The View From the Outback

• Thoughts While Staring at the Ceiling Fan
• Carly Fiorina Of Hewlett-Packard - A Truly Inspiring Story
• My Medical Writing Credentials - Such As They Are
• The New Cholesterol Guidelines - Everybody Gets A Pill
• Suggested Reading From Past Columns

There must be a lot of depressed people at Eli Lilly and Co. The patent for their popular antidepressant drug Prozac expires this year. The company also inadvertently released over the Internet the e-mail addresses of more than 600 Prozac users. The e-mail list was for people who had signed up to be reminded by e-mail when it was time to take their pill or renew their prescription. You gotta be kidding! Maybe those people should have invested in a Palm Pilot or used the antiquated idea of noting the days on a calendar pasted to the refrigerator door.

A headline read "International Paper Cuts 3000 Jobs." Nobody likes "Paper Cuts." Maybe a better choice would have been "International Paper Trims 3000 Jobs."

There was a TV rerun of a biography of Margot Kidder (Superman's gal pal). She worked on her laptop for a long time on her life story, which is rather bizarre even by Hollywood standards. Somehow her computer got a virus that erased her hard drive. She had never made a backup copy. Think about that the next time you go a couple of months without backing up anything, or worse, never back up your data. Even Superman can't save you.

Why does Henry Kissinger still speak with a pronounced German accent? He has lived in this country since 1938! He is, after all, a Ph.D. professor from Harvard, a former Secretary of State, and a Nobel Prize winner. As a ham-radio-operator, I hear English being spoken by people from over a hundred countries. Many friends in Germany speak such unaccented English that you cannot tell them from an American. My dear friend Toivo from Estonia speaks such pure English that people think he is an American on vacation there. And so it goes, in country after country. When I lived in Germany, although my grammar was not excellent, my accent was nearly perfect - and I often passed as a German. My limited Spanish, Italian, and French never got any snickers from the locals - because I worked hard at mimicking the accents. I have concluded that Henry Kissinger hangs on to his accent as part of his "act," part of his inscrutable persona as an international expert. Vell, Doktor Kissinger, vhat do you say to dat?

TIME-LIFE is going to discontinue the sale of those "how to fix your plumbing, etc." books they pitched so relentlessly for years on TV. You know, buy one book and get 50 more over time unless you put in a "STOP" order. No, I didn't buy any. I read the fine print.

Hitler's mountain retreat in the Bavarian Alps, "The Eagle's Nest," is being turned into a luxury hotel and golf course. When we lived in Germany in the '60s, Germans shied away from talking about Hitler. At the general site of his mountain retreat, where you could look up at the "Eagle's Nest" on the mountain, our guide said that on the site where we stood a chalet belonging to Hitler had been demolished so as not to let it stand as a memorial to Herr Adolph. Now, they want to build a resort at the Eagle's Nest? It must be a new generation of Germans whose history books have some omissions.

The lawyer for members of the New York Gambino mob family, in a clear reference to the Clinton family, said they were "low-rent, trailer-park trash." Isn't that a hoot! As one who spent some time chasing the mob around Philadelphia, I can say that there are a lot of "trailer-park trash" I would rather associate with than guys from the New York or Philly mobs. And as one who lived in a "trailer" out here in the Outback for several years, I take offense at the condescending attitude of a gangster and thug from New York At least I did not have to rob, steal, or kill to get the money for the trailer. Some nerve this guy has. This is what happens when books, movies, and TV glorify being a gangster. Now, if he had called the Clintons "white trash," I would have no problem with that.

Wilford Brimley, the portly and grandfatherly actor, became about as famous for his TV ads for Quaker Oats as he did for his acting. At the time, I wondered if I would have chosen an obviously overweight man to pitch my cereal, which as I recall was hinting that it was "heart healthy" or might lower cholesterol. Now, the corpulent Mr. Brimley is back in a new commercial on TV. This time he is advertising a company that provides supplies for diabetics. It seems that Mr. Brimley is a diabetic. As one who has a diabetic in the family, I know that the first rule is lose weight, and the second is exercise - in addition to watching sugar intake. The new ad seems to prove that celebrity is more important than logic in a TV commercial. The thin and stylish Mary Tyler Moore (who has diabetes) would be a fine choice for the diabetes supplies ad. But, an overweight guy? Not a good role model for diabetics. Nobody said TV producers are smart.

COMP USA is a big name in computer software and hardware retailing. I wonder how many people know its genesis? Many years ago, two brothers and their father from South Africa started a small retail store in Addison, Texas near Dallas. It was in a kind of office strip mall, not far from the line of liquor stores in town. They had rough wooden shelves and a small assortment of software titles. They called themselves "SoftWarehouse." They added hard drives, memory, printers, and thus the business grew. Eventually, they were bought out by a bigger outfit and moved into spacious quarters a few blocks away. It was fun to seek out the father, Gilly, as I recall his name, and see the wonderment in his eyes as we cruised the aisles of the superstore looking for a graphics card or whatever. Later, the store became COMP USA and went national. You would think that some of us customers from the original SoftWarehouse might get a frequent-customer discount at COMP USA. After all, we built the business with our loyalty. All we get now is a security guard who peers at us and pokes in packages to see if we have stolen something. Ah, progress.

The Egg misinformation wars continue. Some media reported that the FDA prohibited restaurants from serving sunny-side up eggs. The FDA put out a press release saying that there was no such rule about sunny-side up eggs. But, if you want my advice, I would make sure that the yolks are cracked and well cooked or the eggs are scrambled. You can do what you want, just don't complain if you get Salmonella. Starting September 4, 2001, egg cartons sold in retail groceries must bear safe-handling instructions about raw and undercooked eggs. Hardboiled eggs make a good snack and no runny yokes. (For more, see: www.foodsafety.gov)

Carly Fiorina Of Hewlett-Packard - A Truly Inspiring Story

Carly Fiorina is the Chairman and CEO of Hewlett-Packard. She gave the commencement speech at Stanford University recently. Her story is an inspiration on several levels. She graduated from Stanford with a B.A. and went on to law school. Her father had been a law- school dean and judge, and Carly assumed she was expected to pursue a law degree. She hated law school, and early on told her parents that she was quitting.

So, with her degree from Stanford, she was able to land a job at a real-estate firm in Palo Alto, California - as a receptionist. Here is where the plot thickens. Across the street was a giant in American technology, Hewlett-Packard (HP). Tiring of typing and answering the phone, Carly moved to Italy and taught English.

Back in the states, she earned an M.B.A. and later a Master of Science degree from MIT's Sloan School. She held several senior positions at AT&T and Lucent Technologies for about 20 years. She was asked to interview for the CEO job at Hewlett-Packard. In her Stanford commencement speech, she tells of deciding to sit in her car in the parking lot of her old real-estate firm, where she had been the receptionist. She could see the imposing HP headquarters across the street - where the interview was about to take place.

Although she did not engage in any hyperbole about her emotions at that time, tears were streaming down my face as she told the story. The former receptionist now being asked to be the CEO of one of the giants in American technology. It must have been an enormously moving few minutes in that parking lot as she thought about the past and what the future might bring. I bet she had to reapply her makeup.

Well, it was a slam dunk. She got the job at HP and was later named Chairman of the Board of Directors - and she was not yet 50 years old.

The messages she left with the Stanford grads were at least two. Follow your own course, not what someone else thinks you ought to do. And never let the "conventional wisdom" get in your way. In her case, the conventional wisdom was that a woman had never been the head of a company as large as HP.

In her 2000 commencement speech to MIT, Carly also said the following: ".... or when I worked as a secretary in the shipping department of a company called Hewlett- Packard, typing bills of lading, logic and intellect would never have predicted that I would one day return to run that same Palo Alto company." I don't know whether that was before or after the receptionist's job across the street from HP.

There are few in the business world whom I admire. Carly Fiorina leads my list. I have a long association with HP and its products, going back to some work they did for the CIA decades ago. Today, my home office is filled with three HP printers, scanner, tape backup drive, CD-RW drive, and so on. (Sorry, Carly, I built my own computer.) In truth, even when a review gives the nod to a competing product, I tend to buy HP. Part of it is their long and proud tradition for quality. Part of it is that Carly Fiorina is so darn cute. And I can't resist her sales pitch. Can you imagine being Mr. Fiorina sitting at the dinner table and saying, "Honey, how was your day at the office?" That's a story I would never tire of hearing.

My Medical Writing Credentials - Such As They Are

I write a lot about medically-related matters. Sometimes, I may even come close to making sense. Where does all this "medical expertise" come from? For nearly 20 years I was a member of the Aerobics Center in Dallas. Associated with the exercise center is one of the finest medical diagnostic clinics in the world, The Cooper Clinic. The staff ranges from nutritionists, to cardiologists, to radiologists, to internists, to a dentist, to exercise physiologists. I had the chance to jog with several of the staff over the years and sit down at lunch or by the pool to discuss preventive medicine. Twice I took the course on nutrition offered at the Clinic.

I was married for a time to a doctor's widow, who herself had been to medical school and had worked in DNA research. Our bookshelves were full of medical books and the conversation often turned to medical topics, especially when a friend or relative would call and wanted something looked up - or wanted free advice.

When the Internet began to blossom, I identified some authoritative medical information sites and began to download articles for my "medical archive." Most of my life I have fought a weight problem. So, I read an inordinate amount about diet and nutrition. For many years I have been treated (successfully) for hypertension. Again, a shelf full of books and piles of medical papers from the Internet. Three years ago, I started getting chest pains. Finally, after weeks of tests, and the opinions of three cardiologists, I had extensive bypass surgery. Along the way, I started buying books on heart disease and alternative medicines. I have shelves full of medical books and books on supplements and vitamins. I am registered with the premier Internet medical site as a medical journalist and have access to the same reports and studies as doctors.

I subscribe to several health newsletters, such as the "Harvard Heart Letter," the "Harvard Health Letter," " The Heart Advisor" from The Cleveland Clinic and several prestigious general health newsletters. Every morning, I read the summaries of health news and download the full text of things I find new or interesting.

For years, friends have asked me to research various diseases for them or for relatives, from neurologic disorders, to Cancer, to heart disease. One thing my legal training did equip me for was distilling piles of information in useable gulps.

While living overseas with my wife and two sons, we got to see some interesting medical approaches. In Laos I fell from a motorcycle in a skid and ruptured some rib cartilages. The U.S. Embassy doctor said he was all out of pain killers and that there basically was no treatment for my problem except rest and time. To ease the severe pain, he suggested that I sit in a chair and drink Cognac until the glass finally dropped from my hand. This, of course, was the origin of the phrase "feeling no pain." It worked, but man what a hangover. I went to the local dentist to have a tooth extracted. He used the same cup on his stand for every patient to use to rinse his or her mouth. I ended up with complications and had to go to Bangkok for treatment. In Germany, my son broke his collarbone. The doctor at the Army hospital looked at the X-ray and said that he was going to put some kind of truss on the Right Clavicle. But, the broken bone of the Left Clavicle was clearly trying to pierce the skin. When I pointed this out, the doctor said, "Oh, I had the X-ray backwards." Thank God none of us ever got seriously ill or injured.

My personal experiences and the results of my medical associations and research has led me to be convinced that doctors primarily practice "crisis medicine." The areas of prevention, lifestyle changes, a foundation in religion, the use of herbal and vitamin supplements, yoga, sound therapy, proper diet, and so on, show great promise in slowing down the rate of illness and death. Thus, I rant about doctors who prescribe drugs at the drop of a hat and those stupid commercials for pills on TV. Some pills are useful. A lot cause more problems than they cure.

One blessing I have is a Cardiologist (I drive 5 hours round-trip to visit him) who shares my disdain for medications as the "first thought" and has spent many hours with me as I covered the exam table with books and papers and lists of questions. He is nearly unique, and I call him to his face, "The World's Greatest Doctor." He is my mentor, my friend and one hell of a doctor.

The New Cholesterol Guidelines - Everybody Gets A Pill

The National Cholesterol Education Program, coordinated by the National Heart, Lung, and Blood Institute, released new Cholesterol guidelines. The target levels vary by whether you have heart-disease risks, have heart disease, or have diabetes, for example. In general a Total Cholesterol of less than 200 mg/dl is desirable, and 240 and up is "High." The LDL optimum level is less than 100. A Triglyceride level of less than 150 is normal, and 200-499 is High. An HDL level (the good Cholesterol) of less than 40 is low and 60 and above is high (good).

The updated standards, especially for those for who have risks for heart disease, heart disease or diabetes, will overall perhaps triple the number of Americans who doctors will consider as candidates for lowering their cholesterol. Regrettably, one can predict that much, if not most of the emphasis will be on placing patients on "statins," such as Zocor, Mevacor, and the others. The first line of attack ought to be losing weight, more exercise, and less saturated fat in the diet. Don't take just my word for it. I was pleased to see a letter-to-the-editor from Rudloph M. Keimowitz, M.D., in the June 26 issue of The Wall Street Journal in response to an article entitled, "How Drugs Got Boost Over Diet In Cholesterol War." In part, Dr. K said: "The issue is convenience. Taking a pill is easier than dieting and exercise. It is as simple (and expensive) as that."

First some thoughts to put the issue into perspective. About half of the people who have heart attacks have normal cholesterol levels. Cholesterol levels are important, but there are many other factors in heart disease, such as Homocysteine levels, smoking, obesity, the levels of C- reactive protein (CRP) in the blood, exercise (mostly the lack), the type of plaque that forms (some are referred to as hard or soft), and yet unknown precursors, such as possibly viral infections. So, don't put all your eggs, or your money, in the Cholesterol basket and think you are home free. Now, there is even evidence that the Cholesterol tests should be broken down even further into 21 lipid subclasses (VAP test), such one that detects Lp(a) levels - among others. There is still an enormous amount we don't know about heart disease.

So, you will be further inundated with TV ads for cholesterol-lowering drugs, mostly the "statins." And your doctor may be suggesting a statin after your next blood lipid test. But wait! There is an enormous body of scientific evidence that there are better ways to lower your cholesterol than taking a prescription drug, which like all drugs may have undesirable side effects.

We see a concerted PR effort by the pharmaceutical industry to attempt to ascribe more claims for statin drugs than just the lowering of cholesterol. There are "studies" that tend to indicate that statins may be good for your bone density, decrease inflamed arteries, and a bunch of wonderful things I can't remember at the moment. The point is that the public must be wary of the "studies" that show up in the daily news or on the various news outlets on the Internet. Many are stretching some limited facts from a small statistical analysis about patients in one hospital about as far as one could imagine. Wait until there are some long-term controlled studies on these "ancillary benefits" before you get too excited. Statins do lower cholesterol. No question about that. Let's wait for them to proven as "miracle drugs."

Before you start popping prescription drugs to lower you cholesterol, consider some of the alternatives. While it is not scientific to take one person's case and try to deduce medical wisdom from it, I am going to share some personal experiences. And point you to some areas where you might want to do your own research.

In the last five years, my total cholesterol has been as high as 240 and as low as 150. I got it to 150 by following exactly the Dr. Dean Ornish diet, which is basically vegetarian. In the past couple of years, I have altered my diet and increased the number of supplements. For a couple of years, my cholesterol has been around 160. I eat several eggs a week, some bacon, maybe a steak, some rich bakery cookies now and then, a couple of doughnuts, and a chocolate bar at least once a week. Yesterday, I had a piece of Pecan Pie. There is some good medical evidence that a cholesterol of around 170-180 may be optimum for the average person. I'm eating more Pecan Pie until I get mine to 170! I read of one doctor whose cholesterol is 150, and he is going to raise it! So, for all those with values of around 130-150, it may not be the blessing they think it is.

I try to keep my overall intake of Saturated Fat to less than 10%. If you track your Saturated Fat, your overall intake of fats will take care of itself. There are some good fats (monounsaturated and polyunsaturated), such as in nuts, seeds, many fish, flaxseed, soybeans, olive oil, and so on. A high intake of overall fats is not a serious concern if most of those fats are the good fats, such as from the sources I just mentioned. I am overweight (working on it) and have had by-pass surgery a couple of years ago.

I eat a handful of nuts each day, usually Walnuts, Pecans, or Almonds. Some studies have indicated that eating five servings of nuts a week may reduce the risk of heart attack by 40-50%. A new study found that Walnuts reduced cholesteril significantly. Walnuts are high in Polyunsaturated fats, while other nuts tend to be high in Monounsaturated fats. Like Walnuts, Sunflower seeds are high in Polyunsaturated fat, so they would also seem to be a good choice in lowering cholesterol. (For nuts, see: www.walnutacres.com) I eat at least two servings of fish each week, always at least one big Salmon filet and some Albacore Tuna in salads maybe three times a week. I usually eat a multi-grain cereal for breakfast and now sprinkle 1/4 of a cup of ground flaxseed (from S. Dakota) on the cereal. I use soy milk on the cereal and always top it with a banana. (Check out Flaxseed. It is potent stuff. see: www.flaxgold.com). I try to eat at least two pieces of fruit a day. One outstanding choice is an Apple.

One or two days, I may have two eggs and two pieces of bacon. For lunch I may have a smoked pork chop sandwich (the thin porkchop has only 2.5 gr of Sat. Fat) on 100% wholewheat bread. The bread is slathered with "Take Control" spread (let's not call it a margarine). This stuff does lower cholesterol, but you have to use a lot to make a significant dent. Still, a little adds to my total package of the cholesterol-lowering regimen. "Benecol" has similar benefits.

Sometimes, I have a cold Cuban bean and rice salad with long-grain brown rice and black beans sprinkled with balsamic vinegar. Don't knock it until you try it. I may eat a TV dinner, which no more than 5 gr. of Sat. Fat per serving. For dinner, I often eat a huge salad of tuna, broccoli, black olives, tomatoes, onions, minced garlic, Greek salad peppers, tofu, fat-free croutons, a tablespoon of Parmesan cheese, and sprinkled with balsamic vinegar and olive oil. Or, whole- wheat pasta with copious amounts of Barilla pasta sauce - with textured soy protein (the stuff looks like crumbled hamburger). And topped off with some Parmesan cheese and olive oil. Maybe I'll have a T-bone steak. For desert, I usually have a low-fat fruit yogurt. I bake Ore-Ida "fries" in the oven until crisp. Some have as little as 1.5 gr Sat Fat per serving.

If I eat at a fast-food place, I usually get a chicken or turkey sandwich at Scholtzsky's or a BK Broiler chicken sandwich (hold the Mayo) at Burger King. Both are very low in Sat. Fat. I have downloaded the "nutritional information" from every fast-food place that has a web site. That is how I came to the two selections I usually eat. There are some other low-fat sandwiches, such as at Subway, and so on. I'm in a rut.

This is by no means my total diet. But, it shows you that I eat tasty and nutritious foods and still keep my Sat Fat to less than 10%. (Calories times %/9) On an 1800 calorie diet, 10% is 20 grams of fat. That is 1800 X .10/9=20.

There is no free lunch. A handful of healthful nuts is around 180 calories and about 1.5 gr. of Sat. Fat. You just can't snack on nuts all evening. It's that simple. And 1/4 cup of ground flaxseed is about 245 calories and about 2 grams of Sat. Fat. Compare those choices to a small chocolate bar with 230 calories and 9 grams of Sat. Fat.

Along with Soy, in the form of Soy Milk, Tofu, Textured Soy Protein, Flaxseed, and nuts (which tend to lower cholesterol and are "good" for your heart), I take several supplements. Some, or all, may be contributing to my 160 cholesterol reading (my HDL was 64 the last time we tested - and above 50 is very good). They say that Red Wine (and maybe other alcohols) will raise your HDL (good) cholesterol, as will exercise. I subscribe to those theories.

Coenzyme Q-10 (my cardiologist is a primary researcher on Q-10), Garlic, Chinese Red Yeast (as close as you will get to a Statin drug without a prescription), Vitamin E, Vitamin C, and Calcium. To keep my Homocysteine level within the normal range, I take B-6, Folic Acid, and B-12 (there is nearly universal medical agreement here).

The Co-Q-10 is heart healthy (and gives you healthier gums in the bargain). I also take Hawthorn Berry, Taurine, Alpha Lipoic Acid, Selenium (up to 200 mcg a day), and L-Carnitine (doctor's orders), and a daily Aspirin (81mg or more). For my eyes, I take Bilberry and Lutein. In the last four years, vision in one eye has remained the same. Vision in the other eye has improved by two steps on the chart! And I am an old geezer. To help me remember where I put my truck keys, I take Ginko Boloba. The jury is still out on that one. I just went to the kitchen to eat a banana and forgot where I laid the draft of this column. I walk at least a mile on the treadmill several days a week and do a lot of mowing and yard work When I think of it, I do some light lifting with free weights. Last night, I shot some baskets. My BP is normal and my resting pulse is 60 or less.

Each time I visit my Cardiologist, I bring along a printed list of my vitamins and supplements and we go over them. The best that he can come up with as a medical man and a serious researcher is "I don't see anything there that will hurt you." Of course, he has "prescribed" several of the supplements. Little has changed in several years. Just the change from Flax Oil caps to ground Flaxseed (the literature is overwhelming about the benefits of the ground Flaxseed).

Like I said, I am only one guy, and I would not presume to tell you what to do. I can only tell you that by fiddling with diet, vitamins, exercise, and supplements for over 20 years, I have found a regimen that appears to work for me. Obviously, something was out of whack in many of those early years, as I ended up with heart disease, although never a heart attack. I have no side effects, that I am aware of, from all the stuff I take. My medical plan has a prescription co-pay which is very low. I could take Zocor or one of the other statins many times cheaper than taking the supplements I take. My reasons should be clear by now. Yes, it is easier to take a prescribed drug - and maybe cheaper. Do read the literature on the statins (or other prescription drugs) before you agree to take them.

Suggested Reading From Past Columns

Global warming and environmental debate:

"John Stossel And ABC's 'Tampering With Nature,'" June 29, 2001
"The Kyoto Protocol & Global Warming - A Monumental Scam?" June 16, 2001
"Environmentalism For Dummies," April 7, 2001
"Environmentalism For Dummies - Part II," April 21, 2001
"Public Interest Groups With Sometimes Very Little Public Interest," May 12, 2001

Prescription drugs being advertised on TV - abuses in the pharmaceutical industry - supplements:

"Bitter Pills To Swallow," June 2, 2001
"The Drug Companies Continue Their Assault On Your Pocketbook," May 19, 2001
"Herbal Remedies, Supplements, And Alternative Therapies," September 18, 2000
"Prescription for Disaster," September 11, 2000

A case history of horrendous abuse by Federal law enforcement:

"FBI Sniper At Ruby Ridge My Be Tried For Manslaughter," June 9, 2001.

Late Night TV Cruel Humor, et al.

"David Letterman Grovels For The Colombians," May 19, 2001
"Are Leno And Letterman Using The Same CD-ROM For Constructing Jokes?" May 12, 2001
"Late Night Comedians Struggle To Lampoon Bush," May 5, 2001
"Late-Night TV Sick Humor," August 28, 2000
"Late-Night TV Political Comedy," August 14, 2000

Crime, guns, gun-control:

"The AMA Is Losing Its Way," June 29 2001

Politics:

"President Bush's Excellent Adventure," June 29, 2001
"The Bush Budget - Fighting Over 4% Growth Versus 8% Growth Is Nonsense," April 21, 2001
"Campaign Finance Reform - A Senatorial Catharsis - And National Snow Job," March 31, 2001
"Florida Secretary Of State Literally Begged Networks Not To Call Election Early," March 24, 2001
"The Ever-Expanding First Amendment," January 26, 2001
"Bush Administration Needs To Review The Mission Of Federal Law Enforcement," January 26, 2001
"New York, What Were You Thinking?" November 13, 2000
"Lessons Learned In Election 2000?" November 13, 2000
"How The Federal Government Corrupts The Constitution To Intrude Into Your Life," October 30, 2000

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COPYRIGHT 2001 Richard C. Rhodes

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