Category: personal science

Let Them Get Sick (running)

Seth Roberts14 Comments

I wrote recently about how our health care system resembles a protection racket. In a protection racket, you or someone else threatens people so that you can make money protecting them. Modern health care, especially in America, ignores prevention. It says let them get sick. Let the general public get sick so that we (health care providers) can make money treating them.

The profitability of let them get sick is illustrated by some numbers in Run Barefoot Run Healthy, a new book by Ashish Mukharji (who gave me a copy). Ashish has run several marathons. Before he started running barefoot, running caused all sorts of problems. To deal with them was costly:

  • Two or three pairs of orthotics (a type of insole): $200-$300 each.
  • One MRI, for what turned out to be ITBS (Iliotibial Band Syndrome, a thigh injury): around $1,000.
  • Twenty or more deep-tissue massage treatments for ITBS: around $80 each.
  • Corns removed (twice): $500 per treatment.
  • Twenty or more sessions of physical therapy for ITBS and Achilles tendonitis: $100-$250 per session.
  • Several visits to orthopedists and podiatrists: $150 per visit.
  • Cortisone injection for plantar fasciitis: $200.

Since he started barefoot running (3 years and 2 marathons ago), he has incurred no (zero) running-injury expenses. Interviews with other barefoot runners convince him this is typical. Long ago a runner friend of mine told me everyone who runs eventually hurts themselves. The truth of this was confirmed many times by runners I met after she said this. Now it appears she was right because all the runners she and I knew wore shoes.

I started barefoot running/walking on my treadmill a year ago. I have never had running injuries (probably because I walk — uphill fast — much more than run). Going barefoot saved time. During the first few months, I got four or five cuts (actually, splits) on the sides of my feet. The skin was split by downward pressure. The cuts made ordinary walking (in shoes) a little unpleasant. I did nothing about them. They healed and have not recurred.

A better health care system would have discovered the damage caused by running shoes long ago. We are lucky to live when personal scientists such as Ashish can figure out the truth themselves and tell others.

Morning Faces Therapy: Personal Account

Seth Roberts6 Comments

Five years ago I heard from someone that he had been successfully using my discovery that seeing faces in the morning improved my mood the next day. Recently I asked him to write about his experiences with it. Here’s what he wrote:

I’m a male professional in my 30s and have had mild to moderate depression since my early teens. I am a considerable rationalist and skeptic, so when I read about Seth’s morning faces therapy in a New York Times article about 5 years ago, my first thought was to doubt its effectiveness. But it was so easy and simple to try, with nothing to lose, that I gave it a shot. To my surprise, it really worked, and the change was quite noticeable.

I do 30-40 minutes of faces therapy every morning, starting around 7:00, 7:15, but the timing moves around a bit based on my schedule or sometimes for experimentation purposes. My first few years I used videos of actual faces (some of the recommendations that I found on Seth’s blog and others that I found on my own). Over time it’s become harder to find quality videos of sufficient length and compelling interest, and I now more often use a mirror. The effect, for me, usually lags by a day or two. So if I haven’t been doing faces for a while and I’m depressed then it takes a couple of day or so to get back to where I should be, and similarly when I stop the faces therapy it takes a few days or so for the depression to return.

While the therapy itself is simple, getting up on time and doing it every single morning has proven more difficult than expected. Even when I do it for several weeks in a row with no break, at some point the tiredness and weariness inevitably kicks in, whether because I was up late several nights in a row and am too tired to get up early, or because I’m traveling, or for other reasons.

Proof the therapy works is that I’m still carrying on five years after discovering it! When I stop for more than a few days, the resultant drop in mood inevitably brings me back.

As an aside, I sometimes spend time in the evening or morning doing other depression exercises, such as writing a gratitude list (google “count your blessings exercise”) or doing meditation/self-hypnosis. In the spirit of self-experimentation, I am currently seeing whether I can get the equivalent effect I get from the faces, by doing these other therapies in morning sunlight at the same early hour as I do the faces therapy. Full results are not yet in.
More about morning faces therapy.

Assorted Links

Seth Roberts2 Comments
  • Benefits of fermented wheat germ extract
  • Why Anthropogenic Global Warming (AGW) is unlikely. A list of AGW-associated “miracles”. Some of my favorites: “Unique among all sciences, climatology develops yet finds no surprises whatsoever, apart from when it’s worse than we thought” and “AGW is a grave threat to humanity, yet it can take the backseat when AGWers have to score their petty points (such as not sharing their data with the “wrong” people)” and “Having won an Oscar, a Nobel Prize and innumerable awards, having occupied more or less every audio or video broadcast for years, having had the run of more or less every newspaper for the same length of time, suddenly AGW leaders declare they’re not “great communicators” and blame this for the generally high levels of skepticism.”
  • Denmark has started to tax butter. “To discourage poor eating habits and raise revenue.”
  • Life-saving personal science: Mom figures out cause of daughter’s problems. “One spring night in 2002, she stumbled upon an old photocopy of a 1991 Los Angeles Times article that described a young girl whose condition had uncanny parallels with [her daughter’s].”

Thanks to David Cramer.

Cheap Safe Remedies: Oatmeal (Cholesterol) & Deep Breathing (Blood Pressure)

Seth Roberts7 Comments

A friend who lives in New York City writes:

The doctor I had when I lived in San Diego believed in always trying the gentlest and simplest remedies before resorting to anything as drastic as drugs or surgery. My cholesterol was high and she suggested I try lowering it by eating oatmeal for breakfast every day, saying it didn’t work for everybody but a lot of her patients had been able to avoid going on statins that way. “But I hate oatmeal,” I whined, like a sulky child. She said perhaps I would get used to it; wouldn’t it be better than being dependent on medications for the rest of my life? So, reluctantly, I bought some Quaker Oats and gave it a try. The results were dramatic — my cholesterol numbers were “perfect” the next time I had a blood test. Dr. Yu was right about getting used to oatmeal, too — I actually like it now, and look forward to my daily bowl.

Perhaps inspired by my success with the oatmeal, I also lowered my blood pressure myself, through breathing exercises. A friend who is into alternative medicine had told me about being advised by several of her alternative-medicine practitioners to try lowering her blood pressure in that way, so when mine was high, I just googled about lowering it until I found a site that offered free demo clips of a kind of breathing exercise geared to music — you can choose whether classical or new age. As it said on the site, they don’t work for everybody, and most people have to do them for twenty minutes daily for a couple of weeks before the benefits begin showing up at all, but some lucky folks see an immediate and drastic drop in blood pressure the first time they try. I turned out to be one of the lucky ones. For months, I did the breathing exercises daily, cued to inhale and exhale by their demo tapes, and my blood pressure stayed down. Eventually i even sprang for the CD set they were selling on the site, just because I got sick of hearing those same melodies on the free demo clips over and over. Now I’ve internalized the rhythms so I don’t need any music at all to cue me, and I can do the exercises anywhere, while doing other things, and my blood pressure has remained low. I do notice that if I ever neglect the exercises, when my life gets busy and I just forget to do them, it starts creeping up again — which is good incentive to keep them up. Basically, the exercises just consist of inhaling to a slow count of 8 and exhaling to a slow count of 16, and doing that for about 20 minutes every day. My blood pressure was around 160/90 before I started the exercises. Now it’s 120/80, just as it should be.

I also find the breathing exercises very soothing, in general. When I’m upset about something like, say, being stuck on a slow bus that is crawling through traffic while I’m in danger of being late to something and am surrounded by screeching children, I find that doing those exercises enables me to be reasonably serene and philosophical instead of miserable and angry and anxious.

Notice that by measuring her blood pressure regularly my friend (a) learned how to control it and (b) collected excellent evidence that breathing exercises help. Because individuals can easily collect such evidence — my friend did so by being lazy — a good response to “where’s the double-blind randomized trial?” is Mark Frauenfelder’s: Big Brother loves you.

Spycraft, Personal Science, and Overconfidence in What We Know

Seth Roberts14 Comments

Edward Jay Epstein‘s newest Kindle book is James Jesus Angleton: Was He Right?. Angleton worked at the CIA most of his career, which spanned the Cold War. He struck some of his colleagues as paranoid: He believed that the CIA could easily contain Russian spies. Colleagues said Oh, no, that couldn’t happen. After his death, it turned out he was right (e.g., Aldrich Ames). At one point he warned the CIA director, “an intelligence [agency] is most vulnerable to deception when it considers itself invulnerable to deception.”

What interests me is the asymmetry of the mistakes. When it really matters, we overestimate far more than underestimate our understanding. CIA employees’ overestimation of their ability to detect deception is a big example. There are innumerable small examples. When people are asked to guess everyday facts (e.g., height of the Empire State Building) and provide 95% confidence intervals for their guesses, their intervals are too short, usually much too short (e.g., the correct answer is outside the intervals 20% of the time). People arrive at destinations more often later than expected than earlier than expected. Projects large and small take longer than expected far more often than shorter than expected. For any one example, there are many possible explanations. But the diversity of examples suggests the common thread is true: We are too sure of what we know.

There are several plausible explanations. One is that it helps groups work together. If people work together toward a single goal, they are more likely to reach that goal and at least learn what happens than if they squabble. Another is the same idea at an individual level. Overconfidence in our beliefs helps us act on them. By acting on them, we learn. Doing nothing teaches less. A third is a mismatch idea: We are overconfident because modern life is more complicated than the Stone-Age world to which evolution adjusted our brains. No one asked Stone-Age people How tall is the Empire State Building? A fourth is that we assume what physicists assume: the distant world follows the same rules as the world close to us. This is a natural assumption, but it’s wrong.

Early in Angleton’s career, he had a very unpleasant shock: He realized he had been fooled by the Russians in a big way for a long time. This led him to try to understand why he’d been fooled. Early in my scientific career, I too was shocked: Rats in Skinner boxes did not act as expected far more often than I would have thought. I overestimated my understanding of them. In a heavily-controlled heavily-studied situation! I generalized from this. If I couldn’t predict the behavior of rats in a Skinner box, I couldn’t predict human behavior in ordinary life. My conclusion was data is more precious than we think. In other words, data is underpriced. If a stock is underpriced, you buy as much of it as possible. I tried to collect as much data as possible. Personal science — studying my sleep, my weight, and so on — was a way to gather data at essentially zero cost. And, indeed, the results surprised me far more than I expected. I could act based on the overconfidence effect but I could not remove it from my expectations.

Why is Health Care So Expensive?

Seth Roberts21 Comments

Because health care costs have been increasing faster than other costs for a long time. Everyone knows that. But why is that happening? Not so clear. This excellent article (via Marginal Revolution) says that health care is not subject to the same pressures as industries where costs have come down. Off-shore manufacturing is one such pressure. For example, a cell phone used in California can easily be made in China. In contrast, the health care a person in California is likely to want (e.g., X-rays, check-ups) must be supplied locally.

Let me suggest other reasons:

1. A large fraction of medical school professors are co-opted by industry. They get lots of money from health care companies. The companies have no interest in cutting costs. They fund research by medical school professors for exactly one reason: to sell more product.

2. The average medical school professor has little idea how to do research. Recently I mentioned a study in which they threw away half of their data. An article about the Potti scandal revealed that Potti’s main co-author, Dr. Nevins, essentially confessed he didn’t understand the research in the papers he had co-authored with Potti. As far as I can tell, medical school professors usually know so little statistics they cannot analyze the data from the studies they do. If you don’t understand how to do research, innovation will be difficult.

But I think the bigger and less obvious reasons are these:

3. The health-care supply chain is long. Some medical school professors can innovate — Peter Provonost, for example. But they face a special problem: the enormous health-care supply chain. It includes doctors, nurses, hospital workers, drug company employees, health insurance employees, medical equipment manufacturers, alternative medicine practitioners, psychotherapists, X-ray techs, health food store employees, and on and on. No other industry is like this. No one in the supply chain can innovate, yet all of them can block innovation. Everyone in the health-care supply chain must be paid. They care enormously about being paid. They hate to take a pay cut. Any innovation — unless it increases the cost of health care — threatens their paycheck. So there is a huge bias in favor of change that increases cost and a huge bias against change that decreases costs.

4. Let them get sick. If a man is not afraid, you cannot sell him protection. This is why protection rackets have two parts: (a) threat followed by (b) offer of (expensive) protection. Modern health care workers understand a similar truth: If a person is not sick, you cannot sell him (expensive) health care. Modern health care workers do not actively make people sick, they let a dysfunctional research system do that. (E.g., cluelessness about how to stimulate the immune system.) Then they pounce — and the money starts to flow. Once the money starts flowing, political power builds up. In a sane world, schools of public health, which care about prevention, would receive vastly more money than medical schools, which ignore prevention. In fact, the opposite is true.

This is why personal science will be so important: It is a way around our massively-dysfunctional health-care system — dysfunctional, that is, for everyone outside it.

 

Assorted Links

Seth Roberts16 Comments

Thanks to Peter Spero and Alex Chernavsky.

Van Gogh Defense Project: Rationale

Seth Roberts2 Comments

A colleague I’ll call John has decided to start tracking his mood for a long period of time (years). He explains why:

A few years ago, after a severe manic attack, I was diagnosed with bipolar disorder. The attack was preceded by an intense period of stress, then two weeks of elevated mood, increased social activity (hanging out and meeting people), and racing thoughts (hypomania). Then I skipped a few nights of sleep, wandered down roads in the middle of the night, and eventually became psychotic, in that I could no longer distinguish between reality and imagination. I was chased by cops on several occasions, and was involuntarily committed to the mental health wing of a hospital for a month. It put a massive dent in my life.

Family, medicine, and time helped me recover. Being out of control like that was fun only for the first two weeks. Having my life turned upside down was not fun either. As I recovered I became increasingly interested in finding ways to prevent a relapse. One doctor said: You have a vulnerability. You need to protect yourself. I agreed.

Looking back on the experience, I realized there was a rise in odd behaviors two weeks before I started to skip nights of sleep and fell into psychosis. There was an even longer buildup of stress, anxiety, and fear in the months before the mania hit. During the last two weeks before the mania, my behavior was different from what is normal for me. I felt elated and had a sense of general “breakthrough”. I suddenly felt no fear and anxiety. I felt on top of the world. I was constantly taking notes because ideas and thoughts were running through my head. I scheduled meetings and social activities almost constantly throughout these two weeks and shared my experiences as my new self. As I started to sleep less and skip nights of sleep, others later told me I seemed agitated and down.

Maybe it is possible to catch these early warning signs and take counter measures before they worsen into mania or depression. This is why I have started to track my behavior starting with mood and sleep. If I can get a baseline of my behavior and know what is ‘normal’ for me, it will be easier to notice when I am outside my normal range. I can alert myself or be alerted by others around me who are monitoring me. Long-term records of mood will also help me experiment to see which things influence my mood. This may give me more control over my mood.

Mood tracking might be a good idea for anyone to do, but it may be especially helpful for people with a bipolar diagnosis. Everyone has mood variation. For bipolars, however, mood swings can be more extreme (in both directions, up and down) , have far worse consequences (psychosis on one end and suicide on the other), change more rapidly, and be more vulnerable to environmental triggers like stress. The good news is that the first changes in mood can happen hours or days before more extreme changes. This gives people a chance to take countermeasures to prevent more extreme states.

The project name refers to the fact that Van Gogh had bipolar disorder.

More About the Migraine Story Comments

Seth Roberts1 Comment

My post at Boing Boing about a woman who figured out the sources of her migraines attracted lots of comments, some of them preventive stupidity (e.g., “anecdotes are not evidence”). I asked the subject of the story what she thought of it. Here’s what she said:

I feel that many people entirely missed the point when reading the original article. I wasn’t trying to communicate that a) all doctors are evil/drug-pushing/uncaring or b) my ‘natural’ solution would magically cure everyone. I have to admit, I’m a little tired of both sides of that old ‘Real Science vs. Natural Healing’ argument anyway. In my case, at least, both extremes are obvious oversimplifications of years of my life that were a very trying, difficult struggle for me.

I am quite aware that the number of drugs I had been tried on was absurd (and layering them as was done: some to ‘prevent’, some to treat as needed, etc, definitely did not help. How can you distinguish what works? You can’t). The armful of drugs to “try until one works” left me dumbfounded for that very reason. At the same time, without the help of a doctor (who happened to be a naturopath, but that is beside the point) who was willing to take a look at my data and listen and apply what she knew, I’d never have reached the stable, much healthier point I’m at now. She hit on a pattern that made a significant difference. One that I wouldn’t have known how to help had I even seen it, because I’m not a doctor.

I believe the take-away message from my story ought to be simply: take charge of your health. I’m also well-aware that this isn’t a new message.
Nevertheless, if you have migraines, there’s only one person who wants them solved more than anyone else in the world, and that’s you. So tracking, I believe, is necessary.

As for my self-experimenting on removing harsh chemicals: so what? It made (and continues to make) a significant difference for me. Perhaps it is placebo, perhaps it’s a sensitivity. I have to say, the allegations that ‘spreading lies about how cleaners cause migraines cause doctors to have to clean up the mess’ strike me as particularly amusing because, with a touch of further digging, one quickly realises that switching to a fragrance-free, SLS-free, paraben-free cleaner isn’t exactly the kind of thing that lands people in the hospital.

I don’t care to argue about so-called natural living. Annie B. Bond’s story (and if I’m tooting horns for anyone, it’s her) and contributions to various websites made me start to wonder about the things I took for granted in the world around me and their impact on my health. If reading my story gave someone else a moment’s pause to consider what had changed in their environment along with the return or start of a health issue, well. I’m the first to admit that correlation is not causation. The science isn’t “perfect”: you don’t live in a lab. To my mind, that’s poor reason to give up before trying. It’s a terrible reason to give up before even considering. Critical thinking about your life, habits, environment, health, and how they intersect is not wasted thinking.

In any case, I have to admit, the only thing that surprised me is how willing people are to get into the arguments. I’ve commented on the natural-vs.-real-science bit above; the anecdotes-don’t-make-good-research theme is really an equally old and equally tedious argument to have with someone (my current faculty still tries to balance on the qualitative vs. quantitative data debate). For those who care, then, I hope they can come to consider this a piece of a much larger, multivariate puzzle of “everyone’s health”. Migraine sufferers, as far as I know, don’t have a “patients-like-me” site dedicated to them. Even if you get nothing else out of a story, you should get a sense of community. Other people are also going through what you’re going through- whatever the cause, whatever the outcome.

One person helped by the Boing Boing story. My comment on the comments.

My Self-Tracking Wish List

Seth Roberts11 Comments

Right now I am tracking 6 things:

  1. Sleep. I use a stopwatch and Zeo.
  2. Weight. I use three expensive scales.
  3. Blood glucose (fasting). I use Abbott’s Freestyle Lite system. I get the blood by pricking my forearm; it’s painless.
  4. Brain function. I use an arithmetic test.
  5. Morning energy. I rate my energy on a 0-100 scale at 8 am and 9 am.
  6. Productivity. I use the percentile feedback system I’ve described.

I keep crude measures of my workouts (on scraps of paper). Two more things I want to track:

  1. Inflammation. I would like to measure the redness of my gums. This is possible (take photo, measure redness), but hard.
  2. The effects of fermented foods, especially their effect on my immune system. I believe fermented foods differ greatly in potency but I am unable to do any quantification.