Itching

I probably shouldn’t have delved into this topic. It’s horribly complicated. I was curious about the fact that I have an itchy spot under my left collar bone (hard to reach!). My little itch is small potatoes compared to the suffering that many people endure.

Dermatology websites list the causes of itching: extremely dry skin; bug bites; skin conditions, such as eczema, hives, and psoriasis; skin cancer; warning signs of diseases, especially of the kidney and liver, and overactive thyroid gland; allergic skin reaction; reaction to a plant or marine life; medication or cancer treatment; nerve problem. Scratching alleviates itch by interrupting it: the pain of scratching creates the pleasure of relief.

One in five people experience chronic itch in their lifetime, often caused by cancer, a skin condition, or liver or kidney disease. (There are no medications for it.) Some unlucky people have a rare disease in which itching can be unrelenting and extreme.

The kind of itching that’s acute (not chronic), and caused by irritants such as poison ivy, is caused by the immune system’s reactions: immune cells secrete histamine that activates the nervous system, making you itch and scratch. Medications, such as steroids or antihistamines, may help in these cases. Some people itch for no clear reason and their bodies don’t respond to steroids or antihistamines.

In 2007, neuroscientists figured out itch-specific nerve receptors that are triggered by substances other than histamines. Some itching—such as that caused eczema—is caused by the body’s secretion of certain proteins (cytokines) that rev up the immune system. In 2017, the FDA approved a drug called Dupixent, which reduces the immune system's overreaction that causes eczema. Apparently, it works. It can be yours for $59,000 a year (retail).

My research yielded nothing in the way of explanation for my little itch--at least nothing definitive. I can live with it.

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

The big business of sleep

I never get what is considered a “good night’s sleep,” that is, seven or eight hours uninterrupted. I never sleep more than six hours, and it’s always interrupted, sometimes for more than an hour. It’s no fun, but I don’t worry about it. I figure it’s my normal sleep pattern. But millions of people are becoming preoccupied with obtaining a perfect night’s rest.

That preoccupation is a bonanza for business. The “sleep economy” is worth billions of dollars. Venture capital funding for sleep tech has been steadily rising, from around $400 million in 2017 to close to $800 million in 2021. As one sleep neuroscientist noted, there’s more money going into sleep-related products than ever before.

Here are some examples:

• “Wearables”: Electronic sleep-tracking devices. The latest sleep-tracking gadget, the Oura ring, is a $350 miniature computer that collects data on vitals like heart rate, body temperature and movement.
• Fancy bedding: mattresses with sensors, weighted blankets, adjustable pillows. (The U.S. mattress industry doubled in value from 2015 to 2020, swelling from $8 billion to $16 billion.)
• Other gadgets: Timed lights, eye masks, smart thermostats, cool air fans, bedtime headbands.
• Supplements and such: Melatonin, magnesium, herbal teas, CBD gummies, sleeping pills. (About eight percent of Americans take sleeping pills, such as Ambien).

It seems like the media is fueling this preoccupation, scaring us with alarming adverse outcomes such as diabetes, heart disease, hypertension, and immune system problems. Because of worrying about falling asleep, people become anxious with obsessive thoughts that keep them awake even longer.

Plenty of people do well on less than seven hours sleep: Thomas Edison (three or four hours); President Clinton (five to six hours); Martha Stewart (four to five hours); Jay Leno (five hours). Stop worrying about how much sleep you’re getting. It’s unhealthy.

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

Value of supplemental vitamins (not)

I’ve never taken vitamins, but plenty of people do. According to Johns Hopkins researchers, half of all American adults—including 70 percent of those age 65 and older—take a multivitamin or another vitamin or mineral supplement regularly. Their primary motivation is to prevent disease. The total price tag exceeds $12 billion per year. It’s a waste of money.

The most recent twenty-year study of 390,124 healthy adults, reported by The Journal of the American Medical Association, showed that taking a multivitamin daily was not associated with a lower risk of dying. Other studies have shown similar results:

• Research involving 450,000 people found that multivitamins did not reduce risk for heart disease or cancer.
• A study that tracked the mental functioning and multivitamin use of 5,947 men for 12 years found that multivitamins did not reduce risk for mental declines such as memory loss or slowed-down thinking.
• A study of 1,708 heart attack survivors who took a high-dose multivitamin or placebo for up to 55 months showed that rates of later heart attacks, heart surgeries and deaths were similar in the two groups.

Then there’s this: according to the U.S. Preventive Services Task Force, beta-carotene and vitamin E supplements can be harmful, especially at high doses. Beta-carotene may increase the risk of cancer and the risk of death from heart disease or stroke. Vitamin E may promote tumor formation and may cause nausea, diarrhea, intestinal cramps, fatigue, weakness, headache, blurred vision, or rash. 

Here’s an exception to avoiding vitamin supplements: Because folic acid prevents neural tube defects in babies, experts recommend that women take it before getting pregnant and during early pregnancy. Otherwise, as the director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research says, “Pills are not a shortcut to better health and the prevention of chronic diseases. You get all the vitamins and minerals you need from food.”

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

Report of my spine surgery

On September 18^th of this year, at age 88, I had a laminectomy: surgery to remove part of the bone (lamina) that was pressing on my spinal nerves and causing burning pain that ran from my butt to my ankle—basically sciatic pain. I’d had the pain for a couple of years or more, and it kept getting worse. My efforts to fix it myself through stretching and postural changes had no effect; neither did chiropractic and acupuncture treatments or two injections of steroids in my spine.

Of course I’d had an MRI, which showed the problematic area (L4-5). But the surgeon also ordered a series of spine X-rays in various poses. She doesn’t proceed unless the X-rays show a configuration—don’t ask me what—that she deems will ensure success. So, I gave the OK to go ahead. Still, it’s a scary prospect. Although you sometimes hear horror stories about spine surgeries, the people I’d talked to who’d had a similar surgery were enthusiastic.

Under general anesthesia, the surgeon made about a two-inch incision and used a drill to remove the offending bone parts. She also performed a bunch of other procedures to clean everything up. I have a copy of her report. It says things like “There was severe facet hypertrophy, which I drilled down also with the Anspach drill” (photo). The surgery started around 2:00. I was home by 6:00.

The pain relief was immediate and permanent (as of now, anyway). After about a week and a half, I started to gingerly do my regular exercises. At three weeks, I was back at yoga. At four weeks I was golfing. This surgery has changed my life. I no longer plan my days around pain or take any anti-inflammatories, which I’d been taking daily. I’m enormously grateful to my doctor and her skill. Sometimes we need doctors in our lives.

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