Busy as a bee this summer.

Here’s to hoping for a return to Bloggery this coming cold season.
Kim Kimberly George Flower Gardens by Kim coach kimi Ohio Chagrin Falls Solon Aurora Hunting Valley Joseph Benner Way Out Vegan

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You have to read the instructions. And obey them, by the way.

When I managed a pet store, I tried to sell a small book with each reptile.  Philippe de Vosjoli wrote great little books that offered tons of information including dietary concerns.  Reptiles are cold-blooded and their intestinal flora only get up to working temperature when the rest animal’s whole body is warm enough. Many of them are fully vegetarian and therefore can not get vitamin D from animal products. They must get it from the sun. Vitamin D is part of calcium use and affects bone density.  If you don’t get as much sun in your area as they get where they evolved, or if your reptiles never go outside, you have to replace that sunlight by artificial means; with full-spectrum light bulbs. Metal halides are good because they produce heat as well as full-spectrum.

It’s quite a different metabolism from a mammal. Bringing a reptile into your home is like obtaining a diabetic infant.  It can’t tell you it is sick, weak or mal-nourished and its diet and environment must be micromanaged every single day. And small changes can affect it quickly and disastrously.

Philippe explains this very thoroughly, but somehow people always missed that chapter. They missed the chapter that said that $20 lizard needs a $400 light fixture and the $80 bulb needs to be replaced every six months.  Inevitably, 4 months later, the customer might bring the animal back to me with a soft jaw or bony hip/tail joints and ask me what’s wrong – if I were lucky.

If the lizard were lucky.

Usually, no questions were asked and no sick animal was produced. They were just in the store again 4 months later to buy another $20 lizard. In the years I spent at the pet store, I sent many, many animals home to a wasting death. Ask a pet store employee why he or she works there and they will tell you that they love animals. Gah. You must heed the whole set of instructions.

I now recommend Melissa Kaplan’s website for that information.

I told you that story to tell you this one:

A few weeks ago I was doing a project in my basement where it’s kind of dark. I came upstairs into the bright light and found that I couldn’t see.  First I thought my computer was dying. Then I developed total tunnel vision and couldn’t look outside into the snow. I said (to Lucie), “Well, this is alarming.”

That night I was reading in bed and realized it was only my right eye.  I hoped that after sleeping, I would just wake up and it would be OK.  But, no. It wasn’t. The next morning I looked into a mirror (yes, it took me 15 hours to look into a mirror) and the situation was obvious- my right pupil was 3 times bigger than the left.  I had what is called a bilateral posterior ischemic optic nerve neuropathy (PION). So I did an internet search and of course WebMD pops up and tells you you’ve had  a stroke or a transient ischemic attack and/or you have dain bramage. Or diabetes or severe ketoacidosis.

Oh crap. What? Ketoacidosis? Let’s see if this is associated with regular dietary Ketosis.

Yep. I did this to myself.

So I do this Ketogenic diet, right?  Like many people my age and older, I first learned about it from Dr. Atkins. Now there is much more sophisticated science and Dr. Atkins is no longer revolutionary or the wellspring of information on this.  If you’ve been following this year’s weight loss journal, you know that this year has been a stunning success. I lost over 30lbsin just several weeks. But I made a mistake.  I didn’t heed the whole set of instructions.

I have often mentioned that my only problem with Ketosis is charlie horses. So I supplement with Magnesium and Potassium. But that’s not what Dr. Atkins advised. He did, in fact, include a whole chapter in his book about supplementation and why you should do it.  But I missed it.  I missed the chapter that said I need $40 in vitamins. In fact he wrote a whole follow-up book called “Dr. Atkins’ Vita-Nutrient Solution: Nature’s Answer to Drugs”.   Atkinsexposed.org also missed this chapter, then posted an article called “Vision Loss on Low Carb Diets: Low-Carbohydrate Diet Optic Neuropathy.”

So what caused it?  Thiamin deficiency, which stuck in my craw because nutritional yeast is one of my favorite things in the world. This should be one of the best sources and I eat a lot of it.  So I went out and bought a B-Complex vitamin and it fixed up in a few harrowing days.  And boy, oh boy was my wife pissed.

This is also a lesson to those who criticize something without investigating thoroughly.  How often do we dismiss something or speak ill of it while ignorant of what it really is.  Never happens with politics, right?

Read up! Challenge your sources and challenge your instincts.


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In which Jimm becomes trendy and puts butter into coffee

I was writing this as an entry to my diet journal, but as usual, it became long and involved enough to become its own post.

On a lark, I decided to try the trendy butter-in-the-coffee thing.  I like Dave Asprey. He’s the “Bulletproof Coffee” guy.  Originally, I had an immediate disdain for him because I loathe the word “hacking” used in any context that doesn’t involve Oliver Wendell Jones. “Bio-hack” especially. No, I don’t want to “hack my sleep”, thank you. But some dudes I respect like him, so I have to listen to him, though I really have to review his science sources. I find a lot of it far-fetched or over-reaching in claims. If minor changes made such obvious beneficial differences, we would all be doing it. I think a lot of placebo is involved. That or you have to buy into his whole lifestyle, otherwise you make each individual effort null and void.

But I reserve judgement, I promise.

I like his bulletproof podcast and his interviewing technique but ultimately I find his diet plan too restrictive and diminishing of my quality of life.  I appreciate his research and take it to heart and apply what I think is reasonable under the umbrella of Mark Sisson’s 80/20 rule.

I keep in mind that much of his advice ties into some product that he sells. I don’t think he’s a huckster. I believe him and Mark Sisson when they say they want to make products they believe in available to others. But my goal is to show people that they can get healthy without spending money. No Weight Watchers, No DVD sets, no boxes of supplements, no mass-produced Gluten-free and no mass-produced “paleo” analogues of “normal” food, no Atkins Brand chocolate cake.  A gym membership is strictly optional. I just want you to invest in higher-quality meat and vegetables and put a little time into some Youtube videos instead of your regular TV mush. And ain’t nothing cheaper than intermittent fasting, which is very healthy for you.

In the long run you will save money- not only on fitness products and food, but how much will diabetes or cancer or a heart attack cost you or your loved ones once you’re gone? Once you are lean and feeling good and want to start advancing, Then feel free to dabble in Dave’s sub-atomic particle activated carbon, or Mark Sisson’s multi-vitamin supplements, or Sally Fallon’s $40 cod liver oil or a membership to a High Intensity Training gym or Dave’s super-computer systems that help you build a six-pack through guided imagery. I’m all for it if you’ve got the money, but insist that it is not required for health.

Based on an old Tibetan tradition of putting Yak butter into tea,  Dave Asprey wants you to drink a lot of coffee (mold-free coffee, and of course only his coffee is mold-free)  and add cultured, grass-fed butter and MCT (Medium-Chain Triglyceride) oil. I’ll let you investigate his whole story and reasoning on your own if you are interested. There is a big debate out there as to whether you should use MCT oil or the whole food from which it comes, coconut oil. Dave of course sells “Brain Octane” oil, which is a super MCT oil that was probably “hacked” (rolleyes). This is all supposed to give you unbelievable energy and brain clarity.

Of course you will find a million websites claiming this is all B.S. But not many of them are talking real science.  There are claims that Dave’s experience can be chalked up to his Thyroid medication, or whatever. And of course he’s selling stuff, which bothers people. But to research this you really have to look at the science of coffee polyphenols and the science of how grass-fed butter makes them more bioavailable.  Dave usually has hundreds of scientific papers sourced for his claims. To have one dipshit throw it all away because, “well, you know…Tibetans and Sherpas have altered mitochondria from living at high altitudes, so this is all bunk” is actually a little unintellectual, though it’s what some people want to hear. You have to refute all of his sources, not him personally.

Do intense research and personal experiments, especially before you give people money but before you dismiss out of hand. Finding people ranting in ignorance is the easiest thing in the world.  I have so many friends who have never read a book yet have all of the answers. Misguided vocal minorities are shaping your world every day, so take this seriously.

I’m on the grass-fed butter bandwagon because of Sally Fallon  and have been looking for a way to get more of it into my diet. I just happened to have a jar of coconut oil which is a normal grocery store item (actually my mom gave it to me).  So what the heck. Let’s try it. MCT /Coconut oil is supposedly very ketogenic. I don’t know why I would want ketosis of dietary fats. I want the ketosis to use my spare tire & belly as fuel, not exogenous calories. But maybe it gives that metabolic pathway a boost. In regards to brain/mind clarity, I do know that the brain loves ketones.

When we were young in our relationship, my wife tried a culinary experiment.  We were out of cream for coffee but we had butter and she reasoned, “Well, butter is dairy. How bad could it be?”
Pretty bad, let me tell you.  That one still comes up from time to time when discussing our bad food decisions.  Apparently the trick is to use a blender, not a spoon. You need emulsion.

Most importantly!! When you put hot liquids into a blender, they pressurize and blow the heck up. You must use something big like a Vitamix. I’ve never seen this mentioned in “Bulletproof” coffee discussions, but luckily, I’ve already blown up hot soup in the past and happen to have a Vitamix.

The taste result: Not bad at all. I enjoy coffee purely as a gastronomic experience and will not tolerate a change in flavor at all. I don’t drink coffee as an “energy boost” as my body is not sensitive enough to sense it. I have made this coffee a few times now and decided that I don’t like the coconut oil in it. If I find a way to ingest a tablespoon of that right before drinking the coffee I’m fine. I also add a little heavy cream after blending.

The physiological response: I honestly had the most energetic day of this year. I am not kidding.  I shoveled the driveway, went to the gym and did a full run on the elliptical and was ready to do it all over again.  So I did a full circuit of weight machines which I am normally very tepid with owing to the myriad joint injuries I’m currently suffering. Then I went swimming for half an hour and left the gym feeling great. This morning, my circulating ketone level is pegged and the scale is two pounds lighter than yesterday (possibly water weight from the intense workout depleted hydrated glycogen).

Now, I didn’t  feel energized during this. I wasn’t jittery. It’s just that nothing was fatiguing me. Normally I do a little work at the gym and I’m ready to hit the sauna. But I was flying. I wasn’t  expecting a result from the coffee and as I mentioned, I didn’t feel energized.  So I don’t think it was psychosomatic but you know what? Placebo is a very powerful drug. I don’t care if that’s it. Somehow I doubt it.  Only prolonged experimentation with this will tell me.

I don’t know if you could experience this as I did because I am already ketotic and feeling the perceived energy boost from the fact that insulin is not making me sluggish, stimulating anabolic hormonal pathways and blocking my leptin signalling. If you are currently metabolically tuned to burn carbs preferentially and insulin is ruling your system, I’m guessing you won’t have the results I had. But who knows. Let me know if you do. I’ll be making notes in the weight-loss journal.

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“Stay Out of the Belly of The Beast”

In a 2012 Talk entitled Fitness, Health, and Liberty at the 21Convention, Doug McGuff, an Emergency Room MD from South Carolina explains exactly what is already irrevocably around your neck and only going to tighten by giving a history of our healthcare system over the past 100 years. There is something in it for the liberals because he’s going to beat up on the Big Business. There is something in it for the conservatives because he is going to indict the Government. He will undeniably show how everyone involved, including 100 years-worth of stupid voters are at fault for this mess and why you really only have one job now which is to Stay out of the belly of this beast.

Which I have painstakingly transcribed for you for review of and comment upon. If you pinch the text, please give me transcription credit. But this labor is my gift to the world.

If you have neither time to read this nor watch it, I suggest making an MP3 out of it and listening during a commute, mowing the lawn, running on a tread mill, etc. I have very few friends who stand to learn nothing from this lecture. Doug will:

  • Demonstrate well-meaning, community-intended ideas that came with criminal fiscal irresponsibility.
  • Explain why your inner city emergency rooms look like 19th Century Flop Houses.
  • Show why everything medical you do is at an out-patient center
  • Parse out details such as: HIPAA is not for your confidentiality or assurance of consistent records-it hides the collectivism trumping your personal rights
  • Support my idea that we should just kill all the Baby Boomers now.

~~begin transcript~~

Normally I talk about exercise and diet but there’s not anything that I can tell you about exercise that you are going to remember that Skyler did not cover beautifully yesterday in his lecture so if you’re watching this on video, go watch Skyler’s Talk and you will have everything you need to know about exercise in that talk.  Likewise, with regard to diet, there is nothing that I could tell you today that you are going to remember that wasn’t beautifully covered by Jolly or Dave Asprey in their talks today. So I would reference those for you. So instead of like in 2010 me telling you the how of the Paleo diet and the how of exercise I wanna tell you why.  And I wanna do that from a very unique perspective and that perspective is: 23 years practicing in the epicenter of the implosion of the American healthcare system.

If you care about your liberty and preserving it, you need to care about your health. Now, everyone that’s sitting on an aisle seat on this side of the room, please raise your hand. OK, everyone look around for those of you that are younger than 35-years-old in this room, statistically speaking, this is the number of you that will be dead before you are 35. Keep your hands up. Everyone on this side of the room please raise your hand.   That is the number of people, statistically speaking that is going to have a serious life-threatening health condition or injury before they reach age 35. That’s why this is important that is why I want to talk to you about fitness, health and liberty: preserving personal freedom by staying out of the Belly of the Beast.

Now one thing that I want to make reference to as we go through all this is remember that every step of the way in this story that I am going to tell you. When we made a mistake or did something wrong, we never go back on that mistake. This is true of individuals but it is particularly true of bureaucracies and government. If they make a mistake that did not work out, well they never go back on it. They always double down and do even more of it.

So, medical care.  What is it? What should it be vs. what it is. What medical care should be, is a free market exchange; a fiduciary relationship between the provider of a service and a consumer. The moment that you engage me as a physician, I should have a fiduciary relationship to you to take your best interest at heart. But what is it actually today? What it is, is a 3rd party relationship where the provider is coerced to place the needs of a collective over the needs of an individual. Now in a proper circumstance when you engage me as a physician we would be discussing both the price and the extent of the care that would provided up front.

As it stands nowadays if a patient’s coming through the E.R. even with something as simple as a laceration and they ask me, “Doc, what’s this going to cost me?” I have no idea what to tell the patient. If you get admitted to a hospital you have no real means of negotiating what your extent of treatment is going to be. In most cases, the extent of what is provided to you would be way beyond what you would normally negotiate under a correct provider / recipient relationship. The other thing that happens is: instead of you getting to decide what you want and what you don’t want, whether you want a statin or not want a statin, you kind of get a take-it-or-leave-it attitude because the system is now protocol-driven.  If you don’t fit in to the protocol or accept the protocol…you know, there is no negotiation. It’s all or nothing.

So who’s to blame for all this mess? Doctors.

This is an important point for all of you. Whenever anything is screwed up in your life I want you to say four words: It is all my fault.  Five words?  It’s all my fault. Assume responsibility for everything that’s screwed up in your life. Doctors did this to ourselves. The doctors that did it did it with short-term gain in mind, and they probably knew that the consequences of this would not be born in their lifetime but in the life time of future physicians and future patients. But they sought the help of the Government for short term gain and they set in motion the long term unintended consequences that has resulted in our ultimate enslavement.  So what’d they do?

Anyone ever heard of Blue Cross and Blue Shield?  This came about in the Great Depression. Now before the onslaught of everything that we currently have, a lot of physicians provided a very large mass of charity care and during the Great Depression- a calamitous economic event triggered by Government regulation – not many patients were being paid for their services. This is where you heard about doctors being paid in chickens and eggs and milk and what not because this is all that people had to exchange with. The medium of exchange had gone down to that. That they devised was an insurance system whereby they were guaranteed to receive a payment for their services but they bastardized what insurance actually is. What insurance should be is you pay a premium along with a lot of other people that goes into a kitty that will pay you should you encounter some catastrophic unforeseen event, but the insurance structure that they made was something to pay for everything: routine office visits, medications, screening tests, the whole nine yards. Come to the office with an ear ache or a sore throat, it was under the umbrella of this insurance that you paid premiums for.

Furthermore, they sought a tax-exempt status. What they wanted to happen was people that were buying their insurance plan was for them to be buying that with pre-tax dollars. Normally when you buy insurance, when you buy automobile insurance…when you buy life insurance, you buy it with post-tax dollars. That means if you made $100 the government takes $40 and leaves you with $60 and you buy your premiums with that. When something is allowed on a pre-tax basis, you get to buy it with the $100 you originally made. So in essence, you’re buying it at a 40% discount. Well the Government said “OK, we’ll do that but what we want in exchange for that is a community rating.”  Does anyone know what a community rating is? Basically what that says is: anyone within a geographic catchment area pays the same premium regardless of their pre-existing health status.  So that’s created layers of what are called moral hazards.

So what’s Moral Hazard? Well, Moral Hazard just has to do with what your behavior is under different circumstances. Let’s string a tight rope on the top floor of this building across the street to the other building. Well, Moral Hazard is the difference in the way you behave on that tight rope when there’s a safety net eight feet below you versus when there isn’t. So people’s behavior was changed by the fact that they were covered for everything. The consequences of not washing your hands or eating something that sat out for too long were now much smaller. You didn’t have to pay if you got sick even for the most minor of illnesses. More importantly, you felt as if you were going to be taken care of even if even got a more major illness that ocurred as a result of your behavior over time.

So this was great for the doctors at the beginning of the medical Ponzi scheme. But not so great for those of us down the line. So- what happens next? Well remember this is occurring in a medical market where different providers are competing within that market. So, commercial insurers tried to compete. People that aren’t Blue Cross / Blue Shield that don’t have the pre-tax benefit- they have a lack of tax-exempt status, they’re forced to compete by offering a similar product. So what happens then is the concept of third-party payment for medical services becomes entrenched. This essentially becomes pre-paid medical care. This makes comparison shopping near-impossible because you’re not comparing price as you would in an open free market – its premiums and it creates another moral hazard that’s called Friedman’s Quadrants. And it refers to Milton Friedman.

And I wanted to have a white board up here to draw it for you but to spare us all the rigmarole of trying to get that thing up here let’s just divide this screen into quadrants. And on one side what we’re going to have is your money and then below is going to be someone else’s money. That’s the Y axis. So on the Y axis, we’re going to have your money and someone else’s money. On the X axis, we’re going to have yourself and someone else. So, when a person spends their money on themselves they’re going to worry very much about the price and they’re going to worry about the quality of what’s supplied. That is where the most conservative economic calculations occurs. Now if you’re going to spend your money one someone else, you’re still very concerned about price but you’re not quite so concerned about quality. You’re buying a birthday present for someone and you’re like, “Eh, I think they’ll like it. Maybe they’ll hate it. I will never know so I don’t really care that much.”

So down in this quadrant you’re going to spend someone else’s money on yourself. And that’s kind of where we’re starting off with this. There, you don’t care so much about price but you care about quality and you want to make darned sure that you get the quality you want but you don’t really care what it costs someone else to provide you with what you want. This is sort of the equivalent of being a welfare Medicaid recipient. And in the last quadrant is the worst kind of spending you can do and that is to spend someone else’s money on someone else. When you’re in that quadrant and you are spending you don’t care about the price and you don’t care about the quality. And when you create a third party payer medical system, that’s what you have.

Your money

Spent on Yourself

Your money

Spent on Someone Else

Someone Else’s money

Spent on Yourself

Someone Else’s money

Spent on Someone Else

People are not buying their healthcare in a direct transaction. Healthcare is bought with premiums that you have no idea what the cost is and you don’t care. How many of you people are employed and covered under employer insurance? Do you know how much it costs you every month? We got one guy? Do you know how much comes out of your paycheck? Dollars and cents?

Audience member: “$92…126?”

It’s variable but the number of employees that actually know what’s being taken out of their paycheck and whether those are pre or post tax dollars and all sorts of … If you go to an ER do you know how much you’re going to pay?

Audience member: “Just my deductible, 100 bucks”

So you pay a hundred dollars and you’re covered 100%? You don’t have an 80/20 or anything like that? So most people – they don’t know how much is being taken out and they don’t know what’s it’s going to cost when they show up for care. So this creates another moral hazard because you’re down in this quadrant- you don’t care about price, you don’t care about quality.

So, the situation was made worse by the 1942 Stabilization act– we’re in the middle of WWII. A lot of America’s men in the work force are off fighting war. And the thing you’ve got to realize about labor is like anything that’s bought and sold, or anything that’s scarce it has a price. So wages could potentially go up during this time of economic hardship which could put a real strain on employers so there’s a lot of political pressure to freeze wages and that’s what they did. But all of a sudden, employers were hamstrung for competing for very limited labor supply. So what happened then is the government allowed employers to compete for scarce labor by offering benefits such as their health insurance to not be considered in the wages act. What happens then…is these are pre-tax dollars and they’re not taxed and that amplifies this whole effect. So remember price controls will always create shortages. They applied price controls on wages which created a shortage a shortage of labor. So they had to find an end-around and their end-around was to offer benefits or things that were not counted as wages under the act.

Then what happens? The IRS gets involved. In 1943, they made certain that any premiums paid by employees in a group plan were exempt from federal income tax and they decreed that health insurance premiums are now legitimate cost of doing business and they can be deducted from the employer’s taxable income, too. So this has collectivized things both on the employee and the employer side. So collectivism is incentivized. So these tax incentives were available to anyone that got their healthcare collectively through employers but it was not applied to individuals who individually bought their insurance policies for themselves who wanted to stay independent, who wanted to preserve as much as possible that relationship between themselves and their doctors so they were financially punished for trying to remain independent.

So what are the logical consequences? Employees become unaware of the cost of what they’re seeking. And because it’s bought with pre-tax dollars dollars and there is no apples to apples comparison of what that really means in terms of your salary. Especially since taxation rates are gradated. The first money that you make is taxed at a lower rate than the middle money that you make which is taxed at a different rate that the top-end money that you make. So it makes it very hard to form any economic calculations. Employers insure the group without any concern for the given individual’s circumstance so you may have very peculiar or particular healthcare needs based on pre-existing conditions, congenital problems…but it doesn’t matter. They’re insuring the collective- the whole. That’s their concern. There is no concern for the individual anymore and worst of all it feels like an entitlement. It feels like something that just comes along with being employed. When I’m employed, I have “benefits”. I’m covered for my health insurance. And it engenders a buffet mentality. You’ve paid in a certain amount for your premium and now when you go to a buffet there’s a lot of food in front of you and you have to pay $14 to go the buffet are you really going to stick to your diet or are you going to get your money’s worth by gorging yourself? That’s the problem with a buffet. And that’s the problem with the logical consequences of making this sort of system.

So then what happens next? Well, prior to 1965, there’s always been indigent care. There’s always been a need to care the poor or the elderly who became destitute, either because of their actions or innocent of their actions. And prior to 1965 this was done on a charity basis by almost every doctor in the country. There were entire charity hospitals for providing care to the indigent. If it wasn’t a charity hospital almost every hospital in this country had a charity wing. Which is separate from the rest of the hospital where charity care was provided to those who needed it. But what Medicare and Medicaid wanted to do is they promised not to control medicine…”We just want to pay the bill.” But the real point of the thing was not just to take care of the elderly and the poor, the point was to spare them the humiliation of means testing. To actually spare them the humiliation of having to put their hand out and say, “I need help.” But that is the difference between a charitable act and an act of force. Putting your hand out and saying, “Can you please help me.” vs. putting a gun to someone and saying, “Give me this”.

The other thing that is did and the insurance companies rather liked this is it removed anyone over 65 from the insurance pool. So you’re a commercial insurance companies- you just took the totality of your highest risk covered lives out of your bailiwick and you don’t have to worry about it anymore. The public sector is going to take of that so your profit margins just went through the roof and it shifts the cost on the government which is you the tax-payer. Oops.

So, what are the logical consequences of that? Remember, at every step of this process when we screw up we don’t go “oops” and go back, we go, “oops” and double down. So what’s the Oops?

Baby Boomers. Holy Crap! The hugest population explosion in the history of our country was going to come to fruition under this act. So what happened is- you’re promising care to a huge number or people who paid in when it was extraordinarily cheap but you’ve created a system where the cost of providing that care has to go up exponentially. So now you have a situation where if you’re going to keep this thing propped up from one election to the next, which is very important because this is also a demographic that votes and votes with fierce self-interest very much in mind. If you doubt if the baby boom generation has screwed you young guys -they know that they were at the beginning of a Ponzi scheme. And they were more than happy to pass that debt off onto you. You’re going to pay for this with money you’re not going to earn until you are 50 years old.

So how do we keep propping this up from one election to the other? Well we have to control costs. Well we do that by limiting treatment to what is considered appropriate or medically necessary and we try to limit payment to doctors. The other thing it did is it outlawed any supplemental payment form the patient to the doctor. So they start limiting how much they pay doctors- doctors don’t want to see patients anymore. Well a lot of people that were forced into Medicare said “Eh, I’m well-to-do. I’ve got plenty of money, Doc. I’ll pay you the difference between what you get from an insurer- someone that pays out of pocket- I’ll pay you the difference between what Medicare pays you and what you would have gotten.”

Well guess what? The government will not allow the doctor to do that if he participates in Medicare. So if you take that kind of money from someone you are subject to a federal crime that is going to send you to jail and you’re going to be subject to fines which under federal law have treble damages which means that whatever they decide to fine you- you owe 3x that amount. If someone in your office finds out- there’s something called ‘qui-tam’ which is a whistle-blower statute that says not only do you pay treble damages, the person that rat-finked on you, whose payroll you meet, gets treble reward too. So you end up paying six times the fine that is levied against you. So this has huge teeth. So what’s the next thing that happened? That wasn’t enough. It didn’t stop it.

Next thing was DRGs – Diagnosis-Related Groups. This came about in 1982. And it was courtesy of a couple academics by the name of Robert Fetter and John Thompson who were public health and epidemiology experts from Yale. And they came up with this system of paying doctors in what are called diagnosis-related groups. And what they did was they standardized different diagnosis through this giant manual called the ICD which is I can’t remember what is stands for- The International Compendium of Diseases or something of that nature (International Classification of diseases ~Jimm), but what it boils down to is that if you get admitted to the hospital and you have a certain primary diagnosis you get a certain number of hospitalization – a fixed amount they are going to pay for and that’s it. And it’s on the lowest possible end of what you can be paid from something of that complexity. Well what that is, is essentially, is a price control on in-patient medical care. Remember any time you apply price controls you get shortages. This created a shortage of in-patient hospital beds because hospitals could not admit that many people into the hospital and incur those kinds of losses. They had to back off on the number of people they were admitting – make the hospital smaller, have fewer beds because they can’t take that many losses under this payment system. This is why if you go back to your home towns and you look at a local community hospital what you’ll see is this dilapidated, old ugly building that has maybe 134 beds in it. But right next door to it, you’ll see a palatial, beautiful, bigger-than-the-hospital outpatient surgery center or an outpatient radiology center or a blood collection/transfusion center. Because they’re trying to divert their activities into the out-patient setting where these price controls did not exist.

The other thing that happened is it triggered cost-shifting. If you’re going to lose that money on the in-patient side of medicine, you’re going to shift that cost to other areas. This is where you get your $200 Aspirin in the E.R. We’re trying to make up for the constraints there. You push down on a balloon on one area, it’s got to expand in another. So they’re trying to preserve market signaling in the presence of something that distorts it. So that’s going on.

Then next thing that happens is what has affected my life so immensely. 1986 – Signed into law by one of our most conservative Republican presidents in modern history – EMTALA stands for…it was part of COBRA: Congressional Omnibus Reconciliation Act of 1986. This was a sub-component of COBRA called EMTALA: Emergency Medical Treatment and Active Labor Act of 1986. And what was happening is, when you go to do a residency at a public hospital or a county hospital -residency: you’re going to specialize in internal medicine, family practice, surgery, neurosurgery, orthopedics; ophthalmology-residencies are paid for with CMS funds- with funds from the Center for Medicare Services. So that created an obligation for hospitals that had residencies because they were receiving funds and tax advantages to take care of indigent care. So in 1985, if you were a private hospital and you have an indigent person show up with a medical condition, you just tell the ambulance to do a U-turn. You go to the public hospital. They receive funds for this kind of care. Go get your care there. And that’s what happened. And that’s how the indigent paid for their medical care was by essentially being the patient for medical residents. But public funds were going to those hospitals. It was considered fair but all of a sudden the public hospitals under the effects of the DRGs were getting all these non-paying patients coming in and suffering even further loss than the constraints of the DRGs. You had non-paying people. So they started to scream and yell that this was dumping. “You’re dumping your undesirable patients on us simply because we’re good guys.” So we signed this into law and what it does now is it requires any emergency department, any E.R. to treat anyone who presents within the hospital property or 250 yards of the E.R. regardless of their ability to pay. What that also means is regardless of their intention to pay.

How quick did you think it took people to figure out how to game this system? You want to talk about viral spread of an idea? It happened overnight. The public hospitals…emptied out. They were like, “What happened? Our waiting room used to be jam-packed” and everyone was going to the more desirable hospitals because they were given a political mandate by force that they could go get that care for free. And it’s an un-funded mandate with severe penalties. There is no mechanism to pay an emergency physician for seeing this.

So what this did is it made emergency rooms the de facto national health plan for the uninsured. State and local governments abdicated all responsibility for charity care and based on statistics, that were done around 2000, they said the average Emergency physician is providing $138,000 a year in uncompensated care, I myself- when I calculate- provide approximately $350,000 in uncompensated care based on Medicare payment rates. Which as we’ve already discussed are price-controlled. So that’s the low end of the spectrum assuming that applying that, I provide about $350,0000 in uncompensated care. About 23-30%, depending on the quarter that you look at, of the patients that I see pay me anything. So this resulted in further cost-shifting just to survive. This is where you get your $200 Aspirin in the ER. And the thing is- it’s the law that was intended to help the poor hurt them the worst.

There was a massive influx of non-paying patients and that contributed to ER overcrowding. And most people when they think of an over-crowded ER, blame this scenario for the overcrowding. But I’m here to tell you it’s maybe 15% of it. Where the real overcrowding in the ER comes from is the lack of inpatient beds because of the price-controls applied by DRGs. Because the people coming into the ER are sick. There’s a lot of minor stuff that comes through and you’re always kind of turning that wheel but there is no shortage of critically ill people coming through the ER. And you have to get them. You have to stabilize them. Get them treated. Get them ready to be admitted to the hospital but guess what? There’s nowhere for them to go. There no bed upstairs. So they end up boarding in the ER. So the size of your ERs bed capacity starts to shrink. So then instead of having 20 beds to move a big back log of patients in the waiting room through, you now have ten. And in a few more hours, you’ve got five. And then you’re really hosed. So the real problem with the over-crowding is not just the massive influx of people coming in the front door, you’ve got nowhere to send them upstairs because of in-patient price controls.

The other thing that happens is the on-call doctors- the people you need for back-up- the orthopedist for the broken hip, the neurosurgeon for the gunshot wound to the head- they stop taking call. And they stop taking call because they know that when they get a call from the ER at 3 in the morning there is a 70% chance that they’re going to get up, go out of bed, take the risk of taking care this patient for no compensation, finish up that surgery and go to an office that’s backed up. So they stop taking call. So we’ve got no back up for a lot of different specialties.

Next thing that happens: 1996 – HIPAA. That stands for Health Insurance Portability and Accountability Act of 1996. And basically what this law was to do was to give Government enforcement of the Hippocratic Oath, part of which is to say: Anything that happens between the doctor and his patient remains confidential. And the reason for this is when you collectivize medicine , the ability to keep it confidential because you’re serving the collective and not the individual becomes compromised.

The other thing that was happening was the government was already planning to mandate – remember this is 1996 the internet boom was going, computers are going to solve every problem on the face of the Earth. So there is this huge governmental push for electronic medical records and they worried about sensitive personal information being stolen so they impose imposed huge penalties if you even inadvertently violated anyone’s confidentiality. I cannot practice medicine on a day by day basis without violating this law every time. If someone comes from a drug house or a rave party unconscious, whoever’s with him, you know, some kid with pink hair and a bone in his nose- I gotta drag this kid in that’s remotely their friend and say, “Here’s the circumstance with this guy -he’s dying right in front of my eyes do you know what he did?” Under this law, that’s a violation. But I have to do it every day just in order to be able to practice. It’s impossible to comply with.

But if you have something called a “compliance program”, if you hire someone to serve basically as a government rat-fink within your own organization, then if you have a slip-up, then you’ve at least demonstrated that is an honest slip up and the penalties are less severe. You have to incur essentially a full-time equivalent of hiring a person on board to make sure that you’re being HIPAA-compliant. And every time you go into your doctor’s office- the first thing they give you is this big long sheet of paper about your privacy rights that you have to sign. Anyone that’s been to the doctor’s office recently knows what I’m talking about. But this was greasing the path for the electronic medical records which I now have to deal with. This all combined, signals the death of private practice.

Overhead burden from Medicare Medicaid, private insurers, HIPAA, it eats up all of your profit margins. In the past four years, 80% of family practice doctors in my community paid themselves no salary. Of the ones that did, they paid their nurses and mid-level providers more money than they were able to net out of their practice. As a consequence, these people were bought up by hospitals who had the scale to deal with the regulatory burden. It’s wasn’t like they were brought in by a hostile take over. These people begged the hospitals to be employees because they couldn’t make it otherwise. That’s what happened. So now what you have is medicine is collectivized both on the provider and the recipient side. Control is easier. You have control of both sides of the equation from the government standpoint.

Even if this was an unintended consequence, you couldn’t have devised a more diabolical system for getting complete control.

Ultimately this created a Hospitalist movement. If you get sick in the old days, your doctor would see you in the office, say “You’re really sick, you need to be in the hospital.” He’d do a complete history, physical exam, write admission orders, send you over to the hospital, you go upstairs and he’d see you. From his office-he’d either see you immediately if it’s urgent or see you later in the evening after office hours. But your doctor who knew you intimately would take care of you in the hospital. No more. All in-patient care is shifted to hospital employees which are Hospitalist. They provide the in-patient care when the patient comes into the hospital. And this happens because the hospital practitioners that became hospital employees are now under sever scrutiny to be productive within the office and if they have to come and provide in-patient care mess up their schedule, they’re productivity falls and they get in trouble for it.

There’s also a refusal to take call because EMTALA increases their exposure to making their bottom line look bad and make them look bad and the hospital and the hospital has no conception of calculating the economic value of doing something that the government has mandated that you do. So the hospital’s been hired to provide in-patient care and these are excellent physicians. But they’re excellent physicians who’re under enormous pressure to practice for the collective rather than the individual. And to their credit what they’ve done because these are doctors – very smart people – is they have become very creative at kind of subverting the system and making it work but what happens is the Government constantly changes the rules of what they’ll pay for and what they won’t pay for so it’s always a moving goalpost. So in order to the help the Hospitalists, the hospitals now hire case managers. Case managers are usually nurses who have the good sense to get out of clinical care or social workers. And they have this big manual from the government about what they will and will and what they won’t pay for and what the diagnostic criteria for being admitted into the hospital are. And they help the Hospitalists figure out what they can and cannot do. Now make no mistake, if something doesn’t fit this template, they’re not saying you can’t admit the patient to the hospital. They can and we do all the time. They’re just saying “We’re not going to pay for it.” And when the hospital is under this much financial pressure, there’s very huge pressure to predicate your admissions to the hospital based on what’s allowed.

So finally, the Patient Portability and Affordability Care Act – Obamacare.

This was signed into law on March 23rd, 2010. I watched it while waiting in a neurologist’s office for four hours to be seen. The reason I was in the neurologist’s office is that I got a weird neuropathy. I thought it was a pinched nerve in my neck. Maybe from working out. But my intrinsic hand muscles atrophied to the point where I could no longer pinch or turn a key. One day I had a patient that went into respiratory arrest. I had to intubate them. I used a laryngoscope to expose their vocal cords and the endotracheal tube- the plastic tube we put down your windpipe- I couldn’t hold onto it as I was passing it through. And I was like, “Oh, crap-I gotta figure this out.” So I was waiting to have a nerve conduction velocity done. As it turns out I had something called Cubital Tunnel Syndrome. We were mandated to have electronic medical records or face severe financial penalties in terms of what Medicare would pay you. So, huge pressure from the hospital – we went to instead of voice-dictation that was transcribed to this computer template that you had to mouse every little bit of the patient encounter. And what is was, was a desk with a glass table top and I was raking my ulnar nerve over and over again. I never thought after 20 years of education I would have the sort of job where I would have a repetitive motion injury. But I was there being evaluated for it while as I watched this being signed into law. And the thing is that everyone’s just really up in arms about this thinking that this is going to do new and horrible things and it’s not.

Here’s what it does: is it just takes everything that horrible about our current system and mandates that you buy into it, even if you object. And the scariest thing about the latest court case is, the first time in American history someone can tax you for something you did not do. You’re not being taxed for taking an action you’re not being taxed for producing something or selling something. Or bartering any sort of transaction. You’re being taxed for an inaction.

So this includes all the negative elements of what brought us here. But the other thing it does- it shuts off any escape valve for cost shifting. Everyone’s co-opted into this thing. So what’s going to happen now is once these price controls are enacted and they cannot be dissipated by cost shifting , you’re going to have massive shortages. It’s going to be really hard to get in to see anyone or get care. So if you get sick, expect to be deflected to the ER when you go to your doctor’s office. The doctor’s office is for routine care and simple stuff. You do anything that screws up the flow of the schedule, they’re going to punch you to the ER. When you get to the ER, expect long waits because everything’s being shunted there. And EMTALA remains in effect. Call your doctor’s office. Go out in the hall; call your doctor’s office on the cell phone. (They) will say, “If you think this is an emergency call 911 go directly to the emergency department. When you get to the Emergency Department, what’s the thing the triage nurse says to you? “Didn’t you call your doctor” No one wants you. Because you are a liability to everyone involved in this system now.

If you need admission, it’s going to be a fight. We’re going to have to find a damn good reason for you to get in and we’re going to have to ram a square peg into a round hole to make sure we get some sort or reimbursement and you’ll be kicked out as soon as possible whether you’re ready or not. It’s all protocol-driven. Any time you receive a treatment it will be per protocol. If you come in chest pains, you’re going to be discharged on a statin. And if you’re not discharged on a statin, that’s going to create the physician being flagged as an outlier and a troublemaker.

The sicker you are the more you’re viewed as a liability. Be prepared to be discharged prematurely. Come in with pneumonia, you’re not completely better, but maybe good enough, they’ll send you home and right now we’re experiencing multiple ambulance u-turns. And what I mean by that is almost every single shift I work I will see at least one ambulance patient that was someone that was discharged from a hospital being driven home in an ambulance that has to do a U-turn and come back because they are decompensating. Guess what? If you’re at risk of re-admission within 48 hours, they ain’t paying. So now the re-admission is even more of a fight than the original admission because no matter what you do, no one’s getting paid. But lots of people are doing the U-turn because of the premature discharges. And understand this is not because the doctors aren’t good. These are extraordinarily smart and well-meaning people. They’re just operating under the constraints of enormous pressures.

So remember, he who holds the gold makes the rules. What becomes protocol is subject to lobbying groups. And what treatments are approved are influenced by Big Pharma. Big Agri is subsidized corn and you end up “needing” Lipitor and “needing” Glucovance. And what lands most people in the hospital is the dietary habits that are created by a Big Agri and the USDA. And you get admitted into the hospital what they bring to feed you will be what the USDA says to feed you.

So remember getting sick – it’s always meant a loss of control but now it means a loss of control and a loss of your liberty. Your doctor no longer serves you. He serves the collective. His compliance is strongly coerced if not forced. Currently it is coerced very strongly. Soon it will be forced. And remember you are a financial loss to everyone involved. It’s cheaper if you die. As long the protocol was followed it’s in your best interest to be a quick healer. That’s why you want to eat the Paleo diet. That’s why you want to do high intensity exercise. That’s why everything that we talk about here is so important. You do not want to get in the belly of this beast.

So, you doubt me? Take the airport test. When you guys are flying back home, look around. The vast majority of people are already within the belly of the beast. And that’s the thing that always cracks me up when you hear, you know, fitness guys that get up here and say, “I’m going to change the healthcare system. We’re going to be more about prevention and health than we are about disease.” Come to work with me one day.

You. Have. No. Idea. How sick people are.

I saw a 48-pound two year old with Type 2 diabetes. At Walmart you can buy nipples that screw on to a Mountain Dew Bottle. Look around you. Just walk out front look at someone out in the smoking area that’s you know, a hundred pounds over-fat. And realize- this person gets the flu? They’re going to be real sick. The onslaught of sick people that need big Pharma-type interventions because it’s all predicated and focused on that sort of recovery from the brink. There is so much of that coming at you so fast you don’t have any time to think of alternative medicine or prevention or anything like that. Doctors are buried by this. So being fit and medication free gives you an enormous competitive advantage and it subverts dependency. Direct control over your life is removed. It leaves you in a much more resourceful mode of being able to deal with the multiple indirect controls that are being exerted over you right now.

So how do you do it? Eat a Paleo diet.

And you don’t have to eat Paleo.

What that means is “avoid Neolithic agents of disease”. Eat nutrient dense whole foods. Single-ingredient diet. You should eat something that has a single ingredient: Broccoli. Meat. Eggs. I was talking to Dave earlier and we were talking about eggs, fat and the diet and how important it was and particularly how important it is in pregnancy and gestation. Dave said, “Look at an egg. Look at a yolk. Everything you need to make a chicken is right there.” That’s nutrient density. Eat a Paleo diet. Find a book: Primal Blueprint {by Mark Sisson}. Rob Wolf’s book, The Paleo Solution. The ONE diet by Simon Shawcross who spoke in London. Primal Body Primal Mind by Nora Gedgaudas and The New Evolution Diet by Art Devany. Pick any one that appeals to you and follow it. If you respond better to visual and aural presentation, see my 21 Convention Talk on Youtube 2010. I’ll lay it all out for you in technical detail so you’ll understand both the ‘why’ and the ‘how’.

Exercise. Do high intensity, low force exercise with plenty of recovery. What Skyler told you is gospel truth. You can read my book “Body by Science”.

“First, do no harm.”


Find Bill DeSimone’s work and read it. Moment Arm Exercise. You don’t want to injure yourself either. It’s not enough not to be sick. You tear your rotator cuff. Guess what? You’re in the belly of the beast. So you should avoid ballistic exercise and if they use skill based movements in a fatiguing protocol. I love the spirit of Crossfit. I love the notion of: doing-hard-things-builds-character. But what I don’t love is a fatiguing protocol with skill-based movements that are going to get you injured. Same thing with P90X or Insanity workouts. Do high intensity, low force workouts. Because injury will put you into the belly of the beast very quickly. Remember, when you’re becoming super-human, the way to do that is to remember you’re only human. And biohacking -everyone referred to it as cheating. It’s not. It’s not cheating. You’re not cheating anything.

Francis Bacon said it best: “Nature, to be Commanded, Must Be Obeyed”.

You’re obeying nature when you’re following a Paleo diet, when you’re doing what Dave Asprey tells you when you’re doing what Skyler Tanner tells you, you’re being a good animal. A cheetah doesn’t have to count his calories. A lion doesn’t count his calories. They’re in perfect metabolic and physical conditioning without even thinking about it. The same is true for us. The reason it seems like such hard work is we’ve become so far removed from the evolutionary dictates that made us what we were meant to be.

The other thing you want to do is what I call Black Swan Avoidance. Or my dirty dozen plus one. So let’s talk about them.

~~Break transcript~~

Doug humorously reviews a bunch of ways he has seen people die as an emergency room doctor and suggests ways to not get yourself into those situations. I’m not going to transcribe it at this time. But a couple of key quotes/paraphrases are:

“Force is Mass Times Acceleration. Take it from an Emergency room doctor”

“If the grill won’t light, walk away”

“The ladder. This is the white man’s scourge”

“Buy your home to retire in. Don’t build it. I see guys die of a myocardial infarction from arguing with a contractor once a week. We live in a resort area so there may be selection bias.”

“If you ever get into a car at the point of a weapon, you will most certainly die but not until you have really, really suffered.”

“Be Kind. It’s the most important thing for your health and our society.”

“Speaking of kindness-We have these huge forebrains. It’s very important for communication. And it’s what’s lacking when you communicate of the then interact or over the cell phone or by text messaging. There’s a very strange version of stroke called Aboulia, when you have a stroke in the frontal lobe of your brain. I can walk up and talk to the patient and speak to them and they just stare at me with this dead-pan face. And their answer doesn’t come out until 10 -15 minutes after I ask the question. But I can give them a cell phone and call them, step outside of the room and get a complete history from them because they’re communicating in a mechanism that is not at all facial recognition in the pre-frontal lobes of the brain. Realize that when you are communicating over the internet and you are flaming someone on the internet and you’re getting into these little pissing matches that you are not engaging your frontal lobes. You are saying things that you would never say to someone’s because you know damn well you’re likely to get punched or killed. Kindness matters. Because we all must die.”

“I’ll leave you with the words of Ron Harris who wrote The End of Faith and he said this: ‘Consider it. Every person you have ever met. Every person you will ever pass in the street today is going to die. Living long enough each of us will suffer the loss of friends and family. All are going to lose everything they love in this world. Why would we want to be anything but kind in the mean time?’”


“Stay Out of the Belly of the Beast”.

Doug then takes some questions and tackles subjects such as:

Walmart and it being the logical consequence of the removal or market forces (i.e. You can buy donuts right next to antacids and diabetes medication)

Sexuality and sexual health

Recommendations for health insurance (already out of date)

More details on the bureaucratic Armageddon of Obamacare

Why do other countries with socialized medicine look so cool and we don’t?

Posted in Health, Fitness & Nutrition | Leave a comment

Why do we have to get healthy RIGHT NOW? It’s not about looks.

Why do I blather on so?

I didn’t have to share my weight loss journal with you. I do these weight drops routinely.  It’s very trendy these days to cry “narcissism” at anyone sharing anything personal on social media, but that’s cheap.  At this point, this blog is only read by a percentage of my Facebook friends, so I really am writing to friends and I want to help people understand my alarmist view. Stuff is going to get expensive really soon and if I can convince you of the urgency you need getting out from under it, maybe I can help you accomplish getting out from under it as well.

As I have stated, I have an interest in the science, but I also have civic-mindedness that grows from this; from inner city food deserts to helpless children who can’t yet read but need insulin shots owing to no other reason than diet. What a world we’ve created, where 3rd world countries that formerly called pathogen-carrying insects its biggest killer now succumb mostly to metabolic diseases. We’re exporting the sickness.

Ask the World Health Organization

Hopefully by now I have given you the impression that my concern with the obesity epidemic is not “looksist”. I don’t care what you look like naked (we have alcohol for that, baby) and all of the information I give you is to get you healthy, not make you look like an underwear model.

Obesity is a normal part of the human condition.  But jump from ~12% to ~33% in one generation is not in our genetics. This is indicative of exposure-the effect of an outside influence, not nature. Our workforce is sluggish and useless at a public a cost of millions. Our military is in a panic. Every industry has been re-tooling for morbidly obese clients, from giant wheelchairs to plane, car and theater seats (with costs passed on to you). All occupancy signs must be changed.  A boat sank because it was loaded to occupancy but everyone on it was as big as two people. Most of us just laugh at this.

OK, we enjoy the misery of our fellow man and our own in a cynical way. If you warned me of the dangers of fat when I were a 19-year-old, I would have said, “Good, I hope I’m dead before I’m 30.” or “Well, something’s going to kill me.” We’re all just too cool.  But what about the epidemic of obese and Type-2 diabetic two-year-olds? They aren’t on the diet & exercise program. We don’t know how to feed our children. There are those out there who are of the politic that says children should be taken away from parents for child abuse like that. Sound ridiculous? Have you never seen Governments do ridiculous things?

Complications from metabolic syndrome account for a large percentage of healthcare costs.  Think it doesn’t affect you? Most bankruptcies are attributed to healthcare bills. When someone has to give up their home in your neighborhood, it lowers your property value. Every company you interact with passes along the cost of its productivity losses to its customers.  And these sick people are chewing through healthcare costs at an unbelievable clip. No one can afford it. We expect the other guy to pay because “it’s our right”.  That’s a Faustian bargain, my friend. And you’ve already signed with blood.

Obesity compounds almost every disease out there and every disease research entity has had to add a new wing called “Our Disease + Morbid Obesity”.  In fact, Big Pharma has moved is resources away from investigating drugs that can knock out a disease in one treatment or drugs that have small population targets, Orphan Drug Act be damned. They are much more interested in drugs like statins that they can keep large populations on for decades. I wonder why. We have not increased our lifespans, we have increased our dying spans. You can now founder along for decades as a diabetic with chronic liver dysfunction who can have heart surgery every 7 years. Hooray!

As Doug McGuff says, “Nature is a hanging judge.”  There is no room for this in nature. And the baby boomers set up a Government Ponzi Scheme and fully expect all 37 of us Gen Xers to pay for their entire boom generation to go through this. And everyone younger than us expects us to pay for college tuition.  Prepare for clock tower snipers.

Now lets talk about this menace of a healthcare system. My right-winger and libertarian friends need to understand that the Libertarian Dream is dead. Also, The personal responsibility argument has scattered to the four winds as will be explained over several posts. We all live in the same healthcare bubble all of a sudden.

You didn’t stop Obamacare (not that you had a chance, you would have had to start the fight 90 years ago). The horse is out of the barn and we’re headed for a single-payer health system faster than Rosie headed for the pie table. Gub’mint regulations and compliance orders have already effectively destroyed private practice. Those doctors begged to become hospital employees because they couldn’t afford the regulatory burden.  The next step is for small and local hospitals to beg to be bought up by Mega Hospitals.  Begin the count-down to Lake Hospital System becoming the Cleveland Clinic now.

The same will happen with insurance. You will eventually drop your private insurance and employer plans and pay the relatively smaller price or tax penalty through the exchanges. That or your employer will do it for you. Then when private healthcare collapses (if the medical loss ratio provision doesn’t do it first ) and it’s just you and the government looking at each other, the sky will be the limit on cost. There are thousands of pages out there explaining how and why this will happen. If you haven’t dug it up by now, you won’t.  And you’re likely one of the ones who think you have a nice free ride coming.  Just in case you would like to review current supposedly non-partisan projections, here’s the Congressional Budget Office Outlook for 2015 that claims this will cost $50,000 per person (NOT counting your premiums or out-of-pocket spending) and Trillions (a figure to which you’re numb) in taxes.

Just keep in mind that the United Kingdom’s NHS is one of the top 5 largest employers on the planet. Like, world-wide Walmart-sized.  The UK has the population of California + Texas and land mass a bit smaller than Texas. The cost of something like this on a scale the size of America’s is insurmountable.  And we plan oversight and enforcement and data mining and regulatory costs at unprecedented levels (for taxes, silly, not for quality).

What is “insurance”?

You are insuring against unforeseen future events.  This is why people say “no one buys insurance for a house that is already on fire”.  This is meant to define “pre-existing conditions”.  Pre-existing conditions are the difference between insurance and charity. If you were born with Phenylketoneuria and suffer life-long cripplingly-expensive complications, there is nothing to insure against. They knew it was there at birth. You need charity, not insurance. If you are indigent, you need charity. But our modern “healthcare system” rolls them together. Add to that the ability for larger groups of people to have greater buying power for supplies and services. Your insurance group is a buying group, which replaces our old-time systems of Fraternal Orders (Eagles, Oddfellows, Etc.).

Add to that the use of premiums to pay for low-level office visits, exams and procedures so you have the comfort of no out-of pocket expense all trying to ride in the front seat of a massive technology curve which makes this a multi-headed hydra of money-suck with no accounting, accountability and vague or hidden prices all removed from your paycheck before you have a chance to review. And politicians love to conflate these functions and dance around their definitions and re-characterize the goals of healthcare to achieve political ends.

And now buy-in is law. Criticize and beg for accountability of your money all you want, sucker!

What does this have to do with being overweight?  As we head toward single-payerdom, obesity, dietarily-induced metabolic dysfunction, tobacco use and maybe alcohol consumption will head toward heavy penalization in the name of personal responsibility. And they don’t care if BMI is not an accurate marker for health. They don’t care if subcutaneous fat has a different health profile from visceral fat. And they don’t care if inner city children are being fed sugar water called “Juice” on the WIC program because the USDA thinks that’s health food.  They don’t care if inner city children have insanely high blood glucose levels 20 hours a day because they are fed nothing but boxed food. We’ll just give them all gastric by-pass surgery and guess what – you’re going to pay for that, too! Then they’ll be old enough to move to Gatorade.

What do you expect to happen when the government runs the healthcare system? Your ill health is costing everyone else money. And right now, societies believe that it is the fault and personal responsibility of the obese person to correct this. Yep, hold those 2-year-old diabetics responsible for their gluttony! Where could this all go? To what could it lead?

Japan has a state-prescribed waistline measurement. The Japanese who do not comport are given guidelines for health. If improvement isn’t shown within 90 days, they are sent for “re-education”, whatever that means.

Now this conjures expeditionary enforcement of citizen behavior by its Government but things don’t work like that in America. We were founded by people who don’t like being told what to do.  But it’s just not very hard to outwit us, especially if Football is on or if we have a sparkly gadget. Or a cheeseburger (guilty).

The government knows that all they have to do is bungle things up until you just beg them to take the whole thing over and make life easier for you.  This is why law enforcement is shrugging their shoulders over gun crime. They are waiting for you to beg them to take them all away after you see enough senseless death.  This is a lesson in all collectivism.

First off, keep in mind incrementalism and “mission creep”.  That 50-employee cut-off will eventually become 35, then 10, then 2, then 1.

What you see up top is coming your way.

If you work for a large entity (say, CWRU or Progessive)- you may have available to you a Wellness Program.

Perhaps you work for a smaller company and a “wellness consultant” has mysteriously shown up in the past year.

This is a nice perk if you need it.

The next step is “incentivizement”. Whole Foods will give you a better employee discount based on your blood pressure, cholesterol and BMI.

Here is an Email that went out 16 days ago from CWRU:

Dear CWRU employee, 

Welcome to the first wellness newsletter of the new year! The 54% of benefits eligible employees who completed the three wellness activities last fall will receive this newsletter and the $25 monthly Wellness Premium Incentive this year.  If you are a new wellness participant, welcome.  Please look for the $25 in the “earnings” section of each paycheck.
A full schedule of programs has been planned for 2015. Each of these will be offered throughout the year so that as many people as possible may participate. New stress management programs will be offered. In addition, a new program to support Healthy Backs & Bodies will occur. 
A Weight Watchers Subsidy Program began on January 1st for all benefits-eligible faculty and staff.  Details of this new offering are below.
Finally, 121 Fitness Center is launching new versions of the popular Get Fit series. Registration is now available for all of the programs below.

Great! More crap to keep track of in your paycheck and uses of your time that may or may not be beneficial, but covers your employer’s ass.

The “programs” you are coerced to take part in are things like “Stress Management & Resilience Training (S.M.A.R.T.)”, “Meditation”, “Mindfulness” and “Smoking Cessation”.

The next step is: Participate in these programs, or pay higher insurance

The step after that is: Participate in these programs, or pay insanely higher insurance.

The next step after that may be: Participate in these programs in order to have a job.

And the Employer or the Insurance company gets to look like the bad guy. Remember when CVS forced employees to report weight, glucose levels, and body fat to their insurer, or pay a penalty of $600?  They were called everything but white women, but this is the same situation. They just brought in WebMD Health Services Group to provide health management programs as coerced by federal guidelines.

Here is the kick in the ass: It’s almost all because of what you eat and the Government is making sure (with your tax money) you get garbage at a discount. But we’ll get into that later. For now we need to keep discussing the urgency with which you need to lose weight and probably quit smoking unless you make a lot of money.

In a 2012 Talk entitled Fitness, Health, and Liberty at the 21Convention, Doug McGuff, an Emergency Room MD from South Carolina explains exactly how this is already irrevocably around your neck and only going to tighten by giving a history of our healthcare system over the past 100 years. There is something in it for the liberals because he’s going to beat up on the Big Business. There is something in it for the conservatives because he is going to indict the Government. He will undeniably show how everyone involved, including 100 years worth of stupid voters are at fault for this mess and why you really only have one job now which is to

Stay Out of The Belly of This Beast.

Which I have painstakingly transcribed for you for review of and comment upon.

Please follow the link in the large text just above in order to watch or read it.


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The Definitive Photographic Guide to Making Souse

updated 23Feb16

Many of you know it as head cheese or Brawn if you’re British. Some confuse it with Scrapple (Head cheese + corn meal) which is similar to Goetta (with oats) if you live in Cincinatti. It can be made into a loaf and sliced for sandwiches, but I prefer to prepare it the way my grandmother did, which is canned in mason jars.

My particular Hillbilly heritage hails from the Big Savage Mountain area of the Alleghenies. We’re from Frostburg & Cumberland, MD and Salisbury, PA. We’re mountain folk who tended to be Methodists, whose preachers had no church hall, but rode a circuit on horseback with little more than a blanket- traveling to the isolated hillfolk to spread the Gospel. We are also the type of hillfolk that call headcheese,”souse”, which is also how we describe being drunk.  Getting “soused” and staying “soused” is all my people had to do when snowed in from harvest-time to spring thaw.

Heh, “My people”.

Whenever my schedule allows, I pick up a pig head from New Creation Farm. I understand that in some parts of the country, Walmart carries frozen pig heads.  God Bless. But I try to source local meats from places where I am fairly certain I am aware of their husbandry practices. There is much to read about New Creation Farm (and pictures) as well as philosophizing about meat-sourcing in the post entitled “On Buying meat for food“.

This is how you sneak a pig head into the house. This is all your wife should see until the canning is done. Even then, it’s best to have a hiding spot in the basement (not for the canning jars, for you). Take a spoon.

Prepare your work-space out of doors, if you can. Especially if your wife has locked you out.

Here’s how it looks when you first unwrap it. It needs a little shave. Some people have a (hopefully) dedicated straight razor just for this job.

I, however, just use a torch. Don’t forget to get deep into the ears.

The Foxfire Book‘s second chapter concerns a couple of young guys who are helping an elderly lady named “Aunt Arie”  butcher a pig head.  There is a humorous moment when she digs one of the eyes out with a butcher knife and flings it outside, onto a near-by tin roof and it rolls off and hangs “bobbing on a clothes line”. They ask her if it bothers her and she replies, “I don’t care fer’t bit more’n spit’n’th’fire”.

That is not a great way to accomplish this job.  I now pull on the eye with a pair of needle-nose pliers and cut the optic nerve with a pair of kitchen shears.

There is a Department of Agriculture stamp. I don’t know if it’s edible. I cut it off just to be safe.

I also remove the ears.  Some people don’t, they add it to the Souse.  But some complain that the ears are too gristley. I don’t know because I don’t want to risk making a whole batch that is not to my liking, so I remove them just in case. There are recipes out there for just the ears, so maybe I will try one of those one day but it hardly seems worth it for two ears. I throw these into the woods for the animals and let the thought of one of the neighbor dogs running home with these or a skull entertain me.

Next I cut them down to stock pot size with a Sawzall fitted with a long wood blade. You see here in the cross section the hog jowels- pretty much the most delectable meat on the planet. Like a butt roast, it is strong, well-used muscle that must be cooked slow and low into a mouth-watering thing of beauty.

If you can get a hold of some trotters, they add a lot of gelatin (aspic) to the mixture and help a lot when trying to get this to set up if you choose to make a loaf instead of canning it.

You can throw anything you like in at this point. Use spices, trotters, herbs (traditionally Sage), vegetables-whatever suits your fancy. This is your time to make a personal recipe they will be begging for at the company pot lucks. If you are uninspired or not handy with spices, search for bone broth / soup stock recipes and use those spice mixtures.

Next boil it forever. The longer you boil it, the more you will cook out of the bones.  I suggest 6-8 hours at minimum.  I often simmer it overnight and if I can stand it, 18 hours. This would be a good project on a wood stove.

I was visiting my cajun-country friend not long ago and he had recently taken his kids on a pig hunt. Feral animals of the Porcine persuasion are BIG TROUBLE in the South and they are heading north.  They are super-aggressive, a threat to children, property (I’ve seen full-sized pig roadkill – imagine THAT crash!) and the environment. If you go on a feral pig hunt, you are a hero to society. Them Cajuns trap wild piglets and raise them in pens for a season or two.

This is “Rooty”.

So my cajun-country friend and I decide to make some souse in a a Crawfish boiler.   Taking a cue from the bone broth recipes, I had been adding vinegar early on in the water to leach calcium out of the bones.  I said, “OK, add a bunch of vinegar”. I meant a few good splashes. After I heard about the 10th, “glub-glub-glub” I looked over to see that he had added about 1/3 of a gallon of apple cider vinegar.

“Whoa! Dude! That’s a lot!”

I need one of these crawfish pots SO BAD!!

I was worried, and for a moment assumed we had ruined it.  But the end result was delicious. He set it up as a loaf-style terrine. And the skull was so soft I could crush it with my hands (but I left it for his kids to play with).  That bony goodness was now bio-available, set in aspic. For the love of Ted Nugent.  So don’t be afraid of vinegar.

Next, remove the head from the water. Be careful because it is pig-fat slippery and will fall apart and splash into the boiling water if you’re not careful. It is easy to pick the bones out at this point.

A quick hammer whack will get you to the brain. Be sure to keep yelling “BRAAAAAINNNNNN…MORE BRAINN!!” to the annoyance of those around you.

(no one will be around you)

I try to grind it as fast as possible so that I can hot-pack into the Mason jars.Try not to think about The Wall. Damn You, Roger Waters! Or if you’ve ever been to a GWAR show…

The stock that is left behind will settle into 3 layers: a snow-white mild lard that can be used for baking, a dark, flavorful lard that is similar to bacon grease, and a thick, rich bone broth that can be used for soup stocks, making rice or drinking, etc…

If you cook a long time or add a trotter or two, the bone broth will be so thick and gelatinous, you can stand a heavy spoon in it once it chills. Lovely for your hair and nails.

If you are on a budget, this is the way to feed your family.  A $15 head will give you several quarts of stock and many pounds of meat. One day I will figure out the calorie price. You can’t beat this anywhere and it’s such nourishing meat.

I’ve been experimenting with smoking the head instead of boiling. I was VERY happy with this. And the big pressure canner is big enough to accommodate a whole head. I don’t need to use the sawzall.

Since I don’t have a great smoker, I finish it in a pressure cooker with very little water. When you do it this way, you don’t lose the fats into the broth. It gets mixed in with the meat canning. The smoked head is hard as shoe leather. Once again, I was convinced I had ruined it, but it softened beautifully in the pressure cooker.

This is what a smoked head looks like after pressure cooking. Spooky, no?

Here’s a jar of smoked souse in front of “regular”. It has a very rich, dark color.

Here we’re packed and ready for the canner. Use your canner’s instructions.

I’ve even tried a dry brine. I like what “Meathead Goldwyn” has to say about dry brining as opposed to bath brining over at Amazing Ribs. I also find this science of brining article helpful not only for meats but Lactofermentation of vegetables.

My favorite preparation is just nested within (or next to) a bed of Collard or Mustard greens. Here, served with the bone broth and pink salt. I also love to toss the greens in flavored vinegar.

Another is rolled into steamed or blanched Chard leaves which are crisp and bitter enough to mitigate the high-fat mouthfeel of the souse which is salted and cooked to just a little crisp. I just need to come up with a sauce now. I’m thinking Sage-based. I may add a filler (more greens?)

And at the end of the day you have a new toy! Play ‘Lord of the Flies’ or make a scarecrow or marionette. Give it to the kids for crafts. Or just hope one of the neighbor dogs picks it up. It’s the gift that keeps on giving. I usually chase my wife around with it, making it yell, “Sucks to your ass-mar, Piggy!”

I will keep updating this post as the experiments continue.

Lastly, the number of youtube videos about this this are finally growing but here is my favorite. Dude just cuts it off the skull and rolls it into a loaf. Forgive his hairstyle.  I will definitely be trying this technique one day. I think I need a better knife first.

More info on the Feral Hog problem:

Posted in Health, Fitness & Nutrition | Leave a comment

On Buying Meat for Food

 As opposed to for art & entertainment.

This was originally an introduction to another post I’m writing called “The Definitive Photographic Guide to Making Souse“. But it got a little big and I want to be able to share this with those whose sensibilities are too delicate to enjoy the Souse post. Or as one great blogger (I will credit as soon as I remember) wrote: “Those who can not handle that strange alchemy by which animals become food.”

Do we need meat? I think so. I think you require animal meat and fats. Very little, though.  I subscribe to the gram of protein per kilogram of body weight theory, and subtract out the protein you get from plants. To me, the ideal diet would be to eat an allotment of meat as described above with all of the fat that comes with it, being 100 calories or 1000 calories of fat. There is no reason to eschew fatty meats for lean (especially if the lean has added nitrites & nitrates).  Then the balance of your caloric need should be nutrient-dense vegetables. Go easy on the fruit, especially when not in season and go easy on the root vegetables that are just under-ground carbohydrate bombs. But I’ve been known to hurt myself on roasted beets.  I try to eat more organ meats and offal than skeletal meat. I’ll get into the science and nutrition of all this in other posts.

Not that I stick to that eating plan worth a damn. But that is my goal. Only my social life throws me off.

“Meatless Monday” is about the stupidest thing I’ve ever seen.  What we need is “Carbless Mondays, Wednesdays and Fridays” and 24 hour fasts 2-4 times a month before our pancreases go down like the runner at Marathon, as they have been left and right. Carbon tax on meat?  Well, the Gub’mint will never pass up an opportunity to regulate, but I’m more concerned about the fertilizers used in those Government-subsidized monocrop fields that feed those CAFOs washing down into the Gulf of Mexico.  I don’t even let myself think about the Government-approved meat now coming from China or what is really in those breaded and boxed frozen packages.  I’ve never eaten those as an adult.

 I no longer have to wander into the grocery and see that acre of red meat and just wonder what conditions produced it or what strange compounds they carry. I am fortunate to live moments way from New Creation Farm, a wonderful family that provides Scottish Highland Cattle, Free-range pigs, chicken and eggs.  Please read the article written about them in Edible Cleveland.

At New Creation Farm, I can meet & pet my food before I eat it, see where they live and ask Scott or Kristen all the questions I like about feed & preventative medicine.

Is it “expensive”?  Yes and no. You may pay more than you are used to paying, but what is the real cost of food?

Since you require so very little protein-you can take the time to source “expensive” ethically produced and chemically unmolested meats. In truth, you probably need a whole lot less than you’ve been buying. “Value prices” in meat are subsidized by animal misery, counterproductive medication and questionable shipping and storage practices, not to mention use of abused illegal immigrants that you subsidize 100 different ways through taxes.  Choose respectfully. Not that I’m proselytizing.

When we are so disconnected from our food- when we pay people to do our dirty work, this ultimately fosters more and worse animal abuse.  This is also why I think those of us who can hunt and fish really should. When you watch that thing die, you may develop a sense of what it really means to take a life to continue yours.  The deli doesn’t inspire much introspection toward that end.  I have a big post brewing on that topic, but that will be for  another day.

Here are some pictures from New Creation’s open house. If you live within 90 minutes of something like this, it may be worth considering making infrequent, large meat purchases instead of traipsing through the  grocery store and seeing what hits your whim.

Oh, Mommy! Can I eat it NOW??”

I bet know who’s getting a meat locker for Christmas.

Not Exactly a CAFO.

Scott entertains questions during the Open House.

“Oh, Yeah- MOO and stuff!”

“Hi, I’m Checkers. I’m a dog! I watch the chickens. Pleased to meet you. Don’t come come over the fence or I’ll have to kill ya. Thanks, now!”

And now! What to do with it once you get it home:

The Definitive Photographic Guide to Making Souse“-NOT for the faint of heart.

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2015 Weight-loss Journal

Instead of multiple posts, I’ll just edit this one daily, all Morgan Spurlock-style.


Like most people, I tend to start “diets” or implement lifestyle changes around the first of the year. I have no philosophical “new year/new me” feelings. It just happens to be the time when holiday / social activity dies and the weather pushes me inside and forces me to be more sedentary. For some crazy reason, when I am alone and suicidal and freezing through bleak winter months, no one wants to hang out unless it’s at a restaurant. Then all summer long, every Saturday I have to make a choice between three or five different invitations. Clearly my friends are just trying to give me ulcers and drive me to an early grave. So I hang out at the gym when I can.

This is an Ohio problem. In New Orleans, Carnival starts on epiphany and runs until our livers explode on Mardi Gras. They start baking King Cakes on Jan 6th. Truth be told I never really get involved with Mardi Gras stuff. It was awesome when I were a college-age neophyte. It was a hindrance when I lived in New Orleans and had to fight the crowds to live my life. Then, last year, at 40, I got to thoroughly enjoy it as an adult. I attended parades and marched in parades and met wonderful people and many artists with only one earth-shattering, humiliating, can’t-live-it-down drunken episode. Still, I gained 40 lbs in 5 months. Can’t do that year after year, either!

This year, I have no work-related pot-lucks or bar outings to attend, so my last scheduled bacchanal was today. I got to enjoy lots of Champagne, several refills of Scotch, at least four beers (though I tend to set them down while talking and lose track of them) and fist-fulls of food, including stuff I don’t even like, like mini-eclairs. And we’re going to call that a season!

My personal choice for fat loss is a Ketogenic diet with intermittent fasting which I induce with a multi-day fast.

This may seem harsh and restrictive to some, but I thrive on it. I am fully keto-adapted (explained later) and have tons of energy on this diet once I get through the carb flu. Insulin apparently makes me sluggish and miserable (this is conjecture based on experience-I have no way to know). This isn’t for everyone and it takes a long time to become keto-adapted so don’t expect similar results if you do what I do. I can get to ketosis in a couple of days.  It may take you over a week the first few times you try this. But you can become as keto-adapted as I am if you would like to be. Just keep doing it and your genes will make the enzymes.

4Jan15 Sun

Time to get on the scale. I normally don’t get on the scale until a week into this, but for the sake of writing this for you…HOLY JESUS CRAP! 207 pounds! And 40% Body fat! 1: 40% fat is not possible. 2: I was just telling someone at the party last night that I was under 200lbs. At least I was before the party started! My yearly weight swing in my 20s was between 205-235 lbs. The past 10 years, it’s been it’s 175-205lbs. OK. I am focused now.

I am not hungry today, still quite bloated from the party, so it will be easy to fast. Whenever I say fast- that means water + coffee + heavy cream. I will die before I give up the coffee.

Today’s Food: Coffee + Heavy cream, 2 Tbsp Psyllium husk, for an awesome bowel movement. Remember “The Cleaner” from Labyrinth?

5Jan15 Mon

203.6 lbs! Must have been an awesome bowel movement! The scale lies and don’t forget that a cup of water weighs over 8 ounces. This is why you want to shoot for a target fat%, not a target weight. Part of the weight you lose may be loss of muscle mass when your body turns your protein into sugar via gluconeogenesis. Ignore the scale for at least a week when you start a diet.

Today’s food: Coffee + Heavy cream. I made a second pot, shared some with the wiff.

6Jan15 Tue

200.4 lbs. 21% body fat

The biometric scale was absolutely off for body fat. I changed the batteries, reprogrammed my age, sex, height, etc. and got a more realistic reading of 21%. That’s still 40lbs of fat. I have arbitrarily decided that I don’t need more than 20lbs of fat in my body and that’s only if I can add significant amounts of muscle. My target fat% is 11-15%. My target weight is still 180lbs (still arbitrary), but I don’t actually have enough muscle mass, which is a whole separate problem.I only have about 150lbs of lean weight.

I woke up with headache which is normal. This could be for several reasons, most likely mineral loss. I was OK after coffee
Coffee + Whipping cream. I also had some Bone Broth with a big pinch of pink salt and took two Potassium Glutamate pills. One thing I suffer from while ketotic is charlie horses. So I have to supplement. At least I know things are happening metabolically.

7Jan15 Wed

198.4 lbs. 20% fat

To quote Sleazy P. Martini:”We’re rockin’ now!” Right? No.

Again, weight is deceiving. There is no way that I have lost nine pounds since Sunday. How many times have you seen a friend make an announcement on Facebook similar to: “Wow! I ran a 5K and lost 7 pounds!” or “I’ve lost 8 pounds since joining the gym last week! I must be doing something right!” Then 3 days later, they don’t want to talk about it.

This is because water is heavy, and your stored glucose is stored “hydrated”. Each molecule of glucose is stored with several molecules of water. All your friend did was burn up his or her glucose stores which was replaced as soon as they ate. This is “water weight”. They lost no fat and neither have I at this point. But wait- I have!

Today is a good day to check for ketones. I like ketosis because you can test for it. No other weight loss program can be tested for at home that I know of. If you are pissing beta-Hydroxybuterate and your breath smells like acetone, it can only come from fat, scale reading be damned. The fat is going away, verified.

This is just a journal, so I’m not going to explain Ketosis Biochem right now, but I need you to know that Ketosis is a normal part of your metabolism, as is fat-burning through metabolism of fatty acids, as is dietary glucose & fructose and even ethanol. The Atkins Diet simply tries to induce Ketosis and argue it’s safety and normalcy. When you see someone call Atkins a “fad diet” or disregard it as “ultimately, a calorie-restricting diet” or claim “all you lose is water weight” -that person knows nothing about metabolic biochemistry. And I can show you M.D.s who think this way. In the absence of dietary glucose, your body will use up its stores. Then, for a brief time it tears down muscle (proteolysis) and turns it into glucose (gluconeogenesis) while your Ketosis metabolism is ramping up.
Ketones are just fat made water-soluble, since your brain needs ~600 calories a day and can only use Glucose or Ketones because fatty acids can not cross the blood/brain barrier. Once your ketosis metabolism is going strong (when your body senses high circulating ketone levels) your body stops “calling” for glucose (and stops ripping apart your muscles) and burns ketones preferentially.

But not until your hormone system makes you pay Hell for it. Insulin does not go away quietly. It can take days to over a week to get your ketotic metabolism up and running and one muffin can make you start over. You may experience headaches, extreme cravings and other miseries. This is known science, not a fad. Atkins can’t not work. If it failed you, unless you have a metabolic disease, you just didn’t do it correctly.

So I peed on one of those Ketostix (very affordable from your pharmacist) and I was at the top of the chart.


So then I tested my blood Glucose & Ketones with a meter used by diabetics (Precision Xtra by Abbot labs). My circulating blood glucose is 43mg/dl (quite low) and Ketones are 2.6 mmol/L (quite high). Those ketones came from body fat, nowhere else.

These meters are cheap to buy but quite expensive to use, so I don’t do it every day. It is really cool because you can actually watch your blood glucose drop, then rise and stabilize without dietary glucose. This is the proteolysis. Life sciences are freaking beautiful to see! We are poetry in chemistry. Mammals, and even more so, Humans are really the most incredible thing on the planet. Why we gotta screw it up?

Philosophical musings are inevitable, but more importantly I am free to start eating now. But I’m really not hungry, even now. Why?

The hormone Leptin was only discovered in the 90’s. 1996, I think. It is released by your fat cells and tells your hypothalamus that you don’t need food. The more fat you have, the stronger the signal to your brain. However, insulin receptors co-localize with Leptin receptors and insulin blocks leptin. Make this your mantra: INSULIN BLOCKS LEPTIN. This is why, even if you have 60lbs of fat and just took in 300 calories of sugary beverage, your brain thinks you are starving. You are not leptin deficient, you are leptin resistant.

When you are starving (or your brain thinks you’re starving), your hormonal system wants you to take in energy and conserve energy (eat and don’t move). As Robert Lustig will tell you: Yes, you are fat and a glutton and a sloth, but being a glutton and a sloth did not make you fat. Insulin from your carb-based diet made you a glutton and a sloth which made you fat. So please stop beating yourself up and blaming yourself for not getting enough exercise and eating too much. You just ate the wrong stuff (based on USDA guidelines).

Michelle Obama thinks you just need to do some jumping jacks and grow a garden. She’s says, “It’s your fault. You conservatives like personal responsibility, right? By the way, my husband is going to keep subsidizing sugar, corn and wheat. Good luck with that insulin!”

So with insulin out of the way, my 40lbs of fat is freely telling my brain, “Don’t worry, we have months of food on board. Where’s the coffee?” And lack of sluggishness dictated by my parasympathetic nervous system  triggered by lack of insulin is perceived as “extra energy”.  I haven’t been to the gym since the big party. I just may go today if I can dig the car out of the snow.

Small headache again this morning and threats of charlie horses.

Evening note

So I did go to the gym, but decided to eat first.  I’m not going to do a full food journal, but I will share a lot of food detail this first week or two and highlight things of note.

Today’s food: Coffee this morning and Collard greens and Souse (head cheese) with red pepper, pink salt and bone broth Pretty much my favorite meal, right now.

That's P-I-G, Hog!

That’s P-I-G, Hog!

8Jan15 Thurs

196.4 lbs. 20% fat

Same food as yesterday + 2 eggs & cheese
No headache or charlie horse. Feel good all day.

9Jan15 Fri

196.8 lbs. 20% fat

OK, so now we see the slow-down. Ketone level is still up so there is no need to worry. Depending on how much I eat, my weight may even go up. No worries.
The glucose stores are depleted. The, uh, intestinal contents are depleted.  Water weight is gone. Now it’s just me vs. the fat. I predict a lull for a few days, then another precipitous drop next week as the brain figures out over the weekend that it has no other choice but to tear down fat for fuel now.

Food: Coffee + Heavy cream, 3 eggs + cheese

Notice that up to this point, we have moved the scale over 10 lbs but the fat weight is constant.

Slope of Fat Weight vs. Total Weight

Slope of Fat Weight vs. Total Weight

10Jan15 Sat

194.2  lbs   20% Fat

The fact that the scale can only do whole percent numbers make for a jagged graph.  But as I keep saying, you can’t obsess over day-to-day numbers. Watch the trendline.

Food: Coffee + Heavy cream, 2 eggs + cheese, Tuna salad with home-made mayo. I skipped the capers because I went over to mom’s house earlier and she was cooking down a killer corn chowder to which I could not say no. I just ate around the potatoes. but the sauce was full of flour. Social activity can scuttle this diet so quickly.

11Jan15 Sun

193.6lbs 20%

Today for food I was cooking down a bone broth (pork) and ended up just picking out of that for food. Meat that has been boiled for 24 hours is not necessarily delectable, but once you fry it up in a skillet and add some spices, it’s pretty tasty.
Went to bed feeling like I ate an entire pig.

broth pork

12Jan15 Mon

193.0 lbs 21%

Today I made a dish that was foisted upon me by the Interweb. It’s avocado baked with egg.  I was pretty underwhelmed. I love the taste of ripe raw avocado. Baking it does not make it better.

Drowned my sorrows in Coffee with Heavy cream.

I weighed in at 195.2 when I first woke up- yep, too much pork!

13Jan15 Tue
191.6lbs 21%

Almost time to start digging out old trousers!

Tried to re-jigger the avocado recipe by whisking the egg with cream & thyme. It helped but didn’t knock my jock off.

Starting to lose track of the food. I also had some eggs, souse, cheese…

14Jan15 Wed

190 lbs! 21%

Had some social activity today.

Tommy’s has a sandwich called the T.N.T. It’s a giant sub full of uncountable types of hot lunch meat, slathered in cheese and topped with tomatoes & pickles. If you order it without a bun, they make a really nice presentation on lettuce or baby greens.  I usually skip the tomato if trying to stay ketotic but not today.  Then I shared a bottle and a half of red wine.  Still ketotic according to the Ketostix when I got home. But as I have explained elsewhere, Ethanol screws up metabolism hormonally. The ethanol is metabolized first and accompanying calories are turned into fat.

15Jan15 Thurs

192.6lbs 21%

I regret nothing!

But I still feel like I ate a cow yesterday. Today might be a good day for intermittent fasting.  It’s called intermittent fasting because you really want to randomize it. If you fast on a schedule, your brain will  figure it out and protect your fat accordingly hormonally.

16Jan15 Fri

191.8 lbs 20%

Kept busy today, I got a cup  of coffee while picking my wife up at the airport then ate a couple of pieces of cheese when I got home, so my fast was 48 hours, after all.

17Jan15 Sat

190.0 lbs 20%  Fat

After the dairy last night, I wake up feeling kind of full, but not quite bloated. I certainly don’t feel like I’ve only eaten ~300 calories in the past 56 hours, but that is the case.  2 eggs for breakfast.

I’ve been snacking on anchovies wrapped around giant capers.
Oh and some crappy pseudo-cheese my wife bought for grilled cheese sandwiches.


18Jan15 Sun

191.2 lbs 19%  Fat

Again, it’s hard not to panic if you live by the scale.  How could I eat so little, yet weigh more than yesterday? Especially after a kick-ass gym session? It doesn’t matter.  If you are spilling ketones into your urine-the fat is going away.

Something special has happened, though- my first fat % reading under 20%.  I awarded myself a little glass (or two) of Vermouth.

Instead of the gym today, I shoveled the driveway and moved a rick of firewood.

19Jan15 Mon

191.4 lbs 19%  Fat

Beginning to look like a stall.

20Jan15 Tue

191.2 lbs 19%  Fat

Yeah, I think I’ve stalled. But that didn’t prevent me from engaging in a little social activity. Tonight I met up with some old CWRU friends and had a very lovely time reconnecting. I had 2 glasses of wine and part of a charcuterie plate, but with that little food I got just drunk enough to forget I am not drinking beer presently and ordered two giant beers at the bar a few doors down after the party mostly broke up. Whoops. It happens. Didn’t lose the ketosis, though.

21Jan15 Wed

185.8 lbs, Too early for Fat%

Well this is a pleasant surprise. I highly doubt that I lost 5 pounds since yesterday, but I’ll take it! Perhaps the scale wasn’t level (though it usually tells me if that’s the case).  Perhaps I was standing on it incorrectly (for 3 days in a row?).  Who knows.  As I keep saying, the scale and it’s wily ways is merely a tool for following a larger trend. So I retrieved the “target trousers”!  Sure enough, I can get them on.  I can button them and zip them but not much else. So things have happened. 3 weeks ago, I couldn’t get my thigh through. Being squarely in the 180’s after reaching over 200lbs this year has a tremendous psychological effect.  You get reinforcement and pep to keep going forward. Someone-anyone tell me this was water weight. And please share this with your friends who poo-poo ketogenic diets.

You may have ascertained that I’m not exactly a gym rat.  I have so many injuries that I only do few basic machines and spend a lot of time on an elliptical.  Then I go splash around in the pool for 25 minutes because I’m not yet a talented-enough swimmer or have the stamina to swim true laps. Body composition is 80% (at least) dietarily controlled, though exercise is compulsory.

Results are half of the game, here.  I’mma a go eat a mess o’ greens.

28Jan15 Wed

I’m still here!  I took a week off of the journal to tend to some stuff. I have had a bit of social / family activity and stayed pretty well on the diet, but not losing. I was conned into drinking a whole bunch of booze. They held me down and poured it in, I swear!  Hovering around the 186-8 range.  Back at it!

 01Feb15 Sun

184.8 lbs / 19% fat

Today’s comments became a post:
In Which Jimm Becomes Trendy and Puts Butter into Coffee.

 03Feb15 Tue

180.4 lbs / 19% fat


Well this should be a momentous occasion as this is my target weight, but celebration is brief. The caveat being: the fat/lean ratio is still off. At the 19-21% body fat, whatever it is, means I am still carrying way over 20 lbs. of fat, which I think is unnecessary.  And I just checked my phone – American Apparel has not called for a photo shoot.  So forward and onward.

Seriously, the butter in the coffee thing has had a profound affect on me. I’m killing it at the gym. I bought food after leaving the gym but couldn’t bring myself to eat it. I had a couple of pieces of cheese and that was enough.  Last night, however, I had the charlie horse of the century. I knew it was coming after depleting myself at the gym yesterday. But like an idiot I didn’t take any supplement before bed.  I haven’t had one since the last time I mentioned it in this journal, but holy cow!  This was the killer-diller. I almost couldn’t get down the stairs.

Target trousers are wearable, but still a little attention-getting if you would like to make guesses as to my religion.

Today’s feast: a mess o’ smelt fried in butter!


 04Feb15 Wed

178.6 lbs /% fat

Still moving at a good clip. I’m actually a little weak and have a minor background headache today so I’m going to take a day off from the gym. I made the butter coffee again but just couldn’t drink it. In my weak state it’s just too rich. I’m going to have to stop for a bit, though I cannot believe this weight loss. I need to get some vitamins & minerals into my body.

I ate a lot of collard greens and souse and a good scoop of Sauerkraut that I’ve had aging in the basement. It was DELICIOUS. I could have eaten the whole quart.

In the evening I went to a restaurant and had a chicken Caesar (no croutons) and 2 glasses of wine.  Then I shared another bottle of wine with a friend. So this should slow me down a little.

 04Feb15 Wed

178.0 lbs /% fat

29 lbs, kids! I’ll make another big hoopla on Facebook when I reach 177. That will be 30lbs since Jan 3rd and maybe time to return to a normalish diet.

09Mar15 Mon

Today’s entry is so awesome it had to be its own post.
You have to read the instructions. And obey them, by the way.

11Apr15 Sat

168.8 lbs / 12% fat

I’ve been in New Orleans since the end of February and made the decision to leave the scale at home. I lost enough weight by the end of February that it’s pointless to watch the scale daily. I haven’t been in need of a large, rapid drop in weight.   The trousers all fit correctly and it’s now a fight to get rid of the spare tire, which really can’t be done with ketosis easily.  You end up losing muscle, too. Subcutaneous fat is not mobilized as readily as inguinal fat. So you have to fight it off by lifting weights and sprinting. But my interest in sharing this journal with you only extends to helping you get to a healthy weight range.  If you want to look like an underwear model, you’re on your own.  Then you come back and tell me how to do it.

But in the mean time, I lost another ten pounds. I haven’t been to the gym since the 3rd week of February and my exercise now is comprised of walking around a New Orleans neighborhood with a cup of coffee for a couple of hours each morning or evening and a daily quick power walk around Audubon Park which takes me about half an hour.  If I feel spritely, I try to run a little, but this usually doesn’t last more than several yards. As you have known all along, I’m a lousy gym rat.

I have, however been without the Spousal Unit since February, so I have been free to do wild and crazy and experimental dietary things without gentle persuasion (nagging) or cautionary advisement (bitching) one would expect to hear from one with whom you share your life (from the ball & chain).  If you know my wife, you know that’s a joke, but she can talk me into going out for bruschetta, cheese nibblers and boozin’ faster than anyone, so she is ruinous nonetheless.

Experiments in calorie restriction

So I’ve basically been living on coffee and a fine selection of herbal teas down at the local coffee shop where I write this drivel. Remember the coconut oil & grass-fed butter in the coffee?  I recently went for two or three 7-10 day jags eating only this once a day:  2 Tbsp Coconut Oil + 1 Tbsp Butter + 2 Tbsp Nutritional yeast all mixed together then rolled into kind of a power bar, washed down with a 20oz coffee & chicory (I actually really love this!). It has not only sustained me, but I have been very active these two months- even attempting to run a bit, which I really can’t do owing to my back problem and zero history running. I have had abundant energy to burn and no insulin-mediated false cravings.


I am fed by the sun – your red sun gives me strength.

When not on these strict jags, I fit in a second meal- I go to Rouse’s Grocery and get some crack & peel shrimp and collard greens or green beans or I hit the Whole Foods salad bar.  I can not really pack in lots of food if I’m being active in warm weather. Those second meals were almost too much.  My social life didn’t suffer.  I went out for a few beers with friends and I went to a pig smoke (we made hog’s head cheese) and a crawfish boil.  I ate many things, drank many beers, then usually fasted 24 hours afterward and returned to form.  No problem or guilt or stress.

Last weekend I met up with my wife in Nashville and had her bring me the Biometric scale from home which has been giving me a range of 12-16% body fat and weight range from 168-174lbs.   16% of 174 is 27.84lbs of body fat.  12% of 168.8 is 20.25lbs.   Since my stated arbitrary 1st goal of this diet was to have no more than 20lbs of body fat as indicated by body fat percentage, it would be nice to know if I still want to lose 8lbs or only 1/2lb. So I will have to do a couple of weeks of carefully-timed readings to see if I can reign in some accuracy. I have been getting some very interesting results that I will share when I am able to graph them.

Once I get a consistent reading of 10-15% body fat range with a maximum of 20lbs of fat, I will consider this project really done.  Then on to the horrible task of attempting to add muscle mass.

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In which Doug explains, ‘Cardio’ Does Not Exist

…and High Intensity Training overview.

Weight training is the hardest thing in the world for me. I hate it. I’m not motivated. It takes me away form my creative hobbies and even at my personal peak fitness and long-held routine, I was never energized and eager to work out. I know that once puberty is over, if you’re not gaining muscle mass, you’re losing it. And muscle mass sets your resting metabolism rate. Muscle mass determines how well you handle sickness. If someone is 70 years old and faces multiple months of chronic wasting cachexia from a sickness, or has to face chemo, which body type do you think will fare better going in- one that is thin and frail or one with more muscle than he/she had at age 20?

You have to build muscle mass one way or another or you essentially spend your life slowly wasting away and gathering pains. Many pains from getting older could be allayed by increased musculature to hold everything in place. I would like to add 10 or more pounds of muscle mass. But then I buy a package of meat that weighs 2 lbs and think of what kind of effort it must take to synthesize that, molecule by molecule, workout after workout and become completely demoralized.

Doug McGuff is an emergency room doctor (and Philosopher King, as far as I’m concerned) in South Carolina and runs a gym called “Ultimate Exercise“, where he teaches a modern version of a weight training method called High Intensity Training (HIT) that is very different from the explosive push / controlled return methods that are so popular.

Funnily enough, this “modern method” was actually invented 100 years ago by a Swedish physician named Gustav Zander. Though he won a gold medal at the 1876 Centennial Exhibition for his exercise machines, exercise wasn’t quite mainstream yet and he faded into history with  his machines. Arthur Jones (I know, I said he was a dead dinosaur) resurrected it in the 70s, ignorant of Zander and it enjoys a growing following today. Doug’s book is called ‘Body By Science‘.

The core concept is that you are working out to get your body to build muscle, right? To take the evolutionary view; you want your DNA to signal to build muscle, as an adaptive response. To take the Paleo/Primal view: You want to trick your body into thinking a Sabre Tooth Tiger almost killed you and when he comes back you had better be bigger and stronger. The common weight training method tears down muscle by working to the point of failure in an effort to get it to rebuild bigger in response to the tear-down.

If you don’t work to failure, you can’t be sure how well you are triggering an adaptive response.

This works just fine, eventually, but it has great risk for injury. If you do a work-out too soon, when your body needs rest because it is still re-building muscle, you can do counter-productive tear-down of muscle or even create chronic systemic inflammation.  And you will stall. And most people who stall in the gym respond to that stall with increased effort. They hit it harder. This only makes things worse.

And it takes SO MUCH TIME. Who wants to be a gym rat, really? Endorphin-addicted weirdos, that’s who. What if you could trigger that adaptive response and build muscle with minutes of training instead of hours? And once or twice a week instead of living at the gym. Go home. Be with your family.

In high intensity training, you don’t wear workout clothes, you wear loose, comfortable street clothes and flat shoes- NO Running shoes!

There is no sweating. They say that by the time you sweat, you are already counter-productive (not sure on the science of that yet).

There is no stretching or warm up. Each workout puts the muscles through a full range of motions and you actually avoid aerobic exercise, doing a slow, intense, mostly anaerobic workout. Though anaerobic metabolism creates far less energy than aerobic metabolism, it is a faster cycle and you can quickly overwhelm the system with Pyruvate that would normally enter your aerobic metabolism cycle. The excess Pyruvate is then converted to lactic acid (which may make you cramp).

After muscle fatigue (not failure) the excess lactic acid created (don’t worry about it now) gets turned back into Pyruvate while you rest then goes through your aerobic metabolism cycle, theoretically giving you the equivalent of a massive aerobic workout while you are laying on the floor crying after a HIT workout. As you continue working out, your ability to buffer lactic acid increases by 12-50% and cramping is not such a problem.

Doug dismisses Yoga and Pilates as a waste of time. Also I recommend investigating (1980 Olympic-qualifying runner) Mark Sisson’s view on “Chronic Cardio”. He asks what the quality of family life is when dad’s gone half of Saturday on a bike ride then has to spend the rest of the day on the couch. Though if you want to train for a race, go for it. But it may not be wise as a lifestyle.

And I thank Doug for introducing me to the term “cardio bunnies”.

You don’t want your fitness to undermine your health. I think most of us work out in order to be healthy and not be sickly and stay out of the hospital, which is right where an injury can put you. The HIT method is through muscular fatigue in a controlled, injury-free environment. When you fatigue, you are moving in slow motion, too weak to hurt yourself and not sitting there with a barbell over your throat while your spotter is looking at chick on the treadmill. You’re not going to have a kettle ball flying through the air when you suddenly lose all of your strength. You are not given the opportunity to be sloppy in form from exhaustion, eliminating that counter-productiveness.

Doug is also very cautious about Crossfit (Doug LOVES Crossfit) and things like P90X or Insanity. You really need to be an athlete, preferably young with strong bones before attempting this, not to mention unfailingly coordinated. Skill-based exercise can certainly undermine your health if you don’t have the skills. When you have moderate athletic ability and you dive in and try to do a back flip off of a truck tire that’s rolling along the top of a climbing wall and land incorrectly, you end up in the E.R., where unhealthy people go. HIT is effort-based, not technique. “Insanity” has that name for a reason. Perhaps a more reliable, sustainable method is in order. But while you feel young and invincible go for it.

Lastly, HIT is perfect for morbidly obese, very out of shape or geriatric people. The fatigue level is the fatigue level, and you’re already moving slowly with little chance of injury. The explosive, rip-tearing muscle carnage of common weight training is usually what causes people to freak out and give up in agony or exhaustion very shortly after beginning a new routine.

If you are local to NE Ohio, our Doug McGuff-approved gym is called Overload Fitness in Beachwood. I checked them out. It is a wonderful operation. I loved my introduction but ultimately it was prohibitively expensive. Like, 40% of my take-home pay expensive. Other gyms can be found at his website, Body by science.

Here’s Doug’s workout:

I’m going to share A LOT from Doug, but I think this is enough for an introduction. Here is a short video in which he explains that none of us understand what “cardio” or “aerobics” means. Respiratory control happens in your cells, mostly muscle, not in your cardiovascular system. HIT builds your aerobic capacity just fine without blowing out your joints or heart and forcing you on a mouse-wheel of carb consumption.

This does not to say that you should not run or bike or train to be an endurance athlete. You may have your own goals with them. This does, however show that strength training will also help endurance sports.  But if you hate cardio but do it because you believe it is improving cardiovascular health, this is your free pass out.
Tsis is in no way an effort by me to dissuade you from Yoga, Pilates, P90X, Insanity or Crossfit and does not reflect my opinion of them. This is an exchange of ideas that I have found enlightening and very helpful. I am much better in any situation when I know the nuts & bolts behind the…uh, curtain…of the…man in the mirror.

Or something.


6Jan15 Edit:

Just got to reading this. Doug has published a paper on this with James Steele II (and a few others):

Resistance Training to Momentary Muscular Failure Improves Cardiovascular Fitness in Humans: A Review of Acute Physiological Responses and Chronic Physiological Adaptations” (PDF)

Here’s James giving it a little more depth

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We’re from the Gub’mint and we’re here to help (ourselves)…


The sixth meeting of the 2015 Dietary Guidelines Advisory Committee has recently drawn to a close. The Gub’mint is about to re-discover that you should not eat what you ate for the last 2.5 million years, and will suggest that you eat more of what the Gub’mint subsidizes (Wheat, Soy, Corn, Sugar…just in balanced portions like they instruct). This graph shows what eating by Gub’mint guidelines has done for us.

I want you to investigate the following:
It now looks like (thanks to new science): Bacon will not give you a heart attack and meat is not “rotting in your colon”. Heart attacks are caused by inflammation from chronic obesity and inflammatory foods. The true threat to arteries are not cholesterol blockage, but hardening caused by the Maillard reaction from chronic high blood glucose, though you were told that the threat from chronic high blood sugar is just insulin resistance and diabetes.

But Jimm! You can SEE blocked arteries! It happens.

Yes. Arteries get blocked. But If you eat more cholesterol, you will up-regulate the machinery that metabolizes cholesterol and it will not clog up your arteries-it will be metabolized. Compare this to up-regulating the machinery that darkens your skin when you spend more time in the sun.Spend all winter inside then go to Florida and get a sun burn and die. Spend all of your time avoiding fat & cholesterol because the Gub’mint/AMA told you to, then eat a pound of bacon, you get a blockage and die. Gradual increased exposure can get your body to a state to deal with sunlight or cholesterol and fat. Avoid them chronically and you will die. Fat, Cholesterol and sunlight are healthy and required.

Also, since you have down-regulated your fat-metabolizing machinery in favor of a high-carb diet GOOD LUCK losing fat. You will kill yourself trying to exercise it away, when all you have to do is train your body to burn fat preferentially. If I stop eating, I start burning fat. When someone with a carb-based diet stops eating, his or her body will turn muscle into sugar before touching the fat.

It looks like (thanks to Freedom of Information Act requests): The Lipid Hypothesis and all of the science of Ancel Keys was bunk. As was The China Study and most of the work that defines your ideas of health. You are fat because of a Nixon election policy scheme & the evolution of corn to an industrial commodity, which happened to coincide nicely with Cuban politics, resulting in loss of their sugar cane which happened to coincide nicely with the invention of High Fructose Corn syrup.

I can explain all of this in obscene biochemical detail for you if you like. But for now, I will just put some links in for reading below.

You are not comfortable being overweight. It is NOT a vanity or social image acceptance/standards issue. And you voted for (or failed to stop) Governmental policy that is going to make it very expensive to not be lean very soon. You demanded the Government chew your food & wipe your ass. It is coming and there is no longer an opt-out.

links of interest:

USDA Dietary Guidelines for Americans, 2015 Meetings

Change Coming to the Dietary Guidelines for Americans?

Mark’s Daily Apple 20Nov14

A Brief History of U.S. Dietary Guidelines

Mark’s Daily Apple 22Oct14

Graph adapted from For a Healthy Nation (data sources there)

The Last Anti-Fat Crusaders

~Opinion By Nina Teicholzfrom WSJ Oct 2014


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