Category Archives: medical

Still mortal (after all these years)

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Screenshot anime Hanada Shounen Shi.

Give me immortality or give me resurrection! Death is not on my wishlist at all. Unfortunately, it won’t always be up to me.

“My goal is to be immortal. So far, so good.” Uh, about that…

I am double-vaccinated against COVID-19, but I can still get cancer. And probably have, but we’ll know more about that by the end of August at the earliest. But when I saw the patch of red, scabby skin on my face had grown a new little blood vessel, I did not tarry overlong requesting a doctor appointment. Angiogenesis – the creation of new blood vessels – is not something bacteria or fungi can do, but cancers do this routinely as they mature, because without extra blood supply their growth is limited. So yeah, probably cancer this time, or at least a precancerous growth. Which sucks, but not as much as it did a couple of generations ago.

When I was a kid, the word “cancer” was pretty much a death sentence. But that is no longer the case, especially with cancers that are easily detected, like basal and squamous skin cancers. (This is probably one of those, if it has even advanced to the cancer stage at all.) Today, the greater risk for me is the simple and streamlined structure of Norwegian public health care (which is almost all the health care we have, except for a booming beauty industry).

***

Norwegian health care: Each person is assigned a regular doctor, called “fastlege” in Norwegian. Unfortunately this has nothing to do with the English words “fast” as in speedy, but rather means fixed, immovable doctor. (They can be replaced though, but it is a procedure.) Mine has been looking out for me for many years, most lately by gambling on me getting vaccinated in a far-away location without getting infected along the way. So I’m fine with the system in general. But doctors need a vacation too. Regular doctors, specialists, all kinds of health personnel celebrate the short Norwegian summer by taking a month or so off. Last time I was suspected to have cancer (false alarm, yay) I had to wait a couple of months for further investigation because of summer vacation. This time I am only waiting 1 month for my regular doctor, but of course it feels longer.

After seeing my doctor, he will hopefully apply for an appointment with a dermatologist. (Ideally my local doctor would remove the skin lesion first, but that may be too much to hope for.) Then a couple more months (possibly more since people have stayed away for 18 months during the pandemic). Hopefully the dermatologist will remove the thing and get it checked for cancer. I would like to have this done before Christmas, but again, there is likely a backlog from the pandemic. And I guess I have contributed to that, so fair is fair.

Generally, our health care has two lanes: Emergency and everything else. Cancer is not an emergency, at least not until it is too late. So it is perfectly normal for people to wait for months to diagnose and remove a small cancer, and then have a fortune of tax money spent trying in vain to get rid of all the metastases that were created during the wait. This may not be perfect, but it is simple and streamlined, the way we like things here in Norway. It wouldn’t be like this unless the people wanted it this way, what with us having a pretty effective democracy as such things go. A small downside of our current democracy is that dead people don’t vote. (Unlike what I hear from some other countries.) So if some feature causes people to get removed from the voting pool, those who suffered from it will not be around to vote against it.

***

Well, it is not like I was in doubt about the mortality of my flesh before. I am that age after all, where I could live another thirty years or another thirty seconds. You have to get used to it. “All flesh is grass” a better prophet than me once said. But episodes like this one remind me of the unofficial motto of the Chaos Node: “We must say all the words that should be spoken, before they are lost forever.” And I wonder if I have done that. Probably, and then some. But as long as you live, there are new things to learn.

COVID-19: Sing alone, if at all

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Screenshot anime MomoKuri

“I’ve disinfected my hands.” Unfortunately, disinfecting your hands may not be enough, or even the most important thing this time.

The COVID-19 pandemic has entered its second wave here in Europe. In much of the Americas and some other parts of the world, the first wave is not even over. Ironically, a vaccine seems to be only a few months away. If only we could keep it away a brief time longer!

At least we know more about how it is transmitted now. Or at least some of us know. So I thought I should say a few words about that. (A few words, hah.)

When the pandemic was new, we were in the strange situation of having its entire genome but not knowing for sure how it spread. This has never happened before, and it may have caused some of the jumping to conclusions that made the first wave so bad. See, the genome showed that the virus was fairly closely related to the original SARS virus from 2002. In fact, the new virus was named SARS-CoV-2 and still is. So it seemed a reasonable assumption that it spread similarly. Not quite the same way obviously, but perhaps that way too.

The original SARS was infamous for spreading by indirect contact. Its first “shock and awe” episode was when several people died after touching the same elevator button as a patient. As a result, some of the first advice was to wash your hands thoroughly and for a long time with soap, disinfect door handles and other shared surfaces, and not touch your face. (Leaving alone the stupidity of telling people to not touch their face, which even the health advisors continued to do at the press conferences where they told people not to do it, it is actually only the eyes, nostrils and mouth that needs avoiding even with surface contamination. Unbroken skin is very resistant to virus infection, even when it is thin.) People were also encouraged to wash perishable food (but not with chemicals!) and disinfect packaging, and let non-perishables stand untouched for three days to let the virus die.

Today we know that while this “hygiene theater” is mostly harmless, it is also mostly useless when it comes to COVID-19. The virus is mostly airborne, and resides in droplets that come out of people’s mouth and occasionally nose. Larger droplets fall to the ground after a distance of around 6 feet or close to 2 meters. But it has gradually become necessary to admit that a main pathway – perhaps THE main pathway – of transmission is aerosols,  or micro-droplets if you will use a more understandable name. These are so small and lightweight, they can float in he air for hours. And they are expelled even when breathing, particularly through the mouth, even more so when breathing heavily or talking, very much when talking loudly, and excessively when singing.

The great “shock and awe” episode of COVID-19, at least in the western world, was when a large part of a choir died after singing together, despite keeping the recommended distance and not facing each other. Similar but lesser episodes have happened elsewhere, among other places in Sweden where a local outbreak started after a song gathering. Here in Norway, a severe outbreak started in a Muslim community and spread to many schools after a festival.

Unlike some virus, the severity of this one seems to depend somewhat on how much virus you inhale, if you have a functioning immune system at all. Inhaling just a few virus seems to not cause infection at all in most, while inhaling a small dose will usually cause a mild disease except in the very old or sickly. Conversely, health workers who are exposed to massive doses of the virus often get critically ill and sometimes die, even when young and healthy.

In this situation, you would expect teachers to die like canaries in a coal mine, given how ubiquitous singing is in especially primary school. But there is one thing that comes to their rescue: The amazing ability of children to infect everyone around them with every germ that comes to town.

A Swedish study showed that in a control group who had not had COVID-19, about 1/3 still had T-cells that reacted against the virus. It is believed that these had been exposed to other corona-virus which cause common cold. (Please note that there are many different virus that cause “common cold”, which is merely a set of symptoms and not a particular species of virus.) There are at least four common colds that come from corona-virus, the latest one having split from bovine corona-virus around 1880. It is possible that the current pandemic will eventually join this crowd and become a recurring but mostly harmless cold, but for now it must be taken much more seriously. The good news is that most kids and their teachers probably have some resistance to it already because they have been exposed to related virus.

That said, if at all possible, singing should be suspended for the duration of the pandemic, or until a vaccine or effective treatment is widely available. Locales should be aired as much as feasible, and any activity that can take place outdoors should do so. Outdoors, the micro-droplets will rapidly disperse: Even if there is no breeze, convection and Brownian motion will quickly remove them from face height. This would explain why the large demonstrations in many countries this summer had minimal effect, while weddings and birthday celebrations are pure murder, since they tend to be held indoors in whole or in part.

For more reading, not by me, Elemental has an article on this topic, partly overlapping with mine but with a different focus: The most likely way you’ll get infected with COVID-19

COVID-19: Be like Norway, maybe?

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“Be like Sweden” they said. “It will be fun, they said.” (Image from the Swedish course on Duolingo.com.)

Since I am still alive (surprise!), I should probably write this. It is still a time of confusion for many, and a time of uncertainty even for me. How long I shall remain in the world of forms is literally up in the air. But at least I am still alive as of writing this. And living in Norway may be a big part of that.

“Be like Sweden” say homemade banners from people who are not usually big fans of the Nordic social democracy. Social Democracy is generally grouped with Socialism among those who have no education in the field beyond hearsay and rumors. So what did Sweden do to summon forth this sudden love? It allowed a few thousand people to die for the economy, it seems.

I should make it clear that we are not talking about “Hey, we have too many old people here, let’s kill some of them off for the good of all of us, except the ones who are dead.” Nope, nothing like that. More like “Some of you are going to die, probably, but that is a sacrifice I am willing to make.” Obviously, with COVID-19 being a brand new disease, nobody knew for sure how many might die, but optimism prevailed. It was thought that children were immune and also could not spread the virus, and that maybe 95% of those infected never developed the disease at all, or not beyond a common cold. Hey, seriously, people believed that for a while. So much like any drunk driver, Sweden took the chance that it would probably be fine. Well, they were kind of right, in that only 5000 have died so far (officially at least) out of 10 million. Of course, those who died might have seen it in a less positive light.

My native Norway, Sweden’s smaller brother to the west, was || this close to taking the same path. But our female Prime Minister chickened out and slammed the emergency brakes. As a result Norway could open up again around the time Sweden realized that things were not really going as well as expected.

***

On March 12, the Norwegian government declared the most severe restrictions in peacetime ever. (Arguably the most severe ever, since we’ve only been in war once after our independence in 1905, and then it was the German occupation force that introduced the severity.) Schools and kindergartens were closed down, as were one-on-one services like hairdressers or physical therapy; gatherings of more than 5 people outside the household were forbidden, and travel was severely restricted even inside the country while the borders were closed almost completely. Health personnel were forbidden from leaving the country, and others who crossed the borders were required to quarantine on return.

Groceries and supermarkets were kept open and it was made clear that they would remain so. This prevented most of the hoarding seen in some other nations. Actually, my local supermarket had a sale on toilet paper at the time when lack of toilet paper was a recurring headline in many other countries. There was some extra sale of dry and canned food. (I had shopped that a month or two in advance, since it was glaringly obvious already in January that the pandemic would hit us like a giant wave.)

I had also worked from home for a while when the order came for all office workers to work from home wherever possible. Mass transit was ordered to leave every other seat marked as unavailable. Like that would be enough, as one person sneezing in a bus will reach at least half the bus if not all of it. Data so far imply that mass transit has been the main scene of transmission along with shared workspace, so sending most office workers home was probably the single most effective move, far more than some of the more draconian restrictions.

By the end of April, the first wave of the pandemic was fast receding in Norway, and society began to open up.

***

The re-opening of Norway started with kindergarten, as one could expect since it is quite rare to have stay-at-home parents here, of either gender. If you’ve ever seen pre-school children awake, you probably can imagine what having them around would do for productivity at the home office. Even grade school kids tend to get restless pretty quickly if they don’t get attention (especially if they don’t have the good luck to be born introverts). So a week after their smaller siblings, the first four grades of primary school were off to class, followed by the rest in early May.

Also in early May, gatherings of up to 20 people were allowed, or 50 for formal gatherings in public spaces. Recommended distance was lowered from 2 meters (yards) to 1.

In May, the rapid fall in new infections stopped and the disease stabilized on a very low level, typically 10-20 new cases registered per day, in a population of 5 million. For some reason everyone seems happy with having rolled the boulder almost to the top of the hill and leaving it there, ready to roll all the way back down again, rather than end the threat more definitely. One reason for that can be seen by looking over the border to the east: Neighboring Sweden still had a raging epidemic, even though the top of the first wave had been passed even there. The top was far higher though, and the decline slower. Eradicating the disease in Norway was perhaps pointless if anyone sneaking across the border could set it off again from the start.

***

It is now late June, and contrary to my expectations, we have not had a second wave. The number of infections has increased marginally, occasionally rising above 30 new cases per day. We also know that there are some unregistered cases, because we get new patients who have no idea where they were infected. There are probably some asymptomatic carriers, or people with so mild symptoms that they can’t be bothered to get tested, as well as people who avoid health personnel or anything resembling government for personal reasons. The testing capacity is far, far higher than needed, although there are occasionally unnecessary wait times for results. Mostly just a couple days though.

Norwegians have been encouraged to vacation in Norway, meaning evidently that they are supposed to travel to other parts of Norway on vacation instead of staying at home as would be the sane thing to do. Now they are going to throng together at the popular tourist spots (one of which is right here where I live) and we can expect local outbreaks.

***

Speaking of local outbreaks, one reason the topic came to mind again was that a shop worker sneezed right by me this past Friday. Nobody here wears face masks – by ancient tradition, only criminals wear masks outside certain parts of hospitals – so now I’m waiting to see whether I got COVID-19 or not. A bit of excitement in everyday life, since I’m in a couple risk groups. That said, there’s been like 1 registered case in this province so far in June, so if I get COVID-19 from this episode I think we’ll have to chalk it up to Divine intervention. Which admittedly seems to play a pretty big role in my life, looking back on it, but usually for the better. Starting with the amazingly great fortune of being born into Norwegian citizenship, which is already like winning a lottery.

Mighty judgment coming

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Sceenshot anime Tokyo Mag 8

In the anime “Tokyo Mag 8”, a girl writes an angry text, wishing that the world would just break. Right after she sends it, the city is hit by a devastating earthquake. Even in the anime, she is not the reason for the disaster, but it still has to feel pretty bad looking back on it.

I live in Norway, but most of my online friends and acquaintances are American. Among the Democrats there circulate some “funny” memes like “Godzilla 2020” or “Giant Meteor 2020”. The meaning behind this is that even a horror or a natural disaster would be better than the current Trump administration.

Rejoice, then, for your cries have come before the ears of the LORD. A new coronavirus has emerged that preferably kills elderly men, although it will attempt to devour also others who are elderly or sick. It seems to leave children and the young mostly untouched, so far, and is rarely severe in those under 40 and rarely (so far) deadly in those under 60. When this spreads in the USA, it should thoroughly decimate the Republican voter base, where the elderly and men in particular are over-represented.

Are you happy now? Of course, as such things go, it won’t spare your own friends and relatives, or yourself if you are in the risk group. But at least it is a more “surgical strike” than the disasters you mockingly invoked.

(I should probably note here that of course I don’t literally believe American Democrats have some kind of divine backchannel that lets them unleash death on the patriarchy. Just that, like the girl in the anime, it is not really something I think they will be happy about when looking back. Not that they don’t sincerely think of the current government as a disaster, since thousands of real lives could have been saved if the US had a Europe-style health care system. So it is easy to think that the wealthy old men presiding over the system could deserve to taste their own medicine, or lack thereof.)

Now you may say that I’ve grown bitter,
but of this you may be sure:
The rich have got their channels in the bedrooms of the poor,
and there’s a mighty judgment coming…
but I may be wrong.
You see, you hear these funny voices, in the Tower of Song.
-Leonard Cohen, Tower of Song.

I don’t look forward to this one myself either. I’m 61, with moderate exercise asthma and paroxysmal atrial fibrillation. I’m in the “maybe die, maybe struggle for breath a couple weeks” category. My brothers are all older than me, but seem to be in better health, long may it last. Whether any, some or all of us will survive this year is all up in the air now. More than usual, I mean.

It may still not be too late to make a vaccine and distribute it, but there probably isn’t enough time to prevent at least some degree of disaster. The latest reports from China say that the virus incubates for up to 14 days, but transmits during part of that time. That means screening at airports is pretty much a waste of time and money – patients with the virus will go undetected for days, go about their lives, interact with friends and families and coworkers and door knobs. This puts the virus squarely in the pandemic class, unlike the previous outbreaks of SARS and MERS which could be quarantined once authorities took them seriously. It is more like the swine flu, only (so far) without the vaccine. And much more deadly.

Looking at the current stats from China, with 56 dead and 2000 sick, it does not seem particularly lethal. Until you realize that those 56 dead are people who were hospitalized when there were 500 diagnosed or less. And of those, there are still some – or many, we don’t know – who are going to die in the days ahead.

The World Health Organization originally wrote it off as a Chinese problem rather than a global one. I hope they are willing to admit their error and allocate any available resources. The virus is already in the United States, there is nowhere in the world it can’t reach from there, and quickly. It is time to hide your kings, presidents, prime ministers and supreme court judges. There’s a mighty judgment coming… but I may be wrong. Let’s all hope so.

Life. Change. Delta waves??

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Sceenshot TED talk change-curve

Change slows down as we age. But not for all of us equally. It seems delta sleep keeps us younger for longer, and we can induce delta waves artificially.

A while ago I watched a TED video with Dan Gilbert which centered on the fact that people poorly estimate their future change. (Not pocket change, but change in values, behavior etc.) A study asked a wide range of people either a) how much they had changed over the last 10 years or b) how much they expected to change over the next ten years. Then they matched the answers by age: The 18 year olds thought they would not change much by the age of 28, but the 28 year olds thought they had changed a lot since they were 18, and so on. This is the focus of the story.

But I noticed the shape of the curve they drew. Three curves actually, but they were very similar for a number of ways in which people change over the course of their life. The change is rapid at first, and declines gradually but with some noticeable steps, then declining greatly in old age. The curve is familiar, but it took me some hours to recognize it, because I had not seen it before, just seen it described in text form. Oh, and I had described it myself too. I often answer basic questions about sleep on Quora, and one of the things I explained was the function of “delta sleep”.

Called NREM stage 3 these days, this deepest sleep is less formally called “slow-wave sleep”, because the brainwaves that dominate the whole brain in this sleep stage are large and slow. The slow, regular brainwaves are called “delta waves” and technically waves below 4 Hz fall in this category. The dominant waves during slow-wave sleep however are usually 1 Hz or less, in other words less than one complete wave per second! They can go as far as 1/3 Hz, where one wave takes 3 seconds.

Despite the slowness of the delta brain waves, the brain is actually doing various useful things. One of them is related to learning. A study shows that people who have been training to learn a 3D maze during the day have increased blood flow in the same brain area during slow-wave sleep, compared to a control group that did not undergo intensive training. Another important thing that happens during this deep sleep phase is the release of Human Growth Hormone. In children this hormone triggers growth, as the name implies, but in adults it triggers regeneration. Basically it keeps us young and healthy.

We know that delta sleep is important, because bad things happen to test animals who are kept away from it. Their learning is impaired, but worse, their immune system is also weakened, and they lose the ability to deal with stress. Eventually they die early. Luckily the body goes very far to recover this type of sleep. If you stay awake for days, the body first recovers delta sleep and also REM sleep, the vivid dream sleep that seems important for memory and sanity. If you become chronically sleep deprived, the body will start running short periods of slow-wave sleep, so-called “microsleep”, while you are awake. Thoughtfully this is done when there seems to be downtime, when nothing particularly challenging is going on. Like at school, at office … or on a long stretch of road. Suddenly 10 seconds are missing from your life. If those seconds should have included some adjustment to the car’s trajectory, they may be the last 10 seconds of your life. So don’t go around missing delta sleep.

***

In babies, delta waves take up much of their sleeping time and some of their waking time. The waking delta fades later in childhood. Delta sleep remains fairly high in teenagers, and may appear in all the sleep cycles. (The first sleep cycle is from falling asleep to the end of the first REM sleep. The later cycles are from the end of one REM period to the end of the next. Each sleep cycle features first a slowing of the brain waves, and later the waves become faster again, until REM – vivid dream sleep – where brainwaves are as fast and irregular as during excited waking activities.) In children and teenagers, the deep delta sleep can occur in all sleep cycles, but is longer in the first cycles. In adults, delta sleep only occurs during the first sleep cycles, and is markedly longer during the first of them. Delta sleep continues to shrink during life, and in the elderly it can cease entirely, especially in men, or occur only some nights and not others.

There is a remarkable parallel between the decline of delta sleep and the complex process we call aging. But is one the cause of the other? Or is there some underlying process that causes them both? This is a very good question. If delta waves keep us young, we could stay young longer by increasing the amount of time our brain spends in delta sleep, or perhaps even in delta waves during waking time, which is rare but possible.

As it happens, there is a drug that can induce delta sleep. It seems to have no serious side effects when used clinically. Apart from the usual conservatism of the medical establishment, there is one big reason why it is not more widespread: It is the best date rape drug on the market. You are not going to get this drug on prescription or walk out of the lab with it in your pocket. All legal sources of the drug are strictly controlled. And as long as humans are the way they are, this is not likely to change, unfortunately. So we won’t know whether people who take this drug regularly live longer and healthier lives, as they would if delta sleep was the “fountain of youth” that some suspect.

And here our story could have ended. But there is another, more cumbersome way to induce delta waves – or any frequency of brain waves that can occur naturally – and I have mentioned it repeatedly over the last few years. It is called brainwave entrainment.

***

Brainwave entrainment means that we use an outside impulse to synchronize brainwaves to a particular frequency. Sound, light and even touch can be used for this, but sound is by far the most common, cheap and convenient. There are several different sound effects that can be used as well. In the beginning, binaural beats were most popular. This is the coolest of the bunch, as you send sound to each ear with a slightly different frequency. The brain starts to resonate to the difference between the frequencies. So you could play back a speech or a piece of music but having altered the frequency slight on one ear, and simply listening to this would gradually induce the specific frequency of brain waves.

Other systems such as monaural beats and isochronic tones exist, and isochronic tones are actually considered the most effective, but they tend to be clearly audible unless masked with other more complex sounds. If you buy pre-packaged sound tracks you will normally find that they have some kind of soundscape like rainfall or other nature sounds that take the edge off the repetitive sounds that trigger the actual entrainment.

At first it takes up to 8 minutes to entrain the brain so that most of the brainwaves resonate to the same frequency across almost the whole brain. With practice this time can be lowered significantly, so that one slips into a familiar frequency more easily.

Brainwave entrainment can happen during sleep or while awake. Because delta waves only occur naturally during sleep, there is a tendency at first to fall asleep when these are induced while you are awake. With practice you become better at staying awake, but that may not necessarily be what you want. Certainly if you use brainwave entrainment as an aid in meditation, then you should practice while you are rested and train yourself to remain awake. But if you want the deep sleep effect, you would want to put on the delta soundtrack when you are going to sleep or taking a nap. If you suffer from insomnia, brainwave entrainment is awesome: If you fall asleep, good. If you stay awake, you still get the deep restful brainwaves.

I should caution here that from my own experience and that of my friends, some trippy and unpleasant side effects can appear if you start doing deep brainwave entrainment suddenly without gradually building up to it with shorter periods and less deep frequencies. Migraines, double vision, nightmares and temporary loss of short-term memory can appear during or after use, although this does not happen to all and is always temporary. For this reason I recommend starting with alpha wave entrainment, which induces waves you normally have during relaxation and when falling asleep. The brain is used to having these experiences, so side effects are likely to be harmless and often pleasant: A feeling of weightlessness, seeing lights while your eyes are closed, sudden bursts of memories or emotions, or sometimes a feeling of “energy” running along your body. But most of the time nothing, or just a sense of peace and relaxation.

With some months of practice, you should be able to use delta wave entrainment with no side effects, like I do. I did not actually get into this for reasons of longevity, and certainly not to change. It was pretty much scientific curiosity that made me try out Holosync, and later Lifeflow, and eventually making my own tracks using Gnaural, a public domain software that is not very intuitive to use but totally free and fairly flexible. After satisfying my curiosity, I continued because it helped with a completely different problem for me: Delayed Sleep Phase Syndrome, a situation where the patient does not become sleepy until the morning, and has a hard time staying awake early in the workday. By using delta brainwave entrainment I could go to bed earlier, and if I did not fall asleep I would still get a decent degree of rest from meditating with the entrainment. Ironically, knowing that you don’t  need to fall asleep is the best cure for insomnia.

I remember mentioning around New Years (after I started with delta wave entrainment in spring), that I had changed so much that year. But I was not sure whether it was because of the brainwave entrainment, or the “Happy Science” books by Ryuho Okawa, or the mostly Christian spiritual literature recommended on the One Cosmos blog. All of these things kind of heaped up in that year. But would the books have made the same impression on me if I had less delta waves in my life? I don’t know. I am just a single person (literally so) and there is just too much outside influences for my personal experience to prove or disprove anything. (As skeptics say: The plural of anecdote is not data.) In order to know more, we need many more people to try this course of action.

The way I see it, there is very little to lose. If you have the patience to start easy, there should be no unpleasant side effects, and it is in any case totally harmless. On the other hand there are the benefits of better learning, better health, and a subjective experience of having more time (because time does not just fly by without you learning from it). It may not be a magic pill, but it is close enough that I recommend it. Unless you think change could only be for the worse – after all, perhaps you are already close enough to perfect. ^_^

In praise of sugar

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1.5 liter bottle of Pepsi Cola, 3/4 full

This acidic solution of sugar passes quickly through an empty stomach and is absorbed by the body in a matter of minutes. It also tastes quite good. I would not recommend downing a large bottle of the stuff in one sitting, though! One glass at a time is enough.

I notice lately that popular science and health sites brand ordinary table sugar as “toxic” and “white poison”. I hope to convince you, noble reader, that sugar is actually the power of this planet’s yellow sun, stored in crystals that can be readily used even by ordinary humans.

Let me say a few words about myself. I am a (physically) ordinary man in my fifties, with an office job but also an outdoors hobby: The Augmented Reality game “Ingress”, where players have to visit “portals” scattered around town. Because of this, it is normal for me to walk 10 kilometers in a day, some days 20 kilometers or above. (10 miles is about 16 km, for those on that side of the sea.)

When a man my age has walked 10 km, it is normal to feel a bit tired in the legs. I am not actually an athlete, after all, but an office worker. This is when I sit down, drink half a small bottle of Pepsi Cola, and wait for the effects to kick in.

Pepsi contains a small amount of caffeine, which probably helps with feeling a bit more energetic. But it also contains 10% sugar, your supposed “white poison”. Let us take a closer look at this substance, and what happens when it is ingested by the human body.

***

Sucrose or table sugar is at the same time one substance and two: Each molecule of sucrose contains one molecule of glucose and one molecule of fructose, held together by a single atomic bond. The combined molecule is stable when stored, but breaks readily into its two parts early in the digestion. What is absorbed from the small intestine is therefore actually molecules of glucose and fructose. These are treated differently by the body.

The glucose passes directly into the bloodstream and is brought to every cell in the body. Muscles will absorb glucose if they have been used, as they seek to replenish their energy and glucose is the easiest form of energy carrier to be shared through the blood. It can also be used by all other cells, and is the preferred fuel of the brain. (The brain can switch to an alternate fuel source in emergencies such as hunger, but will use glucose if this is found.)

Meanwhile the fructose is held back in the liver, the gatekeeper of the inner body, as all blood from the intestines passes through there. The reason it is held back is that the cells of the body cannot burn fructose directly. But the liver can convert it into any of two other substances. The preferred substance is glycogen, which is the body’s medium-length energy storage. The liver contains enough glycogen to power the body for about 24 hours of normal activity. The more active you are, the more glycogen is stored. If this reserve is not full, the liver will mainly convert fructose to glycogen and put it away. When the body has burned through the glucose from the first sugar rush, and the blood sugar starts to fall below ideal values, glycogen is converted to glucose again and released in the blood. In this way, fructose become glucose by an indirect process, one that only releases the sugar into the blood when needed.

If the glycogen storage is full, the liver will instead seek to convert fructose into triglycerides, the building blocks of fat. These are then released in the bloodstream, and will hopefully find a hungry muscle eventually. If not, they may be put away in fat cells for further use, or if worst comes to worst, they may settle on the walls of arteries. This is widely agreed to be a bad thing, causing angina and heart infarct, blood clots and stroke.

So what happens to the sugar from my half bottle (about one and a half table glass) of Pepsi? Well, I have just walked 10 kilometers and burned about 500 calories. (That corresponds to more than a deciliter — half a glass — of pure white sugar, if you wondered.) It is a safe bet that the fructose will go straight in the liver’s storage this time. Your liver may vary, depending on your activity level.

When the first surge of glucose raises the blood sugar above normal levels, the pancreas releases insulin. This hormone basically declares hunting season on glucose: The muscles open up their membranes and draw in as much glucose as they can handle, burning it instead of fat while supplies last. They can also rebuild their own little storage of glycogen, if they have the time. This storage is local to each muscle cell and is not released in the blood like the liver does.

In addition to muscle cells, fat cells also are invited to the glucose rush. But they are slower and less efficient, and they are not going to get that time: The feedback from the muscles and the brain itself inform me that the sugar rush has begun. My body is now burning with the atomic power from the core of the sun, captured by unsuspecting sugar cane which made the ultimate sacrifice to bring me their precious sugar crystals. It is time to get to my feet again and enlighten the city for another hour or two!

***

And this, noble reader, is why I want to tell overly eager science journalists: It is not sugar which is toxic; it is the passive lifestyle that is toxic. If you don’t make a serious dip in your energy storage, then indeed sugar will do bad things to your body. Your muscles won’t absorb more sugar than they need, your fat cells will grow as fast as they can but the sugar may still linger in the blood for quite a while. The blood pressure will increase, the arterial walls will harden and attract fat made from fructose in the liver. So remember: Friends don’t let friends eat sugar and drive. Let’s go hack some Ingress portals instead … or play in the hay or whatever tide lifts all your boats. ^_^

Old age: Wisdom or dementia?

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Screenshot Sims 2 - elderly sims hobbying

At least my Sims stay vital until the last!

In olden days, a society where most people were gray-haired elders would have seemed like an impossible dream. Today it seems like an unavoidable nightmare. What changed? When did the natural condition of the old stop being wise and start being demented? When did they stop being a resource and start being clients? Has something physically changed, or is it just our perception of old age that has changed? Perhaps a bit of each?

It strikes me when reading books from centuries ago that old people were held in high regard all over the world. Clearly the young were stronger even then, but the wisdom of the old was expected to rule the strength of the young. While wisdom did not always come with gray hairs, there was expected to be a much higher chance of it. It was accepted as a fact of life that the old would grow frail and eventually die, but dementia seems to be either absent or very rare. Today this is considered the natural end of life for most people.

Perhaps dementia was always common, but it was just bad form to talk about it? The old were respected and looked up to, and children owed their parents and grandparents a debt of gratitude for being in the world in the first place. Honor your mother and your father! That might not go along well with recording their descent into babbling helplessness.  Still, you’d think there would be more references to it, even if in an indirect and opposite way, like “do not look down on the old when they become witless”. But there is no such commandment that I can remember.

Perhaps the old were not really that old? In a world where the average lifespan was 35 years, perhaps someone aged 50 was considered old and someone aged 60 ancient? At that age they would have almost all of their life experience and not yet much chance of dementia. But the figure of life expectancy includes a massive infant mortality. Even later in childhood, you were still vulnerable to epidemics: There were no vaccines against smallpox, polio, diphtheria, or even measles which could easily kill underfed children with no medical recourse.  A third of those who were born died while they were children, and then many young men were killed in war. Childbirth was not entirely safe either. So those who lived to 40 had already run the gauntlet; they stood an excellent chance of living till they were 70 or 80. Indeed, a normal lifespan of 70 – 80 is mentioned in the Old Testament, with a maximum of 120 (barring divine intervention). This is practically the same as today, except now most children grow up to experience it for themselves.

I have even considered whether there could be a genetic difference: The current civilization is largely dominated by people from Europe north of the alps; but if you read anything older than 500 years, it is likely written somewhere else in the world. What if the Germanic and Celtic tribes shared some particular weakness to Alzheimer’s or brain stroke? But if so, it ought to be all over the medical textbooks by now. There are indeed some ethnic groups who seem to be less susceptible to it, notably in the Far East, but this could be due to lifestyle rather than genes.

First, I think we should bear in mind that the current generation of elders, and the couple generations before, are a bit of a historical anomaly. For one thing, they are the only generations in human history where smoking was widespread. It is not just dementia that is uncommon in history, so was lung cancer and heart infarct at the age of 50. A diet rich in refined sugar and saturated fat, and a habit of smoking, were simply not possible until well after the Industrial Revolution was complete.

Some of these trends have already reversed. For instance, blood pressure is lower today than in the 1970es. More than that: Typical blood pressure is lower today in overweight/borderline obese people (BMI 30) than it was in normal-weight (BMI 20-25) in the 1970es! When hypertension occurs, it is treated at a much earlier stage and with drugs with less side effects. Since hypertension is a major predictor of stroke, this is a Big Deal. Another important flag for stroke is fat in the bloodstream, particularly cholesterol. This is also monitored much more closely today and treatment starts earlier.

There is in other words a good chance that you are not going to become demented from stroke at the age where your grandparents did. And there is a good chance that their grandparents again didn’t, either, or at least their great-grandparents.

Alzheimer’s is a little different. We know there is a genetic component, but there also seems to be geographical variations. Here in Norway, the south coast (where I live) has the highest prevalence. A study some years ago proposed that aluminum in the water might contribute to triggering the disease. This would be interesting, because a major reason for aluminum in the water is acid rain, which was very rare before the industrial revolution, and is becoming rare again recently in the rich world.

There are also a number of old people who are not actually demented, they have just always been stupid. You may have heard of the Flynn Effect, the continuous growth in IQ since the first IQ tests began in 1914. The growth is typically around 3 points per decade, so it is not something you notice at a glance, but it really adds up over the course of a long life. When someone is 80, their grandchildren at 20 will have on average 18 points higher IQ. In a family where the IQ runs a bit low already, it could be enough that the elderly person is unable to function normally in today’s complex society.

A final consideration is that when your brain function seriously starts shrinking, the last things to go are the memories from your childhood. In the past when elderly people were the libraries of the tribe, they would remember the tales they themselves listened to when they were children, even after they had forgotten the names of their own children. So they would still fulfill a valuable mission almost to the last breath.

But in today’s society, we have gone all out in the opposite direction. The knowledge of the old is held in low regard, if not actually worse than nothing. Anything that is new is supposed to be better than the old unless proven otherwise. And so the dream has become a nightmare, the secure foundation has become a heavy burden. Perhaps we should think that over one more time.

I am energetic?

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Screenshot anime Sakurasou, featuring Misaki

Genki girl. Not larger than life, just much more energetic. Not like me. For one thing, I am not a girl.

I couple of things came together recently. The Norwegian winter seems to have a dragged on for months now, and it came on the heels of the rainiest November I can remember (at least here on the South coast of Norway). So I haven’t really exercised my body since sometime in October. Instead of a 1 1/2 to 2 hours of walking and jogging, I am just walking briskly for about half an hour a day.

Wait, what? The other day I read an article by a Norwegian cardiologist, who said that he personally walked half an hour a day; that was a sufficient, in his opinion. I’ve seen a number of seemingly sane medical experts say approximately the same thing, some of them adding that if you can’t walk half an hour a day, you should at least try to walk a quarter of an hour.

When I try to imagine someone exercising less than a quarter of an hour a day, I automatically imagine something like the illustration photos for articles about the “obesity epidemic”, a triple-sized American whose gender is half lost in the rubber tires surrounding their vaguely humanoid body. (My visual imagination is very hazy, admittedly.) I am like “how do they do that?” because I hurry to the bus, hurry from the bus to the office, hurry up the stairs, often take a walk during lunch break, and do the same thing again on my way home, except I hurry to the bus station across downtown. Then I may or may not go get some groceries after I am home. I guess having a car can be pretty bad for your health.

But the thing is, it does not feel like I am exercising or even being active. These are all things that just happen. And it matters who I compare myself to.

***

If you have read the early years of the Chaos Node, you will notice that I occasionally wrote about my then best friend, the girl I loved approximately like myself, the amazing Supergirl (later called SuperWoman, at her request.). (She has a name, but did not feel comfortable with being online, so I don’t have her name or address or photo anywhere on the site.) What I noticed the most about her was her intelligence, because she was one of the few people I had met (at that time) outside my family that was actually more intelligent than me. This fascinated me. She was much younger than me, so I knew and understood many things she didn’t (at least back then), but in raw processing power she was high, high above me.

But intriguingly, this was not the only thing she excelled at. She was also good at sports, good with people, played a couple of instruments and could sing and dance well. It was as if everything she put her mind to, whether for the body or the mind or a combination of the two, she mastered easily. Well, it did not always seem easy to her, but by human standards it was amazing. It seemed like she came with 300% energy in a human-sized body. That is the best way I can think of it.

I came to think of this because I recently watched two episodes of an anime, Sakurasou no Pet na Kanojo (the pet girl of Cherry Hall). One of the characters there is a girl who is just way too energetic for a single human body. Her teacher refers to her as an alien, hopefully in jest, but she feels kind of lonely among all the normal people who cannot do what she can and who grow tired easily. It was hauntingly familiar.

***

It really seems to me that some people come with more energy than others, and that this energy often shows both in the body and the mind. (Of course, the two are not really separate beings that just happen to travel together for a while – they are very much intertwined or even aspects of the same being, I have compared them before to the metal and the imprint of a coin.)

I have not thought of myself as an energetic person, although I have learned things fairly easily all my life. I did not do really well in grade school and even most of middle school, as I was home sick whenever I could think of an excuse for it (so as to not be bullied) and because I was lazy and did as little school work as possible. But when something interested me, I learned it easily. But only theoretical knowledge. I was small and weak and frail, and moved as little as possible. Therefore, I could never see myself as energetic.

Ever since I started running around as a toddler, I had asthma attacks. Likely I was born that way and am still that way – the attacks may simply have stopped because it was exercise asthma and I stopped exercising. The last years before the attacks stopped (around the age of 10, I think) they mostly appeared in the morning, I woke up gasping for breath. This week I am doing that again and it really drives home how creepy it was. But I realize, looking back, that the attacks back then were probably triggered by dreams of running and jumping and all the things ordinary humans did. Only when I became very, very quiet even in my dreams did the attacks stop.  And that is how I remained for the next four decades or so.

I have had my heart tested a few times during the last decade or so, last May very thoroughly by a cardiologist with modern equipment, and before that a few times with EKG machines for anything from a few minutes to hours. In each case, the result was something I had a hard time believing: That my heart was like that of an athlete. Not a world class athlete obviously but perhaps not too far off: The cardiologist said I could participate in “Birken”, the Birkebeiner race which is a national-level competition of unusual endurance. Surely the man was exaggerating, but my resting pulse was in fact squarely in the bracket of endurance athletes on a regional level. (It is higher now, but then I have a chronic infection these days.)

If not for the asthma, it seems, I might have been an athlete as well as a genius, like my brother, although perhaps not quite at the same level in either. That would take a lot.

What does this difference in people come from? Is it some kind of spiritual “life force” or does it come from differences in the metabolism? Perhaps in the mitochondria, the organelles in each human cell which is the only part of the cell that transforms fat and sugar and oxygen into energy for the cell? But the mitochondria are all inherited from one’s mother – the sperm cells leave theirs behind when they enter the ovum. If the mitochondria were to blame (or praise), you should be roughly as energetic as your mother. I am not sure that is how it works: Supergirl had the energy and smarts of two normal girls ever from she was little, but her numerous siblings were quite normal, as was her mother from what I could see and hear.

I don’t have all the answers, although I like to play someone who has all the answers on the Internet. Perhaps I will learn the answer if I live long enough. For now, I wish my supposed energy could be used to get rid of this infection of the sinuses and thereabout. Even with the return of daylight up north here, I can’t exercise with infection in my body. If I do, I tire quickly and the infection flares and spreads.

The Japanese word “genki” translates both as “energetic” and “healthy” or even “well” (Genki desu ka = How are you?) “Ki” is of course the Japanese word for energy and also spirit (also known from Chinese as “chi” or “qui”). I don’t feel entirely genki these days, but perhaps I am simply used to being among the 1% of energy?

Do this for 5 years

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Screenshot Sims 3: Sim meditating outside

Meditation is good for body and mind. (But playing The Sims 3 is more fun.)

Another question from Quora: What can I start doing now that will help me a lot in about five years?

The asker identifies as a 23-year old student, but the answer I will give here in some detail applies to pretty much everyone who is not a child and who expects to live for another five years or more.

Get started with meditation and/or brainwave entrainment.

Get started today, because the benefits accumulate over time. They actually compound, as in compound interest. Meaning: Not only is your brain slightly improved each time you meditate, but after you have meditated for five years, each 20-minute session is more effective than it was when you started. After ten year years, it is even more effective, and so on. After decades of reasonably regular meditation practice, meditation is amazingly powerful. You can enter into a deep state of meditation literally in a heartbeat, faster than a single breath. I am not making this up, I just tested this standing on my cold kitchen floor before I started writing this entry. There are others who are far more attuned to meditation than I am. But the point is, the sooner you get started, the more difference it will make every day for the rest of your life.

A habit of meditation will actually change your brain in ways that are visible on a tomography, but this takes many years. The changes first happen on a microscopic level. As more and more connections form in higher levels of your brain, the way it functions is slowly improved. This is how meditation becomes more powerful over time. It is not pure magic, although it was indistinguishable from magic until a few years ago. (And thus was often ridiculed by the would-be scientific classes of non-scientists.)

Get started today also because it does not take any time, so you won’t lose out on anything else you do. Meditation and brainwave entrainment both reduce the time you need to sleep to retain the same wakefulness, concentration and body repair. Most of you probably sleep too little as is, so I don’t recommend you sleep less. But you can, if you don’t want to be more clear-headed, energetic and healthy than you are today. A rule of thumb is that half an hour of meditation replaces an hour of sleep, but an hour of meditation does not replace two hours of sleep. In other words, you cannot simply replace sleep with meditation. But a moderate amount of meditation – up to an hour at least – will actually be free or more than free, leaving you as much time as before to do all the other things you want to do in life. More time, actually, especially as you get more attuned and your meditation becomes more powerful.

Secular meditation is now widely taught. If you already have a religion, you may want to learn the form of spiritual practice that is practiced in it, whether it be meditation, contemplation, chanting, holy dance, ritual prayers, holy reading or something else. But I will assume that the reader does not already practice wordless prayer or something equal to it, and recommend that you take up scientific meditation.

Rather than instruct you in meditation, as I did when the Internet was young, I think I should just refer you to the mostly harmless website Project Meditation. I am not really affiliated with them, I just hang out at their forum occasionally and also use their brainwave entrainment product, LifeFlow. You don’t need to be a customer to use their other services, including a thorough introduction to meditation, and a very good section called Principles of Meditation & Entrainment. It is written by one of the forum members, not the site staff. This particular person was the reason why I decided to go for Project Meditation rather than their more advertising competitor. His writing resonates so much with my heart that I would recommend him over myself if you want advice.

The text also refers to brainwave entrainment. There are various technologies for doing this, and the LifeFlow sound track used three of them. There are also visual systems. I recommend first practicing meditation without entrainment for a couple weeks, then use entrainment if you want, and eventually you will no longer need it for ordinary meditation. You may use them for special purposes perhaps. I use delta entrainment as a prelude to sleep, since I have Delayed Sleep Phase Syndrome and cannot naturally produce deep sleep early in the night. But I would not recommend a newbie to use delta entrainment. I have recommended it before, but it seems to cause various nasty side effects in untrained people, or at least some untrained people, such as headache or seeing double. I guess it is a bit like asking a couch potato to run a competition sprint. Start with something easier.

Project Meditation has a free 10Hz sample you can download. Looping this MP3 file, you can use it for as long as you want, so you don’t need to buy anything unless you want to proceed to the more fancy stuff. There are also various other free brainwave entrainment opportunities on the Web, including some YouTube videos. Video can help you concentrate in some cases if your mind tends to wander a lot.

Again, let me say: You don’t spend time on meditation. You gain time from meditation. The exception is the first day, when you learn what it is about and decide on which technique to use. After that, it is free and more than free. It improves your brain, it improves your immune system, and it makes you feel better throughout the days and years remaining of your life.

One small warning: I only recommend a modest amount of meditation for ordinary people who want to stay ordinary people. Excessive meditation can cause dramatic changes in personality, seemingly supernatural experiences, and in some cases actual psychosis (insanity), at least if there is a family disposition toward it. 20-40 minutes a day should be fine, but meditation for hours a day should only be undertaken under the guidance of an expert and after conferring with health professionals. Of course, the same goes for eating several pounds of oranges a day, so I am mostly disclaiming here.

Read for your life!

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Graybeard, from game Skyrim

A Graybeard, the vaguely religious old scholars / monks of Skyrim.

Does exercise of the mind cause longevity more than exercise of the body?

In fantasy novels, wizards tend to live much longer than ordinary people, although they don’t stay young. They generally tend to be healthy and spry for their age, though. This trope probably came to be because the real-life template for wizards were sages, who needed that long and healthy life to acquire all that knowledge and insight. So the long life was the cause rather than the effect, whereas in the fantasy stories it is the other way around.

Then again, the other day I read in Dagens Næringsliv (Daily Business in Norwegian) that male priests and university lecturers lived on average 11 years longer than farmhands and deckhands. It was implied that these groups represented the opposite sides when it came to career and longevity. I have mentioned before that gardeners tend to live long as well, but these were the groups that were listed this time, here in Norway at least. That brings up a fascinating reflection: If exercise is good for your health, why do those who don’t have time for it outlive those who do it for a living?

There is hardly any doubt that physical movement is a good thing. I know this from experience. Back when I was on the verge of losing my job due to wrist and arm pain, my doctor told me to exercise – fast walking at the very least – for an hour a day. In 2005 I started doing just that, and my body healed considerably. Not only did the pain recede, but skin rashes and wounds that refused to grow also healed. Moving about is warmly recommended. But it is not something scholars are famous for. Well, they may pace back and forth, but they are not famous for excessive physical activity. Mental activity, on the other hand…

In my own fantasy novel in progress, The 1001st Book, the final Gift of Thoth is that studying his books will not contribute to your aging. That is obviously not what happens in real life, but there may be more subtle ways in which serious study contributes to a long and reasonably healthy life. Let me bring up two hypotheses.

One is that aging of the body is a very slow process. It is usually when the mind falters that things take a sharp turn for the worse. When Alzheimer’s disease, small strokes or other forms of dementia robs you of your survival skills, you get in trouble: You forget to eat, or forget that you have already eaten; you forget to take your prescription drugs, or forget that you already took them; you forget to wear suitable clothes for the weather; you try to do things that your body is no longer strong enough for; your friendships unravel and you may even distrust your own family, causing fear and frustration. In short, a lot of stress for body and mind hasten your decline.

Building a lot of connections in your brain will not hold dementia at bay forever, but it is shown to delay its onset quite a bit. (It happens faster once it happens, but by then you may already have outlived your less thoughtful classmates.) Lifelong studying helps build those plentiful connections. So does spiritual practices. Whether it is the actual study or the willpower you train up by sticking to it, the result is that the higher centers of coordination in the front of the brain grow larger and stay alive longer, as well as developing multiple pathways to connect the various parts of the brain.

The other hypothesis I have is that people who read a lot tend to eat less. While not all scholars are thin, it is a stereotype for a reason. They are certainly less likely to be obese than the average, not to mention their opposites. With all due respect for running around, there is only so much you can do if you are alleviating your boredom by eating. If you don’t have the boredom in the first place because you are deep in a book until hunger starts gnawing on your stomach, that’s one less problem. And there is also the aforementioned willpower to consider.

We live in a world where there is a certain magnitude of chaos, so we may fall over dead any day for any number of reasons. Doing one thing or another will not guarantee us a long life. But still, if someone came to me and asked: “What shall I do to live a long life in this world?” I would feel obliged to reply: “Read a lot. Don’t rest until you have read a thousand books, not counting airport literature. And then keep reading. Read for your life. Read heavily, think deeply, and live purposefully.”