Williams Surgical Rejuva Center #faqs, #questions, #answers, #cost, #plastic #surgery, #recovery,


Williams Surgical Rejuva Center in Albany, NY

What is a Rejuva Center?

There are several innovative beauty breakthroughs that can rejuvenate the face instantly and affordably without the risks and downtime of surgery. The Williams Rejuva Center offers these innovations to reduce wrinkles improve your skin and beautifully reshape your face in one simple office treatment that can last for 6 months or longer.

The Williams Rejuva Center assures clinical excellence under the direction of Dr. Edwin Williams. We offer convenient scheduling, efficient, courteous service and follow-up care, and all in a private and secure setting.

Understanding Minimally Invasive Procedures

Minimally invasive procedures are those that require little or no downtime. The Williams Rejuva Center offers a number of minimally invasive procedures including BOTOX®. Restylane. Juvederm, Sculprta, Radiesse. medicated skin creams, medical facial peels, laser treatments, and skin rejuvenation programs .

While BOTOX® Cosmetic act to relax the muscles and smooth lines, Juvederm. Restylane and Radiesse act to plump up or fill in lines. Medicated creams, medical facial peels, and Lite Touch laser treatments are all scientifically proven to stimulate collagen production. As we age, we lose collagen, so why not stimulate it!

BOTOX® Cosmetic and the new state-of-the-art dermal fillers, such as Restylane and Radiesse. have transformed the war against wrinkles. It s all about technique. They are used in creative ways to compliment each other. BOTOX® Cosmetic is used to minimize wrinkles in the forehead, around the eyes, upper lips and mouth. Restylane and Radiesse are used to restore a more youthful appearance by enhancing the size and shape of your lip and by countering the downward sagging that occurs with aging. These products are combined for a nonsurgical lift that is ideal for patients who want a viable and safe alternative to surgery.

Medicated skin creams that contain Trentenoin (Retin-A) are scientifically proven to stimulate collagen production. The Williams Rejuva Center makes these creams available to our patients. We have found that, in the past, many patients have not been properly instructed on the use of these medicated creams. Our highly trained Cosmetic Nurse Specialists are here to teach you how to apply these creams to obtain their maximum benefits. Dr. Edwin Williams feels that most patients benefit from Tretinoin, and has formulated this ingredient into products with a creamier less irritating base. These products stimulate collagen, lighten brown spots, and are to be used in conjunction with the cleansers and moisturizers that are recommended by your esthetician. If you are not currently working with an esthetician, the Cosmetic Nurse Specialist would be happy to refer you to someone.

Medical facial peels are also proven to stimulate collagen. Increased collagen production helps tighten the skin and smooth out lines. The surface layer of old skin peels off and a new layer of skin is revealed. Then, medicated creams and moisturizers are able to penetrate the new cells more effectively. These peels are also effective for pigmentation irregularities and help to even out skin tone. These peels usually require a 3 day recovery period.

Lite Touch laser treatments also stimulate collagen and are effective in the treatment of rosacea and spider veins. The Willliams Rejuva Center s laser was scientifically proven to stimulate the production of collagen in a study conducted by Dr. Edwin Williams, the findings of his study were published in the Facial Plastic Surgery Archives magazine in 2001. These laser treatments will affect the color, texture, and tone of your skin, giving you a brighter more youthful look.

The Williams Rejuva Center s 6-month skin rejuvenation program incorporates treatments that stimulate collagen, improve hyper pigmentation problems (brown spots), and erase redness or spider veins. It improves skin texture, tone and color. This program offers two medicated peels, four Lite Touch laser treatments, medicated creams, and a basic skin care regime to maintain your beautiful results. The Williams Rejuva Center also offers a maintenance package of four full face smoothbeam laser treatments for after the 6 month program, please feel free to call the Williams Rejuva Center for more information.

About the Cosmetic Nurse Specialists

Our Cosmetic Nurse Specialists are highly trained registered nurses practicing under the direction of Dr. Edwin F. Williams. With Dr. Edwin Williams, you are assured clinical and professional excellence.

A visit to The Williams Rejuva Center begins with an in-depth consultation with the Nurse Practitioner and/or Cosmetic Nurse Specialist under the direction of Dr. Edwin Williams. You will learn about the latest techniques and innovative procedures and medically based skin-care treatments that will noticeably improve your skin s overall look, vitality, and performance. Dr. Edwin Williams, the Nurse Practitioner and/or the Cosmetic Nurse Specialists will then design a program to help you meet your individual goals and needs.

Education on personalized medical products continue to support and enhance the benefits of the Williams Rejuva Center s treatments, ensuring the beauty of your skin.

Same-day consultations as well as treatments, are available for your convenience.

A. No. The Williams Center for Excellence is recognized by BOTOX® Cosmetic as a National Training Center. We have a large number of clients enjoying the results of BOTOX® Cosmetic and offers BOTOX® Cosmetic treatments daily. Because we provide such a high volume of BOTOX® Cosmetic treatment Allergan the makers of Botox offer are patient exclusive rewards.

Q. How long does it take to make an appointment?

A. The Williams Rejuva Center offer Non surgical facial rejuvenation and laser hair removal appointments for same-day treatments. Walk-ins are welcome, but we recommend calling prior to coming in.

Q. Are there things I can do to help slow down the aging process?

A. Yes. The key is to stimulate collagen. There are many treatments offered at The Williams Rejuva Center to do just that. We are seeing younger patients, as early as their early twenties who are looking for help in preventing lines from forming, or slow the aging process by stimulating collagen production.

Q. Does Dr. Edwin Williams perform the treatments?

A. No, a team of highly trained cosmetic nurse specialists perform the cosmetic treatments. A treatment plan is formulated by Dr. Pontius or Veronica Armbruster, NP

*Patient Results May Vary


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Dopps Chiropractic Clinic Wichita Chiropractor #dopps, #dopps #chiropractic, #wichita, #chiropractor #wichita,


A t Dopps Chiropractic at 6820 W. Central in Wichita, we have provided chiropractic relief of neck pain, back pain, headaches, and many other conditions. for over 35 years! Dopps is Chiropractic.

We provide an integrated approach to your health care needs. We believe chiropractic care along with diet, rest, and exercise and educating our patients, so that they can figure out what daily activities are causing their health problems. We work to provide the highest quality care available.

We believe health is the natural state of your body. So let our friendly and experienced staff help you start enjoying more out of life with less pain and more vitality, naturally! Contact us today for an appointment .

Yours in Health,

6820 W. Central


The doctor of the future will give no medicine but will interest his patients in the care of the human frame,
in diet and in the cause and prevention of disease.
–Thomas Edison

Dan is the best atheletic chiropractor in Wichita, KS 67212. Specializing in sport injuries with Wichita professional athletes and Wichita’s hopefuls. Providing families in the Wichita are with drug free back treatment and affordable spinal health care. Our chiropractic office is located in West Wichita, Kansas. We are close to 67205, 67235, and 67209 zip codes, but are located in the 67212 zip code. Dr. Daniel and Doctor Rory Dopps are the best chiropractic physicians in Wichita.
Exam, x-ray, and therapy are provided for back pain, neck pain, knee pain, hip pain, shoulder pain, foot pain, running pain, hockey injuries, and golf pain. We provide treatment for adults, teens, and children. We offer services for for scoliosis, pregnancy, sciatica, whiplash, migraines, fibromyalgia, arthritis, bone spurs, stenosis, headaches, and rehab. We treat pinched nerves. We work closely with insurance to provide care for auto and car accidents and injury. We work with area doctors for referrals, spine evaluation, physical therapy needs, surgery prevention, and wellness care. Our office uses digital xray, electronic health records, online scheduling, text remind messages. We accept all insurances and have contracts with most major insurance companies.


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What Exercise Machine Works the Tensor Fasciae Latae? #tensor #fasciae #latae


What Exercise Machine Works the Tensor Fasciae Latae?

by JEN WEIR Last Updated: Feb 04, 2014

Jen Weir writes for several websites, specializing in the health and fitness field. She holds a Bachelor of Science in exercise science from Montana State University, is an NSCA-certified strength and conditioning specialist and maintains a personal trainer certification from the American College of Sports Medicine.

Climb your way to stronger hips. Photo Credit Joseph C. Justice Jr./iStock/Getty Images

Located on the upper side of your thigh, the tensor fasciae latae is enclosed between layers of fascia, or fibrous tissue. This muscle works with the iliopsoas to flex your hip and with the gluteus medius and minimus muscles to abduct your hip. The tensor fasciae latea plays a key role in hip and knee stability. Several exercise machines work the tensor fascia latae to keep it strong.

Stair Climber Machine

Stair climber machines come in various forms but they all use the same basic concept — repetitive hip flexion. This flexion works your tensor fascia latae and iliopsoas muscles in a continuous manner. If you’re one of many who have weak hip flexors, you will feel obvious fatigue in the front of your hips after several minutes of stair climbing. With most stair climbers, you simply step onto the machine and begin to climb or push the power button to begin. Adjust the resistance and speed of the machine to match your fitness level.

Cable Machine

Cable machines can be used to work the tensor fasciae latae in both flexion and abduction. The resistance provided by a cable machine will significantly strengthen the muscles of your hips. Use the cable machine to abduct your hip by standing with your left side facing the machine. Attach the ankle cuff to your right ankle and transfer your weight to your left leg. Pull against the cable to lift your right leg out to the side as high as possible. Pause at the top of the movement, then carefully lower to the starting position.

The standing cable raise works your tensor fasicae latae through hip flexion. Begin with your back toward the machine. Attach the ankle cuff to your right ankle, take a step forward with your left foot and transfer your weight to your left leg. Pull against the cable to pull your right knee forward and up until it reaches hip level. Slowly return to the starting position.

Hip Abductor Machine

The hip abductor machine comes in two forms: standing and seated. Both types of machines allow you to perform the same exercise. Use this machine to work your tensor fasciae latae and develop your gluteal muscles. To work out on the seated hip abduction machine, sit at the machine with your back snug against the back rest. Adjust the resistance on the machine to your fitness level. Position your legs in the pads and slowly press your legs against the pads to spread them as wide as possible. Pause, then carefully return to the starting position.

Parallel Bars

Parallel bars are most often used to work the arms and abdomen but are also great for working the muscles responsible for hip flexion. When you use this machine you can use your own body weight or opt for additional resistance by holding a dumbbell between your feet. Work your tensor fasciae latae by placing your forearms on padded parallel bars. Grasp the handles and press your back into the vertical pad. Begin with your legs hanging straight down. Keeping your legs together, raise your knees as high as possible by flexing your hips. Lower your legs back down until your hips are completely extended.

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POST OPERATIVE VASECTOMY – The Michigan Vasectomy Center, post vasectomy pain.#Post


post vasectomy pain


There are a few routines and instructions we would like to pass along to assure the greatest degree of comfort possible after your vasectomy. The counseling session you had provided an opportunity to ask any and all questions and to prepare you. To remind you of suggestions given on the videotape and during the private interview, keep this instruction sheet handy. Please feel free to call if you have any further questions.

This is the day of surgery. Wear a jock strap. Use gauze or a wash cloth inside the supporter to keep pressure on the area. After you go to the bathroom, put some antibiotic ointment over the incision. Do this for 2-3 days. Stay in the house lying down or in an easy chair with an ice bag over the groin area to reduce the swelling and bleeding. You can put the ice over the supporter under your pants. Use ice as much as possible until you go to bed. Get up only to go to the bathroom and to eat. Take the ibuprofen, three (3) tablets 4 times a day (daily total of 2400 mg). If there is still pain, it’s okay to add on Tylenol but not aspirin.

Cool shower, walk around; no heavy lifting or vigorous physical exercise. If swelling increases, sit down and relax as you did the first day. Wear a supporter but you don’t need ice, the gauze, or the wash cloth (see below). Take the ibuprofen (3 tablets 4x/day). Stay in the house.

You can now go outside. Increase activity but continue to limit maximum activity. Walking, golfing with a cart or other nonstrenuous activity is OK. Continue wearing athletic supporter for comfort, if needed. Use ibuprofen up to 2400 mg per day for any pain.

Return to normal activity and work. Limit jogging and pumping weights for at least one week.

Take (3) 200 mg ibuprofen four times per day (maximum of 2400 mg or 12 of the 200 mg tablets per day) for the first two days whether you need it or not. If you feel you need something more, take 2 or 3 Tylenol up to 4 times per day, 2 hrs. after each dose of ibuprofen. After two days, use it only as needed.

Day #1 – When you leave the office, you will be wearing an athletic supporter filled with gauze. This is fine for day 1. When you go to the bathroom, replace the gauze or use a washcloth to keep pressure on the scrotum. This reduces swelling and bleeding. Use an antibiotic ointment over the wound for the first 2-3 days.

Day #3 – Athletic supporter until comfortable without it.

1st Week – Once* after 1 week, if comfortable

* Remember to use contraception until you have two negative semen checks.

Infections – are rare, but call if excessive redness, swelling, tenderness, fever, or oozing of pus from incision occurs. This usually will occur after the second day but infections have been identified up to 6 weeks after surgery. It’s OK to put antibiotic ointment on the surgery site if you want.

Bruising – over the scrotum is normal for up to about 2 weeks. You may get a “purple penis”.

Swelling – a small amount is not uncommon. Anything more should be reported. You will feel a small “lump” inside where the surgery was done for a few weeks. It will go away.

Granuloma – some men get another type of nodule where the vas was cut. Usually this is not painful and will go away. If it is larger than 1/2 inch, call me and we will begin medication to shrink it. This can start a few months or even years after a vasectomy. (Remember, a small lump can usually be felt for up to three months in most cases.)

Failure – is always a possibility. Use contraception until you have two semen checks without sperm in them.

Bloody Ejaculate – rare but possible for up to six months.

Pain – like an old fracture, a few men can have a long-term ache in the scrotum (or even in the groin) where the surgery was done. Rarely is any treatment even needed.

Long Term – No long term side effects like prostate cancer, high blood pressure, etc. have been proven with vasectomy.

Problems After Hours Call the hospital (989-839-3000) and ask them to page Dr. Pfenninger.

SEMEN CHECKS : We will do two semen checks to confirm sterilization. Although no appointment is needed, call to be sure that the office is open. The first will be done at 6 weeks after the procedure or after 15 ejaculations (which ever is later). The second will be done at 3 months after the procedure. There is no extra charge for this. Bring a semen sample in a clean jar or in the container provided within an hour or two after ejaculation. If ever you are concerned or want reassurance of sterilization, we will examine your semen for one year, at no charge. Be sure your name is on the container. Please use the OSHA approved medical hazard Ziplock bags.



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Consultant directory #consultants, #gps, #doctors, #surgeons, #anaesthetics, #burns #and #plastics, #cardiology,


Consultant directory

With so many consultants, all with special interests, we appreciate it can be difficult for GPs to make the right referral choice, and it can be confusing for patients.

This consultant directory is offered as an easy reference guide to the specific clinical services and interests of all the consultants working at or for University Hospitals Birmingham NHS Foundation Trust.

Browse by category

Browse by category results: neurology

Dr Hani Benamer, Consultant Neurologist, Neurology Acute

Graduated from Tripoli. Obtained MRCP and neurology training in Glasgow. Gained PhD CCST. Special interest in movement disorders. Honorary lecturer at UoB with interest in medical education. Senior editor of Libyan Journal of Medicine.

Dr Nicholas P Davies, Consultant Neurologist, Neurology and Neuromuscular Conditions

Trained in Birmingham and the National Hospital for Neurology and Neurosurgery, London. Specialist interests include: Neuromuscular disorders, metabolic diseases and ion channel disorders.

Dr Roland O Etti, Consultant Neurologist, Neurology and Neuro Rehabilitation

Trained in neurology in Hull and Birmingham. Has an interest in general neurology, headaches and management of multiple sclerosis symptoms.

Dr Tom Hayton, Consultant Neurologist

MBChB from University of Edinburgh, PhD from UCL; trained in London and West Midlands;sub-speciality interest in traumatic brain injury.

Dr M Tom Heafield, Consultant Neurologist, Neurology Acute

Qualified at St Mary’s Hospital London in 1984, he was appointed to the Trust as consultant neurologist in 1994. He has a varied and broad interest in all aspects of clinical neurology and service developments.

Dr Saiju Jacob, Consultant Neurologist and Clinical Service Lead

Neurology training done in London and West Midlands with doctoral research and fellowship at Oxford. Special interest includes neuromuscular and neuroimmunology, with weekly clinics for each

Dr Alistair John Lewthwaite, Consultant Neurologist

Graduated from University of Birmingham, 2000. PhD in the Genetics of Parkinson’s Disease, 2009. Specialist interest in Parkinson’s Disease and other movement disorders, including assessment of patients for deep brain stimulation.

Dr Edward Littleton, Consultant Neurologist

Graduated from University College London (1996), having trained at Jesus College Cambridge and UCL medical school. Doctoral research in neuroimmunology undertaken at Oxford. Has a special interest in stroke.

Dr Gordon Mazibrada, Consultant Neurologist

Qualified as Doctor of Medicine from the University of Zagreb, Croatia in 1991. Professional areas of interest are multiple sclerosis and inflammatory disorders of the central nervous system.

Dr Dougall McCorry, Neuroscience Consultant

Trained at the Walton Centre, Liverpool, his MD is on the subject of understanding antiepileptic decision making. He is a member of the Association of British Neurology and International League Against Epilepsy.

Dr Niraj Mistry, Consultant Neurologist

Specialist interest MS. Clinical and pre-clinical training at the University of Cambridge, followed by basic Neurosciences training in Oxford then higher specialist Neurology training in Nottingham. Research MD from University of Cambridge.

Dr David Nicholl, Consultant Neurologist, Neurology Acute, Neuro-Genetics and Movement Disorders

Main research interests are in Parkinson’s disease and the genetics of neurodegenerative diseases. He also works at Birmingham City Hospital and lectures at the University of Birmingham.

Dr Hardev S Pall, Consultant Neurologist, Neurology Acute, Neurodegenerative and Parkinson’s Disease

Graduated from Bristol University in 1979. Had postgraduate training in Birmingham, London and Cambridge. Clinical interests in movement and motor neurone disorders. Has clinics for movement disorders and patients for deep brain stimulation surgery.

Professor Yusuf A Rajabally, Consultant Neurologist, Neuromuscular Disease and Peripheral Neuropathy

Main specialist interest in inflammatory neuropathy management. Runs several other specialist neuropathy clinics. Research active in chronic inflammatory demyelinating polyneuropathy (CIDP), Guillain-Barré syndrome and other acquired neuropathies.

Dr Vijay Sawlani, Consultant Neuroradiologist

Masters in neurovascular diseases, from the University of Paris and Mahidol. Interests include: advance applications of MRI including spectroscopy, perfusion, DTI and functional imaging in brain tumours, epilepsy and neurological disorders.

Dr Shanika Samarasekera, Consultant Neurologist

Graduated and trained in Newcastle and the West Midlands. Has a background in both Psychiatry (to membership level) and Neurology. Specialist interest in Epilepsy.

Dr Alexandra Sinclair, Consultant Neurologist

Graduated from the University of Birmingham in 2000 and obtained her MRCP in 2003, PhD in 2010 and her Certificate of Completion of Training in January 2012. Interests: headache and idiopathic intracranial hypertension.

Dr Imad N Soryal, Consultant in Rehabilitation, Medicine and Neurology

Qualified in Sudan in 1978. His specialties are in rehabilitation medicine and neurology.

Professor Steve Sturman, Consultant Neurologist, Neurology and Rehabilitation

A specialist in MS and Motor Assessment. he has interests in post-polio, head injuries, neuro-disabilities, stroke and neurorehabilitation.

Professor Adrian C Williams, Consultant Neurologist, Neurology Acute, Parkinson’s, MND

Professor of Clinical Neurology at the Regional Centre for Neurology at the Trust. He is also a senior advisor to the Parkinson’s Society.

Dr Mark Willmot, Consultant Neurologist with Interest in Stroke

Dr Willmot is a consultant neurologist with a sub-specialty interest in stroke. His interests involve the role of nitric oxide in the pathophysiology of stroke, patent foramen ovale in young stroke, blood pressure and the management of acute stroke.

Dr John B Winer, Consultant Neurologist, Neurology Acute, Neuromuscular Disorders and Polymyositis

Trained in Neurology at the Middlesex, Guy’s and St Mary’s hospitals in London, and the National Hospital for Neurology and Neurosurgery. Gained his first qualification in 1978. Current research is mainly focused on neuromuscular disease.

Dr John Woolmore, Consultant Neurologist

Clinical and research interests include multiple sclerosis and neuroinflammatory conditions of the central nervous system. He has two specialist clinics at the QE where his clinical focus is on disease modifying therapies within the field of MS care.

Dr Ben Wright. Consultant Neurologist

Graduated from University College London. Postgraduate training in Cambridge and Birmingham. Specialist interest in dystonia, Parkinson’s disease and other movement disorders. I run the adult Wolfram syndrome multi-disciplinary clinic.

Contact us

Heritage Building
(Queen Elizabeth Hospital)

Mindelsohn Way
Edgbaston, Birmingham
B15 2TH

Tel: 0121 627 2000

Queen Elizabeth
Hospital Birmingham

Mindelsohn Way
Edgbaston, Birmingham
B15 2GW

Tel: 0121 627 2000


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Ketamine not effective in surgery study #delirium, #ketamine, #opioids, #surgery, #pain,


Ketamine not effective in surgery study

At a Glance

  • Researchers found that low doses of ketamine didn’t reduce delirium, postoperative pain, or other complications related to major surgeries.
  • The results suggest that the common practice of giving ketamine to patients during surgery may need to be re-evaluated.

Ketamine is commonly used in the operating room as an alternative to opioids, but results from a new study suggest the practice should be reconsidered. Purestock/Thinkstock

Patients who are ill or undergoing surgery sometimes experience delirium, a confused mental state that includes changes in awareness, thinking, judgment, sleeping patterns, and behavior. This is most common in adults over 60 years old. Many episodes of delirium are caused by medicine or dehydration and are reversible. However, some episodes of delirium can have long-term effects. Patients who become delirious after surgery can have longer hospital stays and be at a higher risk of dying.

Opioid pain relievers are thought to be a risk factor for delirium and are addictive. Ketamine is commonly used in the operating room as an alternative to opioids to prevent pain from surgery and reduce the need for opioids.

To investigate whether ketamine alleviates pain and prevents delirium from surgery, a team led by Dr. Michael Avidan of Washington University followed 672 patients (254 women and 418 men) over the age of 60 who were undergoing major surgery in the United States, Canada, India, and South Korea. The study was funded in part by NIH’s National Institute on Aging (NIA), National Institute of General Medical Sciences (NIGMS), and National Cancer Institute (NCI). Results were published online on May 30, 2017, in the Lancet .

The team randomly assigned the patients to three treatment groups. Patients received either a placebo, a 0.5 mg/kg dose of ketamine, or a 1.0 mg/kg dose ketamine following general anesthesia but prior to any surgical incision. Patients were evaluated for delirium from 1 to 3 days following the surgery.

There were no significant differences between the groups in patients experiencing delirium (19.82%, placebo; 17.65%, 0.5 mg/kg; 21.3%, 1.0 mg/kg). Nor were there any significant differences across groups in pain experienced in the days following the surgery.

Patients given ketamine didn’t show any increased risk for adverse events. However, as the dose of ketamine increased, so did the reports of hallucinations and nightmares over the 3 days following surgery.

“We were particularly surprised by the lack of an effect on postoperative pain,” says the study’s senior author, Dr. George Mashour of the University of Michigan. “Giving single doses of ketamine during surgery to prevent postoperative pain is increasingly common, but our data challenge that practice and suggest that even after decades of use, more research is required if we hope to understand ketamine.”

“We found that the current practice of giving low doses of ketamine to patients during surgery is not having the desired effect,” Avidan says. “So we need to determine whether higher doses might be more effective, or we need to find other alternatives to opioids.”

—by Tianna Hicklin, Ph.D.

Related Links

References: Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Avidan MS, Maybrier HR, Abdallah AB, Jacobsohn E, Vlisides PE, Pryor KO, Veselis RA, Grocott HP, Emmert DA, Rogers EM, Downey RJ, Yulico H, Noh GJ, Lee YH, Waszynski CM, Arya VK, Pagel PS, Hudetz JA, Muench MR, Fritz BA, Waberski W, Inouye SK, Mashour GA; PODCAST Research Group. Lancet. 2017 May 30. pii: S0140-6736(17)31467-8. doi: 10.1016/S0140-6736(17)31467-8. [Epub ahead of print]. PMID: 28576285.

Funding: National Institutes of Health National Institute on Aging (NIA), National Institute of General Medical Sciences (NIGMS), and National Cancer Institute (NCI); the Dr Seymour and Rose T Brown Endowed Chair; and all the participating international institutions provided generous additional support for the study.

Search NIH Research Matters


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How to Determine Pain and Suffering in a Car Accident Case


How to Determine Pain and Suffering in a Car Accident Case

If you’re making an injury claim after a car accident, you’re probably wondering what your claim is actually worth. Insurance companies use various methods to calculate the value of a personal injury claim, which generally includes compensation for actual medical bills and lost wages, coupled with some amount of money for “pain and suffering.” This article addresses how to calculate the value of a car accident claim using two common formulas – the multiplier method and the per diem method.

(We also have a calculator that compares the two methods, on this page. Keep in mind the outputs cover pain and suffering only – not the total claim value.)

The Multiplier Method

An often-used method for evaluating pain and suffering damages is to multiple the actual damages (medical bills and lost wages) by a certain number. Many personal injury lawyers have been trained to multiply the actual damages by three to reach a reasonable damages amount. So, if your medical bills were $5,000.00 and your lost wages were $1,000.00, you would multiply $6,000.00 by 3 for a total of $18,000.00.

In recent years, however, insurance companies have become more reluctant to automatically concede that a multiple of three is a reasonable way to quantify pain and suffering damages.

Now, the approach is often to take the actual damages and multiply that amount by a figure that is arrived at through the use of complex software programs, and the result will often undervalue your claim. The multiplier generally depends on the seriousness of your injuries, any aggravating circumstances, and the length of your recovery. For instance, if you suffer a broken femur and undergo multiple surgeries, the pain and suffering you experience is naturally going to be worse than that from a minor fender bender.

So, in the more serious accident, the multiplier might be three or four, whereas in the fender bender, the multiplier might be 1 or 2. The multiplier might be even higher if there are aggravating circumstances, such as the at-fault driver being intoxicated. In that case, you might reasonably use a higher multiplier. Likewise, if your own actions (or inactions) were partly to blame for the accident, it is reasonable to use a lower multiplier to evaluate your compensable pain and suffering.

It is also important to consider the type of treatment received in relation to the injuries incurred in choosing a reasonable multiplier. Some injury claimants seek an excessive amount of medical care in relationship to the injury sustained. For instance, one might obtain three or four months of chiropractic care of physical therapy for a minor injury. Insurance companies are usually unwilling to consider excessive medical treatment in their calculation of pain and suffering.

So, don’t keep treating for minor injuries in the hope that this will increase the value of your case. Over-treating injuries can often backfire, leaving you with unpaid medical bills and insufficient compensation.

The Daily Rate Method

Some insurers and personal injury attorneys use a daily rate to calculate the pain and suffering aspect of an injury claim. Under a daily rate or “per diem” calculation, an amount of money is assigned to each day (or week) that you suffer from injury after a car accident.

For example, suppose you incurred medical bills in the amount of $5,000.00 and lost income of $1,000.00 for a total of $6,000.00. For three months after the accident you saw a physician regularly and took daily pain medication. After about three months, the pain eased and you were able to resume normal activities again. You might assign a daily value of $200.00. Under the per diem method, you would multiple 90 days (3 months) by $200.00 to reach $18,000.00.

How do you choose the daily rate? One way might be to rely on the income you would make in a given day if you were not injured. So, if you typically earned $200.00 per day, but were unable to go to work, this might be a reasonable method of valuation.

While it may seem arbitrary to choose a per diem number, you should be able to articulate a legitimate reason for why you chose that amount. This is because when you take your case to a judge or jury, you cannot simply state “my pain and suffering is worth $200.00 per day.” Rather, you will need to offer the jury or judge a reason upon which they can base such an award.

Getting a Final Value

Probably the most efficient and systematic way to value your claim is to use both the multiplier and per diem method to get a ballpark figure. From there you need to adjust your expectations based on a variety of factors, such as the severity of your injuries. whether others were involved and injured, the permanence of any injury. whether you were out of work for an extended period of time or laid off as a result of not working, and whether you believe you will make a strong witness on your own behalf.

Applying all these factors together will help you create a reasonable value for your claim. For instance, if your multiplier gives you a value of $18,000.00 and your per diem gives you a value of $30,000.00, you might choose a ballpark figure of $24,000.00. If you suffered a broken bone, underwent surgery, and may have a permanent limp, you should add some amount to your valuation. On the other hand, if you had a sprained wrist and the accident was partly your fault, you should subtract from that $24,000.00 figure.

Once you come up with a number that you’re comfortable with as a starting point for settlement negotiations, it’s time to craft your demand letter .

Get the compensation you deserve.


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Chiropractor, Pain Management #chiropractor, #chiropractic, #rehabilitation, #rehab, #pain #management, #workers #compensation,

We look forward to every call!

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Massage Therapy

If you need to be kneaded, we have the ability to take those knots right out.

  • Rehabilitation

    Whether Chiropractic, Rehabilitation or Spinal Decompression. We use the most appropriate tool to get the best result.

  • Pain Management

    Whether your pain is chronic or acute, we have the tools to put your pain at bay.

  • Chiropractic Care

    Our chiropractic services are gentle and effective. We have a number of techniques we can use to get optimal results.

  • Spinal Decompression

    Spinal Decompression can be extremely effective for most vertebral disc-related disease. We have performed 1000’s of sessions.

    South Texas Spine Rehab

    Medical Care Pain Management

    Medical care can range from simple care for a simple injury or Pain Management for a serious injury. The combination of medical care and physical medicine can yield powerful results regarding short-term gains and long-term positive outcomes.

    Chiropractic Rehabilitation

    Chiropractic and Rehabilitation are used in combination for many patients in our clinics. We do not believe these disciplines are either-or but should be used together to provide the patient with the best possible outcome. When you have a hammer, every problem looks like a nail. We try to use all of the tools in our toolbelt to customize our treatment to the patients needs.

    Spinal Decompression

    Do you have herniated discs, bulging discs, degenerative disc disease, facet syndromes, or any other type of disc issue? Is your doctor suggesting surgery as an option? Non-surgical spinal decompression may be your answer to avoiding surgery. We have performed over 12,000 spinal decompression sessions at our offices and have 4 spinal decompression tables for you.


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  • Orthopedic Center in Providence, East Greenwich, Middletown, Barrington – University Orthopedics



    The Physical Therapists at University Orthopedics are important members of the multidisciplinary health care team. Upon referral to physical therapy at our Rhode Island offices, each patient receives a thorough assessment of his or her impairment and the physical therapist will plan a treatment regimen best suited to the individual problem. Read more.


    One of the key features that differentiates us from other Rhode Island centers that treat back pain, including low back pain and sciatica, and neck pain is the spine-specialized therapy department at the University Orthopedics Spine Center. Read more.


    Our hand therapy department provides specialized rehabilitation services for patients with upper extremity dysfunction due to trauma or medical conditions. Services are provided by registered occupational therapists that have obtained specialized knowledge of the upper extremity through advanced training, continuing education courses, and independent study. Read more.


    A home exercise program is typically customized for an individual’s specific back problem. These exercises can be done on the living room rug while watching TV. Other stretching exercises can be done throughout the day to increase flexibility. Read more.


    Injection therapy is intended to be a means to an end. The goal is to provide the patient with enough pain relief to bridge from inactivity to physical therapy, where orthopedic problems can be better treated with special exercises. Read more.


    The orthopedic center includes more than 25 board-certified orthopedic surgeons who are fellowship-trained, the highest level of medical training in the U.S. These specialists are clinical professors on the faculty of Brown University’s medical school as teachers of other new physicians, and leading the way with clinical research of the latest advances in orthopedic surgery and injury prevention.


    Our specialists use advanced surgical instrumentation to correct the injury, enables the patient to go home the same day to the comfort of their home. Every medical specialty has become “sub-specialized” with super specialists that have the most advanced expertise in their particular niche.


    University Orthopedics directs many clinical research efforts intended to innovate new orthopedic surgery techniques; new surgical implant devices that improve the success of various procedures; and new ways to prevent orthopedic injury.


    The physicians at University Orthopedics believe that just as they benefited from the educational training they received early on in their careers, they should return the expertise they gain through private practice by educating those coming out of medical schools who in turn take their expertise into the community.

    I can’t say enough great things about Dr. Mark Palumbo. I injured my back at work, had some disc issues with horrible pain to the point I could barely walk. When other doctors said I would not ever be able to work my very physical job again, Dr. Palumbo proved them wrong. I have been back to work for over a year now.”

    “I broke my left humerus in September 2013, I saw Dr. Got and he operated on me in October, it was a smooth recovery for me with the great team he had. I was back to work and back in the gym in four months. I would recommend anyone who experiences any bone break to go see Dr. Got.”

    Dr. Bliss is awesome. I’m so grateful to have a doctor who cares about me. He listens and is genuinely concerned about my injury. The facility is well kept and staff is wonderful. I’d recommend them in a heartbeat.”

    Amazing doctors, physical therapists, and facilities. The doctors are all very well educated and their staff are friendly as well. They also do a very good job of matching their patients to the physical therapists both in specialty and personality.”


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    Acid Reflux Symptoms: Heartburn, Regurgitation, Dyspepsia, and More #acid #reflux #symptoms,


    Acid Reflux Symptoms

    Lots of people are intimately familiar with acid reflux symptoms. More than 60 million Americans experience acid reflux at least once a month. Acid reflux disease, also known as gastroesophageal reflux disease (GERD ), can produce a variety of symptoms.

    What Are the Common Acid Reflux Symptoms?

    Heartburn. regurgitation, and dyspepsia are a few of the most common acid reflux symptoms.

    Heartburn. Also called acid indigestion. heartburn is a burning pain or discomfort that can move up from your stomach to the middle of your abdomen and chest. The pain can also move into your throat. Despite its name, heartburn doesn’t affect your heart .

    Regurgitation. Another common symptom of acid reflux is regurgitation — or the sensation of acid backing up into your throat or mouth. Regurgitation can produce a sour or bitter taste, and you may experience a “wet burp” or even vomit some contents of your stomach .

    Dyspepsia. Many people with acid reflux disease also have a syndrome called dyspepsia. Dyspepsia is a general term for stomach discomfort. Symptoms of dyspepsia include:

    Symptoms of acid reflux may be a sign that stomach acid has inflamed your esophagus. When that happens, stomach acid can damage the lining of your esophagus and cause bleeding.

    Although acid reflux is extremely common and rarely serious, don’t ignore your acid reflux symptoms. Making a few lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.

    When Do Acid Reflux Symptoms Occur?

    Acid reflux symptoms most often occur:

    • After eating a heavy meal
    • When bending over or lifting an object
    • When lying down, especially on your back

    People who have frequent acid reflux symptoms most often experience them at night. Nighttime GERD also produces the most pain. However, the level of pain does not always indicate the degree of damage to your esophagus.

    More than half of all pregnant women experience heartburn during pregnancy. Increased hormones and pressure from a growing fetus can combine to produce this acid reflux symptom. In most cases, heartburn goes away after delivery.


    What Makes Acid Reflux Symptoms Worse?

    Certain foods can make the symptoms of acid reflux worse for some people. To lessen your symptoms, try avoiding:

    • Citrus fruits
    • Chocolate
    • Caffeinated drinks or alcohol
    • Spicy, fatty, or fried foods
    • Garlic and onions
    • Peppermint
    • Tomatoes

    Are There Potential Complications With Acid Reflux Symptoms?

    Usually, acid reflux symptoms cause no complications. In a few cases, continued esophageal damage can lead to scarring, which may cause the esophagus to narrow. The narrowing creates strictures and makes it difficult to swallow. You may have dysphagia. a sensation that food is stuck in your esophagus. In some cases, normal cells in the lining of the esophagus may be replaced by a different type of cell. This is called Barrett’s esophagus. which can sometimes develop into cancer .

    When Should I Call the Doctor With Acid Reflux Symptoms?

    Be sure to call your doctor if you don’t get lasting relief from medications. Also call the doctor right away if you have any “alarm” acid reflux symptoms, such as these:

    • Unexpected weight loss
    • Blood in vomit
    • Black, tarry, or maroon-colored stools
    • Difficulty or pain with swallowing

    Other acid reflux symptoms that should prompt a call to your doctor include:

    Sometimes, people confuse the symptoms of heart attack with symptoms of acid reflux disease. That’s because pain in the chest can feel like heartburn. When in doubt, call your doctor.

    • Chest pain. pressure, or fullness lasting more than a few minutes or that goes away and comes back
    • Pain or discomfort in your neck, shoulder. upper back, or jaw
    • Shortness of breath, with or without chest pain
    • Dizziness. lightheadedness, or nausea
    • Sweating along with chest pain

    WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on February 22, 2016


    The American College of Gastroenterology: “Heartburn or Gastroesophageal Reflux Disease.” University of Maryland Medical Center: “Gastroesophageal reflux disease and heartburn.” National Digestive Diseases Information Clearinghouse: “Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease.”

    American Academy of Family Physicians: “Dyspepsia: What It Is and What to Do About It.”

    American Academy of Family Physicians: “Heartburn: Hints on Dealing With the Discomfort.”

    © 2016 WebMD, LLC. All rights reserved.


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    Ask the Coaches: Pain Along the Inside of the Foot #inside


    Ask the Coaches: Pain Along the Inside of the Foot

    A: Pain along the inside of the foot may be due to inflammation of a tendon (posterior tibialis) that attaches to the bone that is the keystone of the arch (navicular). The posterior tibialis muscle helps to support the arch of the foot. Since you have low arches, it is possible that the muscle and tendon are overworked, causing inflammation and pain. Another possible cause of pain is a stress fracture of the navicular.

    The wear pattern on your shoe may not necessarily mean that you underpronate. A running coach or knowledgeable running shoe sales person could evaluate your running form.

    Work on strengthening your foot and ankle muscles. Put an ankle weight on your foot and point your foot inward 10 times, outward 10 times and upward 10 times. Perform 3 sets of these exercises. Pick up small objects, such as marbles, with your toes for about 5 minutes twice a day. Apply ice to your foot for 15 minutes 3 times per day. If symptoms persist, you should see a sports medicine specialist to make sure that you do not have a stress fracture.

    –Dr. Cathy Fiseler

    Copyright 2017 Rodale Inc.

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    Alfa travel what a pain – Review of Cumberland Hotel, Scarborough

    #alfa travel

    Manchester, United Kingdom

    I stayed in room 108 at the Cumberland for 6 nights, while on an Alfa coach tour.

    This hotel seems to be owned by the same company as Alfa, and, consequently, it was pretty.

    I stayed in room 108 at the Cumberland for 6 nights, while on an Alfa coach tour.

    This hotel seems to be owned by the same company as Alfa, and, consequently, it was pretty full with coach parties when I was there. On the whole this was not problem, but mealtimes felt like an exercise in crowd control, with rigid rules about when we were allowed to sit down for our meal, and some long waits to be served (although sometimes we were lucky and were served immediately).

    The food for meat-eaters seemed pretty good, but I am vegetarian and, although there was a menu of vegetarian main courses, this was unimaginative and of fairly poor quality. It also appeared that the full menu was standard across all of the hotels owned by this company and so it was impossible to have any variation. Having said this, the prescribed desserts were varied and excellent.

    The room, although a little small, was clean, and the en-suite shower worked extremely well. The only problem that we experienced was squeaky floorboards, which was odd, because, in all other respects, the building appeared to have been very well refurbished, with plain, clean, decor and furnishings. As a result of the floorboards, we could hear every bathroom trip during the night in the room upstairs as well as in our own room.

    As others have said, the 4 person lift was inadequate, and would have been a real problem if we had been on a higher floor. But the staff were (with one notable exception) friendly, and it wasn’t their fault that the Spa lift to and from the seafront closed for repair on the day that we arrived, leaving us with a steep walk back to the hotel from the town.

    On balance, this was a pleasant stay, though I would be unlikely to book into any hotel owned by this company in the future, because of the poor vegetarian food.


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