It’s not entirely clear how cannabis hyperemesis syndrome occurs though there are several theories. One is that since cannabinoids have long-half lives and are lipid soluble, they accumulate in the brain and over time cause symptoms, particularly in young people who may have genetic variations in enzymes which lead to further accumulation. Another theory is that there is a thermoregulatory and autonomic imbalance in the limbic system caused by chronic use. Other suggestions are that with long-term consumption cannabis becomes a receptor antagonist, or that they become down-regulated or de-sensitised over time. This reverses the antiemetic effect of cannabis. It seems that chronic over-stimulation of receptors leads to dysregulation of the body’s control of nausea and vomiting, leading to CHS.
“Some of the best evidence for the role of exercise in maintaining weight loss comes from the National Weight Control Registry, an online group of over ten thousand men and women who have lost at least thirty pounds and kept it off for at least a year. These folks defy the cynical view that meaningful, sustainable weight loss is impossible. The average Registry member has lost over sixty pounds and kept it off for more than four years. They are truly exceptional…Nearly all of them (98 percent) report changing their diet to lose weight, which makes sense given how diet can affect the reward and satiety systems in our brain and impact how much we eat.”
It took a while for me to find the manila folder hanging somewhere in one of my file drawers. Surprising because I have a lot less paper files gathering dust in hanging folders. I know it’s here but where? Ah, there it is… Desk 2 south of the tax files, north of my paper life insurance policies. I am participant number 8784.
The National Weight Control Registry (NWCR) was established in 1994 by Rena Wing, Ph.D. from Brown Medical School and James O. Hill, Ph.D. from the University of Colorado. This study is the largest investigation of long-term successful weight loss maintenance. Few individuals succeed at long-term weight loss. The NWCR was developed to identify and investigate the characteristics of individuals who have succeeded at long-term weight loss. The NWCR is tracking over 10,000 individuals who have lost significant amounts of weight and kept it off for long periods of time. http://www.nwcr.ws/
I started sending data to this study in 2007. Most years I get one annual survey. Occasionally I’ve received and completed a number of smaller supplemental surveys. I am 8784 and have kept the weight off for nearly 50 years. Since the Great Melt of 1975 I’ve cycled between 163 and 205 pounds. For the past decade I carried 200-205 pounds on my 5.10 frame. During the first year of the pandemic I dropped 25 pounds (again). Currently I’m holding around 170.
I am exceptional but you can be exceptional too. 8784 signing out.
Andel’s suggestion to anyone contemplating retirement: “Find a new routine that’s meaningful.” He points to people living in the Blue Zones, regions of the world that have been identified to be home to a greater number of residents who’ve reached the age of 100 and beyond. One of the common characteristics among Blue Zone inhabitants is, says Andel, “these people all have purpose.”
In this post, Julie Zook and I sit down to discuss some key headlines of our recent co-edited book, The Covert Life of Hospital Architecture, which was published open access with UCL Press on 22 March 22. Health as social, hospitals as social We conceived The Covert Life of Hospital Architecture in late 2019, just […]
The incidence of TIA in the United States is estimated to be 200,000-500,000 per year, with a prevalence of 5 million individuals, but is likely underreported.2 Stroke is preceded by TIA in 12-30% of patients and is the 5th leading cause of death in the US, contributing significantly to long term disability.2,3 Strokes occur more commonly in men than women, but women experience more severe morbidity.2,3 Stroke prevalence increases with age and occurs more frequently in black and Hispanic populations.3 It should also be noted that 90% of strokes worldwide occur in the setting of potentially modifiable risk factors which presents an incredible opportunity for early intervention, especially following TIA.2
Way back in the Dark Ages I borrowed a total of $8000.00 and worked summers and during the school years to pay for my college education. It took me ten years of payments at $69.72 a month to pay the loan off. I promised myself no matter the hardship my own children would not borrow money for their undergraduate degrees (medical school different story). There were reasons why I drove a 2006 Ford Taurus for 15 effing years.
One of the joys of aging is you get to a point where you say what you want to say and the hell with everyone else. Charles Hugh Smith is one of us who possess critical thinking skills and will always tell it like it is. Check out his blog.
And this is a perfect time to remind all of my readers that the opinions expressed in this and my other blog are mine alone and do not represent the views of any corporate entity that I may or may not be involved with either in the present or past.
I’ve finished looking at the newspaper. Afterwards, I started browsing my RSS feed and for some inexplicable reason I read an article on whole bowel irrigation at https://emcrit.org/toxhound/the-purge/.
Memo to My Life Underwriting Colleagues:
Retire before you get to this point in your career. Reading articles like this will not facilitate advancement in your chosen profession. Get out. Get a life.
#2 Remember naloxone, glucose, and thiamine (NGT) Original: Consider or give naloxone, glucose and thiamine The number of patients presenting with opioid intoxication is growing, and the gentle reversal of patients without severe respiratory depression with naloxone is in the art of medicine – consider starting with 0.4mg and titrate to effect.
In contrast to empiric administration of glucose in the altered or ill patient, rapid assessment of glucose level with point-of-care testing is recommended.
Thiamine deficiency may be less prevalent than previously thought in intoxicated patients, but we now know that giving 100mg of IV thiamine can benefit other malnourished patients, including those with calorie-malnourishment from cancer, gastric bypass, hyperemesis gravidarum, and eating disorders. Personally, I use the ‘T’ of ‘NGT’ to remind myself not to miss alcohol withdrawal.
Why does this matter? I hear you thinking we underwrite life insurance, we’re not doctors. So true. But if we think like doctors we will get better at what we do by recognizing the subtleties buried within the medical charts we read. Here’s what my eyes/brain picked up.
The bold in the excerpt above are mine to illustrate how the mind of a mortality risk expert works. In Emergency Department records pay attention to the initial treatments provided which in some cases hints to a serious condition impacting mortality. Naloxone and opioids are obvious. But would you have associated the administration of IV thiamine to malnutrition or alcohol withdrawal? I thought so.
So read and research widely. You’ll always find little jewels to improve your skills and to impress your friends with. Or in my case to make Dr. Lee think his old man knows more than he actually does.