inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #26 of 62: flash gordon md (flash) Mon 5 May 08 12:58
    
sorry i was m.i.a. - had a column to finish. 

anyhow, sleepiness when riding is definitely a cause of fatalities. in
fact, the most common drug found in the bloodstream of general
aviation pilots who die in crashes is antihistamines. 

antihistamines, as you probably know, include older "sedating" ones
like benadryl and chlortrimeton, and the newer less-sedating ones like
claritin, zyrtec and allegra. of all of these, only allegra is really
"non-sedating" - zyrtec is pretty sedating, claritin a little less so.

the best way i know of to not get sleepy when riding is not to use an
alarm clock. if you do use one to wake up, then by definition you're
sleep deprived. 

when i'm on a road trip i won't use any kind of alarm. if i need to
get an early start, i'll go to sleep early.

oh, and as far as riding to the Very Boring Rally in duluth in august:
i just can't afford it. every day i'm not at work costs me $2k (my
employees and the expenses continue whether i'm there or not). and the
folks putting on the rally didn't offer to pay any of my travel or
lodging expenses - i'm hoping i can hit 'em up for a few meals, at
least.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #27 of 62: Michael Psycle Bettinger (mcpsycle) Mon 5 May 08 18:33
    
The financial part of the medical business appears to be getting
tougher over the years.   They are going to need to have physicians get
an MBA along with their MD if they want to succeed in private
practice.  When you have mentioned your fixed expenses here and in
other conferences, I am always stunned at how much it cost to keep a
medical office open and running.   You sure have to see a lot of
clients to make it pay, given that the government and insurance
companies are always trying to reimburse as little as possible.   Seems
like working for an organization like Kaiser might be quite appealing
to many physicians.

There is forever on the news stories about Wellness programs
(unrelated to the WELL) where patients are encouraged to check in with
their primary care providers on a regular basis to stay healthy.  Only
problem is the American medical industry doesn't really appear to
support this.

I hope you guys can get that together, along with medical insurance
for all, etc.   It seems like a lot of the fun of being a physician
must disappear under all the financial stress.  No?
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #28 of 62: Michael Psycle Bettinger (mcpsycle) Mon 5 May 08 20:29
    
>had a column to finish. 

What's the topic this time?
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #29 of 62: Joe Ehrlich (static) Mon 5 May 08 21:49
    
"How column-writing deadlines increase anxiety among motorcyclists"
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #30 of 62: Robert Hill (rob) Tue 6 May 08 06:39
    
flash, while you were out I was talking about a burning in the eyes I
often get when I take a motorcycle trip. I was wondering what causes
that. BS&2ndG has a chapter on the eyes but it is mainly on how to get
stuff out of them. Useful, but not helpful for my problem. I wear
sunglasses, but maybe there are better ones? Or is there something
else? 
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #31 of 62: Michael Psycle Bettinger (mcpsycle) Tue 6 May 08 06:42
    
(rob) - I guess suggesting keeping your eyes closed while riding would
not be helpful. Is this happening with a helmet with a good face
shield?  If not, how about goggles? 
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #32 of 62: I dare you to make less sense! (jet) Tue 6 May 08 19:46
    
<flash>, other than injuries due to accidents, what sort of health
issues to riders have that non-riders don't?  For example, I can
imagine the Harley crowd having hearing problems from open pipes and
all of us having more respiratory problems thanks to directly
breathing in air on the road.  After a day of riding in SF and the bay
area I can sometimes scrape black junk off my face; after I changed my
first cabin air filter in the car I know why.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #33 of 62: Michael Psycle Bettinger (mcpsycle) Tue 6 May 08 21:07
    
and how about any problems due to riding position.  are there more 
back issues/injuries riding sport bikes.

I know I don't like to ride a bike without a windshield.  I like the
upright riding position.  If I don't have a windshield, I feel too much
pressures on my shoulders from the wind, and that makes riding
uncomfortable.  So I always have a windshield.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #34 of 62: flash gordon md (flash) Wed 7 May 08 10:03
    
good questions.

the column i just wrote was about bugs and how they can affect
motorcyclists, whether it's a bee inside the helmet (which has
happened to me - and i'm allergic to beestings) or other common bugs
that bug us.

it's interesting that you mention dry eyes when riding - that's
another topic that my editor suggested (along w/ bugs). maybe i'll
make that one of my next columns. but keeping the wind out of your
eyes should keep them from getting dry: i've seen sunglasses that can
act as goggles - they have foam around each eye to keep in the
humidity.

most everything i write about in the book is applicable to
non-motorcyclists. in fact, i just had a couple here at the office who
wanted to buy one of my books - they'd read the copy in the waiting
area of the berkeley heart lab (a cardiovascular risk assessment lab /
gym / counseling center where i send folks) and wanted to buy one.
neither of them were motorcyclists.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #35 of 62: Ed Ward (captward) Wed 7 May 08 10:19
    
Which brings up a question of mine: 

I'm never getting on another motorcycle if I can help it, and
certainly not as the driver. But I like your no-nonsense, but
understandable approach to health. How much of the info in this book
would you say is biker-specific (ie, most of the rest of us will
probably never have to deal with road-rash)?
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #36 of 62: Michael Psycle Bettinger (mcpsycle) Wed 7 May 08 11:24
    
As I mentioned earlier, I believe this is much more of a book about
flash as a physician than as a biker.  He happens to be writing these
columns in a motorcycle publication, so it is aimed toward bikers.  
But this is about the body and his approach to that as a physician.

There is very little in the book that would only concern bikers,
however.  Like most things in the book that flash talks about, one
hopes that one never has to deal with any of that (road rash, things in
the eye, depression, obseity, etc.), regardless of whether one is a
biker or not.  But I would say less than half the stuff in the book is
a bit more likely to happen to bikers than non bikers.  The rest just
happens to everyone.  So bikers may be more likely to have to deal with
some of this stuff, but is human stuff.  

One of the strengths of the book is how flash explains how the body's
systems work.  He is giving us an education here is what is going on
inside of us.  I think this leaves us with a better understanding of
how to triage oneself when something just doesn't seem right.    

As for bugs, ugh.  I guess if someone has never been hit in the face
by a bug at 75 mph, they have no idea how they sting!  I mentioned
earlier I like riding with a windshield to take pressure off my
shoulders.   The other huge advantage of a windshield is that the bugs
hit the windshield, and not my face!  I like something to ride with the
face shield of my helmet open (I am also wearing sunglasses).  If not
for the windshield, I would occasionally take a bee or mosquite to the
cheek bone.  And yes, mosquitos do hurt at 75 mph.   

So, flash, do we get a special preview of what you are going to say in
the column about bugs.    Perhaps you can give us the equivalent of a
"coming attraction" that we might see at the movie theater, making us
want to run/ride out and buy the magazine.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #37 of 62: flash gordon md (flash) Wed 7 May 08 12:38
    
motorcycle consumer news is a subscription only publication - no
advertising. a "preview of coming attractions" wouldn't really do
much.

as for how much in the book is biker only - well, the two chapters you
can read in the preview here:

http://www.whitehorsepress.com/download/products/bs2g.pdf

probably include one of the most "bike specific" chapters, which is
one on hypothermia. however, it includes a lot of non bike specific
info, too.

here are a list of the chapters:

Introduction 
Injuries caused by accidents 
Pavement Dermatitis 
Skin Infections 
First Aid, at Last 
Saving Face 
Shoulders 
Tennis Elbow 
Ribs 
Don't Miss This! 
Potential troubles on the road 
Hypothermia 
Rednecks 
Feet, Don't Fail Me Now 
Ouch! 
Bend or Break? 
Cramps 101 
Numb Hands 
Bad Vibes 
What's a Joint Like This Doing in a Nice Girl Like You? 
Get Back 
Backs Gone Bad 
A Pain in the Neck 
These Old Bones 
Don't Blink! 
Earplugs 
The Balancing Act 
Your Gut Feelings Count 
Farts 
Stoned 
For Men Only 
Hemorrhoids 
Concerns on long trips 
Monkey Butt 
Born to Run 
Constipation: The Straight Poop 
Effect of emotions on riding 
Testosterone Poisoning 
Hearts 
Depression 
Post-Traumatic Stress Disorder 
Fitness for Riding 
The Common Cold:Nothing to Sneeze At 
Allergies 
Sinuses 
Asthma 
Smoking: Don't Say, "I'll Never Smoke Again" 
Asleep at the Handlebars 
Brain Farts...Brrp!! 
Fighting Riding Suit Shrink 
Wide Load 
How to Keep Your Internal Combustion Engine Running 
Fitness 


here's a link to the product page at the publisher, which includes a
few reviews:

http://www.whitehorsepress.com/product_info.php?products_id=5708

and here's the amazon link:

http://tinyurl.com/4r9hvo

note that it's in stock at amazon, and five bucks cheaper than the
publisher's price.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #38 of 62: Michael Psycle Bettinger (mcpsycle) Wed 7 May 08 14:45
    
Ain't that something about Amazon.  I really, really like to use local
book merchants when I can.  But sometimes it is so much easier to use
Amazon, especially when it is a book that would not normally be in
stock in a regular book store.  And at cheaper prices, too.  Amazon's
one click buying of a book makes it so easy.  

My understanding is that about 3/4 of the local, independent
bookstores have gone out of business over the last number of years,
killed irst by the big chain bookstores, and then by Amazon.   It's a
shame because I still like browsing books, and one cannot do that as
easily on the Intenet.  But for convenience and price, Amazon has my
busiess a lot of time time.

Your book I am much more likely to be on the shelves of a bookstore
since it is a "popular" book, as opposed to most of the stuff I buy
from Amazon, which are books written for a very narrow niche market,
often by scholars.  It is the type of book I might buy if I were
browsing it in a bookstore, rather than on the web.  Something visceral
about being able to pick up the book.  

And I'm kidding you about getting a preview.  I'm not a subscriber to
Motorcycle Consumer News right now.  My subscription ran out and I
haven't gotten around to renewing it.  I will eventually.  It is a
magazine I have subscribed to on and off for many years.  

But for all those years, it is the only motorcycle magazine I
subscribed to.   I really like that MCN gets by without advertising
from the motorcycle companies.   A magazine that lives on advertising
creates a conflict of interest for the writers.  It is difficult ot
criticize the company that is indirectly paying your salary through
advertising.  While most of those journalists I believe have integrity,
I just have a feeling that their opinions are at least unconsciously
swayed by knowing the company whose bike they are talking about is also
paying their salary.   At MCN, that conflict doesn't exist.  So I
trust them more.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #39 of 62: Linda Castellani (castle) Wed 7 May 08 15:09
    

So what is MonkeyButt??  I saw something in the hardware store the other 
day called Anti-MonkeyButt Powder, and I was going WTF??
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #40 of 62: Michael Psycle Bettinger (mcpsycle) Wed 7 May 08 15:19
    
flash will tell you more but it is what sometimes happens to one's
butt and inner thighs when you've been riding all day in hot weather,
sweating down there, moving around a bit, and having the skin rub
against your pants and seat.  you get the idea.  I'll let the good
doctor fill you in on all the details....
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #41 of 62: Linda Castellani (castle) Wed 7 May 08 15:37
    

That's probably a good enough description!
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #42 of 62: flash gordon md (flash) Wed 7 May 08 22:23
    
http://i210.photobucket.com/albums/bb292/adelinechanz/100_0803.jpg

good case of monkeybutt (safe for work).

yes, lots of local bookstores have been put out of business: that is
kind of sad. so, too, have many travel agents (and i had a cousin who
is- that is, *was* - a travel agent (before orbitz et. al).

the times, they are a-changing.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #43 of 62: Michael Psycle Bettinger (mcpsycle) Wed 7 May 08 22:54
    
There is an interestingn juxtoposition here.  The picture in the above
link might be safe for work, but not for lunchtime.   Usually it's the
other way around.

The times are a changing in the motorcycle world, too.  Something I
thought I would never see but is just about here now, electric 
motorcycles.   I guess hybrid ones can't be far behind.    

The same, I guess is true for medicine. Did you have to make any
changes to your columns for the book because the medicine changed in
the time between when you wrote them for the magazine and when the book
was published?
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #44 of 62: flash gordon md (flash) Thu 8 May 08 20:39
    
no, there weren't many changes. but one thing that did change was my
knowledge about fat metabolism. 

if you read about the "thrift gene" theory, it explains how humans
evolved to have great fat storing ability - it's a survival trait for
hard times. i've found that many problems ranging from "middle age
spread" to mild depression seem to have to do with that. basically, if
folks don't burn 300 calories daily (the equivalent of an hour's
walking) they're likely to have a lot of problems.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #45 of 62: Michael Psycle Bettinger (mcpsycle) Fri 9 May 08 10:44
    
You brought up some interesting points in the book about weight gain
and the problems we have as a result as we get older.  I have a
personal "theory" on all this that just seems to make sense to me but I
have never run it by any scientist or medical person.

I have a feeling that nature, for most of human history, prefered
people to be able to gain a lot of weight easily.  Those are the genes
that nature favors most and here is my pet theory as to why.

Nature wants us to survive and to be able to raise children, so the
species can go on.  In order to do this, nature has made it easy for
some of us to gain weight easily.  The reason nature is doing this is
that it wants us as parents to be able to survive years when there is a
famine.  Those of us who have been able to store lots of body fat are
much less likely to die in a famine and thus we can be around to
continue to raise our children.

I also suspect that nature doesn't care much about what happens to us
after age 40-45.  By that time, our children are raised and having
their own children.   So nature doesn't care if we develop heart
disease, stroke, cancer, type 2 diabetes, or any other age related
malady.  Nature only wants us to be able to survive long enough to be
able to raise our children, and that job is done by age 40-45.

What nature never figured on was modern medicine, and the 24 hour
supermarket.  Modern medicine has enabled us to live longer, and the 24
hour supermarket has made food available in any quantity at any time. 
So we always have a lot of food to eat and gain weight easily.   Those
of us, like myself, who have a lot of trouble gaining weight were not
natures preferred body type for most of human history, but we have the
preferred body types now in the age of plenty of food.  I would never
have survived a famine, whereas others who gain weight easily would
survive.

So now we are stuck with a population where most of us gain weight
easily, and have all the medical problems associated with weight gain. 
 

So, flash, any comments on this theory?
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #46 of 62: Cogito? (robertflink) Fri 9 May 08 15:23
    
While waiting for flash:

"When we get what we want, that's when our troubles begin."
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #47 of 62: Michael Psycle Bettinger (mcpsycle) Fri 9 May 08 18:34
    
hi there (robertflink) - Wellcome to the discussion.   What you just
said sounds like a variation of "You should never pray for anything,
you might just get it".
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #48 of 62: flash gordon md (flash) Sun 11 May 08 21:30
    
yes, that's the "thrifty gene" theory i mentioned earlier. 

as i posted before, you need to burn about 300 calories a day to
convince your body it's not "in a cave." it should get burned in at
least 15 minute / 75 calorie segments, so if you're walking, walk at
least 3/4 of a mile non-stop. 

the best way to lose weight is to convince your body that you're not
"stuck in the cave" and don't *need* to keep holding on to the fat.

i believe the chapter that talks about that is the one called
'internal combustion'.
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #49 of 62: Michael Psycle Bettinger (mcpsycle) Sun 11 May 08 22:07
    
I wish you had some special advice for someone like myself to gain
weight.  I'm not kidding.  I have a long term issue with losing weight
and having a difficult time keeping it on.   If I get even a little
stressed, my appetite shuts down.  I've dealt with this with my doctor
and nutritionist a lot over the years so we've gone over all the major
options, etc.   So I'm not expecting you to come up with anything new
for me.  

Now I know a lot of people with just the opposite condition would
imagine they would love to be in my position.  And it does leave me
with a lean, muscular body.  So I can't complain on that account.   But
skinny me, who would not survive a famine in ancient times, actually
has considerable trouble putting on weight even with a 24 hour
supermarket available.

So, any general advice to someone like myself to gain weight.  (btw, I
eat the classic health diet, very few sugars or simple starches and
just enough fat, not a lot.  mostly complex carbs and proteins)
  
inkwell.vue.326 : flash gordon, Blood, Sweat, and 2nd Gear: More Medicine for Motorcyclists
permalink #50 of 62: Linda Castellani (castle) Mon 12 May 08 00:23
    

Well, that's your problem right there.  Not enough sugar and fat.

Fried chicken, french fries, ice cream, pancakes and waffles with butter 
and syrup...
  

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