Archive for the ‘Health’ Category

Cold Turkey – an update after 100 days

March 17, 2023

There are other stories regarding the origins of the term “cold turkey” but I prefer this one.

Scholars of 19th-century British periodicals have pointed to the UK satirical magazine Judy as the true catalyst of “cold turkey”‘s evolution in meaning. The journal’s issue of January 3, 1877, featured the fictional diary of one John Humes, Esquire. The diary’s transcript on the day in question details Mr Humes’ exploits over his Christmas holiday. Throughout, Humes demonstrates a humbug attitude, complaining to every shopkeeper and acquaintance about the irony of the words “merry” and “jolly” being attached to the season. Most significantly, Hume is invited to stay at his cousin Clara’s as a part of her household’s celebrations. Hume, the miser to the core, is shocked that Clara serves him slices of (literal) cold turkey with his pudding and other side dishes on the evening of his arrival. A poor substitute for the roasted and dressed kind of turkey is the continually played-up implication in the comedy piece. The dissatisfied barrister stays several days nonetheless, and with each passing day, he is more and more shocked that the cold turkey finds its way onto his plate again. Finally, Hume arrives home, utterly disgusted at having been treated so badly. He calls for his estate lawyer and chops Clara completely out of his will and testament.


100 days have gone since I quit smoking cold turkey and I am now into week 15. There has been no gnashing of teeth or pulling of hair. Withdrawal effects have been subtle rather than obvious. When I quit smoking on 7th December last year I had 2 cartons of cigarettes and 3 lighters in my study. Many suggested that I should remove all traces of cigarette smoking from my presence but this seemed wrong to me. They are all still all there in full view.

Does the urge to smoke return?

Of course it does.

Every, single day.

But what is clear to me is that it is not a physical craving but something connected to habitual behaviour and entirely in the mind. The urge is triggerred by some action (or inaction) which my brain associates with lighting up. I find I need just a short physical/mental diversion to get rid of the urge. Initially I used conventional chewing gum (not the nicotine kind but sugar free) but now find even that unnecessary. Just thinking about something else or doing something else usually suffices. I am pretty sure that the sight of my cigarette cartons and lighters does not trigger the urge to smoke. There are some physical effects which persist. I “feel” colder than I used to. I feel a little more light-headed more often than I used to. I get the shivers and goose bumps from time to time and I attribute these to quitting smoking rather than to the blood-thinners I now take.

I am sure I am gaining the benefits of quitting smoking but they are gradual and not spectacular. I think I cough less and my breathing is easier. I seem to generate much less phlegm than I used to. I am pretty sure my lungs are in a much better state than they were. Of course, I am sure I am also spending less money but, again, this is not a spectacular benefit. It is difficult to notice the smells – on me, my clothes or in the house – that are no longer there, but I certainly notice the smells of others smoking when I come across them. These smells when noticed, are becoming, gradually but more often, disgusting rather than alluring.

So far so good.

I am not sure when I will be qualified to join the ranks of “non-smokers”. Perhaps in another 200 days.


On quitting smoking – cold turkey and silver linings

December 31, 2022

Giving up smoking suddenly, with no outside help or support, is known as going ‘cold turkey’.


More by accident rather than by design, I am quitting smoking by going “cold turkey”. I had an infarct episode just over 3 weeks ago which led to hospitalisation and the insertion of 2 stents. During my 3.5 days in hospital I had no desire to – and did not – smoke. If I had any withdrawal symptoms at that time I was not aware of them. Presumably, I had other more pressing concerns. Now I am home again and still have not smoked. Withdrawal symptoms are present in force and the urge to light up can be extremely strong – though only for short periods. I am extremely irritable and find I cannot focus for long periods. I have, so far, declined offers of nicotine plasters, nicotine replacement, some other drugs and counselling.  Of course, three weeks without a cigarette proves very little. I did though wonder why nicotine replacement was being promoted so heavily and – mainly by neglect – going cold turkey was being discouraged.

Heavy googling with multiple search terms reveals a sharp divide between those promoting going “cold turkey” and those opposed to it. But then it becomes apparent that all those opposed to going cold turkey are – not unsurprisingly – those who are promoting an alternative. They include promoters of  Nicotine Replacement Therapies (NRT), or some particular drugs, or some particular kind of counselling.

Harvard Health:  A recent study randomly assigned about 700 participants to either gradually cut back on smoking over two weeks or quit abruptly on a set quit date. Both groups were offered counseling support as well as nicotine patches and other forms of short-acting nicotine replacement. The group assigned to cold turkey was significantly more successful at quitting smoking, both at the 4-week follow-up (49% vs. 39%) and the 6-month follow-up (22% vs. 15%).

The promoters of nicotine replacement would have it that my decision to go “cold turkey” has little chance of success.

TruthinitiativeRelying on willpower alone, however, is not likely to be successful. Research over the past 25 years has shown that, out of 100 people trying to quit smoking cold turkey, only about three to five of them will succeed for longer than six months, according to Hays. In other words, while some people can quit this way, at least 95 percent of people can’t. Quitting cold turkey has such a low success rate due to the nature of addiction. Addiction undermines willpower, or the ability to control impulses through decision-making.

My googling is hardly research, but I have come to the conclusion that while quitting cold turkey does not work for all smokers, most smokers finally quit smoking this way  The simple reality seems to be that successfully going cold turkey is likely to be most successful in avoiding a return to smoking. I find I resent the claims of the promoters of NRT – though they may well be correct. “Quitting cold turkey has such a low success rate due to the nature of addiction”. I think I have to take the challenge. My rational mind tells me that if my body has done without a cigarette for 3 weeks then there can be no desperate physical need for nicotine. There is no doubt that the most insidious part of the craving is when the mind imagines the previously experienced pleasures at certain trigger points (cup of coffee, cold beer, particular meal ……). I can never, now, claim the identity of being a non-smoker, but an identity as an ex-smoker will do for me. But I think I shall need to wait for a year before I can claim to be an ex-smoker.

Going cold turkey is perhaps the silver lining to my infarct cloud.

(Note that the purpose of this post is not to give advice to anyone but to create an additional pressure on myself to help resist the urge to return to smoking).


Please don’t diss my elephant

December 21, 2022

My blog posts here are fed on to Linked In and to Twitter though I never use either of them. So my apologies for not replying to those who have responded to my previous post and sent greetings and good wishes and comments on those channels. (I stopped using Facebook over a year ago and my blog posts no longer feed in there).

Many comments have been along the lines of keeping my elephant at bay and – by lifestyle changes – denying him entrance. But this misunderstands my intended meaning. There is no need to diss the elephant. My elephant is a friendly guy. He has impeccable timing and is scrupulously fair. He is not – for me – an object of fear or resentment at all. Rather he is the familiar, friendly, Solid (with a capital S), pachyderm who can accompany me on mysterious journeys to unknown places – whenever they may occur. He is a comfort not a fear.

My elephant does not lead me to morbid thoughts but he does keep me anchored in reality. He may nor be back for a day or a month or for 25 years. (I take 25 years as a practical upper limit since I would then be older than any male relative I know of). Modern medicine does wonders for heart conditions. So my heart attack two weeks ago and the insertion of 2 stents is quite unremarkable in terms of what medical practitioners can do these days. I am struck by wonder at the skill and ingenuity involved in these procedures. However a friend of mine brought me down to earth when he described the 12 stents he has in addition to his pacemaker. My experience was not remarkable as such things go, but it was a remarkable and unforgettable experience for me. The pain was real and the fear was real and the elephant imagery I saw was real. I could see him clearly – sitting right there. I can rationalise now and speculate that I was so scared that I conjured up my friendly elephant to cope with the fear. Clearly, in my mind, an elephant is a reassuring, comforting image.

It has been two weeks and I am recovering steadily. But, most remarkably, I have not smoked in 2 weeks.

So, don’t diss my elephant. He’s a good guy. He helps me handle my fears.


My elephant came calling ….


My elephant came calling ….

December 18, 2022

“Gosh”, I said “You’re heavy”!

I thought I had eaten too much. Heartburn I thought. It had started as just a rumble, just discomfiting enough to make me squirm. I stood up, I sat down, I breathed deep, I breathed fast, I breathed slow but the pressure kept growing. From discomfiture it became severe discomfort and then the crushing pressure reached ginormous proportions. “Hello Mr. Elephant”, I said. “Why are you sitting on my chest?” I do like elephants so I did not want to be rude and scream. I did not like to mention that he was crushing the life out of me. He didn’t look like he was trying to hurt me. In fact he looked quite friendly – even avuncular.

“Gosh”, I said again. “You’re really very, very heavy”! “Am I?” he asked and seemed to float above my chest. “I just came to introduce myself,” he said. “I am your elephant after all”. And then, just like that, the pressure eased. He was no longer on my chest but inside my chest and started pushing out. “Steady on,” I said “I could easily burst. A choice between bursting or being crushed was not very nice” I said. “No, no” said my impossible elephant, “I wouldn’t do that – yet” and he eased himself out of my chest and rested – lightly – outside it again. “You do not seem so heavy now” I murmured. “Of course not” he whispered in my ear. “It isn’t quite time yet. The important thing is that we have been introduced. Now you will recognise me when I come calling”. 

“I am not in any particular hurry” he said, “but remember that I am your very own elephant. And I will be back”.


And then the ambulance came.


Vaccinations may have helped against severe illness but neither masks nor vaccinations have shortened the pandemic

February 10, 2022

For almost 3 years, epidemiology and rock-star epidemiologists have been flailing their way through the pandemic. Ridiculous modelling and constantly changing and contradictory advice have become the norm. 

At least there are some few who are beginning to be self-critical about all the mistakes that  epidemiology – which is no science – has made. Even fewer are willing to admit that blindly “following the science” means also following the 90+% of scientific research which goes down the wrong path. 

  • It was first thought that the infection would spread like influenza. But instead it spread in clusters which negated all hopes for achieving some kind of herd immunity.
  • the pattern of mutations of the corona virus was not as predicted (more hope than prediction) and that made specific vaccines less useful and for shorter times than expected.
  • vaccination has probably helped more in preventing serious illness than in preventing any spread of infection.
  • Infection was first thought to be air-borne. Then it was thought to be liquid-borne. In fact it is both and neither. These assumptions led to confused advice about the use of masks and types of masks. In fact, the use of masks may have helped in preventing a few of the infected from infecting others but has had little effect in stopping the mask-wearers from being infected.
  • even if the WHO had not tried to avoid blaming China and had raised the warning flag two months earlier than they did, no country had any useful plans for preventing the spread of infection in place.
  • Travel restrictions were never introduced fast enough to prevent the entry of a virus into a region.

The response to the pandemic will be studied for a long time yet and all the mistakes made will be the subject of many PhD theses to come. The social “sciences” are going to have a field day.

I believe in vaccines. I am sufficiently scared of serious illness to have taken all the vaccinations and boosters as they have become available. No doubt I will also take the 4th shot if and when it becomes available. It has generally been forgotten that for an effective vaccine to be useful and do its work, a vaccinated person needs first to be infected. But it is perfectly clear to me that, of course with the best intentions, vaccines have been grossly over-hyped as a means of preventing infection. Uncertain and bad science has also been used to justify the introduction of authoritarian and mandatory measures by governments. It may even be that the over-reliance on over-hyped vaccinations has prolonged the effects of the pandemic for longer than necessary. The purpose of mandatory vaccinations has misguidedly been the prevention of infection (not the prevention of serious illness) but the stark reality is that vaccinations have not been, and cannot be, very effective in preventing infection. The various mask mandates introduced in many countries have been both ridiculous and ineffective.

 


Why are vaccines not shortening the length of the pandemic?

January 27, 2022

The Covid-19 virus was first encountered at the end of 2019 though the World Health Organization only declared the outbreak a Public Health Emergency of International Concern on 30 January 2020, and a pandemic on 11 March 2020. Total global deaths now exceed 5.6 million and after over 2 years, the pandemic continues. We received our first doses of vaccine in April 2021, the second dose in June 2021 and the third, booster shot in December 2021.

The major difference – for a layman – between the Spanish flu pandemic of 1918-1920 and this Covid pandemic is that there were no vaccines available 100 years ago. The Spanish flu hit in 4 major waves; one in March 1918, the second (the deadliest) in August 1918, a third, mainly in Australia, in January 1919 and the final fourth wave in early 1920. By March 1920 the Spanish flu was less deadly than common influenza and the pandemic was over. With no vaccines of any sort available, the Spanish influenza pandemic lasted just 2 years. It is estimated that the total number of deaths was somewhere between 17 and 50 million and that up to 500 million were infected.

With Covid-19, vaccines were available first about 11 months after the outbreak though most received vaccines in the second year of the outbreak. A remarkable achievement. The logistics of carrying out mass vaccinations has been equally impressive. So far over 5 billion of the 7.3 billion global population have received at least one dose. Around 4 billion have received two doses. Close to 60% of the global population has been vaccinated to some extent. Around 360 million are thought to have been infected and around 5.6 million have lost their lives.

There is little doubt that the quality of health care after being infected is orders of magnitude more effective than 100 years ago. It is also reasonable to conclude that the vaccines have prevented many deaths. Numbers infected are similar to 100 years ago (360 m / 500 m) but number of deaths are drastically lower (5.6m / 17 – 50 m). Yet the pandemic continues and the earliest it may recede – we think – is this autumn of 2022 which will be 3 years after it started.

It would seem that vaccines have not reduced the length of the pandemic at all. In spite of all the advances in health care and the huge medical/pharmaceutical efforts in understanding the virus and creating vaccines, we are entirely reactive in our response. Vaccine development is reactive. Getting vaccinated is proactive but defensive and does not harm the virus. Health care is reactive. We have no means, it would seem, of taking the initiative and attacking the virus. We are forced to rely on natural mutations eventually reducing its virulence. Our actions, being reactive, would seem to have no impact on the length of the pandemic. Epidemiology has not impressed me during this pandemic. Every so-called mathematical model (which depends finally upon human behaviour) was wrong. (Of course epidemiology is a discipline of clerks and statistics – a social “science” if it must be called a science). They have not been able to do more than regurgitate the same advice as from 700 years ago at the time of the Black Death. Avoid the infected, wash your hands, wear a mask, burn your dead!


Austria: Could next step be branding and internment of the unvaccinated?

January 20, 2022

The Austrian parliament is showing Europe the way and has made vaccination mandatory for the over 18s.

Austria parliament approves mandatory Covid vaccination

Vienna (AFP) – Austria’s parliament on Thursday approved making Covid-19 vaccinations mandatory for adults from next month, becoming the first European country to do so despite a wave of protests opposing the measure. Tens of thousands have demonstrated against mandatory vaccination in regular weekend rallies since the measure was announced in November in a bid to drive up the country’s vaccination rate. But all parties, except the far-right, supported the measure, with the new legislation passing with 137 votes in favour and 33 votes against it.

I wonder what they will do with the unvaccinated. First, brand them by pinning a coloured label on them so they can be avoided? If they persist, they could  vaccinated by force? If they still resist, their property could be confiscated and they could be sent to special internment camps?

A final solution for the pandemic?

You would think the Austrians might have learned their lesson. 

Exterminating The Unvaccinated

…….. It stands to reason that forcible vaccination of the reluctant is preferable to their incarceration. A quick execution would be much cheaper if a little unethical. Deprival of employment is already here for some. Deprival of citizenship has been suggested for others. Maybe they could be branded with a yellow star and used  – forcibly – for the trial of untested vaccines? 

……..


Exterminating The Unvaccinated

January 6, 2022

Italy will now make it mandatory for over 50s to be vaccinated. If it is mandatory I expect that appropriate force will be used. One would expect that a single 20 year old should be able to subdue and jab around fifty 80 year-olds per day. It might take 2 to subdue a 50 year-old.

Macron has been mouthing off (apparently literally) about making life as difficult as possible for the unvaccinated. Sweden has now made it perfectly legal for any establishment to discriminate as desired against those without proof of full vaccination (thought it is unclear if “full” means 2, 3 or 4 shots). The market for fake vaccination certificates has been given a boost and is booming. The Australians have made idiots of themselves with the Novak Djokovic affair. (Of course, Novak has been a little idiotic himself).

It is apparent that, among the politically correct and the unthinking, the unvaccinated are the new scum of the earth – even if vaccinations provide no great protection from being infected by the Omicron variant. I wonder what the hierarchy of incorrectness is?

  1. Unvaccinated, infected are clearly the worst sort.
  2. Unvaccinated, uninfected are somewhat better
  3. Unvaccinated with natural immunity are not to be assumed to exist
  4. Infected though vaccinated
  5. Vaccinated and uninfected have a place reserved in heaven.

It stands to reason that forcible vaccination of the reluctant is preferable to their incarceration. A quick execution would be much cheaper if a little unethical. Deprival of employment is already here for some. Deprival of citizenship has been suggested for others. Maybe they could be branded with a yellow star and used  – forcibly – for the trial of untested vaccines? 


Most of science is about discarding what is wrong and “following the science” leads to many false trails and cul-de-sacs

December 31, 2021

I see that the CDC is under fire – again – for producing confusing and contradictory recommendations. The CDC defends itself by claiming that they are “just following the science”. The scientific method is a long process from observation to theory and – as I take it to be – goes as follows:

Observation > correlation/ analysis > hypothesis

hypothesis > experiment/falsification/analysis > hindcasts/forecasts/nowcasts > verification > theory

Probably less than one in a 1,000 hypotheses get to being considered a theory of any significance. Probably less than one in a 100 “sound” theories stand the test of time. Anybody who thinks any science is settled is just an idiot. Science is not a thing but a process. True science is – and needs to be – permanently skeptical. Most of the work of science actually consists of discarding what is wrong. It is inevitable that “following the science” will lead you down more false paths than correct ones. Yet “following the science” is claimed as justification for actions. Following false trails is imbued with a sanctity and a virtue it does not have. It is also a way of avoiding blame.

Backtracking from previous advice, giving conflicting advice and following false trails has been evident more often than not over the last two years as authorities have tried to deal with the Covid-19 pandemic. The medical response to the pandemic can be classed into 3 areas.

  1. Public health measures
  2. Vaccination
  3. clinical treatment (including drugs for clinical use)

Public health measures across the globe have been confusing, contradictory and blatantly political. Of course, epidemiology is no science even if it tries to cloak itself in scientific methods. What is certain with the spread of the Delta and the Omicron variants is that public health advice today is much the same as it was 700 years ago with the Black Death in Europe. “Avoid the infected, wear a mask and burn your dead”. Pharmaceuticals are doing very well as programs of mass vaccination are rolled out across the globe every 3 months. It is a business which has a bright future ahead of it. Certainly the speed with which testing methods and vaccines are being produced and rolled out is impressive. Both the testing and the vaccination production industries are proving to be wonderfully remunerative. There have been great advances in the clinical treatment of those infected and in the identification of drugs (many taken from other uses) for effective treatment. But there have also been a very large number of false starts with “promising” drugs which have later been found to be not very effective. Health services and health care personnel have been rushed of their feet and have done a remarkable job. They have also gone down many cul-de-sacs. In spite of the advances in treatment many of those infected are still losing their lives.

The Centers for Disease Control and Prevention (CDC) backtracked on a few more facets of COVID-19-related guidance this week, leaving the agency open to more social media mockery.

This week the CDC admitted its initial estimates about the prevalence of the omicron variant were way off. A few days earlier, the agency also revealed it was shortening the length of quarantine for COVID patients from 10 days to five if they were asymptomatic at that time. Those walk backs followed a series of other confusing announcements from the CDC, including fluctuating guidance on masks. The agency initially said only unvaccinated individuals should wear face coverings, until July, when the CDC changed course to say vaccinated individuals should resume wearing masks in certain situations.

NBC’s Peter Alexander confronted CDC Director Rochelle Walensky Wednesday, wondering why Americans should “trust” her and her agency in light of all the “mixed messaging.” She said they are simply following the science.

I am afraid the CDC is just going through a CYA exercise.

It has been 2 years now. We have followed the recommendations of the medical and public health fraternity. We have had 3 vaccinations so far. I expect we shall have to have a fourth in April or May.  And a fifth and a sixth before this pandemic is over.

It is almost time to rename the Omicron variant as the Covid-21 virus.


Virus GoT as Omicron mates with Delta to give us Delmicron

December 24, 2021

It sounds like the Game of Thrones. Which virus strain is going to conquer?

Hindustan Times:

As cases of the Omicron variant of the coronavirus are being reported in the US and Europe and rising in India, reports about “Delmicron” have emerged over the last few days. A member of the Covid-19 task force in Maharashtra has said there is a possibility that the West is caught between twin spikes of the Delta and the Omicron variants of the coronavirus.

“Delmicron, the twin spikes of Delta and Omicron, in Europe and US has led to a mini tsunami of cases,” Dr Shashank Joshi was quoted as saying by a leading newspaper. The highly contagious Omicron variant was first detected last month in southern Africa and has now been reported in 89 countries, according to the World Health Organization (WHO). Delmicron is not a new variant of the coronavirus but the Delta and the Omicron strains together fuelling Covid-19 cases. Data shows Omicron is the more dominant variant in the US and accounts for 73 per cent of all new cases, up from less than 1 per cent at the beginning of the month. The Centers for Disease Control and Prevention has said the Delta variant was responsible for more than 99.5 per cent of the Covid-19 infections in the US last month.

……..

Doctors say people with a weak immune system, the elderly and ones with comorbidities are at higher risk of getting infected with the Delta and Omicron variants, simultaneously, according to a report. It added that areas with low vaccinations rates are also at risk. However, health experts are divided on whether the combination of the two variants can lead to a super strain.

That’s all we need now. Virus strains selectively sharing the characteristics most suited to their own survival.


 


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