SMOKINCHOICES (and other musings)

January 30, 2014

Stop Farm Bill or die sooner

Fellow Americans, when one reads the following communication,  It is so evident that the Representatives who go to Washington are not there to speak nor act on our behalf.  Since that is the only purpose for their jobs for which they were duly elected, might one think that it is time to take action against such incompetence?   We can’t go down without a royal stand opposing this flagrant un-American behavior and obvious self-interest — fattening their wallets while poisoning the populace.   VOTE THEM OUT!  While there is still time,  call your Senator and try to stop this.    Jan

January 30, 2014

 

Dear Jan:

 

On Monday, the Conference Committee on the Agricultural Act of 2014 released the final compromise language for the legislation, also known as the “Farm Bill.” The committee added the following language at the eleventh hour, that reverses EPA’s proposed phase-out of the neurotoxic fumigant sulfuryl fluoride (which took 8 years in a hard-won victory by FAN):

 

Agricultural Act of 2014 – Sec. 10015 Regulation of sulfuryl fluoride.

 

Notwithstanding any other provision of law, the Administrator of the Environmental Protection Agency shall exclude non-pesticideal sources of fluoride from any aggregate exposure assessment required under section 408 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 346a) when assessing tolerances associated with residues from the pesticide. (PAGE 806 at http://www.agri-pulse.com/uploaded/Farm-Bill-conference-summary-2014.pdf)

Legislative leaders in the House quickly scheduled a vote on the 1,000 page bill for Wednesday, giving Congressional members no time to read the full text, and opponents little time to organize opposition. As a result, the House of Representatives voted 251-166 in favor of the bill yesterday afternoon, sending it now to the Senate where it’s expected to be approved before Friday night.

See how your Representatives voted

Read FAN’s Press Release on the vote:“Kids Get More Brain-Damaging Fluoride Thanks to Dow’s Lobbyists”

If the Senate approves this legislation, then the U.S. will remain one of only two countries in the world that allows this highly toxic fumigant to be sprayed directly on food, leaving unsafe levels of fluoride residue to be eaten by consumers and putting infants and children at risk of exceeding the EPA’s own reference dose for fluoride. If passed, it will be even more imperative that we end water fluoridation as soon as possible—if we can’t eat our food, let’s at least be able to drink our water!

Our only chance of stopping this horrible legislation is to contact Senators and demand they VOTE NO on the Farm bill. Please take a few minutes to use our automated system to email your Senator. Please also call their Washington, D.C. and local offices to tell their staff that as a constituent you expect your Senator to VOTE NO. Remember, a phone call is worth 100 emails.

PLEASE CONTACT YOUR SENATOR NOW

 

Stuart Cooper,

 

Campaign Director

 

Fluoride Action Network
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January 28, 2014

Warm – nourish yourself

Wintery Comfort Food

From John Gallagher at LEARNING HERBS,  a comforting message greets me in my inbox. How lovely. . .    so, in case all this endless snow has you grumbling too,    enjoy.       Jan

       . . . go ahead, make your LIVER  happy

Ya know?

It’s about this time of year people start telling me they want to cleanse or “detox.”

Folks feel spring around the corner and most likely are feeling a little tired, as we often do in winter.

However, in winter, eating raw and cold foods as well as eliminating “detox” herbs is not such a good idea.

Now is the time to rest, warm and nourish.

Today, Rosalee has an amazing recipe using two common winter foods and spices.

The main plant used in this recipe is an incredible food that supports your liver, one of the main detox organs.

This food also has a special pigment that supports the body’s “phase 2 detoxification.”

You can get all the ingredients you need for today’s recipe at your local market. So…

Does that look yummy or what?

Go here to find out what today’s two magic herbs are.

Detoxing should not be a harsh regiment.

Your body naturally knows how to detox, you just have to support yourself with nourishing herbs and foods.

Enjoy today’s recipe!

-John from LearningHerbs

W/Drugs less is more

THIS MONTH’S TOPIC: HEALTHY SENIORS

CHARLIE ZIMKUS DISPATCH

DEADLY COMBINATION

    The more pills we take as we age, the greater the risk of health problems, dangerous interactions

By Misti Crane • THE COLUMBUS DISPATCH

The medication your doctor suggested when you were 55 could be the very pill he wants you to ditch at 70. • Aging bodies metabolize medication differently, meaning that some drugs we tolerate when we’re younger can be bigger threats to our kidneys and liver when we’re older. Furthermore, prescriptions and over-the-counter treatments that carry risks such as dizziness can be more dangerous to older patients who are more prone to falling.

And then there’s the challenge of volume. About half of patients older than 75 take at least five prescription medications, and a similar percentage are taking something over-the-counter routinely, said Dr. Tanya Gure, the chief of geriatrics at Ohio State University’s Wexner Medical Center.

  • The more pills you take, the higher the likelihood they’ll interact with one another or stack up to a bigger side-effect burden than they would on their own.
EAMON QUEENEY DISPATCH Dr. Greg Wise says some medications pose a greater health risk as we age.

Older people also tend to have central nervous systems that don’t work as well and face a higher risk of low blood pressure and low blood sugar, said Dr. Greg Wise, the chief medical officer at MediGold, Mount Carmel Health System’s Medicare Advantage plan. On top of that, liver and kidney function isn’t what it used to be, he said.

The American Geriatrics Society maintains and recently updated a list of medications that should be avoided or seriously evaluated in older patients. The list, called the Beers Criteria, helps guide doctors and pharmacists to protect patients and can be found at http://www.americangeriatrics.org  .

  • Sleeping pills, anxiety pills and anti-inflammatory drugs are among the common medications that pose greater risk as we age. In most cases, doctors recommend other ways to cope with problems such as arthritis pain — exercise, for example.

“There are generally options, but there are some very difficult decisions to make,” Wise said. “It’s a careful transition, and it’s not exactly black and white.”

Ann Collins, one of Wise’s patients, had been taking the same antidepressant since her 20s when he suggested she stop last year. The medication she took can cause dizziness and heart problems, both of which are of greater concern among senior citizens.

Collins, who is 70, said her depression had been under control for decades and she was apprehensive about a change.

“He said, ‘I cannot in good conscience let you take it any further,’” Collins said. “I said, ‘Well, we’ve got some problems because this stuff isn’t easy to get off of.’”

She tapered off her original medication and tried another that didn’t do her any good.

“Every day I was crying, and my husband was miserable, and my sisters were miserable,” said Collins, who lives in Groveport.

She tried a third medication, Paxil, which has worked.

Decisions to stop a medication at a certain age aren’t always clear-cut and should be made in partnership with patients, said Dr. Marian Schuda, the medical director of OhioHealth’s Gerlach Center for Senior Health.

“You have to be very open and compassionate with people. People take medicine to feel better or to try to stay healthy. … The question is, do you need the drug?” said Schuda, who routinely does medication audits with older patients, including looking at supplements and over-the-counter pills.

  • “Most people have a drug we can eliminate, and lots of people need better drugs than they’re getting.”
  • One of the most-common concerns, and one that surprises many seniors, is the use of non-steroidal anti-inflammatory drugs, such as Advil, Aleve and Motrin. They can cause stomach bleeding.

“I spend a lot of time talking to people about the fact that, for most pain, acetaminophen works as well in most studies and it’s safer,” Schuda said.

Acetaminophen (the active ingredient in Tylenol) carries a risk of liver damage, which must be considered in people with existing liver problems. But in most cases, low doses don’t pose problems, Schuda said.

She said she has a lot of conversations about over-the-counter sleeping aids as well. They are risky, and there aren’t many good options, so Schuda said she often suggests changes such as eliminating naps to encourage better rest at night.

Another problem is testing. Older adults often are left out of research that leads to a drug’s approval, and doctors should be mindful of that, Gure said. Dosing recommendations for a healthy middle-age man might be toxic to a frail 85-year-old woman.

Guidelines such as those offered by the Geriatrics Society shouldn’t be seen as dictatorial, she said, but as a good tool to help clinicians, patients and family members talk about what course is best.

“Prescribing medications is a very complex process,” Gure said. mcrane@dispatch.com

@MistiCrane

(My comment:

This is a brief nod of approval to these physicians who are showing discriminating discernment in trying to audit the rx-medical  load their aging patients are carrying.  This is a world where practicality and idealism must find a way to exist respectfully.  Jan)

Get preapproved B4 shop’g

Personal finance

Find additional advice at Dispatch.com/business  .

DISPATCH FILE PHOTO    With loan pre-approval, you get an idea of what type of loan rate would apply to someone with your credit score, experts say.

Get pre-approved for loan before car shopping

By Susan Tompor • DETROIT FREE PRESS

For many consumers, the great car deals in 2014 are the ultra-low auto-loan rates combined with easier credit. • But saving real money will require digging through cryptic lingo for car loans, going beyond some wacky ads and, yes, even decoding some charges. • We’ve seen federal regulators in the past month highlight some ways consumers have been taken for a ride in the car-buying process.

In January, the Federal Trade Commission announced “Operation Steer Clear,” which cracked down on deceptive advertising. Get a postcard from a car dealer saying you won a prize at a dealership? Don’t bank on a fat check.

The Consumer Financial Protection Bureau also is taking issue with dealer markups involving car loans obtained at dealerships, bringing home the point that consumers need to shop around for loans before heading into the showroom.

For consumers, it’s essential to know the traps and tips.

• Should I worry about being able to get a car loan?

Not really. Mark Zandi, chief economist for Moody’s Analytics, said auto lending had one of its best years in 2013, and lending should remain strong in 2014.

“Sub-prime auto lending is almost back to its prerecession levels,” Zandi said.

Overall, borrowers with good credit can expect to see rates below 4 percent on both new- and used-car loans, said Greg McBride, senior financial analyst for Bankrate.com  .

• Take steps to lock up a loan before you take a test drive.

In December, the U.S. Department of Justice and the Consumer Financial Protection Bureau brought to light charges of discrimination in lending that allegedly took place through dealer markups regarding interest rates.

More than 235,000 African-American, Latino and other minority auto-loan borrowers who dealt with Ally Financial were unfairly charged higher interest rates for loans on cars or trucks because of discriminatory practices, the federal regulators said.

Ally Financial and Ally Bank were ordered to pay $80 million to harmed borrowers and $18 million in penalties relating to auto loans made between April 2011 and December 2013.

In a statement, Ally said the company does not engage in or condone violations of law or discriminatory practices and, based on the company’s analysis of its business, does not believe that there is measurable discrimination by auto dealers.

The lesson for consumers: Make absolutely certain to be pre-approved for a car loan before shopping for a car. Then, you have a better idea of what type of loan rate would apply to someone with your credit score, said Christopher Kukla, senior vice president for the Center for Responsible Lending.

Kukla pointed out that consumers don’t know what kind of extra compensation dealers might be getting on the auto-loan markups.

Money-saving tips

   Don’t be pressured for extra services or fees. Consider VIN etching. Some dealers might want to charge extra for the somewhat added security of etching a car’s vehicle identification number onto a windshield, warned Consumer Reports ShopSmart magazine. It could be a better deal if you have it done elsewhere.   

  Karl Brauer, senior analyst for Kelley Blue Book, said consumers need an itemized list of everything they’re paying for in a proposed deal. If you know you can buy wheel locks online for $30 or $40, for example, you can tell the dealer you don’t want to pay $120 for them, he said.    Source: Detroit Free Press research

Nice report for those who are lucky enough to be able to go out and buy a car — way to go!  Jan

January 27, 2014

Gal’s Heart-Thyroid health link

Heart Sense for Thyroid Patients

An Interview with Cardiologist Dr. Stephen Sinatra

Dr. Stephen Sinatra

By Mary Shomon

December 13, 2003

Heart disease is the leading cause of death among women today, yet women’s heart problems are frequently overlooked. Many of us are more worried about breast cancer, which is far less likely to strike a woman than a heart attack. Stephen Sinatra, M.D., F.A.C.C., F.A.C.N., is a board-certified cardiologist and certified pyschotherapist with more than 25 years of experience helping patients prevent and reverse heart disease.

In Dr. Sinatra’s new book, Heart Sense for Women: Your Plan for Natural Prevention and Treatment, published by LifeLine Press, he explores the innovative information about heart disease and women, including early warning symptoms, cholesterol, homocysteine, lipoprotein , and LDL oxidation, plus a natural program for reducing blood pressure and reducing reliance on medication.

I had an opportunity to talk to Dr. Sinatra about Heart Sense for Women, and what he felt that women with thyroid disease should know about thyroid disease.

Is There An Increased Risk of Heart Disease for Thyroid Patients?

According to Dr. Sinatra, writing in the September 2000 edition of his newsletter, “HeartSense,” even subclinical hypothyroidism — having normal to high-normal TSH levels — can increase risk of heart disease in women. Dr. Sinatra puts that risk at ’14 percent, or similar to the risk associated with the combination of high blood pressure and cigarette smoking.”

Still, Dr. Sinatra believes that the main risk is not a causal one, where thyroid problems directly cause the heart problems. Rather, says Sinatra, “if a woman has a thyroid problem, she needs to know that her risk is increased not necessarily because of the thyroid disease or the drugs she’s taking specifically, but because of the other risk factors — weight gain, lipid abnormalities, etc. — that result from the thyroid disease. A woman with thyroid disease needs to take more responsibility for her heart.”

What’s the Role of Coenzyme Q10?

One contributing risk factor, according to Dr. Sinatra, is deficiency of Coenzyme Q10, or CoQ10, as it’s known. Dr. Sinatra considers CoQ10 a true wonder-nutrient, because, as he says in his book, “it essentially improves the heart’s ability to pump more effectively.”

Women are naturally more deficient in CoQ10, and nowhere are deficiencies in this nutrient greater than in women with thyroid conditions. “If there is one thing a female thyroid patient can do, it’s supplement with CoQ10,” Dr. Sinatra says.

In particular, hyperthyroidism is a key risk for women. Says Dr. Sinatra, “If a woman is hyperthyroid, this can be a disaster, because in hyperthyroidism, a hyperactive thyroid gland can burn up all the CoQ10 in the body. The metabolism is so high that CoQ10 is stolen away from the heart. When this happens, the woman can go into heart failure. “Many times I have seen hyperthyroid storm in a woman associated with heart failure. We didn’t understand why women got heart failure and hyperthyroidism at the same time. We used to think it was a virus, but now we know the hyperthyroidism takes away the CoQ10.”

Dr. Sinatra could not emphasize enough how important he feels CoQ10 is for women with thyroid disease. “The way I treat women with any thyroid problem is with a minimum of 100-200 mg of CoQ10. If a woman is on a statin drug, or has heart problems, then 200-400 mg a day.”

Thyroid Drugs: The Controversy Over T3

I asked Dr. Sinatra if he felt that the use of T3 was a danger to the heart, as some doctors claim. With some patients, Dr. Sinatra is particularly cautious. “For a woman with heart disease or active angina, T3 can be a problem. It can make the heart work harder. Under those circumstances I would hold back T3.”

Otherwise, Dr. Sinatra prefers the desiccated natural form of thyroid hormone, Armour, which includes both T4 and T3. He did not feel that it poses any special dangers to patients.

“If there is one thing a female thyroid patient can do, it’s supplement with CoQ10,” — Dr. Stephen Sinatra

In the October 2000 issue of his newsletter, Dr. Sinatra says, “Be very skeptical of any health care provider who says that there’s only one type of thyroid treatment that works. There are generally two opposing ‘camps’ on this subject, each with their own dogma. One postulates that synthetic thyroid is the only safe and effective medication, while the other endorses only ‘natural’ thyroid as an effective treatment option. However, both camps are correct in part. Some patients respond only to traditional pharmacologics while others will respond only to Armour, or natural hormone.”

Dr. Sinatra’s philosophy is, “When it comes to thyroid, one size doesn’t fit all. I treat patients, not lab data. I treat quality of life issues.”

Says Dr. Sinatra: “There are a lot of doctors who call themselves thyroid specialists, but they’re just treating numbers. When I run into patients with more difficult thyroid problems, I refer them to my colleague, Dr. Robert Lang, M.D., an anti-aging medical expert and endocrinologist who specializes in thyroid disease.”

The Issue of Soy

Dr. Sinatra recommends soy for women, but I asked him about the soy/thyroid connection. Says Sinatra: “Daily soy can be a problem for women. (?) I still think soy is one of the healthy foods for women,  (?) although women with a risk of breast cancer need to do their homework before they take soy. But, ultimately, the best soy for women is from foods — fresh soybeans……natural soy, tofu. I’m a believer in natural soy.”

Dr. Sinatra’s book provides greater details on other top foods for women, which include: flax, fish, nuts, and legumes, like chickpeas and lentils.

The Cholesterol Connection

While Dr. Sinatra believes that cholesterol levels should be controlled, he feels that the role of cholesterol is overplayed. “There are probably millions of women who are being treated too aggressively for high cholesterol,” he says. I do not like to give women statins, I try to treat cholesterol by natural means. His concern with statin drugs are that “they knock out the natural pathway for CoQ10, increasing the risk for cancer.” So, he tends to focus on his natural approaches.

For a women with high cholesterol who has a thyroid problem, Dr. Sinatra feels that sufficient thyroid treatment is the place to start. But if your cholesterol is still elevated, he recommends a low-carbohydrate “Mediterranean” diet to combat insulin resistance, with more healthy fats, and slightly increased protein. He would also add fish oil, garlic, l-carnitine, CoQ10,  plus regular exercise, such as 20 to 60 minutes of walking a day.

Conjugated Linoleic Acid (CLA), L-carnitine and CoQ10 for Weight Loss

I asked Dr. Sinatra if he had any thoughts about the current popularity of CLA for weight loss and muscle development.

Sinatra thought CLA could be a help to some. “It’s one area a woman can investigate. I haven’t seen any downside, except that it’s expensive. But I do know many anti-aging physicians who take it themselves for weight control. I don’t take it myself — what I do is l-carnitine and CoQ10. In a woman who exercises and does restrict calories somewhat, the combination of l-carnitine and CoQ10 will facilitate fatty acid metabolism and help her lose weight.

From Heart Sense for Women
Dr. Sinatra’s Top Ten Nutritional Supplements for Women

Coenzyme Q10
L-carnitine
B-vitamins (folic acid, B12, B6)
Carotenoids (lutein)
Magnesium/calcium
Vitamin E
Vitamin C
OPCs (grape seed, pycnogenol)
Alpha lipoic acid (ALA)
NAC (N-acetylcysteine)

Mitral Valve Prolapse

Some patients with thyroid problems also suffer from Mitral Valve Prolapse (MVP). I asked Dr. Sinatra if he had any special tips.

First, Dr. Sinatra recommends that any woman with MVP be taking supplemental CoQ10. In addition, “What I like for MVP is magnesium…400-800 mg. a day. You can eradicate about 70% of the symptoms with MVP. ”

About Dr. Sinatra

Dr. Stephen Sinatra is a Fellow of the American College of Cardiology and former Chief of Cardiology at Manchester Memorial Hospital where he has been Director of Medical education for the last ten years. Dr. Sinatra also is an Assistant Clinical Professor of Medicine at the University of Connecticut School of Medicine. His New England Heart & Longevity Center in Manchester, Conn., integrates conventional medical treatments for heart disease with complementary nutritional, anti-aging and psychological therapies that help heal the heart.

(My Comment: 

Let me begin by stating that I did find this article online while researching a particular cardiac therapy in something Dr Blaylock had said and referenced Dr Sinatra’s protocol. As this is something I very much like to do. . .had a blast!  The article links the two disease areas together in a way I thought was interesting and for that reason, I am showing it.  But it is my opinion that since this was created in 2003, I rather suspect there might have been some growth in Dr Sinatra’s thinking.   But, I’ll get to that.  Dr Sinatra is a respected and distinguished physician, if not a bit up there on the monetizing end of things. Whatever works. . . 

The changes I am suggesting that have occurred and potentially might have occurred are tied into the usage of Statin drugs for the first and the rather vague discussion of choice A or B with regard to how best to treat for thyroid disease on a second issue and third — the whole topic of soy usage.  

Statin Drug therapy

As to the statin drugs, I have posted quite a bit on this for it is shameful the way it is being pushed on trusting, unsuspecting people.  We trust our doctors to do what is right for us and often as in this case — they become as lemmings or sheep and follow the herd in group-thinking just the way BIG PhRMA insists. It is akin to a scam.  To bring my point home I have used several doctors, running videos of them as they describe why statin use is wrong in their opinion and ineffectual for stopping heart attacks, but instead set people up to vulnerability to having cardiac episodes or distress.  I have used recently (to the best of my memory), Dr. Saul, Blaylock and also Sinatra in different posts. 

Thyroid Disease

In the second issue of thyroid disease, I perceive a bit of ‘fence-straddling’ — neither yea nor nay. See, this was my own biggie in my life. . . . entire adult life til well past 60, I had pleaded for any doctor to give me helpful medicine for my gland. I was only asking for iodine. My problems were text-book (I learned later, much later).  At  22, doctors removed a lobe of my thyroid gland.  They were satisfied with my surgery and recuperation.  Said I did not need any further treatment.  The fact that my goiter had grown so noticeable, apparently was reason enough to operate, but to their minds, my gland was fine.  According to my test results, all was in normal limits.  That’s what I was always told decade after decade.  There’s a book out there called “STOP THE THYROID MADNESS” by Janie Bowthorpe which I learned about from a compassionate commenter to my blog 5 or 6 years ago.  Sad, but a very good read.  Opened my eyes.  So yes, the large majority of doctors only look at the numbers of the test, but deaf, dumb and blind to the patient’s story, pain, experience – SYMPTOMS! 

But as to how to treat a patient with this or any disease,, be compassionate.  Listen to the patient.  See the whole person. If one wishes to be a healer, one must lead with heart energy and a clear mind, not one with biased predilections built on BIG PhRMA’s old boy’s club with walls so high that truth can’t get in and the  corporate structure calls all the shots built on materialistic exclusivity.  One must be open, able to use the scientific approach of seeing what really is.  The body can only use what is biologically compatible with it, and that connotes the stuff of nature, not some contrivance of chemicals in a laboratory.  Pharmaceuticals force and manipulate, while the materials of nature’s flora and fauna support and are recognized by the body.  Drugs can burden the body while biological material nourishes and enables the body to heal itself. Which is why the porcine hormone of desiccated hormone like Armour which has all the elements our own thyroid produces -T4, T3, T2, T1 and calcitonin, is so beneficial and welcomed by the body.  It gets the job done.

Just as the Synthroid synthetic hormone was equally acceptable along with Armour porcine hormone to Dr Sinatra, I found it confusing, or at the least — difficult to reconcile knowing the pain, damage and frustration it brings.  Using only the organic product, it is still a big juggling act to get it right.  Nothing would have been needed; it would not have become the epidemic problem it is, had iodine not been removed from our daily lives. 

Gong back in history, iodine was used in the baking industry (it helped condition the dough prior to baking);  was used in dairies to cleanse the teats of the cow’s udder and also as a perfect antiseptic for the dairy equipment.  It became the law to replace iodine and use bromine instead.  It cost substantially more, smelled bad and tasted worse.  Those in the various industries had no choice – it was now the law. Goodbye iodine. But this has resulted in nearly universal deficiency of iodine in the American populace. We had all relied on iodine to help eliminate fluoride, bromine, lead, cadmium, arsenic, aluminum and mercury.  Good thing we aren’t some of those conspiracy-minded people or we might think that all this might have been carried out to increase diseases and thus create more need for pharmaceuticals. (Elaine Hollingsworth’s book “Take Control of your Health” and escape the sickness industry).  

S O Y  

Finally, the 3rd point – Soy. It is difficult for me to understand Dr Sinatra’s endorsement of soy. First and foremost, it is almost 98 % GMO.  I am not aware of many organic-minded, health-oriented people who would indulge in genetically modified anything. Because it is high protein, it has long been a desirable choice, but lost much favor after it became almost 100%  GMO.  The second issue with it is the messing around with [especially] women’s hormonal systems. — wrong — its both sexes.   

CoQ10 and Magnesium

Okay, so I have an additional thought. . .I totally agree about the CoQ10 being super SUPER important. But if you really want to bless the body, give it the form it can most readily use and quickly absorb which is UBIQUINOL .I buy the  100 mg bottle and take  1 am; 1 w /dinner and sometimes 1 @ bedtime. A must with the cardio thing. 

Both with heart problems and with brain, body in general the need for Magnesium is paramount.  My heart has been beaten up pretty bad with all the hyper-activity my thyroid eventually went into after a lifetime of being hypo.  I went thru 5 years of continuous, stressful A-fib. Every doctor I saw demanded that I take more Magnesium.  But no matter how much I took, the problem was not handled.  My blessed heart was overworked; diarrhea was a huge problem as I had long before exceeded my limit and obviously, was not utilizing what I was taking. . . . which is why I couldn’t get enough. Wasn’t going to happen.  Problem has been solved.  I told this before, but it’s so important to so many, thought I’d tell it again.  

The very latest form of magnesium is something called Magnesium L-Threonate    the product I use is called MAGTEIN  by Source Naturals. 180 caps and its 667 mg.  I take 3 a day [divided].  I also use a product called Calm by Natural Vitality [a powder].  16 oz.   I started with 1/2 tsp mixed into boiled water; stir, then add to a quart jar of pure cold water to drink throughout the day.  Perceptible taste which I like.  Use 1 tsp now.  Think I’m getting what I need now and don’t have to use the topical or transdermal magnesium I used to spray on, though I could if I wanted to use it – this is easier. 

So between my magnesium balanced out,  the taking of my two L-carnitine tabs in the morning plus  a Taurine 1000 tablet also in the am, I no longer have A-fib and I can now sleep like a baby again. (Oh, what a relief it is).  and all the other supplements I take, still doing okay,  just a hell of a lot slower  Good nite.  Jan)

January 25, 2014

Glycemic INDEX – LOAD

Glycemic Load – Paleo

Glycemic Load – by Maelán Fontes and Pedro Bastos

Greetings,
I took the course Dr. Cordain gave to optometrists in Calgary, AB in 2009 on nutrition and quite enjoyed it, and found the discussion about glycemic load of special interest. He said that dairy products and fructose especially had a high glycemic load rating yet in the chart produced by Dr. Jenny Brand-Miller of the U. of Sydney, in Australia, her chart shows the opposite for those two items. Where does Dr. Cordain get his information, and where do I go from here? Thanks.
Dr. H. T. Warner
Vernon, BC Canada

Dear Dr. Warner,
Thanks for following our work. I think there might be some kind of misinterpretation of Dr. Cordain’s slides or words, since his slides do not show that dairy products and fructose have high glycemic loads, and his scientific work demonstrates otherwise (1-3).  While I am sure you are familiar with the glycemic index (GI)  and glycemic load (GL) concepts, however, I’ll briefly explain them.

Glycemic Index (GI)            (the Speed Blood Sugar rises after carbohydrate consumption)                                                           Glycemic Load  (GL)            (customizes GI with defining amt of Carbs in  each food serving )

The glycemic index (GI) was created in 1981 and it is a measure of how quickly food containing 25 or 50 grams of carbohydrates raise blood sugar levels (4).  Because the carbohydrate content of foods varies enormously from food to food and from serving to serving, Harvard researchers created the glycemic load (GL), which takes into account the GI and the amount of carbohydrates in a given serving of a food (4)  which provides a more useful measure (1).

Calculate the GL

To calculate the GL, we simply multiply the GI by the amount of carbohydrates in a given portion size and divide by 100 (GL=GI x amount of carbohydrate in a given serving/100) (4).

It has been established that in most carbohydrate-containing foods blood insulin response is closely linked to the food’s GL2.
As such, a high GL food (such as white bread, which is many time used as a reference, because of its very high GI/GL (4), by rapidly increasing blood sugar levels, stimulates the pancreas to produce more insulin than a low GL food (such as an apple1, (4).  This is why people who consume these foods (sugar containing foods, potatoes and many grain based products (1) present  (5)  higher 24-hour plasma insulin levels than individuals who follow a low GL diet, such as The Paleo Diet. The Paleo Diet’s main sources of carbohydrates are fruits, vegetables and nuts, which present a much lower GL than most cereal grains (even whole grains) (1),  (4).

As I’m sure you are aware, a chronic state of hyperinsulinemia may lead to insulin resistance (IR)6-9 (the primary metabolic defect underlying The Metabolic Syndrome, which greatly increases the risk for cardiovascular disease and mortality1). Insulin resistance can also be a driving force in obesity10-12 and can cause a hormonal cascade that ultimately results in certain epithelial cell cancers, Polycystic Ovarian Syndrome, Male Vertex Balding, Acne and Juvenile Myopia, among other diseases1, 13.

Regarding the GL of fructose, if you review at Dr. Cordain’s scientific paper1 entitled “Hyperinsulinemic diseases of civilization: more than just Syndrome X,” you will see in Table 1 that the GL of fructose (per 100 g portion) is low (22.9). Nevertheless, despite having a low GL, fructose may lead to IR through different mechanisms (e.g. increasing triglycerides and uric acid)1, 14, and play an important role in all the diseases associated with IR1, 14.

Concerning the GL of Milk, if you review his papers (Hoyt G, Hickey MS and Cordain L. “Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk.” British Journal of Nutrition 2005; 93: 175–177, and Cordain et al. “Origins and evolution of the Western diet: health implications for the 21st century.” Am J Clin Nutr 2005;81:341–54), you will see that whole milk and skim milk both have a low GL, but unexpectedly, they elicit a very high insulin response similar to that of glucose2.
This is explained by the presence of whey in milk, since whey proteins induces high insulin production, perhaps by increasing GLP-1 and GIP2, 13.

Taken together, the common use of high GL foods, fructose (including high-fructose corn syrup), and dairy products in the Western diet1 may contribute to the high prevalence of Western diseases named above. These types of foods were rarely, if ever, consumed by our hunter-gatherers ancestors3.

References:

1. Cordain L, Eades MR and Eades MD. Hyperinsulinemic diseases of civilization: more than just Syndrome X. Comparative Biochemistry and Physiology Part A 136 (2003) 95–112.
2. Hoyt G, Hickey MS and Cordain L. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk. British Journal of Nutrition (2005), 93, 175–177.
3. Cordain et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr 2005;81:341–54.
4. Foster-Powell K, Holt SHA, and Brand-Miller. JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 2002;76:5–56.
5. Kiens B, Richter EA. Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans. Am J Clin Nutr. 1996 Jan;63(1):47-53.
6. Rizza RA, Mandarino LJ, Genest J, Baker BA, Gerich JE. Production of insulin resistance by hyperinsulinaemia in man. Diabetologia. 1985 Feb;28(2):70-5.
7. Treadway JL, Whittaker J, Pessin JE. Regulation of the insulin receptor kinase by hyperinsulinism. J Biol Chem 1989;264:15136–15143.
8. DelPrato S, Leonetti F, Simonson DC, et al. Effect of sustained physiologic hyperinsulinaemia and hyperglycaemia on insulin secretion and insulin sensitivity in man. Diabetologia 1994;37:1025-1035.
9. Flores-Rivers JR, McLenithan JC, Ezaki O, Lane MD. Insulin down-regulates expression of the insulin-responsive glucose transporter (GLUT4) gene: effects on transcription and mRNA turnover. Proc Natl Acad Sci 1993;90:512–6.
10. Thomas DE, Elliott EJ, Baur L. Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005105.
11. de Rougemont A, Normand S, Nazare JA, Skilton MR, Sothier M, Vinoy S, Laville M. Beneficial effects of a 5-week low-glycaemic index regimen on weight control and cardiovascular risk factors in overweight non-diabetic subjects. Br J Nutr. 2007 Dec;98(6):1288-98. Epub 2007 Jul 9.
12. Nishino N, Tamori Y, Kasuga M. Insulin efficiently stores triglycerides in adipocytes by inhibiting lipolysis and repressing PGC-1alpha induction. Kobe J Med Sci. 2007;53(3):99-106.
13. Melnik BC. Permanent impairment of insulin resistance from pregnancy to adulthood: The primary basic risk factor of chronic Western diseases. Medical Hypotheses 73 (2009) 670–681.
14. Segal MS, Gollub E and Johnson RJ. Is the fructose index more relevant with regards to

Acceptd, audition web portal

Q&A / ACCEPTD

For more, visit ColumbusCEO.com

 

Serving up simpler college auditions

By Debbie Briner • FOR COLUMBUS CEO MAGAZINE

The competition for admission into the nation’s top college performing-arts programs is grueling for potential students and professors alike. A company created by entrepreneurs Derek Brown and Don Hunter is finding success as a Web portal that simplifies the audition process.

Acceptd is an online application platform that allows students to audition for their top-choice programs without the expense of traveling to multiple campuses for small windows of time in crowded auditions.

“We saw a need in the marketplace to help students interested in the performing arts be able to apply to the school of their dreams,” said Hunter, the company’s president.

  • Now in its third year, Acceptd has 39,480 users, and 5,623 programs have admitted Acceptd applicants. Hunter sat down with Columbus CEO magazine to discuss the company’s origins and its future.

Q: What inspired you to develop this online platform for digital application and audition submissions?

A: Derek and I were always interested in creating opportunities for students. We were lucky to go to the college (University of Cincinnati) we wanted to go to and (get) scholarships to help us go there. So we really worked hard there.

We started talking about “How can we create these similar opportunities for others?” We noticed the rise of students using video in their college applications to get accepted to schools that are hard to get into. There was a trend of voluntarily submitting videos with their Harvard essays or applications. We started trying to figure out how that could be applied with the use of performing and visual arts audition tapes.

Q: How quickly has Acceptd caught on?

A: We started with two schools in the fall of 2011: our alma mater, the University of Cincinnati; and Otterbein (University). We said, “Hey, do you want to give this a shot and see if it can help you?”

Today, we’re up to 400. That includes schools, festivals, competitions, marching bands, professional-level services and even some high schools.

Q: What benefits does Acceptd offer to both students and programs for the performance and visual arts?

A: For students as well as families, they can spend a lot of money on audition tapes, production costs, traveling across the country to audition at schools, hotel costs. From a university perspective, you’re holding live auditions all around the country and may be watching upwards of 1,000 students, but maybe you really only need 30 for your program. It’s a lot of extra work and a lot of extra time. Acceptd is a recruiting tool and also an educational resource. We want to help students learn about performing-arts and visual-arts programs that they otherwise would not have heard of. There are even great associate-level community college programs out there. There are great fits for everybody.

Q: How were you able to fund your startup?

A: We completed the 10x Accelerator program at the (Ohio State University) Fisher College of Business. We got a $500,000 investment to us through a partnership with TechColumbus and NCT Ventures. Another $75,000 came from three private investors. Just this past spring, we got an additional $1 million through TechAngels.

Q: Does Acceptd charge a user fee for this virtual service?

A: We follow a normal business model with tiered pricing to deliver our services. It’s free for institutions or programs. Applicants pay a nominal $25 fee (per application). Students with limited or no financial resources to apply can use our fee waiver program.

Q: Some universities and other arts programs are using a virtual portfolio service that you now offer. How does that work?

  • A: Applicants can submit a virtual portfolio of their work and auditions and a public profile or a discoverable profile. It’s especially helpful for programs that might not be as well-known. We now have over 20,000 profiles for music, theater, dance and the visual arts. Say a program is looking to recruit a student with a 3.8 GPA who’s into theater or stage management on the East Coast. Schools can access profiles submitted to our site to recruit students to match their program needs. We just debuted that in the summer. That’s been a great tool and resource that both sides seem to be very excited about.

Q: What do you hear from clients that you find the most gratifying?

A: One of the biggest compliments we get is how great our customer service is. We like to follow the Zappos model. If you call Zappos and you want to order a pizza, it doesn’t matter that they do shoes. They find a way to help you get pizza.

We want to provide new and innovative services to blow our customers away. Probably the other thing that’s really satisfying is that Acceptd can be used by students who otherwise wouldn’t have been able to apply.

Acceptd

1550 OLD HENDERSON RD., SUITE E175   

Business: Online application platform for performing- and visual-arts college prospects   

Year launched: 2011   

Owners: Don Hunter, co-founder and president; Derek Brown, co-founder and CEO   

2013 revenue: approximately $700,000   

Employees: 12 full-time, seven part-time   

Website: getacceptd.com

(My Comment:

Anything which comes along that I hear about, which seems that it can offer benefit to kids trying to get  their educational stuff nailed down or ‘up and running’ should I say — well, I’m for it.  And this sounds like such a great idea  Go Acceptd!   Jan)

January 23, 2014

Golden Eagles, rare sight

                                     Fred Rau  Golden Eagles prey can include larger animals.

Golden Eagles a rare, beautiful sight

Jim McCormac

The untamable ferocity of birds of prey is awe-inspiring. In a field crowded with formidable predators, the golden eagle rules.

A golden eagle is daunting. Females are larger than males, and a hefty specimen can weigh 14 pounds and have a wingspan longer than 7 feet. Golden feathers cap the crown and nape, making identification easy if the bird is seen.

It takes five years for a golden eagle to reach maturity, and first-year birds have prominent white splashes at the base of the tail and on the underwings. They become increasingly dark with age. The oldest known wild eagle reached 23 years; one in captivity lived to 46.

s befits their size, golden eagles capture prey off limits to lesser raptors. Rabbits are a dietary staple, but much larger fare is sometimes caught. They sometimes take bobcats, coyotes, herons, turkeys and even young white-tailed deer. In days of yore, when falconry was an entitlement of nobility, the golden eagle was the bird of kings.

Although golden eagles prefer live prey, they are not above sampling carrion, especially if it is venison. Fred Rau of Dayton recently sent me a series of spectacular images from western Pike County. Rau had focused a trail camera on a fresh deer carcass and was rewarded with crisp images of a golden eagle.

Golden eagles are quite rare in Ohio, with perhaps a half-dozen sightings a year. Although fairly common in mountainous regions of western North America, they are far scarcer in the East. There is a breeding population in northern Quebec and Labrador, and evidence suggests that area is the origin of Ohio birds.

Small numbers of them winter in Ohio, but they’re tough to find. Golden eagles frequent remote, sparsely populated regions, keep huge territories and are people-shy. Trail cams fixed on deer carcasses are an effective technique for documenting the birds.

Historical records suggest that small numbers of golden eagles have long wintered along Ohio’s glaciated Allegheny Plateau. The region is the interface of unglaciated hill country and the flatlands to the west. Records from the early 1900s include birds in Adams, Highland and Pike counties. Vast reclaimed strip mines such as the Wilds in Muskingum County have also harbored win tering golden eagles.

While these eagles undoubtedly take plenty of rabbits and other small mammals, an abundant deer population provides lots of carrion. Increased efforts to place trail cams on deer carcasses might catch photos of more golden eagles.

For those who think of Ohio as all industry and agriculture, think again. Golden eagles are among the wildest of North American birds, and their presence in Ohio’s hill country speaks to our wilderness heritage.

Naturalist Jim McCormac writes a column for The Dispatch on the first and third Sundays of the month. He also writes about nature at http://www.jim   mccormac.blogspot.com  . cdecker@dispatch.com

                                Thai Panda blogspot;    Wing Commanders

(In deference to disclosure, I Googled Golden Eagles and found many lovely visions, two of which I inserted in the article: one from Thai-Panda blogspot and the ‘headshot’ further up from UK.  Hopefully, in the interest of beauty, won’t offend Mr McCormac or Mr Rau  . . . just call me incorrigible.  Jan)

Easy fix 4 Flu – colds

Your health

Hospital admissions for flu up 63 percent

(and what you can do about it 4 you)

By Misti Crane THE COLUMBUS DISPATCH

Flu hospitalizations climbed 63 percent in Franklin County and 33 percent statewide last week.

And many of those who have been to the hospital are in their 50s, leading health officials to think that H1N1 is disproportionately affecting working-age adults, as it did during the 2009 outbreak.

There were 49 people in Franklin County and 401 people statewide hospitalized for flu last week, the most recent for which data is available.

So far this season, 162 people have been hospitalized with complications from the virus in Franklin County.

Last week’s increase is concerning but isn’t wildly out of the norm, said Dr. Mysheika Williams Roberts, medical director at Columbus Public Health. Last year at this time, there had been 320 hospitalizations. The 2012-13 season was marked by relatively low flu activity but an unusually high number of hospitalizations early on.

The numbers should serve as encouragement to those who have not yet been vaccinated, said Jose Rodriguez, Columbus Public Health spokesman.

Vaccination is no guarantee that you won’t get the virus, but it’s the best protection against a disease that sidelines people in the best of cases and kills in the worst.

In a typical year, flu hospitalizations are most common in the elderly.

But this year’s hospitalizations in Ohio have been highest among those 50 to 59 years old. That group represents 269 of the 1,234 hospitalizations so far this season, according to data from the Ohio Department of Health.

H1N1, the primary strain circulating this season, has a history of sickening more younger people than other strains. mcrane@dispatch.com

@MistiCrane

(My Comment:

My own story regarding colds, flu, pneumonia, or for that matter, almost any other germ that was floating around for most of my adult life was a bit like a crap-shoot.   If it was out there, it usually found me.  Had good genes,  ate well, was healthy and strong – seemingly blessed.  Apparently the pulmonary thing was my Achilles heel. Like everyone else, I’d heard of Vitamin D3, but never delved into it until after I had started my blog.  What I learned from Dr Cannell opened my eyes and changed my life.  Had my doctor test me and I registered at 13 – off the charts low.  She put me on 50K mg weekly and quite swiftly, my body responded – brought me up to 40.  Fine for many, but I wanted to be around 70 to 100, plus I realized that prescription D is always D2 and I wasn’t willing to settle for anything but D3.  Bought my own and began taking 10K daily and soon got up to 70 and have kept it since.  As I’m able to be outside and in the sunshine to garden and walk, I drop it down to 5000 units daily.  So far – so good.  Have not been sick or so afflicted since I started with the D.  That was my saving grace.

If you knew how I used to suffer with the episodes of illness with symptoms of colds, the flu and pneumonia, you could maybe understand why I was convinced it would kill me someday.   Now, I have no fears at all of any of that.  People are social creatures and we can’t help being exposed to the germs of others — happens to all of us.  So If I do get that old tickle in the throat or some other strange combination of symptoms which suggest that I’ve picked up an undesirable bug,  I have a simple, inexpensive few things I do and that is what I wanted to tell you and why I am running this post.  It is NOT to scare or alarm you, or heaven forbid  — suggest that you get one of those horrid, ineffective and in my opinion – dangerous flu shots.  Nor am I shilling for OTC stuff either.  My solution is not going to add a toxic burden to the liver or kidney.  Nothing iffy or dangerous here.

At the first inkling drink water which is automatic assist for body’s defense system.   I’ve spoken of vitamin C Crystals frequently, its the way I consume vitamin C since I don’t like pills in any form (gag-reflex thing) and the second item is Oil of Oregano which is an extract in softgel form.  Puritan’s Pride is the source on both of these battles.  They do a good job with them, they are effective and always highly competitive pricing – often with buy one, get one free. (works for me)  C Crystal container says  1 tsp = 5 gms  or 5000 mg.. I take 1/2 tsp full and  and 2 Oregano capsules (1500 mg each).  C jar is 20 oz and will last me for years.   Once is generally enough for me to knock it out.  I waken in morning and its gone.  But if you wait too long before taking action, the condition can get a head start and you may have to treat repeatedly til gone.  (every hour or two) and that’s okay, can’t hurt you. Well, let me add a caveat here.  I have in fact taken a  tsp of C Crystals and got diarrhea from it, so I don’t advise taking 5K at one time.  Helps to take lesser amount and more often – possibly with something to eat to mix it up with.  Some therapeutic doses can run into the hundreds of thousands, but that is usually done by IV to fight cancer or something truly serious.

I am not pushing ‘Puritan’s Pride’,  by all means google both products get quantity and pricing and try for free shipping from whomever looks best at the time.  That’s what I do, and I would hope you do too.  Stay well and happy.    Jan) 

January 22, 2014

Specialties bad 4 us

Health care

Specialty docs cost patients

By Elisabeth Rosenthal THE NEW YORK TIMES

CONWAY, Ark. — Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer & Dermatology Center in Little Rock, 30 miles away.

That was the prelude to a daylong medical odyssey several weeks later, through different private offices on the manicured campus at the Baptist Health Medical Center that involved a dermatologist, an anesthesiologist and an ophthalmologist who practices plastic surgery. It generated bills of more than $25,000.

“I felt like I was a hostage,” said Little, a professor of history at the University of Central Arkansas, who had been told beforehand that she would need just a couple of stitches. “I didn’t have any clue how much they were going to bill. I had no idea it would be so much.”

Little’s seemingly minor medical problem — she had the least-dangerous form of skin cancer — racked up big bills because it involved three doctors from specialties that are among the highest compensated in medicine, and it was done on the grounds of a hospital.

Many specialists have become particularly adept at the business of medicine by becoming more entrepreneurial, protecting their turf through aggressive lobbying by their medical societies, and most of all, increasing revenue by offering new procedures — or doing more of lucrative ones.

  • It does not matter if the procedure is big or small, learned in a decade of training or a weeklong course. In fact, minor procedures typically offer the best return on investment: A cardiac surgeon can perform only a couple of bypass operations a day, but other specialists can perform a dozen procedures in that time span.

That math explains why the incomes of dermatologists, gastroenterologists and oncologists rose 50 percent or more between 1995 and 2012, even when adjusted for inflation, while those for primary-care physicians rose only 10 percent and lag far behind. Insurers pay far less for traditional doctoring tasks, such as listening for a heart murmur or prescribing the right antibiotic.

  • By 2012, dermatologists — whose incomes were more or less on par with internists in 1985 — had become the fourth-highest earners in American medicine in some surveys, bringing in an average of $471,555 though their workload is one of the lightest, according to the Medical Group Management Association, which tracks doctors’ income.

In addition, salary figures often understate physician earning power because they often do not include revenue from business activities: fees for blood or pathology tests at a lab that the doctor owns, or “facility” charges at an ambulatory surgery center where the physician is an investor, for example.

“The high earning in many fields relates mostly to how well they’ve managed to monetize treatment — if you freeze off 18 lesions and bill separately for surgery for each, it can be very lucrative,” said Dr. Steven Schroeder, a professor at the University of California and the chairman of the National Commission on Physician Payment Reform, an initiative funded in part by the Robert Wood Johnson Foundation.

Doctors’ charges — and the incentives they reflect — are a major factor in the nation’s $2.7 trillion medical bill. Payments to doctors in the United States, who make far more than their counterparts in other developed countries, account for 20 percent of American health-care expenses, second only to hospital costs.

  • Specialists earn an average of two and often four times as much as primary-care physicians in the United States, a differential that far surpasses that in all other developed countries, said Miriam Laugesen, a professor at Columbia University’s Mailman School of Public Health.

That earnings gap has deleterious effects: Only an estimated 25 percent of new physicians end up in primary care, at the very time that health policy experts say front-line doctors are badly needed, said Dr. Christine Sinsky, an Iowa internist who studies physician satisfaction. In fact, many pediatricians and general doctors in private practice say they are struggling to survive.

  • Studies show that more specialists mean more tests and more-expensive care.

“It may be better to wait and see, but waiting doesn’t make you money,” said Jean Mitchell, a professor of health economics at Georgetown University. “It’s, ‘Let me do a little snip of tissue,’ and then they get professional, lab and facility fees. Each patient is like an ATM machine.”

LUKE SHARRETT THE NEW YORK TIMES    Dr. Jennifer Cafardi inspects a skin sample under a microscope at the Skin Cancer Center in Cincinnati.

For example, the procedure performed on Little, called Mohs surgery, involves slicing off a skin cancer in layers under local anesthesia, with microscopic pathology performed between each “stage” until the growth has been removed.

  • Although it offers clear advantages in certain cases, it is more expensive than simply cutting or freezing off a lesion. (Hospitals seeking to hire a staff dermatologist for Mohs surgery had to offer an average of $586,083 in 2010, even more than for a cardiac surgeon, according to Becker’s Hospital Review.)

Use of the surgery has skyrocketed in the United States — more than 400 percent in a little over a decade — to the point that last summer, Medicare put it at the top of its “potentially misvalued” list of overused or overpriced procedures.

  • Even the American Academy of Dermatology agrees that the surgery is sometimes used inappropriately.

Dr. Brett Coldiron, president-elect of the academy, defended skin doctors as “very cost-efficient” specialists who deal in thousands of diagnoses, and called Mohs “a wonderful tool.” He said that his specialty was being unfairly targeted by insurers because of general frustration with medical prices.

“Health-care reform is a subsidized buffet, and if it’s too expensive, you go to the kitchen and shoot one of the cooks,” he said. “Now they’re shooting dermatologists.”

The specialists point to an epidemic, noting there are 2 million to 4 million skin cancers diagnosed in the United States each year, with a huge increase in basal-cell carcinomas, the type Little had, which usually do not metastasize. (A small fraction of the cancers are melanomas, a far more serious condition.)

But, said Dr. Cary Gross, a cancer epidemiologist at Yale University School of Medicine, “The real question is: Is there a true epidemic, or is there an epidemic of biopsies and treatments that are not needed? I think the answer is both.”

Profitable dermatology

In America’s for-profit, fee-for-service medical system, dermatology has proved especially profitable because it offers doctors diverse revenue streams — from cosmetic treatments that are fully paid by the patient to medical treatments that are covered by insurance.

Cosmetic dermatology is a big moneymaker in high-income markets such as New York and Miami.   Botox injections take 15 minutes and cost a minimum of $500; doctors pay about $100 for the amount of medicine needed for a typical session, dermatologists say. Still, cosmetic work makes up less than 10 percent of all skin procedures, studies show, and their volume fluctuates with the economy.

For medical treatment, many dermatologists have been able to compensate for cutbacks in insurance payments by offering new services and by increasing their patient volume through hiring “physician extenders” — nurse practitioners and physicians’ assistants — to do basic tasks such as biopsies and chemical peels. Whether the physician or the nurse wields the scalpel, the charge is generally the same.

The dermatology office where Little’s initial biopsy was performed is one of six satellite offices operated by the Arkansas Skin Cancer and Dermatology Center. They are often staffed by physician assistants, who refer patients to the dermatologists in Little Rock for Mohs surgery. The dermatologists also do their own pathology, meaning that they can sometimes bill extra for that service. (That also means there is no independent confirmation of a cancer diagnosis.)

With such practices, even minor dermatology procedures can lead to big bills.

Harris Williams and Co., a consulting firm, estimates the $10.1 billion dermatology market in the United States will grow to more than $13 billion by 2017, in part because of an aging population. The Affordable Care Act requires 100 percent coverage for preventive dermatology screening sessions for seniors, which will inevitably lead to more biopsies and treatment. With more doctors being trained in Mohs surgery — generally an extra year of training, though it is not required — it has become a go-to treatment.

Outrage at charges

Little left Baptist Health Medical Center with a tiny skin flap and more than two dozen stitches. For five days she said she was “hung over” from the IV sedation that she had not wanted — a problem because she drives 60 miles on rural Arkansas roads to her university each day.

She spent months arguing down her bills, which were finally reduced: About $1,400 for the Mohs surgeon, $765 for the anesthesiologist, $1,375 for the ophthalmological plastic surgeon, plus $1,050 in operating-room charges from the hospital.

For her follow-up, she refused to return to Baptist Health and went instead to the University of Arkansas medical center, where a dermatologist told her she likely had not needed such an extensive procedure. But that was hard to judge, because the records forwarded from Baptist did not include the photo that was taken of the initial lesion.

She was outraged as she wrote checks for the nearly $3,000 she owed to the doctors under the terms of her insurance.

“It was like, ‘Take out your purse, we’re robbing you,’” she said.

(My Comment:

Primarily because of the plight of our beleaguered medical-care system; it’s global ranking with regard to outcomes being near the cellar;  and the mere accessibility of it financially to the average American,  coupled with what it is doing to the budgetary limits of our government to manage, . . . it strikes me as near the point of being scurrilous.   Yes, scurrilous for it far surpasses mere greed, it borders on buffoonery!  

My own experience of dis-satisfaction began rather decisively in the ’70’s when my teenager was being deeply traumatized by acne.  I felt it was diet somehow and suspected his over-emphasis on protein and and dairy in general, but had no proof – only instinct.  Even as a kid, his interests were anchored in physicality and sports and body building.  Tho a novice, he seemed well directed and I admired his sense of purpose.  But I also suffered with ongoing adult acne, so what did I know?  Ergo, the dermatologist.   

That office wouldn’t accept the new patient without the patient  and parent sitting in on their “brain-washing” video where one was schooled on current thinking. . .DIET HAD NOTHING WHATEVER TO DO WITH ACNE.   That was so stunning to me that I barely remember anything else contained in the instructions.  Emotionally and intellectually, I bolted and was outta there,  but he believed this to be his last hope.  Others he knew had been successful and he pleaded to be allowed to try it.  I was opposed to the endless anti-botics – it was just wrong-headed, but I couldn’t ignore his genuine need, and thus relented.   Later as he engaged in the program and had to endure the weekly puncturing,  probing and squeezing of each pustule, he found much to dislike as well. 

It doesn’t seem fair to leave it at that; of course, the body’s systems can be over-ridden – can be made to do almost anything.  Anti-biotics can indeed shut down the body’s natural reaction to something to which it is strongly defending with a so-called allergic reaction.   So his symptoms were shelved, but nothing was fixed.  His acne returned and again was treated, endlessly.  .  eventually, I learned from a Dr John McDougall whose books I bought and learned from that drinking the milk of cows was not a normal thing to do.  No other species in the world does that, nor should we if we want to be healthy.  It was in fact why and what primarily triggers acne for either sex and all the monthly problems young girls go through with the advent of menses.    Then eventually learned from Dr Loren Cordain with his Paleo Diet, the easy to understand logic and sequential events behind acne (one of his books), arthritis, the balancing of the ins and outs of Calcium and how to handle all that. Both of these men are highlighted in their own categories up in FIND IT and in section 4 (docs).

Gimme a Doc who treats the whole Me

But this article is about the fleecing of America via (pick your poison) – any Specialty one can imagine, medically.  

Who could question anyone’s desire to be the best, have the best — or for sure, when sick, be able to be treated by the best?  When one is heavily credentialed, it is assumed that it connotes a superior status or greater knowledge. . . but assumptions don’t always pan out.  And this story details the very things about which we should all be cautious.  When dermatologists are commanding greater incomes than cardiac surgeons, one wants to go off somewhere and be sick.  How ridiculous can anything be? 

The story above starts off with a simple query from an assistant to biopsy an innocuous white spot which was not even in the running for anything serious — but the word biopsy strikes fear into anyone’s mind, can rattle you. So part of the trickery here is not only the excessive “monetization” of their craft (trade, talent), but also the vulnerability of most of us — the uninformed and trusting public. . . read that as F-E-A-R. This is a frightful state of our current medical community.  And so prevalent.  Our nation is in desperate need of competent physicians who are trained to understand the the entire body and how all the pieces and parts relate to one another.  That is what I prefer,  moreover;  it is about all I can trust.  I don’t like being referred out to anyone. I still believe our country should be footing the bills educationally for new doctors in exchange for some agreed upon period of time in service to the general population (5 years?), especially, under-served areas.  We’ve done it before, we could and should do it again. 

Do your due diligence folks,    Jan)

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