How to go downstairs

As with my post on how to climb stairs, the  information in this post comes from Esther Gokhale, the posture lady.

To begin with, here’s an interesting study about going up and down stairs: Researchers in England conducted a study wherein people walked either up or down the stairs of a ten-story building. They’d either take the elevator up and walk down, or walk up and take the elevator down. While both groups became fitter, the group that walked down the stairs did better fitness-wise than those who walked upstairs. They had lower insulin sensitivity, lower blood fat levels, better bone density, superior balance, and twice the improvement in muscle strength. That’s kind of hard to believe. Going downstairs seems so much easier!

Anyhow, here are the instructions:

Position your body in a shallow zigzag squat. 

As with going upstairs, keep your butt behind and your torso angled forward from the hip joint. Don’t tuck your pelvis. You want your glutes (butt muscles) to stabilize you. Use the thigh muscle to lower you as your front foot approaches the step below.

Rotate your feet and legs externally. This encourages optimal alignment of your knees, hips  and pelvis.

Click on video in this sentence to see how you should look. 

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How anger affects your body

 You may get angry for good reasons. Still, it’s best not to. Anger is hard on your body.

Your heart: When you get into a rage, your blood pressure increases, blood vessels constrict, and inflammatory cells are released by the immune system. These actions can rupture plaques inside your coronary artery. If the plaque forms a clot, blood supply to the heart can be cut off, causing a heart attack.

Your brain: When you’re angry, you’re less likely to make good judgements or pay attention to what’s going on around you. Anger and chronic stress also have a negative effect on your memory, inhibiting your ability to remember things.

Your gut: Your GI tract is made up of muscle tissue and is innervated by nerves. Because of the strong link between your gut and brain, anger and rage can trigger abdominal pain, malabsorption of food, and loss of appetite. Anger also releases adrenaline, which causes the gut muscles to be over-active, giving you cramps and diarrhea.

Chill, if you can.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

More about the new weight loss drugs

 On January 15th, 2023, I posted an article about a new weight loss drug called Wegovy. I had learned about it on the TV show, 60 Minutes. (Wegovy and a similar drug called Ozempic are modified diabetes drugs.) Because the show used terms such as “highly effective,” “safe,” and “impressive,” a nonprofit group called Physicians Committee for Responsible Medicine has filed a formal complaint saying that the program segment essentially meets the definition of an advertisement. I have to admit, the show did make the drug appear impressive and my blog post didn’t question the program’s message.

But here are a couple of things to consider: in the first place, because the drugs are new, long-term effects are not known. Secondly, to keep the weight off, you have to keep taking them—that is, injecting them—for life. Otherwise, you just regain the weight you’ve lost, as is the case with most weight loss efforts. (One woman, who stopped the medication, reported that she was insatiable. "I'm hungry all the time.")

Wegovy and Ozempic, are the first to manipulate one of the hormonal regulatory systems that govern appetite. They work by mimicking the hormone glucagon-like-peptide, which is produced in the gut, and which tells the brain when you’ve had enough to eat. The ability to sense fullness and hunger varies among us and is the result of genetic differences in brain circuits that control appetite.

One woman who has injected Ozempic for nine months reports that she planned to stay on the drug for life because it “shut off the intrusive constant thoughts about food” that had consumed her mental space since childhood. In taking this drug, she realized that her overeating wasn’t lack of willpower but was the product of her physiology. Good to know.

Scientists admit that they have very little understanding of how the new medicines affect other regulatory mechanisms that depend on the crosstalk between the gut and the brain. With so many people trying the new drugs, I guess they’ll find out—sooner or later. 

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

How to climb stairs

I got the following information from Esther Gokhale’s newsletter. I call her the posture lady. Here’s how she says you should climb stairs:

Angle your body forward. This puts your glutes (your butt muscles) in an optimal position. The glutes, she says, are an important part of the posterior chain—the muscles in the back of the body that should play a prominent role in powering you forward. Most people, she says, rely on pulling up their body weight using the anterior chain, which overuses the hip flexor and thigh muscles as well as the knee joint.

As you stand on one leg preparing to step up, adopt your forward stance and contract the glutes of that standing leg. Two glute muscles are involved: The gluteus medius, which is close to the hip joint on the side, will help maintain balance and add momentum. The gluteus maximus, the big muscle in the rear, will propel you forward and up.

Your calves and feet also provide propulsion. Contracting your calf lifts your heel and drives your forefoot against the ground and your body up—good ways to give your feet and ankle joints a healthy workout.

I think this is excellent advice, especially because it exercises the muscles (glutes, especially) that keep us from falling. I go up and down stairs often in our two-story house. I now follow Gokhale’s advice—to a point. I make sure to angle forward. This seems to do do the trick.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Hospice care—money makers moving in

 Hospice care, as you know, is comfort care provided to people who are dying—specifically, those certified by doctors as having less than six months to live. Hospice care began in 1974 as a non-profit enterprise. That has changed. As a New Yorker article notes, “…hospice evolved from a constellation of charities, mostly reliant on volunteers, into a twenty-two-billion-dollar juggernaut funded almost entirely by taxpayers. At the start of this century, for-profit enterprises made up thirty percent of the field. Today they represent more than seventy percent.”  Private providers cost Medicare three times that of their non-profit counterparts.

For-profit hospice companies use a variety of schemes to enroll patients. They’ll prey on sick people, duping them into the program by claiming that it’s free home health care. Or they’ll ask oncologists to turn over their “last breath” cases. Or they’ll bribe physicians to bring them new patients by offering all-expense trips to Las Vegas. Or they’ll put doctors on their payrolls. One doctor was employed as medical director by eight hospice companies, receiving $400,000 for his services. Over the course of twenty years, he had referred approximately 763 patients to hospice care.

Many of the patients enrolled with for-profit hospice companies are not on the brink of death. In fact, most of Medicare spending on hospice is for patients whose stays exceed six months. (Note that during their hospice stay, patients must forgo curative care, such as chemotherapy or dialysis or lifesaving medications.) The federal government demands repayment from hospices when the average length of stay of all patients exceeds six months. Companies avoid this outcome in a number of ways. They’ll dump patients (one company discharged 93 percent of its patients alive). Or they’ll shut down, keep the money, buy a new license and Medicare billing number, and transfer their patients to the new entity. They have even been known to overdose patients who are staying on the service too long. (One hospice owner texted his nurse, “He better not make it tomorrow.”)

When looking for hospice care, choose for a non-profit organization!

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.