Why Diet Programs Ignore Common Sense! Or How to Lose Weight without even Trying!

marthas-vineyard-detox-diet

There are two rules of wisdom that I think most of us believe in.  They are:

  1. If it is too good to be true, it probably isn’t
  2. There are no free lunches

I have found the above precepts to be good guideposts for my life.  They are so often noted that we begin to take them for granted.  It could be argued that perhaps they are not true in every situation, but I believe that they are more often true than not true.  This brings us to the issue of diet programs.  Consider the following statistics:

  • An estimated 108 million American adults were dieting in 2012.
  • Each year, more and more adults are trying to lose weight
  • 80% of dieters try to lose weight on their own
  • In 2012, Americans spent an estimated $65 billion trying to lose weight
  • 90-95 percent of all dieters gain their weight back

(Statistics are from Fitness for Weight Loss)

HT_rocco_dispirito_book_jef_140109_16x9_608If I go to Amazon.com and type in “diet books”, I find that there are 184,291 books available to sell me on a strategy for losing weight.   There were 424 “Diet Best Sellers” in 2016 and 209 “Best Sellers” published already in 2017.  These are only the “Best Sellers.”  There were a total of 39,673 diet books listed as published in 2016.  Many if not most diet books do not make the “Best Seller” lists.  In terms of magazines dealing with diets and weight loss, there are over a dozen magazines that you can buy each week at your local grocery store (that you will find stocked right next to the chocolates) that will tell you how to lose weight “without even trying.”

fad-diet-adsHowever, the above statistics are only the tip of the proverbial iceberg.  If I go to Google and type in the words “diet strategies” in parentheses, I find that there are over 319,000 listings concerning various diets, stratagems, plans, tips, secrets, etc., that will show you how to lose weight “without even trying.”

Here are some typical headlines that you will find as you peruse any of the above information that is offered for those of us that need to lose weight “without even trying”:

  • The Harcombe Diet 3-Step Plan: Lose 7 lbs. in 5 days and end food cravings forever
  • 1200 Calorie Diet Menu – 7 Day Lose 20 Pounds Weight Loss Meal Plan
  • Win at Slim: New Secrets to Lasting Weight Loss
  • Outsmart Your Cravings: Sweet, Salty, Crunchy
  • How I Lost 42 lbs.
  • Eat, Drink, Shrink: No Diet Ways to Fight Holiday Gain
  • No More Guilt: Stop Dwelling, Start Enjoying

no exercise or dieting

The beauty of all these weight loss schemes is that you can lose weight “without (you guessed it) even trying.”  Any half-way intelligent person would regard these titles and by applying either of the two rules noted earlier decide that they were pure bunko.  Lose weight without trying!  End food cravings forever!  Lose 7 lbs. in 5 days!  No sane person would believe any of this BS.  Nevertheless, the diet magazines, diet plans and diet books sell like crazy.  Every year a plethora of new diet strategies replace last year’s models.  Why do people continue taking the bait when they know that it is a sucker’s game?  The simple answer is that when it comes to looking like Jennifer Lopes, Christie Brinkley or any of the Kardashians, all brain power and rational thinking goes down the drains.  Everyone in America wants to be thin and beautiful “without even trying.”

SUPER-SHRED-DIET-ROTATOR-617x241Every new diet strategy renews hope for the downtrodden and overweight oppressed masses.  Every new diet plan offers the possibility that beauty and slimness might be had before Christmas or at least before the New Year.  Every new weight loss scheme provides the potential to become the person that we dream of being.  Hope springs not just eternal in the human breast, but perpetually, irrationally and beyond all measures of logic or intellect:  To hell with “no free lunches!”  To hell with “it probably is not true!”

If even the remotest opportunity exists that I can lose weight “without even trying”, I will take the bait like a mouse eats peanut butter or a cat eats catnip or a bear eats donuts.  “Dam the torpedoes, full speed ahead.”  Who cares about logic?  Who cares that no evidence exists to back these claims up?

before and after maleSo now we come to the real issue.  You wanted to know if there actually might be a method for losing weight “without even trying.”  My answer is YES!  But there is even better news.  I will send you the secret strategy for my quick weight loss “without even trying” plan that I have developed for only $9.95 plus postage and handling.  In six weeks or less, I will give you a money back guarantee that you will lose twenty pounds “without even trying” or I will send you a full refund.  This offer is good for only thirty days after you read this blog and it will then expire.  The following stipulations also apply:

  • You must reside on a lake
  • You must be over 99 years of age
  • You must have been born in Last Chance, New Mexico
  • You must be at least 100 lbs. overweight at the start of this offer
  • You must believe everything you read or hear

Time for Questions:

Do you need to lose weight?  Have you been trying to lose weight?  How successful have your efforts been?  What has worked for you?  What did not work for you?  What would you like to change in your diet?

Life is just beginning.

“I believe that parents need to make nutrition education a priority in their home environment. It’s crucial for good health and longevity to instill in your children sound eating habits from an early age.” — Cat Cora
 

 

 

 

How Can We Set Realistic Exercise Goals as We Age?

time to set goals concept clock
Goal setting is as American as mom, God and apple pie.  Every exercise book, life improvement book and management book has a section on goal setting and accolades for the process.  I too once subscribed to the philosophy that those who did not set goals for their life were losers, losers and losers.  Winners set goals.  When winners reach their goals, they up the bar and set them even higher.  That is the American Way.  Set unreachable goals and if you should meet those goals, then move the bar up, ever up, ever higher.

Well, I am going to tell you that everything in the above paragraph is STUPID advice.  Most of the wisdom around goal setting is simply dumb.  Unfortunately, when it comes to your health, it is not only dumb, it is dangerous.  It was not until 1986 that I met the man who would change my mind and my attitudes towards setting goals.  This man was the renowned quality expert and statistician Dr. W. E. Deming.

demingI had just finished my PhD program in Training and Organization Development and joined the consulting firm of Process Management International.  One of the founders Lou Schultz was a follower and friend of Dr. Deming and I was soon introduced to Dr. Deming and his world.  It was a world based on 14 Principles of Management which defied everything I had been taught in my business classes at the University of Minnesota.  Dr. Deming, upon meeting me, challenged me with the comment that “Everything they taught you in your business classes is wrong.”  I was stunned and somewhat chagrined by his comment.  It struck me as rude and extremely arrogant.  In six months, I learned that Dr. Deming was more than ½ right.  In side of three years, I learned that he was at least 99 percent right.  Do not think I was brain washed.  I have always verified new knowledge by theory and personal experience.  Considering the hypothesis that Deming threw out, I was provided a new theory.  I became religious about testing his ideas and seeing if he was wrong.  Time and time again, Deming proved correct.

Deming’s 14 Points for Management are as follows:

  1. Create constancy of purpose for improving products and services.
  2. Adopt the new philosophy.
  3. Cease dependence on inspection to achieve quality.
  4. End the practice of awarding business on price alone; instead, minimize total cost by working with a single supplier.
  5. Improve constantly and forever every process for planning, production and service.
  6. Institute training on the job.
  7. Adopt and institute leadership.
  8. Drive out fear.
  9. Break down barriers between staff areas.
  10. Eliminate slogans, exhortations and targets for the workforce.
  11. Eliminate numerical quotas for the workforce and numerical goals for management.
  12. Remove barriers that rob people of pride of workmanship, and eliminate the annual rating or merit system.
  13. Institute a vigorous program of education and self-improvement for everyone.
  14. Put everybody in the company to work accomplishing the transformation.

Note number eleven above, where he says to eliminate quotas and numerical goals.  How can he advocate this when every single expert in the world says to do the opposite?  Setting goals and establish quotas and targets is the refrain most often heard in business.   Dr. Deming says that following the traditional rules on goal setting is counterproductive.

“Management by numerical goal is an attempt to manage without knowledge of what to do, and in fact is usually management by fear.”  — W. E. Deming

Problems with Goal Setting:

exercising

There are several problems with goal setting which I would like to discuss.  You need to understand these problems to understand why goal setting my hurt your health.  If you have some knowledge of the statistical concepts that Dr. Deming puts forth so much the better.  However, I will try to explain Deming’s opposition to goal setting for the reader that has no statistical background.  The four major problems are:

  1. Where did your goals come from and how realistic are they?
  2. Is your system/body capable?
  3. What is your apex?
  4. Are your goals sustainable?

I will try to explain how each of these four problems impacts the goal setting process.  I hope you will have a better idea of the pros and cons of goal setting after reading this blog.

  1. Where did your goals come from and how realistic are they?

Dr. Deming always said that if you do not know what a process is capable of (measured by standard deviation and CPK) than any attempt to set a goal would be foolish.  Under these conditions, it would just constitute wishful thinking.  For instance, organizations will often set sales goals by simply decrying that they want a 10 percent increase in sales over the previous year.  The first question I would have is why 10 percent?  Why not 1,000 percent?  Ridiculous you might say to a 1,000 percent increase but it is no more ridiculous than 10 percent if I do not have a system that can handle or produce that kind of an increase.  Any goal is ridiculous if you do not have a system and a process capable of achieving that goal.  Unfortunately, too many goals are simply pulled out of thin air and have no roots in reality.

  1. Is your system/body capable?

set huge goalsLet me illustrate the problem addressed by this question with an example from my own life.  Several years ago, I had just turned sixty years of age and I thought it would be cool to be able to do twenty pullups.  I could usually do about ten or so and so I thought it would be a snap to increase my routine and get to the goal of twenty.  At first, I simply increased the number of pull-ups I did each week but this did not work very well as I soon plateaued.  I then decided to find some “established” routines.  These established routines generally involved doing at least three sets three times per week and having the number of repetitions in each set increasing each week.  The formula upon which these increases were based was never disclosed.

recon ron

I tried several different routines including the Marine program, a program called Recon Ron and several online programs that outlined a systematic way to reach twenty pull-ups.  In each case, I followed the program but after six or so weeks, I would reach a point at which I could not advance to the next level.  Sometimes the number of reps required for the next level was down right ridiculous.  For instance, one day my total repetitions might be five sets of 10- 13 pull-ups each set.  The next day, they would have five sets of between 13-16 pull-ups.  The jump between 13 and 16 was like trying to jump across a mile-wide chasm.  No way could I make the transition.

myth of sisyphusIn hopes of salvaging the program, I would often drop back to the previous level and try to continue my progress.  However, every time I started to progress again, I would reach a point where my body could not obtain the increases dictated by the regime I had selected.  I once reached as high as sixteen pull-ups before I crashed.  The crashes would usually take the form of having an acute muscle pain or sometimes getting sick and not feeling like I had the energy to continue.  Laying off for two weeks or so to recover, I would find that when I tried to start the program again, I had now dropped down to a much lower level than I had previously attained.  It was like starting all over again.  Over the years, trying to reach my twenty pull up goal, I have felt like Sisyphus pushing the rock up the hill and nearly reaching the top only to have the rock roll all the way down again.

exercise-stress_640-480

I am now of the belief that first, at my age, I may not have the system or body capability to achieve twenty pull-ups and second, (more importantly) that I am not doing my body any good by trying to push it to some arbitrary goal.  What is magic about twenty pull-ups?  Am I going to be any healthier or fitter?  Furthermore, trying to achieve some arbitrary goal, I could end up doing real damage to my shoulders or back.

  1. What is your apex?

hippo to unicorn

An apex is the top or highest part of anything.  Most athletes reach their physical peak at about twenty-nine years of age.  This is true for many but not all sports.  I did my best 10K run of 38:48 when I was thirty years old.  Since then, my running times have become slower and slower.  Some athletes, particularly swimmers may maintain their peaks for many years past their apex.  This is not the general rule.  It is more likely that whatever sport you excel in your apex performance will deteriorate with age.

The importance of one’s apex performance lies in the recognition that it will be impossible to maintain this performance over time.  Moreover, it is foolish and unproductive to try to use such prior performance measures as goals for one’s fitness.  The outcome will likely be pulled muscles or worse.  What makes more sense is to set “maintenance goals” that are well within your reach and work towards or with them.

A maintenance goal is much different than a stretch goal.  Most books on physical fitness emphasize stretch goals.  This concept of stretch goals represents a state wherein you are constantly setting lofty goals and moving them forward as you accomplish them.  This is very dangerous and frustrating.  The first problem with the stretch goal strategy is that they are arbitrary and have no empirical relationship to how fit you are or want to be.  The second is the danger of hurting yourself as you constantly try to increase the number, weight or time involved with each goal.

In a maintenance goal, you decide first on the level of fitness that you think makes sense.  For instance, do I want to be able to bench press 150 lbs. or do I want to be able to bench press 50 lbs. three or more times?  If I am working to become a champion weight lifter than lifting large weights is a must.  If I am working to have good muscle tone, flexibility and a relative level of arm strength necessary for normal every day lifting, then being able to life 25 lbs. ten or twenty times will make much more sense than being able to bench press 300 lbs. once.  Furthermore, with maintenance goals, I am much less likely to injure myself by tearing or pulling a muscle.

Perhaps you have never had an apex performance in any sport.  This is not important.   An apex performance simply gives you a relative benchmark based on your best ability at a certain age.  If you have never worked out a day in your life, then simply start with what I call a 1-1-1 program.  I developed this concept when I was being discharged from the Air Force after serving four years.  I had to go in for a discharge physical with 12 other men.  After the physical, the doctor called us all together and told us we were all overweight and fat.  I was so embarrassed, I determined to start exercising the next day.

The following day after my physical, I had my wife drive the car about a mile down a dirt road and drop me off.  I told her to drive down to the end of the road and wait for me.  I started to jog down the road.  I did not even make it half way down the road before I became sick to my stomach.  I walked the rest of the way to the car and asked my wife to take me home.  Once home, I went to bed and stayed there until the next morning.

I knew right then and there that I had to start off small and work up.  I decided to walk about a block each day.   Do one push up each day and attempt one pull up each day.  Eventually, I shed my excess weight and got back into the best shape I had seen in three years.  I labeled my program, the 1-1-1 program after my three goals or starting points.  I allowed myself to progress naturally and not to adopt any outlandish and wishful stretch goals.  Later, I started competing regularly in running, biking, swimming, canoeing and skiing events.  I continued this competing until I burnt out on the extra load that competing places on one’s body.  As the years went by, I could clearly see I was not going to win any gold medals.  Based on a knowledge of my body and the realization that my goals needed to adapt over time, I set a series of basic maintenance goals which over the past ten years I still try to follow.   My goals are:

  • 4 or 5 runs per week with an average run of 30 minutes for the month. Average 60 percent “days run per month” based on 30 days in the month. 
  • 10 Pullups 3x per week
  • 200 bicep curls with five lb. weights, 3x per week
  • 45 Triceps presses, 3x per week
  • Calf stretch and knee bends, 3x per week, 3 minutes stretches with 1 minute for knee bends
  • Yoga 25 minutes, 3x per week
  • Ab exercises 8 minutes, 3x per week

The above routine is my basic routine which I do each week.  I do not increase my goals.  I do not try to stretch myself.  I measure and monitor my routines each week to accomplish what I consider to be my maintenance goals.  I call them maintenance goals because I am focused on simply maintaining my present state of fitness.  This is a level of fitness that enables me to do the activities I enjoy and not feel exhausted or overly worn out.  I can hike, bike, canoe or do a relative amount of physical labor without my body protesting too much.  Just a few weeks ago, I helped my stepdaughter move into her new home.  Her boyfriend and I rented a U-Haul truck and did all the furniture moving ourselves.  I had no unusual aches or pains the next day.

Some experts would say that I am going to decline in fitness since my body will acclimate to these goals and then my level of fitness will deteriorate.  My reply would be to have them wait until they are 70 years old and see if they still believe this.  The truth of the matter is, I occasionally must adjust my goals downward some months.  If I have been sick, been traveling or had company and not able to exercise, I may not be able to make my maintenance goals.  I will set my sights lower for a while and then work towards getting back to my maintenance level of activity.

  1. Are your goals sustainable?

fitness goalsThe fourth question you will want to address concerns the sustainability of your goals.  I raise this question since the Second Law of Thermodynamics says that all systems will deteriorate unless energy is put into them.  Our bodies are simply physical and biological systems interacting with our environment.  Over time the energy that we can put into our systems will inevitably decrease with age.

The effects of this decline will mean that any goals, maintenance or otherwise that you have set for your body will be that much harder to attain.  Just like a clock runs down when the battery gets weak, your body is going to run down as your energy level declines.  This decline will be caused by a combination of age, physical condition, life style, motivation and illness. There is no escaping this.  However, this does not mean that you need to give up.  The goal you need to have for your body is to be in the best physical condition possible given the exigencies facing you each day.  This is going to be different for each of us.  My goals, your best friend’s goals, the goals in some exercise book are not going to be the right goals for you or anyone else.

Conclusions:

Don’t let me tell you what your goals should be.  Don’t let anyone else tell you either.  Decide what your priorities are in life and set your goals or exercise program to match your priorities.  Keep in mind that if good health is your priority, you will need to spend some time in physical activities that promote good health.  How long and how hard your time and activities will need to be will depend on how you feel and how you want to feel.  Start small and remember that progress is not always upwards.

Time for Questions:

Do you exercise?  Do you have a written exercise program?  Do you have goals?  What has been your experience with goals?  Have you ever had any bad experiences with goal setting?  Can you share them in the comments section?  As you age, how have your goals changed?

Life is just beginning.

“An individual will of course have his own goals.  A man may set his heart on a college education.  He may resolve to finish this chapter by morning: I give myself a deadline.  Goals are necessary for you and me, but numerical goals set for other people, without a road map to reach the goal, have effects opposite to the effects sought.” — Dr. W. E. Deming

“A goal such as “improve throughput by 20%” or “reduce lead time from 10 days to 5 days” is incomplete or worse, unachievable or irrelevant, because it doesn’t relate to the process capability. The danger of setting goals without understanding the process capability is twofold.

  1. If the goal was set beyond the process/system’s capability (or expected range of performance), the only way to achieve the goal is to change the process. However, in many cases, the critical variables in the process are outside the control/scope of the people who are tasked with achieving the goal.

For example, you are getting 25 miles per gallon from your car in the last 3 fill-ups. If you don’t know the capability of 20-30 MPG fuel efficiency, it doesn’t matter if your goal is set at 35MPG (because of your desire or economic need). You might try to change driving habits, keep tires properly inflated, use some additives, or perform more routine maintenance. You might even get rid of some stuff in the car or pick a route with less stop and go traffic. What you will find is that despite great effort, your MPGis still below 30. In some rare occasions, you might achieve 35 MPG or greater because it’s mostly downhill. But you know you would give up the gain when coming back uphill.

  1. If the goal was set within the process capability, there is always a finite probability of achieving it without any effort or change in the process. The goal without an associated probability target is pointless.” —- Goals and Process CapabilityFang Zhou

 

Is the War on Drugs Real? — Drugs, Medicine and Pharmaceuticals

pills

Introduction:

Perhaps few subjects are more complex than the relationship between drugs and medicine.  While the word drug often denotes something “illegal”, medicine comes across with very benign connotations.  Drugs are bad for you.  Medicine is good for you.  However, what is the difference between a drug and a medicine?  Do you have to be sick before it is medicine?  Does everyone occasionally need medicine but no one ever needs drugs?  Why are some drugs legal and others illegal?  Why is it that some legal drugs are illegal unless we have a prescription?  In this blog, I will try to provide you some “divergent” views on drugs and medicines and the Pharmaceutical industry.

Pharmaceuticals:

First, we need to define the term pharmaceutical.  We can find the following definition online:

Adjective:  1.  relating to medicinal drugs, or their preparation, use, or sale.

Noun:  1. a compound manufactured for use as a medicinal drug.

It is important to understand the distinction between the medicinal use and the non-medicinal use of drugs.  Obviously, any drug can be used for either purpose.  However, the “moral” authorities which include the government, your neighbors, various religions and others who believe they have a right to dictate human behavior have used this distinction to decide when it is a crime to use drugs and when it is perfectly okay.  Thus, in many states I may now use marijuana but only if it is for a bona fide medicinal purpose.  If I want to simply use it like I use alcohol or caffeine or nicotine for recreational purposes, it is illegal and I will find myself in jail if I get caught.

three colors of pills

This distinction between drugs and medicine is further complicated by the fact that some drugs are simply considered “bad” drugs whether they have a medicinal use or not.  This category of “bad” drugs once included alcohol when (as many of you are aware) the 18th amendment to the US Constitution was passed to ban its legal use.  Prohibition was perhaps one of the most misguided episodes in American history.  However, it does have the unique distinction of being perhaps the only time in our history when a substance was banned strictly on moral terms.  The prohibition against alcohol was primarily based on the idea that drunkenness was a threat to the moral fiber of the nation.   Since then, our “War on Drugs” has been based on several reasons but morality is no longer a major reason.

Let’s get one thing clear from the start.  There is no “War on Drugs” in the USA.  If there were a war on drugs, then bars, cigarette shops, coffee shops, liquor stores, drug stores and doctors’ offices would be raided and closed.  Doctors, baristas, druggists and Pharmaceutical CEO’s would be arrested along with the rest of the drug pushers on the street.  We would need to build an entire prison system to house all the pharmaceutical executives, managers and workers who routinely make and sell drugs.

The “War on Drugs” is a sham, a myth and a hypocrisy of epic proportions.  There are two reasons for this so-called war.  The first is prejudice and the second is monetary.  These two reasons are curiously intertwined.

Docs and Big Pharma

Prejudice as a Factor in the Drug Wars:

Our prisons today are overflowing with people who have used or sold illegal street drugs.  Drugs like heroin, cocaine, marijuana and methamphetamines make up the bulk of illegal drugs sold on the street.  The majority of people selling these drugs are poor.  Minorities make up a disproportionate number of the poor in America.   Consider the following facts:

war on blacks

Poverty rates for blacks and Hispanics greatly exceed the national average. In 2014, 26.2 percent of blacks and 23.6 percent of Hispanics were poor, compared to 10.1 percent of non-Hispanic whites and 12 percent of Asians.National Poverty Center

Of course, if minorities are a large percentage of the poor and if the drug war is really an attack on the poor, then it should follow that minorities will make up a larger percentage of those convicted of drug crimes and sent to prison.  The facts support this:

  • African Americans now constitute nearly 1 million of the total 2.3 million incarcerated population
  • African American and Hispanics comprised 58% of all prisoners in 2008, even though African Americans and Hispanics make up approximately 25% of the US population
  • About 14 million Whites and 2.6 million African Americans report using an illicit drug
  • 5 times as many Whites are using drugs as African Americans, yet African Americans are sent to prison for drug offenses at 10 times the rate of Whites

The facts support that the so-called “War on Drugs” is really a war on the poor.  Why war on the poor?  Because they are regarded as a threat to the lifestyle of the wealthy.  The wealthy in America are of course predominately White.

2_war-on-drugs

“96.1 percent of the 1.2 million households in the top one percent by income were White, a total of about 1,150,000 households. In addition, these families were found to have a median net asset worth of $8.3 million dollars.”  — America’s Financial Divide: The Racial Breakdown of U.S. Wealth in Black and White, Huffington Post, 2015

It is seldom mentioned but wealthy people are fully aware of the fact that healthy non-drug addicted citizens make better workers.  Furthermore, non-drug addicted people who are addicted to hard work are less likely to break into your house in the middle of the night and steal your Gucci purse and your Rolex watch.

On the other hand, if you are poor and uneducated, drugs might seem like a decent way to spend a day rather than knocking on closed doors for a job.  I spent four years in the military from 1964 to 1968.   Any war is an ideal breeding ground for drug use.  Consider the daily effects of stress, confusion, attacks, wounds, death and uncertainty.  The military was rife with drugs when I was in.  Would anyone like to guess how much illegal drug use there was during the Vietnam War?

colors arrested more

“In 1971, a report by the House Select Committee on Crime revealed that from 1966 to 1969, the armed forces had used 225 million tablets of stimulants, mostly Dexedrine (dextroamphetamine), an amphetamine derivative that is nearly twice as strong as the Benzedrine used in the Second World War. The annual consumption of Dexedrine per person was 21.1 pills in the navy, 17.5 in the air force, and 13.8 in the army.”  — The Drugs That Built a Super Soldier, The Atlantic, 2016

 The above article concerns speed only and does not deal with marijuanaMy own personal experience was spending many weekends high on pot mixed with copious amount of whatever liquor we could get our hands on.  Beer would do if liquor was not available.  There were also many who simply sniffed glue and destroyed their brains.  To the best of my knowledge, I knew of no one who was ever busted for drug use on any base I was stationed at.  The moral is that it is okay to use drugs if they help you kill people but not simply to feel good about yourself.

The sanctimonious politicians who make drug laws in this country should be shot.  Am I being too “divergent” in my condemnation of these hypocrites?  Believe me, I could not be too hard on them.  Consider the damage that their greedy misguided policies have done to our nation and our citizens.  Millions of people have languished in jail only to serve their sentence and find that when they come out, they are even worse off than when they went in.

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Consider the effects of a felony record for drugs in America:  A convicted felon in Connecticut faces the following array of restrictions and constraints:

  1. Loses the right to become an elector and cannot vote, hold public office, or run for office, although he can have these rights restored
  2. Is disqualified from jury service for seven years, or while he is a defendant in a pending felony case (CGS § 51-217)
  3. Loses the ability to have firearms
  4. Could lose a professional license or permit,
  5. Employers can ask job applicants whether they have been convicted of a crime although federal anti-discrimination laws place some restrictions on the use of criminal histories.
  6. The State Board of Education (SBE) cannot issue or renew, and must revoke, a certificate, authorization, or permit to someone convicted of certain crimes. The SBE can also take one of these actions if the person is convicted of a crime of moral turpitude or of such a nature that the board feels that allowing the holder to have the credential would impair the credential’s standing.
  7. The Department of Children and Families must deny a license or approval for a foster family or prospective adoptive family if any member of the family’s household was convicted of a crime that falls within certain categories, which can include felonies.
  8. Landlords can evict a tenant who was convicted of a violation of federal, state, or local law that is detrimental to the health, safety, and welfare of other residents. Federal and state law for public housing allows eviction based on conviction of certain felonies. Different rules apply to elderly people.
  9. Someone convicted under federal or state law of a crime involving possession or sale of a controlled substance is not eligible for federal assistance for higher education expenses for certain periods.
  10. State law bars anyone convicted of a drug possession or use felony under federal or state law from receiving benefits under the temporary assistance for needy families or food stamp programs unless the person (1) has completed his court imposed sentence, (2) is satisfactorily serving probation, or (3) completed or will complete a court imposed mandatory substance abuse treatment or testing program (CGS § 17b-112d).

You have served your sentence for possession of a marijuana joint.  You might have served between one and five years.  You are now ready to return to society and be a hard-working honest citizen.  Regard the above list!  No one will hire you. You cannot get a student loan.  You cannot get certain licenses and even some landlords will be legally able to not rent you a place to live.  What would you do?  What would Jesus do?  Well, unfortunately, many of these people are not you and they are not Jesus.  Thus, a life of crime on the street seems to offer more preferences for some than begging for money with a cup.  Besides, every business endeavor has certain risks and the gains from drug dealing may seem to far outweigh the risks, particularly when you consider the alternatives.

drug-war-cartoon

What Role Does Greed Play in the So-Called War on Drugs?

Pharmaceutical companies are huge and make huge profits.  They are consistently listed among the top most profitable companies in America.  Here are the top ten most profitable drug companies by market value:

  • Johnson & Johnson: $276 billion (market value)
  • Novartis: $273 billion
  • Roche: $248 billion
  • Pfizer: $212 billion
  • Merck: $164 billion
  • Sanofi: $134 billion
  • Bayer: $123 billion
  • Novo-Nordisk: $118 billion
  • Bristol-Myers Squibb: $115 billion
  • AbbVie: $110 billion

In 2016, the Pharmaceutical Industry was at the top of the list for most profitable industries.  Forbes, citing data from Factset, recently released its list of the 10 most profitable industries of 2016. “Pharma: Generic” led the way as the most profitable industry with a 30 percent net profit margin”

  1. Pharma: Generic: 30%
  2. Investment managers: 29.1 percent
  3. Tobacco: 27.2 percent
  4. Pharma: major: 25.5 percent
  5. Internet Software and Services: 25 percent
  6. Biotechnology: 24.6 percent
  7. Savings Banks: 24 percent
  8. IT Services: 23 percent
  9. Regional Banks: 23 percent
  10. Major Banks: 22.9 percent

https://www.surepayroll.com/resources/blog/the-10-most-profitable-industries#sthash.rVW6a7fs.dpuf

big-pharma-mafia

Please note where the tobacco industry is on this list.  Now ask yourself this question.  Do you think either big Pharma or Big Tobacco wants competition in the form of legalized drugs?  I hope you answered NO! to this question because there is ample evidence that both industries spend a great deal of money lobbying against drugs that would pose competition to their industries.

“Both pharmaceutical companies and alcohol brands are spending money to keep prohibition around, too.  As we reported last year, certain anti-cannabis academics are funded by big pharma.  Alcohol companies are also lobbying against legalization.  In one example, the California Beer & Beverage Distributors made campaign contributions to a committee dedicated to preventing marijuana legalization and taxation. 

 To summarize, police unions, prison guard unions, for-profit prisons, and drug and alcohol companies spend huge sums of money each year to keep cannabis illegal, and why?  Because it ensures job security and profits.”  — The Top 5 Industries Lobbying Against Cannabis Legalization Will Infuriate You by Sara Lilley in Leafly

Perhaps you are inclined to think that the prejudice and greed fueling the drug industry is not that bad.  Perhaps you do not mind that America has one of the highest rates of incarceration of any developed country.  Perhaps you do not mind that millions of your citizens are in jail for smoking or selling a joint.  Perhaps you are happy smoking and drinking and do not want any other drugs.  Maybe you feel that “Big Pharma” is on your side and helps you with all the new medicines they have coming down the pipeline.  If so, you are living in a fools’ paradise.  Big Pharma is more likely to steal from you and or kill you than the drug pusher on your street corner.  In fact, they do so every single day.

ethical-criteria-for-medicinal-drug-promotion-schedule-g-17-638

They steal from you with exorbitant profits.  Who do you think pays for all their advertising and research?  They actually spend more money on advertising than they do on research.

“Prescription drug companies aren’t putting a lot of resources toward new, groundbreaking medication, according to a recent report in BMJ, a medical journal based in London. Instead, it’s more profitable for them to simply to create a bunch of products that are only slightly different from drugs already on the market, the reports authors said.  The authors go on to say that for every dollar pharmaceutical companies spend on “basic research,” $19 goes toward promotion and marketing.” — Pharmaceutical Companies Spent 19 Times More On Self-Promotion Than Basic Research: by Alexander Eichler

Big Pharma also leads all industries in spending your money on lobbying.  From 1998 to 2016, they spent over 3.5 billion dollars on lobbying.  This was more than a billion dollars higher than for the next highest industry which was insurance.  — Top Industries.

ee545df3eb331cc722ed7088791e9a5eAre you still wondering why drug costs are so high? Did you really think it was all research and development costs?  The three major factors are:  Profits, lobbying and Marketing.  How much do you think these all add to the costs of your prescription drugs?

Well, perhaps you still do not care.  After all, if the drugs do their job, what do you care if they cost a lot.  Perhaps your insurance pays it all anyway.  Well friend, what if you knew some of these drugs were going to kill you?  Do you think I am exaggerating?

Here are some examples of potentially lethal side effects:

“Baycol, which lowers cholesterol, was strongly linked to a potentially fatal breakdown of muscle tissue.  Approved in 1997, it was voluntarily withdrawn four years later.  The anti-inflammatory drug Duract spent just one year on the market. Approved as a strictly short-term use product, the FDA found serious liver problems with people taking the drug for longer than what was recommended.

In 1985, employees of two drug companies were fined and/or sentenced to community service for not reporting adverse events involving the blood pressure drug Selacryn and arthritis drug Oraflex.” — Drug Side Effects Explained

Of course, drug companies do not want to kill you because that could result in costly litigation and even worse, bad publicity.  Thus, most drugs come with a lengthy disclaimer and long list of potential side effects.  These are more designed to protect the drug company than you or your health.  You will probably not be able to read the small print on the label and even if you are able, you will probably not have a clue what they are talking about.  On the odd chance that you do know what it all means, it would not matter anyway, since what is your recourse?  If you are in pain and have gone through the process of obtaining your prescription how likely are you to decide that you will not take the risks associated with the drug?  But, and here is the important “but”, all drugs, even over the counter drugs have potential side effects.

viagra

And this brings us to another major factor affecting the cost of drugs.  This is the cost for Big Pharma to cover its butt when caught doing something wrong.  A report by Pubic Citizen noted the following information:

In December 2010, Public Citizen published a report that, for the first time, documented all major financial settlements and court judgments between pharmaceutical manufacturers and the federal and state governments since 1991.  At the time of the report’s publication, almost $20 billion had been paid out by the pharmaceutical industry to settle allegations of numerous violations, including illegal, off-label marketing and the deliberate overcharging of taxpayer-funded health programs, such as Medicare and Medicaid.  Three-fourths of the settlements and accompanying financial penalties had occurred in just the five-year period prior to 2010.  At the time of the report’s publication, there was no indication that this upward trend was subsiding.

adhdThere are many other egregious practices that go on in Big Pharma and which are beyond the scope of this blog.  My point in writing this was first to help alert you to the hypocrisy of the so-called drug wars and second to bring to your attention the inordinate amount of effort and money that Big Pharma spends in trying to get you to buy their drugs.  If you watch TV or read any mainstream magazines, you cannot help but become inundated with ads for drugs to cure any problem you can think of.

larrythecableguyprilosecThe drug companies are the biggest pushers of drugs in the world today and all for a profit.  The fact that these drugs may help your condition is very secondary to Big Pharma’s primary goal which is profits.  The fact that many drugs should not be taken long-term and may have life threatening side effects is also not particularly important to the drug industry.  Between the ignorance of many medical doctors anxious to provide a fast treatment and the greed of the drug industry, you had best become a very informed and cautious consumer of any drugs you are going to take.  You should also be skeptical of any information provided by the drug industry.

Time for Questions:

What medications do you take?  Why?  What has been your history with drugs?  How informative has the drug information you have received been?  What do you think about all the drug advertising on TV and in magazines?  Do you think we live in an addicted society? Do you think the Drug War is real?

Life is just beginning.

 “People use drugs, legal and illegal, because their lives are intolerably painful or dull. They hate their work and find no rest in their leisure. They are estranged from their families and their neighbors. It should tell us something that in healthy societies drug use is celebrative, convivial, and occasional, whereas among us it is lonely, shameful, and addictive. We need drugs, apparently, because we have lost each other.”  ― Wendell BerryThe Art of the Commonplace: The Agrarian Essays

 

 

 

 

 

How much Pain is Caused by Aging Versus Laziness and Ignorance?

lazy_workout

Have you ever head the saying “no pain, no gain?”  This is one of the most idiotic pieces of advice ever given.  Pain is a signal that our body wants us to stop something or that it needs help.  I have little doubt that many people have been severely damaged by this so-called piece of wisdom.  However, taken to the other extreme, we see people who are so afraid of hard work and exercise that they have become couch potatoes.  I believe that many Americans have veered so far off the trail of pain that they have gone to the other extreme.  Look around you and what do you see?  Fat people everywhere you look.  We have an epidemic of obesity in America.  Regard the following facts: (From the Center for Disease Control)

  • The prevalence of obesity was 36.5% (crude estimate) among U.S. adults during 2011–2014.
  • The prevalence of obesity among U.S. youth was 17.0% in 2011–2014.
  • From 1999 through 2014, obesity prevalence increased among adults and youth.

The above data pertain to the frequency of obesity in the USA.  Keep in mind that there are many more people who are overweight than there are who are obese.  Obesity is defined as: “Excess amount of body fat with a BMI of over 30.”  Overweight is defined as: “Having more body weight than is considered normal or healthy for one’s age or build.”  If we were to include the amount of people who were both overweight as well as obese, the figures for “fat” people in the USA would skyrocket.

Several years ago, I attended a World Future Conference.  The former founder and CEO of Medtronic was one of the keynote speakers. His talk was on the topic of rising health care costs.  Many people focus on only one or two causes for the escalation of health care costs.  However, Earl Bakken presented a pie chart which showed several reasons for the rise.  These included:

  • Increased cost of technology
  • People living longer
  • Increased percentage of older people in the population
  • Litigation
  • Inflation
  • Lifestyle choices

obesity-is-preventable_52fc767facaae_w1500

Earl noted that all of these issues have had an impact on health costs.  You will notice that the last issue in his list included “lifestyle choices.”  This category includes such problems as diet, smoking, obesity, drugs, alcoholism, lack of exercise and poor health choices.  Contrary to what many people think, this issue was not the major cause of health care cost increases.  Nevertheless, the category is one of the factors linked to the increase in health care costs.

Looking only at obesity as a contributor to health care costs, we note the following facts: (From the Health Care Costs of Obesity)

  • Obesity is one of the biggest drivers of preventable chronic diseases and healthcare costs in the United States. Currently, estimates for these costs range from $147 billion to nearly $210 billion per year. In addition, obesity is associated with job absenteeism, costing approximately $4.3 billion annually and with lower productivity while at work, costing employers $506 per obese worker per year.  As a person’s, BMI increases, so do the number of sick days, medical claims and healthcare costs.
  •  Obese adults spend 42 percent more on direct healthcare costs than adults who are a healthy weight.
  •  Per capita healthcare costs for severely or morbidly obese adults (BMI >40) are 81 percent higher than for healthy weight adults. In 2000, around $11 billion was spent on medical expenditures for morbidly obese U.S. adults.
  •  Moderately obese (BMI between 30 and 35) individuals are more than twice as likely as healthy weight individuals to be prescribed prescription pharmaceuticals to manage medical conditions.
  •  Costs for patients presenting at emergency rooms with chest pains are 41 percent higher for severely obese patients, 28 percent higher for obese patients and 22 percent higher for overweight patients than for healthy- weight patients.

 People who are obese, compared to those with a normal or healthy weight, are at an increased risk for many serious diseases and health conditions, including the following: (From the Center for Disease Control and Prevention)

  • All-causes of death (mortality)
  • High blood pressure (Hypertension)
  • High LDL cholesterol, low HDL cholesterol, or high levels of triglycerides (Dyslipidemia)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Gallbladder disease
  • Osteoarthritis (a breakdown of cartilage and bone within a joint)
  • Sleep apnea and breathing problems
  • Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
  • Low quality of life
  • Mental illness such as clinical depression, anxiety, and other mental disorders
  • Body pain and difficulty with physical functioning

Please notice that the CDC list does not explicitly include hip, knee and back problems.  Of course, many people who are not overweight suffer from these problems, but there is considerable evidence that obesity contributes to these problems.  People who are obese often lack muscle tissue and ligament flexibility which help support their knees, backs and hips.  The less exercise they get, the more the problem is exacerbated.  They may go to doctors and chiropractors to get help but the underlying cause of obesity is seldom treated.  Finally, surgery is performed when exercise, diet and physical therapy could be more effective treatments.  So why do so many people get surgery or pills when there are cheaper and more effective treatments with less side effects?

Let’s go back to what I said in the title of this blog.  Laziness and Ignorance.

too lazy to exercise

Laziness and Ignorance:

Every year, it is a well-known fact at health clubs across the country that right after New Year’s Day, the membership will increase dramatically and the parking lot will fill up with new members. This phenomenon will last about 15 weeks after which the new members will slowly drop off and the parking lot will go back to normal.  Why do you think this happens?  I will give you two reasons:

First:  The assumption that they will get instant results.  Too many people read the magazines at the grocery store promising “Six Weeks to Abs of Steel” or “Lose 40 lbs. in Eight Weeks.”  I would argue that if you can lose 1 lb. in a month, you are doing a great job.  As for the abs of steel, first you will need to lose a large amount of body fat and second, it may take you a year of hard dedicated disciplined ab exercises.  As someone who does regular ab exercises, they hurt.  They are no fun.

20170406_155206There is a difference between pain and hurt.  When I tried to continue my ab exercises after my prostate surgery and then after my hernia surgery, I experienced pain.  I wanted to get back into shape too quickly both times.  I stopped the exercises and worked on other routines that did not cause pain.  Mind you, the ab exercises still hurt and I have been doing them for six years.  I am making a big distinction here between pain and hurt. Perhaps, I should say they “burn.”  Burn is the athletic euphemism for hurt.  Most people don’t like hurt.  However, if you expect that you can get in shape without some discomfort, you are destined for life as a couch potato or in a surgery ward.

Second:  People are ignorant when it comes to exercise.  How many Americans do you think have ever read a book on exercise?  Unless, you are willing to become a student of exercise or trust in an athletic trainer, the knowledge that most people have regarding exercise is insufficient for them to attain the results they seek.  Sadly, most medical practitioners are just as ignorant when it comes to the role of exercise and diet in a healthy lifestyle.

How many exercise books do you think make Amazon’s “best seller” list.  To determine this, I went to Amazon and pulled up their top 100 best sellers.   In the entire list, there was not one book on exercise protocols.  There were two books on dieting at number 41 and number 42 in the top 100 list.  You could find several books on menus and cooking.  It is much easier in the USA to eat, then it is too exercise.

kaelinAmericans are enamored with diets and each new diet best seller promises fantastic results in a short amount of time.  The Amazon number 1 best seller in the health and exercise category was a book titled “Big Fat Lies.”  The author promises you the “truths” that helped her to lose 65 lbs. “without giving up pizza or ice cream.”  The author is Kaelin Tuell Poulin and the book has a very high rating in the customer reviews section.  Ninety-eight percent of the 235 reviewers gave it a 5-star rating.  However, while I often put a great deal of store in ratings, you must be careful about inflated ratings.  The one negative rater had this to say about the book: (typos in the review were not changed)

“Dont be fooled into purchasing a book that was reviewed by 200 hundred women who never read the book (her followees) I have read the book it is subpar at best and not worth the money. My origional review included picture evidence of her asking for reviews but it was removed because it included her identity i suppose. I hope this one stays up so no one else is fooled into buying this. I give this book 1 star only to post. She is a salesperson and she is a great one at that! but if one person reads this and doesnt feed into the hype it was worth the time and effort to type it.”

I would not call the above review a particularly good piece of criticism.  However, the author does alert us to the possibility that the book suffers from a sort of follower worship.  Nevertheless, I would risk the small cost of the book if I were looking for a diet program.  Consider the following review from one of Kaelin’s “ladyBoss” more ardent followers:

“This program has TWO things that every other weight loss program out there is missing.  For ONE Kaelin was heavy once she was 185 pounds herself but with hard work and dedication lost the weight and has kept it off for 5 years.”

This is a great testimonial.  I am not sure if “every other weight program is missing” these two factors, but I am sure that dedication and hard work were necessary for Kaelin to keep the weight off for five years.  One problem with many exercise and diet programs is that the participant is naive and believes that once they lose the weight, their hard work is over.  They may also lack the discipline to continue the work once a certain goal is achieved.  Lack of discipline?  Laziness?  Ignorance? This is a volatile mix.  They seem to go together like salt and pepper.

WWS-Obesity

There is one final factor that we must discuss and that studies have shown have a direct bearing on obesity and poor health.  This is the factor of poverty.  Many studies have shown a direct relationship between income and obesity and between income and exercise.  Poor people get less exercise and generally have poorer nutrition.  There are several explanations for this.  We can posit some possible cause and effect relationships:

  1. Lack of education leads to obesity
  2. Poverty leads to high fat diet and poor nutrition
  3. Lack of education leads to poverty
  4. Poverty leads to low exercise priorities

You might notice that there is a kind of circularity to the above relationships.  Perhaps, if they are circular it does not matter which is cause and which is effect since the result is the same.  The outcomes for poor people are poor nutrition, lack of exercise and obesity.

There are some who dispute the above correlations.  The claim is made that the relationship between poverty and obesity is not linear but varies by age, gender and ethnicity.  It has also been pointed out that rich countries throughout the world have a higher incidence of obesity than poor countries.

“While all segments of the U.S. population are affected by obesity, one of the common myths that exists is that all or virtually all low-income people are far more likely to be obese. In this generalization, two facts commonly are overlooked(1) the relationship between income and weight can vary by gender, race-ethnicity, or age and (2) disparities by income have been weakening with time, particularly for adults.” — Relationship Between Poverty and Obesity, Food Research and Action Center

However, if we look at obesity from an aggregate point of view and disregard the effects of ethnicity, age and gender, we find the following evidence to show a linkage between poverty and obesity:

“Poverty rates and obesity were reviewed across 3,139 counties in the U.S.  In contrast to international trends, people in America who live in the most poverty-dense counties are those most prone to obesity.  Counties with poverty rates of >35% have obesity rates 145% greater than wealthy counties.”Poverty and Obesity by James Levine (2011)

Furthermore, even the Food Research and Action Center admits to the problem that obesity poses for America and state on their site that:

“While all segments of the U.S. population can be affected by poor dietary intake and obesity, low-income and food insecure people are especially vulnerable due to the additional risk factors associated with inadequate resources and under-resourced communities.” 

Note the above statement that “poor people” are especially vulnerable.  Let me tell you the following story that illustrates some of my admittedly selective experience with this issue of poverty and obesity.

One day, Karen and I went to Scottsdale Arizona to visit and do some shopping.  We went to several art galleries and jewelry stores.  When it was time for lunch, we found an authentic looking Mexican restaurant and decided to eat outside.  We were right in the heart of Scottsdale and many people kept walking by our table.  It was fun people watching, but something kept nagging at my mind.  I was not sure why, but there was a difference between the average people I was used to seeing and the people I saw in Scottsdale.

Suddenly, I realized what was bothering me.  In the hour or so that we were eating, we did not see one obese or even moderately overweight person walk by.  All the people that passed by us were healthy and athletic looking.  This was my first realization of the connection between wealth and obesity.  I don’t know about the rest of the world but ever since then, I have observed that most overweight people I see in America are either poor or middle class.  In my opinion, rich people have much lower incidences of obesity in this country.

Aging and Pain:

You will notice that I have not attributed pain to aging.  This is not an oversight.  Neither is it denial.  You can have pain when you are young and you can have pain when you are old.  In either case, there is no way you should just accept the pain.  Unfortunately, what medical practitioners often diagnose and treat with young people, they are willing to accept with old people.  Let me give you another personal example.

20170406_155432Two years ago, I started developing a pain in my right shoulder. I was not sure where it came from but after several months of it getting worse, I went to see an orthopedic doctor.  He asked what if anything I might be doing to aggravate the shoulder.  I mentioned that I swim frequently and am aggressive with my laps.  His simple answer was “Well then, stop swimming.”  I decided to follow his advice and for the next year, I stopped swimming.  However, my shoulder pain did not get any better.

A year later, I went to see another orthopedic doctor and he could not find anything wrong with my shoulder.  He did no MRIs or X-ray’s.  I suggested he give me an injection of cortisone, which he did.  I had moderate pain relief for about six weeks and then the pain resumed and continued to get worse.  At this point, I decided to do some of my own research into shoulder pain.  This research was very productive.

I found some very good descriptions of the exact type of pain I was incurring and a few different suggestions on how I could treat the pain without pills or surgery.  The best and most positive ideas I found came from a Doctor John M. Kirsch in Wisconsin.  Dr. Kirsch put his ideas and supporting evidence for his theory of what causes some types of shoulder pain into a small book titled “Shoulder Pain:  The Solution and Prevention.”  I have since been following his treatment regimen with good results.  My shoulder pain has been decreasing and the range of motion in my right shoulder is improving.

I mentioned earlier that I am 70 years old.  I think that there is too often the attitude among people my age and the doctors they see that “pain with aging is inevitable.”  If it is inevitable, then we should just “suck it up” and live with it.  Sometimes, this might be true.  However, the assumption that aging and pain need to go together is a prescription that does not serve any of the elderly very well.  I have talked to many older people and I often find the same set of attitudes either on their part or their doctors.  It is basically “Well, getting old is a bitch and you just have to live with pain.”

No, you do not have to live with pain!   

I have been running 4 or 5 times a week for over 40 years now.  During this time, I have had shin sprints, knee pain, hip pain, big toe pain, back pain, Morton’s neuroma, plantar fasciitis, sesamoiditis, corns, calluses and blisters.  Each time the pain came, I have gone through the following sequence of activities:

  1. Awareness of discomfort
  2. Try to ignore it
  3. Discomfort moves into the pain stage
  4. Take over-the-counter meds
  5. Go to see a doctor
  6. Pain improved by prescription pills or shots
  7. Pain returned in a short while
  8. Do research on other remedies
  9. Trial and error with other remedies
  10. Voila, eventually find the right remedy (no surgery and no prescription drugs)
  11. Pain goes away and does not return
  12. Sometimes, continuous exercise such as leg stretches and yoga are necessary to keep conditions from returning or getting worse. g., must do calf stretches 3x per week to stop plantar fasciitis from returning.  

20170406_155233Some people are not so lucky.  However, I hesitate to call all of my good health “Luck.”  There is a saying by Thomas Jefferson that “The harder I work the luckier I get.”  I have worked hard to stay in shape.  I exercise regularly.  I watch what I eat.  I try to avoid excesses.  No doubt, I have had some luck that goes beyond hard work and discipline.  Nevertheless, I believe that hard work and discipline has played a large role in my ability to be healthy and still active at my age.

I wish I had a dollar for everyone that has come up to me and said “I wish I could run but I have bad knees.”   Many people do have bad knees.  But many people do not see a connection between their “bad” knees and their obesity.  Their cycle is more like this:

  1. Overeat
  2. Gain weight
  3. Do no exercise
  4. Get pain someplace
  5. Do less exercise
  6. Get more pain
  7. Go to doctor
  8. Get knee or hip or some other surgery
  9. Continue being overweight and doing little or no exercise
  10. Take pills

4 weeks to a healthier

The only way the above activities relate to aging is that it takes some time to destroy your body through lack of exercise and poor diet.  I guarantee you though, it will happen eventually depending on how much you abuse your body.  It may happen when you are young or it may happen when you are old.  The longer you wait to do something about it, the more difficult it will be to repair the damage you have done.  It seems like my body takes more time to repair itself the older I get.

Finally, you do not have to be rich to have good health.  Money will not bring you good health if you abuse your body, overeat, drink too much, smoke too much and avoid exercise.  You can pay all the doctors in the world and you will still have bad health if you follow the 10 steps listed above.

Time for Questions:

Do you exercise regularly?  Why or why not?  Do you have a program to help keep track of your weight?  Why or why not?  Do you have a weight problem?  What do you do about it?  How effective have your efforts been?  What do you think would help them be more effective?

Life is just beginning.

“My mother was a P.E. teacher, and she was kind of a fanatic about fitness and nutrition growing up, so it was ingrained in me at a young age.  As I get older, I’m finding out it’s not about getting all buffed up and looking good.  It’s more about staying healthy and flexible.” — Josh Duhamel
 

 

 

 

 

 

 

 

 

 

 

 

Is Chiropractic an Art or a Science? 

When I grew up on the East Coast, I had little or no contact with chiropractors.  Back then, most people I knew and most medical centers did not regard them as real medical practitioners.  Years later, after I came out to the Mid-West, I found a much wider acceptance of chiropractors.  Over the past 40 years of living in Minnesota and Wisconsin, I have known many people who have gone to chiropractors and who firmly believe that they were being helped.  Most of the people I have known were suffering from back problems.  Here is one comment regarding chiropractors from an obviously very satisfied patient:

“I go to a chiropractor irregularly, usually when my neck is bothering me.  He uses heat, ultrasound, and massage therapy to undo the tension in my back and neck, caused by two vertebrae in my back that have been out of alignment since I was 16.  I go away, and am usually good for another 6 months.

I’ve never had a chiropractor offer to cure anything, from gallstones to depression by cracking my back; I’ve never had one suggest I needed to try any homeopathic remedies; I’ve never had one claim my bipolar disorder was all due to a misaligned spine. When I did have gall bladder trouble, my then chiropractor told me to see my primary care doctor post-haste.”

reno-chiropractor-940x627

If chiropractic medicine has any single claim to fame it is in dealing with back and skeletal muscle problems.  Chiropractors are famous for treating such problems with spinal manipulation and “adjustments.”  Often the diagnosis given to the patient will include the claim that the patient has a “pinched” nerve or some type of “subluxation”.  The patient spends an hour or so with the doctor getting an adjustment to treat the problem.  Many patients will then leave feeling much better then when they arrived.  They will also be out between 65 to 200 dollars per visit.  In most states, Chiropractic medicine is recognized and eligible for insurance reimbursement.

“Medicare does cover medically necessary chiropractic services.  According to the CMS,  Medicare Part B now covers 80% of the cost for ‘manipulation of the spine if medically necessary to correct a subluxation.’  There is no cap on the number of medically necessary visits to a chiropractor.”  — Does Medicare Cover Acupuncture or Chiropractic?, Senior 65

OK, so far, we have happy patients, insurance reimbursement in most states and Medicare coverage for chiropractic service, so what is my problem with chiropractors?  What if it is an art, what’s wrong with that?  Well, an art is something that as opposed to a science does not have objective reproducibility.  There is little or no evidence for cause and effect in an artistic relationship.  From an art, we would expect a much wider variation of results then we would get from something that has demonstrated scientific reproducibility.

“Chiropractic theory and practice are not based on the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community.

 Most chiropractors believe that spinal problems, which they call “subluxations,” cause ill health and that fixing them by “adjusting” the spine will promote and restore health. The extent of this belief varies from chiropractor to chiropractor. Some believe that subluxations are the primary cause of ill health; others consider them an underlying cause.” —- Twenty Things Most Chiropractors Won’t Tell You  by Dr. Preston H. Long

Another way of looking at the difference between and an art and a science lies in the ability to assign risk factors.  With a science, we should be able to assign a probably of risk in terms of outcomes.  With an art, we cannot reliably assign risk factors since they have no bearing in empirical outcomes.  What difference does this make to a potential chiropractic patient?  It should make a great difference since their chances of getting an accurate diagnosis for many potential problems is much less with chiropractic medicine than with traditional medicine.  Here are two comments from people who have gone to chiropractors.  These comments are from the http://www.spine-health.com forum and website.  The subject was: “Does chiropractic treatment help with pinched nerves:”

“Chiropractic “medicine” deals with the musculoskeletal system. However, many chiropractic offices use TENS therapy, which stimulates the nerves. Most of my back problems come from nerve issues and I have personally never found relief from chiropractic, in fact, it made me worse. But this is only my personal experience. My portable TENS unit helps me; I would ask the doctor who is managing your condition if TENS therapy may be right for you. Good luck!”

“In my case, I made the biggest mistake in my life, I was complaining about little pain in my knee but my chiropractor damaged my upper back T5 and T6 which I’m suffering now with a lot of symptoms nerve pain in between my shoulder, legs , arms , headache ….., I’ll never advise anybody to go to the chiropractor , and this is my own  experience.”

Anecdotes and grievances do not prove a case against chiropractic.  However neither do testimonials from satisfied patients prove the efficacy of chiropractic treatment.  It can be argued that the placebo effect will explain much of chiropractic’s reported success.  I have often argued that massage therapy will produce the same results with lower cost.  Some evidence exists to support my contention.

“A study called Patterns and Perceptions of Care for Treatment of Back and Neck Pain appeared in 2003. The studied questioned over 2,000 people on how they dealt with their aches and pains. Massage took home the gold with people preferring it to chiropractic for any kind of back pain or general body pain, but chiropractic led the race in upper-back pain and neck pain. Even with these results, visits to chiropractors were much more common than visits to massage therapists.”  — Chiropractor Vs. Massage

The above study notes that more people go to chiropractors than massage therapists.  You might wonder why?  Especially since seeing a massage therapist will cost you about 1/2 to 1/3 the cost of seeing a chiropractor.  I propose that the reasons for this propensity of people to prefer chiropractors to massage therapists lies in the more successful lobbying and marketing that chiropractors have done.  A second and related reason is that massage therapy will generally not be covered by most insurance plans or Medicare.  The following applies to Medicare coverage for massage reimbursement:

“Original Medicare does not cover massage therapy. Services that are not covered by Medicare are the sole responsibility of the patient.  In some cases, Medicare Part B will cover chiropractic services if they are medically necessary and are meant to correct a subluxation of the spine. In most cases, Original Medicare pays 80% of the cost for this treatment, but the patient is responsible for the other 20% and all other tests and services performed by the chiropractor.” —  Does Medicare Cover Massage Therapy?

Note that in the above description that chiropractic care is covered but massage therapy is not.  The lobby for chiropractors is much more powerful than the lobby for massage therapists.  This latter fact demonstrates that the type of medical care and medical coverage you are eligible for will be determined not by objective scientific facts but by political persuasion and money spent by lobbyists.  How does that make you feel?  But let’s get back to chiropractic treatments and look more specifically at “adjustments”.  This is the bread and butter treatment for chiropractic patients.  Do you need them?  Will they help you?

Chiropractic Adjustments:

chiro with an adjustmentIf homo sapiens have a weak link in their skeletal structure it is the back.  It has been argued that the problem arose when we switched from hanging in trees to walking upright.  Whatever the cause, back problems are easily the most common and perhaps one of the most painful problems faced by Americans today.  I have heard it said that the “opioid epidemic” is really a “pain epidemic” as more people age and have to deal with back problems, knee problems and hip problems.  No one beset by continuous pain can be blamed for wanting to find an escape from that pain.  However, as I noted in the previous blog, this desire to escape pain often leads to bad choices.  Surgery is too often prescribed when other treatment modalities would be more effective with less side effects.  This brings us to the issue of chiropractic adjustments for back pain.  How effective are they?  Here is another comment from Dr. Preston H. Long regarding the effectiveness of spinal manipulation:

“Research studies that look at spinal manipulation are generally done under strict protocols that protect patients from harm. The results reflect what happens when manipulation is done on patients who are appropriately screened—usually by medical teams that exclude people with conditions that would make manipulation dangerous. The results do not reflect what typically happens when patients select chiropractors on their own. The chiropractic marketplace is a mess because most chiropractors ignore research findings and subject their patients to procedures that are unnecessary and/or senseless.”Chiropractic Abuse: An Insider’s Lament Paperback – 8 Oct 2013, by  PhD. Preston H Long D.C

abuse

I highly recommend you read the book by Dr. Long.  If you are going to go to a chiropractor, you should have a realistic assessment of finding out your chances of getting help and relief.  Too many people leave their medical treatment entirely in the hands of so-called experts.  This is a big mistake.  I will discuss this later in another blog, but you need to be a strong advocate for your health care and not trust any one medical practitioner too much.  How much is too much?

 

  • It is too much if you are uninformed and have done little or no research into the causes and treatments of your illness.
  • It is too much if you expect that your treatment will take the place of discipline and hard work on your part.
  •  It is too much if you would rather get surgery than lose weight or exercise.
  •  It is too much if you expect that your doctor will advise you to pursue less invasive treatments before surgery or pills.
  •  It is too much if your doctor is overweight, has no exercise program of his/her own or smokes.
  •  It is too much if you have not pursued a second or third opinion.
  •  It is too much if your doctor cannot show you fairly persuasive evidence of a diagnosis and an empirically related treatment modality.

Conclusions:

For the record, I have no vendetta or grudge against chiropractors.  However, it has been my observation that they often treat many problems that they are not competent to treat or that have not had a proper diagnosis.  I have seen too many friends go to a chiropractor and not have a long-term fix to their pain or problem.  Chiropractors may offer a good short term fix to some pain problems but usually no long-term fix.  For the record though, massage, surgery and pills do not usually provide a long-term fix and with surgery, there will usually be consequences that the patient was probably not aware of.

(For more facts on the pro’s and con’s of chiropractic treatment see “Evidence for Chiropractic Treatment“) 

Chiropractors are no better than regular medical doctors when it comes to dealing with the underlying cause of pain.  Sadly, some of the problem for hasty diagnosis must be laid on the patient’s doorstep.  Many pain sufferers want either instant relief or relief that will entail little or no effort on their part.  Doctors too readily give into this desire either because of the financial remuneration that awaits them for treatment or laziness or perhaps simple ignorance.  My skeptical side says that giving a patient an exercise program or diet program is not nearly as lucrative as treating the patient with adjustments or surgery.  Back surgery will generally cost between 50k and 100k.  Spinal adjustments may take place for up to 6 months and final costs may total nearly $5000 dollars (computed as 50 treatments multiplied by an average cost of $65 dollars per treatment.)

On the positive side, there are many chiropractors who offer an alternative to the pills and surgeries so often recommended by mainstream medical doctors.  Perhaps because they have been viewed as less professional by traditional medicine, many chiropractors have considered a variety of non-traditional treatment options.  Many of these treatments are not very scientific or have no proven scientific effectiveness but this does not mean that they may not be effective.  Scientific proof has often taken many years to prove things that traditional folk medicine long knew was true.  However, there is a drawback in delaying some treatments to pursue unscientific remedies.  For instance, when I was diagnosed with prostate cancer, I decided to pursue a “wait and see” or “active surveillance” policy.  I was not ready to accept either the PSA reading or the biopsy or even the MRI results.

During my wait and see time, I opted to try some herbal remedies that were reported to have some success with prostate cancer.  I started taking several of these remedies each day in the hopes that a future biopsy would show a decrease in cancer cells or even the disappearance of my cancer.  No luck.  My next biopsy and a third biopsy all showed increases.  In addition, my Gleason score and PSA scores kept going up.  I now risked the danger that the cancer would spread out of my prostate and migrate to other organs.  It was time for surgery.  Not to pursue surgery at this point would have been foolish and even hopeless.

Thus, there is an ever-present danger that pursuing treatment programs that are a dead end might endanger your life and prevent you from going down more fruitful paths.  There is a reason that many people pursue such options.  It is called “hopefulness.”  I cannot blame anyone for this outlook.  I too was hopeful that I could keep my prostate and continue to pursue a normal life.  Many people go to chiropractors rather than medical doctors in the hope that they will find a cure beyond pills and surgeries.  Some do and some don’t.

Time for Questions:

Have you ever been to a chiropractor?  Why or why not?  Did you find them helpful?  Why?  What evidence did your doctor provide to show why he/she gave you the diagnosis you received?  What kind of exercise program do you follow?  Do you think people without an exercise program are higher risks for medical problems and pain?

Life is just beginning.

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” – Thomas A. Edison

 

 

 

 

 

 

 

 

 

 

 

 

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