Namo amitabha Buddhaya, y'all.
This here's a religious establishment. Act respectable.

Friday, March 8, 2024

Guest Post: Chicken Fat and Me!

So my Buddhist monk friend ChiSing, who died in 2018, gave a sermon once (we call them "dharma talks," but they're sermons, so let's just call a spade a shovel) where he had this big bowl. He said something like, "Imagine this bowl is full of all the suffering in the world. You see this bowl and say, 'Wow, that's a lot of suffering.' And you want to help, and you should help, of course, when you can. But a lot of people are doing this." (Picks up the bowl and puts it completely over his face) "And you're saying, 'Oh, the whole world is suffering!' When that's not true at all."


(Puts down the bowl.) "Friends, put down the bowl. Yes, there is suffering, but there are also good things in the world. People love you every day. There is laughter and song every day. The sun rises every day, and every night there are stars, even behind the clouds. Help where you can and when you can, and do what you can to make life easier for other beings. But put down the bowl, friends. Put. Down. The. Bowl."


Which brings me to the election. (!) If you were to watch the news or browse stories on CNN or Yahoo News or any one of a dozen other sites, you might be forgiven for thinking that the 2024 U.S. national presidential election this coming November was the only thing going on in the whole world. And you might think the Orange Shitgibbon was a shoo-in to win this thing, and that the U.S. is going to rocket straight into fascism. I don't think any of that's going to happen. First of all, His Orangeness is showing some very obvious signs of being sick in a way that would negate the possibility of his being President. Second, we're not that fucking stupid.


Yes, there's a mighty cult of orange; of course there is. Cult members generally don't leave cults, which is how you end up with 900 people dead in Guyana. They don't leave because literally everything is there. Their family members. Their friends. Their homes. Often also their livelihoods. To say nothing of eternal salvation. And the sunk cost fallacy. If they leave, what's left? Plus, they'd then have to admit that they've been played, which most people are loath to admit. And all their friends are still voting for His Orangeness.


Maybe they'll lie and secretly vote like a sane person. Maybe they just won't vote. I don't know. But I do know that nothing His Orangeness has done or said in the last six months has won him any new fans. All it's done is continued to justify to his current fans why they should keep hanging in there.


Also, that stuff he's saying on social media? That's not him. As I said, he's not well. The rambling, slightly incoherent stuff he's saying on a regular basis? That's him. That's where he's really at mentally. Stuck in about 2007 and not really sure which way is up. I don't know who's tweeting for him. Probably not one of his kids, as they seem to have fled the scene. Not his wife, either, who might have actually left him. Maybe Steve Bannon. I don't know.


But here's what I think is going to happen; this whole facade is going to build to a crisis point, and probably in the next few months, where it becomes obvious, even to the cultists, that he can't be President. He will have to withdraw from the race. And the Republican Party will be thrown into a state of panic unlike anything seen since the passing of Obamacare. Biden will win the election. The problems and issues we have that got us into this mess will still be there, of course. But we'll have four more years to try to solve some of them. And without His Orangeness, the cult members might be able to start walking away.


I mean, I could be wrong. I have been wrong before. If I'm wrong, you can, I dunno, throw Tarot cards at me. But I don't think I'm wrong. By the way, did you guys see the State of the Union Address? I didn't, but I heard it was a barn-burner. Put down the bowl, friends. Put down the bowl.


Speaking of Tarot cards and crystal balls (bowls)? we have a guest post for today from my wife.  It's all about chicken fat. I'll let her continue from here.


"Chicken Fat" and Me, by J.C.


I have a love-hate relationship with the "Chicken Fat" song. If you're of a certain age, you at least know the chorus "Go, you chicken fat, go away! Go, you chicken fat, go!" Yeah. That one. (And if you don't know it, click here.  Warning, it is loud. )


It played very often in my 1st? 3rd? grade classroom. And on the playground, all the mean kids would start singing that chorus when they saw me. Fun times. At least it was a musical interlude amongst the general fat-bullying. So, yeah. I hated it. Except that I love the song and still do.


There are a plethora of reasons why I love "Chicken Fat."


I love musicals. I blame "The Music Man". When I was 6 or 7, I went to a high school production of it. My first live theater experience of any kind. I was completely captivated. And when Mayor Shinn was berating the River City-izens for falling for Harold Hill's chicanery, and bellows "He promised us a band. Where's the band? WHERE'S THE BAND??!?!!???", the high school's marching band came down the aisles playing "76 Trombones" full blast.


Mind. Blown.


(Hang on, I will get to "Chicken Fat.")


I imprinted on "The Music Man" like a baby duck on its mama. I have seen the movie so many times I can do the dialogue as well as sing all the songs - and both parts of the ones in counterpoint. Robert Preston's voice will grab my attention like a tornado siren. (Loved him in "Victor, Victoria' as well - his drag version of "The Shady Dame From Seville" is pure gold.) So here we get the first connection to "Chicken Fat": Robert Preston. How can I not love a Robert Preston song?


Not only that, guess who wrote "Chicken Fat?" If you clicked on the YouTube link to it, you know the answer: Meredith Willson. And who wrote "The Music Man?" Yup. Same guy. Composer, flutist, radio & television musical director, etc. etc. etc. Very talented man. Very fond of counterpoint. The Christmas song "It's Beginning to Look a Lot Like Christmas/Pine Cones and Holly Berries" ought to ring a bell. That's him, too.


On top of being a HUGE fan of Meredith Willson, I've got a 5th-degree connection to him. My grandfather--his father--Arthur Pryor--John Philip Sousa--Meredith Willson. (And then on to Arturo Toscanini, according to Willson's Wikipedia bio.) A pilgrimage to Mason City, Iowa and the Meredith Willson Museum is on my bucket list.


Finally, to put a big ol' bow on it:  Willson and Preston recorded "Chicken Fat" while making the movie version of "The Music Man" which is why it sounds like it's being sung by Harold Hill.


I can't not love this song.


But I hate this song because it was used by bullies as a weapon against me.


Conflicted, me.

dis-MISSED!! 

Friday, March 1, 2024

Fun with Drug Interactions

 First of all, for no particular reason, here's a video of my happy feet.


Secondly, here's a video of one of my finish line dances.  Whenever I swim 1600 meters or more at a swim practice, I post one of these, though it's happening so often now I'm probably gonna need to up it to 1700.  So if you like fat chicks dancing or you wanna see updates. follow me on Threads @J3ninDallas. 


Thirdly, let's consider for a minute our nation's pharmaceutical companies.  These bold pioneers make wonder drugs so that their shareholders can make lots and lots of money.  Oh, and to cure diseases and treat conditions and whatnot.  This is a cautionary tale of what can happen when two prescription drugs collide with each other and make a big mess.

I think I told you guys I was diagnosed with Type 2 diabetes and a rare neurological condition the same week.  Which doesn't take into account that I already had ADHD and bipolar disorder and was being treated for those. Four conditions to monitor at the same time is a little flipping ridiculous, especially considering that two of them require testing and worksheets and, in one case, drops of blood.  Eesh.  Sure, years from now I'll probably also have heart disease and need three surgeries, but anyway, It's A Lot.  And finding a combination of medications that treat diabetes without also killing you is kind of like finding a combination of medications to treat bipolar disorder without killing you, only with some luck it only takes like six months instead of (in my case) three years, not counting lots of adjustments since.

Anyway, the first drug we tried is like the standard drug for diabetes, Metformin.  500 mg of this was fine, but it Did Not Do The Job; my numbers were still too high.  So my doc upped the dose to 1000 milligrams.  This was a mistake.  I had crippling nausea, not like minor stomach pain but as in I stopped being functional and had to go lie down on my side for half an hour.  A couple of times this happened in traffic and after the second time I called my doc back and said, "This is not safe."  I was being stubborn and trying to make it to three weeks, after which it (usually) gets better on its own. 

So back down to 500 we went.  Again, fine but not effective.  The next likely culprit in the arsenal is one of the semaglutide drugs, made somewhat famous (and infamous) for being prescribed off label for celebrity weight loss.  We're talking Ozempic, only I wouldn't take Ozempic because I didn't want an injectible that lasted for two weeks after my Metformin experience.  No, if it was gonna upset my stomach (which happens to me with basically every prescription drug made, never mind those that are  particularly known for that sort of thing) I wanted to be able to stop taking it Right Then.

Fortunately there is a pill version of one of these, which is called Rybelsus, and it starts out at a very low dose, just 3mg.  So we tried that and it worked great.  That plus the 500 mg of Metformin brought my numbers down where they should be.  There was, of course, some nausea, but nothing like Metformin.  It was a little like morning sickness.  It usually wore off by around 11:00, sometimes flaring up briefly later in the day. So I hit up all my friends who had ever been pregnant to find out what their go-to nausea treatments were. The surprising answer: Ginger.  Ginger tea in particular but also ginger candy and dried crystallized ginger (a little bitter but you get used to it, and Grayson likes it, too.)  So I lived on ginger and saltine crackers for a while, and the morning sickness gradually went away.  

Unfortunately, something else went away at the same time:  My ability to do my job.  I began falling asleep at my desk.  Like, routinely.  I can fall asleep just about anywhere, and in just about any position, but concentrating deeply on something and then suddenly startling awake and realizing that 20 minutes had gone by and I didn't know where I was or what was going on because I had, uh, been asleep was kind of a new thing.  Also, that deep concentration?  Disappeared. Kind of gradually but once it was gone, it was gone.  After two weeks I was going in to work and just kind of taking up space until I could go home.  Which is, you know, kind of bad when you manage a large number of complex things that keep the revenue generating machines chugging along.  

Right about this time, my doc was going to up my dose of the new diabetes med to 7 mg, but fortunately we had a problem with my health insurance. 🙄 The Ozempic class meds, in addition to being known for weight loss, are also expensive. The problem, apparently, is that I don't have T2D and you have to have T2D to take Rybelsus.  I of course have T2D, and we've sent them records showing this a couple of times, but I don't think an actual human being has looked at them.  So I have to appeal and so on, which should prompt an actual human being to look at them.  But I haven't done that yet because I got this text from a good friend.  I paraphrase:  "Hey, have you heard that those new diabetes meds can interfere with medications for ADHD and bipolar disorder?  Something about dopamine receptors and poor absorption?  You might want to check that out."  

WELL, HOLY CRAP.  

That was exactly what was happening.  It was like not being on meds at all.  Apparently the problem is particularly acute with extended-release meds, which my most important one is.  It's called Vyvanse and it's the one that keeps me awake in the face of the two or maybe three other meds (I lose track) that want to put me to sleep.  I went without Vyvanse for a month last summer during a national shortage and it was kind of like trying to rouse myself from a coma.  My psychiatrist ended up prescribing Adderall temporarily, which did the job, but it was like using a bulldozer to find a china cup, if I can quote Rene Belloq.  I mean it was harsh. I still take Adderall once in a while but it's a desperate times/desperate measures sort of thing.

Anyway.  The problem is that semaglutide disrupts absorption of certain substances by the stomach and intestines.  If you're not taking any other meds, this isn't a big deal, but if you are, it can be a real problem.  You're supposed to take the diabetes med right when you wake up and then not eat for 30 minutes so it can get going.  (This delay in my morning coffee has only been mildly dangerous for the population at large, though Joan has the Joint Chiefs of Staff on speed dial just in case.)  So I was doing that and then taking everything else when I got to work.  Which meant I was taking everything else right when Rybelsus was at its strongest.  No wonder nothing else was getting through.  There's also some problem with disruption of dopamine receptors in the brain that I'm not quite sure I understand, but that didn't seem to be my biggest issue.  My biggest issue was that the stuff couldn't get in. 

So I notified my Regular Doc about this and called my psychiatrist.  He called me right back (he usually does; he's a rare specimen of the breed) and said that he had an idea.  Try taking the Vyvanse about an hour before the Rybelsus and -- you'll love this -- take the capsule apart and pour the contents into a glass of water.  Then drink the water.  I bet you always wanted to know what the inside of a capsule looks like, right?  Well, sorry to disappoint, but it's just kind of this plain white powder.  

So that's what I've been doing.  My Regular Doc is holding off on increased doses and fighting with my insurance company before we find out if it works, but so far it seems to be.  I was going to take a whole week off work but instead I took half-days, and I was able to work the half-days (though I seem to be crashing and burning about 2:00 -- not surprising if I'm taking the Vyvanse three hours earlier.)  And the other meds seem to be working better, too.  I'm taking them all at the same time, before the Rybelsus.  This would not work with Ozempic or any of the other injectables, so I dodged a bullet there. 

There are, of course, some wrinkles in the plan.  Firstly there's the crashing and burning early part.  That might be solvable with a suitable application of Adderall; again, desperate times desperate measures.  Then there's the problem of waking up basically in the middle of the night, slamming down the powder for a strong stimulant that's supposed to be in a time release capsule, and then trying to go back to sleep.  Yeah, that's not working very well. And probably contributes to the 2:00 crash and burn.  There is a chewable version of Vyvanse, for little kids, that might also work.  It's absorbed in your mouth and bypasses your stomach entirely.  But it's kind of not as strong, so my psych doesn't want to do that unless the drinking the powder doesn't work.  And then there are the empty capsules themselves, left on the night stand after I swallow the powder and try to go back to sleep.  Guess what makes a great, rattly cat toy and makes a bunch of noise at 5 am? 

By the way, how cool is drinking powder?  Think Maria de Medici tipping her poison ring into your glass of water.  Sometimes it tastes bitter and sometimes it's kind of mildly sweet, so there must be two different components in there, at least.  Of course, it tickles my throat and makes me cough, too.  Nothing is ever perfect.  

I've reported this whole mess to the drug companies involved and I told my psychiatrist that he needs to Tell People.  Neither he nor my Regular Doc saw this coming.  I mean, there is one tiny line on the Rybelsus warning label that says something about malabsorption.  But it's awfully arrogant of Rybelsus, really, to act like it's the only important medication anybody out there is taking. This could be a big problem.  What if you're being medicated for schizophrenia and you start hallucinating because you also have T2D?  What if you're depressed and you go from mildly unhappy to actively suicidal?  I mean, people should know about this. I'm sure all of you know at least one person with ADHD and/or bipolar disorder and/or schizophrenia who also has T2D.  (If you don't, you're probably not hanging around with the fun crowd.)  So, like, tell people.  Thank you for coming to my TED talk. 

Saturday, January 6, 2024

2024

Happy New Year and thank God 2023 is over. 

I dunno about you guys, but I had one hell of a year.

Just briefly:

  • Bad car accident in April.

  • Had to buy a new car.

  • My asymptomatic condition that I've had since I was roughly 40 became symptomatic and I had to get this therapy that wasn't really horrible or anything but I had to drive across town every single workday in 7 am rush hour traffic for eight fucking weeks.

  • Therapy side effect: Free floating anger at pretty much everything.

  • Saw a therapist to help with the free floating anger thing and he managed to make everything worse

  • Diagnosed with two (count them! 2!) new and exciting medical conditions that are complicated and require a lot of monitoring.

  • One neurologist refused to see me because I'd been in a car accident in April. True story. Next time I'm just gonna lie.

  • One amazing week I had three doctor's appointments in three days. I also burned through almost a week of sick time.

  • For Condition No. 1, I get to wear a little sensor on my arm all the time, which talks to my cell phone about me behind my back and rats me out to my doctor when I do something it doesn't like. It's kind of like having a personal private stool pigeon.

  • Condition No. 2 is treatable, sort of, but the drugs are very new and still experimental. My insurance company approved them, surprisingly, but finding a pharmacy to fill it was a whole nother thing. Hardly anybody carries them and my doctor's office has a full time person who does nothing but handle problems like this. We did finally find a pharmacy. In Philadelphia.

  • Had a minor medical emergency and spent 45 minutes sitting in the parking lot outside the local ER trying to decide A. if it was really bad enough to go in there and B. if I'd bankrupt myself and my family if I did, since I didn't know for sure if that particular hospital was on my insurance or not.

  • I finally didn't. Go in, I mean. (I lived. Obviously.) And I don't need to go off on a rant about how messed up our medical system is. But seriously. What if I'd dropped dead right there in the parking lot? Would they have charged me for parking?

  • Spent the rest of that day wrapped in a blanket on the couch feeling sorry for myself.

  • The same week (yes, the same fucking week) I went for a mammogram and got injured (!). I've talked to the manager and the Director of Clinical Services and all that and they all said This Happens Sometimes.

  • I don't seem to be able to make it understood that This Should Not Happen Ever. It's a ridiculously easy thing to prevent. And I can't think of a single time I've ever gone in for a medical procedure and come out with an unrelated injury. 25 years in the legal field and I have never once personally sued anybody. But I might have to do it here.

  • I couldn't wear a bra for a week. I didn't go to the office and just worked at home because I kept thinking that everybody was staring at me. Which they probably weren't and it would have been creepy if they had.

  • Went to Galveston over Christmas and had a great time the first two nights. The third night, our a/c malfunctioned and the only thing they could think of to do was move us to another room at 4 in the morning. That was fun.

  • I think I'm gonna have to file a complaint with the state about the therapist.

The good news is that 2024 looks better. I'm adjusting to the new and exciting meds. My blood glucose numbers are still way too high and I will probably need to see an endocrinologist because I have A Lot More Going On than your average person, but at least I know that. Oh, and I got promoted again and got a nice raise. I'm now the Special Projects Manager. As they say, that and a quarter...

In December 2021, I had emergency knee surgery after tearing my meniscus through some unknown mechanism. (Worst pre-op experience ever, but that's a whole nother blog post. Just, if you can, don't ever have surgery during a pandemic.) For 7-8 months I had to hobble around, first with a walker and then with a cane. I thought I would never get away from the cane. I also thought I'd never be able to walk a decent distance again, or have any endurance, or--or, I dunno, have any kind of life. Well. I haven't used a cane in almost a year, tho I still use a Rollator when there's a lot of walking involved. I still can't do stairs, but I can walk almost half a mile (hoping to hit that goal by the end of January). Also, my swim team that went under during the pandemic has come back as 2 different entities. I joined one of them, had my first practice last week, and swam for an entire hour, nonstop. So apparently my endurance has not gone anywhere. And I'm still married and we still have a cute little house in Dallas and two great cats and we're going out later to buy a new sofa, which would not have been possible even a few years ago. And my family members are doing well. 

And I am very tired sometimes but I do have a life. And I'm 55 years old. So, when you think things are never going to get better, remember that they do get better. Almost whether you want them to or not.

Saturday, November 11, 2023

Mini-Post: Veterans Day!

Way back when I was a young pup, in early college, I had a four year scholarship that turned into a two year scholarship and then disappeared entirely when I changed my major.  This was back when college didn't cost like $30,000 a semester, but still, there was some consternation about how I was gonna pay for the rest of school.  So I thought what the hell, I'll join the Air Force like my dad did.  Then I'll have a job waiting for me when I get out, and school will be paid for, and all manner o'things will be well. 


So I went down and saw a recruiter, as one does. He kind of looked at me funny when I asked about being stationed in Minot, North Dakota but said "Yeah, I'm pretty sure we can do that."  I mentioned all this to my dad. He was happy.  He brought home a bottle of champagne and an impromptu celebration broke out. Everything was going great until my dad suddenly said, "Wait a minute. This is a really bad idea."  


He's only ever said this one other time, that I can remember, so I stopped and asked why. He said I did not have the right stuff for military service. Specifically, he said I had a "low bullshit tolerance."  Which, in the military, can be fatal. So I ended up not joining the Air Force. I think that was probably the right call.  And we found other ways to pay for school and I did not have a job waiting for me when I got out. But I eventually found one and life went on. 


Today is Veterans Day.  If you know a veteran, or a soldier, please take a sec to say thank you to them for getting shot at on your behalf.  If you can, maybe also offer to give that person a hand with something.  Older vets might, say, need their lawn mowed, or need a ride to a medical appointment.  Or maybe you could help them change their light bulbs because they're not very handy getting up on a ladder these days.  Younger vets and soldiers might need a hand with child care, or help understanding tax forms, or just some of the weird stuff in life that a lot of us struggle with.  If nothing else, most of them could use an ear.  It never hurts to ask.  


I'm fresh off a project at work where I talked to a lot of veterans on the phone. Most of them were from the Desert Storm era but some were younger.  All of them had some pretty amazing stories. Like the guy (they were mostly guys, but a few ladies) who participated in a prank that pissed off a superior officer and ended up getting reassigned to Diego Garcia. I had to ask him where that was. (It's a little island in the middle of the Indian Ocean, literally a thousand miles from the nearest land mass.) One guy, when I asked where he was stationed in Iraq, said, "Well, we weren't really stationed anywhere. I mean, we slept on the runway the first few days. Then in some abandoned houses. I stayed at Saddam's palace for a week. That was nice.  And in the Holiday Inn Baghdad. There is one. They didn't have the free breakfast, though."  A couple of them saw IEDs explode and kill people, some at close range, some farther away.  Some had been attacked by angry civilians.  And one guy was captured tortured, and eventually ransomed back to his outfit by some local tribesmen after his convoy was hit by a kind of improvised missile that killed three of his men. "But it's cool. I've had therapy." (!!)


I was doing this project from my house, or from a climate controlled office near downtown Dallas. The closest I ever got to doing anything dangerous in life was working for the U.S. Government when I was younger and more spry, working on disaster relief after Hurricane Katrina. And even then I was doing exciting stuff like proofreading mortgage documents and making sure field agents had good maps and directions in a landscape where many of the road signs had been washed away. I have never flown a helicopter or carried sandbags or pointed a rifle at anybody. I think my dad was right. I do not have the right stuff. I do, however, have a famously low bullshit tolerance. This can only help you in life. 


Also, I vote. And you should too. You can vote because a whole lot of veterans stood up to a somewhat addled English king and an emperor and a guy with a toothbrush moustache and some other emperor and Saddam Hussein and a scad of Karl Marx cultists and and said, "No, I don't think so."  Voting is how we help keep people from having to go fight wars in the first place. I hope that one of these days, the idea of needing armies to be ready to fight people will become sort of a joke, like how we joke now about needing garlic to fend off vampires. But until that happens, we will have more soldiers and more wars and more veterans. So when you can, help them out. Slava Ukranii. Thank you and goodnight.

Sunday, October 22, 2023

How Aunt Frieda Did It

In our last blog post, we talked about Aunt Frieda, everybody's best friend's cousin' sister-in-law, who lost a large amount of weight and kept it off forever.  By doing this, Aunt Frieda accomplished something that only 10-20% of people can do (and I’ve seen some studies that say more like 4%). Still, Aunt Friedas do exist.  People with six fingers exist, too, and so do ethical politicians, and I once heard about a guy who was born with only a brain stem, or what we call the “lizard brain,” and the rest of his brain was essentially missing.  He was in medical school and having probable stress-induced migraines when they did an MRI and found this out.  So, you know, weird stuff does happen. 


The reason so few of us can lose weight and keep it off is because we evolved over 2.5 million years to be very good at surviving famines, which were frequent for pretty much that entire time. As a species, we are not good at losing weight.  We’re good at gaining it, so as to survive the next famine and the next one and the one after that.  Getting enough to eat was a constant problem from the time we first stood upright on that African plain.  


First, we invented agriculture in BCE 12,500, approximately.  (It was a Tuesday.)  This helped a lot, and was a huge game-changer both in producing enough food for everybody and for kick-starting the development of civilization. Fast forward to the 1900s, when we fought World War I, then II.  That helped even more. Besides adding essential nutrients to food, which we did because the Army was so unhappy about how many malnourished recruits were showing up to fight, we also made several very important discoveries about farming and fertilizer right around this time. We sort of had to, because much of Europe’s agricultural countryside was either blasted apart by shells or poisoned with mustard and chlorine gas. (In fact, there are areas in France where to this day, one hundred years later, nothing will grow.  Not even crab grass.  And there are signs that say, in French, something to the effect of “Do not walk here,” because some experts are afraid gas could still seep out of the ground and kill people if, say, it rained a lot.)


So that left it up to the Americans, in large part, to grow enough food to feed everybody. Luckily, we had lots of available land.  We spread out into the Midwest, made lots of farms, grew lots of grain.  We’d suffer a major setback in the 1930s, when a lengthy drought created the “Dust Bowl,” but for the most part, we got better and better at growing more and more.  New farming innovations spread around the planet.  Today there are 8.2 billion people, and at no time in history have we been better fed, better educated or better medicated. (But, see also, climate change, and ideal crop temperatures, and cross reference large-scale crop failures.)


Anyway, back to Aunt Frieda.  Yes, there are people who lose weight and keep it off.  I don’t want to suggest that they don’t exist at all.  They’re just rare.  Most people (80-90%) who lose weight gain it back, and usually more.  But since there are Aunt Friedas, and everybody wants to be an Aunt Frieda, let’s take a look at what those ladies have in common.


(Some of them are men, but we’re calling them Aunt Frieda, so we’re going to use female pronouns. You guys don't mind if we use female pronouns, acknowledging they mean both men and women, right? Oh, you do? Too bad. It's my blog post. Go write your own.)


First and foremost, Aunt Friedas were probably a normal size for much of their lives.  They were smallish or average size babies. They weren't fat kids. They probably hit all the growth markers.  They didn't gain the Freshman 15 in college. They reached a certain adult weight and more or less stayed there until Something Happened. 


Aunt Friedas are also pretty active.  They often have jobs that involve a lot of physical activity, like a lot of walking, or manual labor, or they’re on their feet a lot.  Think gardeners, construction workers, postal workers/letter carriers.  If they are desk jockeys, they probably are or once were high school and/or college athletes.  Even if not, they have a sport they love.  They run, they play team basketball, maybe they swim on a swim team. They love their workouts and they’d never miss them.  Some of them are Olympians, or would-be Olympians. They probably eat a lot compared to most folks, to fuel all this activity.


But, for Aunt Frieda to lose weight, she had to gain it in the first place.  So what happened?  Probably something medical.  She got sick, she got hurt, she got pregnant. She had to stay home, on bed rest, couldn’t be as active as she had been previously.  Maybe she was in the hospital.  Maybe even the ICU (which helps you survive the crisis, whatever it is, but it’s really hard on the rest of you, especially your psyche).  So she gained some weight.  Maybe a lot, maybe just a moderate amount. 


Then she got better.  She had the baby, got out of the hospital, recovered from the injury.  Being athletic, she doesn’t want to stay at the higher weight, not because she can’t fit into a size 6 anymore but because it’s messing with her center of gravity when she goes for a layup on the basketball court.  So she embarks upon a campaign to lose weight, maybe medically supervised, maybe not.


So she loses the weight.  Great.  Now what?  Well, Aunt Frieda monitors her weight, her exercise level and her calorie intake every day for, pretty much, the rest of her life. She writes down what she eats.  She weighs herself at least once a week. She charts her workouts.  Again, she’s probably athletic. A big part of how athletes perform at an elite level has to do with what they eat. So monitoring food and exercise is not foreign to her.  She’s probably done it all along.


Aunt Frieda either knows, or is told, that now that she's gained weight and lost it again, she can't eat the way she used to. Every time a person gains and then loses weight, they have to eat fewer calories each time to stay there. For example, say we have a moderately active 40 year old man who weighs 180 pounds. He eats, say, 2600 calories a day. If he gains 30 pounds, and then loses it again, he will gain weight again on 2600 calories a day. To stay at 180 pounds, he can only eat maybe 2300 calories a day.  If you lose a bunch of weight, your 2.5 million year old ancestral body will think you are starving. As soon as food is abundant again, you will want to eat a lot of it to get back to where you were.  And a few pounds extra for security.  Why? So you can survive the next famine, of course. And the next one and the one after that. If our 40 year old man gains 30 pounds a second time, and then loses it again, he may not be able to eat any more than 2000 calories a day. 


And here’s the other thing. Probably the most important thing: Aunt Frieda only does this once.  If she gains it back, it’s going to be harder to lose a second time, and harder still the third time, and so on.  Each time she gains weight back, she’s likely to gain more than she lost, so she’ll end up at a higher weight than she started out. This is called “weight cycling”.  Once this starts happening, we can’t call her Aunt Frieda anymore. She’s becoming one of the rest of us. People aren’t born weighing 300 pounds, you know. People get there by going on diets, losing weight, and gaining more back. It has nothing to do with being lazy or not having enough "willpower." It's about basic biology. You learned this in ninth grade.


We know that weight cycling has this result.  We also know that it's hazardous to your health in lots of other ways. It causes muscle tissue loss, osteoporosis and damage to major organs. It's associated with depression, anxiety and a sense of failure. It's probably the major cause of type 2 diabetes (if, that is, diabetes has 2 types; some scientists think there are more like 4 or 5 types).  Some diseases that are associated with being at a higher weight, like heart disease, are probably more closely associated with weight cycling. If you stayed at the higher weight and didn't try to lose weight, your risk of heart disease would drop proportionally.  At least in theory, because we can't seem to find test subjects who haven't tried to lose weight. They basically don't exist. So we're stuck with algorithms. All else being equal, though, you will be in poorer health after two or three weight cycles than you were when you started out, no matter where you end up weight-wise.


So given all that, I would think that the responsible thing would be to, I dunno, tell people not to go out there and try to lose weight. That it would be better to just focus on getting exercise, because that's good for everybody in lots of ways, and eating better food, more fresh fruits and vegetables.


 But. 


First of all, there’s this huge weight-loss industry out there that is financially vested in making sure you keep trying to lose weight.  Like to the tune of $75 billion a year. That's billion, with a b. This industry even funds scientific studies centered around proving that thinner is better.  Also, most doctors learned in med school that no matter what, thin is better than fat.  So they keep harping on you to lose weight, either unaware or not caring that doing so is actively causing you harm.


Secondly, besides the weight-loss industry, we have the food industry, which has also paid scientists to conclude that it's some other villain causing people to gain weight. It isn't the weight loss industry that created Big Macs or "family size" boxes of cereal. Look at commercials on TV.  All the holidays, family times and "good times" mean there's lots of food.  We even have an entire holiday, Thanksgiving, based on the idea of eating a lot.  The food industry pays "influencers" to try to get you to eat more. Garfield said this first in 1980, and it's still basically true, that a huge percentage of Americans get their pay checks in some way from the food industry.  So there's serious money behind how much you eat.


Thirdly, finally and most importantly, most fat people start dieting as kids.  Just for example, I was nine; my wife was six.  In both cases, the doctors told our mothers that we were too fat and they had to fix us. If you start dieting that young, it isn’t likely that you’re ever going to be an Aunt Frieda. Kids gain weight as they grow. It’s what they do. And since they keep gaining weight, the odds of somebody freaking out and putting them on a diet again and kicking off the weight cycling is, uh, extraordinarily high.  You start doing that at nine,  or God forbid six, honey, you are pretty much screwed.


If you want to be an Aunt Frieda in spite of all this, and you've been fat most of your life, what should you do?


Well: Scientists say that first, you should monitor everything you eat. Write it down and keep track of your daily calorie intake. You can use one of many calorie calculators that float around on the Internet to get an average number to aim for. Try to use one that asks for activity level and age, and remember that whatever "average" is may not work for you. You will have to try it out and move that number up or down. If you've gained and lost weight a bunch of times, the number is going to be way too high, so maybe adjust your activity level down in the calculator or just take the number with a grain of salt.


Second, if you do not have an active job and you don't walk a lot (ie, you drive a car and don't walk to work or school or to public transit), you need to exercise 60 to 90 minutes a day.  Regular people can get away with about 30 minutes, but if you have lost weight and want to keep it off, you will need to do three times that. (Hey. If you have been a couch potato for years, please do not immediately start doing 90 minutes of exercise a day. Please oh please. You will hurt yourself. You will need to start small, like 10 to 15 minutes, and build up from there.)


Third, you are probably going to need some help.  A doctor, for sure; maybe a Regular Doc, but maybe also an endocrinologist, especially if you have diabetes. A nutritionist or dietician to help you design an eating plan is not a bad idea, and if you have multiple food allergies or any known metabolic issues, it's basically a requirement. You might want a therapist if you have major issues with food or dieting. You might also want a coach or a support group. Overeaters Anonymous is a good place to start, if you believe in God. (I don't and I've never been 100% comfortable there, though they are good people and the program did help me.) 


If this sounds like it might be pricey, well, it is. There are programs, especially in Canada, that have all this stuff under one roof, but in Canada they have (gasp!) Socialized Medicine. Down here, you have to cobble it together yourself. Insurance may pay for it and it may not, and if they won't or you don't have insurance, you're talking about thousands of dollars a month, probably.  Oh, and don't forget you have to do all this stuff forever.  Every day.  For the rest of your life. 


Given all that, I can totally see saying, "Fuck it," eating whatever you want, and exercising basically never. But because I'm a Buddhist and this is a Buddhist blog (no really, it is), I have to suggest the Middle Way. That's where you do the best you can to eat healthy foods, especially fresh fruits and veggies, but also have treats sometimes and even maybe share fries with somebody once in a while. Where you don't write down what you eat but you do try to pay attention to your stomach and when you start to feel full, you stop eating, even if there's food left. Where you don't eat stuff just because your mom made it for you special or you got it as a present at Christmas or because it was free at work, but because you actually like it and want to eat it. Where you find an exercise you like and do it as often as you can, but you don't count daily minutes and you just have a good time doing it. Where you don't weigh yourself. Let the doctor do that.


And you may lose weight and you may not, but you are absolutely guaranteed to feel better. 


I'm just sayin'. 

Monday, October 9, 2023

From Australopithecus to the Battle of Verdun

There have, of course, always been some fat people.  Renaissance-era paintings show plenty of big women, and some men.  King Henry VIII was famously fat, as was Henry Knox (George Washington's best friend). George IV, king of England in 1820, was fat. Mae West was certainly not skinny. But, back when most people had very physical jobs, there were no cars, and food insecurity was a real thing and not just something that sounds good in government publications, fat people were kind of rare.


In the 21st century, we keep hearing about an "epidemic" of fatness.  Some 70% of Americans are said to be overweight. (Which makes us the majority. So don't piss us off.)  Health pundits blame different things. It's because of sugar. No, it's because of corn syrup. No, it's because of feeding antibiotics to cows. No, it's actually because of aliens abducting humans and running fertility tests. Well, probably none of those things really help, but I think it's inaccurate to blame the number of fat people on any of them.  


No, we need to blame the "epidemic" on evolution. And the First World War.


Lemme 'splain:


A Brief History of Human Evolution


The first critter that was pretty obviously a proto-human was Australopithecus, which showed up in Africa a mind-bogglingly long time ago. These guys were about 4 feet tall, walked upright, and probably looked like hairy humans, except their faces were more simian. Between then and now, about 30 different kinds of humans sprang up, branched out and died off until 50,000 years ago, when homo sapiens found itself the last man standing. 


(Our nearest cousins, h. neandertalis, lived in the same spaces we did for tens of thousands of years before they were decimated by a pandemic disease, or climate change, or both.  We hunted the same animals, ate the same berries, apparently didn't fight much, and occasionally dated (!). H. sapiens may have also coexisted with h. florensis and h. denisova.)


During most of that entire 2.5 million year time span, which is so much time I really can't even wrap my brain around it, our biggest problem was getting enough to eat.  We hunted, we gathered, we gathered and we hunted, most of our waking hours, for most of our history.  We got better at it, as evidenced by spear points and arrowheads and cave art and beaded objects that indicate we had more spare time as we went along, but a lot of us still starved to death before anything else could kill us.  This pattern didn't really change until about B.C.E. 12,500 (ish), when we invented agriculture. 


It's hard to explain what a game changer was this business of farming.  For the first time in our history, there was plenty of food.  Not only that, but there was enough left over to save some for next year, in case the harvest was bad or the weather wasn't friendly or--whatever. Fertility shot up.  People lived longer, fought off diseases, survived broken bones. Our population doubled and doubled again.  We spread out across the globe.  We made buildings and houses and cities and civilizations.  We invented laws and gods and religions.  We came up with writing and started keeping records.  We created countries and armies and ships and lots of nifty gizmos.  It was huge. 


12,000 years later, we fought World War I, and had another big leap forward.  


A Brief History of World War I


In case you missed this part in history class, France and Germany started squabbling over some land called Alsace-Lorraine, as well as a number of other things. In February of 1916, Germany decided to march through Belgium to attack France. Belgium said the hell you will, somebody shot the Archduke Ferdinand and total pandemonium broke out. 


Unfortunately, before any of that happened, we had the American Civil War.  This occasioned the invention of the machine gun and the explosive shell. We then had sixty years after that to get even better at making efficient weapons to kill people. The Battle of Verdun began on February 2, 1916.  Thirty thousand men died in a single afternoon.


Two years later, having basically lost an entire generation of young men, France appealed to England for help in its war against Germany.  England did what they usually do; they turned around and asked us. I forget how we let them talk us into it. But they did, a draft was instituted, and thousands of American men, mostly the ones that weren't rich enough to get out of it, began pouring into Army camps.  The Army took one look at these guys and got very unhappy. More than half of them were suffering from rickets, pellagra, beriberi and other diseases of nutritional deficiency.  What's more, a lot of them were stunted, having never reached their full height or breadth of shoulders because, simply put, they hadn't had enough to eat for most of their lives. (They also, by and large, had bad teeth. But that's another blog post.) 


The Army complained to the government.  The government passed some laws. After the war, a number of food products sold in the U.S. were enriched; that is to say, they had nutrients added that weren't there before.  Guess what, milk does not naturally have vitamin A and D.  They added that when they put it into cartons.  Wheat does not naturally contain vitamin B complex in it either.  We added thiamin, riboflavin, niacin, and folic acid.  And it worked.  Nutritional deficiency diseases almost disappeared overnight.  Other countries passed similar laws. Between that and significant developments in farming, more babies survived infancy.  Life spans shot up, from an average of 47 years in 1900 to 63 years by 1940.  We invented vaccines for more diseases.  We made better drugs, including antibiotics. Life got a lot better.  


We still haven't completely solved the problem of getting everyone enough to eat. There are still famines, and people still sometimes starve to death.  But by and large, most modern famines are political. It's not that there isn't enough food, it's that we can't, or won't, get it to the people who need it.  Either we can't pry it loose from the people who have it or someone is preventing us from getting it where it needs to go.  But the last hundred or so years has still been a significant reversal in our relationship to food.  


Which is, of course, why we have an "epidemic" of fat people.


Remember that 2.5 million or so years where food was scarce?  Humans who, by some genetic twist of fate, were good at surviving famines were more likely to live long enough to reproduce, and their kids were also good at surviving famines. Do this generation after generation for 2.5 million years and you end up with a bunch of humans who are really good at surviving famines.  Any time we lose significant weight, we quickly gain it back as soon as there's available food again.  By doing that, we're better prepared for next famine, and the next, and the one after that.  Having extra weight is like a bank account for times of unemployment.


In short, we have evolved to gain weight, not lose it.  We did this over 2.5 million years. 100 years of food security are a drop in the evolutionary bucket.


Then, during and after World War I, we suddenly had abundant food for the first time.  Couple that with the improvements in technology and labor saving devices, and the invention of cars and other forms of transportation.  What you get is a lot more food and a lot less energy being expended through exercise, ie, labor. People began to gain weight.  Not just fat people but everybody.  We also got taller.  The average American man is 5' 9" and weighs 200 pounds. In 1900, American men stood an average of 5'5" and weighed about 140 pounds.


By and large, we don't have famines anymore, but human beings still lose a significant amount of body weight (say, 10% or more) with great frequency. It's called dieting. What happens, when a modern human loses lots of body weight?  Well, the same thing that used to happen before we were modern humans. Studies show that regardless of the method of weight loss, 80 to 90% of patients gain it all back, and usually more, in about 3 years' time.  That's evolution in action, baby.


"But my Aunt Frieda lost 90 pounds and kept it off." Sure. Aunt Friedas exist. But we cannot all be Aunt Frieda. In fact, only about 10-20% of us can. That makes about 80% of the population not Aunt Frieda. When the system us not working for 80% of the participants, the problem is not the participants. It's the system. 


(By the way, Americans spend about 70 billion--with a b--dollars on weight loss programs and devices every year. There are a lot of people out there heavily invested in convincing you that you, too, can be Aunt Frieda. The problem is, theyre not interested in your health. They want your money, honey.)


Since our culture values thinness to a degree that's pathological, people lose and gain weight over and over again. It's called weight cycling, and it turns out that weight cycling is really bad for you in the long term, even if it's good at keeping you alive long enough to reproduce.  (Evolution is all about reproduction.  The goal is to pass on your DNA.  Evolution does not care if you live a long and healthy life.  Once you've had your babies, you're a dead end.) 


Look. If evolution wasn't real, fat people could go on one diet once, lose the weight, and be fine thereafter. But that's not what happens. In fact, people who lose weight, then gain it back (ie, basically everybody) often find that they have to eat fewer calories to keep from gaining even more weight. A man who can eat, say, 2000 calories a day at 180 pounds, can only eat 1800 calories a day to maintain the same 180 pounds after he loses 25 pounds and gains them back. 


What's more, weight cycling causes bone loss and osteoporosis, muscle loss, diabetes and heart damage. It probably also causes mental health issues like depression and anxiety.  It is said, and it is true, that fat people get more heart disease than skinny people. But, what's causing the heart disease? Is it being fat? Or is it all the damage done to your heart and your organs because you've lost and gained weight so many times? 


The way to find out, of course, would be to get a bunch of fat people who have never tried to lose weight and follow them around for 40 years to see what their incidence of heart disease looks like. The trouble is, there are no such people.

Wednesday, September 13, 2023

This Didn't Happen. To Me.

So I’ve been really, really tired for quite a while.  Part of that was because I was having some medical treatment that just makes you tired; I mean, that is a known side effect.  Also, things have been insane at my office.  I won’t go into the whole deal, but the short version is, we had to call 1300 people on the phone, get their consent to settle, verify their demographic info, and stuff like that, all on a very tight timetable.  Which took a lot of hours. But besides all that, it turns out I’ve been sick (!). 


I had emergency dental surgery about 2 months ago.  The dentist took a bunch of X rays, as they do.  After the procedure he told me that my left maxillary sinus looked “weird.”  “I’m not a doctor,” he said, “but I think you should have one check it out.” So I called my Regular Doc.  She said that if somebody needed to poke around with an endoscope in my sinuses, it should probably be an ENT and not her.


She gave me some names and I called around for an appointment.  There was like a 6 week wait for a new patient appointment. In the meantime, of course, I Googled my symptoms, which I kind of hadn’t noticed up until that point. They could have meant a number of things, among them nasopharyngeal carcinoma. (This is the bad side of Dr. Google.  The good side, of course, is that you’ll know the terminology when you get in there.)  A friend of mine died of this. Obviously I didn’t want to have it.


Well, good news.  I don’t.  I have a garden variety sinus infection, which I’ve apparently had for a year or more (!).  I had sinus surgery in 1997 after years of chronic sinus infections, and this is not at all what used to happen. No pain. No fever. Not going to bed for a week and wanting someone to shoot me.  So you can forgive me for not knowing about it.  Anyway, I’m being treated now, and I should start to feel less tired. Also, I’m planning to sleep all day Saturday.  You have been warned.


Speaking of sleep:  I had probably the strangest dream of my entire life a couple of nights ago.  Most particularly, it was strange because it wasn’t strange at all.  When I'm dreaming, about 90% of the time there’s a part of my brain that kind of stays awake and makes pithy observations about what’s going on, especially when things get weird.  That didn’t happen this time around.  What’s more, there weren’t any leaps of logic or brightly colored scenery like there usually are in dreams.  It was all just straight up narrative.  Kind of like it was actually happening, though it didn’t happen.  To me.  That I’m aware of.


So I'm a 28 year old male. I'm in college. I go to a literature class and I'm late because of work. The professor makes a joke about it and everyone laughs; I kind of wave abashedly and sit down. This is one of those dreams where everybody is speaking another language (Spanish, in this case) but it's fine. When class is over I head to the bookstore to pick up some pens and notepads and grab a bite to eat from a little campus restaurant.  Then I hop on my bicycle to ride home.  It's a 1970s era Schwinn, dark green, looks pretty new. Groovy baskets on the back, too.


If I had to guess I'd say I live in Chile or Argentina in a medium-sized city in the early 1970s. I have a modest house in an older neighborhood. My girls run out to meet me.  They look to be 4 and 6. I walk them in while they tell me stories about their day. We talk for a while and then they head off to bed because it's late.  

I sit down on the couch with my wife. Her name is Tonna. I tell her that going to school and working is really hard, and it was a lot easier when I was a younger man.  She pats me on the shoulder and reminds me I'm going to graduate soon, that I'm doing this so my girls can have a better life.  And she knows I can do it.  Some smooching happens.  I fall asleep on the couch.

I wake up because there are men in my house.  I can hear them but I can't see because there something over my head. I hear somebody crying and I think it's one of my girls.  I start freaking out and two or three guys grab me and drag me out down the front steps.

Next thing, we're in a boat.  We're hitting all these waves. Chop. Chop. Chop.  I must be right next to the outboard motor because it's so loud.  It's the only thing I can hear.  This seems to go on for a long time.  I probably pass out again. 

Then I can see a little.  It's still very dark but there's some pink and orange streaks starting to appear in part of the sky.  The boat is a small speedboat, nothing fancy.  We're in the middle of a broad river, probably half a mile across.  The boat has stopped.  There are bright lights in the back and somebody's pounding on the motor with a wrench, swearing.  I glance at the sky and realize it's going to be light soon.  If I'm going to escape, now's the time.

I throw myself over the side of the boat.  The second I hit the water I realize I have a problem.  I can't swim because my hands are tied.  I can't get my head out of the water.  I'm drowning.  I hold my breath as long as I can.  Finally I let out the breath and gasp in water.  I can feel my lungs filling up.  I'm definitely going to die.

Someone lands in the water next to me.  Somebody's grabbing me from the boat and they manage to get a rope around my chest.  (Interruption here for one of those odd observations.  It didn't really feel like a rope.  It felt like a silver chain.  I mention this because people who have had out of body experiences sometimes talk about being tethered to their unconscious bodies by a silver chain.  I'm just saying.  It was odd.)  Two or three guys on the boat and the guy in the water are able to get me back in the boat.   

Somebody pounds all the water out of my lungs just as everything starts going all grey and swimmy.  I manage to get a couple of breaths and maybe I'm not going to die after all.  One of the men is yelling my name. ("Fernando!!" Because of course.  The old ABBA song.)  And I recognize him.  It's my cousin, Miguel.  I start yelling.  "Leave Miguel alone! Don't hurt Miguel!" 

And then I wake up(!).

Only I'm not awake.  I mean, I am awake, because I'm trying to get out of my blanket and pry the plantar fasciitis thingy off my foot so I can stand up. But the dream is still going on. I was looking at the group of men in the boat.  I was looking down the hallway.  I could hear somebody screaming. I could hear a cat meowing.  And I was literally halfway down the hall before I was really all the way back.  And one of my cats was sniffing around my ankles and meowing like where have you been?

I don't know what to make of this.  I don't have dreams like that.  I dream fragmented chunks of stuff with an early 80s dance mix soundtrack.  And sex.  I dream a lot about sex.  I'd almost think past life experience or something, except I was alive in the early 1970s.  I mean, unless time works differently over there.  Or it could have been a 1960s Schwinn and I just couldn't tell the difference.  But I always thought last time around I was a Russian cosmonaut who died in some horrible training accident that they never told the outside world about.  No particular reason, though, except for really wanting to be an astronaut when I was a young kid.


Or, I guess it is possible that my own pet theory about reincarnation, which differs somewhat from the Buddhist theory, might actually be correct.  I could write books about this, but basically. the re are two Buddhist ideas that are totally in conflict with each other where reincarnation is concerned.  There's this idea that we've all lived many times, and it would stand to reason that some of us remember some of that. (I do.) Then there's this idea that there is no ego, no "I".  This notion that we exist as independent beings is just an illusion.  


What I think, briefly, is that we're all the same being, parts of a whole.  When we die, we go back into the soup, and when we're born, some of the soup gets ladled into our craniums and becomes our consciousness.  That's why more than one person remembers being Napoleon, say.  Because we've all been everybody, and Napoleon had a pretty memorable life, so it stands to reason that a lot of us would remember parts of it. There was an episode of Star Trek The Next Generation that explained this pretty well, though I hated it because Q was in it and I hate Q. 


Well, anyway.  Times like this I wish I had a night vision security camera in my room to see if I was actually there the whole night or if I disappeared for a couple of hours in the middle.  Of course, there’s a very good reason why I don’t have a night vision security camera in my room, besides all the other obvious ones.  I am not at all sensitive to paranormal stuff. Not at all. I'm not saying there aren't ghosts out there, because lots of together people I know have encountered them, but I have not. Cameras, however, record what they see.  And I know, I just know that if I had a night vision security camera in my room, it would absolutely pick up a black, menacing, shadowy looking figure coming out of my closet and looming over me in my sleep.  If that happened, of course I’d have to burn the house down and flee with all my possessions and wife and cats in a cardboard box. 


Well, maybe more than one cardboard box.