Desicritics Author: Ravi Kulkarni

Health Care at Home

Ravi Kulkarni — Sun, 8 Mar 2009 03:30:23 EDT

In my previous blog I listed a litany of complaints about the health care system. In this blog, I will talk about some actions I have taken to ensure a healthy lifestyle.

By most standards, I am a health freak. It is not that I always do optimal things nor that I am in perfect health. But I have improved my health considerably in the last ten years or so and my blog is an effort to share my learning.

Over a period of time, I have been consulting doctors and getting lab reports. In order to improve something, one needs a baseline. One measure is to count the number of times a person falls sick. This is very subjective and sometimes deceptive too as major diseases can lurk under seemingly good health. The metrics in the lab reports provide a more objective basis. Based on these metrics I do my own research on possible lifestyle, diet and exercise changes that are needed to get better. I have realized measurable improvements of health over several years.

In my opinion, diet is the primary source of our health issues. After all we are what we eat. I avoid junk food, including all sodas, colas, synthetic additives and preservatives, synthetic sugar substitutes and so on. Where possible I have substituted whole grains for bleached floor, brown rice for white rice, olive oil for peanut oil and so on. I buy organic where I can. About 50% of my personal diet consists of only raw fruits, vegetables and nuts. For example today my lunch consisted of the following (all raw): sprouted moong (green gram), red and yellow bell peppers, Persian cucumbers, broccoli, apple slices, a mango, blue berries, raspberries, almonds and walnuts. I try to consume flaxseed in many different preparations.

Recently I purchased a Vita-mix whole food machine. It is an excellent device for making juices, soups, dips and assorted other things. I highly recommend this product to anyone interested in cooking and especially those who enjoy raw food.

Our teeth play a very important role in our health. It is not just the social consequences of bad breath or discolored teeth; they have a much more profound impact on our lives. Treatments like root canal can do more harm than good in some cases. I have followed a very simple regimen: I make sure to brush at least twice a day and floss after every meal for at least 2-3 minutes. Just flossing alone has made a tremendous difference in my dental health. Recently I also purchased a Panasonic mouth irrigator. This product is available for about $25 at amazon.com and worth its weight in gold.

As I am an IT professional besides being an internet junkie, it is almost certain that my eyesight is weak. However, I have always resisted wearing glasses and never got a pair. I think eyes are the best optical instruments ever designed and they are capable of working under extreme conditions. I have always relied on eye exercises and yoga to keep them in reasonably good condition. I definitely need reading glasses but don't yet wear any. I also do no wear sunglasses even in the sunny locale where I live. I think sunlight is good because we just don't get enough of it in our home and office bound existence.

I have mixed feelings about supplements. If one is deficient in certain vitamins or minerals, it may make sense to take a few supplements until that deficiency is overcome. But I am not sure about the effectiveness of multivitamins. Ideally we should get all our vitamins and minerals from our diet. It is almost impossible to determine the action and interaction of so many different nutrients which are present in foods an isolated in a pill form. Our ancestors did not take any supplements but at least some of them enjoyed perfect health. However, I must admit I have taken certain supplements over the years and they have certainly helped. In particular, Co-Q10 which helped eliminate PVC (premature ventricular contraction, a benign heart condition) and Niacin which helped reduce tri glycerides. I have discontinued use of both.

Our ancestors used to rely a lot on the natural and home remedies. As a result they probably lived a much healthier lives than we do, though our life spans have increased during the last century. Invention of antibiotics and vaccines have reduced deaths due to many infectious diseases. That the overuse of antibiotics is now being seen as a leading cause of super infections is the irony of progress. We are born with amazing healing capabilities. And yet we provide crutches and artificial props in the form of concoctions of harsh chemicals in the mistaken belief that intervention is better than letting the nature take its course. As a result we compromise the very body we want to keep strong and fit for a hundred years.

My favorite home remedies are: turmeric, cinnamon, ginger and garlic for simple infections. Home made yogurt, buttermilk with asafoetida for many stomach ailments. There are a few commercial preparations that have become standard faire at our home. These are:

Inflameric as an anti inflammatory supplement
Oil of Oregano as a powerful natural antibiotic
Calendula Ointment (homeopathic) for cuts and bruises
Septilin for colds and flu

As a family, we have almost eliminated consumption of any prescription medicines. Neither of my kids, ten and six years old, have had to take antibiotics, ever.

We do consult doctors on a regular basis, but we tend to pay more attention to their diagnosis and much less to prescription. But once I have confirmed a diagnosis, subsequent course of action depends on my own research. Nobody knows my body, diet and lifestyle better than myself. Best course of action often depends more on these factors and less on a formulaic prescription. An average doctor does not have enough time or patience to take into account all these factors. My source of information:

Curezone - Lot of information, user contributed information, first hand reports etc.
WebMD - Information about diseases, medicines
FDA - US Food and Drug Administration
Allayurveda - Information about Ayurvedic medicines and principles
Yahoo groups - Individual ailment discussion groups

Our modern lifestyle almost ensures that we need to exercise on a regular basis in order to maintain good health. I try to get at least 45 minutes of 3-4 days a week, mostly on a treadmill. I probably need more flexibility and strength training, but I guess I will get there. While my lifestyle and diet do provide major benefits, exercise provides a further boost to it. My tri-glycerides have been high for the last several years. I have noticed that they come down measurably whenever I exercise regularly and go easy on simple carbohydrates and fat.

Yoga and meditation provide benefits to body, mind and spirit. I am still struggling to incorporate these into my daily routine. When I do that, my at-home health care should be complete.

Disclaimer: I am not a doctor and this article is not medical advice. Please do your own research and always consult a physician for your health concerns. If I am mentioning certain brands and products here, it is because I found them to be useful, not because I derive any benefits from this mention.

The Healthcare Crisis, Part One

Ravi Kulkarni — Thu, 26 Feb 2009 08:28:32 EST

There is a big crisis in the health care system (some would like to call it sick care system). The prices are going up by 10-15% every year, and correspondingly the insurance premiums. There is a tuberculosis epidemic that is threatening to breakout anytime, even in the developed countries. The chronic diseases, such as cancer, diabetes, hypertension continue to plague us with no solution in sight. The pharmaceutical companies and the medical community have managed to find palliative measures that keep a patient alive for a long time, but there is no true cure for many health problems. Every new drug invented, every new procedure developed is costlier than the one before, but with few exceptions, most of them do not cure the patient. Instead they keep him or her dependent on the system for a long time, with attendant expenses and unwanted side effects. Even antibiotics which saved so many lives in the 20th century have become ineffective against increasingly virulent and resistant bugs.

Every spoke in the wheel of health has had its own role to play in creating the mess we find ourselves today. Let's start with the health care professionals. General physicians seldom get to spend enough time to understand an individual patient, his or her lifestyle or diet. More than 50% feel they are overworked. More often than not, it is a quick enumeration of symptoms and some lab tests and a prescription. Physicians are happy to prescribe antibiotics and other strong medications even when they are not strictly called for. The pediatricians are the worst offenders of overprescribing antibiotics. Majority of the cases do not even need them because the infections are viral. This not only creates super bugs, but also weakens the immunity of a child. My reasoning is simple – if you give a crutch to the body, the body stops making an effort to heal itself and comes to rely on the crutch. See this article on antibiotics. Specialists such as dentists and orthopedics doctors are even more culpable. Often they tend to treat individuals like mechanics treat your cars – the more repairs the better – for them. This is not to say that there are no ethical, sincere and loving doctors around. But often they become unwitting part of an establishment that is too hard to navigate and change.

Next come the insurance companies. They show no interest in ensuring that an individual gets proper health care. For them every medical expense is another expense and it is their stated goal to reduce this expense. For example, most insurance policies do not cover preventive measures such as multi vitamins or supplementation. Most policies won't cover the membership of a health club or give discounts if you are an active member. Most often they are not interested because the employers who provide the biggest chunk of insurance policies, keep changing the insurance companies frequently. Thus insurance companies have zero incentive in keeping an individual healthy.

Then come the pharmaceutical companies. While they have done some wonderful work in the past in developing life saving drugs, now they are in a rat race. Their credibility lies in tatters due to recent scandals. Peddling drugs that are of dubious efficacy, suppressing research that shows negative aspects of their drugs, bribing doctors to prescribe more medicines, encourage doctors to use the drugs off label, you name a perversion, they have indulged in it. The scandal goes on and on and with no end in sight. What is worse, there is hardly any liability for the individuals who consciously swindle the society. At the most they get a slap on their wrists.

This brings us to the fourth spoke – the regulator – FDA in America. For all practical purposes they do the bidding of the pharma companies. It is a revolving door at the FDA, often professors and researchers with deep connections to pharma industry head the FDA. While there is a process to certify and monitor drugs, FDA uses its big stick to beat back any attempt by alternative medicines to address a market need. In the States, no supplement or food producer can make a claim that his ware can cure anything. There are many such instances where a traditional (really traditional like an Ayurvedic preparation) can and does alleviate a certain condition, but they are not allowed by FDA to make that claim or at least FDA won't certify them. According to FDA, something is a drug only if it has gone through certified clinical study. No matter that these clinical studies are conducted by the interested parties, and that the traditional medicines have gone through millennia long trials. A lot of the funding for FDA comes from the pharma industry itself.

The final spoke is the consumer. This is where the biggest blame lies in the whole system. People tend to believe that a doctor knows everything. We are ultimately responsible for our own health – failure to recognize this simple truth often results in fatal consequences. People go to doctors with their mundane problems and accept prescriptions which are often not necessary. Doctors have become very defensive because of the ever hanging threat of malpractice lawsuits. So they will choose the strongest measure even when a wait and watch method will work just as well. We are too lazy to choose a careful diet that's suitable for our lifestyle, genes and body. We do not exercise enough. We eat and drink a lot of junk food. In the end is it any surprise that we are at the mercy of harsh chemicals and - at best - indifferent professionals?

In the second part of this article I will write about some of the methods we have adapted to ensure a healthy lifestyle.

A Limitation Of The Scientific Method

Ravi Kulkarni — Mon, 2 Feb 2009 01:42:36 EST

The Scientific method (from wikipedia)

"Scientific method refers to bodies of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering observable, empirical and measurable evidence subject to specific principles of reasoning. A scientific method consists of the collection of data through observation and experimentation, and the formulation and testing of hypotheses."

I often hear from scientists and wanna-be scientists (like me) that the scientific method is the only way possible forward in understanding the universe. Logical reasoning and the scientific method have their place in the scheme of things. But to say that they are primarily responsible for all progress is putting the cart before the horse. In the definition above, formulation of a hypothesis is taken as a part of the scientific method. However, this formulation is often mysterious, and no one can really explain how a "productive" hypothesis is arrived at. Most of the times logic and reasoning have nothing to do with it.

The anonymous Indian genius that conceived zero, Kepler, Newton, Kekulé, Marie Curie and Einstein all have one thing in common: they created a paradigm shift in our understanding of nature. The paradigm shift was not in the proof they offered but the hypothesis itself. While proof is important, it is secondary to the hypothesis. I doubt if anyone of these giants have explained how they came up with the hypotheses. Given a "productive" and viable hypothesis, someone can and will come up with a proof eventually just as Fermat's last theorem demonstrated.

The modern scientists spend their lifetimes perfecting the scientific method. But they probably do not spend enough time understanding how the hypotheses are made. It is assumed that a good scientist "knows" how to arrive at one. There is no process, no class (that I know of) and no "formal" guidelines to come up with a good hypothesis. No good hypothesis no significant progress. That's a limitation of the scientific method.

The ancient Indian sages approached the process in a different manner. Many of them were true yogis and attained samadhi by meditation. The claim is that when one attains samadhi, the knowledge about the true nature of the universe arises spontaneously. Perhaps this is the source of all hypotheses. They made seemingly amazing leaps in understanding the nature. Often they didn't explain how they arrived at that knowledge, but only stated it with authority. Frequently one hears the phrase "self evident" with such statements. It is left for the later commentators to comment on that statement and expound it. Some commentaries on Patanjali's Yoga Sutras say this: if all the books are burnt and all knowledge is lost save the Yoga Sutras, then rest of the knowledge can still be developed by accomplished yogis.

I know that there will be some scientist types on DC who will grill me on this one (where is Commonsense?), but I will make this claim: scientists will do much better in their disciplines if they include meditation in their curriculum. Have you noticed how often multiple scientists come up with the same new idea that miraculously solves a difficult problem that mankind has grappled with for ages? In my opinion this phenomenon is not magic or coincidence, but it can be explained by our spiritual nature. We are all connected by an underlying thread and that manifests itself in these mysterious ways. In fact someone even conducted a maze running experiment on rats that showed that once a particular maze is solved by one rat, other rats find it easy to solve.

Bubbles and The Current Financial Crisis

Ravi Kulkarni — Tue, 21 Oct 2008 14:36:55 EDT

"Bubbles! Bubbles!... My bubbles!"
-a cartoon character from Finding Nemo

Is there an end to the current financial bloodbath that is plaguing the world markets? Like a recursive nightmare, you wake up from one nightmare to find yourself in the middle of another. I am still in the middle of my productive career, and I don't find it amusing that my life savings go down 5% everyday. I just can't imagine what it must be for those who are staring retirement in the face or who have already retired. The only light I see at the end of the tunnel is the proverbial headlight of an approaching express train.

Folding banks, closing auto dealerships, collapsing companies, massive layoffs, government defaults; the looming specter is stunning. Many pundits are saying that this will be a mild recession and we should be back on track in a couple of years. In particular let me quote the following:

'Standard & Poor's chief economist David Wyss expects a mild recession that ends next spring. "Gradually we will regain confidence in the market. Lower oil prices and a falling trade deficit will help," he says. "This is a financial panic, not an economic one." '

I don't know what weeds these people are smoking. A lot more bad news awaits us. What we are seeing today is a result of 60 years of unbridled growth and reckless spending. The dominoes are falling and there is no telling when or where they will stop. They blame it on many factors: corporate greed, extreme leverage, wall street excesses, mortgage crisis and so on.

I remember reading this article by S Gurumurthy of RSS. Though the article itself has been ridiculed by the economists and intellectuals in various forums, and there are some factual errors in the numbers quoted, I felt there was an element of truth in it. This article was written in 2002 or thereabouts. Common sense tells me that I can not continue to spend more than I have. A day will come when the bill collectors come calling. This is true for individuals and also true for institutions. But there is a white elephant in the room everyone seems intent on ignoring.

I laughed out loud when President Bush doled out money to people as a stimulus package. The trouble with the economy was not that people were not spending enough; it was that people have spent way too much and they can no longer finance their profligate ways. During the last several years rate of personal savings by Americans has turned negative. The so-called stimulus package only inflated various bubbles a little more. Besides it encouraged people to be even more reckless with their money.

Since the 1940s, America has managed to build a huge economy based on consumer spending. It starts with how money is created (primarily through bank lending, see here). Every time someone borrows money (say to pay for a new car), the system creates a little bubble and new money is injected into the system. This money is supposed to be taken out at a later stage when the loan is paid off, but people keep spending money all the time so the money is never really destroyed except during serious economic contractions. This is not specific to the US economy, most of the modern economies have grown in this way.

This bubble creates other bubbles. Consider this: when there is more economic activity, the governments have more tax revenue and therefore bigger budgets. The current political wisdom tells us that the money should be spent immediately on populist and not-so populist schemes such as the earmarks. After all, one must get elected again in a few years. Once a particular expense head has been created by a government, it seldom goes away. Many economists argue that deficit financing is good for the economy. Wars and natural disasters have contributed by further expanding the budgets. Among certain quarters, there is almost a macabre glee whenever natural disaster such as an earthquake or a hurricane hits.

Without intervention this unstable system will seek some stability through cyclical economic downturns and many of the bubbles will gradually deflate. There have been downturns in the American economy, such as the recession of 80s and 90s, hyper inflation of 70s, stock market crash of 1987 and dotcom crash of 2000. Every time the government intervention has been short sighted with no attention paid to long term consequences of these actions. None of these events convinced the political leaders, financial leaders and individuals that they must spend less than they have or else...

If you remember the dotcom bubble of the 1990s, many people believed that the stock market will never go down. Ditto with housing markets of early 2000s. Similarly for too long, investors all over the world have nursed a belief that dollar is a safe haven and Americans will never default. This has caused them to send money to America in unrealistically large amounts of money through real estate investments, government bonds and lately purchases of assets of large financial institutions. This has significantly contributed to the financial bubble.

To keep this bubble inflated, governments and institutions have to spend more money and foreigners have to keep pouring their savings into American economy. To encourage these events, the lowest pillar that is bearing the weight of all these bubbles, our friend Joe, must keep spending. The trouble is that Joe can't spend any more money because his account is overdrawn. Nobody is willing to lend him either.

The credit crisis is a sign that people have understood the true nature of our economy. Money in my pocket is better than money in yours. Nobody trusts the bogus credit ratings of individuals and institutions anymore. At some level one can blame the banks for lending to one and all, but the blame must be shared by everyone; legislators for not providing enough oversight; bankers for not ensuring the borrowers have capacity to repay; borrowers for being greedy.

Americans have a total debt of about 120% of the GDP. The companies collectively have a debt of 160% of the GDP. Total American debt reached 53 Trillion dollars. That's about $176,000 of debt for each resident of the country. People and institutions have leveraged way beyond their means to pay back. To paraphrase Nouriel Roubini, now "the housing bubble, the mortgage bubble, the equity bubble, the bond bubble, the credit bubble, the commodity bubble, the private equity bubble, the hedge funds bubble are all now bursting at once in the biggest real sector and financial sector deleveraging since the Great Depression".

The casino culture has taken over the American financial markets. Short selling of stocks is the most obvious and glaring example of the gambling that savvy stock market players indulge in. There is also the futures market for commodities. For example the much maligned speculators who have presumably driven up the price of oil and other commodities. In the 1990s new instruments of financial trade called derivatives were created. These are the CDOs, the CDSs and many others from the alphabet soup, which Warren Buffet famously called financial instruments of mass destruction. That bubble is now worth 55 Trillion dollars. To put it in perspective, it is more than the annual gross product of the entire world. This is nothing but suicidal gambling by large financial institutions hedge funds, and wealthy individuals with no added benefit to the society at large. This is another bubble that is waiting to burst and who knows what happens then.

If my hypothesis about the economy is correct, then there are three ways this crisis will resolve itself. Firstly the obvious one, in which there will be a catastrophic crash of markets and institutions all over the world. This will be too chaotic for anyone to predict the sequence of events accurately. The consequences are too horrific even to contemplate, but humanity will survive. It may take a decade or two to recover to some semblance of normalcy.

Second way is that the current patchwork of interventions will work and somehow the world markets will be stabilize. However, I think this only be temporary and we will come back to the same situation sooner or later, perhaps with a bigger bubble, because we not really addressing the underlying causes.

Third way is when our leaders act responsibly, the markets respond in a sane manner and people correct their ways. Government will stop wasteful spending, wall street will stop being greedy and people will start saving more responsibly for their retirement and their children's education. If by some miracle this sequence of events comes to pass, then it will still take a couple of decades for us to come back to stability. The reasons are obvious, the the bubbles are simply too large and they can't be deflated in a short time. However the likelihood of this happening are extremely remote. Consider:

Law makers are short sighted and often ignorant
Government likes to keep borrowing to spend even more money and has zero credibility with the main street having spent all of its political capital waging pointless wars
Washington is full of wested interests, but none protecting Joe's interests
Wall Street has a short memory and within a few years it will retrace the history
Regulators have no credibility as they are either corrupt or ideological but almost never right

This problem is not unique to America. I am only using her example because I have lived here for the last 8 years or so and seen what is happening first hand. I am sure similar things are happening in many other countries as well.

The situation is rather bleak, but people change only when there are catastrophic events that overtake them, or a JFKesque leader guides them. Is Obama the JFK of our generation? I sincerely hope so, but I am very skeptical.

What are the lessons for India in this crisis? Unfortunately I don't believe India will escape it unscathed. The only silver lining is that India is not yet that highly leveraged that it will suffer as deeply as the US. However, India is following the path that US took in the '50s and '60s. We can yet avoid it by ensuring that the truly important issues are addressed and never compromised in the name of capitalism. These issues are, savings for retirement, ensuring universal health care and providing good education to all those who want it. Most importantly we should not build our future on bubbles.