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I have been chuckling at this all day:
Which isn’t to say that I have anything against nutritionists. Especially fat nutritionists, and especially especially The Fat Nutritionist. But I still think those guys are on to something, here.
It’s not like I expected any better from a Men’s Health article reprinted on the Health section of MSN’s website, but I was still annoyed after reading about the 8 Drugs Doctors Wouldn’t Take. I skimmed most of the article because most of the drugs doctors wouldn’t take are also drugs for which I have no need. Except for number five, Prilosec and Nexium.
Now, I don’t take prescription Prilosec or Nexium because my health insurance decided long ago when Prilosec became available OTC that it would be much better for them if I would use my own dollars to pay for this medicine, thanks. These days, I technically don’t take Prilosec at all, since Walgreens, bless ’em, now sells a generic version. But I do take a proton-pump inhibitor, omeprazole, nearly every day. Sometimes, on bad days (like, for example, today), I take three or four of these fuckers.
I am certainly alarmed to discover that doing so might result in a heart attack as well as increase my risk of pneumonia and bone loss, but for right now, the possibility of developing those ailments feels distant and unlikely, whereas the incredible, breath-stealing, throat burning, wretch-inducing, gut-clenching, audible-moan-inciting pain that I experience when I don’t take the pills is quite immediate.* For the moment, I’m willing to gamble that “no likely connection” between proton pump inhibitors and heart attacks actually means “no likely connection” between proton pump inhibitors and heart attacks. And pneumonia and bone loss, because nothing ramps up the capacity for denial like chronic stomach pain, eh?
Still, given that the older I get, the greater the risks posed by omeprazole become, I would certainly like to discuss other options with my doctor. Despite my generally high regard for my personal doctor, I’m suspicious of the conversation given that one doctor quoted in the article recommends taking Zantac (at which my personal stomach issues LAUGH RIOTOUSLY because seriously Zantac, Tagamet, and those other histamine blockers are about as effective as eating this bowl of paperclips on my desk) and the other doctor suggests, of course, being thin:
“To really cure the problem, lose weight,” says Michael Roizen, M.D., chief wellness officer at the Cleveland Clinic and co-author of “YOU: The Owner’s Manual.” That’s because when you’re overweight, excess belly fat puts pressure on and changes the angle of your esophagus, pulling open the valve that’s supposed to prevent stomach-acid leaks. This in turn makes it easier for that burning sensation to travel up into your chest.
I developed acid reflux when I was in my early 20s and weighed 130 pounds, and I have had it ever since–as a skinny person, chubby person, and a downright fat person. Since developing reflux, I’ve been skinny and then fat and then skinny and then fat again, and while my weight fluctuates like the tides, one thing that never goes away for any great duration is my searing stomach pain. (I have also suffered from acid reflux as a regular exerciser, as a slothful couch potato, as a pack-a-day smoker, as a only-smoke-when-I-drink-smoker, as a non-smoker, as a vegetarian, as an Atkins dieter, as a heavy drinker, as a tea-totaller (or, as close to a tea totaller as I ever get), as a coffee drinker, as a tea drinker, as a water drinker, as a stress-case, as a zen-like relaxed person, as a single woman, as a married person, as a red-head and as a brunette, as a resident of six different states, and as I pursued three different careers.) I know fat people with acid reflux. I know skinny people with acid reflux. I mean, hell, have you ever tried to eat with stomach acid roiling up into your esophagus? It’s a wonder that fat and acid reflux are linked at all.
Perhaps this is what the great Dr. Roizen is actually suggesting! Leaving your acid reflux untreated so that you are unable to eat, until you lose enough weight that the reflux magically corrects itself. Or you die. Whichever. I guess we’ll have to buy his book and find out.
*You know, I’m also sort of fascinated by this side effect (lol get it) of the over-the-counterization of pharmaceuticals. Before my doctor would write me a prescription for Nexium, back when it was prescription only, he subjected me to a few blood tests to make sure I didn’t have an ulcer. Satisfied that I did not have an ulcer, the doctor assumed I had acid reflux (there might have been some fat prejudice there, since I was fat the first time I actually sought treatment for chronic heartburn, although I’d experienced it for about eight years by then) and away I went. Shortly thereafter, my insurance company dropped proton pump inhibitors from their list of covered drugs and I have been self medicating ever since. When the pain gets worse, I take more pills. Every once in awhile, I skip a couple of days to see if whatever ails me has miraculously resolved itself and then spend the next three days in severe pain, doubling up on the pills, and eating nothing with a pH under 7. At this point, there could be a giant acid-producing alien parasite in my stomach and I would never know, because I don’t need to go to a doctor for this medicine, so why should I seek medical care for a condition that is, as far as I’m concerned, treatable. If inconvenient.
We all know that losing weight is merely a matter of exerting sufficient will power and self control, right? And that any failure to do so is our own moral failing? Well, quel surprise, perhaps not:
Focusing attention and using one part of your brain against another part, that takes significant energy. The brain is already our most energy-intensive organ, so adding the demands of “self control” on top of that is likely to have presented some adaptive issues in the past. Put differently, it’s unlikely to expect that we’ve evolved to be able to maintain self control over extremely long periods of time (say, months), simply because such problems rarely presented themselves in the past (there were few adaptive benefits) and because the energetic costs of doing so would have been quite high.
And as for losing weight?
Diets are often marked by periods of effortful weight loss, followed by a slide back, where weight is regained. That pattern is not simply a matter of mind over matter, of willpower so we can match a cultural and cognitive ideal. It’s hard for people to maintain sustained mental efforts, it costs energy, and there’s little evolutionary reason to expect everybody’s brains to suddenly begin cooperating with what our culture tells us we should be able to do.
I’m way out of my depth here, but if focusing attention towards will power and self control uses a significant amount of energy, wouldn’t it follow that a human being needs to take in more calories to make up for the additional energy expenditure that it costs to diet? Now put that in your Points (TM!) slider and calculate it.
You know, I always thought it was normal, even desirable, to feel full after eating. That’s how you know you did it right! But I guess in this time of rampant, world-destroying obesity, we’ll pathologize anything related to the consumption of food. Witness this call for volunteers for a medical study at Northwestern:
“Do you have stomach problems? Many people have stomach discomfort, stomach pain, feel full after eating and other problems will meals. Researchers at Northwestern University are conducting a research study using two FDA-approved medications to treat stomach symptoms that occur after eating. You may be eligible to participate if: You are 18 to 75 years of age; You experience stomach discomfort or pain, or other stomach problems after eating.” (Emphasis added. Also [sic].)
Note: I looked up the study on-line and what they are actually looking for are “patients with chronic abdominal discomfort, bloating, or early fullness after eating a meal,” which makes me think that one, they ought to hire somebody from the English department to write their “Participants Wanted” signs, and two, they are going to get a lot of unqualified people signed up for this particular trial.
Thanks to the husband for pointing me to this post on Chicago Metblogs.
Chicago’s hilarious local WGN News aired a clip in support of this study about how fat people are destroying the environment by being all fat and gross and stuff. I really have to thank Gina Kolata and the fat blogs (is that a band? Gina and the Fat Blogs?) exposing the ridiculousness of the old “if fat people just did X, they would lose Y number of pounds every year!” trope. That was the sort of non-info that just kind of rolled right off my brain, leaving maybe an ooze of self loathing behind, but no real cognitive understanding of what it even meant to lose 13 pounds every year because I parked at the ass-end of the Shop Rite* parking lot.
Over video footage of the headless fatties (Gina and the Fat Blogs is playing a double bill at the Empty Bottle with Teh Headless Fatties next week, I hear – no cover and there will be snacks!), the WGN news anchor encouraged fat folks to get out of their cars, and stop eating hamburgers! Also, walk instead of drive. And I had to laugh into my beer at that one because this fatty walks at least a half hour every day (unless it’s one of those housework-focused days when I just putter around the casa, in which case I get all the cancer-fighting, slimming, gender-essentializing benefits of housework so I figure it evens out) and doesn’t even own a car, much less sit in one and eat hamburgers. So where is my 13 pounds of annual weight loss? Where do I write a letter of complaint? I have been walking at least a mile a day for the last three and a half years, so I should be showing a net loss of 45 pounds. I have been cheated and I demand to know who is responsible! Preferably before next Sunday when I attend a clothing swap and dump all my size 8 – 12 clothes, which, according to Dr. Georges Benjamin should fit me just fine, thanks, since I walk so fucking much.
This also made me think about the similar conundrum I faced while living in Atlanta. Against (white people’s) social custom and despite some serious inconvenience, when I lived in Atlanta, I took MARTA to work every day. At least until I joined a gym in my office building. Because, see, if I wanted to go to the gym, I had to schlep way to much stuff with me to take MARTA, since the gym had no lockers, so I had to drive. Plus, since I went at lunch, I had to shower before going back to work, which meant two showers a day. Plus I created extra laundry in the form of towels and gym clothes. I actually wrote on the blog I had at the time about how I was torn between being environmentally conscious by taking public transportation, or being environmentally conscious by exercising so I wouldn’t be such an over-consuming Fatty McFatpants. Given that Atlanta is about a week from completely drying up and blowing away, I wonder which course of action good Dr. Benjamin would advocate for me were I in the same situation now?
All of which just serves as more anecdotal evidence on how damn dumb, not to mention demonizing, that study and its attendant news coverage really is.
* What’s up, Delaware!
This pretty much sums it up:
- I have a classifiable shape, and that shape is Figure Eight. Despite having always prided myself on being indefinable, this comforts me immensely. I even look like the drawing! Well, except for the hair and the coloring and the fact that I don’t wear high heels.
- My fat upper arms are going to help me live longer.
- Neuroscience (translated into understandable people talk by Harriet Brown) tells us that eating when you’re hungry is good for your health. Imagine that!
Bonus good news: In a clothing-related breakthrough, I did some successful shopping, and I have made the executive decision to put all my beautiful but way too small vintage dresses up for sale on Ebay. While I am a figure eight, I will never be a size eight again, and friends, this is all right with me. But more on that later.
As careful as consumers may be about revealing personal information to product companies, few take the same care when it comes to volunteering private health information to third parties who aren’t their doctors or healthcare providers. Yet, online health risk assessments, offered by growing numbers of employers and insurance companies, ask for even more personal information about lifestyle habits, medical histories, and health. The information is compiled into electronic medical databases and used to identify people to be targeted for health tests, monitoring, education and health care management.
Many are promoted as online medical records to make it easier for consumers to put all of their records and health information in one place for ready access wherever they are. In return, besides free tote bags or discounts on their insurance, participants are given targeted health information to guide them to healthful behaviors. Growing concerns are being raised about these electronic databases, including how personal information is being shared, sold and used, especially as the marketing interests behind them are becoming better recognized.
HIPAA is not my area of expertise. Does it only apply to care providers and pharmacies? Why not on-line medical records repositories? That certainly seems in line with the purpose of the law.
Edit! I have access to a HIPAA expert, and here is what she had to say:
The only entities that are required by federal law to comply with HIPAA are health plans, health care clearinghouses and health care providers, if the provider transmits any health information in electronic form. That means that Google, Microsoft and these state networks cropping up all over the place to provide health information statewide, generally do not have to comply with any privacy laws.
. . .
At this point there are no safeguards on the system. There are no audits of access. . . . I would not use anything on the Internet to collect any personal information about me, especially my health information, and I would tell all my friends and families to forgo that opportunity as well. Those businesses are not required to provide any privacy protections for health information. Depending on the state in which you live, they may be required to protect your personal information like address, phone number, date of birth and social security number.
I think the answer is to assimilate all of my health information on my personal password protected jump drive that I can then carry with me, and have available as I need it. Of course there are problems with that as well. If I get hit by a car, and I’m the only person who knows the password, it’s useless.
So there you have it. Avoid these on-line repositories of healthcare info, get a jump drive, and tell your BFF your password in case you get hit by a car.
The Trib picked up this AP story about the rise of maternal death rates for this morning’s paper. In the US, we medicalize childbirth as an illness. Women give birth in hospitals with IVs and invasive monitors, attended by nurses and doctors, who treat childbirth as an inconvenience that can be addressed through drugs and invasive, painful, dangerous, and unnecessary surgeries. We do all these things in the name of health and safety, whether because we value the lives of women (I’m skeptical) and newborns (or at least the white ones, and as long as the act of valuing them coincides with the act of dominion and control over women’s reproductive organs), or because we fear lawsuits and the rising costs of malpractice insurance.
Although we cry “health and safety!” we continue to employ methods that don’t meet our own goals. We shave women, tilt women on their backs to work against gravity, pump them full of pitocen when their labor fails to conform to timing charts, slice their vaginas, and finally cut them open. And why? If these methods aren’t giving us the results that we claim to want, why do we persist in using them?
Usually when I sit down to ponder these sorts of questions, I follow the money. These procedures are expensive. Doctors, hospitals, insurance companies, medical supply companies, and drug companies make a lot of money off women who give birth in medicalized settings. And when corporations are making bucks, they tend to overlook the resulting harm to people, especially oppressed peoples (by which I mean women, generally, with the recognition that middle class (mostly white) women have the means to pursue alternatives, like birthing centers and doulas, while lower income women (mostly of color) are herded into hospitals, where the obstetrical-industrial complex can continue to make money off the exploitation of their bodies).
If you doubt me, look at how the medical establishment (predominately male) treats the profession of midwifery (predmonately female). Some doctors in Missouri just filed suit against a midwives practice group in an attempt to have a law that would allow midwives to deliver babies without consulting with doctors unconstitutional. This law was passed as part of a measure to reduce the costs of healthcare, but the obstetrical industrial complex apologists see it as a loss of revenue. Of course they couch their objection in terms of maternal and neonate health, which brings me neatly full circle: Doctors’ methods aren’t working. If an existing method is causing harm, how can anyone argue for their continued employment using health and safety as a justification?
And of course, no modern article on women’s health issues would be complete without a little (fat) woman-blaming:
Experts also say obesity may be a factor. Heavier women are more prone to diabetes and other complications, and they may have excess tissue and larger babies that make a vaginal delivery more problematic. That can lead to more C-sections. “It becomes this sort of snowball effect,” said King, who is now medical director of maternal-fetal medicine at Riverside Methodist Hospital in Columbus, Ohio.
You hear that fat mamas? It’s not the money or the convenience or the general contempt that the medical profession has exhibited towards women’s bodies since the dawn of fucking time that leads to unnecessary surgery and death. It’s your fat. So please excuse the medical researchers while they wring their hands over the cause of death of thin mothers.