John H. Keefe III, D.C.
IN THE NEWS: Lutein — An Important Nutrient for Eye and Brain Health Lutein is well-known for its vision-enhancing properties. It helps stave off age-related eye diseases such as cataracts and macular degeneration, which is the No. 1 cause of blindness among the elderly. Lutein may also play an important role in brain health and may help prevent cognitive decline. Those with higher levels of lutein in middle-age had more youthful neural responses than those with lower levels. Eating plenty of dark leafy greens, rich in carotenoids like lutein, can go a long way toward maintaining healthy vision and keeping cognitively fit into old age. Lutein, which you have to get from your diet as your body cannot manufacture it, is well-known for its vision-enhancing properties. Along with zeaxanthin, it's found in high concentrations in your macular pigment and macula lutea,1the small central part of your retina responsible for detailed central vision. Other nutrients that are important for brain health and cognition include animal-based omega-3 fats, vitamin D, and B vitamins. Good food sources for these, and lutein are included.
WELLNESS: What Are the Health Benefits of (Chokeberries)? Native to North America, Aronia berries had a long history of helping to keep Native American tribes alive for centuries due to the berries’ abundance and powerful nutritional properties. "(The) fruits (have) relatively thick, pigmented skin in pendulous clusters. Red berries are sweeter than black varieties, while the latter is slightly bitter in taste. However, black and blue color berries are rather rich sources [of the] anthocyanin class of pigment antioxidants." Fiber is one of their greatest contributions to health because it helps slough old food particles from your colon as they move through, effectively serving as a cancer-protective agent. Aronia berries are rich in antioxidant polyphenols, part of the significance of antioxidants is their ability to protect your body's cells from the damaging effects of oxidation. Clinical studies indicate that eating berries, including Aronia berries, on a regular basis helps fight neurological diseases, cancer, aging, inflammation, diabetes and bacterial infections.
CHIROPRACTIC: Chiropractic and Leg Length Because the spinal cord is housed by the spine and the exiting nerve roots communicate with the autonomic nerves that basically run our organ function, maintaining alignment of the spine and pelvis is very important to minimize nerve irritation and subsequent health-related problems. The focus of this article is on leg length, its effect on our posture, methods of assessment, and treatment. Leg length plays an important role in posture. When there is a difference in leg length, the pelvis cannot maintain a level position, and because the spine’s base is the pelvis, it cannot stay straight if there is a leg length discrepancy. Doctors of all disciplines realize the importance of leg length, especially orthopedic surgeons as they consider a hip or knee replacement! There are many causes of leg length issues, and some include a genetic predisposition (inherited) or trauma during bone growth years. From a treatment standpoint, a heel lift (with or without arch supports) can be placed into the shoe on the short leg side. At 12mm (0.5”), problems with the heel lift being pushed out of the shoe and/or sliding forwards in the shoe may prohibit the use of these thicker lifts after which point the bottom of the shoe can be built up by a shoe cobbler (some services can be found online as well).
FUNNY BONES: "I gave up jogging for health reasons. My thighs kept rubbing together and setting my pantyhose on fire."—Judy Franconi@@A man and his wife were having some problems at home and were giving each other the silent treatment. Suddenly the man realizes that the next day he would need his wife to wake him up at 5 AM for an early morning business flight. Not wanting to be the 1st to break the silence (and LOSE), he wrote on a piece of paper, "Please wake me at 5 AM. "He left it where he knew she would find it. The next morning the men woke up, only to discover it was 9 AM and he had missed his flight. Furious, he was about to go to see why his wife hadn't wakened him when he noticed a piece of paper by the bed. The paper said, "It's 5 AM. WAKE UP." Men are not equipped for these kinds of contests.@@ After 3 years, a wife starts to think that their child looks different, so she decides to do a DNA test. She finds out that the child is actually from completely different parents. Wife: "Honey, I have something very serious to tell you." Husband: "What's wrong?" Wife: "According to DNA test results, this is not our child." Husband: "Well don't you remember? When we were leaving the hospital, we noticed that our baby had a wet diaper and you said, 'Honey, go change the baby, I'll wait for you here'." @@A Russian scientist and a Czech scientist had spent their lives studying the grizzly bear. Each year they petitioned their respective governments to allow them to go to Yellowstone to study the bears. Finally, their request was granted and they immediately flew to New York and on west to Yellowstone Park. They reported to the ranger station and were told that it was the grizzly mating season and it was too dangerous to go out and study the animals. They pleaded that this was their only chance and finally the ranger relented. The Russian and the Czech were given portable phones and told to report in every day. For several days they called in, and then nothing was heard from the two scientists. The rangers mounted a search party and found the camp completely ravaged, with no sign of the missing men. They took followed the trail of a male and a female bear. They found the female and decided they must kill the animal to find out if she had eaten the scientists because they feared an international incident. They killed the female animal and opened the stomach to find the remains of the Russian. One ranger turned to the other and said: “You know what this means, don’t you? “The other ranger responded: “Of course...The Czech is in the male.”
When you have a long-term migraine, it's about much more than a headache. You may feel sick to your stomach and find it hard to handle light, sounds, and smells. For some folks, though, it doesn't stop there. They also get something called an aura.
Most often, an aura causes you to see strange things, like colored spots or flashing lights. It can be pretty scary, especially the first time it happens.
Migraines without auras are much more common than any other kind. You can get them as often as several times a week or as little as once a year.
Auras show up in about 1 in 3 people with a migraine, but you're not likely to get them every time. So it's possible you might have both types of migraine, with auras happening here and there.
In both, you get the typical migraine symptoms, which may last anywhere from a few hours to a few days. That can include:
The difference is whether or not you get an aura. When you do, it typically sets in slowly over 5 to 20 minutes. It may last up to an hour. It often acts as a warning sign, coming on before any pain shows up. But it can happen during a migraine as well.
Visual auras. These are the most common ones. You might see bizarre shapes or effects that grow or move, such as:
Other auras. Less often, they can affect your other senses and even your ability to move. You might have:
But these may also be symptoms of a stroke. If you have any of them, and your doctor has not already told you that they are a part of your migraine, call 911.
Sometimes you can get an aura without any other symptoms. That's called a silent migraine. It's more common in people 50 and older.
Chiropractic adjustments alone can correct most types of headaches. Migraines present certain challenges because there can be many factors. A number of factors may trigger migraines, including Hormonal changes in women. Hormonal medications, Foods, Food additives, Drinks, Stress, Sensory stimuli, Changes in the wake-sleep pattern, Physical factors, Changes in the environment, and Medications.
So knowing what factors trigger migraines can help in the solution. Besides chiropractic adjustments, you should work in getting the amount of fluid you need to help your body detox. Most adults need between 7 or 8 hours of sleep each night. Exercise can help reduce the effects of stress.
To your better health,
If you have not set up your account at natural partners then go to npscript.com/Keefeclinic and set up an account (if a code is asked for use 6631111). There is no charge to set up this account and they do not sell email addresses. Once the account is set up you can order any of their over 9000 products in the comfort of your own home and have them shipped to your door. Note: for a period of time you can get free shipping, order today! For help ordering call 888-950-2767
John H. Keefe III, D.C.
IN THE NEWS: Researchers Find Grave Downside to Sleeping More Than 8 Hours a Day It’s no secret that chronic sleep deprivation is taking its toll on America’s health, but a new study suggests that those who get more than ample sleep aren’t that safe either. Seemingly counterintuitive results reported in the Journal of the American Heart Association on Wednesday suggest that oversleeping might put you at higher risk for certain heart conditions. The study, conducted at Keele University, was a systematic review and meta-analysis of 74 existing studies — collectively covering three million patients — that investigated how sleep hours impacted overall health. Lead author and clinical lecturer in cardiology Chun Shing Kwok, Ph.D. and his team noted a link between consistently sleeping more than eight hours and the risk of all-cause mortality (dying of anything) and the risk of cardiovascular conditions. Those who consistently slept for ten hours had a 30 percent increase in their risk of all-cause mortality and a 49 percent increase in the risk of cardiovascular-related death, the team writes. “Sleep is complex and related to many factors such as lifestyle, occupation, caring needs for children and relatives as well as physical illness,” he adds. “Too much sleep may be related to conditions like obstructive sleep apnea and hypothyroidism.” Instead, sleeping longer than ten hours might be indicative of other problems that might give cardiologists concern, adds Brooke Aggarwal, Ph.D., a behavioral scientist and clinical health education specialist in the Division of Cardiology at Columbia University Medical Center who was not involved in the study. “Scientists are not totally sure if sleeping too much is a risk to health itself, or if it is simply a marker of increased risk, she tells Inverse.
WELLNESS: Surprising truth about exercise and better brain health When it comes to the physical and mental benefits of exercise, research has focused on the effects of consistent, long-term exercise routines. But an intriguing review shows that a single episode of exercising can offer substantial and immediate brain health dividends that promote mental clarity and improve cognition. (how cool is that?!) This review also highlighted results from steady exercise (over time) – with promising implications for preventing cognitive decline and protecting against Alzheimer’s disease or other forms of dementia. A wide range of mental functions are benefited, including attention, working memory, problem solving, cognitive flexibility, verbal fluency, decision making and inhibitory control. Mental processing speed also increases. And, positive effects from a single exercise session can last for up to two hours post-workout. Also (no surprise here), researchers reported that acute exercise had the effect of enhancing mood and decreasing stress. Acute exercise triggers neurochemical changes that affect large areas of the brain, impacting emotional states and relieving symptoms associated with mood and psychological disorders – such as depression, anxiety, post-traumatic stress disorder, schizophrenia and more. In one study, 30 minutes of walking and running at 60 to 70 percent of VO2 max improved mood and cognition – results that were duplicated time and again by other studies. It’s no wonder that scientists say: ‘regular exercise is as effective as antidepressant medication in treating depression.’ No matter which type of exercise you choose, there’s one undeniable fact, physical activity is a potent therapeutic tool to address depression, alleviate anxiety and avoid significant cognitive decline.
CHIROPRACTIC: Research results: For Acute and Chronic Pain In a Randomized controlled trial, 183 patients with neck pain were randomly allocated to manual therapy (spinal mobilization), physiotherapy (mainly exercise) or general practitioner care (counseling, education and drugs) in a 52-week study. The clinical outcomes measures showed that manual therapy (chiropractic care) resulted in faster recovery than physiotherapy and general practitioner care. Moreover, the total costs of the manual therapy-treated patients were about one-third of the costs of physiotherapy or general practitioner care. Korthals-de Bos et al (2003), British Medical Journal “Patients with chronic low-back pain treated by chiropractors showed greater improvement and satisfaction at one month than patients treated by family physicians. Satisfaction scores were higher for chiropractic patients. A higher proportion of chiropractic patients (56 percent vs. 13 percent) reported that their low-back pain was better or much better, whereas nearly one-third of medical patients reported their low-back pain was worse or much worse.” Nyiendo et al (2000), Journal of Manipulative and Physiological Therapeutics "Reduced odds of surgery were observed for...those whose first provider was a chiropractor. 42.7% of workers [with back injuries] who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor." Keeney et al (2012), Spine “Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction; clinically important differences in pain and disability improvement were found for chronic patients.” “Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache.” McCrory, Penzlen, Hasselblad, Gray (2001), Duke Evidence Report “The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. . . Four weeks after cessation of treatment . . . the patients who received spinal manipulative therapy experienced a sustained therapeutic benefit in all major outcomes in contrast to the patients that received amitriptyline therapy, who reverted to baseline values.” Boline et al. (1995), Journal of Manipulative and Physiological Therapeutics In a study funded by NIH’s National Center for Complementary and Alternative Medicine to test the effectiveness of different approaches for treating mechanical neck pain, 272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic (DC), pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with DCs and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain; compared to just 38 percent pain reduction among those who took medication. Bronfort et al. (2012), Annals of Internal Medicine
FUNNY BONE: If a book about failures doesn’t sell, is it a success? Jerry Seinfeld@@I always wanted to be somebody, but now I realize I should have been more specific. Lily Tomlin@@It’s okay if you don’t like me. Not everyone has good taste.@@Knowledge is like underwear. It is useful to have it, but not necessary to show it off. Bill Murray@@Everything is changing. People are taking the comedians seriously and the politicians as a joke. Will Rogers
John H. Keefe III, D.C.
IN THE NEWS: Magnesium preventing cancer Pancreatic cancer – which claims roughly 49,000 lives every year in the United States – is notoriously difficult to detect and treat, conventionally speaking. Sadly, rates of this lethal cancer have been rising steadily over the past ten years, and the National Cancer Society predicts that there will be over 55,000 new cases diagnosed in 2018 alone. Yet, we know based on published research, that magnesium deficiency can play a role in the development of this dreadful disease. Fact: magnesium deficiency is common in the United States – with the World Health Organization reporting that less than 60 percent of the American adult population ingests enough of this life-sustaining essential mineral. Let’s take a closer look at some of the ways in which magnesium intake impacts your health – and some methods for increasing levels. Scientists found that magnesium levels were associated with pancreatic cancer risk, with the odds of the disease rising by 24 percent for every 100 mg decrease in daily magnesium intake. And, if intakes dropped to less than 75 percent of the recommended daily amount – established by the Institute of Medicine as 420 mg a day for men and 320 mg a day for women – the risk of pancreatic cancer rose by a stunning 76 percent.
WELLNESS: Honey is a blend of sugar, trace enzymes, minerals, vitamins, and amino acids that has antibacterial, anti-fungal, and antioxidant properties. Honey works as well as dextromethorphan, a common ingredient in over-the-counter cough medications, to soothe cough and related sleeping difficulties. Unprocessed honey can help treat skin infections, helps wounds heal, and improves dandruff and itchy scalp. It takes about 60,000 bees, collectively traveling up to 55,000 miles and visiting more than 2 million flowers, to gather enough nectar to make one pound of honey. Choose raw, unfiltered honey for medicinal properties; most honey on the market is highly processed and may even contain additives like corn syrup. Manuka honey is produced in New Zealand by bees that pollinate the native manuka bush. Advocates say it treats wound infections and other conditions. Components of Manuka Honey Hydrogen peroxide is produced by honey. It gives most honey its antibiotic quality. But some types of honey, including manuka honey, also have other components with antibacterial qualities. Another antibacterial component in manuka honey is methylglyoxal (MG). MG is a compound found in most types of honey, but usually only in small quantities. In manuka honey, MG comes from the conversion of another compound -- dihydroxyacetone -- that is found in the nectar of manuka flowers. MG is thought to give manuka honey some of its antibacterial power. The higher the concentration of MG, the possibly stronger the antibiotic effect. But, there may also be other compounds involved in the medicinal effect of manuka honey.
CONDITION OF THE WEEK: Health is a choice Working with patients for over 42+ years I’ve learned the importance of proper lifestyle choices. It’s been said there are no incurable diseases just some incurable patients. Outside of rare genetic disorders most people have the inborn ability to live a healthy, pain-free life. But that ability requires making quality life choices. I’m pretty sure most people realize what shape your house would be in you never cleaned it in 20 years. A similar thing is true about your body; if you’re not proactive in taking care of your health then complicated health issues can develop that take time to repair. Unfortunately, in most cases, we are unaware that our bodies are breaking down because we have no obvious symptoms. It’s similar to drinking water, as we age our sense of thirst diminishes and we can be significantly dehydrated and not even know it. A lot of times it is just simple things that need to be addressed in order to maintain excellent health. Movement is important, you don’t have to be conditioning for the Olympics to stay in good health even three days a week of walking or other exercises can have a significant benefit. Rest and relaxation including refreshing sleep are crucial for regulating stress hormones that can have a profound effect on your health over time. Positive mental and spiritual attitude have a healing effect on the mind as well as the body, practicing an act of kindness not only helps others in our society but floods your body with important hormones and chemicals that not only give you a sense of well-being but have health-promoting benefits. Since the nervous system controls and coordinates, everything in the body maintaining a stress-free nervous system through regular chiropractic adjustments are crucial. Chiropractic keeps the communication channels open and allows the body to self-regulate and heal. And what you put in your mouth is crucial, it has been said that “We dig our own graves with a fork.”
FUNNY BONE: What did the skeleton say while riding his Harley Davidson motorcycle? I’m bone to be wild!@@ What did the skeleton say before dinner? BONE appetite. His whole family found that HUMERUS.@@ I AM A SEENAGER (Senior teenager) I have everything that I wanted as a teenager, only 50 years later. • I don’t have to go to school or work. • I get an allowance every month. • I have my own pad. • I don’t have a curfew. • I have a driver’s license and my own car. • And I don’t have acne. Life is Good!@@ A pilot is flying a small, single-engine, charter plane with a couple of really important executives on board into Seattle airport. There is fog so thick that visibility is 40 feet, and his instruments are out. He circles looking for a landmark and after an hour, he is low on fuel and his passengers are very nervous. At last, through a small opening in the fog he sees a tall building with one guy working alone on the fifth floor. Circling, the pilot banks and shouts through his open window: "Hey, where am I?". The solitary office worker replies: "You're in an airplane.". The pilot immediately executes a swift 275 degree turn and executes a perfect blind landing on the airport's runway five miles away. Just as the plane stops, the engines cough and die from lack of fuel. The stunned passengers ask the pilot how he did it. "Elementary," replies the pilot, "I asked the guy in that building a simple question. The answer he gave me was 100% correct but absolutely useless; therefore, I knew that must be Microsoft's support office and from there the airport is three minutes away on a course of 87 degrees."
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a. In this review of the literature, the authors note that exercise is often one of the things commonly recommended to patients in an effort to prevent and manage osteoporosis.
b. Bone densitometry is the most common method used to monitor the effect of these interventions. Although areal bone mineral density (Defined as “The bone mineral content, measured by dual-energy x-ray absorptiometry (DEXA), divided by the bone area in square-centimeters.”) is closely associated to fracture risk it “does not provide a reliable indication of bone geometry or morphological adaptation to stimuli.”
c. The effects of exercise on aBMD are often modest. But this “may not fully represent the benefit of exercise to the bone.”
d. “Ultimately, monitoring changes in bone geometry beyond DXA-derived
aBMD will provide further insight into the optimal therapeutic exercise program to enhance bone strength and reduce susceptibility to osteoporotic fracture.”
e. “Animal models suggest that mechanical loading indeed influences bone geometry and thus strength.”
f. Evidence exists that either in combination or alone resistance training and weight-bearing impact type exercise “will prevent postmenopausal bone loss at clinically relevant sites”
g. “In keeping with the basic rules of bone adaptation that mechanical strains above those habitually experienced are required, it is unsurprising that walking has been found to be essentially ineffective for enhancing aBMD .”
h. In one study of 164 postmenopausal women involving multidirectional jumping and bench stepping combined with antiresorptive drug therapy, “Exercise did not enhance the effect on bone mass, but increased the ratio of cortical bone to the total bone area at the distal tibia by 3.7% compared with the non-exercise group.”
i. “A meta-analysis examining the effects of progressive, “high-intensity” resistance training interventions (eight to twelve repetitions, corresponding to 60% to 70% of one repetition maximum) on changes in aBMD in postmenopausal women reported a significant training effect at the lumbar spine, a non-significant positive effect at the total hip, but no effect at the femoral neck.”
j. “…there is currently strong (Level A) evidence to support the positive effect of physical activity on bone mass, evidence supporting the effect of physical activity on the bone structure is less compelling (Level B).”
Physical activity can have a beneficial effect on bone mass and perhaps on bone structure.
As in many articles, the results are complex and at times not straightforward. But overall the higher intensity exercises seem to be the most important for those seeking to retain their bone mass. I often opine on the geometry of spines and I predict that we will be hearing about more than just the bone mass in the future.
Reviewer: Roger Coleman DC
Editor: Mark R. Payne DC
Reference:Harding AT, Beck BR. Exercise, Osteoporosis, and Bone Geometry. Sports (Basel). 2017 May 12;5(2). pii: E29. doi: 10.3390/sports5020029.
John H. Keefe III, D.C.
IN THE NEWS: Depressed and Anxious Patients Receive More Than Half of All Opioid Prescriptions In 2014, 1.2 million Americans ended up in the emergency room with an opioid-related side effect; in 2015, 33,000 died from an opioid-associated drug overdose. Adults with depression and anxiety receive 51 percent of all opioid prescriptions in the U.S.; 19 percent of the 38.6 million Americans diagnosed with a mental health disorder use opioids, compared to 5 percent of the general population. Women are being prescribed opioids during pregnancy and after delivery, creating drug-dependent mothers and infants; 23 percent of 1.1 million pregnant women enrolled in Medicaid filled a prescription for an opioid in 2007. If you or someone you love struggles with anxiety or depression, it would be wise to take whatever steps necessary to minimize your exposure to cell phones, portable phones, Wi-Fi routers, smart meters, wireless computers, and tablets. You may also need to address other sources of dirty electricity in your home. Note: See or pamphlet on grounding and dirty electricity or visit Keefeclinic.com.
WELLNESS: B vitamins- With our deteriorating food quality, rising assaults on gut health, and a living environment that becomes more toxic by the day, it’s clear that we need this complex of brain and body nutrients more than ever. As you’ll soon see, researchers are discovering potential benefits of the family of B vitamins that are much greater than we ever imagined. 13 Signs You May Be Low in B Vitamins-Low levels of B vitamins can affect your body in many different ways because of the vitamins’ far-reaching and interrelated effects. Anyone of these common symptoms could be a result of low levels of one or more B vitamins:Inability to sleep well, Fatigue and apathy, Mental “fog,” confusion, and forgetfulness, Mood swings and irritability, Gastrointestinal symptoms, Joint or muscle discomfort, Muscle weakness, Loss of muscle mass, Numbness or tingling in fingers and toes, Frequent bruising, Headaches, Irritability, Dry, cracking skin. Because the vitamin B complex is a group of eight major B vitamins that work together, you can impact their synergy just by running low on one. Note: With Vega testing, we can determine if a B complex or a single B vitamin would be the most effective for your health.
CHIROPRACTIC: CHIROPRACTIC RELEASES YOUR INBORN ABILITY TO HEAL You are a natural born healer! What? Didn’t you know that? Indeed, even before you breathed your first breath, you were designed with an amazing innate healing ability that allows your body to heal all disease! Yes, it’s true! Your body is fully equipped to heal everything from a cut on your hand to cancer in your colon and everything in between. That is, as long as there is no interference. In fact, we have all witnessed this amazing healing in action on many occasions throughout our lives. Think about the last time you cut your finger. Maybe you were distracted by your computer screen as you reached across your desk for a piece of paper and then – suddenly – felt that all too familiar intense, burning pain of a paper cut. Now, once you stop the bleeding and move past the pain, what do you do to cause that little cut to heal? You may cover it with a bandage to keep it clean but does the bandage heal the cut? No, the cut will heal with or without a bandage. It is an irreducibly complex process, a process that none of us could ever fashion on our own – truly a stamp of our Creator. Your nervous system is the master control system of your body controlling every function and all innate healing in your body. In fact, your body’s ability to heal itself is directly related to the health of your nervous system. When your nervous system is healthy and unobstructed, your body can function and heal at 100%. However, if there is any interference in this normal flow of information from your brain to your body, healing is interrupted. Remember-chiropractic first, drug second and surgery last.
FUNNY BONE: Doctors Are Sharing Their Stupidest And Funniest Patient Stories--As I leaned in to check her eyes, my older patient got a little frisky. “You remind me of my third husband,” she said coyly. “Third husband?” I asked. “How many have you had?” “Two.”@@My patient announced she had good news … and bad. “The medicine for my earache worked,” she said. “What’s the bad news?” I asked. “It tasted awful.” Since she was feeling better, I didn’t have the heart to tell her they’re called eardrops for a reason.@@“Here,” says the nurse, handing the patient a urine specimen container. “The bathroom’s over there.” A few minutes later, the patient comes out of the bathroom. “Thanks,” he says, returning the empty container. “But there was a toilet in there, so I didn’t need this after all.”@@Guy comes into the emergency department via Ambulance with burns on his lower extremities. His shoes are charred and the bottoms of his pants are definitely burned away but his skin isn't so bad. He had been trying to use a propane-powered weed burner in his yard (think flamethrower) and things got a little out of control. I smelled alcohol on his breath so I asked the guy if he had been drinking and he looked me directly in the eye and said, "Nooooo". I got drunk just standing next to him. It was a once in a lifetime set up and I couldn't help myself. As straight-faced and professionally as possible I said, "Sir...liar, liar, pants on fire". The paramedics all turned at once and ran out of the room they were laughing so hard! The patient just stared at me. He was so drunk it went totally over his head.