Coffee for Long Life

Posted on May 18, 2012 by

I’ve blogged before about the relationship between coffee and psoriasis, i.e. that a study has not shown any evidence that coffee makes psoriasis worse (or better).  However there are many studies showing the benefits of coffee.  Now it seems that we can add one more, it may be that coffee drinkers live longer than non-coffee drinkers.

Although the study did emphasize:

“this doesn’t prove that coffee makes people live longer, only that the two seem related”

As good as this news is, I noted that the article states early on that coffee may raise blood pressure and LDL (the bad cholesterol).  This spiked my interest as I just had my blood test results come back from my remicade infusion on Wednesday, and although my blood pressure was fine during my infusion my blood tests showed that my LDL is raised.  My doctor told me to decrease my intake of animal proteins and eat low fat diary products.  My diet is pretty good however I have been eating a lot of fried chicken as I find it helps settle my bowels.  My doc wants me to take some medication but I think I’ll try cutting out the fried chicken first to see if it makes a difference.

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Kettlebells & Jujitsu

Posted on May 17, 2012 by

I realized I haven’t given an update for some time on my exercise routine, so here it is.

I found that my enthusiasm for going to the gym in the last few months has really dropped off and so I started looking at what other exercises I was interested in trying.  I had heard a lot recently about kettlebells and as it wasn’t something I had ever done before I decided to give it a try.  Another benefit to using kettlebells is that I can do it at home.  As you may recall the gym I belong to was getting really crowded during the my usual workout times and I’m sure that not being able to use my regular machines had a big part in my interest falling off.  Another benefit was that since I’m training at home, I could rope in the wife and kids to exercise along with me too.

With this in mind I ordered four kettlebells.  The first question I had was what size kettlebell should I start with?  I read on bodybuilding.com that:

“A male starting to work out should begin with a 16 kg/35-lb kettlebell, while a fit man can begin with a 24 kg/53-lb kettlebell.”

Meanwhile this site and this site stated that men should start with a 35lb kettlebell.

Well, I do go to the gym pretty regularly so considering myself fit I ordered the 24 kg kettlebell.  Now with the benefit of hindsight I should probably have gone with the 35lb!

I bought a kettlebell workout DVD recommended by Joe Rogan (which name I can’t remember as I type this), and with the whole family ready I plugged it in and started it up.  I managed ok with the 24kg kettlebell with all the arm exercises close to the body, and the leg exercises where also the kettlebell is held close to the body.  However problems came with exercises requiring holding the kettlebell away from the body.  For example there is an exercise called the windmill, where one holds the kettlebell with a locked out arm above the head and then bend down and touch the floor with the other hand (thus looking like a windmill), and I just couldn’t manage that with 24kg.  It was just too heavy.

I was a little worried when I started kettlebells about losing some muscle size as kettlebells aren’t really acknowledged as the best type of exercise to put on muscle mass.  This indeed is probably the case for the serious bodybuilder who is training to put on muscle mass for a competition in the future, however for a simple Joe Blog such as myself who wishes to just keep in good shape, I’ve found it to be excellent.  So far I haven’t noticeably lost any size, although if I had to be a severe critic then my shoulders and arms may be a little down.

The kettlebells are excellent for the “core”, which really is just a trendy term for the abdominals and muscles in the lower back.  Doing something like the windmill really forces you to contract your stomach and lower back to keep it firmly in place during the exercise.

The other thing I like about working out with kettlebells is that the workouts are a little shorter than going to the gym. They are more intense, which cuts down on the workout time.  So overall I’m really enjoying the change – which is exactly what I wanted, i.e. getting my motivation to exercise back up.  Yet another added benefit is now that I’m training at home I have a team to keep me on track.  Yesterday I was feeling dog tired after work and would have skipped the workout however once I got home my kids had already set up and were waiting to exercise.  I had no choice but to workout, and once I got going it really wasn’t so bad!

I have also started doing some Jujitsu on Saturdays.  I had heard Joe Rogan rave about how fun jujitsu is and so I decided to try it out, again roping my boys into doing it with me.  Well we had our first lesson on Saturday and I can confirm it is a whole lot of fun!  We can’t wait to have our next lesson next Saturday.  What a wonderful way to exercise – i.e. it doesn’t seem like exercise at all.  One has to really use one’s brain as well as muscles to work out the best place to position hands and body; get the best leverage etc.  It is an amazing combination of mind and muscle working together.  If you haven’t tried jujitsu and are looking for something to help you regularly exercise, I highly recommend trying jujitsu.

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Snugfleece – Mmmmmmmm

Posted on May 12, 2012 by

I’ve blogged many times about the difficulty I have sleeping due to pain in my back and ribs from PsA, and how the pain gets worse the closer I get to the time for my Remicade infusion.

I find my bed to be pretty hard – which seems to accentuate the pain – and therefore usually put down 3 pillows to lie on to try and soften it up.  I also take celebrex and tramadol before I sleep.  Invariably I wake up though at around 2am and have to take another dose of tramadol.

Well in 2010 I stayed at the Trump Soho hotel in New York and absolutely loved the beds there.  I had a wonderful sleep and have kicked myself for not looking into what type of mattress they had.  I was looking on Amazon the other day and stumbled on an advertisement for the Snugfleece.  Is this what they had at the Trump Soho?  I took the plunge and ordered from Amazon the 1 3/4 inch pile height wool mattress cover.  Since I live in Thailand they can’t deliver here, so I have to deliver first to a US address I have set up.  I use myus.com and have found them to be really good.  Once it arrives at my US address they then forward it to me in Thailand.

They used DHL and I found out that unfortunately DHL don’t have a very good relationship with Thai customs.  You see, Thai customs is famous for being the most corrupt government department in Thailand.  This is a well known fact in Thailand.  So when the package from DHL got to customs, they slapped on a duty that came to the same amount as the purchase price!  Basically I ended up paying double.  Ugh.  My wife called and spoke to someone there and they nicely told her off the record that she should try and avoid using DHL if possible.  However I think the issue is not DHL, but rather express delivery, with custom’s logic being if someone is paying for super quick delivery then they’ll pay more for duty. Interestingly, the following day I had another package arrive from the US which came via DHL but was “super saver” so took about 20 days to arrive.  I didn’t have to pay any duty on that and yet the purchase price was more than the snugfleece!

I promptly set up the snugfleece on my bed and have had 2 sleeps on it since.  First reports are that it is indeed very good.  I have had two nights of great sleep so far and my fingers are crossed that it continues.  I am surprised that I am sleeping so well less than a week out from my remicade.  The snugfleece sure is making a difference at this point.

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Why the US Healthcare System Absolutely Sucks

Posted on May 7, 2012 by

Imagine a struggling family with a sick child.  Now imagine a very wealthy corporation that has hired a muscle bound brute to stand at the door of the local clinic and prevent the parents from taking their sick child inside to get medical treatment.  The child gradually gets worse, and sadly passes away.  The grieving parents are distraught.  What to make of that wealthy corporation which denied treatment?

This isn’t a movie, or an experience from a 3rd world developing country.  This is today’s experience in the USA.  Now, if you are a US citizen and your reaction to this is denial, then guess what, you’ve been bought by the lies from that wealthy corporation.

The crazy thing is, the fact that the US healthcare system is unfair, expensive and corrupt (as it is manipulated via the huge profits to the pharmaceutical and health insurance industries) is well researched, documented and published. About a decade ago I did a research paper for an MBA, comparing the US healthcare system with other healthcare systems, and I was amazed then at the amount of data on just how bad the US healthcare system is.  Nothing has changed.  I then read an article a couple of days ago about yet another study:

“A study of 13 industrialized countries released Thursday showed Japan spends the least on health care, while the United States spends the most without providing superior care for the money.”

To someone with a scientific, logical mind, the facts are startling.

“When added to the population of uninsured (approximately 16% of the U.S. population), a total of 40% of Americans ages 18–64 have inadequate access to health care, according to the Consumer Reports study”

Now all the other first world countries have a version of a universal healthcare system, which basically guarantees healthcare for everyone.  For a good summary of the issues between the US system and a universal system, read this blog. It is buried down in the article, however the author pinpoints the crux of the issue, succinctly stating:

American democracy runs on money. Pharmaceutical and insurance companies have the fuel.

To put it bluntly, pharmaceutical and insurance companies pay huge dollars to influence the government to maintain the present system.  They are the “wealthy corporation” blocking the door for the ’40% of Americans aged 18-64′ who cannot get adequate access to healthcare.

Still in denial?  How about another quote from the study:

“Common prescription drugs cost one third more in the United States compared to Canada and Germany, and were more than double that paid for the same drugs in Australia, Britain, France, the Netherlands and New Zealand.”

That’s right US Citizens, in the ‘world pharmacy’ every time you walk in that door the owner rubs his hands in glee and brazenly charges you double what the Aussie, Brit, or Kiwi just paid.  And you bend over and take it saying “thank you sir, may I have another?”

So why are these pharmaceutical and insurance companies able to effectively get away with murder in the US?  They have beaten David Copperfield at his own game, and managed to deceive a huge portion of the public through deceit.  Firstly, they lobby government for favorable laws and regulations, through the billions of dollars at their disposal.  Secondly they do a wonderful job of using the best public relations company money can buy to deceive the public.  What are the weapons of propaganda they use?

They know that Americans are fiercely proud of their victory of democracy over communism, so they link universal healthcare to communism. “Universal healthcare is socialist” they cry.  “We aren’t communists!” they cry.  Then they laugh as the US public fall in line and continue to pay double prices.

They use their public relations company to find and promote “outliers”.  What are outliers?  These are isolated incidents that happen outside of normal practice.  Typically they will find a Canadian (or anyone from a universal healthcare system) who died while waiting for a surgery and bleat “see, their healthcare system isn’t better – you will die while waiting for treatment”.  Naturally they don’t address the millions who get much better treatment in comparison to those in the US, or the millions in the US who die or are bankrupted through not being able to afford treatment.  They pay big money to the public relations company to make sure you don’t get those facts.

And the third reason is they appeal to every human’s fear of failure.  They turn the healthcare system into some kind of competition, implying that if Americans change the system then they are somehow “losing” and have personally “failed”.  And no one wants to be a failure!  The best example of this is how they portray the comparison with the Canadian system.  Many studies of the US system look at it compared to their neighbors.  This is because both healthcare systems were similar in the 1960s and then took different paths.  Actually the Canadian system is just one example of a universal healthcare system, and any type of universal healthcare system is going to be better than what the US currently has.  However the pharmaceutical and health insurance companies know that they are going to lose huge profits if the system changes, therefore they imply rather strongly that somehow if the US discards the current system in favor of a better universal healthcare system, then somehow they have “lost” some kind of competition to Canada.  Smart eh!  Those public relation companies really know how to manipulate the emotions. No countryman in the world wants to lose to their neighbor, and by turning the decision on a healthcare system into some kind of national competition the pharmaceutical and insurance companies are laughing all the way to the bank.

How does all this relate to psoriasis and psoriatic arthritis?  Well, in the UK, Australia, NZ, Canada and every country with some type of universal healthcare system, if one is diagnosed with PsA then one will be reviewed by a rheumatologist, and if appropriate will be put on some kind of biologic treatment.  Taxes will provide for the treatment, so it isn’t dependent on whether you have money or not.  It is fair.  It is universal treatment, i.e. the same conditions are applied to everyone.  In the US, if you are one of the millions without insurance or with inadequate insurance, then you will have to either suffer while the muscle bound brute laughs, or use your life savings / mortgage your house to pay for your treatment.

The bottom line – everyone in the US would not only get better access to treatment but also it would cost the government much much less if some kind of universal treatment was adopted.

Stop the bully.  Stop the pharmaceutical and health insurance companies from murdering people.

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Religion Holding Back Humanity

Posted on May 3, 2012 by

I usually don’t delve into such a controversial subject on this blog, however my psoriasis is pretty good for this stage before my next remicade infusion, and my arthritis is not painful either, so I’ve gotta talk about somethin’!  As regular readers will know, I love science fiction and research into anti-aging etc.  I certainly have an eye on the future and since I have a couple of young kids I often wonder what kind of world they will find themselves in, in 20 years time.  One aspect that does make me worry is how evil religion is.  Now, if you believe in a particular religion and are not confident in yourself and thus are feeling some revulsion at that last sentence, you probably should not read on.

When I was a teenager I joined the church and became a Christian.  This was a fundamentalist church so I got to experience lots of things such as noisy singing sessions, hell fire & brimstone preaching, casting out ‘the devil’, speaking in tongues, healing the sick etc. etc.  I was also part of a youth organization that arranged interdenominational (that means Christians from different churches, e.g. Baptist, Anglican, Brethren) concerts and so I got a good look at how more traditional Churches held meetings too.  I stayed a Christian for about 5 years, and did a lot of study over those years in order to answer the questions that came up as well as become proficient at ‘defending the faith’.  As a teenager of course I had many of my classmates questioning every aspect of Christianity, so I needed to be able to defend it in order to avoid embarrassment (which as most people know is probably at its worst in teenage years).

I became very proficient at arguing Christianity’s case.  However the problem was that as I gained more knowledge, although I was able to easily fend off questions from ‘non-believers’ as they hadn’t done the level of study I had, I found that I was developing more and more questions to the ‘evidence’ I had, and no suitable answers were forthcoming.

I consider myself a fairly logical person, and most people who know me would probably nod their heads and say ‘yup’.  I am also fairly confident in myself, so am not afraid to ask searching questions about why I believe a particular thing or act in a particular way. When I brought my questions to senior people in the Church whom I respected, I found that they had no answers. Actually, most of the time they would just reply with canned responses which were drilled into all of us at meetings, e.g. “you must trust god”, “he loved you so much that he died for your sins”, or the classic “he is testing your faith”. Later I came to realize that this kind of control is not confined to Christianity.  Practically all the major religions will make you the ‘bad guy’ if you ask a question which gets close to exposing the truth. “You don’t have enough faith”, or “god will give you more wisdom in time”.

After many years I came to the point where I had to make a choice.  Throw away my brain and reasoning, accepting that Christianity is not logical, or accept that Christianity is a man-made fairy tale.  Fortunately I held onto my brain, as in the following years I discovered so much evidence that Christianity (and many major religions) follow a familiar pattern.  That is, they are extremely old, were originally founded by someone with good principles at heart, and were consequently ‘commercialized’ by a corrupt group of ‘leaders’ who realized that they had a great tool to control people and make a huge amount of money.  These people ‘crafted’ the religious story to make it much more palatable to ordinary people, and thus cement their grip on power and money.

Now don’t get me wrong, there are great things within religion.  Foremost is probably their ability to create a caring community.  Loneliness, lack of friends, lack of companionship, and a lack of a sense of belonging are incredibly strong emotions which can in turn make a person incredibly unhappy. Loneliness is so prevalent in today’s society – especially in the West where independence pushes young adults out of the family home early.  There are many people within the church primarily because they have found a surrogate family.

Although the church provides this “sense of community” or “family” benefit, from my point of view it comes at an unacceptable price. That price is prejudice and intolerance.  Add to that a generous dose of guilt and low self esteem.  See how well a gay is accepted as normal as a person’s skin color is accepted, in a church.  Or how about being told that you are unacceptable as a person and you will never ever meet the grade, without accepting the blood of this person who lived 2000 years ago (and by the way, never claimed that they were god).  Absolutely bizarre.

After I left the church I found that I also had to make a new set of friends. You see unfortunately my “Christian friends” could not accept me as I was.  They would fall back into old “taped” routines and think I had “slid back” rather than actually moved forward – which is what had happened.  Instead of trying to understand with an open mind I guess they felt threatened and tried to bring me back to their level.  Ridiculous phrases such as “you’re going to burn in hell” comes to mind.  People for centuries sincerely believed that the earth was flat, and also that the Earth was the center of the universe.  In time people will come to accept the truth, however I do wonder at how much this crazy belief system is holding back humanity’s progress.  Ugh, don’t get started on how much war and violence is instigated due to religious prejudice and intolerance.

I recently read a book (The Heathen’s Guide to World Religions by William Hopper) that really does a great job at exploring the facts behind the major religions, looking at the evidence that exists on how they originated and how they have evolved over time.  With my fondness for logic and scientific evidence, I found the book covered the facts well in a light-hearted manner.  Very easy reading.  Having spent time previously in a Christian church I was particularly interested in the section on Christianity, and the explanation of the history of the bible was something new for me.  The majority of Christians have no idea where the bible came from.  “From God” they will say.  But how did it actually get put together?  Who wrote the parts and put them together?  I was amazed to read that the bible as we know it today wasn’t actually put together until over 300 years after the death of Christ.  There existed a whole lot of religious writings and a group of a couple of hundred religious leaders got together to debate and vote on which should be included in the bible.  There was a lot of arguing and certainly no unified agreement on what should be in and what should be out.  So much for divine direction!

The purpose of this blog isn’t to debate whether a religion is correct or not.  If someone wants some “truth” (which I define as scientific facts) then I encourage you to read William’s book about religions.  If there are any Christians still reading at this point they may be playing an old tape in their head such as “Christianity is not a religion, it is a way of life”.  Ha.

One of the guys I follow on twitter is friendly atheist Hemant Mehta. He also writes a really entertaining blog and I’d like to link to a couple of brilliant articles he has written recently.  Hemant lives in the US where there is a huge religious base of people blindly following Christianity as this is what they were brought up with.  Even though I’m living in a culture with a huge religious base (in my case it is Buddhism) I don’t envy Hemant as in my experience Buddhists are far more tolerant than Christians.  The first article is where he so nicely replies to an email sent to him by a 14 year old girl regarding religion, and gets a response from her mother.  You can read that here.

The next article is about pastors from Christian churches ‘coming out’ and admitting that god doesn’t exist.  As one can imagine this would be an incredibly difficult thing to make public.  It is a really interesting read – and you can find that here.

I dream of the day when we will look back on religion in the same light as how we now look on the generations who believed that the world was flat.  A day when we will have wonderful caring communities, based on our common aspects, i.e. our humanity, our joy of spending time together with friends and family, health, excitement and enjoyment of new discoveries.

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What Happens If I Stop Remicade?

Posted on April 26, 2012 by

In the lead up to each remicade infusion I look closely for any arthritis symptoms.  Sure I am aware that my psoriasis gets worse before my infusion is due, however I’m unsure whether there is any hint of arthritis peaking through.  I know my lower back pain and ribs get very sore before I have my remicade and have blogged about this – however I don’t see any signs of sausage fingers which I used to get quite severely in my right hand before I started on biologics.

The reason I look for arthritis symptoms is because in the back of my mind I have a little “what if” itch.  The itch is “what if I ever have to change my job?”  Why is changing my job important?  Because my current employer covers the cost of my remicade and there is no guarantee that any future employer would be so accommodating.  To any non-biologic-taking people out there, you may be wondering why this could be a big deal.  Well, the cost of my remicade infusion is currently around 150K baht for each dose.  That is around USD$4,900.  So my annual cost of remicade comes in at close to USD$20K.  Basically I could not afford to cover that cost myself.

So I look for arthritis symptoms wondering if the remicade has pushed it into remission, and that the arthritis may not return if remicade was stopped.  “Does this happen”?  I hear you ask.  Well, maybe only the people with PsA and on biologics are asking!  Well, I’m not sure.  However recently a scientific paper was released regarding patients with inflammatory bowel disease taking remicade:

A recent study was published showing that patients that were in remission as a result of infliximab and immunosuppressive therapy (no steroids) had a 50 percent chance of relapsing within a year after ending the treatment.

That is, patients with IBD (which like PsA is a result of an overactive immune system) who are taking remicade, can go into remission.  Further, it seems that 50% maintain that remission for more than a year.  Would the same hold true for PsA?  I’d like to see some studies.

Am I likely to stop taking remicade to see if I’m in remission?  No way!  Apparently if one is on a biologic and stop taking if for a period, and then start up again there is no guarantee that it will work anymore.  Apparently 30% of people with IBD who stop remicade will fail to have any response if they start again.  However it depends on how well the remicade worked for you in the first place.  The better the response you had then the more likely it will work again after taking a break.

I got all this wonderful information from Dr. Karen’s colitis blog here.  Well worth the read.

Posted in Psoriasis, Psoriasis Treatment, Psoriatic Arthritis, Remicade, Remicade Administration, TNF Blocker | Tagged | Leave a comment

Put Women In Charge

Posted on April 18, 2012 by

Before we go any further I must stress again that I am a male!

Last year I blogged about an American psychologist studying the incidence of violence throughout world history, who noted that our current period is the most peaceful (in terms of violence) that has ever existed and that this is in part due to the empowering of women.  He stated:

By all measures men are the more violent gender.

At the time I wondered out loud what would be the effect of making it compulsory that all head military positions in the world be occupied by women.  I would hazard a guess that the world would be even more peaceful.

Well related to this a scientist has been studying “morality”.  He has devised a test to measure morality and see how it changes over time (i.e. how our work experience affects our morals).  You can read the entire article here and even take the test to see how moral you are, however in summary he found that overall women are more moral than men.

“Women prefer to make their decisions based on how it impacts others – which tends to produce better decisions – while men have a more individual approach and are more self-interested.”

So again I wonder what would the world be like if we put women in the major decision making roles.  Now I know that this would not be perfect – I have had my share of scary bitch bosses in my time and I shudder to think what damage they would do if in control of a country – however overall I’m sure it would be better than our current practice. Just think of the crazy violent places in the world right now and who controls them – North Korea, Afghanistan, many countries in Africa etc. We need an overhaul.

I love science fiction, especially space opera, and I’ve just finished reading the Sundiver novel.  I’ve finished all the recent books of the great space opera writers and so have been going back to those novels written 30-40 years ago.  I’ve found a lot of them are crap as they weren’t able to accurately predict the way the world would go (e.g. they talk about storing information on tapes in the year 2145 or something like that), however the Sundiver novel was actually pretty good.  One really interesting part was how in the future the governments of Earth had devised a scientific and accurate test to measure one’s propensity to violence.  It was compulsory for every citizen (men and women) to undergo (regularly) this test, and anyone testing positive was prohibited from certain occupations / privileges.

I really believe that for the human race to steam ahead at great speed we need to solve this issue of violence.

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Cryogenic Chamber Therapy for Psoriasis?

Posted on April 15, 2012 by

I was listening to Joe Rogan’s podcast the other day (I’m usually a few days behind as I download them and listen when I have time), and one of his guests talked about top level football athletes in the US taking a radical new treatment called Cryogenic Therapy in order to aid recovery.  Listening to a description of the treatment on the podcast had me shaking my head in disbelief.

Apparently the process is one first strips off to wearing just a bathing suit, and gloves, earmuffs and surgical mask in order to protect from frostbite.  Then there are three steps:

It’s actually a complex consisting of three rooms: in one the temperature is a constant -10, in the second -60 and in the third -110 degrees Celsius.

A study has been performed on the treatment and you can read about it here.  Apparently the benefits are:

When parts of your body are sore, you apply an ice pack, because the sudden cooling creates a numbing sensation which overrides the pain. Entering the chamber can also work in the same way. If there is a nerve in your body which is causing a lot of pain, it can be desensitized by the effect of the cryogenic chamber. This is why many athletes and pro sportspersons use cryogenic chamber therapy in the process of recovering from injuries or recuperating after a hard season.

This can help in various conditions such as muscle and joint pain due to excess wear and tear and activity, fibromyalgia and psoriasis. The release of endorphins has a long lasting beneficial effect on the body and even inflammations have been seen to reduce quickly.

On the other hand, people suffering from age related problems such as rheumatism or chronic joint pains, can also benefit from spending time in a cryogenic chamber. They are reported to feel reinvigorated and more mobile after therapy in a cryo chamber.

Are there risks?  One only spends a maximum of 3 minutes in the coldest chamber, to minimize the risk of hypothermia and permanent nerve damage, however there is some speculation that the destruction of cells through freezing may raise the risk of cancer – although no studies have been done.

Here is a great video of a center in Germany, explaining how it works:

Icelab -110° Celsius

Does it work?  There are lots of athletes who believe so, and the study quoted above also demonstrated a definite benefit in recovery time.

Does it work for psoriasis?  I’d like to see more studies on this or try it out myself.  Unfortunately I don’t live near anywhere with a Cryogenic Chamber.  If you live in Texas or Northern California though, you are in luck.  Here is a good video of the one in Texas.  If you try it out, let us know if it works!

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Baloney Mass Index – BMI is WRONG 50% of the time

Posted on April 11, 2012 by

I’ve ranted before about the problems using BMI to try and determine if one is overweight or not.  The Body Mass Index (BMI) was created to review large (excuse the pun) populations, NOT individuals. As Wikipedia notes on explaining the creation of the BMI:

BMI was explicitly cited by Keys as being appropriate for population studies, and inappropriate for individual diagnosis. Nevertheless, due to its simplicity, it came to be widely used for individual diagnosis, despite its inappropriateness.

The article further clarifies:

BMI has become controversial because many people, including physicians, have come to rely on its apparent numerical authority for medical diagnosis, but that was never the BMI’s purpose…

I explained in an earlier blog that hip to waist measurement is actually a much better predictor of obesity than BMI.  Just Google “BMI vs. hip to waist ratio” and you’ll see all the studies.  One of the quotes from these studies is:

Cutlip agrees that BMI can be way off, especially when it comes to assessing a particular individual. The commonly used measure can give a skewed result not only for fit body builders who come out with a high number because of the extra weight associated with muscle, but also for the elderly, who tend to have scores that underestimate obesity because they have so much less muscle.

The study succinctly states:

New research shows that there’s a better, more informative way to figure out if you are overweight — the waist-to-hip ratio

Now these studies are from 6 years ago!  So why when I go to see my doctor do the nurses still take my height and weight to work out my BMI (and then consequently tell me that I am overweight)!  Why aren’t they taking my hip and waist measurements?

I’m not sure.  Maybe it is perhaps some conspiracy with insurance companies, pharmaceutical companies and doctors.  Obesity is big business = big money.  When I applied for life insurance one of the companies wanted to double my premium because my BMI showed I was “overweight”.  Hang on, I said, my body fat percentage is at the level of an athlete – who are you calling fat?

Then this last week I see another study has been produced showing that using BMI as a measurement of “fatness” is flawed.  “But hang on” I hear you say, “if the BMI is right in about 90% of cases, isn’t it worth hanging on to it?”.  Absolutely – if it will pick up 90 out of 100 people correctly (sorry to the remaining 10 who will get ‘misdiagnosed’).  So how accurate is BMI?  Here is the kicker:

An analysis comparing the BMI to a blood test and body scan found that the BMI was wrong for half of women and 1 in 4 men.

Yep, you read that right – BMI is wrong in 50% of cases for women.

Doctors it is time to kick out BMI and bring in the tape measure.  Don’t make excuses because the studies don’t back up your practice.  Just do it.

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Tests for Arthritis

Posted on April 3, 2012 by

I read another great article this week by Dr. Nathan Wei on the usual tests ordered to confirm or monitor the disease of arthritis.  The tests he lists are:

ESR (erythrocyte sedimentation rate) which measures inflammation.  Naturally someone with active arthritis will have a lot of inflammation, which is what causes the pain.  Normal value is 0-15 and when my arthritis was really flaring before I was on a TNF inhibitor it was over 50.

CRP (C-reactive protein) also measures inflammation. Hmmmm – looking at my history I see it got up to 154 – not sure if that is high though – for a reference I have 0-10 but it seems pretty low!

Rheumatoid Factor is positive in about 70-75% of patients with rheumatoid arthritis.  I had the test twice in 2004 and once in 2007, and it was negative in all cases.

Anti-CCP is apparently more specific than Rheumatoid Factor and if positive early in the disease may indicate a more aggressive arthritis.  I’ve never had this test.

ANA is useful for testing for lupus.  Patients who test negative for ANA are 99% certain not to have lupus.  However apparently 30% of healthy people will test positive.  So I guess ANA is perhaps useful for showing if someone is more likely to have an autoimmune condition.  As Dr. Wei notes, if it is positive then it indicates to doctors to test further.  My ANA was negative twice in 2004, and positive in 2007.

 

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