How to construct an emergency custom back support car seat for under $20

Imagine that you have been lying flat in the back of a van for almost 3 days.

True, your back is healing. On the other hand even a small head-on collision will fracture your neck, it's very uncomfortable, the ceiling is exceedingly dull, and the dog is smelly:

Clearly, inspiration is needed.

Experimentation shows that any time spent in a conventional car seat is a painful trip to acute muscle spasm. On the other hand, maintenance of exaggerated lumbar lordosis (curvature of lower back) and neck extension is well tolerated.

How can one transform a conventional bucket car seat into something that will support an upright posture for 1,500 miles of driving over about 8 hours a day for two days?

Well, it has been done. In fact, while sitting in my custom rig I healed more quickly than when lying flat on the rather uncomfortable van floor.

The total cost for the rig would be about $25. Since I already had the freezer insert and the neoprene wrap it cost me about $8 for the Walmart mini-boogie board [3]. (See photo below, it's about 24" tall.)

1. I adjusted the seat so that it was as close to a right angle as possible, with the base as flat as possible.


2. I placed the foam boogie board along the seat back to create a non-yielding seat back.


3. I removed the seat's neck protector as I found I needed more neck extension than the seat headrest allowed [2]


4. I inserted the 1" thick red hard plastic frozen picnic cooler [1] into the neoprene wrap and fitted it so the plastic spacer was either in the middle of my lumbar curve or just below the curve. This created a fixed exaggerated super-cooled [1] lumbar curve.


5. Every 2-3 hours we stopped the car. I walked until I'd loosened up, then attached my inline skates (I figured out how to do this while keeping my lordosis extended) and skated for 10-15 minutes with Kateva to keep the back as limber as possible.

And so I drove for two days. I was very careful to enter and exit laterally, so at no time did I reverse my lumbar lordosis.

When we finally arrived home, I exited without pain. I even fell a step at the neighbors and my back survived.

Next week I have my first appointment for back care in over 27 years of 1-2 times/year severe disabling acute back pain. It's time for me to get a serious lifelong exercise program in place so I don't have to do this one again.

I will be using my custom back support for a few days however, and when we do our next car trip I'll put the boogie board somewhere. The kids can use it in the pool anyway ...

[1] This is medically illegal. It will cause you to develop frostbite, skin and muscle necrosis, toxic shock and you will die. You should use a non-frozen item of similar size and shape.

[2] This will cause you to fracture your neck in a car accident. You will be paralyzed and on a ventilator, then you will die a slow death that will bankrupt your family.

[3] I wandered the aisles waiting for inspiration to strike, looking for something that would provide firm but lightweight back support. High impact styrofoam in a fabric cover was perfect. I just happened to set eyes on the mini-boogie board ...
PS. There's a bit of irony here. I first wrecked my back 27 years ago boogie-boarding with a full-sized board in Southern California. Maybe that's why I really chose this fix.

Update 7/7/08: I received a post skeptical of my enthusiasm for cold therapy vs. hot packs. I followed up with my new team at Physicians Neck and Back Clinics (profiled in the New Yorker in April 2002, they represent the "new wave" approach of aggressive exercise based rehab). They never use heat or hot packs. They use only cold therapy, though for them strength and flexibility are 90% of the solution. I suspect hot packs can be very helpful for some, but they're really out of fashion. I've only ever bothered with cryotherapy.

Update 3/4/09: I'm going to write a bit more on this topic in July of 2009, when I'm a year post event. I've done well for long enough though that I'm a cautious fan of the extreme core strengthening approach of Physicians Neck and Back Clinics. It might be overkill, but I wouldn't be surprised if it turns out to be about the right balance.

Update 8/1/10: I did the f/u post in Nov 2009, but forgot to backlink it here.

The mysterious bicycle path of Rochelle Illinois

Google chose our route from New Hampshire to Minneapolis.

I like to think it chose the route to minimize construction delays, but to get past Chicago we used Google traffic maps time snapshots to spot the route that had the least stop zones as of 3 pm yesterday. The Chicago route more or less worked -- Google inexplicably missed a big construction project on route 88 west to Rochelle. Even so, it was our fastest Chicago transit ever.

As usual we stopped in Rochelle, Illinois, a railway crossroad town that survives because it's a highway crossroad town now. (In a related vein I've a post-pending on ultra-wealthy Chicagoland and the devastated Erie Canal strip, probably with an Obama comment). My back recovery program (post pending on my patent-pending seat optimization rig that got me off the floor) meant that this time Kateva and I had to inline skate Rochelle (ok, so she has never mastered skating)...

Rochelle, Illinois - Wikipedia, the free encyclopedia

Rochelle is known as the "Hub City" because of its location at the intersection of several major transportation routes. The first transcontinental highway in the United States, the Lincoln Highway, passed through Rochelle, as did US-51, one the first highways to go the full north-south length of the United States. Both these roads have diminished in importance (and are now state highways 38 and 251, respectively), but Rochelle continues to be crossed by major highways, especially Interstates 88 and 39...

Rochelle is not a wealthy town, but it's proud of its park district, and a mysterious bicycle path. I skated and drove around the town and couldn't spot the bike path, but a satellite shot tells the tale:

 

View Larger Map

Yeah, that's the path. About 300 yards or so. It does look nice though. Funny thing -- there are signs throughout town referring to the path, but when you finally find it, there are no more signs. I guess someone had mixed feelings about advertising it.

Update 8/14/08: See comments. Technically, the path is 4.1 miles long! It continues on from this park path onto what I think are city streets. I couldn't find any signs during my reconnaissance, so I missed the extension. I remember some of them as pretty busy streets -- so if the path is really not segregated from traffic it's not for youngsters. More than 300 yards anyway!

My iPhone purchase strategy looks like a really bad bet ...

About a year ago my wife needed a smartphone to replace the excellent Samsung Palm i500. I figured we'd switch to AT&T so I'd be ready for iPhone 2.0, and get her a BlackBerry Pearl. In the meantime I'd get rid of my hated Motorola RAZR and live with a generic cheap Nokia.

I should have just bought iPhone 1.0, because I'm going to get hit with the unsubsidized price AND the increased monthly data rate:

AT&T's official iPhone 3G pricing/plans: $199 to $499 ... Although AT&T continues to be vague on exactly what it means to be 'eligible' (a spokesperson said that, among other factors, it depends on where a customer is in his or her contract), the company does tell us that if you're not eligible, you can still buy the iPhone 3G for $399 and $499 for the 8GB and 16GB models respectively. Unfortunately, these bumped-up prices still require a two-year service agreement, so this is pretty much the worst end of the stick if you're a prospective iPhone customer...

I'll try to sort this out with the AT&T outlet near my office, but we already know AT&T uses price complexity as a weapon.

I'm in line for a $500+ total charge from AT&T compared to a customer switching today from Spring.

More when I get the full story. I knew I was dealing with Satan when I signed.

Update: This is such a raw deal I might be better off ordering iPhone 1.0 prior to July 11, then maybe transferring it in future.

Update 7/1/08: From Tidbits:

The current 2G iPhone plans will continue to be available for people who want to start up new service plans with someone's old phone. That means that instead of the $30 per month for unlimited 3G data required for the iPhone 3G, plus a minimum of $5 per month for 200 incoming and outgoing text messages, a 2G iPhone buyer or gift recipient can pay $20 per month for unlimited EDGE and 200 text messages. The original GoPhone prepaid option is also available, which costs $20 per month for unlimited EDGE data, but does not include text messages...

...Also today, AT&T clarified who qualifies for a subsidized iPhone, and how much a contract-fee iPhone will cost. If you are in the middle of a contract period with any handset but an iPhone, you don't qualify; that's also true if your account isn't in good standing. Users who meet that bill pay $400 (8 GB) or $500 (16 GB). No-contract iPhone 3Gs won't be available at launch, but when that option comes around, it will cost $600 (8 GB) and $700 (16 GB). (At least one site has pointed out that buying an iPhone 3G, keeping the plan for over 30 days, and then canceling service and paying the early-termination fee is much cheaper. AT&T may offer a wrinkle there to prevent this.)...

So, what about existing AT&T customers who buy a used iPhone 1.0? Do we get the old plan too? Probably not, but I wonder about buying under the old contract with a used iPhone, then buying a new iPhone with their special iPhone upgrade contract deal then selling the used iPhone again. Nahhh..

Missing iPhone cut, copy, paste lost in patent wars?

The Palm is dead. The Blackberry deserves to die.

So I'm ready for the iPhone, even if it's missing critical features.

Except...

How the #$!$# can I live without cut, copy and paste? The Palm has that. Every machine I've used in decades had it. It's absurd that there's still no CCP in iPhone 2.

So why?

I don't believe it's that hard to do. Good enough is a lot better than nothing.

So why?

One clue is a patent application from months ago:

Apple Depicts Advanced Multitouch Gesturing Control Panel in Mac OS X - Mac Forums

...editing operations such as Copy, Cut, Paste, Undo, Select All, Tab, and Cancel using gestures based on your Thumb and Two Fingers...

Could CCP be tied up in a patent battle somewhere? Is that why Apple won't show it?

Anyone have another theory? I'm all eyes.

It's scary insane not to have this functionality yet ...

Silence a dripping hotel faucet with a towel

I was surprised I didn't find this one in a quick search: dripping towel silence - Google Search.

Dripping hotel tap keeping you awake?

Tie a towel to the faucet. The water tracks down the towel silently. In the morning, mention on checkout why there's a towel on the faucet.

If not for the anthrax attacks, would the US have invaded Iraq?

The post-9/11 epoch looks worse and worse as time goes by. The torture, the incompetent invasion (great move - start by alienating Turkey), the worse-than-incompetent occupation, the lies, the falsified intelligence ... and now we're reminded that the FBI and the Bushies botched the anthrax investigation. The Bushies, in particular, were keen to use the attacks to build the case for invading Iraq. They were much less interested in finding out what the heck was going on.

Much was made in 2001 and 2002 of an alleged relationship between Iraq and the anthrax attack. It was used to build the political case for war.

That was one hell of a big story. Many deaths, survivors suffering immensely, and a war.

And it's all but forgotten today ...

Scientist Is Paid Millions by U.S. in Anthrax Suit - NYTimes.com

.... The settlement called new attention to the fact that nearly seven years after the toxic letters were mailed, killing five people and sickening at least 17 others, the case has not been solved...

.... An F.B.I. spokesman, Jason Pack, said the anthrax investigation “is one of the largest and most complex investigations ever conducted by law enforcement” and is currently being pursued by more than 20 agents of the F.B.I. and the Postal Inspection Service.

“Solving this case is a top priority for the F.B.I. and for the family members of the victims who were killed,” Mr. Pack said.

But Representative Rush Holt, a New Jersey Democrat whose district was the site of a postal box believed to have been used in the attacks, said he would press Robert S. Mueller III, director of the F.B.I., for more answers about the status of the case.

“As today’s settlement announcement confirms, this case was botched from the very beginning,” Mr. Holt said. “The F.B.I. did a poor job of collecting evidence, and then inappropriately focused on one individual as a suspect for too long, developing an erroneous theory of the case that has led to this very expensive dead end."...

The NYT blew the anthrax coverage so many different ways I've lost count. That may explain why they've never returned to the mystery. Including the mystery of why this was never repeated.

Incidentally, the great Tylenol poisoning case of my youth was never solved either.

Sometimes the really bad guys win.

Reasons to feel better about the iPhone: secure wipe

Yes, it should have been part of the initial release, but it's coming with iPhone 2. It increases my trust in the iPhone ecosystem. Now if they'd do "cut and paste" and "full data search" and a few more things ...

AppleInsider | Secure data wipe built into iPhone Software v2.0: "People familiar with the beta versions of iPhone Software v2.0 say the upcoming release will employ a more foolproof method of erasing all personal data and settings from an iPhone. As is the case with the existing version of iPhone software, the function will be accessible by selecting Settings > General > Reset > Erase All Contents and Settings.

Unlike today's iPhone software, however, the revised function will wipe data in similar fashion to the 'Secure Empty Trash' function of Mac OS X, by which all data is deleted, unlinked, and then overwritten several times to make it irretrievable by even the savviest of recovery tools."

ED treatment of acute back pain - what's missing and why

[There's something messed up with how Scribefire and Blogger are formatting this post, but for the life of me I can't fix it! So, there are no real paragraphs. I'm going to forego use of Scribefire with FF3 until I sort this one out.]

I had the 2nd ambulance ride of my life recently.The ambulance was overkill. Four strong bodies, duct tape and a door would have been more appropriate, and cheaper too.

Alas there was no intermediate alternative. I was unable to stand or crawl with mere ibuprofen and canes, and that becomes a problem over time. Since nobody will prescribe narcotics and valium over the phone this left me with only one route to medical care -- a back board.

The ED got adequate control over the back spasms with modest doses of IV valium and morphine [1]. I was a pathetic sight hobbling out of the ED on two canes to lie flat in an emptied van, but six hours later, after continuous ambulation, I walked a mile without difficulty using a single cane as a psychological aid. I was on the way to rehab. [2]

I'll have a bit more to say in a later post on the pointless cost of this episode vs. the intelligent alternative, but this particular post is about three very simple things that the ED didn't do. I had them covered myself, but without them I'd still be in the hospital.

So these interventions matter. The important question is why did I have to take care of them?

Now I think I was the guest of a quite good rural ED, and I felt feel confident that ER doc who took care of me seemed confident and competent (and comely too!), so I suspect these are common omissions:

• a cold pack and a neoprene waist belt to provide continuous cold therapy to the acutely spasmed back
• two canes to enable ambulation
• a urinal to enable sleep at home
• (see more here)

The urinal is key for the first day or two at home, yet I had to keep reminding the staff that it needed to go with me.

The ED had no canes, but I could never have done my pathetic totter out of the facility without them. They did have a walker I could test my gait with, but a walker isn't designed to support body weight while in motion. They didn't think to train me on how to use a cane (I knew how), but any significant back pain requires days of cane use. (If your acute musculoskeletal back pain doesn't require a cane, do you really need an ED?)

Continuous cold therapy during the acute episode is an key part of most therapeutic recommendations. I realize reactions differ, but cold therapy is essential for me. I had to bring my own neoprene cold pack belt, and I had to request ice (they had no cold packs).

In the end everything worked, but acute back pain is hardly a rare ED event. Why didn't they have the key ingredients in place?

I'd like to see someone do a survey article on what percentage of EDs provide these 3 items on discharge, in addition to whatever else they do:

1. local cold therapy (an ace wrap and an Rx for a neoprene belt would do - total cost $4)
2. canes with usage instructions ($10 each at Walmart - crummy but effective)
3. a disposable urinal for men (free, since you keep the one you use in the ED).

My guess is that less than 10% of EDs meet this standard, and the result is a horrendous waste of money nationally.

So why hasn't the study been done? If it has been done, why aren't payors making these steps a part of their quality measures used to justify reimbursement? If this stuff isn't in the standard ED guidelines, then we have an even more interesting set of "why" questions.Understanding these "why" questions would tell us a lot of interesting things about health care and where money is spent.

[1] The cognitive effect of the "morphine" was so modest I wondered if it was saline placebo (which would have been fine really -- anything that works!). I think they were just doing small incremental dosing

[2] Once the pain is under some control, and improvement has begun, the rehab process has a certain appeal. Every day actions are a bit like mountain climbing, with the same need for concentration, precision, and planned motion. Also, the same sense of risk with error. It appeals to a certain twisted mind.

Philip Carter summarizes the Senate torture report: affirms use of Stalin's regimen

Phillip "Intel Dump" Carter, now writing for the Washington Post summarizes the Senate report on torture techniques used at Guantanamo Bay...

The Genesis of Torture - Intel Dump - Phillip Carter on national security and the military.

Yesterday, the Senate Armed Services Committee released a 63-page set of documents that illuminates how the Pentagon developed, selected and approved its list of coercive interrogation techniques for Guantanamo Bay.

As Joby Warrick reports in today's Post, the documents clarify the role that the CIA (and senior government officials such as DoD General Counsel William "Jim" Haynes) played. "If the detainee dies, you're doing it wrong," CIA lawyer Jonathan Friedman proclaimed in a working group meeting that led to the development of this DoD memo on approved interrogation techniques...

It's the best short summary I've seen. A few take-away points:

1. After 3 years of acquiescence, the uniformed military finally began to rebel.
2. The report only deals with Guantanamo, we don't know what techniques were used elsewhere. The US outsourced torture extensively, we bear full responsibility for what was done in foreign prisons on our behalf.
3. This will be a significant part of future war crimes trials.
4. The sources I read have felt that the regiment we use was based on Korean and Soviet torture designed to produce on-demand confessions. The Senate report confirms this.

Global warming: what you can do ...

Technically, it's not worth bothering with wall warts and light bulbs. If you buy a new car it makes sense to get something like a Honda Civic.

Otherwise ...

Ask Pablo, Global warming | Salon Life

... So to recap: Pester your local, state and federal politicians, eat less meat and make your home more energy efficient...

Of these, the first is most important.

Which brings me to where I disagree with Charlie's Diary. Yes, technically the light bulb and wall wart fuss is a waste of time better spent opposing GOP candidates, but humans aren't technical animals. Fussing about florescents fosters a culture that can support about a carbon tax, and it helps make global warming something a politician can campaign on.

So don't mock the the folks who worry about "vampire" appliances. They are making it possible to elect and support the politicians who will make the real changes.

The Last Lesson

Narrative comics from China's recent earthquake. Including The Last Lesson.

Via Fallows.

Journalists like politicians that make them feel smart

It makes sense. Bush II isn't as dumb as he acts (he doesn't have that excuse), but he seems dumb to journalists. They feel good about that.

McCain, even without dementia, has the same feature.

Grasping Reality with Both Hands: The Semi-Daily Journal Economist Brad DeLong

...The number of mulligans that America's press corps gives John McCain is truly remarkable. I'm becoming increasingly convinced that it's because he doesn't threaten them--just as George W. Bush doesn't threaten them. By contrast, Bill Clinton and Al Gore and John Kerry and John Edwards and Hillary Rodham Clinton and Barack Obama are scary-smart, in the way that my ex-boss Alicia Munnell once spoke of Lloyd Bentsen: 'It only takes fifteen minutes before it is very clear why he is the Secretary of the Treasury and I am the Assistant Secretary.' That seems to provoke a reaction from many journalists...

Minneapolis is 9th on the top 10 bike city list. St Paul is ?

I'm surprised Minneapolis is only #9. I think they missed a heck of a lot of trails. Two or three of the other "cities" are barely towns, and Boulder is a college town for Pete's sake.

Montreal is a great town, but there's no chance it's a better biking place than Minneapolis.

Of course St Paul, the other half of the Twin Cities, is probably #20. Shame on my city! We need to put together a St. Paul pressure group and start making some progress.

Bottom line, adjusting the list for reality and eliminating towns, Minneapolis is genuinely the 3rd or 4th best biking city in America*. The real rivals (winter-free Portland has it easy) are far more expensive places to live, and Montreal* requires a change in citizenship.

Going by Gordon's Law (ye may know a city by its bike trails) Minneapolis is absolutely a great place to live, and Saint Paul, after all, is only a ten minute bike ride away.

* In the original version of this post I unfairly disparaged Montreal's bike network based on old data. Yesterday we completed a road survey (kids on strike) of part of the network, and Kateva and I sampled a stretch. It's a good bit more extensive than when I last checked, and it's tough to compete with Montreal's attractions. So, I admit, Montreal moves ahead of Minneapolis.

More on the US torture program, and preparing for the war crimes trials

Yes, more on torture. This is part of my duty as an American citizen. McCain would do his best to silence these stories. For now, they're coming out.

A NYT article that's ostensibly about the post-torture interrogation of KSM also tells us more about how the torture program came together ...

Inside a 9/11 Mastermind’s Interrogation - Series - NYTimes.com

.... In its scramble, the agency made the momentous decision to use harsh methods the United States had long condemned. With little research or reflection, it borrowed its techniques from an American military training program modeled on the torture repertories of the Soviet Union and other cold-war adversaries, a lineage that would come to haunt the agency.

It located its overseas jails based largely on which foreign intelligence officials were most accommodating and rushed to move the prisoners when word of locations leaked. Seeking a longer-term solution, the C.I.A. spent millions to build a high-security prison in a remote desert location, according to two former intelligence officials. The prison, whose existence has never been disclosed, was completed — and then apparently abandoned unused — when President Bush decided in 2006 to move all the prisoners to Guantanamo...

Yes, "apparently abandoned". I suspect we'll hear more about that prison. Such things find a use.

The groundwork is being laid for what, if it takes place, will be the trial of the century. The war crimes trial of George W. Bush, Donald Rumsfeld, Condeleezza Rice and their colleagues may yet come to an iPhone near you sometime in the next twenty years ...

Update 6/24: The story is probably a deceptive plant. Makes sense that the torture was more entangled with the "good cop" routine than the NYT tells us.

Wiretaps are legal now

It's good to note these things.

This Modern World - It’s Repentin’ Time in Heaven:

....here’s Sen. Kit Bond of Missouri this morning, explaining why Congress is making it legal for giant telecoms to wiretap us: "When the government tells you to do something, I’m sure you would all agree that I think you all recognize that is something you need to do."

We need a new American tradition.

Every time a traditional protection of the citizen is removed, we should have a national moment of silence.

Is this the right thing to do? The Cost of Havoc will continue to fall for the foreseeable future. There is an argument for reducing the freedom of citizens in proportion to the cost of this freedom. (Torture? No.)

This is a grave choice though, and it should be made with great thought and much discussion. It should be accompanied by greater oversight of government, strengthening the adversarial roles of the three branches, and greater penalties for incompetent and malign leadership.

We're not having those discussions, so this vote is a grievous thing.

Please don't vote for McCain. He is more, much more, of the same. If you can't manage to vote for Obama, vote for a libertarian.