You all know I mentor at Rock Health, the San Francisco-based accelerator for health care startups. I am very impressed with the energy and passion with which the startups there address the broken health care industry.

So it is with total conflict of interest , but also a lot of pride, that I announce the merger of Health in Reach, a member of Rock Health’s first class, with PriceDoc.

Health in Reach helps consumers get greater insight into fees for medical services. The combination of Health In Reach and PriceDoc will let consumers  control  their out-of-pocket expenses by providing a single destination where they can research the costs of specific medical and dental procedures, save up to 50 percent or more on service fees, and conveniently schedule appointments online.

Today, more than 130 million Americans do not have dental insurance and pay billions of dollars out-of-pocket without knowing the prices in advance or having the ability to comparison shop.

“The promise of consumer-directed healthcare starts with an empowered consumer. The marriage of Health in Reach and PriceDoc is a perfect fit because we share the same mission – to help consumers become more proactive in their medical decisions,” said Scott Sangster, founder and CEO of Health in Reach. “When people go to the doctor or dentist, they rarely know how much the treatment will cost, or what’s included, until after their appointment when the bill arrives. By preventing surprises, we believe people become confident enough to visit doctors more often, which improves patient care.”

Health In Reach now offers more than 1.6 million appointments  every month. The site also offers descriptions and prices for nearly 50,000 specific procedures. Consumers can easily schedule appointments online, receive appointment reminders, and lock-in fee discounts before they arrive at the doctor’s office.

“Health In Reach is addressing the lack of consumer confidence and affordability prevalent in our current healthcare system, which is a major market problem,” said Halle Tecco, CEO of Rock Health, the San Francisco-based digital health startup accelerator sponsored by partners including the Mayo Clinic, Harvard Medical School, UCSF, Accel Partners, NEA, Nike and Mohr Davidow.

From the Health In Reach website, consumers can search a proprietary database of medical, dental and vision providers around the country, and using its patented technology, can find and schedule the providers who best match their criteria. After an appointment, users can leave reviews and other comments about their experience.

Together, Health In Reach and PriceDoc have raised over $6 million from investors.

Health In Reach offers a nationwide dentist and doctor marketplace connecting consumers and healthcare providers. Consumers access descriptions and prices for nearly 50,000 specific procedures, save up to 50% or more on service fees when paying out of pocket, and schedule appointments online instantly and securely. Health In Reach was founded in 2009 and in 2011 was selected as one of the inaugural companies for Rock Health’s startup accelerator program. 

This is too important not to share. I’ve been reading the newspaper articles about it, but here’s the ABIM Foundation’s original list. What do you think?

Nine United States specialty societies representing 374,000 physicians developed lists of “Five Things Physicians and Patients Should Question” in recognition of the importance of physician and patient conversations to improve care and eliminate unnecessary tests and procedures.

These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate, as well as the methodology used in its creation.

What tests and procedures should patients and physicians talk about? Read the lists:

• American Academy of Allergy, Asthma & Immunology
• American Academy of Family Physicians
• American College of Cardiology
• American College of Physicians
• American College of Radiology
• American Gastroenterological Association
• American Society of Clinical Oncology
• American Society of Nephrology
• American Society of Nuclear Cardiology

Related articles

• Physician Groups Call for Fewer Medical Tests (news.health.com)

Image via Wikipedia

About  twenty years ago, when my physician husband was diagnosed with cancer, he made an important decision for both of us. He self-prescribed antidepressants, relatively new at the time, for both of us. I don’t remember why, but he gave me the Zoloft, and himself Prozac. He said they would help us have  an easier time with his diagnosis, and they probably did.

I resisted mightily, having never taken anything but an antibiotic before in my life, but he reasoned that, since America invested so much money developing these drugs, we should take advantage of them. Fine, I said, terrified by the fact that he might die.

Five years later, he did. We were still both on the antidepressants, and after he died, in my grief I went back to Dr. Carl Hammerschlag, a psychiatrist I knew well, and he changed me from Zoloft to Lexapro, a newer med with fewer side effects and better anxiety control. I should say here that Carl is a  healer in the Native  American tradition and a Yale-trained physician, not a thoughtless drug- dispenser.  He knows me, and he’s nobody’s fool. He knows what I can do to myself. He has seen me through three businesses and two husbands.

As an entrepreneur, depression was never my problem, but anxiety always affected my life. I had so much responsibility: for clients, for employees, for children, foster children, dogs, houses. How was I ever going to do it all? Every once in a while, my anxiety manifested as some physical symptom– hyperventilation, acid reflux — that would send me off for a battery of tests,  and I’d be reassured and then feel fine! That’s called  ”generalized anxiety disorder.” it is common in women, and I think it was called hysteria in the Victorian era. Carl, the shrink, walked me through it all, lighting sage as I walked into his office and treating me with a sense of irony as well as his monumental clinical experience.  I was the Woody Allen of Phoenix. And then I “got well” and stopped seeing him.

Fast forward fifteen years.  I have learned a lot about putting chemicals into my body, and no longer eat processed food at all.  I feel very healthy. So I decide to go off the SSRI ( the Seratonin reuptake inhibitor) Lexapro because I am a happy optimistic person and clearly I don’t  need it.

Sure.

Having read a lot about these drugs in the intervening years, I first go to a clinical nutritionist who is also a pharmacist, and get a bunch of specially blended enzymes and vitamins. Then I carefully titrate off the drugs, feeling fine all the way. Ahhh, I have done it. A daughter warns me not to go off them, but I don’t listen.

Two months later, I awake in the middle of the night wondering if I am dying,  heart pounding and stomach churning.  I calm myself down, but can’t go back to sleep, and for the next week, I wake up three hours after going to sleep and lay awake all night. I wind up tighter and tighter, secretly thinking I am dying, and running off to the doctor for tests. My digestion speeds up inappropriately.

Although I have normal tests,  I am not normal in my head. I think my life is over, no one wants me, I will starve, and on and on. The anxious mind plays terrible tricks. But I have studied enough mindful meditation and yoga to observe myself even while all this is happening. I  know I am freaking out, losing my equilibrium, so I reach out: to friends, to my yoga community, to nightly podcasts on Zen.  I refuse to go to the emergency room, because I know all these physical symptoms ( the racing pulse, the queasiness, the sleeplessness) are part of me by now. But I want relief. I feel like I am dying. Or maybe I’d rather be dying.

So I go back to my old friend Carl. “yeah,” he says,” you never come here until you are three sheets to the wind.”  I tell my story of going off the Lexapro, and we discuss whether, indeed, these drugs destroy the body’s ability to produce its own Seratonin over time, and thus produce something like insulin dependence.  The patients all write about this on online message boards, but there have been no clinical trials that I can find. And seratonin is made in the gut, so it’s presence or absence affects the digestion.

Carl doesn’t care about clinical trials. He wants to help. He prescribes Lexapro again, but the first week I am on it, I am still very anxious. When I come back the next week, he adds Xanax.

Not a fan of Xanax, I lead him into a long discussion about whether it’s a good idea to be on those benzos, because I know they are addicting. He tells me I never will be addicted, so I accept a very small dose and enjoy the first week of uninterrupted sleep in a month.

But just as I am feeling like myself again, I see on Twitter that Whitney Houston has died. And later, I find out she took Xanax.

That’s enough for me; I opt for insomnia and titrate (the magic word), off the Xanax.

The Lexapro has kicked in, and I feel like “myself” again. But I haven’t forgotten why I went on and off SSRIs, and how I felt. So I  am appealing  for clinical trials or longitudinal studies about the long term effects of these drugs and whether, indeed, they actually do shut down the body’s ability to make its own seratonin, or if I never was able to make it or use it correctly in the first place.

A recent 60 Minutes episode insisted that anti-depressants have no more effect than placebos. Dr. Irving Kirsch, the researcher on the segment, concluded that it’s not the chemicals in the anti-depressants that make people better, but the placebo effect. For the vast majority of people, Kirsch says, the chemicals in the drugs do not make any difference.

Kirsch also said that the therapist who prescribes the pills contributes to the placebo. Mine certainly did, because the first one was my husband, the second a psychiatrist I really trust. The segment even questioned whether depression has anything to do with seratonin levels in the blood.!  It is about time we studied these heavily prescribed drugs, especially in this era when they’re routinely given to kids and to people on the advice of a  primary care doctor untrained in psychiatry. I’ll be the first volunteer.

Every once in a while I find that America’s acclaimed free market health care system (it’s a joke, folks, just a joke) has hit a new bottom. Today I found a piece in Health Business Blog that asked

Are you commercially insured with cancer, heart disease or an orthopedic problem? If so, you are a juicy marketing target for hospitals, which drool over the prospect of high fee for service reimbursements. USA Today (Hospitals mine patient records in search of customers) explores how hospitals are combining their own data with information from consumer marketing agencies to pinpoint likely customers for their services.

Give me a break! It’s one thing to mine data for its public health implications, or for clinical trials, but IMHO it is quite another to use my personal health data for marketing purposes. The original article from USA Today told the story of a middle-aged smoker who got a targeted postcard offering him a lung cancer screening. Other people in the service area of the hospital did not get the same postcard.

The non-profit facility is one of a growing number of hospitals using their patients’ health and financial records to help pitch their most lucrative services, such as cancer, heart and orthopedic care. As part of these direct mail campaigns, they are also buying detailed information about local residents compiled by consumer marketing firms — everything from age, income and marital status to shopping habits and whether residents have children or pets at home.

Why, because in our current system, employer-based insurance foots the bill for uncompensated care (the poor) and Medicare/Medicaid patients. That’s the Great American Cost Shift, in which because we don’t have a universal health care system, some of us pay sky-high premiums to insure the rest of us. If I were part of the commercially insured segment,  wouldn’t fight for the continuation of this system for a single minute more.  You are not fortunate, as your premiums go up and your co-pays increase: rather, you are paying for every senior and every poor person whose care is not reimbursed adequately by the government.

I’ve never understood why people whose employers offer health insurance are not in favor of universal health care. Do they think they will lose the ability to choose a physician? I didn’t when I went on Medicare, and my foster kids who are on Medicaid can also choose their physicians.

In the mean time, the system deteriorates and becomes more expensive for those who pay. The hospitals are not forced to change their business models; they are only forced to become better data miners and targeted marketers. But is that what we want our hospital to be known for?

Don’t ever tell me online relationships can’t be strong. On Sunday, I had a premonition that drove me to “catch up” with a blogger whose site I hadn’t been to for a while. When I got there, the last post began this way:

– A conversation with my husband, shortly after arriving home this afternoon with fresh oxygen tanks, spots on my liver, fluid pushing around my lungs (likely filled with cancer, as are the tumors inside) and at least one broken vertebra that must be healed before we resume any kind of treatment. –

How did we get here? I asked my love, across the bed strewn with children’s toys, books, and an oxygen tank.

The post goes on to admit that Susan Neibur,  a woman we all knew as @whymommy, the author of the truly magnificent blog Toddler Planet, had asked for in-home hospice “at least for a while.”

The post is dated January 22. It encouraged me to keep checking back, and today I am grieving today for a woman I met in person only once, at a BlogHer conference, which she struggled to attend so she could give a keynote presentation.

Susan was a planetary scientist, and she was diagnosed with inflammatory breast cancer, a rare and aggressive form of breast cancer that doesn’t get talked about much ( the news covers things like whether women should have mammograms at 40 or 50.) But it kills young women, and now it has killed Susan. It is undignified to say that sucks.

I met Susan BlogHer and Twitter, where she actively shared all her experiences — sometimes with the clinical detachment of the scientists. I tried hard to engage with her in the only way I could, by writing encouraging comments on her blog and offering to introduce her to EmpowHer, a network of women interested in women’s health headed by a friend of mine who is a fierce patient advocate.

But, like all the women who read her posts and somehow believed she would defeat this terrible disease, there wasn’t anything I could do in her individual case. So now, I raise my voice: perhaps too late for her, but not for other women, and indeed not for other men as well, who suffer and died way too young.

And here is what her husband says about all of us here online, where some still doubt that relationships are “real”:

 I can’t begin to describe how her friends, those physically nearby and those she knew only on the internet, enabled her to carry on through five years of treatment and recurrence.  Many of you have commented on Susan’s strength and grace, but these were traits that she pulled from all of you.

Related articles

• Goodbye, WhyMommy (betterinbulk.net)
• Goodbye (toddlerplanet.wordpress.com)
• What. A. Wonderful. World. (theyearofwhatif.com)

Image by mariachily via Flickr

I was fortunate enough to be able to attend the Rock HealthHealth Innovation Summit onJan.20th. It was the third day of a conference that highlighteddevelopment, design, and business issues around the potential for health care transformation through technology. The room was full, and the audience stayed until the end, even on a Friday afternoon.

Why? Because they knew something big was up. What’s up is the awareness of the Rock Health accelerator and the move to change a system only a young person from outside the industry could even hope to change. For three days, enthusiastic developers listened to cynics like me talk about business models, chasms, and challenges. I hope our doubts didn’t make a dent in their drive.

A year ago, there was no Rock Health, but more important, there was no community pulled together around the cause of health care innovation brought about by young people largely focused on digital and mobile technologies. A scant one year later, there is a vibrant health tech community in San Francisco, supported by large hospital systems, insurance providers, VCs, angels, entrepreneurs and mentors. The need is recognized, but until Rock Health, there hasn’t been a community. Health 2.0, another wonderful step in the direction of change, focused more on showcasing change than on financing or mentoring change.

The second class in the Rock Health program kicks off this week. Some of the grads from the first have already received additional funding or gotten to revenue.

They won’t all succeed. They have no concept of how complicated this industry is. But here’s the most important point: Rock Health has drawn together all the people inside and outside the system who want it to change, who are willing to take chances, and willing to support the effort to move the needle.

And thus I feel like 2011 was a tipping point for health care as an industry. After last year, for many reasons, it can’t remain the same. The larger providers and payers have already begun to circle the wagons around Obama’s health care reform law, because they are realists and know it’s not going to be repealed completely no matter who gets elected. So they’ve begun the journey toward bundled payments, Accountable Care Organizations, medical practice acquisitions, and better electronic health records. The battleships are slowly changing direction.

And the best part, Rock Health was founded and is run by women — the very people who make most of the health care decisions anyway.

Related articles

• A Dozen New Health Care Startups at Rock Health (ushealthcrisis.com)
• Rock Health Gathers Healthcare & Technology Stars: A Photo Gallery (xconomy.com)

The difficulties that health technology innovators will have breaking into the health care industry were no more clearly illustrated than by the talk given by Dr. Sam Ho, Chief Medical Officer of United Health Benefits Group, on the third day of San Francisco-based health incubator Rock Health’s  Health Innovation Summit. After two days of exciting stuff about design and development, CEO day presented the cruel reality of the market .

Dr. Ho began by admitting the system was broken. Payments, he admitted,  didn’t align with objectives, and outcomes were an afterthought.  But now things are in the process of change, partly because of the passage of Obamacare (although he didn’t mention it by name), partly because of the too-temporary tenure of  Dr. Donald Berwick at CMS, and partly because in a worldwide recession, we can’t afford our health care costs any longer.

So the big players, fearing innovation from without, have decided to try to innovate from within, and came up with a slogan called “The “Triple Aim:”  a slogan that embraces how to improve the individual experience, improve population health, and control inflation of per capita costs. Dr. Ho believes these three aims are separate now, but they must be aligned  to succeed.

For United Health, this means Care Management Programs, Transparency and Premium Designation Programs, Hi Performing Preferred Networks, Value-Based Benefits, and Value-Based Contracting. These can be read as forms of rationing and cost shifting by the more cynical among us. However, for him,  it mans developing more and more incentives for changing consumer behavior. For example, patent premiums will get lower and benefits richer if consumers enroll in a diabetes plan and stick to it. If they manage their blood pressure or lipid levels, they will also have richer benefits. But what if they try and fail? I’m all for outcomes-based medicine, but we have to be careful we are measuring things that are within the control of either patient or provider. And how do we judge?

Five years ago, I lost a dear friend to a situation that never should have
happened. Although, if I were to ask him, he would tell me otherwise.
He would say his life’s journey was over. I would say the ignorance
and arrogance of his adopted country’s medical system killed him.  I am writing about this five years later because I was reminded of him this week by the Dalai Lama’s presence in Bodh Gaya, India. Things in American medicine have not improved since Sri’s death;if anything, they are quickly devolving.

N.S. (Sri) Sidharan was a retired technologist from Intel who devoted
his life to peaceful causes. He travelled frequently to and from Bodh
Gaya, India (the place where Buddha received enlightenment) to visit
Dwarko Sundrani, one of the last active followers of Ghandi. Dwarko
runs the Samanway Ashram, a school for village childen in the Bihar
province of India, far from the Bangalores and Hyderabads. Bihar is
poor. Not only can’t people afford to educate their children; they
don’t even understand why education is necessary. Some of the children
Dwarko-ji cares for are tribal. They only come to school because he
feeds them, and he teaches them only farming. With oxen.

Dwarko-ji was 85, and had no succession plan for the Ashram. Sri spent
his retirement years trying to raise money for the school and figure
out a way for it to go on after Dwarko-ji passed. Between trips to
India, he helped a bunch of start-up companies in Arizona, including
one that has a new method for diagnosing heart disease, participated
in several meditation groups, and began a business called Technology
Initiatives for Peace. He was a big proponent of trust.

Sri was my friend, and I admired him. I went to India with Sri twice, the first time
when Dwarko-ji was travelling from Bodh Gaya to Dharamshala
for an audience with the Dalai Lama. We flew to Delhi, took an
overnight train to Pathamkot, stayed in an ashram that served as a
retreat center for the people who run other, more public ashrams, and
then went to Dharamsala, the seat of the Tibetan government in exile.
Not one touristy thing did I see.

Although I didn’t personally meet His Holiness, I did meet Dwarko-ji,
and see the Dalai Lama and the chanting monks from afar. It was a
life-changing experience. Sri took incredible care of me.

I went back to India, to meet Sri in Bodh Gaya for
Dwarko-ji’s “eye camp”, an annual event in which tens of thousands of
blind Indians are restored to vision by cataract surgery in a
week-long surgical marathon that takes place in tents on a dirt field.
In the years since the eye camp began, they have never had a fatality,
and rarely an infection, despite the sheer numbers of surgeries and
the dusty, hot, crowded conditions. Volunteer doctors come from all
over to participate.

Sri wanted to spread the good will of the eye camp from India to
Africa, and in July 2006 he went to Ghana to try to scope out the
situation and set things up. He was very excited.

And then I never heard from him again. One day I awoke in the
morning, opened my email, and saw this message: “NS Sidharan died last
evening in Good Samaritan Hospital. He had recently returned from
Ghana. Details to follow.”

I freaked. It doesn’t take a rocket scientist to figure out what
happened. Sri returned from Ghana with a fever. He went to the
hospital. They diagnosed flu. He told them he had come back from
Africa. They suspected malaria. But they didn’t begin treatment.
They kept sending him home while they did tests. Some of the tests
were “inconclusive” (meaning the pathologist probably didn’t know how
to read for malaria).

By the time they got the diagnosis and admitted him to Banner Good Samaritan Hospital

Image via Wikipedi

his body was overwhelmed by the bacteria. Then they had to use drugs
so powerful that he died.

The friends who were with him told me he got good medical care. I beg
to differ. I googled malaria. Here’s the CDC web site: “Malaria should
be considered a potential medical emergency and should be treated
accordingly. Delay in diagnosis and treatment is a leading cause of
death in malaria patients in the United States.”

More: “Where malaria is not endemic any more (such as the United
States), health care providers are not familiar with the disease.
Clinicians seeing a malaria patient may forget to consider malaria
among the potential diagnoses and not order the needed diagnostic
tests. Laboratorians may lack experience with malaria and fail to
detect parasites when examining blood smears under the microscope.”

And the last quote: “This sometimes fatal disease can be prevented and
cured. Bednets, insecticides, and antimalarial drugs are effective
tools to fight malaria in areas where it is transmitted.”

In other words, if Sri had stayed in Ghana, or any underdeveloped
country, he’d probably be alive today. Only in America, where we think
we know everything about how everyone “should” live, from what they
should eat to how they should vote, is he dead. This teaches me
humility. And I grieve

Related articles

• Ngondro interrupted – Bodh Gaya, India (travelpod.com)

Until you have gone off the deep end on nutritional therapy as I have, a Western medicine aficionado has every reason to doubt its effectiveness. Thr only people who know how useful it is to tightly control the toxins, vitamins, and foods that go into their bodies are the people who MUST know: very sick people, usually with cancer or diseases that can’t be diagnosed and are chronically debilitating, people who sell supplements, and wackos like me who want to live long and prosper.

When I undertook my journey to better health, it was for many reasons. First, the US health care system is broken; it is costly and access is limited by a critical doctor shortage. Second, I have two young grandsons, for one of whom I will soon be the only surviving grandparent. Third, two former husbands, a former lover, and my daughter’s inlaws all suffered from cancer. Fourth, I was on anti-depressants since the death of my last husband almost fifteen years ago.

I wasn’t a bad eater to start with: no fast food, little processed food, organic fruits and vegetables, limited amounts of meat.

But then I went to the nutritionist/pharmacist in North Scottsdale, where wealthy people have access to treatments the ret of us lack. They pay out of pocket, as I did.

The nutritionist (http://www.time4health.com) administered an IGC panel for food sensitivities and then prescribed fish oil, immune support, digestive enzymes, probiotics, and a multi-vitamin high in B Complex.

He also told me to eat only grass fed beef if at all, only Wild fish, no gluten, and for me especially no dairy of any kind and no Lima,kidney, or navy beans. (the blood test showed I have intolerances to them).

He also told me to get off frappacinos and start the day with protein rather than a banana, get off the single Diet Coke I drank a day, and stick to a pretty much plant based diet.

I balked. So would you. After all, I am a healthy person. I didn’t feel bad to begin with, although I did have a little joint pain and some digestive bubbles, which I thought normal for my age.

But I am now six weeks into the program. I can stand at a cocktail party without feeling my back. I easily gave up Diet Coke and Frappacinos, without even missing them. I have ten times the energy I had before.

But the most important result so far: I am off Lexapro. Those SSRIs are supposedly very difficult to get off, with major withdrawal. I, However, cut my pills in half for a few weeks, then went to half a pill every day, and then to nothing. With no withdrawal that I noticed.

One of my best friends is an MD. He kept asking me for the “literature.” My family doctor called me “meshuga,” Yiddish for crazy. But he did agree to order another series of blood tests to find out even more about me. Trust me, there is literature being written about this every day at major medical centers as a result of new clinical trials– trials that were forced into existence by patients who demanded them, patients who offered their own experiences online, and patients simply desperate for remedies for chronic conditions. Oh, and by a health care system staggering under the costs of treating these conditions– conditions that could be halted or prevented by proper nutrition.

Don’t let the American food-industrial complex maim you. Do your own research.

Food, Inc. (Image via RottenTomatoes.com)

As the widow of a doctor, I have devoted a lot of energy to thinking how to live to a healthy old age. Life extension theory has changed radically over the course of my life.

When I was a kid, there was not much processed food, and we ate meat, vegetables, and potatoes, along with dreadful stuff like jello. Yes, we ate cookies and cake,but my mother went to a butcher and a bakery, and our foods were fresh. Calories were the main concern. You had to limit the number of calories.

Oh, and drugs were just being discovered. My doctor put me cheerfully on amphetamines to lose weight, barbiturates to sleep, and tranquilizers for anxiety. We thought they were all good for you. We now know they are as addictive as “street drugs.” Indeed, the current wave of addiction is to prescription drugs, not street drugs. Even then, I hated the side effects of those drugs and quit taking them as soon as I could.

Things changed in the 70s. When I met my mother-in-law, she had just turned 65, she was concerned with longevity, and she followed Adele Davis, who believed in high protein diets and B-12 shots. She took those. At the time, they were called “liver shots.” Those of us who didn’t take shots ate liver, because it was high in vitamin B, protein, and iron. Only later, when they began to put cows on hormones, did people become afraid to eat liver because that’s where the toxins accumulated in the cow.

When I got pregnant with my daughters, I stayed on a very high protein-and-vegetable diet because it was supposedly brain food. Pregnancy taught me about salt: cans of tuna made my ankles swell. Excessive salt, which is put into our depleted processed food to make it taste better, causes high blood pressure. So does smoking.

I had already given up smoking, because the very first inkling about the relationship of lifestyle to disease was the Surgeon General’s report in 1964 that linked smoking to heart disease.

In the 80′s, Diet for a Small Planet came out and we all became vegetarians. I grew vegetables in the 70s as well. Even then I stayed away from fast and processed food.

All the while, food processing has become more and more a chemical affair, and most food chemists and nutrition scientists trace heart disease, diabetes, and cancer to food processing: the addition of chemical preservatives, the leaching out of vital minerals and vitamins by pesticide depleted soil, and so on.

I’ve seen “Food, Inc“., in addition to “Forks Over Knives” and “Fat Sick and Nearly Dead.” The agricultural products that are subsidized (corn, dairy, beef) have ginormous PR campaigns that tell you what to eat. Then the government puts it in the school lunches and the food pyramid.

Bottom line: stay as pure as you can. I have read the medical studies. “It’s the toxins, stupid.”

You can eat beef and chicken as long as they are free range and grass-fed, and not injected with hormones, steroids, etc. Or fed wheat and corn, because those crops are now toxic because of the pesticides and the soils they are grown in. And as long as they make up less than 20% of the calories in your diet (and they have more calories than plant-based foods). My nutritionist says to prefer grass-fed beef (if eating out) to farmed fish, because farmed fish is fed toxic grains and hormones. Wild fish is best, but even it is polluted with mercury.

Stick to green leafy vegetables and fruits like berries and watermelon and citrus that don’t have much sugar. Sugar creates havoc in the blood, because it causes your energy to fluctuate wildly even if you aren’t diabetic. Protein evens out the blood sugar, which is why you need it. Nuts and seeds are also good, although you have to be careful what chemicals they are prepared with (barbecued or honey roasted nuts can be full of chemicals). Starch, by the way, becomes sugar during the digestive process, so forget potatoes and anything but whole grain bread.

Wheat free is desirable, but not necessary. I am now wheat free, and have more energy. I am also dairy free, which probably IS necessary because of the toxins in the feed our cows are given. And in my case, I’m intolerant of dairy.

Which brings me to my final step of how to fine tune: I went for a series of blood tests, including an IGC panel. That panel told me what foods I was sensitive to, which means which foods cause inflammation in my particular body. I eliminated them.

The current scientific thinking is that most disease is caused by inflammation. Cholesterol doesn’t necessarily cause heart attacks; inflammation does. It breaks the cholesterol loose and sends it through the blood. Cancer is also thought to be inflammation, which weakens the immune system so it doesn’t automatically just kill the cells that become aberrant.

And here’s where stress comes in: stress also weakens the immune system. Anything that causes the immune system, which weakens anyway with age, to weaken further could be a cause of disease. For example, stress causes the blood to pump harder against the walls of the heart, which causes high blood pressure,
which in turn causes thickening and enlarging, which in turn causes less efficient pumping, which can cause heart failure.

The health care system has known all this for a while, but has chosen to address it with technological fixes (surgery) rather than root causes (change the way you live). Now that we can’t afford ourselves as a sickly nation, you will see the preventive measures come into play. They are our “austerity program,” but they should have been our program all along, IMHO.

On balance, I feel great. My arthritis and high blood pressure, caused by excessive exercise and stress, are now controlled. What have I given up? Dairy, wheat, and processed food (which I never ate anyway). What haven’t I given up? Red wine and dark chocolate. I haven’t found any articles that tell me they aren’t good for me.