distraction
“Done in an arm chair, with scissors, double-sided tape, and watercolor crayons.”
By Samantha Kira of Journal Girl.
March 11, 2010
March 8, 2010
You can help Dr. Barrett
Dr. Stephen Barrett was instrumental in helping to get Paul Whitcomb’s chiropractic license revoked (see sidebar for my collection of posts concerning Whitcomb; all ICI Whitcomb posts are here). Dr. Barrett’s Quackwatch site is one of my top two to go to when I suspect quackery. If the practitioner isn’t mentioned on Quackwatch, I run the site on The Quackometer. But that one is for a different blog post.
Practitioners who are mentioned on Quackwatch sometimes retaliate to the facts written about themselves there by resorting to smear campaigns and even frivolous lawsuits against Dr. Barrett. I’m still getting crazy comments on my posts that mention Dr. Barrett and I haven’t even written anything about him since August of last year, so I can only imagine the kind of stuff he gets.
I got this from the Quackwatch Consumer Health Digest weekly e-newsletter:
Issue #09-45, November 4, 2009Please Help Quackwatch and Dr. BarrettA personal Message from Robert S. Baratz, MD, PhD, DDS member National Council Against Health FraudDr. Stephen Barrett has been a leader the worldwide struggle against quackery and health fraud for more than 35 years. In addition to publishing the weekly Consumer Health Digest, he has written and/or edited 50 books and manages 24 consumer protection Web sites, including Quackwatch, which has more than 100,000 page views per month and has won many awards for its accuracy and quality. Dr. Barrett also serves as a trusted resource for the media, law-enforcement agencies, educators, and thousands of individual consumers who contact him each year for help.Quackery promoters have tried to counter his influence by libeling him and filing groundless lawsuits. One campaign has falsely suggested that he had lost his medical license.http://www.quackwatch.org/11Ind/bolen.html
Another is falsely accusing him of being a habitual criminal.The legal fees and other costs of defending against this campaign, while partially defrayed by donations, have been much higher than the cost of running the sites.Very few people have the courage and persistence to engage in the struggle against quackery. Dr. Barrett intends to continue, but can use help in defraying legal expenses. Quackwatch and its companion Web sites are important consumer resources. They are free to the public, but maintaining them requires the ability to deal with frivolous assaults by well-financed quacks and the special interests that profit from quackery. If you appreciate Dr. Barrett’s work, please make a contribution. Please give whatever you can.For amounts under $50, or for contributions of any size from foreign countries, please use the PayPal link on the Quackwatch donations page. http://www.quackwatch.org/00AboutQuackwatch/donations.html It is not necessary to be a PayPal subscriber to do this. It can be done by anyone with a credit card, regardless of where you reside.If you can give $50 or more and live in the United States, it would be best to mail a donation to:Barrett Defense FundChatham Crossing, Suite 107/20811312 US 15-501 NorthChapel Hill, NC 27517
I’ve added my drop of money to the bucket; I hope you will consider doing so also. Every little bit helps.
February 14, 2010
For Thyroid Awareness Month: Check out this Today Show excerpt where the conventional Dr. accuses cutting edge thyroid practitioners of charlotry
Today Show excerpt on 1/28/10 in which conventional endocrinologist Dr. Peter Singer basically describes integrative thyroid expert Dr. Kent Holtof’s treatment as “laying on of hands.”
Visit msnbc.com for breaking news, world news, and news about the economy
My current favorite thyroid site is Stop the Thyroid Madness. It’s by Janie Bowthorpe, thyroid patient activist. The only advertising on the site is for her book of the same title. It’s my favorite because she tells it like it is without mincing words, as evidenced by her take on the above Today Show excerpt, Endocrinologists and the loony tune TSH lab test.
Mary Shomon’s about.com Thyroid Disease Blog runs a close second for my favorite thyroid site. Here’s her take on the Today Show excerpt.
Kudos to both of these women for getting excellent posts up immediately after the Today Show excerpt ran.
On my own thyroid situation, I have Hashimoto’s disease. It would probably still be undiagnosed if not for the fact that in 2008 I went into my rheumatologist’s office with Dr. Jacob Teitelbaum’s book From Fatigued to Fantastic and the printout of my treatment protocol results from his Symptom Analysis Program and strongly requested that all of the suggested testing in that printout be done.
A year and a half later, my thyroid is still not balanced. They got me started on the right road at the Fibro and Fatigue Center in Atlanta; I take a compounded mix of time-release T3, and T4. Then I found a local doc who knows about the more cutting edge stuff and who has been working with me on it for quite awhile now. I am slowly but surely educating myself; it’s probable that my adrenals are exhausted and this problem will have to be addressed before my thyroid will ever get right. My next step will be to keep a metabolic temperature graph according to Dr. Rind’s method. He even has an Excel spreadsheet that you can download to keep track of it all. Many thanks to STTM for turning me on to this site.
Ending on a lighter note, from Janie’s STTM Facebook Photos page, check out Barbie at age 50: “She got FAT! Nope, she hasn’t been overeating or not exercising. She’s been on SYNTHROID!!”
Savella: Love it or hate it, we have the right to choose it as a treatment option!
First, I apologize to my readers who subscribe to this blog via email, for the blog post from May of 2009 that went out to them on Saturday morning. To the best of my knowledge I didn’t do anything to make that happen. I’ll be checking in with FeedBurner on that.
Here’s today’s post on Savella. Brand new and fresh content, I promise.
You may have already heard that a Petition to Ban Fibromyalgia Drug Milnacipran (Savella) was filed with the FDA on January 20, 2010 by a group called Public Citizen. This petition was immediately picked up by the Associated Press. Word gets around (and around) when an article gets picked up by the AP. More on that later.
My first reaction was, who the hell is Public Citizen???
“Public Citizen is a non-partisan, politically left-of-center, non-profit public interest advocacy organization based in Washington, D.C., with a branch in Austin, Texas. Public Citizen was founded by Ralph Nader in 1971.”
http://en.wikipedia.org/wiki/Public_Citizen
Normally this is a group that would be right up my alley. But in this case I think they have butted in where they have no business, and more to the point, where they do not have enough knowledge of the subject at hand to offer an opinion, much less to make a recommendation to the FDA.
Immediately, and I mean the same day that the Public Citizen petition became public, our old friend Matthew Perrone of the Associated Press (and author of the 2009 article Disease may not be real but the drug profits are, infamy) came out with an article titled Group urges recall of drug for fibromyalgia. You know that once an article hits the AP it travels all over the world in the most reputable and prestigious of publications. If not for the AP picking this up, I don’t think we would have heard another peep about Public Citizen’s petition.
A bit off topic, but Perrone ended his current article on Fibromyalgia on quite a different note than the article from last year: “The cause of fibromyalgia is not known, though some researchers point to abnormalities in how patients with the disorder process pain nerve signals.” I’d call that a major victory for Fibromyalgia advocacy and awareness!
There ARE people who are helped by this drug; I happen to be one of them. I started on Savella in August of 2009. By the time I ramped up to the minimum recommended effective dose of 100 mg per day almost a month later, my pain levels had subsided to the point that I wasn’t taking ANYTHING else for pain. My energy level went up. I started to think in terms of returning to work: I started physical therapy for my neck at TRMC Spine Therapy Center – in spite of the mandate of the spine specialist that I saw back in June of last year, that PT would not work for me because my pain had “gone on for too long.” Luckily for me, my rheumatologist has a “never say never” policy and he referred me for PT. Anyway, I believe Savella should continue to be available because when it does help, it REALLY helps. Even if it’s only helping one third of the people who take it (and I’m willing to bet that those numbers would go up if a few dosage changes were made during the clinical trials), it’s totally worth it to keep Savella on the market.
Although I had to contend with nausea (the most common side effect) from the first day I started to take Savella, by happy accident and my inability to get the prescription medicine Zofran for nausea fast enough, I found that ginger capsules worked just as well for me. They kept the nausea in check.
Savella also caused me to have tachycardia, or rapid heart rate, so I am currently at one quarter of the minimum effective dose, hoping that my body will adjust to the medicine so I can eventually up the doseage, but I am also prepared to be one person that Savella is just not right for.
The Fibromyalgia Network October 2009 newsletter article titled “What Are We Learning About Savella?” is the most helpful resource I’ve seen, aside from the actual Prescribing Information (this is the complete pdf in a font size that’s actually legible). More on this in a future post, but here are the major points covered in the FM Network article:
• What Are We Learning About Savella?
- How the drug works to target symptoms
- 503 fibromyalgia patients respond to a survey spurring discussion on Savella (milnacipran), the latest FDA-approved drug to treat fibromyalgia.
- Clinical trial results on which symptoms are likely to improve and the most common side effects that may occur
- 8 physicians and researchers offer advice on overcoming common side effects, drug interactions, and signs of trouble
You might also be interested in the FM Network article on Imaging the Effects of Savella.
It’s always great fun to see what the Big Pharma Reps are saying about their drugs: From Cafe Pharma – Savella Questioned, Might Be Pulled and The End of Savella… Pulled Off Market. They almost all post anonymously and say some pretty aggressive, even combative things. For example, here are some responses to the second thread which was a partial quote from the AP article:
“While I absolutely hate working for CYP (Cypress BioScience,who manufactures Savella along with Forest Pharmaceuticals), I hate your posts as much. Your style is recognizable in every thread as a doomsday, “sky is falling” chicken-little attitude.“For once- shut your mouth & do you home work before you post without all the facts. In this case, look up Dr. Wolfe’s history and all of the drugs he’s trashed & tried to get pulled off the market. Read his newsletter to see that he pretty much hates every new drug and trashes them straight from the PI and not from any clinical experience.
“This news is not new and is in the package insert. Guess what? Drugs are chemicals-when put in the human body they produce side-effects and affect individuals differently. Every now then there is an outlying patient that has an unpredictable reaction to a drug or class of drugs. Can you say Celebrex? It helped millions of people, yet causes high blood pressure in some people- like it’s cousin Vioxx. And if it hadn’t been for this crazy legal world we live in, Vioxx would still be on the market helping people.
“So don’t be so quick to ASSUME that Savella will be immediately pulled off the market. No one knows what the future brings for any drug…… so try to post with responsible info instead of being a sensationalist like a newspaper reporter.”
“This post is a bunch of hogwash. If drug companies wouldnt hide clinical data, the mortality rates would drop significantly with marketed pharmaceuticals. In the case of Vioxx it was the “hiding” of data and poor promotion of the sales reps that was the cause. This poster is right on target to share with you something that your company and wimpy DM would not. Grow up. Your sky has been falling since the day you took this job. Savella BP profile and clinical findings are well known, it is all over the EU and all over the data accumulated from Europe for Depression. You should check yourself before you come on here bloating your mouth out like some slug marketing fool who sits in an office at HO all day!”
Interesting, yes?
FibroFocus is a new website provided by Forest Labs, Inc., for real medical professionals only. I tried to register. Not allowed. The faculty is rather impressive, especially Kim DuPree Jones, PhD, FNP. She has been affiliated with Dr. Bennett and the Fibromyalgia Info Foundation since WAY back.
“FibroFocus is a web/teleconference series designed to provide healthcare professionals with information and strategies in the management of fibromyalgia. Led by a fibromyalgia expert, this interactive program will focus on enhancing your ability to diagnose this condition, while providing you with information regarding the safety and efficacy of Savella, the most recently approved agent for the management of fibromyalgia.”
It’s good that they are making the effort to train doctors. I say this because it was my PCP who originally started me on Savella but it was my rheumatologist who said basically ‘Your heart rate is WAY up and you need to decrease your dosage of Savella immediately.’ (Actually it was his nurse who said my heart rate was high, immediately upon taking it, at a regularly scheduled follow up visit) Would my PCP have just let me keep on taking Savella with a seriously elevated heart rate, which was very different from my usual low-normal rate? I wonder. I saw him one month after he started me on Savella; I had worked up to the minimum effective dose of 100 mg per day and I’m sure my heart rate was high. I could feel it beating crazy at odd times when I wasn’t even doing anything. The next time I saw the PCP after I saw the rheumatologist, I gave him a copy of the FM Network article. So at least he knows better now.
So the rheumatologist cut my dose in half, to 50 mg per day. After a month at that dose my heart rate was better but it was still kind of crazy. And every day when I woke up I had a headache all along the top of my forehead. So I dropped the dose again, to 25 mg per day. The headache stopped immediately and my heart rate started to feel normal again.
Everyone who takes this drug should be under the care of a knowledgeable doctor that they see regularly.
For you folks who understand the scientific stuff:
Milnacipran hydrochloride is a selective norepinephrine and serotonin reuptake inhibitor; it inhibits norepinephrine uptake with greater potency than serotonin. It is a racemic mixture with the chemical name: (±)-[1R(S),2S(R)]-2-(aminomethyl)-N,N-diethyl-1-phenylcyclopropanecarboxamide hydrochloride. The structural formula is:
From RxList
It looks like they’re going ahead with the third in the series of clinical trials on Savella:
Paid Volunteers Needed for FIBROMYALGIA clinical research study (IU School of Medicine) Date: 2010-01-26, 2:38PM EST
Reply to: comm-4jjrk-1571737714@craigslist.orgFibromyalgia Clinical Research Center at Indiana University is pleased to announce the third in a continuing series of research studies for fibromyalgia entitled: Drug and Talk Therapy for Fibromyalgia is currently open to recruitment.
We are conducting this study to better understand how talk therapies, such as education and cognitive behavioral therapy (CBT), can improve the therapeutic benefits of medications for fibromyalgia.
Savella ®, (milnacipran) is an FDA approved drug for fibromyalgia. The safety and efficacy of Savella has been established in two US-based clinical studies involving over 2,000 patients with fibromyalgia. Because Savella has already been shown to be effective when used in isolation to treat fibromyalgia, we are conducting the study to determine whether combination treatment (Savella + talk therapy) is more efficacious than just Savella or talk therapy alone. Participants are randomized to either Savella or placebo (sugar pill) and will receive either CBT or an educational phone series.
If you are interested in learning more about this study, including inclusion and exclusion criteria, associated risks, and potential benefits; PLEASE feel free to contact the Fibromyalgia Clinical Research Center at 317-278-3971. Location: IU School of Medicine
PostingID: 1571737714
Patient Assistance Program: This is where you can apply to receive Savella at no charge.
And last but not least (this only happened to one person; it won’t happen to you), from the great folks at Crazy Meds! The Good, The Bad and the Funny of Neurological Medications:
“Unfortunately the PI sheet omits the best freaky rare side effect. EVER!“Ejaculation After Defecation Without Orgasm Induced by Milnacipran
“You know what makes that the best ever? Even after reading the full text it’s unclear as to exactly what happened.
“Did he require milnacipran to have an orgasm, otherwise he normally ejaculates after defecating without an orgasm?
“Did he not have his usual orgasm during defecation, and the milnacipran induced ejaculation after he wiped?
“Did the milnacipran induce an orgasm-free ejaculation after he defecated? Did he normally have orgasms during his post-defecation ejaculations?
“In the report it is noted, more than once, he observed “emission of sperm.” He must have Gojira-sized swimmers. It also notes that “overpooling of sperm” (a.k.a. blue balls) can be responsible for spontaneous ejaculation. Yeah, right. I bet it hurts if they don’t get a happy ending.”
Yeah, so I have a warped sense of humor. It runs in my family.
January 29, 2010
For Thyroid Awareness Month: Check out this Today Show excerpt where the conventioal Dr. accuses cutting edge thyroid practitioners of charlotry
Today Show excerpt on 1/28/10 in which conventional endocrinologist Dr. Peter Singer basically describes integrative thyroid expert Dr. Kent Holtof’s treatment as “laying on of hands.”
Visit msnbc.com for breaking news, world news, and news about the economy
My current favorite thyroid site is Stop the Thyroid Madness. It’s by Janie Bowman, thyroid patient activist. The only advertising on the site is for her book of the same title. It’s my favorite because she tells it like it is without mincing words, as evidenced by her take on the above Today Show excerpt, Endocrinologists and the loony tune TSH lab test .
January 19, 2010
Fractured Ankle
Sorry to be so long in posting again, but I have a good excuse. After arriving home from the Christmas Eve candlelight service, I was turning from the bathroom sink and the traction on my right Dansko Professional Stapled clog (that I blogged and bragged about when I got them last year) was so good that that foot didn’t turn with the rest of me. Now this all happened in the blink of an eye, but this is what I think happened. When my brain realized that the foot hadn’t turned to the left with the rest of the body (because of the pain it caused!), the body snapped back around to the right and the right ankle rolled to the outside and I went down, trying in vain to catch myself on the sink vanity. I heard or felt a snap that I hoped was the outside ankle bone/bump hitting the floor. On the way down I believe I started cussing like a sailor. I tend to do that in certain situations.
I thought I was alone in the house, but my Dear Nephew had come in from somewhere and was right there asking if I was all right. I was feeling the ankle and my face became wet with tears but I didn’t feel any bones sticking out so we eventually decided I should get up off the bathroom floor.
This is a couple of hours after The Fall, in spite of ice and elevation. 
This is a couple of days later. 
I kept seeing the Dansko ad above and it started to irritate me, so I brought it into my post as a way of beginning the process of forgiving my shoes. Ridiculous, I know. And yes, it has occurred to me that my own ankle/leg strength (or lack of) might have had something to do with what happened… but I like blaming the shoe better.
I continued the ice and elevation and stayed off it as much as possible, and waited until Monday 12/28 to call my doctor’s office. Both my PCP and my rheumatologist were taking the week off. So there was nothing to do but make a trip to the ER. I lucked out and arrived when no one else was waiting. There was a long line of sick looking people waiting by the time I was taken back. Long story short, $982.30 (so far) later (including $21.30 for four Percoset the PA “gave” me so I could see if I have an allergic reaction to them like I do to most other pain meds that actually work) I was told my ankle was fractured, given a splint ($64.00) and a referral to an orthopedic doc. RE: the Percoset, one pill=extreme itching=Percocet is now on my “do not take” list.
This is now. The Boot, aka the air cast. It pumps up to hold the ankle secure.
I’m trying to figure out what purpose it’s meant that I should use this time for, since my already curtailed activities have had to be pared down even more. It’s my driving foot that’s hurt so I’m a passenger. When things settled down I realized my right shoulder where I tried to catch myself as I fell also has something pulled that’s painful when I try to do things like shampoo my hair.
I am going to stop with the after Christmas sales via the internet and spend time meditating on domethig productive to do in the forced down time, here:
Our winter view from the deck.
December 28, 2009
Add yourself to the ME/CFS & FM World Map – help build a picture of the global ME/CFS and FM community and see whether there are any "hotspots"
The website and blog that go along with the map seem to have some useful information. For instance, I had not heard that Annette Whittemore, who founded The Whittemore Peterson Institute (the private not-for-profit research organization that found the presence XMRV in blood samples from a high percentage of Chronic Fatigue (ME/CFS) patients and in small number of Fibromyalgia samples), has a daughter who suffers from ME.
December 22, 2009
Catching up
I haven’t posted much to the blog lately; I was able to spend Thanksgiving with relatives in Tampa, FL and when I got back I was of course exhausted and unable to do anything beyond my mountain of laundry, for a whole week. Then the doctor’s follow up appointments started. I’m stating here and now for the record that from 2010 forward, I will not schedule any medical appointments in November or December. Those months are on for family and other, more spiritual pursuits.
Found a hibiscus bloom on the ground at the hotel, and had fun playing with in on the drive to the cousin’s house for the Thanksgiving Day gathering.
From Cousin David’s orchard, Temple Terrace, Florida
Thanksgiving Day 2009
Adding to the overload, in early November I had a referral appointment to a neurologist in Atlanta. I had to travel three hours and stay overnight in a motel for this one. The referral was from my rheumatologist because of the results of an MRI he ordered to rule out the possibility of a pituitary tumor. It showed no tumor but some possible abnormality/atrophy to a couple of important lobes of my brain.
I went to Atlanta to the Emory Neurology Clinic because the local neurologist who read my MRI does not see patients who do not have insurance. The Emory Clinic is very highly rated, and I figured, hey, IT’S MY BRAIN we’re talking about here! I can’t praise the Neurology Clinic, the doctors and the staff at Emory highly enough. They were great. Emory is a teaching facility, so I had one doctor who seemed quite competent examine me, then another with more experience examine me again based on what the first doctor found.
The verdict: MRIs are not a complete diagnostic tool. My physical examination showed no problems. It could be that my lobes started out in life a bit smaller than normal. The opinion of the specialist was that there’s nothing wrong with my brain. Yay!
The rheumy still seems convinced that something’s wrong but he’s not the brain specialist. Going forward I will have the MRI that he ordered to use as a baseline, and I’m glad of that.
I also started physical therapy for my neck (degenerative disc disease, herniated and bulging cervical discs) this month. More on that later, I’m sure. Anyway, other than that I’m through with medical appointments for the rest of the year!
Found a hibiscus bloom on the ground at the hotel, and had fun playing with in on the drive to the cousin’s house for the Thanksgiving Day gathering.
December 3, 2009
Get the Floor Mats and Keeps Your Garage Floor Dirt Free
The garage appears to be the most difficult area of the house. Things tend to be tossed is similar to the storage, bicycles, lawn mowers and other large items, vehicles are parked there, and, often, sometimes, the little motor or household maintenance and repair work is done in the garage. Not surprisingly, keeping a garage of a pure white is a work in itself. One area that needs special care is the word, especially a discharge. Effective prevention easiest and most economical are taken every floor mats.
Catch all floor mats do just that – they catch everything that lands on the ground. They are designed to prevent permanent damage to the floor in the case of oil, rust, or water leak or spill. While commonly used for garage floors, floor mats can also be used on driveways, basements, or any other surface where oil, transmission fluid, antifreeze, grease or other fluid leaks or difficult stains can occur.
There are different types of catch all mats. The type of absorbent mats is most effective in cleaning up the mess. You want the kind that is super absorbent, absorbing all kinds of fluids and maintenance of gallons of oil or other liquid over time.
With catch all floor mats, you do not have to worry about the application of degreasing, cleaning, or scrubbing the floor. The floor mats are free from chemicals, they are safe to use. Depending on your use, the carpets are of various sizes. Catch all floor mats can also be purchased in a roll and cut to size.
Good catch all floor mats should be made of quality products and about 1/8-inch thick. The top should be non-flammable and be super absorbent polypropylene to absorb liquids difficult. Polypropylene is the same material used for cleaning oil spills in the oceans. The bottom part should be clearly defined at the top and material support that will stop the stain to penetrate and prevent spills from leaking through. They must also be non-slip, and be made of durable material like vinyl, to 
prevent curling, buckling, tearing, or cracking. Mats best guarantee of their performance.
Pads are an economical way to stop spills on floors harmful. They are inexpensive and long term. Once they are completely saturated, replace it altogether. They are recyclable and they prevent harmful fluids seep into the ground or end up in storm sewers.
Besides offering garage driveway and protection, many people use these types of carpet under their barbecue grills to catch the drops under their bikes or golf carts, and in dishes of food for pets. Because these rugs can be easily cut by scissors, they are also ideal as a lining in the trunk of cars or trucks, or as a hedge Workbench.
With their ease of use and functionality, it is logical to use the catch all floor mat to catch spills evil in your house, garage and outdoor areas. It keeps areas looking new for many years because they avoid stains.
Benefits of Anti-Fatigue Kitchen Floor Mats
Floor Mats Anti-fatigue is becoming popular in the kitchen because of the many benefits they provide. How an anti-fatigue floor mat works is it forces the subtle movements of your legs and calf muscles. If you’re standing in one position for a long period of time, especially on a hard surface like a kitchen floor, often what happens is the muscles of the legs begin to tighten and constrict. Constriction reduces your body’s ability to supply blood to the legs, causing pain and muscle spasms. You end up feeling 
tired from standing all day because your heart must work harder to get the blood flowing to where it is supposed to be.
Using anti-fatigue floor mats in your kitchen can help mitigate these problems because of subtle movements in your legs. By making the muscles of the legs move you reduce the constriction of your leg muscles, which means your heart does not have to work so hard to get the blood flowing. Having normal blood flow and less work on your heart, you will not feel as tired standing on a hard floor all day.
Another advantage of installing anti-fatigue mats in your kitchen is that it can help reduce the amount of impact force that your body absorbs during the day eh. Every time you walk on a kitchen floor, especially hard tiled floors, your spouse receives a shock for them, which can make your legs ache at the end of the day. If you choose to install anti-fatigue ma
ts carpets themselves will absorb some of the shock that would normally be absorbed by your joints. The reason is that the anti-fatigue mats are amortized rubber, so walking on cushion helps reduce stress on your joints.
The best part of the installation of these types of rugs in your kitchen is that many studies have been done on them, and studies have proven that they are useful. A study was done by the University of Michigan shows that standing on anti-fatigue matting rather than a hard kitchen floor can reduce the amount of fatigue and discomfort that people know almost 50%. This study shows that anti-fatigue mats are an excellent solution for foot and back pain due to standing on hard surfaces for prolonged periods.
