Motorola DROID: I'm in love.

I resisted getting an IPhone until it met four benchmarks. Well I serendipitously was in the Verizon store on Friday November 6th(the first day of release) because my phone hinge spring was sprung. I saw the signage for the new Droid and asked about it and found it met all four of my criteria to get an IPhone. I've learned that it not only met those but exceeded any and all expectations. It can truly be the IPhone Killer Motorola and Verizon wants. The four criteria were:

1. Data plan less them $70/ month for ATT: It was $30/month for Data on top of phone plan
2. Cost less then $400 or even $200: It was $100 for me with rebate with 2 yr contract
3. 16 or 32 Gigs Mem for that price: It comes with 16 and owner can increase with Mem card.
4. Being usable on Verizon ( I'm stuck with verizon plus network coverage the best): It was
5. An added bonus was that all the programing was by Google (Big Brother but the best software producers)
6. Another added bonus: All the accessories are significantly cheaper then for IPhone and they were all 25% off list (more on that below).

So I bought it.

I then had to decide on the accessories to get. So I got one of each and returned those I didn't like. Here is what I consider the minimum to get full use out of your phone (w what I paid):

1. GPS car window mount ($30, $22.50 w discount): $130 for IPhone version
2. Bedside Base ($30, $22.50 w discount)
3. Extra battery, but only if you listen to 9-12 hours of podcasts or music daily like me ($40, $30 w discount).
4. Hands free wired headset with headset button ($20 at best buy)
5. Waist/belt pouch ($10 at walmart)
6. Car Charger($12)
7. Car radio Sync (I use a cassette type that plugs into my cassette player)($20).

I want to give you some examples of how smoothly and integrated this phone and the apps are. The app I use the most is Doggcatcher. It took about 8-10 hours to get set up but saves me 30 minutes a day. It downloads all my audio podcasts I subscribe to (186) and places them in a playlist. When I have listened to them they are removed. If I want to pause them or take a phone call I click the in line headset switch and the podcasts pauses and/or answers the call. When I click again it restarts the podcast were I left off or 15 seconds before , if a call. Last week I was in New Orleans and needed to travel. I set up the GPS navigator and began listening to my podcasts. When the GPS needed to give me directions it turned off the podcast, gave the directions and resumed the podcast. I didn't miss a second. I next found out that if I got a call all I needed to do was swipe the screen with my finger and I had a handsfree speaker system that both I could hear well and it picked up my voice at normal volume from 2.5 to 3 feet away. It turned off the podcast and then when it needed to give me directions it did (I could hear it but the caller didn't). Then when the call was over it started the podcast 15 seconds before it had stopped it. That was perfectly designed and met all me needs.

Well I then had a one week odyssey of 3-4 hours a day to get it close to how I like it. That was the biggest downside. Since then I have been in love. I have been in love with three other pieces of electronics: 1) My first HP-35 in 1971 ( I was the first engineering student to have one: cost $400); 2) My first palm pilot in 1995; and 3) my first IPod Classic in 2005, when I learned about podcasts (from my friend T Morris himself {he wrote the Idiots Guide to Podcasting}). All of these devices changed my life each in its own but very significant way and they became constant companions never leaving home without them. Well the Droid surpasses them all.

I bought it planning to have it replace four devices. I found that it replaced twelve items I use all the time or daily worth $ 2300 all together. The first four on this list were the original four and here is the entire list of those items I used to use almost everyday:

1. My Phone (obvious): $100 that I paid, $400 list price.
2. My Ipod 80 Gig with two year service: $290
3. Digital Camera (Droid is 5 MegaPixals): $200
4. Video Camera ( I was about to buy flip video): $150
5. Voice recorder to dictate my medical notes: $200
6. GPS with Google Maps and Traffic alerts: $200 plus $30 per month for service.
7. Clock radio: $50
8. My travel bedside radio: $25
9. I-Home or equivelant ( I use this getting up & dressed in AM about 15-20mins/day):$50
10. Pedometer: $30-70
11. Laptop (now obsolete for travel, about 2 trips a month of 2-3 days each): $500
12. Remote temperature sensor and base next to bed: $65

Those were the devices I used almost daily. I then found out there were many devices I have not had that I now did with the Droid. Some I have gotten to use regularly while some I know I will use infrequently, but they are neat to have:

1. calculator
2. compass
3. metal detector
4. Star Trek TriCorder
5. Flash light
6. Barcode scanner
7. Leveling bubble.
8. plus many more available through apps market.

Now that I mentioned apps I have to tell you about the top apps that I use. First I have only spent $15 on apps so far and have about 100 free apps. So apps do not have to be a big expense (but they can). Here are the apps I use the most, some daily and all weekly, and now feel I cannot live without:

1. Doggcatcher ($5): My podcast catcher. It works the best of the 12 that I tried. It saves me 30 minutes everyday (15 in AM and 15 in PM)
2. Google Chrome full screen web Browser
3. Pandora internet music radio
4. e-book reader
5. Movies: Tells me what is showing and time in all the local theaters
6. YouTube: Lets me watch YouTube videos anytime anywhere
7. Facebook and Twitter aps
8. Amazon.com with bar code reader
9. weather bug
10. CardioTrainer
11. plus lots of cool games

So I want to hear if your experiences match mine. Please post this and pass it around.

facebook.com/alan.koslow

Gates Foundation Donates $ 120 M Dollars To Change Paradigm for Allelviating World Hunger

I covered Keynote speaker Bill Gates of the Bill and Melinda Gates Foundation today at the World Food Prize Symposium announcing his foundation will be donating $ 120 Million to support the worlds poorest farmers with new agricultural grants. He said. 'How do you help those people who live on less then $1 / day. Helping the world's poorest farmers grow more crops and get those crops to market will be the biggest thing we can do to eliviate hunger.'

'The Green Revolution did amazing things but it didn't do enough. It did not get to Africa, specificly Sub-Saharan Africa.'

'There is also trouble' 'The Global effort to help small farmersis endangered by an ideological wedge that threatens to split the movement in two........One side is a technological approach that increases productivity (Big Ag, many of the attendees at the World Food Prize cinf.) ...the other is an environmental approach that promotes sustainability. (the Community Food Security Coalition, their conf. preceded the World Food prize Conf.)' I posted a blog two days ago highlighting this contrast.

He goes on to say this is a false choice, that blocks important advances. 'We need productivity and sustainability, and I feel we can do both..........The next green revolution must do both and must be guided by small-holder farmers, adapted to local circumstances, and sustainable for the economy and the envirnment.'

'We have to develop crops that can grow in a drought; that can grow in flood; that can resist pest and disease.'

'We need rigorous science to accomplish this.'

'It is essential for Africa to get a hardiar Maze that can grow in a draught and be a complete food source.' 'In some grants, we include transgenic approaches.....because it can address challenges faster.....Of course these technologies must be subject to rigorous scientific review to ensure they are safe and effective.'

We are developing this maze and it will be released royalty free to all of Africa.

Swarna sub-1 rice species was tested in India. when floods came 90% of normal crops dies. 95% of new variety survived.

Wheat rust is fast-moving and threatening the world wheat supply. 'We are partnering with 15 research stations..using a number of approaches to bread wheat varieties that will offer farmers some lasting protection.'

'We focus on small farmers and make investments across the value chain.....and look at the expertise of woman farmers who do most of the farming in Africa.'

African countries must lead. Most countries have pledged 10% of their National Budget. Ghana is the first country to do this and they have turned around their poverty and are almost at the Millennium Goal.

Here is the Video to his talk and the following discussion.

'Poor farmers are not a problem to be solved: they are the solution.'

A book will come out soon called 'Millions Fed" to follow up on 'Millions Saved' The vacine and health story.

He finished with a standing ovation and then went into a Q&A with Dr. Ejeta this years Food Prize laureate.

This was an amazing speach which clearly showed that an over riding philosophy that is rational and that doesn't try to impose a specific solution and which take into account the needs of stake holders from all levels may have a chance to change the world for the better. However this speech was followed by Dr Jeffery Sachs, the Director of the Earth Institute at Columbia University. In this speech he laid out an analysis that was sobering and scary. My next blog will be on that.

Food Security: Two world Outlooks, A World Apart

This week I attended two main conferences: The World Food Prize (WFP), and 'From Commodity to Community', the 13th Annual Community Food Security Conference (CFSC), with a buffer conference between them the Third Iowa Hunger Summit (IHS). (#foodprize, #csfc) I saw two movements unfortunately a WORLD APART. The first, the CFSC, was attended by 800 passionate activists. Seventy percent of them in their 20's, dungaree and tee shirt wearing, with a passion and energy level that was exhilarating. The second, the WFP, was attended by 950 gray haired, three piece suited, corporate or governmental officials. The sessions were educational, stimulating with a call to action clearly stated. What was missing was the passion of the CFSC. What was missing from both was the missed opportunity for cross pollination between the two. When I had heard the CFSC was being held immediately before the WFP I expected this was done to foster this. However, I was severely disappointed.

There were many areas of common goals between the conferences and their attendees. They both agreed that within 40 years the world population will increase 50% and the need for food will therefore double ( to take into account those living in Hunger now). That this increase needs to be done in a sustainable manner. That women were the key to success (give women: 1-Educational access {the most important}, 2-Economic equality with men, 3-health access, and 4-Political equality with men). That agricultural improvements need to be done in a sustainable manner. Climate change will significantly hinder the ability to meet the world food demand.

There were some serious areas of conflict. Simply put those attending the CFSC felt all solutions needed to be bottom up, while the WFP attendees felt the solutions need to mostly be top down (however they felt bottom-up needs to be incorporated). The CFSC attendees were violently opposed to genetically modified organisms (GMO), while the WFP attendees were it's prophets. They each have their own research the one that shows GMO's are nothing but pure evil while the other has their research that GMO's are manna from heaven. If only there could be more dialogue and sharing of those studies. There was more talking past each other then to each other. However, I did feel that the WFP attendees were more open to bringing in the CSFC people then the other way around.

Those attending CSFC complained of lack of access to the discission makers both in the US and abroad. Yet hardly any of them stayed on (actually in talking to over one hundred of them, most didn't even know anything about the WFP meeting - A failure of the CSFC to inform their members), to interact at the WFP conference. There were many world discission makers at the WFP. Secretary of Agriculture Tom Vilsak, eight Ministers of Agriculture, several former heads of state and multiple CEO's of the most important corporations in Big-AG-Biz.

The big shining light was Dr. Gebisa Ejeta, the WFP winner, in his talk at Iowa State on Monday to kick off the WFP meeting. He talked about the importance of Ag. extension type programs to get small farmers into the 21st century through education while also needing the large Ag-Biz to be the structure over this agricultural revolution.

So I hope that there is more dialogue between the dungarees and the three piece suits. We need both to move this forward and to have any chance of solving the loaming food and climate crisis.

Sustainable Food Conference, An Eye Opening: Hope for the Future.

I was at first shocked and surprised then encouraged by the distribution of attendees at the Food Security Conference. This week in Des Moines is a series of three international food conferences. The first one 'From Commodity to Community' the 13th Annual Community Food Security Conference, began Saturday 10/10 and will run through Tuesday 10/13. The first day was taken up with field trips to see the state of agriculture in Iowa. Today began with everyone at a breakfast plenary session setting the tone for the conference. But that is not what this first blog is about.

What I noticed, and as I interviewed many people, I found I wasn't the only one to notice, was that there was a bi-modal distribution of ages. Almost everyone fell into two age groups, either 20-32 or over 50. This made me wonder both about why and then what it means for the sustainable food movement. I talking to several attendees, the consensus seemed to be that those over fifty were motivated by the various movements of the sixties and early seventies. These participants felt that they had maintained their drive to improve and save the world. One women expressed despair that here 28 year old daughter was working for a defense contractor and felt having a nicer car and clothes was all she wished for. The older group was after almost four years seeing a new younger generation get enthusiastic about their causes.

The missing group, the doughnut hole, of those between 32 and 50 that were glaringly absent. To a person the attendees felt they were products of the me generation. The generation that went through high school and college and then entered the work force during the late seventies through the ME eighties and into the corporate boom of the nineties. They never got that spark of as the jewish religion says 'Tachun-o-lum', Repair the World. Fortunately, the generation to follow got the bug.

So what does this mean for the sustainable food movement. Well, the movement will survive and thrive. The young blood was both excited and enthusiastic. I saw a movement that has a new strong base that will work hard to move the movement forward. However it will be another ten to fifteen years till this momentum will cause a major shift in public opinion. That fifteen years will though have lots of small victories. Those who have been fighting this battle for four decades can be encouraged that there is a new generation who will take their fight to it succesful conclusion.

IOWA BOARD OF PHARMACY LIKELY TO RECOMMEND LEGALIZING MEDICAL MARIJUANA

I didn't write this. It is from Iowapolitics.com. However, I post it as follow-up on my previous posts on this. This is the only rational move.

I was at the first of the Boards public hearing and testified. The patients (none of whom I would label as Pot heads were so compelling there were times I saw tears in the eyes of the Bo9ard members.

Below is the news story.

Iowa is moving a step closer to legalizing the medicinal use of marijuana.

The chairman of the Iowa Board of Pharmacy told IowaPolitics.com that if public hearings on the issue this week in Iowa City and Nov. 4 in Council Bluffs are similar to ones held Sept. 2 in Mason City and Aug. 19 in Des Moines, the board will likely recommend that the Iowa Legislature allow medicinal use of the drug.

“I would say that if all the other three had a similar kind of content that we had, the board would probably be looking at having to digest that information and make a decision that there is probably a legitimate medical use for some people,” said Vernon Benjamin, a pharmacist from Argyle.

But even if the board does eventually make that recommendation – they are expected to vote on the matter before the end of the year - there is no guarantee legislators will heed the advice of the board.

“This one is a pretty political issue, so I can’t say if they’re going to follow it or not,” said Lloyd Jessen, director of the board.

Jessen said in the past, recommendations haven’t been political and have generally been changes to bring Iowa law into line with federal law. “It's anybody’s guess if they put any weight in the recommendation or not,” Jessen said. “You have to remember Iowa is a pretty conservative state.”

Senate Majority Leader Mike Gronstal was noncommittal on the topic, saying he will wait and see what the board’s recommendation is, whether a bill comes out of committee and what other stakeholders have to say.

“I think it’s very much up in the air,” the Council Bluffs Democrat said. “I’m certain there’s a law enforcement side to be heard on this issue.”

Thirteen states currently allow the medicinal use of marijuana, Jessen said, while another dozen are considering the issue. Michigan is the only Midwestern state that currently allows its use, while much of the western part of the country has moved toward that policy.

“It seems to be a pretty common topic right now,” Jessen said.

Ann Diehl, a public member of the board from Osceola, said she’s glad the board decided to hold the hearings. Diehl used to be a detoxification nurse at Broadlawns Medical Center in Des Moines.

“It’s been a really interesting experience for me because I just had a totally one-sided view of it, and that was not good,” Diehl said. “I have learned a lot, and I have learned a lot about the medical benefits just from one hearing I've gone to.”

Diehl said she has heard scientific evidence and a lot of compelling stories from people who do have serious medical problems that they feel it helps. “I can say I have a much more open mind on it as far as medical use goes, but I haven’t come to any conclusion yet,” Diehl said.

Peggy Whitworth, a public board member from Cedar Rapids, attended the Iowa City meeting and said she’s been contacted by individuals eager to speak and get their thoughts on the record.

“I think those that have participated have found them interesting and helpful, and I think there are many rank-and-file citizens who are appreciative of an opportunity to express their views,” Whitworth said.

Whitworth said she encouraged the board to gather some solid information through public hearings and base any decision on science. “The reason for the hearings is to gather information from the citizens of Iowa, basically so any action by the Board of Pharmacy is grounded in reality, not simply in vague stories,” Whitworth said.

Benjamin agreed, saying board members are learning about switching the schedule of marijuana just like everybody else is. "You can’t do things like that lightly when federal law says it’s schedule one,” Benjamin said. “We wanted to make sure we had a case to argue if we do support the legalization of it.”

Hospitals in for $200 Billion Windfall Profits per Year from Health Reform.

I am amazed at the low profile the AHA (American Hospital Association) has been taking in the debate over health care reform. Think back you have heard and seen ads from every other sector but Hospitals, yet hospitals are 31% of the cost of medical care in the USA. Why have they been so quiet? Maybe they have a good reason to take a low profile. Maybe they don't want politicians and the public to realize they will be in for as much as $100-200 billion dollar windfall profits.

When you examine a major change think about who are the biggest losers and winners both before and after the change. This will help you understand the rhetoric or lack of it. Currently the hospital are, along with the uninsured patients, the biggest losers. The pharmaceutical and insurance industry the biggest. Using figures from Iowa from 2006, in a survey by the State Health Department, the states hospitals reported their expenses on unreimbursed indigent (uninsured) care. In Iowa the hospital spent $600,000,000 on care to the uninsured that was not reimbursed. This was not what they would have billed, but their actual expenses. They made this up by offsetting costs to those with private insurance. They still operated in the black. You cannot say they made a profit since they are non-profit. However many executives received large salaries and bonuses and many hospitals did expensive capital investments. This was in the face of $600 million write off. Amazing!!!

Well let us snap our finger and let every uninsured have insurance. Lets also say that this insurance will reimburse hospitals at the same rate (so they are competitive with private insurance) as private insurance. This rate is double or more over the reimbursement rate of Medicare or Medicaid. So the hospitals in Iowa will instead of writing off $600 million will be getting a check for $1.2 Billion. This is a swing on their ledger of $1.8 Billion. Now Iowa has a population of about 3,000,000 or one percent (1%) of the population of the entire country. So, if the number can be expanded to the entire country the hospitals of the United States will have as much as $180 Billion windfall profit each and every year.

$180 Billion is enough to pay f0or the cost of even the more expensive House bill for two years. So what I'm saying is that the hospitals will not be doing any more work (they are doing it now as charity) but will be making $180 Billion each year for no further work. Why not give them only $90 Billion windfall (they should be very happy with this) and pay for the entire system.

Please tell me where my logic is flawed.

Everyone Can Afford College. All Can Go.

We have a crisis in higher education. Like health care the cost of a college education is increasing at more then twice the rate of inflation, while the money available for scholarships and grants is shrinking. Many cannot attend the college of their choice or attend at all. Private Universities tend to get a disproportionate number of upper middle class to upper class students rather then the best students. I have given this a lot of thought and see a rational plan to solve this. First let me say not everyone should or needs to go to college, but some would benefit from a technical training and this covers that also. Read on to see the plan.

Society and our country benefits by having a more educated workforce and a educated class that can develop new inventions or processes. The person getting an education benefits from added earning potential. Also more lower income and middle income students will be able to attend better schools and not be worried about affording school or being saddled with burdensome debt. Many people will go into teaching or nursing since they will not need to find high paying jobs to pay off college debt. Keep reading the plan is coming.

The individual will benefit from this plan because of increased earning potential. US Census Bureau report shows that: '$4.4 million Estimated lifetime earnings of professional (i.e., medical, law, dentistry and veterinary medicine) degree-holders. This compares with $3.4 million for those with Ph.D.s, $2.5 million for master’s degree-holders, $2.1 million for those with bachelor’s degrees, $1.2 million for high school graduates and $1.0 million for high school dropouts'. Also the individual will be able to go to the best school they qualify with economic resources being no barrier and massive debt will be no barrier to taking the job they want rather then the job they need to pay off their debt. Here comes the plan.

Here is the plan. I will give the numbers to justify it below. The plan is simple students will apply to the colleges they want without concern for the cost. They will be accepted on their qualifications not the ability of their parents to afford it or the desire of the students to go into massive debt. After finishing school, graduate school and any required internships or residencies to complete their training they will pay back the loan this program gives them. They will pay back 0.75- 1.5% of their net income for each year of school they attend for 10 years. i.e. someone going to only four years of school will pay 3-6% of their income (net not gross) for ten years while those doing Medical School will pay 12% of their income for 10 years after they finish their residencies. These percentages are first guesses it may be slightly higher or lower. The final number will have inflation built in so once you fund the first four years the program will pay for itself.

Lets look at some numbers. There are approximately 5,000,000 in each grade level although only 3,000,000 graduate high school (2 million do not, see their lifetime earning potential above, I will present a plan to improve drop out levels in future blog). There are roughly 2,500,000 students entering college each year but there are 18,000,000 in colleges and universities at all levels including college, professional schools and graduate schools. 14,000,000 are in public institutions and 4,000,000 are in private. The total cost of those(14m) in public institutions is 250 billion dollars or $17,000 per student (room, board and expenses averaged of all levels) and those (4M) in private schools is 150 billion dollars or $37,000 per student. Whether private or public the students pay (via loans, scholarships, parent contribution and work study) all but $10,000. So of the 400 billion dollars spent each year on higher education $140B is paid by government, $40B by endowment funds of private universities and colleges and $210B by the student (using: loans; parents contribution, scholarships and work study). Once the program is in place and up and running it will be self supporting. This will mean that local, state and federal government will save $140B yearly or $1.4 trillion over ten years after the first four years and people start repaying loans. Both private and public schools will be able to use the money saved to improve the faculty (both pay and quality) and to improve facilities ( to accommodate the increased number of students that will be attending).

When the program starts those already in school can participate and reimburse the program at 2% each year for ten years of their net income. The repayment will be handled on the persons tax returns.

The beauty of this is that the job a person obtains and therefor the income is based upon the education they get and the field they pick. By setting reimbursement to your income if you decide to go into a low paying job you reimburse less and if you decide to go into a higher paying job you reimburse more. The individual decides. Two people with the same degree may go into opposite ends of the pay schedule.

After eight years there will be approximately 28 million (this number could be almost double if more students go to college then would have) that will be paying back into the program with an average income of $75,000(assuming a combination of those in professions and in trades, with more data this number could be precisely calculated) paying roughly 15% each (averaging those that do just bachelors and those that do graduate or professional degrees) or 315 billion dollars and thus close to self sustaining.

Any one could elect not to be part of the program but they will then need to pay full room/board/tuition of $37,000 yearly at private school and $19,000 at a public school.

This is a first approximation kind of a back of envelope calculation. I want lots of comments and criticism and if you know a college administrator please forward it to them. also to any state or federal legislators.

Sorry I haven't posted in three weeks.

Those of you friends with me on facebook (www.facebook.com/alan.koslow) know I had a full three weeks. Two Guinness world record attempts. Brunch with Al Franken and Senator Harkin. Presenting at annual Gala for Am. Diabetes Association, Attending worlds largest SciFi convention and Chairing Blood Drive (we had 2628 units of blood donated and after splitting them we had 6300 transfusable units), Preparing for Step Out the annual walk for Diabetes (this Saturday), Attending Get Motivated Seminar (amazing list of speakers and I was on stage dancing to compete for trip), my two radio shows and over a dozen board meetings. All in the last three weeks. I started another Blog devoted to my Weight reduction http://weightloss-skepticdoctor.blogspot.com/. I am making a commitment to post a new Blog at least weekly if not twice a week.

It's the Calories and Only the Calories. Duh!! How I'm Doing It.

I am 14 1/2 weeks into my diet and exactly halfway done. I am down 46 pounds, as of this morning, with my goal being 90 pounds, so 44 more to go. I posted this on my facebook page and 14 people asked me what I was doing to lose weight so I was stimulated to write this blog on diets and dieting from a skeptical point of view.

Multiple times each day we are bombarded with ads that promise the weight will melt away. When you look at the fine print they almost always say either when combined with an exercise program or even they have the nerve to say when combined with exercise and reducing intake...DUH. Rarely do the diet products work. If they did they would blow the competition out of the market and capture that whole market. The fact that they don't should tell you something.

Science is science and we cannot change the rules of biochemistry, chemistry, thermodynamics or physics. To burn one pound fat you need to burn 3500-4200 calories more then you take in this varies based upon efficiency of converting fat to energy). Now here is where it can get confusion but I will walk you through it. Go to this page http://walking.about.com/cs/calories/l/blcalcalc.htm and calculate your basal metabolic rate(the back ground rate at which you burn calories before you add your exercise). This can vary based upon lots of factors some individual metabolic rate, age weight. I recommend for this number use light activity ( i will explain in a moment), I was 2555 calories at my starting weight and 2300 at my current weight. You then add your exercise, here is a calculator: http://www.neversaydiet.com/tools/calories-burned-calculator?ivNPA=1&sky=ggl|hco|ns|calories|PPCA7FBa|c , When I started I burned 783 calories per day and now am burning 661 calories per day. The reason for the difference is that as you lose weight you are carrying less and therefore both your basal metabolic rate and your calories burned from the same exercise goes down. So at the beginning of my diet I was burning 3338 calories per day and now I am burning 2961 calories per day. This is one of the main reasons as you continue to diet you loss less weight for the same effort and the same calorie intake. So this is one of the reasons but there is evidence also that as you lose weight your abdominal fat cells release a hormone that slows your basal metabolic rate. This number is hard to get a grasp of.

Lets look at the intake side. I cut down to 1200-1500 calories per day lets say 1350. I will talk about how below. So if we subtract this from calories burned you get 1980 calories when I started my diet/exercise and 1610 calories now. That would mean I would lose about .55 pounds at the beginning and about .4 pounds now. Surprise surprise that is exactly what I am losing. If you lose less then you calculate you are either eating more then you think ( patients always say they are eating like a bird and I see in my mind a candor) or exercising less. This is straight math and science. It is so easy to delude yourself. I have not missed a day exercising and have only had 6 days I ate more then my 1200-1500 calories.

O.K. here it is my diet:

1. Eliminate fried food. I have only had one fried item in 14 weeks.
2. Eliminate fat containing condiments. No mayonnaise or salad dressing. I have not had any tuna/egg/potato salad and have only had plain balsamic vinegar on my salads. No deviled eggs.
3. No bread and butter. I have had 3 pieces of bread and butter in 14 weeks
4. No starch with meals. If you eat out ask for double veggies
5. When I eat out I ask the waitstaff to only give me half the meal and pack up the rest before they give it to me so it is never on the plate.
6. Eat as many raw fruits and veggies as you want. Some days I eat 2-3 pounds of melon.
7. Subway is your friend . A half chicken breast sandwich without dressing (just vinegar) and no cheese is 320 calories for a six inch. Make sure you put on loads of veggies (so 3/4 of the thickness of the sandwich is veggies about 4 times what they normally put on the sandwich)

• Have lots of low calorie snacks, here are some of mine:
• Pickles 20 calories for large pickle
• stick pretzels 5-8 calories each
• slice of white meat turkey breast 20 calories with spicy mustard - no calories
• slice of smoked salmon 40 calories
• assorted nuts 100 calories for one ounce.

I do ask restaurants if they know the calories of the item I want to order. I do keep track in my mind to how many calories I'm eating each day.

Now the exercise. When I started I could only walk briskly for 15 minutes it took me 3 weeks to be able to walk a full hour. At that point I was walking about 2 miles in an hour. by week 5 I was walking 3.0 miles in 50 minutes. A few weeks ago I added stair climbing and now in 60-65 minutes I do 3.0 miles, 17 flights up and 17 flight down. So as you loss weight and sweat less you need to increase what you do. Now about safety. If you are over 40 or get winded when you exercise you need to be concerned. I recommend you get one of those pulse monitors at a pharmacy that you wear on a finger or your wrist. When you start to exercise monitor your pulse rate. Then do the calculation of 220 minus your age. So for me 164. Then take 80% of that so for me 131. If your pulse rate goes over the number for you stop exercising and see you physician before doing anymore exercise. If you have chest pain while exercising stop immediately and call 911.

The final way to be successful and also help others. Tell everyone, and I mean everyone (no exceptions) that you are dieting and exercising to lose weight. The more people you tell the stronger social contract you are making and the more likely you are to stay on your diet. Also this will have a positive effect to get more people to be successful in dieting them self. That is why I blog and post it on my facebook page.

Another One Bites The Dust: Creationist/Inteligent Design Proponents Major Gap Gets Filled.

One of the biggest Gaps that has been pointed to by Creationist/Intelligent Design advocates has been filled.

The evolution of life is one of the most beautiful things I have studied. I am a puzzle fan. I love to put together complex puzzles whether jigsaw, three dimensional, mathematical or geometric. I have had a fascination with puzzles my whole life. When I have trouble putting it together I don't say there has to be a magical step I sit down and try to solve the step or Gap that I'm having trouble with. I have also been a fan of evolution since I first read The Origin of the Species (celebrating it's 150 anniversary this past February) at the age of nine. When you think about the bits of information on life it is not the 2500 pieces of a complex jigsaw puzzle that gets me excited but the billions of facts that we have amassed from almost every field of science by 100's of thousands of scientists from every country in the world. These scientific disciplines include : biology, biochemistry, chemistry, physics, geology, paleontology, archeology, anthropology mathematics, genetics, mathematics and statistics, plus many more. The amazing thing is that these billions of independently arrived at facts all fit together with very few contradictions and these contradictions do not disprove the theory of evolution but just point out holes or as creationist call them gaps. When there are contradictions or gaps this points to areas were research needs to be done.

It is a thing of beauty how nicely this fits together. An example of this is the biologic clock. Scientist have determined the relative rate at which random changes in amino acids lead to substantive genetic changes. Scientist have found that these happen at relatively fixed periods based upon the number of generations. The beauty is that in any two species ( and ten's of thousands of pairs of animals have been looked at) when you look at the number of differences between them and then calculate when they should have a common ancestor it works out to a very high degree of accuracy. This method has been used by scientists to predict what geological layers these common ancestors will be found in and when they look they find the fossils in the right place. This is the most powerful proof of evolution. There are other similar spectacular predictive aspects to evolution and an amazing array of puzzle pieces, literally billions, that fit the puzzle precisely.

Well that Gap was how did Eukariotic(cells with a nucleus) cells develop from prokaryotic(cells without a nucleus) cells. Well in today's Nature researches using two different prokaryotic cells have seen one cell get engulfed by the other forming an endosymbiote or a cell living in harmony within another cell. Over time there is an exchange of genetic material and the engulfed cell becomes the nucleus for the other cell. Also this occurred in an oxygen poor environment. Photosynthesis could not occur until you had eukaryotic cells. This symbiosis led to terraforming of the entire earth to an oxygen rich environment that allowed life as we know it to evolve. In addition this fusion of two cells produced the mitochondria that is present in all eukaryotic cells.

I am sure that the Creationists will find excuses, such as, this happened in a glass dish and there were no glass dishes in the soup that was our early oceans. They may then say that there are now two gaps, one on each side of this finding. The point is that science predicted this result and it fits all of the mountain of data we have and contradicts none. Why would they want a God of the Gaps whose domain keeps getting cut into smaller and smaller pieces. If there is a God isn't it better to envision that that entity created a universe were life can form and not have to do mental gymnastics that try to fit God into gaps we just haven't filled with facts yet.

Neutriceutical Supplements Can Kill or Help You or Just Waste Your Money!

When was the last time your doctor asked you if you are taking any supplements? Most of you probably never. I have had patients die or loss a limb from over the counter supplement use.

A recent article from Mayo Clinic Health letter they clarified that over the counter supplements are not always safe. They pointed out that,

"St. John's wort: This supplement can greatly increase or decrease the potency of many medications and cause serious side effects. Patients who take antidepressants, anti-blood-clotting drugs, certain asthma drugs, immune-suppressing medications or steroids should probably avoid St. John's wort.

S-adenosylmethionine (SAM-e): This can cause serious side effects when taken with antidepressant medications that affect serotonin.
Garlic, ginseng, ginger and feverfew: Patients who take anti-clotting medications such as aspirin, warfarin (Coumadin) and clopidogrel (Plavix) should avoid these supplements. They may increase the risk of bleeding. Supplements chondroitin and glucosamine also may interfere with warfarin.
Ginkgo: Ginkgo may increase the risk of bleeding in patients taking anti-clotting medications. Ginkgo can counteract the blood pressure-lowering benefits of thiazide diuretic drugs. It also can interfere with anti-seizure medications."

This is why every Doctor should ask you if you take any Vitamins, supplements or over the counter meds. Unfortunately very few do. You should tell them if they don't. You should also notify your doctor if you add one.

VITAMINS AND SUPPLEMENTS. There are multiple vitamins and supplements that are available on the market. Actually, there are over 3000 uniquely different vitamins and supplements. During a nine-month period of time, I actually reviewed all 3000 of these in order to determine which ones have actual evidence that is peer reviewed and are blinded studies to confirm that these work. I had a second level that they had studies that were not necessarily blinded. Out of the 3000 supplements, there were actually approximately 120 that had more than one study that showed some form of efficacy whether it was blinded or not blinded. 25 of these substances either had such dangerous side effects that I eliminated from my ultimate list or that were not available in the United States in a dosage that was comparable to the dosage used in the study. Either the dose available in the United States was multiple; one is a magnitude larger or multiple others with magnitude smaller. I have therefore distilled this down to a list of 95 substances that had a hint of some level of efficacy. I have to say that for all but a small few there still is not enough data to say they are efficacious or safe. I do not recommend, unless you are having a specific problem that you are taking the supplement for, that you do take the supplement just to prevent the problem. There is no evidence for any supplement whatsoever that they can prevent you from developing a problem except for the ones which I am going to be listing below. The following lists of supplements are ones which, if you fit into the category mentioned, you should be taking these.

1.MULTIVITAMINS – Many adults should be taking a multivitamin because of the highly processed foods that we eat. However, if you eat a balanced diet you most likely do not need one. Many people who do not eat this balanced diet (40% carbs, 30% calories from fat, 30% of calories from protein with 8-12 portions of fresh fruits and vegies per day) do not get the minimal requirements of the full range of multivitamins. I actually recommend taking the senior types of multivitamins and this is because you want to keep down on the total amount of the vitamin A that you have. Vitamin A at 5000 per day will accelerate osteoporosis and the regular multivitamins, usually at 5000, where the senior has 2500 of vitamin A. So if your multivitamin has more then 2500 of vitamin A take it every other day.

2.B-COMPLEX – B-complex has multiple advantages and multiple studies that show it has advantages. Among women who were of child bearing age, it obviously gives them the folic acid (folate) that they need to prevent birth defects. There have been many studies that have shown that Folate actually does prevent birth defects. I recommend taking a B-complex 100 which has 100 mg of each of the B vitamins and then also has folate appropriately dosed. There are many studies that show B-complex reduces Homocysteine and that leads to a decrease in cardiovascular risk.

3.OMEGA 3 FISH OILS – The recommended dose is 3 g per days which is usually three soft gel capsules. This is very important to prevent atherosclerosis and stroke. It has actually been shown in patients who take this versus controls who do not, that you decrease by between 10% and 25% the incidents of heart attacks and strokes in these patients.

4.LUTEIN 20-40 mg – This has been demonstrated to prevent development of macular degeneration, the most common cause of blindness in the entire population followed closely by diabetes-related blindness. It actually has also been shown to reverse the early blindness caused by macular degeneration (in the higher dose). This should be taken by everyone over the age of 45 and should essentially be taken for the rest of your life to prevent macular degenerative blindness.

5.BABY ASPIRIN – The use of aspirin to prevent heart attack and stroke has clearly been demonstrated. There is still some controversy as to whether everyone should be taking this or whether only people at high risk should be taking it. My read of the research studies and my read of the literature indicate that I feel all adults should be taking a baby aspirin. Now, the actual dose is if you take a chewable form of baby aspirin, you take one everyday. If you take an enteric-coated form of the baby aspirin, you take two every day and you try not to take any aspirin for any other cause. Obviously, if you do have an allergy to aspirin or have intolerance to aspirin, you should not use this and you should check with your physician.

6.CALCIUM – Most people and particularly women, postmenopausal, and patients who are obese with a BMI over 35 need to be taking calcium supplementation. Fat and the change in hormonal balance in old women both seem to be contributory factors to loss of calcium. I recommend between 1500 and 3000 mg of calcium per day. The calcium should definitely have vitamin D in it. Note here about vitamin D, 70% to 80% of all adults not living in the Sun Belt are vitamin D deficient. If you have any problem with calcium metabolism, have osteopenia or your have osteoporosis, I strongly recommend that your doctor obtain a vitamin D level on you because that is probably the biggest cause of osteoporosis (pathologically decreased calcium levels in bone) and osteopenia (mildly depleted calcium levels in the bone). Some people might need mega supplementation with vitamin D to get them back to a therapeutic level.

7.GLUCOSAMINE – There has been a lot of discussion about glucosamine and chondroitin and as individuals or as combinations. I have looked at multiple different studies and the bottom line is that these do work. They do decrease joint complications. Every orthopedic surgeon who does total hip or total knee replacement says that every adult should be on glucosamine on a daily basis, although there is no research evidence that supports this position. However, if you do have any jont problems at all, then this is definitely supported by the medical literature to be one of either medication or the combination. Now, let me talk about which of the three forms you should take. I personally recommend glucosamine for multiple reasons. The typical dosage would be 1500 mg per day. There has not been any study that shows that chondroitin has better or worse response than glucosamine and there is no study that shows that the combination of chondroitin and glucosamine increases the efficacy of either one.

8.VITAMIN D – 70% of all children in the USA are vitamin D deficit and 15% serriously. The rate for adults is even higher especially if you live north of the Mason-Dixon Line. This is a vitamin you cannot take too much of. I recommend 2000 per day in summer months and 3000 per day in winter months.

Breast Rescission: or How you can be Raped by your Health Insurance Company.

I heard the testimony given at a recent senate hearing on a policy called Rescission by Health Insurance Companies. The first testimony was by a woman who had her health insurance for many years having paid her premiums for many years and her Insurance company accepted these premiums. They had the option of not issuing insurance to her in the first place. However, they did issue a policy to her and went along happily taking her money and having very small payout, making lots of money off her. Then one day she comes down with invasive breast cancer involving both her breasts. Her doctor wanted her to have bilateral mastectomies ASAP. They were scheduled for the next week. In the next couple days before she went into the hospital she was told by her insurance company they were canceling her health insurance policy. They broke their explicit contract they had with her. They said she lied on her policy. It turns out she had been diagnosed by a Dermatologist with dermatitis. They claimed this was a precancerous condition and she had lied on her application when she had said she never had cancer or a precancerous lesion. The dermatologist spoke with the insurance company and told them this was acne and completely benign condition and not a pre-cancerous lesion. The insurance company still refused to re-establish her insurance. She could not afford to pay the 10's of thousands of dollars the hospital required to let her have the surgery. Finally after 5 or 6 months she got the decision reversed but she now had a much more advanced cancer that metastasized to her lymph nodes. She is much more likely to die because of this.

Blue Cross Blue Shield of California( not even the largest insurer in Ca.) rescinded 20,000 policy holders over a five year period. This can be extrapolated to hundreds of thousands losing their policy when most vulnerable. Leading to untold pain, suffering and deaths. But hey, they had to protect their profits. When asked if a client did not intentionally lie would they stop rescission all the Insurance CEO's said no they would not. however they would continue to take their clients money.

Half of the people in the United States between Medicare, Medicaid and Veterans services, are insured by the federal government. In 45 years not a single person has had their insurance rescinded by the feds.

This is criminal and should be banned. If there is no allowance for insurance companies to deny people insurance for pre-existing conditions then this will never happen. Rise up and revolt against rescission for you may be the next insured person that finds out on the doorstep of the hospital that you suddenly have no insurance, ending up either bankrupt or dead. RIP.

Medical Marijuana, I'm Skeptical About a Ban.

One week from today the State Board of Pharmacy of Iowa will hold a public hearing on medicinal use of marijuana. This is an issue that has vexed me for many years. As a physician who treats patients with severe pain syndromes I have seen many a patient get addicted to legal prescription pain medication while still suffering. This is because the legal pain medication is not the best medication to treat a pain syndrome called neuropathic pain. How I explain it to my patients is that narcotic pain medications will knock you out and as you're drifting off you are still experiencing pain. There are multiple studies which have documented good pain relief with smoking marijuana for neuropathic pain syndromes. There are many other proven uses for medical marijuana. However, our prejudices prevent us from using a proven remedy.

Marijuana has a history that is a mixture of myths and falsehoods that make it problematic for opponents to change their attitude. If you haven't seen the film 'Reefer Madness' you should. It is available free on the web if you look for it. This is the beginning of many of the myths. Regardless of how you feel about those myths, and I'm not going to debunk them in this piece, it is important to put marijuana in perspective to both legal over the counter products (alcohol and tobacco) and prescription products (Morphine, Vicodin, Methadone, and many others).

Marijuana has shown no adverse health effects when compared to either alcohol or tobacco. I think you all know the terrible health effects of both alcohol and tobacco. Alcohol and alcoholism causes 85,000 deaths each year from a combination of direct medical problems or traffic related deaths. Tobacco causes 430,000 deaths each year. In Britain, official government statistics listed five deaths from cannabis in the period 1993-1995. "Tetrahydrocannabinol is a very safe drug. Laboratory animals (rats, mice, dogs, monkeys) can tolerate doses about 5,000 times more than is required to produce a high." (from a British government report). When compared to tobacco there are equal or less effect on the lungs.

Alcohol and tobacco are two of the most addictive products in our society. Millions of people are addicted to both. There are questions about the true physical addiction potential of marijuana but most experts agree it is less then either of the two legal products. So if it is purely the addictive potential alcohol and tobacco should be banned and medical marijuana should be approved. Now the real question is, since we are only talking about medical marijuana, how addictive is it compared to prescription pain and anti-nausea medication. All the evidence points to marijuana is far less addictive then almost all prescription pain medication.

So let us get over our paranoia and allow our patients to have the best treatment available for certain conditions.

Senator Tom Harkin Supporter Rants on his Complementary and Alternative Med (CAM) Proposal

As a strong supporter of Senator Harkin I cannot standby and allow him to put forth an irresponsible,

irrational and dangerous proposal. His proposal is basically the Inclusion of alternative medicine workers in the bill's definition of "health care workforce". This at first seems innocuous, however the consequences will be harmful to our system of evidence based medicine (EBM) and patients health.

The consequences of this is that the government and private insurance companies will be required to pay alternative medicine workers as if they have medical decrees. In other words someone with no education, no certified program, practicing a form of medicine that has no evidence it works and is safe must be reimbursed at the same rate as someone practicing EBM. Currently 34 billion dollars is being spent and not reimbursed for complementary medical care and an additional 34 Billion on over the counter supplements, vitamins, homeopathic (equals water) and naturopathy products. None of them, either the therapies or the products have a single paper showing the work and are safe when compared to placebo.

Senator Harkin claims this will save money. I ask him to explain how......Oh wait..... Maybe the deathers are right Harkins secret plan is that patients who use CAM will not use EBM, that have 150 years and continuing research that shows they work. Instead they will forgo the expensive chemotherapy and go to the Naturopathy for extract of apricot pits (long since proven not to work). This will save money but cost livesI know the Senator is upset. He pushed through and set up the National Center for Complementary and Alternative Medicine, which the taxpayer has spent 100's of millions of dollars to prove that alternative medicine techniques work. However, not a single trial has shown that a CAM technique or product is effective. This has upset the Senator and he feels that the Institute has purposely designed the studies so they would fail. In a statement he said, “One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.” Senator you loaded the institute with people that are true believers and even they cannot prove (or approve) the unprovable when the magnifier of science is applied. Science does not and should never be established to 'validate' or 'approve' something but like Justice, should be blindfolded to the results. As you said during 'W's administration, 'we need to bring rationality back to science instead of politics or ideology'. Well hold a mirror up to yourself who is putting ideology before science who is upset if science doesn't meet your pre-conceived expectation. Except the results of the nearly 1one billion dollars 'your' institute spent ( some would say wasted, not me) and realize that when some CAM modality is shown to work it is then mainstream medicine. I can give you many examples.

There are many reasons on separation of powers and states rule that this should not be done. It removes States rights to license and certify practitioners of medicine and to control the practice of medicine within their state.

So Senator please remove this provision from the bill.

n.b. I apologize the program formatted this weirdly and split words inappropriately.

Dumb, Dumber and Deather

I don't know who is dumb or dumber the Republican/conservative machine(the deathers) or those in the public who believe them. There are few other issues more important for a patient to discuss with their physician then their living will and what their wishes are if and when they get close to death as we all will one day. Now when a physician who usually spends only 12-15 minutes per patient discusses these issues, which require much more time, they have to lie and claim that they are treating the patient for one of their conditions.

The more rational thing is to allow doctors to have open and frank discussions on these issues with their patients. Then allow the doctor to honestly bill for these services. To think that a legislation is going to get doctors to violate our Hippocratic Oath, how ridiculous. Patients need to understand what their choices are in a living will and their doctor needs to understand their end of life wishes. The proposed legislation simply allows physicians to have the appropriate time for this and to get fairly reimbursed for it. So don't be a dead head, a dumber or a dummy and work to get good health reform that covers everyone, has no pre-existing provisions and prevents Insurance Companies from denying care to those they insure.

Science based Medicin e conferance at TAM-7

Great Lectures today on Science based medicine. Case studies in Cancer Quackery, Scientific Critique of Chiropractic, Lyme Disease. I will be blogging on each of these after I inteview the presentors friday and saturday. I will give one highlight from each talk.
1) while we need to individualize each patients treatment we often ( and I can see myself doing it) we let errors like false pattern recognition, influenced by quirky personal experience , over reliance on non-specific signs and symptonsand conformational bias.
2)Suzzanne Summers only had Stage one Cancer and had 94-96% chance of 10 year survival with or without additional treatment and chemo would only have added 1-4 % improvement in survival so her claims of alternative medicine cured her is blatantly wrong.
3) 20% of all Basilar strokes are caused by chiropractic manipulation, 1/2 of all chiropractic manipulation has negative side effects, Children should never be manipulated by chiropractor.
4) Chronic Lyme disease: most likely no such thing as chronic Lyme disease ;
definitely no such thing as chronic Lyme disease that responds to antibiotic
Check back over next couple days for full story.

the Science-Based Medicine Conference to start July 9th morning

I will be attending the Science-Based Medicine Conference chaired by Dr Novella. I will be blogging about it during conference and reporting on it on my radio show The Doctor Is In on macsworldlive.com every Monday at 2 PM central