Well, really, I can’t complain SO much about wheel-spinning. Even though I managed to evade working on the Big Annoyance of the Day — shoveling a foot-deep stack of accursed paperwork off the desk — a bunch of stuff actually has gotten done. Ditz, it’s true…but stuff that needed to get done.
Do you ever feel like, even after you’ve managed to power through a lot of tasks, that you still have been spinning your wheels half the day?
🙂 Clean out pool pump pot; clean out pool strainer basket; reinstall pool cleaner, run pump
🙂 Figure out why irrigation system stopped working (FAIL!)
🙂 Water citrus trees manually
🙂 Water other plants manually
🙂 Spray Dawn detergent solution on plants infested with skeletonizing bugs
🙂 Repair back gate latch
🙂 Repair kitchen cabinet pull
🙂 Pick up mess in house
🙂 Change bed; wash sheets & towels
🙂 Cook and concoct dog food
🙂 Clean up ensuing mess in kitchen
🙂 Pick up dog mounds
🙂 Drag trash out to alley
🙂 Post today’s chapter of If You’d Asked Me… (how to handle harassment of cute young teenager)
🙂 Post link to that on Facebook
🙂 Enter comments in FB writer’s community
🙁 Write the next installment of the Drugging of America series
🙁 Iron jeans
🙁 Write more of Ella’s Story
🙁 Cope with gigantic stack of accursed paper
AND…as you might guess, “Cope with gigantic stack of accursed paper” is the chore that all this wheel-spinning has been designed to avoid. I hate, hate, hate dorking with paperwork.
So I put it off. The bills come in. The checks to deposit come in. The statements come in. This nag, that nag, and the other nag comes in from various vendors and doctors’ offices and creditors. They all get tossed on a table.
They’ve been sitting here for upwards of a month now. The table is beginning to groan under the pile’s weight.
Yes. I’ve paid the bills. But all the rest of it is just sitting there.
It is going to take several hours to plow through all that brain-banging shit. And no. I just do. not. want. to. do. it.
Should write the next Drugging of America piece. And could. That also will be a time-consuming and energy-sucking task. If I start on that now, not enough time will be left in the day to fart with the pile of paper distractions. To say nothing of enough ambition.
One thing I probably could do is have the credit union send statements electronically. That would create three fewer pieces of trash to be plucked out of the mailbox. I’m already downloading all the transactions into Excel as it is.
But you just know, don’t you, that whatever form they use to send these proposed electronic statements will not readily convert to Excel. So that will just inflict three more pieces of useless electronic junkmail to deal with. Like I don’t have enough of that?
So little worthwhile stuff comes in the mail anymore, I hardly ever bother to open the thing. Now that the mailbox has to be fortified and locked, the extra effort entailed in tracking down the key, traipsing it out to the curb, wrestling with the mailbox lid, relocking it, traipsing the key back to the house, and hiding it again makes picking up the mail counterproductive. There simply isn’t enough real mail in there to make it worth being bothered to walk out there and wrestle it out of the box.
Consequently, these days I pick up snail-mail about once a week.
Yesterday, it occurred to me to count: EIGHT out of nine pieces of delivered mail went directly into the trash.
That suggests that about 90 percent of mail being delivered by the U.S. Post Office is junk advertising circulars.
And, therefore, for every piece of nuisance paperwork that arrives here, nine pieces of trash have to be toted to a recycling bin. Ninety percent of delivered mail represents pointlessly destroyed trees, pointlessly polluting paper mills, pointlessly polluting ink manufacture, pointlessly expended gasoline to tote trees, paper, ink, and junk mail around, pointlessly expended power to run those mills and drive the printing presses and operate the equipment to recycle trash that is never even opened or looked at.
That pisses me off. It ought to piss you off, too.
Oh, well. /rant.
I’d better get up and go deal with the pieces of paper that actually do require attention. Of a sort.
Hilariously, I’m prancing off to choir this morning with a black eye. First in my over-long lifetime!
Thought I was too smart for this: I walked into a closed Arcadia door.
In my partial defense, I hadn’t replaced the stick that goes in the runner to wedge the door shut against intruders. And I was bopping around carelessly — headed outside to take a photo of the first-time-ever calla blooms on the side deck. Out of the corner of an eye, I saw the stick laying on the floor and must have unconsciously assumed the door was hanging open, as it often is on a gorgeous day like yesterday.
Fortunately, neither the door nor I broke. After applying a cold pack for a few minutes, I figured it was OK — no sign of any damage except for a sore eyebrow, which was neither swollen nor bruised.
Doesn’t hurt. This morning it was an hour after the dogs rousted me out of the sack before I happened to glance in a mirror and notice…WTF???
So that’s amusing. The whole eye is black and blue!
BUT…I managed to cover it up pretty well with a thick coat of L’Oréal. Yes, Virginia, there are some benefits to being female, after all. A little purple eye shadow on the other eye, and voilá! An old lady wearing too much make-up!
Around here we don’t get April showers. We get April winds. Howling April winds.
In normal times (which we haven’t seen for some years) we get February rains and April winds. But once again this winter brought almost no rain. So the place is dry as…yeah: dust. If you don’t breathe, you’re fine. But if you do…too bad: allergy season with a vengeance.
The wind has been roaring around for days. For hours last night it was banging stuff up against the house and whacking birds into the westside Arcadia doors. And this morning? The air is still (for the nonce), but what a mess to clean up!
Leaves and palm tree debris all over the yard. Junk from the surviving Devil Pod Tree on the southwest side blown all the way over into the patio on the northeast side…and of course, into the pool.
I’m thinking I’ll plug in the blower, blast the stuff off the patios, and mound it into a couple of haystacks, over which I’ll toss tarps to hold it down until Gerardo gets here to haul it off. Can’t step onto the back porch barefooted without puncturing the soles of my feet, so at least need to get the trash piled up somewhere out of the way.
And it’s blowing the oranges out of the trees. True, they’re pushing over-ripe… I’ve been gorging myself on the delicious things for weeks. But once they’re thrown on the ground, they’ll spoil within a day. So these winds usually mean the end of the orange harvest.
So, so, SO much ditzy, distracting work to do. I really want to finish the current chapter of Ella’s Story, which is painfully slow going. But some of this stuff has been put off too long, and some of it has to be done now…
Shovel out the wind debris
Clean the mustard algae off the pool walls
Shovel the mountain of paper off the dining-room table (damned piles of mail that get left there to attend to…later. Much later.)
Do battle with the effing credit bureaus again, trying to get the bastards to reinstall the fraud alert needed thanks to Equifax’s having shared my private information with bad actors around the world
Spray the alley weeds behind my house and the feckless neighbor’s house
Pick up the dog mounds
Haul the trash
Run two more loads of laundry
Figure out how to put a battery in that damn modem Cox attached the phones to
Free the Bear Spray cans from Costco’s consumer-proof wrapping and figure how to use the stuff
The kids who moved into Sally’s house either have a moral objection to Roundup or are too preoccupied with parenthood to be bothered to clean up the weeds. In the spring their front yard looks like a slum property — eventually he’ll get out there and manually pull up the weeds, a tedious chore, indeed. You can’t blame him for putting it off as long as possible. But they never do a damn thing about the alley weeds, which are a serious fire hazard. And it’s against the law to let them grow up as high as your butt…a law most honored in the breach.
But I can’t complain: when the ex- and I were young things, we never touched the alley behind our shack. Partly because we were above all that (weren’t we? after all!) and partly because we didn’t know it was our responsibility to keep the area weed-free.
😀 The young things haven’t been here long enough to watch a neighbor’s house burn to the ground (!) after some of the neighborhood brats set fire to the brush in the alley, out of idle mischief.
So I’ve sprayed once out there — it’s killed off most of the weeds outside my fence and theirs, but a few outliers and newcomers remain to be attacked.
The wind is quiet just now, so I should get out there and do that right this second, before it starts to blow again. Typically it’ll die down fairly late at night and then start again mid-morning. But just now am busy swilling coffee.
The wind blew over the giant garbage bin in the alley. Noticed this yesterday. It’s too heavy for me to haul back upright, and (though I haven’t looked) I’d put money on it that the kid back there hasn’t lifted it, either. So I’ll have to drag the trash down about three city lots to the next set of neighbors’ bin. That doesn’t exactly fill me with inspiration to take out the trash! 😀
Chances are very good that you’ve been told you have high blood pressure — or are about to get it — and so need to take pills to keep your numbers down. Some 70 million Americans — a third of us — have been told we’re suffering from hypertension, and another third have been diagnosed with “pre-hypertension.” That’s two thirds of the population of the United States who supposedly should be on blood pressure meds.
Well, maybe not. Let’s listen in on what an expert from the University of Massachusetts Medical School has to say on the subject:
Notice that this gentleman was speaking in 2014. What he advises has been known for at least four years. And yet if you go to your GP for a check-up — or even to a trained cardiologist — you are likely to find yourself added to the majority of Americans put on anti-hypertensive medications.
You will be told, as I was, that if you don’t start taking these drugs immediately — and stay on them for the rest of your life — you are going to have a heart attack or a stroke. This, even if your blood pressure is fairly low — my systolic BP averages around 123.5.
One reason for this is the steady pressure on practitioners to diagnose hypertension and prehypertension, a campaign to convince them that patients are at risk if their numbers are above a certain level. Within the past year, that level has been dropped by ten points. Until just a few months ago, “normal” blood pressure was defined as a systolic reading of 120-129, and “prehypertension” was 130-139. Now, lo! We’re told numbers in the 120s indicate “elevated” blood pressure — and need to be treated — whereas numbers in the 130s are now defined as “Stage 1 hypertension.” This rejiggering of definitions puts a large new cohort into the category of “patients” who must be medicated. Or, we might say more realistically, makes them eligible for overtreatment.
But how beneficial are these medications?
Let’s check the Number Needed to Treat. Among people treated with anti-hypertensives, overall 1 in 125 were helped in that they did not die. Strokes were prevented among 1 in 67. One in 100 were helped in that they did not have a heart attack. But 1 in 10 were harmed. Obviously, one would like not to experience a cardiac event. But do you really want to be one of the 1 in 10 who are harmed by the drugs?
None of these drugs is completely benign. All of the classes of antihypertensives have side effects, which affect different people in different ways. You may experience no side effects. Or you may have one or two side effects that are so minimal they don’t bother you. The most common is hypotension, the result of overtreatment, leading to dizziness, fatigue, tiredness, and anxiety. However, the potential for serious side effects is there:
Abnormally low potassium levels (hypokalaemia), which can lead to heart failure
Low levels of magnesium (hypomagnesaemia)
Abnormally low sodium levels (hyponatraemia), also potentially life-threatening Glucose intolerance (a risk factor for mortality)
High calcium levels (hypercalcaemia), which can lead to abdominal pain, bone pain, confusion, depression, weakness, kidney stones, or arrhythmia (an abnormal heart rhythm including cardiac arrest)
Wheezing or asthma,
Masking of hypoglycaemia Sleep disturbances
Worsening of peripheral vascular disease
Drowsiness Raynaud’s phenomenon
Elevated triglycerides, cholesterol and/or fat phospholipids (dyslipidaemia)
Angina caused by sudden withdrawal.
Postural hypotension (sudden drop in blood pressure, causing dizziness or fainting)
Precipitation of heart failure.
Well, you think — as your doctor is telling you that if you don’t push your systolic blood pressure into the 110s, you’re going to drop dead of a heart attack or a stroke — maybe it would be better to risk or tolerate these unpleasant ailments than to die.Think again.
The fact is, despite the hype to the contrary, treating mild to moderate hypertension has not been shown to improve outcomes: it does not change rates of mortality or sickness. A recent study published by the widely respected Cochrane Group found that “No evidence of a difference in total mortality and serious adverse events was found between treating to a lower or to a standard blood pressure target in people with hypertension and cardiovascular disease. This suggests no net health benefit from a lower systolic blood pressure target despite the small absolute reduction in total cardiovascular serious adverse events. There was very limited evidence on adverse events, which lead to high uncertainty. At present there is insufficient evidence to justify lower blood pressure targets (≤ 135/85 mmHg) in people with hypertension and established cardiovascular disease.”
And that’s for people who have identifiable cardiovascular disease — not for the hordes of asymptomatic patients assigned to take these drugs.
Another effort to determine the benefits of treating low-level hypertension showed that “Antihypertensive drugs used in the treatment of adults (primary prevention) with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg) have not been shown to reduce mortality or morbidity in RCTs ” (randomized controlled trials; my emphasis). The authors continued, “Individuals with mildly elevated blood pressures, but no previous cardiovascular events, make up the majority of those considered for and receiving antihypertensive therapy. The decision to treat this population has important consequences for both the patients (e.g. adverse drug effects, lifetime of drug therapy, cost of treatment, etc.) and any third party payer (e.g. high cost of drugs, physician services, laboratory tests, etc.)…. Available data from the limited number of available trials and participants showed no difference between treated and untreated individuals in heart attack, stroke, and death. About 9% of patients treated with drugs discontinued treatment due to adverse effects.”
Note that this second study defined “mild” hypertension as 140-159/90-99 mmHg — and remember that today the American Heart Association would have us believe systolic readings of 120-129 are “elevated” and 130-139 are full-blown hypertension.
In 2017, another set of researchers found that treating people to lower blood pressure targets made no difference in cardiovascular outcomes: “We found and included three unblinded randomised trials in 8221 older adults (mean age 74.8 years), in which higher BP targets of less than 150/90 mmHg (two trials) and less than 160/90 mmHg (one trial) were compared to a lower target of less than 140/90 mmHg. Treatment to the two different BP targets over two to four years failed to produce a difference in any of our primary outcomes, including all-cause mortality (RR 1.24 95% CI 0.99 to 1.54), stroke (RR 1.25 95% CI 0.94 to 1.67) and total cardiovascular serious adverse events (RR 1.19 95% CI 0.98 to 1.45).” (My emphasis.)
Unfortunately, big drugs are big business, and wherever money is involved, motivations can come into question when medications are prescribed to people who might not need them.“I think doctors are induced by pharmaceutical companies to use their products,” says medical malpractice attorney Andrew J. Barovick. “Whether they’ll acknowledge it or not, there’s often a quid pro quo.”
Wildly hectic week! Today is the first time I’ve had a chance to attend to my own stuff all week, and tomorrow will be turned over to other activities again.
Honest: I will write the next installment in the Drugging of America series. This afternoon. Really. First, it’s off to buy some dog food — otherwise, it’s spend this afternoon in the kitchen, lest the pooches run out.
I’ve decided to add another post in the Drugging report: funding sources of the major organizations that recommend treatment, provide information for patients and doctors, and advise on guidelines.
The more you look into this issue, the farther your jaw drops...
The previous two posts in this series have shown that overprescribing of expensive, powerful drugs has become a serious problem in developed countries — especially in the United States and especially among women and elders. Gulping down handsful of drugs a day is now so commonplace that doctors’ assistants react with surprise when told someone over 50 is taking no meds. And we’ve seen that many widely prescribed drugs help surprisingly few patients but do inflict real harm on a lot. Even unto death.
One reason for this is obvious: the money motive. At this time, prescription drugs generate billions of dollars for Big Pharma — accounting for some 12% of the total cost of personal medical care in the US. As the Baby Boom generation gallops into old age, that profit will grow exponentially. With fully a quarter of Americans in their 60s and almost half of those in their 70s already taking at least five prescription drugs for this or that condition, just imagine the profits the vastly growing number of aging pill-poppers will generate over the next two or three decades!
Other causes, as we’ve seen: the ongoing multi-billion-dollar promotion of pharmaceuticals, overwork among doctors who have little time to sift through research reports that come out at the rate of one a minute(!), and commonplace publication ofweak, flawed, or even fraudulent research“studies.”
Let’s take a look now at a fairly new phenomenon that is being used, more and more, as a device to urge doctors to put you on medication — for the rest of your life.
Osteopeniais a big one: what woman over the age of 45 or 50 has not been told that if she doesn’t start swallowing Vitamin D, calcium pills, and Fosamax her spine will surely crumble and she’ll end up in a wheelchair with a broken hip? I personally have had doctors try to pressure me into taking hormone replacement therapy or Fosamax by way of staving off what was depicted as an otherwise unavoidable disintegration of my skeleton.
Yet, as it develops, osteopenia is not the same as osteoporosis. Osteopenia is a normal thinning of the bones that occurs in all women as they age. It does not amount to a lifetime of broken bones, crumbling vertebrae, and dowager’s hump.
Osteoporosis is a real problem with real, hazardous effects. It does need to be treated. Bisphosphonates (Fosamax and related drugs) are the most effective treatments we have for this disease. Nevertheless, Merck, seeing an opportunity to sell its drug more widely, developed a machine to measure bone density and launched a powerful marketing program, the upshot of which was to persuade doctors across the land and around the world that all their middle-aged women patients must be put on drugs right away, lest the normal aging of their bones turn into the dread osteoporosis.
So: imagine the profits if every baby-boom woman is taking drugs to enhance the normal state of her bones and also is put on drugs to push her blood pressure down below 120 hg! And in the bargain, every medical practice that treats women has to buy a bone density machine or refer patients to a lab with one of the things.
In fact, though, current thinking suggests that these drugs do little to prevent bone fractures, although they may help defer fractures in spinal vertebrae. Susan Ott, an associate professor of medicine at the University of Washington, told NPR: “There was no difference in the number of [nonspine] fractures you had, whether you took the medicine or a placebo. It does make your bone density go up higher, but the number of fractures is what really matters, and that didn’t really change.”
Elsewhere, Dr. Ott noted that bisphosphonates (of which Fosamax is one) can actually cause fractures in women with osteopenia. Speaking to BottomLine, she reiterated that osteopenia is a normal process that is different from osteoporosis and that treating with bisphosphonates not only does no good but may actually cause harm.
Have you been told you have “prediabetes“? I sure have. And no, I am not obese: my BMI is smack in the middle of the “normal” range. No, I do not drink sugary sodas or sit around scarfing ice cream and carbs. Yes, I do exercise every day: walking at least a mile and often slamming around a great deal more than that.
One school of medical practice would put you on cholesterol meds (statins) or metformin, either of whose side effects can make you very sick, indeed. Others regard the first line of attack as…well, yes: a healthy lifestyle. Nutritious foods, moderate exercise, moderate weight, not smoking.
“Prehypertension” is another huge bugabear. Interestingly, the bar keeps being lowered here. It used to be that “prehypertension” was indicated by a systolic blood pressure measurement of 130–139. Within the past year, though, the American Heart Association (which, interestingly, receives funding from pharmaceutical companies) lowered that standard to 120–129: deep in what used to be regarded as “normal” territory. Now we’re told that the only way to avoid dropping dead of a heart attack or stroke is to keep your blood pressure under 120! A systolic reading of 130, formerly classified as “prehypertension,” is now “high blood pressure.” The term “prehypertension” (120–129)has been replaced with the much scarier-sounding “elevated blood pressure.”
We’ll look at the blood pressure issue in more depth. For the nonce, though, take note: this is one of several ailments that are flagged for early medicating, and whose standard for early medicating is pretty slippery. Just as osteopenia’s standard is slippery.
In fact, these alleged diseases can often be treated with exercise, a decent diet, moderating alcohol intake, and getting off the tobacco.
For the moment, I’ll leave you with this entertaining and interesting TED talk by the executive editor of Reuters Health, Ivan Oransky, who also lurks at the endlessly jaw-dropping site, Retraction Watch.
This is the third of seven planned posts on the Drugging of America: