HinesSight

I have glaucoma but not worried about CBD raising eye pressure

About three months ago I was diagnosed with glaucoma. I'm very nearsighted, which is a risk factor, along with age (I'm 73). The good news is that my eye pressure has dropped from 20-21 to 11-14 via prescription eye drops.

(Lowering eye pressure is the only way of preventing further optic nerve damage from glaucoma.)

Early on, though, I had a lot of anxious moments. After all, going blind from glaucoma or "just" experiencing functional loss of vision is scary. 

My anxiety increased after my wife wondered if my use of CBD could have been a cause of the glaucoma. My first reaction was to tell her, of course not, because it's well-known that THC, another form of cannabis, lowers eye pressure.

But some Googling revealed numerous articles about how CBD raises eye pressure, so glaucoma patients should be wary of using it.

However, I've asked two optometrists and an ophthalmologist who specializes in glaucoma if I should stop using CBD. All three said "No."

Here's what one optometrist said in a reply to my question about whether I should be concerned. The small doses of CBD he refers to me using are 20 mg twice a day and 10 mg once a day, spread out during the day.

After his message I'll share additional reasons why I'm not worried about CBD raising my eye pressure.

~Brian
Hello there ~ the article from the AAO [American Academy of Ophthalmology] you cited is likely referring to this study, which was performed at Indiana University in 2018:

https://iovs.arvojournals.org/article.aspx?articleid=2718702

In that study, the researchers found that dosing mice with THC (the active ingredient in marijuana) lowered eye pressure, while CBD transiently raised eye pressure. This information has been known for a while, but has perhaps become more relevant recently as CBD products have become more available.

While it is easy to draw conclusions from the study, I would caution you from throwing away all of your CBD product. Instead, I would draw your attention to this study, completed at the University of Aberdeen in 2006:

https://pubmed.ncbi.nlm.nih.gov/16988594/

While the Indiana study was performed on mice, this study was performed with human subjects. Though the sample size was small (six individuals), it did provide some comforting information. The researchers found that while high doses of CBD (40 mg) did raise eye pressure, small doses (20 mg) had no effect. This suggests that small doses can likely be tolerated without producing eye pressure-raising effects.

Of course, much more research needs to be completed on human subjects for us to determine exactly what strength/dosage of these products is safe. But you can take heart that your small doses are unlikely to have a significant effect on your eye pressure.

My suggestion would be to continue your CBD use for now. If anything, prematurely stopping it would potentially color the results that your glaucoma medication provides. I would recommend continuing to keep your single doses at 20 mL/mg or below and spread them throughout the day.

We will be monitoring your eye pressure at each visit and should it start to creep up, we have other ways to bring it down than for you to cease your CBD treatment. At this point, I wouldn’t stress about it too much.

Good advice. I've stopped stressing about using CBD entirely, for these reasons.

First, the December 2018 IOVS Journal article described how eye pressure in mice responded to doses of THC and CBD. Mice aren't people, obviously. The article says:

Three of four studies that have tested CBD for effects on IOP [intraocular pressure] have reported no effect, but the fourth has reported an increase in IOP.

Somewhat strangely, the article doesn't give references to the three studies that showed CBD having no effect on eye pressure, just the single study that reported an increase.

But that study was the 2006 University of Aberdeen research which my optometrist referred to as showing that only a CBD dose of 40 mg raised eye pressure, while 20 mg of CBD had no effect. Since I assume the other three no-effect studies mentioned in the IOVS Journal article also were on humans, seemingly the only evidence that CBD raises eye pressure in people is the 2006 study.

Then there's the issue of CBDA, a precursor of CBD that an Oregon State University lab study found prevented cells from being infected by the coronavirus. I've been using CBDA rather than CBD for about a week, as described in my blog post, "I got some CBDA. Covid can't touch me now!"

I'm no expert on the pharmacology of CBD and CBDA. However, it seems to me that CBDA is even less likely than CBD to raise eye pressure, since CBD and CBDA work in considerably different ways. Meaning, the mechanisms by which they have effects on the human body are different.

The IOVS article says "there is no effect on IOP by CBD if GPR18 and CB1 are both blocked/deleted." In other words, eye pressure in the mice didn't increase if the receptors GPR18 and CB1 weren't functional. 

I found a lengthy study that looked at how various forms of cannabis operate. In the CBDA section, it says:

Bolognini et al. (2013) also found that, in contrast to CBD (section 7.3.1), CBDA did not display significant activity as either an agonist or an inverse agonist at cannabinoid CB1 receptors in mouse whole brain membranes, even at a concentration 100,000-fold higher than a concentration (0.1 nM) at which it potentiated 8-OH-DPAT in rat brainstem membranes.

I don't understand much of that language, but it seems clear that CBDA didn't have any significant activity at the CB1 receptor that could cause CBD to raise eye pressure at high doses. 

So I'm comfortable with using CBD even though I have glaucoma, and I'm considerably more comfortable with using CBDA. 

Nothing to celebrate on this Martin Luther King day

I was nineteen years old when Martin Luther King Jr. was killed by James Earl Ray on April 4, 1968. When it happened I was on a sophomore semester abroad in Zadar, Yugoslavia along with a couple of dozen other students from San Jose State College and a few professors.

I remember local people coming up to me and my classmates expressing sympathy for King's death in broken English. The same thing happened a few months later when Bobby Kennedy was assassinated on June 6, 1968.

That year, 1968, was a dark time for the United States. So is 2022. It's depressing that 54 years after King was murdered, our country is still struggling mightily to preserve the voting rights that he and other Black leaders fought for so bravely and vigorously.

Yet here we are, on Martin Luther King day, with the Senate scheduled to begin debating two voting rights bills that have a vanishingly small chance of becoming law. 

Senate Democrats plan to press ahead this week with an effort to push new voting rights protections through Congress, in an all but doomed attempt to enact a key piece of President Biden’s agenda that has been undercut by members of his own party.

The Senate on Tuesday will begin to debate legislation that combines two separate bills already passed by the House — the Freedom to Vote Act and the John Lewis Voting Rights Advancement Act — and folds them into an unrelated measure. The move would allow the Senate to bring the bill directly to the floor, avoiding an initial filibuster.

But that strategy would still allow Republicans to block it from coming to a final vote, and Democrats lack the unanimous support needed in their party to change Senate rules to muscle through the legislation themselves. Still, Senator Chuck Schumer of New York, the majority leader, said late last week that Democrats would forge ahead anyway, forcing Republicans to publicly declare their opposition to the bill.

“We all have to be recorded at this moment in time about where are we in protecting the right to vote,” Senator Tim Kaine, Democrat of Virginia, said on CBS’s “Face the Nation” on Sunday. “Right now, it doesn’t look like it has the votes to pass, but we’re going to cancel our Martin Luther King Day recess and be there this week because we think it’s so important for the country.”

Well, if it was so important for the country, why did it take a year after Biden was inaugurated for Democrats to get around to seriously pressing for passage of the voting rights bills? Biden has spoken dozens of times about coronavirus and infrastructure legislation. He's spoken exactly twice about voting rights, with one of those speeches last week.

It's easy to understand why Blacks who were key to electing Biden are so disappointed at his lukewarm commitment to voting rights. Politico says in today's Playbook:

For decades, MARTIN LUTHER KING III has heard his father’s words invoked by politicians across the ideological spectrum on behalf of all sorts of positions — even ones antithetical to his beliefs.

“Everyone believes or says they believe in the words and values of Dad, but they try to extract various portions to make it fit their narrative,” MLK III told me on Sunday. “I have to constantly challenge people and say, ‘No, that's not what dad meant; this is what Dad meant.’ I have to push back because every politician, every elected official is going to be out making statements about how ‘I loved Dr. King,’ ‘I support Dr. King,’ and then … they’re voting against voting rights.”

That’s why today, as Americans mark Martin Luther King Jr. Day, the family of the late civil rights leader is cutting through the usual lofty invocations to make a specific ask: “No celebration without legislation.”

“[CORETTA SCOTT KING], when she was working so many years to make sure that there was a King holiday, her vision of it always was a day of action — a day on, not a day off,” ARNDREA WATERS KING, MLK III’s wife, told me. “There was no way that we, in good conscience, could celebrate Martin Luther King Jr. this year without [progress on] the legislation that was the cornerstone of his legacy.”

Today, Arndrea, MLK III and their 13-year-old daughter will take part in the “D.C. Peace Walk” across Washington’s Frederick Douglass Bridge and hold a press conference with House Speaker NANCY PELOSI and Congressional Black Caucus Chair JOYCE BEATTY (D-Ohio) aimed at ramping up pressure on Democrats to move voting rights legislation forward ahead of a planned Senate vote on Tuesday. That’s an uphill effort: Neither the Freedom to Vote Act nor the John Lewis Voting Rights Advancement Act have anywhere close to 60 votes in the Senate, and Sens. KYRSTEN SINEMA and JOE MANCHIN aren’t budging in their opposition to reforming the filibuster.

Be that as it may, the Kings don’t hold moderates on the Hill solely responsible for the lack of forward movement.

“What we’ve seen with President [JOE] BIDEN is what happens when he puts his full force and power behind an issue like infrastructure. What we want to see is that same power and passion being put behind voting rights,” said Arndrea Waters King. “We hope that [Monday] is a working day for President Biden.”

The Kings know that the short-term outlook doesn’t look good. But they see keeping the faith — and pushing it forward, no matter the odds — as central to maintaining the late Dr. King’s legacy.

“Had he lived, we would be a fundamentally different place,” MLK III said of his father. “[But] if he just arrived today as a 93-year-old man, he would certainly be very frustrated, but not deterred. He understood that you had to look at the long game. He’d certainly be disappointed that we seem to be going around in a circle. … Not only have we been down this road so many times, we are people who will not give up. We're not going to give in, we're not going to give out.”

I admire that determination to never give up.

But the sad truth is that Donald Trump and his fellow Republicans have been working hugely harder to make it more difficult for minorities to vote than Joe Biden and his fellow Democrats have been working to protect voting rights.

The time to start a full court press to pass voting rights legislation was the day after Biden took office. Now the Democratic push to do this is too little and too late, which is infuriating.

Lastly, if you're a progressive like me who supports voting rights, and you're open to reading something  really depressing, check out "How Manchin and Sinema Completed a Conservative Vision" in The Atlantic. Ron Brownstein lays out how dismal the future looks for voting rights, ending with:

The one force that was best positioned to resist Roberts’s zealous vision was the ability of Congress and a president to sign new laws reasserting federal voting protections. And now Manchin and Sinema, combined with the impenetrable Senate Republican opposition, have blocked that route—possibly for years. Without federal legislation restoring a baseline set of national voting rights, “it’s hard to imagine the political process delivering any sense of fairness that represents the will of the majority,” Nelson said. “I think the ramifications will endure for generations. It is truly that consequential.”

With crucial help from Manchin and Sinema, Roberts’s triumph now appears complete. And that could trigger a decade of struggle over access to the ballot, unmatched since the days of Jim Crow segregation.

I got some CBDA. Covid can't touch me now!

Like I said in a recent post about an Oregon State University study that found CBDA and CBGA prevented Covid infection in a laboratory study of cells, regular CBD has very little of these acids that are  precursors to CBD, so mostly disappear when CBD is created from hemp.

But I found several online sources of CBDA. Fewer seem to exist for CBGA. This story describes the key differences between CBD, CBDA, and CBGA, with this takeaway quote.

A study published this week by researchers at Oregon State University found some hemp compounds have the ability to prevent the virus that causes COVID-19 from entering human cells.

Findings of the study led by Richard van Breemen, a researcher with Oregon State’s Global Hemp Innovation Center, College of Pharmacy and Linus Pauling Institute, were published this week in the Journal of Natural Products.

...“We identified several cannabinoid ligands and ranked them by affinity to the spike protein,” van Breemen said. “The two cannabinoids with the highest affinities for the spike protein were CBDA and CBGA, and they were confirmed to block infection.”

So I was thrilled to find this bottle in our mail today, which arrived quickly from FluxxLab, a Colorado company.

The label on the back says that half a dropper contains about 10 mg of CBDA and 6.6 mg of CBD. I've had two doses today, so it's pretty clear...

Covid can't touch me now!

Leaving aside the minor detail that there's no evidence CBDA actually prevents Covid in humans, as opposed to cells in a lab dish. But if the placebo effect is at play here, I'm even more protected, since I believe in CBD and CBDA.

I don't claim to fully understand what makes Fluxxlab products different from regular CBD, but this excerpt from the product page for their CBDA oil say those products are considerably more potent -- five times as much. 

FluxxLab™ CBDA Tinctures

Expect results that will outperform any CBD you have ever experienced. Completely natural, this pure CBDA oil tincture delivers potency many times greater than standard CBD. Carefully crafted in our own Colorado lab, we have added exactly the right natural terpenes to precisely balance the performance of what our customers tell us is “The World’s most perfect Tincture.”One ounce will provide you with a full month’s supply of the Best CBDA Rich Oil tincture you will ever find anywhere. Satisfaction always guaranteed.

Beyond all other tinctures

FluxxLab™ tinctures are precisely formulated to fit your needs and usage levels. Experience tells us that 90% of people who use CBD don’t take enough and don’t get the full benefits that they need or expect. At Fluxxlab™, we have addressed that problem with an economical and effective solution. We offer you three carefully selected CBDA tinctures. Our 500mg tincture is exactly right for those serious users who would otherwise be taking 2,500mg of regular CBD per month. We refer to this as the normal CBD dosage level. Our 1000mg CBDA oil is correct for users who would otherwise be taking 5,000mg of CBD per month, on average.

OK. I've been taking about 50 mg of CBD a day, so that comes out to 1,500 mg a month. Thus supposedly I've been well under the normal CBD dosage level of 2,500 mg.

Regardless, I'm enthused about trying out CBGA, a new thing for me. There hasn't been as much research on it as on CBD, but there's some intriguing potential benefits aside from preventing Covid.

CBDA shows promise as an effective medicine in the treatment of a variety of conditions. CBDA’s affinity for serotonin receptors helps it affect everything from mood to nausea to inflammation.

CBDA has shown to have a more intense activation of 5-HT1A serotonin receptors compared to CBD. Serotonin can affect a variety of physiological functions including mood regulation, nausea, vomiting, and intestinal motility. 

Based on the current research, CBDA’s potential as a medicine is still up in the air. 

Up until now, clinical trials have largely focused on animal models. Until trials focus on human health and how CBDA works, we will not know the full extent of CBDA’s power.

Pain relief also is a possibility (scroll down and click on benefits). 

There can be dramatic results when using CBD products. At FluxxLab™ we have first-hand experience with many hundreds of cases where our customers have experienced dramatic and amazing results using CBDA as compared to plain CBD.

The overall Endocannabinoid response to CBDA appears to be far more powerful than it is with CBD. CBDA binds with some of the same Endocannabinoid receptors in the human body as CBD, but it is also known to bind with different receptors.

Expect to find many cases where CBDA acts in similar but more powerful and effective ways than plain CBD. For example: Research indicates that CBDA acts on the human body by inhibiting COX-1, an enzyme linked to inflammation. When the human body feels there is a problem in a particular organ, it sends this enzyme to cause inflammation and stop the problem from spreading throughout the body. Inflammation is a natural body response. However, our body often creates inflammation even when there is no real problem. People suffering from such inflammation usually complain about chronic pain. CBDA appears to be as much as 100 times more effective in targeting this receptor, compared to CBD.

Not much Covid-fighting CBDA and CBGA in regular CBD

I've been using CBD oil and capsules for quite a while. So I got excited yesterday when I saw reports of an Oregon State University study that found precursors to CBD, CBDA and CBGA, prevented Covid infection in a laboratory study of cells.

Hemp

CORVALLIS, Ore. – Hemp compounds identified by Oregon State University research via a chemical screening technique invented at OSU show the ability to prevent the virus that causes COVID-19 from entering human cells.

Findings of the study led by Richard van Breemen, a researcher with Oregon State’s Global Hemp Innovation Center, College of Pharmacy and Linus Pauling Institute, were published today in the Journal of Natural Products.

Hemp, known scientifically as Cannabis sativa, is a source of fiber, food and animal feed, and multiple hemp extracts and compounds are added to cosmetics, body lotions, dietary supplements and food, van Breemen said.

Van Breemen and collaborators, including scientists at Oregon Health & Science University, found that a pair of cannabinoid acids bind to the SARS-CoV-2 spike protein, blocking a critical step in the process the virus uses to infect people.

The compounds are cannabigerolic acid, or CBGA, and cannabidiolic acid, CBDA, and the spike protein is the same drug target used in COVID-19 vaccines and antibody therapy. A drug target is any molecule critical to the process a disease follows, meaning its disruption can thwart infection or disease progression.

“These cannabinoid acids are abundant in hemp and in many hemp extracts,” van Breemen said. “They are not controlled substances like THC, the psychoactive ingredient in marijuana, and have a good safety profile in humans. And our research showed the hemp compounds were equally effective against variants of SARS-CoV-2, including variant B.1.1.7, which was first detected in the United Kingdom, and variant B.1.351, first detected in South Africa.”

Those two variants are also known the alpha and beta variant, respectively.

But since the news release spoke of CBGA and CBDA being precursors to CBD, this paragraph caused me to wonder whether the CBD drops and capsules I'd been taking were Covid fighters.

“These compounds can be taken orally and have a long history of safe use in humans,” van Breemen said. “They have the potential to prevent as well as treat infection by SARS-CoV-2. CBDA and CBGA are produced by the hemp plant as precursors to CBD and CBG, which are familiar to many consumers. However, they are different from the acids and are not contained in hemp products.”

So last night I emailed the folks at Sunsoil, a Vermont company where I've been buying CBD, asking if their products contained CBDA and CBGA. They replied promptly today, referencing a news story I'd sent them about the OSU study.

Hi Brian,

 

Thanks for sending this article along! We've had a few customers forward it to us today as well 😀 We post all of our lab reports on our website and you can find them here: https://www.sunsoil.com/pages/lab-results-1. You can match your specific bottles and batch/lot # to the reports on our website.

 

As you will see, our products do contain the full range of cannabinoids present in the hemp plant, but we definitely focus on and propagate our seeds and plants to product more CBD than other cannabinoids. Our oil does contain CBGA and CBDA but in very small quantities so that on the reports you may see either "ND" (none detected) or <LOQ (below the limit of quantification). Both of these mean that there is trace amounts of these cannabinoids in our oil, but lower amounts than the lab equipment used for results can detect.

 

Let me know if you have any other questions or need clarification! The reports can be tricky to read so I always recommend scrolling down to the Sunsoil header report as it's a bit more reader friendly. Hope this helps!

 

Have a great day,

Tia

Following the link in the email message, I checked out the lab results for the Sunsoil CBD drops I've been taking with 20 mg of CBD in a serving. Here's a table of what they contained.

The easiest way to look at this, assuming I'm reading the table correctly, which I think I am, is that the sample totaled 27.55 mg of Cannabinoids, with 22.43 mg being CBD. There was 1.83 mg of CBDA in the sample, and just a trace amount of CBGA, not enough to measure.

So, hey, almost 2 mg of CBDA is better than nothing, Covid-fighting-wise, but pretty minimal. That led me to a Google search for real CBDA or CBGA.

I focused on CBDA, since there seemed to be more sellers of this. Montkush has a detailed description of CBDA, which educated me about this CBD precursor. Excerpt:

What Is CBDA?

All cannabinoids in cannabis and hemp come from cannabigerolic acid (CBGa), the mother of all cannabinoids.

Plant enzymes then convert the CBGa into a combination of the three major cannabinoid precursor compounds: tetrahydrocannabinolic acid (THCA), cannabichromenic acid (CBCA), and cannabidiolic acid (CBDA). The combination will depend on the unique cannabis strain they are derived from.

CBDA is a non-psychoactive compound that serves as a precursor to CBD. More specifically, CBDA is decarboxylated to create CBD, meaning it is heated. This can happen instantly if smoked or vaped, or slowly if the plant material is left to dry in the sun or even at room temperature.

Cannabidiolic acid can, therefore, be thought of as raw CBD. CBDA is most often found in the live or raw hemp plants bred for high CBD levels.

Cannabidiolic acid is often consumed as CBD, but it can also be beneficial in its raw form. CBDA oil can be consumed or absorbed via tinctures, raw cannabis juice, topical creams, and raw CBDA oil.

To date, CBDA has attracted much less public attention and is seen less on the market. However, the raw juicing cannabis trend is bringing CBDA into the spotlight. People are wondering about the differences between CBD and CBDA and if CBDA is better than CBD.

So is it?

Let’s take a look.

The Differences Between CBDA & CBD

The major difference between CBDA and CBD is actually the amount of heat applied to the substance.

As we mentioned, the main difference is that CBDA is a precursor to CBD. You create CBD by heating CBDA or raw CBD.

While research in CBDA is in much earlier stages than even CBD, we know that they share some similarities.

Unfortunately, Monkush was sold out of CBDA. I signed up for an email alert for when it is expected to be available at the end of January.

I had better luck with Myriam's Hemp, which offered CBDA oil. I also got some from FluxxLab, even though their ordering process was frustrating. The box I had to check to agree to the terms of service didn't work with Safari or Chrome, but using Firefox enabled me to make an order. 

Of course, the OSU study was just laboratory research. There's no evidence, so far as I know, that CBDA prevents Covid in humans. But I figure that taking some CBDA won't hurt me, and it may have a placebo effect.

I also read that CBDA has a much stronger antidepressant effect that CBD, so if I do get Covid, hopefully I won't feel as sad about that.

Time has a different flavor for old folks like me

Remember when you were three? Probably not. I recall what that age was like via my memory of what my young daughter and her friends would say when asked how old they are.

"Three going on four." They were so eager to be older, they'd fudge their age to get the next birthday into the answer.

Believe me, those days are long gone for us old folks. I'm fine with saying "73" when asked my age. What's more annoying is having to scroll down through history when a web site wants me to select the year I was born.

2000's, gone. 1990's, keep going. 1980's, around halfway there. 1970's, graduated from college. 1960's, high school. 1950's, childhood. 1940's, ah, finally reached the promised age-land. Which reminds me that World War II had only been over for a few years when I was born in 1948.

Dude, you're ancient! I'll say to myself.

For sure you'll never hear someone my age say "Seventy-three going on seventy-four." We've already got plenty of reminders that while time marches on for everybody, it feels like it's sprinting after you qualify for Medicare.

Every night just before I go to sleep I read a few pages from a book in the Gabriel Allon series by Daniel Silva. Allon is an Israeli government assassin, counterterrorist spy, and world class art restorer. The twenty books in the series are so compellingly well-written, at first I never wanted them to end.

But now that I've read eight of them, I'm getting worried that I'll die before I finish the series. A thought like that wouldn't have crossed my mind when I was younger. Hey, there's plenty of time to do whatever, including reading books.

I used to just read a couple of pages every night. A few months ago I switched to four pages so I could finish a Gabriel Allon book twice as fast. Hopefully I won't get a terminal cancer diagnosis. However, the good news, aside from impending death, would be that I'm a rapid reader.

Last November I got a glaucoma diagnosis. Unsettling, for sure. However, medicated drops have lowered my eye pressure considerably, so I've been told it's pretty unlikely that I'll go blind or even lose functional vision.

Last month my eye doctor referred me to a glaucoma specialist in Portland. After I had a bunch of tests, the ophthalmologist sat down with me and talked about my condition. 

"I think we're going to be able to get you across the finish line," he said. I let those words sink in for a few seconds. Then I replied, "Given my age, 73, it sounds like you're saying that I'm going to die before losing my sight -- not that I'll be raising my hands in victory as crowds cheer me across the finish line."

"Correct," he said. So what I can look forward to is being able to see on my death bed.

Such is how medical care tends to go after a certain age. A friend who's younger than me, but still old, related how his doctor told him that prostate cancer no longer is a big concern, since probably he'll die from something else before the slow-growing cancer got him.

I don't want to give the impression that old age is only about disease, disability, and death. It is true, though, that us old folks tend to have lower expectations for what a good day consists of.

There's a front desk person at my athletic club who likes to ask me "How was your workout?" as I'm leaving. If I say, "fine," he'll reply "What, just fine? Not great!" A few days ago the question was asked again.

After hearing "How was your workout?" this time I said, "Absolutely amazing. The most enjoyable experience I've ever had. Nothing will ever compare to the joy of this gym visit." The point I was trying to get across with my sarcasm is that fine is pretty damn good when you're over 70.

Covid has magnified the differences between young and old. I feel this when I'm exercising on an elliptical trainer in the athletic club's aerobics room, N-95 quality mask firmly affixed to my face, watching young people walk by mostly maskless.

They have that air of confidence, a strut, really, that wordlessly screams to me, I'm fit, healthy, and young; the coronavirus scares me not at all; masks are for fearful old folks.

I envy their attitude, even though it doesn't accurately reflect the full picture of the public health reality. I just remember what it was like to have time stretching out before me as if the years remaining would never end.

Time is relative. Not in an Einstein'ian sense for us non-physicists, in the sense expressed by a man who wrote a moving essay for The Atlantic, "A Neuroscientist Prepares For Death." Highly recommended, though obviously it isn't the cheeriest reading. David Linden writes:

While I was recovering from surgery, the pathology report came back and the news was bad—it wasn’t a benign teratoma after all, but rather a malignant cancer called synovial sarcoma. Because of its location, embedded in my heart wall, the surgeon could not remove all of the cancer cells. Doing so would have rendered my heart unable to pump blood. The oncologist told me to expect to live an additional six to 18 months.

...If someone had told me one year ago, when I was 59, that I had five years left to live, I would have been devastated and felt cheated by fate. Now the prospect of five more years strikes me as an impossible gift. With five more years, I could spend good times with all of my people, get some important work done, and still be able to travel and savor life’s sweetness. The point is that, in our minds, there is no such thing as objective value, even for something as fundamental as five years of life.

I recall what a modern practitioner of the Stoic philosophy said in a recording I listened to: "We are all living the dream life. Because no matter how bad our life may seem to us, it would be a dream life for someone in a worse situation."

Linden would rejoice if he had five years to live, even though that prognosis would have appeared dismal before his cancer diagnosis. This is one of the bright sides of growing old.

I'm much better at appreciating the present moment now, because at 73, I'm well aware that there's no guarantee how many moment-filled years remain to me. As my (fairly old) dentist says when I ask how he's doing, "Keeping my head above water."

Not swimming the English Channel. Not training to break a personal 200 meter time. Just keeping the head above water. Sounds good enough to me.

Salem, be Covid-safe on New Year's Eve

After almost two years, we're all tired of dealing with Covid. A lot of people in Salem are going to want to party-on tomorrow night. 

I urge you to do that responsibly. 

Just as the admonition, "if you drink, don't drive," is intended to both protect the person who's drinking and others who could be harmed if they drive, the same applies to Covid.

You might think that it would be no big deal if you were infected, which probably would be with the Omicron variant. But keep in mind the risk to your friends, family members, co-workers, and such.

Omicron is super-contagious. That's why Covid cases in Oregon have been rising rapidly.

So seriously consider wearing a mask when you're not eating or drinking if you're out and about, even if you're vaccinated. 

Reportedly most Omicron cases are like the flu if someone is fully vaccinated with a booster shot, and like a bad case of the flu if they haven't had a booster. 

But having the flu isn't fun. And Covid can be much worse than the flu, especially if you're in a high risk group. Wearing a proper mask will help protect you and other people.

Here's some good news. South Africa, where the Omicron variant was first reported, says that the country has passed the peak of cases without a major spike in deaths. 

“The speed with which the Omicron-driven fourth wave rose, peaked and then declined has been staggering,” said Fareed Abdullah of the South African Medical Research Council. “Peak in four weeks and precipitous decline in another two. This Omicron wave is over in the city of Tshwane. It was a flash flood more than a wave.” The rise in deaths over the period was small, and in the last week, officials said, “marginal.”

So the United States could see the same rapid fall in Omicron cases sometime in early 2022 -- all the more reason to be extra careful now.

“We’ll be in for a tough January, as cases will keep going up and peak, and then fall fast,” said Ali Mokdad, a University of Washington epidemiologist who is a former Centers for Disease Control and Prevention scientist. While cases will still overwhelm hospitals, he said, he expects that the proportion of hospitalized cases will be lower than in earlier waves.

Our 2021 Christmas letter adds an asterisk to how we're doing: Fine*

If you're a store employee, or someone else who asked us how we're doing in 2021, likely we said "Fine." But that wasn't really true. We just either felt that they really didn't want a full answer, or there wasn't time to provide one. 

Thankfully, we were able to correct this through our 2021 Christmas Letter. Here it is in both PDF and JPEG formats.
Download 2021 Christmas Letter PDF

Two things gym users do that really bugs me

Yeah, I know. It's almost Christmas. I'm supposed to be in a Happy Holidays cheerful mood.

But today I was reminded of two things that fellow users of Courthouse Club Fitness do that irritate me enough to warrant a complaining blog post on the eve of Christmas Eve.

One relates to sanitation.

I always carry a small "sweat towel" with me to wipe off the handles of the equipment I was on after I'm finished with it: first, the elliptical trainer in the aerobics room, then the weight machines in the circuit training room.

I also always wear a mask while exercising at the gym in these Covid times. There's a sign next to the door of the River Road Courthouse Club Fitness saying that a mask or face shield is required.

Most gym users don't wear a mask, though. I'd say three-fourths.

OK, that's an irresponsible decision that puts both them and other people at risk. But I wouldn't find those people nearly as irritating if many of them didn't also drench the machine they're using in sanitizer both before and after they use it.

That's bizarre.

The risk of getting a health problem, including Covid, by touching an unsanitized surface is hugely less than the risk of becoming seriously ill, or even dying, because of not wearing a mask in an indoor public space like a gym where many are maskless and breathing hard.

Maybe these people don't realize that Covid is almost entirely spread through the air, not by touching something someone infected with the virus has handled.

Also, I don't see them sanitizing the handles on the door they have to use to enter and leave the gym. For some reason they just have a fetish of wiping down the exercise equipment far beyond what is necessary for health and cleanliness.

My second gripe is about cell phone use by young people using the weight machines in the circuit training room.

Google images photo. 
I don't have my phone out when I'm exercising,
so I can't take a photo of the irritating people who do.

I don't do free weights, so I'm not sure if they also clog up that equipment with their obsessive need to check their phone before and after doing a few repetitions on a weight machine. Me, I've got the old-fashioned attitude that when you're at the gym, you should be exercising, not clicking away on your phone.

Yes, I do some repetitions, usually twelve, then take a short break before I do eight more repetitions. During that break I -- shock! -- simply sit on the machine, take a few deep breaths, and then resume my workout.

But almost every young person at the gym carries their phone with them while exercising. I find this to be akin to an obsessive mental health disorder. It's hard for me to believe that whatever vital information they're reading and writing about on their phone couldn't wait until they've finished their workout.

When someone sits down at a weight machine that I need to use, pulls out their phone, and proceeds to type away for several minutes, I'm tempted to go over and say to them, "Are you done using this machine as a place to play around with your phone? If so, I'd like to actually use it for the purpose it was intended."

But because I'm a polite senior citizen, I don't do this. Maybe instead I should casually drop a copy of an article at their feet, "Get off your phone at the gym, says Lou Ferrigno."

Speaking on Instagram, the New York native said:

"It's very frustrating that you go to the gym and want to have the quality of time to workout.

"I can't tell you how many times I go to the gym, I walk over to a piece of equipment, and I see some guys sitting there, holding their phone like this."

Ferrigno didn't hold back when sharing his thoughts on time-wasting gym goers.

"I'm here to train. If you don't want to work out, don't waste your time at the gym."

Although Ferrigno is best known as the original Hulk, he's also a bodybuilding icon. He hails from the Arnold Schwarzenegger heyday, and actually finished third behind the Austrian and Serge Nubret at the 1975 Mr. Olympia contest.

Yelling at a grocery store clerk isn't cool. They're Covid heroes.

When I was ready to checkout after grocery shopping at the South Salem Fred Meyer store today, there were long lines at every register.

I picked the most promising line. There were just a few people ahead of me.

But one of them was an older woman who not only wasn't wearing a mask, she had a humungous amount of groceries and other items piled high in her cart.

That worried me. However, I figured that it wouldn't take very long for the clerk to handle her purchases, and those of the woman just ahead of me.

I was wrong.

For one thing, it turned out that the maskless woman was buying even more items that I originally thought. She must have had a hidden compartment in her cart, because she kept piling stuff on the conveyor belt beyond what I thought was possible.

Plus, I was too far back to hear the details of the problem that arose when it was about time for the woman to pay, but I could see the clerk reach for her phone -- which usually means a manager is needed.

It was. I'm not sure why. Maybe a dispute about the cost of an item.

Regardless, the manager's involvement took more time. All told, I guess it took at least ten minutes for the clerk to checkout the maskless woman. She ended up paying well over $400, I recall.

The woman ahead of me didn't have nearly as much stuff, so I thought it wouldn't be long before I got to the head of the checkout line.

Wrong again.

This time the reason for calling a manager had something to do with the price of a big package of Brawny paper towels. I got the impression that the woman wanted a sale price for an individual roll to be applied to each of the dozen or so rolls in the package, or something like that.

At first the clerk tried to calculate what the cost should be by using her touch screen. Then, confused, she asked a manager who was standing nearby for his help. He told her she should cancel the original paper towel purchase and enter a new price.

That didn't work either. 

The clerk picked up the phone, asked for the manager, and tried once more after getting some additional instructions about what to do. Still no luck. So she had to call the manager again.

By this point I was getting irritated. Not at the clerk. At the woman who was adamant about getting a lower price for the Brawny paper towels. The line had gotten longer behind me. Clearly the clerk was getting stressed at not being able to figure out how to put in a different price for the paper towels.

I toyed with the idea of telling the woman that I'd be glad to give her a few dollars if she'd give up on trying to get the reduced price.

Upon further reflection, though, it seemed like this wasn't wise, so I just kept adjusting my posture to look as irked at possible at the woman who was holding up the long line of shoppers behind me just so she could save a small amount of money that maybe she wasn't really entitled to anyway.

Then I heard one of those shoppers yell at the clerk. I couldn't tell what was said, just that it was a complaint about how slow her line was moving. The clerk politely said, "I'm doing the best I can." Which, she was.

The manager had to come back one more time to help the clerk adjust the paper towels price. She told him, "I don't know how to do this very well. I've got to learn how to do it." The manager was supportive. "Hey," he said, "we're not on strike, which is good. Don't worry, you're doing great." 

(Fred Meyer stores in the Portland area went on strike recently, but it only lasted a day until an agreement was reached.)

My checkout went smoothly. I told the clerk, "You deserve an easy customer after your previous two." When she handed the receipt to me I patted her shoulder and said, "Thanks for what you're doing. Much appreciated." I heard the man behind me say something similar as I left the checkout line.

We've got to remember what a tough job grocery store clerks have had in the almost two years since the Covid pandemic hit. They've got to stand there, facing irritated customers, some of whom refuse to wear a mask, not knowing if they're going to become infected during their shift. 

Yes, most of us feel stressed around the holidays, especially this year, with the highly contagious Omicron variant lurking around. But this isn't an excuse for yelling at a grocery store clerk. They're Covid heroes.

Take Omicron seriously, Salem. Very seriously.

Omicron, the newest Covid variant to impact our country, is more attractive than original Covid and the Delta variant. But even though it looks like a Christmas ornament, don't be fooled. 

It appears Omicron could devastate Oregon in the coming weeks. So says an excellent Oregon Capital Chronicle story, "Governor, health experts brace Oregonians for a serious impact from Omicron by February."

In the past week, the Covid-19 outlook for Oregon shifted dramatically, with the state now facing the prospect of having the highest surge yet of infections and hospitalizations.

A new forecast by Oregon Health & Science University indicates that more than 3,000 people would need to be hospitalized in Oregon by early February, surpassing the 1,200 hospitalized during Delta’s peak. 

If that develops Oregon will not have enough hospital beds for everyone who needs one and hospitals will have to decide who to treat.

“We’re seeing all the pieces we need to say that it could be bad,” Peter Graven, director of OHSU’s Office of Advanced Analytics, told the Capital Chronicle after a news conference Friday with Gov. Kate Brown and Oregon Health Authority officials.

The dire forecast stands in contrast to general expectations that Omicron would be little worse than a bad cold while the Delta variant continued to fade.

Earlier projections expected infections in the state to continue declining, but Graven said he noticed an uptick in Covid-19 cases. He said he received new information in recent days from Kentucky, Washington state and Denmark that led him to calculate that Omicron could become the dominant strain in Oregon in two to three weeks. 

Governor Brown isn't planning any new Covid restrictions at the moment, but she leaves open that this may be necessary. Getting a booster shot into the arms of as many Oregonians as possible is the main public health approach that needs to happen now.

Hopefully people in Salem, and elsewhere, will realize that Omicron shouldn't be taken lightly.

Omicron spreads much more rapidly than original Covid and the Delta variant. So even if cases are milder on the whole, with so many people slated to come down with Omicron, serious cases are going to rise markedly.

Today I went to exercise at the River Road branch of Courthouse Club Fitness. I always wear my mask the whole time I'm at the gym. However, most of those at the club don't. Before, this bothered me. With the rise of the Omicron variant, I'm more irritated by the maskless people.

Because most of the elliptical trainers were being used in the aerobics room, I had to use a machine in-between two maskless guys exercising away. As soon as one of them finished, I moved to a machine further away from the other maskless guy. 

I understand why people are getting complacent about wearing a mask in indoor public spaces where you don't know the vaccination status of others in the area. But this isn't the time to get more lax. The rise of Omicron (which sounds like a super-villain movie) demands increased vigilance. 

Here's a series of tweets by physician Bob Wachter today that do a good job of explaining what's currently known about Omicron and how we should react to it.