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.
Wrong.
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
Iron clothes
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.
Really?
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)
Erectile dysfunction
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)
Gout
Glucose intolerance
Bradycardia
Wheezing or asthma,
Masking of hypoglycaemia Sleep disturbances
Fatigue
Exercise intolerance
Erectile dysfunction
Glucose intolerance
Worsening of peripheral vascular disease
Drowsiness Raynaud’s phenomenon
Heart failure
Elevated triglycerides, cholesterol and/or fat phospholipids (dyslipidaemia)
Angina caused by sudden withdrawal.
Alpha blockers
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.)
As you can see, then, overtreatment of mild hypertension (or possibly of what we’re now told is serious hypertension) may be doing more harm than good. Even when “mild” or “stage 1” hypertension was defined as 140-49/90-99, there was no evidence that people at “low risk” (i.e., with no existing heart disease, diabetes, or kidney disease) are helped by going on antihypertensive medications. To the contrary, they are presented with a wide array of uncomfortable and even life-threatening drug side effects.
Meanwhile, for some years practicing doctors have been reporting rampant overprescription of these medicatons; one even called it “an epidemic” of hypertension overtreatment. Not to be left behind, the legal profession has noticed the phenomenon, too; one lawyer suggests, almost circumspectly, that Big Pharma and the money motive might be at the bottom of it all:
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.”
Whether or not doctors get paid for putting you on a given drug, there’s no question that the prospect of putting two-thirds of Americans on blood pressure meds represents a vast reservoir of profit for Big Pharma. That alone is reason to be skeptical.
Remember this principle: always get a second opinion.
This is the fourth of seven planned posts on The Drugging of America.
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.
That would bethe enthusiastic trendtoward diagnosing “pre-conditions”: pre-hypertension, pre-diabetes, osteopenia as “pre-osteoporosis.”
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.
What would be a better, cheaper way to treat this supposed ailment? Regular exercise, a healthy diet that includes calcium, a few minutes of sunshine each day, cutting out the smoking, and limiting the booze to one drink a day.
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:
That old chestnut simply has to have been written by someone from Phoenix. About Phoenix. What a f*ckin’ zoo this place is!
Having failed to get to yesterday’s West Valley Writer’s Workshop shindig, today I determined to go to a weekly Central Phoenix Writing Workshop, therein — with any luck — to meet some new people and maybe even make some new friends. A guy who shows up at the WVWW events is one of the Central Phoenix organizers, and I thought it would be nice to see him, he being a pretty interesting fella.
But no.
It should be a straight shot down Central Avenue. This outfit meets in a hipster coffee house dead center in the renovated downtown.
Li’l hipsters…
To give you an idea: During the recession, I considered (in passing) buying a condo within walking distance of this place. They wanted as much as my four-bedroom house costs for 1 tiny living/dining room, 2 “bedrooms” (one would suffice as a small office), and a kitchenette.
Yeah.
But that’s not so much here nor there.
Turn out of a neighboring ‘Hood and head south on Central.
It is slow going.
And then it gets slower.
And then it comes to a dead stop.
WTF? I can’t figure out what the problem is. Must be an accident up ahead.
At Indian School Road, traffic just sits at the light. After awhile, we inch close enough to the intersection that I can see Indian School is closed east of Central. Cop lights are flashing: must be a Wreck from Hell…not an uncommon event in these parts, as you can imagine.
By now it’s quarter to two. The group’s meeting starts at 2:00 p.m. I’m not gonna make it if I stay in this mess. If I veer right and then dart south on Seventh, maybe I can get around the mess. Fortunately, I’m already in the right-hand lane. I nuzzle the car into the right-turn lane, cutting off some poor wretch who has the same idea.
We sit through FOUR SIGNALS before I get to the front of the line to turn right on Indian School.
Westbound traffic is OK.
Turn south on Third, knowing that at Thomas (this being my old stomping grounds) I’ll have to jog west and then south onto Fifth, since those two streets convert to one-way at that point. PITA.
It gets later.
By the time the supercharged Venza reaches Thomas, we’re just a few brief minutes short of two o’clock
At this point, I figure I’ve had about enough of this run-around.
For.
Get.
THAT!
North on Seventh Ave, headed back to Bum Central, way far to the north of these gentrified confines.
…Meet yo’ daddies and yo’ mamas!
Cruising north, back at Indian School I come to this organic market that I’ve always wanted to visit but usually can’t because when I’m northbound on 7th Ave I’m in a ball-busting hurry (yes, I do always run late…why do you ask?) or it’s late at night after some downtown event or I’m evading the Hated I-17 or I have someplace to go on Seventh. None of those eventualities invite one to diddle around in a grocery store.
Dart right out of the middle lane, tromp the brakes, annoy the guy who was flying along in that lane about 10 mph over the limit. (I know, because we were pacing each other.) Whip into the store’s parking lot.
What a freaking blast from the past!
If you are old enough to remember the 1960s and 70s, then you are old enough to remember organic food co-ops.
This place is like an organic food co-op, only clean. Only with pretty damn good-looking produce. What it really makes you think of is a Whole Foods crammed into the space the size of a typical Sprouts.
Remember the allegedly “organic” produce in those 1970s co-ops? Wilted. Brown. Soggy. Looked like it had been picked from somebody’s backyard garden and left to ferment in a warehouse for three weeks? Yeah: you had to be a true believer to buy that pre-garbage.
The produce in this store was FREAKING GORGEOUS! Plump and handsome and happy and calling out to your taste buds: Come to me, come to meeeee!
The clientele? Omigod. You never saw so many aging hippies in your life. And of course health-conscious gay guys. The store is on the edge of the Melrose district, the home of many gay couples. Everyone in the store was visibly having a wonderful time shopping. No irony there: it was clear these people loved it.
And they had hippy-dippy personal products, so many organic combs and brushes and creams and soaps and toothpastes and beard softeners and hair pomades and…the boggle minded.
Naturally I bought a piece of (YES!) unscented Castile soap (couldn’t believe it) and a little pottle of unscented workingman’s hand softener gunk (think udder cream gone to San Francisco). Hallelujah brothers and sisters!
If they’d had some tie-died clothes, you can be sure I’d’ve bought some of that, too.
Raced back home bearing a beautiful, ripe (!!!!) acorn squash, a perfect unblemished yellow onion, and a pound of allegedly organic, allegedly hormone-free, allegedly grass-fed ground meat from the loins of the perfect cow.
Nice. Will I go back? Probably. It was overpriced. Yes: prices outstripped Whole Paycheck even before that honorable store was kidnapped by Amazon. But did it have things I don’t think I can find elsewhere? Yeah. Definitely. I will go back.
So.
Even though you can’t get wherever it is you think you’re going from here, you can get somewhere interesting. 😀
Hilariously, I’m prancing off to choir this morning with a black eye. First in my over-long lifetime!
