Prescription For Hospital Survival Is Growth, Not Cutbacks

The United Health Fund recently reported that 13 of 35 non-profit, acute care hospitals in New York City are in such financial distress that their long-term viability is in doubt — a warning for all health care institutions struggling to survive.

But the traditional cost-cutting and layoff prescriptions for health care providers in trouble are not sufficient to solve this growing problem. Hospitals cannot continue to slash their way to survival without sacrificing quality and patient services. Traditional cost reduction often leads to additional market share erosion and revenue loss. As the health care system moves into an environment focusing more on patient/customer satisfaction, the traditional management responses could result in even greater losses for the hospital. Patients may stop coming because of reduced or non-existent services, the fact that their doctors have gone elsewhere, or the perception that the hospitals reputation is declining. Doctors may leave due to declining service quality, experiences with inadequate clinical and support staff, and frustration with outdated equipment and facilities.

Maverick Healthcare Consulting has found that financial difficulties can often be more effectively solved with growth strategies that expand and enhance existing revenue streams, create new sources of revenue and increase market share. These strategies include investments in enhanced quality to increase patient and physician satisfaction; investments in equipment and staffing that will speed the patient experience, improve convenience and increase patient volume and throughput; and investments in new services that enhance a hospitals profile and make it much more competitive for market share.

Maverick Healthcare Consulting has had the opportunity to assist a number of Greater New York hospitals in designing and implementing creative approaches towards growing out of the financial doldrums. Following are some examples of these types of improvements. In addition to improving quality and service, such actions were instrumental in avoiding layoffs and other sacrifices for the communities they serve, and in creating new employment opportunities as projected revenue streams and services were successfully achieved.

A New York City community hospital was losing hundreds of thousands of dollars each month and was about to close its doors. Although its cost structure was well below almost any of the other hospitals in the area, it was still suffering financially. In light of declining reimbursement and patient volume, and with a growing concern regarding continued liquidity, in order to preserve its vital core of services for the community, the hospital turned to the tactic that had helped it avoid past financial difficulties: cost reduction. However, this time the tactic worked against the hospital. Having eliminated virtually all of the fat from the organization, in desperation, the hospital was left with little to reduce other than the muscle. To better manage expenditures, the hospital reduced surgical hours of operation, postponed needed investments in the expansion of surgical services, and delayed replenishment of surgical equipment required by many of its surgeons. This resulted in surgeons beginning to take their patients elsewhere. Vital patient flow improvements to the emergency department (the major source of admissions for the hospital) were postponed, and increasing overcrowding resulted in more patient walkouts and more frequent diversion of ambulance traffic to other hospitals. Admissions declined, exacerbating the financial crisis. Vendor payables were stretched to the limit and the hospital began having difficulties receiving shipment of necessary supplies. The hospital was in a classic downward spiral.

To halt the precipitous decline, the popular prescription for a sick hospital was changed, and an entirely different regimen of investment and growth was implemented. Through a strategic mind-shift, management took a new approach towards the situation. Cost cutting and layoffs were out, and focusing the remaining capital of the institution on investment in growth became the master game plan. Investments were made in quality and staff education, surgical and emergency services capacity, and in service lines that both fill a vital community health need and produce a positive bottom line contribution. The hospital’s investment orientation, and its careful selection of key productive assets in which to invest, was the fulcrum around which a new team turned itself around and became an inspiration to its community, physicians and employees

The hospital has not lost a cent in the last six months and is well on the road to recovery.

The North Shore/Long Island Jewish Health System on Long Island in New York is another organization that has improved its market position through investment and growth. North Shore/LIJ is one of the larger not-for-profit health-care systems in the country with 18 hospitals and revenues in excess of $3.2 billion. The System has a record of stellar growth over the last decade as it came to realize that cutting costs was not the only way to prosper in a competitive New York environment. Instead, the System focused on growth through development of new services for existing markets throughout Long Island, Queens and Brooklyn.

Early on, the Glen Cove Community hospital joined the North Shore /LIJ System. Glen Cove was a very traditional community hospital facing an increasingly hostile competitive environment. Its board realized that if things continued the way they were going, the hospital would soon deplete its reserves. A new direction was needed. So it joined the North Shore/LIJ Health System.

The North Shore at Glen Cove growth plan began with the development of a patient rehabilitation program. Once this program took hold and was successful, a second phase of growth was started. A surgical services program was created and an orthopedic surgeon employed. As a result, this 250-bed community hospital is financially solvent and a successful member of the North Shore/LIJ Health System.

North Shore applied this successful formula in several other institutions on Long Island, including, for example, Syossett, Plainview, and Forest Hills – all of which are successful organizations and prospering from investments in growth initiatives.

Additionally, early in its formation, the System invested in a rigorous quality management system that has shown its worth through the introduction of common policies and procedures geared towards the measurement and production of higher quality outcomes. Working in concert with the medical staffs of each of its member hospitals, the System has been able to raise the standard of care for all patients and the expectations of its medical staff to levels not previously available on Long Island. A direct result of these activities is the designation by AARP of the North Shore University Hospital in Manhasset as the Best Hospital in America for customer service by its membership.

Obviously, not all hospitals and health systems have the resources, stamina, desire or know-how to implement a successful growth strategy similar to NSLIJ. In fact, some have determined that in light of the risk and challenges associated with a merger/acquisition oriented expansion strategy (despite the success of NSLIJ, there have been many other publicly discussed merger/acquisition failures), they would be better served to invest in quality of service and throughput improvements in their core facility. The University Hospital in Newark, associated with the University of Medicine and Dentistry of New Jersey, presents an example of a hospital that has done this last approach extremely well.

Like most other large academic hospitals, years of continuing governmental and commercial reimbursement reductions, deferring investment in aging plant and equipment, increasing indigent volume and escalating costs of labor and materials had taken their toll on University Hospital. To break the downward spiral, University Hospital leadership developed a multi-tiered growth plan. The first tier of the plan focused on the financial stabilization to stop the spiral. The organization focused the talent of hundreds of skilled employees and physicians on the design of dozens of Strategic Work Group (SWG) initiatives to improve the core operational and financial process effectiveness of the hospital. SWG success provided investment capital to fund the second tier of activity: Strategic Growth. University Hospital invested in the renovation and enlargement of its trauma center, the enhancement of staffing and equipment, and in the redesign of dozens of cross-departmental processes that had previously created barriers to entry in the ED. Similarly intense investment and improvement efforts focused on the Operating Room. Key ancillary and support departments such as the Laboratory, Radiology, Admitting, Discharge Planning, Environmental Services and Transport were redesigned and enhanced to support an increased volume of patients. At the same time, improved contracting and physician services brought more throughput to revenue generating centers such as the OR, ED and Patient Care beds. This leadership insight and courage produced results: hospital revenues, cash and volumes increased dramatically, and in 2003 the hospital experienced its first positive operating margin in many years.

These experiences are just a few examples of why growth in times of crisis, as opposed to layoffs and cutbacks, can be exactly the prescription to hospital illness.

Moreover, the impact of such growth strategies can be optimized when an organization establishes aggressive goals in each of its functional areas; selects a measurable approach, monitors activity, and addresses underlying process and workflow redesign resulting in positive and lasting change; allocates sufficient resources to achieve growth; and measures progress against objectives making necessary modifications along the way.

In place of cutbacks and layoffs, hospitals should be thinking about the following strategies to preclude or overcome financial instability:

o Increasing quality, capacity and patient flow in areas that produce revenue

o Producing new business from new patient bases

o Expanding revenue-producing areas

o Improving medical research and grants management.

To build the revenue base and increase market share, health-care organizations should also consider:

o New program development

o New ambulatory services strategies

o New provider/payer network planning

o New mergers and acquisitions

o Increasing quality of care, patient safety and satisfaction

o Increasing physician job satisfaction.

The winds of change continue to blow throughout the health-care system, scattering old ideas and failed solutions. But one major change is long overdue: struggling hospitals must begin to choose growth over decline. From better access management to improved staff scheduling and patient care, to the development of new businesses and markets, a turnaround action plan can be implemented without cutbacks and layoffs. It is one medicine with very pleasant side effects.

The Brain Tumor Symptoms

The symptoms of brain tumor vary from patient to patient, and most of these symptoms can also be found in people without brain tumors. So the only way to know if you really have a brain tumor or not is to consult your doctor and get a brain scan.

Headache is the symptom that is common with 46% of patients with tumors. They described this headache in a different way and no reason is a sure sign of a brain tumor for many. Perhaps most people have headaches at some point in their lives, so it is not sure sign of brain tumors. You should talk to your doctor if your headaches are different than you’ve ever had, with nausea / vomiting, aggravated by bending or effort to go to the bathroom.

Seizures: This was the second most common symptom reported, with 33% of patients reporting a seizure before the diagnosis was made. Seizures can be caused by other things, such high fever, as epilepsy, stroke, trauma and other disorders. This is a symptom that should never be ignored, whatever the cause. In a person who has never had a seizure before, it usually indicates something serious and you should get a brain scan.

A crisis is a sudden and involuntary change in behavior, muscle control, consciousness, and / or sensation. Symptoms can vary from attack and sudden loss of consciousness total agitation of the violent shaking or slight shaking of a limb. A person can experience blurred vision, slurred speech or staring into space and doing other odd behaviors, while having a seizure. About 10% of United States population will experience a single seizure in their lives.

Nausea and Vomiting: As with headaches, these are non-specific – meaning that most people who have nausea and vomiting do not have a brain tumor. Twenty-two percent of our respondents said nausea / vomiting as a symptom.

Nausea and / or vomiting are more likely to look for a brain tumor which is accompanied by other symptoms mentioned here.

Vision problems or hearing: Twenty-five percent reported vision problems first. It is not easy if you have a problem with your hearing or sight, to be extracted. I have often heard that the eye doctor is the first to make diagnoses. When you look in your eyes, sometimes you can see the signs more. Intracranial pressure, because it must be studied.

Problems with the weakness of the arms, legs and facial muscles, and strange sensations in the head or hands: Twenty-five percent reported weakness in the arms or legs. Sixteen percent expressed feelings of weird and strange sensations in there head. This can lead to an altered gait, falling objects, falls, or asymmetric facial expression. These can be symptoms of a stroke. Sudden onset of symptoms is an emergency – you should go to medical emergencies. If you notice a gradual change over time, you should know.

Depression Causes and Treatment – Are You Depressed

Depression is one of the most serious medical and psychological problems. It is caused by different factors from physical to emotional to intellectual and spiritual aspects of being; and it could also result to various circumstances like suicide and mental abnormalities. Depression is the feeling of being low, sad and down for a long period of time.

Causes of Depression

Teens and young professionals are the age brackets most susceptible to depression. With teenagers it is usually caused by personality and identity crises. As they search for the meaning of life and the purpose of their actions, they are sometimes caught into too many questions they all try to seek answer for at the same time. Many of these circumstances tangle especially when they encounter philosophical issues that shake their beliefs and stands.

Still other teenagers especially those victims of physical abuse and brokenness in the family suffer from depression. These situations appear to them like there are no other options and no other way out than to be with them, lock inside their rooms and encourage depression to eat them out.

To young professionals, it is usually known as the quarter life crisis depression. It is the time when they feel unaccomplished in their lives. Their nostalgia of still being in school also causes them depression. They opt to become responsible to themselves and to their families but on the other hand the idea of enjoying life with their new earned freedom keeps them from doing so. Depression to them is the feeling of discontentment to what is happening in their careers and love life.

To other people, depression is caused by a loss of love one, financial and economic incapacity, emotional stress, tiredness from work and worrying among others.

Signs and Symptoms

There are various signs and symptoms of depression and it varies from one person to another. The most common of course is the persistent feeling of sadness and anxiety, hopelessness, helplessness and unworthiness.

Other signs include the loss of interest in normal daily activities. You may seem to be doing something but are not accomplishing anything. You are thinking of doing something at a certain time but just can not get yourself started. You could also have sleeping disturbances like waking up in the middle of the night with heavy feeling, inability to sleep or too much sleeping. You may also have difficulty concentrating with your supposed work and you delve too much in thinking about your problems.

Sometimes other people are not aware that changes in weight like becoming heavier and lighter is also a sign of depression. You may have the appetite in eating but what you eat is not reflected in your body in terms of your weight and complexion. Other symptoms include easy fatigue ability, irritation and restlessness, low self esteem, pessimism and thoughts of dying.

Treatments of Depression

More than a medical condition, depression is actually more of a psychological one. Treatment for depression really goes to a therapy. Taking anti-depressant medicines are good and could give a little room for change but consulting professional psychologist or guidance counselors are better.

There are also self-motivated treatments like going back to a hobby and enjoying it until a change in the mood happens. This can clear the mind and gives an opportunity for you to think logical steps you could take to move out from depression. Moreover, unloading the difficult feelings to a friend also helps.

Results of Depression

As said, untreated depression can lead to different results. The most common is suicide. This is the result of hopelessness and pessimism and according to study, men have higher rate of suicide than women. Other results include, drug dependence, alcoholism and other mental imbalances.

In societal perspective, depression result to broken families and compromised relationships with friends and other people. Not only a cause but also a result that depressed people loss their jobs and sense of responsibility.

Asbestosis and the Respiratory Distress Due to Asbestos

Asbestosis: respiratory distress due to asbestos

Asbestosis, the name says it all, is a disease caused by the inhalation of asbestos. The lungs become less elastic so that the patient may have difficulty breathing, the patient also has a greater chance of lung cancer. The therm Asbestos is a generic term for a number of naturally occurring minerals, which are made up of microscopic fibers.

Asbestosis is a disease of the lungs, which, the name says it all, is caused by exposure to asbestos. The disease is ranged under the heading of pneumoconioses, also known as ‘dust lung’. The affection is discovered around 1930. It’s a rare affection.

When large quantities of asbestos is inhaled, the body reacts to this with an inflammatory response, whereby connective tissue is produced in the lungs. Through this connective tissue, the lungs are getting less elastic and thus less air can be inhaled.

Asbestosis can develop in different ways, namely prolonged exposure to small amounts of asbestos, but also by a very brief exposure to a large amount of asbestos. Asbestosis is a recognized occupational disease, but you do not for example, construction work to do to get it, considering asbestos in former years in many different places has been processed.

The time between exposure to asbestos and the manifestation of symptoms is often between 10 and 20 years after exposure, but this time is dependent on the duration of exposure and the concentration of asbestos.


Anyone who suspects that they have been in contact with asbestos can do nothing until he or she receives complaints. That is the harsh truth behind the matter with the fibers enter the body and their destructive and sometimes deadly work does. Testing for the substance is not possible and if the asbestos once has invaded there is nothing to do about it.

Here are the symptoms:

  • Shortness of breath
  • A dry and sore cough sometimes accompanied by stabbing in the chess
  • Shortness of breath (this usually happens only when the patient is at least 10 years been exposed to asbestos)
  • Heart failure (in an advanced stage of asbestosis)

Which diseases can be caused by inhaling asbestos dust? People who inhale asbestos dust can get diseases like:

  • Asbestosis (also called dust lung)
  • Asbestos pleurisy
  • Peritoneal Cancer
  • Lung Cancer
  • Mesothelioma (asbestos lung cancer)
  • Pleural thickening

Diagnosis and therapy

The diagnosis can be made by means of an extensive investigation into the occupational history, living conditions and medical history of the patient. There follows an X-ray of the lungs, a test to determine how the lungs function and if necessary a lung lavage or lung biopsy.

Asbestosis is a progressive disease that does not heal. There is no treatment for patients with asbestosis, the only thing that can be done is treating the symptoms. Asbestosis usually leads to respiratory symptoms and in the worst cases to death because the heart becomes overloaded. The symptoms can be controlled by oxygen administration, nebulisers and medication to prevent heart failure. In some cases there is a possible lung transplant.

Asbestosis Patients have an increased risk of getting lung cancer. Therefore is it necessary to take a regular X-rays from the lungs, people with asbestosis is also advised to stop smoking. They are also eligible for a vaccination against flu and pneumonia.

Cough In Children

Childhood coughing can be due to many factors, often more than one in a given child. Certainly the most common causes are common colds, more serious respiratory infections like pneumonia, and asthma. Aspirated foreign bodies to the airways, sinusitis and psychogenic cough are other causes.

The typical cough from a cold virus is associated with other symptoms of a cold. These usually include runny nose, sneezing, sore throat and low-grade fever. Often there are other family members who are sick. This type of cough tends to resolve as the cold gets better, but commonly lasts a few days to a week or two after the rest of the cold symptoms go away.

More serious bacterial respiratory infections include pneumonia. Although pneumonia can develop quickly and without a preceding cold, often it complicates a cold or influenza. A typical cold that gets much worse after a few days, with higher fever, cough, often production of a lot of sputum or phlegm, and sometimes with shortness of breath or chest pain is suspicious for pneumonia and is best to be evaluated by your physician.

Croup is a specific type of respiratory viral illness. It is caused by the respiratory syncytial virus (RSV) and other related viruses. It is fairly minor, but can be severe and require respiratory support with oxygen, or rarely mechanical ventilation in an intensive care unit. It tends to be more severe in younger children. In infants, especially premature infants, it can present as a wheezing illness called bronchiolitis that can be more serious.

Asthma tends to cause wheezing also, but can present primarily as a cough. It tends to come in children with a family history of asthma or allergies. Treatment is beyond the scope of this article, but is best discussed with your physician.

Aspiration of a foreign body, like a nut, bead or particle of food can lead to a chronic cough, and although uncommon, can be extremely refractory and needs to be considered in longstanding coughs in children.

Psychogenic cough is uncommon but worth considering, especially when the cough is not associated with other symptoms of illness. It is treated with behavior modification including ignoring and can often be cured with suggestion type therapy.

How to Get Rid of Uric Acid in the Body Naturally

Gout sufferers need to get rid of high uric acid in the body. You can use drugs or natural remedies. Here are 3 natural ways to get rid of uric acid without the side effects and cost of drugs.

High uric acid in the body over time can produce crystals in your joints, which then cause the horribly painful symptoms of gout.

Uric acid is produced by purines in the body and in foods. Purines help to produce our protein and energy needs, but in that process they breakdown and uric acid is formed as a byproduct.

The acid is processed by your kidneys and most of it is excreted through urine. Relatively low levels are then retained in your blood as an antioxidant, doing things like looking after your blood vessel linings for example.

High uric acid in the body can occur if your kidneys aren’t working efficiently, or, if your body is producing too much acid so that your kidneys just can’t cope.

Gout sufferers need to get rid of those high levels, to help get gout relief, and, to prevent further gout attacks. And as a gout sufferer, you are highly likely to have recurring gout episodes.

Modern medicine can do both through drugs that can be very effective. Things like NSAIDs (non-steroidal anti-inflammatories), colchicines and corticosteroids for relieving gout symptoms and pain, and, drugs like allopurinol and probenecid for reducing high acid levels.

But they can have very bad side effects such as vomiting, diarrhea, nausea, stomach pain, ulcers, bleeding, skin allergies, etc. And the drugs for reducing the acid need to be taken over the longer term because they only work while you take them. Stop, and there isn’t anything to prevent your levels rising again.

So many people are using natural gout remedies. These can act in the same way as drugs, i.e. reducing inflammation, relieving pain, and, lowering uric acid.

There are many natural ways to get rid of uric acid in the body by using specific herbs, fruits, vegetables, supplements, and so on. Some seem to work better for some people than others, so you have to discover the ones that work best in your particular case.

Here are three that people have found to be effective in getting rid of uric acid from the body…


Dr. Ludwig Blau is said to have cured his own gout in 1950 by eating between 6 and 8 cherries every day. But more recent studies suggest anything up to 40 can be effective. Between 30 and 40 is probably nearest the mark.

Cherries contain anthocyanins which act like NSAIDs and studies have also shown that they can actually lower uric acid in the body.


These also have anthocyanins allowing them to act as natural NSAIDs and help reduce inflammation and pain. Probably 1 cup of blueberries every day should be enough, but you need to find out what level is best for you.


This is perhaps very overlooked by gout sufferers. A dehydrated body finds it more difficult to get rid of uric acid, and it is easier for uric acid crystals to form. Plenty of water helps to prevent crystals forming, and, helps your kidneys to get rid of uric acid more effectively. Drink at least 12 x 8oz glasses every day.

These three can work quite well to get rid of uric acid in the body, but there are many more issues to consider for staying free of more gout attacks. And, remember, if you have suffered even one gout attack, you’re very likely to have more.

You should avoid this as recurring gout can lead to permanent joint damage and kidney problems over time.

Her Most Famous Painting (The Roots) – Frida Kahlo

Frida Kahlo, born on July 6, 1907, was an incredibly strong woman and an internationally recognized Mexican painter. She was married to a Mexican painter Diego Rivera, whose artistry she admired. Her work used to carry a competent blend of the Mexican and European cultures. Most of her paintings were self-portraits (55 out of 143), mostly remarkably portraying her pain and sexuality. Kahlo’s “The Roots” is one of her most magnificent works.

In her short span of life, Frida endured what most people cannot even imagine. When she was 19, she met with an accident, with a trolley car. She broke her spinal column, collarbone, ribs, pelvis, eleven fractures in her right leg, the right foot crushed & dislocated, and a shoulder also got dislocated. She had as many as 35 operations, owing to this accident. To give vent to all her trauma, she transformed her sufferings, on the canvas, as self-portraits, especially “The Roots.” To justify her obsession with self-portraits, she once said, “I paint self-portraits because I am the person I know best. I paint my own reality. The only thing I know is that I paint because I need to and I paint whatever passes through my head without any other considerations.”

“The Roots,” painted in 1943, as mentioned above, was one of her most beautiful and identifying self-portraits. She painted it to mark her reunion with her estranged husband, Diego Rivera, after an undesirable phase of pain and suffering. The painting, in the background of happiness, also displays her feelings about her ‘developed’ physical inabilities in life. Frida had lost her reproductive ability in the accident and carried that incompleteness and pain in her heart. This 12″ X 19.5″ oil on metal work canvassed Frida’s desire to be a part of feminine genesis and to be connected to life like others. It displays her desire of having her own children. Frida Kahlo adored Pedregal’s rough grey rocks in South Mexico and she set them in the backdrop of her painting. The detailed, leafless stems around Frida, in the painting, portray her ‘deliberate’ infertility, her severely injured body, her lost loves, and the other misses of her life.

Sotheby’s auctioned “The Roots” at a record price of $5,616,000, the highest price a Latin Mexican artist ever commanded. Her other popular paintings were, “The Two Fridas,” painted to mark her divorce with Diego, “Tree of Hope,” and “My Nurse and I.” Kahlo’s artistic ability was amazing. She imbibed inspirations from different people, cultures, and her surroundings, blending their essence in her customized, fresh, and distinct style. She competently canvassed not only her physical trauma, but also the life-long psychological one, translating into numerous unexplored ideas and emotions. Frida did not paint dream or fantasies, but her own reality. She truly said, ‘I am not sick. I am broken. But I am happy as long as I can paint.” The tower of strength, Frida died of her pain on July13, 1954.

Football Related Knee Injuries

Ligament Injuries

Football players frequently injure one or more of the knee ligaments. These ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL).

ACL Injury – When an athlete changes direction rapidly, lands wrong from a jump, or simply slows down when running, the ACL could tear. With this injury, knee swelling immediately occurs and walking is painful. The knee may have loss of range of motion and tenderness with an ACL injury. Treatment for this type of injury depends on the degree of tear to the ligament, whether or not there are other associated injuries, and how much physical demand the patient puts on their knee. Sometimes, the orthopedic specialist needs to operate to repair a complete tear of the ACL. Recovery is measured in months, rather than weeks for this type of injury.

MCL Injury – The MCL is generally injured from a direct blow to the outside portion of the knee. The ligament is torn or stretched when the foot is planted firmly on the ground and a sideways force hits the knee. An injured MCL causes pain, difficulty walking, and tenderness. Therapy involves the use of a knee immobilizer, rest, ice applications, compression with a support bandage, and frequent knee elevation. Surgery is only necessary for severe tears of the MCL.

PCL Injury – The PCL is injured when a football player receives a blow to the front aspect of the knee or makes a simple misstep on the turf. Most PCL tears and injuries will heal with conservative treatment. An injured PCL leads to pain with walking, instability, and swelling of the knee. Surgery may be necessary with complete tearing and extensive damage to the PCL.

LCL Injury – The LCL is the least likely ligament to be injured during football activities. When severe force is applied to the inside of the knee, a LCL injury could occur. Symptoms include pain, swelling, weakness, tenderness, and discomfort to the outside of the knee. Treatment involves the RICE method, anti-inflammatory medications, and immobilization. Surgery to reattach the ligament to the bone is sometimes required.

Cartilage Injuries

Torn Cartilage – Most of the time, the meniscus is the cartilage that is torn during a football game. This rubbery, tough structure serves as a shock absorber during athletic activities. The meniscus tears with cutting, decelerating, pivoting, twisting, or from being tackled. Most torn meniscus injuries cause gradual pain and swelling, worse with climbing steps or uphill. Not all meniscus tears require surgery, but frequently the damage can only be repaired through an operation.


The patella can break if the football player falls directly onto it or receives a direct blow in that area. If the bone is fragmented, surgery will be required for repair. If the bone is in appropriate position, the orthopedic specialist may prescribe an immobilizer and rest for the injury. The head of the fibula on the outside area of the knee joint is easily fractured from direct blows or as part of an injury to the lower leg. If the bone is not out of alignment, immobilization and conventional therapy will treat the injury. Sometimes, however, the fibula fracture is complex and requires surgical repair. With jumping types of injuries, the tibia bone can be damaged. If the fracture occurs in the tibial plateau, surgery is often necessary.

Bursa Inflammation

Bursa inflammation is also called ‘housemaid’s knee’ or prepatellar bursitis and is the result of repetitive kneeling or crawling on the knees. The space between the kneecap and skin is called the bursa and it becomes irritated and fills with fluid. Bursa inflammation is a common type of knee injury of football players. Treatment includes using anti-inflammatory medications and rest. Occasionally the bursa needs to be drained for resolution of the problem.

Patellar Injuries

The patella can dislocate if it receives a direct blow. The blow can force this bone toward the outside area of the knee. Most dislocations of the patella easily return to normal alignment by simply straightening out the knee. However, some patella dislocations are serious and require surgery. Also, patella-femoral syndrome is inflammation to the underside of the patella. This condition causes localized pain, which is worse with running and walking down stairs. Treatment involves strengthening exercises, the use of ice therapy, and anti-inflammatory medications. Severe cases of this disorder require arthroscopic surgery to remove the damaged cartilage and realign parts of the quadriceps muscle.

Muscle and Tendon Strain

Most strains of the knee are treated with rest, ice therapy, elevation, and compression. Crutches help with walking, and the doctor may order an anti-inflammatory medication. These injuries are often the result of hyper-extension involving the hamstring muscles or hyperflexion causing the quadriceps to be injured. If the patellar or quadriceps tendon is ruptured, there is inability to extend the knee. Surgery is necessary to repair this type of injury.

Bowling Rules: How The Game Works

Obviously, any bowling rules will be relevant and important, but keeping score? You have to learn all of the bowling rules there are, but before I tried my first game my father showed me how. You will learn many bowling rules as you continue bowling–from your very first day!

· Bowling Scores:

There are 10 “frames”, (i.e. turns you get) in a bowling game. A score of about 120 in the 9th frame the absolute most points this person could get would add up to 150–however, the player would have to roll three strikes in a row when he or she plays the 10th frame, if this happens the player continues rolling the ball–achieving 30 pins for each strike he or she makes. The basic notion of this bowling rule is also recognized by other players, but by adding only 10-pins to the score.

· Bowling rules for bowling attire:

a) There really is one essential kind of bowling attire is that the players wear bowling shoes when they play. This is why having the appropriate shoes is up on the top of the list of bowling rules.

When someone does not follow basic bowling rules and wears their street shoes on the floor. If a ball drops on his or her foot, well it is likely that he or she will never make that mistake again. Seriously, a heavy bowling ball can fracture your toes–and sometimes people drop things.

· Another one of the most important bowling rules is to use the proper technique for bowling.

a) Bowling rules about technique:

Primarily there are a couple of simple, physical moves that will improve your bowling skills. They are different depending on whether the person is right-handed or left-handed–but quite basically the same bowling rules of posture, pressure and release.

b) Bowling rules about mental preparation:

Perhaps it sounds pretty ridiculous, but concentration on your bowling can really help when you are trying to get that high score. Re-think the physical bowling rules, and then envision your ball rolling down the lane towards a perfect strike.

The saddest bowlers are the ones who toss the ball carelessly and have poor technique. Usually, in such circumstances, the bowling ball will end up in the gutter–so knowing the basic bowling rules is very important.

Exogen Express Bone Healing System

The Exogen Express Bone Healing system by Smith and Nephew works by using ultrasound waves to speed up the bone healing process, particularly in the case of wrist, ankle and shin fractures. Ultrasound waves can stimulate the mechanical receptors in the bone thus producing faster healing, resulting in a faster return to everyday and sporting activities.

The Exogen is portable and lightweight, having being designed for both home and professional use and has a simple push-button operation and easy-to-follow instructions. It can be be used over a plaster cast or dressing if required. Timewise, it should be worn for 20 minutes a day and can be used for up to three months. Although usage is straightforward, it should always be used after seeking advice from a medical practitioner.

Not only can it be used for fresh, straightforward fractures, but the Exogen Express Bone Healing System can be used where there are complications such as delayed healing, delayed union or fracture non union. It can also be used where there are metal implants, such as screws, plates and nails.

The device should not be used for fractures of the skull or vertebrae or on children or pregnant women. In addition, if you have any other medical conditions or illnesses or are currently taking medication, you should seek the advice of your doctor before proceeding with use.

As with any ultrasound device, you will need to use a transducer gel to ensure that contact is made with the skin. The operation itself is completely painless.

Sarcoidosis Cure – Natural Treatments For Sarcoid

Looking for a sarcoidosis cure? It is often true that nothing works better than natural treatments when it comes to finding a sarcoid cure. There is an array of contemporary medicines available these days, however, they all come with their share of side effects, many of which can actually make the condition worse.

Alternative Sarcoidosis Treatment Methods

People suffering with chronic Sarcoidosis often respond better to alternative sarcoidosis treatments, especially the natural and ayurvedic ones which are very good in treating this problem.

Sarcoidosis is a disease which starts by inflammation of different body organs. The lungs are normally the first part to get affected, however, the issue gradually spreads to other parts of the body. Inherited strain and extreme pollution levels may cause sarcoidosis, though the precise cause of sarcoid remains largely unknown.

Herbal Solutions for Natural Sarcoidosis Relief

Herbal solutions for natural sarcoidosis treatments include home made and natural treatments. There have been instances when patients may see small lumps in their stomach. These usually cannot be treated without the use of medicines. Through natural sarcoidosis cure these medicines can be treated and you can stay away from harsh medical treatments.

Sarcoidosis patients usually witness symptoms like:

  • Breathlessness
  • Unrelenting cough
  • Low feeling or depression
  • Pain in chest
  • Lack of appetite

Physical exercises is one of the most suggested natural solutions or sarcoidosis cures. This way you can stay fit and avoid many other diseases also. Through exercising immunity levels of the body improve, which helps as a sarcoidosis cure.

Always consult a doctor before you start off with any kind of exercise regime. There are many simple techniques that you can try here like sleeping in a well-ventilated room. A room with fresh air allows lot of oxygen to enter the patient’s lungs

Some herbal medicines and natural sarcoidosis cures include ayurvedic herbs:

  • Ginger
  • Peppermint
  • Milk thistle
  • Chinese herbs that balance immunity levels
  • Maha-Manjishthadi-Qadha
  • Ras-Sindoor
  • Guduchyadi-Qadha
  • Saarivasav

These are herbs that help often help people suffering with sarcoid. Using them may further enhance the immunity status of your body and reduce inflammation of the tissue.

More Natural Herbal Remedies That You Can Use to Treat Sarcoid

  • Shatavari and Asperagus racemosus
  • Ashwagandha or Withania somnifera
  • Tulsi or Ocimum sanctum

Before trying any natural approach to reducing sarcoidosis symptoms you should consult your doctor. An initial examination by a chest physician or even a Rheumatologist is suggested to ensure that the condition is not at a serious stage. Even though herbal treatments are affective in treating the disorder, it is always safer to get a second opinion

Alternative Natural Sarcoidosis Solution-Searching For Answers?

How to Make the Right Decisions to Get Ahead in Life

Doesn’t it piss you off when you make stupid decisions? Doesn’t it piss you off EVEN MORE when you miss an opportunity for not having made a decision fast enough?

This is my little guide to make smart decisions. I don’t claim to be a decision-making expert. This is what works for me and hopefully it will help you too.

Planning Too Far Ahead Doesn’t Make Sense

I don’t like business plans that cover three years. This is especially true for startups. You have no idea what’s going to happen next week, how the heck will you know what’s going to happen three years from now?

You don’t need to have plans for the next 10 years of your life. It’s always good to have a rough idea of your life goals, but you can’t plan the whole path to get there and expect it to happen the exact way you planned it. Write down your goals and then make a list of all the things you can do THIS WEEK to get closer to those goals.

Sometimes You Don’t Need to Make a Decision at All

I try not to waste mental energy worrying about decisions I might never have to make. For example, I want to go with my wife on a safari to Africa. There are way too many choices. I don’t waste my time trying to decide what tour I’m going to go with because I’ll take this trip in about a year and a lot of things could happen between now and then. I could meet someone who has been on a safari already and can make a recommendation. I could find information on a safari I really like in a newspaper. I might decide to go to some other destination instead. I might be broke in a year and might not be able to go anywhere at all (although I hope this isn’t the case!)

My point is that way too often we worry about problems that don’t even happen now. Last week I had a problem with one of our vendors. We talked over the phone and they told me they were going to call me back. In the meantime I started looking for other vendors. I spent a whole day doing this. Finally, the vendor I had been working with called me, apologized for the issue they caused and gave me a whole year of service for free. They earned my loyalty forever. In retrospect, I should have waited for their phone call before wasting a whole day assuming that they wouldn’t make it right for me. I could have spent that day much more productively.

Avoiding Analysis Paralysis

One of the more sure-fire ways to never get ahead in life is to procrastinate making decisions because you don’t know what the right decision is. The truth is that most of the time what decision you make doesn’t matter that much (that is, as long as you make a decision). I’m a big fan of making decisions fast and then evaluating those decisions later. If I made the right decision, great! If I didn’t, I’ll correct it. Let me give you some examples:

  • A few months ago we were offering a service that was bringing us a lot of headaches. I wanted to get rid of it but wasn’t sure. So I decided to stop offering it for two months. 50% of my problems suddenly disappeared and our bottom line didn’t suffer much. It was the right decision, but if it had been the wrong one, I could always start offering the service again.
  • Last month I needed to buy some speakers for my iPhone. There were two I really liked. After five minutes of time-wasting, I finally decided to call my wife. “Honey, pick a number: one or two.” She picked two and I bought the second set of speakers. I love them.
  • Last week we had to choose between two vendors. There were both really good. I could’ve spent a whole day analyzing the pros and cons of each one, but I decided to toss a coin. So far they’ve been great. If that changes, I can always switch to the other company.

Trust Your Intuition

Intuition isn’t a voodoo thing that magically makes good decisions. Your intuition learns from past experiences and analyzes your subconscious for how certain experiences worked out for you. It perceives things that your conscious mind can’t. For example, if you’ve been lied to by people who wanted to take advantage of you, the next time something similar is about to happen, your intuition will warn you, even if on paper the decision you’re about to make looks great. Listen to it.

Cancer Treatment in India – Lung Cancer

Medical Tourism is the most recent trend in privatization of healthcare services and is gaining prominence in developing countries like India. The term ‘medical tourism’ here is not tourism in real sense of the word i.e. it is not destination tourism rather it involves medical health package tourism. Tourism here refers to the provision of ‘cost effective’ private medical care in collaboration with the tourism industry for patients coming from foreign countries so that they could get good health care package.

Medical tourism or health care package tourism covers broad spectrum of medical services and has become a common form of vacationing. The objective of medical tourism package is to mingle wellness and healthcare with relaxation and leisure and to provide best of medical tour package to foreign patients.

India is a recent entrant into the global medical tourism map and medical tourism in India is at boom. McKinsey and the confederation of Indian Industry made a study and stated that medical tourism in India could become a $ 1 billion business by 2012. Government and private sector studies estimate that medical tourism in India is growing by 30 percent a year.

India has caught the attention of foreign patients with high quality treatment and services at private hospitals and those run by voluntary services. Some of the pluses offered in India are the international standard of medical attention, high-end equipments, personalized attention and minimum waiting period that too at a fraction of costs incurred overseas.

India with its culture and scenic beauty is becoming a popular medical tourism destination for foreign patients needing surgery and other specialized treatment and is providing cost effective medical tour packages. Many patients are pleased with the Indian Medical package tour like getting their tummy tucks with a trip to mesmerizing Tajmahal Agra.

Indian hospitals like Apollo are providing a nice blend of top-class medical expertise at affordable prices and thus are attracting foreign patients. Apollo hospitals are one of the leading medical corporations of India serving medical tourists from foreign countries.

Book Review: The Shallows, by Nicholas Carr

The question of whether new media technologies are mind numbing is an age old one, going back to classical antiquity. Nicholas Carr, in his new book The Shallows, a nuanced and considered study on the ill effects of too much Internet usage, uses the fascinating example of Plato and Socrates.

History of New Media Technologies

In Plato’s well-known dialogue Phaedrus, the philosopher has Socrates discussing the merits of writing with Phaedrus. Socrates relates a story about a meeting between the Egyptian god Theuth, who amongst other things invented the alphabet, and Thamus, a king of Egypt. The technologically savvy Theuth argues that writing will be a boon to society, allowing for the storage of information and hence providing ‘a recipe for memory and wisdom’. Thamus disagrees, and suggests that writing will have a deleterious effect on memory as people lazily rely on what is held in these early data banks. Thamus goes on to say that writing will not create true wisdom, as people will not cultivate their minds. It will rather create a kind of fake wisdom. The dialogue makes clear that Socrates agrees with Thamus.

Plato was not on Socrates’ side in this matter. In The Republic he argues against poetry, which in antiquity represented the oral tradition. Poetry was declaimed in public, rather than written down. Plato felt the advantages of writing superior to a purely oral culture. Writing would encourage the reader to be logical, self-reliant and rigorous.

Even back in fourth century BC Greece there was concern that the new technology of alphabet based writing had the power to change the way the mind worked. Many centuries later, modern machines would have a noticeable effect on thought and literature. In 1882 German philosopher Friedrich Nietzsche found his eye sight failing and couldn’t concentrate when trying to write with pen and paper. To resolve this problem he ordered a Danish-made Malling-Hansen Writing Ball typewriter, which would allow him to close his eyes and tap away on the keys. The philosopher found that the forceful banging of the contraption during composition had a discernable effect on his writing, making his prose tighter and more telegraphic. He concluded that, ‘Our writing equipment takes part in the forming of our thoughts.’

The Shallows has an alarming subtitle: what the Internet is doing to our brains. It’s tempting to think from this eye-catching book blurb that Nicholas Carr is keen to scold Internet users and predict the decline and fall of Western civilisation. This is thankfully not the case, and The Shallows surprises with its long historical view and balanced analysis of how media affects the quality of our thinking and reading. For every advance in information technology, there has been a clamour of voices warning of its dangers. When the Gutenberg press revolutionised the accessibility of information, Robert Burton, author of An Anatomy of Melancholy (1628), bemoaned the plethora of books and the mental befuddlement they caused. “One of the great diseases of the age is the multitude of books that doth so overcharge the world that it is not able to digest the abundance of idle matter that is every day hatched and brought into the world”. Sound familiar?

How the Internet Affects the Way We Read and Think

The basic conclusion of The Shallows is that what a new technology gives with the one hand, it takes away with the other. The more ease and convenience the Internet places before us, the more it takes away from our ability to exercise our brains more rigorously. It promotes light, scattered reading. And for all the information we so hurriedly glean, much of it is quickly forgotten. If it is remembered, it’s so fractured that it can’t be integrated into an overriding schema or logic that benefits our understanding of the world, or ourselves.

The Shallows provides many examples of how cognition is diminished by the Internet’s powerful ability to store, collect and sort information for us. In one study, two separate groups of people were set an identical online task. One group used programs that provided helpful prompts, therefore making the task more ‘user friendly’. The second group were not given these same prompts, but had to figure out the task more for themselves. Eight months later the two groups were assembled again to do the same puzzle. Those who had done the more intellectually demanding program, were able to complete the task twice as quickly as the ‘user friendly’ program group. Dutch Researcher Christof van Nimwegen found that the group using the more difficult program were able to plan ahead and plot strategy, while the other group relied more on trial and error to get through their puzzle.

Another study mapped how much information is retained when reading text with hyperlinks. Hyperlinks have been hailed by many educationalists as a new path to improved learning. To test this theory, Canadian scholars gave seventy people an Elizabeth Bowen short story to read, ‘The Demon Lover’. One group read the story straight through, without links. The second group read the story studded with hyperlinks, as you’d find in any online article. The hypertext readers in subsequent interviews on what they had read reported they found the story confusing and ‘very jumpy’. The other group had no such difficulties.

To add further alarm to this mix, one researcher tracked the eye movements of Web users, by attaching a small camera that plotted eye movements as they read pages of text. The eye reads Web pages in the shape of an F. We merely read the first few lines of text, then the eye quickly plummets to the bottom of the page. (Disheartening news for those writing online articles!)

What are the lessons to be drawn from The Shallows? The Internet is surely an awesome and powerful tool that has enhanced our lives incredibly. Who wants to go back to standing in bank queues when all your banking can be done from the comfort of home? What writer or researcher would want to go back to haunting the stacks and dusty corridors of libraries, when so much more can be accessed with the click of a mouse?

An over reliance, or obsession, with the Internet as the be all and end all of wisdom, intelligence and information, however, is a mistake. Just as pre-literate societies produced great oral poetry, and could cultivate a deep intellectual and philosophical consciousness, so can we moderns also find other routes to intellectual stimulation. Reading books without the non-stop interruptions of the Internet is one way. Sitting in a silent natural setting, and ‘reading nature’, is another way (again, studies have found that we think much more clearly in these peaceful environments).

A reading culture that is now moving inexorably to the Internet from the printed page is a culture of ‘F’ shaped reading: superficial, fragmented, shallow and forgetful. What this means for our intellectual and cultural future is anyone’s guess.

The Shallows: What the Internet is Doing to Our Brains, by Nicholas Carr. Published 2010 by W. W. Norton and Company. ISBN: 978-0-393-07222-8

The All New 2012 Toyota Camry

Toyota, the name to be reckoned with in the automotive industry, has been a major torch-bearer for all car manufacturer’s world over by constantly improving its car designs and features as anticipated by its customers. It made its debut nearly 3 decades ago and has been quite a successful car by Toyota Motor Company. After the last revamping of the Camry in 2007, Toyota is now giving a new lease to its design and features re-branding it as 2012 Toyota Camry and will be in race with Honda Accord, Ford Fusion and Hyundai Sonata. Originally, and still continuing, designed as the 4 door compact sedan, it will be rolled out in various model right from the basic one to the premium XLE and it all will be very much apparent after going through the following car review.

The architecture of the 2012 Camry will be based on the dimensions of its previous models with some minor changes. The new Camry is expected to roll out with somewhat bigger wheelbase which facilitates the comfortable cabin area. The aerodynamically designed styling will include lower roof line and the ground clearance level will also be reduced as a result it will offer comfortable transit through the sedan along with the comfortable headroom. This design offers sleek looks to the vehicle making its appearance bolder.

Under the aggressive metallic front the sedan is powered to generate 169 horsepower of momentum. This is facilitated with the power pack of 2.5 liters displacement along with four cylinder incorporated with 16 valves and operating on DOHC technology. Toyota will offer 2012 Camry with the latest assembly of 3.5 liter and V6 engine which is powered to produce the momentum of around 268 horsepower. These two engine mechanisms are believed to be mated with six speed manual transmission with the liberty to select even the six speed automatic transmission according to the interest of car enthusiasts. Design of these engines achieves fluency with front wheel drive system. The engine with 2.5 liter displacement is offers ultimate performance of 33 miles per gallon on city streets and 34 miles per gallon on highways.

Toyota’s 2012 Camry is offered with a wide array of innovative standard and optional features. The optional features may be standard with some trim models whereas the same can be optional for another. The standard features include power locks, power windows mounted with power mirrors and the rear view mirror. The dashboard offers sophisticated looks with the presence of tilt and telescopic steering wheel which is preloaded with audio system controls, USB connection to facilitate the functioning of iPods and MP3 player as well as Bluetooth connectivity which offers the luxury for communicating over phone keeping your hands free. The driver’s seat can be adjusted to easily command over the sedan. Additionally the rear seats are features with split function to give extra comfort. An array of optional features include key-less remote controlled start, moon-roof or sunroof, navigation system featured with touch screen and leather upholstery which gives luxurious feel.

The 2012 Toyota Camry is believed to come with innovative safety features such as override technology. This technology functions by cutting the fuel flow through the valves if the brakes and acceleration are applied at a same time. The addition of safety features include cruise control, traction control and vehicle stability control supported by anti-skid system and anti-lock disc brakes which offers grip over bad roads. The new Camry will come with unique star safety system from Toyota.

The sophisticated elegant looking 2012 Camry is expected to come by the beginning of next year carrying the beat deal rolling from $21,400 to $25,700. This innovative design with advanced styling supports the reputation of Toyota’s tradition.