Back pain and back injuries

I have suffered from back pain for more than 30 years and have experienced multiple flare-ups when I could not leave my house, and occasionally was unable to even get out of bed.

Back pain is not unique to me. It’s one of the most common reasons for a patient to seek medical care. Indeed, 80 percent of all Americans will experience back pain during some point in their life.Back pain

Although back pain tends to come and go with most people, it can be chronic and even permanently disabling.

The most common cause of disability among Americans under the age of 45 is actually chronic back pain. Its economic impact is enormous and exceeds an estimated $1 billion annually.

These staggering associated costs are better appreciated by understanding the significant time period which can accompany recovery from acute back pain. While 60 percent of acute back pain sufferers recover in six weeks, another 20-30 percent require 6-12 weeks. The remaining 10-20percent have a more uncertain recovery period.

Understandably, economic losses from time off and other economic impacts to employers can quickly add up. As much as 20 percent of all workers’ compensation claims can be attributed to back injuries with most of those occurring in individuals involved in heavy manual labor and material handling activities.

The most common form is lower back pain, which results from protracted standing or sitting, long lever activities involving arm extension such as painting, vacuuming, and equipment operation. In these situations a person’s arms are both elevated and extended away from the body or frequently from levered postures where the body is bending forward which includes lifting injuries.

Studies have shown that both injury and discomfort is reduced when a person’s spinal column is balanced by multi-directional forces, which results from frequently changing positions, walking and moving.

Preventing back pain is strongly recommended. But how can we do that? For some time now, studies have shown that yoga can be more effective than surgery and medical care when dealing with back pain.

As a former police officer and “hard-charging” Army guy, I never thought I would do yoga. But after numerous medical and scientific studies touting yoga’s advantages for back pain, and 30 years of recurring problems, I finally tried it. Guess what? My back has never been better!

Yoga, which requires an individual to hold gentle poses anywhere from 10 to 60 seconds, is based on centuries of developed symmetry within the body to balance flexion, extension, rotation and stretching. Very often back injuries happen from an asymmetric state within the back.

In my personal experience, yoga has helped my body, especially my back, become better conditioned through various beneficial poses that have improved flexibility, posture and deportment.

Doing yoga has helped my back more than anything else I have personally tried. And many of my patients say the same thing.

Below are some tips to prevent back pain.

Before you begin:

  • Assess the weight of the object before lifting
  • Know your lifting limit
  • Examine the object for potential hazards
  • Ask for help if needed, or divide the load to make it lighter
  • Make sure the area around you is free of clutter

Proper Lifting Techniques

  • Stand close to the load with your feet shoulder width apart
  • Squat down keeping your back in a neutral posture
  • Get a firm close grasp of the object before beginning the lift
  • Lift with your legs and in a non-jerky manner
  • Keep the object close to the body within your base of support. Finish the lift maintaining a good base of support and neutral spine

Remember, injuries can be permanent, so work carefully to prevent them and stay healthy by practicing sensible exercise, yoga and always eating properly.

Sean O’Mara, MD, is a Medical Director for U.S. HealthWorks. Dr. O’Mara works in our Minneapolis centers. 

Image courtesy/

Does this ‘injury’ require medical care?

This is a question supervisors, bosses, and Human Resource specialists ask themselves constantly, albeit quietly.

Everyone wants zero injuries and companies have been known to insist on watchful waiting before committing to medical care and a reportable injury.















This is a risky game! But as a doctor with U.S. HealthWorks, one of the country’s largest operators of occupational healthcare centers, I offer some guidelines during Occupational Therapy Month that should help you avoid some of the deepest pitfalls.

Does this “injury” need medical care?

I will start with the disclaimer that the safest thing to do is have any injury evaluated. The injured employee will do better and you and your company will stay out of trouble. But if I were a supervisor, I would want some help in trying to sort the serious from the nonsense.

In looking at a possible injury, the first thing an employer naturally considers is who the employee is. They are thinking of his HR file: attitude, reliability, productivity, attendance.

Essentially, are they a great employee, or a marginal one? That approach may guide you in determining whether the employee will be here next year or will get a promotion. But it’s the wrong place to start for work-related injuries because it has nothing to do with the outcome from a specific event.

So put down the HR file and start somewhere else.

A good place to start is with the “mechanism of injury.” That is a term for “what happened” – the employee got hit with a hammer, fell down, or lifted something heavy. Would you expect a serious injury from this particular circumstance? How much force is involved?

For example: If someone falls off the loading dock onto concrete, and doesn’t land gracefully on their feet, a fracture is more than possible, even expected.

The opposite circumstance is someone hitting an elbow against a doorframe while walking through an opening. That would not be expected to produce a major elbow injury. So consider the force put upon the body at the time of injury.

Rule 1: Big force causes big injuries. That tells you to be very concerned about even an apparently minor injury if there was major force involved. An employee falls off the roof – have them checked out, even if that person attempts to brush it off.

Injuries come from outside forces acting on the outside of the body. Since the body is conveniently covered with flesh and blood, there is often physical evidence of this injury.

Especially in an extremity, there will often be swelling, a black-and-blue skin coloring, tenderness and sometimes “it just doesn’t look right” – because there is a minor deformity. If it doesn’t look right, that’s a definite sign, so beware.

Rule 2: All of these suggest more injury rather than less. So the second rule is if it looks injured, get it checked out sooner.

Rule 3: Minimize the downside risk. In medicine, downside risk is a tragically bad outcome, disability, death, medical complications – all very bad stuff.

Doctors are trained to instantly think the worst, and go about proving to ourselves it isn’t that bad. That approach avoids missing something important that will cause great grief if missed.

In essence, you ask yourself: “What is the chance of this becoming a big problem if it doesn’t get treatment quickly?” That is, admittedly, difficult to do without a lot of medical background, but we can suggest a few scenarios.

A head injury with even a brief loss of consciousness or appearing dazed is concerning. This is a brain injury. Brain injuries are always serious, because they can quickly turn out very badly. This employee needs to be evaluated even if they claim to be fine. The downside risk is too great not to aggressively look for trouble.

Broken bones can have really lousy outcomes if not addressed. Quite often the injured employee can tell you they have a broken bone. They hear or feel the bone break. Believe them and get them checked out promptly.

Foreign bodies in eyes are a very common industrial injury. The employee will tell you they have something in their eye. They are almost always right. If a foreign body is not removed it will become harder and harder to remove and put your eye and vision at risk.

It’s always worth trying to wash the eye out at work, and if that solves the problem, no worries. But don’t waste more than 10 minutes trying to wash it out. If you can’t get it out right away, it needs to be removed by a doctor.

All employers attempt to separate the truly injured from the minor stuff. A little common sense when combined with some thought about mechanism of injury, signs of injury, and downside risk will go a long way toward helping you make safe decisions.

Of course, the safest course of action is to have a medical provider evaluate the injury right away, which is our recommendation.

Remember that medical advice is a phone call away if you need specific and immediate advice.

Take Care.

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/


Joys of Occupational Medicine

Occupational medicine. You’re kidding, right? It involves a lot of paperwork, phone calls, employer meetings, union representatives, state administrative codes, federal regulations, urgent fit for duty exams.

And often times, it also involves this request – “Can you give me a week off to recover, Doc?”



How could this possibly be a practice a doctor finds enjoyable? It sounds more like a recipe for chronic daily headaches! Certainly, it doesn’t possess the prestige of cardiology, the panache of neurosurgery, or the lifestyle of dermatology.

However, there is something about occupational medicine that is truly unique and wonderful.A doctor or clinical specialist is duty bound to do the right thing for all stakeholders: the patient, employer, and the state fund/insurer.  And that, it turns out, is a good thing.

Other ways that occupational medicine differs from other medical practices? For example, at U.S. HealthWorks Medical Group we typically see patients at the request of the employer. We are a single-solution provider that employers, patients and insurance companies can trust to optimize the quality of patient care we provide, while assisting with complex healthcare issues.

Our occupational medicine – available through our urgent care centers  – runs the gamut, from wellness and injury prevention to early return-to-work programs. It meets the specific needs of the employer, while attending to the health and safety of the patient.

Every injured worker is thoroughly evaluated. A careful and thorough history of the patient is executed and a reasoned decision is made if the injury was in fact work-related.

The next step is a treatment plan that maximizes the employee’s recovery, while minimizing the lost work productivity to the employer. Our occupational healthcare facilities do their absolute best to turn this into a win for both worker and employer.

But occupational medicine is much more diverse; it’s not all about treating injured workers. Other areas of our expertise include:

  • Pre-employment physical exams
  • Physical ability testing
  • Drug and alcohol testing
  • National Medical Review Officer (MRO) Services
  • Partnering with employer health and safety, and human resource departments to coordinate Hazmat, Asbestos, Respiratory Protection, and other types of surveillance exams
  • Vaccination programs
  • Specialty care that includes orthopedics, physical medicine and rehabilitation, spine specialist, anesthesiology/pain management, plastic surgery, hand surgery, neurology, and podiatry

Yes, occupational medicine can be a difficult balancing act and some days it does cause headaches. But take it from this doctor – it is truly rewarding. Why? Because when done correctly, everyone comes out ahead.  We don’t just help our patients. We help all the stakeholders and even the economy.

Yes, that’s right, even the economy.

For example, when possible, we keep an injured worker right where he wants to be – at work. The data is strong. Treated by an occupational healthcare doctor or specialist, it’s a fact that workers recover more quickly. They also have a better chance of full recovery. And, in the long run, they are financially better off.

For the company, there are benefits as well because workers can continue to contribute even when placed on light or modified duty.

All told, the companies pay less for workers’ compensation coverage, they have a healthy workforce that produces more, and the economy thrives. There’s the evidence; occupational medicine does play a role in helping the economy.

So next time you are shopping for lettuce, think about how many workers might have been involved in getting that lettuce to your store. Think about their jobs and how important it is to have healthy farmers, warehouse workers, truck drivers, and grocery store employees.

Maybe some of the workers were injured in the course of producing that lettuce.  Hopefully they received what U.S. HealthWorks calls, “The Right Care, Right Away,” and are continuing on in their productive work lives … so that we can continue to enjoy our salads.

Better yet, maybe none of the workers were injured producing the lettuce because their occupational provider gave a great safety talk. But that’s another topic for another time.

Yes, there is joy in occupational medicine. It sometimes is lost in the details of the day’s work, but if we take a step back for the big picture, the expertise we provide is helping a lot of people and our economy too!

David Hoffman, MD, is a Regional Medical Director for U.S. HealthWorks. Dr. Hoffman works in our Washington centers. 

Image courtesy/

Don’t Be So Quick to Dismiss Measles

Measles outbreaks have been recently reported in Ohio and California. Measles, mumps and rubella – really!

Have we become complacent in the face of all the current medical technology? Are we more worried about which vitamin is best than we are about vaccinating our children?  Does the average doctor even know how to diagnose measles?Doctor treating child

Measles, a classic childhood disease 60 years ago, is caused by a tiny and well-defended virus. When it was widespread in my own childhood, it was considered simply the cost of being a kid. Nobody got overly excited about measles, and the most severe complications are not common in healthy kids. It was no big deal.

The isolation of the measles virus in 1954 allowed an effective vaccine to be produced. Why produce a vaccine against what was considered a rite of passage? Because our parents didn’t tell us the truth about measles; it is a nasty disease that can have frequent and devastating complications.

Garden variety measles is highly contagious. If you are unvaccinated and living with someone who gets measles, the chance of catching it is more than 90 percent. If it’s around and you are not immune, you will likely get it.

It takes a week or two to get the symptoms after exposure. This usually starts with a very high fever (104 is common), runny nose, red eyes, deep cough, and feeling like “death warmed over.”

A few days after this, the rash develops and red spots are all over your body and they often itch. All this “fun” goes on for about a week to 10 days if nothing bad happens.

What could happen? A surprising variety of complications are relatively common.  Pneumonia is one of the most common. The virus weakens you, and you can develop either a viral pneumonia or the more severe and dangerous bacterial pneumonia. If you thought you were sick before, welcome to the 7th circle of hell!

The nervous system can also get into the act. Encephalitis is a brain inflammation/infection from measles that can cause all manner of mayhem, and even be fatal. This is the most feared complication of measles.

Of course, measles is a much worse disease in adults (as most childhood illnesses are).  Adults typically get sicker.

This is a hard virus to avoid if you have not been vaccinated. If you call a doctor or urgent care center and say you may have been exposed to measles, and were not vaccinated, there is nothing we can do except offer you the vaccine.

The vaccine is unlikely to work because it is racing the live virus to see which one infects you first. Remember, the measles virus got a head start!

Measles is well worth avoiding, so why does anyone skip the vaccine? There was an unfortunate article in The Lancet medical journal a dozen or more years ago that suggested there was a connection between the measles vaccine and autism.

This was such bad science that the British medical board took the medical licenses away from the doctors after writing this erroneous article.

Lancet withdrew the article with a full explanation of why there was no connection between measles and autism. However, the damage had been done and this evil Genie would not go back in the bottle. The bogus article even generated a cottage industry of supposed vaccine-caused problems that still exists today.

Measles has no animal reservoir, so it is possible to wipe it from the planet, like smallpox. The usual vaccine schedule in the U.S. is to give the first dose at 18 months. Much earlier and the vaccine doesn’t work because the mother’s antibodies against measles kill the vaccine.

The second dose is just before starting school (age 4-6), and confers lifetime immunity.  You can always get an extra dose of vaccine as an adult if you are unsure of your vaccine status.

So contrary to popular belief, measles is a big deal. It will make you plenty sick and is worth avoiding. The advice here is get your shot at an urgent care center like U.S. HealthWorks Medical Group and avoid needlessly suffering.

Stay well.

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/

Hearty April Fool’s Day Laugh Is Good For Your Health

April Fool’s Day has a long and glorious history that deserves to be celebrated by fools, would-be-fools, and soon-to-be fools, which pretty much takes care of the rest of us.

The origin of the celebration dates back at least to the Canterbury’s Tales (1392), but the play on words, in old English, is lost in translation.

One can easily imagine medieval practical jokes – probably reminiscent of Monty Python’s Holy Grail movie. But the true glory of the April 1st practical joke only reached its pinnacle with the advent of modern communications.

The year of my birth (1957) featured one of the most famous April Fool’s jokes. The irony is not lost on me.

The British Broadcasting Company (BBC) showed a television program with people in Switzerland harvesting spaghetti. It was a normal enough appearing farm with 3-foot long spaghetti noodles hanging from the trees, and farm workers on ladders busily harvesting them.

In usual dry British wit, the narrator noted the harvest was particularly good this year due to the absence of the spaghetti weevil. The segment talked up the taste of home-grown spaghetti so much that people called the BBC asking how to grow their own.

“Put a sprig of spaghetti in a can of tomato sauce and wait,” they were told. More than a few gullible souls did just that.

The Brits were at it again about 20 years later, coming up with another doozy, this time on BBC radio. An interview with a famous astronomer Patrick Moore was broadcast.

Moore was someone of Carl Sagan’s stature, who explained in detail how the planet Pluto would be passing behind the earth, causing a gravitational alignment that would temporarily nullify the earth’s gravity at exactly 9:47 a.m.

Moore said if anyone jumped into the air at that moment, they would feel a strange floating sensation. At exactly 9:47 that morning, Moore shouted on the airwaves – “Jump!” And most of Great Britain did. And the surprising thing was many people reported feeling that strange floating sensation at the peak of their jump!

In the U.S., our pranks are more of the knock-knock variety than shaggy dog story. One of our most famous was rather recent. In 1998, Burger King ran a full-page ad in USA Today, announcing a new item on the menu, the left-handed Whopper.

Burger King did this for the 32 million southpaws in the nation, and claimed to have rotated all condiments 180 degrees so they would drip out of the other side of the burger. Many people tried to order the left-handed burger. One wonders how many got them?

Another fast food mischievous prank had Taco Bell claiming to have purchased the famed Liberty Bell in Philadelphia and renaming it the Taco Bell Liberty Bell.

There was public outrage, followed closely by embarrassment – and finally laughter.

Laughter is definitely healthy, a balm for much of what ails us. A hearty laugh gives the body a little more oxygen, drops the blood pressure, and feels like rinsing our brains off with cool clear water.

Laughter is stronger than Prozac and works instantly. If you do nothing else this April Fool’s Day, try to laugh a little and maybe help a few of the hopeless Type As in our lives, who could definitely benefit from a good belly laugh.

Happy Fool’s Day.

Dr. B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Managing stress during tax season

Spring is here and the usual severe desert landscape in the Phoenix area becomes suddenly beautiful for a brief couple of weeks.

Entire hillsides are transformed with desert wildflowers — purple lupine, yellow bells – and the red desert paintbrush competes with the wildflowers for both space and glory.Tax season

But there are rattlesnakes that live beneath the desert flowers, providing a reminder that not everything associated with the arrival of spring is a good thing.

Rattlesnakes, like taxes, must be contended with each spring. Given my choice between taxes and rattlesnakes, I would pick the rattlesnakes. I know how to avoid getting snake bitten.

Tax time is a “special time” in many marriages. The No. 1 cause of marital strife in America is boredom; and a close second is money stress. Tax time is definitely not boring, so home life can be very interesting.

I think few of us would argue that taxes are sort of the scorpion in the smooth balm of springtime. It is one of the more stressful times of the year.

Stress is an insidious cause for a number of serious health issues. Stress can give you the chance to try on a Type A personality for size. Most of us recognize that headaches, indigestion and insomnia can be related to stress, among other causes.

Many a patient has gone to get medical help, thinking they were sick. And more than a few medical providers have “barked up the wrong diagnostic tree” before figuring out these were stress-induced symptoms.

But stress doesn’t stop with these fairly obvious symptoms, it smolders along much deeper. Stress increases your blood pressure and that puts a strain on your heart. Stress also triggers some coping strategies that can further abuse the blood vessels.

Nicotine has tranquilizer properties (among less desirable characteristics), and smoking is common in stressed people. Stress eating is also a known phenomenon, and fresh steamed broccoli is usually not the preferred comfort food! Put these together and you get stress-induced heart attacks.

Many diseases and conditions are worsened by stress. Diabetes is harder to manage because stress hormones raise the blood sugar. Stress won’t give you an ulcer, but it will worsen any digestive problems you came in with.

Depression, anxiety and most mental illness are seriously worsened by stress. Even Alzheimer’s disease can be accelerated by stress.

If that isn’t enough, stress is believed to accelerate aging (now we’re paying attention).     Genetic studies compared telomere length in stressed vs. unstressed people, and stressed individuals looked older genetically (shorter telomeres).

What do we do about this, besides getting motivated to do our darn taxes?

Spend some time quietly contemplating those wildflowers instead of focusing on the rattlesnakes. You can almost feel your blood pressure drop. Keep in mind you can always get an extension on your taxes, but not on the wildflowers.

Exercise away some of that edginess. Stress can literally be sweated-out with some hard physical activity.

Get some reality education to chase those stressors away. Note that the audit rate for the vast majority of taxpayers is below 1 percent. And most of us don’t have the income or the brains to figure out big tax hedges so an audit won’t bankrupt you. And very few normal taxpayers end up in jail for long (now that’s a reassuring thought!).

But if all else fails, consider every symptom you have, a result of Tax-Time stress, and a holiday in Tahiti would be just the cure. And you can deduct it.

Do they extradite from Tahiti?

Take care.

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/


We’re springing into allergy season

The days are getting longer, which means I don’t leave and arrive home in the dark any longer.

A few more chirps are in the air, more bugs on the windshield, and I can hear the distant whine of a lawnmower. Spring flowers in the Phoenix desert are very transient, and made more precious because of it. It’s all good stuff.Allergy sufferer

Your immune system is also waking up from a winter’s hibernation.

The immune system, for all we have learned about it during the past 15 years of AIDS research, still remains somewhat of a black box. Allergens in, sneezes out.

You actually can’t be allergic to something your body has never seen before. Yes, you can run buck naked through the poison ivy patch without fear of rash; as long as you are correct that you have never come into contact with it before.

Once your body has seen an allergen, it starts making antibodies against it. That is the least understood detail of this whole process.

The system works well when you quite sensibly make antibodies against flu, polio or measles. When you make them against ragweed, or your own heart or muscle proteins, you have allergies or worse, autoimmune disease. And note that allergies don’t turn into autoimmune disease.

So you have made lots of antibodies against spring pollen. These little IgE antibodies are like circulating time-bombs, peacefully going round and round until they run into one of these pollens/allergens. The mystery is why one person develops antibodies against mulberry trees, and the next one doesn’t.

Once the IgE antibodies and allergen meet, a reaction occurs that medicine has pretty well figured out. This IgE-pollen complex finds a mast cell and causes histamine to be released. Mast cells release histamine to fight this terrible invasion of pansy or petunia – pollen.

Histamine sounds familiar from all the thousands of antihistamine commercials we have sat through. There is a pretty good reason to have an antihistamine because histamines make vessels in the nose and sinuses leaky; thus the runny nose and sneezing.

Histamines also cause inflammation in mucus membranes, including the ones lining the eyes. The result: red, itchy, watery eyes. The lungs often get into the act with inflammation in the tiny vessels lining the airway. This can cause a cough, or in some people, wheezing.

Put up with this for 3-6 months and see how much you’re enjoying life!

The good news is we have been battling histamine and allergies for a long time and almost everyone can be helped. Mast cell stabilizers stop the mast cells from leaking histamine. These medications come in eye drops and nose spray, and are generally well tolerated and a pretty elegant solution if your symptoms are worse in your eyes or nose.

One of the most effective things you can do when Allergic Rhinitis (nasal inflammation) occurs is use a nasal steroid spray. This dramatically reduces the inflammation in the nose. Since the eyes and chest connect, nasal steroids often help combat all allergy symptoms.

Antihistamines and antihistamine/decongestants are the most common treatment for allergies. The medications are pretty effective, but they are sedating to some patients.

We now have non-sedating antihistamines – and they work. With any antihistamine you will have increased symptom control if you use them on bad days and occasionally take a day off these meds.

Immunotherapy is done by allergists; it’s the classic allergy shot series. There are mixed results from shots; some patients do wonderfully and some do not. One of the problems with immunotherapy is we don’t really understand why you started attacking stuff that isn’t too threatening (flower pollen).

Like everything else, lifestyle can be helpful for allergies. A radical approach – move.  People with bad allergies may move to the desert to escape the offending pollen. Of course, sometimes you develop allergies to the desert pollen.

You can banish pollen from your house by keeping your windows closed, effectively keeping the outside – outside. Another factor is clean surfaces. Tile is cleaner that carpet and shutters are cleaner that drapes. I suppose spandex is cleaner than fir (but perhaps we go too far).

Allergic Rhinitis is a well understood condition. There are a variety of good treatments and almost everybody can be helped.

Take care

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona

Image courtesy/

A Rite of Spring: Sunshine

Every spring, the sun seems newly discovered. I take it for granted most of the time, and instead worry about painting the house, washing the truck or ninth grade math homework.

But sometimes I notice and it can occur during the most mundane errand, like refilling my blood pressure prescription. I’m walking across the parking lot and suddenly notice the sun warming my skin.

Some ancient reptilian area of your brain wakes up and the thought comes to mind – stop and bask, photosynthesize a while. Get in your car and sit a moment in the sunshine and feel the warmth come over your body.ID-10021313

The sun is the single most dominant force on the planet (at least in our little corner of the solar system). You have to travel a dozen light years to find a star that can compete with the sun.

Sun worship has waxed and waned through human history, but it certainly has to be seen as one of the dominant belief systems as people struggle to find their place in the universe.

The sun is pretty hard to ignore. Its radius is about 100 times the radius of the Earth and about a quarter million times the mass (weight) of our planet. It’s made of hot plasma and magnetic fields; whatever that means. That doesn’t even sound like something from our universe.

The sun is almost entirely made of hydrogen. It’s a giant nuclear reactor fusing hydrogen into helium at the rate of approximately 600 million metric tons a second. And we are eight minutes away as sunlight travels. A little closer or a bit further away gives you a frozen planet or a cinder of one.

You can think of the Earth as surfing on a great wave of sunshine energy. With a little luck we can do it another 4 billion years – talk about endless summer. Maybe the Beach Boys were right!

Our entire planet runs on less than 1 percent of the energy put out by the sun.  That is ultimately the energy budget for everything that we do, think, consume or look at. Without our 1 percent of sunshine, none of us would be here, not even Apple.

And while we’re basking in the sunshine, notice that our sun rotates around the center of the Milky Way galaxy like a giant clock, once every 225 to 250 million years. All of human history has occurred in a couple of seconds as counted on this timepiece.

The next time you walk outside, stop and savor this microsecond in cosmic time that allows you to be effortlessly balanced between forces of unimaginable strength. It’s a moment that should bring a smile to your face.

Take care and have an enjoyable, sunny spring day.

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/



Going green (food) for St. Patrick’s Day

I’m half Irish, and my most memorable St. Patrick’s days were spent in college, drinking green beer for breakfast!

’Tis a shame, Guinness or Murphy’s are Irish, and are much more pleasing on the palette. They are also packed with good stuff you won’t find in the average green-dyed lager.St. Patrick's Day

Naturally occurring pigments in foods often have strong antioxidant properties, and dark beers are full of them. These flavonoids reduce heart disease and hypertension; both of which are of little interest to the average collegiate immortals (the only explanation for a lot of college behavior, including mine).

The Irish have always had a connection to green that, of course, stands today. St. Patrick, a 5th century Bishop, supposedly used a shamrock to teach the Holy Trinity. He also is falsely celebrated for banishing snakes from Ireland (although a legless lizard lives there that looks pretty snake-like to most people – seriously).

Pondering green foods to accompany your Irish beer, it’s difficult to find an unhealthy one, once you get away from green eggs and ham. With all due respect to Dr. Seuss, who was neither Irish nor a real doctor, his green food advice may be suspect.

“Greens” refers to dark green leafy vegetables: spinach, mustard greens, collard greens, chicory and Swiss chard.

Spinach is one of the best green foods around. In fact, it’s called a super food.   Perhaps you remember Popeye, our first superhero, who got a curious instant forearm, fist pump from spinach, which he ate out of a can (opened with his teeth).

Fresh or steamed is better and the list of spinach benefits is long. Highlights include  antioxidants, folate, iron, B6 and protein. Probably a little exercise will spread the pump to the rest of your muscles; and your dentist will be happy if you don’t use your teeth.

These dark greens also abound in carotenoids and flavonoids (organic pigments) that show promise in preventing cancer, and can (in theory) slow down the clock.

These days, dark mixed greens are easily found prewashed, packaged and ready to go in your local supermarket. If you eat like Roger Rabbit, there’s hope you may live a long life and meet someone like Jessica, his red-headed,  presumably Irish girlfriend.

Potatoes are as Irish as Leprechauns, and are unfairly maligned for their derivative fast food products. Few foods gain healthful benefits from deep fat frying.

The potato is a good source of inexpensive complex carbohydrate calories, vitamin C and fiber. The health benefits are diluted by butter, sour cream, bacon crumbles and chives. Take a potato skin, fill it with greens, and you have the healthiest Irish Taco you will ever consume.

Corned beef and cabbage will grace the tables of many Irish on St. Patty’s Day.  Corned beef is actually salt-cured beef, about halfway to beef jerky and almost as indestructible.

The “corn” refers to the small hard salt crystals. It was used extensively in World War II because it required no refrigeration and doesn’t spoil.

Although not the biggest concern when people are shooting at you, corned beef has all the cholesterol and saturated fat of beef, plus a sodium load best measured with the Richter Scale. The cabbage is of course a “green,” which by law of nature must be good for you.

And for dessert on St. Patrick’s Day, a jigger of Jameson Irish Whiskey would be appropriate. You can toast your health as an ounce of alcohol a day is good for you. It gets your good cholesterol up and slightly thins the blood.

Wear some green on March 17th and stay lucky!

Happy St. Patrick’s Day.

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/

Daylight saving time: Spring forward means different things to different folks

Daylight saving time is approaching again, arriving this Sunday. At first glance, it might seem enough to just remember to spring forward. But do you realize daylight saving time is one of the grandest social engineering experiments in America?

Almost the entire country moves their schedule up one hour. Every meeting, romantic dinner, and heart transplant occurs one hour later. Every business, court appointment and movie showing is one hour later. In virtual lockstep, the entire nation boldly takes a step into the future.ID-10050881

To put it in perspective, all the millions of dollars, countless man hours, programs, and smart people’s best efforts spent convincing the public to stop smoking, has only reduced the smoking rate by 15 percent. And smoking gives you cancer – it should be an easy sell, right?

But almost by decree, we get nearly 100 percent of the people to move their entire lives an hour forward!

Curious …

Modern society requires us to be a slave to the clock, a cog in the great machine.   Organize almost any human activity and there is implicit agreement to the rule of time. But we are more than machines; we are complex biological organisms that sometimes rebel to even well-meaning change.

Daylight saving time was conceived 100 years ago as a way to save lamp oil during World War 1. Moving the clock forward extended daylight later in the evening, and less whale oil was used in lighting the parlor, which was a noble goal.

When we moved away from lamps that burn oil to ones that require electricity, the equation changed a bit. Now light could be made quite inexpensively, but heating and cooling was less efficient, so daylight saving costs us money.

Trade is modestly increased by daylight saving time. People are more willing to go out and spend money when it is light. A dinner out, a movie, some light shopping, they are all more attractive when you can see where you’re going and don’t need multiple clothing layers.

As you might guess, there is also a biologic cost. There is a measurable spike in heart attacks in the weeks following daylight saving time.

Many people are wandering around critically sleep deprived, and taking away one more hour spills the apple cart (a scary thought as sleeping is not one of my talents). When the clocks fall back in the autumn, heart attacks temporarily go down, and balance is preserved in some weird way.

But most people have only mild challenges from the leap forward. If you are sensitive, it can take several weeks for your sleep cycle to straighten out. Like all human attributes, adaptability to sleep disturbance is quite varied. Some people are challenged and some don’t notice.

But daylight saving is not really about saving money, saving whale oil or increasing trade. Daylight saving is about quality time.

Arriving home from work every night in the dark tends to discourage family activity. That extra hour of sunshine can be the excuse for eating on the patio or going for a walk after dinner – anything to dislodge the family from the TV set is a good thing!

Daylight saving is perhaps wasted on adults. Kids live for it. We all have fond memories of neighborhood gatherings on bright evenings. The chance to burn off a little energy and practice your negotiating and social skills.

Daylight savings is a rite of spring, and a promise of more time to add something fun to our lives. A few fragile people may become unbalanced, but most of us find an extra hour to enjoy life.

Kick the can, anyone?

Take care.

Dr. B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy/