Sunday, April 24, 2016

Obamacare Alternatives

It isn't the worst problem to have: to be so healthy you don't need medications or regular medical care. Even so, in the US under Obamacare, you are required to have a medical maintenance plan through a health insurance company. Not traditional insurance that protects you against catastrophes like accidents and serious illnesses, but a maintenance plan that covers, among other things, childbirth, drug and alcohol rehab, and prescription medicines, regardless of whether you need or want any of those things. Scofflaws are subject to the smug-sounding "shared responsibility penalty" regardless of whether they cost anybody anything by giving birth, drying out or needing pills.

Lest anyone think uninsured people are all deadbeats, I for one paid all my dental bills from my bike accident a few years ago that weren't covered by my insurance. So far, those bills have been about $8,000 for braces (not covered), a dental implant (not covered), a tooth extraction and a root canal (the last two only partly covered). Long ago, I was charged full freight and paid cash--my life's savings at the time--for an emergency room visit. I have never dodged any bill that was legitimately charged to me.

So I know the value of being insured against catastrophes; I just don't need a maintenance plan, especially at $400 a month through COBRA (continuing my health insurance through my last regular employer) or $385 a month through Obamacare. That kind of money, even earning just 1% in a savings account, would amount to over $50,000 in ten years. That'll buy a house in Indianapolis. (Four hundred a month will also go a long way here towards a higher-quality diet, safer neighborhood and better schools for your kids--in other words, staying out of the ghetto.) Invested in the stock market over 20 years, assuming 10% annual returns, that's $300,000, or a big chunk of a retirement plan. Healthy people need money to retire on.

What to do? A blog called Self Pay Patient has a few suggestions: short-term insurance, joining a health sharing ministry, and alternate insurance products like accident or critical care insurance. I chose short-term insurance. It covers major medical expenses and some prescriptions after a deductible and cost less than $300 for six months' coverage. It's almost exactly the kind of coverage I used to buy as a student at $50 a month before the great state of Colorado dictated that health insurance had to cover a variety of procedures and medications whether consumers wanted the coverage or not--and regardless of the fact that such insurance was already available for those who wanted to buy it. After changes to the law, I couldn't afford health insurance at $300 a month as a laid-off engineer making a living doing odd jobs. Not if I wanted to buy groceries or keep the utilities on.

Friday, April 15, 2016

Regaining Health after Antibiotics and a Lot of Stress

Readers know I've had a stressful 18 months: family problems, a root canal that took three rounds of antibiotics to clear up, a move across the country, and a job change. My job back in Denver saw me going at ramming speed, spending two hours a day commuting, and dealing with a couple of vile coworkers. House cleaning and repairs took up my weekends and evenings for a few months, my realtor wildly overpriced my house, and I stepped on a nail a few days before I moved. I ate a lot of take-out while my house was for sale and figured I'd get back on track when I got to Indiana.

It's taken five months to get back to normal. My stomach and skin were a mess from the antibiotics--I had cystic acne and just thinking about eating a lot of fat turned my stomach. I couldn't stand for long without a backache. I was so exhausted when I got here that it was a few months before I felt like working full-time again.

Probiotics really helped my skin and stomach. I started taking two per day (Nature's Way Optima) but I've cut back to one a week. I'm eating a lot more home cooking and my stomach feels pretty good again. Getting more sleep has helped in general, too. But the yoga classes I was taking here sometimes left me with aches and pains I didn't go there with.

About a month ago, I took a temp job testing voting machines, which required me to stand all day. Surprise--no back ache! Maybe it's from leading a lower-stress life: ten-minute commute, sufficient sleep, pleasant coworkers, and work that goes at a reasonable pace. And over the past few weeks, I've been taking part in neighborhood cleanups and spent time over the past few days mowing my lawn with a manual mower and weeding my yard and the neighbor's yard. (Their house is for sale and I'd rather attract high-quality neighbors, not people who don't want to do any upkeep.) Surprise--no aches or pains and I feel great!

One good thing about Indianapolis is that if you need exercise, you can just clean up a park or walkway. (Be careful where you go.) There is so much to clean up within a few miles of my house, plus keeping my own property neat and repaired, that I don't see a need for exercise classes. (Aside: want to buy a house in an up-and-coming neighborhood on the cheap--I mean really cheap? Got more time and energy than money?  Homestead an abandoned, historical house here in Indy.)

I've started watching only shows and videos that make me feel good. Watch people who are smart (interviews with Judge Judy, Thomas Sowell), funny (Stephen Colbert, Seinfeld, WKRP in Cincinnati), or go-getters (Better Call Saul, Streets of San Francisco) or can teach you something (Wise Owl tutorials, for example) or otherwise lift your spirit (the guitarist is as good as Eddie Van Halen--who says Japanese musicians aren't passionate?), and the depression box becomes a source of inspiration. Facebook? All I ever hear about it is how depressing and annoying it is. Chat rooms? In my experience, they have too much emotional thinking by what I call "not-willings": people who are very limited in what they're willing to do to improve their lives, then complain about their lack of success. All the otherwise well-done shows where people do rotten things to each other? Pass.

Am I eating clean and avoiding processed foods? Not really. But I'm eating a lot less take-out and more grass-fed beef and free-range eggs and cooking with pastured lard. I'm also eating Quest bars, dark chocolate, take-out French fries, potato chips and meaty, cheesy sandwiches on gluten-free bread from the little co-op where I shop. I avoid nuts--they're worse than wheat for me. I inhaled five slices of pizza at work when I didn't eat enough breakfast--and I didn't regret it. I'm not making a habit of it, though: I still remember how sick I ended up on a high-carb diet several years ago. It doesn't take many meals like that for my stomach to start punishing me for my debauchery. Just being pretty good works for me.

So far, I've been working part time, so I've been able to relax and take care of myself. Going forward, I'm starting a full-time job in a week. There's 15-minute commute and a 30-minute lunch, giving me back two hours a day of my life compared to my job in Denver. Once I'm trained, I'll be working afternoons and nights. In other words, I can sleep as late as I want and run errands when stores and offices aren't busy. I've worked the same shift before and loved it. It's a lot less money than my old job, but with the lower cost of living here, my house being completely paid for and not requiring any significant repairs like the old one, it's more than adequate. I was literally coming home and falling on the bed every day in Denver. It was time for a change.

Thursday, February 25, 2016

Saturday, February 20, 2016

Groceries from a Food Desert in Indianapolis

Of all the research I did before moving to Indianapolis from Denver (looking at crime maps, flood maps, demographics by neighborhood, tax rates, growth policies, local news, and Google street view over time), none of it suggested I'd have to try to shop in a food desert. Not even when I came here on reconnaissance and shopped at the co-op in the area I was planning to move to did I realize I was in the middle of a food desert. That's right--you can have a grocery store in the middle of a food desert. Here are some groceries I bought at Pogue's Run, a co-op in the food desert just above the word "Indianapolis" in the map in the link above.

Purchased in a food desert: free range eggs, coconut milk, fresh produce, beef and raw cheese from grass-fed cows, and bacon and lard from pastured pigs. I couldn't find real lard even back in trendy, crowded, overpriced Denver. The animal products are all from here in Indiana. Would that everyone lived in such a desert.
The co-op carries cage-free chickens, too, but they're cheaper (and plucked better) at the Kroger down the street. Kroger has grass-fed ground beef and a much bigger selection of produce, gluten-free this and that, and cage-free eggs, but they don't carry beef tongue, heart or liver and their butter doesn't compare to Organic Valley, sold at Pogue's Run. Neither store has a big enough selection of Quest bars.

How is it even possible to compare the finer points of fresh, healthy, top-notch foods from two stores, one of which is in a food desert? It's the way food deserts are defined:

  • 20 percent to 40 percent of residents must make 200 percent or less of the federal poverty level
  • In an urban area, residents must have to travel a mile or more to get to groceries 
  • In a rural area they must have to travel more than 10 miles to get groceries(1)

Note that the definition isn't "There aren't any groceries in food deserts." What it amounts to is a low-income neighborhood. There's the distance thing, but even most poor people have cars.(2) There are cars parked up and down streets with crumbling, abandoned houses. Further, the aforementioned stores are on a bus line with only 20 minutes between stops--a lot handier (and a lot safer around the co-op) than a long walk home loaded down with groceries.

What about Ft. Harrison State Park? It's one big food desert on the map. Of course there aren't any grocery stores there, but do we need them there? If there are people squatting in the park, is someone supposed to build a grocery store for them?

All of this makes me think that good quality groceries aren't  nearly as inaccessible as they're made out to be. If they were, "food deserts" would have an obvious definition: a place where you can't get decent food.

1. "Indianapolis Ranks Worst in the Nation for Food Deserts" by Sara Wittmeyer. Indiana Public Media, May 30, 2014.
2. "Understanding Poverty in the United States: Surprising Facts about America's Poor" by Robert Rector and Rachel Sheffield. The Heritage Foundation, September 11, 2013.

Sunday, January 17, 2016

Fishing for Depression Patients

I knew last summer when I saw the headline that there had to be a new depression medication out. How? The news was "All Americans Should be Screened for Depression."(1) That's a good idea because, as you know, depression is a menace, affecting tens of millions and leaving many of its victims tired, overweight, prone to heart disease, impotent, blind, and--wait, I'm thinking of diabetes. It might make sense to screen everyone for diabetes. No, the reason for screening everyone for depression, I figured, was that there was a new drug someone was looking to peddle. Sure enough, the FDA approved a depression drug a few weeks earlier.(2)

Some doctors are already screening patients--like me--for depression during routine office visits. My invoice for being seen for a puncture wound included "brief behavioral assessment," which I didn't remember getting. When I called the office about it, they said they gave everyone that assessment through a questionnaire. I do remember filling out a large amount of paperwork.

Some depression drugs have been shown to be no more effective than a placebo and can have serious side effects. Further, it's one more thing for doctors and patients--many in an overburdened system--have to do. This particular drug may even kill you--there's a warning about suicidal thoughts and increased risk of death for certain patients, and weight gain and a sense of restlessness common among people in a study who took the drug. And all they got was a lousy reduction of symptoms. (3)

The article about recommending depression screening made no mention of the other trade-offs involved in adding another step to routine patient visits: more time filling out paperwork for patients, more prescriptions that may or may not do any good, and less time and money for everything else that doctors and patients already have on their plates.


  1. "All Americans Should be Screened for Depression, Panel Recommends" by Andrew M. Seaman. Huffington Post, July 8, 2015.
  2. "FDA Approved New Drug, Rexulti, for Depression, Schizophrenia" by Robert Preidt. July 13, 2015.
  3. Ibid.

Tuesday, December 29, 2015

GI Distress and Moderation

It started with a round of healthy exercise back in 2012. I was riding my bike one minute and face-down on the sidewalk the next. My dentist predicted the two teeth that were knocked out of place would need a root canal someday, and early this year, one of them did. It took three rounds of antibiotics to clear the infection.

The antibiotics left my already-touchy stomach railing against anything fatty--in other words, my normal diet. A few months later, the stress from a cross-country move where a lot was up in the air for months (my job, the purchase of one house while selling another, getting ready to sell the house, researching where to move), plus taking and then giving up my mother's dog, made 2015 the most stressful year I've ever been through. My nearly hour-long commute and going at ramming speed at work added to the stress. Then I stepped on a nail the night before I was going to pack up my stuff and leave--and I'm bad at packing. I pack up what I think is everything, look around, and see more stuff to pack. Repeat several times--with an injured foot. (ETA: I conveniently lost the antibiotics for my punctured foot after a couple of doses.)

I tend to undereat when I'm stressed out. Therefore, my diet for most of the year was moderate-calorie and rather high-carb. The original reason I went on a low-carb diet was upper GI distress. Probably, I have FODMAPS problems. I can eat a little bit of almost anything without distress, but no way can I eat the recommended six to 12 servings of grains and bushel of fruits and vegetables without bloating and acid reflux.

With little appetite and a lot of adrenaline, though, I could do the recommended high-carb moderation thing, and had to since my stomach wouldn't tolerate anything else. And I ate things like rice, egg rolls, and even a few Hostess cherry pies, which I don't normally eat. It was comfort food, and I needed comforting. (I don't recommend following my lead if a little bad food sends you on a bender or you have a condition that requires strict adherence to a diet.)

Pros and cons:

  • Acne. I had cystic acne, which I hadn't had since my early 20s. 
  • Racing, fluttering heart. 
  • Weight loss. I got down to 118; I look better at 122.
  • I got to eat two Hostess cherry pies and some egg rolls without distress.
  • No tooth decay.

It's hard to say how much was due to stress, diet, or antibiotics. What's really helped everything, though, is probiotics. I've been taking super probiotics at twice the recommended rate and everything has started getting back to normal: my skin is clearing up and my heart feels normal. Yes, I was completely wrong before about gut bugs being unimportant.

I've been eating a little bit more carbohydrate than I did before all this started, though. For years, I've gotten palpitations on very low-carb, and I don't have a need, either for weight control or my stomach, to restrict carbohydrates to an Atkins induction level. That's a good level for some people, but not for me.

There's a lot less stress and more rest in my life now, too. The move is over, my house in Colorado is sold, and in a few days I'll have my new, nicer house completely paid for. My commute is now half an hour and even though I'm working part time, the other day I woke up feeling like I'd been on a long, strange vacation and it was time to go home and go back to work. 

Tuesday, December 15, 2015

What Difference Does it Make Why it Works?

This is the question someone asked me the other day in regards to the good results I've had on low-carb. Beyond just satisfying your curiosity, having a lattice work of mental models, as Charlie Munger puts it, can save you a lot of trouble. Without mental models of (in this case) human digestion, evolution, nutrition research, journalism, medical education, and even politics, all I'd have is just something that works for acid reflux.

A little knowledge is a dangerous thing. Something that works might only work in certain situations, could be unpredictable, could have unintended consequences, or could just be a placebo effect. Knowing how something works reduces the danger.  As Munger's partner Warren Buffett put it, "Risk comes from not knowing what you're doing."

Yet how often are people overconfident when they only know a thing or two? The web is full of bros who cut down on the beer and pizza, got some exercise and lost 40 pounds--and you can, too! Their moms recommend more fiber, less fat and fewer calories, which everybody knows works: it's in all their women's magazines.

Doing what everybody else isn't can be intimidating. Knowing what you're doing, having arrived at the same conclusion from different disciplines, can inform you if you're on the right track and help you stay the course. Here's where the lattice of mental models comes in: facts are connected to other facts. Those facts form the lattices of disciplines and some of the lattices are connected. To pick an example, veganism weaves an interesting lattice with claims of good health, environmental consciousness, and humane treatment of animals. And a juice fast is something that works for certain health problems. But approach the lattice from the disciplines of evolution, or ancestral diets, or digestion, or nutritional requirements, and the lattice of veganism falls apart.

Without a lattice of knowledge--knowing how a system works--all you have is a collection of facts that may be a collection of fairy tales. Like most collections, it can't do anything but be displayed. It's hard to verify unrelated facts, assuming you can remember them. You can't build on them--anything new has to be through trial and error and luck. It's a way of going through life otherwise known as stupidity. I've done it--I have a mouthful of fillings to prove it.

ETA: This could be one reason engineers are so subject to wackiness (e.g., being overrepresented in terrorist groups and fringe religions): they learn pretty much only mental models of engineering subjects, which aren't exactly metaphors for life. Requiring courses in comparative religion, epistemology, and human evolution for an engineering degree could well rid the world of a lot of terrorists.