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4A – Daily News – Monday, August 16, 2010 Vitality & health MINNEAPOLIS (MCT) —Three years ago, Amy Leyden took her 10- year-old son, Luke, on a vacation to Oregon. Her back hasn't been the same since. Pushing back on back surgery In a furious game of touch football, Leyden made a spectacular catch but landed flat on her back. That night, she slept on a friend's couch, and the next day, the fearless duo went on an ill-advised dune buggy ride on the Oregon coast. Within a month, the "40- something" marketing man- ager at the University of Minnesota was diagnosed with a herniated disk, a con- dition so painful she had to conduct meetings lying flat on her belly in her office. "It was excruciating," she said. Leyden's story is an increasingly familiar one in American medicine. Four out of five Americans will suffer from disabling back pain during their lifetimes, according to the National Institutes of Health. Spend- ing on back care soared between 1997 and 2005, reaching $86 billion — just shy of what Americans spent battling cancer. As those numbers have multiplied, so have ques- tions about the more aggres- sive forms of back treat- ment. A 2008 study in the Journal of the American Medical Association, for example, noted that the increase in back-care spend- ing occurred "without evi- dence of corresponding improvement" in patients' health. "Intense pain is not nec- essarily an indication for surgery," said Dr. Richard Deyo, a professor of family medicine at Oregon Health and Science University and one author of the study. "You can't fix everything with a knife." troversy involves an inva- sive surgery called spine fusion, which attempts to relieve back pain by perma- nently connecting (or fus- ing) several levels of bone in the spine. While the over- all number of back opera- tions has flattened out in recent years, complex fusion surgeries, which can cost upward of $80,000, continue to proliferate. American surgeons now perform twice as many of these operations as their Perhaps the biggest con- said Dr. Sam Ho, chief medical officer for United- Health Group, the nation's largest insurer. "We all want to be as active as we can _ and for as long as possible." The surge in fusion surgery has meant big money for Fridley, Minn.- based Medtronic, whose spine business reported some $3.5 billion in sales last year. MCT photo Amy Leyden does a chest bump with her 12- year-old son Luke Schroeder in St.Paul, Minn. counterparts in most Euro- pean countries, Australia and New Zealand, and five times more than the United Kingdom, despite similar patient populations. This debate is likely to intensify under the sweep- ing new federal health legis- lation that President Obama signed in March, which will gradually require doctors and hospitals to demon- strate that their services are cost-effective. In that vein, the New England Health- Care Institute estimates the United States could save roughly $1 billion a year by eliminating unnecessary back surgeries. Minnesota is likely to be a crucible in this debate. The state is home to Medtronic Inc., the world's largest maker of devices used in spine surgery, as well as Abbott Northwest- ern Hospital, which per- forms more spine fusion surgeries on Medicare patients than any other hos- pital in the country, accord- ing to the industry publica- tion Orthopedic Network News. Fusion surgery has his- torically been used to cor- rect deformities, fractures, complications related to tumors and other rare condi- tions. The surgical results have been good, and largely noncontroversial. But in recent years, more and more of these proce- dures have been used to treat back pain related to aging, prompting several studies to question whether the expensive intervention is worth it. Fusion involves a surgi- cal toolkit consisting of screws, rods, cages and plates, and sometimes a bio- logic product made by Medtronic called Infuse, which grows bone between the vertebrae in an effort to stabilize the spine. Critics argue that influ- ence by big medical device companies_including lucra- tive royalty and consulting arrangements bestowed on top surgeons whose opin- ions hold sway among their colleagues _ is one reason why the number of spine fusion surgeries has sky- rocketed. Earlier this year, Medtronic disclosed these payments to doctors for the first quarter; of the $16 mil- lion Medtronic paid in those three months, $14 million went to spine and orthope- dic specialists, mostly for royalties. In 2006, American doc- tors performed approxi- mately 343,000 spine fusion operations, up 82 percent from 1999, accord- ing to the National Center for Health Statistics, which tracks Medicare data, omit- ting perhaps thousands more paid by other sources. Since then, the number has continued to rise, though not as explosively. The Mil- lennium Research Group estimates 445,300 spine fusion surgeries were done last year. surgery varies widely, according to data compiled by UnitedHealth Group, the Minnetonka, Minn.-based insurer. For a complex lum- bar fusion surgery, the cost can vary from $25,000 to almost $80,000 in a "typi- cal" major metropolitan market. Deyo has argued that the rising costs, high rates of complications and second surgeries and wide varia- tions in the number of pro- cedures performed from one state to another "gener- ate concern that the proce- dure may be overused." Others claim the increase in fusion surgery may be related to improve- ments in technology and the simple fact that baby boomers are aging. "Ameri- cans think longevity is a right and death is optional," The cost of fusion fitness Nutrition Quiz: Bananas (MCT) We'll use any excuse to write about bananas, a personal favorite of the Nutrition Quiz. 1. Bananas are renowned for being a rich source of potassium, which, among other benefits, helps regulate blood pressure. Which of these fruits con- tains more potassium than a large banana (806 mil- ligrams)? a) One cup of sliced kiwi b) One cup of raisins c) One medium apple 2. The high content of vitamin B6 in bananas pro- vides what health benefit? a) Strengthens bone development b) Converts blood glucose into energy c) Improves nerve-impulse stimulation in brain function what? 3. The fruit also is rich in magnesium, which does a) Strengthens bone development b) Converts blood glucose into energy c) Helps prevent gout 4. Uganda is a banana-loving country. How many bananas does each person in the country consume daily? a) 1.3 pounds b) 2.5 pounds c) 5 pounds Medtronic and others insist that collaboration with doctors is crucial for creat- ing and perfecting innova- tive new tools to treat patients. But Dr. Charles Rosen, a California spine surgeon and the head of the Association for Ethics in Spine Surgery, says these financial incentives create demand for certain brands of product. "That's one rea- son why you're seeing so many fusion surgeries," he said. Other specialists say the situation is more nuanced. Each patient is different, they say. surgery? Yes," said Dr. John Sherman, an orthopedic sur- geon with Twin Cities Orthopedics, one of the nation's biggest practices of its kind. "But it's not as dark as (Dr.) Deyo portrays it, nor is surgery a panacea for curing all back pain." One satisfied patient is Amy Leyden, who turned down surgery "out of pure fear" and went to 24 rehab sessions at Physicians Neck & Back Pain instead. "You're pushed," she said. "It's like having a per- sonal trainer. But I would have never done it on my own. As soon as it got painful, I would have quit." It worked. Today, Ley- den keeps up with two kids, plays tennis and goes to the Y a couple of times a week. Fly-fishing retreat helps breast cancer survivors find strength WEST CORNWALL, Conn. (MCT) — Barbara Scott's hair fell out in hand- fuls, and yet she could not bring herself to talk to fami- ly members about the can- cer in her breast. The side effects from radiation thera- py stiffened her hands and made her fingers swell. "I couldn't button my shirt or tie my own shoes," said Scott, 55. But still she could not talk with family mem- bers about the cancer in her breast. Five years after being diagnosed with breast can- cer, Scott, of Windsor, Conn., told her story of silence and survival Sunday to 13 women she'd known for less than three days, and discovered that her reti- cence wasn't "crazy" or "strange." "I found out that none of Jack the Ribber Come by for the Best Lunch in town • Ribs •Tri-Tip • Pulled Pork • Specials Tues.-Sat. 6am-8pm Sun. 10am-3pm Closed Monday 1150 Monroe St. 527-6108 us talked to our families about it, especially our mates," said Scott, who attended the Connecticut Casting for Recovery retreat at the Trinity Conference Center in West Cornwall, Conn. The 2 {-day retreat helps women with breast cancer recover their physi- cal strength — and often their spirits — through fire- side chats, counseling and fly-fishing. "You can do as much or as little with fly-fishing as you want," said Kate Fox, the group's national pro- gram director. "The most important thing is the bond- ing of the women here," said Fox, who helped orga- nize the West Cornwall retreat. attend have never been part of a breast cancer support "Many women who 645 Main St., Red Bluff • 529-2482 Monday Morning, 8am-noon Wednesday Evenings, 5-9pm Join us for neighborhood Bring your jars & ingredients. CANNING & PRESERVING www.californiakitchencompany.com $1 We’ll help you and provide equipment. a jar group," Fox said. "So many will say, 'I'm done with treatment. I'm not sick any- more. I want to move on,' but they haven't dealt with issues of sexuality or family or anxiety. This gives them a chance to finally talk about these things and ask questions. We have medical experts and counselors on hand to help." and Windsor raised $13,000 of the $15,000 required to cover the cost of a retreat, which is free to the 14 breast cancer survivors who attend. The Hartford has been the organization's lead sponsor since 2006. Nearby, Jennifer Slade In the mid-1990s, Dr. Benita Walton, a breast reconstructive surgeon and an avid fly fisherman, real- ized that the physical motion of casting is similar to the therapeutic exercises intended to rebuild the mus- cles lost to breast cancer surgery. Teach a breast can- cer survivor to fly-fish and you give her the means to empower herself physically and emotionally. In 1996, Walton founded 2390 Athens Ave. Redding CA 96001 530 244 1400 www.avantitravel.com *NO CHARGE FOR OUR CRUISE AND TOUR BOOKINGS Why Use a Travel Agent? *EXPERTISE *SAVINGS * PEACE OF MIND * BEST PRICING Wedding registry and destination weddings Remember without a Travel Agent you are on your own cst# 2007495-40 MCT photo Pat Gondek takes a lesson from fly fisherman Larry Wolff during the Connecticut Casting for Recovery Retreat in West Cornwall. Casting for Recovery. Since then, the national nonprofit organization based in Man- chester, Vt., has staged retreats for more than 4,500 breast cancer survivors. BOOK BARN Used Books Tues-Fri 10-5 Sat 10-2 THANK YOU RED BLUFF We are now celebrating our 16th Anniversary 619 Oak St., Red Bluff (530) 528-2665 organizes annual catch-and- release fly-fishing retreats in 30 states. It hopes to expand its reach and retreats to all 50 states. "We have three applications for every one spot," Fox said. "Every day 500 women are diag- nosed with breast cancer. There's a huge need." This year, employees of The Hartford in Simsbury Casting for Recovery of West Granby, Conn., who was diagnosed with breast cancer a year ago, caught three bass. "My hus- band will be thrilled," said Slade, 38, the mother of two small children. "I learned we all have so many of the same worries. If I have a pain in my leg, I think it's bone cancer. I'm not alone in thinking that!" "Is there too much back 5. According to Dole, which of these cities is not considered a "top banana market" by the company? a) New Orleans b) Albany, N.Y. c) Des Moines, Iowa Sources: nutritiondata.self.com; www.ehow.com; www.dole.com/bananas A half-dozen men joined the group to help hone the women's casting skills. "I'm a fly fisherman and this is an opportunity to give back," said Stephan Prucnal of Marlborough, Conn. Sunday marked his first stint as a volunteer. "I can hardly wait to come back next year," said Prucnal, 53, whose mother-in-law had breast cancer. ANSWERS: 1: b (raisins: 1,086 mg in potassi- um); 2: c; 3: b; 4: a; 5: b.