Notice - Shift - Rewire

 

Negativity bias. We all have it. It's is a very human thing that we developed hundreds of thousands of years ago to keep us safe. The negativity bias, also known as the negativity effect, is a cognitive bias that, even when positive or neutral things of equal intensity occur, things of a more negative nature have a greater effect on one's psychological state and processes than neutral or positive things.So why would be be hardwired to focus on the negative?

Our tendency to pay more attention to bad things and overlook good things is likely a result of evolution. Earlier in human history, paying attention to bad, dangerous, and negative threats in the world was literally a matter of life and death. We had to be alert for rampaging mammoths and stealthy saber-toothed tigers. Those who were more attuned to danger and who paid more attention to the bad things around them were more likely to survive. This meant they were also more likely to hand down the genes that made them more attentive to danger.

Very few of us need to be concerned about being eaten by tigers these days. Yet our negative bias persists. Research suggests that this negativity bias starts to emerge in infancy. Very young infants tend to pay greater attention to positive facial expression and tone of voice, but this begins to shift as they near one year of age. Brain studies indicate that around this time, babies begin to experience greater brain responses to negative stimuli. This suggests that the brain's negative bias emerges during the latter half of a child’s first year of life. There is some evidence that the bias may actually start even earlier in development. 

Research has shown that negative bias can have a wide variety of effects on how people think, respond, and feel, impacting our mood, decision making and relationships in (surprise!) negative ways. Our old protection mechanism no longer serves us well in the modern world. Interestingly, there is a difference between how men and women register negative comments. Dr. Timothy J. Bono, PhD, who teaches a course in the Science of Happiness at Washington University in St. Louis, explains, "The negative-positive asymmetry effect holds for both men and women. The difference, however, is typically found in how the emotions become manifest. Women are much more likely to internalize them (in the form of sadness or depression, for example), and men are more likely to externalize (as with outward anger)."

Fortunately, as the new science of epigenetics shows us, our genes are often predilections and not destiny. Neuroscientists and psychologists say that we can overcome our inherent negative bias and one simple (if not easy) method for doing so is called the Notice - Shift - Rewire approach. Click Here to read more about it.

This is not about transforming into an unfettered optimist or becoming a Pollyanna who sees only the good in everything. But controling our automatic bias toward the negative can help us feel better, be happier, less prone to suffering, act more kindly, to people around us, be more effective at home and work, and have more sense of a kind of inner peace and connectedness with all things. That seems worth a shot to me.

Do You Know Your Numbers?

 

We live in a world of numbers. Phone numbers, addresses, account numbers, dates, bank balances, distances, times. Most of us are pretty familiar with the numbers we need to navigate through the tasks and routines of our day-to-day lives. But what about the numbers that tell the story of our wellness and health?

Our health is a world of numbers too but all to many of us don't know the ones that tell our story. 

When I work with someone who is eager to lose some weight, I usually begin by asking about numbers. What do you weigh now? How much weight do you really want to lose? Almost everyone knows these numbers.

But when I ask about the calories that they consume on an average day or how many they burn off between their daily routines and exercise, most don't have any idea. You can't create a calorie deficit that will produce weight loss if you have no idea how many calories you consume and burn. 

Many people, especially older people like me, are concerned about eating too many carbohydrates or not getting enough protein. But when I ask how much they are consuming day-to-day the most common response is a blank stare.

Hypertension is called "the silent killer" because it typically presents no symptoms until your blood pressure has reached a problematic level and already harmed your health. Yet even the people who know what a good blood pressure target is (hint: 120/80 or lower) rarely know what their own blood pressure is. Some may remember it from their last doctor visit (not the best reading, it tends to be high) but have no idea what it was yesterday.

If you want to improve your health in some way, it makes sense to know where you are starting from. There are apps and tools and inexpensive equipment available to everyone these days that can provide you with the numbers you need to know with very little effort on your part. Do you know your numbers?

Here is some advice from the American Heart Association on the ones that you should know. If weight loss or nutrition are your focus, here are some great tools you can rely on.

Ignorance is not bliss. It's ignorance. 

Pain in the Ass

 

Ok so this is one of those days that I would not wish on anyone. Ok, on only a very few people. It is colonoscopy prep day for me, arguably the least favorite medical procedure of my lifetime (so far). It will be my third time doing this, and no, it has not gotten less awful. "Its not the procedure, its the prep" is pretty much the truth of it. It is 12 miserable hours during which I cannot wander very far from a toilet. So why do it when there are alternatives?

Because colonoscopy is the Gold Standard for colorectal cancer screening. None of the alternatives approach it in accuracy or effectiveness, and none of them allow minor problems (aka polyps or biopsies) to be resolved at the same time, in the same procedure.

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States and the second highest cause of cancer deaths. About 152,000 cases are diagnosed every year. The rate of people being diagnosed with colon or rectal cancer each year has dropped overall since the mid-1980s, mainly because more people are getting screened and making lifestyle-related changes to lower their risk. From 2011 to 2019, incidence rates dropped by about 1% each year. But this downward trend is mostly in older adults. In people younger than 55 years of age, rates have been increasing by 1% to 2% a year since the mid-1990s. In 2024, colorectal cancers are expected to cause 53,010 deaths. As with many cancers, early detection greatly improves the odds of effective treatment. Found after the cancer has existed for a while, the odds of dying from it are brutally high.

I only have to do this every 5 to 10 years, so I will deal with it. No matter how much this sucks right now, it could be so very much worse. 

Counterfeit Eclipse Glasses Pose a Risk

 

If you are planning to watch all or any of the solar eclipse next week, please plan to do so safely. I am sure everyone knows that this means watching either on a pinhole projection box or wearing special protective glasses. Unfortunately, there have been many credible reports of companies selling counterfeit products labeled as if they conform to international safety standards, including online marketplaces like Amazon and Ebay.

We can hope that there is a special place in Hell reserved for those who would knowingly sell products that could do serious damage to an unsuspecting customer's vision. It would need to be a large space because there apparently are a lot of them.

Here is a deeper dive into this possibly serious problem along with a list of reliable vendors actually approved by the American Astronomical Society. Or you could just follow NASA's recommendation and make your own projector box.

Either way, make sure that you, your family and your friends are safe as you enjoy the spectacle. 

Yes, It CAN Happen to You

In 2023, American consumers lost $10 billion to fraud, and by far the most common swindles were internet imposter schemes. According to a CNBC report, nearly 854,000 people filed complaints to the FTC about imposter scams in 2023, representing about a third the total consumer fraud reports that the agency received. Consumers lost $2.7 billion to such scams and the average loss was $800. How many such scams went unreported is anyone's guess.

An imposter scam is when someone pretends to be someone you trust to persuade you to send them money, or to give them information that they can use to steal your identity (any your money) later. A scammer may falsely claim to be a romantic interest, the government, the IRS, a relative in distress, a well-known business (Amazon is especially popular with scammers), or a customer or technical support expert. A particularly popular scam is to claim to be the "security department" at a company you do business with claiming that there is suspicious activity on your account and asking for you help to get to the bottom if it.

Surprisingly, Millennials, Gen X, GenY are about 30% more likely to fall for such schemes than are people over 60. But older people are much more likely to get in deeply and lose more money than younger ones. For example, victims age 80 and older had a median loss of $1,450. By comparison, the typical loss didn’t exceed $500 for those younger than 70.

Right about now you are congratulating yourself for being too skeptical, to well informed or just too smart to fall for any such nonsense. And yet hundreds of people just as skeptical, informed and smart as you are do fall for them every day.

Internet scams are carefully designed by scammers and criminals to manipulate your emotions and tap into your unconscious biases, so you are practically hardwired to fall for them, says cybersecurity expert and computer scientist Daniela Oliveira, an associate professor at the University of Florida in Gainesville. In one study a group of people who ranging in age from 18 to 89 were sent a variety of  so-called “spear-phishing emails,” that is, phishing emails that are somewhat tailored to the individual and targeting different approaches such as finances, health, ideological issues, legal issues, security and social issues. If the user took the bait and clicked on the link in the phishing email, they were sent to a fake, innocuous webpage, and the researchers recorded a hit. 

At the end of the study, the participants were asked to read a set of 21 phishing emails and rate how likely they would be to click on each one. People indicated a very low likelihood that they’d fall for them even though 43 percent of them took the bait during the study and clicked on the links at least once and 11.9 percent clicked more than once when they were not told in advance that the email was a scam.

So yes, even you can fall for it. 

Here is the rest of the CNBC report, including suggestions for how you can reduce the odds of getting caught up in an internet scam yourself.

 

Why Does Everything Taste Meh?

 

By now we are all familiar with the way inflation makes us poorer day by day. Anyone who has been to the grocery store lately is familiar with how much everything costs now compared to a year or two ago.

You may already have become wise to "shrinkflation" too. That is the sneaky way companies raise prices on you by holding the cost the same but putting less and less product in the package. Everything from breakfast cereal to toilet paper has gotten smaller while prices have stayed the same or even gone up. Or how my chocolate chip cookies suddenly went from 16 per box to 12.

But have you heard of the latest trick that companies, especially food producers, have been playing to get more of your money for less of what you buy with it?

It is called "skimpflation" and it is the substitution of cheaper of fewer ingredients for more expensive ones. An example is Conagra reducing the fat content in its Wish-Bone House Italian Dressing by 10%, replacing it with additional salt and... water. Yes, water. The most egregious example seen recently was in October 2022, when Conagra reduced the amount of fat in its dairy-free Smart Balance spread from 64% to 39%, which meant water became the most plentiful ingredient in the product.

One reason that companies are turning to skimpflation to deceive you is that they aren’t under any obligation to announce when they make changes to their recipes (as long as all the ingredients are accurately reflected on the label). 

And skimpflation in not new.  In 2013, Breyers was forced to legally change the labeling of its products from ice cream to “frozen dairy dessert.” Why? Because the company had reduced the amount of dairy fat in its product to the point that it didn’t legally qualify as ice cream anymore.

Don't think that skimpflation is limited to things you find at the grocery store, it is everywhere. Any time that a company lowers the quality of its product or service to same money (aka, make a greater profit) that is skimpflation. Some other examples include:

• Airlines reducing the number of air stewards and therefore giving consumers less service during a long haul flight.
• Phone companies reducing the number of workers in call centers so that when you try to call with a technical problem, it  takes longer to get through - if you get through at all. (Your call is important to us! Please hit one if you would rather have a callback from us that you will never receive or just stay on the line for 45 minutes till we get to you. After all, your call is important to us!)
  
• Hotels not providing waiter service, but relying on customers to do self-checkouts for breakfast and meals. Or asking you to help "save the planet" by not having your sheets changed.
  
• Disney World and Disneyland have eliminated their tram services to and from parking lots, forcing visitors to walk nearly a mile to enter and exit the parks.

We should note that not all companies are motivated by greed or disingenuousness. Many businesses, especially small businesses, are struggling to cope with the surging costs of regular, old fashioned inflation. They're having a hard time finding workers at the wages they used to pay. And some businesses may be unable to afford paying what it takes to recruit workers in the current environment. Nonetheless, whether it's because they can't afford to, they don't want to or they're being greedy, instead of enticing workers with higher wages, many businesses are cutting back on the quality of their services in order to stay profitable.

The bottom line is that real inflation, the kind you see on your credit card statements, is much higher than the figure reported by the government suggests.

Action vs Outcomes

 

If you Google this topic you will get a long list of hits, and just about all of them will insist that you should set "results-based" goals for yourself rather than goals based on your activity. Activity, they will say, does not equal results. It seems to me that what they are suggesting is that simply being "busy" will not achieve the results you want. This is hard to argue with, since doing the wrong things will rarely produce the right results.

But I want to suggest that they are 100% incorrect in suggesting that activity does not equal results. In fact, other than pure, dumb luck, nothing else does. Whatever it is you want to accomplish, being it to lose some weight and keep it off, to start a new relationship, to add new customers to your business or anything else, those outcomes are not under your control. What you DO control are whether or not you actually perform the activities that will (eventually) lead you to the result you want.

Suppose, for example, you want to lose 20 pounds by St Patrick's day and then keep it off. Setting THAT as your goal is not going to get you there. What actions will you take that will inevitably produce the desired result if you keep doing them? Will you find and use an App to track your calorie deficit? Will you go for a 30 minute walk every day? Will you start making your own meals 4 days a week instead of eating out? If you really do those things, you will likely achieve your goal. Maybe not by March 17th, but eventually you will. Simply saying you will lose weight based on good intentions most likely won't make you successful.

Of course there are a couple of caveats here.

You have to set the right activity goals based on what you want to achieve, and then you have to actually accomplish them. Either way the activities needed to reach your goal are under your control. They produce the desired result.

I'm not saying that activity goals are easy. Around 75% of Americans make New Year's Resolutions every year, usually results that they want to achieve. By far most of these relate in some way to health and fitness. Despite the fact that over half of those who did set goals claimed to be "very confident" that they would have success, less than 10% of them actually succeed. 

Clearly there is more to it than simply renewing your annual pledge to "go to the gym more often".

Tony Robbins preaches that to have real success you must alter your habits and routines to include the activities that you want to carry out, otherwise your existing routines will simply prevent you from doing so. This can be hard work.

But difficult or not, setting realistic activity goals that will, if carried on long enough, make your desired results inevitable is the way to go. Despite what you may hear from Mr Google.

Know Your Numbers

 

High blood pressure, or hypertension, is often called the silent killer. And for good reason. Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels and even though high blood pressure increases the risk of heart attack, stroke and other serious health problems. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.

If there is any upside to this, it would be that hypertension is easily treated once it is diagnosed. Lifestyle changes such as adopting a low-sodium diet and regular exercise can help control high blood pressure. When lifestyle modifications aren't enough doctors may also prescribe effective medications like diuretics or ACE inhibitors.

But before anything can address the problem, a person must realize that they have it. Things that increase the risk of having high blood pressure include: older age, genetics, being overweight or obese, not being physically active, a high-salt diet and drinking too much alcohol. In the US, nearly half of adults already have hypertension but only 1 in 4 of them have it under control. A great many of them do not even realize that they already have the condition.

Finding out where you stand is as simple as having your blood pressure taken. Your doctor can do it at your annual checkup (and probably already is), although the "white coat factor" can make the readings a little higher than normal. Or (better) you can check it yourself at home.

Go ahead and read this to learn about how to properly take your blood pressure and what the readings mean for you. Then do it. It pays to know your numbers.

Aging is Society's Problem Too

 

 

For many of us, growing older is a personal issue. An issue for us and our families to sort through and deal with. But the fact is that, globally, aging populations are a demographic time bomb that is mostly being ignored by nations and societies. The world is experiencing a seismic demographic shift—and no country is immune to the consequences

By 2050, there will be 10 billion people on earth, compared to 7.7 billion today—and many of them will be living longer. Much longer. As a result, the number of elderly people per 100 working-age people will nearly triple—from 20 in 1980, to 58 in 2060. That's right. There will be nearly 3 times more elderly people for those young, working age people to support as there are now. Globally, the working-age population will see a 10% decrease by 2060. It will fall the most drastically, by 35% or more, in Greece, Japan, Korea, Latvia, Lithuania, and Poland.

There are many other social and economic changes that we can come to expect as the global population continues to age, including:

• With more people claiming pension benefits but less people paying income taxes, the shrinking workforce may be forced to pay higher and higher taxes. How long will they be willing to do so?
  
• As we have discussed before, longer lives do not necessarily mean healthier lives, with those over 65 more likely to have at least one chronic disease and require expensive, long-term care. Where will that money come from?
• Changing workforces may lead capital to flow away from rapidly aging countries to younger countries, shifting the global distribution of economic power. Standards of living will rise in a few places, such as India, but decline in many others.
  
• The strain on pension systems is perhaps the most evident sign of a drastically aging population. Although the average retirement age is gradually increasing in many countries, people are saving insufficiently for their increased life span—resulting in an estimated $400 trillion deficit by 2050. Who will pay for that?
  
• A pension is promised, but not necessarily guaranteed. Any changes made to existing government programs can alter the lives of future retirees entirely—but effective pension reforms that lessen the growing deficit are politically risky and so mostly ignored. How long can it be ignored?
  

Societies will have to divert a larger and larger share of national income to support a growing population of retirees. Many are already far along this path. Figures released by the United Nations Population Division show that Asia is at the forefront of this trend with Hong Kong, South Korea, and Japan expected to have the highest share at roughly 40 percent of their populations aged 65 and older by 2050. But Western Europe and North America are not far behind.

What does a world with billions of elderly people look like? Here is a preview.

 

Embracing Aging

 

All of us age. And we are going to continue to age, until we don't. In 2020, about 17% of the US population was over 65 years old and by 2050 that is expected to increase to about 1 in 4 Americans. The negative perceptions of aging are many and so it is no surprise that a $40B (2020) "anti-aging" market has emerged and is projected to reach over $80B by 2030.

But here is the thing..... you can have facelifts until your navel is on your chin but you are still going to age. Your body is going to change and there is not a lot you can do about that other than die. But the news is not all bad. While there is no way to "turn off the clock" (let alone to turn it back), it absolutely is possible to age better, healthier and happier than ever before. There is a lot that you can do to ensure that your seventies, eighties and even more are vital, active, healthy and happy years.

September is Healthy Aging Month. Now in its second decade, Healthy Aging Month provides focus, inspiration and practical ideas for adults to improve their physical, mental, social and financial well-being. “Use September as the motivation to take stock of where you’ve been, what you really would like to do if money was no object,” says Carolyn Worthington, editor-in-chief of Healthy Aging^® Magazine. “And try it! Who says you have to do something related to what you studied in school? Who says, you can’t start your own home business later in life, test you’re your physical prowess, or do something wildly different from anything you’ve done before? Only that person you see in the mirror! It’s never too late to find a new career, a new sport, passion or hobby.”

Since I turned 70 in January, healthy aging is of more than academic interest to me. So I will be using September to explore a range of topics of interest to us old codgers. Hope you will be here and please do contribute your own ideas and experiences.

Making Lifespan = Healthspan

When we think about living a long life, we picture ourselves in good health, mobile, active, spending time with family and friends and doing the things that we enjoy. In other words, we picture ourselves healthy, not simply alive. For most of us though, that is not how it is going to work out. We spend the first half of our lives sacrificing our health for money, and then spend the second half spending our money trying to restore our health. "We need to adjust our thinking and aim for 'healthspan'," says Prof. Michael Thorner, an endocrinologist at the University of Virginia. "Improving how long we have a robust and functional life."

In the United States in 2022, the average lifespan is 79 years (a bit higher for women and a bit lower for men, but not a lot). This is up from 66 years in 1960, quite an impressive improvement. But after age 60, 1 in 4 of us is diabetic and 60% of us have hypertension. At age 65, 41% of us will have cancer - 21% fatally. Our Lifespan is exceeding our Healthspan by 25 - 30 years! This is fantastic news if you are a healthcare provider or a pharmaceutical company. For the rest of us, no so much.

In the United States, we talk a lot about healthcare but what we are really talking about is sickcare. The entire system is focused on treating illness and disease after we have it. For Americans, medical expenses are the number one cause of personal bankruptcy. Yes, insurance is a big part of this problem. But a bigger part of it is that too many of us are just too sick in our senior years. Despite the fact that every one of us is going to get older and older until we die, there is little attention being paid to how we can age in a healthy way. 

There is a lot that you can do to make your lifespan equal your healthspan. Healthy Aging is completely possible. So what is it going to be? A long, infirm life? Or a long, healthy life? Lets explore that together.

This Is Your Brain On Air Pollution

Numerous studies have connected air pollution to higher rates of lung and heart disease. Now a new study led by researchers at the Keck School of Medicine of the University of Southern California (USC) shows for the first time that it may also have a negative impact on how the brain’s white matter ages. That is to say, it accelerates cognitive decline and brain aging. 

The researchers measured the cognitive and episodic memory of over 2,200 older women over a 10 year period and correlated that to the concentration of air pollution at their home addresses. The women who lived in geographic locations with higher levels of fine particulate matter in ambient air had significantly smaller white matter volumes across a wide range of brain areas. The study corrected for  the geographic region where they lived, their race or ethnic background, socioeconomic status, lifestyle, or medical conditions that may also influence brain volumes. White matter connects brain regions and determines how information is processed in the brain. Fine particulate matter is smaller than 2.5 micrometers and is known as PM2.5, a form of pollution that easily enters the lungs and possibly the bloodstream.

For reasons not yet fully understood, women in their 70s and 80s who live in areas with high levels of air pollution are at particular risk for Alzheimer’s-like brain shrinkage compared with women who routinely breathe cleaner air. But nobody is immune. Other studies have shown that even at relatively low levels, toxic air may alter the size of a child’s developing brain and boost the risk of cognitive and emotional problems in adolescence.

What can we do to protect our brain health? Moving away from highly polluted areas may be the ultimate protective strategy, but that option isn’t open to everyone. So USC scientists are on the hunt for other defenses. In the meantime, they recommend that you be aware of pollution levels where you live (here is one of many resources that will keep you informed: https://airly.org/en/). Minimize ourdoor exercises such as running on high pollution days, avoid traveling at high traffic congestion times if possible, use low traffic roads when walking, running or cycling and, yes, wear a mask on particularly bad days. I know it doesn't look cool but it sure beats forgetting who you are.

Reducing Your Colon Cancer Risk

 

We talked yesterday about the importance of regular screening for correctional cancer. Early detection is the best way to a good outcome. If you are over 50 years old (40 years if you have personal risk factors) you need to talk with your primary healthcare provider about it.

That being said, there lifestyle adjustments that you can make that are well proven to lower your risk. Here are five.

Diet. Diets rich in fruits, vegetables and whole grains are strongly linked with a lower risk of colorectal cancer. Eating less red meat and avoiding processed meats also helps. Make sure you have adequate vitamin D levels, as low levels are linked to a higher risk. Bonus: This is the same diet advice given for lowering the risk of other cancers, coronary disease and diabetes.

Exercise. Cancer doesn't care if you feel like exercising. In fact it would prefer that you didn't. "Exercise may decrease gut inflammation and improve immune surveillance to prevent cancer," says Dr Vi Chiu, director of Gastrointestinal Oncology at Cedars Sinai Clinic and Research Institute in Los Angeles. Aim for 150 minutes of moderate intensity exercise like brisk walking every week. In fact, don't aim for it. Do it.

Manage your weight.  Being overweight increases your risk of developing colorectal cancers because it interferes with the function of various hormones like insulin and leptin. For example, obese people have much higher levels of insulin which can cause abnormal cell growth in the colon. Stop making excuses and get down to your healthy weight.

Drink less alcohol. "Alcohol is a toxin whose byproducts can damage DNA and cause intestinal damage," Dr Chiu tells us. Limit your consumption to no more than one serving of alcohol per day. Less is better. How much is a serving? Google knows.

Stop smoking. Seriously? You need to be told this in 2022? A study of almost 5,000 people published in the British Journal of Cancer found that smokers had an almost 60% higher risk of developing colorectal cancers than non-smokers. Quitting reduces the increased risk to 20%. Staying clean for 20+ years eliminated the added risk entirely. Like you needed yet another reason to stop.

Colorectal cancer is a nasty, painful, terrible way to die. It not only affects you but your family and loved ones. There is a lot you can do to greatly reduce your risk. Just freaking do it for christ's sake.

Let's Talk About It

 

The images are disturbing and the whole thing is something we'd all just rather not think about, much less talk about. But the fact is that colorectal cancer is the second leading cause of cancer deaths worldwide. Only lung cancers kill more people every year. The American Cancer Society estimates that in the US in 2022 alone about 106,000 people will receive an initial diagnosis and nearly 45,000 will die from it.

When detected early, colorectal cancers are highly treatable and survival rates increase dramatically. This means that screening is the first line of defense. There are three common types of colorectal cancer screening.

Colonoscopy is the gold standard for early detection. A long flexible tube with a light and video camera is inserted deeply and the anus, rectum and colon, which  can then be visually inspected for any cancer. Any pre-cancerous polyps can be removed during the procedure. Since you will be under a general anesthesia for the entire procedure, it is neither painful nor unpleasant, despite how it sounds. The dreaded "prep" process of cleaning yourself out the night before is, well, unpleasant. But it is neither painful nor complicated. Just keep something interesting to read by the toilet. Average adults with no family history of colorectal cancer should begin screenings at age 40 and then every 10 years if no problems are found.

FIT-DNA testing checks your stool for blood - a possible early warning sign - and screens for cancerous DNA. If you have low risk factors and no family history of colorectal cancer, this is a good alternative to a full colonoscopy.

FIT-only testing (you have seen this on on TV) screens for blood in your stool but only from the lower intestines. It can be done at home but it is the least comprehensive screening method.

If you have been screened (I am 0 - 2 on colonoscopies) stick to the schedule your gastroenterologist recommends. If you have never been screened and are past 40 years old, talk with your primary health care provider about what might be best in your specific situation. Screening can often find colorectal cancer early, when it's small, hasn't spread, and is easier to treat. Regular screening can even prevent colorectal cancer. A polyp can take as many as 10 to 15 years to develop into cancer. With screening, doctors can find and remove polyps before they have the chance to turn into cancer.

I know its not a subject you want to think about. In fact don't think about it. Just go get screened.

Bad News for Hay Fever Sufferers

 

In the last 12 months, over 19 million people have been diagnosed with hay fever in the US alone. Nearly 40% of American children have pollen allergies. "Hay fever", or allergic rhinitis, is a seasonal allergy that causes the eyes to water, nose to run, throat to itch, and lungs to feel tight. It can be triggered by pollen from trees, grasses, weeds, ragweed, and other plants. Exposure to allergens is the cause of a hay fever allergy. Hay fever is caused by an allergic reaction to pollen from trees, grasses, weeds, shrubs, and other plants that are pollinated by insects such as bees, wasps, flies, beetles, moths, butterflies, and mosquitoes.

The symptoms of hay fever can vary from person to person. Some people may experience a few days or weeks of sneezing and itchy eyes before the allergy subsides; others may have more severe reactions that persist for months at a time. The length of your reaction depends on how much pollen is in the air when you are exposed to it during pollen season. If there’s not enough pollen around, then your body will be less likely to produce an allergic response.

"No one really knows why hay fever affects some people and not others. Whether or not you get hay fever may be down to genetics or the state of your gut health," says Dr Luke Powles, clinical director of Bupa Health Clinics in the UK. “People may be more prone to hay fever if stressed, as your body releases hormones and other chemicals, including histamine, the powerful chemical that leads to allergy symptoms,” Dr Powles says. “While stress doesn’t actually cause allergies, it can worsen an allergic reaction by increasing the histamine in your bloodstream.

And there is bad news if you suffer from seasonal allergies. It is only going to get worse. Perhaps much worse.

Based on current trends of rising global temperature and carbon dioxide levels in the atmosphere, annual pollen emissions are projected to increase by as much as 40% by 2100. At the same time, the pollen season is expected to begin 40 days earlier and end 20 days later than presently.

There is little that you can do other that treat the symptoms either.

 

Lifestyle Tweeks for Osteoarthritis

 

One of the delights of getting older is the emergence of various aches and pains in our joints. One of the most common causes of chronic joint pain is osteoarthritis (OA). OA is a progressive condition in which the cushioning material that keeps the ends of our joints from rubbing together gradually wears away. Presently there is no way to reverse the condition.

Medical treatment for OA runs the gamut from prescription drugs to relieve the pain, to steroid injections into the joints to reduce inflammation to, in extreme cases, the replacement of the joint with an artificial one. Knee and hip joint replacements are the most common orthopedic surgical procedures, with over a million performed annually in the US, and this is expected to grow over 600% to 3.5 million a year by 2030.

Artificial hip and knee recipients generally express satisfaction with the results and regain mobility despite advanced OA. In very advanced cases, they may be the only practical alternative for treatment.

If there is any good news to be had for OA sufferers, it is that there are lifestyle changes and non-drug treatments that can help ease the symptoms and slow the progression of the condition. Here is what orthopedic experts advise.

1. Improve the quality of your sleep.
That may sound surprising but clinical evidence suggests that reducing stress and getting a better night's sleep may help. "Sleep is crucial to pain perception," explains Heidi Prather, DO, at the Hospital for Special Surgery in NYC. Insufficient sleep time or poor quality sleep can reduce the level of neurotransmitters in your brain - chemicals like serotonin that can help lessen your perception of pain. Stressful days can lead to sleepless nights.

2. Lose weight.
If you are overweight, losing as little as 5 to 10 pounds can make a positive difference to join pain and mobility. A 2021 study published in the International Journal of Obesity found that losing 7.5% of body weight significantly reduced the frequency of knee and hip replacement surgeries compared with those who did not lose weight.

3. Move toward a more plant-based diet.
A 2018 study found that people who followed a plant-based eating style for eight weeks reported significantly less joint pain even if they did not lose weight. A whole food, nutrient dense diet helps reduce the inflammation that contributes to pain.

4. Keep exercising - in the right ways.
What is most helpful in dealing with OA is a combination of aerobics, strength training and flexibility exercises. "Exercise not only strengthens the surrounding muscles, taking pressure off the joints, but improves overall joint function and mental well being, which can make coping with pain easier," according to Timothy Gibson, MD, medical director of the MemorialCare Joint Replacement Center in Fountain Valley, CA. It is important, however, to tailor your exercise routine to your OA status and fitness level, so working with your doctor or a physical therapist can be best.

I just got my own "advanced OA" diagnosis two months ago, so I will be trying these suggestions to see if they make a positive difference for me.

Too Many Meds for Us Older Folks

 

In a recent study of 422 adults with early signs of dementia, 55% were regularly taking six or more prescription medications. “Many drugs may be especially harmful to older adults with cognitive impairment, such as benzodiazepines, used to treat anxiety, and oxybutynin, used to treat urinary incontinence. These drugs have sedating effects that increase the risk of delirium and can worsen dementia,” said study author Matthew Growdon, MD, an aging research fellow at the San Francisco VAMC and the University of California San Francisco’s Division of Geriatrics. In addition to adverse interactions and outcomes, overprescribing of medications (polypharmacy) also contributes to challenges with adherence, since more complicated medication regimens require more time and attention, and increase the potential for making mistakes and inadvertent misuse.

Of particular concern is the administration of drugs to elderly residents of nursing homes and elder care facilities primarily for the purpose of keeping them sedated and easier to mange. Often the problem arises because a patient is seeing several different medical providers and none of them communicate with the others regarding prescriptions. Often, a pharmacist will catch a problem, but only if someone obtains all of their prescriptions from the same pharmacy.

In addition to making dementia worse, drug interactions can have many other serious health effects.

The researchers advise reviewing all the medications that you or a loved one may be taking with your primary healthcare provider on a regular basis. I can personally attest the the effectiveness of this. In the case of my mother, who was suffering from Alzheimer's, she had been taking 13 different prescription medications. After a review with a new primary care physician, she was taking only 3.

Don't assume that your doctor or pharmacist is aware of every medication that you are taking. Make certain that they are.

Hydration and Your Heart

 

It is hard to live in this world of ubiquitous water bottles and not be aware of the importance of staying well hydrated. New findings suggest that consuming sufficient amounts of fluids throughout life not only supports essential body functioning but may also reduce the risk of severe heart problems in the future. Staying well-hydrated may be associated with a reduced risk for developing heart failure. 

Heart failure, a chronic condition that develops when the heart does not pump enough blood for the body's needs, affects more than 6.2 million Americans, a little more than 2% of the population. It is also more common among adults ages 65 and older.

The study, conducted by the National Heart, Lung and Blood Institute in Bethesda, MD and published in the European Heart Journal, found that people with a high serum sodium level in their blood, an indicator of chronic dehydration, were 54% more likely to develop heart failure in later years than those with normal serum sodium levels. Those with the most elevated serum sodium levels were twice as likely to develop a condition where the heart muscle becomes thickened and pumps blood less efficiently (ventricular hypertrophy).

What should you do? The study authors suggest that most people should consume four to six 8oz glasses of water every day. If you are younger, larger, or more physically active or if you live in a hotter, more humid environment, you probably need a bit more. Also, it need not literally be glasses of water. Juices, tea, coffee and many fruits and vegetables contribute to your intake. A simple way to remember? Keep one of those water bottles with you and sip on it through the day.

Overtesting Your Heart

 

According to research by the American Heart Association and published in the journal Circulation earlier this year, about half of all US adults who undergo a heart procedure or test did not need it. 

The issue of "low-value" medical care is a longstanding one, the heart association notes. The term refers to health care services that are unlikely to benefit patients in a meaningful way, exposing them to potential harm and wasting money. It's estimated that low-value medical care accounts for about 30% of health care spending in the United States — or up to $101 billion annually.

Among the low-value tests and treatments are annual exercise stress tests for people who have undergone angioplasty or surgery to clear blocked arteries, echocardiograms to assess people who have fainted but show no signs or symptoms of heart problems, and coronary calcium tests for people already known to have heart disease.

Individual doctors may rely on their personal experience, and the belief that a test or treatment helps patients, and just stick with it. Or they may simply be unaware of the evidence that a given practice is actually low-value. Then there is the fear of being sued, which can prompt doctors to practice "defensive medicine" and order tests to be sure nothing was missed.

Research suggests that up to half of stress tests performed in the United States would be rated as "rarely appropriate," the AHA says. The problem with that is not only time and money wasted but that it can also lead to invasive testing that carries more risks and yet more expense.

What can be done? Actions on different levels are needed, said Dr. Vinay Kini, chair of the AHA statement writing group.

On the broad level, the U.S. health care system is designed to reward quantity — more tests, more treatments — versus quality. A payment system based on quality of care is the "way forward," Kini said, though it is complicated to define quality. Patients also play a role.. In some cases, they demand tests or treatments that are not necessary, and their provider accommodates them.

What should you do? Be skeptical. Unless it is an emergency, like a heart attack, have a conversation with your provider about any tests being recommended and be sure that you fully understand not only the reason for the test but also the risks and benefits of going ahead with it. The final decision is yours.

Experts vs Expertise

 

The other day I saw a post on Tic Tok by someone I follow and respect. In this particular post she was on a rant about people who had successfully lost a significant amount of weight, made a video about their experience and were then garnering lots of followers from among other people who were hoping to lose weight. Her objection, it seems, was that these people did not have "credentials" (she does). In other words they had not been certified as weight loss experts by virtue of their education.

Now to be clear, I have nothing against experts. For the many years I was working my consulting business, I was one. But as I re-watched her video I had several problems with her whole premise.

First of all, education and credentials may make you an expert in the sense that they certify that you have taken classes and passed tests. They are a pretty good (but not infallible) indication that you posses some specialized knowledge about something. But that really says very little about your expertise or your practical, hands on experience. Being an expert means you are knowledgeable. Having expertise means you are skilled. Clearly they are closely related but they are not the same thing. Someone can have both, or can have either one without the other.

Second, while experts do indeed posses specialized knowledge, they may or may not be capable of using that knowledge in a practical way, or even communicating it to non-experts. Someone with expertise may not have a deep understanding of the theory underpinning what they do, but they can never-the-less do it well. I doubt that the mechanics who worked on the engine of my airplane were especially well versed in fluid dynamics or thermodynamics. But they sure could keep airplane engines running. It has been shown that actual penal system inmates are more effective at making a positive impression on troubled teens than are licensed physiologists. Knowledge vs skill.

Now I am not suggesting that you steer clear of experts. Experts create new knowledge and advance our understanding. But if you want to lose weight and have a choice between a college educated nutritionist or a certified nutrition counselor who knows how to do it but has never actually had to do it themselves, or someone who has personally lost say 45 pounds and kept it off for a few years, who do you want to talk with?