Category Archives: medical thoughts

A slice of half-baked pie

It’s tricky being in the advice business, especially the “what is right to eat” one.  There are thousands of diet books enthusiastically embracing a “correct way to eat.”  I’ve read a few recently published, written by smart, educated, scientific minds, several with medical degrees — strongly advising us what we ‘should eat’ to be our healthiest, giving us our best chance to avoid disease.  They all agree on one thing:  we should be eating real whole food and avoiding highly processed (junk).  That makes sense to any dummy.  Eating an apple, they agree, is healthier than a Snickers bar.  Duh.  

Since we are all so “food group” conscious, what the books don’t agree on are the ideal proportions of those whole food groups.  Some are polar opposites over saturated fats, particularly from meats and dairy, whether they are good or harmful.  One camp exposes a strictly plant based diet, showing studies of how animal fats are directly related to our maladies.  Others point to similar studies showing why animal fats and good dairy may help cure them.  Some champion low fat in general.  Others high fat.  Some encourage whole grains, yet others endorse avoiding them.  There are loads of conflicting beliefs and recommendations.  How can smart, educated, studied, professionals be so at odds about what whole foods we should eat?  They all can’t be right.  Or can they?

We’ve all been somewhat dimwitted when it comes to what we’ve been sticking in our mouths over the last century as we’ve radically changed our diets away from natural whole to processed food.  We gain weight and have health problems, then try to reverse years of bad habits, so we listen to what we hope is smart advice.  The thing is, most well-intentioned smart, nutritional advice givers, dedicated to helping people, don’t really know what is the best formula for eating. They can only look at slices of the pie.

We know that our bodies are a collection of atoms, too numerous to put a number to.  We’ve learned that atoms join together to form molecules and that these molecules are in constant communication with each other.  Life at the molecular level is highly dynamic and interactive.  What we eat and breath, ends up communicating with our cells, made up of those molecules.  Throw in coded messages from our non-stop thoughts and the quality of sleep, and our internal systems, from brain to toes, are constantly buzzing with vibrant interactions.

In affect, the advice-business folks make blanket claims about what is good or bad with blinders on.  We are learning that our molecular messaging system is so complex that  effects are sometimes not known for decades, or even generations, leaving us little choice but to make assumptions by looking at slices.

As a complex species we are somewhat the same, but each with unique messaging systems.  Is there a “best diet” for everyone?  From a logical perspective it’s highly unlikely.  At the same time, what is also logical is that food (including the food’s source) which has been manipulated (altering the original intended message) is most probably sending less-than-desirable information to our cells, whether that food is processed, whole fruits and vegetables, or animal origin.

So a hearty thanks to those doing the hard research and giving sound advice, particularly those warning that vegetable oils and sugars are highly toxic.  At the same time, it might be helpful for certain advise givers to qualify their advice and offer caveats, that studies have limitations and that their advice may not be for everyone.  Anything less is a half-baked slice of delicious home-made pie.

Duh,..I can’t remember

And I’m not sure if it’s buried, misfiled, or purged.  After all, there’s only so much memory space, right?

Kind of.  As much as memory storage is relative to overall health, which is affected by all the stuff we are familiar with, like diet, exercise, sleep, and stress.

Memory serves us well, as long as we don’t live in the storage bins.  But what is memory? (Don’t worry, you won’t learn that here.)  As we know it, it is simply a dynamic process of neurons encoded by conscious and unconscious thought, with a measure of observation and dash of awareness.

Supposedly, we can train and expand our recollection ability through learning.  There are volumes written about theories and methods for the most efficient ways to build the encoding, storing, and recalling process.  The thing is though, memories are not frozen in time, but rather experiences and associations which change over time.  I can’t recall who (duh), but someone in the know described remembering as creative reimagination. 

Talking to one of my sisters yesterday, we joked that when remembering events, we don’t know whether we remember what actually happened, or remember what we remembered.  In either case, remembering is, at best, a reconstruction colored by our own (unique) awareness.

Memories, or what we remember, isn’t stored in some kind of brain ether.  Memories are stored in specialized, information-transmitting cells.  But those cells, like all our cells, are constantly changing.  In a real sense, we are completely different people than we were 10 years ago.  Cells that make up our body are not the same cells of 10 years ago.  Which means life is fluid (duh).  And so is our memory (double duh).

The storage and retrieval function ends up corrupted from time to time.

For those so inclined. the good news is, they say, that a healthy mix of aerobic and anaerobic exercise improves oxygen and nutrient delivery to the brain, increasing neurotransmitter levels (slowing down normal decay), and giving us our best chance to recollect what we care to remember.

Now if only I could remember what that was, duh.

Four Books

That just may enrich your life.  Sure, there’s an avalanche of perspective-changing books floating around.  But the following four are damn worthy of a read or listen if you are up for possible improvement.

A New Earth — Eckhart Tolle a-new-earth

Mentioned in a post last year, this book helps put spirituality in context.  Grounded in logic with valuable pointers for almost anyone, of any point of view, to be better humans.  The last couple of chapters are especially profound.  We alone posess ownership of our  “happiness” destiny.  If you are not a highly-developed spiritual yogi, this book is a perspective-expander for the everyday hu-man.

Deep Nutrition — Catherine Shanahan, Luke Shanahan

deep-nutrition

Just out this year, this book breaks down, in detail, how our diets have changed dramatically over the last hundred years, which coincide to the rise in the majority of health problems, and why.  This is pertinent to societies anywhere in the world as it becomes increasingly challenging to avoid industrially prepared (altered) food.  The authors explain how the two biggest culprits, vegetable oils and sugar, have combined to create wide-scale toxic damage which is having compromising physical effects not only on us, but also detrimental hereditary effects.  The medical community at large is considerably fuzzy over how alterted food has chromosonal and molecular effects (look no further than what almost every hospital serves its patients). If you can stomach the details, this is a must read.

Extra Virginity — Tom Muellerextra-virginity

Getting past the history at the beginning, this book explains how much of the olive oil in the market today, the world’s oldest and most prized “healthy” oil, has been corrupted by mafia organizations, and more recently by global food congolermates.  Extra Virgin Olive Oil,  actually a fruit juice, is known to have complex antioxidant properties with an abundance of health benefits.  Unfortunately, the majority of Extra Virgin Olive Oil sold in supermarkets around the world has been bastardized (contaminated), mixed with cheap seed oil and perfumed, almost impossible to detect without thorough testing.  The EU and the FDA are virtually powerless to stop the blatant misrepresentation.  It’s simply too costly.  For anyone who doesn’t use (real) olive oil, well, too bad for them.  For anyone who does, it’s an engrossing and educational read for buyer beware.

sapiensSapiens, (A Brief History of Mankind) — Yuval Noah Harari

You might not be able to take individual action based on this book, but the author eloquently lays out the history of man, offering a bird’s eye perspective of how humankind has evolved.  We think what is going on in our individual worlds and societies as all-important.  This book provides an intelligent, macro frame of reference, helping to contextualize how we, civilizations, and now nations, have transformed to interact with each other (and are continuing to do so).

 

 

 

Bangkok Dental

It must be a karmic debt that I’ve had issues inside my mouth since I can remember. The first recallable episode was at five years old. While carrying a sledge hammer up the outdoor concrete basement stairs at our home in Baltimore, I slipped on a step which somehow resulted in a deep slice in my tongue. The tongue scar is still there. Why the sledgehammer? Must have been my workout at that time. At ten or eleven, while sledding downhill after a snowfall, I ran into a stone wall, teeth first. A few years later, an elbow during a pick-up basketball game had me spitting out another piece of front tooth. And so on, and so on.

Sure, every kid has their accident stories. Mine seemed to involve the mouth and lots dentists.

Most dentists have good intentions. What I didn’t realize soon enough, is that the medical community in general is paid, not for brilliant fixes, but for the amount of work they perform. When I first went away to college after high school, the ache from an impacted wisdom tooth took me to a nearby dentist. He said it needed to be pulled. He also explained that pulling all four wisdom teeth at once would be as easy as pulling one. Not only would I avoid an additional pulling process later, but it would also eliminate the issue with the opposing tooth coming loose. I’d be preventing future issues with a one-shot deal, he said. So like a naive 18 year old, I submitted to his laughing gas and walked out an hour later with four holes in my mouth, one in each quadrant.

Much later, in my early 30’s when I lived in San Francisco, the west coast hare-krishna-like dentist I visited in the Marina District recommended that the last bottom molar come out. It was just a bad tooth, he said. Like I never learned my lesson, I agreed. He struggled getting it out. He was sweating so much he had to take a ‘tooth pulling’ break. It wasn’t a pleasant feeling seeing him sweating and wrestling with a tooth in my mouth, or seeing he needed a breather, and worse, the sudden realization that because it was so difficult to remove that maybe it didn’t need to be extracted. When it was all said and done, he recommended shaving the tooth next to the vacancy and installing a cantilever bridge in gold metal. What could I say, “go pound sand?” I negotiated with him for the next several weeks until he agreed to a two-for-one price since it was a one-piece bridge. That bridge held for the next 25 years, until this past week.

It must have been a yen for comfort food, as dear ole mom used to put it, that I found a pint of organic New Zealand ice-cream packed with chocolate chunks. As soon as I (too eagerly) dug into the not-quite-at-ideal thaw temperature pre-bed treat three nights ago, the bond that had lasted so many years finally gave way while clamping down on the cold, hard chocolate. I was thankful, at least, that I didn’t swallow the gold piece.

Internet to the rescue. I didn’t want to wait until I was back in New York and preferred to avoid getting the fix done in China. I felt fortunate it happened in Bangkok.

After a quick search, there were several recommendations, but Dental Hospital, in Soi 49 of Sukhumvit, was not far from where I am staying. I emailed them details of the issue the following morning and received a response within the hour complete with an explanation of their process, prices, and tentative appointment times with two doctors set up for that afternoon. I had overall evaluation, an X-ray of the tooth in question, the tooth and the bridge cleaned of old cement, and the bridge re-cemented — all for $40 usd. In New York, it would have been $40 just for greeting the receptionist.

you could do laps in this pool if it wasn't a soothing waterfall

you could do laps in this pool if it wasn’t a soothing waterfall in the hospital lobby

The place was impressive — five stories, with a large waterfall pool in the lobby. It appeared that everyone working there, from administration, to assistants to the dentists were female — all smart, professional, and efficient. The place was alive with patients. If you can feel at ease about having dental work done, they’ve created that environment.

Bottom line, it’s comforting to know that if a dental issue comes up while in Bangkok, Dental Hospital is an option certainly worth checking out.

P.S. I had no problem bridgelessly finishing the pint NZ organic cream.

“what a racket,”

says the surgeon specialists during our last appointment in October.  He wants me to have (another) CT scan, this time of the mandible, (to compare structural stability from six months ago).  Since he is affiliated with NYU (New York University Medical Center), the scans are automatically scheduled at the NYU hospital.  Procedures like this need to be authorized by the insurance company, so the one I use called me to explain that since my deductible is quite high, the scan cost would be out-of-pocket.  Therefore, they said, I might want to consider options for the same scan at other nearby locations were costs are considerably lower.  At NYU hospital the cost is $1,000 for the mandible scan.  Not much, as scans go, but the alternate locations had list prices for the same scan between $200-300.

I had asked the doctor’s assistant prior to our appointment if there was a problem using one of these alternative scan locations and the response was “the doctor prefers the scans done at NYU hospital.”  I also checked to make sure that the scans were equal in quality machine and results.  They are.  And, since spending $700-800 more for the same thing doesn’t seem prudent, I brought this up again at my appointment in front of the doctor and his assistants.  His response, as he shook his head from side to side, was “what a racket.”  I was puzzled by his reaction as I thought the comparable pricing the insurance company gave me was a good service to protect the consumer (from the racket).

I really like the doctor and have known him now for five years.  He’s fairly young, but not too young, and serious.  I’ve been under his knife at least three times so far (unfortunately).  His speciality is head and neck micro-vascular surgery.  Usually during our appointments we talk about cycling and physical fitness.  I’ve shared some good cycling information with him since he enjoys serious cycling as I do.  So when he made the “what a racket” comment, I reacted with, “doc, with all due respect, you want to know what a racket is?  Let me show you your bill from my last office visit when you checked my ear.”

During a trip home in July, GV and I spent a few days at the Connecticut shoreline.  One of those days while GV was out running, I was reading by the surf and a bee flew into my ear.  I could hear the buzzing for a few seconds and couldn’t do anything as my finger could only push the bug in further.  I pounded on the side of my head which was tilted over, but I was alone in the sand and one one could really help me.  I picked inside my ear with a small stick and eventually the buzzing stopped.  When GV joined me about an hour later I asked her if she could see anything in my ear and she could not.  (It’s hard to see inside an ear without proper light.)  I then forgot about the episode as all felt normal again.

About a week later I had a follow up appointment with the doc.  Since he is a head/neck specialist, I asked him to do me a favor and look in my ear.  With his ear light-scope and tweezers he pulled out the body and wing of a dead bee.  “Wow,” he said, “good thing you had wax in your ears or the bee could have gone further in and created a problem.”  He also pulled out a chunk of wax.  The entire procedure took less than two minutes.  I thanked him and was relieved that the bee and wax were no longer in my head.  It didn’t register that there would be an extra cost to this as I assumed it would be part of the cost of the routine visit. I thought wrong.

Itemized on the surprise bill, beside the $400 routine visit cost, were line item costs for; 1) removing impacted ear wax @ $580, and 2) removing a foreign body from ear canal @ $1,457.  In other words, the tweezer operation which took less than two minutes was costing $2,037, or $17 per second.

When I asked him about the exorbitant charge(s), he said he just writes down what he does during the appointments and the billing coordinator makes the invoices from codes.  I chided him and said, “look doc, I thought this was a favor and it took less than two minutes.  Had I known it was going to cost this much I would have gone to a regular ENT as my insurance isn’t paying for this.”  He shrugged his shoulders and told me to duke it out with the billing coordinator, which I’m still doing.

No doubt most of the medical community does great things — healing (what they think) needs healing.  At the same time though, for most, it’s a business — and indeed, quite a racket.

It’s a secret

To say there are all kinds of secrets would be an understatement. We all have things, little or big, that we’d prefer to keep to ourselves. They can be secret thoughts, actions, or our state of health.

Our thoughts are our ultimate secrets, our privacy. Unless we are hypnotized or up against a mind reader, we can normally keep our thoughts safely guarded. It’s become much less so about what we do. We can be in a place we wish we weren’t, say or do something we wish we hadn’t, and if caught on tape (as they say), that action could become viral in light speed.

As far as our own personal health goes, we live in a world where we’ve demanded privacy. As long as we are not carrying a contagious disease, we each have the right to keep our health history to ourselves. On could argue whether that is right or wrong, but legally, we’ve been given that right. One could argue about our rights of privacy vs full disclosure for days, and in the end, it might come down to “it depends.”

There could be reasons a person might want to keep their own health situation to themselves when those with inquiring (or non inquiring) minds might not understand fully.  One might also say that it is prudent for a person to keep their children always informed of their complete health condition.  If it’s a genetic condition, there is little question that it would be helpful.  But once a decision of disclosure is made, it’s no longer private.  As Benjamin Franklin once said, “three can keep a secret as long as two are dead.”

We can also try to steer how public our privacy is. My pen name of FS was concocted at the start of this blog’s creation. Being that a blog is public domain, I chose to keep my name out of it, especially to prevent it from ending up on search engines. Still, innocent (and well received) comments from supporters occasionally inserted my real name in the comments.  No big deal as I usually edited the name out. I was also very loose by adding pictures along the way. Anyone with a pea brain effort at investigation could find out who I am if it mattered.  And as I mentioned a few posts ago, it’s only a thing, and not a big deal (who knows and doesn’t).

But this post is not about me. It’s about our right to health privacy – our right to keep that secret. I’ve signed enough forms over the past year reminding me of our legal rights to privacy. Our moral rights about that privacy is another, maybe more sticky matter.

I’m not connected enough with higher powers to say what is right or not right about disclosure vs privacy, but I am of the opinion that partial disclosure might as well be full disclosure. We don’t do others a favor by imposing secrets on them, especially without their consent. A secret can be a burden. If someone willingly accepts that burden, all well and good. It would not be fair of me to say to Charlie Carbonara, “I have xxx syndrome, but Paula Penne must not know,” unless Charlie willingly consented to keep that information to himself.

The point of this post being, that if we want to keep something private, then best to do it, say it, think it, or keep it in private. Otherwise, secrets are better off mixed with spilled beans (some love and all war excepted). Keeping the secrets of others is a tiny burden each of us needs to judiciously decide how to handle from time to time – and also one we could do without.  More importantly, deciding what, how and with whom to disclose private information is less about keeping something private, and more about simply doing the right thing (and finding out what that is, is the secret).  But we all know it’s much more complicated than this short rambling post, and that’s no secret.

my doctor

Never have I been accustomed to hearing that phrase, letting alone saying it. “My doctor.”  It just sounds way too possessive.  Like the doctor is the personal doctor of whoever is saying “my doctor.”  I’ve tried to stop myself, but every time I hear someone saying “my doctor”, I think, “so he’s your personal doctor? He’s your’s?”  It just sounds too weird.

It’s normal to refer to some people as possessive.  My father, my sister, my cousin, etc.  But in those cases it really is possessive.  If it’s a blood relation, even if it’s in-law, it’s logical to connect family with “my.”

As well, there are people we are involved with more frequently, say during a course, as in my teacher, my pupil, or even my boss.  Those are people connected to us on a frequent basis, really part of our lives for a certain period.  It makes sense, given the frequency of the connection, that we would use “my” to refer to that connection.

But “my doctor?”  Doctors, after all, heal sickness.  And maybe it’s driven by the commercials.  There is an overdose of commercials spewing mega marketing about all types of pharmaceuticals that might be good for us, which in itself is a type of societal sickness.  But they all tell us to “see our doctor.”  Like we should all maintain possessive connections with a sickness-healing guru.

I could never say “my doctor.”  Besides not having frequented one often enough to call one my own, even if I did, I don’t think I’d want to admit that he or she was mine.  Even the dentist, whom I’ve seen regularly twice a hear for several years.  Never would I refer to her as “my dentist.”  She is, the dentist that I go to.  She’s not mine.  And I don’t go to her often enough that there is a connection that warrants me calling her my…

Some things are just not meant to be so personal.  The bank that I go to isn’t “my bank.”  But I guess that so many feel good personalizing people and things.  The other day when I was in the airport, at the adjacent gate I heard the announcer call out those seated in “my first and business class cabins.”  Maybe she just wanted to get attention.  It certainly got mine. My attention was to the weirdness of how that sounded. (The airline was not one where the employees are part owners).

Even hearing people talk about their food as possessive is weird.  Not “I’m going to eat breakfast,” but “I’m going to eat my breakfast.”  Why the my? “My sandwich.”  It’s my, my, mine.

Well, oh my god, this is certainly an interesting topic.  Not.

I just hope I can recuperate enough that I won’t need to see a medic, or a specialist, often enough to want to call one or more my own.