intended to rectify his knee. He was, furthermore, not given any instructions about doing maintenance exercises whilst he was in bed.

When obliged to resort to prolonged bed rest, make sure that the bed-base and mattress are designed to provide adequate and correct spinal support. The current state of the mattress, in particular, is important. During sitting, standing and walking, your "precious spine" is kept erect by the continuous interplay of various muscle groups. Circulation, particularly of the lower extremities, is greatly aided by the pumping action of the leg muscles when walking.

The nature of the condition, for which bed rest is prescribed, will influence the amount of exercises you are allowed to do.

To expedite your rapid recovery, insist on the expert tuition and supervision of a physiotherapist, to match your maintenance exercise requirements to the varying states of your condition. An exercised body is far better equipped to deal with the onslaught and conflicts of disease or trauma. This is equally true of operatively induced trauma!

"I sort of sat in a void," complained the delicate Mrs. Seymour. "I don't know what they think of in hospital! My poor back," she indicated the area between her shoulder blades. "My poor back became awfully painful. And then it came through to the front."

Guard against that comfortable-looking, but terrible sitting posture. It lacks support where it is most needed for back protection.

Following prolonged bed rest, be particularly careful when getting out of the bed for the first time. A sudden change in relative blood-distribution, in response to gravity, can cause instability, with the associated risk of a fall and injury.

At this stage, an assistant is essential.

You should first sit over the edge of the bed. You may feel light- headed.

At a later stage, depending on the duration of the bed rest, proceed to a standing position. Progressively longer distances may be walked on subsequent days.

You will feel fatigued. This, however, would have been much worse without the aid of bed exercises.

Continued pressure by the bedclothes, particularly on the heels and buttocks, can cause circulatory problems. The use of a bed-cradle, to ease the weight of the bedclothes off the feet, can be most helpful in avoiding pressure sores.

Heat and rest can ameliorate an aching back. Another excellent adjunct for prolonged bedrest patients, is the use of sheepskin under the areas most prone to pressure-sores. These areas are the heels and the buttocks.

"Productivity is smart work, not hard work."

"Pain is like old age; it does not ask to be there!

CHAPTER 16

MY PRECIOUS SPINE AND OFFICE WORK

"Altering the desk has made all the difference!" exclaimed the grateful secretary, Miss Carter. The pressure of work, in association with ill-designed office furniture, caused unnecessary stresses and strains. Add to this, an inconsiderate office layout -- and tension is bound to rise!

During the past week, I heard the following comment by a stressed-out office worker: "We are under office arrest!"

SELECTION OF OFFICE FURNITURE AND CABINETS:

You must determine, beforehand, what requirements each piece of furniture should meet.

DESK:

The physical relationship between you and your work- associated equipment must be correct. This influences the choice of a desk.

The desk may have to accommodate a typewriter, computer, modems, dictaphone, telephone, calculator, note books, and a variety of other items.

Drawers must be easy rolling and lacking sharp, damaging edges.

I have had many patients, complain about the "work-posture-induced neck and upper-spinal strains." the problem is often markedly alleviated by bringing the work to the worker, instead of bending down to it.

Elevation of the far side of the desk, by about five centimetres, is a valuable help. Trial and error, about the exact amount of elevation, will provide the answer.

CHAIR:

I am astounded that office furniture manufacturers should credit the executive with as little intelligence as is often reflected in the design of their chairs! These chairs are, elegantly covered with heat-retaining synthetic leather, and provide totally inadequate body support! The chair must have a shock-absorbing pneumatic or hydraulic system. It must, furthermore, be height adjustable, back-support adjustable and provide for adjustment of the relative seat backrest relationship. It must be mounted on stable castors.

The sitting posture, on the chair, must allow for a ninety-degree bend at the hips, knees and ankles. This posture must be used when determining the height of the desk to be used in conjunction with the chair.

CABINETS:

Filing cabinets must have freely accessible and easy-moving drawers. I have had quite a few patients who fell victim to the distorted and replaced centre of gravity of a filing cabinet.

What happened, was the following: too many of the drawers were pulled out at the same time. The cabinet simply toppled over, falling on the unsuspecting victim.

Frequently used smaller filing cabinets, can be mounted on a trolley, thus providing mobility.

TYPEWRITER, WORD-PROCESSOR, TERMINALS, TELEPHONE, COMMUNICATION SYSTEMS:

Connecting points for this equipment must be located in such a manner as to avoid trailing and dangerous cords. Cordless equipment, for inter-communication systems, fortunately, is doing away with the need for many of the "spiderweb" systems frequently seen in both office and home.

OFFICE LAYOUT:

The "frequency of use" priority must be borne in mind with the office layout design.

Where a great deal of telephone answering and note- taking is involved for a right-handed person, the telephone must be on the left side of the desk. Even better, of course, is the use of a telephone with a headset or separate volume controllable loudspeaker, thus freeing both hands for work.

Administrative articles, most frequently used, should be stored in the upper desk drawers.

"I have to spend hours on my hands and knees," protested Mrs. June Watson, a capable secretary. "It just gives me such backache, not to mention stiff knees!"

Several months later, she informed me that she had, in fact brought the work up to her level. She was much happier and, I'm sure, so was her employer.

Miss Tiny actually had to resort to standing on a chair to get to the photocopying machine. This may, no doubt, provide the employer with another point of view, but is deplorable from a safety point of view.

LIGHTING AND VENTILATION:

Ensure that the office lighting is adequate and glare-free. Noisy light-fittings increase prevailing fatigue factors. Stale air induces stale thinking!

Well-regulated air- flow, avoiding draughts, reduces the risks of chills and many associated discomfort.

MONITOR SCREEN SYNDROME:

Monitor and display-screens have become an integral part of modern-day communication, information and technology management. A high degree of visual concentration, resulting in your body being relatively tense. This results in raised shoulder girdle and spinal tension, often with associated headaches.

A ten-minute break, during every sixty-minute working period, should be mandatory. During that ten-minute break, take a brisk walk, also do some "shoulder girdle exercises" to reduce tension and improve the circulation to the shoulder muscles, neck, head and brain.

Two simple and effective "shoulder-girdle exercises" to do -- even whilst working -- are as follows:

Shoulder raising and lowering -- slowly raise the shoulder tips towards your ears and then gently lower them again.

Shoulder blade pinching -- slowly pull the shoulders back as far as possible. Then reverse the procedure, by pulling them as far forward as possible. With the first phase of both exercises -- the first, pulling up; the second, pulling backward -- always take a deep breath. At phase two, breathe out (You should not be breathing through a cigarette!)

"Ignore an injury and you frequently inherit compound interest discomfort."

CHAPTER 17

MY PRECIOUS SPINE AND INDUSTRY

The majority of industrial spinal injuries that have come my way have been the result of lifting accidents.

When lifting heavy weights the lumbar spine in particular is subjected to enormous mechanical compressive forces. The vertebral- column alone, cannot withstand such forces. By contracting the pelvic muscles at the commencement of a lift, the abdominal and pelvic cavities are converted into a comparatively rigid cylinder. This redistribution of the lifting force, can alleviate the enormous compressing strain on the lumbo-sacral spinal components.

The industry, that you are associated with must provide practical back-care demonstrations and discussions. This must be implemented at shop-floor level by concerned supervisors.

A spine that is well looked after enhances productivity and job satisfaction. Valuable productive person hours are saved. Spinal-injury misery, with associated financial implications, is reduced.

"Well," Mr. Smith explained, "one of my mates lost his grip. I couldn't hold it on my own! My back just went on me!"

He echoed the experience of many sad back injured workers.

Manual lifting consists of seven basic phases. They are:

1. Assessing the weight and shape of the object to be lifted.

2. Evaluating the future resting point of the object to be lifted and ease of access to this point.

3. The approach to the object to be lifted.

4. Synchronised lifting.

5. Gripping and preparing to lift.

6. Transferring the object to its future resting point.

7. Synchronised lowering of the object to its resting point.

1. Assessing the weight and shape of the object to be lifted:

Ascertain, beforehand, how many persons will be required to lift the object.

Does it offer a secure, non-slip gripping area? Will rest periods be required when transporting it?

2. Evaluating the future resting point:

Can we lift the object to its future resting place? Are there any obstacles or slippery spots on the surfaces along which it is to be transported? Is there enough space for the lifting team to move unhindered?

3. Approach to the object to be lifted:

You must wear the required protective clothing -- boots, gloves, headgear etc.

4. Synchronised lifting:

At this point, it is advisable to nominate a team synchroniser. Members of the team stand at the predetermined lifting position. Bend down by bending at the hips and knees.

5. Gripping and preparing to lift the object:

Grip the load and on the command of the team synchroniser, lift steadily and evenly, by straightening hips and knees.

6. Transferring the load to the future resting point:

The "transfer" must be well directed and smooth moving.

7. Lowering the load at its destination:

Once in position to lower the object, await the command "lower!" Then bend hips and knees, place the object in position, let go and straighten up by straightening hips and knees once more.

MECHANICAL LIFTING-AIDS:

A wide variety of industrial, mechanical lifting and transportation aids are available. It is your duty, to your "precious spine", to use them at all times!

These aids do not feel painful stresses and strains!

James Earthmann is a self-employed, enthusiastic and successful earth-moving contractor. "Lifting the heavy metal ramps into position to get the earth moving equipment onto the low-bed trailer, really irritated my back. However," he continued with great delight, "since I acquired the `tag-along` trailer, my problems are at an end." The "tag-along" trailer has a pivoting, well-balanced tray. With this "loading" facility, there is no need for the use of the "heavy" loading ramp. Your body is flexible and adaptable. Persistent abuse of these qualities will ultimately yield a harvest of spinal and other discomforts. If you sustain a work-related injury you should insist on full functional rehabilitation to the degree of fitness demanded by your work.

"Work-induced back injuries have a tendency to feel secure and at home with their hosts." It is, therefore, unreasonable to expect a person to work hard to rid themselves of a disability in which they have a financial stake. Bear in mind that pain often transcends prevailing orthodox concept boundaries; beliefs, pre-judice and expertise particularly when the body has been subjected to major and massive trauma. Such trauma often is associated with and results from automobile or industry-related accidents.

Mr. Moans was a singularly remarkable gentleman. He carried, in his head, a well- catalogued inventory of his many ailments, real and imaginary. Treating him for any of his work or motor-vehicle related injuries caused the healthcare team many frustrations. His satisfactory" progress was always impeded by the anticipation of substantial financial compensation for the injury in question.

Once again, this gentleman portrayed the truism that where there's money involved, healing is slow.

A handy hint!

If help, or the required equipment, is not available, for moving heavy objects to be off-loaded, from a truck or trailer, use a few straight pipes or similar cylinders to roll the weight on.

Disillusioned and retired Mr. Clark: "Ignorance ruined my back." Compassion lubricates healing.

CHAPTER 18

MY PRECIOUS SPINE AND SPORT AND RECREATION

More and more emphasis is laid on the valuable gains to be had by active participation in sport.

Back-straining exercises are far too often equated with good exercises. Lack of knowledge of the anatomical structures involved, fathered this concept among many physical education teachers and sports coaches.

The challenge facing us is motivating more people toward a level of physical activity that can benefit their health and well being. An appreciation of mechanical and anatomical considerations, when looking at functional anatomy, in relation to training and sport, pays handsome stress-reducing dividends. This knowledge, must be taught to all those whose future obligations will include servicing and care of the most sophisticated "machine" yet devised -- the human body. It should, during their training, be stressed that they will be called upon to impart correct advice and treatment, to, particularly, the young sporting fraternity.

CORRECT SPORTING GEAR AND KNOWLEDGE:

It is essential that you use the required apparel for the sport in question. Protective gear has been designed because of the need that manifested itself, therefore, do not ignore its use.

Knowledge of the rules governing the game is essential. It eliminates confusion, with its attendant traumatic risks.

Training: Preparatory training must be geared to the particular sport that you wish to participate in. Emphasise specific considerations, such as speed, special skills, agility, strength and endurance, as they may be required.

WARMING UP ADEQUATELY:

"I don't think I was warm enough!" I have, during my long association with sports-injury care, often heard this comment. Think of "warming up" as "tuning the engine for the job ahead." the best "tuned" motor is the most efficient. Warming up thoroughly, and stretching tight structures, such as hamstrings, groin muscles and hip flexors, provides a well "tuned," supple and agile "machine."

LIFTING:

Sports such as weightlifting require skill, strength and co-ordination. You should, preparatory to weightlifting, also warm up thoroughly. Systematic incremental weight progression, based on "what I can," instead of "what I think I can," guards your spine against "overburden abuse." A stable base is essential when doing weightlifting.

To lift, bend down by bending your hips and knees, keeping the back straight, grip the bar, gradually taking tension and straighten up.

To be more adventurous and indulge in sophisticated manoeuvres, seek the advice of a trained weightlifting instructor.

JOGGING:

This form of exercise is gaining in popularity amongst both men and women. The spinal pain associated with jogging is often the result of continuous and repetitive jarring. This impact jarring is transmitted via the leg to the spine.

In addition, with road-running at least, the camber of the road causes a relative leg length discrepancy. This, in turn, influences the level of the pelvis, the foundation of the spinal-column. To reduce the negative effect of jogging impact, it is advisable to run on a pliable and even surface, wearing lightweight, well-ventilated and pliable shoes. An even grass-covered surface, if available, provides the best running surface.

More often than not, air pollution in park-like surroundings, is less than on the polluted vehicle-populated public roads or streets. I have had several patients who were "struck" by motor vehicles, whilst out running on the public road systems. The "logic" of "inhaling excessive volumes of pollutants," as part of an "exercise program," has yet to dawn on me.

If, however, you wish to persist with road-running, an adjustment to your shoes will aid in compensating for the road-camber.

If you sustain an injury, during your sporting or recreational activity, immediate remedial action should be taken. There are mechanical factors, of paramount importance, that come into play following an injury. To ignore them, sets the stage for further future injuries.

Following an injury, fibrous tissue develops at the site of the injury. In the absence of functional movement, proper directional orientation of this tissue does not take place, and a scar forms. This scar is adherent in all directions. Correct functional movements, at this early stage, direct the newly forming tissue towards minimising future stresses. Too early a return to the causative activity will cause a series of excessive strains to be put upon the delicate new fibres. This causes repeated rupturing with the result that a "painful scar" forms in the healing process.

Quick treatment and rehabilitation, is king.

"It is such a pity this is the end of the line. The other buggers pass you down having taken your money! Oh yes! The next is the mortuary!"

Although our body has the innate ability to mostly heal itself, physiotherapy treatment can accelerate this process, and help ensure a more complete recovery. Early physiotherapeutic intervention, -- preferably within minutes, is thus imperative. Early active treatment and guidance, soon restores functional mobility, and diminishes the risk of repeat or injury associated injury.

One mistake, athletes often make, is to terminate the rehabilitation process prematurely. They stop corrective treatment before the injury has healed completely. The result, is "an injury pre-disposing to yet another injury" -- compounding frustration and rapidly declining fitness. This is particularly true, of older "more mature" people. Their joint mobility and muscular flexibility, is inclined to diminish with the rapid passage of time, setting the stage for injury.

Early and functionally orientated post- operative rehabilitation, especially for the sportsperson, is vitally important.

The "operating job", is not complete with the "laying down of the surgical tools." The really "patient operative procedure outcome" concerned surgeon, must emphasise the absolute importance of active functionally orientated post-operative treatment and rehabilitation.

In the long term, implementing such a program, under the supervision of an experienced physiotherapist, will yield gratifying results, gratifying for both the patient and the surgeon alike.

The belatedly enlightened Mr. John Stein, about back care: "When you're past seventy you say: "why didn't I do it before!`"

Physiotherapists have more intimate knowledge of functional anatomy. They are thus in a good position, to determine -- by assessment the need for radiological, surgical or orthopaedic intervention, in there case of Recent Trauma, particularly sporting injuries.

HIKING:

More money, time, enthusiasm and nature-awareness has led to increased active participation in hiking. The general health and tension-relieving benefits are gaining in popularity. Backpackers value the companionship and sense of adventure.

Here, too, your "precious spine" can be damaged by acquiring ill-advised equipment and apparel. Indulging in this healthy pastime requires information and planning.

SELECTION OF FOOTWEAR:

When selecting hiking footwear, consider the prevailing climatic and weather conditions as well as the terrain to be traversed. Additional attention must be paid to the following points:

**FIRM GRIP** : The shoes or boots must provide good adhesion to the surface under foot. With a load on the back and a distortion in balance, injury and discomfort may result. The sole, must be pliable and shock absorbing.

**LIGHTWEIGHT AND SUPPORT:** Carrying unnecessarily heavy shoes or boots is tiring. The shoes, or boots, must provide adequate ankle support, without cutting into the Achilles tendon at the back of the calf. Easy and supportive lacing is imperative.

**EASY TO DRY:** The construction material used for the footwear must be of such a nature as to be able to dry easily. Once again, conferring with fellow hikers or backpackers will highlight the merits of commercially available footwear.

PROTECTIVE CLOTHING:

Proper protective clothing against thermal and climatic abuse is essential. In warm climates it is advisable to guard against sun and insect exposure. In colder climates, energy dissipation, through the hands, face and head, is quite marked. Here, too, adequate protection is required.

RUCKSACK OR BACKPACK:

A rucksack or backpack, constructed of durable lightweight material, is advised. When packed, it should, in fact, sit on the hips, and not hang from the shoulders.

Backpack guidelines: The total weight of the loaded backpack should not exceed 15 to 20 percent of the body's weight. Use a backpack with hip straps and wide padded shoulder straps. Keep the centre of gravity as low as possible when packing the rucksack or backpack. Heavy articles must be packed at the bottom, thus providing better walking stability and ease of handling.

Where possible, partners should aid one another with hoisting and lowering of the packed rucksack onto the carrier's back. In this manner, spinal rotation, while lifting a heavy load on to the back is minimised; so too, is unnecessary exposure to back-strain.

WALKINGSTICK:

Additional stability and weight distribution is afforded by the use of a good quality walking stick.

I have a collection of walking sticks. One has a concealed compartment, housing a little bottle for "liquid refreshment."

CAMPING REQUIREMENTS:

Technological advances, in terms of lightweight camping materials, have leaped ahead. The back-packer reaps the rewards with the advent of easy-to-erect tents, with built-in ground sheets, aluminium poles and pegs, plus weather shielding fly sheets. Compact gas-cookers and lamps, also reduce the carrying burden.

Compact, good quality mattresses and sleeping-bags are plentiful. A first aid kit and walking-stick always takes care of minor traumas.

CHAPTER 19

MY PRECIOUS SPINE AND INJURY PREVENTION

Your entire life and activities evolve around your "precious spine". This is so very important, I repeat: Your entire life and activities evolve around your "precious spine". There is almost nothing that we do, that does not involve, one way or another, our body communication system -- our Precious Spine!!

To guard against its abuse and premature wear and tear, are the essential objectives of spinal injury prevention.

"My word, now that my neck is fixed, that woolliness has gone from my brain. My mind is clear again!"

Clarity of thought, was a necessity for this busy accountant. "Fuzziness" hindered his efficiency, causing frustration and tension.

How can you minimise the risk of spinal injury?

You simply, cannot harvest the crop of a painless and supportive back, and good health, if you have not planted the seeds of injury and abuse prevention, in the spring, watered it with caution, weeded the prejudices and cultivated, a protective muscular system, during the summer.

In later life, when you will more realistically treasure your spine, there may be no quick-fix to neglected, earlier back care! You must, in all your daily activities, display a spinal-care awareness attitude.

This must, also extend to the example, that you set for your family and fellow workers.

Many of our future pains, were conceived when negligence sired body abuse, during our youth.

The preceding chapters listed a wide variety of practical considerations to be aware of. The following, however, are basic considerations that I now emphasise:

HOME AND WORK FUNCTIONING ENVIRONMENT:

The mechanical and structural environment, in your home and at your place of work, will each make their own particular calls upon the resources of your spine. The less abusive these calls are, the better the prospects for injury avoidance.

SPINAL-CARE AWARENESS EDUCATION:

This is one of the "most neglected" subjects, of both formal and informal education programs. It should be priority number one, for every education planning authority, to incorporate a comprehensive Spinal Awareness Care education program, into the education curriculum. The neglect of this form of education, has far-reaching social and economic ramifications!

At the industrial level, information is available. Available, however, is not enough! It must be disseminated meaningfully!

In fact, I make a very urgent plea to all child educational planning authorities, to implement body-care -- with the emphasis on spinal-care -- as an integral part of their educational program. The misery that you will avoid, through averting worker's pain, is almost beyond calculation.

An equally important subject, for children \-- and therefore the future nation, as a whole -- is financial, attitude and health resource management.

Careful and judicious management, of the various facets of our personal resources, (including our Spinal Resource), reduces life's burdens, thus acting as a lubricant to success and happiness.

BENDING AND LIFTING:

Unplanned, and uncoordinated lifting, can be catastrophic. Proceeding in the correct manner, by bending hips and knees, and lifting by straightening them, is essential. This procedure must be executed on a wide and stable base.

"When young, learn to manage your health for security and comfort in old age tenure."

CHAPTER 20

MY PRECIOUS SPINE AND REMEDIAL ACTION

"I had no idea what to do! A wee drop of `medicinal water`, helped a little!"

Mr. McDermit sustained a lumbar injury, while gardening. Four weeks later, he was referred to me for treatment of his complaint. He had seen a service-provider, who recognised the mechanical derangement of the lumbar spine, for what it was. His former practitioner, regrettably, tried to rectify a mechanical derangement with the aid of an abundance of chemicals. The patient, by now, had lost a fair amount of time off work, was irritated, frustrated and weak. Furthermore, at this advanced stage of his "condition," he had become disenchanted with the poor quality of the healthcare service that he had experienced.

What is needed, is a bill of rights, regarding the back-sufferer's partnership with the healthcare professions. This will help the healthcare team, to take better care of the back-sufferer's problems. The healthcare mindset, needs radical readjustment, to accept that patients are partners in their input to healthcare education, service provision, research, and policy-making.

This back sufferer's bill of rights could be stated as follows:

1. The back sufferer shall have a right to sound mechanical, anatomical, medical, psychological and Back-care knowledge, regarding the present condition, and future prospects, of their spine.

2. The back-sufferer shall have a right to information regarding available "spinal-care and abuse prevention programs" to meet his or her financial, occupational, intellectual and any other specific needs.

3. The backsufferer shall have the right to demand \-- by cumulative force -- to get an environment that, takes cognizance of the integration of the human spinal-column in the following areas.

DOMESTIC ACCOMMODATION AND FURNITURE:

Architects and designers -- please take note of the requirements of the human spine in relation to your valuable work.

TRANSPORTATION SYSTEMS

Designers of both public and private transport systems please take note of the safety elements regarding ease of access and comfort requirements of prospective passengers. Particular attention must be paid to seating design on buses, trains and aircraft.

EMPLOYERS:

Provision of functionally designed equipment, to allow your employees to work in a comfortable posture-related environment. The back- sufferer shall, at all times, have access to an, employer directed, spinal-care program -- under the supervision of a physiotherapist.

What then, should you do when you injure your spine?

If the injury is sustained at work, it should immediately be reported to the healthcare officer of the company. This will be, to your advantage, in the event of future injury-related healthcare expenses or claims. The nature and severity of the injury will determine whether you should consult your local healthcare service provider, or whether to be admitted to the casualty department of the local hospital. You will feel much more at ease, if the practitioner takes time to investigate your problem. The practitioner must have time to listen to your narrative, concerning the history of the complaint.

If the practitioner, displays the "think in reverse ability," it will stand you in good stead, because the practitioner will be able to visualise the trauma causing situation. An experienced clinical practitioner, can assess the desirability of X-rays, or any other investigatory procedures, to be performed.

A thorough clinical assessment, is essential. This may be aided by radiological or magnetic resonance imaging (MRI) findings. However, be wary of the practitioner who makes the diagnosis solely based on X-rays. It often happens that mechanical derangement does not show up on X-ray films.

Experience, has taught that practitioners, who are too reliant on radiological diagnosis, often label their patients "neurotic." This, regrettably, often reflects the lack of thorough history-taking and clinical assessment of the patient.

If, therefore, you are told, that there is "nothing wrong with your spine," despite the persistent pain, seek an alternative opinion and advice.

"Well, mate. I was a walking `pillbox` until I saw the other doctor. He listened to my story, and immediately put his finger on the trouble. Since he referred me for treatment, I'm a new man!"

Mr. Stubbs, a garbage collector, sustained a spinal-injury at work. The radiological findings were normal for his age. Various chemicals -- pain relieving and anti- inflammatory \-- did not relieve his predicament. His original practitioner, then tagged him a "malingerer." A conservative approach of electro-mechanical treatment and manipulation soon restored him to functional normality.

If the nature of your spinal lesion, is such, that it does not respond to a reasonable number of physiotherapeutic treatments, you must confer with an orthopaedic or neurosurgeon. An independent second opinion, concerning any proposed elective surgical intervention, is cardinal.

The goal of treatment, by orthopaedic-means, is the restoration of the form and function of the body, as a whole, so that individuals can perform their duties and recreation, in the most efficient possible manner. It is, therefore, essential that a careful analysis be made -- of your spinal requirements -- before planning any treatment. The steps of the therapeutic-program, should follow progressively, from the preparatory, pre-operative phase, to the ultimate post-operative attainment of maximum possible functional recovery. The optimal recovery, may, in some instances, only follow several months later.

The success or failure of the program, depends on teamwork -- complete systematic and meticulous performance of each succeeding treatment and rehabilitation phase must be well coordinated.

It is vitally important, for both your physician and your physiotherapist, to be aware of your needs, as a total human being. There must, at all times, be "cross consultation" between the members of your health- care team as well as yourself.

Total patient-care, avoids the catastrophe of "the operation being a success," with the patient being left destitute, frustrated and a dependent "cripple."

Evidence suggests, that where patients are informed and supported to participate in decisions, healthcare outcomes are better, services are used more appropriately, patient satisfaction is higher, and there is less risk of litigation. "Patient Involvement", is also a very effective way of improving services.

Your healthcare team, should advise you about the long-term prospects and implications of your spinal-injury. This is particularly essential, in the event of a spinal-injury being associated with a motor-vehicle accident. Often, a period of weeks, months or years elapse, since the time of the accident, before accident-related problems manifest themselves. This "long interval" between cause and effect, may cause a multitude of medico-legal and financial headaches. Timely advice about this possible "latent" period, could save you a great deal of hardship and financial embarrassment.

Next, you must try to analyse and locate the causative factor of the injury. Once this has been established, future evasive injury- prevention action can be taken. It may involve altering your work-posture relationship; it may require the use of a lifting and transport- aid; a change of occupation, may, as a final resort, be beneficial.

Once your injury has been rectified, it is advisable that you should, periodically, avail yourself of the preventive-care facilities offered by your physiotherapist. An assessment of your posture, muscle tone, general mobility and agility, related to the work and leisure demands you place upon your body, is helpful. It focuses attention upon your changing circumstances, and provides the opportunity for sound age-adaptive advice.

"The first forty years," Mr McNab observed, "causes no problems. It's the second forty that concerns me! Retirement, an abused spine; increased hobbies and manual work, and no advice about spinal care, given during the first forty years!"

CHAPTER 21

MY PRECIOUS SPINE AND AVAILABLE AIDS

By far the best aid available is to acquire a spinal-care way of living. Next in line is retaining the spinal-muscles in a good state of fitness and care. Your trunk is rather like a pliable tube, supported on one side by a structure, renowned for its stable instability. This structure is your spinal-column. You can, when lifting, disperse part of the load from your spine to the other walls of the tube. This will convert the pliable tube, into a relatively rigid column. This conversion, requires the use of muscles. Think of the muscles involved, as the spinal, or lifting muscles. They consist of, in addition to the leg and buttock muscles, the powerful muscles running along either side of the spinal-column. The other walls of the tube, are reinforced by, respectively, the abdominal muscles -- covering the front and sides. The pelvic-floor muscles -- forming the floor of the tube. The diaphragm, the muscular sheath separating the chest and abdominal cavities forms the "lid" of the tube.

It is, therefore, evident that excessive weight, carried inside the abdominal cavity, will increase the burden on these muscles. To protect your spine, it is imperative that you should keep all these muscle groups, in good tone, by regular moderate exercises.

I will, for convenience, mention once more, the various mechanical back-saving aids.

Your precious spine, has access to a few additional aids, too.

CORRECT FURNITURE FOR SLEEPING AND SITTING ON:

You spend a considerable amount of your life, in either a recumbent or sitting posture. You know what is required, and should insist on having it, when purchasing new furniture.

**CASTORS AND TROLLEYS** : Heavy domestic appliances which, from time to time, have to be moved for cleaning or other reasons, must be mounted on castors. It saves labour, strains and damaged floors.

Trolleys, have an invaluable part to play, in transport, both in and outside the home.

Further handy aids include: Cordless and cell-phones; portable cordless door-chimes.

HOME DESIGN:

This is one factor, that continuously influences your spine. Incorrect heights or difficult access, causes back-strains. Facilities provided in the kitchen and bathroom, require particular attention.

Ease of cleaning and maintaining the home, is a vital consideration. This also applies to the surrounding garden, pool and tennis court.

MODE OF TRANSPORT:

Power-steering, power-brakes and automatic transmission, in conjunction with supportive and protective seating, correctly aligned to the control-mechanisms, are highly desirable features in a motor-vehicle.

LIFTING AIDS:

Various domestic or light industrial lifting-aids, are available. Small mobile mechanical aids, assist with lifting any incapacitated member of the family, who requires home-nursing. Electro-mechanical or hydraulic-hoists, have an important part to play with patient and material-care. They certainly save your back, thus enhancing your quality of life.

A wheelchair, and the aid of access ramps, provides easier and less strenuous patient manoeuvrability.

DRESSING-AIDS:

Devices that put less strain on the back, when dressing, are of particular value during the "injury-phase" and thereafter. Their use eliminates excessive bending.

The stocking-aid, helps you to get your stockings on. The long-handled shoehorn, easily guides the heel of your foot to nestle in the shoe. Laceless "slip-on" shoes, eliminate the necessity of bending down. Velcro shoe fastening, is yet another helpful aid.

Creative problem-solving ingenuity, can put Velcro to many irritation-saving applications.

A zipping-aid, provides better access to zippers, at the back of dresses. It is, however, advisable to have zippers and buttons on the front or side of the dress or any other clothing.

EXTENSION AIDS:

These aids, extend your reaching capacity, without causing undue strain to your body. They include long-handled gardening-tools, long-handled roller paintbrushes, stools and lightweight ladders to enable you to reach things with ease.

Particularly appreciated, amongst mature citizens, is the helping hand. A magnet, at the tip, enables you to lift metallic objects, such as pins off the floor.

KNEELING--AID:

This friend in need, assists you to get erect after kneeling while gardening. A gardening-platform, on castors, brings the weeds within easy reach too.

However, bear in mind that the castors will function best on concrete or other hard surfaces.

Aerosol pest and weed control chemicals, make easy work of spraying.

BLOCK-AND-TACKLE:

The gantry, block-and-tackle, provide enormous lifting power. This is helpful with the loading, and unloading, of heavy objects onto or off vehicles.

FORKLIFT:

Lifting, transporting and stacking goods, is facilitated by the use of this very handy device.

BOWLING-AID:

"Well, my dear. My sciatica stopped me from bowling. I couldn't pick up the bowls. Then I found this tremendous aid!"

Top: Bowling-aid  
Centre: Helping-hand  
Bottom: Automatic plant-watering device

Mrs. Rowland is now a much better and a happier lady. Bowling, is, once more, within her grasp!

CRUTCHES, WALKING AIDS AND WALKING STICKS:

When your back is sore, it is convenient and pain saving to redistribute your body-weight, by using a pair of crutches or walking sticks.

CORSETS AND NECK COLLARS:

The best possible corset or spinal-support system, consists of two parts. First, think automatic spinal-care! Second, well-maintained spinal, abdominal and pelvic floor muscles.

Corsets and neck braces, by and large, restrict movement. This is often associated with stiffness of the joints involved, as well as weakness of the corresponding muscles. There is restricted scope for the judicious use of these external- fixing aids. The logical approach is to acquire the spinal protective frame of mind in conjunction with a well-maintained muscular SYSTEM!

CHAPTER 22

MY PRECIOUS SPINE AND EXERCISES

"If I'm not hungry, I do not eat!"

Experience has repeatedly taught me the same about "elaborate" prescribed exercise programs. Initially, the patient will adhere to an elaborate scheme of exercises. The passage of time -- frequently very short -- brings an ingrained resentment to formal exercises to bear. The patient slides back, if that is the correct word, to old habits.

The large number of patients, who adhere to a simple and practical maintenance exercise regime, has however, pleasantly surprised me. If you are a senior citizen, first confer with your physician, before embarking upon any vigorous exercise program. His or her guidance, in terms of your cardiac and general health tolerance, will be valuable. Next, you should confer with your physiotherapist for assessment of your present joint and muscle condition to be used as a base for any intended exercise program.

Difficulty and strenuousness of performance of exercises, is often regrettably, equated with the beneficial value of an exercise.

A few "good" exercises, depicting this misinformed notion, are the following:

1. STANDING AND TOUCHING YOUR TOES:

It is odd, that a substantial part of the population, should be persuaded to display its "bottom," instead of its brains!

"I will concede, my dear fellow that in an effort to display my agility, I damn nearly lost my versatility," explained the sadder but wiser Mr. Bottomsly.

He had been enticed, the most "beneficial" exercise. The result was most rewarding for both his general practitioner and myself!

To retain mobility of the spine is fine. But under no circumstance, should you force yourself to touch the floor, from a standing position, if it causes stress or discomfort.

To force young students, to do it, is criminal. It can cause, irreversible ligamentous and other structural damage to the spine.

2. STRAIGHT-LEGGED SIT UPS

This exercise consists of lying flat on your back with straight legs. The feet, are hooked under some restraints. You lift your trunk to touch your toes. The leverage disadvantage inherent in this exercise is enormous. What happens, is that your hip flexors bend your lower spine forward, in an effort to lift the rest of your trunk. The initial objective of this exercise, was to strengthen your abdominal muscles. What in fact you are doing, is to ruin your lumbar spine.

There is, fortunately, a better way of doing this exercise. I shall deal with it later.

3. LYING ON YOUR BACK, AND RAISING BOTH LEGS, KEEPING THEM STRAIGHT:

The negative effect of this exercise, is identical to the previous one. The anchorage points only, are reversed. It too, can be done in a better way.

To illustrate the enormous stresses involved with incorrectly executing the preceding two exercises. Grip the handle of a broom, at its tip with one hand, then try to lift the broom handle parallel to the floor.

In the preceding two exercises, the broom will represent, respectively, your trunk and your legs. The stress on your hand, and wrist joint, as well as the "gripping" muscles involved, is enormous!

Which exercises then, will stand your spine in good stead? Two exercises, that are of particular general value, are swimming and walking. It is, in both instances advisable to embark on a progressive program.

EXERCISE PROGRAM:

(All these exercises are to be done on a carpet on the floor).

**1. ABDOMINAL EXERCISE** \-- Lying on your back, knees bent, hands under head. Lift head and shoulders as far as possible, thrusting the lower, "lumbar" part of the spine flush against the floor. Lower back to starting position. This exercise develops the front muscles of your abdominal wall.

**2. BACK-EXTENSION EXERCISE** – Lying on your tummy, pillow under hips, arms (palm down) by the side. Lift head, shoulders and upper trunk. Pinch shoulder blades back while lifting. Lower to starting position. This exercise develops the back and buttock muscles.

**3. ABDOMINAL EXERCISE** \-- Lying on your back, knees bent as in Exercise 1. Hands behind head. Lift head and shoulders, turning left elbow to right knee. Lower to starting position, and repeat turning right elbow to left knee. Lower to starting position. This exercise helps develop the side muscles of the abdominal cavity.

**4. PELVIC-FLOOR MUSCLES EXERCISE** \-- Lying on your back, legs straight, arms by the side. Squeeze knees together, tighten buttocks and pull up back passage as if to retain a motion, hold for four counts and relax. The pelvic-floor muscles, the lower component of the tube, are exercised.

EXERCISE PROGRESSION:

Repeat each of these exercises six times during the morning and evening for two days, then progress to eight repetitions of each for two days. On the next two days do ten of each during morning and evening. Progress by doing lots of six of each exercise with two days followed by two lots of eight for another two days. Finally, progress to two lots of ten of each exercise.

If you have the aptitude, energy and inclination, you may safely repeat the same progression pattern to the final three sets of ten of each exercise, during the morning and evening. Persist with these exercises until the age of ninety-three. At this point, you must re-assess their beneficial value! Your mature judgement will, no doubt, direct your further participation in the scheme! If, for any reason, you are determined to do "sit-ups," then do them correctly.

SIT-UPS, CORRECT METHOD:

_(It is extremely important to do this exercise on a thick and yielding mat. Omitting this will result in a "grinding" of the lower back -- the lumbar area -- into the hard floor, not particularly good for the back.)_ Lying on your back, knees bent, feet hooked under bar, hands under head, commence a rolling action, by lifting your head and shoulders, then brace the small of your back into the floor and proceed to lift your trunk into the sitting position. Revert to the starting position by rolling the small of your back onto the floor and lowering your shoulders, neck and head.

EXERCISES WHEN TRAVELLING:

The profit margins of airlines seem to be enhanced by squeezing as many passengers as is almost impossible, into their aircraft. This impedes the opportunity for movement, whilst seated, a great deal. Long-distance travel, particularly by air, imposes restrictions of movement, with the associated circulatory sluggishness. One is forced to use relatively little energy.

The airline operators, on the other hand seem to be of the opinion that their passengers are destined to visit a hunger-stricken country. The successful and comfortable passing of food through your digestive system, is dependent on body movement and energy consumption. A happy combination of two options makes your long-distance air travel that much more pleasant. Firstly, when travelling from east to west or vice versa, synchronise mealtimes and energy intake, with your normal times. You should not be intimidated to consume large out of phase meals. Fruit is a less stodgy and far better substitute. Secondly, try to burn up some of the extra energy by doing exercises. These static exercises, require a minimum of movement, and you can do them while sitting down.

If you have any circulatory or other health problems, such as varicose veins, you should consult your physician to obtain the necessary precautionary pre-flight advice and medication. Blood-flow sluggishness, the result of relative immobility for extended periods, can be the cause of blood-clots that can be very dangerous.

STATIC TRAVEL--EXERCISES:

**1. Foot Rolling** \- The knees are bent at a right angle. The feet are a fist's width apart. First, roll the ankles towards one another and then apart.

**2. Foot Pivoting** \-- The knees are bent at a right angle, feet slightly apart. First, raise the heels as high as possible from the floor, then lower. Now lift the toes, and lower.

**3. Chair pushing and Pulling** \-- With the knees at right angles, try to gently push the seat backward. Relax. Now try to equally gently pull it forward. No movement of the seat will take place. The thigh muscles get excellent exercise.

**4. Buttockpinching** \-- This does not refer to the office executive's social cult. While sitting, tighten the buttocks. This will result in a slight reduction of buttock-pressure on the seat. Relax.

**5. Chest-Expansion** \-- Sit with the arms supported on the armrests. Gently push down on the hands while forcing the elbows backward into the backrest. Take a deep breath at the same time. Hold for two counts. Relax and let go the breath.

**6. Shoulder-Shrugging:** While sitting, pull both shoulders up to try and touch the ears. Lower to the starting position. Now pull the shoulders back, while breathing in at the same time. Relax and return to the starting position. These two exercises, are done alternately until the required number is reached.

FREQUENCY OF DOING TRAVEL EXERCISES:

In doing the exercises, be guided by your age, healthcare advice you have obtained prior to the flight; and physical condition. A rule of thumb however, is not to exceed three sets of ten repetitions of each exercise at a session. The sessions may be three or four hours apart, followed by a walk along the aisle.

EXERCISES FOR PROLONGED BED-REST:

A physically fit body, is a poor vehicle for disease or trauma. Occasions do arise when prolonged bed-rest is indicated. The nature of the "condition," dictating this course of action, will determine the scope of the exercise program. You should confer with your physician and physiotherapist about implementing a maintenance exercise program. The latter will instruct you about desirable exercises and superintend their correct execution.

The primary physical problems, attending prolonged bed-rest, are circulatory sluggishness; muscular weakening; respiratory insufficiency; bone-density loss on account of diminished weight-bearing activity; spinal and joint misalignment and stiffness. The muscular weakness associated with prolonged bed-rest, for a period of even two days, is considerable. The negative effects are compounded by maturity.

Should, however, the services of a physiotherapist not be available, then the following course of action will be helpful: Make sure that you will not be lying on a belly-bed. The pliable mattress must be well supported. If the peripheral circulation, in particular, is sluggish, your neck must not be dangling somewhere in mid-air, when lying down.

Adequate and correct support, is essential. The bedclothes, on account of being tucked in too tightly, should not convert your feet and toes into a supporting tent post. This will restrict movement and cause unnecessary frictional pressure on the toes and heels. The use of a bed-cradle, will alleviate bedclothes pressure on the feet during prolonged bed rest. The cradle, consist of a metal or a timber structure, such as a stool, with two legs pushed under the mattress while the upper two legs support the bedclothes. You should, from time to time, perhaps sit up in bed. The "armchair" arrangement of the pillows, must give adequate, and correct spinal support.

Too often, in hospitals, patients sit upright with their shoulders and hips supported. The part of the spine, in between, hanging unseen and concealed by the pillows, in mid- air. This often causes spinal distortion pain to develop between the shoulder blades.

It is not uncommon for irritation, emanating from the thoracic spine, to manifest itself, painfully, over the front of the chest. This mimics a "heart attack," the symptoms should at all times be regarded as serious. A systematic clinical examination and assessment, should, however, point the finger to the reason.

BED EXERCISES:

**1. LYING ON YOUR BACK, ARMS BY THE SIDE - LEGPUMP** \- bedclothes loose over feet. Pull the feet up until the toes point to the head, and return till the toes point toward the bottom of the bed. This aids the return of the blood from the lower limbs, and should be done slowly and rhythmically.

**2. ANKLE-ROLLING** \- Feet slightly apart, toes pointing to the ceiling. Turn the soles of the feet in to face one another. Then turn the feet out for the soles to face sideways.

**3. KNEE AND BUTTOCK BRACING** \- Tighten the front of the thighs by pulling the kneecaps up. Tighten the buttocks and pull up the back passage, as in stopping a motion. Hold for three counts and relax.

**4. ABDOMINAL EXERCISE** \- Lying on your back, hands behind the head. Press the lower spine into the mattress, by attempting to raise the head and shoulders. Hold for three counts and relax.

**5. BACK-EXTENSION EXERCISE** \- Lying on your back, hands, with slightly clenched fists, by the sides with the thumbs pointing towards the ceiling. Legs straight, feet slightly apart. Squeeze the buttocks together, thrust the fists into the mattress and pinch the shoulder-blades together. Hold for three counts and relax.

**6. NECK EXERCISE** \- Lying flat on your back with one pillow under your head. Keep chin tucked in, thrust the back of the head into the pillow. Hold for three counts and relax.

**7. BREATHING EXERCISE** \- Fists loosely clenched, arms by the sides, thumbs pointing towards the ceiling. Thrust the fists into the mattress by bracing the arms backwards. Take a deep breath through the nose and feel the lower part of the rib cage expand against the mattress. Hold for one count and breathe out through the open mouth.

FREQUENCY OF EXERCISE AND MODE OF PROGRESS:

You should do the exercises in the morning, afternoon and evening. The best time is at least an hour before meal times. Your exercise tolerance will guide you to the correct starting point.

CHAPTER 23.

MY PRECIOUS SPINE AND FOOTWEAR

The trendy Mr. James Spikes left the perch of his high-heeled sandals in an unplanned, uncoordinated and undignified manner.

"I fell off my sandals," he explained rather sheepishly. "And that's how I injured my ankle!"

Your "precious spine" is vitally reliant upon your footwear for its correct alignment and protection while walking, jogging, running or standing. The surfaces, on which you walk and stand, are, by and large, hard and unyielding. Each time your foot "hits" the ground, impact shock is transmitted along the leg to the spinal column.

I believe that the repetitive blow impact effect on the sensitive spinal-cord, housed in the central canal of the spinal-column, is grossly underestimated in terms of causing general body fatigue.

The alliance between the "hope" industry and certain areas of the "footwear" industry, has devastating consequences for many unfortunate consumers. The nature of the activity in question, at the time of wearing the footwear, has a great bearing on the ultimate choice of shoes or boots.

Firstly, you must decide who is in charge of the future well-being of your body. Will some fashion designer, prescribe the commencement of your future deformities, aches and pains? Or, will your common sense and informed opinion prevail, during the selection of the correct footwear to minimise future foot and spinal deformities?

What are the requirements for footwear, on which you should be basing your decision?

The shoe must have a pliable, shock-absorbing sole. The heel of the shoe must be low and stable. Your heel must rest on a level platform inside the shoe. Failing this, the foot will be forced forward inside the shoe, bunching the toes together and distributing your body weight incorrectly along your foot.

The shoe must conform to the normal anatomical shape of your foot. Cornering your toes, into pointed shoes, is a lucrative windfall for the orthopaedic surgeon, at a later stage in your life.

The weight of the shoe, too, is important. Each step you take, means lifting some weight. Slip-on shoes are a back-saver, particularly at the time of a painful back episode.

Specialised and corrective footwear may, on occasion, be called for. Here, fortunately, your practitioner will direct you to the appropriate specialist.

The pattern of tread on your shoes, is a valuable diagnostic aid concerning your "locomotion mechanism." You must, therefore, periodically examine your shoes to see whether your "wheels" are still in fine "balance and alignment."

Your hips, knees and particularly feet, will find a predisposition to a higher than necessary calorie intake, joint-wearing, fatiguing, and depressing. You must, at all times, guard against obesity.

CHAPTER 24

MY PRECIOUS SPINE AND MATURITY

"If only I knew!" exclaimed the remorseful Mr. Jack Jones. "If only I had known HOW to look after my back. I might have got better mileage out of it. "Well," he smiled, "my retirement might have been less restricted. It's ironic, you know," he continued, "now I've got the time, the old machine is reluctant!"

If you know how to "drive" and "service" your body correctly, it certainly will give you far better mileage. And this, of course, is what quality of life and spinal-care is all about.

It is the "individual bricks", that make the "building." Lay them with care, and your "building" will be sound.

A harvest of good health at maturity, does, however, not exclude a continued spinal-care awareness program. In fact, it will, no doubt, by now be automatic.

A few considerations, to accommodate your "changing health circumstances," will aid you on a path of well-being and happiness.

ACCOMMODATION:

Last evening I attended an eighty-three year young and very bright lady at her home. She is addicted to the ritual of "burning paper-wrapped tobacco leaves." She lives on her own in a rambling old double-storey home. Her complaint: bronchitis.

"You know," she informed me, "They tried to get me out of my house. First, the outer walls were run down twice." She paused for a spell of ventilation. "And then," she continued with an undertone of disgust, "the painter fell through the ceiling!" She laughed. "Can you believe it," she continued, "then I had a fire in the kitchen! But you know, they won't get me out of here!" She settled herself comfortably in a commodious low lounge-chair. "Thank God," she informed me with gratitude, "thank God I lost my sight while living in my own home. You see, I am fortunate. I store all the information up here," and she indicated her head. "At least I know where everything is. Can you imagine if I were suddenly to be relocated to another home, I'd have no idea where 'they'd' put everything!"

I suppose, old people grow accustomed to loneliness, though no one expects to spend his or her last years in financial depravation, solitude, and absent from loved ones.

If you should decide, to dislodge yourself from a trusted and comfortable old home, and social circle, you must be sure that the new home will be easy to manage and safe to live in. It must be easily accessible and should be on one level.

GARDENING:

A variety of gardening approaches, to lighten the burden, are at your disposal.

Vermiculaponic gardening, may be labour, time and material saving. I can assure you. The results are rewarding and excellent. A small area can, yield substantial crops.

An elevated, non-dig organic garden is yet another possibility.

Pots, tubs and window boxes can be put to good advantage and provide much pleasure in very restricted areas. Tubs can be mounted on a timber base with castors. Tubs with castors are also commercially available.

TRANSPORTATION:

It is advisable, to have public transport-facilities within a safe and easy walking distance from your accommodation. A variety of health and other considerations may, in due course, deprive you of the use of your independent mode of transport.

Carrying heavy shopping, over long distances, under these circumstances, is irksome, tiring and inconvenient. However, if you are confronted with this problem, get a lightweight, collapsible, shopping trolley to do the "carrying" for you.

The vehicle you use, particularly at this phase of your life, should have automatic transmission, power-steering and power-brakes.

RECREATION:

Active participation, in physical and cultural activities, is essential.

AIDS:

"This bowling aid has brought me back onto the green," explained Mrs. Whitehorn proudly, while demonstrating its use to me.

It is a valuable lifting aid, for the player with "sciatica," hip or knee pain. The wood is simply scooped up from the green and lifted to the hand.

Slip-on shoes, assisted by long-handled shoehorns, are appreciated dressing aids.

A good view, on your path of progress through life, certainly eliminates many stumbles. Periodic consultation, with your optician, for reassessment of your sight, is important, as you get older.

GRANDCHILDREN:

"They run up to me, expecting to be picked up," recounted Mrs. Nancy Biheart dolefully. "But my back, they always seem so disappointed!"

When you have to carry, or lift grandchildren, you must take the normal precautions, bend down from the hips and knees. The little people, have a nasty habit of becoming heavier. Take note of this fact. It may, in fact, be better and more entertaining for them, if you get down to their level of living.

Elderly, buoyant Mrs. Carter: "You know, it's rather fun wondering what part of you is going to go next!"

Pensive Mr. Layton: "Why don't they add these painful days at the end of our lives? Cut it short! I'll sign up for that!"

CHAPTER 25

MY PRECIOUS SPINE AND RETIREMENT

Relative to the content of this book, Chapter 25 Retirement -- is rather extended; reflecting the relative present, and expected future prolonged time, to be spent in retirement.

I have also harvested, the experience-based input from many of my elderly, "have-been-there," patient's views about what they consider to be valuable preparation for retirement.

It reflects about 31 percent of the total text.

"Retirement," certainly is not a static occasion but an on-going, ever-changing and ever-adapting process. At present, retirement time consumes almost one-fifth of a person's life. With improving life expectancy, this time will no doubt expand.

Continuing Change is incessant, "a rejuvenating friend, not an enemy". Make an associate, and mentor of Continuity of change. Change is constant ... if ever noticed.

Growing old is unavoidable, fortunately, growing wise is optional.

The courage and insight, to imagine the "otherwise," is our greatest resource, adding a broader view of the multi-faceted "retirement."

"It is so nice, not to be under the continuous deadlines and discipline of business or work-hours." "Now that I'm no longer working, I can spend more time looking after my health!"

Bear in mind, that change is hard work, and "accepted routine" can be disruptive, for many people. It takes time just to get used to time on your hands; to adjust your life-style and rhythm; to ease the foot off the accelerator.

"You know, it takes a little time to develop the "successful mental retirement software." But, I think it's very important to have the adequate health and financial facilities for a full retirement life.

When one retires, it is advisable to have at least the following three important things in place:

A roof over one's head; A reliable and growing income stream; And Membership of a Good Quality Health Care Expenses Cover Company.

Principles incorporated in this text, are there to help one, to guide one, not to imprison one.

An attitude of flexibility, within the pre-determined retirement objectives, is essential to accommodate the many "bumps" that we encounter during our retirement voyage.

The courage, to stick to the broad retirement plan, is the quality which guarantees all others.

Look facts in the face, bitter though they may be. Make a decision, and after you have once made the decision, devote all your time to carrying it out. Don't spend any time worrying about, whether or not, it is right. Make it right!

It is strange, and terrifying, how many people hit a certain phase or age in their lives (usually their mid 40's and 50's), and start coasting. And they coast. And continue aimlessly to coast. But some brave and enthusiastic people break out. They dislocate themselves from their present comfort zone.

They start renewing, living, striving, and exploring again. They deliberately, and vigorously, snatch back their enthusiasm and zest for life. They bring hope, insight and excitement into the lives of so many less venturesome folks.

Because they have been there, they are admired, council and respected by everyone. Among their age group, they often are the trend-setters.

To relocate, is a question of basic attitude, - whether you are open to the future, or fearful of it. Whether you see the world evolving and getting better; or deteriorating.

We have long known, that some positive people, favour "change and innovation, and look enthusiastically toward the future, while others, are frightened of change, and want to halt technical innovation.

When you consider relocating, for any reason at all, do so during the productive years - the years when you can still make a contribution to the economy and development of the new country. Failing that, you might well learn the following:

Generally people applying for these visas, are at the tail end of their careers, or have already retired, and are moving into higher health risk categories, therefore are not contributing to the new country's economy, and may put increasing pressure on the health system.

If you consider relocating, but are afraid of what the future may present, make a list of your future fears and priorities. Make choices about the activities in your future life; as with most endeavours, you can either focus deep or wide.

However, it's best to aim for security, safety and efficiency.

Do not take on something with a steep and expensive, learning curve, if you do not have either the required funds or time.

Live life "by active choice, and by design, not default."

You have worked hard, and tried to put something aside for retirement. You and your family need certain things, and you deserve them. But how do you get them with minimum effort?

By now, you will have established a passive income stream; something that generates funds even while you are sleeping!

Furthermore, it helps by cutting out those "must have" things that are superfluous.

Scale down, hold on to a life of simplicity.

Actively avoid pessimists, energy and time-wasters.

"Drain people and pessimists are people, who harvest and drain you of your valuable long-time acquired experience, expertise, time, energy, peace of mind, relaxation, comfort and money."

What do they put back in to your life? More likely than not: "it can't be done; you'll waist your money and time!"

Your chances of success, increase dramatically to the extent, that you eliminate these people from your life. It is certain, that if you associate with the enthusiastic "right" wrong people, it's virtually impossible to succeed.

Instead, rather budget your valuable time for the necessary self-enriching activities.

Keep in mind, that we live in a very contagious, negative world, a world in which we continually meet "looking on the negative side" folks, who try to convince us, that what we want to do, can't be done.

Do you want to tune in to the negative news? Destruction by burning assets, murder, rape, destruction of work opportunity, property, corruption, fraud and so many more, that are a part of this depressing catalogue?

If not, Turn off the news, because, it's mostly very "low positive energy," which only strengthens feelings of frustration, anger, depression and desperation.

As we recall from looking back, every successful person in history, has been told many times that what he wanted to accomplish, couldn't be done.

To be successful, you need to realise that a lot of the time you will fail, sometimes in a big disappointing way.

I often point out, that it is no failure, but rather a learning experience.

Learn from these "experiences," and you become more competent, until eventually, with a liberal application of optimism and determination, you succeed.

Remember, in the long run, if you persist, the law of success averages is on your side.

Always, be an active learner, learning new ways of doing things or using new skills, techniques, and tools, that can save you retirement time on costly mundane tasks.

Remember, too, that the very nature of our existence on the planet, involves us with a certain degree of "failure" or restriction.

Action!:

Nothing Happens Until you get Something to move. If you stop learning in this world, it will be four years later, whether you have done anything or nothing, and the world would have been rushing right by you.

Anyway, I'd say, the average person, should start using, what's left of his or her own informed brain, instead of relying on experts, whether those be government-stooge scientists or financial and retirement wizards!

Are you successfully, and Happily Procrastinating, or Waiting for something to happen?

You need to operate on the opportunity opening important principle, that if you want something to happen, you have to actively make it happen. If you depend on "them" to open the door, How long are you prepared to procrastinate and wait for "them" to do it?

You have to personally take actions to make things happen.

The time is never right. Procrastination, or postponed opportunity-killing Procrastination, is probably the most insidious obstacle to action. As all of us are aware, there are always a thousand, or even more, "reasons" to postpone an action or to wait for the "right time." why not face the truth in our lives \-- the subject of Procrastination.

The simplest, and most successful method for immediately overcoming the obstacle, is to make a written list of the things you need to do, prioritised your list, and perform the necessary actions.

Anytime you want people to take action, to better their lives, they have to be pro-active and "DO SOMETHING" to make it happen.

When you are enthusiastic, persistent, extraordinary at being pro-active, and skilled, you write your own ticket to any place.

Whether you have rapidly declining income and health, or not, focus on what you can actively do to improve both your health and finances.

But, there is a great difference between failure and success!

If you accept full responsibility for your life, you will accept that your destiny is created by you.

Of course, one can always join The failure's Hall of Fame!

When I started this book, did I have reservations? Of course! But that did not put me of; I realised that, judging by the interesting, life enriching questions, the patients often asked, there must be a down to earth, non-technical book, based on practical, personal experience, to address these questions.

Yet, here I am, able to share my experiences with you. If I can do it, so can you!

Do not waste your precious time, energy, or money, focusing on what you cannot do. Rather, Focus on what you can Successfully do. Accept, and be delighted, that you will encounter, and certainly learn from them, Small, Negative People, who are first class active pessimists and jerks. You will soon learn, what you cannot learn from them!

When you do, immediately disassociate yourself from them. Remember, pessimism is a very contagious, and dangerous disease!

NEVER stop reaching out to find others, who are open-minded, keen to learn, and are like you, and share the same visions and ideals and ideas, and develop friendships with them.

However, Never be afraid to let people go if they are not right; often that is the only way you can make room for the right person.

Also, keep in mind, that you are doing them a service.

Build reciprocating alliances and network, with stimulating, successful and good people. Reach out, and Help those who help you; each of you will be richer and stronger for it.

As you start affiliating with competent, successful people and advisors, they will begin referring you around.

Remember, obstacles are opportunities in disguise. Without learning opportunities, obstacles, the products we create or services we provide, cannot improve.

Do you enjoy creating unproductive worry? Unnecessary Worry, lives a long way from informed rational thought.

Remember, when relocating to a potential new home: that the buying and selling of a house is a lot like the emotional expectations of dating. The same emotional expectations and over-investment; the same daydreaming about the potential of the home; the shortsightedness of not seeing the possible flaws and pitfalls associated with the actual building and the location of the property.

Keep in mind that The agent's well polished vocabulary of real estate selling, is seductive, classic, beauty," "Light and lovely," "Cute and cozy," "Enjoy this unique little well-priced charmer."

When you move to a new neighbourhood, it's power for the course. Walk around, at various times, listen, smell, talk to the locals and look.

Also, keep in mind, that the following items, will almost certainly go up in price. Therefore, be future budget aware of this fact!

Fuel and energy; transport; medical expenses; property rates and taxes; security; food and entertainment.

To minimise the future home-related rising expenses, it is also prudent to acquire a new home, or accommodation, that is eco friendly. This refers to energy saving, water saving, maintenance expenses and safety and security.

It has, long been an axiom of mine, that the little things are infinitely the most important.

Listening, is as important as talking. One too easily acquires, the professional tone and loses vision.

Never underestimate, how contagious moods are between people. With your experience, I depend on you to be my mentor in this venture.

The quality of life, during your latter years, is very strongly influenced by the planning made in the preceding years, especially in regard to healthcare and financial and investment prudence. "Retirement," therefore, should commence at a very early age.

Life is hard, but it's infinitely harder if you're uninformed and stupid.

Become financially and investment literate, as early in life as you can.

Financial planning, is about planning for the worst.

"RETIREMENT READINESS":

Saving for retirement is much different.

It's about "accumulating wisdom, insight and capital, for the sole purpose of creating Sustainable Wealth, to accomplish the Goal of Being Independent and Able to achieve "Retirement Readiness. This is frustration-saving, worry-saving income yielding, capital, hopefully, wisely earmarked for 20 years down the road and should be used for no other purpose.

This is monthly income yielding, capital, that must be accumulated above and beyond your normal living expenses.

Capital, is the money you keep after you spend what you need and want. It's what you use, to invest in new wealth-building opportunities. Without capital, you have no chance of becoming financially independent and free.

To be Free is a great gift. To achieve that, you do not need great amounts of money, or influence or power.

A patient just recounted the following financially devastating episode to me:

"Seven years ago, I was invited by a well-remunerated friend, to attend his retirement dinner, at a very expensive restaurant.

His investment advisor -- from one of the well known companies, was also present.

"John, he said, you must let Peter here, have a look at your investment portfolio. He's a top expert; he'll do much better than you are getting right now."

"I'm sorry, but I don't understand advanced mathematics -- those figures don't mean anything to me. I'm a simple fellow, never had math's at school. I just quietly started investing in property at an early age -- and now -- I'm quite comfortable."

Well, now, seven years later. "My friend now has to live with his parents, has a small car, is, in fact, battling with his well diminished portfolio."

So much then, for the top investment expert's achievements.

Are you well-prepared for retirement, particularly, in the following areas:

Can you continue generating adequate income to cover living expenses throughout your remaining lifetime?

Can you continue to work, in some form or another, while allowing for leisure time to enjoy life.

Are you vigilant, about your investments in the following areas?

Retirement savings and investments, employer pension benefits, government benefits?

It is obvious, that Retirement security is in your own hands. This applies particularly to the ladies.

So often, a successful marriage partnership builds up assets to support their future. Sadly, though, often the "financial driver", the husband falls away prematurely.

The "financial and investment" illiterate, or semi-illiterate, remaining partner, now easily falls victim to "vultures" of various skills, well polished sales experience, slickness of word and dubious intentions.

Financial provisions, therefore, must be made for the economic security of the remaining partner. This, of course, applies equally to a relationship in which the partners are not married to one another, but are living together.

Take the example of a man, who married a woman five years younger than himself. At the time that he turns sixty-five, he has a life expectancy of approximately sixteen more years.

(Note: with improved life expectancy, that figure has to be revised upwards -- or, problems may lie ahead.)

The sting in the tail, however, is this: when the man is sixty-five, his wife who is five years younger is sixty years young. Her life expectancy, at age sixty, will probably be, twenty-four more years.

The probability, that she will experience eight to ten years widowhood, is therefore evident.

The sooner, therefore, one refocuses from life-expectancy, to greater expectations from life, the more enjoyable the quality of life is.

With the rapid medico-technical developments, that impact our life expectancy, it is probable that right now there are people already born who will turn 150 years old down the track.

Note, the relative times spent on actively working till the mandatory 65 years and the long retirement phase of one's possible life. Could this mean a possible 100 years of retirement -- with no active and growing income stream?

A rather daunting financial prospect, considering the associated health care costs to achieve this prolonged life span.

Maybe you will hear this refrain: "Will You Still Need Me When I Am 165 Years Old?"

Some health-care orientated pharmaceutical companies, are -- backed by venture capital establishments -- already focusing on vanquishing disease, slowing aging -- maybe, even stopping aging -- banishing Alzheimer's, creating a life free of disease, general and joint decay, quality of life depriving pain and fear.

According to mounting scientific data, the most important social factor predicting longevity, is continuing education. Education appears to teach people the important factors for both health and financial success: about how to delay gratification and how to plan and use a financial budget for the future.

Your caring social and family support system is also very important.

Social and intellectual isolation, can also predispose to poor health and a shorter lifespan

The trade-off for this longevity, on the part of the woman, brings with it an awesome obligation. She must be aware of this, and prepare herself in advance, emotionally and financially, for some years of widowhood.

However, sad to say, I have known of cases where the "widowhood" proved to be a liberating experience!!

I have seen the "bitter experience" of so many of my elderly lady patients that I cannot but emphasise the importance of becoming "money-wise" and "investment and economically literate" at a very early age.

It is never too early to protect your family's present and future financial well-being. Failure to plan, is a huge mistake.

Adversity, introduces us to ourselves. The most important reason for failure, is not taking timely action. If you take no action, don't be too surprised if you suffer negative consequences by default.

You need to take the future landscape widening initiative. You have to take a calculated chance to get a reasonable chance. Many people fail, simply because they never start, or if they start, with the first hurdle, they quit.

Action Is Life; Inaction Is Death. It's Our Choice.

What do you do to live your dream?

Various routes, or combination of routes, are available to achieve these objectives. These include subscriptions to financial and investment publications; reading the financial and investment sections of the daily press; reading books on these subjects; joining an investment information club; attending lectures and seminars; keeping an eye and ear on television and radio programs dealing with these matters; and, of course, gleaning information by talking to people whom you perceive to be "successful!" Few successful people have qualms about sharing basic principles that opened doors to them.

To win, and to be Successful in the Retirement Future, you must Pay the Planning Price Now. You've got to prepare yourself, develop yourself and your mindset for the retirees' winners circle.

By active planning and participation, you will not get locked out of your future, suddenly you will see the retirement journey you're going to travel.

You need to regard life as an exciting, enriching, and stimulating journey rather than a final destination.

Without early planning, we might fall short in the future; but getting as far as we can, is often the best we can do.

There is an old saying: "money runs to outstanding service; people will pay for it. If you have enough of the latter, you can also have the former."

It is your self preservation duty, to know what is not going on around you.

Clear and methodical thinking, is hard work. A great many people outsource their common sense and go through life without doing creative thinking to any noticeable extent. Nothing is negligible, that is a symptom of loose thinking.

Maybe, it is a good idea to outsource fear and failure. In so doing, one may be Learning more by not succeeding.

Fear, has been known to kill a man, as speedily as a bullet, and it is continually killing thousands of people, just as surely as the bullets are killing people.

It seems that the people, who live in fear of a particular disease, are the very people who often get the disease they fear!

Thoughts of doubt and fear, are destructive, self demeaning, energy depleting and can never accomplish anything, and never can. They always lead to inevitable failure and disappointment!

If you wish to accomplish little, you must sacrifice little; if you wish to achieve much, you must sacrifice much; if you wish to be an outstanding achiever, you must sacrifice a good deal!

That may call for Delayed or Postponed Gratification. We sometimes, must be willing to grow beyond the need for any immediate particular comfort, in order to later achieve an even greater compounded comfort.

You must also be aware that law is an expensive pastime. Slander depends so much on what other people remember, or, more important, will admit to remembering.

Thousands are x-rayed for aches and pains, that are in the emotions and can never be seen on the x-rays. Some people complain so effectively to the health care provider that it is not difficult to convince the average doctor, particularly in financially declining times, that an immediate emergency operation is needed. You would be amazed and shocked if you knew how many organs you can lose that way, too.

Gillian, suffering a severe stress-related blinding head ache, told me that she knew perfectly well that the doctor would be quite busy, or performing an emergency operation. "It's standard procedure. No self-respecting financially and socially upwardly mobile doctor, lawyer or professional person, in the world, will admit, or will have, his secretary admit that he is anything less than extremely busy."

Yes, cancellation, surely not "no patients."

The tragedy, is that so many patients suffer unnecessarily, on account of the prejudice, or self-imposed ignorance, of some healthcare service providers, About alternative solutions to the health problem.

Design your own improved health, and financial coincidences.

Brains, like hearts, and money, go where they feel safe and where they are appreciated.

Few things move past us as quietly as the future.

So, if we are not proactively involved in life, to harvest the potentials and opportunities, the train will rush by, and we will still be standing with almost empty hands, purses and experiences.

Passion, and experience, not necessarily learning or pedigree, will win in the end. If you transgress the boundaries of God, you are punished.

The older you are, the more difficult it is to scuttle your favourite prejudices.

Humour, the survival first aid, is laughter at what you haven't got when you ought to have it. Wise are those who, early in life, learn that the bottom line doesn't always have Their Top Priority.

Sadly, Not everybody knows how to experience!

Many '"glued to their location" people, live their whole lives and never get beyond the real exciting "skin of life!"

Fortunately, I am no longer afraid of becoming lost, because The journey back, always reveals something new, and that is ultimately mind expanding for the keen and investigative traveller.

Journeys lead to expanded vistas, experience and knowledge.

Pro-active people, exercise free choice and will; the freedom to choose the response that best applies to their values. In that way, they certainly gain control of their, and their family's circumstance, rather than being controlled by them. The last ultimate freedom of choice, could not be taken from them.

Political Liberty that we value, is a condition of the environment; on the other hand, freedom is a condition of the person. Political democracy and Liberty means that we and our family, have many options to choose from. This includes, in which country, social and financial environment we wish to work and live. Freedom, means we have the internal willingness and power to exercise those options. That is what it means to be truly pro-active. That is what it means to be actively in charge of your life, to emotionally and financially except this.

But, for many politically submissive people, this is a very difficult doctrine, particularly if they have had years and years of explanation by the all-knowing authorities as to why they were unhappy and miserable in the name of somebody else, or something else. To achieve this, You have to swallow a bitter liberating and empowering pill, but once you swallow it, it is completely freeing, exciting, at a level you have never enjoyed before.

Laughter is the sunshine of the soul. The difference between a happy person and a broken soul, is the attitude towards the problem. That makes us either the happy, or miserable, people that we are.

The mind, that has free access to books, can roam virtually at will across the face of the planet.

"I don't see arbitrary age, imposed by someone -- as an impediment to doing what I want to do."

Often, a small amount of wisely allocated money carries a large leverage.

So there you have it -- there is another valuable brick in the wall of your Self Education.

Why not early in life, Limit your credit card and cash-burn rate. The gratifying music will always offer something in return.

With early retirement, the loss of prolonged work time, is the enemy of security and profit.

Early in life, learn How to take care of your money, so your money later in life, takes good care of you. In this Financial Self Empowerment Process, Formulate a mental picture of yourself succeeding. Inner peace and harmony, without health and financial stress, is the easiest form of existence.

Worry about the family, security, health and financial freedom, is the most subtle, corrosive and destructive of all modern diseases. Unnecessary Anxiety and stress, is the great modern health destruction plague.

Can you successfully cope with stress?

In a very busy world, with all the duties and obligations we take on, stress is natural.

There is not a lot of point, in discussing investment and financial self empowerment literature, with someone in an uninformed money management voice.

That is one of the benefits, of becoming financially independent. You have to answer to no one.

One of the rarely cited advantages of having money, is that you're less beholden to others, who have it too. The more you have, at least in theory, the more you can ignore the other person with it, and go about your choice of living, and choice of business.

In short, with a little independence and freedom capital of your own, you can do what you want.

The Importance of Capital.

If you are dependant on someone else, for a job and income, If, for some reason, they don't keep the cash flowing, you may not have any. You stress, and fearfully, serve at the pleasure and good will of others. If you give them any reason, real or imagined, they can cut off your career and income.

Capital is different. If you have enough of it, you don't have to work for anyone. You can enjoy life on your terms, and maintain seemingly unpatriotic opinions.

Capital frees you from the dictates of politics too.

As Ronald Reagan once said, "the nine most terrifying words in the English language are: I'm from the government and I'm here to help."

If you want to be financially free, you have to have diversified shares in the "means of future progress and production."

Broadly speaking, the data now indicate, that as people get richer, they report getting happier too. However, there is more to the story. It appears that poor people in poor countries, are not unhappy simply because they don't have wads of cash. They are more likely to have fewer job and political choices, less freedom, more children, who die in childbirth, and other stressful and serious health and financial problems.

It takes wisdom, enthusiasm, experience, and investigation time to build a great and successful investment portfolio.

However, once the umbrella of the correctly selected, "formula" and implementation guidelines, have been put in place, it requires only periodic tweaking to keep it running successfully up to date.

A sure way not to be successful, with making money, is Not using a methodical systems, for making money.

It is, of course, vitally important to have a well defined, and investigated, investment system in place.

A system for investing and making money, is something that takes the emotion out of your investment decisions and makes the results more reproducible.

The important "I don't know" liberating key, is to recognise that, while you don't know everything, and you never will, you do know enough to get started, with your investing program. And you will learn more along the way, as you apply your increasing knowledge in the real world, surviving any mistakes -- learning curves -- and challenges along the way.

Once you create a proven system for making money, there is no limit to the money you can make.

Warren Buffet once said: "wealth is the transfer of money from the impatient to the patient".

To become a successful investor, requires patience and persistence. You must not only investigate and get started, but you must continue on and follow through.

Another reason so many investors fail, is that they try and do it all themselves. The sometimes inconvenient truth, is that there is no such thing as a self-made millionaire.

Successful investors, build a great team around them, and have mentors and models -- they learn from people that have already achieved what they want to achieve.

They look for people, who give them independent unbiased advice.

Always be aware of The fact that science has so far been unable to explain exactly how various disease processes originate and evolve. It may only mean, that our present understanding of the world of health, is incomplete.

"It's never, too late, to be what you might have been." George Eliot.

We cannot let our net worth determine our self-worth.

Remember, that uncontrolled and unnecessary Debt, is a vicious health, asset and money devaluating spiral.

However, most of us have to utilise access to debt, to either acquire a good education, use the funds as seed capital to start a venture, or to do both. This is creative and necessary controlled debt!

When, you finally have -- after starting early to save -- an abundance of money, you realise that it has its place. It definitely brings certain comforts, and cuts down on unnecessary health depriving worries. It gives us choices -- the kind of options I believe every diligent, hard working and planning person should have. It also gives us choices, to tackle problems, and aid with the creation of work, and opportunities for our fellow citizens.

But money alone, is far from the true measure of our most valuable asset: integrity and worth.

"Until you make peace with who you are," writer Doris Mortman once said, "you'll never be content with what you have."

And who are you? To me, You're absolutely priceless.

The problem that many people have, is that they leave home and school, and never learn or understand, the possible uplifting vocabulary associated with health and money. Resulting, in a prolonged, needless, life-time of financial struggle.

To make money, and unproductively hoard it, is a misuse of the possible creative and employment power of money.

The Physical condition, is also largely determined by emotional conditions. Do not feel responsible for everything. Accept that what has been happening. Try to believe in yourself and in what you are doing.

Lack of early and on-going retirement planning, is a certain seal on the doomsday misery certificate.

The great thing in this life, is not so much where we are, but in which desired direction we are moving. Don't be afraid of change. The world is advancing, advance with it.

Too many people, are afraid to step out of their established comfort zones. And so end up living frustrated lives, hopelessly unfulfilled... which to my way of thinking, is a real opportunity, and life experience enriching waste.

Let not your mind dwell, on what you perceive you lack, as much as on what innate abilities and skills you have.

Of the things you have, select and focus on the best; and then reflect how eagerly they would have been sought if you did not have them.

The happiest and, by far, the healthiest people, I had the fortune to meet during my long, stimulating and varied career as a Chartered Physiotherapist, were people, who retained continuing achievement drive and ambition, in both work and recreation. Furthermore, almost all of them developed a "passion for what they do.

The happiest of people, don't necessarily have the best of everything, they just harvest and make the most of everything that comes along their way.

Nursing-homes, are filled with "survivors," whose lives are subconsciously focused on "dead man's" boots. In view of this, the successful retirees also retained an "independence and stimulated" state of mind attitude to aging itself.

The stimulated conscience is an amazing, dynamic and creative dynamo. Furthermore, the successful retirees did not fail to take good advice from younger people. The surprising thing about young people, to many of the older folks, was how many of them were keen to capitalise from their experience and expertise.

They find it easier to believe someone "who has tried it."

The jaws of both time and expertise of the retired folks, have chewed their experiences and produced this valuable insight and information.

Keep your mind, open to change all the time. Welcome it.

ATTITUDE:

Our society has inundated us with the importance of importance. The urgency of urgency.

Sad to admit, it's often become a status symbol in our society. If we're busy, we're important; if we are not busy, many of us are almost embarrassed to admit it.

Have confidence in yourself, and others will too. Show confidence, to reap confidence.

There is a difference, between feeling confident, and projecting confidence.

Lack of something to feel important about, is almost the greatest tragedy a person can experience.

Do not try to conform to some perceived "dramatised" version of yourself.

Don't ever let someone's opinion of you, become your reality!

Always be aware, that the person expressing a negative opinion of you, your work or professional "capabilities, may be based on that person's underlying addition to alcohol, medical or social drugs, suffering from a inferiority complex or just total lack of insight in to the reality world around them.

Not to forget, that that person may also be suffering any number of personality or psychological deficits that might underlay their expressed opinions.

Today, the value of paying practical attention to the protective voice of your gut feeling, was highlighted by Aldred, fifty years old. About fifteen years ago, a friend challenged him to join him in running a marathon. Aldred, who never before ran long distances, enthusiastically responded to his friend's challenge: "come on, don't be a ..."

The outcome, running on the soft sand on the beach, the slight incline of the running surface, all set the stage for a low back catastrophe that plagued him ever since.

"I started off well, then suddenly this burning pain came on in my left buttock. I stopped. It subsided. I continued running; it got worse. I have consulted with neurosurgeon, who suggested a lumbar fusion; various spinal care and treatment practitioners.

Still, I'm paying the price for not listening to my gut feeling at that long time ago."

Don't secure yourself to your history; lock yourself in to your untapped potential; and if you learn to imagine vividly, and also draw heavily upon the power of the inner sense, or consciousness, of what is right or wrong, you will come to detect the most fundamental principles, that should direct your life.

For an easy at hand reference, you can easily distill them in the form of a printed formula or mission statement. Or a value system, or a life's purpose statement.

The breakers-away are the successful creators. Remember, you are under no obligation to live within the perspective of another person's view about you.

Learn to say "no", It will be of more use to you than to be able to read Latin or understand the theory of quantum mechanics.

Remember, people will always try to manipulate you into their way of thinking. They will want you to think, and act in a way that supports them.

Fortunately, The World Assists and Stands Aside, to let anyone who's enthusiastic pass, who knows where They're Going. Often, What one is trying to be, is exactly the opposite of all these "expert" people's opinions who prevent you from being what you really want to be.

I think I was fortunate, in that I grew up without having to worry about food and clothing and things like that. Sadly at that time, the vast majority of people in my country, were worrying about where the next meal is coming from.

Has it by now, changed for the better? It's many years later -- again, equally sadly, no!

The ability, to understand and adjust to one's present and anticipated future "condition," instead of just passively accepting someone else's "verdicts," is a powerful age prolonger.

After all, it always is best to actively take the "driver's seat" in one's life. By so doing, fellow-travellers and "advisers" soon realise that you know where you are heading, and even more importantly, which route to take.

Meeting other people's priorities and expectations, whether they're important or not, can be both time and energy draining.

The mental attitude of anyone, is the sum total of various aspects of their life experience. Therefore, the earlier in life one "develops" a positive and humourous sense of living, the better the chances for desirable retirement health and happiness are.

It soon became evident that these happy people did not anchor themselves to their history; instead, they logged on to their untapped potential. Then, once they had unsaddled many of the entrenched habits and prejudices, and drew aside the curtain of lethargy, they were able to imagine quite vividly enough, how they could harvest and enjoy their hidden potential treasures.

Everything can be taken from a person, but one thing: the freedom to choose their attitude in any given set of circumstances.

Almost all of the successful and happy retired patients, that I have dealt with in several countries over many years, retained sovereignty of their thought and decision-making processes. After all, most of us desire dominion over ourselves dominion over our prejudices, our thoughts, our fears, our destiny, our mind and our spirit. One can attain this dominion, to a large extent, by controlling and regulating ones desires, actions, reactions and association with either positive or negative-minded people.

Keep in mind that, sometimes, taking the shortest distance between you and your objectives, may have long-term consequences.

If you treat people in negative ways, they will act negatively toward you; if you treat people in respectful and positive ways, they will act positively toward you.

Actively and progressively, move beyond the prevailing negative energy pattern. Develop a mind set within yourself, that really is you. If you think the way everybody else does, there is no originality within it. You are, after all, an outstanding individual; you should not be affected by the prevailing negativity, or with demoralising thought patterns of the world around you.

As you create this positive mind set within yourself, you step beyond corrupt, demoralising, frustrating and severely restricting government.

Right now, - 2013 -- it is obvious that The depressed international economy is anemic. People have been burned so often, they just try to keep their powder dry.

Remember, One mediocre meeting, doesn't destroy a career.

It is true that they that lose money, lose little, they that lose health, lose much, but they that lose courage and hope lose all.

Hope endures and overcomes misfortune, disappointment and evil.

Don't become the victim of The torture of hope. You, too, might have noticed that Hope, a dwindling commodity, is in critically short supply.

It is very strange, that the years teach us patience -- that the shorter our time, the greater our capacity for waiting.

Greatness lives in those, who triumph equally over defeat and victory.

Be wary of people who sprout contagious toxic emotions, as well as toxic prejudices, that often entrap and stifle progress and the ability to enjoy life. Associate with positively minded people.

Positive people attract others, while negative people repel, and often suck you into their "negative" world. Frequently too, they drain your positive mental resources, and fortify you with nothing in return.

On reflection, one of the very best decisions, we took many years ago, was "to drop our "negative friends." At first it might seem selfish. However, in the longterm, this decision enhanced our quality of life; put more positive time at our disposal to interact in a more meaningful manner with our fellows.

Our life is what our thoughts make it. Good thoughts bear good fruit, bad thoughts bad fruit.

People do not attract that which they want, but that which they are.

Always, keep your hand firmly upon the helm of well directed positive thought. Good thoughts and actions, can never produce bad results; bad thoughts and actions, can never produce good results.

It is important to marshal one's thoughts, by setting aside time to contemplate, meditate, read and "filter" the value (if any) of negative and "distressing" information, targeted at one.

Courage, like pessimism, is contagious. I have found it advisable, not to give too much attention and worry time, to what terminally pessimistic people say, when I am trying to achieve something of consequence. Invariably, their opinion, is "that it can't be done." this, I believe to be the best motive for progress.

After all, there is no failure except in no longer trying. There is no defeat except from within; no really insurmountable barrier, save our own inherited weakness of purpose.

It is a crisis, that will reveal your powers and resilience to yourself. Find the hidden opportunity in failure. You may be disappointed if you fail, but you are certainly doomed if you don't try.

Important: Take Yourself for a Treat: today, Give Yourself Liberal Permission to Succeed.

By doing this, you can Make disappointment your strength. You will also learn, how to Be prepared to be disappointed. Only regularly disappointed fools, expect things to go the way they want. But never do!

Expecting, and to be ready, to be disappointed, is a way of mentally and emotionally, preparing yourself to be Ready for Unwanted Surprises. By being emotionally prepared, you can act with self-restraint, calm and dignity, when things do not go your anticipated way".

If you're informed and calm, you can think better. We all make mistakes; we all feel upset and disappointed, when things do not go as planned.

Yet, the difference lies, in how we apply past learning curve experience, and internally process that disappointment.

I selected, rather than emphasising on restricting disappointments, to look at the bright future prospects. For me, this philosophy works splendidly.

Also, I am extremely fortunate, to have married an eternal, buoyant and energy-laden, enchanting, and optimistic wife.

In Japan, there is an entire world view, that appreciates the value of the imperfect. Wabi Sabi, is the aesthetic view that sees beauty in the modest and humble, the irregular and earthy. It holds that beauty comes with the patina of age, and in the ages that come with use.

In the West, no one took more pleasure in painting Old people than Rembrandt. Young people, didn't interest him as models. Age spots, wrinkled hands, the lines of experience, the lifetime you can see in an older person's eyes -- these fascinated him more than untested beauty of youth.

Day, by day, tiny specks of us float away.

No matter which complicated, time consuming exercises or expensive diet regimen we follow, no matter which renowned self-help guru we believe in, nothing will dispel the reality that we are not built to last. Death, is our supreme limitation, the final proof that perfection was never meant to be part of the human experience. Yet to feel our mortality in our bones, is the best condition we can have, for waking up each day, to the miracle that we are here at all. And if you think about it, that is the brilliance of the human design plan: The built-in -- sometimes niggling "defect" is the very thing that can spur us to drink down the full draft, as it comes to us. Better to taste it now, this life that we have, than to defer to some future, that may never come.

Roger Housden is the author of 14 books and lives in New York City. This excerpt is from Seven Sins for a Life Worth Living (Harmony Books.)

Fear of failure, can destroy creativity and initiative. There is evidence, that optimism bolsters the immune system. . Optimism, is a habitual way of explaining setbacks to yourself. The pessimist, allows a disappointment in one area of his life, to pervade the rest. The optimist, doesn't let one setback contaminate his whole life.

You can't force happiness to happen -- but certainly, you can be prepared, and make sure you are ready and aware of it, when it knocks at your receptive door. Happiness, is a positive mind set and attitude, not an expensively acquired fashionable condition.

Is deliberately changing direction really failure? You "Don't want the perfect outcome to be the enemy of the potential hidden good!" Insecurity breeds greatness. You won't ever find, a highly motivated super achiever anywhere, who wasn't or isn't motivated, at least partially, by a nagging sense of insecurity.

Don't procrastinate, because spending More time, costs even more missed opportunities and money. In fact, if you procrastinate, do you believe that you Are losing valuable experience and money on schedule?

Considering retirement relocation, ask yourself this important question: "are you Moving away from what you don't want rather than moving towards what you want!"

What makes something special, is not just what you have to gain, but what you feel there is to lose.

In times of great personal, or political turmoil, it's important to be with friends.

However, be careful not to be lying down with dogs; you might get up with fleas.

"There is never enough time, to do all the nothing we want to do."

The secret of enduring happiness, is to make others believe they are the active cause of it.

One's dignity may be assaulted, vandalised and cruelly mocked, but cannot be taken away unless it is voluntarily surrendered. Treat people on the content of their character, not their colour.

Remember, It's a very shallow life that doesn't give another person a well deserved few recognition stars.

Contagious Misery loves enthusiastic reciprocating company.

If I were to continuously focus on what other unsuccessful people are doing, it would detract from what I am trying to achieve and do.

A combination of Talent, and enthusiasm, is the greatest passport in the world, it can get you anywhere. To adapt quickly and time and frustration saving is even more important than planning.

Remember, that What gets measured, gets better managed.

Retirement relocation selection Success, is about knowing where you want to go.

Never leave a place, without in depth investigation, where you're having a good time to go somewhere else where you only think you'll have a better time.

Always remember, that important Things that matter most, must never be at the mercy of things which matter least.

Look backward. Can't you see where your failures have helped you?

Do you wish to be part of A policy of dynamic inaction. Fraud; Crime; Corruption.

Do the thing you fear, and the death of fear is certain. Our greatest achievement and glory, is not in never falling, but in rising every time we fall.

Firmness of purpose, is one of the most necessary sinews of character, and one of the best and undervalued instruments of success. Without it, unrewarded genius, wastes its effort, in a maze of frustrating inconsistencies.

I have noticed, and so have many unfortunate, "High Yield" fast-gain investors, that The "Sure Thing" Boat never gets Far from Shore.

Just take one step. After that, you'll take another, then another, then another. Before you know it, you will have made it.

"I just resolutely and persistently, kept knocking on doors, until the Right one opened."

What is a locked door, if you have the key: Knowledge, Persistence and Insight?

Why not Plan to be "a one-in-a-million.?"

Most achievers know, that success, is less a matter of talent, than of working hard, and remaining undaunted by failure. Determined Achievers know, that beginner's luck rarely has a hand in true success -- and persistence almost always does.

The motivating key, is remembering, that every hurdle crossed, is one less hurdle, in pursuit of your personal ambition.

Success, is the natural by Product of full, joyful Living.

Real personal success, can only be defined by you.

Again, avoid Reaching for someone else's definition of success. Because you will end up living a mirror life, of another person's ideas, objectives, ideals, hopes, and either lack or plenty of energy!

Work expands so, as to fill the time available for its completion.

Intimidation, is no substitute for creative and focused thought.

Why should some other person's perception of the truth, pervert the course of dogma?

Should one person's prejudice and ignorance, determine another's progress?

It is Your qualification, not your excellence, that often predisposes towards a high income.

What we must decide, is, how we are valuable, rather than how valuable we are.

Focus on what you do best, and success will follow.

Ignore weaknesses, and prejudices, that don't impede or hinder you.

One of the great mistakes people make, is believing they must correct their weaknesses before they can capitalise on their strengths.

Instead, you should work on a problem only if it's lessening your productivity or self-esteem. By thus "managing" your weaknesses, you allow your strengths to overpower them, ultimately making them irrelevant.

How a person masters his fate, is more important, than what his fate is.

Everything can be taken from a person, but one thing: the freedom to choose their attitude and action in any given set of circumstances.

Never forget that: "To the world, you may be one person, but to one person you may be the world."

If you haven't any charity in your heart, you have the worst kind of heart trouble.

A keen sense of humour helps us to overlook the unbecoming, understand the unconventional, tolerate the unpleasant, overcome the unexpected, and outlast the unbearable.

If we're not joyful all the time, we conclude there's a "medical" problem.

Acquiring and Maintaining, an expensive and complicated lifestyle, is a great way to avoid, changing it during later retirement.

When locating to another country, I want to find and associate with successful people, who have had to work hard, and who have been prepared to learn from their mistakes and failures.

After all, You come together with other people for growth, not for life.

Remember: When evil political men plot, concerned citizens and their family must plan for a better and safer future. When frustrated and evil destructive men burn and bomb, concerned citizens must seriously consider the merits of becoming an international citizen. Obtaining alternative citizenship, banking facilities and health care cover.

When evil men persistently shout ugly words of hatred, to their fellow countrymen, concerned citizens must try their best to break down the barriers of prejudice.

When established culture, is degraded and vulgarity enthroned, when the social system does not build security, but induces fear, crime and peril, inexorably, the individual is impelled to pull away from a crime ridden, corrupt, discriminating, unjust, highly prejudiced and soulless society.

Is this the fiber and structure, of the country in which you, and your family, are trying to make a living his

Political instability; civil unrest; social and political violence -- wealth destruction; job destruction; confidence destruction; hope destruction; atmosphere of despair.

Have you contemplated the possible impact on your future life of a government failure?

The important question now arises: what motivates good folks to move away -- if the authority or government of the day displays a no-care attitude towards a policy of dynamic inaction -- to fraud; crime; corruption.

Then, take action and Be the change you want to see.

It may also be, that A passion for corruption and violent crime, blossomed in the country, from which you are leaving.

Witch, for you, and your family, amounts to politically engineered penury.

Does your country provide adequate safety and security for you and your family? Or must you, have a pistol or machinegun at hand, or, at considerable mounting extra expense, make the necessary provisions for that lacking safety and security? Which, in fact, you probably have already paid for, by way of the hefty taxation system!

So, what does your present country do with their perceived good fortune?

Do They perhaps, systematically sabotage it?

Do they perhaps, channel the bounty of the country in to their private wealth producing facilities?

Does your present government, perhaps consider to expropriate the country's biggest work-creating, mineral sources; the biggest wealth-creating private companies; the vital starvation prevention food production farms?

If you look back, on the politico-economic recent past, can you see the disturbing and threatening whole gamut, of how much damage economists and self-centered politicians can do.

Do you wish to continue living and working in a country that has huge potential?

But no long-term guarantee of access to the assets that you and your family, have acquired and created?

A country with potential on all these fronts:

Maybe, with the richest farmland in the world... plenty of water... plenty of minerals and other resources.

Or, are you not concerned about the possible mass land expropriations.

Do you love living in a country, hellbound on self destruction; the rapidly filling balloon, that's sooner or later, is destined to burst? Growing income and financial inequality; increasing citizen fear and political instability?

A culture of Mounting Rape and Violence.

As someone told me with mounting dismay, "the multi-cultural society in which we were living, and in which we were so proud, is systematically degenerating and fracturing."

You don't have to burn libraries, museums, schools or books to destroy a civilisation and culture. Just get young people to stop having access to them, and stop reading books.

Yet another reason for relocating, to another state or country, is simply, fleeing crippling taxes.

It could be like getting a 10 % plus or even more raise.

And, it might make sense for you, and your family, to consider relocating, too.

Yet another, and growing reason for folks to relocate, is that you may be living in a country where, for various reasons, you and your children, are penalised from equal opportunity access to a growing number of work situations.

This leads to the frustrating and demoralising situation, of" "unoccupied expertise" and professional capacity.

Knowledge and professional or any other expertise is not knowledge unless it is rewardingly shared.

The young and enthusiastic fellow told me: "I just offered to prostitute my expensive and time consuming education, practical training, hard gained experience, expertise and on-going personal development, for something far less than the best, and it landed me on the sidewalk of despair and unemployment in a matter of minutes. I've diligently worked on this "We are needed in this country" synopsis for a while now, fine-tuning it every time some potential employer would read it."

"Each time, they turned me down"

I feel like the rug has been pulled out from under me. The survival plan I've been working on, the plan my family and I have put everything into, is suddenly gone. I really don't know what else to do. I feel, the only smart thing to do, is to cut back; or relocate to another, more open, country!"

The lesson: Don't go where you're needed; go where you and your brain, skills and expertise, are appreciated and needed the most.

There are basically two competing factors that influence one's decision to relocate to another country. Either one is pushed out of the present country; or, one is pulled to another country. The balance works almost like a see-saw!

From this, it is clear, that people definitely need to do something, to spread their safety, financial and political risk, beyond a single jurisdiction, if they have not yet done so.

This, is the single most important security and life saving thing, I can recommend you do today.

When you don't have to worry about protecting the spoils, of you and your family's expertise, effort and labour, from some other party, or corrupt government, you can work that much harder.

Free of unnecessary government, restricting regulatory distraction and impediments, you can focus your full energy and dedication on your objectives.

And, if your labours are fruitful, you can use the resulting wealth, and your own enthusiasm, expertise and keen insight, to contribute to the growth of your new country's economy at large. You can innovate, help create jobs, and effect vast changes to the landscape of your choice!

That's likely to be the kind of political, personal and financial freedom at the heart of your value system!

Gravity causes planes to crash, and galloping greed and corrupt governments, do the same to companies. It doesn't matter which country you are talking about.

You cannot strengthen the weak, by weakening the strong.

You cannot uplift the poor by destroying the rich.

By shouting the word of value and job destruction, often enough, they hope to turn it in to a financial, and political self-uplifting reality.

The western society, is claiming something of a highly priced mortgage on morality.

More and more you hear this comment: "The situation is worse: we must take the next step."

This unfortunate, and often imposed stressful situation, produces unwanted alienation deprivation of skills, and the international fragmentation of families.

This is perhaps, one of the most pervasive and insidious development in contemporary society.

Do not give undue momentum to the political ill wind, that's already blowing.

However, always keep your ears to the ground \-- be on top of what the groundswell, political and financial pressure views are."

Cleverness is the shadow, whereas informed intelligence, is the successful survival substance.

Successful Survival, is a matter of actively making the prevailing system work for you, rather than attempting merely to survive it.

The truth of what your investigations reveal, can only add to the sum of what you know, while a harmless mystery, left unexplored, often adds to the meaning of life. Therefore, When a Truth, is not so important, it is best left as a mystery.

Unfortunately, and equally sadly, we more and more frequently hear this opinion expressed: "I'm not interested in the recital of crime and corruption fact, after fact, after fact, after fact." "For me not the local horrifying facts."

Instead, to justify their comfort zone existence, and the privileged way of life, the negative emphasis must therefore be focused elsewhere.

They want to hear, how bad and unfortunate things are in other countries, cities or far off places. "For me, not the facts."

Numerous and frightening economic changes, are occurring throughout the world. For me, the way to get at the way other folks live and cope, is to spend some meaningful and enlightening time in their country.

With the locals, I like to embrace local contradiction and to talk about the type and quality of life and their ambitions and frustrations.

In politics, if you are a good word smith, and if you are slight of tongue, and have a Persuasive gesture, You can take a fact and you can dress it up, and make it look and sound a certain impressive and attractive way. We can even see it in our political situation. They're taking not even so well concealed advantage, of their elevated political positions, for under the carpet financial self enrichment, and additional perks.

Politicians do it all the time, and corporations do it all the time. They manipulate and dress up, these things called figures and facts. Fortunately, often, in the long run, they can't manipulate and conceal the truth.

With the wonderful culture of storytelling rapidly vanishing, The collective memory of our society, is becoming shorter, and capable of holding less of the family and historic past. Consequently, the collective pool of commonly recognizable past images is growing smaller and more impermanent.

Memory, and it's vivid recallable content, is what makes us the dynamic persons we are.

If we lost all our memory whenever we fell asleep at night, it would be the same as if we died and a new person woke up in our body the next morning. What a shock -- or even delight -- it might be for many folks to find themselves in another body the next morning.

Person to person transmitted History, is the memory of a family and nation.

Knowledge, is what best to do.

Skill is how best and most valuable time and money to do.

Attitude, is the powerful motive and driving force, coaching why to, Or Want to do!

Perseverance, is no guarantee you'll succeed. But without it, it's almost guaranteed you won't.

A mind, troubled by procrastination an doubt, cannot focus on the door opening course to victory. Remember, that anything that is life enhancing important cannot be really learned in the classroom. It must be learned by taking action -- making mistakes and then correcting them. That's when wisdom sets in.

One of The greatest of all gifts, is the ability to estimate possible life impacting things at their true worth.

Although it may be a good idea to consult with an expert about both your health and finance, it is certainly very prudent to pay attention to your gut feeling and in-built common sense.

Again, I stress: If a consultants advice or service is no good, hire a new one. Similarly, If your health is the goal, and the doctor isn't helping you attain what you want, get a new doctor.

Remember, if procrastination, is the handbrake on your progress or ambitions, that Opportunities multiply as they are seized.

Always be aware, that Somewhere along the line, the "expert" may have had a common sense bypass.

Also keep in mind, the possible Foolproof systems that do not take into account the ingenuity of experts and fools.

The best brain stimulating way, to keep moving forward, is to keep on learning.

"The rung of a ladder, is never meant to rest upon, but only to hold a man's foot long enough, to enable him to put the other somewhat higher." Thomas Henry Huxley.

When political, social, economic and draconian things are moving fast, standing still certainly is the best assured way to get destroyed and run over.

When you find yourself in a retirement career trap, how you climb out may ultimately be more important than how you progressively fell in.

If you have but one wish, let it be for an uplifting and goal-setting idea.

An idea, coupled with enthusiasm and persistent action, is a powerful success force.

It might even involve, that your future Growth demands a temporary surrender of security.

Select your "correct time" to present a new idea. A great idea, may result in a total flop, if presented at the wrong time.

As you gradually move along life's escalator, you learn that the art of being wise is the art of knowing what to overlook.

Always hear this echoing in your mind: "A man can't damage both your self-esteem and ride your back, unless it's voluntarily bent."

You may have been cheated and humiliated. But there is no valid voluntary reason, to bend over for someone to ride on your back.

Perpetual optimism is a powerful force multiplier.

In this world, the optimists have it, not because they are always right, but because they are positive. Even when wrong, they are positive, and that is the sure way to success and achievement.

You can breed self-destroying pessimism; you can never stifle enthusiasm and optimism.

Check the opportunity door three times, as well as the prevailing window of opportunity.

There is no limit to which a person will not resort to avoid the exhausting labour of thinking.

A person should so live that their happiness shall depend as little as possible on external things.

Failure is not a disgrace. The only disgrace, is to give up and not to try.

Give your dedicated, and very best in every circumstance, so that you have no reason to judge yourself and create guilt and shame.

Live so, that at the end of each day, you can say, "I did my very best." That's what it means to excel at the great game of living your enjoyable and best life.

I am a keen and enthusiastic investigator, reader, searcher for information that can impact and improve our quality of life. In this quest, I have learned, that The larger the island of knowledge, the longer the shoreline of wonder.

Remember the lesson of the pyramids. Each brick, is insignificant; together, they amount to a wonder of the world.

No mystery is closed to an open and unprejudiced mind.

Ignore the professional, well experienced pessimists, who want to bring you down to their miserable level, and stand in the way of your dreams.

THE creative visionaries and dreamers, are the saviours of the world. Often, they are solitary visionaries and dreamers.

Just look at the famous world-changing inventors, composers, sculptors, painters, poets, and prophets.

If you feel tired, depressed, anxious, and lacking both energy and enthusiasm, and don't think every second, minute and day is a good day, just try missing one.

Don't lose your individuality. Education and conforming society, may try to deprive you of it. Don't let that individuality and creative spark be lost; its your only individual real claim to success and importance.

Nothing in the world can take the place of persistence and perseverance.

Talent will not; nothing is more common than unsuccessful people with talent.

As history has proved: Genius will certainly not; unrewarded genius is well recorded.

It is an education, to face what you don't know.

At the time of writing -- January 2013 -- the world is in a crippling financial and unemployment grip.

Many young people are carrying the financial, rather huge burden, of acquiring a good education. How, with mounting inflation and increasing mechanisation, they will overcome this headache, will yet prove their innate abilities and strengths. Hopefully, aided by governments, that make it much easier for the small entrepreneurs of the future to bring their skills and innovations to the public at large.

Sadly, where we always believed that good education is the key to both employment and self-esteem success, the world is full of highly educated and frustrated derelicts.

However, Before you despair, remember the immortal words of Derek Bok, former president of Harvard. "If you think education is expensive, try ignorance."

However, An academic qualification does not necessarily have extraordinary positive outcomes.

As you will notice, I am Evangelising the subject "of Quality Of Life And Back Care.

A university or college education, certainly does not mean you are educated. Quite the contrary.

It means that your receptive and keen mind has been opened up to a perpetual state of ignorance. And, thus a lifelong hunger for obtaining more. More stimulating ideas, more knowledge, more uplifting and perspective widening thoughts, more of life's challenges, in fact, more of everything.

Wisdom that comes from expensively personally acquired experience. Its the best gift, you can give your kids and grandkids.

Another great gift, is the strength to live life on your terms, not being beholden to some authority, company or to the government of the day.

With this gigantic financial obligation, rapidly and possibly financially devastating episode bearing down on them, it's very critical that right now your children, and grandchildren, learn about the workings of money and finance.

They need to know the basic principles, such as, how to be independent, why debt is crippling, and potentially dangerous, and how to successfully grow money.

They don't -- or hardly -- teach practical, and meaningful, finance in schools.

If you, as parents and grandparents, don't teach them this valuable, first-hand acquired knowledge, no one will.

Also, don't forget to Teach them that life was never meant to be a struggle.

In fact, I believe it is actually a potential Quality Of life Depravation Disease. They call this sometimes, terminal `Disease," financial Illiteracy.

We have seen this rather sad and devastating situation, with some of our older friends. The wife simply refused, to get involved with the ways, in which the family finance is run, or organised.

With the death of the husband, they were simply left in the total money management darkness! The "Sitting Duck", for the various investment vultures, to descend for the "Pickings."

If our children are investment and financially illiterate, they have as much chance of survival as a melting block of ice on a hot day.

I Urgently emphasise, Please Assist, where you can, with Passing the Experience Baton on to your Children and Grand Children. Because, There will be no mercy for the financially illiterate in the future.

It's likely, that these investment and finance illiterate people, will live as indentured servants, to the government and its energy sucking creditors.

But if our children, and grand children, have from a young age, a practical grasp of how money works, and finance and its basics and they obey its laws, they will grow up rich. They will also be in a fortunate position, to help other folks as well.

Below, you'll find the three vital financial concepts that adults and all children need to understand. Please pass them on to your children and grandchildren as soon as you can.

First, our kids must know, that they are not entitled to money or wealth or anything for that matter. Even Christmas presents. They must earn Loyalty, Trust, Respect and Money.

The second important concept our children need to understand, is debt.

Debt, is work, energy and value-destroying and very expensive. If you abuse it, it will ultimately destroy you.

We note, the advertisements are only focusing on the monthly repayments on items -- such as even the expensive commodities like motor vehicles, and other luxury life choice, and must have now items.

The best way to illustrate the cost of debt, is to calculate the total amount of interest, the debt generates, in dollars, over the lifetime of the loan, instead of looking at the present interest rate (like most people do). Once you look at it like that, you can immediately see how ruinously expensive borrowing money really is.

The third thing, our kids need to learn, at an early age, is the Magical Power Of Compound Interest, And the best way to harness it.

Compound Interest is the Most Powerful force in finance. It is the force behind almost every fortune.

The brilliant Richard Russell, calls Compound Interest "The Royal Road to Riches." And it's mathematically guaranteed.

Important formula to look at: Let's say, for example, you have $100 earning 10 % annual interest. At the end of a year, you'll have $110.

During the second year, you'll earn interest on $110 instead of $100.

In the third year, you'll earn interest on $121, and so on.

This is the power of compound interest.

The numbers get enormous over time, simply because you're earning interest on your interest.

Because time is the most important element in compounding, it's an incredibly powerful idea for children to early in life learn about and understand. They have the ultimate time edge in the market: the time to progressively Compound over Decades.

"Time," working for you, is more valuable than money. You can get more money, but you cannot get more time.

The stock market, is the best place to earn compound interest.

You buy companies, that have a long term internationally diversified history of dividend payments, that also have many years of rising dividend payments ahead of them. Then you let the Miracle of Compound Mathematics Work.

In truth, as I have already emphasised, you have the awesome but pleasant responsibility to educate your children and grand children about finance. If you don't, rest assured, no one else will, and, in the long run, they will suffer for it.

Encourage them to work diligently and hard, and to avoid the prevailing entitlement mentality.

Teach them, by using games, and with practical statistics and graphs, the Power of Compound Interest and explain the Potential Hidden "Dangers Of Debt.

If you do this, you will equip your kids and grandkids, to survive financially in the difficult circumstances ahead. You'll provide them with something that nobody can place a price on: The Awesome And Liberating Power Of Social And Financial Independence.

If, in the future, we are to be effective, in both work and financial independence, we are going to have to investigate and think.

THE GENERATIONAL WEALTH PHENOMENON

There is an important Chinese proverb that extols the reality of building real wealth.

It says, "Wealth does not pass three generations." The first generation of wealth creators, will be lucky and persevere, hardworking and diligent in saving for their family.

The second generation, will not face the same challenges. While it enjoys the fruits of the first generation's hard work, it will fail to appreciate the hard work that goes into building wealth.

And sadly, by the third generation, the wealth will be squandered. or, more correctly, subtlety, wealth-shrinkingly relocated to various slick of word, selling trade folk, selling the "must have now" products and services!

Another form of destroying wealth, is to insist on buying only new products. Here too, with some financial planning and diligence, large amounts of money can be saved and rather channelled to productive, compounding international stable investments.

For example, Buy "pre-loved" goods. In the age of internet auctions, we are becoming more aware that new products are not always the best value.

Many shrewd car buyers and experts, buy experienced or one-year old cars, or demonstrator models, at enormous discounts.

I recently told a car enthusiastic friend about my "New car."

You too, might be interested in my "New Car." It's the latest model Mervobm C 429. Ms. (Moneysaver)

(This is a fictitious vehicle, as you may guess.) Which I bought on FRIDAY 20 April 2012. Price, $40 123. Keep in mind, that when I signed for the splendid virtual vehicle, even before it left the floor, it depreciated 25 percent. Then add the insurance of $1 200 for the first year, and I'm totalling $41 323.

As you may deduct, I rather like the idea of acquiring an "Experienced" vehicle, as opposed to launching into the upper financial stratosphere of the stomach ulcer brigades. I will revalue the new car total portfolio's worth after 12 months -- on 20 April 2013. This portfolio increased 12.5%.

Not bad!!!

Cars are famous for substantially depreciating, the minute you drive them out of the sales room.

Buying a new car is, of course, frequently a status, life-style and ego choice.

However, sometimes, it may also be a financially motivated work-related tax deductible sound option.

A car, is a well known classic creator of prolonged bad debt. (Apologies to car salespeople.)

I find it most difficult to keep the door of information, from a person sitting next to me on an aircraft, shut. I have learned so much, from these "mobile And Life Enriching" libraries, simply by tapping into their wide and venture filled fields of endeavor, and past experience.

By saving now, and delaying the need "to enjoy something" right now, gives the advantage of putting your funds to the eighths miracle of Wealth Creation Compounding.

Getting better, like saving money, is a process, not an event.

Start small, be determined, but make the commitment. In addition, commit yourself to remain being steadfastly committed to your objectives.

As you watch your savings grow, the preferred process, is to find financial and investment self-empowerment ways, to make it grow faster.

Interestingly, and excitingly enough, once you have commenced on this investment avenue, it becomes a delightfully self-fulfilling prophecy: the more the portfolio grows, the more excited it becomes, and the more it accelerates.

One advantage of saving in this way, is the miracle of the compounding effect.

I must once again, emphasise: As you see your wealth begin to accumulate, you need to continually educate yourself about how to invest wisely. This too, is a process, not an event.

Many of my generation, realised that living within -- and below -- our means is a good thing before and when we retired.

As always, early in life, start to pay yourself first, and learn to invest and to live "on the rest."

The following, is an extract from an email that I undertook to forward to the lady who sat next to me on a flight; she told me about her very enthusiastic savings-orientated daughter:

Please find appended information re financial and investment self-empowerment that, if one takes it to heart at an early age, certainly will mostly assure a relatively secure and happy later years quality of living.

Have fun. Don't forget to create and collect a treasure of pleasant memories for future reflections -- and mostly, enjoyment with someone for whom you care a great deal.

Of course, we would be delighted to learn how your family unit is progressing along your chosen financial and investment Self Empowerment routes in life.

One of my missions in life is to channel, particularly young kids -- with the emphasis on young girls, to become Investment and Financial literal as soon as possible in life.

To this end, I have made three timber boxes \-- for our Australian grand children -- with two slots at the top through which money -- no, even better, savings must be deposited into the two compartments of the "Investment Box."

The back compartment is the larger and long-term savings division; here must be deposited at least 60 percent of their savings. The front, smaller, compartment, caters for the "I may spend" money; here too, it is not absolutely necessary to deposit 40 percent, what's left, obviously goes to the back long-term compound savings and riches creating division.

(Of course, the preceding is totally irrelevant. The only caveat is that one simply never knows what might be the outcome of planting and nurturing a good and enriching idea with a "Young and informed person.")

Regards,

Eugene (and my wife Tineke) van Wyk.

Mcsp. London. England.

Author of:

My Precious Spine And I -- A Self-care Manual For You And Your spine.

You may well wonder what the response from this lady was -- I waited in excitement -- none.

My sincere hope, is that our grandchildren will one day say: "My grandparents led by enticement, rather than obligation."

Important: The whole point of financial planning is to find a way to make sure your investment portfolio doesn't forcefully and painfully kick the bucket before you do.

Remember, if you don't look after your money, Your Money Will Retire Before You Do

If you're in good health, you may live a lot longer than you think.

That means, you must be on top of the ever changing technology and investment knowledge information situation.

Many people do not understand, what medical, or health care procedures, are available. In fact, they prefer to remain technologically illiterate.

Take note of the following:

Biomedical gerontologist Aubrey de Grey thinks the first person to live to see their 150th birthday is already born.

Modern bio-Medical technology is awesome.

A cancer-stricken man from Eritrea received an artificially grown trachea derived from his own cells. Yet More awesome medical technology at work.

Part of the reason, our health system is a money swallowing financial monster, is, because we are living much longer than previously expected. However, I can think of much worse problems.

Try successfully living, with a underdeveloped a health care system.

Life expectancy, for someone born today, is eight years longer, than someone born in 1960.

Yet another quality of life inspiring health statistic: In the U.S., and Europe, death by stroke has fallen 70 % since the 1950's.

Patient Mrs. Gloria Herrington (aged 80) 14 November 2007) "It was ten days when they would take the clips out; and then after 13 days, they took the two big stitches out. And then you really wanted to die! Because the pins and needles in your stomach was something that you couldn't take! And you also couldn't really stand up properly, you were so weak, after lying still for 13 days!! And hum, they wouldn't even let you move over in bed. They came along and turned you over to wash you. You were not allowed to sit up. You had to lie with a bulster under your knees! Knees up! Is that all you wanted to know?? "How many years ago?" "Well! I was 17 and I'm 80 now!"

You must consult with your registered and experienced financial advisor, or advisors, about having your money safely tucked away, in tax-free potentially growing international, and diversified investments.

Remember, these prudent investments are going to play an important worry-free part in your retirement, and present retirement planning.

Once more, I must emphasise: cross check the registration with the appropriate financial regulation authority, about the up-to-date valid, qualification, and registration, of the financial investment consultant, you wish to confer with.

Far too many, glib and most persuasive experts, are ready to take both your confidence and funds, to add to their kitty. We keep on hearing, and reading, of these financially devastating, relatively regular episodes.

Somehow, I get the impression that so many folks are honesty and expert assessment trustworthy "illiterate.

Unfortunately, this thought scares the daylight out of novice investors, as well as a few old hands too!

Who can blame them when the typical stock market nest egg has been gyrating like an Egyptian belly dancer lately?

Relax. At present, This is the norm. The previous five years, without so much as a 10 % correction, in the market, is the exception.

Investors, who expect to earn the generous returns, only a diversified stock portfolio can deliver, while watching their net worth rise, as smoothly as a bank balance, are kidding themselves.

That's not how the reality world works.

The way it works, is this.

Capitalism creates more work and prosperity than any competing economic system. The essence of capitalism, is the private ownership of the means of production. And the stock market is the true democratisation of capitalism.

Even young people of modest means can own a stake in a profitable business by simply buying a few shares. With just a small outlay, they can even reduce their risk by owning shares in several well known international and consistently dividend yielding, businesses or in a mutual fund.

Yes, the stock market can be frightening at times. But almost nothing else, offers you the prospect of earning higher long-term returns.

The slogan: "press on and work diligently and hard" -- has solved, and always will solve, the problems of the human race.

It has been my observation, that most folks get ahead, during the procrastination, and sitting on the fence valuable time, that others waste.

Every noble and gratifying work, is at first impossible.

Remember: Heights by great men reached and kept, were not attained by sudden flight, but they, while their companions slept, were toiling upward in the night.

If you only knock long enough and loud enough at the correct gate, you are sure to wake up someone.

Learn how to co-operate with the inevitable.

Failure is not the falling down but the staying down. The man or woman, who makes their own opportunities, is, bearing an accident, a sure-fire success!"

An important facet of negotiating, is to recall, that Next to knowing when to seize an opportunity, the most important thing in life is to know when to forgo a perceived advantage.

No one has a finer command of reasoning and language, than the person who keeps his mouth shut.

Don't put off being happy until some future date. Either your health or funds -- or both -- may run out on you.

What you give, both good and bad, sooner or later in life, you get with compound interest.

He who enthusiastically enjoys doing and enjoys what he has done, is happy. At the work place, as well as at home, It is not the revolution that destroys the machinery, but the friction.

When negotiating, or trying to lay a dispute to bed, remember that a problem well stated is a problem half solved.

Shut out all of your past negative experiences, except that which will help you successfully weather your tomorrow!

Tomorrow is another exciting day; and I'll do all in my power to harness the opportunities, and make it a better one.

The unnecessary worry vogue, kills more people than work -- because more people tackle it with persistent long-term super enthusiasm.

one of The sure keys to failure, is always trying to please everybody.

The irony: related the blind patient, the less I could see of the physical world, the more I could see of a wider horizon and a infinitely more intricate world and the people that inhabit it.

If at first you don't succeed, find out if the unhappy loser gets anything.

Most of us have heard of the 80-20 rule, in other words, 80 percent of our success, comes from 20 percent of our efforts; originated by the Italian economist Vilfredo Paretto in 1897; also knows as the principal of least effort.

We don't know, who we are, or what we can do, until we see what we have done, despite our previously held sceptical views.

Your philosophy, is your grease, or your rust in life. Therefore, positively and deliberately strive to have a buoyant and enthusiastic outlook on life, and all it offers, both good and bad.

They, who don't accept the conditions and restraints of life, forfeit their heritage and happiness, and sell their soul.

Do not fight against the huge number of things you cannot change. Instead, learn to manage them to best health, financial and happiness advantage.

Remember, no door or window of opportunity, is on automatic mode, you'll have to open it yourself! Maybe, perhaps, forcefully open the window or door, or even move on to several other doors, or windows.

"God grant me serenity to accept the things I cannot change, the courage to change the things I can; and the wisdom to know the difference."

Adversity in health, is the mental strengthening gymnasium of the spirit.

The other day, this was demonstrated in such an enchanting and skillful manner. An artist patient who's lower leg had been amputated, came in for treatment.

"Where is your leg?" an enthusiastic little four-year-old boy enquired.

"I lost it on the road. Please be very careful when next you go on the road," came the reply without missing a beat.

I might add that this diabetic gentleman who, like all of us, was so dependent on his legs, is such an irrepressible optimist with a buoyant sense of humour.

It is so true, that the gem cannot be polished without friction. Frequently, struggling against obstacles makes us innovative, resilient and strong.

Count your plusses, not your minuses.

Tune into your intuition, your safety valve, conscience, your personal internal GPS guidance-system. You have on-board, a most sophisticated, self-guidance and protection "system."

It connects us with the collective insights and wisdom of the ages. Pay attention to it; logic and reason may not always be the best way to solve all of life's manifold problems. You could be better off developing your intuition or gut feeling.

When it comes to danger or risk, trust your intuition and common sense, it always has your best interests at heart.

David Lands, Harvard historian and economist: No empowerment is so effective as self-empowerment. Nothing worth having happens without work.

There is never a good or best time to lose money or to get sick.

Financial decisions, should not be rooted in investment ignorance, but in the informed future, you want to build for yourself. You can decide, whether you want to live in financial and emotional poverty.

Expending energy, in a wasteful way, is the road to poverty and struggle.

Every day you spent, trapped in any form of health and financial ignorance, is a precious enriching day you have wasted!

The best investment, you can make, is in your future; money can't take the place of a lonely or empty heart. But a self-empowered health and financial background, will have the capacity and energy to fill up an empty bank account. Be informed \-- Act on what your future and heart needs.

There is only one real and important sound. The rest, is often distorted echo!

There are no real secrets, only everlasting simple basics!

Sadly, so many older folks, having experienced almost all shades of life's colours and patterns, don't transfer their accumulated and valuable life's lessons, to their children or grandchildren.

We must answer the question:

"Why do you think you survived? Is it only because my day, my hour, my minute has not yet come?

However, I believe I lived so that I could tell my children and grandchildren as well as the world this back saving and other stories.

No one was born to be a great investor.

"Instead, investing, is a craft, that is learned somewhere outside of your genetic code. Get someone to show you the ropes.

The Best Investment Book of All time.

And when it comes to stock market investment advice, there's no better place to start than with "the dean of Wall Street," Benjamin Graham.

In fact his book Security Analysis, written in 1934 with David Dodd, is practically revered as the bible by serious investors. From the Intelligent Investor:

We learned that human consciousness, isn't locked within the physical body. Therefore, it does not necessarily follow that Those who labour in the field are not equal to those who labour in the mind.

Being afraid to venture outside our established comfort zone, often seriously inhibits our future quality of life. Like with, delayed or postponed gratification, we sometimes must be willing to grow beyond the need for any immediate particular comfort in order to later achieve an even greater comfort. I begin to suspect that a man's bewilderment is the lack, or evidence, of his wisdom.

If you believe in your heart that you are right, you must fight with all your might to do it your way. Remember, that Only dead fish swim with the stream all the time.

The uninformed mind can be the most frightening wilderness. Make your own rules. Successful people are entrepreneurs and mavericks whose minds roam outside traditional ways of thinking. Instead of trying to refine old formulas, they invent new ones.

Top performers in any field, get to the top by frequently confronting things they are afraid of. If you and your partner, are lucky enough to find a way of life you love, you have to find the courage and financial backing to live it.

Anyone who takes himself too seriously, always runs the risk of looking ridiculous; anyone who can consistently laugh at himself does not.

Be predictable and selective in your goals but flexible and unpredictable in your means to achieve them.

The public is mostly resentful to acquire and pay for that which they cannot take and show to their friends. This includes health care and financial advice!

A frank addition that an answer cannot be given is better than an answer that looks as if it means something but really means nothing. So, even though mathematical accuracy may in the nature of things be unattainable, identifiable inaccuracy must at least be avoided.

PLANNING:

The realisation that the very job that once thrilled you, now keeps you from progressing and enjoying life, can dawn in many subtle ways. At that stage, a "back-up retirement plan" should be in place. The best preparation for a better and happier life next year, is a balanced, complete, enthusiastic, full, happy, and joyous life this year. Our belief in a richer and happier future life is of minimum consequence unless we implement them into a meaningful and happy present life.

If one advances confidently in the direction of one's retirement dreams, and endeavours to actively live the life which one has planned and imagined, one will, more often than not, meet with success and happiness.

True joy of life, is the planning the trip. The ultimate station is only a dream. It constantly outdistance us.

GET THE FACTS:

Do not even attempt to outline, resolve and implement a retirement plan and horizon without first collecting all the relevant facts, in an impartial and systematic manner. See first that the retirement design-plan of action is wise and just; that ascertained, pursue it objectively-focused and resolutely; do not, for one moment, forgo the purpose and objectives that you resolved to effect.

For the determined and goal-oriented person, the impossible just takes a little longer.

I cannot over emphasise: look, investigate, gather relevant information and feedback from those who "are there," before you leap but leap anyway. I frequently emphasise: Don't be intimidated and paralyzed by other people's negative perceptions or perspectives. The main thing, is to keep the principal focus the main focus. "Stick with the plan!"

As always, mix judgment with ambition, enthusiasm and season it with well goal-directed energy. It is a splendid recipe for success.

Experience shows that success, is often due less to ability and overrated qualifications, than to zeal and enthusiasm. Today should always be our most wonderful day. So often we rob tomorrow's pleasant memories by today's economies and thrift on enjoyment of the little "here-today" things. Don't be miserable today to be happy tomorrow. By tomorrow, the price of happiness might very well have gone up, putting it out of reach!

One of the secrets of a happy life is periodic small treats. Last Monday a middle-aged lady told me: "Friday was my birthday! No, my husband does not believe in celebrating anything! In fact, it also happened to be our anniversary!"

The fate of the "if only it were next year; or if only I were elsewhere" people, is very debilitating and wearisome, not least for those living with them.

Nothing of consequence was ever achieved without enthusiasm. The winners and happier persons are the ones who give themselves to their interests, body and soul.

When "circumstances" seem loaded against one, it is time to decide whether "circumstances" can be changed; if they can be changed, resolve to put all enthusiasm, zeal and energy into changing them. However, if the current perception is that "circumstances" cannot be changed, learn how to co-operate with the inevitable. The "inevitable," too, can often be "directed" in a more favourable direction.

RETIREMENT-TIME TIMING:

If one has an option, it is wise and profitable to phase the actual Retirement Date to get the optimal tax benefits during the retirement year in question. This applies particularly to self-employed business and professional people. It is prudent, and most advisable to confer and consult with an accountant, estate-planner, financial-planner and taxation-adviser about this matter.

Thinking too much, in solitude and isolation, can lead to procrastination, dithering and bad decision making. It is, therefore, important to consult with pragmatic and trusted friends and advisers about any weighty matters concerning the immediate or long-term future.

GRADUAL PHASE-OUT FROM WORK:

If people slow down a little, as years go by, they have the luxury of time and insight to gradually refocus their remaining energies, as narrowly or broadly, on their future goals and interests, as they choose. It is easy to calculate the weekly paid job and travel time now available to retirees. Fortunately, women mostly glide with apparent ease and dignity from the full-time day job to the ever-present domestic occupation. I firmly believe, that women's innate ability to keep meaningfully occupied is an important factor in their better life expectancy.

What you can do, or dream you can do, now if ever is the best time to begin it. Work, like water, almost always fills the time and space allocated to it. So does idleness! With this added "free time," kicking in with retirement, comes even more opportunities for life-enhancing experiences to be attained. How we spend our days is, of course, how we spend our lives. If we live good lives, the times are also good. As we are, such are the times. If it is to be, it is up to me to let it be.

This retirement time, like all times, is a very good time if only we know what to do with it. However, what to do with that time, often seems to cause frustration, particularly for the women who now have a "full-time" husband at home.

Once I met with a wealthy and prominent man who made a lot of money in an obscure world. He was possessed with the desire of stability and the preference for eminence in a small world over competition in a larger. When he retired, he told me that he used to get a hundred or more telephone calls each day. Suddenly, on retirement, he became mister nobody. This evidently concerned him a great deal, with mounting stress and frustration. Fortunately, he saw the wisdom of unretiring, by actively getting involved in ventures where his expertise and skills plus the past's associations, made a huge and exciting difference.

Life is much too beautiful to live it alone.

If we are ever to enjoy life, now is the best time not tomorrow nor next year; nor in some future life after we have died.

However, again, a life lived well today, will also take care of life after death.

Pray as if everything depends on your God, and work and plan as if everything depends upon yourself. Remember, faith is household capital. When we pray, we link ourselves with the inexhaustible motive power that drives the universe. We ask that a part of this "power and motive force", be allocated to our present and future needs. We are twice armed if we fight with faith. Faith can have a profound impact on the quality of life and health. It is a very intimate and personal experience of thought and surrender, which can comfort and relieve in every situation.

Faith is free and freely available to all people at all times. To log on, requires that one fully and unconditionally embrace the possibility, and the ultimate values and potentials in the extent of that experience.

If you are trusting in nature, in a God in something every now and again there is an unexpected bounty of gifts that come your way.

Don't put off being happy until some future date. Do the best with conditions as you find them. Do not wait until next year for better conditions. Make "conditions" better this day. Tomorrow might have its own health or financial penalties. The great opportunity, is where you are, just draw aside the curtain of prejudice and apathy. Throw aside the blinkers. Seize this day and opportunity. It will never come again.

Never argue or debate with individuals or institutions, who's preselected prejudices or dogmas are genetically "right."

With retirement, also comes the opportunity of putting some thoughts and life's experiences to either paper or, even better for editing, to the electronic format on your computer.

Feel free to transcend present limiting realities, and keenly reach out for new and creative ideas. If you're going to create, you might as well create a worthwhile lot. With creativity, if you do not win, you're usually no worse off than if you hasn't played.

If you can sell the result of your effort, hopefully the more financial and satisfaction power to you. If you can produce good writing, photography, specialised goods of any kind, and sell your work, may even be on the internet, even better.

If you have got a good concept, and it works, and you own it, the better.

Remember, You can only do either productively or by procrastinating, what you do for a limited number of years, and you're rapidly using up more of that valuable remaining time every day.

Start investigating, whether there is possibly a more rewarding, satisfying and better way to do, or sell, your business, service or product, so that you can sell it to more than one person at a time!

Or, rather, Are you going to die happily glued to your desk?

With the ever-mounting cost of living, more folks are continuing to be gainfully employed, or even self employed. Internationally, retirement is about to become a rare luxury.

At our hands and command, is the judicious implementation of outreaching technology. What you have to be able to do, is to create a greater market for yourself, create more jobs, through, in fact, increasing your market share internationally.

Take advantage of technology leapfrogging.

Many years ago, I realised, that, sooner or later, people who are self-employed, may experience a situation, in which they may be unable to generate income on their own

In fact, these folks are only a motor vehicle or any other accident away from a possible financial disaster. I well recall the case of a mid-aged dentist. he was working on his farm; doing some tilling, or pulling a heavy trailer. Suddenly, the front end of the tractor lifted, and the unit flipped over. The gentleman's right hand got caught under the machine. The battery acid poured out over his right hand and lower arm. Fortunately, he only sustained further minor injuries. However, the catastrophe, despite surgery and early active rehabilitation, it meant the loss of his most vital income generating instrument -- his right hand!

Another, sad and devastating case, is that of a young fellow who set out late one evening, to travel to the coast, to go an establish his own business. During the nighttime travel, he fell asleep; left the road; sustained multiple word-depriving injuries. The end of a dream for a better future!

With this in mind, I decided to put in place a plan, that made us less dependent on a one person income. This meant, financial self-empowerment; giving us access to the top, relatively safe and stable international companies; and, of course, some top quality company managers.

You, too, have some expertise, experience and other life enhancing qualities, that you can distribute, thus also making you less dependent on the "one person" income generating facility. One of those exciting, life-altering changes, that happens in knowledge, product and business distribution, is going on right now. It is changing the way information is exchanged, knowledge is passed on, advice is given, wisdom is relayed, and the way informed and keen people are impacting and helping other people.

You can empower yourself to understand how to take advantage of it! What is this door and opportunity opening technology?

As I have mentioned, you too, have expertise, experience and other life enhancing qualities, that you can pass on to a gradually expanding population.

It is the ability to own the international distribution channels of your own hard work, knowledge, expertise, experience and other life enhancing qualities.

For example, if you're a professional, doctor or dentist, you automatically, and incorrectly, assume that there is no way to do what you do without attending to one patient at a time. Sadly, for many people, that's just how it works.

Instead of selling your expertise, experience and valuable time to only one person at a time, why not expand your audience -- "sell" to infinitely more folks at the same time!

Well, the delightful truth is, there is always another way to do, what you now do for a single person, at one time.

When you're selling hours for bucks, you are experiencing little to no growth: you are completely dependent on yourself. If you get sick or injured, or have a personal problem that keeps you from working a period of time, you can't make any money.

Sad to say, you're not getting any younger. Also, there is always the younger and more up-to-date generation, on its way in to the work force.

You can only do, what you successfully do for a certain number of years and you're using up more of that valuable time every day.

So whatever you do, don't kill valuable time! Please don't procrastinate!

Of course, we want to set up a recurring, safe and regular income stream from our current business, investments or customers, so we don't have to generate, new investment formulas or events, every few weeks.

Another field, in which one can be of value to yourself and the specific focus areas of the community, is with mentoring. If one is reasonably good with words, concepts and a keen desire to pass on valuable acquired skills and information, this may also be a people-meeting and enriching venue to apply your abilities.

Those who successfully survive make a clean break ... from something you cannot come back from ... because it makes the past cease to exist.

Some folks like revisiting. Sad times for only the sake of sadness.

They don't like to stray too far from melancholy.

FEARS:

Life is a compromise, we've got to negotiate as best we can between our health and financial fears (perceived or real) and reality. The nightmares and evils that never happen cost a lot. A person is not hurt so much by what actually happens, as they are by their opinion and perceptions of what happens. There are so many "patients" who have collapsed under the devastating burden of accumulated "bad" yesterdays and fearful tomorrow.

Fear about the future, results from ignorance and failing to take early control of our destiny. If we do all we can to learn about our destiny, never lose sight of our goals and stay in charge of our destiny, then the future is not so frightening.

Destiny is not a matter of chance; it is a matter of active choice. It is not a thing to be dreaming of or waited for; it is a most valuable thing to be achieved.

"There are two ways to be rich: one is to have great wealth; the other is to have few wants."

If you sometimes don't vigourously shake the trees, nothing of value will fall out of them. When times are hard, let's go and shake the trees.

You cannot perform against a discriminating and declining economy; irrespective of your outstanding ability.

As always, the more one learns, the less scary the future seems. Fear and lack of insight and understanding, magnifies the problem. Understanding diminishes it.

There are things, people and circumstances, ruling our lives, that do not conform to rules or reason. Be flexible in one's planning, always provides space for accommodation manoeuvrability.

When we are "patients," our needs are in direct relationship to our pains, fear, lack of insight about our "condition," loss of function and income. It's when you run away from a problem, that you're most liable to stumble. "Problems," methodically addressed immediately, drain less energy, cause less anxiety and mostly seem to shrink away rapidly. It is never safe to look into the future with fear. Do the thing you fear, and the death of fear is certain. Curiosity will always conquer fear even more than bravery will. Therefore, never be "silenced" by any person whenever you make an enquiry, either about your health care or financial and investment affairs.

Let us be of good cheer, remembering that the misfortunes and catastrophes hardest to bear are those which never happen. Nothing in life is to be feared. It is only to be understood. The more you know, the more you can control your destiny.

Disintegrate "fear" into its component parts, give each part its due investigative attention and time. Happy is the person who has broken the chains imposed by others which strangle the investigative and creative mind, and has given up worrying. Shut out all of your negative past experiences, except those which will help and positively support you weather your future better. Worry kills and disables more people than work does because more people tackle it with great vigour, persistent enthusiasm and without planning. Decide just how much "anxiety" a thing may be worth, and refuse to give it any more. After all, it is prudent to reserve some "anxiety" for the "things" that most certainly will never happen. It is better to let our advance worrying become our advance thinking and planning. This tactic discards much of the "cluttering garbage," that so desires to intrude upon the quality of our lives. Live in day-tight compartments. Let all things and irritations have their place; let each part of your business and pleasure have its time. Today well-lived, makes every yesterday a dream of happiness and pleasant memories and every tomorrow a vision of hope and achievement.

FRIENDS:

We should keep our meaningful friendships in constant repair. Those who do not reach out to others, have none reaching out to them. A periodic phone call, letter, e-mail or visit, is an important part of a "friendship maintenance program."

Nobody prepares for being alone; even less so for being lonely. Bear in mind that friendship is a currency that never depreciates or has no national boundaries. This is particularly highlighted by the ease of communication via e-mail.

The recently retired person, will frequently meet up with fellows who have some "conspicuous" physical disability. Recognise the kinship of Spirit. By so doing, you will infinitely diminish someone's physical disability and enhance their self-esteem and their respect for you. After all, compassion lubricates healing.

Don't forget a little genuine respect. the greatest challenge, is that able-bodied people have a restricted and limited understanding, of the potential and capabilities of people with disabilities, as the vast majority, have never physically encountered them in the workplace, and therefore, conclude that disabled persons simply cannot do many of the things that others can do!

So often, we try to hide those things, but in today's world, authenticity and transparency is the most impacting factor on people.

The Respect People and the community Have for You, is an important and serious Business. It Impacts Every Aspect of Your life, your health, Wealth and Your Happiness.

Lack of respect can rob you of nearly TEN years of life.

For many older folks, The mitigation of loneliness was certain by the advent of the radio.

The analogy of the blind fellows and the elephant one discovers the tail; one discovers the ear; one discovers the trunk now we know it's one hell of an elephant.

There is no physician like cheerful thought for dissipating the collected ills of the body; there is no comforter to compare with goodwill for dispersing the shadows of grief and sorrow.

To live continually in negative self-destroying thoughts of illness, ill-will, cynicism, suspicion, and envy, is to be confined in a self-made health destroying prison hole. I am aware, that often it is extremely taxing to think well of all, to be cheerful with all, to patiently learn to find the good in all.

Recently, a "physically disabled" person recounted his "visit" to a medical "specialist." "My wife accompanied me into the examination-room. The sad part," he related, "was that the specialist conferred with my wife about me, as if I were not present!"

Let there be space in your togetherness.

"I'm so glad I got this pain, it at least gets me away from my husband for a while!"

It is one of the underestimated truisms of retirement, that often too little space or room is left for the other partner's "freedom of movement, thoughts and initiative."

"O no!" Mrs. Hannah objected vehemently. "I can't come tomorrow. You see, my husband has to go to his French class." On my enquiry about the class, she responded enthusiastically: "You must understand, when he retired," she laughed happily, "I told him that he had to take French language lessons. "Well, he's been at it the past four years." "Do the two of you converse in French?" I enquired. "You don't understand," she responded with delight. "I made sure that he would be out of the house at least once a week. It's wonderful!"

"Lord, where we are wrong, make us willing to change; where we are right, make us easy to live with."

FINANCIAL-PLANNING AND PREPARATION:

One's biggest nightmare old age nursing-home bills that deplete a retiree's wealth like a leaking bucket.

The mould of a person's present and future fortune is in their own hands.

The well-being of your spinal-column is, at all times, pivotal in your capacity to integrate socially, to generate income, partake in sport and recreation and the many-fold other social activities that constitute and enhance life.

I have, in previous chapters, highlighted many practical aspects of "functional spinal-care."

We have been conditioned to believe in the big, the expensive, fast, the "latest" and the far-away "dream" holiday destination. I'm convinced that, with growing vested interest pressure, "to harvest the baby boomers or elderly," early financial-planning prudence, must be taken most seriously.

Furthermore, I note, when attending many of the retirement preparation presentations, that the focus is often on the allocation of funds for the world trip, the new, expensive car, the relocation to very expensive retirement facilities. When I enquire what funds are set aside for the first, second or maybe, even the third divorce, nothing is included in the plan!

Yes, it still remains true: The most efficient frustration and labour-saving device, is still money.

I am taken aback, by the rather large number of folks who plunder through life without a financial compass or income and expenditure budget.

With no road map or compass, how can one possibly know where one is financially headed. With no budget, you have no idea where the hard worked for money is going. In fact, your funds will but jet away from you and your family.

Note that I say "jet away!"

Today, a fifty-year young gentleman asked me how much money one must have to start a savings plan. I told him to just allocate whatever is available, and soon the habit to financial freedom will be on its way.

"But I'm too old," he objected. "Both my wife and myself are working. We have a daughter at university; the accommodation, transport, tuition, fees, and you know, well, it soon mounts. We simply have nothing left at the end of the month."

"But have you got a budget to determine and assess your spending habits," I enquired.

"No. although my wife is far better at taking care of our moneys; still, we don't save."

I believe that most people have the innate ability to make a reasonable amount of money. However, for success, "the making of money," is subservient to the prudent management of the acquired assets. Always, remember, it isn't how much you make, but how much you keep, that matters most.

The surest road to success is methodical and informed preparation.

Any major move in life entails some risk. International financial circumstances can be very volatile and fluctuate a great deal. There always is the risk you cannot afford to take, and there is the risk you cannot afford not to take.

To get a clearer focus and understanding of the "important" issues at stake about these very valid points, it is prudent and most advisable to confer with a competent, caring and registered financial and retirement planning adviser or advisors; and an equally competent and caring healthcare service team.

The more experienced practitioner and adviser, has an expanded RAEEM (random access experience expertise memory). An evidence-based (EB) physiotherapist is a powerful professional who can, and should, play a pivotal role in the development and structuring of all services for elderly patients and service users. To forego this "RAEEM" input into one's future financial and health-planning, is a disinvestment that might turn out to be most costly and diminish your quality of life and experience.

Many of our "future dreams, plans and objectives," might be short served by lack of the appropriate and timely correct financial and investment planning. Too often I come across the "if only I knew" syndrome. Mostly this refers to the rapidly ever-diminishing income, that has to service the ever-increasing health cost of living and having fun. Also, it frequently reflects the elderly patient's belated concern about earlier year's "body-abuse investment" that now comes home to roost with compound interest pains and disabilities.

Our yesteryear's "future health and financial perceptions," often lag well behind present-day cost escalating reality. You must get actively involved, at an early age, to have a meaningful impact on your retirement financial status and, consequently, enjoyment and quality of life.

Always remember, that successful financial retirement security is in your own hands. Early financial expenditure control discipline, is the first step toward assured future income victory and financial security.

Self-discipline, has to do with selecting of being a master of yourself, acting according to your well informed intellectual conclusions rather than your emotions.

Only then, can you be master of your destiny. Self-discipline, often involves self-control, sometimes foregoing instant gratification for long-term compound benefit.

At the time of retirement, preferably much earlier, debt with an interest rate greater than what you're earning on your investment should be eliminated.

I regard it as part of my mandate to advise and direct, particularly young people, to become "financially and investment literate." I always emphasise the wisdom of "living under your income," and to commence early in life with a balanced investment strategy. to that end, I suggest paying yourself at least ten percent of your monthly earnings, when you begin working.

Our financial situation or status does not define us. We are defined, more accurately, by our ability or lack thereof to successfully overcome it.

Important: Generate income as long as you can. This might be by way of part-time work, it keeps one in contact with the "therapeutic benefits" of associating with people and reduces the erosion on capital. Look for opportunities in today's changing technologies and workplace.

Whatever you do, you'll be happiest if it satisfies your deepest ambitions, desires and soul. The longer, therefore, one can retain an "independent" lifestyle, the healthier and happier one seems to be.

We all have got a routine of work to enjoy meaningful and stimulating retirement. Similarly establish a recreation and hobbies routine.

It is also true that you are judged by your contribution to your community.

This was particularly graphically brought home to me, whilst treating a "health-retired" bank manager.

"How many of your friends come to visit you," I asked.

"Well, to be truthful," he panted, "none!"

He leaned back in his chair, panting for breath, trying to move the well-swollen legs.

"You see, since, since I'm no longer of 'value' to them" His voice faded away, trailing into some obscure, yet pleasant, past, as he slumped back into the chair.

Sad too, for by then his wife had returned to full-time work mostly, I believe, because she could not handle the "full-time disabled" husband.

Active participants in life, enjoy taking big, strongly stimulating bites of heavily spiced "life." Work keeps at bay three great social depressing evils: boredom, need and vice.

At all times, be on guard against the "bicycle theory:" If you stop pedalling, you fall off. The consequences of that fall are often devastatingly dramatic, bruising and ego-denting.

Acquire quality of life-enhancing skills such as becoming computer literate. Voice-recognition computer-software brings communication within bounds for people with hand or coordination impairments that make the use of an ordinary keyboard difficult. Also direct voice communication on-line is available. The latter can incorporate direct on-line visual-communication too.

Our friend Peter: who is an excellent and very proud builder, unfortunately with a communication restrictive English speaking ability said: "Judge the quality of the work, not the communication."

Recently, I had a splendid fellow attend for treatment of his painful back. in the course of the time spent together, i learned that he was handicapped by his inability to read. The dyslexia turned out to be frustrating in his self employment career. Fortunately, his girl friend was most helpful. It so happened, at that time, that it came to my attention about the availability of suitable computer software that can give him access to both reading and getting on the net. He was rather delighted with the information.

Attend special computer-classes for seniors. Senior-friendly software is available with programs that run in large type.

E-mail communication with family, children, grandchildren and friends, all over the world, keeps people in meaningful contact. Other doors that are opened by the use of the computer, particularly when one is isolated on account of poor health or lack of transport, is the growing ease of shopping on-line; getting involved with community on-line services; on line access to health and medical information where one can check current state of treatment and care-related to a particular condition or disease.

Join on-line senior chat-rooms ranging from widow support groups to book and hobby clubs; make travel arrangements on-line.

Want to get out into the bigger world, while restricted to your own accommodation? Travel on the net without leaving the comfort of your home.

Yet another handy on-line key, is the ease with which one can keep track of one's investment portfolios, finances and retirement funds.

How do we -- as responsible parents and grandparents -- teach our children and grand children to use technology responsibly and thoughtfully?

as we, as responsible parents and grandparents already know: Parental guidance is infinitely more critical in an ever-expanding world of many virtual worlds where realities are often very blurred. Similarly, as most of us already know: Digital smart kids can easily outsmart their technology left behind parents

The answer, is to get technology literate -- particularly computer literate to enable one to be of critical assistance to your children and grand children.

The stories of some of our youth are becoming sadly familiar. They are consumed by their online existence. They are deprived of the valuable social skills to practice eye contact, read body language, speak with confidence, or hone real-time emotional intelligence skills.

Because their reality exists increasingly in someone else' cyberspace, navigating the face-to face world is growing more challenging. For many parents and grandparents, This is very worrying.

No one quite knows what long term social and financial effect this will have. Sadly, the creative, imaginative and formative culture of childhood is being high-jacked and compressed. Those healthy outdoor activities and things, which young people once did, are now earmarked to the various screens.

Even more important, some young people seem to be growing up without learning the basic distinction between respectability and attention. I doubt adults can totally protect and shelter young people from the things they will find online, but adults can provide the accepted norms and values that Civilised societies recognise as socially acceptable.

Today, the world is at one's fingertips with the advent of freely available i-phones and on-line radio that connects directly to the Internet without a PC.

Acquire money-saving skills, such as basic home and home-equipment maintenance and repair skills.

Don't dig into pension capital. Plan to have everything paid off on retirement.

Do not acquire growing money-demanding habits, that you cannot afford to maintain during retirement. As all of us know, High spending habits die hard and painfully.

Bearing in mind, that frequently the "elderly", particularly women, are victimised by unscrupulous "consultants;" "advisers;" and numerous other financial "vultures," it is vitally important to overcome resistance to cope with adverse agents and "consultants."

Making money, is not the pushing of a wheelbarrow, it is an intellectual thing. Therefore, never ever say: "I know nothing about money or investments!" It leaves the newly bereaved, open to vicious predatory attacks, by galloping greed motivated "investment consultants," who prey particularly on "investment illiterate" widows.

Make sure that any investment products, are totally clear about terms of procuring, holding and disposal costs.

This is very important; because each percentage of your funds that go to the consultant, obviously does not work for you.

Also, make sure what the consultant fees are, and what percentage of the investment will commence working for your future.

Remember, that no one can make you feel inferior without your consent. Only your God is in a position to look down on anyone.

There is nothing in the world, like a persuasive speech, to confuse the mental discriminating process, and direct assets towards the speaker's "management skills."

Don't let someone else's enthusiasm and greed run away with what good health, happiness or money you have. In fact, be careful not to let someone convert their future riches dreams into your long-term financial obligations. These include "specialists", that periodically have a well-motivated go at our perceived or real health and material assets. This is particularly true when one is at an emotionally vulnerable phase; such as when "having to deal" with business and investment affairs, after one of the marriage partners has passed away.

Watch out for unscrupulous salespeople, who take advantage of your disability, complaint, "condition" or ignorance, to "advise you" on expensive "must-have-now" pieces of health enhancing apparatus, check with your physiotherapist first, (frequently such equipment "treats" symptoms only and does not address the underlying "cause" of the problem).

However, do make sure that the physiotherapist has no vested financial interest in promoting the device in question! Bear in mind, that when a healthcare service-provider stands to gain from something a patient buys, it creates a conflict of interest because it can influence the healthcare advice given. Only when a patient has difficulty finding a product or item, should it come from a service-provider's office. And then it should be free of charge or sold at cost.

Monies available for purchasing a new home, maintaining it and paying escalating property taxes must be calculated and allocated with diligence.

I vividly recall living in a "most sought-after" area with wonderful water views and spectacular waterways. The sad part, however, for many of the now disillusioned retirees, who had settled their in their "dream house," was, that property taxes escalated, and consequently ultimately made life unaffordable on this piece of prime real estate. "A retirement dream gone sour." It so happened, that a slump in real estate prices made it almost impossible to dispose of the property to allow owners to downscale their accommodation. Suddenly, work-life success and future dreams, turned into retirement and social failure and misery.

Particular attention, therefore, has to be focused on the possible anticipated future effects of "inflation" and "run-away" property taxes, and insurance and healthcare cover.

Never accept or submit to any attempt to be sidetracked or intimidated, when conferring with a "consultant" about either your health and its future prospects or your financial and investment horizons.

This is so important, i repeat: Never accept or submit to any attempt to be sidetracked or intimidated, when conferring with a "consultant" about either your health and its future prospects or your financial and investment horizons.

In fact, it is advisable to procure the services of a reputable, well-qualified and registered financial and investment and taxation consultant on both retirement tax-effective investments and capital growth. A wise financial and investment consultant and adviser, will often make more opportunities for secure capital-growth than they find in your present portfolio.

The world is small, individual countries even smaller. With this in mind, it is essential to diversify and dilute investment risks by spreading the investment in some other suitable countries, companies and sectors of various markets. Consult with the appropriate consultant or adviser, on a "a fee for services" basis as opposed to paying a percentage of the funds to be handled as remuneration for their services.

The onus is on you, to ask the advisor to let you have a look at his or her personal investment track record. If he or she is reluctant, get another advisor.

This is so important and vital, I repeat: Always check the personal and corporate "investment track record" and investment strategy of the "consultant" and their company, to whom you are prepared to entrust your moneys.

In fact, once again, it is advisable to utilise the services of at least three different reputable companies. In this manner, not only is the investment risk diluted and spread, but one also has the advantage of "cross reference," and consequent assessment of the investment portfolio development and progress.

This is so important, I repeat it from a patient just recounted the following financially devastating episode to me: "seven years ago, I was invited by a well-remunerated friend, to attend his retirement dinner, at a very expensive restaurant.

His investment advisor -- from one of the well known companies, was also present.

"John, he said, you must let peter here, have a look at your investment portfolio.

He's a top expert; he'll do much better than you are getting right now."

"I'm sorry, but I don't understand advanced mathematics -- those figures don't mean anything to me. I'm a simple fellow, never had maths at school. I just quietly started investing in property at an early age -- and now -- I'm quite comfortable."

Well, now, seven years later. "My friend now has to live with his parents, has a small car, is in fact, battling with his well diminished portfolio."

So much then, for the top investment expert's achievements.

Remember, none are as fallible as those specialists or experts who are absolutely sure they're right.

Differences of opinion, amongst consultants and clients, are bound to occur. They can be resolved, if conflict is managed in a polite, informed and courteous manner.

The more "investment and financial literate" you are when conferring with investment consultants or advisers, the more meaningful your input in directing matters towards your goals.

FINAL WILL AND TESTAMENT:

We are all mortal. Sooner or later often unexpectedly we change "status" when death overtakes us. It is, therefore, vitally important to have a "current" will and final testament in place. Furthermore, this document has frequently to be updated to reflect and take account of present conditions. Again, knowledge expedites movement. With this in mind, it is only logical to make sure that some beneficiaries of the will, will know where the document is lodged, deposited or stored. It might also be prudent, in consultation with the family and legal adviser, to pay attention to a "living will."

SLEEP ON MAJOR DECISIONS:

It is prudent to take some time, before making any "major" decisions that might impact severely and adversely on future health, happiness and quality of life. This includes, major "investment decisions" immediately after one of the partners has passed away. Frequently, this is a very volatile and emotional time and not necessarily the "best time" to change course. On many occasions, a person jumps from one boat to another at this time, only to miss the boat by falling in the water between the two craft!

HEALTH:

A long life may not be good enough, but a good life is long enough. Of course not all will agree! The courage we desire and prize the most, is not only the courage to die decently, but to live meaningfully and happily to the fullest possible degree within our capacity.

Health, is always relative to past illness, mental stresses and strains, relative to current body performance expectations. There is, therefore, no single state of health or fitness. We all wish to be able to move about pain-free, with ease and, above else, dignity. "Fitness" is being able to enjoy all aspects of work, recreation and companionship without undue physical or mental strain and stress.

Despite a widespread perception, "strenuous" exercise is not essential for better health and fitness. The body and brain, however, grows fastest in the area you use it the most. Moderate, general exercises, are thus essential for continued good health and vitality.

You are entrusted with the most delicate and intricate "machine" yet devised your precious body.

Is it, therefore, disproportionate to invest a few hour's exercise per week, in keeping that instrument at the optimum level of functioning?

Judge not the spirit by the architecture and shortcomings of the body it inhabits. The label does not necessarily reflect the enthusiasm and drive of the contents.

On many occasions, during my practice, I have been absolutely astounded by what was forthcoming from many "bodies!" I vividly recall Paul. A war-time veteran, who carried with him "a veritable catalogue and cornucopia of ever-changing pains, disabilities, physical impairments and handicaps!" Although in his seventies, he drove his specially adapted motor-car with great enthusiasm and vigour. He mowed his lawn with a "sit-on" mower. I could but guess as to how he mounted the machine, or, for that matter, how he got off it.

The most amazing thing, to me at least, was the fact that he rigged up a harness to suspend himself in the shower-cubicle while enjoying a shower.

"I must admit," mused the "earlier body-abuse harvesting" Mr. Brian Gilling-pain, "I am now certainly paying for my misspent youth I didn't want to listen! We do the mess-ups; you have to do the fix-ups!"

If you sit back and passively observe what other people's minds do, and have achieved, then the body and brain does nothing but deteriorate.

Brisk walking and swimming, are most commendable exercises, aiding both circulation and breathing, keeping your muscles stimulated. Continual joint-impact, such as occurs with jogging, is however considerably less commendable. Furthermore, taking your worries for a walk, may just let them fly away.

If more vigorous exercise-programs are to be attempted, then it is wise to first confer with a physician and physiotherapist to make sure that present health, muscle and joint conditions can safely handle the proposed program. The physiotherapist will be able to give the necessary body-care exercise advice and guidance.

The challenge facing healthcare service-providers, is motivating all people toward a level of mental and physical activity, that can benefit their long-term health, happiness and well-being. Advice and guidance given must not be focused on short-term benefits, to the detriment of the long-term health and quality of life gains.

Sometimes, the danger of over enthusiastically trying to prolong your life, is ruining what happens to be left of it.

Life's a series of either good or bad moments. When we were young, we were taught that diligent and dedicated work is everything and we believed it -- witch later proved to be to our advantage.

If you don't work, no fortune comes.

There is nothing to stop you, to reach the lucky place, where good fortune spots you, and lets you shine.

Ethical decisions, in all fields, trump egotistical and financial ones Fortunately, at an early age, as a result of my innate curiosity, i learned, that a man knows things, and when he stops knowing things, he's like anybody else, and the thing is to get acquainted and power before he stops knowing things.

In life, To adapt quickly is more important than planning.

Remember: when negotiating. Always put yourself in other's shoes. If you feel that it hurts you, it probably hurts the other person, too.

The advantage of travel, Whatever you see from here, you don't see from there.

Long term Chronic pain sufferers often feel sideline by their doctors.

To live" meaningfully, is not merely to breathe and pay taxes. It is to act; to give direction to one's life; to actively partake in both recreation and creative work; it is to make use of our healthy body parts, senses, faculties and feeling of being exuberant and alive.

A large and growing number of people, positively motivated by rapidly growing health-awareness information, do not want to wait for the "disease" to first happen.

Man is ever surging forcefully ahead in his effort to unravel and understand the mysteries of the unknown.

To forego a "new" treatment approach or technology to resolve a health problem, because of someone else's preferential ignorance or well entrenched dogma, is to lend power to something, that may, in the long run, be proven to have no power, other than what we give it by our own ignorance and fears.

Please take your foot of dogma off the brake on the quality of my life, take your foot off the accelerator of stress provocation of my life!"

When seeking a healthcare team, take note of any adviser-reluctance and referral-reluctance (rr) signs or indications, displayed by any members of the healthcare team.

Such "referral reluctance" might well be motivated by pecuniary considerations, favouring the healthcare service provider consulted.

Situations might arise where the healthcare insurance-company or medical-aid company allocates a sum of money for the care of the patient. By not referring the patient elsewhere, the "personal kitty" of the healthcare service provider, is augmented, to the detriment of the patient.

When selecting a healthcare insurance or medical aid company, it is essential to clear up this matter. Failing to do so, can be most disillusioning and prolong unnecessary pain! Such "referral reluctance," might also prove to be the source of unnecessarily prolonged pain, disability or ultimately deprivation of long-term quality of life.

No single member of a professional team, can lay claim to be an "expert" in the total management and treatment of pain, body dysfunction and disability.

One way to get the big and total picture, is to look beyond the "specialist". Consult your experienced physiotherapist, generalists, internists and family healthcare practitioners.

As always, in a functioning democracy, the choice is "yours.

Obviously, the primary focus of this self empowerment back care book, is to Short circuit potential back ache at source.

"Often it's what they 'cut' into you that causes more problems than what they 'cut' out of you!"

It is the little traumas we ignore, that nibble away at the quality of our lives. Therefore, whenever "pains or impaired body-part functions" encroach upon the quality of one's life, it's time to consult with one's physiotherapist to ascertain whether help can be obtained.

"It's "old age."

It is sad but regrettably true that, the higher your age above fifty years, the more frequently you will be "diagnosed" as "it's only old age, my dear!" the sting in the tail: "Afraid you'll have to learn to live with it!"

I find this "diagnostic" trend most disturbing as it deprives so many elderly people of the quality of life-enhancing services of physiotherapists.

By the pro-active patient, couching the experienced problem in a pain and disfunction framework, it brings the process into personal perspective, and allows the service provider to understand the implications of the debilitating and or painful situation, and then, the appropriate treatment can be applied through identification of the main source of possible trouble.

Which I believe is one of the key values of thorough listening and examination of the patient.

One cannot make all systems new, but if one controls symptoms, if one provides basic support to patients and their families, one sees enormous and gratifying growth during the senior years at the end of life. With treatment for a chronic condition, chances are that you won't get everything back to normal. There will be an improvement ceiling. But no one knows exactly how far you can progress on your recovery route.

I well recall, a most stimulating disaster revealing patient. When you meet her, she keenly pours out a well rehearsed and memorised heart rendering litany of disasters.

"Old-age is not so bad if you consider the alternative", mused Mr. Saunders.

However, it is always helpful to be hopeful and to focus on other avenues of "improvement."

"I've lost my ring," the elderly Mrs. Joyce Dunn informed me quite happily.

She came in for treatment of a back complaint. She also in passing mentioned her "swollen fingers."

"Well," she continued enthusiastically, "it's indisputable evidence that my fingers are thinner!"

I too, was delighted that the treatment helped her fingers.

"Fortunately, I found the missing ring in the house."

Age, after all, is only a relative number. If you see your age as a handicap, it's that much closer to becoming a self-fulfilling prophecy. Never use your "age" as an excuse NOT to get involved or partake in life.

"Am I not entitled to two pains concurrently?" It is true that the older one is, the greater the chances of having more than one complaint at the same time.

Important: Older patients are diagnosable, treatable, teachable, speak-to-able and appreciate that physiotherapy treatment and advice is valuable to their quality of life.

Forget not the value of communication. Often, "elderly" people have very little social contact with their fellow humans.

Many valuable things, experiences and insights are lost for want of asking or talking to someone else.

A single conversation with a wise person is worth a month's study of books.

Life is an enjoyable and exciting book, you've got to explore and read it.

Life is an equally exciting story, and you've got to tell it to your grand children.

Here again, over and above "treating" any "physical conditions," the physiotherapist can dispense sympathy, empathy, compassion and provide a "listening ear." Listening to patients, and responding to their needs, helps break down the wall between patients and professionals. Patients always have important stories and insights and priorities; conceptions and misconceptions, that healthcare professionals miss.

One of my favourite patient quotes, referring to perceived quality of service, is: "When they become them; when them become us, I know they have insight."

Empathetic and caring Language, is real people.

However, sometimes it may be the right message delivered to the wrong audience.

Furthermore, I have noticed of late, that the public is becoming more informed about the possible adverse side effects of drug-therapy treatments for "conditions", that can often be resolved by non-drug approaches that are offered by physiotherapy treatment. Sadly for the patients, though, they frequently and belatedly, quite serendipitously learn about "what can be done for my condition by the physiotherapist." Often, at this stage, considerable time and fortunes have been spent on multitudes of tests, complemented by an equally liberal application of painkillers and anti-inflammatory drugs.

Frequently, the patients have also acquired "drugs- induced" secondary problems, such as bleeding stomach-ulcers, chronic constipation with all its associated self-intoxication risks.

"Just think of the unnecessary pains loads of painkillers and all the tests that I had to endure the past nineteen months," reflected Mrs. Johnston wryly.

She was trapped by "referral-reluctance."

The disillusioned, but wiser victim of the "leash syndrome" (the leash syndrome refers to: erroneous assumptions made on behalf of a fellow healthcare service provider's quality of life enhancing abilities).

"If only I had known, well, when it all started! Known how much physiotherapy treatment could help me, improve the quality of my life!"

The older you are, the more difficult it is to scuttle your favourite bad habits and prejudices. Unfortunately, this often also applies to healthcare providers.

Mature Mr. Wilson: "You go to the same doctor so long that he gets immune to you!"

COMMUNICATION:

The deepest hunger of the human soul (including patients) is to be understood. Once a patient feels understood, defences are lowered; they become more open and they relax. The windfall is, that if one meets the human need to be understood, and appreciated, they feel appreciated as a human-being.

Words of comfort, skillfully and caringly administered, are the oldest therapy known to man. What is said to a patient, and how it is said, can be a very potent and influential factor in how patients view their current "condition" and future health-prospects. Patient advice often fails, because it fails to concur with the patient's own perceptions, perspectives, thoughts and opinions about their "condition," or how to rectify or "cure" that condition.

Too often one hears people complain that "the practitioner just did not seem to have the time or interest to listen to my version of the problem. However, there's always plenty of time to reach for your purse or payment-card."

By taking the time, to really listen and actively hear what the patient, is saying and offering quality, empathetic customer service, you will reap repeated rewards, with referrals and repeat business.

Your biggest investment, still is your time.

The patient, certainly won't tell his or her friends and neighbours, how great his or her experience was, if he or she felt rushed, unheard, or didn't get the desired time and finished quality service.

The gently touching hand is an extension of the caring human mind and personality. The "informed" patient compels the practitioner to focus on the real issues and complaints at hand.

When consulting with any practitioner, be systematic and methodical about preparing the written questions list for the presentation about your "condition."

I repeat: Make written notes including questions to be asked.

Man is not made to understand life, but to live it.

Viewing the patient from a holistic electromechanical perspective, I find no "health or body malfunction" to be too trivial not to take into account on examination. The onus is on the practitioner, to make sure that the patient understands, in practical daily living terms, the implications of their "condition." Furthermore, it is essential that the practitioner informs the patient about possible future "health developments" and the practical impact they might have on his or her future quality of life and available resources.

Positively oriented language, builds rapport, trust and stimulates patients' innate healing and confidence abilities.

"If I treat you for your liver, of your liver you will die."

So often, healthcare practitioners have little or no idea what impact their glib and easy-flowing opinions have on patients. One of the most important, yet practically unappreciated facets of healthcare, is to instill hope in patients. It is much better to hope than not to.

Not a single healthcare provider, can escape the judgment of history and time, which will be rendered upon the actions positive or negative, we take or fail to take today. Patients consult with us, because they need our skills, our compassion, empathy, expertise and time, above all part of our enthusiasm.

When faced with a serious health problem, get at least three healthcare service provider's opinions, enquire about alternative ways and technologies available to resolve the "problem."

Remember that, even when the "experts" all agree, they may well be mistaken. More and more, experts claim that healthcare has become so "specialised" that health-service providers seldom see the "whole patient."

When conferring with an "expert," it is not always a question of how much they know, but of the use they make of what they know and have experienced; not a question of what they have acquired, and how and where they have been trained, but more importantly, their character and what they can do to enhance the quality of your life.

No two patients are alike, and both of them are happy (sometimes sad) for it.

There is no merit in frequently reflecting on Sad times for only the sake of sadness.

Often, I have found that people who have substantial time to compare "health notes," feel "left out" if "their condition" lags in severity, scope, amplitude and conspicuousness, compared with their friends.

With the advent and development of sophisticated life-support systems, patients in "developed countries," often are spending more time in the grip of expensive hospital machinery than makes sense financially or emotionally.

AIDS TO ASSIST WITH ENHANCING QUALITY OF LIFE:

Various practical support-systems, aids and gadgets are available to help and enhance the ease and quality of life.

See Chapter 21 My Precious Spine and Available Aids.

These include:

Car washing and valet services;

Cell-phones (I believe the verdict has yet to come on the long-term health implications of these devices);

Chiropodist;

Computer remote control and equipment regulating systems;

Cordless, portable door-chimes easy to put in a pocket or fix to a garment while moving about the home or garden bear in mind that the press button too, is portable;

Cordless mobile telephones;

Dietitian at hospital minimise overweight and associated operation risks (if an operation is necessary, expedite post operative recovery by enlisting the rehabilitation services of a physiotherapist, this will reduce the "good surgery," bad follow-up patient penalised syndrome");

Eye-level oven preferably with a thermo-fan system this reduces "bending strains" on both hips and knees do, however, make sure that the oven-door hinges on (preferably) the right-hand side, failing to take note of this, can cause forearm burns from a bottom-hinged door);

Gardening and landscaping services;

Home adjustments to meet with the access, ambulatory, safety and security requirements and needs of the "patient" or "disabled" person;

Home cleaning and laundry services;

Home delivery meals;

Home delivery shopping services now more accessible via the internet, this is where the "local" smaller, more personal store comes into its most appreciated right;

Home fire-alarm, safety and security system preferably with an electronic radio-wave link to a monitoring and response facility (for elderly people living on their own, a "panic-button" fixed to the wrist, can be a life-saver in an emergency);

Home help;

Home-visits by members of the healthcare team;

Library services often a mobile library van with cd, tape-cassette recorded or large print material, books support us in our solitude and keep us from being a burden to our fellows and ourselves, without libraries, we have no past and no future;

Retirees' associations;

Senior citizens' associations;

Vehicle-mounted electrical hoist to manoeuvre wheelchairs;

Wheelchairs mechanical and electrical.

Individuals with long-term health problems and disabilities, should make use of all local authority and social services support and help facilities available, take advantage of "supporter" support facilities and groups.

When dealing with a patient or disabled person, one often forgets that the "supporters" too, have "needs, frustrations, desires and ambitions" that must be taken into consideration and looked after. Of course, never neglect to take care of the "caretaker." the "patient" or "disabled" is not the only one who needs care and support. The physical and mental demands often placed on "caretakers" are mostly not appreciated. They too, more often than not, are of a similar age to the "patient" or "disabled," and also have many "problems" to contend with.

Make a point of investigating the facilities offered by the social services department of the local authority. These might include:

chiropodist; Dietitian services for health, disease and weight control; gadgets; guide dog and service dog facilities; home adjustments; home help; home meals; material needs aids; social workers; specific disability interest groups; supplementary allowances and benefits for the physically disabled, those on special diets or requiring special care; physiotherapists; occupational therapists; speech therapists; vehicle adaptation facilities; walking-and-riding aids.

Keep your weight down to minimise the necessity for surgery and, if an operation is necessary, to expedite post-operative recovery. With a reasonable level of physical fitness, operative risks, too, are reduced.

BE YOUR OWN HEALTHCARE INFORMATION PROVIDER.

To qualify, follow the following course:

Go to your computer, log on to the Internet and type in the address of your favourite search-engine. Go to the health section and in the "search" box that appears, type in whatever "condition" is ailing you; press the "enter" key and there you are your updated personal "medical" library is at hand.

Fortunately, "tel-healthcare" is bringing "health enlightenment" expertise to more communities.

WHERE TO RETIRE TO

Although far-off, enchanting-sounding and uninvestigated destinations often sound and seem most desirable, it mostly is more prudent to stay where you feel familiar and at home. Too often, I have met with people, who "dislocated" themselves from the comfort of their preceding ten years' home and lifestyle, only to be disillusioned by what they find and experience at the "retirement" location.

The "honeymoon" syndrome

That which looks rosy and fine during a visit, can soon evaporate, when one is actually living in a newly chosen location. Unless one is easily adaptable, the "move" can be traumatic, expensive and cause many unanticipated problems.

This is very important: It is wise, however, before taking such a drastic life changing decision, to let the present residence and to lease a home for a relatively short period at the "new" dream retirement destination. This will allow for adjustment time and, more important, first-hand experience of the feel, taste, sound, smell and general ambience of the place and its people. In fact, "living through the seasons" will soon make it clear whether any existing health conditions might be aggravated by the climate.

During this "rental" stay, one will assess the safety and security status; public transport; health support services; public library services; social and specific interest clubs; intellectual and cultural stimulation and entertainment; the presence of any retirees' association, clubs or any other organisations.

The comforting envelopment of well-known surroundings, support systems such as medical-and-healthcare, social, commerce, and above all, family and friends is, to many people, a very important factor.

Often, the older you get, the more you need the people you knew when you were young. However, always be wary of the danger of the "groove" syndrome, the difference between a groove and a grave is only the depth.

Yet another approach to relocation, is to create a hiatus between the present location and the anticipated future location, by way of an extended travel period.

As always, when contemplating holiday-travel at home or abroad, it is essential to make absolutely sure what accidents, conditions, treatments and aids are covered by your travel health and accident insurance.

Today I had as a patient a lady who was not wearing a seatbelt whilst travelling in a vehicle in a foreign country. She was involved in an accident during which she sustained multiple fractures and soft tissue injuries. To her dismay, when it came to financial assistance from her travel insurance, the "fine print" kicked in and penalised her on many counts.

This caused enormous distress, severely restricted access to the required healthcare services and resulted in premature termination of her tour.

Again, for the more adventurous, the possibility of disposing of the present residence and utilising the capital in a secured growth investment program, opens new doors. This route could be financially risky.

I recall a case where a person disposed of his property, "banked" the monies whilst relocating, only to find that the "bank" had suddenly gone bankrupt! Again, the wisdom of "splitting or diluting" investments to minimise risks was highlighted.

Depending on prevailing economic climates, renting a property might be much cheaper than financing a property purchase. In fact, when the property market is depressed, this route could be a way of enjoying "subsidised" accommodation.

HOUSING: (See also CHAPTER 27. MOVING HOME OR BUSINESS.)

When moving and building a new home, it is long-term money saving to build the home to avoid excessive future maintenance costs. Most houses are hand-me-downs. In fact, one is moving into someone else's dream-home (often limited and restricted by money, space and imagination), someone else's decisions, their problem-solving techniques and abilities (or lack thereof), their hopes and aspirations.

SAFETY AT HOME OR NEW HOME

When acquiring a new home, the following safety risk factors must be borne in mind:

STAIRS:

I have treated so many people who had suffered "stair-related" injuries.

Particular "injury-predisposing" factors, are the following:

Lack of grab-rails on both sides of the stairs. A person loses balance whilst negotiating the stairs, falls and has no adequate grab or supporting rail. Often this results in severe and almost ever-present back injuries not to mention possible fractures. In fact, I had occasion to care for a forty-five year old paraplegic gentleman, following a fall down stairs at work. To protect the equipment that he was carrying, he ultimately paid a very high price.

Check that the steps are even, of equal height and equidistant. Circular staircases by their very nature have narrow stepping areas near the centre of the system. Here too, it is very easy to lose balance and to fall.

One of my elderly patients, found white edging to the front of each step of the stair system, a most valuable and conspicuous guide.

STAIR-LIGHTING:

Adequate lighting, for both indoor and outdoor stairs and steps, is essential. It is a very good idea to have some strategic home and out-door lighting activated by remote control. Again, this provides an added degree of safety and security.

Many a person, is walking about with a damaged lower-back sustained by slipping on a loose-lying carpet, rug or mat on a highly polished floor. Such loose-lying floor coverings should be placed on some non-slip rubber-like sheeting.

Make sure that storage spaces are readily within easy reach. It is frustrating and back straining to hoist heavy suitcases to top cupboard storage. If this is necessary, the use of a lightweight aluminium stepladder, makes matters much easier.

However, as is the case with all equipment and aids, periodic maintenance inspection should be carried out to make sure that everything is in a condition for safe use. I have had occasion when a rung of the aluminium ladder gave way. The consequences could have been quite devastating. On subsequent examination of this handy "uplifting" aid, it came to light that "periodic inspection negligence" was to blame.

SUB-STANDARD ELECTRICAL WIRING:

Many local authorities require that the seller of a property should provide a certificate stating that the electrical wiring and fittings of the property involved, are of a safe and acceptable standard, complying with local statutory requirements. This minimises electrocution and electrical fire risks.

UNEVEN PATHS AND SLOPING GARDENS:

"Built-in extra effort and labour," comes "on the house" when acquiring a property with sloping gardens, terraces, paths and steps. The risks of strains, slipping, falling and generally making gardening more arduous are increased unnecessarily. Also, in cold climates, the risk of slipping on snow or ice covered surfaces, is more likely.

"I have a lovely little garden," Philip told me very proudly a few days ago. "It is hip high and about this deep." He indicated about an arm's length from front to back. "And," he continued enthusiastically, "about ten meters wide. You know, at my age and with my back and knee problems, it's a pleasure!"

DAMP HOME OR ROOMS:

Dampness breeds its own evils. Not least of which is the impact it will ultimately have on one's health and quality of life. When inspecting a prospective new home, do not be persuaded that "it is only transient dampness easily and inexpensively fixed!" the contrary is usually long-lastingly and expensively true.

ADEQUATE VENTILATION HEATING AND COOLING:

When inspecting the home, insist on having the climate control system turned on. Be particularly attentive to ducting and compressor noises in areas where "quietness" is of paramount importance. These areas will be bedrooms; recreational areas; lounge; study or office.

Obtain the required certificate to verify that the ventilation system both heating and cooling are both safe and adequate. The filters must be easily accessible, washable and efficient. Regular check-ups are essential to make sure the filters are not a source of potential health problems.

With climate control systems, it is essential to check that the return air vents do not blow down on one while in bed or sitting at a desk.

ACCESS:

Difficult access up steep and slippery driveways, paths and stairs, are potential "danger" zones. If one is to utilise public transport, then note must be taken of the distance involved to carry the day's shopping; both from the shopping centre, to the transportation system and from the latter to the home.

HOME FIRE AND SMOKE-ALARM, SAFETY AND SECURITY SYSTEM:

A fire hazard is always present. An early warning smoke and fire alarm system can be a lifesaver. A good position to mount the smoke detector alarm, is just outside the main bedroom, against the ceiling.

An electronic burglar alarm system, preferably with a radio wave link to a monitoring and response facility, is yet another peace of mind adjunct to the home safety system. In fact, the smoke and fire alarm can be incorporated with the security system.

With modern systems management technology linked to a computer, many home functions can be even remotely "orchestrated" on a pre-programmed computer.

Those "home functions" can include:

Regulating lighting, climate control, operating irrigation systems, managing kitchen appliances and a yet growing number of other functions.

For elderly people living on their own, a "panic-button," fixed to the wrist, and linked to the alarm system, can be a lifesaver in an emergency.

With progressive quality of life technology assisting the elderly, more individual-based accommodation choices are evolving.

For example:

Interactive house -- advantages for the elderly. Prototype "Smart House," in Glostershire -- England -- using interactive technology, is being designed to help sufferers of dementia maintain their independence longer.

The house is a three year joint project between housing 21 -- a charity which houses the elder people -- the Bath Institute of Medical engineering (Eime), and Dementia Voice. Residents can select from a range of equipments and systems to meet their individual need. Devices include an object locator -- allowing users to track down missing spectacles or door keys at the touch of a button. Other devices are designed to prevent injury or accident, such as a temperature and water level monitor for the bath. The bath monitor knows when a person running a bath, has left the room and will give a voice message "don't forget to turn the taps off!" If the user doesn't respond, the mechanism will actually switch off the water, with the message: "your bath is ready, I've turned off the taps, mam!"

The house uses infrared sensors, which detect the activities and position of the user, and dim and brighten lights appropriately. Lights can be used to guide a person from their bed to the bathroom and back again, in the middle of the night, if needed.

Gill Johnson, we are developing new prototypes, based on needs, rather than adapting existing technology. Needs research highlighted 15 main problem areas: including the need to dress appropriately, knowing when to take medication. The house uses prompts in voices, familiar to the older person, such as a daughter or husband.

Yet another transport option, available in a number of countries, is the option of car sharing. when retired, it may make good financial sense, rather than to own a motor vehicle, which takes up both space and a lot of locked up capital, to consider a car share facility.

Investigate on line for what is available in your area or country.

If using vehicle 10-12 thousand miles (convert to km) per year, it might be worth it. The added beauty, is the fact that one has at your call a well maintained, modern and overhead free vehicle.

If you want to live a long, happy, enjoyable and healthy life, you have to know what your current health status is. This means periodically having a comprehensive physical examination. This examination should cover the following aspects:

blood tests for diabetes and cholesterol; body-fat test; bone-density screening; chest X-rays; complete blood count; complete medical and family history; digital rectal examination and PSA for prostate cancer (beginning age 40); gynecological examination; hearing and vision tests; HIV test; kidney and liver function tests; lung function tests; muscle tone, strength and joint mobility assessment and advice, the province of the physiotherapist; neurological examination; stethoscope examination; stool sample analysis; stress test and resting electrocardiogram; throat examination including vocal cords; thyroid function.

LIST OF PROBABLE CONDITIONS AND COMPLAINTS THAT MIGHT BE MET WITH DURING RETIREMENT

"Alcoholism alcohol-related falls. Preventing osteoporosis, falls, and fractures among the elderly, is essential by promotion of lifelong physical activity.

In recent decades the number and incidence of injuries caused by falls among older adults have increased dramatically throughout the world.

Often the potential for enjoying retirement, is lost on account of the common and insidious combination of alcohol and medication. Sometimes this adverse mixture also contributes to falls and fractures. There's also the link between loneliness, social isolation and drinking as a way of coping with aches and pains;

Alzheimer's disease;

A staggering scary 47 % of Seniors Will Suffer from Alzheimer's Disease

Arthritis;

Asthma;

Back and neck pains often with associated leg and arm pains;

Blindness;

Chronic Bronchitis;

Chronic benign Headache;

"Chronic disgruntleness," a very contagious and self-isolating condition to be guarded against;

Coronary artery bypass grafting (CABG.);

Coronary heart disease (CHD.);

Cumulative trauma disorders (CTD.);

Depression;

Diabetes;

Disseminated sclerosis;

Emphysema;

Erectile dysfunction;

Failed back surgery syndrome;

Fractures often in conjunction with "weak" bone structure in association with a fall (always minimise osteoporosis and fall risks);

"Frozen" shoulder;

"Fused spine syndrome";

Gout;

Gynecological complaints;

Hearing deficit;

Heart and circulatory problems;

Hemiplegia;

Hernias again, the trusted old maxim: "keep the body-weight down," is most accommodating and helpful;

High blood pressure;

HIV;

Incontinence;

Iatrogenic conditions - conditions and or anxiety brought about as a result of medical treatment or inaccurate diagnosis;

Joint problems particularly the "weight-bearing" joints such as the hips, knees and ankles often successful joint replacement might enhance the quality of life;

Kidney problems;

Knee problems;

Lower leg swelling after cancer operations of the bowel or prostate;

"Lumbago";

Mastectomy (swelling of the arm) and associated lymphoedema physiotherapy treatment can be most helpful;

Medical adviser-reluctance syndrome;

Muscular weakness and in-coordination;

Neurological conditions of various types;

Obesity;

"Operating-table-syndrome" too frequently patients suffer "operating table-induced" pains. Particularly of the spinal-column lower back and neck;

Osteo-arthritis;

Osteoporosis;

Pains: joint or muscular pains often associated with "body-abuse" conditions. Bear in mind that pain is a disruption of normality of the quality of life;

Parkinson's disease;

Respiratory insufficiency physiotherapy treatment can be most helpful;

Rheumatoid Arthritis;

Self-neglect;

Shingles (herpes zoster);

Sinusitis;

Slow-incident-accident-abuse these are aches and pains that often manifest themselves many years after the actual "trauma" occurred. This frequently is precipitated by a motor-vehicle accident, industrial injury or a sport injury;

Social isolation;

Spinal-cord injury;

Stomach and bowel dysfunction;

Stomach ulcers;

Strokes;

Tendonitis often associated with over-use enthusiasm during gardening, sport, hobbies and many strength activities;

Tetraplegia;

Tinnitus "ringing" in the ears;

Toxic and contagious misery;

Ulcers associated with prolonged bed-rest and diabetes;

Varicose veins and ulcers; and many more.

CHAPTER 26

"IS IT TRUE THAT?"

Many misconceptions, based on scanty or distorted information, prevail amongst us. Often your body is portrayed as a chemically balanced plant. This is true.

There is also, another most important, electro-mechanical facet to it.

Many patients have, over an extended period of time, posed a wide variety of questions, concerning their body and its care. Some of these frequently asked questions (FAQ) I address in this chapter.

"Why is my progress retarded?"

All of us are a composite of ever-varying, ever-changing systems and structures. Add to this the equally ever-changing social and climatic environment in which we operate, and the stage is set for variations in the speed and degree with which we respond to "treatment!"

One too easily acquires the professional tone and loses the patient's long term vision.

We should "Never underestimate how contagious moods are between people."

George: "With your expertise and professional experience, I depend on you to be my mentor in this better health lesson venture."

"For the complaints that you haven't got, you are losing money!"

Also, when a patient has done the rounds for all the tests, seen all the experts, they become desperate, and they shove the bulging medical records towards me, then wipe their hands disgustedly, as if they are rid of the chronic energy-draining pains.

At this stage, the frustrated patient sat back, confident that the burden of curing their health, has now finally been passed to a newly found miracle worker.

Also keep in mind -- to the frustration of the health care service provider's despondence -- that They are extremely creative when conjuring up ever-changing work or motor vehicle-related injury symptoms.

The larger the possible litigation rewards, the more innovative and original they are.

"Name the ever-changing and sometimes obscure complaint" and he'll try to add monetary value to it; thus enriching himself.

Often, they become another pain-laden motor vehicle casualty; another quality of life deprived statistic; another normally healthy and fit person who's fallen through the nightmares, pitfalls and cracks of the medico-legal profession.

Has not the world enough pain and disability, without making a pastime of income generating mock-pain? Further, bear in mind that some accident policies pay out for "suffering!" Now add to this, the frequently present "vested financial interest," NOT to get better, and often one wonders that some patients do in fact ultimately get better at all!

Where there's money involved, healing is slow.

What the health care persons hear and how they hear it from you, is important. Remember, your quality of voice, is a reflection of your overall physical and mental well-being. Keep this in mind, when you prepare your written self image to be presented in your own voice to the health service provider; the tone, timber, breathing pattern, reflections of weariness, despair, loss of hope, general fatigue and disgruntleness, fear, - all these factors portray your unspoken additional diagnostic aids.

One of the nicest things about life, is the way we must regularly stop whatever stressful activity we are doing, and devote our attention to spending more chewing time to eating.

Yes, that's correct. Chew properly, it gives the important chemicals in the saliva a better chance to help with the successful digestion of the food! It also will reduce the hunger pangs -- helping to keep the body's mass down!

Some of the factors, often encountered, that impede "healing" progress, are the following:

More readily available health-information-driven improvement expectations, creates progressively growing "instant cure" expectations, by patients from the healthcare service-providers.

This brings about high expectations, low trauma-based progress.

Meaningful communication between the healthcare service provider and the patient is vital for the optimum "treatment-outcome."

Lack of insight and empathy; lack of explanation about the nature and course of the "condition" and its quality of life implications by the service-provider.

Lack of confidence or respect in the service-provider. Lack of that "get better feel" at the treatment centre.

Often, the practitioner is a technician only, who turns on the machines; does not even introduce themselves; certainly does not explain what is being done; and even less so, why it is being done! And obviously is not a dedicated humanitarian. They are interested in the purse not the personality

Sadly, too, often, there's money in prolonging the "condition!"

One must always bear in mind that one is buying the skills and expertise of the healthcare service-provider, not their ego.

Yet another factor, growing in importance, is the financial inhibitions and constraints, laid upon your health progress by your healthcare maintenance organisation (HMO) or medical insurance funds' business directors.

So often, a patient sustains an injury and, for various reasons, including the slow-moving bureaucratic machine, delayed implementation of treatment, retards the optimum benefits, that could be had by early treatment. This is "where the "Seven Second Factor" (treatment within seven seconds of sustaining an injury), should aid rapid recovery.

The sooner, after sustaining an injury, active treatment and rehabilitation is commenced, the sooner satisfactory results are obtained.

Fortunately, "patient rights" driven litigation is beginning to address the issue of restrictions of service-provider choice, dictated by business directors.

Quick, certainly is king.

The 160 km per hour (Hundred and sixty kilometres per hour) factor: Patients, who sustain injuries, notably the sporting fraternity, expect to be "fixed," almost before they were injured.

The 160 km per hour (Hundred and sixty per hour) factor, is the following: You are travelling at hundred and sixty kilometres per hour. You expect me to replace your flat wheel at that speed. Almost impossible! However, quite frequently I succeed against very loaded odds! "We do the mess-ups; you do the fix-ups!"

The 100'000 km (Hundred thousand kilometre) service factor: Whilst "driving" your very patient and accommodating body, you notice some "squeaks," some "intractable noise," loss of "power," mounting "disgruntleness," seizure of the "odd joint." Why worry? This unit, has a life-long non-service certificate. Lack of "periodic service" impacts markedly on any "condition," when, in fact, the unit has to be serviced. It is therefore, evident that lack of realistic patient expectation compliance, in terms of their "body abuse symptoms," is out of kilter with reality.

Often, too, our expectations are faster than our recovering ability. "Oh, the price for negligence!"

The analogy, as quoted by one of my patients, is as follows: "new engine old car gearbox packs up."

It is also true, that not all body-models are alike; not all models can handle the stresses and strains with equal equanimity; when commencing running, and terminating "the race!" The instigation of a maintenance service plan, enhances the quality of service rendered by the unit.

The "big bully syndrome." Pains have a propensity to be subjugated by their bigger brothers, or sisters. For example, if one sustained multiple injuries during a motor-vehicle accident, the "big bullies" manifest themselves with great and alarming persistence and enthusiasm. However, with treatment pushing them to the back of the stage, the lesser pain actors venture to the front; they "play" their part with amazing impact and, there you have it the pain and disability scene, is prolonged. The "secondary effect syndrome," has kicked in.

Furthermore, pain resonance might manifest itself in a part of the body, seemingly unrelated to the primary site of injury. This frequently happens with "referred" symptoms associated with a spinal injury. The spinal-nerve is affected in the spinal-column; yet the "pain" is felt elsewhere such as in the arm or leg.

"My job has evaporated!" this comment, coming from a very enthusiastic worker, resulted from the collapse of the company that employed him, at the time of sustaining a work-related injury. The economy was at one of its low cycles. Jobs were difficult to come by. The patient, despondent about his future prospects, was gradually sliding into depression. This affected his recovery adversely. It is clear, that work-achievement-deprivation depression can soon lead to loss of patient satisfaction.

The "wet concrete slab" factor. This manifests itself, when a very enthusiastic person, usually a sports person, "tries out the injury" prematurely. When a slab of concrete is cast, it takes a certain period of time before the concrete has set. Jumping on it, before this time lapse, invariably leaves imprints, an injury on the slab. Recovery is progressing according to expectation; impatience, however, causes retraumatisation of the injury; the healing time is prolonged.

On further enquiry, the "I felt so much better" factor "so I went ahead and caused more damage," is highlighted.

Often, too, it happens that the symptoms the pain or discomfort has cleared up during the course of treatment. The patients thinks they are fixed and therefore discontinues treatment prematurely. However, the underlying mechanical derangement and its associated inflammatory process, is not cleared up.

Total impatience, with the natural course and evolution of the condition, thus penalises the patient.

Yet another recovery hampering factor, is the continual re-aggravation often associated with work-consciousness, associated with work-ethical values.

The patient is advised to abstain from work. In fact, often they are booked off work; but, for various reasons, they continue working; the injury, therefore, is continually traumatised.

At the work-place, too, more frequently than not, the nature of the work; the bad lighting; the poorly designed chairs, work-benches, computer-screen location and many more "bad" ergonomic factors, retard injury or strain recovery. In fact, these negative factors, promote strains, pains, frustration and regrettably lack of work-satisfaction.

If only more enlightened employers would take cognizance of this fact, their worker's output, would improve substantially.

Lack of holistic treatment and rehabilitation approach. This is a factor, that causes much frustration for both the patient and the holistically minded service-provider. During the initial examination, either the examiner does not consider the person as a holistic integrated human being; or the patient omits to reveal "problems," in their past history. Problems that might impact on the progress of the present condition, which sometimes results in "right diagnosis wrong cause of the pain symptoms." This situation is often encountered where pains are experienced; but their origin lies elsewhere such as spinal lesions causing pain in the hip, knee, ankle, shoulder, elbow and hand. Low back lesions, can cause very disconcerting joint and muscular pain, in the legs without the back itself being "sore". The answer, of course, is to focus on the cause of the problem; this will soon rectify the secondary symptoms.

On occasions, when a patient is re-assessed, following a course of treatment, "examination retraumatization" occurs, on account of an over-zealous examination, particularly in the case of soft structures. The patient, is now set back considerably on their road to recovery.

Non-adherence to advice. The best advice is worthless unless adhered to meticulously. Treatment-time, patient-time and all round expenses, are wasted if the patient does NOT follow the advice given by the healthcare service-provider.

Often, too, our expectations are faster than our recovering abilities.

Sadly, too, on occasions, patients only cherish their illness as an instrument of power over their family, friends and employer.

Is it true that "a heart attack-like" pain can come from your spine?

Yesterday Mr. W. Walton, aged fifty-seven years, attended with a "heart attack" pain. He has had this pain over the front and left side of his chest for six years. He has had five electrocardiograms which were negative. Today, following one treatment, the pain is gone.

"They had me in intensive care for one week," explained Mrs. Joyce King. "Nothing showed up."

She is aged forty-three and has had a similar pain for two-and-a-half years. Following treatment of the appropriate part of the spine, it cleared up.

Yes, it is true that irritation of the nerve-roots of the upper thoracic-spine can cause a pain that mimics a heart attack. Methodical history taking and meticulous clinical examination of the patient should reveal this source of trouble.

It is, however, advisable, at all times, to assume that it is a heart attack and to act accordingly, by immediately consulting a physician! Only after this clearance, can the mechanical involvement aspect be investigated.

Once the physiotherapist has rectified the underlying problem, slouching and stooping must be minimised. The appropriate postural advice will be part of the remedial program.

Is it true that "Headaches can be caused by your neck?"

Marginal mal-alignment of the cervical spine can have variable patterns of disturbance. Many headaches do originate from the cervical spine. The ease with which manual intervention, can alter the pattern of the headache or eliminate it, clearly illustrates the association. Other factors, however, can also be causative.

Once "internal abnormalities" of the brain have been excluded as possible causes of the headaches, the appropriate physiotherapy treatment can be very helpful. This is also true of "migraine" headaches.

"I'm so glad that fuzziness is gone," is a gratifying comment to hear. More so, if it had been with the patient for twenty-five years!

Is it true that "pain, pins and needles, in your leg and foot, can come from your spine?"

The body has a most remarkable electrochemical and mechanical communications system. It transmits, the relevant quantity and quality of information, to the correct part of the body, at the required moment in time. It is not unlike, a central control room with substations. A "button" pressed at a substation, may "ring a bell", or turn on a "light", some considerable distance away.

Yes, it is true that a "button" pressed in the lumbar spine may "ring a bell" in the leg or foot. It is therefore, not as absurd as at first it may seem, to treat the "back" when in fact the pain is experienced in the leg or foot. This is a case of "referred" pain.

Is it true "my X-Rays don't show a thing, yet I have pain!"

It often, is true that, although X-Ray findings are negative, clinical examination reveals a lesion. The practitioner, who leans too heavily on X-Ray findings, does so to the disadvantage of the patient.

X-Rays do show up, and exclude, many problems. Thorough clinical assessment, however, in association with radiological findings should be the basis on which diagnosis and treatment is planned.

Many people, live with "radiologically terrible" joints, yet experience no pain or discomfort.

The other side of the coin is equally true.

Is it true that "breast nodules can be associated with your neck lesion?"

Mrs. L.A. King's physician, referred her to me for treatment of her nonmalignant breast nodules. She had no other symptoms, except a periodic headache. The texture of her right breast was that of a bunch of grapes.

Her history, and clinical examination, revealed a previous whiplash injury, sustained some three years earlier. Following treatment of the cervical area in question, the nodules disappeared within minutes. During the following three years, she had no recurrence.

Several other patients, displaying the same symptoms, have responded equally favourably to the appropriate treatment.

Is it true, that "the weather can influence your pains?"

"I could tell it was going to rain, mate! I had them twinges in me knees, mate."

That a change in the weather, adversely influences your pains, is beyond question.

There are basically three patterns of patient response.

The "I feel a change coming"; "it's because it's so cold and wet today"; and the "today it's bad. It must be yesterday's cold spell!"

A rainy, cold and windy Monday is, by and large, the worst day in the practitioner's week. All that can be "painful and sore," will be painful and sore!

A combination of factors, including a change in barometric pressure, and atmospheric electrical charges, play an important part in this "weather" induced pain phenomenon.

Is it true, that "physiotherapists do manipulations?"

Yes! Physiotherapists are trained to apply a wide variety of electro-mechanical types of treatment. Manipulation, and mobilisation, of spinal and other joints of the body, is an integral part of the armaments available to the physiotherapist, for dealing with aches and pains.

Is it true, that "spinal nerve root irritation can cause genital pain?"

The organs of reproduction, are supplied by a network of nerves, associated with the lower part of the spinal column. Correct structural alignment distortion, with consequent irritation of the nerve roots emanating from this area can, and often does, cause pain or muscular weakness of the reproductive structures involved. In fact, this can be a contributory aspect of both impotence and incontinence

"Since my back is better," reported the happy Mr. Joyce, "I'm a different man in bed!"

This gentleman, in his late fifties, suddenly realised that all was not finished, at least as far as his sexual life was concerned.

Is it true, that "carrying your briefcase in the same hand all the time, is bad for your spine?"

A habitually imbalance posture will, in the long run, be detrimental to normal spinal development. The minimum amount of weight should be carried in the briefcase.

It should also, frequently, be changed from one hand to the other. In this manner stress distortion is offset to a large degree.

The body's response to stress is rather like that of a tree. The direction of growth of the sapling is directed, to a large extent, by the direction of the prevailing wind. The more persistent and severe the wind, the less chance there is of the tree growing up straight.

Is it true that "uneven road surfaces are fatiguing to drive on?"

A twisty road, with uneven surfaces, literally shakes the body around in the vehicle. Despite the use of safety belts, great energy expenditure, and body posture distortion, is required to retain the correct position, on the seat. If a spinal injury, is already present, it will soon manifest its objection to travelling on that particular road.

Is it true, that "sheepskin car seat-covers are helpful?"

(Although, with modern vehicle design, internal passenger compartment climate control, is much improved. There is less frequent need drive with open windows. Thus, the use of sheep skin covers, has diminished!)

A sheepskin seat-cover provides a comfortable "friction lock," eliminating sliding about on the seat. They also provide an appreciated cushion of air round the body contact areas. This, in turn, aids improved ventilation.

This is particularly helpful on a warm day, when using a vehicle with a synthetic material or leather seatcover. There is less build up of heat and perspiration behind the back and, consequently, less rapid evaporation when leaving the seat. This minimises the risk of a chill.

The use of a sheepskin to lie on, when prolonged bed-rest is indicated, is very useful to assist in combatting pressure sores. It should be in conjunction with the correct nursing procedures.

Is it true that "a draught can cause backache?"

"The air-conditioner was blowing down the back of my neck," complained Miss Penny Offenski. "That evening my neck became painful and stiff!"

Practical observation has, in many instances, taught that there is a definite relationship between the onset of many aches and pains and a preceding sudden local temperature drop. Neck-aches are sometimes associated with the flow of cold air from an air-conditioner onto the upper part of the spine.

The lower part of the back, too, is vulnerable. This usually follows a build-up of perspiration over the lower back while driving on a hot day. Sudden exposure to the atmosphere causes rapid local evaporation with an associated drop in temperature. A "chill" often results.

A good quality sheepskin seat-cover, does provide comfort and ventilation round the body contact areas.

I have treated several patients, who sustained various "chills," following working in "cold rooms" or "refrigerated" trucks.

Is it true that "exercises are good for your spine?"

The muscles of the lower limbs, trunk and neck, provide a "guy-rope" system to the spinal column. In this way, they help to stabilise the "mast." Their integrity, is the foundation for providing coordinated and balanced flexible stability, to the spine. The correct exercises, to maintain these muscle groups in excellent condition, are a sound and painstaking investment. Your general health will, in addition, reap the benefit of a well-planned and executed exercise program.

Is it true that "head rolling is a good exercise?"

"I was told that I should roll my head in each direction a few times each day. Well, no sooner had I started when this trouble came on."

Mrs. Stella Whethermore, experienced giddiness, headaches and a "grinding" sound in her neck.

To spin the wheels, of a vehicle, on "take-off", does look and sound impressive, to the uninitiated. Excessive use of the tyre, and the "tread life" of the tyre is reduced considerably. Weight-bearing joints, such as the cervical spinal joints, are subjected to pressure wear and tear. Head rolling is, therefore, not a commendable exercise.

Is it true that "shoulder pain can be referred from elsewhere?"

"Yes. A lesion in the neck, with associated nerve root-irritation, can cause shoulder pain. So too, and this is relatively rare, can a lesion of the diaphragm, (the muscular sheet, separating the upper and lower parts of the trunk). Shoulder pains, have also been associated with dental problems.

A reluctance to move the shoulder joint, when pain is referred from the neck, sometimes results in a "frozen shoulder." This condition, is particularly painful, restricting and, generally, unpleasant, to "host!" Early, corrective treatment, of the causative condition, is indeed pain and misery saving.

Is it true, that "a muscular injury should be treated early?"

I have been actively involved with the treatment of sporting injuries for a good number of years. Sportsmen and sportswomen are dedicated people. They spend almost incalculable effort, time, expense and energy on preparing for their particular sporting competition. Their aspirations and expectations, certainly, are boundless.

And yet, so often, they are damned to despair!

This occurs, when they consult an uninformed recent trauma practitioner, after sustaining a muscle, joint or ligament injury. The devastating advice, is "go home, rest and get worse!" This "advice" is both "acquired fitness" and soul destroying, to any athlete or sportsperson.

All muscle, tendon and ligament injuries, must be treated immediately! Not only "treated," but treated correctly!

The integrity of these structures, plays a vital part in their satisfactory future functioning.

With soft tissue injuries, PRICER is the word to remember.

**P** for physiotherapy.

**R** for rest.

**I** for ice.

**C** for compression.

**E** for elevation.

**R** for rehabilitation.

P for PHYSIOTHERAPY (PROMPT PHYSIOTHERAPY TREATMENT):

A competent, well-informed and enthusiastic healthcare team is the patient's best timesaving asset. This is particularly true of sporting injuries. Active physiotherapy treatment must be commenced immediately after the injury has been sustained.

R for REST:

The injured part should be rested, to allow rapid healing to occur. However, the "rest" should not penalise the rest of the body fitness.

I for ICE:

Apply ice immediately, and during the next twenty-four hours. Wrap a wet towel round the injured part and then place crushed ice, in a plastic bag, round this. An abundance of ice at sports venues is essential. The immediate cooling minimises bleeding and swelling.

C for COMPRESSION

When the thirty to forty minutes' application of ice is removed, a pressure bandage is applied, commencing from the area distal to the injury. In the case of a knee injury, for example, bandaging is commenced at the top of the calf and worked towards the thigh.

If the injured part allows, the bandage is soaked in ice water and is then applied. Crushed ice is then applied round this.

Ice is applied for half an hour on, half an hour off. This is continued for three to four hours. Compression minimises the formation of swelling at the injured part.

E for ELEVATION:

Elevate the injured limb, to combat the effects of gravity. Elevation must be continued until the swelling has subsided.

In the case of a lower limb injury, the patient should sleep with the bottom of the bed raised five (5) cm to seven (7) cm.

The upper limb, if injured, must be supported on pillows during the night.

R for REHABILITATION:

When PRICE, the first aid treatment, has been applied, remedial treatment must be implemented by a physiotherapist.

This should, at the very latest, be within twenty-four hours. The earlier, however, the better, for the patient's satisfactory outcome!

Patients should, preferably, attend for active treatment within five minutes of sustaining the injury!

In my practice, the SSF (seven-second factor) is well-known amongst my patients. They are educated, about the value of early physiotherapy treatment, following trauma.

Remedial treatment, may be applied twice, three or even more times per day, depending on the urgency of the situation.

It is, however, imperative to retain the pre-injury level of fitness.

An exercise program, aimed at this objective, is the responsibility of the physiotherapist and sports trainer, working in tandem.

During, and after treatment and rehabilitation of your injury, you must make sure that you are being prepared to fully integrate into your work, social and sporting activities. These you must be able to do without any impediment caused by the preceding injury.

Is it true, that a "neglected muscular injury" can cause future trouble?

A muscular injury, particularly of the lower extremity, incorrectly treated, often upsets the normal rhythmic pattern of walking. This can have a negative influence on the spinal column. The neglected injury can, and often does, cause future trouble!

"Neglect" includes unqualified "rest" advice by an uninformed practitioner! Uninformed, that is, about the demands and needs of the sportsperson. Some of the typical results of injury neglect are the associated compensatory strains, of the opposite side ankle, with a knee injury. The balanced integrity of movement ordination and strength, is lost at the injured knee-joint, and has to be compensated for by excessive strains, on the opposite ankle and foot.

Untreated muscular injuries, particularly in the calf, back and front of the thigh, predisposes toward, what I call, a future "zip-syndrome".

To illustrate the "zip" effect, a balloon is inflated. It then, is punctured with a pin, the "original" injury.

To repair the "puncture", a piece of adhesive tape is stuck over the hole. Once more the balloon is inflated.

The area, around the adhesive tape, the "adhesion" or thickening formed in the muscle, undergoes excessive compensatory extension. The balloon "ruptures" at this weak point. Yet another application of adhesive tape remedies the fault.

Re-inflation predisposes an even larger area of weakness; and so the process can be continued almost indefinitely!

An untreated lesion causes a lesion. Hence the "zip-syndrome", moving up or down a large untreated muscle.

Correct, and early physiotherapy treatment, would, in the first instance, have prevented the formation of the adhesion.

Is it true, that coughing and sneezing can hurt your back?

"Well, my dear lad. It was like this!" explained the jovial Mr. Tinkles Large. A bout of uncontrollable laughter, surreptitiously aided by ill-concealed abdominal adiposity, reprimanded him with strained muscles.

"I could not stop laughing. And then, suddenly this pain interfered. It was terrible, oh dear. This pain, and the joke are still getting the better of me!"

To protect your painful spine, while coughing, sneezing or, for that matter, laughing, pull in your tummy and support it with your hands. You should, at the same time, bend slightly forward from the hips.

Should the desire to sneeze or cough, get the better of you while lying down, turn onto your back and keep the knees bent, with the feet resting on the mattress. Once again, apply counter pressure over your abdominal wall. This procedure also makes post-abdominal surgery coughing, less excruciating.

Is it true that "spinal pain can cause insomnia?"

Good quality, uninterrupted sleep, revitalises the spirit and the flesh! It is certainly true that a painful spinal-lesion can cause sleeplessness.

Trial and error, with the sleeping position, while the back or neck is sore, may provide a better sleep.

Backache, or back-associated, leg pain is often eased by lying on the back or side, with the knees and hips bent. Neck pain, often, is eased by using a "butterfly" pillow. Here, the tendency is for the pillow to reduce the pressure on the neck joints, by having the head pull away from the body.

Is it true, that "your mattress should be very firm?"

Viewed from behind, the body has two noticeably protruding areas, the shoulders and the hips. If they are forced to be in a straight line, the normal spinal column alignment will be distorted. When lying on your side, the mattress must yield to accommodate your shoulder and hip prominence. Failing this, the normal spinal column alignment will be distorted.

A good quality innerspring mattress, must be pliable and be supported on a firm, ventilated board.

Is it true, that "the camber of the road can cause 'jogger's back'?"

The spinal column, is a tower, based on the pelvis. If the surface on which the tower is built, is tilted, the tower will compensate by leaning away from the tilt.

This continuous strain, is aggravated by the repetitive impact force of the foot striking the hard jogging surface. It is therefore, advisable to jog on a soft surface, wearing the correct footwear. a directional change, halfway, when running on a "tilted" surface, is also helpful.

Is it true, that "painkillers can upset your tummy?"

It is a sad reflection on remedial-care that this should ever happen. And yet, an alarming number of patients, are forced upon a course of chemical sedation, for a complaint, amenable to electro-mechanical rectification. This lamentable attitude, on the part of many practitioners, has aided the rapid development of "fringe medicine." Many patients have become victims to persistent prescriptions of painkillers.

Gastric ulcers, with the associated surgery, often is the ultimate price to pay.

Small wonder therefore, that the outcry, "no more painkillers for me!", is heard more and more frequently from people, who no longer are prepared to abdicate their well-being to the "over-use of drugs!"

Why, after all, treat the symptoms, when the underlying mechanical cause of the pain can be rectified electromechanically?

Is it true, that "rubbing liniments and ointments are good for muscle injuries?"

The majority of liniments or rubbing compounds, are indeed excellent, for fortifying the manufacturer's bank account! The "rubbing" action has certain mechanical and psychological advantages.

Is it true, that "I can improve my posture?"

A "good posture," is the least detrimental position of the body to be in to execute a specific task. It is thus evident, that there are a wide variety of activity-related postures.

The normality of the body components in their inter-relationship, while constituting a functional posture, is vitally important.

Structural abnormalities, may, in some instances, be rectified by reconstructive surgery. Muscular and ligamentous imbalance, can be much improved by the correct exercises and mobilisation. The latter course of action, requires determination, on the part of the patient, working under the supervision of a physiotherapist. Round bricks, however, do not make square buildings!

Is it true, that "smoking is bad for your back?"

"I coughed and put my back out!" wheezed Miss McAlpine.

The poor condition of her lungs, reflected her ventilatory pre-occupation. It is custom, if not necessity, amongst the majority of smokers, to emphasise their presence in a voluble and air polluting manner.

I have treated many patients, whose neck or back lesions, were "set off" by a bout of smoke-related coughing. It is better not to acquire a habit that deducts, more and more, from both health and purse.

Also consider, that adverse health habits, have an impact on the quality of nutrition of the structures that comprise the spinal column. This, in turn, can predispose to easier trauma.

Is it true, that "abdominal and pelvic pain can come from your spine?"

The various parts of the body are interconnected to a greater or lesser degree. The communication system is the nervous system.

A "cross-feed" of information, between the various body components, is continuously in progress. It can therefore, happen that a lesion of the lower spine can have referred pain to the abdominal cavity or to the pelvic area. The reverse, of course, also is possible.

Is it true, that "a 'whiplash' injury can give trouble many years later?"

Often, a period of three years, subsequent to the injury-producing accident, elapses before whiplash symptoms begin to manifest themselves. Usually, this is in the form of headaches, neck pain, arm pain and pins and needles.

By this stage, the legal proceedings have been concluded, and the "whiplash" victim has no redress to further treatment expense claims.

It is advisable, to make the necessary provisions for any anticipated future treatment expenses, at the time of the court hearing.

Injury evasive action, however, with the use of a head-restraining device on the backrest of the car seat, is the sensible approach.

Is it true, that "hanging from a suspension bar is good for your back?"

One of the functions of the spinal column, is to transmit the weight of the upper trunk, upper limbs and head, to its base on the pelvis. Gravity, always at hand, even when you are in an erect position, never fails to exert a compressive force on the spine.

Periodic suspension, from a sturdy parallel overhead bar, provides some decompressive force on the mid to lower parts of the spinal column. A suspension period of up to sixty seconds per day is beneficial.

A few precautions, however, are essential.

First, confer with a healthcare practitioner to find out whether any contra-indicating condition exists.

Next, the cross-bar itself must be sturdily mounted at a height of about five centimeters above the outstretched arms and fingers. When discontinuing the suspension, lower on to slightly bent hips, knees and with feet pointed. This absorbs the "landing impact."

Is it true, that "I should learn to live with the ache?"

It is true, but unfortunate, that this "advice" is too often passed on to patients. "Advice" offered by practitioners without considering the contributions that may be made to the wellbeing of the patient by other disciplines in patient-care.

All body mechanical defects, cannot be "made new", or rectified. It is, however, in many instances possible to enhance the quality of life and to provide a longer "tread life" on life's road.

Fortunately, more and more patients realise this and seek alternative advice and are, consequently, much happier. We must, nevertheless, learn to care for our spines as soon as we have the appropriate example set, or advice given, concerning this very serious matter.

Is it true, that "during my old age I will lose in height?"

Approximately a quarter, of the total length, of your spinal column, is made up by the intervertebral discs. After middle age, the discs tend to become thinner, thus causing a loss in height with advancing age. In fact, the gravitational compressive effect on the erect spine, causes the body to be about one to two and a half (1 to 2,5) centimeters shorter at the end of the day.

The awareness of the latter compressive phenomenon was, on an occasion, put to very good use.

A young lad was very keen to join the police force. He was short, by two-and-a-half centimeters, of the mandatory minimum admission height.

He conferred with me about his predicament. We obtained optimum height by the appropriate adjustment of the normal spinal curves. This gave almost, but not quite, enough height.

I next advised him, to be first in line in Sydney, for the following day's measurement.

He just made it! He, no doubt, has settled back to the pre-measurement days. The prime objective, however, was met a satisfied man in the career of his choice!

Is it true that "patients with 'spondylitis' can be helped by physiotherapy treatment?"

Long Established prescription habits, have a way of lingering about, often, not changing, to the disadvantage of the patient!

A very important part, of the spinal-care education program, is that patients should be taught that they should not put up with their pains for as long as they can! To save further debilitating pain, they should seek remedial treatment at once.

An occasional course of remedial treatment, adapted to the patient's changing circumstances, can be of great pain-relieving value.

Is it true, that "cartilage cannot unite?"

Cartilage has no blood supply. Once it has fractured or torn, it cannot unite.

On the technological front, things are moving ahead. What, a few years ago, seemed impossible, now is within the reach of the possible!

(For possible body parts regenerating, check Regenerative medicine.)

Once a dislodged fragment, particularly in the spinal column or the knee, has moved, it can move again. It is cold comfort! Frequently, however, varying trouble-free periods elapse, before surgical intervention may be indicated, by the increased frequency of fragment movement induced discomfort. In some instances manipulative treatment may be of transient value.

However, as I have already highlighted, science and leading edge technology, are rapidly marching along, hand in hand.

Drugs, as we know them, can treat only about 10 % of diseases.

Regenerative medicine, can treat about 60 % by replacing the diseased tissue, or malfunctioning joints.

It is reported, that Every 30 seconds, a patient dies, from diseases, that could be treated with tissue regeneration, or replacement.

Doctor Anthony Atala, announced the breakthrough with colleagues from Wake Forest University School of Medicine and Harvard Medical School.

In fact Dr. Atala's team is currently working on re-growing over 23 different organs including the liver, heart, kidney, and bladder.

(For more and up do date information, Google Regenerative Medicine And Website.)

Is it true, that "physiotherapy treatment can help your bronchitis?"

"If only," Mr. Stockton panted, "I could get some air into my lungs!"

This elderly gentleman's periodic bronchitis, was greatly alleviated by the appropriate physiotherapy treatment. Respiratory aiding equipment, in conjunction with the necessary therapeutic skills, assists many patients with most breathing problems. Included, are problems of young children, periodic respiratory therapy may be indicated. The excessive burden, laid on the heart, can be reduced by having cleared lungs and an improved activity-related breathing pattern. Needless to say, the patient should discontinue active as well as passive smoking. Passive smoking, results when the non-smoker is obliged to inhale the smoke polluted air caused by his fiery friends.

Being overweight, enlarges the body surface area, that has to be serviced by the heart and lungs. Weight reduction, particularly with diminishing respiratory capacity, is very helpful. The hobbyist, must be particularly careful not to clog the lungs with dust. The use of an inexpensive disposable dust filter when doing, for example, woodwork, is invaluable.

"If only I did not smoke," panted the exhausted, retired Mr. Fags. "If only I had looked after my health, I might have had more than forty percent lung capacity today!"

Is it true, that "physiotherapy treatment can help with sinusitis?"

The sinuses form, for practical reasons, an integral part of the respiratory system. They frequently secrete an excessive amount of material. This, the patient notices as a "postnasal drip." this drip can enter the lungs, thus aggravating an already existing lung problem.

The sinus mucus can also drip into the stomach causing nausea, cramps and discomfort.

The appropriate physiotherapy treatment, for children and adults, can alleviate the symptoms, including the headaches associated with sinusitis.

Is it true, that "'stress incontinence' can be helped by physiotherapy treatment?"

"I get a small leak of urine each time I cough, laugh or sneeze," explained the distressed Mrs. Waters.

The pelvic floor, particularly in women, is a very intricate structure. Successful control of the anus, vagina and bladder, depends on the functional integrity of the muscles and associated structures regulating these respective openings.

The "pelvic floor," as the name indicates, has to support the contents of the abdominal and pelvic cavity when sitting, walking, running or standing.

Take a plastic tube seven (7) centimeters long open at both ends. Support it between the index finger and thumb of one hand, thus effectively forming a cylinder, closed at each end. Keep it upright and fill it with water while still closing the other end.

If the bottom finger, is slightly eased off the opening, some water will trickle out. If the pressure, inside the tube, could be raised to some extent, any weak spot at the bottom of the tube would cause water to leak out.

From this example, it is evident that any factors disrupting the integrity of the pelvic floor mechanism, or causing excessively increased abdominal and pelvic cavity pressure, can pre-dispose to stress incontinence. To combat this socially distressing problem, it is absolutely essential to restore the pelvic floor muscles to their normal functional level following childbirth!

It is equally important, to acquire dietary, and toilet habits, that do not predispose one towards constipation and associated raised pressure of the abdominal, and pelvic cavity.

Being overweight, is yet another aggravating factor, that must be guarded against.

A lower back-injury, can adversely affect the nerve-supply to the pelvic-floor regulatory muscles. This should be borne in mind when remedial action is contemplated.

Surgery may be indicated, if some of the non-elastic components of the pelvic-floor mechanism, are overstretched.

Therapeutic remedial action is, however, frequently most rewarding and satisfying.

Is it true, that "tension and depression are amenable to physiotherapy treatment?"

Priority distortion, is the foundation for many of our personal and interpersonal problems. The ever-increasing western Disease", tension, has many of its roots in this priority distortion "base.

"Go well, Hilton," I said to the departing patient. "Enjoy the things that are still free!"

He paused for a pensive moment.

"Yes!" he replied. "Stress!"

Tension may have, as its co-inhabitants, elevated blood pressure, gastric ulcers, a spastic colon, general fatigue, lethargy, irritability, vague pains, headaches and impotence, to mention but a few items in this extensive tension catalogue!

The tension, manifests itself in distorted inter-body part relationships. A vicious circle, feeding on itself, thus evolves.

It is imperative, to enlist the services of the necessary healthcare service-provider, to address this priority distortion initiating the tension.

Physiotherapy treatment, comes into its own right, in rectifying many of the inter-body-part distortion relationships.

To successfully, alleviate the patient of the tension-syndrome, requires teamwork, time and the desire, on the patient's part, to re-appraise, and restructure their immediate and long term priorities. Depression often accompanies tension. This too, can be aided by the appropriate therapeutic treatment.

A new zest and enthusiasm for life evolves. "Problems" get into proper perspective, and energy, to cope with them, gradually supersedes lethargy.

In fact, tension builds up like a gradually rising river. Little, if any, attention is paid to the developing danger. Disaster strikes when it ultimately bursts its banks!

The "mopping up" operation is demanding, time consuming and calls upon many healthcare disciplines to accomplish success.

It is, at this point, essential to establish a "monitoring apparatus," to avert future disaster.

A major source for acquiring aggression, exasperation and tension, is the road and street system on which we travel as passengers and drivers. Driving habits and road safety, can be greatly enhanced, by attending a course, run by the local institute of advanced drivers, or its equivalent.

"Why did it take me this long before I found out how physiotherapy services could help me?"

The physiotherapist's primary avenue of alleviating pain, and promoting healing, is through the skillful and judicious application of physical and electro-mechanical treatment techniques. As far as the patient is concerned, these treatment techniques are nondrug and non-habit forming.

Established treatment prescription patterns, are well known for their longevity.

It is regrettably true, that many physical ailments, that are amenable to physiotherapeutic forms of treatment, have been subjected to symptom suppressive drug therapy.

The rapidly increasing public awareness, of the results and side effects, of drug abuse and drug addiction, is having a rebound on many practitioners. This is, because they do not wish to recognise the invaluable non-drug aids and contributions, that other health disciplines can provide for the benefit of the patient.

In many countries, the physiotherapy profession, is subservient to a set of ethical codes. Direct, or inferred advertising, is forbidden by these ethical codes.

However, the patient, is at all times, at liberty to consult with the local business, or telephone directory, thus opening the door to an informative practising physiotherapist.

No single discipline in healthcare, can at all times provide satisfactory total patient care. Professional autonomy, with a sound inter-disciplinary relationship with the healthcare professions, provides the best patient care atmosphere and treatment facilities.

In a growing number of democratic countries, progressive physiotherapists practice as primary contact practitioners. The patient thus has direct access to the correct treatment facilities at the critical immediate post-traumatic phase. This is particularly valuable for both patient and physiotherapist in the care of sporting injuries.

CHAPTER 27

MY PRECIOUS SPINE AND MOVING HOME OR BUSINESS

Occasions do arise, when you have to dislodge your family, from its present roots, by moving, either your home or business, or both.

At first notice, the obstacles ahead do not seem to justify this awesome and seemingly unnecessary experience! Systematic and analytical planning, brings even this "enormous" task into true and surmountable perspective.

"The difference between a groove and a grave, is the depth." very true words."

Most of us, are inclined to be kept "prisoner" by our fears, prejudices and ignorance. New surroundings, new work and acquaintances, abound with new stimuli. This enhances a broader overview of life and rejuvenates both the spirit and the flesh.

More and more people, divest themselves of geographical boundaries and accept "the world" as their dwelling place.

When you contemplate moving, you must decide, whether the move will take you beyond the boundaries of your current country, or will you remain within the same country?

Some general, and basic, rules underlie both types of move. Additional considerations, however, are to be observed when moving beyond the boundaries of a country.

Preparation for the move:

You must, where possible, first familiarise yourself with the new location. It is essential to ascertain whether the premises are easily accessible. It is also advisable to determine the best unloading time.

Make sure that the doors, stairwells, lifts and corridors are wide enough to accommodate, with ease, the handling of your furniture, household or office goods.

Property inventory:

You have acquired a great number of things, over an extended period of time and at some considerable cost. An inventory, of the family belongings or business equipment, is most helpful in the event of such disasters as burglary, floods or any other property misfortune. A photographic, as well as a video record, taken with cupboard doors and drawers open, also acts to stimulate the memory, particularly the rusty spots, when reviewing lost goods.

A written record is, of course, absolutely essential. A copy of both records must be left in the safe custody of your banker.

Transit insurance coverage:

Our possessions are treasured, valuable and expensive to replace. It is, therefore, imperative that you should acquire adequate transit insurance cover for your goods, while being packed, transported and unpacked at the new destination.

You will get the best services and prices from the cartage contractor or preferably your insurance broker.

Mobile furniture:

If it is evident, that your occupation will involve you and your family in a number of moves, furnish your home accordingly. Be wary of "built-in" furniture, you will be deprived of its utility when you are obliged to leave the home in question. It is infinitely cheaper and more reassuring to have your own furniture available in the new home.

Deadline program:

The "awesomeness" of the move is fragmented into chewable bits by the implementation of a "deadline program." In our household this is called the "to be done list."

On this list, dates are set aside for various tasks to be done. In this manner, "last-minute rush" and "panic" are avoided yet another score against tension and stress!

1. Garage and disposal sale:

The "I will use them later," certainly also resides in our household. However, when a move is impending, "they" feel threatened because we organise a garage sale for "their" disposal. A move presents the ideal occasion for a "general clean-up!"

I place an advertisement, announcing the date time and venue of the garage sale, in the local press and on the local radio. Articles that find their way to this sale include redundant furniture, pot plants, garden equipment, clothing, kitchen utensils, toys, curtains, and much more.

At this time, it is always worthwhile to take note of any charitable community organisations that are operating in your area. Contributions are always welcome.

2. Change of address:

Your move should not disrupt normal and continuous communication channels. To this end you must advise a number of others about your new address; E-mail address; telephone, fax, cell phone and world phone numbers.

These include:

Accountant;

Banker;

Business associates;

Clubs;

Credit companies;

Cultural or recreational organisations of which you are a member;

Employer;

Family;

Friends;

Insurance and investment brokers;

Lawyer;

Professional organisations;

Schools and educational institutions.

In some countries, you can advise the local postal service to re-address your mail to your new address.

3. PACKING OR MOVING CONTRACTORS OR DO-IT-YOURSELF:

The moving contractors have the skill, material and right connections to undertake the job expertly, methodically and pain-savingly. All will be packed well, thus protecting your valued possessions.

You must obtain quotes for undertaking the job, at least two months prior to the actual move.

It is essential to approach at least a few well known and reputable companies for an assessment of the job and the provision of a written quotation.

In the latter, it must be clearly stated whether the quoted price includes packing, moving, unpacking and transit insurance. A "delay" penalty clause may be included.

4. Methodical container numbering and area location:

"Just where can the electric kettle be?"

To arrive at a new residence, in a state of tension and total uncertainty about the whereabouts of specified articles, can cause a highly volatile and explosive family situation. The packers will follow sequential numerical numbering of the packed containers.

When arriving at your new home, you wish to have the contents of the kitchen stacked in the kitchen, the contents of the main bedroom stacked in it, and so on.

To facilitate this procedure, I make cardboard indicators relating to the various rooms of the house.

I, therefore, will have indicators like B-1 for bedroom 1, B-2 for Bedroom 2; G for garage, etc.

In the house that I am about to vacate, I stick the appropriate indicator above the inside lintel of the corresponding room. In this manner, the packers can easily read the code to be marked on their containers being packed.

When the packing has been completed, I remove the indicators and take them with me to the new home or office.

There, prior to the arrival of my household or office effects, I once again mount the indicators above the outside lintel of the corresponding room. Please note, that now, the indicator is placed on the outside of the room in which the boxes are to be packed.

In this way, time and frustration is saved.

5. Cleaning and preparing equipment and appliances:

Damp and soiled cardboard containers can cause havoc with their contents, not of course excluding rust! You must, in good time, prior to the move, defrost the deep-freezer and refrigerator units. This will make sure that they are clean and dry at the time of the actual packing. Many refrigerators have a water-cooling reservoir, connected to the mains water-supply. This must be disconnected, emptied and the connecting hose plugged to stop any water dripping from it.

The dishwasher and clothes washing-machine have to be disconnected, cleaned, dried and plugged in a similar manner. The same applies to garden hoses and ornamental water pumps.

All gardening tools and equipment must be cleaned and greased or oiled prior to a trans-oceanic move, thus protecting against rust.

6. Children and pet-care during the move:

If it is at all possible to "farm out" very young children and pets during the actual move, this should be done. This provides you with undivided attention to superintend and direct the proceedings. As soon as you are in the new home the children and pets must be re-orientated and familiarised with their new surroundings.

7. Selection of new schools:

On departing from your old residential area, obtain "all relevant scholastic records of your school-going children. Armed with these you can easily select a new school that meets with your academic, transportation and any other special needs.

An international move requires attention to a number of additional points:

8. Currency exchange control:

You have spent a lot of time, back support and energy acquiring your present assets. Whenever you move to another country, you wish to be able to take them with you! You should, however, take note of any currency restrictions that your current country of residence imposes on emigrants. If "financial emigrant retaining walls" exist, find out what these currency limits are; what value motor-vehicle and household goods you may take with you. Any additional currency allowance or study allocations must be investigated, also ascertain how long you must have owned a motor-vehicle before it may leave the country and how long you must have owned it before it may enter the new country. Often, restrictive entry taxes and compliance requirements by the new country make it almost prohibitive to take a motor-vehicle from one country to another. In fact it might be cheaper and certainly less frustrating to acquire a vehicle in the new country.

This information will enable you to optimise your asset flow situation. For example if there are currency movement restrictions, then "purchase goods in advance" in your present country. Here you must draw up a shopping list covering the more expensive and durable goods you will be requiring during the next few years in the new country.

This "list" may include: Clothing, footwear, linen, blankets, curtain materials, electrical appliances if applicable as far as voltage is concerned furniture, recreational and hobby requirements, motor vehicle, etc.

9. Pets, fruits, vegetables, plants and dairy products:

You must make sure that there are no restrictions on bringing any of these commodities into the new country. "Restrictive regulations" are usually implemented for pest and plant disease control.

10. Steam cleaning garden equipment and motor vehicles:

Often, it is necessary to have these items steam cleaned to counter the spread of soil or dirt borne disease or plant pests.

11. Motor-vehicle and electrical appliances:

Make sure that your vehicle is compliant with the new country's driving and road safety regulations. This particularly refers to the location of the steering-wheel either left or right. Further "compliance regulations," pertaining to on-board safety equipment, might be in place.

The same applies, to the compatibility of your electrical equipment and appliances to the electrical supply system of the new country.

12. Healthcare examinations:

Comprehensive healthcare examinations, prior to leaving the country, are most helpful. More so when the country has financial exchange restrictions on its emigrants. Arrange for examinations by: family physician; ophthalmologist; physiotherapist; dentist and any other healthcare discipline that you might deem necessary. In this way, you save expenses, at least initially, in the new country.

13. Income tax clearance:

Before departing from your current country, it might be necessary to obtain an income tax clearance certificate, your accountant is the best to advise you about the correct procedures involved.

14. Police clearance for vehicle:

Prior to taking your vehicle to another country, it may be required to obtain police clearance, stating that the vehicle is in fact yours and fully paid for. Your motor association or the cartage contractor will be able to advise you on this matter.

15. International travel arrangements:

Once you know the date of departure, confer with your travel agent to make the necessary travel bookings, arrange for any relevant documentation, health clearance certificates, etc.

16 Currency exchange:

Your bankers should be able to give advice about the most advantageous manner in which to effect your currency transfer. International currency values may be very volatile, this certainly will influence your currency transfer decision. Needless to say, your timing for departure may well be influenced by the time of termination of the financial year in your current country.

17. Settling all accounts and debts:

You must make sure that, at the time of departure, all accounts and debts are settled. These may include:

Stores;

Dentist;

Education;

Electricity;

Gas;

General practitioners;

Healthcare and general accounts;

Motor vehicle care;

Ophthalmologist;

Pharmacy;

Physiotherapist;

Property Rates and Taxes;

Telephone;

Water.

18. Packing order:

After everything has been packed in the cardboard containers, the moving contractors will arrive with a large metal container in which the transport will be done.

A few practical considerations, must be borne in mind with the sequence of packing into this container.

The most essential and helpful articles must be the last to be stowed into the container. By doing this, they will be the first to be accessed on unloading.

With small children in the household, a box of favourite toys to keep them occupied when unloading, is a primary thought.

Immediate and easy access to the following articles is always handy: Transport trolley, beds and mattresses, vacuum-cleaner, kitchen utensils, etc.

On arrival in the new country, the customs authorities might wish to inspect electrical equipment to ascertain whether they conform to the local safety standards. They may also wish to inspect the lawnmower, gardening equipment, and vacuum-cleaners to make sure that they are clean, thus eliminating the spread of pests or plant diseases. These articles, too, should be amongst the last to be packed into the metal container.

19. Will and last testament:

Your changing fortunes and circumstances dictate that you should periodically review your will and last testament. When you have arrived at your new destination you should immediately confer with an attorney to bring your will up to date. Not attending to this duty, may have devastating and disastrous consequences for your family or business.

20. Telephone directory and stationery:

Next, you should acquire the necessary letter-headed stationery and visiting cards. You should also register with any relevant professional, business or other associations. Arrange for your listing in the required and desirable directories.

The end in sight: Once the family has settled in the new home, it gives me great pleasure to arrange for the delivery of a bouquet of flowers to the ever-capable and patient domestic executive my appreciated right hand!

Finally, a settling-in dinner at a local restaurant brings the family together in a pleasant and relaxed atmosphere. Now we have a splendid time to review the experience and "catastrophes" that never occurred, thanks to sound and methodical planning of the whole operation! In fact, the question might even be raised: "when is the next move?"

21. To be done list:

To avoid, or minimise "forgetting" and last minute "panic and frustration," it is advisable to draw up a systematic allocation of duties to be done list. Pre-determined dates on this list, brings the "awesomeness" of the venture into manageable perspective.

CHECKLIST FOR PLACE OF DEPARTURE

1. Obtain insurance covering: packing, transport and unpacking quotations from at least two firms.

2. Obtain lists of goods and materials prohibited from entering foreign states or countries usually available from the foreign country's embassy.

3. Inter-country travel: make travel arrangements with the travel agent. The agent should supply information about any required medical clearances.

4. Arrange interim and new accommodation.

5. Car and electrical equipment: check compatibility with new country.

6. Medical check-ups with:

General healthcare service provider.

Physician.

Dentist.

Ophthalmologist.

Physiotherapist.

Psychiatrist.

Chiropodist.

Gynecologist.

Any other.

7. Settlement of all outstanding bills:

Physiotherapist.

Pharmacist.

General healthcare service provider.

Water, electricity, gas, property rates and taxes.

Credit cards.

Any other.

8. Advise changes of address:

Accountant.

Attorney.

Banker.

Business associates

Clubs.

Credit companies.

Family and friends.

Financial institutions.

Investment companies.

Journals and periodicals.

Professional organisations.

Schools, educational institutions.

Any other.

9. Price additional items that may be sold with the home including curtains, carpets, watering system for garden, garden tools, furniture and any other.

10. Retrieve articles or goods on loan or out on repair.

11. Return borrowed goods.

12. Obtain car valuation and police clearance certificate.

13. Service and clean:

Office equipment.

Food processor.

Sewing machine.

Lawnmower, edge cutter and gardening equipment.

Hobby equipment.

Vacuum cleaner.

Motorcar, caravan, trailer, boat, motorcycle and bicycle.

14. Washing and dry cleaning:

Blankets.

Carpets and wall hangings.

Clothing.

Curtains.

15. Currency transference.

16. Income tax clearance.

17. Shopping list:

Clothing: winter; summer; recreational; sports.

Shoes: ordinary; fancy; recreational.

Blankets and bed linen.

Curtain material.

Dressmaking material.

Electrical appliances if compatible.

Furniture.

Recreational and hobby requirements.

Motor vehicle.

Gardening equipment and furniture.

Jewellery.

18. Number-tag, measure and describe curtains that are being taken from existing home.

19. Garage sale: issue notice, specifying date, time and venue, to local press and radio.

20. Make and mount room indicators above inside of appropriate room doors.

21. Deepfreeze unit, refrigerator, washing-machine and dishwasher disconnect, clean and plug pipes, where applicable.

22. Cancel:

Telephone service.

Paper delivery.

Milk delivery.

Mail delivery. (Take note of the existence of any "mail forwarding service, that might be offered by the local mail service facility.)

23. Implementation of house, business or any other real estate disposal program.

24. Apply protective coating to any equipment that may be subjected to corrosion, during oceanic transport.

25. Dismantle specialised, fragile equipment and furniture, to basic and manageable components.

26. Dismantle audio-visual and computer system to basic components. (The original packing containers are very handy at this stage).

27. Remove any specialised fittings, such as bottle top openers, paper towel holders, etc.

28. Mark all fittings and furniture not to be packed and removed.

29. Take leave of friends, family and business associates.

30. Dispose of perishable foodstuffs.

31. Make list of essential articles to be carried in person:

Medicines;

Travel documents.

Qualification certificates.

References.

Passports and visas.

Birth certificates and health records.

Clothing.

Toiletry.

Any contact E-mail, street and postal addresses; fax and telephone numbers at new destination.

Credit transfer certificates or documents.

International drivers license.

32. Clean home and garden.

33. List of last articles to be stowed in container:

Beds, mattresses, bedding, kitchen utensils not excluding an electric jug or kettle, cups and saucers with spoons, towels, clothing, curtains, toys, gardening tools, lawn mower, electrical equipment, vacuum cleaner, handy trolley, room indicators if not transported in person (if young children are part of the move, a box of favourite toys should also be amongst the last items to be packed into the transport container. They will be most welcome during the unpacking phase at the new home). Furthermore, the local authorities might wish to have "a look at possibly contaminated equipment." this is part of a program to combat the "spread" of "pests and diseases."

34. Estimated time and date of arrival of goods at new destination.

35. Superintend packing of numerically numbered boxes into transport container, against a numerical checklist, supplied by the packing and transport company.

CHECKLIST FOR PLACE OF ARRIVAL At final destination:

1. Organise for power, gas and water supply to residence.

2. Superintend unloading out of container, against the numerical checklist. Tick off numbers as they are unloaded. (Make note of any obviously damaged boxes, by using some "marking" on the checklist.)

3 . Mount room indicators above outside of the appropriate room, to act as location guide for the "unloaders."

4 . Advise unloading crew to stack the boxes in the centre of the rooms. This avoids damage to the paint work of the walls.

5 . Familiarise young children and pets with the immediate environment. Open a box of toys to keep them from under foot.

6 . Establish contact with:

Accountant.

Bank manager.

Insurance broker.

Investment consultant.

7. Register with employment agency.

8. Register with healthcare team:

General healthcare practitioner.

Dentist.

Physiotherapist.

Any other as required.

9. Obtain telephone registration in the telephone directory.

10. Obtain registration in the appropriate business and professional directories.

11. Organise printing of stationery and business cards.

12. Obtain emergency contact telephone numbers fire, police, ambulance, and doctor and fix them to all telephones.

13. While unpacking, keep a checklist of any losses or damages incurred during the transport of the goods. (Remember: loss or damage claims relating to the packing, transport and unpacking have to be lodged with the insurance company concerned, within the specified time.)

14. Organise enrolment at the appropriate institutions of learning school, university, technical college, etc.

15. Join special interest groups, churches or clubs.

16 . Review move and make note of any hitches, problems encountered, time and energy saving experiences learned.

17. Organise a systematic unpacking program. (Remember: All cannot be done in one day! Schedule frustration out of this experience).

18. "We've done it!" this calls for a family dinner and celebration at a select restaurant.

CHAPTER 28

HANDY HINTS.

When relocating, particularly to another country, it is much easier, and likely to be less expensive, to go online to some of the well known stores in the new country, to look at prices. Packing and Transport is expensive. Maybe it will be less costly to replace items in the new country.

Always buy a good bed and mattress and an equally good pair of shoes. Chances are that if you're not in one, you're in the other.

Holiday precautions:

Turn off water-supply and water heating system. Returning from a holiday to find the home "flooded!" Well, it only means expenses and back straining labour.

Do not carry heavy loads well in front of the body. Rather, "hug" the object "close" to the body, thus reducing the leverage disadvantage.

Get some assistance, or use a trolley, whenever possible, to transport loads.

When buying any article, that requires periodic cleaning, watch for sharp and skin abrasive edges. This also applies to an automobile.

Whenever possible, acquire dishwasher-washable kitchen utensils.

Periodically, check the state of inflation of the car's spare-wheel.

Prior to commencing a course of physiotherapy treatment, always inform the therapist about any "hardware" or "electromechanical" implants that may be present in the body. This includes pins, screws, staples, wires, joint replacements, and plates, metallic birth control implant devices or any other metallic implant.

Prior to the commencement of a course of physiotherapy treatment, always advise the therapist about the presence of any electronic aid or electronic biofeedback system, that may be implanted in the body, or used on the body surface. This includes a pacemaker, hearing aid, electronic watch, etc.

An uninterrupted course of physiotherapeutic treatment, yields better results.

In fact, patients often penalise their ultimate "treatment outcome" results, by discontinuing treatment, when they perceive, that they are "well", when the "symptoms" have cleared up. Frequently, though, the "underlying" mechanical derangement and the associated inflammatory process, has not cleared up.

The best treatment results, are certainly obtained, when guided by the experience, and expertise of the treating physiotherapist. They have, after all, experience and expertise equity, underpinned by intensive training to assess and treat trauma and body-abuse-related conditions and to determine when optimal treatment results are obtained.

Often, an experienced physiotherapist can help.

However, too many patients are penalised, by constraints placed upon the physiotherapist's experience, expertise, skills and insights, by fellow healthcare service providers.

Often, too, these practitioner's "judgments" and "presumptions", on behalf of another healthcare service-provider's abilities, to help a patient, might be tainted by genetic prejudice, orthodox narrow visions, lack of information, or, sad to admit, by "vested financial interest-driven" preferential ignorance; or fear of admission that "some other" discipline could actually enhance the quality of life of the sufferer .

Patients and healthcare service-providers, alike, do not want assumptions made on their behalf! Consequently, many patients find their way to the physiotherapist via serendipity, rather than via referral from health professionals.

These often disillusioned patients, vent their compounded frustrations, on the physiotherapist, wanting to know "why only now?" "Why only now? After all the pain, disabling frustration, mountains of painkillers and ant-inflammatories, and on many an occasion "being away from work?"

Technology is moving ahead on all fronts. Consider the possibility of a master gene.

It is therefore, likely that specific components of genes may be located that predispose to certain well-recognised characteristics in our fellow human beings

Scientists isolate -- Master -- Gene -- a Genetic Basis for Controlling Other People. Imagine the possible health service provider impact, if such a gene is located, that is associated with social dominance and strong control over other people.

It is possible, that some financial and health care service providers, hold the view, that other people, need their professional insights, and are unable to manage their own investment, and health lives, without their guidance.

The belief complex, is manifested by a strong feeling of superiority, and certainty, coupled with a powerful sense of status and financial entitlement -- and a equally carefully nurtured ego and sense of resentment, toward those, who don't listen to their expertise.

It is therefore, quite evident, that to be a successful physiotherapist, you have to achieve the daunting task, of delivering "pain-relief" on demand.

Decompression syndrome, may result, following spinal treatment, such as manipulation or traction. This usually means a slight and temporary exaggeration of the symptoms. This, however, soon settles down.

Whenever possible, following spinal treatment, go home and lie down for half an hour's rest, by lying flat on the back with two or three pillows under the head and knees to take off some of the "stress" on the spine.

A wife's back, well looked after, is a family asset. The father-to-be, please, help with lifting, carrying, and moving of goods, particularly during the last three months of pregnancy and during baby rearing. In fact, always offer help.

The elderly person, should change posture from lying to sitting, and from sitting to standing, with prudence. Give a little time, for the circulation to adjust to the new posture. Failure to pay attention to this simple fact, may result in a fall, and a fracture, or other injuries.

A portable alarm activator, can be a lifesaver for a senior citizen or a disabled person living on their own or who spends a substantial period of time alone.

Keep a shopping service telephone number at hand. This is most helpful when one is housebound for any reason. With the advent of "on line" shopping, via the Internet, certain basic and essential goods can be procured without leaving the home.

Push heavy objects, by turning the "backside" on them and using the powerful leg muscles to do the pushing.

When medication is prescribed, enquire about the objective, effects and side effects, of such medication. Also enquire, whether precision and life-essential co-ordination activities, such as driving a motor-vehicle, may safely be continued with during the course of medication. Always make sure that the accompanying information leaflet is supplied with any prescribed medication.

Ironically, elderly people are more likely to suffer from over prescription of medicines. And yet, they are the group standing to gain the most from correct prescription, based on accurate diagnosis.

Furthermore, add to this poor monitoring of side effects; the inter-reaction of drugs; the inter reaction of various medications and alcohol; and adverse drug reactions.

Bring the body to the work-level, when hanging curtains, removing goods from top shelves, cleaning light fittings, etc., by using a lightweight aluminium stepladder.

A few days ago, an old-time patient came in for treatment of her back injury.

"It's like this," she informed me. "I stood on this little table. Well," she hesitated. "Well I've been using it for years! But this time it just collapsed. You can't imagine the pain!"

During a drought, remove the bottoms of plastic bottles and insert them upside down, next to a plant that requires watering. In this manner, less water is wasted, another saving on the carrying back.

Automatic pot plant watering devices are most helpful during a vacation away from home. They keep the homebound plants happy and well watered.

Hot-water storage system:

"Have a great day," I greeted Tom on his way out of the practice.

"Can't! I have to fix the damage caused by the leaking hot-water system in the ceiling. It sprung a leak, flooded the rooms below and caused a lot of damage to the video-recorder and other hi-fi equipment."

Here was a costly, and work-inducing experience to be harvested and harnessed as part of a future evasive action program.

When planning, and designing, a new home, preferably locate the hot water storage system at floor level. Alternately, make absolutely sure that it is mounted on a catchment-tray, that has a waste-water outlet, to drain to the outside of the home. This will prevent the catastrophe of an overflow.

Here too, a periodic check to make sure that the catchment-tray's overflow pipe is not blocked, is time well-spent.

Yet, another energy, water and money saving idea, is to use thermally insulated pipes to transfer the hot water from the hot water storage facility to the respective hot-water taps.

CHAPTER 29

My PRECIOUS SPINE AND SAFETY AND SECURITY

Any unnecessary physical or mental, burden, discomfort or expense, taxes part, therefore, the whole of your body.

Lack of emotional and physical safety, security and stability, gnaws away at your energy resources thus reducing the quality of your life!

Important: The "backbone" of almost all your activities and achievements, is your "precious "spine". Squandering these hard-earned achievements, and assets will place your precious spine in unnecessary debt and labour. Judicious and meticulous attention, to safety and security, minimises these risks.

Financial and economy safeguards:

Financial asset and replacement cover is essential. Any asset loss or destruction, represents a loss of labour, expertise, time and energy on your part.

You must obtain, and update, sworn valuations and insurance coverage, with the aid of your insurance broker, endeavour to build up a "financial emergency buffer fund." this absorbs many of the lesser financial impacts on the irregular financial road of life, thus smoothing your travel along it. Safety and security, have many facets, often intertwined in such a manner as to make their relevance to the whole, seem distant and obscure.

Yet, they are an integral, and important, part of the complete picture.

Fire:

The devastatingly destructive and ruinous nature of fire, requires no emphasis. However, certain preventive and safeguarding measures, do require emphasis!

Emergency contact numbers:

It is frustrating, and often costly and dangerous, not to be able to establish immediate contact with the appropriate help-rendering authority, in an emergency situation. It is a simple and easy procedure to expedite this contact formality when you move into your new home or place of work.

I take self-adhesive paper, and use a "high-liner" to write the appropriate emergency numbers on it. Then I fix a set of numbers to each telephone or telephone extension unit.

All the numbers, should be fixed on corresponding and identical locations, thus avoiding the need for a "search" in an emergency. Inform all members of the household or the members of the work-place staff, about these numbers and their location.

You must inscribe at least the following numbers on this list:

Ambulance service; factory or plant doctor; family doctor; fire department; police department.

Where possible, alternative numbers must be noted down.

Fire drill and evacuation plan:

Your local fire department, will gladly provide you, or your company, with practical advice on fire prevention and the procedure to be followed during a fire. It is, however, essential that your family, or co-workers, should be familiar with the evacuation procedure to be implemented during a fire.

Periodic fire drill practice, gets all concerned well-tuned to the appropriate fire alarm reaction.

Smoke and heat-detectors:

A variety of inexpensive smoke and heat detectors, operating, either from batteries or the mains power supply, are available. Your fire department should be able to give you sound advice on the types to be installed.

You must, however, have both battery and mains power supply operated types installed. In this way, the detector will not be rendered inoperative during a power supply breakdown.

These detector-alarm systems, must be strategically located, usually against the ceiling, to be audible even during the night.

Also, make a regular, at least monthly check to make sure that the systems are functioning correctly.

Fire extinguisher:

It is essential, to have the appropriate type of fire extinguisher, strategically located in both your home, workshop and place of work. In your home, this applies particularly to the kitchen. Your family or co-workers must be familiar with the mode of operation of these devices.

Here, too, a periodic check must be made to ascertain that the fire extinguisher are still in correct working order.

Automatic fire extinguishing systems, are usually a mandatory and integral part of large building complexes.

Fire escape route:

Ensure that the fire-escape route, particularly in large high-rise buildings, is well indicated. Furthermore, good maintenance of exit doors and fire-escape stairs, is lifesaving.

Electrical supply and wiring:

An earth leakage system, as an integral part of the electrical wiring system of the building is essential. Circuit overloading, with its associated fire risks, is then almost impossible. This also minimises the risk of accidental electrocution. Needless to say, the wiring of the building must be in excellent condition.

Fire and child-safety:

The fire safety, of children in the home, is very important.

In considering a fire-safe environment for children and their parents to live in, specific attention must be paid to the following:

Fire Resistant Clothing:

Wherever possible, obtain clothing bearing an authoritative bureau of standards marking, indicating that the product is fire resistant. The impact, of many fire-related child accidents, can be drastically minimised if the victims involved were clad in fire-resistant materials.

Matches and lighters:

Fire is an integral part of man's way of living. It will always fascinate him even if he or she is a "miniature" of the species.

Early fire-safety education, should be commenced with as soon as possible. But until this is commenced, and even afterwards, lighters and matches, must be kept out of reach of enthusiastic little experimenters.

"Fire, help! Help! It's burning! The "house!"

Our little daughter, and her very anxious little friend, cried!

The two little girls, were sitting inside the dried tree branch "house" that the two enthusiastic boys had "built." The two very eager and enthusiastic boys, tried to spruce up the place by "mowing the dry lawn," around the "house," by setting fire to it. Fortunately, an abundance of sand soon had the "emergency" under control.

Gas, oil and electric heaters:

All open flames, or electric elements, must be shielded from inquisitive little hands. These appliances must be topple-proof, automatically turning or switching off if accidentally overturned.

Volatile and flammable fumes or gases:

You must be extremely careful, with the use of these materials, in the proximity of open flames, sparks or the possibility of static electrical discharge. Furthermore, it is imperative, when handling materials such as: petrol or gasoline, benzene, low pressure gas, etc. That you make sure, that the room is well-ventilated. In fact, where possible, it is advisable to work outside.

Cooking oils and fats:

To leave cooking oil or fat unattended, on the burners of the stove, is inviting, and courting disaster! It is equally important, not to leave the home, without leaving the cooker, at least attended by a timing device. If, for any reason, your return is delayed, overcooking and a possible fire may result.

Personal, and toil-laden experience, has taught that cleaning a kitchen in which a fire was entertained, is time consuming, shoulder, back and neck-straining as well as costly.

Fire clearance round home or plant:

If you live, or work, in an area, that is subject to seasonal, or continuous fire hazards, make certain that the necessary fire hazard clearance, around the building, is maintained. This includes trimming overhanging trees, cleaning the gutters of combustible material, removing combustible debris, and maintaining a clean firebreak around the property.

Lightning conductor:

If your home, or business, is in an area that is frequently plagued by electric storms, the installation of a lightning conductor will provide added safety and peace of mind. Additional precautions must, of course, be taken to protect electronic equipment, such as audio-visual, communication and computer equipment from lightning damage.

Documents and valuables:

The loss of valuable documents, or jewellery is at all times a harassing disaster. Adequate fire and burglary protection, for these items, is therefore mandatory.

The bedside location, of a flashlight and alarm whistle, at a strategic and specific area, can be most helpful in the event of an emergency at night.

Burns:

Burns can be lethal, disfiguring or render normal function impaired or impossible. I need hardly emphasise the almost always-present pain.

Burns are usually caused by one of the following factors:

Thermal, chemical, electrical, mechanical frictional and solar.

Thermal:

Most frequently domestic burns result from inadvertent exposure or contact with too hot water, steam or heated appliances. It is always advisable to regulate the temperature of the water running into the tub, to be such that it will not cause any burns, if accidentally stepped into. This point is particularly valid with children and elderly people in the home. Loss of balance, can easily topple one into the over hot water.

I vividly remember one of my patients telling me about the "disaster" that overtook their family.

"What happened", I enquired.

"My four-year old daughter fell into the hot-water!" She remained silent for a moment. And then she continued: "With such pain, the poor little thing!" Some belated regret manifested itself in her voice when she continued: "The scarring! The scar tissue still is evident."

A pre-set temperature regulating system, delivering water to the showerhead, yet again enhances burn safety. You should also avoid working over a steaming kettle or boiling pot.

Utmost care is required when using the electric iron or ironing machine.

All pots and pans must have thermally insulated handles. The use of thermally insulated gloves also provides additional protection, when working with hot utensils.

Stove-guard:

A stovetop guard, is most invaluable to prevent miniature people from pulling hot pots and pans from the cooking surface. The handles of pots and pans on the stove, must at all times be directed away from the front, thus out of harm's way.

Chemical:

The corrosive effects of acids, alkaline, etc., are well-known. Keep all such chemicals in appropriate and well-marked containers in a cool and safe place. This must be beyond the reach of young children and pets.

Electrical:

Electrical burns result when arcing occurs. Periodically examine all electrical equipment and appliances to make sure that they are well earthed as well as ensuring that all connections are in a sound condition.

Tamperproof power outlets safeguard little wandering fingers, particularly those eager to probe metal rods into inviting holes.

Mechanical:

Mechanical burns are the result of high-speed friction. They usually occur in the workshop when a finger accidentally touches a high speed revolving emery wheel, drill chuck, etc. Caution is aided by the correct use of equipment safety guards and fences.

Solar and radiation:

Excessive exposure to sunlight can cause a great deal of discomfort. Overexposure can even precipitate skin cancer. Protective clothing and the correct sun filter lotions are invaluable.

Be particularly careful when using arc-welding equipment, to guard against ultra-violet irradiation by using eye and face protective goggles and mask.

The heat detecting system of the body, can on occasions be thrown out of action by a nerve injury. Therefore, be extremely careful when you have any loss of heat sensation, particularly in your hands, not to burn them on hot surfaces or in hot fluids.

Moving about an open outside barbecue fire on bare feet, is simply to invite any loose-lying ember to painfully indicate its presence on the sole of your foot, indeed a very painful process.

To pour petrol or any similar liquid, on an open fire, to get it started, is a very dangerous practice. The fire may very well get going with an explosion!

Water:

Our family loves the recreational avenues and doors that water opens to us. We enjoy the pool, lakes and surf, equally as much. We indulge in this enjoyment by adhering to the rules of the game.

This, of course, is the first rule of water safety you must get to know and implement the regulations pertaining to swimming-pool safety.

Familiarise yourself with the relevant rules and regulations applicable to any water-sport that you may wish to get involved with.

Unless you have information to the contrary, it is safer to assume that all newcomers to your swimming pool cannot swim. It is surprising how many adults cannot swim.

Swimming instruction and self-help:

It is imperative that children should gain confidence in water from a very early age in fact, when the normal "crawling reflexes" are still present. Swimming tuition, by a competent instructor, spans the pitfalls and aids gracious and confident movement in water.

"Resuscitation techniques should form a part of the swimming tuition.

Swimming-pool safety:

The pool must be enclosed in accordance with the mandatory local authority safety regulations. This will be in such a manner as to prevent young children and pets entering unaccompanied. In addition to this, a pool-cover or net may be used to provide extra safety.

A buoyant rescue ring with a rope fixed must be within easy reach of the pool.

Water-sports:

Alcohol is volatile, it also soon evaporates the enthusiasm, enjoyment and vigilance, associated with sport. It, therefore, has no place at all in association with water-sport!

A variety of water-sports are at your command. These includes power boating, sailing, windsurfing, scuba diving and many more. Here, again, some basic safety principles are to be observed.

Know the rules and regulations regulating the sport:

Familiarise your family, friends and yourself with the rules and regulations pertaining to the sport in question. This, in the case of a waterborne craft, includes the traffic regulating rules and emergency procedures.

Safety equipment:

You must adhere to the mandatory list of safety equipment to be taken on board any pleasure craft. A list of the safety equipment will include: auxiliary motor in case of a powerboat or yacht extra shearing pins, for powerboats propellers; barometer; buckets; extra anchor and rope; first-aid kit; flares and matches (to be kept dry in a water-proof container); flashlight (with an extra bulb); hat; insect repellent; oars; protective clothing; radio communication system; safety jackets; sharp knife; sunglasses; sun shelter and sun sheltering cream; water repellent for powerboat motors.

Power boating:

Always inform some land-based person about the nature of your intended trip, emphasising the anticipated time of return. In fact, it is much safer and infinitely more pleasant to have someone accompany you on an outing.

The meteorological forecast, particularly of sea-areas merits careful and regular attention when planning and setting forth on a boat or sailing trip. The use of an on-board barometer is a helpful early-warning device concerning impending changes in the weather.

It is a sound practice to get an experienced person to teach me how to "'read' the local weather." In this way, you can take heed of nature's warnings about impending changes in the weather conditions timely danger evasive action can then be taken.

Launching:

Launching a pleasure craft incorrectly or without the necessary facilities, can be most taxing and straining. All rollers, on the trailer carrying the boat, must be well lubricated and free moving to facilitate ease of passage of the craft during launching. You will soon learn about the location of safe launching ramps, providing easy access to the various bodies of water you wish to explore or enjoy.

An electric winch, mounted on a trailer, eases boat manoeuvering significantly.

Water-skiing is a very pleasant and exciting sport. I enjoy an unpolluted environment, more so when water-skiing without encountering floating bottles, cans and similar obstacles.

With water-skiing, it is advisable to have an experienced driver and an observant pilot to take care of the skier. The skier should at all times be admonished to stay clear of the propeller of the boat. In fact, when near a person in the water, you should switch the motor to neutral. The motor should also always be in neutral when starting the engine.

A grab handle and ski-step, eases the procedure of getting out of the water into the boat.

When driving a small-powered craft, first make sure that all aboard are seated before you take off.

The use of a pair of elastic ski-pants saves the novice skier a great deal of embarrassment and discomfort. In this way a forceful and unwanted enema is avoided. In fact, it is highly commended that all ladies intending to water-ski, should wear these ski-pants to avoid the risk of gynecological damage or injury.

The use of an electric hoist, with outboard motors is a back and time saver.

Eye protection particularly against glare is absolutely essential.

Sailing:

It is essential that you should be physically fit, mentally alert and conversant with the yacht you are about to use. Practically-based instruction minimises the perils.

Fishing:

There is nothing as painfully embarrassing as "catching" one of your friends while casting. Successful fishing requires skill, methodical thinking, planning and acting, as well as an ability to scale weights and measures down considerably!

Particular attention must be paid to the safe storage of hooks and knives. You must also have knowledge of the various types of fish and the potential problems or dangers associated with them.

CHAPTER 30

HOW CAN PHYSIOTHERAPY SERVICES -- THROUGH ASSESSMENT, TREATMENT, CARE AND ADVICE AID WITH MY MANIFOLD HEALTH PROBLEMS TO IMPROVE THE QUALITY OF MY LIFE?

Patients with "slow-onset conditions," with associated long-standing disabilities, who have the need for my skills, are so often unaware of "what we can offer, or do, to enhance the quality of their lives." Often, they do not think they are entitled to our attention.

For the majority of people, care is provided by partners, friends, relatives and neighbours, and not by the statutory authority-funded health care services.

Caring" for the well-being of the "carer," must at all times be considered to be most important for the quality of care given to the patient.

We, as practitioners, have to maintain the skills to maintain the experience, expertise and knowledge base, derived from the wake of the ever-developing and progressing scientific and technological frontiers. This must be compassionately, and meaningfully, transferred to the enhancement of the holistic quality of life, of our "patients.

Not only our patients, but equally important, to the patient carers, the informal patient supporters.

"Often, the "carers", have much more knowledge of "how to care", but lack real awareness of the "natural progress of the condition."

The multi-facetted physiotherapist, has skills, knowledge, and expertise equity, to aid with liberating the supporting family and co-workers from the demands, mental and physical, resulting from pain, disability and possible handicap.

Physiotherapists, have much practical advice, to offer patient "carers" to enhance the quality of life of the team.

"With which of my health problems can physiotherapy treatment help me?"

Technological progress, continues to advance the frontiers of scientific, holistic and integrated health care-services knowledge. It is therefore, evident that the new technologies are changing the profile of the profession. "Teamwork," amongst the various healthcare disciplines, involved with health care service provision, is at the centre of projecting the appropriate technological discoveries at the "disease process" or "trauma process" of the patient.

After all, no single professional individual, or group, can lay claim to be "expert" in the "total, and holistic management" of pain or disability.

The synergistic interaction, between the various health care providers is to the ultimate credit, and quality of life-enhanced benefit of the patient.

Imagine the "patient" to be sitting in the centrepoint of a multi windowed sphere. All concerned with the patient's health and well-being, are "looking in" through their particular little window, "seeing" only their little segment.

The "problems, life-style and quality of life," of the patient as a socio-economically integrated whole, must be addressed. The various facets, of a person's life-style, work, recreation, social, productive and reproductive, are dynamically interrelated.

The health service-providers, are dynamically interdependent.

The dynamic, ever-changing physiotherapy profession, is at the forefront of implementing these advanced technologies, to improve the quality of life, of patients, "both young and more mature.

The only sure constant, in leading edge physiotherapy technology, is change and adapting.

Technology Breakthroughs, That Used to Be Science Fiction, Are Now already a possible quality of life Reality.

For example: On November 5, 2012, a man walked up 103 flights of Chicago's iconic Willis Tower, becoming the first human in history to complete the task with a mind-controlled prosthetic leg.

How about a retina light sensor, that restores vision to the blind? Or even an "electronic skin", that has actual feeling?

Various retina electronic chip implants, have already been done -- the feedback is still pending -- with much improved Higher Density Pixel possibilities, on high-density chips, I anticipate huge improvements -- including colour "detection.

The most important person in the team, the patient, reaps the beneficial results of these technological benefits, via the skillful care of the empathetic physiotherapist. It is very important to remember, that because a sports-related concussion can't be seen, hyper-enthusiastic parents and coaches, may underestimate its health threat. Various ego, and peer pressures, then may push youngsters to return to the playing field, before they're had a chance to heal, causing a so-called second impact syndrome.

"The more concussions, the higher the risk of a catastrophic injury or death," says Fred Mueller, PhD, director of the National Centre for Catastrophic Sport Injury Research (Nccsi), in Chapel Hill, North Carolina.

One ad features, a youth baseball team in post-game celebration, with the message:

"What will they have longer -- their trophies or their injuries?"

By definition, therefore, it is evident that a static list of complaints and conditions, amenable to physiotherapy treatment, cannot exist.

However, an alphabetical list of complaints and conditions, more frequently encountered, is given. Where possible, "non-jargon", is used in naming conditions.

When in doubt, about the role that physiotherapy treatment can play, in the resolution, and care, of any "condition," it is time to pick up the telephone, to obtain firsthand information from a practising, and "experienced" physiotherapist.

ALPHABETICAL LIST OF CONDITIONS AND COMPLAINTS FREQUENTLY ENCOUNTERED IN WHICH PHYSIOTHERAPY TREATMENT CAN BE OF HELP

### A

**Accident prevention advice** \- at home and in industry.

**Achilles tendon -Tendonitis;** and pain and swelling associated with; post-surgery rehabilitation.

**Adhesions** \- Prevention and treatment of particularly related to: road traffic accident victims; post-operative adhesions; sport injury related adhesions. Muscular injuries often develop adhesions when not treated "immediately" following the post-trauma-causing event. Mostly, sporting and industrial injuries of arm, thigh and lower leg. Post-operative wounds notably over the stomach area. With the growing "popularity" of "elective" Caesarian operations, these "wounds" and "scars" are more frequently appearing in my practice for Low Level Energy Laser Therapy treatment. Patients do not want to display any defacing scars.

Sporting injuries intra-muscular adhesions with "zip syndrome."

Stump non-healing wound and scar care and rehabilitation, including use of any special aids. In my practice, post-amputation wound healing of diabetes sufferers is most responsive to Low Level Energy Laser Therapy treatment. Phantom pains may well be present and require treatment following an amputation.

**Alcohol-related falls** \- Preventing osteoporosis, falls, and fractures among the elderly, is essential by promotion of lifelong physical activity. In recent times the number and incidence of injuries caused by falls among older adults have increased dramatically throughout the world. Often, the potential for enjoying retirement, is lost on account of the common and insidious combination of alcohol and medication.

Sometimes this adverse mixture also contributes to falls and fractures. There's also the link between loneliness, social isolation and drinking as a way of coping with aches and pains.

**Anal sphincter** \- Weakness of deteriorated bowel control a socially most distressing situation.

**Ankylosing Spondylitis**.

**Antenatal exercises** \- Advice and post-birth care and advice.

**Arteriosclerosis** \--General term: Hardening of the arteries

**Arthritis** \- Osteo-arthritis; rheumatoid arthritis; no currently known form of treatment will take arthritis away. At best, pain can be alleviated and movements improved thus providing a longer "tread" life. Periodic treatment is usually indicated with advancing years.

Advancing technology and surgical technology, make joint replacement more feasible. Joints more frequently replaced nowadays, are the knee, hip, shoulder and finger joints. Often, pre-operative consultation with a physiotherapist casts light on the patient's postoperative fears, anxieties and apprehensions. Here too, post-operative physiotherapy treatment and pragmatic advice is vital to enhance the "successful procedure outcome" thus making the "operation investment" more cost-effective. Often patients report to physiotherapists following a "successful" operation, with various "nonpost-operative-treatment" syndromes. Sad to say, that when "the knife is laid down," the "operation" is far from "finished!"

**Asthma**.

Ataxia.

**Athletic injuries** and strains - Immediate and appropriate trauma first aid and injury rehabilitation.

**Atelectasis** \- Periodic aid and advice by the physiotherapist is essential.

**Axillary palsy** \- Saturday night palsy.

### B

**Baby** \- Prematurely born neuro-developmental aid program to be implemented.

**Backache** \- Treatment of.

**Backcare** \- Advice on.

**Backpacker's palsy** \- Resulting from suspending the backpack from the shoulders, instead of carrying most of the weight on the "hips."

**Ballet dancer's strains** \- Covering a wide variety of soft tissue, joint and tendon problems.

**Bed-rest** \- Prolonged maintain muscular tone and joint mobility during; guard against the development of bedsores (pressure sores).

**Bedsores** \- Treatment of, if present.

**Bell's palsy** \- Facial paralysis here, eye-care, in addition to facial muscle rehabilitation, is absolutely vital. Only today, I once again heard a patient report that his elderly mother lost the sight of the side of the face affected by Bell's palsy evidently the result of negligence about eye-care during the acute stage of this affliction.

**Bladder** \- Diminished or poor control of often embarrassing with uncontrolled urine flow during coughing, sneezing, laughing or lifting actions.

Rehabilitation can be most helpful and face-saving. (I vividly remember treating an elderly, vivacious lady who was absolutely "petrified of leaving" her town to visit her daughter elsewhere. The reason: "Well you must understand," she shied away rather embarrassed, "It's like this." She hesitated, seemingly searching in her vocabulary for "just" the "right" word to convey her predicament. "It's so awful the lack of control over 'the flow. '"Much to her delight, she responded very well to treatment and soon was successfully and happily on her way to her daughter flying trouble-free.

**Brachial plexus lesions** Nerve lesions affecting the arm and hand deformity prevention and rehabilitation.

**Bronchiectasis**.

Bronchiolitis.

Bronchio-pneumonia.

**Bronchitis** \- Obtain and maintain unobstructed airways.

**Bruises** \- Frequently encountered with contact sports.

**Buerger's disease** \- A circulatory impairment.

**Burns** \- The advent of Low Level Laser technology treatment, is most helpful in the treatment of open wounds

Burns depending on the severity maintain a well-functioning breathing mechanism. Prevent or minimise contracture. Treat scars. Comprehensive rehabilitation.

**Bursitis** \- Usually encountered at the shoulder, knee or hip.

### C

**Calf muscles** \- "Pulled" and strained.

**Cancer** \- Care of the terminally ill patient.

**Cardiac rehabilitation** program - Care and advice. The heart is a muscular pump. Following injury, it should be actively rehabilitated in a teamwork context to its optimal functional capacity.

**Carpal tunnel syndrome** \- A painful condition at the palmer side of the wrist joint sometimes requires decompression surgery. The worst cases of this condition, I encountered amongst "chicken-pluckers" working in a poultry processing plant. Here was "overuse abuse" at its worst.

**Cerebral palsy** \- Comprehensive team-orientated facilities are usually available at a special centre for cerebral palsied children.

**Cerebra-vascular accident** \- Stroke early active rehabilitation is absolutely essential. Electrical and biofeedback technologies open up more horizons for a growing variety of cerebra-vascular and spinal cord trauma victims.

**Chondromalacia patella** A painful knee condition in which the underside of the kneecap acquires a "sandpaper-like" gliding surface instead of a smooth and well-lubricated surface. Post-operative care and rehabilitation may be indicated.

Chronic benign headache.

Chronic musculo-skeletal pain.

**Constraint-induced movement therapy** " or ci therapy, which is gaining ground among speech and language investigators and specialists in physical rehabilitation.

**Coccyx** \- Pain in often the result of a fall on a "slippery floor," or a fall **downstairs.**

**Cold sores** \- Usually on the lips respond well to Low Level Laser Therapy treatment.

**Coma** \- Maintain a well-functioning respiratory system. Maintain joint mobility. Prevent contracture and deformities. Maintain meaningful and stimulating communication emphasising past associations. Always remember: the patients may very well register what is being said in his or her earshot.

**Community healthcare-program** \- Advice, planning, implementing and assistance with.

**Computer and E-mail induced stress** \- An invasive form of stress and depression.

**Computer mouse syndrome** \- Keeping the arm unsupported.

**Computer-intensive-work-stress** a rapidly growing condition that manifests itself by some or all of the following symptoms: headaches; painful muscles of the neck, shoulders, upper spine, forearm, wrist and hands. Eye-strain too, as a result of prolonged work, poor lighting, as well as inappropriate screen display quality, further aggravates the condition.

This is further augmented by maintaining a relatively static work posture often for prolonged periods. Also resulting from this, can be disturbance of the sleep pattern causing chronic fatigue. Being "glued" to the computer for prolonged periods, results in the large muscle groups doing minimal work. This, too, brings about sluggish circulation; again setting the stage for future possible problems.

Relative physical inactivity, in its turn, can cause constipation; placing yet another "actor" on the stage to aid with retaining "body poisons." It is imperative, therefore, to spend not more than fifty minutes working on a computer, followed by ten minutes whole body activity that involves the large muscle groups, shoulders and some deep breathing.

**Coronary heart** **disease (CHD)**

**Congenital torticollis** Wryneck grafting (CABG.)

Coronary artery bypass

Cumulative trauma disorders

Cystic fibrosis.

### D

**Disc lesions** Spinal.

**Disseminated sclerosis**.

" **Drought syndrome"** \- Carrying heavy buckets of water back-, arm-, wrist- and leg-strains.

Down's syndrome.

**Dupuytren's contracture** \- Contracture in the palm of the hand.

### E

**Elbow** Arthritis at; Bursitis at - Dislocation of; Fractures at; Golfer's elbow painful inside tip; Postoperative stiffness and swelling at; Stiffness at; Swelling at; Tennis elbow painful outside tip.

**Emphysema** \- Respiratory care guidance and care. Adaptive lifestyle advice. The use of dust filters in association with work or hobbies.

**Epilepsy** \- Comprehensive care is usually available at a specialised centre. The advantage of a dedicated clinic for a particular condition, is that it should allow the same patient to be seen by the same service provider on consecutive consultations.

Erectile dysfunction

### F

**"Fibrositis"** \- "Fibrositis" is a symptom and not a condition.

**"Flat feet"** \- The feet are the "foundation" of the body in progress. Debilitating and painful feet problems, are "amplified" by way of "compensatory" activity posture adjustments. Discomfort, therefore, perpetuates further discomfort. Active rehabilitation help is available for painful feet.

**Flu** \- Obtain clear airways by aiding with removal of phlegm.

**Foot** \- Arthritis in; "Burning" feet: Deformities in corrective surgery often is helpful immediate post-operative rehabilitation.

**Fractures** at - Pain in; Painful heel; Stiffness at; Swelling at; "Tired feet."

**Frozen shoulder** \- Often secondary to a neck problem, untreated trauma or a stroke.

**"Fused spine syndrome."** \- This denotes compensatory over-use of spinal joints, adjacent to spinal vertebrae that are "fused" together as a surgical procedure.

### G

**Geriatric care program** \- It is far to often, incorrectly assumed that the "old people" are "entitled to pain or discomfort." the adage: "You'll simply have to learn to live with it," often regrettably reflects ignorance about what can in fact be done, by physiotherapeutic treatment, to alleviate many of the discomforts experienced by the "elderly." By all means, "learn to live with it;" but only after you've had the correct treatment, and that didn't "help!" We all treasure our independence. Independence living advice, therefore, forms an integral part of physiotherapy counselling.

**Golfer's elbow** \- Pain on the inside tip of the elbow.

Gout.

**Gynecological problems** \- Chronic pelvic infection; weakness of the pelvic floor muscles.

### H

**Hamstring injuries** \- Usually amongst sport people, often associated with lower back problems.

**Hand Arthritis** \- Osteo-arthritis and rheumatoid arthritis at; Crush injuries at early post-trauma physiotherapy treatment is most helpful to rehabilitate this most delicate and intricate "instrument of love, care, compassion and work." (I regard negligence of "early hand trauma care," as a gross and devastating infringement of human rights; deliberately depriving any person of the optimum use of any part of their body verges on criminality.) Deformities of; Dupuytren's contracture - contracture of the palmer aspect of the hand; Fractures at; Injuries at; Multiple trauma at; Muscular incoordination and weakness at; Nerve lesions at; Post-traumatic swelling at; Post-operative immediate - rehabilitation of; Scar tissue at; Stiffness at; Stiff and swollen fingers immediate active post-trauma treatment essential for optimum recovery; Tendonitis at often part of the repetitive abuse syndrome frequently encountered amongst workers in industries such as chicken processing plants.

Headaches.

**Head injuries** \- Often the victim of multiple traumas.

**Heart attacks** \- Post-heart attack optimum functional rehabilitation controlled teamwork absolutely essential.

**Heel** \- Painful often amongst athletes. Pain can also be indicative of problems elsewhere; particularly the lower back.

Hemiplegia cerebra-vascular accident - Stroke brain-damage at birth. A holistic teamwork approach involving the patient as total person and an integral part of a family and work situation should immediately be implemented. Special comprehensive care centres exist for the care and treatment of brain-injured children.

**Herpes zoster** \- Shingles.

**Hip joint** \- Arthritis at; Bursitis at; Pain in.

" **Housemaid's knee"** \- Often associated with unduly prolonged healing.

### I

**Ilio-lumbar ligaments** \- Strains at.

Ilio-tibial band syndrome.

**Impotence** \- Often associated with lower back problems and or general tension.

**Incontinence** \- Diminished or poor urine retention or urine flow control most embarrassing. "Well, I can't laugh now without wetting myself!"

**Incoordination** \- Muscular - resulting in clumsy and incoordinated movements.

**Intercostal muscular strains** \- Muscle strains around the ribcage. Often associated with trauma or severe bouts of coughing.

Intercostal neuritis.

**Intervertebral disc lesions** \- The signs and symptoms of the "problems" are many and varied. They can be local, referred or a variable combination of the two. The nature, frequency, intensity and location of the "problems" may vary from moment to moment, depending on several mechanical factors. These variable and varied "problems" may be a variable combination of the following: Pain, pins and needles, numbness, loss of sensation heat, touch, texture co-ordination muscular wasting or weakness, headaches usually from the neck.

Due to the electromechanical inter-body part associations, "problems" associated with intervertebral disc lesions may manifest themselves in normally unexpected areas. It is, therefore, not beyond the association bounds to find a lower back problem being the seat of a headache, abdominal pains or even a pain in the foot. In most instances, conservative non-operative treatment should be the first line of approach to solving the problem. Post-surgical physiotherapeutic rehabilitation, however, is absolutely essential.

### J

**Jaw joint** \- Arthritis at; dysfunction of; pain at; restricted movement at; stiffness at.

**"Jogger's syndrome"** \- Frequently the result of body ability abuse, secondary to misdirected enthusiasm; Achilles tendon pain and swelling associated with; Ankle usually ligament and tendon strains; Back the result of the camber of the road and repetitive, leg transferred impact trauma; Calf muscles "pulled" and strained; Foot pains and strains; Groin strains occasionally secondary to a back "problem"; Hamstring scar tissue in often associated with no or incorrect immediate post injury treatment; Hip pain in; Lumbar spine: often associated with the camber of the road, a hard running surface, and repetitive impact trauma pains manifold and varied. postsurgical repair rehabilitation. Sacroiliac joint strains. Shin-splints pain down the front of the lower leg; Tendonitis more often than not, in the lower leg. It is always advisable to obtain healthcare adviser clearance from the physician prior to indulging in any strenuous exercise program.

**Joints** \- Arthritis at; Bursitis at; Contracture at; Deformities at; Inflammation at; Muscular weakness at; Pain at; Restricted movement at; Stiffness at; Swelling at.

"Jumping legs."

### K

Keep fit classes.

**Knee** \- Arthritis at; Bursitis at; Cartilage lesions at; Chondromalacia at underside of the knee-cap acquires a "sandpaper-like" abrasive character surgical intervention usually helps; Fluid on; Inflammation at; Ligaments of strained; muscular in-coordination at; Muscular weakness at; Pain at; Post-operative rehabilitation is essential; Restricted movements at; Stiffness at; Swelling at.

Kyphosis.

### L

**Leg** \- Abuse syndrome of; pain in referred and in association with a lower back lesion.

**Legionnaire's disease** \- Often has associated respiratory problems.

**Ligaments** \- Strains of; post-operative rehabilitation.

**Lifting** \- Advice

"Lumbago."

**Lumbar disc lesions** \- It is interesting to note that it is estimated that eighty percent of people, sooner or later, develop "back problems." No wonder, considering the almost total lack of back-care education, reflected in the environment that we have to live and work in. Surgical intervention post-operative care, rehabilitation and lifestyle oriented advice.

**Lungs** \- Atelectasis; Bronchiectasis; Bronchiolitis; Bronchitis; Cystic fibrosis; Emphysema; Obstructive airways disease; Operative intervention pre-operative preparation and post-operative care and rehabilitation; Pneumonia respiratory care advice; Post-nasal drip (associated with sinusitis); Respiratory insufficiency; Sino-bronchitis advise activity related breathing patterns, using the appropriate dust filters and ear protection equipment in industry and recreation.

### M

Malnutrition.

**Metatarsalgia** \- Foot pain.

**Migraine** \- Tension often is a contributing factor if malignant brain growths are excluded, migraine and headaches should respond very well to the appropriate physiotherapy treatment.

Motor neuron disease.

**Mobility** \- restriction at joints.

**Motor-vehicle accident** \- Multiple injured patient.

**Muscle:** Function and power assessment of; spasm in; "nodules" in; disorders of.

Muscular dystrophy.

**Muscular in-coordination**.

Muscular injuries.

Muscular pains.

Muscular stiffness.

Muscular swelling.

**Muscular tension** \- Progressively more frequently encountered in my practice, as a direct result of "continuous" computer "over-use," and the cascading "information overkill" with its huge tension-generation capacity.

Muscular weakness.

Multiple disabilities.

**Multiple sclerosis**.

Myo-facial tension.

### N

**Neck** \- Arthritis at; Chronic pain at; Disc lesions at; Ligaments of; Muscle injuries at; Muscle spasm at; Muscular imbalance at; Nerve root irritation at; Pain and weakness at; Surgical intervention at postoperative care.

**Nerve conduction tests** \- To ascertain the nature of the nerve lesion as well as the recovery prospects.

**Nerve lesions** \- rehabilitation following.

Neuritis

" **Nodules"-** In muscles.

### O

Obstructive airways disease.

**Orthopaedic surgery** \- Pre-operative treatment where elective surgery is planned. Obtain and maintain unobstructed airways. Post-operative treatment and functional integration rehabilitation.

**Osteo-arthritis** \- Affecting various joints treatment cannot make joints new. At best, it can improve the quality of life by relieving pain and improving mobility and lifestyle-oriented practical advice. advancing micro-technologies and nano-equipment, make joint replacement more attractive and frequently most gratifying for the patient. Pre-operative advice and post-operative treatment and rehabilitation are essential for optimal functional attainment.

### P

Patelofemoral pain Syndrome (pfps).

**Paediatrics** \- Various conditions, including: obstructive "chest" conditions; "colic" a rather painful condition affecting the "miniature people;" with attendant bowel obstruction, enormous, and most certainly very painful, stomach distension on account of retained winds. The impact on a "young family," can be devastating because of "lack of sleep of both parents!" I have, at present, three "little people, between ages six and eight weeks" who were tortured by this "affliction!" In all three instances, a normal, pain-free sleep and eating pattern was established by at least the third treatment. Mother's comments varied: "I just can't handle it! The continuous 'screaming' at all hours! Our relationship is deteriorating very rapidly!" "I'm so tired". "My husband's nerves". "His work is suffering!!" It is most gratifying to notice the dramatic improvement in the "little people's" state of health, and, of course, the literally overnight return of energy and hope to the parents. yet again, with the aid of modern Low Level Laser technology, the "quality" of "family life" is improved.

**Paralysis of muscles** \- General maintenance program with treatment emphasis on causative factors.

**Paraplegia** \- Very promising experimental results with spinal cord surgery in association with up-to-date neuro-electronic leading edge technologies as well as Low Level Laser technology to enhance the operative outcome potential, hold exciting promise for spinal cord injury victims.

Parkinson's disease.

**Pelvic infection** \- Chronic.

**Peripheral artery disease** \- The arteries in your legs are narrowed or blocked, preventing proper circulation.

**Peripheral nerve lesions** \- Nerves of the arms and legs.

**Pins and needles"** \- Frequently referred from the back or neck.

**Plantar fasciitis** \- Pain under the foot.

**Pleurisy**.

Pneumonia.

**Post-nasal drip** \- Associated with sinusitis.

**Pre-natal practical advice and care**.

Post-natal exercises and advice.

**Post-operative care and advice** \- Pertaining to all major surgical procedures such as: abdominal; amputation; back; chest; deformity correction; fractures; gynecological; hand corrective and reconstructive; joints reconstruction and replacement; thoracic.

Post traumatic stress disorder.

**Posture correction exercises** \- Most helpful for the young. Once the relatively solid "building bricks" the bones have been deformed, posture correction is much more difficult. In fact, corrective surgery, in conjunction with internal and or external support, may have to be resorted to.

**Pregnancy** \- Advice and exercises during and after. Here too, family spinal care must be emphasised. Back-care advice, during and after pregnancy, should relate to baby furniture selection, baby handling with emphasis on baby's back-care and safety-transport from the first moment transport is used.

**Prematurely born baby** \- Neuro-developmental aid program to be implemented.

**Pressure sores** \- Prevention of; treatment of.

**Prevention of accidents** \- At home and at work; advice on.

**Preventive sport trauma care** \- Appropriate pre-sport fitness advice. Sport's safety gear advice.

**Pre-match strapping** where indicated.

Progressive muscular dystrophy.

**Prolonged enforced bed rest** \- Maintenance exercises program.

Pulmonary disease.

### Q

**Quadriceps rehabilitation** \- Following muscular trauma or knee surgery.

Quadriplegia.

### R

**Recent injuries** \- Including immediate correct treatment of sport injuries.

**Rectal control** \- Loss of this embarrassing and socially restricting condition often responds very favourably to the appropriate treatment and rehabilitation.

**Referred symptoms** \- Frequently associated with spinal problems.

**Relaxation therapy** **-** Either individual or in groups. Ever-increasing "demands" imposed upon the human body and spirit, bring about the "compound and mounting tension burdens." The positive contribution of "defusing" this "tension", by means of physiotherapy intervention, is very under-appreciated.

**Repetitive abuse syndrome** \- Also known as repetitive strain injury (RSI), often encountered in industry where repetitive abuse of the forearm or lower back is a feature of the work situation human body abuse or overuse situations, should be rectified.

**Retirement** \- Functional state of health oriented, practical lifestyle advice; advice on "preparation" for; "keep fit" programs during.

**Rheumatoid arthritis** \- Assist with enhancing quality of life particularly hand function.

### S

Sacroiliac joint strain.

**Sciatica** \- "Credit card or wallet sciatica", frequently results from men sitting for prolonged periods on the aforementioned "bulging" keys to either credit, frustration or a balanced life!

**Scoliosis**.

**Senior citizen** activity guidance program.

**Self-neglect.** \- Often, associated with elderly, isolated, folks living on their own.

**Shin-splint** \- Often abuse symptoms associated with long-distance running.

**Shoulder -** Arthritis at; Bursitis at; Frozen; Pain in; Restricted mobility of, supra-spinatus tendonitis.

**Sinusitis-** Acute and chronic both in adults and children.

Social isolation.

Spina bifida.

Spinal cord injury.

**Spinal cord lesions** \- Resulting in various "problems" treatment and rehabilitation often in association with surgery and a "specialised" spinal cord injury centre.

Spondylolisthesis.

**Strains** \- Ligamentous and muscular.

**Stress incontinence** \- With its associated restrictions of mobility and discomfort.

Stroke.

Sub-acute and chronic pain conditions.

### T

**Tendo-achillis** strain.

Tendon injuries.

**Tenosynovitis** \- "Chicken-pluckers' syndrome" particularly at forearm, wrist, hand, ankle and lower leg.

Tempero-mandibular (jaw) joint dysfunction.

Tennis elbow.

Tetraplegia.

**Thumb -** Arthritis at painful joint; Stiffness at.

**Thigh -** Muscle strain and tears in.

Thoracic inlet syndrome.

**Thrombosis -** Deep vein prevention of particularly during "enforced" prolonged bed rest.

**Torticollis** \- Wryneck.

**Torture trauma** \- Renovate the victims of various forms of crime.

**Traveller's ankle"** \- Swelling associated with prolonged bus or air travel.

**Typist's shoulders"** \- A condition usually associated with prolonged computer typing-associated tension.

### U

Ulcers.

**Unconscious patient** \- Care of; Focusing on: Bed sores; Deformities; Joint deformities; Muscle contractions and spasms; Prevent airway obstruction; Stiff joints.

Maintain meaningful and stimulating communication with the patient through: Compassionate care; normal speech conversation albeit one-way positively oriented language builds rapport, confidence and stimulates patients' in-built healing abilities; Perfume, sound and touch association. Always remember that the patient may very well hear and "comprehend" what is being said in his or her presence. Words of comfort skillfully and compassionately administered are the oldest form of therapy known to man.

Un-uniting fractures.

Upper airways obstruction.

### V

Varicose ulcers.

**Vascular diseases** \- Aid with improving circulation.

**Vertigo** \- Balance impairment.

**Veterinary physiotherapy for pets and large animals** \- I have treated, successfully, cats, dogs and race and show horses. Interestingly enough, they always seemed to know that someone was trying to help them. Gratitude, too, was a prominent response.

### W

Warts - Plantar.

Work-related tension, strains and body-abuse syndromes.

**Worry** \- Worry is a quality of life-depriving disease of the inflated imagination, and almost always derives from a distortion of reality. This, in turn, leads to a loss of perspective. Excessive and soul corroding worry, is an unnecessary, unproductive, exhausting and energy-depriving problem, detracting from the quality of life of millions of people.

However, not all worry is bad. Effective future "worry-evasive" planning, depends upon anticipating future "problems and troubles."

Dilute the impact of worry by explaining it to a friend or another person. In this way, you can begin to regain perspective and control of it.

Next, examine these worry producing thoughts for errors in logic, and think of alternative points of view that are more logical.

Ask yourself: what am I basing these conclusions on? Is there another point of view that makes sense? What can I do to increase the likelihood of a more favourable outcome?"

In short, as always get the facts.

If you are determined to worry, base worry on reality, rather than on fantasy. Move outward! Interact with something larger than yourself.

Associate with family, friends, organisations, mutual interest clubs, your neighbourhood, church and work. By increasing your "connectedness" in life, you will increase your feeling of worth, strength, and reduce your sense of vulnerability. Early in life, add structure, and method, to your life.

Many everyday worries are related to time, memory and motion disorganisation.

To remedy this, sometimes irritating loss of memory, compose lists of things to be done or acquire fixed habits for placing articles, such as keys, spectacles and so on, at specific locations. These concrete bits of structured planning, can dramatically reduce the time, and frustration, spent daily in useless or destructive worry.

Do something you really love doing. It is almost impossible to worry destructively if you are engaged in a task you enjoy.

Remember, the longer you let worry last, the harder it becomes to escape, or debunk it. Immediately, and deliberately disengage from toxic and abrasive worry, the minute you feel it enveloping you. Allocate a fixed period of time, the shorter, the better, to constructively worry.

Endeavour to give a positive outcome to this worry session. Then sleep on it, take it for a walk, and, if need be, leave it on the backburner to take care of itself.

Don't drink excessively, or mix alcohol and other drugs. Because they may render you, much less capable of successfully dealing with worry, because they can make you depressed under their influence, they can cause you to do irresponsible things, that will give you infinitely more to worry about later on.

**Wounds** \- Often associated with diabetes.

"Wryneck."

Biography

Eugene J. van Wyk MCSP.

(Chartered Physiotherapist, London, England)

Qualification:

In London, England, 1961 I qualified as a Chartered Physiotherapist.

Over many years, I have always been very proud of my association with the Chartered Society, and the invaluable work that it has done, and still does, for the Promotion of the profession, and the benefits that patients/clients can derive from utilising our skills-equity and services.

This qualification, was the key to a personally very stimulating, quality of life enhancing and rewarding career.

At this early phase of my life, my studies and stay in England, introduced me to "Democracy In Action". Not only democracy, but the larger world of cultural life. The theatre, \- the golden age of musicals and plays -- magnificent concert halls and orchestras; the wonder of outdoor concerts in some of London's finest parks.

Not to forget, feeling safe in your home, accommodation, on the streets and sidewalks, the transport systems and the public parks.

Often, on reflection, I think back with fondness and appreciation, to the enormous impact my stay in London and England had and still has on my life; and the lives of so many people that I had the fortune to associate with.

A Precious Gem in hand!

In 1958, I voyaged to London, England, for my stay as a physiotherapy student.

By now, although certainly in no position to afford a diamond, I had heard and learned much about their wonderful attributes.

Little did I realise, that I, potentially at least, had something infinitely more valuable, sparkling and warm-hearted at hand.

In 1963, circumstances and fate intersected. For the first time, I physically met a young lady with whom I had been corresponding since 1957. We were literally worlds apart; yet intuitively, and emotionally, closely focused during the intervening years.

During our correspondence years, the virtue of "knowing we would never meet," proved to be an enormous prejudice-killing, and "getting to know one another, factor.

Romance, nurtured by mutual respect, a romantic view of life, and an innate belief in where we wanted to go, blossomed.

December 1964, I joined forces with the young lass and multi-facetted diamond, Tineke, in what became a remarkable and very happy marriage.

Key ingredients, in this successful marriage, is our appreciation of the "little bits of fun and pleasure," that we enjoy by eating out; having coffee or tea at various places; not taking quality of life for granted; getting out of routine; the ability to leave room for the parallel development of the partner's interests and personality. Above all, our active sense of humour, that soon deflates any tendency of an inflated ego. And, retaining an uncluttered core belief, and value system.

In January, 1965, we cast our meager financial resources on the tides of fortune and commenced our first physiotherapy practice.

At the time, medical and public ignorance about "What Physiotherapy Could Do to Enhance the Quality of Life of Patients/Clients," was alarming! However, with myself as physiotherapist and With Tineke, as the always buoyant, friendly, empathetic and irrepressible receptionist, we soon built up a successful practice and wonderful rapport with the medical fraternity of the day.

To the medical folks and the public that we had the fortune to associate with, over many years and in various countries and cities, we owe an enormous debt and gratitude.

Only as our practice career evolved, did it become clear how many shortcomings there were in our preparation for our respective professional roles.

And yet, thank goodness, our colleagues, peers and associates, were always helpful and accommodating, without being condescending!

Fortunately, I soon realised, that one does not make mistakes; one is involved in a learning curve. Only those who do not see this, make "mistakes!" No "mistakes," no practical learning.

Humour, empathy, technical skills, soothing, relaxing background music, and the liberal exchange of information, have always been an integral part of my practice.

I have always, endeavoured to stay clear of a formal clinical atmosphere, and attitude, in my practice.

To my patients/clients, I'm known as Eugene. This facilitates the easy flow of the most important, and often "authority-concealed" valuable background information, concerning the patient/client's "problem!" People feel freer; not intimidated by status or setting.

In fact, an extended family atmosphere characterises our place of work.

This, of course, provides for a pleasant, relaxing work-place atmosphere. It is much appreciated by our mostly modern-day tension-laden patients/clients.

In nineteen eighty, while working in Australia, I was exposed to, and met with, the concept of Low Level Laser Therapy Technology and a Holistic approach to patient/client "problems."

At that stage, I was often numbed by a dozen, or more, converging prevailing treatment paradigms and prejudices.

So entrenched in these prevailing rules and regulations, was I, that I sometimes failed to appreciate the potential of the new technologies at hand. Suddenly, the curtain of preconceived ideas, bias and approaches, was drawn aside.

Then, once again, it forcefully struck me, that there is no gratifying music until the bow of experience and the fiddle of expertise are brought together.

At that early phase of the Low Level Laser Technology Evolution,, it once again dawned on me, to be aware of the danger of the "Groove Syndrome!" when viewing and considering, the armament for patient care, at my disposal.

(The difference between a Groove and a Grave, is the Depth.)

We attended the very stimulating Second International Low Level Laser Congress, held in Kansas City, U.S.A., during September, 1998. Again, the merits of leading-edge technology, as a tool to help patients/clients, was highlighted by the excellent papers presented, and the practical feedback from the pragmatic colleagues and "Practitioners at the Coalface".

My early, and longtime association, with the care of "Recent Trauma" either under the guise of Sports Medicine, Industrial Injuries or Motor Vehicle Accident Victims, soon focused my attention on enhancing the holistic quality of life of my patients/clients.

At the other end, of the pain, disability and age spectrum, I dealt with many more mature, experienced and elderly people, who very frequently were so grateful that physiotherapy intervention and age-adaptive advice, made their lives that much more pleasant.

I believe that all peoples, are entitled to the advantages of early appropriate physiotherapy treatment, rehabilitation and lifestyle advice, to enhance the quality of their lives.

This, of course, includes our senior and elderly folks, who, so frequently, are told: "It's only old age, my dear! You'll have to learn to live with it!" And are thus deprived of the enormous help that physiotherapy can provide to make their lives a great deal more pleasant and easier.

We are fortunate, to have two children, a son Jerry with wife Nicole and three lovely children, - they are living and working on the Central Coast, New South Wales, Australia. and a daughter Eunete with husband Simon, living in South Africa

A very independent furry gentleman, Mister Purry, took up residence with our family, a number of years ago. To be truthful, he actually took up residence with our daughter. On an occasion, he was severely mauled by either a motor vehicle or something. This exposed his gullet. The veterinarian wanted to put him "out!" Our daughter, Eunete, would not hear of this.

"Let my dad treat him with laser," she suggested.

The outcome, was that the vet could not believe the result of the treatment.

We, of course, had a very loyal and happy little friend, and residential rodent control officer.

We still have a strong hankering to spend some considerable time in England to have easy access to the many enchantments of the European, U.S., and Canadian culture scenes, that settle so gently on our ears, eyes, intellect and emotions.

Early in our mutual careers, we decided to broaden the mind, reduce the prejudices, by embarking upon a programmed of international travel. On many occasions, this included our very young children. In later years, it always amazed us how much they learned during those early years of travel.

We visited:

1. U.S.A.

(Boston, New York, Kansas City, Washington);

2. Australia (Canberra, Sydney, Perth, Gold Coast, Central Coast, Brisbane);

3. Austria (Vienna Volks Opera House where we enjoyed The Gypsy Baron music, Salzburg);

4. Belgium (Antwerp outstanding quality chocolate);

5. The Channel Islands: Guernsey and Sark;

6. England (Extensively);

7. France (Paris);

8. Germany Bad Fussing, (Wiesbaden, Frankfurt, Mainz, Munich -- visited the BMW -- Stuttgart Mercedes Benz Museum);

9. Greece (Athens, various islands);

10. Hong Kong -- during the mid 1960's -- before most of the world's shops contained the same goods -- it was like stepping off the aircraft in to a totally new, all-round stimulating and enticing world

11. Ireland North and South;

12. Isle of Wight;

13. Italy (the always imposing Rome and its treasures, Sorrento, The Blue Grotto, Pompeii);

14. Japan during the mid 1960's most imposing and eye-opening (Tokyo and surrounding areas);

15. Majorca;

16. Macau

17. Malaysia;

18. Mauritius, where we spent many a very pleasant and relaxing holiday; and from where we sailed on the luxurious and majestic Queen Elizabeth II;

19. Namibia;

20. Netherlands (Amsterdam Konsertgebouw Orchestra in enthusiastic action, Elsmere Flower Market, Halverson and surrounding country side);

21. Portugal;

22. Reunion;

23. Scotland;

24. Singapore;

25. South Africa;

26. Spain;

27. Swaziland

28. Switzerland (Zurich);

29. Thailand (Bangkok);

30. Vatican City;

31. Wales;

32. Zimbabwe (Harare, the majestic, thunderous and imposing Victoria "Falls.)

Present Outside Interests:

We enjoy the tranquility of our home; the lovely garden and the variety of birdsong in the garden. Tineke has a passion for gardening; a therapy and source of great pleasure.

We are pro-active supporters of the performing arts; and attend the theatre, musical concerts; read extensively both fiction and non-fiction.

I spend considerable time each week, reading both via my many on-line libraries, and professional magazines, to keep up to date about scientific developments, that might, and do, impact on my interests and profession.

Special courses, congresses and seminars attended and undertaken:

I attended various Courses on Manipulative Therapy; "Sports Medicine"; Several Practice Administration and Management seminars; Acupuncture and Laser Therapy (Sydney, Australia 1980-1.)

The Second International Low Level Laser Congress, held at Kansas City, U.S.A., September, 1998, (at which I co-hosted the final day's afternoon session).

Cardio-pulmonary-resuscitation (CPR) 1999.

Numerous weekend courses relating to on-going professional education.

The creative side of me enjoys woodwork, wood-turning and writing.

Both of us take a keen and active interest in becoming Investment Literate. To this end, we attend investment seminars, read extensively about the subject and have at hand some very good satellite information channels.

Our emphasis is very much on keeping a balanced life style by doing moderate exercises: walking and swimming. As well as focusing on health-orientated thinking and eating patterns.

The future:

We live by the philosophy, of living day by day, allocating to each "problem," its due time and energy. Also, we have found, that, as one door closes, invariably two other doors open, providing infinitely more stimulating and life-enhancing opportunities.

Although, now retired from fulltime physiotherapy practice, both of us are still enjoying the life-sustaining habit called work! It keeps us fit, and in contact with the people and realities of our time and place.

To us, our work is a mutually enriching and enjoyable life-extending pastime.

There is a growing realisation, that experience, and experience-acquired expertise, is an enormous valuable equity source for any business. This slots in well, with my longtime belief, that a "Health and Happiness Danger", often lies in "compulsory retirement!"

Our future, therefore, lies in continuing to provide service to enhance the quality of our fellow citizen's lives and expectations, based on the dissemination of knowledge about how my profession of physiotherapy, can underpin those expectations.

Eugene van Wyk. MCSP. (Chartered Physiotherapist, London, England.) My precious Spine and I

One person can really make an important difference.

Once you have read this book, and also feel strongly about internationally promoting Back care and Quality of Life enhancing, I extend an invitation for you to become my associate International mentor in this venture.

You have expertise, experience and determination. Above all, you have persistence!

My real motives, for writing this book, if you want to know, are that I didn't ask for this job. I took it on as a personal challenge, to help others in my pear group: back owners, retirees, seniors, and fellow savers just trying to successfully survive. Yes! It's really true. One person can really make a difference.

Knowledge and professional or any other expertise is not knowledge unless it is rewardingly shared.

Never forget that: "To the world, you may be one person, but to one person you may be the world."

Any time you want people to take action, to better their lives, they have to be pro-active and "Do" to make it happen.

Can we help them?

Of course we can! When you are, persistent extraordinary at being pro-active, and skilled, you write your own ticket to any place.

Never stop reaching out to find others, you are open-minded, and keen to learn. Those are like you, and share the same visions, ideals and ideas. Then develop friendships with them.

Build reciprocating alliances and network, with stimulating, successful and good people. Reach out, and Help those who help you; remember each of you will be richer and stronger for it.

More about the author:

Eugene vanWyk is a British qualified Chartered Physiotherapist. He have been involved is private practice since 1965. He also firmly believes in fellow citizen's financial and healthcare self- empowerment. That is what it means to be truly pro-active. That is what it means to be actively in charge of your life, to emotionally and financially accept this. He continues to believe, that one should continue to learn: with the emphasis on health and financial self-empowerment. It gives us choices – the kind of options he believes every diligent, hard working and planning person should have. In fact, if you procrastinate, do you believe that you are painfully losing valuable experience and money on schedule? What you can do, or dream you can do, to help your fellow citizens, now, if ever, is the best time to begin it. He found, that encouraging his patients to become self- empowerment health and investment knowledge enriched, at an early stage, builds up that very important survival endurance.

Is it too late to start with a self-empowerment wake-up call? Certainly not! What we urgently need, is long overdue, health and finance self-empowerment enthusiasm renaissance.

You too, can be part of the renaissance. Don't forget to have fun!!

Eugene van Wyk

Connect with me online: WWW.Samashswords to your author page.

