Cartoon II for the holidays

 

                                              "Oh my God, it feels good to lie down."

Cartoon I for the holidays

 

                                      "Wheatgrass is highly effective at neutralizing joy."

Big bucks for long term care facilities

 As you probably know, the U.S. spends more than any other country on health care: $13,000 per person every year, compared to Japan, for example, that spends $4,700 a year. (Japan also has the longest life expectancy: 87.6 years compared to our 79.3.) The main reason for our outsized expense is that our health care system focuses on maximizing profits. Compared to other countries—which regulate the industry—we allow the market to operate more freely, a situation that began in the 1980s when the U.S. began moving toward a laissez-faire economy. (Competition often fails to bring down prices because the health care sector is so complex, with opaque pricing and bureaucratic insurance plans.)

Assisted living facilities, which are a case in point, are home to 85,000 older Americans. Half of these facilities earn returns of 20 percent or more than it costs to run them—far higher than the money made in most other health sectors. Many facilities charge $5,000 a month or more, then layer on extra fees: $12 for a blood pressure check; $50 per injection (more for insulin); $93 a month to order medications not used by the facility; $315 a month for daily help with an inhaler.

In searching the internet, I came across ads for going into the assisted living business. One said, “You can generate $36,000 of gross monthly income and net $10,000 of monthly cash flow by converting one single-family home into an Assisted Living Home (ALH). It’s easier to do than most people think.” Another site displayed this title: “How to make 42% profit margin in senior housing,” as touted by the CEO of Eldermark. In his talk he said this: "You have to dehumanize the fact of the person and call it a unit, because that's essentially what it is: unit inventory." Enough said.

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

Your body’s clocks

I think most of us are aware of our circadian rhythms—our bodies’ sleep cycles. They’re controlled in the hypothalamus part of the brain. In the evenings, our brains release hormones that lower our body’s temperature and blood pressure and make us feel sleepy. In the morning, cortisol and other hormones restore our alertness, make us warmer, and increase our blood pressure. Now scientists know that every cell in your body contains a group of genes that function as a sort of mechanical watch, keeping time everywhere in our bodies.

These “clock genes” represent every physiological system: skin, liver, immune system, kidney, heart, lungs, muscles, and reproductive system. Disrupting our circadian system can have a significant negative impact. Your liver, for example, determines when to rev up your metabolism based on when you eat.  If you eat in the middle of the night, your liver—which your brain has instructed to rest—will process the midnight food less efficiently than it would have during the day. Among other effects, eating at night increases the risk of glucose intolerance because the kidneys and pancreas are also primed to rest at night. Similarly, being exposed to light when our body ought to be resting can have a negative impact, including impaired glucose and cardiovascular regulation. Some studies have shown that light during sleep—such as leaving the TV on—is a risk factor for obesity.

A bunch of scientists are trying to influence hospitals to change their ways. (As I’m sure you’re aware, hospitals are one of the worst environments for maintaining circadian health—both for staff as well as patients.) For example, research has shown that premature infants who receive 12 hours of light followed by 12 hours of darkness are discharged an average of two weeks earlier than those who are exposed to near constant darkness or near constant light. Scientists are also studying the best time to take drugs. For example, they found that taking low-dose aspirin in the evening is more effective than taking it in the morning.

 The timing of our clocks varies by individual, which in turn is affected by genetic predisposition, the sun, indoor lighting, behavior, and age. In general, circadian researchers suggest getting as much sunlight as you can during your day, especially upon waking, dimming the lights before sleep, making your bedroom dark, and eating most of your calories earlier in the day. Easy for me; not so easy for night-shift workers.

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

Straightening your spine

I’ve recently turned my attention back to “the posture lady,” Esther Gokhale. Years ago, Gokhale was suffering from unrelenting back pain. She had surgery but the pain came back. So she embarked on a quest to get to the source of her problem, starting with learning about “anthropologically-based posture modification” at an institute in Paris, and then by observing, in person, indigenous people in various parts of the world. She discovered that our idea of a normal anatomical stance—the way we hold ourselves—had changed radically in the past century: we have significantly increased curvature in our low backs (lumbar) and upper back (thoracic). The illustration below makes this clear.

The image on the left is from an anatomy book published in 1990, showing what is considered a normal spine. The image on the right is from a book published in 1911, showing significantly less curvature. This is the spine Gokhale believes is the natural human stance. (She gives lots of reasons for why our stance has changed over the years.)

More and more medical people are buying into her view. I recently visited a neurologist (Stanford Neurosurgery Clinic) about my sciatica and gnarly looking spine. I told her that I’d recently had a one-on-one Zoom session with Gokhale. The neurologist was enthusiastic and told me that she often refers patients to Gokhale, as do many other physicians.

 I’ve recently embarked on a do-it-yourself program of improving my posture and movement to straighten my spine, using Gokhale’s methods. Gokhale has lots of offerings that you can find on her Web site. You can also find her on various YouTube videos, such as TED talks.

As to my own efforts, I don't have much to report yet. I’ve only just begun. 

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