Spinal Reflexes and Brain Dead People

In a recent post, I mentioned having learned that “There’s an area of your brain that handles a reflex to turn your head and look before you even form the question ‘What was that streak of orange and roaring noise?'” While this is true, it’s a relatively complicated reflex. There are some reflexes so important that they are completed before any message is sent to the brain at all! A good example of this is pulling back from something that hurts you. You’ve already reacted to the hot pan in your hand or the LEGO you stepped on in the dark before you ever think “Ow!”

One way this was demonstrated in lab was with a short film of a frog that had been “pithed.” It used to be done commonly in some science classes but by watching the film, it didn’t have to be repeated in every lab, every semester. The college saves money, fewer frogs die, we still learn. This procedure does render the frog brain dead: the parts of the frog that say “Heart, beat!” or “Lungs, breathe!” still work; the parts that say “I’m hungry” or “I like lily pads” or “Ow!” are gone. Over the course of this short film, we watched the frog react to painful stimuli using nothing more than spinal reflexes (regrettably, I can’t find a Youtube clip in English that demonstrates well). We were reminded by the narrator several times that the frog is not feeling anything, is not “trying” to do anything. The parts of the brain that feel or try were gone. It’s just reflexes.

At the end, the lab instructor — an older lady who had initially trained as a nurse in Brittain’s Army — told us that we needed to remember this film because those of us going into patient care were likely to someday encounter brain dead patients and their families, and their families would be desperate to attribute reflex movements to improvement in their condition. In fact, she remembers that the first time she saw these reflexes in person, “It scared the bejabbers out of me!”

And this brings me to the sad story of Jahi McMath. Last month, tonsil surgery went wrong for Jahi. She experienced severe bleeding, cardiac arrest, and brain death. She is currently on a ventilator — the part of her brain that would say “Lungs, breathe!” doesn’t work anymore either. The brain death was confirmed by no fewer than 5 licensed physicians, 3 of whom were selected by the girl’s family. She’s actually been declared dead. Nevertheless, the family has hopes that she will get better and wants her transferred to another facility. One doctor says he thinks the girl is not brain dead because “he visited Jahi’s bedside and observed her responding to her grandmother’s voice and touch with a squirming movement.”

Now, I’m not a neurologist, but I think I’ll take the word of multiple neurologists and other doctors over the word of one pediatrician who thinks he saw something that can be explained by simple spinal reflexes.

Talks to allow transfer this unfortunate young lady to another facility are ongoing at this moment. In the highly emotional words of the hospital’s lawyer: “It’s horrible that this child has died. It’s also horrible that it’s so difficult for her family to accept that death.”

In Closing: pre-employment credit checks; college education; sequestration; “reality” TV; deliberately hard maybe?; “Hi guys!”; Bill!; and doge.

 

An apology and explanation, of sorts

A few weeks ago, I needed to buy cat food and cat litter. I was in a little bit of a hurry that particular day, so when I found there were no carts inside the pet supply store, I did not return to the parking lot to search for one. I casually picked up a 30 pound bag of cat litter, placed a 5 pound bag of cat food on top, and briskly walked to the check-out stand.

Now, if you like humor, think about this mental image: a 4’11” redhead in full airport-walking mode carrying two heavy, bulky objects.

I didn’t think a thing of it until the cashier asked if I would like help out to my car.

So this is my apology. I’m sorry that I forget not everybody can do that. I forget that not everybody can hike themselves around 6 miles of hilly sidewalks and still be ready to do it again the next day. Unless I have house-guests to remind me, I forget that many people consider my almost-daily workouts to be “extreme” if not “crazy.” I forget that most of my classmates take the elevators up to third floor classrooms — or avoid classes in those rooms altogether! — instead of taking the stairs.

But here’s why I say it’s only an apology of sorts. I firmly believe that most people can get in pretty good shape too. In fact, almost everybody can engage in some new behavior that will at least let them be healthier next year, as long as you are actually conscious. I was not born with somehow superior genetics, I was not thin and athletic as a child. I can do many things today that I could not when I was younger because I worked at it. This is where you might say “oh sure, she must spend 3 hours a day at the gym!” Not true. Sure, I do some workout most days a week, but it does average out to less than an hour a day and most of it is in the comfort of my own home.

New Years is a time when a lot of people make empty promises to themselves to engage in new, healthier habits. I know that the overwhelming majority of these promises are empty and soon to be broken, because if it were really important, you wouldn’t wait until some magic date on the calendar. However, you’ve got a much better shot at a modest goal or three than a huge change of lifestyle so keep that in mind if you want to make changes for the better.

That said, I will still share some items that I hope will help you be healthier at the end of 2014 than you are today:

  • “If you’re a woman who thinks it’s okay to tell a skinny woman that she needs to eat a sandwich, I hope you don’t mind when that skinny woman tells you that you’re a fat ass.  Because that’s exactly the sort of shaming you’re giving her.” Don’t feel so “good” about yourself that you have to put others down.
  • If you’re going to get busy in the gym, don’t forget flexibility training. Even football players benefit from yoga. That’s right, I linked to the sports section and the world didn’t end.
  • You do have the time to cook good food, if you plan ahead.
  • Two from Tom Venuto: on attitude and predictions.
  • I still stand behind these two posts on diet and exercise.

Good luck next year. We could all use it.

In Closing: I didn’t know legless land fish existed; more researchers under the delusion that people can shop around for a hospital; another crappy ruling from another judge who doesn’t understand security vs liberty; that oughta work!; you don’t suppose income inequality and NAFTA could be related, do you?; new crypto; and a few pictures.

Strange Epidemic

In the last week, I’ve read two completely unrelated stories about two women who came down with one very rare but very serious medical condition while participating in the same activity. That’s the kind of coincidence I don’t like hearing about.

The condition: Rhabdomyolysis. I’ll let WebMD tell you more about it, emphasis mine:

Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from a breakdown of muscle fibers and release of their contents into the bloodstream. This can lead to complications such as kidney (renal) failure. This occurs when the kidneys cannot remove waste and concentrated urine. In rare cases, rhabdomyolysis can even cause death. However, prompt treatment often brings a good outcome.

They go on to say that among the more common causes are “Extreme muscle strain, especially in someone who is an untrained athlete.” Think on that for a moment.

The activity is CrossFit. Here’s the story that started me thinking, and for balance here’s a rebuttal. While I was still digesting this bit, another article on CrossFit induced Rhabdo came across my RSS reader! What a horrible coincidence. For pity sake, they’ve nicknamed this potentially fatal syndrome Uncle Rhabdo! An excerpt from the original item:

A quick search of the Interwebs [sic] reveals copious amounts of information about rhabdo purveyed by none other than CrossFit trainers. Scouring the scientific literature in mainstream medical journals, however, reveals a only a few peer-reviewed papers. The science confirms that exertional rhabdomyolysis, as this form is sometimes referred to, is uncommon and normally reserved for the elite military trainee, ultra-endurance monsters, and for victims of the occasional psychotic football coach. Rhabdomyolysis isn’t a common condition, yet it’s so commonly encountered in CrossFit that they have a cartoon about it, nonchalantly casting humor on something that should never happen.

As you may have guessed from the rebuttal to article one, CrossFit people are passionate about it. I would love to link you to, say, a nice balanced Wikipedia page about CrossFit, but it “has been identified as posing a potential copyright issue….” Here’s some of their WODs, or Workout Of the Day. These are the ones Men’s Health considers the “most brutal.”

Yes, they do this stuff pretty much every day. Yes, they encourage beginners to join them, and the quality of training those beginners receive varies wildly according to the skills of the trainer. I’ve thought about doing it myself, but then I keep running into Youtube videos that convince me I want nothing to do with it, and not just this blooper reel — notice that some of these people are doing it in the gym where somebody should have corrected form. Do you really think these people received adequate training before trying to lift that? Maybe we should work on basic presses and lunges before trying a clean and jerk?? Look at these women being encouraged tokipp” — cheat! — at pull ups. I’d rather do 5 pull ups Tony’s way, Mark’s way, or Scooby’s way than 50 CrossFit’s way; healthier for my shoulders and back, and more honest too. I don’t have room in my life for “Uncle Rhabdo.”

So yeah, “untrained athlete” plus extreme workouts every day equals a high chance of injury.

Alert the media.

Back to School Time is Back to the Vaccine Debate Time

So my local CBS affiliate is trying real hard to do the fair-and-balanced two-sides-of-every-issue thing.

In one corner, we have a highly respected local pediatrician who works in a local hospital pointing out that he’s seen 4 cases of whooping cough in the last 2 months, adding “Vaccines are one of the most important advances in the field of pediatrics in the last fifty years….”

In the other corner, we have a “Holistic Physician” — whose degree, source of expertise, and workplace are undisclosed — saying whoa, just hold on a minute, there are “factors to take into consideration as to if you should vaccinate, when you should vaccinate and what are the alternatives to vaccination.” Apparently “holistic physicians” believe you can prevent measles and other diseases with a proper diet. Seriously.

A little research shows that this “doctor” is a chiropractor, with online reviews that range from good, up to “sounds like it might have been written by a staffer”, down to abysmal. As nearly as I can tell, the scope of practice for chiropractors in Nevada does not include prescribing rights or the ability to perform injections. That would of course include administration of vaccines. At least he’s not a “Naturopathic Physician.” Remember kids, ND means Not a Doctor.

At least nobody brought up that discredited “research” showing vaccines “cause” autism.

Look folks, here’s the alternative to vaccines: your kid could get sick and possibly die from a completely preventable disease. Vaccination doesn’t take long to do, the complication rate is very low, and your kid’s school probably requires it anyway. In this day and age of protecting kids from the imaginary predator around every corner, what excuse is there for not getting it done?

So what’s next, local news? What topic can you pretend there are two sides to present and take up a few minutes of airtime? Here’s an idea for you: Murder! Police and safety experts say it’s bad, but killers say some people just gotta get whacked. You decide!

In closing: “Hey, calm down!”

 

 

Too Late

Great. Swell news. Twinkies will theoretically be back on the shelves next month.

Whatever, nobody cares anymore.

Go ahead. Visit a grocery store or a quickie mart. That shelf that used to have Hostess products is full of knock-off baked goods: Little Debbie; TastyKake, Mrs. Freshly’s; Bimbo Bakeries; even Krispy Kreme. Some of it even tastes better than what it replaced. That space is gone, taken over probably forever. That means no more room for Twinkies.

Stick a fork in Twinkie the Kid, he’s done.

In Closing: Paula Deen; a couple items on climate change; malicious prosecution; and falling wages.

Angelina

Alright, by now everybody and his or her dog has heard the latest about Angelina Jolie, right?

Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.

Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.

On April 27, I finished the three months of medical procedures that the mastectomies involved.

Needless to say, this has sparked much online discussion. Here’s a featured item on BlogHer by a woman considering the same decision. Here’s one from a Professor of Pediatrics (is he also a doctor of medicine? probably?) who points out that this sort of surgery comes with risks and without promises of a cancer free life.

And do you know what I don’t see mentioned much? Time and money.

Most of us don’t have the ability to be in and out of surgery and recovery for three months — more if there are any sort of complications. Heck, many of us can’t really afford to take 2 days off from work (or school, or taking care of family…). Ms. Jolie is truly blessed that not only could she free up her busy schedule to do this, but also that her loving husband Mr. Pitt was able to be there by her side, and further that they were able to arrange adequate childcare for their six children — ranging in age from 5 to 12 — during this stressful time.

Another area where Ms. Jolie is truly blessed is money. Many women can’t justify spending the “approximately $3000” to see if she has the 1 in 100 chance of ridiculously higher breast cancer risk. In a time and country where it can be difficult to figure out exactly how much any given hospital service is going to cost, she didn’t have to worry about it. She knew that the money was in the bank. Perhaps she did get her insurance company to pay for it; after all, this has to be cheaper than cancer treatments followed by reconstructive surgery!

Some people simply have more options than others.

In Closing: transparency and accountability, and why big brother won’t work; it wouldn’t be a bad idea to retire these; austerity, unemployment, and job creation (for the record, I am currently not in the workforce and not officially “unemployed,” more on that later in the week); mobility; interesting point; the law of supply and demand (and why we desperately need a public option).

Well, that tears it.

I like bourbon.

I’m not a particular fan of Jim Beam, unless it’s the hard-to-get Green Label. Under normal circumstances, one of my favorites has been Maker’s Mark. However, I rarely have it at home. To be blunt, it costs twice as much as Evan Williams and just isn’t twice as good.  That’s why Evan is the house bourbon around here: adequate quality at a good price.

However, on those occasions in the future when I have extra money to spend on a higher quality bourbon, The Mark is unlikely to be my bottle of choice anymore. It seems that due to “shortages,” they will be watering the stuff down. Oh rest assured, they say, it will taste the same. Right.

Congratulations guys, I do believe you’ve lost a customer. In the words of Matt Bors:

Maker’s Mark is dead to me.

So maybe there is some Knob Creek or Woodford Reserve or even Bulleit in my future. And don’t think I’ve forgotten that Evan Williams has a very nice single barrel offering….

In Closing: probably a good idea; sequester inbound.

Now see, this is what I was talking about

IMG_20130106_114706

Just the other day, I was mentioning that a weight loss diet should include avoiding most food that comes out of a box. I did not yet know that this abomination of a product existed. Now, pay special attention to the fact that this “Beef Stroganoff” includes a “creamy cheese sauce” that is “made with real cheese.” Let’s just leave aside for the moment the potential nastiness of cheese that doesn’t require refrigeration.

Here’s the ingredient list to Paula Deen’s Stroganoff recipe:

  • 1 1/2 pounds cubed round steak, cut into thin strips
  • House Seasoning, recipe follows
  • All-purpose flour
  • 2 tablespoons olive oil
  • 2 tablespoons butter
  • 1 medium onion, sliced
  • 8 ounces fresh mushrooms, sliced
  • 1 (10 3/4-ounce) can beef broth
  • 1 (10 3/4-ounce) can cream of mushroom soup
  • Salt and black pepper
  • 1 cup sour cream
  • Cooked egg noodles

Notice something? No cheese. The can of soup is suboptimal but alas almost standard in American casserole cooking. Oh look, here’s a similar recipe from the Campbell’s Soup Company!

Here’s what Betty Crocker thinks goes into Stroganoff:

1 1/2 pounds beef sirloin steak, 1/2 inch thick
8 ounces fresh mushrooms, sliced (2 1/2 cups)
2 medium onions, thinly sliced
1 garlic clove, finely chopped
1/4 cup butter or margarine
1 1/2 cups Progresso® beef flavored broth (from 32-ounce carton)
1/2 teaspoon salt
1 teaspoon Worcestershire sauce
1/4 cup Gold Medal® all-purpose flour
1 1/2 cups sour cream
3 cups hot cooked egg noodles

Hmm, no cheese there either. Points to Betty for using broth as the base for the sauce.

Ok, what about Epicurious:
  • 1 2 1/2-pound piece beef tenderloin, well trimmed, meat cut into 2x1x1/2 inch strips
  • 2 tablespoons vegetable oil
  • 6 tablespoons (3/4 stick) butter
  • 1/4 cup finely chopped shallots
  • 1 pound small button mushrooms, thickly sliced
  • 1 cup canned beef broth
  • 2 tablespoons Cognac
  • 3/4 cup crème fraîche or whipping cream
  • 1 tablespoon Dijon mustard
  • 1 tablespoon chopped fresh dill
  • 12 ounces wide egg noodles
  • 1 tablespoon paprika

Ok, crème fraîche instead of sour cream. Still, no cheese.

And just to round out the entries, a less Americanized version:

  • 1 1/2 pounds beef tenderloin, sliced into thin 2-inch-long strips
  • 2 finely chopped onions
  • 4 ounces butter
  • 4 ounces sliced button mushrooms
  • 1 tablespoon all-purpose flour
  • 1/2 cup beef stock
  • Pinch dry mustard
  • 1 tablespoon tomato paste
  • 1/2 cup sour cream
  • 6 ounces white wine (optional)
  • Salt and pepper

Hey, you know what’s missing from that recipe?? Paprika! Ok, just kidding the answer is cheese.

In fact, if you look at the Wikipedia article on Stroganoff, you’ll find sour cream mentioned 5 times and cheese mentioned zero times. Anybody who eats this boxed concoction and then orders the real thing in a restaurant is going to have a big surprise! Whatever this stuff in the box might be, the one thing I am sure it won’t be is Beef Stroganoff. Heck, I’m not really sure it’s food.

In Closing: assassination; special; chicken; payrolls; and FUNCTIONAL STRENGTH!

Diet Research? It must be January.

Yes indeed, it’s the first week of the year, and that means millions of Americans are trying to shed between 5 and 500 pounds. Some scientists were even willing to stick their necks out there and say fructose is a culprit in weight gain (a culprit not the culprit). Check the archives and you will find me many times saying that every weight loss diet that works requires drastically reducing if not altogether eliminating added sugars.

So Loyola University wants to help you out. They’ve got what they think are the top 4 reasons diets fail. Let me save you some reading:

  1. Underestimating calorie intake (e.g. eating too damn much)
  2. Overestimating activity and calories burned (e.g. imagining that an amble around the mall is just like a 5 mile run)
  3. Poor timing of meals (the dreaded “starvation mode“)
  4. Inadequate sleep (having a job and other responsibilities)

Really? I’m on board with reasons 1 and 2, although I see them as two sides of one coin. But do they really think that sleep is a bigger issue than unrealistic expectations in the first place, or diet plans that are for whatever reason unsustainable? Do they think that eating at the wrong time is truly a bigger issue than unsupportive friends and family who –subtly or openly — undermine the dieter’s efforts?

Want to lose weight without torturing yourself? Try eating reasonable portions of real food: plenty of veggies; adequate protein; no sweets, no crap that comes out of a box, no food-like chemistry sets. Hey, it’s no dumber than the other diets you’ve tried over the years.

In Closing: free classes; Downtown Vegas and F15; maybe now somebody will ask banks to follow the law pretty please?; Onnabugeisha; ha!; conform or be called a terrorist; Malala; why oh why did Texas give him a second term?; more employment data than you probably want; somebody inform Scalia that 24 is not a documentary; the estate tax is not a wealth tax, it’s a wealth moving into the hands of someone who didn’t actually earn it tax; it turns out you need facts before you can figure out what to think about them; well that’s gonna have conservative panties in a wad; the Romney Loophole; is anybody surprised by this?; and I think Brent may have been playing Black Ops 2.