Emptying out the mailbag and clearing the history #2

Posted on September 22, 2014

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The first one of these can be found here

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My favorite fitness app so far

Breeze is an app which does one thing, count how many steps you get each day. And that’s why I love it. All you do is load it, it tells you how many steps you’ve done today, and you’re done. You can see how many you’ve done in the past if you like, but that’s about it. Steps and more steps.

Image credit: Apple Insider

Image credit: Apple Insider

I’ve found it to be incredibly accurate, and I enjoy the fact I don’t need to carry another object around. I have my phone on me most of the day already, why not let my phone be a pedometer as well?

The best part of this app is it uses a motion sensor already built into the phone, opposed to the accelerometer. (Only available on iPhone 5s and 6 right now.) This is why it’s so accurate. Plus, it doesn’t use up your battery like other pedometer apps.

Once you download Breeze, it will already load how many steps you’ve taken each of the last seven days. Yes, Apple built this into their phone. No, they didn’t tell anyone the phone does this, nor do they ask for your permission to do so, nor do I think you can even opt out of this. Yes, that’s creepy.

(Steve Jobs was famous for shitting on Google’s “Don’t be evil” mantra. Not sure Apple, or any of these tech companies, are any better.)

10,000 steps per day, roughly five miles or 100 minutes of walking, are good numbers to strive for.

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Some good boots

I’m pretty big on minimalist footwear. I much prefer a light, soft, low if any heel lift, roomy shoe, opposed to many of the cinderblocks out there. This can be hard to find when it comes to non-sneakers though. Work shoes, boots, office attire, etc. Here are a pair of boots a remote client, Malte, who is a police officer, recently showed me:

Click the boot to go to amazon.

Those are a nice compromise between wearing something more minimalist and still having some protection. I really like the lack of heel lift.

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Good comment from a reader on specialization

I had an email exchange with Darrell, and liked this part of the exchange from him:

“…fundamental movement is the common denominator between different clients and desired outcomes. In an industry which is becoming so segregated (eg. strength coach, conditioning coach, physio, nutritionalist etc) all having such specialised roles it seems that too often coaches or trainers miss the complete picture and become too reliant on each specialist. There are advantages to this of course but it’s extremely dependent on exceptional communication between groups and even then without decent understanding of each others roles it can leave plenty of gaps in an athletes development. Being able to appreciate the links in movement patterns from the absolute fundamentals and posture to sports specific stuff certainly has it’s advantages…”

This ties into something I’ve found quite strange, particularly in the exercise world, but it extends to most of healthcare. Using Darrell’s professions above, strength coach, conditioning coach, physio, these professions really all come back to one central theme: They help people move.

It’s strange as a strength coach to have little understanding of what causes say, knee pain. It’s strange as a physio to have little background in say, how to get someone stronger. If you move people, it’s strange to have no nutritional background as if someone is significantly overweight, it’s going to be very hard to perform certain movements. As a conditioning coach, you really need some solid nutrition background to understand why your athletes should not be partaking in paleo, even though it’s all the rage right now. (Carbs are important for most sports!)

All these things are complementary. You can have the greatest physio in the world, but if the strength coach has no idea of what causes a hamstring strain, it’s not going to matter. Any former athlete will be nodding their head in too much agreement right now. You may have a great strength and conditioning coach, yet the head coach, who has a history degree, dictates how many gassers you run at the end of practice.

In terms of a solution: I feel more confident in a system with something like one, maybe two people overseeing a person’s training, than I do in 5-10 people all trying to coordinate with one another. Certain aspects, such as the strength training and nutrition, are simple enough that one brain can handle it. This isn’t like trying to know the nuances of neurosurgery and foot surgery at the same time.

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A reminder about doctors and weight-loss

This article, The Well-Fed Physician, which was also disturbingly titled “DOCTOR: I finally understand how to lose weight” at Business Insider, is a good reminder of what doctors learn in medical school. Whatever the most common issues are, overweight, back pain, knee pain, your average doctor has no clue how to help with those things. They are also hopelessly inadequate even if they do. A 15 minute office visit, once or twice a year, isn’t doing anything. (Hence, “take this drug everyday.”)

It reminds me of this great Louis CK bit about back pain:

Dr. Bigelow: What can I do for you?

Louie: Uh, well, I hurt my back today really bad. Uh. Can you help me with my back? I mean…

Dr. Bigelow: What’s wrong with your back?

Louie: It hurts.

Dr. Bigelow: My professional diagnosis is your back hurts.

Louie: Well, what can I do about it?

Dr. Bigelow: Nothing.

Louie: Nothing?

Dr. Bigelow: The problem is you’re using it wrong. The back isn’t done evolving yet. You see, the spine is a row of vertebrae. It was designed to be horizontal. Then people came along and used it vertical. Wasn’t meant for that. So the disks get all floppy, swollen. Pop out left, pop out right. It’ll take another. I’d say 20,000 years to get straightened out. Till then, it’s going to keep hurting.

Louie: So that’s it?

Dr. Bigelow: It’s an engineering design problem. It’s a misallocation. We were given a clothesline and we’re using it as a flagpole.

Louie: So what should I do?

Dr. Bigelow: Use your back as it was intended. Walk around on your hands and feet. Or accept the fact that your back is going to hurt sometimes. Be very grateful for the moments that it doesn’t. Every second spent without back pain is a lucky second. String enough of those lucky seconds together, you have a lucky minute.

Louie: Okay.

Dr. Bigelow: Come see me when you have something fun like a blood disease. That’s what I went to school for.

(This is just for humor and to make a point about the typical doctor approach to back pain. It’s not actually valid. Our spines handle compression (being upright) very well, and they need it. Keeping your spine only horizontal will lead to issues of its own. (More here if interested.))

What’s particularly distressing is how the doctor closes out his article about his weight-loss:

“So I stick to the study’s guidelines: (1) eat breakfast daily; (2) weigh daily; and, most importantly, (3) don’t let a lapse become a relapse. By following these, I hope to keep the weight off.”

Eating breakfast and weighing yourself everyday are so 1999. (Seriously though, it’s antiquated, bad advice…coming from a Doctor…who works at Brown University…an Ivy League school.)

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Cool story from a client

Lisa N Testimonial

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“All this technology is making us antisocial”

I thought this was amusing:

Technology newspapers

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Few good healthcare articles

-Per Capita Medicare Spending is Actually Falling

-A Single-Payer System Won’t Make Health Care Cheap

-The Health Care Jobs Fallacy

I particularly loved the last article.

“But this focus on health care jobs is misguided. The goal of improving health and economic well-being does not go hand in hand with rising employment in health care. It is tempting to think that rising health care employment is a boon, but if the same outcomes can be achieved with lower employment and fewer resources, that leaves extra money to devote to other important public and private priorities such as education, infrastructure, food, shelter, and retirement savings.”

I’m sure I’ll go on a rant about this someday, but one of the things not being addressed enough in healthcare is that, to truly lessen costs, you need less customers. (Or the customers you have need to use the services less.)

I see many reference other countries and how much better of a job they are doing controlling healthcare costs. First, they are better controlling reactive care costs, but if you factor in proactive care, many countries aren’t doing any better.

American Healthcare Paradox 2

We’re an anomaly in where we allocate our money, but not in how much we spend in aggregate. (Social service + Healthcare services = Total $ on Health Expenditures.)

Second, as far as I know, no developed country has decreased costs. (The difference between lessening the rate of spending increase and actually decreasing costs.) They may not be increasing their spending, or spending overall, as much as us, and sure, there are lessons to be learned from that, but nobody is decreasing costs. And there is one basic economic reason for that.

It’s just like college education. Everyone has all these theories for why college keeps costing more and more. I see these economics professors with all their fancy graphs and way too convoluted mathematical formulas who seem to forget one simplistic point: If people keep paying for your product even though you keep increasing prices, you can keep increasing prices.

The best way for college education prices to come down is the best way for healthcare prices to come down: When people stop paying for it. You don’t want to spend $50,000 a year on a college education? Great! Then don’t!

And the best way to stop paying for healthcare services, especially the most expensive ones, is to already be healthy.

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