Kaizen Curmudgeon 2013 Archive

“Hey, Curmudge, we’re at the end of another calendar year.  Do you think that the information we presented in our blog this year did some good?”

“Not for the 7.2 billion people on this earth who didn’t read it, Julie.  Of course, each person saved about five minutes per posting by not reading each of the 40 postings.  Assuming each person‘s time is worth $0.10 per minute, on a world-wide scale, we saved $144 billion by writing a blog that few people read.”

“I think your numbers are right, Curmudge, but your logic is goofy.  Maybe there’s a job waiting for you in Washington.  But what about those people who did read our blog?”

“There is a high probability that they gained from each posting something that they might not have otherwise learned.  It was free from the Internet and cost a few pennies of their time.  Such a deal!  So here’s what we wrote about in 2013.”

2013 Archive—Table of Contents

Title (Subject)	Date Posted
Risks and Fears—Introduction	1/03/13
Risks and Fears—Examples	1/13/13
Risks and Fears 3 (The Old Risks and Benefits File)	1/20/13
Bloggers—Affiliated or Independent	1/27/13
The Ordeal 1 (Chemotherapy)	2/04/13
The Ordeal 2	2/10/13
The Ordeal 3—Summary	2/16/13
Unconventional Wisdom 1 (Heath Effects of Low Doses of Ionizing Radiation)	2/28/13
Unconventional Wisdom 2—Mice in the Laboratory	3/07/13
Unconventional Wisdom 3—Epidemiology	3/20/13
Unconventional Wisdom 4—Radiation Background	4/01/13
Unconventional Wisdom 5—How much?  How does it work?	4/15/13
Unconventional Wisdom 6—Policy Issues	4/24/13
Happy Sixth Birthday	5/13/13
Kaizen Curmudgeon for Seniors (Introduction and Contents of Interest From Earlier Postings)	5/27/13
A Look Ahead on Kaizen Curmudgeon (An Introduction to Global Warming)	6/04/13
Curmudgeon and Jaded Julie Read the Newspaper	6/17/13
Curmudge and Jaded Julie Talk About Cause and Effect	6/26/13
Curmudge and Jaded Julie Talk About Models and Vested Interest	7/02/13
Peer-Reviewed Publications	7/11/13
600 Years Ago (An Allegory on Global Warming)	7/15/13
Climate Science 1 (Anthropogenic Global Warming)	7/23/13
Climate Science 2	7/30/13
Climate Science 3	8/06/13
Climate Science 4	8/14/13
Climate Science 5	8/21/13
The Almost-Invisible Emotion (Mourning Seven Months Later, written August 11, 2011)	9/03/13
Mourning—Almost Three Years Later: Absence	9/11/13
Companion Qualities	9/20/13
Alternative Medicine 1—Introduction	9/27/13
Alternative Medicine 2—Words of Wisdom and Caution	10/04/13
Alternative Medicine 3—Nutrition	10/14/13
Alternative Medicine 4—Illness and Risk	10/21/13
Alternative Medicine 5—It’s Cancer!  Now What?	10/31/13
Alternative Medicine 6—Alt. Med. 101	11/08/13
Alternative Medicine 7—Mind-Body Medicine	11/20/13
Alternative Medicine 8—Energy and Hands-on Therapies	12/04/13
Your Plastic Brain—The Basics	12/11/13
Holiday Greeting--2013	12/18/13

“Do you suppose, Curmudge, that some of our readers might never have used the Blog Index to access an earlier posting?” 

“If that’s the case, Julie, we’d better provide some help, as follows:  Links to all postings are available via the Blog Index in the right margin of each posting.  But to use it one has to know when the subject of interest was in a posting.  In the Blog Index one clicks on the year and then the month of posting.  Titles of each of that month’s postings appear, and they are links to the posting with that title.  The problem is that one must know the year and month.  What is needed is a table of contents in which one can browse.  That’s what we have created (above) in our current end-of-the-year posting—a table of contents for the 2013 postings.  After one finds a subject of interest, he/she goes to the Blog Archive in the right margin of any posting and clicks on year, month, and title (link).”

“That ought to do it, Old Guy.  Happy New Year.”

“Frohe neues Jahr, Young Lady.”

Link to posting from blog archives: Primary care in 1940 (Doc on call 24/7.)—8/20/09 http://kaizencurmudgeon.blogspot.com/2009/08/primary-care-in-1940.html

Holiday Greetings—2013

“Curmudge, you look as if you just took a dose of unflavored Metamucil_®.  It doesn’t taste really bad but not very good either.  Is your morose expression just for the holidays, or is it for everyday use?”

“I try to be consistent, Julie; it’s now my default mien.  I used to be the happiest guy at St. E’s, but events of recent years have cured that.”

“Okay, Ebenezer.  So how can we conjure up any sort of holiday greeting?”

“I’ve been puzzling over that, Mrs. Claus.  It’s difficult to be cheery about big issues.  Our nation and the world certainly appear to be going to pot.  We’ll discuss that in 2014 under the title, Curmudgeonomics.  That leaves us with personal concerns for which to be thankful and possibly even cheerful.”

“Bravo, Old Guy.  I knew that you would come up with something.  Here’s an example: We are both grateful that last summer’s tornados—only a hundred yards away—didn’t blow in your windows and tear the roof off your apartment.”

“I agree, and here’s another: At my age, I rejoice that I can still see and hear—with assistance—and walk up the steps in the 222 Building.”

“These deserve our prayers of thanksgiving: People we love who have survived melanoma and Burkitt’s lymphoma.”

“And you know, Julie, we are thankful for the advances in neuroplasticity that we are writing about.  Application of that knowledge will give new hope for autistic kids and seniors with age-induced memory loss.”

“So there we have it, Curmudge.  If people take time to think about it, most everyone should be able to find something about which to rejoice this holiday season.”

“Happy Holidays, Julie.”

Link to posting from blog archives: Physicians and Lean—6/25/09

http://kaizencurmudgeon.blogspot.com/2009/06/physicians-and-lean.html

Your Plastic Brain 1—The Basics

“Curmudge, it seems that we have suddenly changed from discussing alternative medicine to brain plasticity.  Is there a connection?”

“Of course there is, Julie.  Techniques that we have already mentioned, like meditation and tai chi, are designed to relax and refocus the mind.  As we quoted a couple of weeks ago, the mind is the software for the brain.  So we are going to move inside and find out what is really going on inside the brain.”

“In your brain, Old Guy, nothing other than a big memory leak is going on.  Even the smallest parts were cemented in place by the time you learned that girls were different from boys.”

“Au contraire, Madame.  That’s what was believed 50 years ago, about the time I finished graduate school (good thing I wasn’t studying physiology).  It was called localization.  Here’s how it is described in Doidge’s book (1): ‘The brain came to be seen as made of parts, each one in a preassigned location, each performing a single function, so that if one of those parts was damaged, nothing could be done to replace it.’  ‘Most scientists believed that the brain areas (devoted to sight, hearing, taste, touch, smell, balance) were so specialized that one area could never do the work of another.’ “

“I anticipate that you are going to tell me that great advances have been made in understanding the brain in recent years and that the localization concept is outmoded.  Please elucidate.”

“Here’s the story: ‘Brain plasticity, also known as neuroplasticity or cortical remapping, is a term that refers to the brain's ability to change as a result of experience. These changes can occur as a result of learning new things or because of damage to the brain.  Up until the 1960’s, experts believed that changes in the brain were only possible during infancy and childhood, but research has demonstrated that the brain is capable of altering existing pathways and even creating new ones.’ “

“Hey, Curmudge, this neuroplasticity stuff is mindboggling.  Don’t stop now.”

“There’s lots more, Julie, such as these two kinds of plasticity: ‘Functional Plasticity—refers to the brain's ability to move functions from a damaged area of the brain to other undamaged areas.  Structural Plasticity—refers to the brain's ability to actually change its physical structure as a result of learning.’  A two-page overview provides more detail.“

“Amazing!  And neuroscientists learned all of that while you were teaching analytical chemistry and helping to make soft toilet tissue.  One might say that from top to bottom, science was advancing.  So what kind of experiments did those brainy people perform to demonstrate neuroplasticity?”

“The researchers and their work are described by Doidge in engaging detail. (1) Merzenich, Taub, and their coworkers, who did basic studies with animals, followed it up with applications to human patients.  Much of this was made possible by the invention of microelectrodes ‘so small and sensitive that they could be inserted inside or beside a single neuron and detect when an individual neuron fires off its electrical signal to other neurons.’  (Unless otherwise indicated, quoted material is from Doidge’s book.)  A portion of a monkey’s skull was cut away over an area of the brain’s sensory cortex believed to respond to the monkey’s hand. Microelectrodes were inserted, tested by touching, e.g., a fingertip, and a micromap of the part of the brain responding to each area of the monkey’s hand was created.”

“I’m certain to feel sorry for the monkeys, Curmudge, but can you tell me what was learned?”

“When two of a monkey’s fingers were sewn together, over time the separate bran maps for the fingers became joined.  Another experiment:  In a monkey’s hand, sensation is conveyed by three nerves, the radial, median, and ulnar.  Merzenich cut the median nerve; when he touched the middle of the monkey’s hand two months later, the area of the brain map that serves the median nerve showed no activity, as expected.  But when he touched the outside of the monkey’s hand, the median brain map lit up.  ‘The brain map for the radian and ulnar nerves had almost doubled in size and invaded what used to be the median nerve map.’ “

“Voilà, Old Guy, plasticity!  That furry fellow was a hero.  He proved that, ‘When it came to allocating brain-processing power, brain maps are governed by competition for precious resources and the principle of use it or lose it.’ “

“Here’s a little more ‘monkey business,’ Julie; the researcher is Edward Taub.  He cut the sensory nerves in one of a monkey’s arms, but not the motor nerves.  Because the monkey had no feeling in his bad arm and couldn’t determine its location in space, he used his good arm and hand for eating.  During its period of nonuse, the brain’s motor map for the bad arm began to atrophy (i.e., use it or lose it).  Taub called this ‘learned nonuse.’   Then he immobilized the monkey’s good arm by putting it in a sling.  In order to survive, the monkey had to use his ‘bad’ arm for eating.  Taub’s finding supported Merzenich’s conclusion that when an animal is motivated to learn, the brain responds plastically.”

“I have the feeling, Professor, that these and other findings have become the basis for alleviating a lot of human beings’ miseries and weaknesses.”

“And, Julie, we’ll say more about them in a week or so.  See you then.”

Kaizen Curmudgeon

(1)  Doidge, Norman, MD The Brain That Changes Itself (2007).

Link to posting from blog archives: Communicate—Think—Diagnose—Communicate  6/18/09 http://kaizencurmudgeon.blogspot.com/2009/06/communicate-think-diagnose-communicate.html

Alternative Medicine 8—Energy and Hands-on Therapies

“Listen up, Julie.  Here’s how Mayo’s describes acupuncture.  It’s pretty typical of the energy therapies: ‘Traditional Chinese medicine is based on the belief that the body contains a vital life energy called qi (chee), which runs along pathways within the body.  Imbalances in the flow of qi are thought to cause illness.  These life-energy pathways are called meridians and are accessible at approximately 400 different locations, or points, on the body.  Practitioners of acupuncture attempt to rebalance your energy flow by inserting extremely fine needles into these points in various combinations.  This allows your body’s natural healing mechanisms to take over.’ (1)”

“Curmudge, I can almost hear your mind squeak as you struggle to understand and fully believe these energy therapies.”

“And all along I thought it was just high-frequency interference in my hearing aids.  But I’m willing to consider anything that might soothe the aches and pains of old age.  Here’s a study performed at McMaster University that actually yielded scientific data: Cell cultures were exposed to acupuncture-like and reiki-like treatments.  The cultures were exposed to x-rays before or after the treatments and were monitored for damage by the radiation.  From their findings, the authors concluded that ‘alternative medicine techniques involving electromagnetic perturbations may modify the response of cells to ionizing radiation.’ (2)”

“Wow!  Now I understand…I think.  But I believe we’d both feel more comfortable with these techniques if we could learn about some real, human examples.  One example is Doc Mack’s use of acupuncture for allergies and stress relief.  Come to think of it Old Guy, I have used the traditional Chinese medicine called acupressure.  It uses pressure at specific points on the body instead of acupuncture needles.  Putting pressure at a point three finger-widths up the inside of the wrist from the base of the hand controls motion sickness.  At the drugstore one can buy elastic wristbands with a rubber button at the right spot for this purpose.  They really work.”

“And this is my own example, Julie.  It’s a hands-on therapy: Several years ago I had constant pain down my right leg all the way to my ankle.  It was even hard to stand up in the church choir.  I went to an orthopedic doc who, after an x-ray, determined that I was in the wrong shop.  He didn’t try to solve my problem; he just established that it wasn’t his.  I subsequently saw a chiropractor who prescribed some stretches that resolved my pain and that I now do every day.  And, by the way, chiropractic is covered by Medicare.”

“And here is another technique that appears to have been successful.  It’s called reiki (RAY-kee), as in the study at McMaster University.  ‘The practitioner delivers reiki therapy through his or her hands with the goal of raising the amount of ki (or qi) in and around the recipient.’ (3)  A member of our editorial board experienced reduced pain in an injured knee after a reiki treatment.  I’ve also heard of reiki treatments reducing the intense pain of terminal cancer patients in a hospice.”

“Of course, Julie, you know how it bothers me not to have a better understanding of how these techniques function.”

“The problem is that you are a hide-bound old relic burdened by a mid-twentieth century education.  You don’t know all that goes on inside my smart phone (neither do I), but you accept it.  Perhaps we could tentatively accept at least some of these obscure mind-and-body aspects of alternative medicine if we used them on a regular basis.  You might try qigong; we mentioned it last week.  It’s like tai chi only less vigorous, and it is reported to relieve depression in old people.”

“Loneliness, but probably not clinical depression, may be endemic among widows and widowers.  But if I go bouncing around in my apartment doing tai chi or qigong, it might disturb the people in the apartment below mine.”

“Then do it in the basement where the cars are parked.”

“If my neighbors see me, they’ll think I’m a nut.”

“Not to worry, Curmudge.  They already know that.”

“Putting aside your levity and attempts at humor, Young Lady, you might have noticed my reading a borrowed copy of Norman Doidge’s book, The Brain That Changes Itself.  We mentioned it in last week’s posting.  Doidge’s discussions of neuroplasticity should be of interest to parents of young children, senior citizens, and people with brain injuries and mental illnesses.  We should share some of his insights in our next postings.”  

“Sounds interesting to me, Old Guy.  I’ll be here.”

Kaizen Curmudgeon

(1) Mayo Clinic Book of Alternative Medicine, Second Edition.  p. 121 (2010, Mayo Foundation for Medical Education and Research).

(2) Mothersill, C. et al. Alternative Medicine Techniques Have Non-Linear Effects on Radiation Response. Dose-Response 11 (1) p. 82-98 (2013).

(3) Mayo Clinic Book of Alternative Medicine, p. 127.

Link to posting from blog archives: Patient-Centered Communications  6/11/09

http://kaizencurmudgeon.blogspot.com/2009/06/patient-centered-communications.html