Old Well: UNC Chapel Hill Campus

Sunday, July 29, 2012

I hadn't realized until recently....

I hadn't realized until recently just how much politics has intruded into medical  funding. And I'm not writing about the controversial "Obamacare," recently validated by the Supreme Court and set to go into full implementation in 2014.  This intrusion has its genesis through several administrations, going all the way back to the early 80s. Consider that current government bio-medical allocations by the National Institutes of Health include the following 2012 funding:
Heart disease: 2.2 billion (Deaths annually: 771,100; expenditure per patient: $27).
Diabetes: 1 billion (Deaths annually: 70,611; expenditure per person: $42).
Breast cancer: 778 million (Deaths annually: 41,049; expenditure per patient: $3,721).
Prostate cancer:  337 million  (Deaths annually: 28,517;  expenditure per patient: $177).
Obviously, men are being short-changed. But that's not the worst of it. Both sexes suffer dismal funding when you take HIV/AIDS funding into account:
HIV/AIDS: 3.2 billion (Deaths annually: 10,295; expenditure per patient: $3,047).
I find this shocking. But there is more to this egregious funding for a disease that pales when it comes to the mortality rates for our primary illnesses.
In addition to research allocations for HIV/AIDS, 15.6 billion has been designated for housing and cash assistance to HIV/AIDS patients. All of this pales when you consider our government, beginning with the recent Bush administration, has pledged itself to spending 50 billion on global AIDS.
Since1981, we've spent 170 billion on AIDS and continue to spend 20 billion annually on it, not including 24 billion in last year's budget.
Currently, there are about 81 million Americans with heart disease, according to the AHA.
The CDC's National Vital Statistics Report says that there are 24 million of us with diabetes, not including a larger number who are pre-diabetic.
Presently, some 1,200,000 of us have cancer.
It should be obvious that our health budget is out-of-wack when it comes to AIDs and blatantly unfair to the vast majority of us threatened with diseases vastly more dangerous.  
How did it get this way? When AIDS first became prominent in the early 80s it was, indeed, a hideous disease growing exponentially. Since then, mortality rates have declined nearly 18% and new medications have made HIV manageable.

At present, government health allocations are skewered and blatantly unfair, as well as injurious to the vast majority of us.  
Can anything be done? Unlikely, for it would be deemed PC, or anti-gay.  
One way out might be doubling the allocations for the 16 diseases with higher incident rates of occurrence and mortality than AIDS such as hepatitis and Alzheimer's. Not likely in a nation still reeling from a stagnant economy and its future enormously compromised with an ever increasing national debt.

Sunday, July 22, 2012

Lately, I've taken a strong interest in....

Lately I've taken a strong interest in meditation to escape stress and feel more relaxed.  From the medical sources I've read, I'm convinced it has a lot going for it. If you're depressed or anxiety prone, meditation may be more helpful than Zoloft or Valium and the like. In his book, When Panic Strikes, noted psychiatrist David Burns, argues that the new research isn't gung-ho anymore on the assumption of chemical imbalance in the brain, resulting in serotonin deficiency.  What success SSRI's seem to have may really be the placebo effect in action.  Control groups in which placebos have been given have shown virtually the same results. Of course, this is bad news for the pharmaceuticals, who keep pumping out their propaganda across the media and offering perks to physicians.  Alas, there are even those in the FDA who have had strong links with the drug companies. One thing we do know:  while meds can be necessary for many, they all have potential side-effects that can do great harm.
Burns eschews the psych meds, favoring the cognitive approach with its advocacy of getting rid of emotional distress by adopting alternative, more positive thoughts in handling stress. It takes work to reprogram your responses, but it can be done. Cognitive therapy now dominates counseling, replacing traditional talk therapy. I agree that it can be helpful.
In the hard scenarios, something more is needed.  (Here I'm writing about anxiety, not depression.)  That something may well be meditation. In the last several months I've been trying out what's called restorative yoga, which consists of simple breathing, visualization, and meditation exercises. I'm not a champ at this kind of endeavor. I can't even say I've got the breath thing down right. Books and videos can help, but ultimately, at least initially, you need a good teacher.
Clumsy as I may be, I know that when I retreat to my sunroom hideaway, unroll my mat, and lie down, beginning with breathing from the stomach up through the nose, four seconds in, six seconds out, I sense my body unwinding from its tightness. I follow with body visualization, letting each limb "fall through" into the mat. Then I transport myself mentally into bliss, a scene that brings pleasure. For me, it's usually my wife and I walking up the steep, narrow pathway of rugged Ben Nevis, the valley below a dense green, splattered by the white wooly sheep grazing contentedly in a rolling landscape fenced by stone walls. I am there again in Scotland, that dear country of green mountains, twisting by-ways, lakes and bubbling brooks, and friendly people. I am at peace.
I follow with actual meditation, or at least the attempt, with the aid of my mantra, the psalmist's "lead me by the still waters," emptying the mind, though it keeps insisting it's the boss.  Whatever my failed attempts, I feel relaxed.
Recently I was virtually mesmerized in reading Tim Park's Teach Us to Sit Still: A Skeptic's Search for Health and Healing.  He could have been writing about me. Both of us have been profs, working with language and literature. Both of us are into the mind thing, analytical and suspicious, reserved in our allegiances.  Both of us were raised in a religious context, which we've now abandoned. Both of us have suffered the same physical ailment with its ubiquitous fall out, always there, seemingly beyond remedy.
 Parks, in his desperation, suspends his cerebral dissonance, to try meditation.  It comes hard.  It's all about breathing.  Though the mind resists emptying, Parks knows there's something to it. He attends a five day retreat.  On the fourth day, it happens. He feels the breath flow across his upper lip.  Heat radiates through his body. And the pain? There is no pain.
Of course the conscious world will bring back the pain with its culminating anxiety. You're not there in a day. But Parks knows now, though he may not understand it fully, that mind isn't separate from the body. The mind and body are one.
The seed has been sown and Parks persists, each attempt in overcoming the chattering mind becoming easier.  
Parks finds his way ultimately to permanent relief from his physical pain.
Nonetheless, as a rationalist, he still finds it paradoxical,  He's a writer with twenty books published, and on one occasion, short-listed for the Booker Award, Britain's highest award for literary achievement.  Words, after all, not only give him employ, they are the essence of what make us human.
And yet there is that world beyond words, vast and ineffable, removed from the mind's ceaseless chatter, bringing us in to touch with our full selves.  Integrated, mind and body become amalgam, and reconciliation grants equanimity.  No longer two selves, in our found wholeness comes peace transcending time and space, circumstance and pain.
Teach us to be still.

Sunday, July 15, 2012

When it comes to stress....

When it comes to stress management, seeing things in perspective can help you get your ducks in a row. I still stumble, but it helps when I get a tip once in a while such as in reading Peter Bergman's insightful article in a recent issue of the Harvard Business Review.
Origins of stress
Bergman points out that a lot of our stress comes from frustration, or this disconnect between expectation and result.  I'll make up some of my own examples here:

1.  You're driving through a residential neighborhood.  There are stop signs at the end of each block.  You're behind this guy who doesn't stop at any of them.  The speed limit, well- posted, says 25.  He's going at least 40.  It gets to you: why is it some people think the law's for other people?
2.  You thought you had a connection with someone, only to learn they've been putting you through a shedder when talking to others.
3.   You haven't heard from your kids in ages. Not the first time.  Do they give a hoot at all?
4.   It's the damned cell phone again. Expensive gadget at high monthly costs and you can't get it to work just when you need it most.
5.   You've paid all this money for a good meal, only to find you've been short-changed on both the food and the service.  
As I write, I find I'm surprised how easily the examples come to my mind of daily frustration. Doubtless, you can add your own.  
Consequences of stress
Frustration mounts up and spills over, souring relationships and potentially impacting your health, both physical and mental:  think ulcers, gastritis, hypertension, depression, etc.  According to the American Psychological Association (2010), stress can have multiple effects on your body, mood, and behavior:
Body:  headache, muscle tension, upset stomach, insomnia
Mood:  anxiety, restlessness, loss of motivation, sadness
Behavior:  overeating/under eating, anger outbursts, drug or alcohol abuse, withdrawal
Oddly, the APA misses out on the worst behavioral response of all:  suicide
In getting a handle on things, it's helpful to gain a sense of perspective.  Say something happens to you. When you can't get out of your head, then all hell can break loose. Maybe you've got something like acid reflux, diabetes, or irritable bowel syndrome. None of them is fun, but resorting to what I call comparison helps put things in perspective.
Better the reflux than the way some people languish. Try on Lou Gehrig's disease, MS, or cancer. Trade places with a paraplegic needing total care. In the news recently comes the story of the pretty Georgia girl recovering from flesh eating bacteria, resulting in multiple amputations. Haven't seen such courage in a very long time.
All over the world are those who suffer grievously and unfairly from natural disasters, famine, disease, poverty. Think Africa.  Think Bangladesh. In our own blessed nation, there are many who've lost their jobs, homes, and health coverage.  
All too often we learn of Man's cruelty to his fellows. Think of today's Syria, of whole families executed, civilians shelled daily, deliberately.
When you lie in bed at night, thinking things are awful for you, try this tactic to get out from under: What's the worst thing that could ever happen to me? Believe me, it will make your present anxieties seem small.
Here's another way you might develop a sense of perspective:  what I call the camera technique.
Ok, the moment you sense stress coming on, imagine you're outside your body, filming yourself. (In yoga, we call this kind of thing the Witness.) Fill the frame with yourself.
Now pull your camera back to fill the frame with people.
Now pull back again to include the landscape.
Then pull the camera back yet again to include the clouds.
Take the shot.
How do you find yourself in the picture now? Seeing yourself in the larger spectrum helps you downsize the seeming magnitude of your stress.  Here, you might look back at the photo that prefaces this entry to catch my meaning.
Set your lens on infinity, whether spatial or temporal. What am I in the backdrop of the stars?
Learning to cope, you'll discover your stress tumors shrink.  
It's then you 'll find freedom in an unfree world.

Thursday, July 12, 2012

i was reading somewhere....

I was reading somewhere that half of those who die from heart disease have low  cholesterol LDL, which of course flies in the face of long-standing medical emphasis on reducing the bad stuff.  But there's a new blood test in town that explains why you can have acceptable LDL, but still be in danger of a heart attack or stroke.  This test, performed by just two labs in the U.S., measures lipid particles for their size and density   Everyone should take this test on an annual basis at the very least. 
Unfortunately, the practice of relying on cholesterol scores can lead to fatal consequences, since it doesn't get at the causes of heart disease--poor nutrition, lack of exercise, and daily stress.  Statins don't even remotely touch on any of these factors, though It may be good for the pharmaceutical industry, contributing substantially to our bloated health costs.
In my last post, I mentioned the crucial role diet plays in preserving good health:  whole grains, fiber, and vegetables versus fats, sugar, refined flour, and lack of sufficient fiber.  As much as you can, focus on a plant based diet.
Writing in the Huffington Post, physician David Hyman cautions that "instead of looking just at the cholesterol numbers, we need to look at the cholesterol particle size. The real question is: Do you have small or large HDL or LDL particles. Small, dense particles are more atherogenic (more likely to cause the plaque in the arteries that leads to heart attacks), than large buoyant, fluffy cholesterol particles. Small particles are associated with pre-diabetes (or metabolic syndrome) and diabetes and are caused by insulin resistance."
What got me started on this entry is that I recently took the new test and was shocked to find I'm excessively high in small LDL particles.  Further that I'm experiencing insulin resistance, which can be a precursor to diabetes.
For years, I've been taking annual blood tests for cholesterol, and thinking everything is well.  Now I think again of that 50% fatality among people displaying low LDL cholesterol, many of them slender types like myself.
I'm actually thankful for the surprise results, as things aren't helpless.  You can decrease small LDL particles by adopting the eating habits I mentioned earlier and doing five thirty-minute exercise sessions weekly.  You might also try niacin supplements, but under a physician's monitoring.  Niacin has proven to be as effective as statins for many. 
One caution I need to add:  choose nutritious foods that have a low glycemic index, or convert to blood sugar more slowly.  Look out for the carbohydrates like white potatoes!
Do well and be well.

Sunday, July 8, 2012

I was recently reading....

I was recently reading a favorite minimalist blog.  You know, the kind that stresses simplifying one's life, something I wrote about recently.  The blogger writes about her teaming up with another blogger to reduce her sugar intake, not a bad idea, considering the increasing occurrence of obesity and diabetes, even in children.

She mentions that she eats an apple a day as her primary sugar intake.  If I remember things right, your sugar intake shouldn't exceed 36 grams daily.  An apple, at 25 grams, almost gets you there.  A medium banana nets you 14 grams.

This leads to a conundrum for me, to say the least.   After all, most medical sources recommend five daily servings of fruit, which help assure proper fiber intake and promote digestive health.  Assuming fruit is loaded with sugar, five helpings would suggest you'd be way over the max.

Out of curiosity, I checked the National Diabetes Association site and found they include fruit as a sugar source.  While they encourage you to eat fruit, you have to trade off with your carb intake.  Rather cumbersome, I'd say.  By the way, I wasn't aware before of how carbohydrates contribute to your blood glucose.  Cutting out sugar isn't as easy as it might appear.  Seems you almost need to be a chemist.  Just looking at the sugar content on a label doesn't suffice. 

On the other hand, there are the well-respected holistic doctors such as Neil Barnard and Joel Fuhrman, who shun limits on intake of fresh fruits, though not fruit drinks.  For them, the key is avoiding processed, or refined, foods.  This includes refined carbohydrates.  What about unrefined carbs such as brown rice?  These are the good guys, the complex carbs, which haven't had their fiber stripped away.

Who's right? I side with Fuhrman and Barnard.  Don't stress about carbs or fruit, unless you're diabetic.  Focus on fruits, plant foods, and the good carbs like oatmeal, rye, multigrain and sourdough breads, brown rice, pasta, etc.

You can also select more wisely by using a glycemic index chart, available online.  The GI indicates how quickly the food item converts to blood sugar.  White potatoes, for example, have a high GI.  Try a sweet potato instead.  Back to the complex carbs.  In general, they have lower GIs.

I've found medicine isn't an exact science.  Abounding in contradiction and uninformed, even dangerous, practices, you always have to be wary.  When it comes to sugar, say no to its common sources-- table sugar, cakes, pastries, sodas, etc.  But then don't forget the carbs and fruit.  Check their GI.  Avocados, for example, have a very low GI.

We are what we eat.  Better:  We become what we eat.  Did you know that 60 percent of our diseases come from what we eat?

Anybody for an apple?

Monday, July 2, 2012

One of my favorite things to do online is ....

One of my favorite things to do online is to read blogs by everyday Joes and Jill's.  I'm even more keen on this, having joined the blogger tribe more than a year ago.  It's fun to be part of a conversation and read what people say and how they say it, and view their web designs.  Blogs have frequently given me good advice and sparked new creativity.  Best, they've linked me to others with similar needs and wants, dreams and fears, as questing, yet fallible, beings in life's journey. 

This morning, my daughter sent me a link to a blog I found just fascinating.  www.theminimalists.com  More than 100,000 subscribers apparently agree.  It's the work of two young men with writing finesse.  You get the feeling they're sitting across the table, talking to you.  I started reading their posts this morning and became this greedy kid with his fingers in the cookie jar, devouring one post after another,

Minimalists, they share a passion for getting down to life's marrow.  They've done this in their own lives, downsizing their living quarters, forfeiting television, that great time mugger. Courageous, they quit their six figure salary positions in the corporate world to live independently, sustaining themselves through their own resourcefulness.  Not many of us enjoy their liberating lifestyle; instead, we often endure life with anxiety riding our backs.

It's like Walden all over again--you know, the hut in the wilderness experience Thoreau undertook to redefine the good life.  (That guy has to be one of my all time favorites.)  I like the way he put the matter of simplicity:  "Our life is fritted away with detail.  Simplify, simplify.”

Yet simplifying doesn’t come easily to me.  I don't know about you, but I cling to memories and am obsessed with routine.  I collect junk.  I hate throwing things out.  I don't like change.  Yeah, the jig is up:  I confess to being a sentimentalist junkie.

I know some people don't seem to have difficulty tossing out past memories or replacing old friends, or moving to new climes.  But I've always been different that way.  When I was a child, I’d frequently make myself scarce to avoid saying good-bye to those I loved.  Silly, I even hated giving up my worn out shoes, friends who'd been with me everywhere.  I remain that way about a lot of things, cluttering my life with the inconsequential.

Still, I'm beginning to do better in lightening the load.  Take the mail for instance. For too long I've been in the habit of creating disheveled piles on any available surface in the house.  Now I sort the mail immediately, sometimes on my way walking up the drive, separating the wheat from the chaff.

I know it doesn't amount to real simplification, but it does indicate my awareness I need to learn how to let go.

In a way, the life Karen and I live is already simple.  Finances make that the only real option. I’m retired and my wife soon will be.  We live in an older house of modest square footage.  We don't purchase frills, or things we don't need.  We seldom get out of town.

Right now, I'm thinking about shedding my many books I've gathered over the years as a prof.  This isn't as easy as it may seem.  I'm a lover of books.  But I'm also more aware I need to give to others what I no longer require.  I haven't looked at most of these books in a very long time anyway. 

Elise Boulding, the renowned sociologist, put the whole thing succinctly:  “The consumer society has made us feel that happiness lies in having things and has failed to teach us the happiness of not having things.”

Like my worn out shoes, it's time to let go.  Time to simplify.