The Tin Lizard

Juice And Old Lace

Everyone seems to be getting excited about arsenic content in commercial fruit juices.  Consumer Reports has put out a report; news media have propagated their study.  Not that we shouldn't expect this news.  Arsenic is not only present in nature - our air, our water - naturally, just as the juice bottlers maintain, but it's also a component of insecticides.

Juice has other disadvantages.  It's usually relatively caloric, because (for example) a typical glass of orange juice contains the juice and calories of at least three oranges.  It's also sweet; naturally, to some extent, but also often excessively so due to the addition of more sugars.   And finally, it's adulterated.  Many juices labeled as a fruit (cranberry juice, cherry juice, apricot juice) contain only a limited percentage of the juice of that fruit, and a large percentage of apple juice.  No doubt this is because apple juice adds sweetness, and because it's cheap.  But it's not what you're paying for.

I was surprised to learn that many mothers are giving infants juice in bottles, several times a day.  Wow.  I suppose they think of it as "natural," but besides the various indignities inflicted upon pure juice by the folks who bottle it, it's useful to keep in mind that drinking juice isn't "natural" at all.  Cavemen, I feel pretty certain, didn't squeeze the juice out of their fruit into some rudimentary stone bowl and drink it.  The ATE THE FRUIT.

So:  Save your kids.  Drink water.  Eat fruit. 

 

Normal Bleeding

A recent commercial message for a pharmaceutical potion warns that if you experience "abnormal bleeding," you should consult a doctor.  This begs the question:  What would "normal bleeding" be?   Wouldn't you interpret most bleeding as "abnormal"?  Does this mean there are people who bleed all the time and might have to be on the lookout for an unexpected uptick in their bleeding?    

Air Travel And Surgery - Are There Differences?

It popped into my head just now that air travel, which has become increasingly unpleasant over the past couple of decades, is now very similar to having surgery.  I'm not currently planning either of these "adventures" for myself, but I note that both experiences:

• have an end benefit that's a bit uncertain: arrival at a destination, or a state of better health; you need to have hope, you can't be certain!
• include an element of danger - it makes no sense to travel by air or to have surgery if it isn't essential
• are priced similarly, i.e., by accretion:  Want an extra bag? That'll be extra.  Want the anaesthesia?  That, and the anaesthesiologist, will be separate on your bill.
• have a long lead-up that takes longer than the process itself, and is generally more unpleasant -- consider hospital check-in forms, restricted diet, and prep for surgery, or getting to the airport and making your way through security.

I think air travel probably has a somewhat better survival rate than surgery but even if that's not the case, if I were facing both experiences, I'd always do the air travel first.  A flight that goes wrong might eliminate the need for surgery, but even a surgery that goes right can't eliminate the need for truly necessary travel.

Bicycling: A Good Investment?

They say bicycling is good for your health.  It may be, for those who engage in the sport, if they don't get creamed on the street.

I've written a time or two before about the dangers of being on a bicycle in car-oriented America.  Drivers need to be aware of cyclists and give them space.  The other side of the coin, about which I've also written, is that cyclists sharing streets with four-wheeled vehicles generally are required to follow the same rules as the cars.  That means staying off the sidewalks, obeying traffic signals and signs, not dodging through a red light in the pedestrian crosswalk.  This, unfortunately, they hardly ever seem to do.

I was on my way home from errands today (in a car) and crossed an intersection on a green light.  To my right, there was one of those curved ramps for traffic turning right onto my street; that traffic has no light, but a yield sign.   I noticed a gang of eight or ten bicyclists zipping along that ramp.  I wondered if they were going to yield.  They didn't.  The whole bunch of them just swooped into my lane without slowing down, about 50 feet ahead of me.  Fortunately for them, I was only going about 30 mph, I was alert to the danger, and traffic was light so I was able to shift to the empty left lane in time to avoid them.

Every one of these guys (they were all guys) really deserves to be dead or badly mangled at this point.  They're fortunate.  I am too, because if I had hit them I'd probably still be there dealing with police reports and besides, there would have been little way to prove they were in the wrong.  

Whenever one of those little arguments about cars and bicycles sharing the road pops up in the media (and they do, of course, every few months), bicyclists comment that they always follow the rules of the road and it's drivers to blame.  I rarely see a cyclist obeying basic traffic regulations; my experience today was far more typical.

As for investment, again, it may work wonders for the cyclists' well-being, but for the rest of us, having cyclists on the road is a terrible investment because it's no-yield.  

How DO You Pick A Doctor, Anyway?

For years, from early childhood up to my retirement, I was the beneficiary (or victim, take your choice) of military and subsequently U.S. State Department medical care.  Whether on a military base, in a combat zone, or in a remote foreign location rife with tropical diseases, the choice of a health care professional was usually not mine; I'd be treated by whomever the government provided. 

After I got past childhood and understood better the economics of health care, I'd often wonder whether physicians who chose to work for a government salary, rather than the distinctly better income they might make in private practice, were necessarily the "best" of their profession.  But surprisingly the system, while producing its share of quacks who clearly couldn't have made it in the private world, coughed up some very good doctors, for a variety of reasons:  surgeons might find that work on combat casualties gave them extensive experience they might not gain in years in a stateside hospital; epidemiologists could benefit from being in a place where weird tropical diseases weren't a rarity; some doctors made a lifestyle choice, trading a high income for more regular hours; and there were always those who just preferred an old-fashioned style of family practice that wasn't any longer the norm in the private world.

Long story short:  It wasn't until late in life that I confronted the problem of how to select a doctor, in particular a primary-care doctor, from the many available.  Ultimately, my choice of primary care physician was made for me by a specialist I consulted on a specific matter, who mentioned a general practitioner who was located right across the corridor.  Of course I wouldn't have stuck with that choice if there were problems, but it turned out the doctor thus "recommended" had an approach I liked and a general theory of treatment similar to my own (minimize the pills, please, and not too many silly tests). 

For specialists needed from time to time, I found that surveys conducted in the local area by magazines or newspapers worked best as a source from which I could select someone who was on my insurance plan.  Generally those surveys combined, in one way or another, polls of medical professionals themselves with patient inputs on matters like bedside manner, waiting times, cost, and the like. 

Unsatisfying and random as that selection process sounds, the situation nowadays, as described in a recent article by Michelle Andrews of Kaiser Health News (published in the Washington Post), seems different and less satisfactory.  I suppose it's not surprising that insurance companies are taking an increasing role in trying to shape the selection process, but as Andrews points out, quality of care is less easily quantified, so for that reason (and other obvious ones), insurance company ratings are likely to be based heavily on cost.  I believe strongly that Americans need to be taught to consider cost in making health choices, but it shouldn't be the only factor.

On the other side of the spectrum are patient ratings such as those being geared up by a number of websites, including "Angie's List."  But most reasonable people will recognize that lists like that are bound to be skewed by responders who have an ax to grind, or who just don't have the same priorities for care that you do.  (E.g., do you want a doctor who's good at listening to your description of your ailment, or one who leaps to the "most likely" conclusion almost before he/she has examined you?)  It's like picking a restaurant from Zagat's -- it can be of some help, but be aware that many responders don't have the same standards you do.  Restaurants are less serious.  Most of us can survive a meal that doesn't meet our expectations, or even a bad repast; so I do offer my reviews of restaurants on Zagat and elsewhere, but I don't review physicians or care facilities online, with one exception. 

Ms. Andrews is correct in surmising that we'll see more and more efforts by insurers and others to "rate" doctors.  It's a trend we can't buck, whether or not it provides us useful information.  I think the best way forward is to be clear what we're seeing, and to use a combination of ratings and other information.  

Sports Figures

I don't watch a lot of sports on TV but when I do, I'm often impressed by the superb physical conditioning of most athletes, male and female, and even in sports where you wouldn't necessarily expect it, like automobile racing.  (Yes, racing!  I remember about 20 years ago that someone set up a sort of modern pentathlon with top names from various sports competing against one another.  The race driver - I don't recall his name - won.)  

But the impression often turns negative when it comes to American football.  Because there, every weekend, on any NFL team's defensive squad, you can see what appear to be giants gone to pot -- beer bellies and balloon butts abound.  They have the physiques of many 60-year-olds, but they're not anywhere near 60; mostly, they're in their 20s.  The only other sport I can think of where you can regularly see specimens of such magnitude but with such clearly unhealthy avoirdupois is sumo wrestling. 

I look at these guys and think, well, they must be able to do something or they wouldn't be on a pro team in the first place...and of course any of them could crush me or rearrange my anatomy with one hand tied behind his back... and I realize they're really selected for that bulk... yet I had to wonder, wouldn't they have a better claim to the title of "athlete" if they could lose some of that loose, floppy heft and just get down to the muscle?   In short: are they really in SHAPE? 

Not to pick on one individual, but the case of Albert Haynesworth, a 29-year-old, six-foot-six, 350-pound defensive lineman for the Washington Redskins, is much in the news in our area and gives at least one answer to that fitness question.  Haynesworth seems to be having a little trouble getting past a conditioning test which is described thusly: 

The conditioning test consists of two 300-yard shuttle runs that must be completed with just a 3½ minute break in between. The player runs 25 yards at a time, back and forth for a total of 12 sprints. Linemen must complete the first shuttle in 70 seconds, the second one in 73 seconds.

Now, we might suppose that Redskins coach Mike Shanahan deserves a lot of credit for recognizing this problem of needless overweight, and doing something about it.  But we'd be wrong.  The conditioning test seems to be available more as a punishment than a fitness tool; nobody on the team is being asked to pass it except Haynesworth, because he played prima donna (oh, the mental picture of that!) by boycotting the team's early off-season workouts amid grumbling about the Redskins' defense strategy. 

The spotlight -- an embarrassing and possibly even unfair one -- may be on Haynesworth but there are many pro footballers out there who I'm sure couldn't pass this same conditioning test.  Maybe Haynesworth will have the last laugh by living a little longer than some of his peers.  

Talking Drugs

An entire new lexicon has come to light over the past ten years.   Do you recognize the following words?

Saxaglyptin
Desvenlafaxine
Bevacuzumab
Ibandronate
Tadalafil
Atorvastatin
Terbenafine
Esomeprazole

They may look like the list of words for the next National Spelling Bee (and perhaps they are) but in fact, they're all drug names, or more properly, chemical compounds.   Even in the 1950s we would occasionally hear a few such terms:  acetosalicylic acid, for example, or ibuprofen, which came along slightly later. 

But as drug manufacturers have introduced more and more new medicines, we've all seen the trend toward advertising them to the public, too -- "ask your doctor if [product name] is right for you!"  And those ads almost always specify the name of the actual drug, as well as the brand name. 

For the linguist, songwriter, or poet, these new words represent an untapped reservoir of material.  Certain ones spark odd associations, or conjure up wondrous images.  For example:

Fluoxetine.  It sounds as if it might describe a rheumy-eyed bovine with muscle pain and mild nausea.  Let's hope they don't use the fluox's tissues to grow the medicine in.

Onglyza.  That's a brand name, not a chemical name, but for me it raises the image of a big fat slug.  Or, if slugs have names and engage in races, maybe slug spectators on the sidelines shout out "On, Glyza!"  or "C'mon Slymeristin!"

Clopidogrel.  This is one of the earliest of these I noticed.  I believe it refers to bad poetry written by a horse. But the very best I have found is:

Rosiglitazone.  Wow.  Makes you think of shimmery pink things, or some hazy nirvana-like state.  Sixties druggie to his pal: "Whoa, man, why'd you go and wake me up?  I was just reachin' the rosiglitazone! Bummer!"  Or a wonderful pinkish, sparkly skyline, maybe with a unicorn standing in the foreground.

We should thank Big Pharma for making life so interesting.

A Hot-Weather Product

The heat wave that peaked yesterday in much of the U.S. (I got a reading of 104 degrees in western Massachusetts) brings to mind lots of hot-weather related images and topics.

For example, how about reaching back in time to Harry Belafonte and that song he used to do about harvesting those bananas?  Definitely a heat-wave image.  Many people used to wonder about the refrain of that song... "day-o, day-o."  Why would banana workers use those particular syllables?  I think the answer lies in another hot-weather association:  They were probably really singing "deo, deo"  --not god, but just the Caribbean-accented first part of the word "de-o-dorant."  (I'm sure the Gillette company would agree, if they thought about it.)

One recent trend in the deodorant industry (men's anyway) has been the switch from "deodorant" to "anti-perspirant."  The former product was intended just to cover up any underarm odor with heavy perfume; the latter is designed to stop you from perspiring at all.  That's why the anti-perspirant canister (in photo) doesn't have the caption "smells great all day" that the other one does. 

For a while, after the anti-perspirant version was introduced, you could buy either, but it's becoming increasing difficult to find old-fashioned "deodorant" these days.  It just isn't trendy, and manufacturers, I'm sure, are looking to close down this legacy product line and push us into the new stuff.  And that's why the AP version has the misleading tag "deodorant" written under "anti-perspirant."  Webster's take note: Deodorant is being redefined!  (Side note: At the same time, it's becoming more costly -- the new high-tech AP is 3.00 ounces, the old stuff, 3.25.) 

Personally, though I was never a huge fan of the overwhelming perfume approach, I don't care much for the new version.  It has the look and consistency of lard (which makes great pie crusts but lacks appeal for use on my body).  It also leaves me feeling ... dry, yes, but the driness is as if I had spread a layer of superglue, or spackling, under my arms.  Which, come to think of it, is probably exactly what's going on.

More important, though, is that the "convenience" of AP over deodorant may have unintended health consequences.  The whole concept of "anti-perspirant" is wrongheaded, maybe even dangerous.  Yes, we all "perspire."  Some of us even "sweat."  And, in polite western society, most of us see that as a problem that we try to cover up.  But it's our body's natural reaction to overheating, just as dogs stick out their tongues and pant for the same reason.  So, if we decide to stop ourselves from sweating (er, "perspiring,"), aren't we going to find out in five or ten years that that practice is causing cancer, giving us heart attacks, or affecting our brains in some way?

In general, I just don't think it's a good idea to try to shut down the body's natural reactions.  My bottom line is this: If somebody started marketing a product to apply to your sphincter, and called it "anti-excretant," would you USE IT?  Good luck with that.  I believe I'll stick with the deodorant, as long as I can still get it.

  

Saving Peanuts

For the second time in just a few days, a food is being maligned.  First it was the poor mulberry, which suffered the ignominy of being labeled un-American (not true) and too often ignored (true, but unreasonable).  Now, however, it's the all-American peanut (not a nut, actually, but a legume) that's under attack.

Of course, as you may guess, the reason is that an estimated 1.8 million in the U.S. are allergic to peanuts, peanut oil, even peanut dust.  And in some cases, the allergic reaction can be fatal.  As a result, several airlines have voluntarily given up serving peanuts on their flights, and many schools have banned anything with peanuts from being served in their cafeterias, or even brought to school in bag lunches.  Now, the Transportation Department is looking at several options for peanuts on airlines, including perhaps a complete ban, or some kind of "peanut-free zone."  (This, even though everybody already complains about lack of legume in those airline seats.)

As columnist Petula Dvorak has pointed out, fears of allergic reactions can really burden the lives of allergy sufferers and their families, restricting their lives, saddling them with constant worry.  That's true, and it's not unreasonable for some limits to be imposed, such as warnings when peanuts are being served, or even the voluntary limitations some airlines have taken upon themselves. 

On the other hand, maybe Dvorak hardly ever eats a peanut, while I probably have some form of peanuts nearly every day (see photo for those I keep within easy reach).  So I can't agree with Dvorak's assertion that "it's not unreasonable" to acquiesce in more and more restrictions on peanuts.  That's a very generous, humanitarian attitude, but if it were extended to everything people can possibly be allergic to, what would result?  

The difficulty is that I don't see how peanut allergies are much different from any other group of allergies.  Shrimp, ginger, strawberries, lactose or wheat -- you name it and somebody is probably allergic to it.  People die from those allergies too.  Further, there have been cases of people dying of anaphylactic shock from eating something they didn't know they were allergic to, or even from eating something they had eaten all their lives without having a reaction.  I have one food allergy that's sent me to the hospital a time or two, and I haven't even been able to identify what it is.  Allergy sufferers need to cope with certain risks that others don't; that's always been the case. 

So yes, by all means, let's do more research about the causes and cures for peanut allergies.  But meantime, please, DoT, keep your hands off my nuts!  And leggo of my legumes!  

Water, Water, Everywhere, BUT

Water - more specifically, the clean, fresh water on which our lives depend in so many ways - is finally getting growing attention, more commensurate with its importance and its scarcity.  

Concerning broader problems of water usage, availability, and shortage worldwide, I recommend a look at the Worldwatch Institute, which did a lot of pioneer work two and three decades ago on the subject and has helped to bring attention to problems.  Also, the National Geographic Magazine published a special issue on water in April.

Today, though, I am more parochially focused on my own corner of the world, Arlington, Virginia, and its water supply.  We are directly across the river from the District of Columbia.  In fact, Arlington's territory is most of what Virginia originally ceded to the nation as part of its federal district (D.C.) but which was transferred back to Virginia in the early nineteenth century. 

Could that be why we share a water system with the District?  Well, the fact is that our water is provided via a large aqueduct that brings it from a reservoir in the District and, though I don't think our water system dates back quite to the early 1800s, it's certainly antiquated.  But that hasn't been an issue except for a recent break in the main.

My gripe?  Our water is putrid, a total turn-off.  Fine for washing the dishes or watering plants, maybe even for making drinks like coffee whose flavor can mask the water itself.  But drink a glass of it?  Not if you have a sense of taste or smell. Right now, the situation is a little worse than normal, thanks to a "temporary" (February through May) change in which the water contains extra-strong doses of chlorine.  As an item by Caroline Butler in today's Washington Post ("Bridging the Water Divide") points out, a glass of water here reminds you of a swimming pool (and I may add, you can smell it from 20 feet away). 

The District will end this temporary situation soon, but only to revert to its "normal" water treatment, the chemical chloramine.  Chloramine differs from chlorine in that it has a different, but still strong and unpleasant, taste and odor; instead of tasting like chemicals, the water will taste sort of flat and dirty, like someone already ran a load of laundry in it.  Further, the bad taste and smell of chlorine will dissipate if the water is left to stand for a while; but no such luck with chloramine, which maintains its foulness unto death (presumably, ours). 

We receive water reports from our county indicating that the water meets all the (federal and state?) specifications, with less than X parts-per-million of this contaminant or that.  All very nice.  I understand that chemicals are a necessary evil to keep our water from becoming the carrier of nasty diseases, and I don't doubt that our water is as safe as any (though perhaps not as pure as we'd like - see Ms. Butler's article again), but the problem our fancy government reports don't address is its taste or drinkability. 

OK, the water may be "safe" to drink, but let's remember that on the Bataan Death March, captive soldiers drank each other's urine without serious ill effects.  Those of us who aren't veterans of that chapter of WWII look for something a little better.  The suggested answer is various types of water filters, but we researched that and found that the cost of replacing filters exceeds the cost of bottled water.  So ... we buy bottled.  Either way, we pay higher and higher prices for water from the tap, but have to spend still more to get something that fulfills water's main purpose in our diet.   

As with our electric utility, which can't seem to deliver power anymore without constant interruptions and surges, our water utilities (mine, anyway) seem to fail us in providing water that's truly potable.