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"Take these crutches and keep off your leg" were the doctors instructions. It sounded easy enough until you tried to use them. They may be awkward, painful or unstable. Maybe crutches just do not fit your life, lifestyle, and livelihood. But you do not have to be condemned to crutches. There are options.
Underarm Crutches
You're probably already using the standard axillary underarm crutches. They have been around for more than 3,000 years. The first recorded reference was found in Egyptian hieroglyphics. Anyone would recognize the pictures on the walls, as they have changed little in form or function. Even when crutches are properly used and adjusted correctly they can cause underarm pain, dermatitis, shoulder wrist and elbow injury and numbness of the arm for up to 12 months. Also, many report falling while using crutches.
Modified Crutches
Variations of the most common underarm crutch have been introduced over the last 50 years. These are forearm crutches or tricep crutches. The most ergonomic crutch recently introduced is the Millenial Crutch. While these variations are improvements, the basic function still requires upper body strength and dictates the use of both arms to compensate for the lost use of the one foot or leg.
Hands-Free Crutches
As its name implies, the Hands-Free Crutch frees up your hands and upper body. Originally designed in Canada in 2002, the iWALKFree Hands-Free Crutch consists of a padded knee platform attached to an aluminum beam. The device is secured to the patient's thigh by two quick-release padded straps and to the patient's calf with one padded quick-release strap. Like a knee scooter or knee walker, the patient's weight is transferred through the knee onto the knee platform. Unlike a knee scooter, it provides the patient with unmatched mobility. It can be used indoors or outdoors, on stairs and even in the shower. Patients have reported using it everywhere from on a plane to in the ocean surf. Activities range from daily living to completing the Army Ten Miler Race. Overseas it is used as an alternative to a permanent prosthesis for below the knee amputees. In all areas it has proved very durable and reliable in the toughest of conditions. As beneficial as the Hands-Free Crutch can be, it is not for every patient as coordination, balance and overall physical fitness is required.
Walking Leg Brace
A prosthetic brace known as a the Freedom Leg fits snugly around the thigh and transfers the patient's weight down carbon fiber beams beams on both sides of the leg to a cross member under the foot. This device was first introduced in the fall of 2009 and is currently being tested for effectiveness and to better determine the range of patients that could benefit from such a device.
Knee Scooter
Also known as a knee walker, it is a wheeled cart-like device where the patient unloads the affected lower limb by transferring their weight through a padded knee platform. Designs vary greatly between three and four wheeled models, those that turn like a bicycle and those that must be lifted to turn. Features vary greatly as do stability, functionality and durability. Baskets are an option and should come with your unit. This allows you to move from point-to-point safely with your hand(s) on the device. Most units fold up small enough to fit in the back seat or trunk of a car for easy transportation or storage. Patients have even reported successfully taking them on airplanes and storing them with baby strollers for an easy exit when you get to your destination.
Seated Scooter
Some people using crutches have knee or hip injuries or cannot comfortably kneel for extended periods. For those patients, theses limitations eliminate the option of both the Hands-Free Crutch and Knee Scooter. The seated scooter is a variation of the Knee Scooter (knee walker) where the patient sits on a bike seat while resting the affected (injured) leg on a foot rest. The good leg propels the scooter around as the person sits. This device can easily be used and may be appropriate even for someone with compromised balance. Like a Knee Scooter, it should come with a basket. It too can be folded down for easy transportation and/or storage.
You have more options than the Egyptian pharaohs, yet the correct solution depends on your individual needs and lifestyle. Items to consider:
- What activities do I NEED to do?
- What activities do I WANT to do?
- Do I have overall fitness and balance?
- Can I comfortably kneel?
- How long will I be off your foot or leg?
- What are my physical surroundings? (stairs or one-level)
- Does my local supplier have it in stock and can I get there easily or should I order online and have it shipped directly to me?
- How much will it cost?
- Will my insurance cover these crutch alternatives? (Insurance code HCPCs E0118)
As Michael Jordan once said, "The only thing worse than being on crutches is being on the sidelines." Taking your individual needs into account and talking with your healthcare provider, you can use the solution that allows you to stay non-weight-bearing while maintaining your life, lifestyle and livelihood.
Tom Schwab is President of Goodbye Crutches, the nation's largest supplier of crutch alternatives. With the widest array of options to fit your life and needs, you are guaranteed to get the best value, best service, free same day shipping and be completely satisfied with your choice.
Goodbye Crutches | (877) 266-3995
Is it Intelligent to Outsource Intelligence?
Another reality in the post-9/11 growth of intelligence analysis capability is outsourcing. We have outsourced the management of billlion-dollar technical collection programs, and we have contracted intelligence analysts.
The National Reconnaissance Office is a lot more than an office; may have the largest budget of all the U.S. intelligence agencies. It may also be the best example of how U.S. government contractors, i.e., private industry, are taking over the government and costing us needless billions of dollars. The NRO buys spy satellites. Over the course of the last ten years, much of its government employee expertise has largely been eliminated by swapping career experts out for military personnel rotated in for a few years. Instead of having an Air Force officer who worked on satellites for ten or fifteen years making decisions, the NRO began bringing in officers on two- and three-year assignments. Someone who was procuring tires last year would be procuring satellite component systems this year. The result was that the big aerospace contractors gained greater influence in the decision making, not only because they were the only ones left with expertise, but also because the NRO decided to transfer much of its own program management responsibility to a single, big contractor.
Simultaneously with handing off management responsibility to the contractor, in the late 1990s and the first five years of this decade, the NRO and the aerospace industry were planning to spend scores of billions of dollars on a new generation of spy satellites with even more marvelous capabilities. The winning contractor was Boeing, which set about to build billions of dollars' worth of new spy satellites with incremental capabilities under the project named Future Imagery Architecture, or FlA. The costs escalated, the delivery dates slipped by years, but the NRO kept going. Eventually, presented with ever bigger bills and ever later schedules, the NRO canceled FIA under congressional pressure. Billions of dollars had been wasted.38
These costly new spacecraft were to be built not so much because we needed to use their capabilities, but rather because if we spent the money, we would keep the industrial base alive by ordering newer and better satellites. It became a perpetual motion machine: constantly building slightly more capable satellites at ever-increasing cost, spending more on research to develop more capabilities, even though those capabilities did not address important intelligence collection needs. I was part of that cycle thirty years ago when, during my one year as an employee at a defense contractor, I was told by the NRO that it had developed a new capability that could lead to a new satellite. My job, at the NRO's request, was to come up with some problem on which we could use the new technology. In other words, I was to figure out the need that the new satellite would meet, the requirement. This same backwards process (first developing the technology and then figuring out why we need it) has been going on for decades.
After you can see really small objects, after you have a synthetic aperture radar satellite that can take pictures at night, after you can pick up any signal released in the radio spectrum, what more do you really need? When most of the world's communication is moving from electrons passing through the air to photons in fiber-optic cables, when commercial imaging satellites allow private companies to sell reconnaissance imagery, should we perhaps consider spending less on satellites, rather than more? Maybe what we do need is more numerous, less expensive spy satellites, capable of being quickly launched in a crisis to augment existing satellites or to replace satellites that may fail or be destroyed. Although the nation's spy satellite agency is not planning to do that, another part of the Defense Department is. In addition to the costly satellites of NRO, the Air Force is planning to build the cheaper, more quickly launched birds as part of an additional program.
We do need to maintain an industrial base with the expertise to innovate intelligence platforms in space, but what we have done is destroy career government expertise and hand the keys to an agency over to giant contractors. These companies have so much congressional influence that feeding the beast becomes the requirement, rather than collecting intelligence we need at a reasonable cost, so that available funds can also be spent on other needs.
In the area of analysis, the number of contractors also grew. Not satisfied with doubling the number of analysts at the CIA, the intelligence community wanted access to even more staff. The intelligence community turned to the private sector, or at least privately owned companies. Many of the companies involved, such as Lockheed Martin, earn almost all of their money by selling to governments. Others, such as Booz Allen Hamilton, also have a commercial line of business. The companies are consultancies, weapons manufacturers, software developers, and IT support firms. What they now have in common is that they have established intelligence analysis staffs that are on contract to support various intelligence agencies.
A drive around northern Virginia reveals the many newly constructed high-rises in which private companies employ intelligence analysts to do the work that was formerly done only by government employees. Inside the buildings, in highly secured suites, analysts with top secret clearances write intelligence analyses for the CIA, DIA, and other agencies. Often the analyses are only slightly edited by government employees before being sent off to policy makers. A former government official told me that the initial draft of one National Intelligence Estimate was reportedly written by an analyst who was not a government employee; it was allegedly revised only slightly by the government. When an analysis is done by a contractor, the corporate logo is usually replaced by CIA letterhead and the policy maker is often unaware that the CIA did not really produce the analysis; a for-profit corporation did.
The private intelligence officers are not just in the corporate high-rises. Many work "on site," meaning they go to the intelligence agencies and work alongside government counterparts doing similar work. As Sebastian Abbot, a former student of mine at Harvard and now with the Associated Press, reported, "That has led to a phenomenon known as 'butss in seats' -- contractors literally sit beside their public sector counterparts and perform equivalent tasks. According to [former CIA official John] Gannon, 'Butts in seats within the analytic community . . . is really a post-9/11 phenomenon, for the most part.' John Brennan, former acting Director of the National Counterterrorism Center (NCTC) and currently President and CEO of TAC, says more than half of the 200 analysts at the NCTC were from the private sector while he was there . . . the vast majority of Booz Allen's intelligence work is not classic management consulting, but simply providing. 'butts in seats' to the intelligence community."39
One colleague of mine being given a tour of the National Counterterrorism Center (NCTC) expressed surprise at the number of people working there and was told that "most of them are contractors." He could have been told the same at the intelligence analysis division at Homeland Security or many other agencies in and around Washington. R. J. Hillhouse has made it her preoccupation to track intelligence outsourcing. She writes, "For all practical purposes, effective control of the NSA is with private corporations, which run its support and management functions . . . more than 70 percent of the staff of the Pentagon's newest intelligence unit, CIFA (Counterintelligence Field Activity), is made up of corporate contractors. Defense Intelligence Agency (DIA) lawyers revealed at a conference in May that contractors make up 51 percent of the staff in DIA offices. At the CIA, the situation is similar. Between 50 and 60 percent of the workforce of the CIA's most important directorate, the National Clandestine Service (NCS), responsible for the gathering of human intelligence, is composed of employees of for-profit corporations."40
The head of one private intelligence analysis program proudly told me that the hundreds of analysts in his division average many more years of experience than do the young analysts now at CIA. Why have these experienced staff left the government to do essentially the same jobs in a privately owned company? The popular assumption is that the pay is better. For the corporate vice presidents and partners, that is the case. They have almost all been senior officials in intelligence agencies for twenty years or more, "retired" to collect their federal pension, and are now also being paid by their new private sector employer, often more than twice their previous federal salary. For the typical analyst, however, the private salary is about the same as what he or she would be paid "on the inside." The analysts I have spoken with say they prefer the corporate environment because "it's just run better" or "there is less bureaucratic chickenshit." Their supervisors all seem to agree that they have "more time to focus on the issues" and "more ability to select only really good staff and an easier time getting rid of the ones who don't work out."
But does it cost more money than if the government's work were done by government employees? Some studies show that a contract for a given number of analysts' time is more expensive than paying a similar number of government employees. The contractors, however, cry foul and note that in an "all-in" comparison including the support costs (IT systems, buildings, and other overhead), the cost of private analysts is about the same. There is, however, a profit margin associated with the contracts. The hefty bonuses given senior officials in the contractor firms, along with the publicly reported profitability, are costs that would nor have been accrued had the jobs been done in-house, in the government agencies. Cost, however, is not the determining factor in the outsourcing boom. Ease of execution is probably the driving consideration. After 9/11, when money flowed quickly and in large sums to intelligence agencies, it was the path of least resistance to simply sign contracts rather than to rebuild the intelligence community in a thoughtful way with a long-term strategic plan.41
Senior intelligence managers have found it easier and quicker to turn to private companies to hire and house staff than to fix their own agencies' hiring systems. The problems of hiring and firing civil servants that are often given as a justification for outsourcing really do not hold. Intelligence agency personnel are exempted from normal civil service personnel rules. They could be paid more than other government employees. They can quickly be fired without cause anytime an agency believes they are doing substandard work or their expertise is no longer in demand. The government could easily rent office space for more analysts. It was just easier for an intelligence agency manager to have a contractor do it all.
The result of all those many decisions to take the easy way out and sign contracts is that we have created a two-tier system for intelligence analysis. For now, at least, the more experienced analysts are often in profit-making firms, aspiring to be among the ranks of their highly paid bosses someday. And their highly paid bosses are motivated to persuade the intelligence agencies, where they once worked, of the continued need for their contracts. And many of the bosses in the intelligence agencies are thinking about what they will do when they have worked twenty years and can begin pulling down a government pension. Given those dynamics, it is unlikely that the post-9/11 boom in intelligence analysis outsourcing will be reversed anytime soon. The CIA did, however, promise in 2007 that there would be a 10 percent cut in outsourcing soon.42 It will, of course, be difficult to know if that really happens.
What is more likely to happen is that the dramatic growth in the intelligence community budget will slow and the budget may even have to retract, given overall federal fiscal realities. When cuts have to be made, based on past tendencies, the agency managers will cut their contracts before they reduce their own staffs and other activities. What we may then discover is that many of the best analysts we had, those with institutional memories, are no longer working on the important problems.
The above is an excerpt from the book Your Government Failed You
by Richard A. Clarke
Published by HarperCollins Publishers; May 2008;$25.95US/$27.95CAN; 978-0-06-147462-0
Copyright © 2008 Richard A. Clarke
For information on the documentary inspired by this book, please visit www.richardaclarke.net.
About the Author
Richard A. Clarke served the Pentagon, the State Department, the intelligence community, and the National Security Council for thirty years. His eleven years of consecutive White House service on national security, for three presidents, is unprecedented. In the Reagan administration he was a deputy assistant secretary for Intelligence. In the Bush (41) administration he was confirmed by the Senate as an assistant secretary of state. In the Clinton and Bush (43) administrations he served as national coordinator for security and counter-terrorism. Since leaving government, Richard Clarke has taught at Harvard's Kennedy School of Government, authored several books (including the number one best-seller Against All Enemies), been an on-air analyst for ABC News, written columns for the New York Times and other papers, and formed the security-risk management firm Good Harbor Consulting.
On a road bike what ways to lower the weight of the bike with out buying a new one?
the WHOLE frame of my raod bike is made of Cro-Moly, with a carbon fiber fork. along with shimano tiagra/ sora derailers. right now it is about 21 pounds. the seat post is not carbon fiber.
While I agree with some guys above, you asked about lightening your bike and there are things you can do. 1st it's a balance of cost vs utility. Basically, think to yourself: is the cost worth it? And cost must be an issue seeing that you bought an entry level bike and not a high end one. To see significant weight change is very expensive so you must shop wisely. The most important place to save weight for performance gain is on the wheel - the rim, tube and tire.
The items that can affect weight on an entry level bike the most excluding the frame are: wheels, tires, tubes, fork, crank and bottom bracket, pedals. The post, saddle, bars and stem to a lesser degree. Your brakes, derailleurs and shifters yield even less an can be very costly for the weight change. Finally realize light weight can be limiting. For example, super light weight tires like Conti Supersonics will save weight BUT they wear fast and are racing, not training tires. If your roads are not smooth and clean you will puncture easily. Also, super light weight parts sometimes have weight limits. If your 150 lbs no worries, but if you are 180+ lbs be careful what you buy.
1st you need to know what your parts weigh to make a decision on replacing them. You can look up specs on the web (this can be difficult if you don't have name brand items) or buy a small electronic mail scale. These can be found on EBay for about $20 shipped.
The 1st and cheapest item to replace would be tubes. Extra lightweight tubes can weigh 70 grams or less. You can buy tubes even lighter but I'm not convinced of the reliability. Mine weigh 65g and replaced standard 100g tubes saving 60 grams for a cost of $10. Everything else gets more expensive.
Here's a few things I've done:
Replaced my Cannondale Carbon Slice fork (525g) with a Reynolds EC90sl fork (270g) for $190 off EBay. Dropped 1/2 pound there.
Replaced the 105 bottom (265g) bracket with a DA (175g) one for $35 EBay again.
Replaced the Ulterga 6500 crank (640g) with FSA Superlights (530g) Got the crank used in A+ condition for $125 on EBay again.
Bought American Classic CR420 wheels, used on EBay, (1425g) replacing Spinnergy Xaero wheels (1760g)
Tires: I run Conti Supersonics, Mich. Pro2 and Kenda Keliente Pros on 3 wheel sets. Tires in the 220g range are about as light as I'd go for high mileage riding on good roads.
I did this and much more as a weight weenie project. Got my Cannondale CAAD 5 bike down to 15.8 lbs (from about 19 lbs) with the lightest wheels.
It was fun to do and I documented the whole thing. But it also cost quite a bit. I re-couped a portion of the cash buy re-selling the parts I replaced.
Now for the bad news. Previous to doing this I had owned a '94 Trek 2200 road bike since I bought it new. 105 equipped, 7 speed, Matrix wheels 21 lbs - a little on the heavy side. Even though my new build was 5 lbs lighter, road better, accelerated faster and worked better in general I was only marginally faster when doing 10 mile flat TTs. I'd assume the wheels made 95% of the difference too. So don't think dropping a pound on your bike will make you faster. While I love tinkering with my bikes but I know it's the rider that makes the real difference.
Check this site out for lots of fun info: http://weightweenies.starbike.com/
A 21 lb bike that fits you well with a good set of wheels will get you 1/2 way there, the rest is all you.
It’s New to Us by Jean Stratton
Nasty post-nasal drip, sinus pressure and headaches, nasal congestion and blockage, sinus infection — few of us escape an encounter with one of these conditions, and for some people, it can be chronic, ongoing misery.
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