SECTION I: FROM THE EDITOR'S KEYBOARD

GOOD NEWS AND BAD NEWS...AND MORE GOOD NEWS

The medical literature continues to encourage us: personal lifestyle choices make a difference in our health. The same is true for employers: corporate choices to prioritize a healthy lifestyle in the workplace also pay health--and economic--dividends. In short, when a company takes the initiative to prioritize health, everyone wins.

That's the good news. The bad news is that changing personal lifestyles or corporate cultures is not easy business. In fact, many times the most necessary changes go completely against our psychological grain.

In this issue of WEJ we feature two radio scripts that look at back pain from a perspective that merges individual and corporate concerns. Cigarette smoking provides one example of the difficult lifestyle challenges relating to this common health concern. Individuals and employers who are serious about decreasing back problems will address the smoking issue head-on.

Lest anyone perceives that I'm ending on a negative note, let me share my ever-growing enthusiasm about the attainability of lofty lifestyle goals. If you have deleterious habits that you feel you *must* eliminate or good ones you *know* that you must adopt, don't despair. With the New Year essentially upon us, don't hesitate to make some serious resolutions--and then take advantage of resources that are available. Whether it's a local park district exercise class, an American Heart Association course, a program sponsored by your local hospital, a church-based support group, or just a supportive friend or family member--take advantage of the resources that are at your disposal.

When it seems as if all your options are exhausted, don't forget to look for other alternatives. Be careful, you may be well aware of some of the most viable options, but have prematurely dismissed them from consideration. For example, I recently read part of Dr. Larry Dossey's book, "Healing Words: The Power of Prayer and the Practice of Medicine" (1993; New York, NY; HarperCollins Publishers). In it, Dr. Dossey describes his transition from an individual who had no desire to pray, to a physician who felt compelled to pray. He relates how his reading of the medical literature on prayer convinced him that if he did not include prayer in his work as a physician, he was depriving his patients of an efficacious remedy. In my work with patients, and in my own life, I have found that prayer sometimes appears to be the only effective agency when options are few. Yet, as was true in Dr. Dossey's early experience, I find that many have given up on prayer, viewing it as an unnecessary relic of their childhood.

As far as options, there is yet another bit of good news. For those who are facing difficult changes personally or institutionally, the concept of "the lifestyle center" is again taking hold in our nation. Called "baths" or "spas" in Europe and "sanitariums" in late 19th century America, health centers that offer live-in options for lifestyle changes are again becoming a hot topic. These Centers offer opportunities for people to leave their ordinary stresses and concerns and focus on tackling the habits that are undermining their health. I feel privileged to be part of one such innovative institution in the American Southwest, the Lifestyle Center of America. Connie, one of our recent program participants, also felt privileged to finally stop smoking at our Center. She shares her experience later in this issue.

My reason for including Connie's brief testimonial is not to imply that anyone needing to make a major lifestyle change must enroll in a residential program. My message is really quite different. I am convinced that most smokers can quit on their own. I see this as equally true of many who are making other major lifestyle changes. Whether they be dietary changes, or changes calculated to help with stress management, or changes motivated by other goals, making a decision on your own is the place to start. And following through with that decision is often all that many people need to do. However, some have reached "the end of their rope" and for them they need to hear stories like those shared by Connie or Larry Dossey. They need to hear some good news as we approach a new year: there are always more options than you realize. It's always premature to give up on change whether it be on a corporate level or on a personal level.

SECTION II

TRANSCRIPTS FROM THE WELLNESSWISE RADIO PROGRAM

(All scripts copyright 1995 and 1996 by David J. DeRose, MD, MPH)

BACK PAIN ON THE JOB

Back pain is costly for the individual and for his or her employer. I'm Dr. David DeRose. In a moment we'll look at "Back Pain on the Job" on WellnessWise.

Back pain costs employers over 10 billion dollars each year. Nearly half of all days missed from the work force are due to back pain--and the condition affects 80% of the working population at some time in their careers.

Evidence indicates that a prevention-oriented back care program at the worksite can protect workers health and employers profits. One study of such a program documented a 25% decrease in back injury-related lost work days. Workplace-based back programs should address the following risk factors: poor posture and lifting techniques, overweight, lack of fitness, excessive stress, and cigarette smoking.

Cigarette smoking is an important and often unrecognized risk factor for back injury and pain. A study of workers in Maine found that smokers of more than one pack per day had triple the risk of significant back pain. Other studies have found that cigarette smokers are more likely to suffer from serious spinal disk disease. And following successful surgery for low back pain, smokers have a greater risk of again experiencing disabling low back pain.

Back pain--lifestyle factors can make a difference. And programs at the work place can play an important role in decreasing physical--and economic--pain.

For WellnessWise, Im Dr. David DeRose.

References: Ian K.Y. Tsang, "Perspective on Low Back Pain," Current Opinion in Rheumatology 1993: 5:219-223.

"Studies Find Adverse Affects of Cigarette Smoking," News Release of 2-18-93 from The American Academy of Orthopedic Surgeons.

David DeRose, Chapter 13: "Designing Wellness and Health Promotion Programs." In: Occupational Health Services: Practical Strategies for Improving Quality and controlling Costs; William L. Newkirk, editor, pages 181-192, American Hospital Publishing, 1993.

BACK PAIN AND YOUR MIND

Your back health may be largely related to your mental health. I'm Dr. David DeRose. "Back Pain and Your Mind" in a moment on WellnessWise.

Each year, low back pain disables over 5 million Americans and costs over 16 billion dollars. Many of these injuries are work related, a fact that prompted the question: "Why do some people injure their backs while others do the same job for years and never have a problem?"

There are actually many answers to this difficult and important question. For example, psychological factors are one important but often neglected contributor to back injury. One study of over 20,000 workers, found that a relatively "poor" psychosocial work environment tripled the risk of back injury. This is the same level of risk produced by physically stressful demands on the back.

Expressed in another way, although physical and other lifestyle factors are important in determining who develops back problems, the social and psychological factors of the job are also important.

Consequently, an employer who goes out of her way to keep employees happy and to foster good relations at work, is doing something that can actually improve the health of workers and thus decrease medical expenses.

For WellnessWise, I'm Dr. David DeRose.

References: Steven J. Linton, et al, "Psychological factors related to health, back pain, and dysfunction," The Journal of Occupational Rehabilitation 4(1):1-10, March 1994

Statistics from: Guide to Clinical Preventive Services, Report of the US Preventive Services Task Force, Williams and Wilkins, 1989, pages 245-249

SECTION III

SCIENCE/HEALTH ABSTRACTS

Children who consume 12 or more hotdogs per month are at increased risk of developing leukemia, according to a report from the University of Southern California School of Medicine. Children of fathers who consumed large numbers of hot dogs were also at increased risk of leukemia. (Cancer Causes and Controls 5(195-202, 1994)

SECTION IV:

WHAT PEOPLE ARE SAYING ABOUT THE LIFESTYLE CENTER OF AMERICA (LCA)

Before coming to the Lifestyle Center of America, Connie described her smoking habit in the following words:

"I was a smoker for 30 years. I had tried everything to quit from the gum to the patch. Nothing would work. My husband was as frustrated as I was. We didn't know where to turn. I felt so helpless to this drug that controlled my life."

Not long ago, Connie arrived at the Lifestyle Center of America for one of our live-in programs. When she checked in she described herself as "a nervous wreck." But she quickly found out that she was in a place where a team of professionals was dedicated to her success. As Connie put it:

"My fears were quickly put to rest. The staff was like family... They were always there ready to help and save me from myself. My schedule during my stay was so well orchestrated that I had no time to wallow in self pity...

"As each day passed I was more and more amazed at how easy my transition was from smoker to non smoker... It has been four months since my last cigarette. I am still amazed at how easy it has been."

You or your friends can join Connie as subjects of the success stories coming from our state of the art preventive medicine center. See details in Section V.

SECTION V

FROM THE LIFESTYLE CENTER OF AMERICA

Call or e-mail today for information on special programs for reversing diabetes and high blood pressure, stopping smoking, optimizing your weight, preventing and treating heart disease (without more drugs or surgery), and a host of other specialized programs for other lifestyle- related conditions. Special pricing is still available for upcoming programs. For further details use the contact numbers below.

The Lifestyle Center of America (LCOA) is happy to sponsor the WellnessWise Electronic Journal. This e-newsletter provides a way for our Center to share its commitment to helping people deal with chronic disease without using drugs or surgery. Located midway between Oklahoma City and Dallas, our state-of-the-art facilities feature structured residential lifestyle programs that can provide a turning point in your life.

PARTING WORDS

SUBSCRIPTION INFORMATION

We continue to distribute The WellnessWise Electronic Journal free of charge via Internet E-mail to all subscribers. Please address subscription requests and any other correspondence to the address below.

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