Trade Schools

“College is like a fountain of knowledge - and the students are there to drink”

A Washington Post story notes that More college-educated jump tracks to become skilled manual laborers.

"They started out studying aerospace engineering, creative writing and urban planning. But somewhere on the path to accumulating academic credentials, they decided that working with their hands sounded more pleasant -- and lucrative -- than a lot of white-collar work. So bye-bye to term papers and graduate theses, and hello to apprenticeships to become plumbers, electricians, auto mechanics
and carpenters."

The poor economy has been a boon for trade schools. The electricians' union program in Washington D.C. has 2,500 applications for 100 slots. And nearly 4,000 are competing for the 300 slots at a plumbers and pipe fitters school.

Pay for trade jobs is good. Apprentices start out at half salary with raises every six months. After five years licensed journeymen can expect to be paid $65,000 to $85,000 a year, depending on the amount of overtime. That beats four+ years of college, graduating deep in debt, and with no job.

In Europe many students begin an apprenticeship at age 18 right out of high school. But in the US, high school counselors rarely recommend trade school (except for their worst students). So American youth try college first and then switch to blue collar. The average age for beginning apprentices in the US is 25.

Bottom Line

This weekend my wife and I bumped into an old friend who is moving in the opposite direction - from blue collar to white collar. He was a long-time union employee at a TV station. However with better technology and greater automation, the station was able to layoff 38 technicians. Now my friend is completing a BS degree in Labor Relations and then plans to study law so he can go back and sue the pants off big companies.

There is merit in having some real-world experience before graduating from college.

"Worst" New Foods

Red meat is not bad for you. Now blue-green meat, that’s bad for you! ~Tommy Smothers

Each year the "Eat This, Not That" organization looks at popular restaurants and publishes the Worst Food list.

"For example, Outback Steakhouse unapologetically packs 2,135 calories, 150 grams of fat, and 2,344 milligrams of sodium into their Aussie Cheese Fries. Or consider the Pizza Skins at Uno Chicago Grill, which will you cost you a day’s worth of calories and more than two days’ worth of fat and sodium."

In the list published today, the "winners" are new menu items in 2010 that are "dietary disasters."

• Wendy’s Honey BBQ Boneless Wings
• Taco Bell Bacon Ranch Tortada
• KFC Double Down
• Cosí Steakhouse Salad
• Cold Stone Creamery Strawberry Cheesecake Ice Cream
• Panera Bread Cuban Chicken Panini
• Burger King A1 Steakhouse XT Burger
• IHOP Pancake Stackers
• Hardee’s Loaded Biscuit ‘N’ Gravy
• Hardee’s Six Dollar Grilled Cheese Bacon Thickburger
• Dairy Queen Buster Bar Blizzard (large)
• Olive Garden Five Cheese Crespelle with Sausage
• Ruby Tuesday Southwestern Quesadilla
• California Pizza Kitchen The Meat Cravers Pizza
• Applebee’s Ultimate Trio

Bottom Line

See http://eatthis.womenshealthmag.com/content/15-worst-food-creations-2010 for details on calories, salt and fat and why each item was selected. Usually the blame lies with the extras - sauce, cheese, butter, bacon, fried onions, and so on that are layered on top an otherwise good meal. Sometimes the calories are less obvious - in the Burger King A1 Steakhouse XT Burger two-thirds of the calories are in the buttery bun!

Online College Courses

"If you were going to create a college from scratch, what would you do?"

Last Sunday at church an old friend was staring raptly at a bulletin board. "Is there something new posted?", I asked. He pointed to a poster for independent study courses at a church university. "Have you looked at the MIT online courses?", I suggested. To my surprise he had no idea what I was talking about.

MIT (the Massachusetts Institute of Technology) is one of the leading Universities in America (and in the World). When I was applying to colleges back in the 80's, I read that one-third of the freshmen admitted to MIT had a perfect 800 score on the SAT mathematics test. The college store proudly sells T-shirts that say, "Harvard is for students who couldn't get into MIT".

Given the elite status of the school and the very high cost of tuition, it is very surprising that MIT offers over 1900 courses online for free at
http://ocw.mit.edu/. You can watch entire courses on your computer, buy the text book and do the homework assignments. Some courses include lecture notes and exams. It's a great way to learn science, business, economics, art, history, philosophy, political science, etc. This will take some time however - these are complete college lectures for an hour or more, several times a week, over many months. And your brain may melt if you watch too many in a row without a break.

I bring this up because I learned today of another online education series that has become very popular on YouTube and rivals MIT online for the number of students. It's called the Khan Academy.
http://www.khanacademy.org/

Salman Khan is a 33-year-old who quit his job as a financial analyst to make homemade lecture videos for his friends and relatives. "My single biggest goal," he says, "is to try to deliver things the way I wish they were delivered to me." He now has 1200+ videos on YouTube covering everything from basic arithmetic and algebra to differential equations, physics, chemistry, biology, finance, and history. Lectures are 10 to 20 minutes long and what you see is a digital blackboard upon which Khan draws as he lectures. I recommend starting at his website to see what's available rather than surfing YouTube for them. I've listened to two of his lectures so far and found both to be entertaining and well-done.

Bottom Line

There are many opportunities to learn online. Expand your brain!

Emergency Response Politics

"It was chaos. There was nobody there, nobody in charge. And there was nobody giving even water. The children . . . they're all just in tears. There are sick people. We saw . . . people who are dying in front of you."
- CNN producer Kim Segal, describing the New Orleans Convention Center the day after Hurricane Katrina

[Note: the Convention Center was NOT an official shelter like the Superdome. Thousands of people just showed up and expected to be taken care of in a city that was official abandoned. The media handled this very poorly- looking for blame instead of helping evacuate the people to real shelters or notifying officials. TV anchor, Ted Koppel, would accuse FEMA of negligence for NOT learning about the crisis at the convention center from TV news reports.]

A reader of the SurvivalBlog.com objects to Firefighter Charles disaster scenario that I quoted in yesterday's post.

"Firefighter Charles's statement about FEMA's response times shows a lack of understanding of how the process works. In the event of another Hurricane Katrina type natural disaster, the following things have to happen, in the following order:

1. Disaster strikes
2. Local officials setup an incident command
3. Local Emergency Operation Centers (EOCs) are activated. The local emergency operations plan (EOP) is put into action.
4. Mutual aid agreements are activated. If the disaster goes beyond this, then...
5. State EOCs are activated. State EOPs are put into action.
6. The state activates it's mutual aid agreements.
7. If the situation is not contained, the Governor declares a State Emergency. He can then.....
8. Appeal to the President to declare the event a federal disaster - whether it is a Stafford Act event or not.
9. FEMA is then activated and ordered to head the rescue/relief efforts. The FBI is the lead investigative agency for any criminal acts, while the BATFE is the lead law enforcement agency for anything law enforcement related such as security, etc."

Now there are some good points here but I think the responder protests too much. The process above makes Firefighter Charles's point even stronger. Before super-slow FEMA can respond, one has to wait for local bureaucracy and then state bureaucracy to run its course. This rarely happens quickly and you can still expect 72-hrs or more to pass before resources like food and mass shelter are available.

In the case of Katrina the emergency response process was stalled by politics. The mayor of New Orleans ordered everyone to abandon his city with just 19 hours notice. The New Orleans official evacuation plan was not activated; school buses sat unused that could have helped evacuate residents. Those who could not leave were ordered to go to shelter of "last resort" without any provisions for food, water, security, or sanitary conditions. The Louisiana Superdome was designed to handle 800 as a shelter but 30,000 arrived.

Immediately after the hurricane had passed on Aug 30, 2005, Michael Chertoff, Secretary of the Department of Homeland Security and FEMA's boss, tried to take over the federal, state, and local operations, citing the National Response Plan. This was refused by Governor Blanco of Louisiana who indicated that her National Guard could manage. President Bush, a former governor of Texas, would not overrule a governor acting within her constitutional rights of state leadership.

Still it is wrong to say the Federal Government did nothing. Naval ships were moved to the Gulf before the hurricane hit and Coast Guard helicopters rescued 35,000 individuals from flood waters. Approximately 58,000 National Guard personnel were activated to deal with the storm's aftermath, with troops coming from all 50 states. The Department of Defense also activated volunteer members of the Civil Air Patrol.

700,000 people applied to FEMA for temporary housing. Tens of thousands of trailers were used but in some parishes the local council refused the trailers (not wanting to create a permanent squatters camp perhaps?). Also FEMA would only deploy trailers to regions with working utilities. (Think of the sewage problems that would result otherwise). For those without trailers, FEMA paid for hotel rooms. Five years after the disaster, there are still 260 families in hotels being paid by FEMA.

A Congressional investigation after Katrina found that FEMA and the Red Cross "did not have a logistics capacity sophisticated enough to fully support the massive number of Gulf coast victims." It placed responsibility for the disaster on all three levels of government.

Bottom Line

The National Incident Management System (NIMS) always puts the onus for response on local governments. However local responders NEVER have the resources for a major emergency. In Westchester county with a population of almost 1 million, the local Red Cross and CERT teams have cots for only 30,000 people. If there were mass evacuation from an accident at Indian Point Nuclear power plant, we'd have to rely on neighboring counties and neighboring states for shelter. That requires lots of high-level politics and lots of time.

The worst part of this is that many townships in Westchester, NY refuse to stockpile supplies and designate shelters. Once a town has a shelter plan, they are responsible to maintain it. For towns without a shelter plan, the responsibility goes upon Westchester county.

http://perpetualpreparedness.blogspot.com/2008/09/waiting-for-cavalry.html
http://perpetualpreparedness.blogspot.com/2008/08/hurrican-ready.html

Is a 72-hr kit sufficient?

"I mean, you have people who don't heed those warnings and then put people at risk as a result of not heeding those warnings. There may be a need to look at tougher penalties on those who decide to ride it out and understand that there are consequences to not leaving." –Sen. Rick Santorum (R-PA), Sept. 6, 2005, after Hurricane Katrina

Survivalblog.com has published an interesting article entitled, Transitioning to Seven Day Bug-Out Bags, by Firefighter Charles. Since Hurricane Katrina the American Red Cross and FEMA have urged families to extend their "72-hr" kit from 3 days to 5 days or even 7 days. Because of this the name "72-hr" kit is now a misnomer and "Go" kit is used instead.

With the success of the 9-1-1 emergency phone system, people have come to expect a quick response to any emergency. But during a disaster, there may be tens of thousands of people trying to reach a very small police/fire department. Of course the local police/fire may itself be destroyed by the disaster (or as in New Orleans, local emergency services fled the town to safety along with the residents.)
with local resources overwhelmed you'll have to wait for outside resources to come to the rescue. Firefighter Charles accurately describes what happen and how long it takes...

Now FEMA’s response times as we all know is pitiful. FEMA’s response time also varies from situation to situation. But for our purposes, let's give FEMA the benefit of doubt. [Imagine] an unlikely yet devastating 7.5 earthquake in New York City (Manhattan). I’ll play with the numbers in their favor. It might take them 8 to 12 hours to figure out logistics and if the area is safe. It may take them another 10 to 12 hours to mobilize and get to the disaster area. Then once there, they set up outside of the disaster area, which might take another 8 to 12 hours. Also having engineers come in to analyze the tunnels and bridges, will further delay the rescue. Depending on the bridge or tunnel they decide analyze, that only can take up to another 12 hours. That would be an estimated FEMA’s response time. You've now exhausted your 72-hour bag. ... The total estimated time would be 62 to 84 hours. ...

Now once FEMA has established itself in, near, and or around the disaster area. It could take another 12-24 hours to receive one-on-one assistance. Considering that thousands to hundreds of thousands will also be on line waiting for “help”. Now, picture yourself being on line for your favorite band and waiting 10-24 hours to get their tickets. Now translate that to a disaster relief line. You exhausted your 72-hour bag and now have to wait in a line for hours maybe even days to be sheltered and fed. You will be beyond hungry, thirsty and tired. Knowing that you are so close yet have to wait for hours more, will really agitate you. Note: That waiting for FEMA support on a line of hundreds of thousands will bring out the good, the bad, and the worst.

Bottom Line

Everything moves slowly after a large-scale emergency. You're mostly on your own and need to be part of the solution and not part of the problem with proper training and food/water storage.

Tornado!!!

"The answer my friend is blowin' in the wind,
the answer is blowin' in the wind"
- lyrics by Bob Dylan

On June 5th an F2 class tornado hit the town Streator, Illinois; in total 15 tornadoes hit the region during the storm. 8,400 residents lost power. Here is a first hand account,

"The twister tore through the southern part of town, wreaking a path of destruction 400 yards wide. It didn’t sound like a freight train — the usual description you read in the newspapers. Freight trains don’t roar like a wild beast and beat holy hell against your windows seeking to get in. The rattling, clacking, and shaking of my brick house was augmented by the rending, tearing sounds of tree limbs snapping, the popping of transformers (sounding just like old-fashioned flash bulbs exploding), and a strange, terrifying high-pitched whine that made it sound as if all the furies in the world had been unleashed and were circling my home in anticipation of its destruction."

Here's an report from trailer park,

"[Dan] ran back inside, told his wife to get their 11-month-old daughter and for several terrifying moments, the mother and father hunkered down over their daughter, their bodies shielding her as windows shattered, appliances tumbled over and the entire trailer shook violently with the force of a tornado passing by. "I just kept praying," [the mother] said. "I thought that my baby would get sucked away."

The good news about this event is that no one was killed (although 50+ were injured and 30+ homes destroyed). Modern weather radar gave advance warning so residents could shelter in their basement. Even so there is an element of luck and fate and fickleness when dealing with tornadoes. It can destroy one house utterly and leave one next door untouched.

Also keep in mind that tornadoes are FAST. The event in Streator was over in three minutes. When the sirens blare you must respond immediately; don't dither and don't step out on the porch to see what the sky looks like.

I read another account today (must have been a different storm) of a father sheltering in the basement with his family. Almost immediately the power when out so he and dog went upstairs to start the emergency power generator. It was at that moment the tornado hit and blew away everything above ground level. If he had stayed in the shelter in the dark he would have lived.

Bottom Line

Most people who die in tornadoes are hit by debris from their own house. Do you have a safe room to shelter in? For tornadoes it should be below ground if possible, if not then a first floor interior room without windows. Stock the room with flashlights, water, blankets, games, hand-powered radio, bucket for a toilet, and anything else you might need for 30-60 minutes while a storm blows overhead. The purpose of the shelter is defeated if you have to leave it to get something you forgot.

Death vs Risk

"Death is not the greatest loss in life. The greatest loss is what dies inside us while we live."-Norman Cousins

My current Commuting to Work CD Lecture Series is about the religious upheaval of the Reformation. In the first lecture, the professor made an interesting comment - religion was a serious matter back in the 1500s. Before modern medicine and modern hygiene, people died all stages of life, especially children. Someone might be healthy today but die tomorrow. Life was short and uncertain and no one truly knew what was safe. Many thought the chill of cold water when bathing was unhealthy. Some thought mercury or arsenic was good for the body. Death was beyond anyone's control.

"But at my back I always hear. Time's winged chariot hurrying near"
- Andrew Marvell in "To his Coy Mistress"

"Because I could not stop for Death, He kindly stopped for me;"
- poem by Emily Dickinson

With death never far away, people were naturally concerned with their soul and the judgement of God. Would they go to heaven if they died the next day? How could they improve their odds for salvation? They relied on the Roman Catholic Church to save them both in life and after death. For example, in the 1500's it was very popular to purchase salvation through the buying of indulgences. Martin Luther objected to this practice in his 95 Theses and the Reformation began.

Today life expectancy is quite long and most people expect to live to a ripe old age. Yes accidents happen but these are rare exceptions. We now live in the material world for many, many decades and the spiritual world is something distant and far off, something to be put off until we're old.

I was reminded of this topic this weekend when discussing risk and what children used to do versus what we allow children to do now-a-days. With a long life expectancy, we fear death more. We have so much more life to lose from an early death caused by accident or disease. Instead of death being a part of life, we do everything in our power to keep death away from the young. Don't climb that tree, you might break your neck. Wear a helmet when you ride your bike. Don't eat that, it's filthy with germs. The odds of a child dying from tree climbing, etc are low but the odds are greater than zero. That makes many parents nervous and they limit opportunities and actions of their kids to lower the risk to as near zero as possible.

"A coward dies a thousand deaths, the brave die but once."
- Shakespeare in Julius Caesar

A life of zero risk and zero exposure has it's own risks. Science is finding that when young children are not exposed to germs, they develop more severe allergies and have less immunity when they grow up. An isolated, at-home child will have weaker social skills which could impact their success on the job later in life.

Bottom Line

Isaiah 22:13 "Let us eat and drink; for tomorrow we shall die."
Don't be so afraid of death that you run away from life. Embrace life and accept a little risk. Live a little. But don't forget the golden mean and go crazy in excess. Personally I'll pass on bungee jumping and sky diving. "Everything in moderation" - Aristotle.

"The unexamined life is not worth living."-at his trial, Socrates argued that life must be about more than making money and being successful in your career. For him it was important to discuss ethics and religion and to determine how best to live with the time given to man. Aim high with your life.

Baking Soda

"Fish and visitors smell in three days."-Benjamin Franklin

There are some items that have hundreds of uses and should also be kept on-hand; examples include duct tape, vinegar, and baking soda. Can these really have over 100 uses? How about 500? Website ShelterPop.com recommends Vicki Lansky's book from 2003, Baking Soda: Over 500 Fabulous, Fun, and Frugal Uses You've Probably Never Thought Of. From the book ShelterPop has identified 15 unusual (but useful) ways to use baking soda:

1. Washing food
Wash toxins off the skin of fruits and vegetables with a baking soda paste on a sponge. Rinse the fruit/veg. well before eating.

2. Drain cleaner
Not as powerful as, say, Drano but much cheaper. Pour a half cup of baking soda down the drain followed by half cup of white vinegar. Wait two hours, then rinse with hot water.

3. Smelly Vacuum?
Sprinkle baking soda on the floor, then vacuum it up to kill odors in your vacuum.

4. Stinky Door Mat?
Deodorize your front door mat by sprinkling baking soda on it.

5. Soft hands
If you wash dishes with a baking soda paste, it'll remove tough baked-on food and soften your hands at the same time.

6. Musty books
Sprinkle baking soda between the pages of musty books, and brush it out a few days later for a fresh scent.

7. Remove Mothball smell
The smell of mothballs on clothing can be removed by adding ½ cup of baking soda to your washing machine's rinse cycle.

8. Oil and grease
Sprinkle soda on the garage or basement floor to soak up oil and grease.

9. Weathered look for a Deck
Remove mildew by washing your deck with a solution of two cups baking soda in one gallon water, and using a stiff straw brush to work the solution into the wood, then rinsing with cool water for a clean desk with an aged patina look. Try this in a hidden corner first to see if you like the weathered look.

10. Weed killer
Sweeping large amounts of sodium-rich baking soda into the cracks of your paved walks and driveways will eliminate weeds and dandelions.

11. Canvas cleaner
To clean canvas, rub on a paste of baking soda, then rub off.

12. Burnt pots
To eliminate seriously burnt-on food, pour in a thick cushion of baking soda, add an inch or so of water, and put the pot on the stove to boil. After boiling for a minute, try scrubbing again. Don't burn yourself!

13. Plastic shower curtains
Wash mildewed or dirty plastic shower curtains in the washing machine on the gentle cycle with a couple of bath towels, and add in a half cup of baking soda and detergent during the wash cycle. Add in one cup of vinegar during the rinse cycle, then let drip dry.

14. Automatic dishwasher detergent
Mix two tablespoons baking soda and two tablespoons borax, as a alternative to commercial dishwasher detergent.

15. Smokey or Smelly clothes
Place the clothing in a plastic bag with baking soda for two days, then wash as usual.

Bottom Line
Baking soda is famous as an odor remover and a cleaner. Do you know the difference between Baking Soda and Baking Powder? If not check out my blog from a year ago at http://perpetualpreparedness.blogspot.com/2009/07/baking-powder-food-science.html

Polio Almost Eradicated

"Apart from the atomic bomb, America's greatest fear was polio.” – 1950s

Polio is another ancient disease that has been known since prehistory; Egyptian paintings show healthy people with withered limbs and children walking with canes. The disease was once called infantile paralysis, based on its propensity to affect children. While now rare in the Western world, polio is still endemic to South Asia and Nigeria. In 1988 a global effort to eradicate polio was begun by the World Health Organization, UNICEF, and The Rotary Foundation. These efforts have reduced the number of diagnosed cases by 99%; from an estimated 350,000 cases in 1988 to 1006 cases in 2009.

Curiously occurrences of polio spiked in the early 20th century to epidemic proportions. The cause: modern sanitation and an odd trait of polio. The disease is bacterial and spread by the “fecal-oral” method which is as awful as it sounds. Persons shit out the disease, which contaminates waters or food, which is then consumed. But what happens next depends upon the age of the victim. The effects of polio are worse the older you are when you contract it. A child might develop a deformed limb while an adult loses the ability to breathe and needs an iron lung. Infants under six months can beat the disease and become immune for life. With modern sanitation providing clean water and food, infants were no longer exposed to polio on a regular basis. Instead the first exposure was occurring later in life with more serious results.

In the United States the polio epidemic began around 1900 and peaked in 1952 with 58,000 cases reported, 3,145 deaths, and 21,269 left with mild to disabling paralysis. In 1977 there were 254,000 persons living in the United States who had been paralyzed by polio as a child. Future president FDR was infected in 1921 and paralyzed from the waist down. Later as President he created the March of Dimes Foundation to raise money to fight polio and a “great race” began to find a cure.

Today there is still no cure but on April 12, 1955 Jonas Salk completed field trials and presented to the world an inactive variant of polio that was 90% effective in immunizing individuals by teaching the body how to produce antibodies to fight a future polio infection. Salk was hailed as a "miracle worker", and the day "almost became a national holiday." Salk had developed a safe and effective vaccine as rapidly as possible, with no interest in personal profit. When he was asked in a televised interview who owned the patent to the vaccine, Salk replied: "There is no patent. Could you patent the sun?" Sadly Salk was not awarded the Nobel Prize. It went instead to others who learned how to grow the polio virus in embryonic tissue so that enough virus culture could be collected to be studied.

You might remember being given a sugar cube to fight polio in grade school. In 1955 Dr. Albert Sabin produced a live-virus vaccine that was placed on a sugar cube and eaten, rather than injected. This was far easier to distribute than Salk’s vaccine but made doctors nervous – could they be infecting persons with a weak constitution? Fortunately the Sabin vaccine was found to be (mostly) safe and by 1967 became the preferred method. Today the preferred method has switched back to injections as being safer.

Bottom Line

Support the effort to make polio the second disease to be eradicated from the Earth. Inoculate your children. Until the disease is 100% dead it is not safe to skip the shot. An infected immigrant could give your child paralysis for life with a contaminated hot dog or other prepared food.

In the early 1900's Typhoid Mary (Mary Mallon) infected 53 people as a cook. She was a healthy carrier of typhoid fever who refused to recognize her own role in spreading the disease and who refused to cease working as a cook. She was forcibly quarantined twice by public health authorities and died in quarantine after 23 years of confinement.

Tuberculosis

“The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted”-Mother Teresa of Calcutta

In the early 1900s, Tuberculosis (TB, also known as consumption) killed one out of every seven people living in the United States and Europe. It was a scourge of mankind and quite common amongst the rich and the poor. It can be found in the bones of cavemen and the bodies of Egyptian mummies. US Presidents who survived TB include George Washington, James Monroe, Andrew Jackson, and Franklin Pierce. Eleanor Roosevelt, wife of FDR, died of TB as did the poet John Keats, the Bronte sisters, Anton Chekhov, Frederic Chopin, and many others. We don’t hear about it much today because a vaccine was discovered in the 1940’s and for awhile it looked like TB would go the way of Smallpox and become eradicated in the world.

With the disease rare but not gone, counties neglected TB control efforts and it has started to creep back. Moreover the treatment for TB requires six to 12 months of drugs. In some parts of the world (like Russia), persons stopped taking the drugs when they felt better but before the disease was 100% gone from their body. This has resulted in drug resistant strains of TB that are now difficult to cure. About 1/3 of the world may be infected with TB (in a latent form) with 1.8 million deaths each year from the active form.

TB usually infects the lungs and this version is contagious and spreads through the air with coughs, sneezes, and normal breathing. You don’t want to be on an airplane with recirculated air when a passenger has TB. People with active TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.

TB may travel from the lungs through the blood to other parts of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. Symptoms depend on where in the body the TB bacteria are growing. TB in the lungs may cause:

•a bad cough that lasts 3 weeks or longer
•pain in the chest
•coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of active TB disease are
•weakness or fatigue
•weight loss
•no appetite
•chills
•fever
•sweating at night

Bottom Line

When someone nearby has a really bad cough, it may be more than the flu. Are you inoculated against TB?

Strange but True?

Wikipedia suggests the possibility that TB inspired the vampire myth. People with TB often have red, swollen eyes (which creates a sensitivity to bright light), pale skin, extremely low body heat, a weak heart and coughing blood, suggesting the idea that the only way for the afflicted to replenish this loss of blood was by sucking blood from others.

Resources

http://www.cdc.gov/tb/publications/factsheets/general/tb.htm
http://www.cdc.gov/tb/publications/faqs/qa_introduction.htm
http://www.cdc.gov/tb/publications/pamphlets/TB_infection.pdf

Dengue Fever

"A danger foreseen is half avoided." - Chinese fortune cookie

It’s sad in our modern age of medicine to see many old diseases returning like whooping cough, measles, TB, etc. Part of the fault is overconfidence, we think the disease is gone and stop taking the shots that protect us. Then one sick person visits from overseas and sets off an epidemic.

Another cause for diseases spreading is a change in habitat or habitat invasion. When a new housing development is built next to a marsh, expect mosquitoes. Global warming is also causing animals and insects to move into new locations. For example, the Florida Keys is experiencing a wave of Dengue fever – huh, what? Isn’t that something out of old jungle stories?

Dengue (pronounced den’ gee) is a viral disease spread by mosquitoes for which there is no immunization and no cure. It affects 100 million people each year – usually in the tropics. An extreme case of Dengue, called Dengue hemorrhagic fever (DHF), can be fatal but with hospitalization the survival rate is 99%.

The principal symptoms of dengue are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding (nose or gums bleed, easy bruising). Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.

Dengue hemorrhagic fever (DHF) produces a fever that lasts from 2 to 7 days, with symptoms consistent with dengue fever. When the fever declines new symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing, may develop. This marks the beginning of a 24- to 48-hour period when the smallest blood vessels (the capillaries) become “leaky” allowing the blood plasma to escape into the body. This can lead to shock and death, if circulatory failure is not corrected.

Treatment

For normal dengue fever the “treatment” is pain relievers with acetaminophen like Tylenol. Do NOT use aspirin – you don’t want to thin the blood any further. Rest, drink plenty of fluids, and consult a physician.

If you feel worse (e.g., develop vomiting, severe abdominal pain, bleeding) in the first 24 hours after the fever declines, go immediately to a hospital for evaluation. You may need a plasma drip to keep you alive during the high risk period of DHF.

Bottom Line

Everything old is new again. Each of us needs to brush up on the symptoms and treatment of “lost” diseases that used to plague our grandparents.

Cassava

"I yam what I yam." - Popeye

Twice this week I've come across a reference to cassava, a yam like vegetable that is rarely seen in America (except as tapioca) but vitally important in other parts of the world. The cassava, also called a yucca, is an odd food that contains nearly the maximum theoretical concentration of starch on a dry weight basis among food crops. Fresh roots contain about 30% starch plus calcium, phosphorus and vitamin C but very little protein or anything else useful. It can be poisonous with traces of cyanide that must be removed when preparing. Nutritionally it's like eating unenriched white bread.

And yet the cassava has fed South America for thousands of years and is today either the primary or secondary food source in the humid and sub-humid areas of tropical Africa and vital to sub-Saharan Africa. It is a vital staple for about 500 million people and is grown in India and across Asia into Thailand, Vietnam and China. On reason for its popularity is its hardiness. Cassava thrives better in poor soils than any other major food plant and rarely needs fertilization. Cassava is very drought resistant and very tolerant of neglect; it can be left for up to three years in the ground before harvesting. So if a farmer catches malaria and is laid up for a month or two, the crop won't care. In additional the cassava leaves contain protein and vitamins.

My first encounter with cassava this week was in a TED talk describing an attempt to genetically alter cassava to contain vitamin A (like a yam) to improve the health of millions. The second encounter was no so positive, there is a global virus infecting cassava crops. “Even the pigs refuse [to eat] this,” said one farmer. Some are comparing this to the great potato famine of the 1840s that caused starvation in Ireland and resulted in mass migration of Irish to the US. Fortunately the Bill and Melinda Gates Foundation (yes the Bill Gates of Microsoft) is spending tens of millions of dollars to find a cure.

Bottom Line

Hopefully a cure to the cassava virus will be found soon and starvation will be prevented. In the meantime the Gates Foundation is teaching farmers how NOT to spread the virus.

See also
http://en.wikipedia.org/wiki/Cassava

My Bread

“The first time I tried organic wheat bread, I thought I was chewing on roofing material”- actor Robin Williams

Unless your food storage is a mountain of tin cans or a closet full of freeze-dried meals, odds are that you will have a few buckets of wheat for emergency use. Now what will you do with that wheat? Back during the Y2K scare we got a good price on a wheat grinder so we were able to make decent flour but had little luck making bread from scratch. Most of our baking efforts came out like bricks with very little yeast rising. We checked our yeast - it was alive but not working for us.

A few months back my wife found a bread recipe that has worked perfectly every time. We now have a new loaf every few days. The recipe was first published in the New York Times back in 2006 by baker Jim Lahey. It was an immediate success with the public and Lahey used his moment of fame to publish a baking book called, My Bread. We've tried a few recipes - we really enjoyed the no-knead olive bread with green olives, no so much a loaf containing peanuts.

The full bread recipe is a bit big for just two; the loaf sometimes goes bad before we can finish it. This won't be a problem if you have kids.

Some things about the recipe that work for us.

1. The long rise time lets the yeast do its job.

2. Use a dutch oven or cast iron pot with lid. The bread rises very little in the oven so it takes the shape of the pot. We had a lot of round low loafs before my wife switched to 2/3 recipe and a cast iron tea pot to give the loaf some height.

3. Definitely preheat the pot (without the lid). We tired once with a cold pot and the bread stuck to the pot and did not want to come out. But with a hot pot and a little corn meal tossed in before the bread, we have no sticking.

4. My wife now mostly skips mini-knead and second rise step. She lets it rise for as long as 24 hours in winter when our house is cold. Then while the pot is preheating in the oven she'll punch the bread or move it around a little inside the rising bowl if it looks too gassy.

5. As some versions of the recipe state, the hardest part is waiting for the bread to cool for one hour after de-potting. The author says this is essential and we haven't broken the rule yet.

Bottom Line

Try it - you'll like it! We liked it so much we bought the book after first borrowing it from the library.

Tanning Salons

“To be successful, keep looking tanned, live in an elegant building (even if you're in the cellar), be seen in smart restaurants (even if you nurse one drink) and if you borrow, borrow big.” -
Aristotle, Ancient Greek Philosopher

A brief note today based upon the Consumerist story Indoor Tanning Quadruples Risk Of Skin Cancer. A new study from the American Association for Cancer Research has determined that frequent use of tanning beds can quadruple your risk of skin cancer. An estimated 30 million Americans visit tanning salons each year and unknowingly(?) endanger the future health of their skin.

A (student?) paper published by Vanderbilt University compares the claims of the Tanning industry vs health professionals. The Tanning Salons say they are safer than sun by using mostly UV-A rays which cause tanning and much less UV-B rays which cause sun burns. UV-A is safe they say. Doctors disagree. UV-B damages just the top of the skin but UV-A goes down deep and can cause damage that will last for a lifetime. Including cell injury that causes wrinkles, tumors and cancer.
And despite Industry safety claims, a study of teenagers in Sweden found that 44% of the participants reported a sunburn from a visit to the tanning bed. 23% of the sunbed users reported skin diseases such as eczema, psoriasis, or acne compared to only 16% of the students who did not use sunbeds.

According to the Consumerist, the FDA is considering banning teens from tanning beds; teenage girls and young women are the largest users of tanning salons.

Bottom Line - Warning Signs of Skin Cancer

Early detection offers your best chance of surviving skin cancer. Here are some signs to look for:

•A skin abnormality that increases in size and appears multicolored, pink, red, black, brown, tan, pearly, translucent, or tan.

•A mole that changes color, textures, grows, becomes irregular in shape, or that is bigger than a pencil eraser.

•A spot or growth that continually itches, hurts, becomes crusty, scabs, or bleeds.

•An open sore that does not heal after 4 weeks or one that heals and reopens.

Regular skin self-exams could save an estimated 4,500 lives annually. Anytime you are concerned about a growth or spot on your skin, it is best to seek the advice of your physician.

Sciatica

Migraines one day, sciatica the next. – from the movie Amelie

Since I appear to have a medical theme this week, I’ll keep the theme going with something I knew nothing about when it happened to me a dozen years ago. I had incredible pain in my left leg which was worst when sitting; the only thing that lessened the pain was lying down. I kept hoping it would go away but an acquaintance of my wife thought it was “sciatica” and recommended I see a doctor.

The sciatic nerve is the largest nerve in the body and begins at the spinal cord in the lower back and extends through the buttock and down each leg to the feet. When the nerve is “pinched” or squeezed in the lumbar region of the back, it sends pain signals down the limb. And oh what a pain it is! The usual cause for a pinched nerve is a herniated disc in the spine; the disc ruptures and cartilage oozes out pressing against the sciatic. Less common is pressure from a tumor, infection, or internal bleeding; injury and inflammation; or irritation from rubbing against a nearby bone spur or muscle.

The initial prognosis was bed rest, pain killers, and a cortisone shot to shrink internal swelling; i.e. the classic “take two aspirin and call me in morning”. This is effective for many and the pain subsides within 12 weeks. But a doctor is just guessing unless they see an X-ray, CT scan, or MRI scan to check for internal damage. My X-ray showed I had a marble sized herniation from a disc low in my back. This made the doctor extremely nervous because with enough pressure, the sciatic could be permanently bruised or damaged; rending me paralyzed below the waist. I was rushed to surgery within days and felt wonderful afterwards (that is after six weeks of recovery for the muscles in the back to repair themselves from the incision.)

Without surgery, treatment for sciatica is limited to what you might do for any pain – take a pain killer and apply heating pads or ice packs. Lie down and rest or go walking (whichever works for you.) After my surgery I was prescribed Physical Therapy which helped. I have very tight calf muscles and stretching exercises helped release pressure. There were also exercises to strengthen the back muscles.

Bottom Line

Sciatica is not usually a medical emergency. At least not until the sciatic nerve is under severe and damaging pressure. If you experience difficulty with bowel or bladder function, decreased sensation around the genitals, or progressive leg weakness or numbness contact your doctor or go to the emergency room immediately. These are the warning signs that paralysis is pending.

Web Sites

http://www.medicinenet.com/sciatica/article.htm
http://orthopedics.about.com/cs/backpain/a/sciatica.htm

Nocturnal Leg Cramps

“For this, be sure, tonight thou shalt have cramps, side-stitches that shall pen thy breath up”- William Shakespeare, The Tempest

This morning I was awoken by a painful leg cramp. It’s an odd feeling to have one or more muscles do their own thing and completely disregard what you want. So what causes nighttime leg cramps and what can you do about it?

Nocturnal leg cramps are true cramps and not spasms. The muscle remains in a cramped and contracted position, which accounts for the intensity of the pain. If you touch the affected region, you may be surprised to discover that your muscles feel very hard, almost like concrete.

Leg cramps usually occur in one of the calf muscles, below and behind a knee, but painful cramps can also occur in the feet, ankles, shins, and big muscles of the thigh (quads). It can be caused by diabetes, hypertension, fibromyalgia, and as a side effect to some medication so if you have frequent cramps, see a doctor to discover if any of these apply. For instance, my wife experiences terrible muscle cramps when taking a statin to lower cholesterol.

There is some evidence that cramps are also caused by a chemical imbalance in the body - some say potassium and recommend bananas, etc.; others magnesium and swear by a nightly dose of Milk of Magnesium; for some a 1/4 cup of pickle juice or vinegar does the trick or Tums for a dose of calcium. Other studies say dehydration is the cause and a glass of water helps.

Tips to Relieve a Cramp

• Pull your toes back towards you (don't point them).
• Try putting your foot on the floor and lean forward to stretch a calf cramp.
• Apply a hot compress to the cramp or take a hot shower/bath
• Massage the cramped muscles

Bottom Line

The most common treatment to prevent leg cramps in bed is stretching exercises. Regular stretching of leg muscles, especially those in the calf, is effective. You should also examine your sleeping posture. If you sleep on your back with tight fitting sheets then your toes are forced to point downwards, compressing the calf. When something triggers the calf to compress even further, there is pain.

Update: June 9

The NY Times has an article today on a similar subject:
Phys Ed: Can Pickle Juice Stop Muscle Cramps?

The conclusion of a scientific study is yes. But no one knows why. The pickle juice or vinegar works within a minute - far too fast for the juice to leave the stomach or enter the bloodstream.

Web Sites

http://www.dummies.com/how-to/content/nocturnal-leg-cramps-nighttime-calf-muscle-pain.html
http://www.buzzle.com/articles/leg-cramps-in-bed.html
http://www.patient.co.uk/health/Cramps-in-the-Leg.htm

Egads, a wart!

“Most journalists are restless voyeurs who see the warts on the world, the imperfections in people and places. gloom is their game, the spectacle their passion, normality their nemesis.” – Gay Talese, author

What’s a wart? A wart is a skin growth caused by a human papillomavirus (HPV). Warts can spread but are not highly contagious. Don't pick at a wart, and wash your hands after touching a wart. Keep hands and feet dry as warts thrive in moist environments.

Common warts come in a variety of shapes and names depending on the infected body part:

* Dome shape warts on backs of hands, feet, and knees
* Plantar warts on the bottom of feet can make standing painful. See a doctor.
* Flat/plane warts on face and legs
* Periungual warts near or under nails
* Filiform warts on stalks on the face
Note: genital warts are different from common warts and caused by a venereal disease. The treatments below do not apply to genital warts and you should see a doctor.

Treatments

Salicylic-acid can be applied in drops, gels, pads and plasters to dissolve the wart (slowly) over weeks or months. The acid also affects skin so apply with care. If the surrounding skin becomes raw take a break from the acid treatment and let the skin recover. For best results file dead skin off the wart and then soften it by soaking in warm water before applying acid.

Freezing – there are over-the-counter aerosols that freeze at -70F and liquid nitrogen used by doctors at a super cold -320F. I once had a toe wart that survived months of acid but died in one application of liquid nitrogen.

Duct tape? – a popular home remedy that might actually work. Apply duct tape to the wart, keep it in place for a week, remove it, soak the wart, and pare it down with a filing (emery) board. Just like Salicylic -acid you’ll repeat this for months and must halt for awhile if the surrounding skin becomes red and soggy.

Surgery – for super stubborn warts a doctor may use a laser or scalpel but this can be painful and leave a scar.

Bottom Line

Sometimes a Wart is not a Wart. It’s a cancer. See a doctor if:

- the wart is anywhere on an infant
- the wart becomes red, swollen, or painful to the touch
- the wart oozes a discharge or bleeds

Web Resources
http://www.medicinenet.com/warts_common_warts/article.htm
http://www.drdaveanddee.com/warts.html (on duct tape)
http://www.warts.org/wart-removal.html

Sunscreen is bad?

“Even if you've been fishing for 3 hours and haven't gotten anything except poison ivy and sunburn, you're still better off than the worm”

Is there nothing safe in this world? A recent story on aolnews.com reports on the dangers of Sunscreen. Personally I use a lot of high SPF sunscreen because I burn quickly. But while sunscreen is protecting us from sunburn it may increase the risk for skin cancer.

Claim #1 - very few sunscreens (39 out of 500) block UV-A rays which penetrate the epidermis and damages living skin cells. Sunscreen does stop the UV-B rays which causes sunburn so we think all is well and stay out in the sun all day; not burning but damaging the lower skin layers. See my posting on Sunburn for more details.

Claim #2 - many sunscreens contain vitamin A for skin rejuvenation. However vitamin A may also stimulate tumor and cancer growth.

Claim #3 - Sunscreens may contain the hormone-disrupting chemical oxybenzone, which penetrates the skin and enters the bloodstream.

Claim #4 - you can protect yourself from claim #3 by switching away from chemical sunscreens that enter the skin, to mineral based ones that sit atop the skin and reflect light. However there is a possible health risk here too. The new trend in titanium dioxide sunscreen is nano-sizing the particles but this raises the risk the metal will be absorbed through the skin.

Claim #5 - The SPF values listed are exaggerated. It's like a bidding war - the lotion with the highest SPF wins. The FDA has asked for a cap at SPF 50 because beyond that the numbers are meaningless. But there are products with SPF 80, 90 and 100 being sold.

Claim #6 - most people apply only 1/4 of the "recommended" amount of sunscreen and so get at best 1/4 of the rated protection (which is itself exaggerated).

Bottom Line

The ideal sunscreen should completely block the UV rays that cause sunburn, immune suppression and damaging free radicals. It should remain effective on the skin for several hours and not form harmful ingredients when degraded by UV light. Unfortunately no sunscreen in America satisfies all these criteria.

So is sunscreen all bad? No says the annual report of the Environmental Working Group (EWG) which raised the concerns above. EWG believes the benefits of sunscreen out way the harm. But they want you to be aware of the side effects, choose your sunscreen wisely, and don't rely on it 100%. The best protection is still a hat, light clothing, and shade.

Barrett’s esophagus

"I would like to find a stew that will give me heartburn immediately, instead of at three o clock in the morning." - John Barrymore, actor

Barrett’s esophagus is a condition in which the tissue lining the esophagus, the tube connecting the mouth to the stomach, is replaced by tissue similar to the lining of the intestine due to frequent exposure to stomach acids from Acid Reflux (see GERD). Barrett’s esophagus affects about 1% of adults in America; most commonly older, white, males. A small number of people with Barrett’s esophagus develop a rare but deadly type of cancer.

Barrett’s esophagus can only be diagnosed using an upper gastrointestinal (GI) endoscopy to obtain biopsies. After the patient is sedated, a doctor inserts a flexible tube (an endoscope) with a light and miniature camera down the throat. If esophagus tissue looks suspicious, several small pieces are removed using the endoscope. A pathologist examines the tissue with a microscope to determine the diagnosis.

If you’re told you have Barrett’s esophagus, here are some questions from the Mayo Clinic to ask your doctor

■Does my pathology report show dysplasia (i.e. cell change)? If so, what is the grade of my dysplasia? High-grade dysplasia is thought to be the final step before cells change into esophageal cancer.
■Were my biopsy samples examined by a gastroenterological pathologist? Did two or more pathologists agree on the diagnosis?
■How much of my esophagus is affected by Barrett's dysplasia?
■Will I need to undergo another endoscopy exam to confirm my diagnosis?
■What is my risk of esophageal cancer?
■What are my options for reducing my risk of esophageal cancer?
■What are my treatment options for Barrett's esophagus?
(Removing damages cells via endoscope or surgery, using heat or light to kill bad cells)
■What are the benefits and risks of each treatment option?
■Do I have to have Barrett's esophagus treatment? What happens if I choose not to have treatment?
■Should I see a specialist? What will that cost, and will my insurance cover it?
■Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?

Bottom Line

Fortunately the odds of cancer from Barrett’s esophagus is less than 1% per year. However it’s not uncommon for esophagus cancer to show no new symptoms not already experienced with GERD. By the time it’s detected through symptoms alone, the cancer is advanced and untreatable and leads to death. Late stage symptoms include difficulty swallowing, vomiting red blood or blood that looks like coffee grounds, passing black, tarry or bloody stools.

Persons with a history of GERD over many years should be examined via GI endoscopy. And if Barrett’s esophagus is diagnosed, schedule an annual GI endoscopy to look for cancer. Also change your lifestyle to minimize the occurrences to GERD to avoid damaging more of the esophagus. See my post on GERD for more details.

Resources

http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/
http://www.mayoclinic.com/health/barretts-esophagus/hq00312
http://www.gicare.com/diseases/barrett-esophagus.aspx
http://en.wikipedia.org/wiki/Barrett

Ten Worst Money Mistakes Anyone Can Make

"Money get back,
I'm alright Jack keep your hands off my stack."
-lyrics to Money by Pink Floyd

FreeMoneyFinance.com says there is just one rule to managing your money:
Spend less than you earn over a long period of time

While this is great advice, you can still lose your shirt by making one these Ten Worst Money Mistakes.

1. No Emergency Fund
Things happen; the washing machine breaks, car needs repairs, kids need braces, and so on. Borrowing money to pay for life’s emergencies will just put you deeper in debt. Protect yourself by keeping six months of living expenses in a SAFE place. Safe means not in stocks or any investment that can lose value suddenly. CDs are nice but the money is locked up for months or years. I keep six months in a savings account. It earns peanuts but it’s always there if I need it.
Corollary: if you use your emergency fund, pay it back ASAP.

2. No Will
57% of Americans have no will, including 69% of parents with kids under 18. If the parents die the State will decide how the money is allocated.

3. Not Enough Insurance
Insurance is the ultimate emergency fund for really big events like the total loss of your house or car. Consider also an umbrella policy on your house that covers lawsuits and liability like someone slipping on your icy sidewalk. Our umbrella policy paid off when a small leak was found in our underground oil tank.

4. Marrying the Wrong Person
Marry someone who agrees with your money style. A miser and a spendthrift are incompatible and divorce is expensive.

5. Not Saving
Put away at least 10% of each paycheck for future expenses like a new car, college tuition, vacation, etc. Don’t borrow for these big ticket items. The only item that is just TOO big to save for is a new house.

6. Too much house
Speaking of houses, don’t buy more house than you can afford. Don’t count on overtime or a future raise to pay the mortgage. Put as much money down as you can, say 20%, and aim to pay off the loan within ten years. The interest on a 20-30 year loan is a monster. My parents bought a $70,000 home but the total mortgage payments over 20 years would total $240,000.

7. Waiting to Invest
Don’t wait for a “good time” to invest. I’ve had stocks plunge to half their value and thought they would never recover. But they did. The NY Lottery (which I don’t recommend) says you have to Play to Win. Likewise you have to invest to make any gains.

8. Being in Debt
Debt eats your money. The goal is to earn interest and make money, not pour it down a hole to make someone else wealthy.

9. Not maximizing your Career
Your job is where you’ll earn most of your money. Even a small raise in pay will accumulate over the years to a nice amount. Work hard and get paid what you’re worth.

10. Over Spending
This violates the prime directive (spend less than you earn) and is a sure way to go into debt. Everyone says, “I don’t earn enough”, but in reality it’s how you spend, not what you earn that makes a difference. Boxer Mike Tyson earned $300 million in his career, but it wasn’t enough for his lavish lifestyle. He filed for bankruptcy in 2003, owing $27 million.

Bottom Line

Check out the full article at Ten Worst Money Mistakes Anyone Can Make. It contains dozens of useful links for Estate Planning, emergency fund planning, Insurance planning, etc, contained within the story.

Hungry?

"Mamma mia,
that's-a spicy meat ball"
- Alka-Seltzer ad

After yesterday's meaty facts, I present an ultimate meat dish, the 100 layer lasagna with 50 layers of sauce and 50 layers of noodles. NY Magazine describes it this way:

Each 80-portion pan has to go into the oven by 1:30 P.M. every day. Otherwise, it doesn’t have enough time to cool and coalesce by dinner and completely collapses when you try to slice it. It takes three kitchen stations and many hands to put it together. Skewers hold it in place while it sets. You need a special spatula to serve it.

Available at Del Posto in NYC.

Bon appetit!

Meaty facts

"June is bustin' out all over!"
- lyrics, Oklahoma!

Not much time today so I'll point you to Men's Health article on 10 Meaty Secrets Revealed.
Just what is meant by the claims of...

"Air Chilled"
"Free Range"
"Raised without Antibiotics"
"Organic"
"No Retained Water"
"USDA Choice Beef"
"Product of USA"

Bottom Line

Food claims are tricky and frequently not what you expect. For example, beef can be a "Product of USA" if raised and fed in China but butchered in America. Never trust claims on packaging.