HinesSight

Ozempic shows that obesity often is a medical problem

I wish Bill Maher was a reader of this blog, because this post was stimulated by him. For Maher, who I argue has become an irritating purveyor of liberal myths, has an outdated view of people who are obese.

Here's how I put it in the above-linked post from last January.

Lastly, I can't disagree with Maher's often-stated point that obesity is a big problem in our country. He's correct that obesity is a risk factor if someone gets Covid. But it's a bit simplistic for Maher to say that all it takes for someone to lose weight is will power. 

Meaning, just eat less and you'll lose weight. I've read about numerous scientific studies that show how some people have a natural, probably genetic, propensity to obesity. Sometimes a person's metabolism is out of whack, which makes it really tough for them to lose weight. Medication and surgery may be called for in some cases of obesity.

The March 27, 2023 issue of The New Yorker has an article that indicates that I'm right and Maher is wrong about obesity. In the print edition it was called The Ozempic Era: Will new medications change how we think about being fat and being thin?

The subtitle of the online version is even more direct about what Maher gets wrong about obesity: A popular, growing class of drugs for obesity and diabetes could, in an ideal world, help us see that metabolism and appetite are biological facts, not moral choices.

If that link doesn't work for you, here's a PDF file of the article.
Download Will Ozempic Change How We Think About Being Fat and Being Thin? | The New Yorker

Some excerpts from the article by Jia Tolentino, along with the illustration that accompanied it:

The ideal female body of the past decade, born through the godless alliance of Instagram and the Kardashian family, was as juicy and uncanny as a silicone-injected peach. Young women all over the Internet copied the shape—a sculpted waist, an enormous ass, hips that spread generously underneath a high-cut bikini—and also the face atop it, a contoured hybrid of recognizably human mannequin and sexy feline. This prototype was as technologically mediated as the era that produced it; women attained the look by injecting artificial substances, removing natural ones, and altering photographic evidence.

Dana Omari, a registered dietitian and an Instagram influencer in Houston, has accumulated a quarter of a million followers by documenting the blepharoplasties, breast implants, and Brazilian butt lifts of the rich and famous. Recently, she noticed that the human weathervanes of the social-media beauty standard were spinning in a new direction.

The Kardashians were shrinking. Having previously appropriated styles created by Black women, they were now leaning into a skinnier, whiter ideal. Kim dropped twenty-one pounds before the Met Gala, where she wore a dress made famous by Marilyn Monroe; Khloé, who has spoken in the past about struggling with her weight, posted fortieth-birthday photos in which she looked as slim and blond as a Barbie. All over Instagram, the wealthy and the professionally attractive were showing newly prominent clavicles and rib cages.

Last spring, Omari shared with her followers the open secret behind such striking thinness: the Kardashians and others, she insisted, were likely taking semaglutide, the active ingredient in the medication Ozempic. “This is the ‘diabetic shot’ for weight loss everyone’s been talking about,” she wrote. “Really good sources have told me that Kim and Khloé allegedly started on their Ozempic journey last year.” Omari was about to start taking a version of the medication herself.

Ozempic, which is manufactured by Novo Nordisk, is part of an expanding class of drugs called GLP-1 receptor agonists, which have dramatically altered the treatment of diabetes and obesity. Ozempic is approved by the Food and Drug Administration only for the treatment of Type 2 diabetes—a condition that accounts for ninety per cent of all diabetes cases—and has been available since 2017. Its name is now shorthand for the entire category of weight-loss injections.

In 2021, Novo Nordisk received approval for Wegovy, which has the same active ingredient as Ozempic but comes with a higher maximum dose, as an anti-obesity drug. On a year-end earnings call in 2022, Novo Nordisk cited worldwide market growth of fifty per cent, with almost forty thousand new Wegovy prescriptions being written every week.

...A healthy body can generally signal to the brain when it has had enough food. But that signalling system can be faulty, or get injured. “One of the most important things about obesity, and something most people don’t understand, is that, in the process of gaining weight, the neural circuitry of the brain that regulates weight is damaged,” Dr. Louis Aronne, the director of the Comprehensive Weight Control Center, at Weill Cornell Medicine, told me. (Aronne, like many other prominent practitioners of obesity medicine, has consulted on trials conducted by Novo Nordisk.)

“The hypothalamus shows signs of inflammation and injury,” he went on. The prevailing theory, he explained, is that “too many calories coming in too quickly damages nerves that respond to the hormones that control body weight.” One of these hormones is leptin, which is produced in body fat, and which signals to the brain that it’s time to stop eating. But, if you gain fat, the oversupply of leptin can cause your body to be desensitized to it, making your brain erroneously believe that you are starving.

“Your body tries to rebalance the system by slowing down the metabolism and increasing appetite,” Aronne said. After a person has gained enough weight to enter this cycle of metabolic misdirection, it becomes nearly impossible to lose that weight and keep it off long-term simply through diet and exercise. (About five per cent of people manage to do it.)

A well-known study followed contestants on “The Biggest Loser,” the weight-loss-competition show, and found that the contestants’ metabolisms slowed so drastically after their weight loss that nearly all of them regained what they’d lost. One contestant, who’d dropped an astonishing two hundred and thirty-nine pounds, soon regained a hundred, and then began gaining weight whenever he ate more than eight hundred calories less than the average amount recommended for a man his size.

...Omari, the Instagram-famous dietitian, is now off her compounded semaglutide, which she’d taken to shed some pandemic pounds. She was optimistic that she’d be able to maintain her weight, as she’d generally been able to do before. But, as I kept reminding Ozempic-curious friends, these medications were designed for chronic conditions, obesity and diabetes.

For people who are dealing with those conditions, Ozempic appears to create a path toward a healthy relationship to food. For those who aren’t, it might function more like an injectable eating disorder. As the side effects make clear, it’s not a casual thing to drastically alter your body’s metabolic process, and there is no large-scale data about the safety of these drugs when taken by people who are mainly interested in treating another chronic condition, the desire to be thin.

...Kaplan, a plastic surgeon, is better known on TikTok as @RealDrBae—in his videos, he wears navy scrubs monogrammed “dr bae” and talks to the camera as though it’s his partner in an absorbing conversation at an airport bar. He believes that more people—a lot more people—are going to start taking GLP-1 drugs soon.

He didn’t have in mind thin people who want to be thinner, he added; he was thinking about fat people who had been struggling with discomfort, with inconvenience, with social pressure all their lives, who might have lately felt encouraged to try to accept their heavier weight. He predicted that the Ozempic era would put an end to all that. “They’re no longer going to accept that they should just be happy with the body they have,” he said.

We get a Generac whole house generator after the ice storm trauma

The memory is still sharp in my mind of the Great Salem Ice Storm of 2021.

Twelve days without electricity. Lots of tree damage. Many trips into town to get more gasoline to keep our Honda generator functioning. Having to keep our wood stove going to keep the house warm.

In short, not fun. So when some friends in our rural south Salem neighborhood told my wife and I that they were getting a Generac whole house generator, our ears perked up.

Turns on automatically when the power goes out. Capable of running a heat pump, hot water heater, well pump, and everything else in a house. Or at least, almost everything. 

Sure sounded good to us.

During the ice storm we had to take showers at our athletic club, since we didn't have a way to hook our hot water heater to the Honda generator. And while our wood stove worked fine, it kept the upper part of our house too warm, and left the lower part too cold. So being able to operate our heat pump was really appealing.

It took quite a while to arrange all the details of getting a Generac whole house generator through Northside Electric here in Salem, but yesterday the final work was completed. It wasn't cheap: $13,250, not including the cost of propane tanks.

However, I told Jeff Buyserie, the Northside Electric guy who handled some tricky final electrical panel work and educated us about the Generac yesterday afternoon, that my magical thinking leads me to believe that now that we've gotten the whole house generator, our electricity will never go off again.

Jeff's apt response: "So get some life insurance and you'll never die."

Here's the 24kW generator. We located it near our firewood stacks. The Generac has to be on almost level ground. Northside supplied the concrete pad the generator sits on.

The Generac can't be right next to a structure. We have it close to where the PGE power enters our house, and the circuit breaker boxes in our utility room. 

Eighteen inch deep trenches had to be dug for the propane and electrical lines feeding the Generac. We haven't had the trenches filled yet. The county inspection has been completed, so the trenches will be filled soon.

The Generac can be fueled by either natural gas or propane. Since our neighborhood doesn't have natural gas, propane was our only option. Given our hilly property, and where we wanted to locate the Generac, a 500 gallon propane tank was too large to be moved close to the generator. So Pratum Co-op installed four 120 gallon tanks, which together equal 480 gallons.

They're hooked together, so function as a single tank. Propane tanks can only be filled 80% full, so that gives us a maximum of about 384 gallons. Jeff from Northside Electric told us that likely the Generac would use around 2 gallons an hour on average. So that would equal 192 hours of run time if the propane tanks were full.

Which is eight days of constant generator operation. Four days if the propane tanks were half full. That's longer than most electrical outages last. And naturally the tanks can be refilled, so long as the roads are passable for a Pratum Co-op truck.

A lot of electrical panel work had to be done by Northside. We now have a Generac circuit breaker box that sits to the left of our old transfer box for our 7,000 watt Honda generator. So we could still use the Honda generator, though I hope we'll never have to. 

The main complication we encountered was getting the 3.5 ton heat pump for the 2,000 square foot main part of our house to work with the Generac. (We also have a smaller 2 ton heat pump for a 1,200 square foot "apartment" area; that part of the house isn't hooked up to the Generac.)

It turned out that the thermostat for the 3.5 ton heat pump was on a circuit that ran the furnace: air handler and heat strips for emergency heat, or when it is too cold for the heat pump to run efficiently. Jeff had to do some rewiring so the thermostat was on the Generac panel, but the heat strips weren't.

He said that the 3.5 ton heat pump heat strips probably took around 15,000 watts. So since we have a 24,000 watt generator, the heat strips plus the heat pump plus the extra wattage needed when the heat pump starts up likely would have sucked up the entire output of the Generac. 

So while we still have the heat strips available when PGE power is available, we'll have to make do with just the heat pump when the Generac is operating. If it's too cold for the heat pump to work without the heat strips (below freezing, basically), we'll have to use our wood stove.

I was grocery shopping when Jeff did the testing of how the Generac handled our house's electrical needs. When I got home, he and my wife told me that the Generac did fine with everything on: well pump, heat pump, hot water heater, lights, cooktop, etc., even the oven. It did strain the generator when the heat pump kicked on. Hopefully that won't be the case when we have a lesser load on the Generac.

I feel good about our Generac purchase.

The generator is set up to turn itself on every two weeks at noon for five minutes to keep the Generac "exercised." Northside Electric will do doing the maintenance on the generator, since I have no interest in doing this, in part because the Generac is much larger and more complicated than our Honda generator.

But we'll have to wait and see how the Generac does in a power outage. Well, unless my magical thinking is correct and we'll never have an outage now that we've spent so much money preparing for one.

LifeSource dumps my favorite veggie burger. I'm crushed.

It was the cheese that first set off the alarm bells in my brain. Up until then, my usual Tuesday afternoon grocery shopping at LifeSource Natural Foods had gone as it usually does. 

Uneventfully.

I had no clue that my vegetarian life would be upended before I reached the dairy aisle, my habitual final stop before heading to a checkout register.

Glancing at my list to see what my wife and I needed there, out of the corner of my eye I noticed that something had changed in the alternatives-to-meat section.

Cheese had taken over several feet of that section, oozing over from the already large cheese department to the right of it.

My sometimes still sharp senior citizen mind jumped to a logical conclusion: The cheese must have displaced some items in the eggs/alternatives-to-meat area.

Jumpy, but not yet panicked, I scanned the shelves for what I usually buy in that section.

Tofurky Treehouse Tempe? Yes, still there. Tofurky Plant-Based Chick'n Barbecue? Yes, still there. Hodo Tofu Veggie Burger? Oh, crap! It's missing!

I peered at the labels under some empty areas of the alternatives-to-meat section. None said "Hodo Tofu  Veggie Burger."

My life didn't exactly feel like it was slipping away. Just markedly diminished.

For the Hodo Tofu Veggie Burger is by far the best vegetarian burger I've ever eaten. And since I've been a vegetarian for over 50 years, I've eaten a heck of a lot of them.

I make a Hodo burger for lunch almost every day.

I love the taste. I love the simple ingredients: organic tofu, carrots, cabbage, onions, soybean oil, salt, dried shiitake mushrooms, garlic powder, white pepper. I love the nutrition facts: 200 calories, 9 grams of fat (just 0.5 grams saturated), 9 grams of dietary fiber, 19 grams of protein.

The Hodo Tofu Veggie Burger kicks the butt of every other vegetarian burger LifeSource carries, in my admittedly personal opinion.

If the Hodo burger was in a boxing match against, say, the LightLife burger that's still on the LifeSource shelf, the referee would stop the contest after the first round, declaring a knock-out. It not only tastes great, and has great nutrition, it looks great after being fried in a pan.

I don't put anything on the Hodo burger, just some salt. Ketchup disguises the taste of the burger, which is so good, I don't want anything coming between me and my beloved Hodo Tofu Veggie Burger.

That's why I stopped by the Customer Service desk at LifeSource and asked why it was discontinued. I didn't get an answer to "why," but was told that someone else also had asked about the Hodo burger, being disappointed that it wasn't available now.

When I got home, I sent a message to LifeSource via their web site. I expressed my dismay at their dumping such a fine upstanding veggie burger, while allowing lesser quality veggie burgers to remain.

It's been about a week. I haven't gotten a reply from LifeSource. 

I told LifeSource that Natural Grocers still carries the Hodo Tofu Veggie Burger, along with three other Hodo products such as the Chinese 5-Spice Tofu Nuggets that I like a lot. LifeSource how has no Hodo products.

Last Sunday I stopped by Natural Grocers, where I rarely shop, and stocked up on the Hodo burger. I also bought some other things that I usually get at LifeSource, as long as I was in the Natural Grocers store. 

I'll ask LifeSource again why they discontinued the Hodo veggie burger. I've bought so many of them over the years, it seems like I should learn this. Maybe the Hodo burger, being tofu-based, fell prey to what I consider an irrational fear of tofu by many people these days. 

Regardless, they'll have to pry the Hodo Tofu Veggie Burger out of my cold dead hands (leaving aside the question of who "they" is).

I just hope that Natural Grocers doesn't discontinue the burger -- which I doubt, since now they're the only place it can be bought in Salem.

Why I enjoy Tai Chi as a martial art

Tai Chi is viewed by most people as merely a gentle form of exercise. Which, it certainly is. But there's another side to Tai Chi -- the martial art aspect. 

I'm familiar with Tai Chi as a martial art because I'm fortunate to have an instructor here in Salem, Oregon who is highly adept at self-defense applications of Tai Chi moves.

Warren Allen came to Tai Chi after a lot of experience in hard style martial arts. So he is able to recognize how Tai Chi can be a soft style martial art like aikido, as contrasted with hard style martial arts like karate.

The Japanese Martial Arts Center has a good definition of hard and soft styles, which basically coincide with external and internal martial arts.

Hard Martial Arts

Hard martial arts are usually synonymous with external martial arts because both focus on physical power. When practicing a hard art, you meet an attack with a forceful opposing attack. Hard arts rely on overpowering the opponent, not just with strength, but also with timing, distance, and angles. That’s true whether you’re engaging in offense, defense, or a combination of both. When you’re sparring in karate and hit your opponent harder than they just hit you, that’s an example of a hard art.

Soft Martial Arts

Soft martial arts are often based on the concept of blending with an opponent’s attack. When you’re attacked, you don’t meet the attack with a block. Instead, you move with it to escape or to improve your position. To win against your attacker, you subdue them before they can attack again. To do this at a high level requires relaxation and a calm perception, qualities that are emphasized in internal martial arts.

I also started my martial arts training in a hard style, Shotokan Karate. After nine years of Shotokan, I started to train in a more eclectic form of karate with Allen at his Pacific Martial Arts studio.

So I have about 12 years of experience with karate, and about 19 years of experience with Tai Chi, which I started learning in 2004 with Allen and have pursued ever since.

Today I took part in a three-hour seminar taught by Allen. Along with four other students, we explored Tai Chi as a soft martial art. All of us had a lot of Tai Chi training.

And all of us found the seminar challenging at times. That's because it is much easier to meet force with force than to respond to force with the above-mentioned blending with an opponent's attack that's the hallmark of soft martial arts.

This is one reason why soft martial arts like Tai Chi are termed "internal." Obviously there is an internal side to karate, just as there's an external side to Tai Chi. It's just a matter of degree. 

If someone attacks us, either physically or verbally, the natural initial reaction of most people, me certainly included, is to respond in kind. Thus karate training is more in line with our usual inclination: if a punch is thrown at our head, we deal with it via an equal or greater physical response.

But with Tai Chi as a martial art, the goal is to blend with the force of an attack to defuse and deflect it as smoothly and effortlessly as possible. 

I find this highly fascinating, intriguing, and, for sure, difficult. I've gotten fairly good at it, though I have to constantly keep in check my usual inclination to match force with force -- again, whether or not the attack is physical or verbal.

And life itself "attacks" all of us regularly, since problems with our health, work, home, relationships, and other areas need to be dealt with. We can't ignore these problems, but sometimes we react to them with more anxious force than is necessary, rather than handling them as gracefully as possible, seeing them not as a malevolent invading army but as troublesome guests deserving of gentle correction.

For me this is why I enjoy Tai Chi so much. It's essentially Taoism in motion, and I've loved Taoist teachings long before I started to learn Tai Chi. 

I have various translations of the Tao Te Ching. The 1972 translation by Gia-Fu Feng and Jane English that I've had since my college days still is my favorite, maybe because it is so familiar to me. Here's a couple of passages that relate to Tai Chi as a martial art.

Yield and overcome;
Bend and be straight;
Empty and be full;
Wear out and be new;
Have little and gain;
Have much and be confused.

The softest thing in the universe
Overcomes the hardest thing in the universe.
That without substance can enter where there is no room.
Hence I know the value of non-action.
Teaching without words and work without doing
Are understood by very few.

Well, I've been trying to understand the Tao Te Ching for most of my life. I'm not sure if I'm any closer to that understanding than I was more than fifty years ago.

But I sure enjoy the searching for Taoist truth. And that's a big reason why I enjoy Tai Chi so much, both in its non-martial and martial forms.

Oscars 2023 was great, but I disagree about Best Picture

I always enjoy watching the Oscars show, and this year was no exception.

I liked having a host back on stage. The tag-team approach I recall from last year didn't work as well as Jimmy Kimmel providing a continuous presence -- for the whole 3 1/2 hours or so of the 3-hour show. One thing I've learned is to always add an hour to our DVR recording time, which came in handy this year.

The way I see it, watching the Oscars is a lot like watching sports. If you have a favorite team, you're going to root for them to win, even as you recognize that they may not be the absolute best team in the league. 

I'd only seen three of the films nominated for Best Picture: Top Gun Maverick, All Quiet on the Western Front, and Everything Everywhere All at Once. I loved the first two films. I didn't like Everything Everywhere All at Once.

So I was pleased when All Quiet on the Western Front and Top Gun Maverick won a bunch of lesser awards.

It wasn't a surprise when Everything Everywhere All at Once walked off with Best Picture, Best Director, Best Actress, Best Supporting Actress, Best Supporting Actor, Best Screenplay, and a couple of other awards. But I felt that this film was overrated and the Academy went overboard on giving it so many awards. 

That said, I enjoyed the acceptance speeches of the Everything Everywhere All at Once winners. Jamie Lee Curtis gave appealing remarks when she won Best Supporting Actress. I just don't think that this film is going to be remembered as a marvelous bit of movie-making. 

It was quirky, creative, and trendy, given how the multiverse has captured people's attention, even though obviously there's no evidence it actually exists. A few years from now, I suspect Everything Everywhere All at Once will be viewed as a production that doesn't age well.

On the plus side, I was thrilled when Navalny got Best Documentary. The acceptance speech for Navalny was the only time Putin's horrendous invasion of Ukraine and his authoritarian rule of Russia was mentioned at the Oscars. 

And having watched and hugely enjoyed RRR, an Indian film, I was rooting for it to win Best Original Song, which it did for the catchy “Naatu Naatu.” The dancing that accompanied the song was as infectious as it was in RRR itself.

Jimmy Kimmel had some good jokes. Naturally I can't remember most of them. One that sticks in my mind came near the end of the show when he observed that whoever edited the voluminous footage of the January 6 insurrection at the nation's capitol into a "film" that made the riot look like a tourist visit deserved an Oscar.

(It was Tucker Carlson of Fox News who fashioned that lie, of course.)

Lastly, my wife and I kept feeling sorry for whoever had to sit behind the woman wearing a large floppy white hat, or head covering. It seemed to us that this was a selfish thing to do, especially since no other people in the Oscars audience had anything comparable on their heads from what we could see.

Science says first humans had black skin and tightly curled hair

Racism is ridiculous for lots of reasons.

A big reason is that science finds no basis for concluding that physical differences between some members of our species, Homo sapiens, make those members inherently superior to other people.

In fact, there's no such thing as race, according to science.

More than 100 years ago, American sociologist W.E.B. Du Bois was concerned that race was being used as a biological explanation for what he understood to be social and cultural differences between different populations of people. He spoke out against the idea of "white" and "black" as discrete groups, claiming that these distinctions ignored the scope of human diversity.

Science would favor Du Bois. Today, the mainstream belief among scientists is that race is a social construct without biological meaning. And yet, you might still open a study on genetics in a major scientific journal and find categories like "white" and "black" being used as biological variables.

Unfortunately, racists who wrongly view White as being superior to Black rarely pay much attention to science. Too bad. Because an article in the February 18, 2023 issue of New Scientist would give them a lot to think about.

Here's excerpts from "Curly hair may have evolved to protect early humans from the sun." You can read the entire article via this PDF file if the New Scientist link doesn't work for you.
Download Curly hair may have evolved to protect early humans from the sun | New Scientist

Hair that is tightly coiled offers the best protection against the sun’s potentially damaging rays, which could explain why this trait evolved in early humans in Africa and straighter hair emerged as some humans moved into cooler areas.

It has long been suggested that the reason our body hair became so fine that it is sometimes barely visible, while our scalp hair remained thick, is to prevent our heads from overheating in the sun. In our bipedal ancestors, the beneficial shading effect of head hair may have outweighed its insulating effect.

Tina Lasisi at Penn State University wondered if the type of hair on a person’s head also makes a difference.

To learn more, Lasisi and her colleagues put three different wigs on a thermal manikin – a model of the human body with heaters and sensors that is used to measure the thermal effects of clothes.

All the wigs were made of human hair from people of Chinese descent. One wig was straight, one had moderate curls and one had tight curls. Lasisi says the tightly coiled wig was within the range of curl found in people of recent African ancestry.

In tests in a climate-controlled wind tunnel, the team found that the hair’s type made a big difference to how much heat the head of the manikin gained from simulated sunshine at 30°C (86°F).

The head with a straight wig gained less than half as much heat as a control head with no wig. The head wearing the moderately curled wig gained around a quarter as much heat and the head with the tightly curled wig gained less than a tenth as much as the no-wig control.

The researchers think that curls reduce how much heat reaches the skin by increasing the gap between it and the hair surface. Making straight hair longer doesn’t achieve this because it flops over and lies flat, says Lasisi.

What’s more, curlier hair appears to maximise the shielding effect from the sun while minimising an unwanted insulating effect. “It has this incredible way of bypassing this trade-off,” says Lasisi.

...“Any mechanism that could help cool the body, and at the same time save precious water, would definitely have been acted on strongly by natural selection,” says Joseph Graves at North Carolina Agricultural & Technical State University.

When some humans left Africa and moved into cooler climes, the selective pressure for tightly coiled hair would have been lost, says Lasisi, allowing variations to emerge from generation to generation by random chance, but the trait may have re-evolved in some peoples.

The study’s findings are important because they could help change some people’s prejudiced views, says Graves, who is the co-author of Racism, Not Race. Research into the physical traits of the first humans can help to erode racist ideas, he says.

The first humans would have had black skin and tightly curled hair, says Graves. It was only relatively recently that other skin colours and hair types appeared, he says. Biologists have begun to study the evolution of skin colour, but this is the first study to look at hair type in an evolutionary context.

Every school child should be taught the persuasive hypothesis expressed by Joseph Graves, which almost certainly is true: The first humans would have had black skin and tightly curled hair.

Of course, this doesn't mean that African-Americans are superior to people in the United States with lighter skin and straight hair. Evolution simply selected for certain physical characteristics as our species left Africa for other parts of the world.

But I do think it'd be wonderful if everybody in our country realized that when early humans were living in Africa, they looked like many African-Americans do today, because those physical features helped them to survive.

This means that racists should be thankful to Blacks, because without black skin and tightly curled hair, our species might have died out early on in the history of Homo sapiens.

My eye surgery went well, though not a load of fun

When I had surgery in 2021 to repair an inguinal hernia, my motivation was to have something wrong with me fixed so I could get back to living life as I did before the hernia popped up (literally).

But the glaucoma surgery I had today was tougher to get enthusiastic about. There's no way to fix damage that's occurred to the optic nerve. All that can be done is reduce the chance of further damage. 

However, Dr. Young, the glaucoma specialist in Portland I was referred to after some significant nerve damage was found in my very nearsighted right eye, felt that a Trabeculectomy surgery was the way to go, even though drops to reduce eye pressure (that's the main cause of glaucoma) had been working quite well for the last 18 months or thereabouts.

So despite some initial qualms -- I view all surgery as scary; eye surgery is extra scary -- after hearing Dr. Young's reasons for wanting me to have a Trabeculectomy, one was scheduled for 11:30 am today at Good Samaritan Hospital in NW Portland.

Here's why I was pleased with the surgery, though obviously it's too early to tell how successful it will be in further reducing the pressure in my right eye. (My left eye is only minimally affected by glaucoma.)

First, the Traffic Gods were with my wife and me.

I'd begged for the latest possible surgery time, because I told the scheduler that we live south of Salem and neither wanted to leave our house at a super-early time for the 75 minute or so drive to Good Samaritan, nor run the very real risk of getting stuck in morning rush-hour traffic heading into Portland.

Pleasingly, we encountered no backups at all today on either our drive to Portland or our drive home. That was a major stress reducer.

Another stress reducer was my surgery starting on time. My hernia surgery was delayed. I found it tough to be all prepped and ready to go, then be told that because a previous surgery took longer than expected, mine wouldn't start for an extra hour.

But today I was wheeled into the outpatient operating room a few minutes early.

And it was good to be awake through the eye surgery, though I'd told the anesthesiologist that I enjoy propofol when I've had it for colonoscopies. He said that he'd put a small amount in my IV tube. Don't know if that happened, though, since I felt pretty much the same during the surgery.

UPDATE: I need to change my "pretty much the same" claim after idly scratching my chest while watching TV last night and feeling a strange lump. A big lump. Checking it out, I found that it was a square of adhesive with a metal connector thingie on the top. And not just one, there were three of them on the top of my chest where they were hard to see without looking in a mirror. Must have been put there in the surgery room to monitor my heart. I have no memory of that happening, nor, as I thought more about it, of being wheeled into the recovery room. So now I believe that while I was conscious during most of the eye surgery, I wasn't for all of it, and the "pretty much the same" feeling I had while the eye was being operated on could have been a propofol effect where propofol reality feels more real than actual reality (and more pleasant). Also, I forgot to credit the anesthesiologist with a clever question. He asked me, "So what did you have for breakfast today?" Quick-witted senior citizen that I am, I replied, "Ha, trick question! I didn't have anything to eat after midnight, as I was told to do by the pre-op instructions." He must feel this gets a more honest answer than "Have you had anything to eat after midnight?"

Good Samaritan is a teaching hospital (maybe all are). A nursing student from the University of Portland accompanied the RN who did my pre-surgery workup. She asked if I was OK with the student inserting the IV tube.

I said, "Sure." I did have some qualms about this, but the student did a good job. I told him that I admired him setting out on a career in nursing, given that so many nurses retired or quit the profession during the high stress time of Covid. 

Having relaxing conversations with the nursing staff goes a long way toward making surgery as pleasant as possible, though in no way was it fun. 

It'll be interesting to see what Regence MedAdvantage is charged for my surgery. When I was wheeled into the operating room, I was surprised to see what appeared to be about a dozen people in the room. I'm sure they're all necessary. I just visualized dollar signs floating above the head of each person.

As with my hernia surgery, once again the anesthesiologist who talked with me just before the eye surgery said "You're really healthy." And once again I replied, "OK, but I'm about to be wheeled into surgery, so I'm not that healthy."

His point, he went on to say, is that I don't have diabetes, heart disease, cancer, a lung problem, an inability to walk, or other common problems that, I assume, he sees in many older patients he works with. So that conversation provided me with some perspective on my glaucoma.

Now I have to do the post-surgery thing. Three kinds of medicated drops that I have to use for several weeks four times a day. Wearing an eye shield while I sleep for a week. Not lifting more than ten pounds for a while. Going to Dr. Young's Tualatin office the next three Friday afternoons to see how the eye is healing.

Which is all fine with me. The best thing about having surgery is that it feels so good to have it over with. I'd worried about all kinds of things going wrong today. None of those things happened. 

I found that sometime last week my attitude toward the surgery changed from "Oh, no, I need to have this damn eye surgery" to "Oh, please, let's get the eye surgery done so I can stop worrying about it."

Mission accomplished. Now I can start worrying about other things that probably won't happen.

When life goes wrong, it can happen in bunches

Anticipating how some people are going to react to this blog post, I want to start off by making one thing clear:

While my wife Laurel, our dog, and I are going through a stretch of more problems in our lives than usual, we're fortunate to have a decent income, good health insurance, and a pleasant home.

Lots of people have worse problems than we do, with fewer resources available to deal with them. Like, anyone homeless.

Having hopefully defused the "privilege" objection to what I'm about to say, my main point is simple:

Life can be tough, no matter who you are, and when things go wrong, it's unfortunate that sometimes those problems occur in bunches.

Mooka is our 5-6 year old Husky mix. She came from a shelter, so we don't know her exact age. As I wrote about in January, her hip dysplasia diagnosis worried us. 

She's an active dog. We live in rural south Salem with hardly any flat areas. Our home has several sets of stairs. Long walks and trips to the Minto Brown dog park were favorite activities of Laurel and Mooka.

That was threatened by the hip dysplasia. But in February Mooka started limping badly after playing with a dog she encountered on a walk. At first she wasn't putting any weight on that paw, though now she can, at least when walking slowly.

However, today a vet told Laurel that Mooka probably has an ACL tear in her knee. There's treatments that we're pursuing. However, knee surgery would involve a lengthy recovery period, which for a dog like Mooka, who really enjoys her twice daily walks and other excursions, would be hard to take.

Laurel had to spend many hours dealing with a screw-up by Best Buy after she ordered an induction cooktop and got something else. Fortunately Kelly's came to our rescue, so that problem has been resolved.

But a few days ago Laurel had a lengthy dentist appointment to have a broken crown replaced, after getting a temporary crown about a month ago. Now she has a toothache in that tooth, which shouldn't happen after a crown replacement.

That tooth has been worked on a lot over the years, so Laurel is worried that the root is damaged, which could require an implant. Not a fun prospect.

As for me, I'm scheduled for eye surgery next Monday at Good Samaritan Hospital in Portland. This is related to the glaucoma diagnosis I got about a year and a half ago. I'm very nearsighted in my right eye, which is where almost all of the optic nerve damage has occurred to my peripheral vision, which happened surprisingly rapidly.

So even though two types of eye drops have lowered my eye pressure from the low 20s to about 10 in each eye (lowering pressure is the only way to slow down glaucoma from progressing), the Portland glaucoma specialist I was referred to wants me to get a Trabeculectomy.

I'm pleased that I can spell the procedure. Not so pleased at having eye surgery, a first for me. It'll be good to get it over with, though, since I had to cancel a February surgery appointment when I got Covid last month.

Anyway, while the health problems of my wife, dog, and myself aren't as serious as many people have to deal with, it's been stressful for us to have to cope with them all at once. But that's the way life is: unpredictable.

We just wish life could have spaced out those problems. Sadly, life isn't a conscious being that demands can be made of. Even so, we look forward to life giving us a break as spring approaches.