Sunday, October 20, 2019

ADVERSE HEALTH OUTCOMES FROM PROLONGED SITTING, LIKE NEGATIVE CARDIOMETABOLIC, I.E., TYPE TWO DIABETES

Who's affected?  Office workers, truck drivers, and others.  
Office workers [truck drivers, couriers, delivery personnel] are exposed to high levels of sedentary time. In addition to cardio-vascular and metabolic health risks, this sedentary time may have musculoskeletal and/or cognitive impacts on office workers.
Cognitive effects of prolonged sitting.  What are they?
low back angle changed towards less lordosis, pelvis movement increased, and mental state deteriorated. 
Metabolic disorders also can result, things like diabetes.  This is serious stuff and not to be trifled with.  
A rapidly increasing body of evidence supports an association between sedentary behaviour and the risk of adverse health outcomes []. These include negative cardiometabolic outcomes such as type two diabetes [], and some cancers []. In addition there is epidemiological evidence of increased risk of premature mortality [,] and obesity [] however this is inconclusive.

Prolonged sitting interferes with insulin sensitivity.  
During sitting, muscular passivity increases insulin resistance and influences the transport and oxidation of fatty acids in muscular tissue, and acute exercise is not sufficient to restore all changes. Accordingly, adequate everyday physical activity seems to be important for maintaining the signaling pathways affecting insulin sensitivity.
Musculoskeletal effects of prolonged sitting.  

How does one repair the damage? 
breaks to interrupt prolonged sitting are recommended. 
In other words, get up and walk around.  



HOW TO IMPROVE INSULIN SENSITIVITY?  
Resveratrol to start.  Also, try Butyrate.  

Of note, the combination of leucine + low-dose resveratrol exhibits synergistic action to manage insulin-resistance and obesity in lab animals.[xxxi] 
Polyphenols is one way to go.  Cranberry is one kind. 
Cranberry extract has been found to increase the population of AKK bacteria in lab animals and exert beneficial effects such as reduced insulin resistance and inflammation.[xxvii]
Starch, too, looks like a remedy for waist size.  
In a human study among adults with metabolic syndrome (obesity, insulin resistance) Fibersol-2 reduced waist circumference, belly fat, blood sugar and other measures of metabolic health compared to tea consumption for comparison.[xxxiv]  Among diabetic women, 10 grams of indigestible (resistant) starch reduced insulin, insulin resistance, markers of inflammation (TNF) compared to plain starch.[xxxv]

"Your brain, in that situation, is your enemy and starts acting like a magnet and tries to attach every bad thing going on at once into one big ball"

Tom cues up some interesting scenarios, and Michael Malice dishes up some excellent insights on directing people how to manage thought to produce healthier outcomes.  I liked it.   In reference to challenging situations.  In reference to going through tough struggles, Michael says, "The insidious part is that your brain starts telling you that you deserve, and you don't.  Well, some people deserve it, but in the main, you don't.  Nathaniel Branden called Ayn Rand's books, Virtue of Selfishness and Capitalism: The Unknown Ideal, "psychologically problematic."  It's not enough to have good principles politically and culturally, but it's important to have techniques to deal with tough things in your life.  And I always find it very helpful when people that I like discuss what they do because whenever you're in a dark place, you always think no one's ever been in this place before and no one can understand it and the insidious part is that your brain starts telling you that you deserve, and you don't.  Well, some people deserve it, but in the main, you don't.  

"There's a lot where you're not being rational any more."  I was the other guy who people went to who didn't have any problems.  Biggest breakthroughs I've had is shucking all of that and be willing to say, at least to close friends, . . ."  Frankly, it's been you [Michael Malice] and it


Here are Tom Woods' Show notes.     

Every weightlifter has a weight that they cannot lift.  At a certain point, the weight's not budging.  Doesn't mean they're weak, it means they have a limit.  This is universal.  Same thing with every person.  People don't realize that if you are someone who your friends respect and you're having a tough time, they don't think you're someone who they disrespect, they think this is someone I respect who's having a tough time.  Just like you don't think that weightlifter is weak, you just think he can't lift THAT weight.  And it's very hard for us to accept.  The other problem in terms of advice, this is something that very helpful when it comes to getting older.  Because when you're in college in your early 20s, you're having these problems--whatever they, professionally, personally--and the only people you know to turn to for advice are your dopey friends.  And sure they're going to give you advice because they get their advice from watching TV, cartoons, what have you, and YouTubes, and  they don't know what the hell they're talking about, and though it's not helpful and you're spiraling and when you get older you develop a lot better techniques and more importantly you have a lot more data.  And what I always do is . . . my friend Jackie as you know, Whacky Jackie, there's this quote that she has that goes, "If it's hysterical, it's historical."  So people who have gone through trauma of some kind, and you know that word . . . I'm going to use it in a loose sense, by trauma, I don't mean you've lost your leg or, you know, you were assaulted by a family member.  It could even be, getting fired . . . is a traumatic experience, something that's an intense, short-term shock that messes up your sense of reality [I will add your sense of meaning and priorities].  What happens in the future, like another time you had a job you didn't really like and you might be fired, you're going to have that same emotional experience that you had the first time and you might not have the presence of mind to realize it . . . then you're freaking out completely out of proportion . . . then you're freaking out about why you're freaking out.  So when that happens when you're in this kind of meltdown place, one technique that is very useful is take a step back and be like, okay, this is something echoing through time.  What is this actually about?  And when you realize that, okay, this is about that other time, well, could you have handled that?  It sucked!  Did you get through it?  Well, you're here now.  So that might not calm down the physical aspect, the adrenaline, that sense of tension, but in a logical sense, it allows you to breathe and localize what your brain is doing to you.  And there's something else you said about catastrophizing, which is very, very useful, which is sometimes you'll have something really awful that happened to you, like let's pretend you're laid off and you're walking around and asking What's the point?  I'm laid off, this and this, I don't have a girlfriend, whatever, my shoes don't fit, and you have to stop and tell yourself, "If you had a job right now, you wouldn't have a girlfriend either."  Your brain, in that situation, is your enemy and starts acting like a magnet and tries to attach every bad thing going on at once into one big ball and you have to take that step back and argue with it, and be like "you're just throwing things on top of this pile to try to make me feel worse and these are non-sequiturs even though on an emotional level it feels logical.  

This sense that your brain is saying, "It's me versus the world, they're not on a team that team is not united in opposition to you at all.  But you have to tell your mind that you're being self-isolating, and this is the thing, it's very hard for many people to have empathy, by which I mean seeing things from other people's perspective and realizing, yeah, every single person in this room has X amount of knowledge and lacks a lot of other knowledge, and is looking at everyone else in the room, they're one unit in this subset . . . just like you.  

It's not like everything that you face can be handled with some technique that you might learn somewhere.  Like, for example, I have a daughter who has everything imaginable going for her but she had a bit of a self-esteem problem for a while.

Sure.


And I would try to deal with that by telling her about all of her good qualities, and these are objectively true.  Anyone can see these qualities in her; this isn't just her dad talking.  But now she has a boyfriend and she's on Cloud 9.  She's had this boyfriend for numerous months now, and that experience meant more than a hundred lectures from her dad about what a great person she is. 

You need to see things for yourself, I can't bring you there, I can't take you there.  

I don't think that's what that is.  Here's my interpretation of that.  Okay, first off what her brain is telling her is "Oh, he's your dad.  He has to say these things.  And where is the proof that I am a quality person?" And then when she finds someone who finds her engaging and attractive, okay.  I had something similar happen to me.  I had a very good friend, very close.  He even had the passwords to my website, I mean that level of closeness.  And then one night he ghosted me.  We never had an argument.  We never had a disagreement, and it really messed me up.  I still don't have an explanation and now I've come to understand that if you're going to do something like that, that's on them not on me.  That's just not appropriate or doesn't follow.  And then I was on Kennedy Show, you know, often, and then she told me, or one of her staff or both told me that I was one of her favorite guests.  It made me realize that wait a minute, how hard, I mean if someone ghosts you, it's jarring.  You're like, "Am I this awful of a person?" that someone didn't bother having a discussion; they're just going to throw you in the garbage, you know?  Break-ups are the same way.  And I go, "Wait a minute.  Kennedy's been on TV like since the '90s.  She's interviewed hundreds of people.  If I'm even close to the top, and she finds me of interest or value, clearly, I can't be a terrible human being.  And that really kind of reassured me in that regard.  So it's tough because you know the brain . . . it's like writer's block.  Writer's block which most people if they've not experienced, they understand the concept, writer's block is your mind turning against you.  Rand called writer's block "Tennis shoes," by which she meant she would sit down and write, but then think that she's got to make some coffee.  

Malice is right about magnesium, that it just helps you bring yourself back to a normal state.  In addition to magnesium, I would add some of the fat-soluble B vitamins, like Allithiamine, Benfotiamine, and Sulbutiamine. 

 

Find Michael Malice's latest book here:

Saturday, October 19, 2019

BUTTERFLY IQ: GAME-CHANGER IN DIAGNOSTIC TECHNOLOGY? PEOPLE WANT SOLUTIONS, NOT GOLD-STANDARDS IN DIAGNOSTIC TECHNOLOGY

It's called the Butterfly IQ.  It is a handheld ultrasound that connects to your Android so that you can see images of tissue on your phone rather than having to go to an expensive specialist to see.  You'll still need some knowledge to be able to identify or discern features in the images, like blood, fluid, muscle, connective tissue, and so on.  You'll also need to have some medical or scientific background to determine if something is wrong or ill.  But it may be a case that the days of the stethoscope are over.  But so what?  I mean, what's the big deal?  Does the app self-diagnose?  Probably not.  Does it give you insights that you might take to your doctor and hammer out a therapy protocol together to solve your condition?  Probably not.  The medical-industrial complex is not going to suddenly step aside just because one clever tool was designed and manufactured.  But Dr. Stephen Stokes says it's a big deal.  
This is the most important piece of diagnostic equipment I have in my office right now. 
From Dr. Stephen Stokes.  


From the Butterfly Network.  So what exactly are the benefits, and for whom are the benefits delivered?  First, it's not the only pocket ultrasound diagnostic tool on the market.  See this list for others.  It's main benefit seems to be its competitive price of $2,000.  
Some of the particularly favored features of the Butterfly iQ are the price, single probe system, and storage capabilities.  The price point is far less than any of the other competitors.  For less than $2000 an individual has an ultrasound machine that can literally fit in a pocket.  Additionally, there are not multiple probes that have to be carried around.  The GE Vscan is the closest competitor with two heads to one probe, but it has other major detractors such as the quality of the images in comparison and its price point.  In addition to being able to storage images to PACS, Buttefly's images are save to a cloud based system which also allows users to share de-identified images to others.  Below, are some images from the first time of using the author's own device on himself. 
The point made here addresses my question about its diagnostic value. 
In EMS, ultrasound is not meant to be used to diagnose conditions such as appendicitis.  However, it can identify serious pathology and help develop an appropriate differential diagnosis as well as change care.  This can drastically change the course of management such as where a patient may be transferred.  For example, a hypotension chest abdominal pain patient with evidence of a large AAA should go to tertiary care rather than a community hospital.