Health – Auxiliary Memory

How Not To Die by Michael Greger, M.D.

by James Wallace Harris, Sunday, July 10, 2016

You will never understand the need for health until you have chronic health issues. I wrote a review of How Not To Die by Michael Greger, M.D, over at Book Riot. It got 4 shares. I had made the mistake of not targeting my audience. Book Riot readers are mostly young, so most of them don’t have health issues – yet.

I believe How Not To Die is an essential book for anyone who craves health, but your willingness to read it will be proportional to had bad you feel. It’s a shame we don’t eat healthy our whole life, rather than waiting until we see the shadow of the Grim Reaper to start. If you suffer poor health for a variety of reasons, you should read this book. To be specific, if you have:

Heart disease
Obesity
Diabetes
Chronic pains due to inflammation
Mystery ailments and autoimmune diseases
Getting old and tired

Then this book is for you. You can get a feeling for why you should buy this book by visiting NutritionFacts.org and watching several of the videos. Dr. Greger is a medical journal reading monster. He analyzes all the data we hear about on the news, that’s always so contradictory and confusing, and then rephrases it so it makes sense. The book is a summary of all this knowledge, broken down into different health problems.

Since I have clogged arteries, and have already had one stent put in, I know what it’s like to hunger for health. I also have spinal stenosis, and know about chronic pain. And I’m overweight. I have learned to control my conditions and lose weight with diet and exercise. I don’t take daily pain pills or anti-inflammation drugs.

Years ago I discovered that physical therapy and exercise would controlled my back and leg pains, and my neuropathy. But I didn’t eat healthy and weighed 240 pounds. Just before I retired, I was having trouble breathing, with dwindling stamina. I had to have a stent put in. That’s when I read Prevent and Reverse Heart Disease by Caldwell B. Esselstyne, Jr., M.D., and saw the documentary Forks Over Knives. Both prescribed a plant-based diet for improved health. Even though I’ve been a vegetarian since the 1960s, my version of vegetarianism wasn’t healthy.

Because I felt bad, I was willing to give up my favorite foods, and go on the plant-based diet. I lost 30 pounds, and felt great. My LDL cholesterol went down to 91. Then I started cheating on the plant based diet. I gain several pounds, and began feeling bad again. My LDL went up. I’ve since become more strict with myself, started losing weight again, and felt better. I know the plant-based diet works because every time I cheat for a week, all my health indicators go negative.

The reason why How Not To Die is such an important book is because Dr. Greger explains the science behind eating a plant-based diet, and why eating what I love is bad. The plant-based diet is not fun. I don’t go hungry, but it’s hard to follow. The main drawback is learning how to cook. The next biggest obstacle is learning to eat different. Plus, I’m troubled because the plant-based diet seems counter to what we’ve been taught about nutrition. I eat little protein and even less fat. Dr. Greger shows overwhelming scientific evidence that following this diet is healthy. And that’s why his book is worth reading. Nutrition science is confusing, and overwhelming. His book and videos carefully shows how in study after study, science is learning that a plant-based diet is healthier, and can reverse the damage done by a lifetime of poor eating. All I can say is the book is convincing, because when I apply it, I feel the results.

The sad thing about all of this is I know how to help myself, but I keep fighting that knowledge. I want to eat foods that hurt me. I know they hurt me because of trial and error. I have more stamina, energy and sense of well-being when I’m on the diet. When I return to eating peanut butter, eggs, cheese and butter, I can feel my arteries clogging. Yet, I crave those foods in an insane way. For the most part I’ve already given up on candy, pop, desserts and other obvious junk foods. When I eat junk food I feel much worse almost immediately. When I give into my sweet tooth, my writing discipline disappears, and I start skipping exercise. I become a couch potato. But with cheese, peanut butter and eggs, its more subtle. I feel happier, but I start slowly gaining weight again, and eventually begin noticing shortness of breath. That’s when I jump back on the diet. But after a couple months, I’ll cheat again.

The title, How Not To Die, is very literal with this book. I doubt many will read it – unless they are suffering. If you are, you might want to give it a try.

JWH

Best Links About Medicare

By James Wallace Harris, Monday, June 13, 2016

I have many friends like me who were born in 1951, and we’re all needing to sign up for Medicare this year. I’ve promised several of them I’d search the web for the best advice. Medicare is amazingly complicated, and can still be quite costly. Make the wrong decision, and you’ll pay. I provide these links with no warranty of accuracy. This page was created to help my friends and I find out more about Medicare, but if they’re helpful to you too, then great.

General Information

Of course, the first place to visit is Medicare.gov, but you actually sign up through Social Security. I’ve got to say, this site is information overload. They also publish Medicare & You 2016 as a pdf booklet. Plus Medicare.gov offers a whole series of publications, some in ebook format. And Medicare even offers a blog. Here is Medicare’s intro video:

My Medicare Matters from the National Council on Aging is a friendlier introduction to Medicare, but still intimidating.

Of course, everyone wants to know what Consumer Reports says.

This video gives a simple intro that’s the first step on a long journey.

This information came from UnitedHealthcare, so I don’t know what their vested interests are, but they have a site Medicare Made Clear, and a series of additional videos that explain more about Medicare on YouTube.

FAQs

Medicare B & D vs. Medicare C (Medicare Advantage)

One thing that came up in the intro videos was the concept of Medicare Advantage. It seems very tempting because it combines several options into one plan. However, after watching this video I assumed it wasn’t for me. I don’t like insurance programs that limit choice of doctors and hospitals, but then I watched the second video.

Now I’m even more confused. “Medigap Vs. Medicare Advantage: Which is Better?” helps some. Probably if you live in a retirement community near good in-network support, and you don’t travel, Medicare Advantage might be a good deal. My fear is something catastrophic would happen to me, and I’d end up with monster medical bills I couldn’t pay without emptying my retirement savings.

It appears that Medicare Advantage often promotes preventative healthcare practices, and they will make sure you stay on top of your medical problems. That might outweigh the problems of working within a network.

Steve Vernon from CBS Money Watch writes, “Should you buy Medigap or Medicare Advantage plan?” Vernon offers additional links and essays on this topic, but I’m still just as confused and undecided. It seems your choice is between choosing parts B & D and spending around $150 a month, and choosing part C and paying lower monthly fees but with co-pays. Some plans have no monthly fees at all. Medicare Advantage sometimes includes dental and prescription drugs all rolled into one plan, but you’re restricted to which doctors and hospitals you can use.

Consumer Reports also has a page about “Medigap vs. Medicare Advantage.” It offers a nice comparison chart.

I then checked the entry on Wikipedia for Medicare Advantage. Evidently it’s a political issue to allow folks to find alternatives to Medicare. Medicare Advantage are private plans that are required to offer the same benefits as Medicare. By law, you can’t buy both. Medicare Advantage plans are more like HMOs or PPOs. If you enroll in a Medicare Advantage program, it collects money from the government’s Medicare program. Which explains why going to an out-of-network healthcare provider might cost you 100%. I highly recommend reading the Wikipedia entry several times. This statement is telling:

There is some evidence that sicker people and people with higher medical expenditures are more likely to disenroll from Medicare Advantage plans and go into Original Medicare instead,^[6] which could be due to the more restricted networks of health providers or to the benefit design of the plans. The federal government makes risk adjusted payments to private plans to avoid this, but it is unclear how effective that policy is.

In other words, if you’re healthy, don’t go to doctors often, and have good in-network support, Medicare Advantage might save you a good deal on monthly costs. Which explains why the advisor in the first video picked it for her father.

Medicare Part D

Part D is drug coverage. You can buy Part D from a private insurance program in regular Medicare, or you can get drug coverage in a Medicare Advantage plan. Consumer Reports offers “How to find the best Medicare drug plan.” There are penalties for not signing up right away, but they are low enough to consider delaying participation – see the skepticism section below.

Supplemental Skepticism

What makes things really confusing are supplemental plans. These are insurance plans to cover costs Medicare doesn’t, including the infamous “donut hole.” More on the donut hole can be found at Wikipedia.

David Belk claims paying for supplemental insurance is basically giving your money away. He says supplement insurance doesn’t cover what a lot of people think it does. However, I’m skeptical of his skepticism.

This just adds to my decision agony. I want to avoid any chance of being stuck with a gigantic medical bill. I hear about that in the news more and more. Belk claims insurance companies are playing into that fear. Belk says insurance companies are mostly insuring against minor costs, not major ones. And they don’t cover what Medicare won’t cover. David Belk is a MD that maintains the website True Cost of Health-Care. He even claims that opting out of Part D might be a good option if you buy low-cost generic drugs out-of-pocket. Check GoodRx.com for drug pricing.

I was all ready to load up on supplemental insurance plans until I saw this video. Now I’m not so sure. However, there are penalties for delaying joining Part B & D. So for those folks who are willing to bet they will always be healthy, they can delay buying Part B & D, but they need to know about the penalties.

Mistakes to Avoid

The penalty for not signing up for Part B on time is stiff – one that lasts the rest of your life.

The penalties for not signing up for Part B & D can be add up to a lot. But there are exceptions. It appears if you are still working and have good insurance coverage you’ll be excepted. Watch out though, how long you go between ending private insurance and starting Medicare is important.

My guess is people trying to keep their monthly costs down will pick a low-cost Medicare Advantage plan, which is a Medicare approved alternative to signing up for Part B & D. These folks will have to go to network doctors, but they may get better preventative medical care. And if Wikipedia is right, these people will eventually switch to traditional Medicare when they get older and sicker, because traditional Medicare covers more.

I thought my monthly bill for health insurance would go down when I joined Medicare, but that won’t be true. The insurance I now get through work is an extremely good retirement perk. If I spring for Medigap insurance, I could end up doubling my existing monthly healthcare bill. However, I have friends that buy their own health insurance and they will save a lot of money.

It’s critical for people to sign up for Medicare promptly. Delay will cause penalties that could continue for the rest of their life. Life would be far simpler if we had a single-payer system. The freedom of options requires both extensive study and risk. There are many private companies offering a variety of options to avoid potential medical expenses. If you have a very small fixed income, you’ll have to navigate these waters very carefully. However, it also appears you can easily overpay searching for peace of mind. None of us know how long we will live, or what kind of healthcare burdens we will face. If we make a mistake in these decisions we could end up spending more each month from our fixed budget, or incur risks to our shrinking nest eggs.

JWH

Diet or Die!

By James Wallace Harris, Monday, May 9, 2016

It’s one thing to choose to diet, it’s another thing to have to diet. I’ve become trapped into eating healthy because of my heart. If I go off my diet, I can feel the symptoms of my arteries clogging, and that isn’t nice. It seems like everyone I know can just chow down on anything they want, and ignore any possible consequences. I resent that. Some of my friends are visibly fat, but others aren’t. Most of my friends take statins or blood pressure medicines, or both. My wife has great cholesterol numbers because of her statin, and she eats what she wants. I have to take a statin and eat vegan just to keep my numbers in line.

They say the first sign of heart disease for many people is the heart attack that kills them. My first signs a few years ago were decreasing vitality, lack of stamina, trouble breathing and tightness in my chest. I was “fixed” by doctors putting a little spring in my widow maker artery called a stent. The trouble with atherosclerosis is it builds up everywhere in your arteries. Unless I change my habits, I’m only waiting for the next clog.

I’ve been experimenting with a plant based diet, something former President Clinton did after his stent was put in. He claims his research revealed that 82% of people who follow a plant based diet after a heart problem heal themselves. I’ve been trying to follow that diet for the last couple of years. When I stick to it, my cholesterol numbers go down. When I don’t, they go up. I keep trying to find ways to cheat with some of my favorite foods (peanut butter, sweets or cheese), but when I do, my LDL goes up again. If I cheat long enough, I can feel some of my old symptoms returning.

The book I try to follow, Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, Jr. M.D., is very strict. When I follow Esselstyn’s diet I feel good, and I lose weight. I can eat as much as I want off the approved foods, but no fun foods. After a year of trying to find ways to tweak his diet in my favor, and four quarterly blood tests, I know I can’t. I’m trapped in this diet. I’ve found a new book, How Not To Die by Michael Greger, M.D. that confirms the claims of a plant based diet with numerous scientific reports. Greger runs a website, nutritionfacts.org, that regularly explains the research in medical journals with short easy-to-understand videos.

My dad died at 49, on his third heart attack. He survived two attacks and a stroke, but was miserable for seven years. He never ate healthy, never stopped smoking, and always ate what he wanted. Evidently, by not smoking and being a vegetarian since the 1960s, has let me beat his record and live to 64. I was always a sweet-tooth vegetarian. Now I’m discovering that I have to jettison the junk food to live longer.

Advocates claim following a plant based diet will reverse heart disease. I hope that’s true. If I’m going to die anyway, I’d rather go out eating Ben & Jerry’s. Right now I don’t have a choice. If I don’t eat healthy I feel my heart clogging up, and that feels pretty much like having a scary guy point a gun at my head and say, “Eat that and die.”

Bummer.

JWH

I Wasn’t Crazy After All—I Can Gain Weight on Fewer Calories

By James Wallace Harris, Tuesday, May 3, 2016

Yesterday, The New York Times ran “After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight” that was an extensive article that explained the science behind regaining weight after dieting. Scientists used contestants from the reality show, The Biggest User in their study. They measured their metabolism before and after their massive weight loss successes. Contestants, as they lost weight, became more efficient at maintaining their weight. The startling news, which many dieters have learned from experience, is after you regain your weight, you also maintain that efficiency. So it gets harder and harder to lose weight. In other words, dieting makes our metabolism slow down, but it doesn’t speed back up when we regain the weight.

“The key point is that you can be on TV, you can lose enormous amounts of weight, you can go on for six years, but you can’t get away from a basic biological reality,” said Dr. Schwartz, who was not involved in the study. “As long as you are below your initial weight, your body is going to try to get you back.”

I lost 30 pounds last year, but keeping it off is a struggle. I kept telling myself that I’m eating less and not losing. How could that be? Well, I wasn’t crazy. Scientists also discovered as we lose weight, we reduce our levels for the hormone leptin, which makes us feel hungry. The study on the Biggest Losers contestants discovered their leptin levels went down almost to zero, leaving them ravenously hungry. Leptin levels went back up when they regained weight, but only to about half the level before, leaving them hungrier than they were before they dieted.

This sucks.

JWH

Writing For Other Sites and My Health

James Wallace Harris, Thursday, April 28, 2016

I’m publishing less here because I’m publishing more elsewhere. That doesn’t mean I want to give up writing for my blog, but I do need to develop a plan for what’s best to post here. When I write about science fiction its obvious to give those essays to SF Signal, because science fiction is what they’re all about. Plus, they get more readers. And I’ve been accepted at a general book site, so now I can write about all the other books I’m reading for them. I’ll let you know what site that is when they publish my first essay and I have a link. They’ve accepted two essays so far. That leaves non-book subjects for me to write about here at Auxiliary Memory. I just need to find the time. My plan is to publish one blog post here each week. All told, that’s committing myself to writing eight essays a month. The ones I write here might be short, like this one.

I’ve been retired two-and-half years now, and writing essays has turned into my retirement hobby. That’s worked out very well because writing counteracts brain rust. I’ve noticed the longer I go without writing, the more trouble I have remembering words and pronouncing them. I’ve always called blogging piano practice for writing essays, well now I know it’s exercise for the mind too. I highly recommend blogging as a hobby, for the young or old. Writing over a 1,000 blog posts has really paid off.

Essay writing is turning out to be preventative medicine for dementia. Writing is showing me my physical and mental limitations. Because the newer essays require so much research, I’m having to push myself much harder, causing me to hit a wall each day. That’s an effective barometer of my mental and physical health. Each day takes more psychic management, and it’s all too obvious each birthday I pass leaves less creative energy. I doubt I’ll be able to do a fraction of what I’m doing now in my seventies. Getting old sucks, but that’s not news to anyone already old. It might be news to my friends who have yet to retired. Before I retired I thought all I needed was time. Well, at least I’m still learning new things.

I’m learning what it takes to do research, and that’s given me much greater respect for serious writers. It’s one thing to write an opinion piece, it takes several magnitudes more effort to include useful facts. Especially if you order them in some kind of coherent fashion.

I’ve had two essays published at SF Signal in April. The first, “The Biographies of Philip K. Dick” is about the many books written about PKD. Duh! Titles are important. The second, “How Well-Read Are You in Science Fiction?” serves two purposes. First, it asks how many classic science fiction books do you have to read to feel like an expert. Second, it describes how to use the Worlds Without End’s database to catalog the science fiction books you’ve read, which then allows you to see how you stack up on more than fifty “Best SF/F/H Books” lists. Read the article if you want to learn how, it’s a lot of fun to use the WWEnd database. Here’s an illustration of how well I did with their “WWEnd Top Listed” list. It’s color coded. Blue and green are books read, with blue being favorites, yellow means the book is on my to-be-read list. Orange means I’m reading that book currently. Yeah, I’m embarrassed to let people know I’ve never read I Am Legend by Richard Matheson or Doomsday Book by Connie Willis – but I own both.

I don’t think I mentioned another article I wrote for SF Signal. Damn, I forget them as fast as I write them. But I do like plugging this Great Course. See “How Great Science Fiction Works – A Great Course in SF by Gary K. Wolfe.” If you love the history of science fiction, this is an excellent overview of the genre, and is only one credit at Audible.

JWH

Why Can’t I Lose Weight?

By James Wallace Harris, April 13, 2016

I know how to lose weight. I lost 29 pounds last year by following a plant based diet. I could eat all I wanted from an approved list of foods, didn’t go hungry, and my doctor was ecstatic. My blood work numbers hadn’t looked so good in decades. Then I started cheating on my diet. I didn’t gain weight, but I stopped losing weight. My blood work numbers ratted on me, and my doctor started nagging again. I cut back on my cheating. Three months later my numbers convinced her to do a happy dance. (For some reason I really love making her happy.) She even told me I could go six month without another blood test. In the moment of feeling successful, I foolishly promised I’d lose another 25 pounds.

Ha-ha, like some crazed sweet-seeking mammal I’ve since gained 8 pounds. I just can’t resist food. Why can’t I control my eating? Why can’t I lose weight? Why can’t I keep weight off once I work so hard to lose it?

Of course millions of people are asking these same questions. Why can’t we lose weight? Why can’t I be like Mr. Spock and do the logical thing? Evidently, I’m suffering from multiple personalities. One being inside me, the one writing this essay, wants to eat healthy, lose weight and be a different person. There’s another person in me that’s illogical and hungry. That person insists I go out for Ben & Jerry’s ice cream, but eat pizza on the way. And I’ve got to tell you, when Mr. Junk Food gets his way, we both feel pretty damn satisfied.

Mr. Spock advises me to write up a mission statement about what to eat, print it up on a nice card, and meditate on that message before every meal. But then my wife and I get hungry for dinner, don’t feel like cooking, or even going to a good restaurant, and end up pigging out on Taco Bell. I weighed two pounds more the next morning. Where did Mr. Spock go? Mr. Junk Food can shanghai my self-control in an instant. I need to kill Mr. Junk Food. Is that even possible? Self-exorcism? But what would life be like without that cute little devil on my shoulder?

Mr. Spock has already settled on a diet. He assures me if I just followed it, I’d be healthy, happy and fat no more. He did get us to read a number of books, and took control long enough to prove that his solution works. I keep telling myself to read those books every day until Mr. Junk Food disappears—but it’s not working. I’m beginning to think Mr. Junk Food stunned Mr. Spock and transported him to another planet. He obviously overheard we were planning on dieting again.

Why can’t I be sensible? Why are my urges as polarized as liberals and conservatives? Why do I have friends who eat everything they can stuff down their gullet – and still stay skinny? Why isn’t feeling better incentive enough to eat healthy? My heart and back loved when I lost the 29 pounds. I think one reason I cheat is because I feel better, but I won’t let myself gain too much because I fear the return of pain. I remember what I felt like before I got my stent, and that helps fight off Mr. Junk Food. But only to a degree. Most of the spinal stenosis pain and numbness in my legs have gone away because of losing weight. The plant-based diet is also an anti-inflammation diet. When I follow that diet I don’t need pills, and I don’t feel the inflammation. Mr. Spock informs me of this logic every day. Why can’t I listen all day long?

Yet, eating two bags of M&M’s and drinking a Dr. Pepper would feel like winning a million bucks right now. Hell, I just realized just how bad off I am. I’d rather be a skinny person who could eat all the junk food they wanted than be rich. That’s how bad I want some Mint Oreos at the moment. (Who’s writing this essay now?)

JWH

Health is Like a Laptop Battery

By James Wallace Harris, Monday, November 30, 2015

Health has to be more than the absence of disease. I sometimes hear the phrase “optimal health” or “maximum health” as if health is a fuel tank and we can fill her up. We often think of health as giving us vitality, but what then, is vitality? Our bodies and brains are the most complex “mechanism” we know of, but we can’t actually fathom how they work. Not without analogies. Our body is dead when we come to the end of health, and run out of vitality.

The ancient Greeks used the concept of the soul to explain how the body was animated. They claimed the soul made our limbs move, but that was long before science knew about different forms of energy. Getting old feels like we’re running down, running out of energy, or our mainspring needs rewinding. I shall make my philosophical analogy for health be the laptop battery. Before batteries, philosophers used the mechanical clock as a model. In the future, some future blogger will have a new technology to use in her essay.

I went to my annual physical today, and told my doctor she made me nervous every time I visited her because it felt like I was up for an important examination. I worried I’d flunk. At the end of our visit, she laughed and told me I passed. But even though I passed, I don’t feel very healthy, or more precisely said, I don’t feel very energetic, not like when I was younger. At 64, I am not old, but I am not young either. I know my body and mind are in decline, and I wished I could recharge my battery to its maximum capacity again.

On my birthday, I went for a long walk in the botanic gardens with my friend Anne, and then she helped me change out a pole for my outdoor TV antenna. While I had the ladder out, I raked some leaves and limbs off the roof (I’m too old to be climbing on the roof). I probably spent two hours walking and climbing, and that exhausted me. It felt like all the cells in my body were screaming for glucose. When I was younger I could work ten hours at manual labor before I felt that way. Why does my battery run out of juice sooner now that I’m older? Health appears related to stamina, and stamina feels like energy. Does our battery for health shrink as we age? Does it become more inefficient?

If health is a full charge, then shouldn’t eating recharge our battery? Eating too much can make me lethargic. Eating the wrong foods can make me feel unhealthy. But it does feel if I eat the right foods, in the right amount, that I feel healthier. That I have more energy. When I was exhausted after my birthday efforts, I ate lunch, took a nap, and I felt better. But I didn’t feel back to normal until the next day, after two more meals and a good night’s sleep. Food and sleep can recharge my health battery, but only slowly, like how old laptops need longer hours plugged in to recharge.

Getting old feel exactly like an old computer battery that won’t hold a charge as long as it did when it was new. I think one reason why I don’t exert myself like I did when I was young is because I need to conserve my battery. Unfortunately, we can’t buy a new battery like we can for a laptop. Human bodies don’t have user replaceable batteries. Image if they did. I’d buy a high capacity one that recharges quickly.

Is it possible to recondition our built-in battery? When I was a kid, I could eat junk food all day long, and my battery didn’t wear down until the end of the day, often late into the night. Now I can burn up a full charge in a couple of hours. That sucks.

Getting old means learning how to nurse my battery to last out the day. I eat better to make my health recharging more efficient. I exercise to regain a bit of a charge, and keep my contacts from corroding. And sleep cleans out all the bad chemicals that using up a healthy charge creates in byproducts. We often euphemize sexual attraction as chemistry, but it seems everything about our body can be explained in terms of chemistry. Batteries are a chemical process.

Getting old means learning to be efficient. Getting old means learning to conserve energy wherever I can. It’s like being a hybrid car that does everything not to drain the battery, or even recharge on the go. Maybe I should use an electric car as my model of health. Then I could describe exercise as regenerative charging.

No model is perfect. What I really want to know is exactly what to eat and when, that would optimize the functionality of my aging battery. How much exercise will recharge the system, and when does exercise deplete the daily charge I get from sleep? Sometimes naps are better for recharging than walks. Why? The new health mantra is “Sitting is the new smoking” but getting old seems to require more sitting. Hell, I could claim, “Napping is the new jogging.”

I just wished I knew how I worked. Reading about health, diet and exercise is very confusing. There’s no simple model to understand. I know my health is not an old laptop battery, but it certainly feels like one.

Essay #983 – Table of Contents