Weighty matters

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can-a-wi-fi-enabled-bathroom-scale-help-you-lose-weight-review--90898cf2ddIt was the Personal Journal section in today’s issue of the Wall Street Journal that brought the subject of weight loss to mind.

The story was titled “A Hidden Perk of Commuting.” It told how people who took public transit or walked even short distances lost weight. Of course since most people ride to work, these folk can’t claim they burned enough calories to subtract pounds from their weight. More likely, they tend to gain.

Checking my weight on the bathroom scales today, I noticed my own weight had crept up a pound. Indeed, this has been a disturbing trend for the past month or so.

I know exactly why, too. About five weeks ago, I developed a sharp pain in my left heel as I was finishing up my four-mile jog in nearby Foster Park. It’s a slow jog but more of a workout than a fast walk. The pain was so bad I called my wife Toni on my cell phone to come and pick me up.

I went to a podiatrist, a first seeing this kind of specialist. He diagnosed my injury as a stress fracture. I confess that’s an ailment I never heard of. He told me it would heal on its own. He didn’t advise me not to go for any long walks.

His silence on the subject I took for permission to walk. And I did. A lot.
This approach to my behavior I learned from Dr. Ray McCoy, dean of the Xavier University graduate school, which I attended in the mid-1960s.

I don’t recall the context of the conversation. But this crusty old Vermonter told me that he always did what he wanted until he was told he couldn’t do that. Whatever it was. Made sense to me.

I immediately adopted that as my life philosophy. So I’m back walking in the park. I’m smart enough not to jog. Oddly enough, about the only time my heel doesn’t hurt is when I’m walking.

As something of a health nut, I probably notice more than most that so many people I see at Kroger’s or Wall-Mart appear to be overweight. I also notice what they’ve put in their shopping carts: sweet snacks and other fattening foods, including lots of frozen diners, also likely to be fattening.

As Pope Francis likes to say, “Who am I to judge.” But judge I’m afraid I do. I suppose I can partly blame this habit on my parents, both of whom had a habit of judging my friends and their parents. They judged with abandon.

The other part of this probably is the result of reading a slew of health letters from medical schools. These summaries of professional journals seem to arrive in the mail at our house almost daily. As an editorial writer for many years, I always wanted to know what the experts said about this or that subject. In retirement, I can’t seem to give up the practice.

What saves me from being an impossible scold and a royal pain is how readily the words of the ancient philosopher Philo of Alexandria comes to mind. As I’m about to mentally slip into judgment mode, his advice of long ago brings me up short: “Be kind – everyone is fighting a great battle.”

I guess that means not only to mentally exercise kindness toward others. I need to be kind toward myself as my foot heals. Then I’ll be able once more to jog and my weight will settle back toward my goal. And my jeans will fit!

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Time for a fresh start

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Hyacinth, photo 04/24/2015 by Victor R. Voklman
Hyacinth, photo 04/24/2015 by Victor R. Volkman

I’ve now seen the family doctor and the chiropractor yet I’m still afflicted with plantar fasciitis in my left heel. Yet despite the pain this late April morning has me in high spirits.

It’s a simple story. Spring has announced itself in glorious fashion. I see it on the outside thermometer. I see it in our brilliantly green yard, back and front. I see it in an array of blossoms to beat the band.

In the front yard yellow and white daffodils announced themselves first. Then came the purple violets. You like tulips? Got them too, back and front yard. I couldn’t forgive myself if I failed to mention the purple and pink hyacinths.

Ah, yes, the trees. We’ve now got blossoms on the cherry and pear trees. In fact, up and down South Wayne Avenue, spring has unfolded like a giant display of banners and balloons at a used car lot.

Mayzi, our five-year-old great niece, took note. “When it’s spring, you roll the windows down,” she noted to Aunt Toni as they discussed signs of spring.

So what about the rest of us? Is it time to get the lawnmower out of the garage? How about cleaning that screened-in back porch and bringing back the warm weather porch furniture from storage in the garden house?

Oil change due for the Honda and Prius? Renew any magazine subscriptions?
Some window washing? I know. I hate that enough to let the job wait for another spring.

One great thing about this season is that you get to decide. You can put off a seasonal cleaning. You can collect the brochures for great summer vacation resorts. Or you can wait until you see how big that check is from your IRS tax refund.

You can make nature’s new beginnings an occasion for you to launch new beginnings for yourself. Is that looking for a new job? Would that be learning a new skill, even another language? How about renewing an old friendship? An old romance? Buy a different home?

One summer, my wife Toni and I drove to New England, then took a ferry to Prince Edward Island. On the road, we made lists of goals. I have no idea what happened to the lists. But as I recall, the exercise helped me focus on personal growth, relationships and on the future.

You can tackle just one thing. Make it simple. Be sure the goal is clear.
It helps, too, if you set a time when you review the status of your goal.
By late June, are you listening to others more? Have you become more open-minded?

Have you lost a few of those extra pounds? No? Maybe your target wasn’t realistic. Remember the coming of spring invited you to set your own goals. You’re free to walk or jog a few miles daily in any nearby park That’s what I plan to do as soon as my sore heel doesn’t hurt any longer.

Or you can sign up to exercise at a gym. Or join a book club. Or watch less TV.

Whatever your personal goals, this is the perfect time to get outdoors, into the neighborhood, into the parks nearby and around the town to enjoy the sights and smells of the season.

You can’t help being a better, happier person. What a deal!

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Ebola panic another disease

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Biohazard (international icon)
Biohazard (international icon)

It was Billy Rider who contracted polio. This was back in the 1950s, so long ago it seems. I knew his sister. She was in my class in Defiance, Ohio. I had known Billy a bit but I heard he would spend his life in an iron lung, the only treatment for a victim of polio then.

At this time, the panic seemed justified. Officials closed swimming pools. I don’t recall getting any days off from school. Years later, as a journalist in Fort Wayne, Ind., I got to shadow Dr. Joel Salin on his hospital rounds. As a young man, Dr. Salin had contracted polio and walked with the aid of a brace on his arm.

As disabling as polio turned out for its victims, only 10 percent of patients died. Still, it was a scary disease that could afflict a person, seemingly out of the blue and would leave its mark on the person for life. By the time I was in graduate school in Cincinnati, in the 1960s, the Salk and Sabin vaccines had been developed. I recall lining up at a suburban elementary school to get my oral dose of the vaccine.

All this came back as I’ve found myself following the news about the Ebola epidemic in West Africa, principally Liberia, Sierra Leone, Guinea. Judging from the stories I’ve read, it looks like about half of them are devoted to correcting the misinformation and myths.

Sadly, the man from Liberia diagnosed with Ebola died. He was being treated at a hospital in Dallas. A nurse who was treating him also contracted Ebola. She and another nurse were the only persons so far who’ve caught the virus in the United States. Both are improving.

By late October, several thousand Ebola patients in those West African countries have died. World Health Organization experts predict this epidemic is far from over. Meantime in this country, even the Centers for Disease Control in Atlanta has admitted that the U.S. response has been slow and disappointing.

But such candor and the CDC’s reputation as probably our most competent federal agency hasn’t kept Republican and a few Democratic critics from pouncing on the CDC’s shortcomings. Of course, the members of Congress bear some of the blame. Draconian budget cuts have hampered the work of our public health officials.

Even worse, prominent leaders such as Sen. Rand Paul and Gen.Martin Dempsey, chairman of the Joint Chiefs, have put out opinions about the risk to Americans of contracting Ebola – opinions that are just flat out wrong. There’s more.

I’ve read accounts of talk radio hosts and television evangelists reciting such nonsense that it only fosters unwarranted fears and makes it hard to get reliable information about Ebola into the public forum.

And what can one say about how quickly Republican and a few Democrats have jumped on the president for naming Ron Klain his Ebola czar? No, his name isn’t a household word. He’s not an expert on infectious diseases. He’s not a physician. But he’s been a top aide in two Democratic administrations. He’s trusted. Sounds to me like he’s got the skills to bring all the American players together. That’s precisely what we need as this country helps West Africa deal with this epidemic.

Ebola surely is a tragic story in a distant part of the world. But it could become a tragic story in this country if people listen to the fear-mongers.

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Don’t eat your heart out

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scaleMy cousin Ken’s daughter Beth told me she had lost a bunch of weight by following my advice.

Beth lives in North Carolina but she was home in Indiana for a grandmother’s funeral. That grandmother was on her mother’s side of the family.

What Beth was referring to was a brief column I had written for the paper about how to lose weight. Her dad had sent him a copy. My method surely was too simple and easy to remember to end up in a book or launch me on a high-paying lecture tour.

I don’t recall what prompted me to write what amounted to a personal advice column. My topics usually were about political and social issues. I’m reasonably sure that I had recently lost some unwanted weight. Here I was playing diet doctor. I don’t even have a college degree in one of the sciences.

As I said, my weight-loss strategy is simple: Just don’t clean your plate. That’s it. Don’t clean your plate at any meal. Ever. Now there must be hundreds of diet and weight-loss books. Many are written by licensed physicians and diet experts. They’ll prescribe foods, exercise and everything else except how to hold your fork.

At Barnes & Noble’s two stores in our city, entire sections are devoted to the subject. Of course, you can’t sell a book if it only contains one or two sentences like my diet plan. There’s more here. I mentioned the cottage industry of diet books. Besides these, there must be hundreds of people who offer seminars and lecture on weight loss. Your family doctor will give you a brochure.

No doubt a few people follow the advice in the diet books. They slim down. They can buy pants a couple of waist sizes smaller. Or they leave the lectures and manage to lose. Weight Watchers seems to be fairly successful. Likewise, a related industry promotes diet pills and other products, such as the popular Slim-Fast.

All these products and the experts, some with impressive credentials, constitute a huge business in this country. One of the main reasons for this is obvious. Most adult Americans are overweight. It’s like three-fourths, I just read in a medical report. Many of these folk are conspicuously obese.

Maybe most would like to lose weight. They really would, which helps account for the growth of the diet and weight-loss industry.

I should mention the small minority of overweight people who shell out thousands of dollars for bariatric surgery. How’s that for motivation! I understand this surgery reduces the size of a person’s stomach. So the patient loses weight because he or she isn’t able to eat as much food without feeling terribly uncomfortable.

Mark Twain said he found it easy to quit smoking. He had done it a thousand times. Lots of dieters would say the same. Moreover, many understand that trimming down isn’t just a matter of getting into one’s clothes comfortably. It’s a matter of protecting one’s health. Excess weight exposes a person to heart disease and cancer. It likely shortens a person’s life.

An important part of weight loss remains physical activity. I’m sure one of the main reasons I’m reasonably thin is that I walk or jog about five miles a day. I also do pushups and crunches and other moves to keep me fairly limber at age 76. Yet I can’t prescribe my regimen and diet for every adult. All I can say is that it seems to work for me. I don’t judge those persons who appear to be overweight.

As Pope Francis said in another context, “Who am I to judge?” Or, as Philo of Alexandria said centuries ago, “Be kind. Everyone is fighting a great battle.” Indeed, in this country staying at a healthy weight is a great battle.

So much conspires to make Americans overweight, from fast food restaurants to the high-calorie, high-fat products in the supermarkets. The advertisers don’t exactly fight fair. They can make people in TV commercials eating Big Macs or pancakes look not only trim and handsome but happy. I mostly avoid such ads by rarely watching commercial television.

I haven’t been in touch with my cousin Beth for some years. So I can’t report that she has kept off the weight my little column inspired her to lose. Even my own weight-loss strategy has its limits. My wife Toni is a terrific cook. Like most people, I love to eat. I particularly love sweets.

One thing I don’t eat is red meat. Researchers associate that with clogged arteries and various diseases. Beyond that, I weigh myself daily when I step out of the shower. If I see my weight creeping up, I try to remember to adjust how much I eat the following few days. Sure enough, my weight will inch downward. It’s a good feeling being in control.

I can’t prevent the terrorist attacks in Iraq, even gang-related shootings in my own city. I can’t stop the spread of a highly infectious disease such as Ebola that’s already claimed thousands of lives in east Africa. I can’t keep voters from electing stupid, self-serving people to state and national office. But I do get to choose what I eat. And what I can say “no” to. It’s a powerful tonic. Powerful.

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The M.D. in me

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love-doctor-mdI really have no business telling other people what to eat, what not to eat and how much to exercise.

Friends and family seem to agree. Not wife, not daughter, not son, not granddaughters and not in-laws ever ask my advice about diet or exercise. I’m not always sure what that means. Are they weary of hearing advice from a long retired editorial writer? Or do they just prefer not to be told what they already know?

Frankly, it’s just as well. After all, anybody can get the latest medical research online. Just type in your medical or health question and within seconds you’ll have a bunch of answers. I’ve used the computer for just such research dozens of times, writing on some health or medical issue for the paper and since retirement.

Backing all that up, I subscribe to half a dozen newsletters from major medical institutions. In fact, I received three such newsletters in the mail today. So in the newsletter from Mayo Clinic, I read about controlling diabetes, surviving cancer and preparing for surgery. At the moment, I’m not facing any of these issues. But if I do, I’ll be better off than if I hadn’t read the articles.

The latest Johns Hopkins newsletter gives you the best research on statins, benefits and risks. It also offers a reminder about reducing salt in one’s diet. If you needed to hear it again, you’re better off healthwise skipping red meat. Then the Johns Hopkins folk give you strategies to combat excess weight. Cutting out soft drinks, the killer to any diet, is one strategy.

On a related note, when we once traveled in Canada, I found – without any empirical research – that I could tell which tour group was from the United States. I often asked. The Americans always appeared more overweight than the European and Asian tourists.

Sometimes, the medical letters can overturn long-held beliefs about health. The Harvard Health Letter reports that conventional wisdom that egg yolks raises your cholesterol is wrong. So go ahead and enjoy a thoroughly cooked egg – one a day. Meantime, the Harvard letter says don’t think drinking red wine will prevent a heart attack or stroke. Research on mice shows benefits, not for people. You can safely switch to white wine or beer now if you prefer.

The Harvard doctors also remind us to get our flu shot and maybe a shot to protect against shingles and pneumonia. Of course, remember to apply 30 plus rated sunscreen before you head out for a jog or long walk. After 10 a.m. for sure. Nationwide, skin cancer claims more than 9,000 deaths a year.

Icahn’s School of Medicine at Mount Sinai provides insights in its newsletter on kidney stones and takes a shot at Alzheimer’s, although there’s still no way to prevent this mind-robbing disease, much less cure it. Researchers, though, keep at the challenge.

I find all such newsletters interesting. Sometimes, such as with the red wine, I might modify my diet or my exercise regimen.

Often, you don’t need to read a newsletter from a prestigious medical school to improve your health. I once wrote an essay for the paper on my own experience losing weight. I simply didn’t clean my plate at dinner. I lost, as I recall, 10 pounds. Some weeks later, I saw a cousin visiting from North Carolina. She said her dad had sent her a copy of that essay and the advice helped her slim down.

I take my hat off to anyone who is seriously trying to stay in good health. I see men and women jogging or walking in the nearby Foster Park. They’re likely to live longer and with less disease than their sedentary friends and relatives. Take it from the kids at the park’s ball diamonds. They’re getting a good start on lifelong health, racking up hits or striking out. It just feels darn good to get moving.

Next to being kind to everyone, nothing beats good health.

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Rx for the right doc

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He just writes a syndicated newspaper column.  But this doc raises a critical issue when it comes to treating a mental health problem.

Peter Gott, M.D., isn’t a psychiatrist.  But in a recent column, a reader had been advised by his family doctor to take an antidepressant.  The reader worried about serious side effects.

Yes, Dr. Gott said, these medications, while generally safe,  have side effects, some unpleasant.    But before taking an antidepressant, the he advised the reader to consult a psychiatrist.  Why?  Because that specialist has lots more experience dealing with the side effects of these medications.

Maybe that’s not always the case.  After all, family doctors do regularly prescribe psychotropic medications.   Lots of them.  And people with depression, for example, more likely seek out the family doctor for help first.  So the family doctors aren’t lacking in experience.

There are two problems, though.   One is they don’t have the extensive training in a field that’s highly complex.  More important, they’re often so rushed, they don’t spend enough time with the patient to fully understand a patient’s mental health problems.

Research shows that family doctors miss a diagnosis of mental illness in about half the cases.  And when they get it right, they prescribe the wrong medication.  But the answer isn’t for the family doctor to routinely ship every person who seems depressed off to a psychiatrist.

A better approach comes from the University of Michigan’s Depression Center.  For the past year, the center has been overseeing a pilot program for family doctors in Flint, Michigan.   The program takes as a given the rush the typical general practitioner is to see each patient.  So this pilot program has assigned a nurse specialist to advise the family doctor and follow the patient’s treatment throughout its course.

If there’s a shortcoming to this program in Flint, it’s that so many people still fail to discuss mental health problems with the family doctor.  And they sure don’t want talk to a psychiatrist.   This powerful stigma means lots of people suffer when they could be helped.

But Dr. Gott’s open discussion of mental health is the sort of thing that can overcome the stigma.   Truly, there is help.

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The wrong side of history

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I just knew Senate Democrats would stick together and pass the move to bring up health care for debate on the floor.

And I figured Republicans would stand together against holding the debate. No lone member of the Grand Old Party would give the go ahead to this historic debate on a matter that affects all Americans.

Frankly, Americans shouldn’t be surprised.  With few exceptions, Republicans opposed the creation of Social Security.  They opposed Medicare.  They were against Medicaid.  They opposed the Great Society programs, such as food stamps and Head Start.    And in this debate, we’ve heard the most outrageous claims, yes, lies from Republican leaders.  They’ve stoked divisions and fostered ignorance.

That’s been the party of Lincoln since the Great Depression – and before.

You’d think the opponents of health care reform would want to get the issues out for a full, robust debate.  You’d think they’d want a crack at changing things they didn’t like about the bill.   Only one House Republican joined a narrow majority of Democrats to pass the more comprehensive bill.  No GOP help in the Senate.

Well, there’s going to be a debate. It will last through the holidays, maybe into the New Year.  But what should promise to be an inspiring, enlightening exercise in democracy likely will be a replay of the acrimony and demagoguery that have characterized the Republican contribution to this point.   So there you have it.  The GOP, once again, on the wrong side of history.

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No coverage, no care

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I don’t believe it.  Now critics of health care reform claim that the new screening recommendations for breast and cervical cancer claim these are the prelude to rationing health care.

This is too much. Here these independent panel of cancer experts issue their reports completely independent of the legislation moving through Congress. Their recommendations are advisory, not prescriptive.  This is rationing?

You want hear about rationing.  What of those with serious disabilities who don’t qualify for Medicaid. I know persons with a mental illness who get turned down or just don’t apply for the government run program. So they don’t have health insurance. Any. Even if they’re working, it’s likely at low-end wages that don’t come with health insurance.

Besides, Congress can always tell insurance companies they can’t dictate at what age they’ll pay for cancer screening.

As for rationing health care: What do the critics think is going on now?

I just ordered new hearing aids. They cost around $5,000. The aids let a person hear plays, music, TV and what your wife just asked you to do.

Thank goodness, I can afford to buy the new aids. But I won’t get a penny toward this considerable expense from Medicare or from my Medicare Advantage plan.

Yet thousands of elderly persons who have major hearing loss, and have no income beside Social Securitysimply do without. Never mind that this is a real, disabling health problem.

This group falls into that category of “under-insured.” And if you add these folk to the nearly 50 million who have no health insurance, you can tack a few more million.

Medicare rations care. Private health insurance rations care, whether you pay or your employer.

Without health insurance, millions of people don’t get health care, at least not when they need it.

Without health insurance, thousands die needlessly ever year.

This is what the debate should focus on. This is what it’s all about. And the lack of health care in a country so rich, so blessed in a thousand ways, is a national disgrace.

For my part, the issue isn’t the cost of health care reform. It’s not the public option. It’s not the deficit. (AS if Iraq didn’t.) It’s about people. It’s about people needing help. It’s about people get sick. It’s about people become disabled. It’s about everyone who doesn’t have health insurance crying out for help and no one, no one is listening.

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