In re: Conquering the New Year

So it’s a new year and a lot of folks are trying to live up to their resolutions. I’ve never been that into them, maybe its the cliche nature of the whole thing, but this year I’ve come up with a few basic ideas of things I’d like to try and do and hopefully cliche or not I can stick to some of them. One of course is going to the gym. Having quit my last gym when I moved a year ago its been quite a while since going and its hard to get back into the routine (when you get into the routine its great – it’s amazing how hard it can be to break the cycle and get going again, seems like the new year is my chance). Found a place near where we live that seems like a good value and not too crowded. I’ll let you know how that turns out.

The Wall Street Journal had a funny list of 27 Rules of Conquering the Gym – which while often unsaid are pretty spot on.

15. If you’re motivated to buy an expensive home exercise machine, consider a “wooden coat rack.” It costs $40, uses no electricity and does the exact same thing.
….
19. If a gym class is going to be effective, it’s hard. If you’re relaxed and enjoying yourself, you’re at brunch.
….
27. There is no secret. Exercise and lay off the fries. The end.

One of the other things I’ve been aiming to stick to in the new year is following some of Mark Bittman’s advice about reducing meat intake and going to a more veggie diet. While I don’t intend to become a vegetarian (just yet at least) making vegetarian meals more often is part of the plan as well as making other meals more veggie focused. To aid in this effort grabbed the How to Cook Everything Vegetarian Edition iPhone app and flipped through it (also plan to buy the paper copy as despite sharing the material they aren’t exactly substitutes). I am surprised to learn from friends that they aren’t that familiar with the original How to Cook Everything cookbook and am always thrilled to point them to it as a reference. Its the first place I usually go for basic dishes and everyday simple things. I’ll probably posting more on some of the new dishes I try out so heads up on that.

In re: Cleveland Clinic to Add Transparency.

The Cleveland Clinic plans to announce this week it has begun publicly reporting the business relationships that any of its 1,800 staff doctors and scientists have with drug and device makers.

The clinic, one of the nation’s most prominent medical research centers, is making a complete disclosure of doctors’ and researchers’ financial ties available on its Web site, http://www.clevelandclinic.org.

via Cleveland Clinic Discloses Doctors’ Industry Ties – NYTimes.com

Seems like a move more will have to follow, but definitely a good move considering the money out there from Rx companies and the possibility of ‘confused’ motives.

In re: Jarvik out as Lipitor Pitchman

If you remember my post on Dr. Robert Jarvik and RX advertising (In re: Rx advertising – Liptor and Dr. Jarvik) you’ll recall that he was mostly a celeb indorser of sorts and that his medical creditenals were dubious at best.  Well now in the wake of an investigation into the advertising by the House Energy & Commerce committee Lipitor has stopped running the ads that “have Dr. Jarvik enthusing over Lipitor “as a doctor and a dad,”

Despite the presentation that he is a doctor “he [Jarvik] is actually an inventor and researcher. He has a medical degree, but did not go through residency training and is not licensed to practice medicine or prescribe drugs. The commercials also fail to note that Dr. Jarvik only started taking Lipitor about a month after he started touting its virtues under a contract that would pay him a minimum of $1.35 million over two years.”  See NY Times Lipitor’s Pitchman Gets the Boot

Personally as you may recall I am not a fan of the way Rx companies present drugs to us and the fact that such huge amounts are spent pitching them to people (us) who are really unqualified to choose among the products.  While there may be some dialogs that open up because of the commercials and some ailments that would not have been treated otherwise I think if looked at in total we gotta figure out someway of reigning in the advertising practices without stepping too much on the commercial free speech of the Rx companies (don’t worry though, with their lobbying dollars there is no way they end up with too bad a situation in anything).  Also see WSJ Health Blog: Jarvik: My Credibility Was Justified and Fairly Represented (“The record needs to show that the ad campaign Pfizer tastefully presented to the public, using beautiful natural settings and high tech modern architecture, fairly represents me as a world recognized heart expert.”)

In re: Cleveland Clinic has gone global

ccad.gifThe Cleveland Clinic is by far and away the biggest brand in Cleveland and the largest employers (probably the biggest real estate holder, but I don’t know about that one – they do seem to grow by a block or two along Carnegie and Euclid Ave every year as well as branches in Florida for all the snowbirds).  The Cleveland Clinic however has now set its sites a lot wider then the area west of University Circle in Cleveland with plans to run a hospital in Abu Dhabi, UAE (Cleveland Clinic Abu Dhabi page) as well as other plans for Shanghai and Austria, and more likely then not other countries will follow (technically they were already global with a branch in Toronto, CA, (Cleveland Clinic Canada) but nothing on the scale of the proposed 2.5 million square foot facility, planned for Abu Dhabi). See article ‘Cleveland Clinic has its eyes on a global brand‘ Cleveland Plain Dealer

In the comments on the Plain Dealer article a few people complain that this is looking past the people of Cleveland and that as a non-profit this is wrong.  I disagree and think that this is exactly what the Clinic should be doing, eventually the Clinic will reach capacity for Cleveland (there are only so many people who can fly in for treatment) and only so many Clevelanders that need the highly specialized treatments that their true value is seen in.  Further its not like Cleveland or the Clinic don’t benefit from expanding the brand, its very likely that gains and experiences halfway around the world will resonate and provide benefits at home, as well as creating pipelines to feed Doctors to Cleveland for training and back again – taking with them positive vibes (hopefully) about Cleveland (and the US).

America has excelled at high level care (private medicines obvious strength over socialized care) and while we struggle to provide care (at least primary/preventive care) for those without insurance or funds, we can use what we have been good at and help the rest of the world – bring good will, and maybe in the process learn things from them as well.  The more ties we develop, the more interconnected we become and I believe we all benefit – maybe a bit lofty thinking for the subject of ‘just’ building hospitals, but I think its tremendous.

The Clinic branch in Abu Dhabi, capital of the United Arab Emirates on the Persian Gulf, will be a landmark structure in a new financial district to be built on al Sowa Island, one of the city’s many islands.  In renderings, the 360-bed, 2.5-million-square-foot facility looks like a collection of interlocking glass rectangles stacked atop one another….The Clinic has a 15-year operating agreement with Mubadala, a government investment company chaired by Sheik Mohammed bin Zayd al Nahyan, the crown prince of the emirate. The government is building the hospital for an undisclosed amount.

In re: Rx advertising – Liptor and Dr. Jarvik

If you’ve watched any TV over the last few years you may have seen a series of ads featuring Richard Jarvik, for Liptor, a Pfizer drug, that is trying to squeak out the most it can get before the patent runs out in a few years and apparently the sales pitch of Dr. Jarvik whose ‘creation’ of an artificial heart give him doubtful credibility to pitch the drug as some kind of expert, but in reality it is his status as pseudo-celebrity from the media circus years earlier when the artificial heart was debuted.

I am not a fan of Rx advertising and our culture of prescription, so I thought this article on Jarvik  on MSNBC here.

“Dr. Robert Jarvik’s ubiquitous appearances as a pitchman for Pfizer’s cholesterol-lowering drug Lipitor  have worked well, according to Rich Thomaselli of Advertising Age. Thomaselli notes that third-quarter sales for Lipitor hit $3.3 billion, a 15 percent increase over the same period last year.  Particularly impressive, he points out, because Lipitor already was the world’s best-selling drug — generating income of $13 billion last year alone”

In re: Is medicine finally advancing?

Obviously in so many ways our health care has advanced, probably faster then ever over recent years.  Yet in so many ways our health care has not, specifically all the paperwork and administrative back ends that support the massive health systems we rely on.  In fact estimates of medical expenses can put the admin costs of medical care at about 1/3 of the cost, when you factor in all the claims work and back and forth between doctors and insurance and the sending of countless forms and test results between primary care and specialists.

“Health Vault will store all its customers’ health data, ranging from test results to doctors’ reports to daily measurements of weight or blood pressure, online. Individuals then have access to those records any time, anywhere, via the internet—a great boon for those who travel a lot. Medical offices and hospitals who sign up for the service could easily send test results in digital form to the vault, and patients could authorise them in turn to have access to various, carefully circumscribed bits of their personal data. ” ‘Vault is open’ – The Economist

It may be starting to change as Microsoft has recently announced a plan to put peoples health records in secure online storage meaning that when one travels or visits another doctor instantly they could pull up their records.  It stuns me that this is still something that doesn’t exist but it makes me excited to think of the prospects of creating a better and more efficient system.  Of course critics may say that this has problems, and sure there are hurdles of security and privacy as always, but technology will hopefully help minimize the paperwork in the future, processing of claims and speed up the delivery of results.  See an article ‘The vault is open’ at the Economist.com

In re: Pooping pill?

You may feel an urgent need to go to the bathroom. Until you have a sense of any treatment effects, it’s probably a smart idea to wear dark pants, and bring a change of clothes with you to work.” 

Alli warning labl on ‘treatment’ side effects.

You may have heard about the new wonder drug, the over the counter weight loss pill Alli (actually its just a lower dosage of a long time Rx drug).  Anyway, the pill is supposed to keep 25% of the fat you eat from being digested (doesn’t do anything to stop calories from carbs and protein from being absorbed – too bad for us carb addicts..)  Anyway, the drug sounds wonderful until you read (and they aren’t being too subtle about this although the angry aussie does translate to even less subtle warnings at Why Am I Angry, alli: Miracle diet pill with teeny-tiny side effect. 

“How do you prevent these side effects? Simple. Just limit yourself to no more than 15 grams of fat per meal. Yes, you heard that right — in order to get the benefit of alli, you’re supposed to eat a low-fat diet. Correct me if I’m missing something, but if you’re already eating a low-fat diet, why would you need alli?

Putting it a different way, if alli prevents you from absorbing a quarter of the fat you eat, that means that for a meal with 15 grams of fat in it (at nine calories per gram), it’d be saving you approximately 36 calories. Not to get all philosophical, but if someone were to ask me how many calories it would take to get me to risk shitting myself in public, it’d be a hell of a lot more than 36.” from Salon Broadsheet

In re: The inreblog.com smoking debate…

In case you don’t visit the comments you have missed a little debate following my post “In re: Head for the border – Ohio smoke free as of today” that touches on some of the issues of smoking bans you can see them here.

In re: Head for the border – Ohio smoke free as of today.

As of today the state of Ohio, the entire state, not just some neighborhoods have gone smoke free.  I think this is great, I love going out and I love coming home not smelling of smoke (and its not just smelling of smoke, its smelling of smoke so much that your clothes need dry cleaning, you need a shower and you can taste it the next morning).  Anyway, some of my favorite bars in Cleveland will now be smoke free which will be a great change.

I also wonder if anything here in Columbus will change now that the state law will provide a bit more enforcement (eventually, they have 6 months to workup a plan)  As of now there are a number of bars I don’t like to be in because they happen to be as smoke filled – if not more so – then they were before Columbus went smoke free.  The problem was in Columbus there is no one to enforce the laws and certain bars, not naming names…B Hamptons, Mickeys, Zenos…among others switched to the infinitely covert system of providing ash trays in the forms of plastic shot glasses of water (B Hamptons) or even more clever the empty altoids tins at Mickeys.

In re: Who runs only one marathon?

Running a marathon sounds so lazy, at least compared to Dean Karnazes, ‘ultra-marathon man’ who is running 50 marathons, not in one year, but rather 50 consecutive days.  He may be crazy, but he is running for a cause, raising money for Karno kids that works to encourage kids to be more active.  Dean has been called the fittest man alive, committing such crazy feats as running 350 miles (without sleep) that make the tour de france look sissy.  Dean is a well educated man and talks very well, in an interview I saw recently I really bought into his message that he is aiming through this ‘North Face Endurance 50′ (everyone needs sponsors!) to show the potentials of the human body and what limits we can be pushed too – and that we are not designed to sit in cubes all day.  While cubicles may be great for our economy it is obvious that it is having disasterous effects upon the health of our nation.  I hope to continue a bit on this later by highlighting a few companies that have attempted innovative ways to get their employees active.

In the mean time you can check out Dean’s site Ultramarathon Man & the North Face Endurance 50 website or check out his blog Endurance Is on the whole thing.

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