palmd | August 19, 2009In his latest comment, Philip H has accelerated my reluctant discussion of health care reform. In fact, it was Philip who bullied me into writing about this topic in the first place. I've been avoiding wading into this mess, but being on the front line, it's in my face every day.
What he says in his latest comment is this:
[T]he idealogical leap PalMD is asking for is a good one, but it misses the mark. The leap we need to make is that healthcare is not a good, like Cheerios, or cars, or flatscreen tv's, that exists in anything like a free marketplace.
Commenter Donna B. makes a tangent…
palmd | August 19, 2009So, I'm at the end of week #2. I started, fully clothed and after breakfast, at 212. Last Wednesday I was 208.
Today I'm 206.
My successes have been in maintaining sustainable eating habits. My failures have been in keeping to an exercise program. I haven't been completely sedentary, but I can do better.
palmd | August 18, 2009Once again, I'm sucked into the discussion on health care reform. I despise this topic, because so much of what is wrong with our current system could be fixed relatively easily, if Americans could just take an ideologic leap.
Most of us have heard of "pre-existing condition (PEC)" clauses---those rules that allow insurance companies to deny payment for care based on your previous history. There's a lot of facets to this, and laws vary tremendously (your results may vary). For example, a company may simply refuse to insure you (although some companies don't have that choice, but they can…
palmd | August 17, 2009I had a chance to watch the President take questions at town hall meetings this weekend. He sought out opposing views, and handled them brilliantly, responding to them rather than giving empty answers. He also didn't talk down to the audience. The pity is that the take home message in the news today is that he may abandon his push for a "public option". This would be a grave mistake.
This President is no dummy. He gets this issue. When a citizen asked how private insurers can possibly compete with a government plan, he responded in great detail, explaining how changes need to be phased…
palmd | August 17, 2009So, my exercise has fallen off a bit, but I think I'm getting back to it. I rode a bit this weekend but the heat drove me inside.
I tend to let myself eat just about whatever on weekends---turns out I don't like to eat that much. I get nauseated (not that it always stops me). Saturday morning I had my morning Irish oatmeal, but at the clinic everyone had brought snacks (including my DrPal's Yummy Salsa Fresca (TM)). I nibbled all day, then went out with friends to a big, Italian dinner.
Sunday I had cereal, and ate a healthy but somewhat too big lunch, and had folks over for burgers and…
palmd | August 16, 2009I'm passionate about medicine. I love practicing it, teaching it, learning it...everything about it. It's also damned scary sometimes. Knowledge changes; patients don't walk in with textbook diseases; and you have to be able to doubt yourself without drowning in indecision. Every time a patient brings me an article or monograph that looks relevant to their care, and it's new to me, I have to go through it and see if there really is something to it.
For example, there has been some data recently about popular medications for acid reflux (called PPIs, including such medications as…
palmd | August 15, 2009This is, of course, an absurd question. Getting all 300 million of us to agree on this isn't going to be easy. But a parody circulating on the internet shows how misunderstood we Americans can be.
National social programs are relatively new in the States---Medicare, the plan that gives medical care to those over 65, is only forty years old. Social security, the national pension plan for people who have worked legally for a wage, is about sixty years old. Welfare programs for the poor are often tolerated at arm's length with the nose held.
But while many view these programs with disdain or…
palmd | August 14, 2009I've been blogging long enough now that it's hard for me to keep track of what I have or have not written, and on which particular blog. I used to be pretty compulsive about digging up old links to my first blog (now in storage) or to denialism, or even to this blog, but this can be paralyzing. I still try to make sure to link to other writer's pieces, whether on denialism blog, or at other blogs that I like, but if I were to be overly compulsive about this, I'd never get any writing done.
And with that in mind, it's time for a review of alternative medicine (one that is a bit more…
palmd | August 13, 2009The cupcake wasn't even that good.
Look, you can say whatever you want about satiety, but I WANT FUCKING CARBS ALL THE TIME!!!!!!
palmd | August 13, 2009So, it's not always easy, creating a new lifestyle. This morning I woke up later than I'd hoped, so I didn't have time to exercise. I didn't really have time to eat either, but I made myself slow down and have a small bowl of shredded wheat. I also forgot to bring a snack to the office.
Anyway, my office neighbor, a cardiologist, had a lunch brought in, as he does every Thursday. It was, unfortunately, one of my favorites---Star Deli. If I'd followed my strongest desires, I would have warmed up some of the corned beef and made a corned beef on twice-baked rye with Swiss cheese, cole…
palmd | August 13, 2009There is no clear definition of "quackery". Stephen Barrett, founder of Quackwatch, discusses the slippery nature of the definition and the issues of intent and competence. Defining quackery of necessity involves some subjective judgment, but there are objective parameters we can apply. If someone is hyping a medical practice without adequate scientific evidence and is profiting from it, they are a quack.
Quackery differs from "fraud", which is a legal concept. In my state health care fraud is defined as:
Intentional deception or misrepresentation made by a person with the knowledge…
palmd | August 12, 2009Science is hard. Real science requires time, patience, modesty, and a high tolerance for failure. Good ideas can lead to better ideas, or to dead ends, and these dead ends actually help us map out our reality. Quite a while back, I wrote about a study of certain compounds in chocolate and their effect on the cardiovascular system. One of the things I liked most about the study was the authors' refusal to draw overly broad, immodest conclusions from their findings. That's how real scientists operate.
This is in stark contrast to undereducated pseudo-scientists---if they see a result…
palmd | August 12, 2009So last Wednesday, I weighed in at 212 pounds (which I rounded to 96kg for some reason). I've struggled, seen a lot of good and bad advice, increased my exercise, decreased my food intake, sinned gravely, and generally whined and moaned.
This morning, clothed and after breakfast, I'm 208 lbs.
Rock on.
palmd | August 11, 2009I woke up this morning and rode the stationary bike. Had a healthy breakfast, lunch, and snack. Took the kiddo for a bike ride.
Then came the carnitas.
palmd | August 11, 2009It seemed inevitable. Crowds more akin to brownshirts than concerned citizens have been disrupting health care town hall meetings, depriving their fellow citizens of their right to be heard. It was only a matter of time before the intimidation become more overt.
Today, a protester showed up outside a venue where the President is appearing. His sign was disturbing enough: "It is time to water the tree of liberty!" To refresh your memory, he is paraphrasing a famous Revolutionary-era quote which says that to water that tree it is, from time to time, necessary to spill the blood of tyrants…
palmd | August 10, 2009So, not so bad so far today, after an imperfect weekend. The weekend was full of swimming and biking, but also food. I didn't eat too many things that were "empty" of nutrients, but I consumed more mass than I'd hoped too.
Today, I'm not doing too badly.
Breakfast:
2 eggs scrambled with a cup of spinach and a couple of pinches of Romano cheese
1/2 cup shredded wheat with 1/4 cup milk
A little over 300 calories
Lunch:
A "cobb" salad from the hospital: fresh greens, some shredded cheese, boiled chicken breast, tomatoes, bacon bits and a tablespoon of fat free italian.
Best guess, about 380-…
palmd | August 10, 2009The Right likes to hold up Sarah Palin as a beacon of morality and virtue in an irredeemably corrupt world. But with her latest words, she has shown herself to be either an immoral, lying sack of crap, or severely cognitively impaired.
And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether…
palmd | August 9, 2009A hot, sunny Midwestern day. A well-groomed rail trail. Two intrepid riders. That's how it started out. My daughter has been going on longer and longer rides with me on the Trail-a-bike, so today I figured we'd try a great rail trail that goes past a heron rookery.
We made it about a mile in before she freaked the fuck out. She was screaming at the top of her lungs behind me, so I stopped. Any time a bug or a fleck of mud landed on her, she couldn't handle it. She felt like she was being attacked by bugs, and nothing was going to get her back on the damned bike. In fact, she was…
palmd | August 9, 2009Thankfully, I'm not a week into this lifestyle change yet, because I'm getting good advice from experts. I know from my reading, that certain foods are better at inducing a durable sense of satiety, and I've been trying to incorporate these foods.
For example, my typical lunch of late has been a good salad with either a few ounces of grilled chicken breast or a hard boiled egg on it, and a nice portion of melon. This gives me a meal with a high volume of fruits and veggies, but still some fats and proteins. I think, and we'll see what the experts say, that it is a bit too carbohydrate-…