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Keep Your Cool

Greetings everyone.

Before we get to the meat of this post, I want to address something that showed up in the comments, poll responses, and emails.

Resistant Starch

People were questioning the bit I wrote about resistant starch in the last Arrow. Resistant starch is a controversial subject. Supposedly, it reduces and reconfigures the starches in potatoes and rice in such a way that they reduce the amount of sugar and/or convert it into a form that isn’t as absorbable. It sounds great to be able to go face down in rice and/or potatoes and not pay the metabolic consequences.

I’m sure a lot of people love those two foods. I, myself, am neither here nor there on rice, but I used to love potatoes. When I first went low-carb about a century ago (it seems), I really missed potatoes. But now, for whatever reason, I’ve more or less lost my taste for them. But if I loved them now, as I used to love them, I would be all over letting them cool then woofing them down just assuming they were filled with resistant starch. 

But since resistant starch is sort of a nebulous idea, I wouldn’t recommend anyone doing that. 

The absolute best thing you can do is get a continuous glucose monitor (CGM), wear it for a month, and watch what happens to your blood sugar when you eat various foods. Cook some rice, test it, then let it cool overnight and test it again. That’s the only way you’re going to know for sure whether or not the supposedly resistant starch is really resistant … to your GI machinery at any rate.

When I first wore a CGM, I discovered that sushi rice sent my blood sugar through the roof. I tried some potatoes figuring they would do the same. My blood sugar barely went up, which figures since I don’t particularly like potatoes now. Most of the foods I tried made my blood sugar respond the way I figured it would. My DIL bought some cupcakes for our grandson’s birthday, and I ate one. My blood sugar went screaming up, much more so than I expected it would. Fortunately, my blood sugar came down pretty quickly too letting me know I was pretty insulin sensitive.

Our biggest surprise when MD and I tried CGMs for a month was what happened when we ate steel-cut oats, the ones that come from Scotland in a can. MD cooked them, then we added a few walnuts, some butter, and ate them with half and half. No sugar, no honey, no sweeteners whatsoever. The steel-cut oats ran both of our blood sugar levels way high, and what’s even worse, they didn’t come down for almost two hours. It’s been adios to the steel-cut oats since then. We used to say to hell with the carbs and eat them every once in a while just for a treat because they’re delicious. But never since our CGM experience. It’s very compelling to see that kind of irrefutable response.

It used to be a hassle to get a CGM. They required a doctor’s prescription. MD and I were able to prescribe it for one another, so it wasn’t much of a hassle for us. Now they can be had over-the-counter. I found a couple of models on Amazon, one by Abbott and another by Stelo. Both are about the same price ($87-$99 for four weeks of monitoring). Both have sensors and apps, so you can read your sugar level on your smart phone.

Get one and give it a try if you’re curious about resistant starch. You’ll find out quickly enough if the starch you think is resistant really is resistant. Just like we did with the steel-cut oats. The CGM is the only way to be sure in terms of your own physiology reacts to specific foods.

Upcoming Post and Great New Book

I’ve been working on a longer post my family insists I write. In fact, they’ve been insisting for over a year now, but I wanted to wait for a while for reasons I’ll explain in the upcoming post.

Instead of completing that post now, I will instead describe a book I just finished reading that describes the fluky nature of life. I can’t remember where I read about this book, or I would give the author of the review describing it credit. I probably don’t remember, because the review wasn’t really a review. It was simply a listing of the best 10 or 15 or whatever number of books the reviewer said were his (I do remember it was a he) favorites. Each book listed was accompanied by a mini review of just a couple of sentences. 

In the review of the book in question, he simply said the book was difficult to describe, but that he couldn’t quit thinking about it since he read it. Which was catnip to me, especially since most of the other books on his list were ones I had already read and thought highly of, so I kind of figured we were like minded.

The paperback version of the book, Fluke: Chance, Chaos, and Why Everything We Do Matters, by Brian Klaas, arrived via Amazon the next day.

I’ve read it, and now, like the guy in the review I read, I can’t quit thinking about it, especially given what I’m going to be writing about in the next Arrow.

The author starts the book off with an incredibly unbelievably and fluky, but accurate, series of events that started in 1926 that resulted in the Americans bombing Hiroshima and Nagasaki. The early pages also describe a grisly event in the early 1900s, without which the author, himself, would never have been born.

We can all probably track back events in our own lives, which had they never happened, we, ourselves might not exist. Or would exist in a much different life situation.

Early on the author, Klaas, defines two different outcomes based on a given set of circumstances. One he calls convergent; the other, contingent.

Let me give you an example.

Let’s say you’re driving to work, and there is one traffic light on your typical journey that seems to last forever. You always breathe a sigh of relief when you end up zipping through on the green without slowing down. You hate sitting there for the two minutes or so (that seem like an eternity) when you catch it on the red.

One day on the way to work, you whiz through the light, get to work on time and start your workday as usual. Which is what happens every workday, even those in which you suffer the aggravation of getting caught by the red light. It doesn’t make you late, because it lasts only two minutes at most. In this case, the status of the red light as you approach it is a convergent event. It doesn’t really matter whether you get stopped by it or not, your day goes on the same.

Now, let’s say you get caught by the red light one morning. You say #4&* to yourself, but sit there patiently waiting for the light to change. It turns green and you accelerate away. But when you get to the next intersection with no stoplight, someone texting drives through it and hits your car broadside. That makes getting stopped at the long red light a contingent event. Had you hit the light on green, you would have long been through the next intersection before the texting driver ran through it and hit you. Instead, you end up in the emergency room with your totaled car towed to the junkyard. In this case, all that followed was contingent on your getting stopped by the traffic light. The rest of your day will definitely not go on as planned.

There may be many important consequences of being hit in such a way that could affect your life going forward.

Obviously contingency is much more influential in our lives than convergence. In fact, it was doubtlessly contingent events that conspired for us even exist.

As the author writes:

It’s like the shopworn trope of the butterfly flapping its wings on one side of the globe creating a typhoon on the other. 

Each chapter save the last two starts with an example of an event, some huge, some just a series of coincidences, that precipitate a plethora of outcomes, many hugely significant.

One chapter in particular I, myself, was involved with at least obliquely. Of course, I was also involved way, way down the evolutionary line from the event that killed the dinosaurs, but in this case it was more personal.

When MD and I lived in Santa Fe, New Mexico I used to play golf a time or two a week with a small group of guys. The three constants in the group were Jim, Frank, and me. The fourth was a rotating player among our group of friends. As you might recall, Jim was my best golf buddy; I wrote previously about his sudden death last December. Frank I lost track of a few years ago, but in my Santa Fe days, he, too, was a close friend.

Frank worked for a company that installed computer systems in banks. He was involved in setting up the computer systems, then maintaining them both on site and remotely. He was tired of all the travel involved, so when the last bank he worked with offered to hire him to maintain their system remotely and travel only occasionally, he jumped at the chance.

Remember Frank as we shift gears.

Chapter 10 of Fluke begins thus:

I’ll abbreviate this story, but I urge you to read it in full should you buy this book.

Somewhere along his life’s path, Joseph Lott developed a love for Impressionist paintings. He often wore ties with Impressionistic images on them. While roaming through a museum on her vacation, Elaine Greenberg found a tie with an Impressionist image on it. She decided to purchase the tie for her boss, Joseph Lott.

 They were to meet the night before a big client presentation to go over the details, but Lott’s plane had been delayed for hours by bad weather, so they decided to meet the morning before. They went over the presentation during breakfast, and Elaine presented Joseph with the tie she had purchased for him. He was delighted with it, but it didn’t go with the green shirt he was wearing.

He went to his room to change shirts while Elaine headed to the meeting.

The meeting was on the 106th floor of Tower 1 of the World Trade Center. The date was, of course, September 11, 2001.

Because of her gift and because Lott had on the wrong shirt, his life was saved. Elaine’s story didn’t turn out so well.

Here is where Frank enters the story. Not in the book, but in my story. And it’s flukes all the way down.

Before Frank switched jobs, he was working for Joseph Lott. Elaine Greenberg took Frank’s position when he left. Had Frank not taken a new job, he would have been on the 106th floor when the planes hit. So would Joseph Lott. Frank would never in a thousand years have a) gone to a museum, nor b) purchased an Impressionistic tie for Joseph.

Had Frank stayed employed with Joseph, they would both be dead, and Elaine would probably still be alive.

To tie this whole story up, Joseph’s entire staff was killed in the 9/11 attack. Joseph was all that was left. He called Frank and begged him to come back. Frank went back, and, as far as I know, is still working with Joseph.

The very next chapter in the book, Chapter 11 “The Emperor's New Equations,” basically shows how rocket science is easier to predict and understand than is human behavior.

This chapter starts out describing how rocket science is really nothing but knowing the right equations and how to apply them. There is very little, if any, guesswork. Not so with human behavior.

The remainder of this chapter is particularly applicable to what I wrote about statin studies in the last Arrow..

If you recall, I wrote about the scads and scads of studies in the scientific/medical literature about statins. I put up the graphic below showing just how many such studies there are out there, with more coming every day.

In this chapter, Klaas describes a study done in 2022 that I wish I had been aware of when I wrote the post on all the statin studies.

A group of social science researchers from Germany and the UK wanted to find the answer to a question that had been plaguing governments and social scientists for years. They wanted to know what citizens of countries with vast social safety nets thought about immigrants coming into their countries and consuming services provided by other citizens to help their own deserving poor. Did the citizens consider the immigrants as parasites and freeloaders, or did they believe the immigrants were deserving, or did they really not care?

It is not as if this question has not been researched. It just hasn’t been aligned. Some of the research shows that citizens get pissed, while other research shows they don’t really care.

The German/UK research team decided to do a study of the people doing the social science studies.

Here is the link to the original study, and below is a graphic showing the findings.

I suspect this is what the thousands and thousands of statin studies are saying as well. Some say statins are the greatest drugs ever developed, while some say they are pretty good, and others say they suck.

Which means, of course, that folks can find whatever they want to find to confirm their own beliefs. And nimrods on X can always find a study that proves their point.

It also means that you have to be very cautious when you read or hear about a given study. You must read it critically. Which is not easy to do if you don’t understand the statistics and the mechanisms involved, and if you get sucked in by relative risk rates instead of absolute risk rates. Plus a lot more.

Always think of the study above. Seventy-six research teams given the same exact data can’t arrive at the same conclusion.

The final couple of chapters of Fluke I found to be a bit of a disappointment when I read them, but they ended up being the ones I think about the most.

The author goes deep into the weeds of whether we live in a deterministic universe or we have free will. He makes an argument for both sides of the debate, but ends up outing himself as being on the deterministic side. I come down mainly on the free-will side, but much of life I’ve got to admit, is absolutely deterministic. 

One of the conclusions I drew from this book is that we should probably take less credit for our successes and less blame for our failures, since luck and randomness play such a huge role in the lottery of the earth and of our lives.

Grab a copy of Fluke so that you, too, can think about it for days.

Fluoroquinolones: The Antibiotic with a Hidden Dark Side

I’m writing this as a sort of public service announcement since I’ve been reading and hearing a lot lately about major issues with fluoroquinolone antibiotics. When the first one I ever used, which was Cipro, came out, I prescribed the heck out of it. It was touted as a great broad-spectrum antibiotic in that it killed almost everything. Cipro and its newer relatives (Levaquin, for one) treat everything from urinary tract infections to pneumonia and are widely prescribed.

After years of use, however, the dark side of these antibiotics has come to light. Side effects and reactions to these antibiotics can be more serious than most people (and probably many doctors) realize.

The problem isn't just a stomachache or a rash like many allergies to meds cause. Fluoroquinolones can cause severe, long-lasting damage to multiple parts of your body: tendons, nerves, muscles, brain function, blood sugar levels, and even your heart. And here's what makes this especially troubling — the side effects can stick around long after you've finished taking the drug.

One of the most well-known risks is tendon damage, particularly to the Achilles tendon, the thick cord running down the back of your ankle. Some patients develop sudden pain and swelling, and in serious cases, the tendon can actually tear or completely rupture. What makes this tricky is that the damage sometimes doesn't show up until long after the patient has finished taking the medicine, making it easy to miss the connection. (See the reading assignment below for an example.)

Fluoroquinolones can also injure peripheral nerves — the nerves that run through your hands and feet. This can cause numbness, burning, tingling, or other strange sensations that may last for months or even years. Imagine finishing a 10-day course of antibiotics and still having numb or burning feet a year later. For some people, that is the reality.

How Does This Happen?

Researchers are still piecing things together, but the leading explanation is that fluoroquinolones disrupt how cells produce energy, increase harmful oxidative stress, and interfere with how the body maintains and repairs connective tissue. Unlike a simple inflammation you'd get from overusing a muscle, this damage is more like a slow, toxic breakdown from the inside. The drugs also interfere with magnesium, binding it up so it can’t be used properly in the 300 plus reactions it catalyzes throughout the body, reactions and other cellular processes important to keeping tissues strong and healthy.

Who's Most at Risk?

Older adults, people on corticosteroids (prednisone, for example), patients with kidney disease, and organ transplant recipients are at higher risk. But what’s more concerning is that serious reactions have also occurred in otherwise healthy people with no obvious risk factors. This isn't an "it only happens to vulnerable people" situation.

Beyond tendons and nerves, fluoroquinolones have been linked to psychiatric symptoms, memory and sleep problems, vision and hearing changes, dangerous swings in blood sugar, muscle weakness, and even problems with the aorta, the body’s largest and arguably most important artery supplying blood to everywhere. These issues may show up one at a time but not always; some patients experience several at once, which points to this being a drug that while it can kill lots of unfriendlies can also disrupt whole systems within the healthy body.

None of this means fluoroquinolones are never worth taking. In serious infections where no other antibiotics will work, they can be genuinely life-saving. The point is that they should be treated with real caution and reserved for situations where the benefit clearly outweighs the not inconsiderable risk and not mindlessly prescribed for routine issues such as uncomplicated urinary infections or bronchitis for which many safer options usually exist.

If you're ever prescribed one of these antibiotics and you notice tendon pain, foot numbness, tingling, unusual weakness, or anything neurological, stop taking it immediately and talk to your doctor ASAP.

The sooner you stop the exposure, the better your chances of avoiding lasting harm.

Fluoroquinolones are powerful and sometimes necessary drugs, but they are far from harmless. MD and I both have it in our medical records that we are allergic to fluoroquinolones.

If you want to read a nicely written piece by someone who had first-hand experience with fluoroquinolones and a bad tendon problem, take a look at this post by Heather Heying. I wish I had her level of creativity. All I could think of for a title for this section is the one you saw at the top. Dull as dishwater. The title for Heather’s post is: “The Achilles Heel of Antibiotics.”

Speaking of Heather Heying…

Australian Doctor’s Revolt

On her Substack, Heather Heying has been posting the experiences of diverse people who were screwed over in some way by various officials during the COVID years. (That’s probably going to give her more post fodder than the alphabet gave Sue Grafton for mysteries and many times over.)

The worst one I’ve read so far is this one by a defiant doctor in Australia. His experience was replicated in many countries without the freedom of speech we in America constitutional enjoy (most of the time).

I read this doc’s story with great interest. I learned from it that Australia isn’t the bastion of free speech I thought it was, and I realized this physician (and many others who were similarly persecuted throughout the world) went through the same intellectual process that MD and I did when the mRNA COVID shots hit the market.

MD and I, both products of a medical education system that assumed vaccines were God’s gift to the world, initially thought the mRNA jabs were ingenious, a terrific scientific achievement. In fact, we were contemplating taking the jabs ourselves when they finally were available.

Then we started reading more deeply about them. We looked into the literature, and what we found was not reassuring. If you have been a reader of the Arrow from the beginning, you can go back and track my study of the whole phenomenon as I posted on it each week, and see the evolution of my (our) thinking.

The Australian doc followed the same process and ended up in the same place MD and I did. We would not take the mRNA shots on a dare. And I warned others about them in my weekly writings.

I am not nearly as high profile as the Australian physician was, so I more or less flew under the radar, whereas he was completely destroyed career-wise. As least in terms of a medical career.

In the US, many physicians who were opposed to the COVID jabs lost their jobs not so much because they protested too much, but because they refused to take the shots themselves as was mandated by their hospitals and universities. But no one I’ve heard about was as abused as the poor doc from Australia.

I encourage everyone to read his story, if for no other reason than to keep fresh in our collective memory how bad it was during the COVID years. And how absolutely awful people could be to their fellow humans who took a different view during those times.

And I encourage you to read other posts in Heather’s series of stories by people deeply affected by the COVID groupthink and outrage. I thank her for being a vehicle for them to get their stories out. Again, let’s never forget.

Odds and Ends

• Decoded secret letter to Ferdinand and Isabela about medieval Britain and Scotland

• Glamping in Yosemite. I've camped in many a tent on many a trail in Yosemite, but I think that fun's behind me now. This one might do, though.

• Take me away! To anyplace without a mosquito. I remember when MD and I were vacationing one summer in Santa Fe, NM and saw in the New Mexican a news article with the headline 'Mosquitos found near drainage ditches' reporting sightings of mosquitos, which they went on to say can cause itchy red welts if they bite. And we thought coming from Arkansas (and how it didn't make the list I can't fathom) take me to a place where it makes the news that mosquitos a) exist and b)cause itchy red welts if they bite! The list of states with the most mosquitos surprised me.

• Incredible find by a teenage German boy -- the first ancient Greek coin ever found in Germany. Lucky devil! Now if he can just unravel the mystery of how it got there.

• I'm not sure I'd agree that the 13 spots on this list are all 'patriotic' though most of them are. They'd all be interesting to visit, I'll grant you, and there are a few left on the list that the Bride and I haven't seen in this list of patriotic sites.

• This piece on the black & white photography of legendary photographer Brassaï (real name Gyula Halàsz) of images of Paris by night is a collection of 1930s intimate moments. If you're a fan of such, it's a fascinating glimpse into Paris in the decadent 1930s. 

• Why are 90% of humans right handed? Fascinating theories about it. All three of my sons write left handed, but there’s a reason for that and it isn’t handedness. Don’t ask.

• Breathtaking national parks around the globe. Haven't been to any of these, but the Bride and I would love to give a few of them a go, except the komodo dragon one. I’d go, but MD gave the thumbs down to getting within spitting distance of those critters.

• Check that dusty back corner of your storage closet for this valuable memorabilia from the early 2000s. You might just spin straw into gold and finance this summer's vacation. Need to go dig into that storage unit.

• Fascinating series of postcards from 1899 with drawings of what they envisioned the year 2000 would be like. Would be interesting to do the same forward guessing to the year 2126 and imagine what there would be. 

• Greatest hoard of Viking coins ever found unearthed recently in Norway. From the time of Aethelred the Unready and King Harald. Just the silver content would be worth a lot, let alone the historic value.

• Long lost copy of what's believed to be the world's oldest surviving English language poem discovered by Dublin researchers in Rome.

• And here is a modern English translation of that poem. Pretty good for an illiterate cow-herder.

Newsletter Recommendations

Video of the Week

The video below popped up on my X feed¹ a few days ago. I don’t have any idea about the story behind it, but it looks like a bunch of frat boys doing some sort of performance. But it was in some language I don’t understand, and the description is in writing I can’t read (it says it’s Turkish, but how do I know?). What I do know is that it took a helluva lot of work to pull this off so smoothly. If anyone has any idea where it came from or what the story is, let me know in the comments or in the poll.

1. I was chastised by a reader for referring to X as Twitter/X. He said it’s been X for years now, so why the double name. He’s got a point, so X it is from here on.

For just a bit of lagniappe and along the same story line, here is a hilarious video of a bunch of 5th grade boys putting on a synchronized swimming performance for a talent show. I’ve endured countless grade school performances of our kids and grandkids, but I don’t ever think I’ve seen one this clever or funny. I hope they won. Enjoy!

Time for the poll, so you can grade my performance this week.

That’s about it for this week. Keep in good cheer, and I’ll be back soon.

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This newsletter is for informational and educational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

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