The Heart (Disease) of the Matter

On May 9th, I had a stent put in my coronary artery.  For months I’ve been having out-of-breath episodes, but I thought it was just because I was getting older, and not getting enough exercise.  In the last few weeks it got worse so I went to see my doctor and she sent me for a bunch of tests that ended up with a heart cath and getting a stent.  It’s been an extremely educational month with lots of philosophical implications.

Our hearts are just pumps, and our veins and arteries just hoses, but when they stop functioning, it feels very metaphysical.  To actually feel them failing is quite revealing about existence and non-existence.  I’m sure the faithful would feel heart disease as a spiritual turning point, a time to communicate with God, and contemplate life after death.  Since I’m an atheist, I contemplated non-existence and thought about physics, chemistry and biology.  The heart and circulatory system is a machine that follows the laws of physics, much like the water pump in your car.  I had a rather fundamental plumbing problem:  a blocked hose.

The first diagnostic test I had was a calcium CT scan.  I got a score of 451, which my doctor didn’t like at all.  My second test was a Thallium treadmill test, which I passed, but the photographs suggested problems.  She sent me to a cardiologist.  It took a couple of weeks to get to see a cardiologist, and that was stressful in itself.  I went to a cardiology center with 32 cardiologists and the earliest appointment I could get was two weeks.  Lots of people with heart problems out there!  Time and again I was told if I needed immediate attention to go to an emergency room.  Fixing hearts is a factory-like affair.  Don’t expect a lot of personal attention.

My advice to the young:  Eat healthy now!  Don’t break your own heart. 

My clogged arteries were my fault.   Yes, the doctors can often fix your heart problems, but if you’ve ever had to deal with an old machine with breaking parts, you know one fix is just temporary before another part will go.  A stent only squishes the plaque up against the artery wall, making more room for blood flow, it’s not a form of healing.  And you don’t get plaque in just one place, it’s all over.  I just had a blockage in two high traffic area, with one bad enough for a stent.

The stent is only part of the solution.  I now have to take a bunch of drugs.  I’ve always been horrified at the sight of elderly people worrying over their prescription medicines.  I’ve always thought being over the hill as living with lots of orange plastic bottles, and now I’m part of that demographic.  Here’s where chemistry and biology comes into this story.  Modern day medicine men are scientists.  Our bodies are biological machines they study.  Millions of chemical reactions go on within our body all the time.  Doctors work by statistical studies, and the numbers tell them that my odds of living longer are improved if I consume certain chemicals.  I can’t argue with them.  I take the drugs.

These are cold equations, indifferent to how we feel philosophical about our health situation.  I hate taking drugs!  I fear drug side effects.  I hate being depended on drugs, even though I’m am quite thankful that science created them.  I’m very lucky to have good health insurance and live in a country where these kinds of problems can routinely be fixed – if they are found in time.  A fellow computer guy died at work from a heart attack recently.

My father died at 49 on his third heart attack.  He also survived a stroke.  He chained smoked Camels, drank a lot of Seagram 7, and his standard chow was steak and potatoes.  I’ve always wondered why he didn’t try to change his lifestyle, and now I know why.  I’ve been overweight for decades.  I didn’t listen to all the warnings.  In the last few years I’ve tried to eat healthier but it’s hard.  Is comes down to this:  Do I do what I like?  Or, do I do what’s good for me?  Even when I was having trouble breathing I’d often be thinking about how I wanted junk food.  I’m pretty sure my father thought “I’d rather die than change.”  Me, I picked change – but at the last minute.  Not very wise.

Since New Year’s I’ve been reading books by Dr. Dean Ornish and Dr. Joel Fuhrman about using diet to reverse heart disease, and watching documentaries on Netflix about reversing chronic disease through proper eating.  Ornish’s book Program for Reversing Heart Disease came out in 1990, and Fuhrman’s Eat to Live came out in 2003.  I even read parts of Eat to Live ten years ago.  But the nightly news programs have been warning about the evils obesity for decades.  Until your heart actually sucker-punches you a good one, it’s hard to take such warnings seriously.  I should have.

My friend Mike asked me if I thought about God in the hospital.  I did, but not in the way he intended.  Feeling the closeness of mortality showed me why people pray.  The gut instinct is to think “Get me out of this!”  You want magic to work.  It doesn’t.  Thinking that an all-powerful being could rescue you is an obvious wish.  I wish there was such a personal savior, but I didn’t find one.  I knew there was a blockage in the artery going to the heart.  I hoped diet would clear it, but my doctor said he doubted it, and I knew I had spent decades building the blockage, so I knew he was probably right.  I knew my only hope was his skill and the scientific knowledge he possessed.  Medicine is collective knowledge that works.  It’s not magic, and it doesn’t always work, but it’s the only real game in town.

We’d like to believe we’re the master of our own fate, or that a magical being cares for us.  But neither positive thinking or spiritual belief affects reality.  My chance of using the power of self-control had long passed.  If I wanted control of my fate, I should have lost weight thirty years ago.  The reality is death comes to us all.  We can extend our lifetimes and improve our health if we work at it, but we have to put in the effort.

I do believe we have the power to affect our health, just watch this video.

I cannot do anything about not starting sooner.  I couldn’t avoid that first stent at the last moment.  I’ve already lost 15 pounds.  Maybe I can avoid the next stent.  I don’t know if a plant based diet can reverse heart disease, but it’s the hypothesis that I’m using  for now.

My final lesson was about dying.  When you think time might be up you learn what you really want:  more time!

Getting close to the end only reinforces the awareness that time comes to an end.

The funny thing was I learned I didn’t want to do big bucket list things, but to have more time for all the little things I do now, and to keep seeing everyone I know now.

JWH –5/12/13

Paradigm Shifts in Medicine–Can Lifestyle Change Cure?

Modern medicine is scientific, evidence based, and very conservative.  Doctors like to treat patients with medicine and procedures that offer the best known odds for success.  No doctor wants to try out something new only to discover it kills their patients.

Patients on the other hand are fearful folk.  They usually know little of their newly diagnosed conditions and they are afraid of suffering or dying.  They are quick to take any cure they are offered.  If they have faith in their doctor and she says  take these pills and have this surgery, they will comply.  However, many people are afraid of pills and surgery.  They hate to suffer, but they are afraid of the cures offered them.  If they hear about alternative medical treatments that are less scary they will chase after them.

I’ve recently discovered I have clogged arteries, but won’t know how bad until next Thursday when I get a heart catheterization.  This is the kind of personal experience where I get to explore very concrete details of reality.  I have choices to make.  If I decide wrong I could die.  If I decide right I get restored health.

The conservative medical solution is to put in a stint and have me take Plavix for a year.

The alternative is a proposed paradigm shift that claims if I eat a radically different diet, I can reverse the buildup in my arteries.  My doctor says there’s not enough research to support this conclusion.  Books by Dr. Ornish and Dr. Fuhrman claim otherwise.  My doctor replies that those doctor’s claims are meant to sell books, and are unproven.

Here’s my problem.  I can’t handle drugs.  My doctors usually pooh-pooh my fear of drugs.  But here’s what topical steroids did to me.

And that photo was after I healed considerably.  It took a year for my face to clear up.

I’ve taken other medicines that filled my mouth and throat with sores.  I often take medicine that tears up my stomach.  I’ve taken medicine that gave me sores under my eyelids.  I’ve taken medicines that gave me pains in my intestines.  I’ve taken medicines that distorted my sense of time.  Taking penicillin once sent me to the emergency room.  And statins really did a number on my body.  I have a hard time taking a 81mg “baby aspirin.”  I even had to give up caffeine.

So the idea of getting a stint and then having to take a powerful drug for a year is pretty scary.  If it was just a stint, I’d say great.  When I had a heart arrhythmia they eventually fixed it by zapping something inside my heart.  That was after years of torturing myself with various heart drugs.  They had offered me the ablation when they offered me the drugs, but I believed I could control my heart arrhythmia with beta blockers, diet and exercise.  I did for years, but ultimately I couldn’t.  Letting them zap my heart was great.

Once again, I’m back toying with the idea of curing myself by diet and exercise.  However, this time, there’s more evidence, supported by real doctors, to suggest that the lifestyle change is a possible cure.

I’ve already shifted towards the new diet, but it’s hard.  Even though I’ve been a vegetarian since 1969, I’m a very poor eater who is addicted to junk food.  Food I found comfortable for my stomach was slowly attacking my heart.  Now switching to healthy food sometimes tears up my stomach like some medicines.  Yet, I do feel better, and I believe if I learn to eat the healthy, and especially if I learn to cook it and make it an easy routine, I could switch my lifestyle.

I do have a proven record of changing.  I did go vegetarian at 16.  And in recent years I’ve control my back and leg pain with physical therapy exercises.  I gave up pain pills and anti-inflammatory meds.

One reason I think conservative doctors are against lifestyle cures is they know few people can change their way of living.  My dad died at 49 after three heart attacks and a stroke.  He never gave up his Camels, Seagram 7, or steaks.  Nor did he try to exercise.  I was in my teens at the time, and I wondered why he wouldn’t change.  Now I know how hard it is to change.  Sometimes I think I’ve lived 12 years longer than my dad because I became a vegetarian.  It also helps that I didn’t follow in his footsteps of smoking and drinking.  What choices can I make to live another 12 years, and maybe 12 more after that?

One reason I believe lifestyle change might work is because bad lifestyle habits clogged my arteries in the first place.  The other bit of logic is if I got a stint and continued to eat and live like I did, wouldn’t I just clog up other arteries?  Isn’t clogged arteries a sign that I’m doing something wrong and should stop?

Such logic can be deceptive.  I’m reading Thinking Fast and Slow by Daniel Kahneman who details all the ways our own brain tricks us.  He chronicles a long list of deceptive psychological mechanisms our brains use to convince us that wrong things are right.  So, how do I know if my cardiologist is right, or Dr. Ornish and Dr. Fuhrman?  Decades ago some researchers suggested that stomach ulcers might be caused by the helicobacter pylori bacteria.  Most doctors said that was insane.  But over time there’s been a paradigm shift.

Are we at the beginning of a paradigm shift with chronic diseases and diet?  We know that the western diet has led to the increase in various chronic diseases, so logically it would seem if we gave up that diet, we might reverse course?

It doesn’t matter what I think.  I know my brain tricks me.  What’s important is what science learns.  My doctor is right to be skeptical of any idea that’s not well backed by lots of scientific studies with huge numbers of participants.  Ornish and Fehrman claim the science is there.  I need to find it.

JWH – 5/3/12

If Science Definitively Proved Junk Food Was Worse Than Heroin Would You Give It Up?

Last night I watched Fat, Sick and Nearly Dead, a film about an overweight Australian, Joe Cross, going on a 60 day juice fast while traveling across America meeting fat people proclaiming their love of junk and fast food.  You can watch Fat, Sick and Nearly Dead right now on Hulu online, or its available for streaming at Netflix, iTunes and Amazon Prime.  Fat, Sick and Nearly Dead is about an obese man, with a rare disease, who had to take a lot of prescription drugs just to survive each day, and during the course of the documentary loses over 100 pounds, gets down to normal weight, and is able to give up all his pills, with doctor approval.

And the documentary goes beyond Joe’s success, because we see other people inspired by Joe.

When Joe first arrives in America, he sees Dr. Joel Fuhrman, of Eat to Live fame, who gives him a medical check up and approves his fast. During the course of his travels across the United States, Joe reports his vital statistics back to Dr. Fuhrman. It’s dramatic. Finally we see Joe back in Australia. reborn as a new man. I’m not giving anything away, because you need to watch the film for yourself to believe.

To me, even more moving than Joe’s story, is Phil’s story, a truck driver Joe meets on his journey across America.  They each have the same rare disease.  Joe gives Phil his number and tells him to call when he gets ready to save himself.  Eventually, Phil does call, and his story is the second half of the documentary.  Joe flies back to America to get Phil started.

Phil dramatically transforms himself losing over two hundred pounds and he also gets off all his meds.  Phil’s success is so striking that he inspires other obese people in his community , becoming a juice faster evangelist.  Even Phil’s brother Bear, who refused to try the diet, gives in after he has a heart attack.

Joe interviews dozens of Americans, mostly fat, but all addicted to fast food and junk food.  Many said they never ate any fruits and vegetables at all, and a number of them said they expected to die by the time they were 55.  We see Joe sitting in diners talking to monstrously big men shoveling down giant portions of artery clogging food.  Most are friendly, and are willing to talk to Joe about juice fasting, some even willing to try a taste of juiced veggies and politely say, “Not bad.”  But none volunteer to give up the junk food.  Phil doesn’t even call Joe, until after Joe has finished his fast and gone back to Australia.

Two sick fat men transformed into healthy go-getters don’t make scientific certainty, but it is very compelling evidence.  I’m working up my nerve to try juice fasting and Dr. Fuhrman’s Eat to Live diet afterwards.  Like most of the people in the film, I just can’t imagine giving up all my fun foods, but like Joe and Phil, I’m overweight, not as much as they are, and I’m not feeling that good overall.  The idea of being more energetic and healthy is very appealing.  This documentary is very convincing.

The real question that this documentary asks indirectly:  If junk food is so poisonous, why do people keep eating it?  I’ve been reading a lot of medical news the past couple years and it’s pretty conclusive that a diet based mainly on fruits and vegetables is not only healthy, but cures many of our modern ailments like diabetes and heart disease.  We literally are poisoning ourselves to death.  Junk food probably is more dangerous than heroin or cigarettes.  We make fun of New Yorkers banning Big Gulps, but what if junk food should be banned?

I suppose we should all be free to kill ourselves any way we wanted, but should junk food come with warning labels like smokes?  What if fast food joints made you sign a waiver every time you ordered a meal?   Would you give it up?  How bad do we have to feel, how strung out on junk food do we have to get, before we really believe its poison?

I’ve known health food nuts all my life.  I’m going to feel very foolish if I start eating healthy at 61 and feel rejuvenated and remember I could have started back in the 1960s.  How much life do we have to waste before we learn what we’ve wasted?

[Thanks Annie for nagging me to watch Fat, Sick and Nearly Dead.]

JWH – 3/20/13

Maybe Howard Hughes Wasn’t So Crazy After All!

At the end of his life, Howard Hughes was the butt of numerous jokes over his germaphobia.  Hughes became a recluse who went to extremes to avoid people and germs.  The past three days I’ve been sick with either the flu or food poisoning.  While laying around waiting for my fever to burn off and bowels to producing something solid, I began imagining how I could avoid this fate in the future.  I thought of Howard Hughes, and his techniques for hiding from unseen foes.

If only I was rich and could afford to buy hotels and occupy their top floors.

I seem to catch something once a year, usually a cold.  I do get the flu shots.  And this bout of whatever only knocked me back for three days.  They say the flu vaccine isn’t perfect but it at least could shorten the duration of the flu.  However my symptoms were more like food poisoning.  I’ve read a lot about what folks call “stomach flu” which more often than not is food poisoning.  But that’s just another way for germs to hitch a ride inside you.  Do such details matter?  Well, yes, it does.  Especially when you learn how some of the bad germs got on the bad foods.  Yuck.  Now I’m paranoid about restaurants and grocery stores.

Is the isolation from humanity worth the cost of avoiding occasional sickness?  Probably not, but then I thought of a novel by Isaac Asimov called The Naked Sun.  It’s a murder mystery set on a planet of agoraphobic inhabitants.  These people are so afraid of other people they never leave their homes, and only socialize via view screens.  Even married couples get queasy over getting physical.  Robots do most of the real work.  It’s a world that Howard Hughes would have loved.  I doubt this planet had many communicable diseases.

Since the news in the past 24 hours has been about the CDC’s report on superbugs, living as a recluse isolated from everyone might become the vogue.  Nor does it help that I’ve recently read a number of history books, covering times when simple fevers and chills killed.  If the age of antibiotics is coming to an end, and we have to return to a time when the little guys are winning again, how will our social lives change?  This time around we know the little critters are culprits.  Would Victorians have lived like they did if they were certain of germ theory?

[This guy is not a bacteria or virus, but a tardigrade – I couldn’t resist copying the photo from NASA.  Pretty scary, huh?]

I doubt we’ll all become as nutty as Howard Hughes, but then maybe we will.   What if germs get the upper hand again?  What if life becomes more like 1813, when the germs were regularly winning their war on humans.  What extremes will we go through to stay well?

I do wish that sick people would stay at home.  I hate meeting coughing, sneezing, hacking, nose-snotty people at work.  And isn’t it a wonderful feeling to have an obvious germ factory sit behind you at the theater?  One thing we could do at least, is all wear a face mask when we’re sick, like the Japanese.  However, that’s got to become a fashion first, and who is going to become the bellwether in your office?   

I think, instead everyone isolating themselves from the sick, the sick should isolate themselves. 

That old belief that no fever equals not contagious isn’t true.  Germs don’t immediately disappear when you get back to 98.6.

I’m also betting on vaccines.  Logic dictates that fewer hosts to infect, means less infectious.  But that only works if everyone gets their shots.

The way hospitals fight outbreaks of infections is by conscious systematic efforts.  Even if germs become immune to our meds, we can still fight them.  That involves killing them outside our bodies and interrupting their vectors of infections.

I’ve got to admit that maybe I’m being more paranoid about germs because I’m getting older.  When you’re young, getting a cold or the flu is no big deal.  When you’re older, it is.  The other night at 3am, when my fever was high, I thought, one of these days I’m going to get sick and not get well.  That was something to think about.  That’s the sucky thing about dying, you have to leave this wonderful world feeling bad.  I want a pill, that no matter how bad I feel, no matter how much pain or nausea I have, that when I know it’s time to go, I can pop that pill and feel good for the last ten minutes of life.  Is there such a pill?  I don’t need euphoria.  Just pain free and clear thoughts will be plenty, so I can think thankful thoughts about my life.

I can coexist with good germs.  I don’t even mind sharing my body with them.  And I don’t resent the bad germs digesting me in the end.  I just wished they didn’t make me feel so bad doing it.

JWH – 3/7/13

Why Can’t We Be Good When We Know What’s Bad?

I’ve been reading about how our western diet is spreading around the world and bringing obesity, diabetes, hypertension and a host of other non-infectious degenerative diseases to people who used to eat differently, and lived healthier.  It’s quite obvious that our high fat, high sugar, high salt, high calorie diets are bad, so why don’t we eat better?  Why can’t we be good when we know what’s bad?

We just can’t seem to resist sweet, salty and fatty foods when they are in abundance.  Generally, where humans are thinner, more active, with little diabetes and hypertension its because they didn’t have a whole lot of food choices to begin with.  The western diet is really one of abundance and variety, and people around the world if given the opportunity to eat like us, become pigs like us.

My question is:  Why can’t we say no?

I have no answer.  I weigh 240 pounds.  I certainly can’t say no.

Actually, that’s not completely true.  I’ve given up many favorite foods over the years, and I still gained weight.  I do eat healthier, but I don’t eat less.  I am driven by hunger.  I can’t say yes to being hungry.

I keep eating more than I should knowing that I will suffer degenerative diseases in the future.  That’s insane.

I find this philosophically fascinating.  Obviously the rational mind has little influence over the physical body and the hormones that regulate it.

What if science could create a pill that makes us shun desserts, fatty foods, fried foods, salty foods, etc., and made us crave just the right amount of healthy foods, would you take that pill?  What if this pill made food a non-issue, so you just ate exactly what your body needed to be healthy.  Would you take that pill?  It might kill off gourmet eating, fast food, candy, pastries, soft drinks, and all the other stuff we so love.

Yeah I know, you’re thinking, “Why can’t what’s bad be good?”  See that opens up another philosophical question.  What if bad food is what we want.  What if bad food is what makes life good?   That’s easy to believe, but remember the heart disease and diabetes?  Remember all the obese children and young adults?  Brownies and Ben & Jerry’s Ice Cream are evil.

What if our current stage of humanity is a paradigm shift like going from hunter and gatherers to an agricultural society?  Humans have always pretty much eaten anything they could put in our mouths that didn’t kill us.  That’s why we’re called omnivores.  But what if we’re moving into a new phase of existence where we must become healthyvores?  Can our species make the transition?  If I had a time machine and could jump ahead a hundred years, or five hundred years, would I find homo sapiens 2.0 living a much longer and healthier life?

I don’t know.  It’s something to think about.  I’m not sure we can always change, to always evolve.

JWH – 2/18/13

Treating Back Pain Without Drugs

Most people I meet with chronic back pain only fight the pain with drugs.  I’ve discovered some other techniques to try.  Overall, what I’ve learned is my back is trying to communicate with me and all pills do is tell it to shut up.

I am not a medical expert of any kind.  I’m only recounting my personal experience with living with back pain.  I’ve greatly benefited from going to physical therapy (PT) and the training the PT doctors gave me to do daily exercises on my own.  Although you can find all kinds of PT exercises for back pain online, I highly recommend talking to a doctor before doing any exercise if you are suffering from chronic back pain.  The point I want to make is I’ve discovered some ways to avoid back pain without depending on powerful drugs.

Years ago when my degenerative back disease began and I was in a lot of pain I took prescription pain pills and muscle relaxers, but when I learned my condition was chronic I stopped taking those pills

I have three kinds of symptoms:

• inflammation/tension/tightness (lower back)
• numbness/nerve sensations (foot and leg)
• muscle pain (lower back, hip, leg)

The inflammation/tension/tightness is almost always present in my lower back but in varying degrees of discomfort.  If things get worse, my foot goes numb and the numbness works up my right leg.  When things get even worse, my left leg goes numb too.  When things get really bad I have increasing constant dull pain and infrequent sharp shooting pains in my lower back, hip and leg.

I can keep the sharp and shooting pains away if I do my PT exercises daily, do regularly rowing exercises on the Bowflex, and if I don’t walk or stand for longer than 10 minutes.

I can keep the numbness to a minimum if I take B vitamins and exercise regularly, and don’t stand straight or lie flat for any length of time.

I used to keep the inflammation/tension/tightness to a low level with anti-inflammation pills, over-the-counter pain pills and regular PT exercises.  However in recent months the anti-inflammation pills have messed up my stomach and intestines and I’ve had to stop them.  I’m learning how to keep this kind of pain at a minimum without those drugs by carefully babying my back and not inflaming it.  No lifting, lots of rest, more exercising.

I now ask younger people to lift stuff for me, and I even take the elevator sometimes.  I’m getting old and creaky.

The exercises I learned from my PT classes are very simple, like these:

I’m writing this because I’ve had to stop taking any anti-inflammation medicine because it’s tore up my stomach and intestines, and I’ve learned that I can get about the same relief without those drugs if I’m careful.  Although my doctors have prescribed some powerful pain pills I’ve avoided taking them.  I have lived off of various anti-inflammation drugs over the last few years, but I can’t take them anymore.  Doctors keep prescribing drugs that are easier on the stomach, but evidently my stomach is on the wimpy side, or years of taking pills have beaten it up badly.

I’ve always liked the anti-inflammation drugs because they reduce the feeling of inflammation and tension in my lower back, but when I had to quit these drugs I realized that those drugs were the cause of some of that inflammation.  Taking a pill would reduce the tension, and the wearing off the pill hours later would make it spring back.   After several days of not taking the anti-inflammation pills, I had much less inflammation and tension.  I’ve started and quit several different kinds of anti-inflammation pills and I’ve noticed this affect twice now.

Lower back tightness and inflammation builds up during the workday, especially when I do a lot of walking and standing, and time and again I’ve discovered I can quiet my back by just exercising and/or resting.  That made me think some of the stuff I was feeling as inflammation was drug withdrawal or drug craving.

I’ve been dealing with my back problem for years and it’s a degenerative disease.  Walking, standing, or lying flat makes my back worse, so I’ve learned to live with limitations by altering my lifestyle.  For instance I no longer sleep in a bed.  Sleeping in a recliner significantly reduced my daily pain.  Not walking for exercise reduced my pain.  Getting a better office chair at work and home help too.

I also bought Z-Coil shoes and they have been a huge help.  Before I got Z-Coil shoes when my back was stressed I’d get weird sensations when walking.  I’d feel like I was stepping into a hole or sliding on ice with some steps.  I assumed I was compressing a nerve.  The Z-Coil shoes act like a shock absorber so I don’t compress the nerve and feel those weird sensations.  I also tried Gravity Defyers but their springs weren’t powerful enough to help me.  Z-Coil springs are very large and visible so they are very ugly shoes, but I wear them because they let me keep working, and they let me walk further than I can without them.

Z-Coil shoe

I’ve tried all kinds of drugs over the years, various pain pills, muscle relaxers, and anti-inflammation meds.  For my particular problem I’ve learned that physical therapy is the most effective treatment.  I do take an occasional Tylenol or aspirin, but daily PT is best.  If I don’t do my PT my back will slowly tense up, and over days I’ll get hip pain, pain down the leg, and numbness in my foot, and then a lot of lower back pain.  When the pain is very bad I have a hard time getting up or down.  Doing daily physical therapy keeps the worst pain away.

I seldom skip my daily PT, and when I do, I regret it.

I still have a certain amount of discomfort, but not the major pain.  I’ve learned I need to do  Bowflex exercises once a day to reduce a lot of tension in my lower back and fight off leg numbness.  I do a rowing exercise daily, just 130 strokes.  I’ve also learned from trial and error that taking a B-complex vitamin reduces the numbness in my foot and leg.

The last technique I’m working on to help myself is losing weight.  I’ve been overweight for decades, and at 235 pounds, just existing is like carry two sacks of cement with me at all time.  However, feeling bad makes me eat, so I’m always gaining weight.  When I get up to 240 my back gets much worse and that pain makes me diet for awhile.  As I drop back to 230 it gets better, I treat myself to junk food, and then I yo-yo back up to 240.  I’m hoping in the next year to get down to 200.

My back doctor has told me time and again to avoid surgery at all costs.  And before I consider surgery to try nerve block shots.  I’ve never liked the idea of nerve block shots and now they are in the news because of contamination, I doubt I’ll ever try them.  I did hear about a new surgical technique that’s just finished clinical trials and could come online in 2014.  The new technique involves regenerating the discs in the back, and I like that idea.  So I’m hoping exercise and losing weight will keep me going until this new technique is FDA approved and my insurance covers it.

JWH – 12/2/12

How Good is Your Visual Memory?

I recently read The Mind’s Eye by Oliver Sacks and I can’t stop thinking about it.  Sacks is professor of neurology and psychiatry that writes about medical oddities relating to cognition.  The Mind’s Eye is about all aspects of vision and how it impacts the brain, our behavior and our perception of reality.

I’ve always assumed I was an average person, with average abilities, so that I was smarter than some, but dumber than others.  That I was stronger than some, and weaker than others.  I’ve always assumed I fit comfortably in the middle of the bell curve of what it means to be human, and thus assumed what I see and feel is pretty much what other people see and feel.  Reading Oliver Sacks proves that assumption completely wrong.

We all see the world drastically different, both at a physical level and at a conceptual level.  People aren’t a homogenous species.  If you’ve watched the recent Olympics you know what physical extremes exists.  Reading Oliver Sacks will illustrate the cognitive extremes.

Even in the snug middle of the bell curve, we’re all very different.  In the last chapter of The Mind’s Eye, Sacks writes about blindness and talked about his essay on John Hull, author of Touching the Rock: An Experience of Blindness.  Hull wrote about losing his sight, and slowly forgetting all visual memories until years later he reached what he called “deep blindness.”   Hull blew my mind, when he wrote that he felt deep blindness was a richer state of mind. 

In his essay on Hull, Sacks seem to imply this was how blindness worked in general.  Later he was surprised by all the letters he got from blind people explaining how their blindness had not worked that way.  He soon learned there was an array of human responses to going blind.

From this Sacks wrote about visual memory.  Sacks himself discovered he himself had poor visual memory when he took a lizard skeleton to his mother and she visually memorized it by turning it 360 degrees, stopping each 30 degrees to memorize that view.  She was a surgeon and had expected her son to be a surgeon too, but when she realized he didn’t have her visual memory, she told Sacks he shouldn’t go into surgery.  I suggest you find a copy of The Mind’s Eye and read the whole chapter rather than me paraphrasing it all, because it has an astounding amount of information about visual memory to contemplate.  Especially the stories about blind people who still feel they live in a visual world – an artificial reality inside their heads.

Like Sacks I have poor visual memory. Sometimes when I listen to music with my eyes closed, I’ll have flashes of visual scenes, but I have no control over them, and they last so little time I can’t study their details.  People with great visual memory can study their mind’s image and draw them.  A stunning example is Stephen Wiltshire, who draws Rome from one helicopter ride.  (See other videos here.)

If I was to go blind, I assume my experience would be pretty much like John Hull, and I’d eventually forget my visual memories and end up in deep blindness.  But thinking about this, I wondered if I couldn’t exercise my visual memory, like doing push-ups to make my arms stronger, and develop my visual memory.  After I read the last chapter in The Mind’s Eye I started paying more attention to visual details and became fixated on a church steeple I see on my drive to work, atop Audubon Baptist Church.  I drive by a 8:25 in the morning when the sun is behind me and there is no shadows, and again at 1:55 when I’m returning from lunch, and it does have shadows.

The first time I noticed this steeple after reading the book, I tried to memorize as much as I could when I was at the light near the church.  The steeple sits on a peaked A-shape roof.  The steeple has four parts, a square based with one round window per side, an eight-sided level above that with large rectangular windows, an even smaller level above that with wooden shudders, again eight sides I think, and a tall steeple that comes to a very sharp point.

When I got back to work the first time I tried to draw it from memory.  But I didn’t have any visual memory.  I remember the peaked roof, the four sided box, an eight-sided box on top of it, and another eight-sided box on it, and then the steeple, so I tried to draw those geometric shapes.  It was a terrible drawing because I tried to draw all the sides.  The next time I drove by I studied it again and realized, duh!, that I only see one side of things, and only a portion of the geometric shapes, and from a certain angle.  I had started my drawing with an 3d octagon wire shape, and that’s a conceptual view, not a visual view.  So if I’m looking from the side, I’ll see one side of the 4 sides, and 3 sides of the 8 sides, and essentially a very long triangle.

To test my memory just now I found a picture of the church on the web and it’s nothing like what I remember seeing.  For some reason I remember the church as having wood siding, and it’s brick.  I did remember the wooden slates on the third level, but I didn’t remember the tall windows of the second layer.  I’m no Stephen Wiltshire.

I remember having a much better visual memory when I was young and smoked pot.  Oliver Sacks said he experimented with large dosages of amphetamines when he was young and for a few weeks could draw quite well, especially from his visual memory.  After he stopped taking the drugs he lost all ability to draw.  The poet W. H. Auden took Benzedrine to write poetry, because it helped him to concentrate intensely on detailed verbal imagery.  I assume drugs in each case helps tune out larger reality so we can zoom in on a single tiny aspect, which helps the brain focus.  But can visual memory be enhanced without drugs?

I’m pretty sure it can because of my experiment with looking at the church steeple.  If I studied that steeple every day, and tried to draw it every day, and checked my errors every day, I’d learn about seeing and drawing, but I don’t know if I would have a better visual memory.  Many of the blind people Oliver Sacks wrote about, have extremely detailed inner worlds.  They know they aren’t accurate compared to the outer world they can’t see, but they are very functional models and maps that help them live and work in reality.  One blind man even re-shingled his own roof, freaking out his neighbors because he worked at night.  Another could design machinery with his inner sight.

I think when I have flashes of visual memory it’s more like dream memory.  I have very vivid dreams, but sometimes I’ll have microsecond flashes of dream memory when I’m awake.  When I took drugs when I was a kid, some of those memory flashes would last seconds.  I remember one of flying over the Golden Gate bridge, as if I was a bird, or riding in a helicopter.  Often my flash memories are visions from great heights – and I can’t explain that.  A person with good visual memory could retain those images in their mind.  I can’t.  My memory of them are more like wordy descriptions, which probably explains why I write rather than paint.

I’ve always been impressed by 19th century scientific drawings.  Drawing was an important skill to a scientist.  I don’t know if this meant they had good visual memory, or just a good eye for detail.  And that makes me wonder if I developed an eye for detail would that enhance my visual memory?

I’ve always wondered if painters had to paint 100% of what they put on canvas while observing their subjects, or did they paint some of their pictures from memory.  Often when I look at photographs I think I remember in great detail, I’m shocked to find my memories are either wrong or just fuzzy smudges at best.  People with perfect visual memories are often autistic.  Temple Grandin, a famous autistic person, profiled by Oliver Sacks and featured in the wonderful HBO movie of the same name, thinks in visual imagery.  I’ve many times wondered if animals, who don’t have our language skills, think in pictures too.

To be honest, I believe I have a poor visual memory because I go through life not paying attention to visual reality.  My life is books and words.  I think in concepts.  And I wondered if John Hull felt deep blindness was more rewarding because it allowed him to focus more intensely on concepts.  Now, I have no desire to go blind, but I can imagine after reading Sacks, that blindness isn’t the sensory depravation I once thought it was.

Also, I wonder if I can improve my current abilities.  The cliché is your hearing and touch senses improve if you go blind, but do you have to go blind to improve your other senses?  Can one enhance all our senses, or is their a limitation in brain processing?  Because I’m getting older and my memory is failing, I pay attention to all that advice about improving memory.  I started playing Words with Friends.  I used to be terrible at Scrabble, but now I keep 6-8 Words with Friends games going and I can now beat people that used to always stomp me.

I’m confident if I got some drawing books and practiced, or even took some drawing classes, I could improve my drawing skills, but I also wonder if those skills would translate into better visual memory?  Is that a physical limitation – you either have it or you don’t?

How good is your visual memory?  Post a comment.

JWH – 8/11/12 

Living in a 2D World

I’m reading The Mind’s Eye by Oliver Sacks, and his chapter on stereoscopic vision made me think about my own vision and how I live my life.  I have a bad right eye and I have poor stereoscopic vision.  When I close one eye I don’t notice any difference.  I was told when I was young that my mind compensates with a pseudo-sense of 3D.  Dr. Sacks spends quite a bit of time talking about how much he loves his stereoscopic vision, that he’s even a member of New York Stereoscopic Society and has been a lifelong collector of stereoscopic cameras and viewers.  When he lost vision in one eye he wrote quite eloquently about what it means to live in a 2D world after being so attuned to 3D reality.  He also chronicles a patient that spent most of her life in a 2D world, and acquired 3D vision late in life.

Sacks mentioned several times in chapter 6 that many people have weak stereoscopic vision and have learned to compensate and don’t even know what they are missing.  I guess I’m one of them.  But then I got to thinking about my visual world.  I spend all day working in front of a computer, and all evening either at the computer, TV set, or reading books, and that means I spend a majority of my day looking at 2D fields, either of LCD or paper.  I also love paintings, cover art on books, CDs, LPs, magazines, and photography.  I also have a tablet computer and iPod touch – more 2D living.

I wonder if my lack of 3D vision pushed me into enjoying 2D hobbies and jobs?  I love hi-rez computer screens.  I’m happiest when I’m immersed in one of my 2D worlds.  But I’m not alone.  Is all our gadgets and screens pushing us all into preferring a 2D world?  If I had been born with great vision would I have become a bookworm and computer geek?  From reading The Mind’s Eye we are warned very vividly to expect a lot of changes and adapting to failing bodies and brains when we get old.  All his case histories are about people adapting, so I assume I adapted before I even knew I was missing anything.

I can’t recommend The Mind’s Eye highly enough.  It’s fucking intense.  It’s the scariest book I’ve ever read.  Most people will find this book immensely depressing and horrifying.  Zombies and vampires are kittens and puppies compared to what awaits us in old age.  It scares me and inspires me at the same time.  It’s about people with various kinds of brain damage, usually from dementia, stroke, aging, birth defects, etc., and how they coped when their way of life was greatly disturbed when one day one of their abilities were taken away.

What’s funny is most of the people that Sacks writes about deal with their disability with great bravery, but Sacks tells us how frightening and depressed he got when he chronicles losing vision in his right eye.  But even with all his physical failings, this 79-year-old man does more each day in old age than I ever did on any day in my prime. 

That’s why this book is so inspiring.  We’re all going to die, and more than likely, we’re all going to see our bodies and minds deteriorate before we get to take that long dirt nap.  It’s going to be painful, scary, depressing and hard.  But Sacks tells us stories about how people go through horrible conditions.  If I have a stroke in my future, then I’ve very glad I read this book.  I once had a stroke like incidence and the details in this book explained what happened to me.  For a short time I lost all language awareness.

We are used to thinking that aging means failure of our physical health.  But our brains wear down too, and in many ways.  Sacks profiles people who have lost the ability to read or recognize faces or objects, things when we read about them sound bizarre.  But if you’ve ever known people who have had a stroke, or dementia, you’ll recognize all of these horrifying failures of brain functionality.

We like to think of ourselves as little souls inside a body.  That if we lose a leg or have a heart attack it’s something that’s happening to our body.  We seldom contemplate what happens when our soul comes apart?  If you woke up one day and couldn’t tell the difference between your wife, mother and daughter, how are you going to react?  Quite a few of these stories are about people who have healthy eyes but can no longer process vision in a normal way.  Sacks explores many subprograms that make up our visual processing of reality.

If you read The Mind’s Eye you’ll see how everyone adapts their limited senses to reality.  No one is 100% functioning in all brain processing.  Reading this book makes me realize how I’ve adapted to living in a 2D reality.  My brain has adapted my vision so I can drive, walk down stairs, wash the dishes, play ball, catch a Frisbee, but from what I’ve read I’ve never known the beauty of stereoscopic vision as Dr. Sacks describes it.  When Sacks lost his 3D vision, he had trouble walking down stairs, taking ahold of objects, and did things like pour wine into people’s laps.

I hope I can remember this book, because when I experience brain damage or mental malfunction, I want to stay calm and not freak out.  When my brain starts breaking down and my consciousness observes the world going wacky, I want to go, “Hey, I know what this is, the area of my brain that processes written words must have conked out.”  Several people in this book described seeing words as if everything was written in a different language and alphabet.  Can you imagine how scary that would be?  Hopefully understanding the ideas in The Mind’s Eye might help deal with such experiences – if I can remember.

The thing I fear the most is not remembering who I am.  But you know what?  People adapt to that too.   

JWH – 8/8/12

Damn, I’m Out of Shape!!!

I went swimming today, the first time in probably a quarter of a century.  It was an eye opening experience.  If I fell off a boat without a life preserver I’d be dead in 2 minutes, maybe even 1 minute.  I was never a good swimmer, nor could tread water well, but I had the stamina to struggle along for maybe 50 yards.  I could have put up a good fight.  At 60 and weighing 232 pounds I’d just go under immediately in open water and not come up.

When I was first married, and we lived at an apartment with a pool, I weighed 155 pounds and could run for miles.  I thought before I got in the pool today that fat floated.  Boy was I wrong.  My fat don’t float!  I sink.

For years people have been telling me to take up swimming to help my back.  I’ve always said no because swimming is inconvenient.  But my neighbor, who has a pool, has been urging me to use her pool, so this morning I gave it a try.  I jumped in off the ladder at the deep end and immediately discovered my lack of buoyancy.  It was a struggle to get back to the surface.

At first I thought her pool too small to do laps, but then I tried to do a lap, on the short length, which can’t be more than 20-25 feet.  I made it, using my flailing doggie paddle style, but I had to grab on the edge of the pool and catch my breath after just the first crossing.

I did some experiments trying to hold my breath under water using the stop-watch feature of my Casio.  At first I could only go 8 seconds.  Eventually I worked up to 13.  That’s pitiful.  I guess that’s a sign of getting old.  When I was young it wasn’t much trouble to hold my breath under water for 60 seconds or more.

I stuck with doing laps and I went back and forth maybe 10 times, either doggie paddling, or some kind of crude breast stroke.  I tried the normal crawl one time but I just don’t have that kind of coordination.

I’m not completely out of shape.  After swimming I did 20 minutes of physical therapy and then 10 minutes of Bowflex.  But it’s obvious that being overweight and 60 that I’m at a lifetime low point when it comes to stamina.  Before my back got bad I did stair walking at work and could do 20-24 floors on my break.  I can ride my bike for 30-45 minutes now, but I’ve discovered that unless I’m riding uphill, bikes are so efficient that it’s not much exercise. 

It so weird watching my body decline, because mentally I feel like I did when I was 19.

So far I’ve lost 6 pounds on my diet.  I do believe if I worked hard I could regain some of my stamina – but will I?  I’ve discovered in recent years I’ve adapted to a very sedentary lifestyle.  My back limits my activities, especially standing or walking, so I’ve just accepted doing less.  I think I need to get an exercise bike to push myself.  Sitting on a bike, leaning forward on the handlebars, doesn’t hurt my back.  Swimming, or more precisely, trying to swim, didn’t seem to hurt my back either.  So I’ll keep it up.  At least in warm weather.

On one hand I feel like just accepting getting old and doing less, on the other hand I believe I should fight the inevitable.  I see all these natural catastrophes on TV and how old people need so much help just to run away from danger.  I don’t want to be like that.  I see news reports of people rushing to rescue stuff in their homes before fires engulf them.  With my stamina I couldn’t rescue much.  And living in an emergency shelter would be very hard on me.  I’ve gotten old and soft and addicted to creature comforts, the crutch of modern air conditioned living. 

I wouldn’t be much of a survivor in a post-apocalyptic world.

I’ve become an animal highly adapted to a very specific environment.  I’ve developed a routine where I expend very little energy to survive.  But what will life be like at 70?  Or 80?  I would ask about 90, but I just can’t imagine my declining stamina letting me live to 90.  But I see 90 year-old people all the  time – but most of them move very little.

Do I ride the current slope of my declining stamina, or do I made a big effort and bend that declining slope into a rising one?  Could I regain the stamina I had at 50 or 40?  That might be dreaming, but I do know people my age that are many times more active than I am.  However, I think they’ve always been many times more active than I was.

I’ll keep you posted.  I need some way of measuring progress though.  Have to think about that.  Are there standardized tests for stamina?

JWH – 6/30/12

Lose It! versus MyFitnessPal

I want to lose weight and my Google research tells me keeping a food diary is essential to this goal.  My wife said they taught her at Weight Watchers:

If you bite it, write it.
If you nibble it, scribble it.
If you drink it, ink it.
If you snack it, track it.
If you steal it, reveal it.
If you sneak it, leak it.
If you chose it, disclose it.
If you hog it, log it.
If you grab it, blab it.
If you indulge it, divulge it.
If you ingest it, you guessed it!
If you imbibe it, inscribe it!
If it goes in your smacker, it goes in your tracker!
If you lick it, bic it!
Grab your pencil before your utensil!

I’m not a joiner, so Weight Watchers isn’t for me.  I’m a do-it-yourselfer, so I found a couple of apps to help me out.

Loset It! and MyFitnessPal are both great programs that help you lose weight by tracking what you eat.  They both work from a web site and/or mobile device.  Both have barcode readers to quickly look up calorie and nutritional content.  Both help you track calorie intake and calories burned through exercise.  Both programs are essential for fighting weight loss.  Both programs have social networking features.  Both are easy to use.  Both work with iOS and Android.  Both are free.

So how to pick one?  Since they are free you could just start with both and see which one you liked.

However, my basic characterization is Lose It! is best for non-techies and MyFitnessPal is best for power users.  Lose It! has an elegantly simple user interface that goes deep with features with the minimum of thinking.  MyFitnessPal is a tiny bit harder to learn, but you can do more customization.  MyFitnessPal gives more nutrient information and it’s barcode scanner seems to recognize slightly more foods, but it’s program menu structure is a touch more cumbersome than Lose It!’s menus.  I like proportion control in Lose It!, but MyFitnessPal can be more accurate if you like math.

You sign up for each program and answer some questions about your height, weight, age and your weight loss goal.  The program then tells you your daily calorie goal and what date you’re reach your weight loss goal if you follow their routine.

My goal is to get down to 180 pounds by July 25, 2013 by losing 1 pound a week.  I get 2,271 calories to work with each day.  I can eat more if I exercise more.  For years I’ve felt like I was dieting all the time because I wasn’t eating all the food I wanted and had given up all my favorite junk food.  But tracking calories closely clearly shows I was still eating too much.  Well, duh!  I’m still fat.

The Math of Weight Loss

I want to lose 1 pound per week.  1 pound is about 3,500 calories, so that’s 3500 / 7 days = 500 less a day.  Lose It! asked my age, height and weight and told me 2,271 calories is what it takes for me to lose 1 pound per week, which means eating 2,771 calories maintains my weight, and eating more means my bodily universe expands.

It’s extremely important to honestly record everything you eat and use accurate proportions, otherwise you are fooling yourself.  Don’t cheat, or you won’t loose weight.

Both programs work in almost an identical way.  You track calories by adding food or exercise to a diary that’s broken down by:

• Breakfast
• Lunch
• Dinner
• Snacks
• Exercise

You add calories to your diary by selecting food items by:

• Scanning the barcode
• Searching a database
• Selecting from items you’ve already added
• Selecting from complete meals you’ve already recorded

You decrease your calorie count by adding an exercise from:

• Menu of exercises
• Exercises you’ve already listed

You can use both of these programs from the web if you don’t have a mobile device.  I don’t have a smart phone but I do have an iPod Touch that I carry with me everywhere.  It’s the current generation with a camera, so I can scan barcodes.  It’s extremely easy to keep a food diary with these programs and a mobile device.  It’s pretty easy to just use the web version, but it will be a bit more work because you have to run find a computer after you eat each meal, or jot down what you eat during the day and enter it at night.

Here’s what the daily diary looks like for the two programs:

Lose It! (the program I use)

MyFitnessPal (the program I’m testing)

Neither program had physical therapy exercises on their list, so I used yoga as a substitute.

Once you’ve looked up most of the common foods you eat, recording a meal or snack in the diary takes seconds.  I make up menus of my favorite meals and just add the whole menu with one click.  I tend to eat a lot of the same meals.  In Lose It!, breakfast is one item that’s a stored recipe, but lunch is from a restaurant.

Eating out is a big problem.  No barcode to scan, or label info to read.  Both programs lists items off of chain restaurants, but if you go somewhere else you have to make the best guess you can, or build an approximate recipe.  This restaurant guide at CalorieKing is very helpful, but I wished they had photos of the food, with dimensions.  At CalorieLab you can search 70,000 foods and 500 restaurants for similar meals and hope you get close.  The FDA is rolling out a law that will require all restaurants with more than 20 locations to list nutritional information.  It would be great if the menus had little barcodes to scan.

More than Counting Calories!

These programs are about more than counting calories, they provide overall nutritional information, like this my current information from Lose It! (I haven’t had dinner yet):

I eat too many carbs, and too much salt, and I need to eat more protein in relationship to the carbs and fats.  I’ve seen all kinds of recommendations for the proper ratio for Carbs/Protein/Fat.  Moderate is 50/25/25, but the Zone diet recommends, 40/30/30.  I’m a vegetarian, and not a particularly healthy eating vegetarian so my protein is low and my carbs high.  As I work on my diet I want to get close to the Zone diet ration of 40/30/30.

Not only do these programs help me watch calories, they help me watch the kind of foods I eat.  When it comes to nutrition data, MyFitnessPal is superior to Lose It!  Here’s what MyFitnessPal shows for Quaker Oat Squares cereal:

Here’s what Lose It! shows (but for 1 and 1/2 cups – Lose It! is easier to adjust proportions):

I find Lose It! a breeze to use and adapted to it quickly.  I’m tempted by MyFitnessPal because of the extra nutritional information, but for now I’m going to stick with Lose It!  When I want to know more I just add the foods to MyFitnessPal.

My wife and two friends use Lose It!  This helps us stay on track and gives us stuff to discuss and argue.  My friend Peggy nags me about my carbs.  I nag her about her cholesterol and protein.

I’ve just started using these programs.  I wished I had discovered them years ago, or I wished they had existed decades ago.  Back then I tried keeping a food diary.  It involved a pen, a notebook, and a nutrition fact book.  It was tedious and I gave it up after a couple of days.  I’ve adapted very easily to Lose It!  But it’s too soon to see if I’ll stick with it for a whole year.  However, I feel closer to dieting success than ever before.

JWH – 6/16/12 (Happy Birthday Susie)

UPDATE: 8/21/12

I ended up picking MyFitnessPal for my standard app.  I preferred the look of Lose It!, but MyFitnessPal had way better barcode scanner and nutritional database.  And being able to scan the barcode for information is just too handy.

After losing 10 pounds I started getting lazy with recording my food intake.  I thought I could remember my good habits, but I was wrong.  If I don’t record everything I don’t lose weight.  I’m now back to using MyFitnessPal, but it’s hard.  I try to tell myself I can’t eat anything unless I record it first.  Or it’s not worth eating if I’m not willing to record it.

I hate having to control what I eat, but the act of maintaining a food diary helps that control.

MyFitnessPal makes it about as easy as possible to record what I eat, but it’s still a pain in the ass.  I’ve even thought of eating the same meals every day so I won’t have to record.

JWH