Thursday Open Thread 9-21-2017

Personal observation over time has revealed an interesting phenomena. Many medical professionals I know who use self-treatment for themselves and their family use different methods than they use to treat patients. Guilty of it myself. Multiple reasons, for one the amount of time and energy it takes to convince someone to take the time to follow a self-directed path towards health or optimal functionality vs their desire for quick fix of take this pill or try a surgery. Monitoring a medical condition being treated or prevented is a major part of self-treatment. It requires an additional layer of education, motivation and critical thinking skills.

Licensing agencies and certification boards encourage health care practitioners to memorize modern (what is popular today)treatment protocols and repeat steps of the protocol for patients. If one varies to far from the current protocols there are consequences. The tools of compliance include insurance company push back regarding payment for treatment or diagnostics, disciplinary action, loss of license, losing malpractice coverage, criminal charges or loss of income/job. If currently accepted protocols are followed there are few external consequences for poor patient outcomes.

Interestingly, another potential advocacy group is beginning to recognize the value of single payer is our business leaders.

Master and other US business executives have come to question the "value proposition" of private health insurers. In other words, they're asking what, if any, value do private insurers bring to the US health care system and economy. Many are concluding not only that insurers provide no essential value, but also that they actually add costs to the system and make US businesses less competitive in an increasingly global marketplace.

Business executives at companies of all sizes are also coming around to understand another important truth about private health insurance companies in the United States: They actually strive to make health care cost more. As Brian Klepper, former CEO of National Business Coalition on Health, wrote in Employee Benefits News in July 2017:

The truth is that group health plans typically earn a percentage of total claims, and it is in their interests for health care to cost as much as possible.... Intentionally meek approaches to health care risk management result in excessive care and cost, in turn fueling higher expenditures, greater net revenues and elevated stock prices.

In the future changes will be forced upon modern medical practices if the reasons contributing to antibiotic resistance are not addressed. Many modern medical treatments and diagnostics rely on invasive procedures which have a risk of infections. Autoimmune disorders and inflammatory conditions are often treated by suppressing the immune system.

There is a serious lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens, including Acinetobacter and Enterobacteriaceae (such as Klebsiella and E.coli) which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.

There are also very few oral antibiotics in the pipeline, yet these are essential formulations for treating infections outside hospitals or in resource-limited settings.

"Pharmaceutical companies and researchers must urgently focus on new antibiotics against certain types of extremely serious infections that can kill patients in a matter of days because we have no line of defence," says Dr Suzanne Hill, Director of the Department of Essential Medicines at WHO.

Growing Fresh Food
As mentioned in these open thread and a few other diaries growing one's own food is a method of resistance to the status quo. If one doesn't have a plot of land, maybe a patio or balcony for container gardens. It only takes a glass jar, a mesh cover and a a strainer for rinsing for sprouts to eat raw or stir fry..

Farm Report
A few photos from my drive Friday.

Mt Hood summer glaciers and smoke from the Eagle Creek fire.
soe hood glaciers.jpg

Bridge of the Gods on the Columbia River and smoke from the Eagle Creek fire.
soe bridge.jpg

On Friday West lanes opened on Interstate 84. The fire had jumped the East lanes and stopped at the edge of the west lanes.
soe 84 south.jpg

Heat damage on the trees North of the Interstate.
soe 84 n heat damage.jpg

This morning clear sky with rain clouds. Mother nature is finishing off the fires.
soe rain.jpg

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Comments

Lookout's picture

Eat well and be active.

Tomorrow is the equinox and Autumn begins. Summer crops are nearly done (sweet potatoes to dig next month), and fall crops are in and growing. Last winter was so mild even our lettuce over wintered (using row covers).

So sorry about all the fire out your way. It was our turn last fall. We had three large fires around us and smoke filled the valley. This year we've had abundant rain. Got 3" off of Irma last week.

One thing is for certain about our future weather...expect uncertainty. We will ride the ever growing pendulum swings of weather for the remainder of our lives.

We continue to be Riders on the Storm (7 min)
https://www.youtube.com/watch?v=lS-af9Q-zvQ

"Riders On The Storm" was the last song recorded by the members of The Doors, according to Ray, as well as Jim´s last recorded song to be released (recorded December 1970 - January 1971 - released in June ´71). According to Robby, it was inspired by the song "(Ghost) Riders in the Sky: A Cowboy Legend." The song is played in the E Dorian mode, and incorporates real sound effects of thunder and rain, along with Ray´s Fender Rhodes electric piano playing, which emulates the sound of rain. The song was recorded at the Doors Workshop in December 1970 with the assistance of Bruce Botnick, their longtime engineer, who was co-producing the recording sessions. Jim recorded his main vocals and then whispered the lyrics over them to create the echo effect. The single was released in 1971, shortly before Jim´s death, entering the Hot 100 on 3 July 1971, the day that Jim died. The Doors' former producer, Paul Rothchild left prior to the sessions as he did not like the album, or the song, calling it "cocktail music". Their engineer Bruce Botnick was selected to produce the album instead. The band's drummer John Densmore wrote a 1990 book called Riders on the Storm, detailing the story of his life and his time with the group. Ray Manzarek and guitarist Roy Rogers covered this song as an instrumental duet on their 2008 album "Ballads Before the Rain". In November 2009, the song was inducted into the Grammy Hall of Fame under the category Rock.

Hope you all have a good day.

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“Until justice rolls down like water and righteousness like a mighty stream.”

studentofearth's picture

@Lookout
environmentally and emotionally. Age old advice we continually need to relearn. Enjoyed the multiple health article links you provided Sunday.Dr Fung is a good example of a the type of practitioner national healthcare systems can create. The system focuses on healthcare outcomes not kickbacks from high priced products and procedures. His information is available free on Youtube, not behind a paywall of a product focused website.

First frost of fall this season, 26 this am. Now I can harvest the last apple tree, which needs cool weather to sweeten. One more rotation of irrigation and am done for the year. Have a good week.

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My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

thanatokephaloides's picture

@studentofearth

First frost of fall this season, 26 this am. Now I can harvest the last apple tree, which needs cool weather to sweeten. One more rotation of irrigation and am done for the year.

1. Technically, that means you got a summer frost (by one day)! I'll bet you grow some sweet apples! And therefore:

2. You do NOT live within convenient driving distance of Azazello in southern Arizona! Smile

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"Some members of the government are now investigating opioid pain killers but they are investigating the wrong thing. Despair-masking drugs are not the problem. Despair is."
-- featheredsprite

studentofearth's picture

@thanatokephaloides
I have my seasons confused and it easier to fly to Arizona before driving around in a car.

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My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

dkmich's picture

Nature is so beautiful and then there are humans.

Blue Cross warns GOP repeal bill 'undermines' pre-existing condition rules BC/BS in MI is still a non-profit. I can't say enough good things about them. I have Medicare Plus Blue subsidized in retirement by my employer. My mom bought a supplemental policy from them when she was 86. It cost $120/mo. Unfortunately, everyone isn't as lucky with their health care. It is why I support single payer.

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*donate *follow us on Twitter *like us on Facebook *dump Google

studentofearth's picture

@dkmich
I have always enjoyed driving around the state. Nature does amaze.

Agree with your sentiment. There are a lot of people in our country who will benefit from single payer. The primary reason to support the policy.

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6 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

detroitmechworks's picture

They tried the drugs that are established to be acceptable under the current legal framework...

when they didn't work, they suggested that I seek alternative stuff... that they couldn't exactly speak about because of DEA rules...

We've gotten to the point where medicine practitioners are actively forced to follow dogmas rather than what they know works. All because somebody wants to make more money.

Rather disgusting, but very American.

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You can't expect to wield Supreme Military power, just cause some corporate tosser lobbed a contract at you!

studentofearth's picture

@detroitmechworks
to monitor adherence to treatment protocols and implement just-in-time employee management. This seems to be the direction rather than improving clinical outcomes. The use tends to force good practitioners out or break their spirit.

Frustrating when as individuals we are caught between the gears of the system. When one is sick, it is hard to push against the system to create a path of self-treatment.

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7 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

thanatokephaloides's picture

@detroitmechworks

They tried the drugs that are established to be acceptable under the current legal framework...

when they didn't work, they suggested that I seek alternative stuff... that they couldn't exactly speak about because of DEA rules...

We don't just need single payer; we also need to abolish the goddamned DEA! Diablo

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7 users have voted.

"Some members of the government are now investigating opioid pain killers but they are investigating the wrong thing. Despair-masking drugs are not the problem. Despair is."
-- featheredsprite

@detroitmechworks

...We've gotten to the point where medicine practitioners are actively forced to follow dogmas rather than what they know works. ...

Once 'public/environmental-protecting-regulation-hating' Repubs got away with forcing disinformation and unwarranted medical procedures into women's health care by law, the sane became the limit...

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1 user has voted.

Psychopathy is not a political position, whether labeled 'conservatism', 'centrism' or 'left'.

A tin labeled 'coffee' may be a can of worms or pathology identified by a lack of empathy/willingness to harm others to achieve personal desires.

enhydra lutris's picture

there is a bit of "what the market will bear" pressure to put a soft cap on the upward impetus. With ACA, however, the law is, as predicted, a driver. The alleged "cost control" measure is either intentionally or ignorantly the driver. Gross margin is capped. As a result, the only way to increase earnings is to increase costs.

Simplified example: Margin is capped at 10%, general and admin expenses are 2 bucks. With costs of 1,000, margin is limited to 100, so revenues are limited to 1,100 and net profit before tax is 1,098. To increase profits, making shareholders happy and increasing executive bonuses, the company must increase costs. Bump the costs up to 2,000 and margin rises to 200, permitting revenues of 2,200 and profits of 198.

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That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

studentofearth's picture

@enhydra lutris
leaders to start to understand how insidious the cost of our healthcare model is to the bottom line. Thought they would figure it out in the 90's when premiums were rising 20%. Most infrastructure costs, training and pensions have been shifted to governments and individuals. Yet for decades mid-size and big business have spent political dollars to keep our healthcare model in place.

Good explanation of how the ACA is not structured to keep cost contained and works in the opposite direction over the long term.

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6 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

eyo's picture

Anyone else notice? He looked kinda grumpy by the time Trump started ragging on Syria,
UNSyriaTrump.jpg
then when the lies words about Assad start, he says nuh-uh! See my middle finger?
UNSyriaTrumpLove.jpg
subtle stink eye
UNSyriaTrumpStinkEye.jpg
Eff you Trump! Liar.

I liked it when the socialists laughed too. What an asshole the U.S. President still is, a giant big one. Assad is evil too, both retirement material if you ask me.
---
I guess some here might like this article: How Bernie Sanders is cultivating California for 2020
Thirty paragraphs of blah blah blah, the end;

DeMoro, in an interview, reflected on Sanders’ Medicare-for-all news conference last week, where a long list of would-be 2020 rivals squeezed into the frame to relay their support. Among them were Harris, and Democratic Sens. Elizabeth Warren of Massachusetts, Kirsten Gillibrand of New York, Cory Booker of New Jersey and Jeff Merkley of Oregon.

As they spoke about the need for the bill, a top priority of DeMoro’s nurses, she imagined onlookers surveying the lineup of senators and asking themselves one question: “Who is going to be Bernie’s vice president?”

good luck

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5 users have voted.

On a blog.

studentofearth's picture

@eyo
to all citizens of the world. Its political class is not answerable to its citizens regarding their needs or desires. US actions are not bound by any treaty or agreement. The US must always have 3 nations identified as the Axis of evil. US does not cooperate, only dominates using its corporations, financial institutions and military.

None of the US's positions have changed, Trump is simply an awkward speaker. He blurts out his thoughts with no softening of their tone.

up
5 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

Wink's picture

but doctors don't even have the time to prescribe a pill. I see my doctor twice a year for 2-4 mins. each time. "How ya doin', good to see ya, any new aches or pains? your heart sounds good... see ya in six months!" wham, bam...
And for that "visit" I get charged $200. Now, I know there's payroll and overhead, so I have no problem with the $200. I just wish my Medicare would pay half. And, for $200 one would think the doctor could spend more than 4 minutes. Like, maybe, spend another two, 3 mins. to educate my butt on this or that that might improve my health. But, nope. "see ya in six months... "

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the little things you can do often are more valuable than the giant things you can't! - @thanatokephaloides. All about building progressive media. (-1.9) On Twitter @winkradio.

studentofearth's picture

@Wink
tend to spend more time with patient. Might need a different practitioner for more interaction time.

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4 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

Wink's picture

@studentofearth
take pulse, blood pressure, tonnage (weight), and prolly spend 5-6 mins. compared to the doctor's 2-4 mins. Total: 7-10 minutes. What passes for health care these days, I guess. Just wish there were more time on the preventive side. Mostly have to guess from online ads, info.

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the little things you can do often are more valuable than the giant things you can't! - @thanatokephaloides. All about building progressive media. (-1.9) On Twitter @winkradio.

Citizen Of Earth's picture

(some anyway) are cashing in on the drugs gold rush. To wit, prescribe drug X and get a kickback from the Pharma Cos that sell it. Cholesterol drugs is my #1 suspect. I have LDL towards the high end of the range and doc keeps suggesting I get on the pills treadmill.

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5 users have voted.

Donnie The Douchebag. The Douchebag Who Would Be King.

studentofearth's picture

@Citizen Of Earth
receive funds from Pharma. Check Dollars for Docs to verify if your physician received payments 2013-2015. A new look at Pharma payments and the opiod crisis: "One in 12 doctors accepts payment from pharmaceutical companies related to opioids". The other push is from Prescription Benefit Managers regarding the specific drug being prescribed, got its start in the nursing home industry. Insurance companies are now requesting their piece of the pie.

This is a couple years old, but still accurate.

Cardiac risk factors and high cholesterol treatment may be changing in the near future and focusing on inflammation. Of course the research is still looking for the magic and profitable pill.

The team reports a significant reduction in risk of recurrent heart attacks, strokes and cardiovascular death among participants who received a targeted anti-inflammatory drug that lowered inflammation but had no effects on cholesterol.

"These findings represent the end game of more than two decades of research, stemming from a critical observation: Half of heart attacks occur in people who do not have high cholesterol," said Ridker. "For the first time, we've been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk. This has far-reaching implications. It tells us that by leveraging an entirely new way to treat patients -- targeting inflammation -- we may be able to significantly improve outcomes for certain very high-risk populations."

There are multiple reasons for high cholesterol and the type of treatment should be based on the cause. Increased cholesterol levels can also be a symptom of Metabolic Syndrome and related to high levels of insulin with type II diabetes. If that is on your suspect list check out the Dr Fung youtube videos reference in Lookouts Sunday diary.

Fasting is a terrific tool for health and weight control that is rarely mentioned. Maybe because it is free?
https://www.youtube.com/watch?v=G7oLbFPo6jY (38 min)
https://www.youtube.com/watch?v=ETJ2YYOdBNE (1.2 hrs – full interview)
https://www.youtube.com/watch?v=tIuj-oMN-Fk (36 min explaining fats, sugars, and insulin's role)

It is also normal when loosing significant weight for cholesterol levels to rise.

At minimum cut out any food products with corn syrup/solids and concentrated fructose (such as fruit drinks)

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5 users have voted.

My top political priorities: 1) Healthcare - Medicare for All, 2) The right to grow food, 3) copyright & patent reform (especially PHARMA)
Live for today, you may not be here tomorrow. Plan for the future, you may live to a 100+.

mhagle's picture

Just looking at it now, but enjoyed the essay and comments.

I am still planting stuff. Later than I wanted to, but maybe I will get lucky with a late frost . . . like December.

Smile

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Marilyn

Let's save the planet for our kids. Tree Hugger to the end.