The World Authority
on Orthopaedic Medicine
Orthopaedic Problems, Innovative Solutions, Since 1983
Message from the President
Paul Lieber, MD

Paul LieberI am saddened by the passing of one of the pioneers in prolotherapy, Jeff Patterson, DO.

I first met Jeff in 1998 at the Annual Hacket Hemwall Foundation (HHF) meeting in Madison on the brink of Gus Hemwall's death. I didn’t fully realize the importance of his passing as this was my first exposure to the world of prolotherapy. Jeff organized an excellent conference and the new science that I learned truly inspired me and gave me a new perspective for patient care. We discussed going to Honduras, but taking 2 weeks away for what promised to be a great hands on learning experience was not an option at the time. Eager to learn more about prolotherapy, I pursued training from a variety of educational settings that included extended time with Kent Pomeroy, courses with the Osteopathic Society for Pain Medicine and Sclerotherapy and ultimately by the AAOM.

Our paths continued to cross in the world of prolotherapy over the years. I invited Jeff to present about the History of Prolotherapy at the AAOM Annual Conference in 2012. In listening to his lecture in 2012 and now in understanding his passing, I realize how much Jeff is the legacy of prolotherapy. And, with Jeff, as with Gus Hemwall, I am only just beginning to realize the significance of their efforts and their passing.

Jeff Patterson died suddenly on January 24th, 2014 while on vacation in NYC. Jeff was a passionate man. He was President of the board of the Hacket Hemwall Foundation for over twenty years. He taught prolotherapy to many hundreds of physicians worldwide and treated countless thousands of patients for free during yearly HHF missions to Honduras. Jeff’s name was synonymous with prolotherapy; he was world–renown. For those of you who don't recall, he was an active AAOM member for approximately 30 years who also served on the BOD and was at one time Secretary –Treasurer. He was an excellent educator and mentor whom I speculate influenced most of us in some significant way over the years.

He was an activist and a visionary. He taught classes through the Department of Family Medicine at the University of Wisconsin School of Medicine on Physician Activism. He was a founding member and served twice as President for the Physicians for Social Responsibility. Jeff's dream was to reverse climate change, abolish nuclear weapons and promote world peace and he worked tirelessly and endlessly travelling the world lecturing and pitching in to help achieve those goals.

At the time of his death, Jeff was with his life partner, Mary Doherty, inseparable, they were vacationing together. In all aspects, he seemed in the prime of his life and was full of vigor. At the time, he was a Professor Emeritus at the UW Medical School where he began his tenure in 1973. He continued to teach and maintained an active practice until the time of his death. He was a principled and spirited man whose life was cut short well before it should have been.

I talk about Jeff now to let you know the AAOM has established a Jeff Patterson, DO Scholarship Award. The AAOM Board met on April 9, 2014 in Clearwater and we felt we wanted to create a way to memorialize Jeff for all of his years of service and involvement in the AAOM. We agreed the best way to perpetuate his memory and his passion for education and prolotherapy, was to create a Scholarship award to encourage continued learning in Orthopaedic Medicine and prolotherapy. The AAOM will award tuition to one MD or DO to attend an International Prolotherapy Workshop each year. We are working to finalize the details and hope to award the first Scholarship in 2014.

Editor's Column: Internet Neutrality and the Evolution of Medicine
Dr. HarshfieldFrom D.L. Harshfield, Jr. M.D., M.S.

In medicine, reviewing our past is often the best way to get our heads around the future (unless our heads are as empty as the above skull films imply). As with most challenges, inequality is the bell ringer, and as usual the biggest force behind most inequality is education, or lack thereof.

SelfieThe internet may be the key to not only understanding the current issues, but in solving them as well. Computational social science teaches us that although humans may not necessarily be evolving at an individual level, the ongoing transformation in the way we communicate and work together is creating a unified intelligence.

For 50,000 years humans wandered the earth in remote, secluded outposts as members of very different tribes. With the growing population of the earth, we no longer have the room or luxury of remaining isolated. Fortunately, the global enlightenment provided by the World Wide Web is helping to diffuse the inevitable conflict that comes from the crowding of cultures and societies. As the internet is teaching us, the desire to synchronize is inherent in our species, and as with shared music, dance and culture, synergy is a byproduct of the growing unified intelligence.

It is the rule rather than the exception these days that many groups of people can speak very different languages and yet enjoy the same music and share the same mathematic formulas. Music and mathematics comprise the universal language of our species. So what do we send aboard our earth projectiles fired into outer space as representative of the human race? –Elvis Presley records and mathematics formulas.

The internet has allowed virtual strangers to trade knowledge and share experiences, bringing everyone closer. Communication technology and social media work by pooling worldwide experiences to make our individual experiences better. This merging of humanity into a single "mind" may not just make for a superior race, but could just make for a superior species (Mammals, by the way, in the grand scheme of things represent one of the rarest of all earth bound species, consisting of those air breathing vertebrates who walk upright and have live offspring). But alas, on May 15, the mischievous Federal Communications Commission (FCC) is bringing to a vote a potentially devastating "man made" change to the ongoing "natural evolution" of the World Wide Web.

Despite the fact that the internet was an American invention, there is a proposal to turn control of the internet over to other countries and interests. There is also a consideration to allow (for a "nominal phenomenal" fee paid to the FCC) the use of an internet "fast lane". Not to advocate the status quo, but the internet is already rapidly changing every day based on the growing "unified intelligence" of planet earth and in a somewhat orderly fashion. But these two "man made" alterations of the internet do not appear to represent the ongoing natural evolution of the web, and therefore may have significant unintended consequences.

Currently, other than the sheer volume of spam, there is no real hierarchy of the traffic or communication on the internet. By giving corporations (such as the pharmaceutical industry and device manufacturers) and other wealthy interests access to a "fast lane", the smaller, slower voices will be minimized. We long ago revised the old adage that 'the big eat the small' into 'the fast eat the slow'. There is no question that the proposed "faster" message on a future "two lane" internet will win out over the "slower" message.

Thus, May 15, 2014 represents yet another date in the long history of confrontations between "government rules and regulations" versus "unrestrained private interests". And medicine will not be unaffected by the outcome of this mischief. At our recent AAOM annual meeting, Dr.s Mayo Friedlis and Andrew Kochan provided an excellent perspective on the history of Orthopedic Medicine, which by the way has also benefitted greatly by the developing World Wide Web. These scholars pointed out that although Orthopedic Medicine had been around for decades, in the absence of honest and verifiable open source communications prior to the internet, it went through a mid 20th century black out.

The "dark ages" for Orthopedic Medicine was brought about by the overzealous and over promising pharmaceutical and orthopedic surgical industries back in the 1960's. Instead of utilizing the existing safe, effective and inexpensive Integrative Orthopedic Medicine techniques (such as nutritional therapy, osteopathic manipulation, proliferative (prolo) therapy and regenerative injection therapy) the medical community was convinced by the existing "peer reviewed" world literature that narcotics and surgical techniques were the way of the future.

In fact, Medicine is replete with excruciating examples of sheer ignorance and idiocy perpetuated in the absence of an internet or even an honest, open access medical literature. But the ongoing development of drug resistant bacteria is proof that even the presence of a pristine and open source internet holds no guarantees. In ancient Egypt, physicians serendipitously but successfully treated infections with molded bread. In 1929, Alexander Fleming discovered penicillin, but it still took the health care industry over a decade to bring the antibiotic era into practice. And despite the enormous capacity and connectivity of the modern internet, over and misuse of antibiotics by mis/uninformed doctors (and patients) has now resulted in the creation of antibiotic resistant superbugs with a propensity to eat mammal flesh.

And although physicians like to bask in the glory of modern accomplishments, the practice of treating patients in absentia was not invented by this generation of internet savvy health care workers. In fact, the medical profession’s tendency to lead from behind was the basis for lawyers providing the first medical therapy by mail. Few doctors braved the trip to the New World, so any educated person was expected to practice medicine in early colonial America. For instance, the Governor of Connecticut, John Winthrop, was a lawyer who also developed a large medical practice. The Governor had several "distant patients" he treated only by mail. But in those days, just having a faster horse than another practitioner to deliver your letters in less time would have little ability to deleteriously alter the practice of medicine. Certainly not in the way having access to a "fast track" on the broad band internet might change Medicine in today's world.

If, as most believe, patient centered health care is the way of the future, two things must co–exist. First, for there to be "patient centered health care", the physicians must step out of the middle of the circle. And second, a free and open internet will be a necessity. Thus, the FCC's existing proposal to induce a dichotomy of the internet into a "fast" and "not so fast" (a.k.a. half–fast) service could thwart all that. Barriers are used to separate factions, but in general walls serve two functions; to keep people out and to keep people in. Over history, humans do not react well to barriers. Human beings are restless, always looking over the rainbow and past the next horizon, not wanting to be limited by either.

The AAOM is the one organization on our ever shrinking planet with the credentials and insight to restore the importance of the practice of Orthopedic Medicine both to patients and physicians alike. And the ICMS (International Cellular Medicine Society, also a global organization) is functioning to review protocols and certify centers of Orthopedic Medicine around the world. The correction of Medicine is inevitable and patients can have an enormous voice, but amidst the current turmoil of misinformation, the public trust is currently up for grabs. The disenfranchised electorate of angered patients has the power to unleash the flying monkeys– but will they, and upon whom? Regardless, the AAOM and the ICMS can bring calm to the crisis by providing the safe, simple, effective and affordable answer for which this chaotic health care system is desperately Googling.

The Internet and the U.S. Health Care System are each now recognized as essential parts of American Society; in essence they have achieved the stature of "Utilities". And if history is any indicator (not unlike the railroads, the oil and gas industries and electricity) the two entities have become infrastructural services that "must be regulated". Providing the much needed insight and education will be best served by a "neutral, free and open" access to the internet and by having a level playing field in the Health Care Industry. But even unified intelligence doesn't guarantee wisdom. As we continue to be taught by Medicine in general and Radiology in particular, it doesn't matter how many resources you have, if you don't know how to use them, they will never be enough.

IllustrationThis editorial is meant not to present one side of or to defend any particular position. Hopefully, this will provide information that will open minds to knowledge, the floor for discussion and the world to wisdom induced action.

You don't have to be a light house, you can be a candle, and nothing is lost when one candle lights another.

Orthopaedic Medicine Matters
From D.L. Harshfield, Jr. M.D., M.S.

Stethoscopes Can Be More Contaminated Than Doctors' Hands
February 28, 2014
[Watch the Video: Physicians' Stethoscopes More Contaminated Than Palms of Their Hands]
Healthcare workers hands are the main method of bacterial transmission in hospitals. They are not, however, the only means of transmission. According to a new study from the University of Geneva Hospitals, doctors' stethoscopes also play a role. The study, published in the Mayo Clinic Proceedings, assessed the level of bacterial contamination on doctors' hands and stethoscopes following a single physical examination.
Read the article >

A Breathalyzer for Lung Cancer May Be On Its Way
Researchers haven't made a cancer-testing breathalyzer reality yet, but a doctor in Kentucky has reported success in scanning exhalations for four cancer compounds that can distinguish between lung tumors and benign growths
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Experts: "Cancer" should not be used to describe certain slow–growing lesions.
The Wall Street Journal (5/5, Subscription Publication) reports that a group of experts advising the National Cancer Institute contends that the word "cancer" should not be used to describe certain slow–growing lesions. The experts, in Lancet Oncology, argue that current technology allows physicians to find small cancers that likely would never become lethal.
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Health care spending surges in first quarter
Health care spending rose at the fastest pace since 1980 in the first quarter as the new health insurance law prompted many more Americans to visit doctors and hospitals. Analysts say the sharp increase reflects other trends that should continue to drive up both medical spending and costs in 2014 after years of slow growth. Health care expenditures climbed at a 9.9% annual rate last quarter, mostly because of increased spending at hospitals, the Bureau of Economic Analysis said last week. That's the biggest jump since 1980's third quarter, and it followed a 5.6% increase in the fourth quarter.
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Medical Schools Embrace Alternative Medicine
Now that nearly 40 percent of American adults swear by some form of complementary and alternative medicine, or CAM–from nutrition and mental relaxation to acupuncture, magnet therapy, and foreign healing systems like traditional Chinese medicine and Indian ayurveda–a growing number of medical schools, too, are supplementing medication with meditation.
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Old mice transfused with blood from younger mice get smarter, exercise better.
The Wall Street Journal (5/5, A8, Winslow, Subscription Publication) reports that according to newly published research, when geriatric mice get blood transfused from younger mice, they get smarter, learn faster, and can exercise better.
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Spinal Corticosteroids Run Risk of Severe Neuro Effects
Epidural injections of corticosteroids to relieve pain – a widespread, off–label use – run the rare risk for blindness, stroke, paralysis, and death, the US Food and Drug Administration (FDA) announced today.
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The Correlation between Food and Joint Pain
Patients with autoimmune diseases such as, rheumatoid arthritis, systemic lupus erythematosus, or Sjogren’s disease are typically given protocol–driven treatments with limited success because an acute care model is given to a chronic problem while the underlying causes are never investigated.
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Vision Test Improves Concussion Detection
PHILADELPHIA — A simple vision test performed on the sidelines can improve the identification of concussion in sports players who have experienced a head injury, a new study suggests.
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Young Blood May Hold Key to Reversing Aging
Two teams of scientists published studies on Sunday showing that blood from young mice reverses aging in old mice, rejuvenating their muscles and brains. As ghoulish as the research may sound, experts said that it could lead to treatments for disorders like Alzheimer's disease and heart disease.
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10 Minutes That Can Save Your Life!
By Michelle "Shelly" Voelker, BS, Biological Sciences

Shelly Voelker10 Minutes That Can Save Your Life!
On February 20, 2014, Gallup–Heathway's researchers unveiled new data from their annual survey, "The State of American Well–Being; 2013 State Rankings and Analysis". This year there has been a marked increase in the rate of obesity across all states. Mississippi and West Virginia are the most obese states in the country with 35% of people in both states qualifying as obese. What really stands out in the study is that in 2012, just 1 year earlier, only 5 states registered more than 30% of their population as obese; and yet, in 2013, every state in the top ten most obese states had surpassed the 30% mark.
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Speed Read

Dropped your toast? Five–second food rule exists, new research suggests
Food picked up just a few seconds after being dropped is less likely to contain bacteria than if it is left for longer periods of time, according to the findings of research carried out at Aston University's School of Life and Health Sciences.
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Every Minute Matters With Clot–Busting Stroke Drug: Study
THURSDAY, March 13, 2014 (HealthDay News) — Every 15–minute delay in receiving a clot–busting drug means stroke survivors will have about one month less of a disability– free life, while every minute sooner that they receive the drug translates into more than one extra day of healthy life.
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As the world celebrates International Day of Happiness today (Thursday, 20 March), can we tell whether people are truly happy just from their laugh? SCIENCE DAILY
A researcher from Royal Holloway, University of London, has found that there are clear differences between how our brains respond to genuine and fake laughter.
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Precise reason for health benefits of dark chocolate: Thank hungry gut microbes
The health benefits of eating dark chocolate have been extolled for centuries, but the exact reason has remained a mystery — until now. Researchers have just reported that certain bacteria in the stomach gobble the chocolate and ferment it into anti-inflammatory compounds that are good for the heart.
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Severe Anger Outbursts May Trigger Cardiovascular Events.
CNN (3/4, 14.53M) reports on its "The Chart" blog that research published in the European Heart Journal indicated that individuals "who experienced severe anger outbursts were more at risk for cardiovascular events in the two hours following the outbursts compared to those who remained calm."
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Spinach extract could help prevent obesity, study shows
A natural compound hidden away in spinach has been shown to reduce food cravings between meals and could help prevent obesity, a Swedish scientist said on Monday.
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Vision Loss Reported After Cosmetic Facial Injections
Irreversible vision loss should be added to the list of potential complications associated with injection of cosmetic facial fillers.
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AAOM Upcoming Events
AAOM Annual Workshop – Register Now

Regenerative Orthopaedic Medicine
—The Works—
"Why it Works – How it Works – When it Works"
Treatment of the Lumbo-Sacral Spine and Lower Extremities

SERI (Scientific, Education, Research Institute)
9005 Grant Street, Thornton, CO 80229
August 8 & 9, 2014

Register Now at www.aaomed.org

The AAOM continues to raise the bar in training in Regenerative Orthopaedic Medicine:

The AAOM Annual Workshop; "Regenerative Orthopaedic Medicine" —The Works&mdashl "Why it Works – How it Works – When it Works" Treatment of the Lumbo–Sacral Spine and Lower Extremities is always "standing room only" so sign up now. The AAOM Annual Workshop is not only about Regenerative Orthopaedic Medicine, it is about understanding the comprehensive curriculum of Regenerative Orthopaedic Medicine, teaching you how to incorporate it into your offices, and giving you the tools to achieve successful patient outcomes in your practice.

This course is for Physiatrists, Sports Medicine Physicians, Orthopedists, Rheumatologists, and more who are ready to add cutting–edge regenerative medicine techniques to their care for patients.

JOIN us in the AAOM - Become a Member!

Why join the AAOM?
You won't find a more open minded, accepting, yet evidence based group of medical professionals. The AAOM provides an exciting and innovative forum for new ideas. By joining the AAOM you will be immersed in excellent, cutting edge, training programs with the latest techniques for treating NMSK injuries. The AAOM is Inclusive, supportive and provides a camaraderie you will not find anywhere else.

The AAOM is a dynamic and extremely unique medical organization that brings together various specialties and elements within the medical profession. This allows us to give you the overall training that is not available elsewhere. If you see patients with undiagnosed pain of probable musculoskeletal origin, then you need to be a member.

The annual membership: Some of the Membership benefits include access to a "members only" section on the website, an online listing of your practice, inclusion on the physician referral line, monthly newsletter, special rates for CME meetings, an online a membership profile.

Why wait? Join today, fill out our Membership Application online.

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