Iowa Pain Center Services Over 24 Years Of Experience

Doctors For Sciatica Nerve Pain in Bellevue IA 52031

There’s nothing funny about being diagnosed with cancer, your Dad falling out a third floor window to his death and your wife and the authorities highly recommending that you get sober! But that is what May, 1998 looked like for me. I needed an alternative to cope with the curve balls life was throwing at me. I was very stressed-out and that’s when I decided to stop crying and start laughing my Doctors For Sciatica Nerve Pain Bellevue IA 52031 back to mental, emotional and physical health! I implemented a Stress Management Program through Laughter Therapy. What is Laughter Therapy? Laughter Therapy is a form of eustress that releases those bad and distressful emotions that cause harmful chemical effects on the body. Laughter Therapy is like any other form of aerobic exercise; that is why your stomach sometimes feels sore after a good belly laugh.

There are two stages to Laughter Therapy: 1) Bellevue IA 52031 Laughter Exercises -the arousal phase–when the heart rate increases–and the resolution phase–when the heart rests. A person’s heart can reach up to 120 beats per minute (bpm) when laughing. Laughing can lower your blood pressure, increase vascular flow, and boost the immune system. It gives the diaphragm, abdominal, intercostals, respiratory accessory, and facial muscles a complete workout. Some people, depending on how they laugh, may even use their arm, leg, and back Doctors For Sciatica Nerve Pain Bellevue IA 52031 muscles when laughing. 2) Laughter Meditation – Laughter also releases endorphins in the brain; these are our bodies’ natural pain killers. Endorphins are neurotransmitters that attach to the same receptors in our brains as the opiates. Opiate drugs not only cause us to lose touch with reality, but they also numb pain. When we laugh, it releases the endorphins in our brain; thus, laughing is like taking opium or morphine without the Bellevue IA 52031 adverse side effects.

Did you know children laugh on average of 400 times per day, and adults only laugh 15 times per day? So if laughter is so good, why are we not doing more of it? Dr. Madan Kataria, a Physician in Bombay, India started the first of the Laughing Clubs International in March of 1995. In a years time eighty clubs had spread throughout India, and Kataria hopes other countries Bellevue IA 52031 will follow their lead. The members of these clubs generally gather in the park in the morning before work. They raise their arms in the air, to erase inhibitions, and start with Ho-ho, ha- ha, Silent laughter with mouth closed, and then Silent laughter with mouth open. Some of the laughing clubs also incorporate jogging with their laughing. When asked why they did not just tell jokes to laugh he replied “at Bellevue IA 52031 first we did take the help of jokes, but the stock of good jokes was over after about 15 days. After that, stale and silly jokes came. Camel jokes, vulgar jokes. It was no good.” Members of the laughing clubs say they feel better, some say they have even lost weight, others say they are not depressed, and still others say it has helped to get out of the house, and meet Bellevue IA 52031 people.

In fact, I was so impressed with Dr. Kataria’ and his work that I personally invited him to Chicago for a speaking and press tour. I then decided to start my own Laughter Club, The Chicago Live Life Laughing Laughter Club, so I could receive monthly doses of laughter. http://www.dougdvorak.com

Do we laugh because we are happy, or are we happy because we laugh? Both of these are probably true, Bellevue IA 52031 but we only exercise the former. Laughter is a fascinating phenomenon that works like a medicine. Although most drugs affect everyone differently, laughter is always the same. It exercises your entire body causing you to feel relaxed and pain free. The fact that laughter is good for one’s health should be quite evident. So why not laugh? When one laughs, it is like taking a drug, yet there is no such thing Bellevue IA 52031 as an overdose or, “laughter toxicity,” as Kataria says. Maybe we can now say “A laugh a day keeps the doctor away.”

Doctors For Sciatica Nerve Pain in Hampton IA 50441

What exactly is a back pain generator and what role does it play in your back problem and cure? You have a pain in the back, maybe it is radiating down your leg. The pain is keeping you up at night, making sitting and bending and even driving a car a painful experience. You go to the doctor’s hoping he can relieve the pain in your backside. I am willing to Doctors For Sciatica Nerve Pain Hampton IA 50441 bet that the outcome of your visit will be much like mine was.

The doctor is probably pressed for time. Most doctors have only ten or fifteen minutes per patient. That means that in a very short period of time he or she will ask you some questions, give a quick exam, make a diagnosis and prescribe a treatment program which will probably include a prescription drug. But did the doctor identify Hampton IA 50441 your pain generator? More than likely he or she will give you an off the cuff diagnosis. This diagnosis will usually be something too vague to be of any real use.

Or sure the pain relievers and muscle relaxants prescribed will ease the pain and give you temporary relief. Hopefully you get lucky and the back will heal itself. But chances are the pain will return. If the pain does return you Doctors For Sciatica Nerve Pain Hampton IA 50441 will probably be referred to a physical therapist, who, like the doctor is also pressed for time and more than likely will use the doctor’s diagnosis as a basis for treatment. Unfortunately all this is doing is addressing the symptoms and not the cause of your pain.

This is exactly what happened to me and when the therapy and drugs did not work I had an MRI and finally surgery. Unfortunately the Hampton IA 50441 pain did not go away. That is when I began looking for alternatives and stumbled upon the term pain generators.

A pain generator is a part of the body that is causing the pain. It might be a bulging disc or a deep muscle spasm in the buttock. In my case the MRI showed a disk that had ruptured. The operation corrected the problem, but the pain returned. Why, because as I Hampton IA 50441 found out later the real problem was the Priformis Muscle. This is a large muscle located in the buttocks which the Sciatic Nerve rounds through. Because of muscle imbalance the Priformis had a deep spasm that was putting pressure on the Sciatic Nerve and that was the pain generator. Once the pain generator was identified a proper series of exercises to restore muscle imbalance gave me real pain relief. If I Hampton IA 50441 was given the proper diagnosis the first time I could have avoided surgery and therapy. But this time instead of being based on a vague diagnosis there was a specific cause and treatment could focus on this cause and not the symptoms.

There are many causes of back pain and sometimes it is a bulging disk. But many people walk around with bulging disks and never have a problem. In many cases Hampton IA 50441 muscle imbalance maybe the cause resulting in muscle weakness and spasms. The muscle imbalance could be caused by your body compensating for an injury or disk problem, but until the imbalance is addressed chance are the pain will continue.

The point of this article is to encourage you to be assertive with your doctor and the treatment he provides. This can be corrected by designing the correct exercises to treat the imbalance. Hampton IA 50441 By working with your doctor and therapist and identifying the pain generator you, the patient now have a definitive plan of action. A plan that if followed will be permanent solution to your back pain.

Doctors For Sciatica Nerve Pain in Corwith IA 50430

Hemorrhoid removal. You’ve tried everything else and now you’re left with a treatment option you really don’t want to have to consider. If you have painful and bleeding hemorrhoids, you probably have a lot questions. “How do I know if I need surgery?” “If I do, what are my options?” “What kind of doctor should I see?” “What are the risks?” Doctors For Sciatica Nerve Pain Corwith IA 50430 “What should I expect before, during, and after surgery?” “Will surgery stop hemorrhoids from coming back?” This article answers some of the most frequently asked questions about hemorrhoid removal.

When Should I Have Hemorrhoid Surgery?

If you have substantial bleeding and pain, it’s time to call the doctor. If your doctor diagnoses your problem as thrombosed external hemorrhoids, which means your hemorrhoids contain Corwith IA 50430 blood clots, or large internal hemorrhoids, he or she may recommend surgery. Hemorrhoid removal is often accomplished through surgery known as a hemorrhoidectomy.

To determine whether you need surgery, your doctor will perform a rectal examination. The doctor wants to rule out other possible causes of your bleeding and pain. Methods your doctor may use to diagnose your condition include:

 

  • Performing an Doctors For Sciatica Nerve Pain Corwith IA 50430 anal examination, by inserting a finger into your anus to feel for a blockage or abnormal growths.
  • Performing an anoscopy, by looking through a small, lit tube, known as an anoscope, to examine the anal canal and lower rectum.
  • Inserting a proctoscope, which is a thin tube containing a camera and a light, into the rectum to examine its interior more Corwith IA 50430 thoroughly. This procedure is called a proctoscopy.
  • Performing a sigmoidoscopy, which examines the rectum and the lower part of the colon to search for polyps. The doctor uses a sigmoidscope, which is a flexible tube that can cut off any polyps discovered. Polyps are growths of tissue extending from mucous membranes. They are usually nonmalignant.
  • Performing a colonoscopy, in which the Corwith IA 50430 doctor sees and examines the large intestine and the rectum, using a long, flexible tube called a colonoscope.

 

Unless there is reason to suspect other problems, your doctor will probably confine the examination to one of the first three methods. If the doctor discovers large internal hemorrhoids or believes your external hemorrhoids warrant surgery, he or she may recommend surgery for Corwith IA 50430 hemorrhoid removal.

What Types of Hemorrhoids Surgery Do Doctors Perform?

Doctors, generally, perform one of two types of surgery to complete hemorrhoid removal: stapled hemorrhoidectomy and conventional hemorrhoidectomy. Let’s look briefly at each.

Stapled Hemorrhoidectomy: Procedure for Prolapse and Hemorrhoids (PPH) Stapled hemorrhoidectomy surgeries are often referred to as PPH. This stands for the “procedure for prolapse and hemorrhoids.” Generally, it’s recommended for people Corwith IA 50430 who suffer with Grade III or IV hemorrhoids, which means their hemorrhoids have prolapsed, or dropped below the anus.

Basically, the surgery staples prolapsed hemorrhoid tissue back into its original position. Because this position is above what is known as a pain line, fewer nerve endings are involved, resulting in less pain for the patient. The staples cut off the blood flow Corwith IA 50430 to the hemorrhoid, which starves it to death.

Benefits to the patient of the procedure include less pain, shorter recovery times, and fewer complaints of post-surgery complications.

Drawbacks to the procedure include a higher incidence of recurring hemorrhoids. Also, some patients complain of pain during bowel movements and internal itching from the staple.

Hemorrhoidectomy: A hemorrhoidectomy actually removes the hemorrhoid, including blood clots and Corwith IA 50430 blood vessels that feed the hemorrhoid. It’s usually performed as an outpatient procedure.

Hemorrhoidectomies offer the most success in preventing the return of hemorrhoids, but patients who have them also experience the most significant complications. Complications include incontinence, frequent gas and bloating, and leaking fecal matter.

Other Minimally Invasive Procedures for Hemorrhoid Removal

If you are a candidate for a less serious form of Corwith IA 50430 surgery, your doctor may perform what is known as a minimally invasive, or fixative, procedure. These procedures focus on cutting off the blood flow to the hemorrhoid rather than removing the hemorrhoid. The most common forms include:

Excision: In which the blood clot of a thrombosed hemorrhoid is removed

Rubber band ligation: In which rubber bands are placed around internal hemorrhoids, cutting off Corwith IA 50430 their blood supply

Sclerotherapy: In which a solution is injected into the hemorrhoid, shutting down entry paths for blood to feed the hemorrhoid

Laser: In which lasers are used to burn and cauterize the ends of hemorrhoid tissue, thereby blocking blood flow to the tissue

Each has a less successful track record in treating Grades III and IV hemorrhoids than hemorrhoidectomy surgery.

What Type of Corwith IA 50430 Doctor Removes Hemorrhoids?

Patients who have had good success with their surgery highly recommend letting a colorectal surgeon do the procedure. These surgeons are also known as colon and rectal surgeons or proctologists. Proctologists specialize in treating diseases of the large intestine, which includes the anus, rectum, and sigmoid colon. You can find a board-certified specialist near you by searching the Corwith IA 50430 American Society for Colon and Rectal Surgeons (ASCRS) website.

What Should I Expect?

Before the Surgery: Your doctor will give you a regimen of things to do to prepare for the surgery. This will probably include directions about what and how late you can eat the day before. Your bowels will need to be emptied prior to the surgery, so you will Corwith IA 50430 be instructed on how to do this. Because you will be placed under anesthesia during the surgery, you will also need to have someone drive you home later. You will be asked to arrive at the outpatient center by a certain time to be prepped for surgery.

During the Surgery: This depends on the type of surgery you receive. In any type, Corwith IA 50430 you will be placed under anesthesia to eliminate pain during the procedure. You may or may not be awake during the procedure.

If you have the stapled hemorrhoidectomy, the doctor will lift the hemorrhoid tissue back in place and then use a circular stapling tool to staple it.

If you have a conventional hemorrhoidectomy, the doctor will

 

  • Make an incision in the hemorrhoid Corwith IA 50430 tissue.
  • Remove any blood clots.
  • Remove the hemorrhoid blood vessels.
  • Remove the hemorrhoid.

 

Some doctors use sutures to close the area. Others think healing is more successful when the wound is left open. The doctor will pack the wound with gauze to absorb bleeding.

After the Surgery The surgical staff will keep you in the outpatient center until the anesthesia wears off. Corwith IA 50430 When you awaken, you will be asked to urinate. This provides the nurses an important clue about whether you have experienced any problematic swelling or spasms in your pelvic muscles. Your nurse will read to you important instructions and precautions to take for the next few days before releasing you. They will probably include things like:

 

  • Don’t drive for the next Corwith IA 50430 24 hours because you’re recovering from the effects of being under anesthesia.
  • Don’t sign important papers.
  • Don’t operate any machinery.
  • Don’t drink any alcohol.
  • Don’t do any heavy lifting.

At-Home Care: Some people experience complications; some don’t. Once you return home, expect some pain. Your doctor will probably prescribe pain medication and perhaps antibiotics. Avoid any aspirin products for at least Corwith IA 50430 two weeks after your surgery. Aspirin can lead to bleeding.

 

Concentrate on keeping stools soft to avoid inflaming areas that are healing after surgery. This may require that you take stool softeners. Begin eating a healthy, fiber-based diet as soon as possible. Drink lots of fluids to soften fiber bulk and keep your stools soft. Some recommend eating broth or other clear Corwith IA 50430 fluids for a couple of days after the surgery to give your body a rest from having bowel movements.

You may experience bleeding with your first few bowel movements. This is not a cause for worry.

While healing, take sitz baths, use ice packs, and sit on a cushion to lessen your discomfort. Wipe yourself with dampened, or medicated, wipes, such as Tucks, Corwith IA 50430 after bowel movements and baths. Make sure you dry yourself completely. Apply a zinc oxide cream or petroleum jelly for soothing.

Your doctor will schedule a return office visit about two to three weeks after your surgery to monitor your progress. At that time, your doctor may discuss scheduling a colonoscopy in the near future to check your entire lower digestive tract Corwith IA 50430 for any potential problems.

Is It Painful?

Most people experience some pain after the surgery. Many will be able to control it with simple over-the-counter-medications, such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). Some will require prescribed medication, such as Percocet.

Common complaints include:

 

  • Spasms (Botox is being studied as a possible remedy)
  • Pain when defecating, especially the first few times after Corwith IA 50430 surgery
  • Internal itching after defecating
  • An urgency to eliminate frequently

What Are the Risks?

 

It is estimated that hemorrhoidectomy surgery is successful in about 95 percent of cases. Still, patients can experience some rather unpleasant side effects, including:

 

  • Pain
  • Bleeding
  • Infection
  • Incontinence
  • Stool leakage
  • Inability to urinate due to swelling and spasms in the pelvic area
  • Bad reactions to anesthesia
  • Bloating Corwith IA 50430 and gas

How Successful Is It?

 

The success rate for hemorrhoid removal is about 95%, but this is contingent on the patient making dietary and lifestyle changes. Without these changes, hemorrhoids may recur. For Grade III or IV hemorrhoids, hemorrhoidectomy, or hemorrhoid removal, seems to offer the best long-term results of all the medical procedures. The downside? The procedure costs more, Corwith IA 50430 causes many patients more pain, costs patients more time away from work as they recover, and results in a higher rate of complications than other medical treatments.

How Long Does It Take to Recover?

Best case: Expect about a two-week recovery period after undergoing a hemorrhoidectomy. For most patients, it takes at least three weeks, and can take as long as three to Corwith IA 50430 six weeks to get back to normal.

What Will It Cost?

Costs vary widely. The best thing to do is consult with your insurance company. If you are not insured, you may encounter the following range of costs:

 

  • Rubber band ligation: $500 to $1500
  • Laser or infrared coagulation: $400 to 500 per treatment, with about four treatments on average needed
  • Hemorrhoidectomy: $9000 to Corwith IA 50430 $12,000

No More Hemorrhoids

 

As always, the best treatment is prevention. For most people, the key to preventing hemorrhoids is preventing hard stools. Hard stools lead to straining on the toilet; straining leads to hemorrhoids. Hard stools bruise hemorrhoids, leading to bleeding hemorrhoids. Repeated instances of this behavior with no change in diet and lifestyle can lead to surgery. Lesson: eat right Corwith IA 50430 and exercise.

Doctors For Sciatica Nerve Pain in Casey IA 50048

It appears that almost everybody encounters lower back pain at least once in their life. It can be added to a wide range of issues from muscle strain, tumor, herniated disc, osteoporosis, aging, lifting too much weight, a previous injury, and even stress.

Back pain influences almost 80% of Americans and the most widely recognized type is Lower Pain. Since you depend on your back for verging on Doctors For Sciatica Nerve Pain Casey IA 50048 each move you make, it tends to hurt the most. The pain can even be debilitating. It is a standout amongst the most widely recognized issues inciting a visit to your doctor and for missing work. Indeed, it is the second most elevated reason for disability in people less than 45 years old.

It is critical to discover what is causing this problem by your primary care physician, Casey IA 50048 however, here are some natural remedies for back pain to consider before your next doctor’s appointment. In spite of the fact that individuals grumble of back pain in, it is not a diagnosis but instead a sign of a hidden issue.

There are two type of pain, chronic and acute. Acute pain is a pain with another onset. It occurs suddenly, generally because of an injury. It is Doctors For Sciatica Nerve Pain Casey IA 50048 normally recovered in one month however not over 6 weeks span. Chronic pain is pain that can have a snappy or moderate onset, however it lasts for longer period. In spite of the fact that it lasts for more than 3 months, a few people experience a lifetime of chronic pain. Chronic pain is not very common type of pain.

What causes back pain?

There are a few causes Casey IA 50048 including different physical and enthusiastic variables that can result in back issues. If it left untreated, can prompt a weakening level of physical uneasiness.

Among various explanations behind back pain, the absolute most basic reasons are:

1. Strenuous physical activities, for example, weight lifting

2. Wrong stance while sitting or standing

3. Sitting for delayed hours similarly situated

4. Stomach issue

5. Pregnancy – Every pregnant lady experiences the pain enduring at a Casey IA 50048 few or the other purpose of time amid the pregnancy time frame. This is particularly so amid the most recent couple of months of pregnancy.

6. Utilization of high heels – This causes strain in the back muscles, prompting extreme pain

7. Open spine surgery can likewise result in FBSS (fizzled back spine surgery), which can prompt incessant hurt in the back, arms or legs. Different causes incorporate spondylosis, Casey IA 50048 herniated circle, sciatica, and spinal stenosis.

What is the right treatment?

In order to find the right remedy for your back pain, you need to get it checked by a specialist. Only after getting it diagnosed, you can opt for natural remedies for back pain. Also, upon visiting a doctor, you should give a clear concise description of your problem. Your doctor should know how the pain began, what Casey IA 50048 you were doing when it began, how serious it is, does it go back and forth or is it steady, and what exacerbates the pain better or worse. There are various natural remedies you can choose such as regular yoga, acupuncture, oil massage, spa and more.

Doctors For Sciatica Nerve Pain in Norwalk IA 50211

By Kevin Nimmo –

Dr. Gregory Futrell, DC, Salt Lake City, has practiced as a Board Licensed Chiropractic Physician in Salt Lake City for the last thirteen years. He is a graduate of Palmer College of Chiropractic and owns Canyon View Chiropractic where he specializes in treating athletes, professionals and many others seeking therapy and treatment for their conditions.

Dr. Futrell uses state of the art techniques to treat low back pain, headaches, neck Doctors For Sciatica Nerve Pain Norwalk IA 50211 pain, fatigue, sleep disorders and auto accident rehabilitation. Today we are focusing in on chronic low back pain and what therapies and corrective measures are available for rehabilitation and pain relief.

Dr. Futrell believes in the merits of Spinal Decompression Therapy for low back pain. He explains that the technology has been around quite some time but has just recently caught the public’s attention with the introduction of some new devices. Therapy on Norwalk IA 50211 these machines can be cost prohibitive he explains. Dr. Futrell added that he personally believes in the therapy, has successfully used it on many of his patients and believes in making it affordable for those that need it. He goes on to explain that he personally consults with every client to make sure they are an appropriate candidate for therapy.

We took a few minutes out of the doctor’s busy schedule to ask Doctors For Sciatica Nerve Pain Norwalk IA 50211 him about Spinal Decompression Therapy, how it works and who it can help.

Doctor, what is spinal decompression therapy and how does it help to alleviate pain?

Dr. Futrell: Spinal decompression therapy is really a traction unit with intermittent degrees of pulled force, allowing mobility in the specific area, unlike static traction that has shown to be less effective. It’s been found that as you are able to keep more of a pumping type Norwalk IA 50211 action into the spine and into the joint it allows for the joint to hydrate more, creating more space, and allowing for the muscles to relax better, bringing the bulging disc or the herniated disc or even just the joint itself more space. How it helps alleviate the pain is to create more space in there, it takes pressures off those structures as well as any kind of spasm.

What specific symptoms does Norwalk IA 50211 this therapy treat?

Dr. Futrell: It can help the low back, neck pain and radiating pain, such as sciatica or symptoms into the shoulder, arm and hand. The symptoms would be more or less the pain, spasms as well as numbness, tingling, pain or even weakness in some cases.

Is this an actual long term solution to the problem of a compressed or out of alignment disc in the patient’s spine?

Dr. Futrell: It can Norwalk IA 50211 be yes, absolutely. It’s probably one of the best non-surgical ways of treating a disc or just the low back or joint problems in general. However, it’s important to understand that even after the symptoms have been resolved, discs do not heal perfectly and the patient can be vulnerable to reinjuring it, even worse than before. I will council people on how they can maintain a strong and healthy back including recommendations Norwalk IA 50211 on proper exercise, posture and activity. In many cases, during the treatment with Spinal Decompression I recommend the need to implement other types of therapy, specifically exercise and soft tissue massage

Is it possible to get ongoing treatment and still go about your normal activities?

Yes, that’s what quite a few of my patients do.

How many treatments are necessary to see results?

The standard is usually close to about twenty visits but normally people will Norwalk IA 50211 see some changes within the first couple of treatments. More than likely within the first ten treatments they will start to see a more substantial reduction of their symptoms.

Doctor, what considerations do you think are necessary to make certain you are a good candidate for this kind of therapy?

Dr. Futrell: MRI is always a good way to determine if you are a good candidate or even if they need other types of Norwalk IA 50211 treatment. In many cases just the fact that they’re having some signs of nerve impingement of the low back or up in the cervical spine. Usually the standard way of determining that is through an X-Ray or an MRI.

Is there another therapy that you recommend in conjunction with Spinal Decompression Therapy?

Dr. Futrell: I always recommend some kind of therapies, usually prior to the Spinal Decompression. It could range anywhere from soft tissue Norwalk IA 50211 manipulation such as massage, far-infrared, some light therapy or physical therapy modalities such as ultra-sound or electrical muscle stimulation as well as adjustments. It could be any combination of these therapies prior to the Spinal Decompression Therapy. Afterwards, it’s highly recommended, especially in the initial treatments, to employ ICE, some light range of motion or stretches after the treatment and then later on training them in some therapeutic exercises and stretches so Norwalk IA 50211 they can maintain and stabilize that area.

Doctor, is there any reason for a patient to believe, once treated, that they will have to come back for more treatments sometime in the future?

Dr. Futrell: It’s going to be case by case depending on how severe the bulge or herniation may have been. In most cases the nature of the disc is that it’s not vascular, the tissue that is in the disc is Norwalk IA 50211 very difficult to heal and so if there is any kind of disruption of the structure itself, whether it’s stretched or torn, there’s always going to be that possibility that it could be weakened. For that reason it’s highly recommended that they continue to exercise and maintain that area. They have to really watch it so they don’t slip back into a bad situation.

Doctor Futrell, thanks for giving us some background on Norwalk IA 50211 Spinal Decompression Therapy

Dr. Futrell: You’re welcome.

Dr. Gregory Futrell, D.C. Salt Lake City, operates Canyon View Chiropractic which offers a full range of chiropractic services including treatment for auto injuries, arthritis, sports injuries, headaches and migraines, osteoporosis and many other conditions. He can be contacted at 801-944-8700. His business website is canyonviewchiro.com

Kevin Nimmo is an online media strategist and writer. He interviews subject matter experts and educates his readers based on information provided Norwalk IA 50211 by experts in their respective fields. He is also Executive Editor of The Western Medical Journal.