Tuesday, December 29, 2015

The flawed system that allows companies to make millions off the injured



Rex Muller has had lots of tenants over the years, but none quite like Terrence Taylor. He moved into a house miles outside of town but couldn’t drive. He was 30 years old but played with toy cars. His face was badly disfigured by burns, but attractive women often accompanied him. Muller nonetheless trusted Taylor more than most. He had lots of money.

When Taylor moved from Fairfax County to Muller’s Martinsburg, W.Va., townhouse in 2012, agreeing to pay $870 in monthly rent, he flashed an insurance document bearing impressive numbers. It said New York Life Insurance was paying him $10,000 every month as a result of a lawsuit settled in 1989. Muller learned that a malfunctioning electric heater had burst into flames when Taylor was a boy, leaving him disfigured — and rich. His settlement would pay him many millions of dollars over the course of his life.

Two years later, in June 2014, Muller watched as a local deputy knocked at Taylor’s door. Muller had just taken his tenant, who had not paid rent in three months, to court and evicted him. He stepped into the darkened home as Taylor, an amputee, descended the stairs and, without a word, limped past him on a prosthetic leg.

Taylor had left behind a mess of toys, dirty dishes and cards written by “go-go girls,” Muller recalled. Strange documents were strewn across the kitchen table. “It was a lot of legal mumbo-jumbo,” Muller said. “A lot of lawyer talk.”

The landlord, however, understood enough to know the tenant had been doing a lot of business deals. “He was selling off his loan,” Muller reasoned.

Not quite. What Taylor had been selling, chunk by chunk, for pennies on the dollar, was a settlement that had a lifetime expected payout of $31.5 million. In numerous deals approved in Virginia courts over two years, Taylor sold everything owed to him through 2044 and was now broke and homeless.
How did this happen, Muller said he wondered as he picked through the detritus.

The hub of sales approvals
 
The answer to that question lay 250 miles south, along the southern maw of the Chesapeake Bay, inside the Portsmouth Circuit Courthouse. For more than a decade, this Virginia institution has operated much like an assembly line for the secretive industry of structured-settlement purchasing. Over the past 15 years, one lawyer has filed thousands of cases — far more than anywhere else in the state — at the courthouse, where almost all of them have been approved.

Portsmouth, Va., Circuit Court Judge Dean W. Sword in 2010.
When four companies struck 10 deals with Terrence Taylor in two years, they hired Portsmouth lawyer Stephen E. Heretick. Nine of those deals were then assigned to now-retired Portsmouth judge Dean W. Sword, the authority tasked with deciding such cases. And Sword approved every one, putting five of the deals under seal.

In all, according to Taylor’s bank records and court documents, the burn survivor sold $11 million of his structured settlement — which had a present value of about $8.5 million — for roughly $1.4 million, or 16 cents on the present dollar. He has sued the companies, focusing on a South Florida firm named Structured Asset Funding, which did six deals with him.

That Taylor, who had received diagnoses of learning and emotional disabilities, could so quickly hemorrhage 30 years’ worth of income in deals approved in a courthouse he never visited is the result of Virginia’s failure to properly regulate and monitor an industry that makes tens of millions off some of the state’s most vulnerable residents, a Washington Post investigation has found.

Unlike traditional settlements, which are paid out in one sum, structured settlements dispense the payout in portions over a lifetime to protect vulnerable people from immediately spending it all. Since 1975, insurance firms have committed an estimated $350 billion to these agreements, spawning a secondary market in which companies compete to buy payments for a smaller amount of upfront cash.

Such deals, industry advocates say, get desperate people the money they need for emergencies and big expenses, such as home purchases. But they also expose sellers to the risk that they will exchange lifetimes’ worth of income for pittances.

Virginia is among 49 states that have passed legislation to protect sellers of structured settlements by requiring county courts to discern whether a deal is in the seller’s best interest. But some laws contain loopholes, and the strongest protections have generally been implemented in states that have seen complaints of abuse.

After a Post report this summer that found judges in Maryland routinely approved deals in which firms bought payments belonging to victims of lead poisoning for dimes on the dollar, that state’s highest court reformed judicial procedures to require that businesses that buy settlements file their cases where sellers live and disclose how often sellers had sold in the past.

To ensure that companies do not file exclusively to amenable judges, deals in New York and Oregon must be submitted where the seller lives. In Illinois, sellers must attend court hearings so that judges can assess whether they understand the deals’ terms. To prevent predatory deals, North Carolina’s 1999 law capped how much companies can profit per deal. And in California, sellers’ attorneys must be notified if they try to sell their payout within five years of getting it. Experts familiar with scrupulous jurisdictions estimate that courts there approve deals at a rate of about 75 percent.

In the District, there is no law addressing the sale of structured settlements, so judges follow laws established in the insurance company’s home state — and sometimes go beyond them. Most judges “make an inquiry to ensure that the person understands, and they’re not getting abused, ” said Thomas Papson, a D.C. Legal Aid Society lawyer whom judges appoint to represent sellers at hearings.

But industry experts say weaknesses in Virginia’s law have made the state particularly appealing to purchasing companies looking for quick and easy profits that could shortchange sellers. Structured-settlement recipients in Virginia who want to sell their payments are not obligated to attend hearings. They’re allowed to waive their right to independent counsel and almost always do. Companies can file their deals anywhere in the state.

The de facto clearinghouse for these transactions has become Portsmouth Circuit Court, where most deals are approved and few sellers attend hearings, according to an examination of thousands of public records and interviews with industry insiders.

Over the past 15 years, Heretick has submitted the overwhelming majority of the state’s cases in Portsmouth, where he has a near monopoly on the legal work. Heretick, who was a Portsmouth City Council member between 2004 and 2012, won a seat in the House of Delegates in November. Since 2000, he has also worked as an attorney for more than a dozen purchasing firms and filed about 6,100 cases in Portsmouth. The Post found fewer than 350 cases that Heretick and other lawyers filed in other Virginia jurisdictions during those years.

Until 2014, when the judge retired from the bench, Heretick’s petitions were almost exclusively assigned to Sword, who once noted in a ruling how little attention the Virginia Supreme Court has paid to structured-settlement cases. “Essentially,” he said, “the circuit courts have been and remain on their own to resolve these matters.”

The Post examined every case Heretick filed in 2013 that was assigned to Sword, when he approved seven of Taylor’s deals. That year, Heretick petitioned Sword at least 594 times and frequently filed deals in bulk. Weeks later, the judge would rule on dozens — and once, 52 — in an hour-long hearing. Overall, Sword approved 95 percent of the deals.

Stephen E. Heretick in 2012, when he was a Portsmouth City Council member. Heretick, a lawyer, represented companies in 10 of the structured-settlement purchases from Terrence Taylor. (Steve Earley/Virginian-Pilot)
Sword didn’t respond to multiple requests for comment, including one letter that asked whether he reviewed the deals before the hearings, as well as other detailed questions.
A survey of the 300 or so cases Heretick filed this year shows that Judge William S. Moore Jr., who now acts as the primary Portsmouth judge handling the settlement sales, approved deals at a rate of nearly 85 percent. Moore did not respond to three requests for comment.

“The feeling within the industry in Virginia is that that particular court would pretty much rubber-stamp anything without much investigation,” said Bobby Waters, a Roanoke consultant who has spent decades working with injured people on structured settlements.

His comments were echoed by eight experts familiar with the deals in Portsmouth. “It’s hard for me to see that a judge could . . . understand what are in the [sellers’] best interests and turn through them this quickly,” said Brennan Neville, an attorney with Berkshire Hathaway Life Insurance Co.

The Post reviewed 160 deals, randomly selected, of the 566 that Sword approved in 2013. The filings generally include affidavits signed by sellers explaining why they wanted the money. They spell out how much sellers would have received, including interest, had they waited to collect everything — called aggregate value. They show how much the payments were worth at the time of sale — called present value. And they also show how much the company agreed to pay the seller upfront.

But the public record in Portsmouth is remarkably skeletal. Ninety-one of the 160 cases The Post reviewed were sealed— a rate that five experts, in interviews, called highly unusual. Portsmouth Chief Judge Johnny E. Morrison declined to comment on why these deals were sealed.

In the remaining 69 deals, the court filings show, companies purchased payments that had an aggregate value of $10 million — and a present value of $7.5 million — for $2.2 million, or about 29 cents on the present dollar.

Andrew Larsen, one of the nation’s foremost experts on structured settlements, called those profit margins “egregious.” “If you look at what is considered a fair profit margin in other industries, I don’t think anyone is making these terms,” said Larsen, former president of the National Structured Settlements Trade Association.

Some of the deals were even more questionable, experts say. For example, Heretick filed one deal in which a Virginia man sold payments that had an aggregate value of $164,760 — and a present value of $106,936 — for $3,000. And another deal the attorney filed sold payments that had an aggregate value of $250,000 — and a present value of $168,531 — for $3,658. Both of these deals paid people less than 3 cents on the dollar.

In an interview, Heretick said the discrepancy between purchase price and present value comes down to risk. For instance, life-contingent payments, which stop if a recipient dies, aren’t guaranteed to purchasers. Payments scheduled decades in the future, he said, have less value because of uncertain economic forecasts.

Sellers who strike these deals, he said, do so out of necessity, securing money through the transactions that they could not get otherwise. “If they didn’t have that ability, there could be lots of people out there who could be getting hundreds of thousands of dollars . . . years from now who might be homeless today.”

Heretick ascribes his high approval rate — “easily” over 90 percent, he said — to his years of experience filing these deals and his understanding of what will and will not be approved in Portsmouth. When he first started in the industry, he said, he drove three hours to Lynchburg, but judges declined to hear multiple cases in one session.

So, he said, he met with then-Portsmouth Chief Judge Judge James A. Cales Jr., who gave him two hour-long slots per month to file as many as he wanted and assigned Sword to the task. Now retired, Cales said he does not recall the meeting with Heretick or making that decision.

“We don’t peddle these to the easiest court we can find,” Heretick said. Portsmouth “happens to be where my office is located. . . . I’m certainly not going to drive six hours for a case in Patrick County.” Instead, sellers need to drive hours to Portsmouth — but few do. Heretick estimated that about 1 in 20 appears in court.

He said he’s never had concerns that people don’t know what they’re getting into.

“I don’t take cases” he said, “that I have doubts about.”

But Heretick later clarified that statement. Had he known what he knows now, he said, there is a case he might have declined to take: “The Terrence Taylor case.”
Fast, easy money
 
On a Wednesday evening in April of 1988, Taylor wandered into the master bedroom at his parents’ Herndon home to watch “Wheel of Fortune” and closed the door. Warmed by a space heater at his side, the 6-year-old fell asleep. Soon after, black smoke wafted from underneath the door. Taylor’s father kicked it open and found his son collapsed on the floor. A helicopter was dispatched to transport Taylor to the District, where doctors at Children’s National Medical Center worried that they could not save him.

Numerous surgeries and several amputations later, Terrence Taylor looked at himself in the mirror. “The 6-year-old who stares back . . . is missing a face, a right leg, the fingers on his right hand, confidence and the innocence of youth,” reads a Post article published in January of 1989.

Months later, Taylor visited a vocational rehabilitation counselor, who described the boy as having a cognitive “deficiency,” which likely predated the burns but could “accelerate” in their aftermath. Taylor was also diagnosed with post-traumatic stress disorder and dysthymic disorder, which related to “feelings of inadequacy, loss of self-esteem [and] decreased attention and concentration.”

That year, in 1989, Taylor settled a lawsuit against the space-heater manufacturer and entered into a structured settlement with a lifetime expected payout of $31.5 million. “Because of the severe physical and psychological injuries to Terrence, all parties . . . were concerned about Terrence’s ability to care for himself,” Taylor’s attorney, Robert Muse, wrote in an affidavit in August of this year.
 
The concerns about Taylor would prove true. He squeaked through high school with the help of special-education classes and weekly psychotherapy. He later earned an associate’s degree at a non-accredited, for-profit school that is now defunct but never landed a job beyond a few months of unskilled work at retail stores. He failed the driver’s license test four times. “The driving test is hard,” said Taylor, 33, who speaks haltingly and without intonation. “Getting your license is hard — the test isn’t easy. The computerized test on the screen.”

His payments protected him financially. By the time he was in his late 20s, his structured settlement was paying him nearly $10,000 monthly in untaxed income. But that money didn’t help him with women. “I can go to the mall and try to start a conversation, and it’s like, ‘I have a boyfriend,’ ” he said. “I’ve heard every excuse there is.”

Taylor did, however, date one woman, getting her pregnant and moving in with her, before the relationship dissolved. To distance himself from her, he planned a move to Martinsburg, W.Va., in the spring of 2012, where he would be closer to a cousin — and, for the first time, live by himself.
One day around this time, Taylor said he was leafing through the mail when he came across an advertisement. It was from a South Florida company named Structured Asset Funding, he said, and it promised fast, easy money.  All he had to do was call.

People ‘in bad situations’
That phone call ushered Taylor into a world where companies compete ferociously to find and poach customers from competitors. They comb through court documents, pay people hundreds of dollars for referrals and even solicit sellers long after they’ve sold everything.

One company that scours records for people like Taylor is Seneca One. Based in Bethesda, it files the majority of its Virginia cases in Portsmouth and has been a client of Stephen Heretick since at least 2006.

Curtis Montgomery, who worked for a few months this year as an account manager at Seneca One, said the firm maintains a database with “thousands of [potential sellers] from all over the country, their names, their phone numbers, their addresses, information we’ve received from court documents and notes — detailed notes.”

A former senior official with Seneca One, who spoke on the condition of anonymity, claiming he feared for his physical safety, said the database is used to “prey on who’s likely to sell their payments the most.” Most people, once they start doing deals, he said, will sell everything within two years — a period referred to as the “perishable period.”

New associates, Montgomery said, go “fishing” by cold-calling people in the database. “They look for the clients that are in bad situations,” he said, adding that he has seen sales agents pay people $50 to stay on the line for five minutes.

“Any way to get in and get them to talk,” he said. An associate might tell a potential client “ ‘You’re owed money. . . . They might not pay you the rest of your money if you don’t do this,’ ” Montgomery said. The goal, he said, is to ultimately build up a “pipeline” of “remarkets” — people who do continuous deals.

Monty Hagler, a spokesman for Seneca One, did not dispute Montgomery’s recollection but questioned his credibility in discussing the company’s work. During his tenure, Montgomery never completed a deal and was terminated because of poor performance, Hagler said, adding that the firing was “ugly. . . . He said, ‘I’m going to expose you.’ ”

Industry depictions do not reflect the practices of Structured Asset Funding, said president Andrew Savysky. “We care about our customers and hope they use the proceeds we give them to better their lives,” he said.

Montgomery’s assertions were echoed by the former Seneca One senior official and a current account executive, who spoke on the condition of anonymity out of fear of losing his job. The three said the most important part of the process is securing court approval.

“Lawyers in each company have [a list of] reasonable explanations that companies will look at,” said the former senior official, such as buying a house or paying off debt. “Then the in-house counsel writes the [seller’s] affidavit knowing what . . . the judge who is likely assigned will like.”
He said Virginia is one of the most popular states in which to file these petitions because it is a “rubber-stamp state where the [seller] doesn’t need to appear.”

And at the Portsmouth courthouse, their names may not appear on the court docket, as well. Many firms, which file using subsidiaries or shell companies, sometimes only refer to sellers by their initials, which Portsmouth Clerk of Circuit Court Cynthia P. Morrison said “should not be.”

Heretick, she said, was “one of the first” attorneys in the area to start using the court’s e-filing system. Sometimes, she said, “The only thing coming when he files is the last name and the first initial, and we are in error. . . . We should never accept a case with a last name and a first initial.”
Heretick said in an interview that he files with initials because that is what judges have requested. He said Sword decided to seal the cases to protect sellers’ personal financial information, calling the practice “commendable.”

People familiar with the industry offered a different interpretation. “The main reason they do it is to wall off [sellers] from competitors,” said John Darer, who runs a blog that monitors the industry.
And in the beginning, when he still had tens of millions available for purchase, there were probably few sellers in Virginia more sought-after than Terrence Taylor.

‘LIFE IS GREAT’
 
Taylor never dreamed it could be so easy. He had to sign only a few papers. Then whenever he was running short on money, according to a lawsuit later file in federal court, he called Rhett Wadsworth, a salesman for Structured Asset Funding, and Wadsworth would get him whatever he needed.
The first infusion of cash reached his account on April 27, 2012 in the amount of $5,000, his bank records show. Another one, for $7,000, arrived on May 2. “In cases where the individual directly requests an advance, we are within our legal means to provide it,” said Savysky, the company president.

Two $3,000 advances then materialized in Taylor’s account, the second landing days before Sword approved Taylor’s first deal in Portsmouth. The burn survivor sold payments that had an aggregate value of $814,999 — and a present value of about $724,000 — for about $300,000, his bank records show.

“LIFE IS GREAT,” he posted on Facebook days after Sword approved the deal. “CANT STOP SMILING AND WONT!!!!!!!!!!!!!!”

It would be the best deal Taylor would strike. Over the next two years, Taylor would do 10 more approved deals with Structured Asset Funding and other companies. One deal, court records show, traded payments that had an aggregate value of $5.3 million — and a present value of $4 million — for $389,000, or less than 10 cents on the present dollar. Another deal, according to filings, exchanged payments that had an aggregate value of $1.6 million — and a present value of $844,000 — for $40,000, or less than 5 cents on the present dollar.

Terrence Taylor at his home in Manassas, Va. When he was living on his own, Taylor, who as a child was diagnosed as having a cognitive “deficiency,” would take out large amounts of cash before going to casinos and strip clubs. (Ricky Carioti/The Washington Post)
In interviews and court documents, Taylor said the purchasing companies “coached” him in coming up with “false” reasons to explain why he needed the money. In one affidavit that Taylor signed, it said he needed money to pay down credit-card debt. Another said he wanted money to start a nonprofit organization. All of these explanations, he now says, were not true.

They “were Rhett Wadsworth ideas. Rhett said it had to look good on paper for the judge to approve it.”  Savysky contested that assertion. “The only reason why Terrence Taylor continues to say this is because he stands to gain by making these and other unfounded allegations,” he said.

Judge Sword sealed five of Taylor’s first six deals, all of which were with Structured Asset Funding. The Post determined the aggregate value of what Taylor received versus the value of what he sold in those sealed transactions by examining his bank records and asking an outside actuary to calculate the present worth of the sold payments at the time the deals were filed.

But one deal, later withdrawn after Taylor’s family realized what had happened, wasn’t sealed. Records show it sold life-contingent payments that had an aggregate value of $9,485,320 and a present value of $4,082,825.
In return, Taylor would have received $12,536.

Casinos and strip clubs
Analyzing Taylor’s bank records is not unlike plotting an earthquake on a seismograph. There’s a influx of money. The balance skyrockets. Then a series of large cash withdrawals — primarily at casinos — sucks it away, before more funds again send the balance soaring.

Cousin Derrik Twyman took Taylor shopping for furniture after he moved to Martinsburg and witnessed the results. The burn survivor bought more items than could fit in his house, Twyman said, and wound up piling armchairs next to his refrigerator.

Another cousin, Willie Stovall, said he watched Taylor head to the Hollywood Casino at Charles Town Races, take out as much as $10,000, then go to local strip clubs where he’d fish out fistfuls of cash for performers who flocked to him.

Strippers “would say, ‘I’m waiting to talk to Terrence.’ They would call and say, ‘Are you coming tonight? Come see me.’ And it fed his ego,” Stovall recalled. He said strip clubs dispatched taxis to bring Taylor to their bars. “I’m not going to say that didn’t happen,” said a manager at Vixens in Bunker Hill, who spoke on the condition of anonymity because he didn’t have permission from the owner to comment.

Taylor doesn’t dispute this portrayal, but he called it incomplete. He said friends and relatives often pressured him into spending money, and he wanted to help people. He said he bought a new car for Stovall and wired thousands of dollars to a needy Las Vegas woman whom he met on Facebook.
By late August of 2012, the $300,000 Taylor had received from his first deal had nearly evaporated. But Taylor still had plenty left to sell — New York Life was pumping $6,700 into his bank account every month — and on Aug. 22, following a two-month absence, Structured Asset Funding again appeared on Taylor’s bank records with a cash infusion of $1,000.

The company flew him to South Florida and took him to two strip clubs, Taylor has alleged in court filings. His bank statements show several purchases in the area that same week in August, including a few expenditures at a Hollywood, Fla., massage parlor that state authorities later investigated for prostitution. Then on Aug. 29, Wadsworth wired Taylor $7,000 from his own account, according to Taylor’s bank records. And days after that, Heretick filed another petition in Portsmouth court.

Reached for comment, Wadsworth, who in all wired Taylor $12,000 from his personal account in four transfers between August of 2012 and October of 2013, said he “would have to consult with our legal counsel to make sure I can make a comment.” Afterward, Wadsworth, now the company’s director of sales, didn’t respond to three requests for comments and one letter asking detailed questions.

“This is not a common practice,” said company president Savysky, commenting on the wiring of money to Taylor by Wadsworth from his personal account. Savysky said Structured Asset Funding sent Taylor money at least 39 times over two years because Taylor asked for it. “Mr. Taylor solicited our business and requested periodic advances,” said Savysky, who did not respond to questions about whether his company took Taylor to strip clubs.

Quick doses of cash are one of the most effective methods of attracting or retaining clients, said four people who have worked in the business. Rhonda Bentzen, president of the purchasing firm Bentzen Financial, said she has seen many companies operate this way. “They love to do that with people who are mentally incompetent,” she said, comparing the easy money to narcotics. “They do it for the sole purpose of getting their hooks into them . . . [and] keep them coming back for more.”

Taylor said he soon came to view Wadsworth as a friend. Even after he’d been evicted from his house and spent weeks bouncing between friends’ places, the pair continued to chat on Facebook. One day early this year, Taylor asked about his payments past 2044. Could Wadsworth do another deal?
This time, however, Wadsworth demurred.

“I won’t be able to make you an offer,” he said in the chat, adding: “What you have remaining is too far out.”
‘Things are going to work out’
 
Terrence Taylor and his daughter watch TV at his home with his mom, Louise Taylor. Terrence Taylor doesn’t dwell on his financial problems, instead focusing on his daughter, singing in a church choir and playing video games. (Ricky Carioti/The Washington Post)
It’s 6 p.m. inside Taylor’s parents’ house. Taylor sits in darkness in the living room, as his mother shears mustard greens under the kitchen’s fluorescent bulb, fretting aloud about paying his daughter’s tuition bill.

Taylor’s daughter, who lives with her mother close by, was bullied in public school. So the family enrolled her at private school. It’s not cheap, she tells her son.

“I think the way things are going,” Taylor replies, “things are going to work out.”
The mother puts down the greens. “You said the way things are going, you think it’s going to work out?” she asks slowly.

“We’ll put it on my Social Security,” says Taylor, who lives again with his parents. “The back money will take care of it.”

“Do you know how much it would take [to pay the tuition] for one year?” she asks him.
Taylor looks at the floor. He doesn’t respond. He doesn’t know that the tuition costs $7,800 every year or how much he’ll get in Social Security if he is approved. He can’t say how much money he sold between 2012 and 2014 or what he received in return.

But he does think something was wrong with what happened. In February, he sued Structured Asset Funding in U.S. District Court in Alexandria, claiming it had “addicted [him] to easy money, induced him to spend lavishly on gambling and women and encouraged him to sell more in future payments than reasonably appropriate so they could extract as much profit as possible.” Taylor later withdrew the suit with plans to refile in Portsmouth.

But before he could, Structured Asset Funding sued him in Portsmouth Circuit Court in August. In filings submitted by Stephen Heretick, the firm said Taylor’s lawsuit breached his contract with the business. His allegations “directly contradict the . . . sworn statements Mr. Taylor made to [Structured Asset Funding] and to the Portsmouth Circuit Court during multiple proceedings.”

Taylor, represented by Connecticut attorney Edward Stone, has since filed a series of counterclaims, asserting Structured Asset Funding “called him 10 times per day . . . sent him [money] cards . . . purchased an ‘X-Box’ and games for Mr. Taylor . . . purchased a cell phone for Mr. Taylor and . . . paid him approximately $250,000 in advances.”

If Taylor wins the case, experts say, it could bolster calls for industry reform while also encouraging other sellers to sue the purchasing companies, which industry blogger Darer and other experts say has been relatively rare.

Even now, said analyst Mark Wahlstrom, who runs a trade website called the Settlement Channel, the case is fomenting “mounting angst” over whether structured settlements achieve their stated goal of protecting vulnerable people. If they do not have the mental acuity to sell their payments, he said, who is to say they had the sophistication necessary to agree to the payout in the first place?

Most of the time, Taylor doesn’t like to dwell on the lawsuit or his money problems. He instead focuses on pleasures that don’t cost anything. He tends to his daughter, sings in a church choir, plays video games. But in between, he said, memories of Martinsburg flash — the strip-club friends who don’t call, the women he now realizes never loved him.

The only people who haven’t forgotten him are the purchasing companies. Even now, he said, they solicit him, asking if he’s interested in making some easy money.

Thursday, December 10, 2015

10 ways to avoid winter joint pain


Office Syndrome: Shoulder Pain
As mercury drops, joint aches rise.

Winter can be the season of pain for people with arthritis. The exact science behind cold-related joint aches is uncertain, but there’s no doubt symptoms can worsen, says Dr. Kelly Weselman, an Atlanta rheumatologist. It could be that muscles, ligaments and joints just get stiffer with lower temperatures, she says. What’s clear is that patients do feel the difference between 90-degree summer days and frigid winter overnight temps. Here are 10 ways to protect vulnerable joints as the weather grows cold.

Realize discomfort is real.
It’s when weather turns chilly or rainy that patients call for treatments like injections in the joint spaces (or intra-articular injections) for aching shoulders or knees, says Dr. Laura Reese, an orthopedic surgeon with Ashland Orthopedic Associates in Kentucky. One likely reason, she says, is that the synovial lining of the joints — filled with fluid that bathes joints and helps keep cartilage healthy — reacts to barometer and temperature changes. Oddly enough, she says, patients who have had joint replacements often continue to complain of cold-weather aches around their new shoulders or knees.

Feel the (exercise) burn.
When cold winds blow, staying cozy indoors is more tempting than taking a walk — but staying active is better for function and mobility, Weselman says. Cutting down on activity only leads to decreased range of motion and more joint pain. Many people who become less active in the winter tend to put on a few pounds, Weselman says: “And we know, especially with the knees, that even 5 pounds can make a difference in the degree of pain.”

Layer up.
Dress warmly and in layers, Weselman advises. “It’s important to keep the core body temperature warm,” she says. Keeping joints warm is also essential, she says, along with surrounding muscles and ligaments. Gloves, scarves, warm boots, long johns — who knows, maybe even legwarmers — protect your skin and joints from outdoor cold exposure. Dress for the changing weather, Reese says: “If it’s going to be 38 degrees, and you tend to wear shorts year-round, put some pants on.”

Tweak your workout for winter.
Adapt to the colder months by doing aerobics indoors, Weselman suggests. “Using equipment like treadmills and exercise bikes is one way to stay warm,” she says. Heated indoor pools also provide good options for joint-friendly fitness.

Stretch against stiffness.
As people get older, their joints tend to get stiffer. “I am a firm believer in stretching for the older population: 60-, 70- and 80-year-olds,” Reese says. Tai Chi or similar stretching maneuvers let you stay inside while keeping joints active. If yoga’s your thing, Jake Panasevich, a yoga motivator and Eat + Run blogger, explains how to ignite your practice in the dead of winter.

Take OTC painkillers with care.
Medicines like acetaminophen (Tylenol), ibuprofen (Advil and Motrin) and naproxen (Naprosyn and Aleve) can help people get through the colder winter months. However, even with these over-the-counter drugs, Reese says, your doctor needs to know you’re taking them — especially if you have kidney problems or stomach ulcers, or if you’re on prescription blood thinners.

Apply heat in moderation.
Warm packs for cold joints hold a certain appeal. “People love to use moist heat, heating pads and things like that,” says Reese, who advises caution. “I’ve seen some bad skin burns,” she says. “People fall asleep on heating pads.” She usually recommends 10 to 20 minutes of heat (or ice) to the affected body part. Patients with neuropathies — damaged nerves to the hands or feet, often from diabetes — should use heat or ice packs for no more than 10 minutes at a time, she says, and check every three to five minutes for skin reactions.

See how skin rubs and creams stack up.
Over-the-counter creams, heat gels and other rub-on remedies for arthritis and joint pain sound soothing and smell medicinal, but do they work? In a recent survey of pharmacists, Capzasin was the top-recommended product (21 percent), followed by Biofreeze (18 percent), Icy Hot (15 percent) and Bengay (11 percent).

Be extra cautious for certain conditions.
People with vascular issues like Raynaud’s phenomenon, which can occur alone or with conditions like lupus, experience cold-related symptoms. As blood vessels constrict, fingers and toes feel numb, and skin turns blue or reddens. “These people have a double whammy,” Reese says. “Not only will they notice the pain in the joint just from the cold, they also get the vascular component that goes with it. That can be pretty profound.” So it’s doubly important to keep the core body warm and make sure hands and feet stay warm and dry.

Look to warmer days.
Unless you live somewhere like Siberia, there’s a (warmer) light at the end of the tunnel. For people suffering from cold-weather joint pain, Weselman offers this advice: “It’s important to keep moving — and remember that summer will come.”