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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Sunday, March 1. 2020Learn a little about cold and flu virusesViruses are strange, parasitic things, hardly living things in the ordinary sense. How Coronaviruses Cause Infection—from Colds to Deadly Pneumonia. The novel coronavirus outbreak raises questions about how such pathogens evolve and what makes infections mild or severe.
Friday, February 21. 2020Fruit FliesThey are annoying in the kitchen, but why are they so useful? Modern genetics would not be possible without the humble fruit fly. Thursday, February 13. 2020From Math To Politics, Some Problems Don’t Have SolutionsIt is hubris to imagine that all problems have solutions. It is nihilistic to imagine that none of them do. Curing death and other ills
Monday, February 10. 2020Autism spectrum updateThis concerns myelin. Could be a theory: Researchers Link Autism To A System That Insulates Brain Wiring Brain Connectivity and the Role of Myelin in Autism Spectrum Disorders Thursday, January 2. 2020Alzheimer's risk factors, and the search for cures
Everybody knows that academic politics are ugly. Alzheimer's is uglier than that, and there is lots of money available too. The problem with searches for cures is that the #1 risk factor for Alheimer's is genetic, via the maternal line. If your Mom has it, your odds for it are worrying but not certain. The second risk factor is being overweight. The viral idea doesn't really seem to fit with the genetic. Maybe they are synergistic? Who knows? Genetic testing for Alheimer's risk is available at any age. With certain genetic conformations, your risk is almost certain. Bad news. From all I have read about it (not an expert at all), the brain rot begins long (years, even decades) before there are obvious clinical symptoms other than, maybe, being less energetic, social, and driven. My amateur guess is that the brain tangles and brain shrinkage are not causal, but results of a genetic brain rot, a sort of programmed obsolescence. "Cures" for genetically-weighted diseases are elusive, of course, because they are baked in the cake. Unbaking a cake is a tough challenge. Carpe diem.
Sunday, December 29. 2019Fitness New Year resolutionsIf you are serious, you get with the program today, not next year. January 1 is for suckers.
Friday, December 13. 2019EMT TrainingA recently-retired friend decided to take up EMT training. He wants to remain a useful citizen. Thus far, he loves it more than he ever liked his job. The chance to save a life is an appealing thing, while learning all sorts of new skills. As an MD, I have to admit that these people can do things that I have no clue about how to do. Never learned, or can't remember. Most of the car crash victims I saw in ERs were DOA, and most MI people were beyond saving. Death happens, often, as it must. That was a while ago, though. There are several levels of it, so you can keep aspiring. There is always work too, part-time or full, or volunteer.
Tuesday, November 5. 2019When we walk into a patient’s room...When we walk into a patient’s room, we are entering a story. That's the correct medical attitude. It doesn't apply to the purely technical specialties, though.
Saturday, November 2. 2019Some info about body fatWhy Hard Belly Fat Is More Dangerous Than Soft Fat People always say "Diet and Exercise." Unless you hike 10 miles daily, or work out 2 hrs/day, I just say "Nutrition" to lose bad fat. Not "diet," "nutrition" because diets fail but appropriate nutrition is a way of life. Just enough of pretty good things for the fitness you want. That article more or less says the same thing. Daily exercise is great for fitness, but not for fat. The bonus is that the less fat you are carrying, the better your exercise and activity endurance. That's enough annoying preaching for today. Friday, November 1. 2019Physicians Struggle to Manage Dual Issues of Pain and AddictionBrief article here. Never forget that pain relief is one of the miracles of modern medical practice.
Friday, October 25. 2019A medical story: "Stopped."
Thursday, October 24. 2019QQQ with a book recommendation"To lengthen the life, lessen the meals." Benjamin Franklin That's in Bill Bryson's excellent new book The Body: A Guide for Occupants. Even doctors can enjoy it. Monday, September 23. 2019PseudoaddictionThe terror of medical opioids is on an upswing. I have seen the upswings and downswings during my career. I wish we could find a middle course, because medical opioids are a blessing to suffering people. Yes, I include Oxycontin in that because it is an excellent medicine. Of course opioids are habit-forming. For refractory pain, they are also life-giving. For people with life-impairing chronic pain, there is something called "pseudoaddiction." AGAINST AGAINST PSEUDOADDICTION These days, I have seen people in that category treated like drug addicts. Sooner or later, there will chemicals with the pain effects of opioids but without the habit-forming effects. Not yet.
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Tuesday, August 27. 2019The New Science of Exercise, reposted
As I have said before, a rigorous exercise program might not extend your life. It will definitely enhance and extend your quality of life even if you begin it at any age. Everybody knows that they ought to do it, but it's hard and it hurts and we're lazy and "busy." Plus there is that terrible part: delayed gratification. Everybody hates that. As I say, "The flesh is willing but the spirit is weak." Our quite well-informed recommendations for general fitness and conditioning for the ordinary person who wants to achieve or maintain maximal functionality for life: 1. Nutrition: Don't be visibly overweight - it's the worst thing you can do to yourself besides being an addict, and no exercise can help being fat. Does a demanding exercise program require a specific pattern of nutrition? Yes. We have discussed that in previous posts here. With a serious exercise program, you have to keep up with the protein and fats - approx. 70-90 gms of protein/day. Under age 35, it can take 12 months to be whipped into decent shape. Over 35-40, depending on your fitness starting point, 18-24 months. Intense sports like basketball can substitute for calisthenics. Yoga is excellent, but does not substitute for any of the above. Many men find Yoga to be quite challenging and helpful. Lots of pro football players do it. If your day job is physical, all of the above recommendations would differ.
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Friday, August 23. 2019A good deathIt's never too soon to have a Will, and a Living Will. Trouble can strike at any time as we all have seen. Lies, Damned Lies, and Medical ScienceMuch of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science. The press makes it all even worse, just to make a story. People of the press rarely have STEM degrees. Friday, August 16. 2019Meta-analysesNot what they were cracked up to be: Meta-analyses were supposed to end scientific debates. Often, they only cause more controversy.
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Sunday, August 4. 2019My summertime question for our readersWhen and why did "medical care" become "health care"? It has been a puzzlement to me. When I first heard the term, I thought "What?!?" Is it just euphemisn, or something more?
Thursday, July 18. 2019Autism is "bad" genes
Given the complexity, I have always been amazed by how often the wiring works fairly well. Thursday, July 11. 2019Chronic pain and opioidsState Regulators Punish Doctor for Cutting a Pain Patient's Opioid Dose and Dropping Him After He Became Suicidal. The decision by the New Hampshire Board of Medicine suggests state officials are beginning to recognize the harm caused by the crackdown on pain pills. It is a difficult issue for physicians. Friday, June 21. 2019Vitamin D updateI still think it's a good idea to get your share of natural sunlight daily, and even more so if healing or recovering from something. Still, much of the Vit D research was apparently wrong: Millions of Americans take vitamin D. Most should just stop. Outside of rare cases, rigorous studies of the supplement don’t find any health benefit. Like many other stories, the moral of this one is that there is no settled science. Tuesday, June 18. 2019Is your waist size a good proxy for body fat?
How to Measure Your Waist
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Thursday, May 2. 2019The CDC and opioids
Until new non-opioid and promising pain meds are available, I am in favor of adequate dosing for pain when nothing else works. Chronic pain is a terribly disabling thing, mentally, spiritually, physically, etc. The two best things medicine has provided mankind have been antibiotics, and anesthesia/analgesia. Can the Damage Done by the CDC's Opioid Guidelines Be Reversed?
Sunday, April 28. 2019The fasting fadCelebrities are always touting the latest nutritional fads like "clean eating", veganism, etc. Now it's the Fasting Plan. Of course, these people know nothing. In fact, little is known about human nutritional needs but we do know some simple things to prevent starvation. For example, your nutrition requires fats. There seem to be all sorts of variants of the Fasting Fad, but there may be something useful in it. For example, no adult without an all-day manual labor job (or a heavy lifter or a distance runner) needs three meals/day unless they are underweight. Three meals/day was designed for farmers, just like summer school vacation. Furthermore, most hunger is what we have described as "false hunger" (meaning it represents no need for significant nutrition) for anybody even 5-10 lbs overweight. Our fat cells are a massive storage battery waiting to be used. So what about fasting, whether it means just skipping one of the conventional meals or even taking a day or two off from food every week? Not as a weight-loss plan, but just as a plan. Many find it increases their energy. When you think about it, during almost all of the 300-500,000 years (except the past few thousand agricultural years) of human life and evolution, food scarcity was the norm. Humans are designed for food scarcity rather than for today's abundance. That's why eating is fun rather than necessary. This is interesting: MIT study: 24-hour fasting regenerates stem cells, doubles metabolism. This gives credence to the 5–2 diet, which has recently gained in popularity thanks to a large celebrity following.
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Friday, April 26. 2019Overeating and inflammationThank you, reader: This month’s Harvard magazine has an article on just this topic. Scroll down to the section titled, ‘Eating to Excess: Metabolic Inflammation’. “The metabolic stress that is a hallmark of modern life, the stress that the body has not evolved to handle, is constant eating, he continues. When people eat, energy and nutrients enter the body rapidly, are processed, produce in turn a lot of by-products, and then need to be reduced to “functional substances that are distributed throughout the body, and then disappear very quickly. Many cells and tissues actually undergo a huge amount of stress during this process,” he explains, “as they store appropriate nutrients and dispose of harmful intermediates.” Part of this process also involves mounting an immune response. “The pancreas, for example, must secrete four to five hundred milliliters of enzymes every day” to be able to manage the incoming energy load with every meal. “If you place these organs under constant stress, they start malfunctioning.” The consequence is that “right now, one out of every 10 individuals has diabetes. One out of every four individuals has fatty liver disease. And if you reach a certain age, one out of every three individuals will develop neurodegenerative disease.” The metabolic stress that underlies these conditions comes from the daily imbalance between how much energy people consume and how much they need, and can process in a healthy manner. The long-term consequence of overconsumption, combined with lack of sufficient expenditure, is stored energy—the accumulation of fat...” Also interesting in that article is a bit about the benefit of muscle inflammation due to stressful exercise. Muscle damage, of course, is how we build strength.
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