Saturday, February 27, 2021

Daily Vitamins and Supplements

Let me be a little revealing about my health…

My number one problem is osteoarthritis, as a rheumatologist, I have read the literature.  

In general, the only non-surgical treatment is keeping muscles strong around your joints!   

Otherwise, there is no clear proven treatment for osteoarthritis.  

You can get some pain relief from NSAIDS such as ibuprofen or naproxen, if your stomach can tolerate it, and even better combined with acetaminophen.  


I usually recommend over the counter ibuprofen 200 mg along with 500 mg immediate release acetaminophen, every 4 hours, up to 6 times daily.  

Or, you could try over the counter naproxen 220 mg twice daily along with acetaminophen extended relase 650-1300 mg twice daily.  

Make sure your liver, kidneys, stomach, can tolerate these doses (check with your primary care provider!).  

I try to avoid long term use of NSAIDS and acetaminophen, lots of possible risks to liver and kidneys, with both, and to your cardiovascular system with NSAIDS.  

Sometimes a steroid injection can help.  But steroids tend to destroy joints when used too often.  

We try to avoid opiods, since you just need more and more to control pain, highly addictive.  

Sometimes we use chronic pain meds such as gabapentin and cymbalta, at least they are non-addictive.  

My osteoarthrtis tends to be inflammatory, I’ll get a joint that even turns red, then calms down with a nice bony osteophyte to show for that episode.  

I am also into CAM, also known as Complementary and Alternative Medicine.  

Acupunture has helped me at times.  

One highly skilled naturopath-acupuncturist recommeded InflamAway, it is by prescription only, a very expensive supplement, being an MD I can get it wholesale.  Even then it is relatively expensive…  

Do I need all these supplements?

Or, am I just making very expensive urine?

Good question…  

I am not sure…  

I do feel that my inflammatory osteoarthritis has been quieter on these supplements, but as an N=1 experiment, and not a placebo controlled trial, it is always hard to tell what is true.  

My second problem is intermittant low back pain.  

I have some slight daily achiness at my right sacroiliac joint area, but not worse at night.  

Started when my kid was about 1-year old and I slipped down the carpeted stairs, holding tightly on to the 1-year old to protect him.  

Years later I was lifting a really cool large round rock for the garden and had pain in that same area.  Probably a bit too heavy a rock, and was very awkward to carry.  


I have a history of scoliosis, actually wore a Milwaukee brace through middle school.  Not clearly related to my back pain.  

The back pain is probably related to my underlying propensity toward osteoarthritis.  

My mom had osteoarthritis of the hands, also had back surgery for disc disease.  She had a hip replacement at age 90!

I have had episodes where I could move only with severe pain due to pain in that right sacroiliac area.  Never missed work.  Did sometimes roll around the exam room on a stool!    

The most important thing that keeps my back pain from flaring is daily exercise.  Rolling on a foam roller helps as well.  
http://enlightenedmdphd.blogspot.com/2018/01/the-space-between.html

In addition to my morning routine, I try to do 1-2 hours of aerobic exercise every other day.  Biking outside if weather permits, or on the ellipitical trainer indoors.  Occasionally, I’ll fit in a weight training day, hope to do that more as I age.  

If I get really severe back pain, I’ll use acetaminophen for a couple of days, happens perhaps once every 2 years, more often if I let go of daily exercise.  Even more rarely needing NSAID therapy added to the acetaminophen.  Maybe once in 4 years.  

I feel very lucky to have very few medical problems.  

I am very nearsighted, have avoided Lasik, due to fears of complications.  Wearing glasses since 3rd grade!  

I am on no prescription medications.  


Product                             Daily dosage         Brand Name        Reason

Mature Multi Vitamin 1 daily                     Kirkland/Costco General supplement
Ginkgo Biloba         120 mg                 Puritan’s Pride Heart and blood health
Glucosamine                 500 mg                 Puritan’s Pride Joint health
MSM                         1000mg x2         Puritan’s Pride Joint health
C-500 timed release 500 mg x2         Puritan’s Pride Antioxidant immune support
Vit E mixed tocopherals  400 IU                 Puritan’s Pride Antioxidant
Pe Min Kan Wan          2/day                 Plum Flower Allergies
Vit D3                         1000 IU                 Whole Foods Bone health
Fish Oil                         1200mg each x4 Puritan’s Pride Cardiovascular health
Calcium w/D                 600 mg Ca/400D Kirkland/Costco Bone Health
Co Q10                 100 mg                 Puritan’s Pride Heart health
B-Complex 50                                 Whole Foods Vitamin
Triple Ginsing                 1 cap                 Whole foods Antioxidant
Bilberry                         60 mg                 Puritan’s Pride        Eye health, antioxidant
Rhodiola extract         120 mg                 Gaia         Antioxidant
 5-HTP                 100 mg ER         Natrol         Mood
Tumeric                         800 mg         Puritan’s Pride Antioxident
InflamAway                 3 capsules         Natura Joint health

It looks like a long list of supplements to me too…  

I have not had a primary doc until this year.  

I had that episode of surgery for hydrocoele last year, first surgery ever.  


So, also got a primary care doc.  Probably a good idea at age 67…   

She is trained in internal medicine, and is a former faculty member, also is trained in CAM throught Dr Weil’s fellowship program.  Very glad to have her as my doc!  

She did not balk at my supplement list, actually recommended I take an additional Vit C daily for my occasional allergies.  

This blog has mostly been about my personal unfolding as to emotional and spiritual growth.  

As well as an occasional rant!  

I am adding this information on my personal health and supplements to fill out the connection between Body, Mind, and Spirit…

Perhaps helpful…  Perhaps not…  

Namaste












Monday, February 15, 2021

What Kind of Lab Are You!

 Expectations…  


So interesting.   


Yes, being quite dog centric these days…  


“Puppy brain”


One of our trainers describing puppies with “the attention span of a gnat…”  


It seems that us owners sometimes have a similar problem.   


Our world revolving around this new member of the family.  


Takes a lot of time, can be very distracting…  


Luckily, after lots of play, naptime can allow room to do some work, some thinking, some writing.  


My family and I only had 2 dogs, the first, Midnight, was an unclear mix of Lab and Great Dane.  


Arrived at about 3 months of age.  


With expectations of a huge dog, we bought a huge crate…  


Midnight only got to about 45 pounds…


A great dog, we probably could have done a better job of training her, but I was new Assistant Professor, working too hard, bucking for tenure…  


I left most the training to my then wife and young kids…  


Midnight did not eat like a Lab, you could leave food in her dish all day, and she would only eat when hungry…  stayed muscular and thin naturally…  


After Midnight passed on, my then wife lasted about a month or so, when the need for a puppy arose…  


This time went for a purebred Lab…  


Dakota was great dog, but ate like a Lab…  


As a small puppy, we visited with family out of town, he found a bag of dog food, then proceeded to almost eat himself to death…  


His belly was so huge, I was sure we would need to take him to the vet for surgery.  


He was known to eat a large portion of a large pumpkin placed on the porch for Halloween…  


We were going on a trip, got cash from the bank.  We left Dakota in the car for a moment, and he proceeded to eat the 200 dollars, including the bank envelope.  


I processed his poop for about 3 days, somehow recovering all but 2 of the $20 dollar bills, required a bleaching process, that still resulted in bile-stained bills to be turned in to the bank…  


Would eat toilet paper, and socks, more like a goat…  


The kitchen floor was always spotless.   Everything was licked and eaten, food, dirt, anything…  


As I mentioned, both my current wife and I have had Labrador Retrievers.  


She has had a similar experience.  


Zev, is a standard poodle.  


Does not eat like a lab…  


You can leave food in his bowl, only eats when hungry, sometimes turns his nose up at anything but special “high value” treats.  


You can drop food on the floor, it gets ignored…  


Treats can roll out of his treat toy and he misses it on the floor, until you point it out…  


Therefore, we often remark “Not a Lab” or “What kind of Lab are you!”   


Expectations…  


We humans fall into expectations…  


Our minds develop grooves…  


We fall into repeated ways of operating in the world…  


We can be thrown off, when things change.  


In the case of Zev, it is fun…  


Fun to watch my mind look at amazement when he does not inhale his entire bowel of food in a minute…  


It is actually nice that Zev does not scarf down everything, food and not food…  


He is a chewer, “puppy piranha,” we are working on that…  


This behavior is a natural part of puppyhood…  


We are both working on training, my wife is taking the lead, and she is laying out quite a bit of money on training classes and instruction…  


This is an investment…  


 It is a pleasure to have a well-trained dog…  


And Zev is quite smart and trainable…  


He is entering his adolescence…  


We are doing our part, reading, taking the time to give him the attention he needs, help him be active, tire him out…  


Training is patterning the brain…  


Creating the grooves, when to sit, to stay, to heel, to come…  


Learning, reading, about puppy growth, about dog communication and behavior…


Humans are complex, I’ve spent my life trying to understand myself, trying to understand other humans, how we grow, how we change, how we can live better lives…    


Bringing dog energy into the family can also help reveal more deeply who we are as humans… 


Humans have been interacting with canines for millenia…  

“The genetic divergence between the dog's ancestor and modern wolves occurred between 20,000 and 40,000 years ago.”

https://en.wikipedia.org/wiki/Origin_of_the_domestic_dog


Dogs are not humans…   


With other humans, our mistakes are often with projection…  


With dogs, we have to be careful of our natural tendencies toward, “anthropomorphism,” perhaps better defined as personification…  


Seeing clearly,


 Seeing everything,


 Just as it is…  


A never-ending unfolding…  


With dogs and without…  


Namaste





Monday, February 8, 2021

Puppy Time

No not entitled “Puppy Love”   


We love our puppies, I don’t think our puppies love us…  


Not in the way we think out puppies love us, that is our projection…    


Often, I believe, that is the beginning of where we get things wrong when bringing up puppies…  probably kids as well...  


Been reading…  always reading…  


I think Melissa Holbrook Pierson gets things right, she usually does.


She does her research…  


Her book is titled, “The Secret History of Kindness:  Learning From How Dogs Learn”  


The title didn’t make sense, until I was about halfway through.  


She is an eclectic writer, started reading her books on motorcycling…  


What could be better that a woman who likes to ride!  


Mellissa has a great voice, very revealing of her failings, and successes… 


My wife was a motorcyclist.  That was before I met her…


Both my wife and I had Labrador Retrievers in our past lives, BWGT…


Before we got together…  


We are both dog people… 


We are also kid people…


My wife is a people person, she even likes adults…  she is an extrovert…   


I prefer dogs and kids…  


I enjoy the company of adults, just for shorter periods of time…  I am an introvert…  


Zev arrived into our lives about 8 week after being born on Halloween 2020


My wife and I have been together for 16 years.


Her 2 kids were grown and out of the house, and I had one kid out on his own when we started living together.


My last child was about 16 when we got together, and he was only with us a couple of days each week, and had a car, so was free to come and go.  An easy kid, did his homework, never got into any trouble, that I got to find out about anyway…  


We always talked about how freeing it was to be without dependent small kids and dogs…  


Yet, we always enjoyed what we called a “dog fix,” similar to a “baby fix,” the joy of spending time with young, usually, joyful creatures.  


We did think we would eventually bring dog presence back into our lives…  


Many conversations about the meaning of dogs in people’s lives…  


We agreed on trying to get a dog that would be easier to train, not one that would be a fixer upper…  


There are many that would fault us on that…  


There are some vet practices that seem to discriminate against people that get a purebred puppy…  apparently, only rescues allowed…  


We love labs, but wanted a breed that would be a bit calmer, and not such a food machine, less likely to eat half a giant pumpkin, $200 in cash, toilet paper (even more true stories, untold)… 


We are still active, wanted a dog that could hike, maybe run along biking…  


Our friend had a lovely Labradoodle, that probably started the ball rolling… 


I had a patient who is a veterinarian, and I asked her about Labradoodles, she said, it is hard to know what you might get, they can have the problems of both breeds, why not get a Standard Poodle.  


My wife took to her research…  Came up with a few breeders that breed for the stockier, original hunting dog type, Standard Poodle.  


She is a small breeder, only 2 litters per year…  


My wife got on the list…  We originally thought next Spring, 2021, but the litter was large, and we got in line for this Fall, 2020.  


We watched the pictures posted each week, not knowing which of the 10 would be ours.  


We made up lists of possible names… 


We made pros and cons of each pup, weight, color, gender…  


We bought a big crate, toys, food, treats, dog bed…  


Then drove 5.5 hours to Nebraska to pick up the little creature…  


I had some underlying resistance…  


Despite being 67, I am not retired, I work full-time, busy weeks in clinic, and really like my free time…  


My wife said she would carry the majority of the work caring for the pup, and she has lived up to that promise.  


However, a puppy is part of a household, changes the whole energy of the house, a lot, almost as much as having a new baby…  


Yet, we can’t help but fall in love with these young creatures…  


And, if we wish a well-behaved dog, we have to start training as puppies…  


Luckily, Melissa’s book came into our lives before Zev.  


The book well outlines the history of behavioral training… 


Highlights BF Skinners work, and, most importantly, the advantages of Karen Pryor’s clicker training.  


Melissa’s book is compelling, with a simple overall message:  


Reward good behavior, IGNORE bad behavior!!!


We don’t always use the clicker.  


We use lots of treats.  


The message is simple, carrying it out is more difficult.  

Humans like to punish.   


I won’t go into the details, read Melissa’s book…  


However, this does not only relate to training animals, this relates to bringing up children, to how we treat prisoners…  


The human obsession with punishment needs to change…  


This is how we can change our society for the better…  


Heretic!  


I love being a Heretic…  


Can’t write as much these days, have a puppy that keeps me busy…  


Oh, to add to being a heretic, as a gun lover, our dog is actually named after a favorite G19 from Zev Industries…  


We tell most people Zev means Wolf in Hebrew…  


We like that too…  


Namaste