Switch Back (Crooked Roads Book 1)

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Ultimately, her in-depth research lights the way to a better path for healing. Ramin argues the psychological impact of back pain She went on to write Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery, an incredible tale of back pain and its treatment, published last May. See all Product description. Share your thoughts with other customers.

Write a customer review. Most helpful customer reviews on Amazon. Lets start with the most important aspect of this book. If you suffer from back or neck pain, this is a MUST read so that you can avoid the cascade of evaluations and treatments that are unlikely to help and often cause great harm not to mention the enormous and unnecessary expense.. My name I Brian Nelson. I am an orthopedic surgeon specializing in spine and I am quoted extensively in this tour de force.

I first met Cathryn many years ago after she was given my name by a colleague. She called me for the first of many interviews and I had a chance to get acquainted with a classic investigative reporter. You know the type: She spent almost ten years on this book which likely explains why it is so outstanding, and carries such credibility. Meticulously sourced and backed up with peer reviewed research, you can believe what she has written.

I have heard stories that would break your heart. I have followed the exploits of spine surgeons I believed should have been jailed to punish them for the trail of broken bodies left in their wake, I saw money corrupt an industry designed to enrich providers and hospitals medical device companies at the expense of patients, I saw doctors collude with attorneys to extract as much money as possible from insurance companies.

You may find Cathryn's book infuriating but after finishing it, she may have been too lenient. Too be clear, I also know many reputable practitioners who consistently strive to deliver the right care to patients regardless of the financial concern. I know many fine surgeons, chiropractors, physiatrists, pain doctors, etc. Nevertheless, there are far too many of the opposite character who shamelessly exploit a system that allows spine care to remain dysfunctional. This wouldn't be a huge problem if patients could differentiate the good from the bad but they cannot.

As Cathryn so amply demonstrates, patients are easily fooled by professional web sites enhanced with state of the art search engine optimization. Patients desperate for relief are easy marks for slick copy writing promising completely unrealistic success rates while ignoring risks and costs.

Look at the number of patients who were willing to pay tens of thousands of dollars out of pocket for unproven treatments that often made them worse. I was always astounded in my own town Minneapolis that surgeons known to have terrible outcomes were nevertheless full. A nice office with an espresso machine and a smiling surgeon in an expensive suit and a starched white coat is no guarantee of good care but many patients are quick to to believe that it is.

I used to tell patients when I was doing surgery that I didn't make any money talking to them. And I also learned early on that because of the vast difference in orthopedic knowledge between me and my patients, I could talk most anyone into surgery if I tried "He would never tell me I needed surgery if it wasn't true". This is a sacred trust given to surgeons but unfortunately, not all have the character to overcome this enormous conflict of interest.. The same applies to pain doctors, chiropractors, therapists, injectionists, etc.

All have the ability to offer and perform unnecessary care and get paid for it.

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Health care providers- including hospitals- are well aware of how much they earn and what their expenses are. If new medical evidence shows that a major source of revenue is ineffective, how many will discontinue its use and perhaps go into the red for their practice or hospital?

This is why , even in the face of the evidence provided in this book supporting the ineffectiveness of opioids, spine surgeries, injections, and MRIs there has been little change in frequency. That our payment incentives have had the unintended consequence of often harming patients has been recognized by payers government included and efforts are underway to change. Can we devise a system that pays for outcomes rather than paying for services regardless of effectiveness? Behind "The Rolling English Road" lies its author's powerfully-felt opposition to the threatened introduction of Prohibition into Britain: But, if moral indignation was the impulse, the resulting poem is miles away from one-sided polemic.

Form and content blend as harmoniously as — well — hops and fresh water. Heptameters, informally known as "fourteeners" because the line usually has 14 syllables, are potentially cumbersome in English, but Chesterton's lines flow effortlessly, without a stumble. They roll like the roads themselves, whose meanderings, the poet ingeniously imagines, were shaped by drunken natives aeons before the Romans introduced more logical and direct and therefore deeply un-English routes from A to B. A clever narrative twist occurs in line five: This is not a hymn to drink, it signals, but middle-age looking back with a forgiving, companionable eye on the escapades of youth.

Chesterton, it almost goes without saying, takes advantage of every opportunity for alliteration. It lubricates the heptameters: Perhaps a respectful nod to the Anglo-Saxon poets is also intended. When he drops the alliterative yoke in the last stanza "Paradise Kensal Green" you know he's being serious.

The joke about setting off to a place by way of another place that's situated at the opposite end of the country beginning from some hostelry in a town unspecified, but probably London could have been overplayed. She is all over the statistics for back surgery.

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But when it comes to the other programs she is brief and uncritical with the stats. I know I sound like a downer on this book. But as a newcomer to the subject I did find it eye-opening. It's a good overview of the industry but I would certainly not take anything in this book as a recommendation even though she sound positive about many of the treatments. She loses the ability to be remotely objective and comes across as all to star-struck because she gets access to specialists whom the average person could never get access to much less afford.

If you are wealthy, that's great. This book will be a helpful guide in helping you get rid of your surplus wealth. If you are a recovering trucker living on social-security and medicare this book will certainly inspire you to seek out different treatments but you may end up like Ramin bouncing around from program to program because they all just sound so nice. View all 4 comments. Sep 02, Peggy Fegler rated it really liked it. Two people can have the same MRI. One will have back pain the other won't.

Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery

Don't have back surgery 3. Don't have epidural spinal injections. Sitting for hour after hour is bad. Get up and move. This is a good take-down of the back surgeons and others who are exploiting back-pain sufferers.

“Improvement makes strait roads, but the crooked roads without Improvement, are roads of Genius.”

Overall, the book is quite good as an expose of what is wrong with the entire American for-profit fee-for-service medical-industrial complex. Its morally hazardous incentive system cannot function without strict regulation. Unfortunately, self-regulation is not happening in the current culture of corruption and incompetence.

For people with a bad back, the problem is that the author's recommendations This is a good take-down of the back surgeons and others who are exploiting back-pain sufferers. For people with a bad back, the problem is that the author's recommendations for what to do are mostly based on low-quality evidence.

She admits this, and so we wind up with anecdotal impressions from her field trips to various healers. This is perhaps reasonable, because at least what she recommends is probably harmless. Nevertheless, it's disappointing after she devotes so many pages to critiquing things for not being evidence-based.

I wish I could recommend a better book about back pain. Jun 23, Nancy Newcomer rated it it was amazing. If you have chronic back pain you need to read this. Hard to know where to start. Author is a decades-long investigative reporter. She suffered back pain and got into the back-pain-industrial - complex. About 3 years ago I developed excruciating lower back pain when I stand or walk more than about 10 minutes. It is caused by arthritis and "natural age-related deterioration. I saw many doctors, including a pain clinic, and have had several bouts of months If you have chronic back pain you need to read this.

I saw many doctors, including a pain clinic, and have had several bouts of months of physical therapy, including deep ultrasound heat massage, epidural steroid injections in the sacro-illiac joints the source of pain , aqua therapy, more injections into the hips when they became painful because of hip bursitis this wakes me up every night about 3 am and more.

For my low back chronic pain I have had radio frequency ablation which severs nerve ends which helped a little temporarily, and many locations of steroid epidural injections. I have a Rx for Percocet opioid pain medication and try not to take more than one a day. That doesn't touch my back pain. I can take two, but that makes me sleepy and I can't drive.

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So can't take these during the day. The author says, "It's amazing the gigantic difference a pain patient can feel when he's had a couple of nights when he doesn't wake up five times. I can't remember the last time I haven't awoken times at least. Also from this book "there are still physicians who tell their low back pain patients to do sit-ups to strengthen their abdominal muscles. She also counsels against doing back stretching exercises when you first wake up and spine is swollen with fluid.

I will probably have to buy this book and re-read it in sections. It was just too much to take in. Depressing but knowledge anyone with chronic back pain should know. Jun 21, Jo Ann rated it really liked it. Having had spinal surgery last year that did nothing for the pain, I related to much of what Ramin had to say.

I would give this a "5" except that many of the recommendations are not available to everyone, and this is a glaring omission. However, I still think it's a fantastic book! Oct 08, Athan Tolis rated it it was amazing Shelves: I was 35 and half in January of , past the age when men get to change the world. My back had never been fantastic.

I had rowed crew, was swimming or lifting daily often both and regularly playing squash. After an unsuccessful first attempt at entrepreneurship I was getting back into trading bonds for a Wall Street house. This entailed a daily commute by car to and from Canary Wharf.

I can remember precisely when it all took a turn for the worse: Driving home I felt this massive discomfort in my back. When I got home, I found it very hard to climb out of my car, not some low-slung thing, but an entirely mundane VW Golf. But I thought nothing of it. The most intense pain ever hit my lower back, like I had not experienced before. This was a sign to get a normal life --of the kind I will never have again, but little did I know that then! All the way back from Salonica to London via Athens, which is the wrong way I stood. I only sat down for takeoff and landing, a figurative ice pick firmly lodged in my lower back.

A week later things were a bit better, but not loads. And then I locked myself in the spare bathroom of my grand but shoddily-kept apartment opposite the Brompton Oratory. The door was of the kind that opens inwards, so breaking it took me three hours and entailed hitting it hard off-center, in order to break its frame. By the time I was done, my fists and forearms were purple, my voice was gone from shouting for help and the police were just about arriving to tell me they had had me covered all along.

I actually appreciated that enormously. Was fantastic to know.

Poem of the week: The Rolling English Road by GK Chesterton | Books | The Guardian

My back, on the other hand, was now totally gone. Needless to say, it had not been written yet. But when I saw it I ordered it immediately. I make a point of always standing, so I can keep my back busy. But the damage was done. I was richly rewarded. First of all, I learned tons. Consistent, for sure, but totally irrelevant, it turns out.

Allow me to quote from page Here in the UK, meantime, I followed all the steps my hyper-generous employer was happy to pay for. I started with infinite amounts of non-steroidal anti-inflammatories. The little red pills of Voltarol were rhomboid in shape and I took them by the ton, as prescribed. They actually did not give me any relief, but what the heck, I would not dream of risking the counterfactual.

Then, on July 14, we forced our boss Stan to take us to the Zuma private room to celebrate the decimation of his ancestors Stan is noble over copious amounts of Chassagne Montrachet and some even more expensive red, also from Burgundy. The morning of the 15th I somehow navigated the Golf to Canary Wharf, where I had a French linker auction to handle, only to wake up at noon, face-down, in a pool of my own drool. That was the last time I tried the Voltarol. And quitting it did not leave me in any less pain. Still, you get a decent tour of the anti-inflammatories. Apart for Voltarol, BUPA sorted me out with twice-weekly manipulation of my spine by a physical therapist.

This entailed the two of us wearing the same wide leather belt, me leaning over at various angles and him an older, unprofessionally effeminate, bald man with semifocals messing with my lower back, and pressing his finger against different places near my spine while I was leaning, for fifteen to twenty minutes at a time. I was given the leaflets, we made the appointment and… …well, I did not go. Well, who woulda thunk, but Cathryn Jakobson Ramin has him covered too: Oh, and if the injection goes wrong, you could be paralyzed for life, or you could die.

For all the wrong reasons, it looks like I dodged a bullet there. Just imagine my therapist had been some type of female bombshell… 4. So I gave up on handling my back myself and left it to my father and brother. My brother may never become a household name, but he teaches heart surgery at Harvard, so he also knows a thing or two about cutting people up.

Daddy accompanied me to my visit with my future surgeon a friend and colleague of his , booked my appointment, told me how to prepare, the whole nine yards.

A week before my operation, daddy called: I strongly advise you to get accustomed to the pain. This time it was my brother George: Doctors never have them. Sinai, at Cornell and at St. So I asked around a bit. These things are for patients only. You have a bad back. They had played me. Cathryn Jakobson Ramin has both my father and my brother covered, though. If only they were as rosy as the stats my father gave me! I can still hear the tour guides at Harvard telling the impressionable tourists that the tiling of the Sackler Museum picks up the hues of the roof of Memorial Hall.

Now I just think of them as the white collar drug dealers that they are. Start with chapter 8!

From there onward the book goes all crunchy for my macho taste. Cathryn Jakobson Ramin gives you the full Grand Tour of all the exercise regimes ever invented for people to deal with their back. So there you have it: Feb 18, Elizabeth Schlatter rated it really liked it Shelves: Last half, or third, is about the author's exploration of mostly non-intervention practices to assist with back pain, everything from intensive 3-week programs to rolfing, Tai Chi, etc. Try preventative things, like the methods she mentions towards the end of the book, e.

Realize that if you have severe but non-specific back pain you main need a more substantial treatment like a sort of physical therapy boot camp that teaches your nerves and brain how to recognize sensations from the spine as NOT being pain, meaning the sensations might not feel good but they don't mean that there is something wrong. Rest is not the best way to improve back pain. And finally, you can't "bank" good exercises for your back. That is, if you have chronic pain, you can't do all this non-invasive work, have the pain subside, and then expect it to never come back.

The author equates it with brushing your teeth. She highly recommends Stuart McGill's "Big Three" exercises to strengthen endurance of the spine a modified crunch, a side plank, and a bird-dog. I'm doing bird-dog right now as I type this. Aug 12, Alison Dawson rated it really liked it.

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