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Maggie's FarmWe are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for. |
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Thursday, March 23. 2023How medical practice has changed
Thursday, March 9. 2023Echo Cardiac Stress TestThis is more relevant for men than women (they are not medically-equal). If over 45-50, never a bad idea to get an echo stress test on some sort of regular basis. I've seen many trim, athletic guys drop dead, or almost drop dead, with cardiac events which could have been dealt with semi-ok for years. While it is a fact that almost half of male Western humans (Asians too) will succumb to arterial disease (and almost the other half to some cancer - something will take us down), there is no reason to speed up the former death. (Less civilized areas have people of all ages dying of infection, accidents, war, etc.) Can treatments for cadiovascular disease keep you going? Yes - just ask my 90+ year old overweight, wine-loving father-in-law who has had stents, bypass, pacemaker, and ongoing treatment for congestive heart failure, and is still truckin' and loving life. Sheesh, it's only arthritis that really limits him now. Too many sports.
Tuesday, January 3. 2023Cardiac arrestPeople have been asking me about Damar Hamlin. Cardiac arrest or, sometimes termed "Sudden Cardiac Arrest", occurs at all ages. It is only newsworthy when it occurs in young, otherwise healthy athletes. Still, it happens enough that many states have rules about medical check-ups for athletes. I suspect that it occurs more often than reported. Sudden Cardiac Arrest is usually associated with a heart arrhythmia called ventricular fibrillation. The heart stops. These have a long list of possible underlying causes, but it seems possible, if rare, that even a blow to the chest can set it off. The risks are that you die, or survive with brain damage. First aid is CPR (all of our readers should know how to do that), then shock from a defibrillator. The brain begins to die after a handful of minutes without a functional heartbeat. In youth, arrest is hardly ever related to a "heart attack," which refers to a Myocardial Infarction.
Tuesday, December 27. 2022Exercise and immune response
Anecdotally, it looks likely. But the catch is that it's the most fit people who do an hour or so most days, so is it causality? Statistically, fitter people are best prepared to deal with the attacks of nature: better disease-resistance, better healing, etc. People with physical jobs do not need to think about it, but most of us do. In a way, daily exercise is an attempt to recreate a bit of what humans were built to do. I feel that exercise (The Maggie's Fitness for Life program, especially) has the main goal of maintaining functionality and vigor for as long as possible. Sure, looking good matters too, in life. Nutrition for weight, exercise for strength. Re immunity: Exercise could bolster immunity in a variety of ways.
Tuesday, December 13. 2022PlacebosThe science of placebos is fueling quackery. The placebo effect is real. So are the ethical conundrums posed by those who would exploit the latest research advances for profit.
Friday, December 9. 2022The Hijacking of Pediatric Medicine
I understand that we live in an hyper-politicized world right now. It seems more so than in the past, but I can't say. It does seem to me that "the long march through the institutions" has been occuring. I especially hate to see it occur in my field of clinical medicine. I do not mind debate about the role of government in medical care, and will even listen to arguments in favor of Medicare for all citizens. That is a different topic.
Tuesday, December 6. 2022How is your hearing?
One aspect of hearing loss is that others notice before the listener does. Sunday, November 13. 2022Why do overweight people ever feel hunger? (re-posted)Why do people with any fat stores ever feel hungry, or eat anything at all, considering they may have 1-5 month's worth of energy stored as fat? (We term the hunger experienced by overweight people "False Hunger," because it is.) Except in the truly malnourished or extremely fit, low body-fat athletes, hunger is rarely a signal of an energy deficit or of any nutritional need. Think about it. Even normal-weight (neither overweight nor underweight) people carry 8-10 weeks of energy stored in fat if they can only access it. You can consider appetite in the pudgy or overweight, not to mention the obese, to be a design flaw based on the hunting and gathering, and, earlier, just plain gathering condition of human existence, same as the other great apes who only become overweight in captivity. Agriculture and food abundance, along with sedentary life, exposed the design flaw for people who overnourish themselves. Of course, physical inadequacy is another side effect. Here are a few issues (below) - Continue reading "Why do overweight people ever feel hunger? (re-posted)"
Posted by Dr. Joy Bliss
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Wednesday, October 26. 2022Treatments for terminal cancer
Oncology therapy at the end-of-life: Have we missed the mark?
Tuesday, October 18. 2022Questions about pooping
It Was Once Someone’s Job to Chat With the King of England While He Used the Toilet, “Groom of the Stool” could be a crappy role, but it came with great benefits. Thursday, September 8. 2022Maintaining fitness and reasonable weight: Strategy/Habits vs. Willpower
If you care about fitness and functionality, staying trim and strong is a good idea. Staying strong is easy: Go to the gym or something daily with weights and cardio and calisthenics. It is rewarding if not exactly fun. Exercise will not keep many people trim. It's an American thing. I don't know why because many parts of the world are full of cheap, tasty fast foods. Without wanting to seem obnoxious to any overweight readers, I have to offer the best article I've seen about nutrition and weight. It's a bit of a long read, but entirely reasonable: Behavioral Nutrition. The authors are correct. For many people, willpower doesn't work. Habits do. A quote:
Wednesday, August 17. 2022Covid-19 is now endemic
Now it appears to be a new virus on the endemic list. It might appear on the CVS annual jab lists in the future. IS COVID OVER?
Friday, August 12. 2022Politics and Medical Institutions
Wednesday, July 13. 2022Who does your doctor work for? While many physicians might like the idea of independence, for most specialties the need for a large back-office staff requires being part of a group practice. Then, sooner or later, somebody buys the group. The buyer could be a hospital, a giant medical business, or even a venture capital fund. Things have changed. In many ways, sharing some income and being a part of a larger business makes it easier than being an old-fashioned independent physician. It's not the same thing, though.
Tuesday, July 12. 2022Balancing on one leg
I think it's a silly article. Obviously, if you are older and in bad shape, you are more likely to be sick and die. But go ahead and try it. For a better test, do it with eyes closed.
Sunday, May 22. 2022Is Male Menopause a thing?Male menopause: Myth or reality? Aging-related hormone changes in men are different from those in women. Understand the signs, symptoms and treatment options. Aging in men is not just about the hormones.
Wednesday, May 4. 2022Abortion
As I have noted in the past, I refused to participate in an abortion in medical school and nobody cared. I was not alone. It was not on any clearly-defined moral or religious grounds really, just more like a disgust for the whole idea. Other people did them as comfortably as doing a tummy-tuck. OK for them. Maybe I was weak. It was an inner conflict. I would never have been willing to do a tranny surgery either, but they were not routine then. I confess that I came from a good, solid family which stayed together and produced a large litter of good, solid citizens. Protestant, not Roman Catholic. Regardless of the above, it is all about sex. Sex is a strong drive in us animals. We do not always use our brains despite every form of birth control.
Wednesday, April 20. 2022Feet
When these things are severe, they can affect your joints and lower back. This is why God made Podiatrists. Thursday, January 27. 2022Viral immunity, jargon-freeWednesday, January 26. 2022Why does exercise reduce appetite? Reposted
That might not apply to 8 hours on the Appalachian Trail or a day job as a lumberjack, but it is certainly true for me with my 1-hr daily exercises. The more consistently I exercise, the less interest I have in food and the smaller the portions I can handle. This effect is most pronounced with demanding cardio and calisthenic exercise, not much with strength exercise or with sports. There is a theory that the effect has something to do with Peptide YY. Nobody wants to eat anything after a hour of tough cardio exercise and that suppressive effect tends to last 24 hrs. Maybe it makes some genetic sense. If you need to move yourself vigorously and frequently, the less fat you have on you the better you can avoid becoming part of a Tiger Dinner Party. Hunger is an interesting instinct and only recently has it been studied biochemically. One thing we know for certain is that subjective hunger or attraction to food is not a signal for a need for nourishment for most adults in a food-rich environment. Overweight people seem to have the strongest subjective hunger, and sedentary people tend to have stronger appetites. Cause or effect? Chicken or egg?
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