Warped

In a very good way!

Bent Objects

Be sure to check out December 17, December 3, and May 23, 2007

But don't miss the rest of them either. They are all very, very good.

(via Non Sequitur)

Yearning for spring

Yet another reason to end the war on drugs

No Relief in Sight

Clinicians and researchers have long remarked on the link between
opiophobia and undertreatment of pain. In a 1966 pharmacology textbook, the
psychiatrist Jerome H. Jaffe, who later became Richard Nixon's drug czar, noted
that patients who take narcotics long enough develop tolerance (a need for
larger doses to achieve the same effect) and physical dependence (resulting in
withdrawal symptoms). But he cautioned that "such considerations should not in
any way prevent the physician from fulfilling his primary obligation to ease the
patient's discomfort. The physician should not wait until the pain becomes
agonizing; no patient should ever wish for death because of his physician's
reluctance to use adequate amounts of potent narcotics."

It's been going on a long time and should end now.

Fat, Fat, Fat

Fat, I am.

Why? One reason is I eat & drink the wrong things - I can't eat too much of anything since I had banded gastroplasty and have about a 4 bite limit on solids, less on lean meats. The limit is higher on liquids, but not infinite. So, most of my weight is probably under my control. But what about that part that is due to inheritance? My mother, and my grandmothers on both sides were obese.

There's plenty of evidence that genetics plays a role in obesity. I thought I'd gather some links here to show how varied and scattered that evidence is, as well as how ineffective current "treatments" are.

CORRELATION OF OBESITY TO THINGS UNRELATED TO BEING AN OVEREATING COUCH POTATO

FTO

Obesity gene may alter brain DNA- certain variants of a gene called FTO is linked with a 70% increased risk of obesity.

New Insight Into The Link Between Genetics And Obesity- "While genetic defects causing human obesity had been previously described, the FTO discovery was of considerable interest because the genetic variant in FTO that predisposes to obesity is very common."

PYY

Brain 'hunger pathways' pinpointed- a hormone called PYY is released by the gut in porportion to how many calories are consumed. In an fMRI study using intravenous PYY, showed that it not only lit up the hypothalamus - the main hub for controlling metabolism - but also increased activity in areas of the brain associated with reward and pleasure. Maybe food isn't addictive, but could eating be?

LEPTIN

Some of us really are addicted to food- It is suggested that the hormone, leptin, suppresses appetite by dampening our perception of how appetising certain foods are. Tests show that individuals with a very rare leptin deficiency showed increased activity in the nucleus accumbens, a brain region thought to spur drug addiction. It's speculated that obese individuals whose bodies do produce sufficient leptin have somehow become insensitive to the hormone.

Obesity-related Hormone is Higher in Children With Down Syndrome- I'm lucky to just be fat and addicted to food, if leptin resistence is part of my problem.

MELANOCORTIN

Brain clue could provide anti-obesity drugs- "Matthias Tschöp of the University of Cincinnati in Ohio used drugs that either stimulated or blocked receptors for the hormone melanocortin on hypothalamus cells in the brains of rats. Those given stimulatory drugs burned more of the carbohydrates in food, while those given inhibitory drugs converted them to fat and made extra fat in their liver. ...The same system may exist in humans, he believes, because people with faulty melanocortin receptors are often morbidly obese."

Fat Fish Put Obesity On The Hook- "The genetic change blocks the activity of a receptor, the melanocortin-4 receptor, which is at the heart of a "device" in our brains called the "adipostat." The adipostat regulates body weight homeostatically, like the thermostat in a house, and works to keep long-term energy stores--a.k.a. body fat--constant. The adipostat is what makes it difficult for people to lose weight and keep it off."

TPPII

Enzyme Promotes Fat Formation- Previously linked to making people feel hungry, the enzyme TPPII has been found to stimulate the formation of fat cells.

RENIN

Mice Lacking Enzyme Renin Stay Lean On High-fat Diet, With Little Exercise- "...mice lacking the enzyme known as renin are lean and resistant to gaining weight on a high-fat diet, even though they continue to eat just as much and don't exercise more." Maybe this should be under treatments, or possible treatments.


LIVER ENZYMES, CD36, CPT1A AND ACYL-COENZYME A DEHYDROGENASE

Metabolic Defect In Liver Can Lead To Obesity- "...intrinsic deficit in fat oxidation was associated with a decrease in the capacity to make two liver enzymes. One, CD36, is responsible for transferring fat fuels into liver cells, while the second enzyme, acyl-coenzyme A dehydrogenase, begins the oxidation process in mitochondria. When fed a high-fat diet, the obesity-prone rats overate and became obese, gaining 36% more weight than resistant animals. Fat oxidation was further compromised due to a decreased ability to make CPT1A, the liver enzyme responsible for transporting fat into mitochondria."

ESTROGEN

Obesity Risks Increase After Menopause- "As women are more at risk for being overweight or obese than men, and women are at risk for gaining weight as they age, postmenopausal women are a particularly vulnerable population."

Estrogen Curbs Appetite In Same Way As The Hormone Leptin- "Estrogen regulates the brain's energy metabolism in the same way as the hormone leptin, leading the way to a viable approach to tackling obesity in people resistant to leptin." I thought estrogen supplements had proven dangerous? Was I wrong? Maybe this article should be under "treatments" anyway.

HUMAN ADENOVIRUS-36 and SMAM-1

Common Virus May Contribute To Obesity In Some People- "In laboratory experiments they (scientists) showed that infection with human adenovirus-36 (Ad-36), long recognized as a cause of respiratory and eye infections in humans, transforms adult stem cells obtained from fat tissue into fat cells. Stem cells not exposed to the virus, in contrast, were unchanged."

Viral Infections May Be Linked To Obesity- "Dr. Atkinson reports that one study tested 52 obese humans for antibodies to SMAM-1. About 20 percent had SMAM-1 antibodies, indicating exposure to this virus. The study participants who had these antibodies were heavier and had a higher body mass index compared with the antibody-negative group."

SH2B1

Mind Over Matter SH2B1 In The Brain Regulates Obesity- "SH2B1 is expressed in many tissues related to obesity, including the brain, liver, pancreas, and fat tissue. Replacing SH2B1 in only the brain of mice lacking SH2B1 prevented the mice from becoming obese. It also prevented the mice from developing obesity after being fed a high-fat diet, indicating that SH2B1 in the brain is required to regulate body weight and fat content."

OSTEOPONTIN

When Does Being Obese Not Lead To Diabetes? When Mice Lack Osteopontin- A protein necessary for immune responses also linked to obesity and the development of insulin resistance and Type II diabetes.

SNP

Genetics Has Key Role In Obesity- "The metabolic rates of 200 obese Pima individuals were measured and revealed that two of the three known SNPs influence metabolic efficiency."

TREATMENTS

SURGERY

Stomach stapling really can save lives- It can also make your life miserable. A 29% lower risk of death from obesity-related illness, but an increase in deaths due to suicide? Is that because those who underwent the surgery lost only 14% to 25% of their body weight? A 5'7" 275 lbs. person losing 25% at 206 lbs. would have a BMI of 32.3. That doesn't really sound like success to me.

UPDATE on bariatric surgery - Was this really proof that bariatric surgeries save lives?
Sandy Szwarc evaluates the above study. Wow, what a mess.

DIETING

Obesity And The Central Nervous System- "...Dr. Levin suggested that the physiological processes which drive all of us to seek and ingest food and limit energy expenditure during periods of negative energy balance provide an irresistible drive to regain lost adipose stores in weight-reduced obese individuals. This provides a potential basis for the well-recognized difficulty of maintaining weight loss."

DIET PILLS

Three Long-term Diet Pills Show Poor Performance, Study Suggests- "The study, which looked at the long-term effectiveness of anti-obesity medications, found that three drugs recommended for long-term use - orlistat, sibutramine and rimonabant, reduced weight by less than 5kg (11 pounds). This equated to a loss of less than 5% of total body weight."

EDUCATION

Diet Education Had No Long Term Impact On Childhood Obesity- "An education programme which successfully cut the level of obesity in children by teaching them about healthy eating and discouraging fizzy drinks was no longer effective three years after the intervention came to an end, according to a study published on the British Medical Journal website."

Why?

This is a bag of potato chips at 8,000 ft.

I'm wondering why - in all the cheesy novels I've read - that no author has ever written about hundreds of tiny bags of pretzels exploding when the plane decompresses.

Binge Drinking Hangovers Last and Last

The more we have binged — and the younger we have started to binge — the more we experience significant, though often subtle, effects on the brain and cognition.

...

As Shakespeare once pointed out without the benefit of studies on lab rats, “O God, that men should put an enemy in their mouths to steal away their brains!”

The Hangover That Lasts by Paul Steinberg, a psychiatrist, offers some realistic and possible resolutions for the New Year:

• Stop after one or two drinks. Studies of the Mediterranean diet have shown that one or two drinks on a consistent basis leads to a longer life than pure teetotaling.
• If you must binge, start at age 40, not at age 16... Just as youth is wasted on the young, so perhaps is alcohol.
• If you have binged excessively when younger, follow it up with some regular exercise. Get those brain cells regenerated.

Dave Barry's Year in Review

A must read. It will brighten your day and make you look forward to next year. I think...

(via QandO)

Another Dubious Honor for Shreveport

Spencer Hall has named Shreveport's Independence Bowl The Grandaddy of Bad Bowl Games.

Still Sick

I think I'm getting better. I got an appointment at the clinic yesterday and am on a different kind of antibiotic.

I have a tendency to bash military health care at times, but I have to report two good recent experiences. First, a visit to the Urgent Care Clinic at Moncrief Army Community Hospital, where I was seen quickly, given some relief immediately and sent away with medicine - no extra trip to a pharmacy.

Unfortunately, the medicine didn't work well enough, or the strain of the 850 mile drive home simply made me worse. So, the day after Christmas I call Barksdale and my description of symptoms (and the fact that they could electronically access the visit to Moncrief) got me an appointment yesterday morning.

I've learned that you don't simply call and ask the appointment person for an appointment. They rarely have any, but they will always get you a call back from a nurse who has much greater appointing powers.

This makes twice, yes that's TWICE in a row that I've seen my assigned PCM! Maybe things are settling down there and she will be around for a while.

Back Home

I'm back from SC now. Despite being sick the entire time, I still managed to have a wonderful time.

Where is my candidate?

My candidate must

• deny creationism in its extreme forms
• allow for immigration at least in some moderate form
• be at least supportive of civil unions, if not gay marriage
• be a capitalist
• be NOT anti-war
• recognize that the president has no power concerning abortion
• recognize the 2nd Amendment means an individual right
• recognize that religion is a private, not a national, public matter
• adhere to a religion that allows it to be a private not a national, public matter
• recognize that the death penalty is appropriate in some circumstances

Where is my candidate?

Rudy Guiliani fits best according to all the online polls, but now well enough.

Am I so different from mainstream America?

Does a secular society exclude religion?

No. Does not "secular" basically mean "not religious" rather than "atheist"? A secular society has a place for everyone, from the most faithfully religious (of any creed) to the most unreligious atheist.

A secular society is the one I want to live in.

Whether I believe in a Supreme Being of the Jewish, Christian, or Islamic types matters not, it is the human organization and interpretation of religion that I distrust. I certainly do not want that human organization or interpretation of religion to inform my government.

I agree with Roger Cohen. "Where Kennedy said he believed in a “president whose religious views are his own private affair,” Romney pledged not to “separate us from our religious heritage.” "

Good for Obama, Bad for Oprah?

Teflon Oprah?

Winfrey has long been able to shake off any seeming crisis that might prove
her to be the Teflon supporter....

no, no wait, wait

I should clarify that I don't support Romney because he is a Mormon, but that I do NOT support him because of his statement of support for all religions.

I cannot support some tenets of Islamism, though I find most tenets of most religions to be silly rather than dangerous. This dangerousness does not apply to what I know... so far... of Mormonism. Yet, it does apply to Islamism.... Please let me be wrong.

Romney's Speech Convinced Me

Everybody seems to be talking about Romney's "Mormon" speech.

Chris Matthews had Pat Buchanan and some guy from beliefnet on, and they all agreed it was a good speech, with Buchanan and Matthews giving it a "great".

Unfortunately for me, hearing this several times today

There is one fundamental question about which I often am asked. What do
I believe about Jesus Christ? I believe that Jesus Christ is the Son of God and
the Savior of mankind. My church's beliefs about Christ may not all be the same
as those of other faiths. Each religion has its own unique doctrines and
history.

has recalled childhood experiences with Mormonism and the horror of having read Jonathan Livingston Seagull.

I'm not particularly religious, in fact, I'm probably particularly not religious. I am, however, religiously curious and have been as long as I can remember. As a child, I went through stages of wanting to be a Catholic, then Jewish, even Mormon for a short period.

Romney went on to say

These are not bases for criticism but rather a test of our tolerance.
Religious tolerance would be a shallow principle indeed if it were reserved
only for faiths with which we agree.

And this I have a problem with. I don't think I want a man as president who is going to be tolerant of the preaching and practice of intolerance, as in the case of the British teacher in Sudan.

So, while Romney's speech appears reasonable and sensible, it has had the unintended consequence for me to put him in my "definitely could not support" category.

Fat and Happy

The Weight Story No One Wants to Talk About

The implications of these findings, which barely registered in the news
cycle, are significant. They suggest that most Americans need not worry about
being too fat, since most mortality is associated with BMI's in excess of 35.
They suggest that the continual message from the government and the public
health community to lose weight or to be as thin as possible lacks a credible
scientific basis. And they suggest that it is those who weigh too little whose
plight also deserves some attention.

Not that I couldn't stand to lose a ::cough:: few pounds ::cough:: but I'm fairly healthy. I have slightly elevated blood pressure which would probably be normal if I quit smoking, no heart blockages (confirmed by a cardiac cath - did you know that dehydration, anxiety, and indigestion combined fairly well mimics a heart attack?)

How does the average American decide how to vote?

Let me first state some "givens" that I believe are true:

The average American

• is neither Democrat nor Republican
• votes with his gut more often than his intellect
• has a gut that identifies with personality more than issues
• has a gut that identifies with leadership & strength more than issues
• (decide for yourself whether leadership & strength are synonymous with personality)

Based on these "givens", should you choose to accept them, Hillary is out - the gut becomes nauseous trying to keep up with the swishing of issues.

Obama is out because he really shows no strength, although he can be inspiring. (Remember Jimmy Carter was inspiring before he was elected, no?)

Guiliani is a possibility - he showed strength and leadership immediately after 9/11.

McCain is a possibility - he didn't buckle under the duress of being a POW, and despite his temper, can be inspiring.

Lieberman - though not officially in the running (that I know of) can also win the "gut vote" on his stance on the war in Iraq, but he's somewhat lacking in the personality department.

Ron Paul, Dennis Kucinich - sorry guys, but your anti-war status rules you out in both leadership and strength. How can you have either if you've ruled them both out to start with?

Fred Thompson - your TV character could win, I'm not sure you could. Ronald Reagan was a lousy actor, all he knew to play was himself. You're a better actor, but I'm not sure who YOU are.

John Edwards - there's a definite corrollary between acting and being a successful trial lawyer. Like Fred Thompson, I wonder who you really are, other than a good actor.

I could live with this combo

I think...

McCain does not meet all my criteria for President. He's a bit power hungry, I think. But not to the extent that Hillary hungers for power. She's also greedy, I think... perhaps McCain is too. Perhaps one has to be a bit of both to win the office. If so, that's a sad comment on U.S. voters, isn't it?

However... this post by the handsome Vodkapundit - Another Quick Take - may be prescient. Who knows at this point?

I am my own PCM

It's not like I planned it this way. I grew up with the idea that one had a family doctor they saw regularly for checkups, shots, broken bones, and skinned knees. That's what I looked for when I was older. I have no opposition to specialists, but I would have preferred the continuity of seeing the same doctor each time I go. I really would like to have a primary care manager.

That's not happening under Tricare Prime. I'm assigned to an MTF (military treatment center) and since I've been in the plan - 2 years now - I've been assigned to five different PCMs. I had 3 visits with the first, 2 with the second, 0 with the third, 3 with the 4th, and one with the current one. Two of these assignments have lasted less than 6 weeks. Three of these visits were for actual illness, the others were to get medication refills. Each new PCM wants to "see" me before refilling scripts I've been on for years, or before putting me on an alternate generic because the DOD has made a new deal with a different drug company.

None of these doctors ever had the chance to get to know me, or for me to know them. The MTF has a nice electronic medical records system, but it's time-consuming and limiting. The doctor or PA is facing the computer, not me.

Before a visit, I do or consider all the things Christine recommends in Preparing for a Doctors Visit. My list of medications includes OTC stuff, meds I previously took, who prescribed them, why I no longer take them, dates of the above, etc.

Not only do I write out questions I want to ask, but I include objectives I want to meet during the visit. Those are most often, get a refill written or get a referral to a specialist. Never have I discussed long-term medical goals with any of them. They know as well as I that we may never see each other again.

The closest I've come to having continuity of care is always getting the same internist when I'm hospitalized (luck of the draw) and the ongoing relationship I had with my radioncologist. But who wants to go the hospital or have radiation treatments to get a little continuity of care?

This is why I am my own PCM. As Christine writes, "You know your body best, and you need to be your own advocate in the doctor's office."

Hillary: The Uniter

The 2000 and 2004 presidential elections contributed to some fairly severe political division in my family.

Not 2008! We're United again and we have Hillary Clinton to thank for it.

• Me, the sort of libertarian, won't consider voting for her.
• My dear husband, the union Democrat, won't consider voting for her.
• My sister, Kos minion and paranoid, won't consider voting for her.
• My brother, socialist and/or classic liberal depending on his mood, won't consider voting for her.

Thank you, Hillary!