cxlxmxrx

Images of positive Allen test due to lack of collateral circulation

I've decided to try to write a publishable peer-review article. In the course of doing initial online research, I came across this case study from Circulation:

A 27-year-old surgical resident from South America noticed occasional tingling in her right hand on awakening. She performed a modified Allen test on her own hands and noticed a subtle line of demarcation on the palm of her right hand accompanied by induction of similar tingling sensations. The demarcation was not seen on the left hand. We suspected an incomplete palmar arch, and to better demonstrate these findings, we wrapped the patient’s right hand with a latex bandage to exsanguinate the extremity. Assistants applied pressure to both the radial and ulnar arteries at the wrist as the latex bandage was removed...

After performing this Allen Test, the assistants were able to obtain the following results. Normally there is an anastamosis between the medial and lateral circulation called the Palmar Arch. Apparently, this subject's Palmar Arch was poorly developed!

I had never seen a positive Allen Test before.

The Fat Trap - NYTimes on fat loss

The NYTimes has a long article on the sciene of weight loss. Much of it covers similar issues as Gina Kolata's Rethinking Thin, in addressing research that shows that the calorie-in-calorie-out model of weight loss is too simplistic as a model.

Fetal cells last in mother's body

Fascinating short article at bOINGbOING about the fact that some fetal cells that cross the placenta to the mother's body continue to live and reproduce for the long term...

I'm a caveman, not a grok

Last year, I had my genetic material tested by 23andMe. Actually, it was pretty boring, uneventful, and uninformative. Guess what... I'm at increased risk for DM2 and heart disease, which I could have figured out by looking at my family tree!

Recently, however, 23andMe added a feature to determine the amount of Neanderthal genes in your mix, which varies from ~1% to ~4%. Razib Khan reported his as ~2.4%. I was pretty sure I was higher than that. Despite eating okay and working out regularly with CrossFit, spinning, and weightlifting, I'm still a pale, hairy, 252 lbs. When I exercise, I seem to be able to add weight and get broader, but never lose weight and get svelt unless I starve myself at the same time. I was hoping this represented an ancestral genetic propensity to add bulk, which you would assume is Neanderthalish from the forensic recreations of those peoples.

It turns out I'm ~2.7%, only the 68th percentile. I'm a little disappointed: apparently, I'm just fat, not representin' a different lineage. On the other hand, I'm taller than average and have seemingly small nasal passages, which tells you...

On the other hand, I'm not a grok. I learned recently that "grok" is actually a term invented by a sci-fi great, Robert Heinlein. It essentially means to copy something. That explains why Grok became the early Paleo logo, but also why it became despised by those who wanted to reject Paleo reenactment.

Well, anyhow, happy DNA hunting. If I might suggest--if you have red hair, please marry another red-head. Thanks.

More medical technology, please?

Chariot of Reaction suggests that Lasik eye surgery is a model for healthcare success. I know other people who have said the same: price transparency, technological innovation, onward and upward!

Technological innovation in healthcare is a double-edged sword. It pushes down overall costs if efficiency gains overcome new costs. I would guess that many of the theoretical gains don't materialize: in the hospital I used to work at, they didn't stop printing a piece of paper for every lab result despite the fact that all results are in the computer--the paper goes straight to the recycling bin. When it comes to medical items like MRIs, I suspect that some diagnoses are better but many just arrived at more easily, with the addition of expensive machines.

But it does seem like R&D should have the ability to bring down costs in the long run, doesn't it? I'm not so sure, unless you are talking about a Fountain of Youth pill that will make older people productive workers like when they were young. If you "cure" DM2 and cancer and find a universal and effective antibiotic, your gains are going to be offset by an increase in non-productive end-of-life years when people are depleting wealth.

For the Edge question this year, Aubrey de Grey has suggested that generalized comfort with risk would improve biotech research.

Part of what drives up healthcare costs is the high reliability of equipment. When was the last time you got an X-ray and it accidentially emitted too much radiation? Have you ever removed a needle from its packaging and discovered it was blunt? Doesn't happen. Cost control in these arenas would involve using new tools in a hospital and having some of them fail periodically and not litigating.

On the other hand, the type of research de Grey is talking about is related to new therapies. A magic pill that would prevent cancer would be a big financial boon to society in the short run. In the long run, it might prove highly problematic and costly.

There aren't good answers to cost control in healthcare. None that I know of at any rate.

DEA constraining pharmaceutical production

The NYTimes reports that there are nationwide shortages of Ritalin and Adderall. Apparently, the DEA constrains the production of active ingredients used in a variety of medications. I had no idea this was the case, and it is perhaps one of the worst aspects of our national war on drugs.

Some problems with the war on drugs are on display over at Mangan's. Commenters are generally ignorant about pharmaceuticals and attention deficit problems and the entire tone is dismissive of the issue.

It may be that there is over-prescribing of Adderall, but I would submit that the problem is that, when people who think they may have ADD or ADHD take Adderall, it makes them feel great. If they have ADD, they don't know what "normal" feels like, and, if they don't have ADD, they don't know that ADD feels like, but they do know what better-than-normal feels like. So who's going to report a failure in cessation of symptoms?

Having taken Adderall before, I can say that it is not an unpleasant experience and would probably improve most people's lives. Frankly, I don't care if it is overprescribed.

Medical humor from xkcd

xkcd 996

New Year's resolutions

Since I quit my job and returned from my cruise, some things have been going well, but some haven't...

While I was on the cruise, I drank a full glass of cognac and didn't get even a buzz. As there is alcoholism in my family, I'm clearly drinking too much. So I am trying to cut back since I returned.

I started CrossFit since getting back from the cruise. But since starting, I have experienced a weight gain of 6 lbs!! as well as a loss of strength. And my knees are starting to show their age by intermittent pain. As I feel great after a CrossFit beat-down, I'm not sure what to do about the apparent fitness regression. One thing I know, however, is that I need to reduce my weight, primarily fat weight, but perhaps some muscle, too. (My goal is 225 Lbs, a loss of 30 lbs at the current time.)

My hometown is virtually devoid of professional/romantic/sexual opportunities for me, and I need to get out. I've quit my job, which is an obvious first step, but I need to move as well, before my $$ runs out. Also, I am bored.

Ergo, New Year's resolutions (which I have never really made before)...

(1) To drink less. Specifically:

To drink my wonderful Tanqueray dirty martini's only on the weekends (or with company or with fillet mignon lunches, which I do not anticipate in the next year, but enjoyed immensely in the past two...)...
To drink Gin-&-Tonics only in summer...
To have the Back-&-Forth (my own concoction of Tanqueray Rangpur and Stone's Ginger Wine on the rocks) only occasionally (objective assessment to be determined)...
To stop drinking Mata Hari's (too much sugar)...
To reduce the frequency of after-dinner cognac (objective assessment to be determined)...
To drink margaritas (mine: 2 parts Don Julio anejo tequila to one part Cointreau and one part fresh-squeezed lime juice, on the rocks, no salt) only before Mexican food...
To not buy another bottle of Nob Creek or Maker's Mark...
To not drink wine with every meal, and to buy only wine I know I will enjoy...
To not add other drinks to my repertoire...

(2) To not eat dessert, sweets or high-carb breakfast (e.g., croissant) except on the following occasions:

birthdays of my family members and me (x4--June, July, October, November)
summer ice cream (homemade ice cream occurs once or twice a year)
Thanksgiving
Little Christmas Eve (gingerbread)
Christmas Day
+ 6 other occasions

For a total of 12 times. I don't eat poorly on a frequent basis, but limiting to 12 times out of 365 possibilities will be a challenge.

(3) To eat more seaweed and kale
I really like seaweed, actually, especially sushi nori, which I buy from the grocery store's sushi chef, who is incredulous that I want to buy nori...

(4) To eat grain-based foods (other than #2) only 4 times!!
Wow, four! On the one hand, once every 3 months doesn't seem like very much sacrifice, as time can fly quickly. On the other hand, it is very common for me to engage in seasonal eating, such as pizza/beer in late summer. This will be a challenge.

(5) To stop watching television
I don't watch much now, and if I lived by myself could easily not own a TV. But I do currently watch shows with other people to be sociable...

Except for (1) The McLaughlin Group and (2) Blue Bloods while at home.
Not to include movies, which should also be reduced in frequency.
Starting after Downton Abbey finishes
When I move, to not have TV at all!

(6) To sleep more
I have really poor sleep habits (e.g., I just slept for 10 hours last night after being up for 2 days straight), and I know it effects my recovery, mental alertness, and long-term health.

(7) To blog less/better
Pointless blogging takes up a lot of time.

(8) To reduce possessions further.
My ideal would be to own only my clothes, some books, some kitchen and table ware, toilettries, a few home furnishings, and my bike. I'm a lot closer to this ideal than I am to most people's level of acquisition, but over time, odds and ends build up somehow. I understand my humidor, but why did I buy glass decanturs? Will my dead grandmother really care if I get rid of the things she gave me when I was 10?

(9) To read a minimum 50 non-fiction books (~1/wk), and read less Internet
It's not like I watch YouTube videos and LOLcat humor when online, but books are better.

(10) To finish a project
I've started a lot of hobby-related projects in the past, from novels to small businesses, but I've never finished one/made it profitable.

2011 year in review: did I write anything worth reading?

Blogging can take up a lot of time. For an amateur, who doesn't blog as a way of making money/promoting himself, there isn't much justification or rationale for blogging unless the writing is valuable in itself. For most us, this isn't the case. The number of bloggers who benefit the world beyond the satisfying of others' attention deficit problems, like Denise Minger, is very small.

So in this spirit, I review cxlxmxrx over the last year and ask whether I wrote anything that might be worth reading...

March: genetic testing & FDA regulation: If you can't tell, I actually enjoy arguing.
April: hospital trash: The amount of trash produced in health care is outrageous. I should have followed up this post by researching the question to see if my estimates are correct.
July: ancestral responses to ancestral relationship issues: It's one thing to investigate the social and sexual arrangements of our ancestors. But in trying to apply the knowledge to modern times, it's instructive to consider how people closer in time to those ancestors dealt with the issues raised by our sexual and social impulses.
September: Cepacol & FDA regulation: My first foray into anything like original reporting.
September: 9/11 Commemoration: This year was the 10th anniversary of the NYC Trade Towers bombing.
September: Critiquing NR's review of The Bond I & II: Against sentimentalism in vegetarianism.
December: Better Angels of Our Nature book review: There were a lot of what I thought were pretty crappy reviews of this interesting book written by academics and journalists who didn't really deal with the book's arguments. While my writing may not be the best, I think the question I asked--whether the pacification of man might not have a trade-off--is the only really relevant response to the book.

Well, seven posts is actually more than I would have expected before reviewing my posts from the year. If this list tells me anything, it's that, if I concentrated on producing only one post per month, I would be producing more posts of a higher quality. Also, it turns out I don't actually post very much on healthcare- or hospital-related issues. Probably I should be more pointed in picking on these subjects.