Migraine Art

Recovering from the debacle of TimesSelect, the New York Times is developing a superb repository of off-the-wall blogs.  I just discovered this one, devoted to migraines. 

The most recent post is a long essay by Jeff Tweedy, leader of Wilco (not one of my favorite bands, sorry to say).  His descriptions of the mysterious condition are compelling, especially to someone like me who’s never had one but has lived with people who have.  Tweedy now claims to have his migraines under control, but only after years of suffering, and a painkiller addiction that was a result of misguided care:

I had had a psychiatrist that was prescribing drugs to me without any conscience. I actually had a psychiatrist prescribe Vicodin to me as a way to alleviate anxiety. And I also had a therapist tell me that I needed the painkillers because I had migraines and that I didn’t need the antidepressants because they were just capping my creative energy. This guy was just a quack, an idiot. But when you’re in such a vulnerable and desperate state as I was, you want somebody to help you. I really wish I had been in a condition where I could have known and listened and understood that these people were out of their minds, but I wasn’t. I was vulnerable and I needed someone to help me. But I got really, really bad help.  

Also on this blog, a slide show of paintings by migraine sufferers.  Here’s an example:

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Blogger, Interrupted

Sorry for the delay in posting. I’ve been on two business trips this past two weeks, to Phoenix, Arizona and to Richmond, Virginia.  I didn’t bring my camera to AZ, but I had it in Richmond, a city I’d never seen before.   I spent most of my time there in the ER at Virginia Commonwealth University Hospital, which was not the plan, obviously.

After discharge and navigating through a Soviet-style pharmacy, I decided to walk back to my hotel. 

Here is a plaque on a building near the hospital.  It seemed strange that I would get a serious diagnosis at such an historical location:

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Then I saw this great old building, which wouldn’t look too out of place in San Francisco.  It was on Governor’s Road, not too far from the Virginia governor’s mansion:

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A little further away from all the Commonwealth’s majesty, I found this odd salute to the classical style of the old city:

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I rested up and reunited with my colleagues for dinner at a restaurant that unabashedly bears the name, “The Tobacco Company.”  You walk in, it smells like smoke.  It has cigarette girls.  You almost want to embrace and love all the tradition.  Almost. My own condition is the result of overyielding the seductive calls of bad food.  The evil of the American diet is in the vast amounts of sugar hidden in it. Tobacco is right out there, telling its users, “I’m killing you.”  Maybe that’s part of its appeal.  If James Dean had a chocolate-chip cookie hanging out of his mouth instead of a cigarette, how many posters would he sell?

So I told my dinner companions about my day at the hospital, then wandered out into the cobblestone street on a cool evening, immersing myself in this curiously timeless little city for the few minutes I had left to enjoy it. 

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I would have to get up at 3:30 a.m. to catch my flight — 12:30 a.m. Los Angeles time, which is my approximate bedtime.  The cab driver who took us to the airport is a local historian who regaled us with tales of the Byrd family and what a close call the ratification of the Constitution had been.  That unassuming plaque commemorates a pivotal moment in the nation’s history, it turns out.  Only fitting that a pivotal moment in my life take place on the same site.

Parents’ Nightmare: A Misdiagnosis of ADHD

chris-kaman.jpgThis story, from Tuesday’s LA Times, frightened and relieved me at the same time. 

Los Angeles Clippers’ center Chris Kaman is an exceptional person.  Only a few men at any given time are capable of playing center in the NBA.  There are hardly enough qualified centers to go around.  Physical gifts like size, speed and shooting accuracy must combine with the ability to process rapidly the flow of the game, the positions of all the players, the coach’s designs. 

Coming up as a ballplayer and student, Kaman had to learn all that, under the influence of powerful psycoactive medications he didn’t need — Ritalin and Adderall — from age 2 1/2 through high school for attention-deficit hyperactivity disorder (ADHD).  However,

Kaman, who had trouble remembering plays and concentrating on the court in college and in the pros, disclosed Sunday that he was misdiagnosed.

Kaman actually had an anxiety disorder that caused him to over-analyze situations and scenarios.

“Growing up, I had to take the medication my whole life,” said Kaman, who said he grew so frustrated taking the medication that he would come home from school and cry.

“I can’t take back time. I wish I could. But I can’t. It really bothered me to take the medication every day. I felt I had to take the medication to make me feel like a regular person. It was kind of backward.”

His misdiagnosis was discovered in July by Hope139, a 5-year old organization based in Grandville, Mich., that studies the brain. According to the National Institute of Mental Health, between 3% and 5% of children have ADHD, with symptoms that include hyperactivity and impulsiveness.

According to Hope139’s research of about 40,000 patients, up to 15% of those on medicine for hyperactivity do not have the affliction.

You got kids?  You get the impression as a parent that it’s a lot more than 3 to 5 percent of kids who are being diagnosed with ADHD. If your kid seems intelligent but gets bad grades, is rambunctious, talks too much, is forgetful, the ADHD diagnosis seems to linger in the air with every doctor visit.

Raising my son, I made up my mind to strap myself to the mast and get us through adolescent and not listen to any such diagnosis.  As frustrating as raising my son could be at times, I did not want him taking these medications.  I figured the cure to what seemed to be ailing him was merely to grow up.  Which, at 17, he’s showing signs of doing, to our relief.

What happened to Kaman is exactly what I worried would happen to my son:

The medication Kaman took had the opposite effect on him, said Dr. Tim Royer, the organization’s chief executive.

Kaman’s brain was already working in overdrive, and the medication provided an added stimulus. The dosage was increased to the point that Kaman’s mind became overloaded and he became less animated. “He stopped being a behavioral problem, but he got too much medicine and it shut him down,” Royer said.

Kaman stopped taking medication once he entered college at Central Michigan because he no longer had to sit in one place for more than a couple of hours.

But his concentration in college, and once he signed with the Clippers, was still lacking. He could focus on the man he was guarding but not on weak-side defense, or as Royer put it, “He could see the tree in front of him, but not the forest.”

How is this generation of parents, pediatricians and psychologists going to be judged?  Kaman’s story is going to become better-known soon, and we’ll all be taking a second look at how these medications were sold as the panacea to so many families.

Kaman is hoping to become a spokesman for children who are misdiagnosed or are simply looking for another alternative instead of taking medication for hyperactivity. “I’m using my resources as much as I can to try and help people,” he said. “I was trying to see if it worked first. I’m on a platform being in the NBA where I can help people.”
 

Gentlemen, Start Your Lobbyists

cheeseburger.jpgI’m sure the City Council is sincere about wanting to improve the diets and health of the residents of South Los Angeles. But they also have to know what will come of the proposal to impose a moratorium on new fast-food restaurants in that area of the city: A gig for every major lobbyist in town.

McDonald’s, Burger King, KFC, Jack-in-the-Box and all their franchisee organizations will all want to strangle this idea in the cradle. They will pay whatever it takes. From a legal standpoint, I don’t know how you distinguish a fast-food chain restaurant from an ordinary restaurant, or what careful balance between unhealthy and healthy menu items would qualify a restaurant for the moratorium, but they will be talking about it at City Hall for months if not years. For the lobbyists, all that talk will be billable.

When was the last time the Council tried to take on so many international corporations at one time? Start looking for a new rush of donations from franchise operators’ associations and restaurant-industry PACs.

Amid worries of an obesity epidemic and its related illnesses, including high blood pressure, diabetes and heart disease, Los Angeles officials, among others around the country, are proposing to limit new fast-food restaurants — a tactic that could be called health zoning.

The City Council will be asked this fall to consider an up to two-year moratorium on new fast-food restaurants in South L.A., a part of the city where fast food is at least as much a practicality as a preference.

“The people don’t want them, but when they don’t have any other options, they may gravitate to what’s there,” said Councilwoman Jan Perry, who proposed the ordinance in June, and whose district includes portions of South L.A. that would be affected by the plan.

In just one-quarter of a mile near USC on Figueroa Street, from Adams Boulevard and south, there are about 20 fast-food outlets.

That particular cluster probably has much more to do with USC kids’ late-night study/beer munchies than with any other part of the neighborhood. They might want to choose another area to make an example of.

“While limiting fast-food restaurants isn’t a solution in itself, it’s an important piece of the puzzle,” said Mark Vallianatos, director of the Center for Food and Justice at Occidental College.

This is “bringing health policy and environmental policy together with land-use planning,” he said. “I think that’s smart, and it’s the wave of the future.”

I think he’s right about the future. I’ve noticed lately the increasing link environmentalists are making between food choices and the health of the planet. I know I read recently something to the effect that one cannot consider themselves an environmentalist and still eat meat. Global warming is as much cow- as car-driven.

The dietary paternalism inherent in this proposal — the claim that City officials know what you should eat — hasn’t registered yet. Maybe it never will. Maybe we all see ourselves as the sheer victims of corporations, and believe it is corporations that are limiting our choices, not government. I’d be curious to see the results of an approval poll comparing the Los Angeles City Council with McDonald’s.

Perhaps the council would win. Maybe all the popularity that fast-food brands have paid so dearly for over the past 40 years will now crash around their deep fryers. But they will not go down without a fight, and in Los Angeles, that means writing a lot of checks.

Vogue Takes A Stand: If You Don’t Want Us to Advertise Cigarettes, Pass a Law

As this country ages away from its founders’ vision, we get more and more ambivalent about free speech.  Examples abound, but today’s story (possibly $$) about Vogue and Glamour‘s publishers’ statements supporting a refusal to stop running ads for cigarettes helps illuminate the labyrinth our culture is building to deal with unpopular speech. 

Magazine ads like this one from Camel have drawn the ire of Rep. Lois Capps.The leader of a group of U.S. representatives that has been asking women’s magazines to voluntarily give up cigarette advertising said she is unsatisfied with publishers’ response — or, more often, their lack of response.

“I am extremely disappointed with the decision of these 11 women’s magazines to continue running ads promoting cigarette smoking,” said Rep. Lois Capps, D-Calif., in her third and latest open letter. “These ads encourage a fatally addictive habit and are especially targeted at young women. It’s just flat-out hypocritical to run stories about becoming more beautiful and healthy while promoting a dangerous product responsible for killing hundreds of thousands of people a year.”

Vogue’s response was disturbing.  Despite his industry’s reliance on the First Amendment, publisher Thomas A. Florio wants Congress to punch a hole in it.  He objects to being pressured politically to withdraw the ad on his own, but he doesn’t object to being compelled to do so by law.   Continue reading

Iced Cappucino, Scourge of Starbucks

If you order an iced cappucino at Starbucks, the cashier will tell you “we’re not supposed to make iced cappucino, but we’ll make one for you.” I guess you’re supposed to feel like they’re cutting you a break but, shh, don’t tell everyone.

Perhaps inspired by the current book I’m reading, “The Curious Incident of the Dog in the Night-Time,” I had an overly literal reaction to this disclosure. I pointed to the menu on the wall above the barrista’s station. It listed all the coffee drinks including cappucino. Each one could be purchased “hot or iced.”

“You got us on a technicality,” one of the employees said, laughing like the jig was up.

A technicality? “It’s on your menu. It’s been there for years.”

Finally, they let me in on the real secret. Apparently, the Starbucks corporation is worried about the possibility of bacteria forming growing when the heated foam hits the ice cubes. So employees are instructed to say what the cashier said to me. I assume the company’s lawyers came up with this.  Perhaps they have gotten a ruling that the company would not be liable if I come down with food poisoning after such a dialogue.

If I keel over in the next few hours, Starbucks will be able to say, “We warned him, but he ignored us, the poor chap.”

It’s a weird way to manage a liability problem, to orchestrate a conversation between employees and customers that’s supposed to seem friendly, spontaneous and intimate.

Corporate practices like this tend to replicate themselves.  I’m already used to being asked at Pavillion’s whether I want help carrying my groceries to my car, even if I’m only buying a tube of toothpaste.  You’d think the clerks would have figured out by now that I’m perfectly capable of pushing a cartful of groceries.  I’ve been shopping there for years, and I don’t recall ever passing out from exhaustion in their presence. But, of course, “we’re required to ask,” so this charade of a friendly offer will continue, and I will continue to be forced to say, “No, but thank you.”

But the Starbucks variation — “We’re not supposed to make it for you” — is a new one.  Anyone else run into something like this?

Persecuting Pain*

We need to figure out a new way for American society to resolve ambiguous issues — an alternative to federal prosecutors making their bones by tossing individuals in prison via smear techniques designed to inflame rather than enlighten juries.

What prompted me to think about this was the cover story of this Sunday’s New York Times magazine, “When is a Pain Doctor a Drug Pusher?”  Author Tina Rosenberg tells two distinct stories here:  One is about Dr. Ronald McIver, a physician whose address is now a medium -security prison in Butner, North Carolina.   The other is about the never-ending quest people in severe pain go through to find relief, a quest that can inadvertently bring them or their doctors into gray legal areas. 

Certainly there are crooked doctors who write fraudulent prescriptions for opiates that drug addicts abuse and drug dealers sell.   Nobody objects when prosecutors pursue them.  It does not appear to me that Dr. McIver was one of those crooked doctors. As Rosenberg writes,

McIver was a particularly aggressive pain doctor. Pain can be measured only by how patients say they feel: on a scale from 0 to 10, a report of 0 signifies the absence of pain; 10 is unbearable pain. Many pain doctors will try to reduce a patient’s pain to the level of 5. McIver tried for a 2. He prescribed more, and sooner, than most doctors.

Perhaps knowing his intolerance for his patients’ pain, some unscrupulous people posing as patients tricked McIver into giving them drugs illegitimately, which they abused or sold.  There’s no evidence McIver ever recognized this or intended to aid them in their criminal schemes.  He comes off as a little credulous. But on at least one occasion, his suspicions about a particular patient led him to call the police to ask for background. 

Later, of course, prosecutors successfully twisted that call into evidence against him.  The logic — very familiar to me now — went like this:  You called the cops about this patient. Yes. What happened next?  The cop never called me back.  What happened next?  I assumed the lack of a return call meant my suspicions were unfounded, so I continued to prescribe medicine to this patient.  Ladies and gentlemen of the jury, you see what we have here.  Dr. McIver knew there was a problem with this patient.  Did he stop giving him dangerous narcotics?  No, he just went right on doing it.  The fact that the law officer was unable to reach him is irrelevant.  By this act, Dr. McIver demonstrated his criminal intent to provide drugs illegally.

Others of his patients were prescribed high doses of powerful opioids.  This is not necessarily a sign of abuse. As Rosenberg takes pains to explain, high levels can be safe if the patient’s dosage is increased gradually through a process called “titration to effect.”  McIver was one of many pain specialists who believed, it appears compassionately, that this was the correct course for some patients.  But prosecutors were able to make the jury quiver, apparently, at the sheer numbers associated with these dosages. 

One of McIver’s patients died with high levels of an opioid in his blood.  The drugs didn’t kill him — a heart problem did it.  But the patient’s death was a good data point in the case the government was able to build against him, a ghost story to frighten jurors.

To find out more about the blow-by-blow of McIver’s outrageous prosecution, please read the story.  For the remainder of this post, I want to focus on the bigger picture:

No one has analyzed the various prosecutions of pain doctors, so it is hard to determine how many of them look like McIver’s. The D.E.A.’s list is incomplete. There have been many cases like McIver’s, and most of these cases are not listed on the D.E.A.’s Web site. (One possible reason for this omission is that some of these cases are still being appealed.) And many cases that do appear on the list detail only vague crimes: convictions for prescribing “beyond the bounds of acceptable medical practice” or “dispensing controlled substances . . . with no legitimate medical purpose” — which is how the agency will most likely describe the McIver case if it ever includes the case on the list.

The D.E.A. claims that it is not criminalizing bad medical decisions. For a prosecutable case, Caverly, the D.E.A. officer, told me: “I need there to be no connection of the drug with a legitimate medical condition. I need the doctor to have prescribed the drug in exchange for an illegal drug, or sex, or just sold the prescription or wrote prescriptions for patients they have never seen, or made up a name.”

I read this statement to Jennifer Bolen, a former federal prosecutor in drug-diversion cases who trained other prosecutors and now advises doctors on the law. “That’s a good goal,” she said. “I don’t think they have yet reached that goal.” McIver’s case had no such broken connection, and in many cases the government has not produced testimony of intent to push drugs, providing evidence only of negligence or recklessness. In 2002, Bolen was one of the authors of a Justice Department document intended as part of a basic guide to prosecuting drug-diversion cases. The document, in the form of a reference card, dispenses with any need for a broken connection. It suggests that prosecutors need not prove a doctor had bad motives, that to be within the law a doctor had to prescribe “in strict compliance with generally accepted medical guidelines” and that doing an abbreviated medical history or physical examination is “probative” of lack of a legitimate medical purpose. The reference card was on the Justice Department’s Web site but was pulled, according to the Pain Relief Network, which provided the card to me. Bolen told me: “I have no problem saying that if the card was all there was, it was not acceptable. But it isn’t all there was.” She described the card as one piece of a more thorough training, but added that many prosecutors followed its theories.

Prosecutors are in essence pressing jurors to decide whether an extra 40 milligrams every four hours or a failure to X-ray is enough to send a doctor to prison for the rest of his life. One doctor, Frank Fisher, was arrested on charges that included the death of a patient taking opioids — who died as a passenger in a car accident. A Florida doctor, James Graves, is serving 63 years for charges including manslaughter after four patients overdosed on OxyContin he prescribed — all either crushed and injected their OxyContin or mixed it with alcohol or other drugs. “A lot of doctors are looking for safe harbor,” Caverly said. “They want to know as long as they do A, B, C, D or E, they’re O.K.”

The D.E.A. once thought that this was not an unreasonable desire. A few years ago, it worked with pain doctors to develop a set of frequently asked questions that set out what doctors needed to do to stay within the law. The FAQ recommended, for example, that doctors should do urine tests and discuss a patient’s treatment with family and friends. In October 2004, the FAQ were erased from the agency’s Web site. One reason was that one of their authors, who is a doctor, was about to use the list to testify on behalf of William Hurwitz, a pain doctor in McLean, Va. (Hurwitz was convicted on 50 counts of drug trafficking in 2004. His conviction was overturned, and he was recently retried and convicted on 16 lesser counts. He is awaiting sentencing.)

Caverly acknowledged the Hurwitz trial was one reason the FAQ were pulled, but said there were other reasons. He said such a checkoff list could tie the D.E.A.’s hands. “Some doctor’s going to pull that list of dos or don’ts out and say: ‘See, I’m O.K. I did these 10.’ But there’s a new wrinkle there — an 11th one the doctor didn’t do,” he said. Most important, he went on to say, the FAQ had stepped over the line to insert the D.E.A. into issues of medical practice. “We have to stay in our lane,” he said. “Those definitions are the professional community’s — not the D.E.A.’s.”

In a perfect world, such reasoning would make sense. But the agency is defining issues of medical practice in dramatic fashion — by jailing doctors who step over the line. It would not seem to be bothering, however, to draw the line first.

The dilemma of preventing diversion without discouraging pain care is part of a larger problem: pain is discussed amid a swirl of ignorance and myth. Howard Heit, a pain and addiction specialist in Fairfax, Va., told me: “If we take the fact that 10 percent of the population has the disease of addiction, and if we say that pain is the most common presentation to a doctor’s office, please tell me why the interface of pain and addiction is not part of the core curriculum of health care training in the United States?” Will Rowe, the executive director of the American Pain Foundation, notes that “pain education is still barely on the radar in most medical schools.”

The public also needs education. Misconception reigns: that addiction is inevitable, that pain is harmless, that suffering has redemptive power, that pain medicine is for sissies, that sufferers are just faking. Many law-enforcement officers are as in the dark as the general public. Very few cities and only one state police force have officers who specialize in prescription-drug cases. Charles Cichon, executive director of the National Association of Drug Diversion Investigators (Naddi), says that Naddi offers just about the only training on prescription drugs and reaches only a small percentage of those who end up investigating diversion. I asked if, absent Naddi training, officers would understand such basics as the whether there is a ceiling dose for opioids. “Probably not,” he said.

There is another factor that might encourage overzealous prosecution: Local police can use these cases to finance further investigations. A doctor’s possessions can be seized as drug profits, and as much as 80 percent can go back to the local police.

I think about people in my family who are, or were, in terrible pain.  Or who might be in the future.  I think of their doctors, reading about McIver and other doctors similarly persecuted.  It was bad enough when doctors’ treatment decisions were based on fear of civil malpractice litigation.  But now the federal prosecutors have joined the party, with all their incentives to win cases no matter what, and with punishments at their disposal that can destroy careers, even lives. 

It’s one thing for a doctor to wear a brave face and put his or her patient first in the face of potential lawsuits. But prison?  The suffering patient will just have to understand. 

The criminalization of gray-area medical decisions is the ultimate empowerment of ignorance, fear and innuendo as the driving forces of our civilization.  Despite miraculous medical and scientific advances, as long as we give power to prosecutors to go “booga-booga” to juries, some of those advances will be shelved. 

There are countless examples of this trend, but this one really turned my stomach.

*Edited and retitled, 6/18/07

Say Goodnight, 2006

With a grateful nod to Ann Althouse, I will commemorate New Year’s Eve with an 11-month-old New York Times column about sleep.  

Ever since I was a child, I have called myself an insomniac.  I’ve always envied those who could fall asleep “when my head hits the pillow.”  My insomnia is a sporadic visitor who won’t leave.  I will be unable to sleep for several nights in a row, interrupted by a night or two of recuperation, then more nights of insomnia, with the pattern repeating for several exhausting weeks. Then, without fanfare, it goes away and I sleep fine for awhile, but the problem always returns.  But during these phases, I always fall asleep when I don’t want to; when my wife and I start watching a DVD for example. Then I awaken.  I feel deeply rested, even if I’ve only slept 20 minutes. And I can’t fall back to sleep for hours.

I’ve tried so many things to deal with it.  Medication, a ban on caffiene after 2 o’clock, yoga-like meditation…. For years I went to sleep with all-news radio, particularly with announcers like Beach Rogers, who could describe a nightful of murder and mayhem in a voice that never strayed from calm rationality.  All in pursuit of the critical eight hours of altered consciousness we are said to need for our health and sanity.  

I figure there must be a Darwinian logic to insomnia.  It’s so common.  I’ve wondered if it has something to do with our ancestors’ need for vigilance against attacks from rival tribes or wild animals.  Maybe my vigilance hormone runs a little hot.

It turns out, according to University of Virginia history professor Roger Ekerch, that I’m misinformed.  Those eight solid hours we’re told we need and feel entitled to… didn’t used to be so solid:

In all likelihood, we have never slept so soundly. Yes, the length of a single night’s sleep has decreased over the years (upward of 30 percent of adults average six or fewer hours), but the quality of our sleep has improved significantly. And quality, not quantity, sleep researchers tell us, is more important to feeling well rested.

This is not to minimize the torment of insomnia over the course of a restless night. But for most of us, slumber is reasonably tranquil — especially when compared with what passed for a night’s rest before the modern era. Despite nostalgic notions about sleep in past centuries, threats to peaceful slumber lurked everywhere, from lice and noxious chamber pots to tempestuous weather.

Worst in this pre-penicillin age was sickness, especially such respiratory tract illnesses as influenza, pulmonary tuberculosis and asthma, all aggravated by bedding rife with mites. One 18th-century diarist recounts that asthma forced her husband to sleep in a chair for months, with “watchers” required to hold his head upright. Among the laboring poor, whose living conditions were horrendous, sleep deprivation was probably chronic, prompting many to nap at midday, much to the annoyance of their masters.

As if these maladies were not enough, we now also know that pre-industrial families commonly experienced a “broken” pattern of sleep, though few contemporaries regarded it in a pejorative light. Until the modern age, most households had two distinct intervals of slumber, known as “first” and “second” sleep, bridged by an hour or more of quiet wakefulness. Usually, people would retire between 9 and 10 o’clock only to stir past midnight to smoke a pipe, brew a tub of ale or even converse with a neighbor.

Others remained in bed to pray or make love. This time after the first sleep was praised as uniquely suited for sexual intimacy; rested couples have “more enjoyment” and “do it better,” as one 16th-century French doctor wrote. Often, people might simply have lain in bed ruminating on the meaning of a fresh dream, thereby permitting the conscious mind a window onto the human psyche that remains shuttered for those in the modern day too quick to awake and arise.

This should make you sleep a little better in 2007, no?  If you can manage to sleep through the night, it’s because you are thankfully free from foul odors and lice anxiety.  If you can’t, maybe it’s because you have some business to attend to, perhaps romantic, perhaps psychological, perhaps sacred.

It’s only due to the influence of light that we have “consolidated” our sleep, according to Ekerch’s column.  The light keeps us awake longer.  In pre-industrial times, we would succumb much earlier to a “first sleep,” and then arise from it in a complacent state caused by a rise in the hormone prolactin — the same hormone that “allows hens to sit happily upon their eggs for long periods.”

That’s contentment.

Ekerch cites Dr. Thomas Wehr, a sleep researcher at the National Institute of Mental Health as suggesting that “some common sleep disorders may be nothing more than sleep’s older, primal pattern trying to reassert itself — ‘breaking through,’ as Dr. Wehr has put it, into today’s ‘artificial world.'”

I resolve, therefore, to stop worrying about insomnia in 2007.  I sleep just fine. 

Happy New Year!

Irony, Defined: PepsiCo in India

indra-nooyi-of-pepsico.jpgIndra Nooyi is an inspirational figure in India, having risen to the position of PepsiCo CEO, and becoming (according to Fortune) the most powerful woman CEO in the world. She is a fascinating person in her own right, and a great symbol of globalism.  

So you would think a visit to Dehli for Nooyi would be a tour of triumph.  Not according to the International Herald Tribune:

Unfortunately, the timing of her return could not have been worse. She walked straight into a dispute about the evils of junk food, arriving just as India’s health minister, Anbumani Ramadoss, announced that he planned to ban colas and greasy snacks in schools because they were ruining the health of the nation’s children.

In a powerful speech days before Nooyi’s arrival, Ramadoss warned that the wealthy middle classes were facing a “galloping” rise in obesity, heart disease and diabetes. He promised to introduce compulsory yoga in schools along with classes on healthy eating.

Moving beyond the allegations of insecticide contamination, which have shaken sales of both Coke and Pepsi in India for the past five months, he added firmly that “with or without pesticides” colas were “harmful for health and should not be consumed.”

It was a rude welcome for the visiting celebrity. Nooyi fought back bravely, stressing that PepsiCo wanted to work with the Indian government to combat “the prevailing sedentary lifestyle,” which she identified as the root cause of obesity-related illnesses. She announced that her company’s “Fun for You” products (colas and snacks) would be balanced by its “Good for You” line (waters and energy drinks). But the expected exuberance of this trip was dampened by the controversy.

The deeper and more tragic irony is that just as India faces an obesity crisis, it continues to struggle to feed its children. According to Ramadoss, 50-60 percent of Indian children are malnourished. 

Certainly, the American stereotype of India has shifted quickly from that of desperate poverty to one of outsourced efficiency and business success.  But with success comes the cycle of workaholism, two-income families, the increased reliance on food you can grab off a convenience store shelf or get through a drive-thru window, and all the health problems that come with living that way.  

Ramadoss made it clear that his strategy for tackling India’s new weight problem would be to target precisely the products Nooyi was in Delhi to sell. He conceded that there might be “legal hindrances” with introducing a blanket ban on colas and chips in schools, and he proposed introducing a system of fines and penalties instead.

Health experts welcomed Ramadoss’s decision to highlight the growing problem of obesity in India.

Ambrish Mithal, senior doctor at an obesity center run by Apollo, a private hospital in Delhi, said that by conservative estimates at least 30 percent of women and 20 percent of men in urban areas were already clinically obese, although some experts put the real figure at closer to two-thirds of women.

“Malnutrition continues to be the bane of India, but the people who matter in this country are affected by the opposite problem,” he said. “The worst sufferers are the people working in the multinationals in urban India; they make up the new work force driving the nation’s economy, working to put India on the world map. A vital component of our manpower will become sick if steps are not taken to address this.”

A world of meaning in the doctor’s use of the phrase “the people who matter in this country.”  Certainly, Nooyi’s company has picked up his not-subtle message about whose problems count the most.  PepsiCo will be investing $500 million in India over the next five years, “part of which will go to building a new research center outside Delhi, where scientists will work on concocting low- calorie and low-caffeine drinks,” according to the IHT.

America’s Starving Obese

bruce-ames.jpgRead this profile of Berkeley biochemist Bruce Ames — an admirably stubborn and brilliant researcher focused on cancer and aging, who made enemies among the environmental community for pooh-poohing their fears about pesticide exposure.  

Ames’ focus now is on obesity and malnutrition — and the millions of American who suffer from both maladies at the same time.

Here’s a long excerpt from a much, much longer piece.  It ran in Sunday’s San Francisco Chronicle.  The whole piece, written by Leah Messinger, is worth your time.

Recently, Ames overheard a colleague mention 60 cases of rickets at nearby Children’s Hospital Oakland. The disease, which is caused by vitamin D or calcium deficiency and had essentially been eliminated in the United States, is still common in countries with an unpredictable food supply. How, Ames wondered, could ailments such as rickets, which have historically been associated with malnutrition occur in a population that grows increasingly plump?

Could it be, he asked, that a society gorging on empty calories is simultaneously starving itself of the vitamins and minerals needed to keep its internal gears churning? Or that children who once played outdoors in the sunshine required to make vitamin D in the skin now stay indoors, hypnotized into inactivity by their TV screens? For years obesity was a sign of wealth; people with limited cash went hungry. But as cheap, highly processed foods have taken root in our supermarkets, narrowing the shelf space for fruits and vegetables, obesity is more frequently associated with poverty.

Ames continues to assemble evidence that a dearth of micronutrients can damage DNA. “We’ve been taking human cells in tissue culture, and they go through a certain number of generations and then they senesce,” he explains, adding that when the cells are deficient in a certain micronutrient, they senesce, or age, prematurely. “We still have to prove it in people and at what level, but so far for every vitamin and mineral deficiency we’ve looked at they senesce early and we see a lot of DNA damage.”

A properly functioning body requires healthy mitochondria, the “power plants” of nearly every human cell. Vitamins and minerals fuel the mitochondria, which in turn burn fats, carbohydrates, and protein in food to form energy for the rest of the body. With age, mitochondria degrade and lose efficiency. Oxygen radicals, atoms with unpaired electrons that are also called “free radicals,” result from that inefficiency and bind with other molecules to interfere with normal cell operations.

Inadequate micronutrient intake, Ames believes, affects the mitochondria in much the same way as aging. He has proved in tissue cultures that micronutrient deficiencies can degrade DNA, leading to the production of mutated chromosomes that can cause cancer. Over the short term, nature appears to be kind to the mildly micronutrient deficient human body. But chromosome disintegration will result in dire long-term health consequences, Ames says. In the absence of enough nutrients, he postures, “What nature would want is for the animal to survive, but anything long term will be ruthlessly dispensed with. So it’s a triage system. And I think DNA damage is long term. It shows up as cancer 30 years later.”

A college roommate of mine was one of Ames’ acolytes, and although I was a mere English major and then a journalism graduate student, I learned quite a bit from Ames through secondary osmosis.  This is a new direction for him.  In the absence of good farmer’s markets and a culture that worships poor eating habits, Ames says in this story that the fastest, cheapest and most effective solution might be widespread distribution of vitamin pills that could provide the ingredients missing from the typical American diet.

A Generation of Wired Shadow-Boxers; or “Wii are the World”*

I raised a son and a step-son during the age of the video game console. I saw video-games become the contemporary symbol for all of what’s wrong with today’s youth, and joined in the worrying. One of the raps against electronic games was players were “sedentary,” just sitting on the sofa for hours pushing buttons rather than enjoying the fresh air outside. (“Fresh air,” a phrase only used by parents.)

Apparently, Nintendo listened to us. (I know I’m late to covering the Wii, but under the rules of blogging, if it’s new to me, it’s news.) Anyway, according to a couple of stories I saw today in the Wall Street Journal, Nintendo designed the Wii’s controller so that players’ body movements control the game, not just their button selections. You have to play it standing up.

And now, parents have a new worry: Their kids might hurt themselves.

But as players spend more time with the Wii, some are noticing that hours waving the game’s controller around can add up to fairly intense exertion — resulting in aches and pains common in more familiar forms of exercise. They’re reporting aching backs, sore shoulders — even something some have dubbed “Wii elbow.”

More fear:

Another hazard: collisions. All those flailing arms can sometimes inadvertently smack into lamps, furniture and even competing players. IGN.com, a popular site that reviews videogames, said one player testing the Wii lost her grip and sent the controller flying into a wall. Blaine Stuart of Rochester, N.Y., mistakenly whacked his fiancée, Shelly Haefele, while playing tennis and also accidentally hit his dog while bowling.

Even the physically fit are challenged by this thing:

Ryan Mercer, a customs broker in Indianapolis, lifts weights several times a week. But that hasn’t helped much with the Wii. After playing the boxing game for an hour and a half, his arms, shoulders and torso were aching. “I was soaking wet with sweat, head to toe — I had to go take a shower,” he says. And the next morning? “I had trouble putting my shirt on,” says the 21-year-old avid gamer.

Nintendo has several videos on Youtube that illustrate what players must do. Here’s one of them:

If you didn’t know any better, you’d think these kids were suffering from advanced case of Tourette’s syndrome. But this is obviously a coming thing. The Wii is outselling the Sony Playstation 3 so far.

And I want one.

*Update: I just came across a fascinating blog post by Michael Zack Urlocker, guest-blogging on his “brother” Michael’s site. Michael is a “disruption consultant,” which sounds like a growth industry to me. (Zack “is a pseudonym for a Silicon Valley software executive rapidly approaching his mid-life crisis.” He is also a busy blogger.) Zack analyzes Nintendo’s business strategy brilliantly.

Read the whole thing, but here’s a tidbit.

The Nintendo Wii is the runt of the litter when it comes to hardware specifications. It doesn’t have the HD graphics, surround sound or DVD drives of its more expensive competitors. But it’s outfoxed both Microsoft and Sony by packing more fun for a fraction of the price. Nintendo Wii sells for $250 compared to $500 for the Sony Playstation and around $400 for the Microsoft Xbox 360. Nintendo also includes throws in a set of 5 simple but addictive games dubbed Wii Sports with every console, making the Wii a much better value and a more complete offering out of the box. More importantly, Nintendo has parlayed their lower cost hardware into two further competitive advantages: games are cheaper to develop and they make money on every console sold. While it sounds like basic common sense, for the gaming industry this goes against all of the conventional rules.

It’s always instructive to watch a successful business innovation unfold before your eyes. “Zack” is a good guide to this one.

**Another Update.  I came across a blog that specializes in California insurance law and, after reading the same WSJ story I read, the writer came to this unsurprising conclusion about what the flailing arms and flying controllers might lead to:  

Sony has included warnings against these and other perils in the product manual [PDF], but little details like that never need to reach the jury if you pick the right venue and play your cards right.  So to our friends of the plaintiff’s bar we say: Fire up the word processors!  Nintendo’s put a shiny new cause of action under your tree! 

Steve Howe, R.I.P.

steve_howe_autograph.jpgSteve Howe, who died this week in an early-morning traffic accident, was one of the most memorable Dodgers, and one of the most frustrating and tragic. The Dodgers didn't have a bad 1980s — they were the only baseball team to win two World Championships in that decade — but I'll bet they would have been much more successful if this great lefthanded closer could have stayed sober.

Rookie of the Year in 1980, key to the 1981 team's triumph, Howe entered drug rehab after the near-miss of the 1982 season, was suspended several times in 1983 (but still managed to earn 18 saves with an ERA of 1.44), missed 1984 entirely after the baseball commissioner suspended him, returned in 1985 but was dumped in July after failing to show up for a couple of games.

After bouncing around the minor leagues and a few false starts with major league teams from 1985-91, Howe had a renaissance with the New York Yankees in the 1990s, but only after enduring another cocaine-related suspension in 1992. Substance abuse continued to give him serious problems even after his baseball career was over. Howe's was a case that traditional rehab methods could not cure — although I have no knowledge of whether he was still a user at the time of his death.

Losing Howe in 1983 forced the Dodgers to scramble to replace him, left-handed relievers of that quality being rare beasts. Before the 1984 season, they traded a promising starter, Sid Fernandez, to the Mets for left-handed reliever Carlos Diaz. Diaz was a flop, while Fernandez had a good career, and helped pitch the Mets into the 1986 World Series. Before the 1986 season they traded catcher Steve Yeager — admittedly an old coot by this time — for lefty reliever Ed Vande Berg, but Vande Berg wasn't the answer either, and was released after one season.

Bullpen failures plagued the Dodgers in the post-season throughout the 80s, most notably in 1985, when Howe's replacement as closer, Tom Neidenfeuer, gave up two game-winning home runs in consecutive games against the Cardinals, costing LA another World Series shot. Howe, who played with a combination of nervous energy and steely focus, might have fared better in these high-pressure situations. But it was not to be.

To me, Steve Howe was an emblematic figure of the early 1980s as I experienced them. Everywhere I went, all I heard about was cocaine. I know cocaine played a factor in the thwarted careers and busted families of some talented people I worked with. I can think of other friends who got themselves into very stupid and dangerous situations thanks to cocaine, and are lucky to be alive today. Almost without exception, cocaine made people act like jerks. Was anything more boring than being forced to listen to someone prattle on as if they were a genius, when in fact they were just high on coke? I was no Nancy Reagan, but I hated what cocaine was doing to Los Angeles.

Robin Williams' famous line of the era was "Cocaine is God's way of saying you're making too much money," but the people I knew who got involved with cocaine didn't have Robin Williams' income to fall back on. A lot of heartbreak in the 1980s thanks to cocaine. Maybe Steve Howe's Dodger career is only a small heartbreak in the grand scheme of things, but I took it personally. I wish his talent had given him a better, happier life.

Hands and Lungs

This flu, or cold, or whatever, is lingering, so my posting is probably going to be short & sweet & infrequent for a few more days.  (Short? Ha! you say.)

It’s too late to help me, but given all the publicity given to the threat of avian flu, this Family Flublog might help you.  Here’s the kind of advice you’ll find.

Children catch flu easily and are a potent source for infecting the whole community by bringing pandemic flu home to their families. A child coming down with pandemic flu will spread it for up to two days before he feels sick. What can schools do to minimize this risk?

CLEAN HANDS
Alcohol-based cleansers are quick and easy to use and better than soap and water for killing flu virus, given the way most people wash their hands. (Squirt a small pool of cleanser into one palm and continue rubbing it over both fronts and backs and between fingers until the hands are dry. Takes about thirty seconds.)

Each child should get a squirt of this cleanser each time she enters the class room. An easy way to do this is for the teacher to give each child a squirt as the line goes past her coming in each morning and coming back from recess and lunch.

This blog just started, but it already has a number of good, sensible posts.  It’s flu — and avian flu panic — prevention.

And I wonder why this blog isn’t being sponsored by a major health insurer, or the federal government? It’s a labor of love and, perhaps, self-promotion by a registered nurse and health care consultant named Mary B. Townsend.

(Hat tip to ScienceBlog, my new favorite site.)

Mighty, Mighty Stress

I wonder if talk-radio fans get embarassed when they hear who sponsors their favorite programs: Peddlers of marginal cures for obesity, baldness and tax problems. I assume there is some basis for their claims, however slight, but it is delightfully surreal to listen to hard-heads like Rush Limbaugh and Hugh Hewitt tout herbal cures that promise to build your brain or restore your eyesight without glasses. The most disquieting ad I’ve heard is for a product that will make your children taller. Please, parents are competitive enough already!

This digression leads into a startling fact I learned this morning via Boing-Boing: Severe stress can cause children to stop growing. The most famous case of psychogenic dwarfism is JM Barrie, author of “Peter Pan.” The site’s Cory Doctorow wants to draw your attention to a couple of “mind-opening” lectures by Dr. Robert Sapolsky, a Stanford researcher and expert on the physiology of stress, now available via podcast. The links are here on Boing-Boing and on BrainConnection.com, which includes a short summary of Sapolsky’s lectures:

Sapolsky related a story about a boy from a very psychologically-abusive setting who was hospitalized in a New York hospital with zero growth hormone in his bloodstream. Over the next two months he developed a close relationship with the nurse at the hospital–undoubtedly the first normal relationship he had ever had–and soon, amazingly enough, the growth hormone levels zoomed back to normal. The nurse then went on vacation and the levels dropped again, rising once more immediately after her return.

“Think about it,” Sapolsky said, commenting upon the story. “The rate at which this child was depositing calcium in his bones could be explained entirely by how safe and loved he was feeling in the world.” He added that while this standard textbook version of stressed dwarfism is rare, there is nevertheless “major league psychopathology” throughout society, retarding human growth.

“Major stress is the police and social workers breaking down the door of the apartment, finding the kids who have been locked in the closet for two months, the food slipped under the door. Total nightmare situations that turn out often in history. . . kids in war zones, kids in areas of civil strife.”

The problem with human beings, Saplosky says, is that unlike animals, we expose ourselves to sustained periods of stress — sometimes through undergoing a prolonged, horrific experience like war or abuse, sometimes because we anticipate, or remember stressful experiences…and sometimes because we choose stress as a lifestyle.

Stress is fundamental to our economy. We make heroes out of people whose work habits are unhealthy, and tell young employees to model themselves after stress addicts. Without asking the question directly, employers try to assess potential employees’ ability to handle stress. Job applicants understand this game, too. They know it won’t be helpful to their employment prospects if show too much curiosity about the company’s “work-life balance policies.” Better to say, “I’m used to working long hours,” or even “I don’t have a life.”

The only job interviews where prospects raise “work-life balance” occur when the prospect knows they have many competitors for their services. But even in cases where bidding is heavy, the potential employee’s perceived market value is usually associated more with their ability to carry a huge workload than their talents. “He’s a horse,” a boss will say admiringly. “She’s got such energy.”

The glorification of stress may never change, but the employer eventually pays a price, Sapolsky research suggests. Stressed-out workers slowly become stupider.

Until recently…it was commonly believed that if you lost brain cells they were lost forever. “You can make new neurons in your brain after all,” Sapolsky said, “and especially in the Hippocampus in response to things like learning and environmental stimulation. But stress will block the formation of new neurons.”

While the hippocampus does have the capacity to regenerate, it’s far from certain that this will occur, Sapolsky asserted. People who have endured horrible stress, such as Vietnam combat veterans and victims of prolonged childhood sexual abuse, are often fated to suffer permanent damage to the hippocampus, resulting in memory loss.

Depression, “what Sapolsky termed the common cold of psychopathology,” also attacked the hippocampus with stress hormones. Massive long-term depression, he said, was almost certain to cause permanent damage in the form of memory loss.

Companies that want to “invest in their employees” need to keep this in mind. Your best employees’ long hours might make them more profitable, but the brainpower-per-square-inch will decline unless you take some of the pressure off.

Two Days in Orange County

My son is part of a high school theater festival at Fullerton College today and tomorrow, so we’re staying in a motel to avoid two additional trips on the 91. Fullerton has a cute downtown area that is entirely wi-fi: Paradise. But old habits die hard, so I’m working from a high-ceilinged Starbucks at the corner of Chapman and Harbor, at least until my wi-fi-enabled motel room is ready.

Eating breakfast at Denny’s, I perused the Orange County Register, which I used to like, but now seems less zesty. I remember it as more of a Mulligan stew — hard-right, Brylcreem’d editorials and op-eds, alongside sunbaked New Age lifestyle pieces. Today’s edition seemed bland. But maybe that’s because, over time, the hard right and New Age began to resemble one another and became dominant strands in our culture — two sides of the same individualistic mentality. Not that there’s anything wrong with that!

Here are a few things I would not have known if I hadn’t read this morning’s Register. (By the way, registration is required to see these stories online, but it’s free):

Music critic Ben Wener freely admits that he lusted after Robert Hilburn’s position as LA Times music critic. From reading today’s column, I think he could have been a good choice. Lamenting that moving to a new condo prevented him from covering the hot new band of the moment, the Arctic Monkeys, Wener shows he’s one newspaperman who sees the writing on the wall:

Here’s the thing, though: I really don’t think you care.

See, we’ve seen these demographic reports lately that say the majority of folks reading doorstep rags are typically over 40, largely uninterested in music writing and still consumed with all the usual baby boomer heroes El Hilburn has been discussing for decades.

Which is why recently I’ve written about 10 inches on the most exciting band right now – and four times as much on Kool & the Gang. I don’t get e-mail when I babble enthusiastically about fresh talent; I get dozens when I write an essay praising the Kinks.

So why should I care that I missed Arctic Monkeys, right? I shouldn’t let it eat at me, lead me to think I’m falling down on the job. If I believe surveys, you have no interest anyway, and I’d only be banging my head against a wall to convince you to listen.

On a more serious note: The SEC’s head of contingency planning thinks the U.S. stock markets should operate normally, even if an avian flu pandemic breaks out. From a Reuters story that appeared in the Register’s print edition:

“We really believe that with proper planning, the markets can stay open, even with the most severe pandemic,” said Alton Harvey, who heads contingency planning for the Securities and Exchange Commission.

“We think this is doable,” he told a conference organized by the Center for Strategic and International Studies. “Because we have to — we have no choice — we will work it out. The markets will trade.”

(snip)

Stephen Malphrus of the Federal Reserve Board agreed. The Federal Open Market Committee, which sets U.S. economic and interest rate policy can meet by telephone if necessary, he said. “The financial sector is generally out in the lead,” Malphrus said. “I would think it would be prudent to have a first draft of a plan … certainly by this summer.”

Phew! Good to know that 100 million severely ill and dying people won’t disrupt bankers’ meeting schedules!

Back to lotus-land: Did you know there was a spa glut?

When Maureen Vipperman took over The Spa at Laguna Cliffs Marriott Resort in Dana Point last year, she quickly added unique treatments to ensure the spa stood out among the 150 in Orange County.

She introduced the Thai-Su, a blend of Eastern-inspired Thai and Shiatsu massages. She added a microdermabrasion facial. She also started accepting discounted spa gift certificates sold at Costco.

“Right now, the fact that there are so many of us to choose from is a big challenge,” Vipperman said. “Trying to distinguish ourselves from the rest has been an ongoing task for many resort/destination spas.”

Other spas around the country are rolling out frequent-flier-style loyalty programs, calling former visitors at home to check on their weight-loss progress and offering discounts to guests who rebook their next visit while they’re still at the spa.

The efforts come on the heels of the industry’s swift growth, which has left consumers with a dizzying array of spa options.

Lastly, back to a more serious topic. At yesterday’s huge Conference on Aging in Anaheim, one expert delivered a plea for understanding on behalf of a heretofore stigmatized group: “Grumpy Old Men.”

“What I’m really talking about are men who are drinking. Men who are isolated. Men at senior centers who are aggressive, who are really angry, who are cynical, who are sarcastic,” said Patrick Arbore, an educator and an expert in suicide and grief-related services for the elderly.

“That’s how they’re masking their pain.”

(snip)

(H)e cited some grim statistics: Men are more than four times more likely to commit suicide than women, and the suicide rate for men 85 and older is more than six times higher than the general population.

What’s wrong, according to Arbore, is that men have been conditioned that it’s not manly to express any emotion except anger, or to cry or feel vulnerable, or to accept and express feelings of helplessness, frailty, sensitivity and empathy.

“It’s not that men are bad or dangerous creatures, but some men are so closed off from their real selves, they’re acting out,” he said.

So, if you see Bob Dole coming down the sidewalk, don’t cross the street to avoid him. Bob Dole needs a hug!

More Cayenne Smoothies, Anyone?

I make a mean smoothie, in more ways than one. It has all the requisite ingredients to make it delicious — strawberries, blueberries, peaches, cherries, blackberries, whatever I have handy (usually frozen). Some whey protein powder and a natural organic fiber. Some juice, some almond milk, some yogurt, maybe a little honey.

But then I add two ingredients that cause most sane people to run the other way: Spirulina and cayenne powder.

Spirulina people get, conceptually. It’s a “superfood,” laden with vitamins, protein, amino acids and many other things. But it’s green, it’s made out of seaweed and some people would just rather not have it.

But cayenne? Is this some hair-shirt type of thing?

I started adding cayenne because a nutritionist who practiced briefly at a wonderful Yoga massage place I visit in Borrego Springs (Devas Day Spa) told me I could address a health problem I had a couple years ago by drinking a gallon of water laced with honey, apple vinegar and cayenne pepper every day. I followed that regimen for about two days until I realized that no one has time to go to the bathroom that often. But she did manage to convince me cayenne was a good thing for circulation. And now that I’m used to it, I rather like the combination of fruity-sweet and spicy-hot. Maybe it distracts me from the spirulina.

And now, some validation, in this post from the Science Blog:

Capsaicin, the stuff that turns up the heat in jalapeños, not only causes the tongue to burn, it also drives prostate cancer cells to kill themselves, according to studies published in the March 15 issue of Cancer Research.

According to a team of researchers from the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center, in collaboration with colleagues from UCLA, the pepper component caused human prostate cancer cells to undergo programmed cell death or apoptosis.

Capsaicin induced approximately 80 percent of prostate cancer cells growing in mice to follow the molecular pathways leading to apoptosis. Prostate cancer tumors treated with capsaicin were about one-fifth the size of tumors in non-treated mice.

“Capsaicin had a profound anti-proliferative effect on human prostate cancer cells in culture,” said Sören Lehmann, M.D., Ph.D., visiting scientist at the Cedars-Sinai Medical Center and the UCLA School of Medicine. “It also dramatically slowed the development of prostate tumors formed by those human cell lines grown in mouse models.”

Lehmann estimated that the dose of pepper extract fed orally to the mice was equivalent to giving 400 milligrams of capsaicin three times a week to a 200 pound man, roughly equivalent to between three and eight fresh habañera peppers – depending on the pepper’s capsaicin content. Habañeras are the highest rated pepper for capsaicin content according to the Scoville heat index. Habañero peppers, which are native to the Yucatan, typically contain up to 300,000 Scoville units. The more popular Jalapeño variety from Oaxaca, Mexico, and the southwest United States, contains 2,500 to 5,000 Scoville units.

Cayenne pepper is another good source of capsaicin, less than the habanero, but more than the jalapeno. If I need more, I guess I could throw in some habaneros….

Score One for the Flu

Spirulina.jpgI think it’s the spirulina. Organic spirulina from Hawaii, in powder form, purchased from Whole Foods. I mix it into fruit smoothies that I drink 3-4 times a week. Spirulina has immensely strengthened my immune system, or so I believe. And that’s why I never get sick any more. My wife, my son, everyone around me can be sick, but not me, thanks to my hero, the Mighty Spirulina.

‘Til now. I got it. Throat sore, feverish, overall exhaustion, chest congestion. The flu.

I still recommend spirulina. I’ll still mix it into my smoothies. But I’ll never look at it quite the same way again.