If your Jim lost a lot of weight like I did, he doesn't have much meat or muscle left in his upper back. I use the heavy rubber cords that poeple use for exercising and thy seem to help. It might make him a little sore until his body gets used to them tho.

Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here