Climate Change - The World's Greatest Problem

How can we prevent despair?  Here is what we can declare:
We can all do something, and together we will do much more.
Find your own creative worth
Give help to others and the earth.
Look to our heroes, where they are at,
Greta Thunberg and Boyan Slat
she mobilizes millions of youth to save the planet;
he is a Dutch inventor who is cleaning the Pacific Garbage Patch,
and preventing rivers from adding more plastic to the ocean.
It is time to save our children and grandchildren.
It is time to act in every way we can.
Eat mostly plants. Support family planning.
Support the worldwide education of girls.
Remember Malala, who was shot in the face in
 Pakistan for going to school.  She survived and has
become a powerful voice for women's education.
She is the youngest Nobel Prize laureate.
Find your own creative worth
Give help to others and the earth.
Sadja Greenwood, MD, MPH

What YOU Can Do About Climate Change

Ideas in this blog are based on DRAWDOWN - a comprehensive plan to reverse global warming - edited by Paul Hawken.  Buy a copy, or request a copy from your local library - it is a very important book.

Go to last week's post on sadjascolumns.blogspot.com to review the ideas on food and food waste:
*eat less meat
*plant your own garden
*reduce food waste
*consult the Monterey Bay Aquarium for wise fish choices if you want fish.

This week's topic is family planning.  Millions of women in low income countries say they want to be able to plan their pregnancies, but lack access to contraception.  Even in the U.S. 45% of pregnancies are unintended.  Finding a clinic for contraception and abortion has become harder under the Trump administration. Lack of supplies of affordable contraception, education about sex and reproduction, social and religious opposition to birth control, partner opposition all play a role.  However, there are success stories.  Iran and Bangladesh brought birthrates down to replacement - with female health workers providing basic care.  Family planning requires social reinforcement.  The United Nations has a goal of there being 9.7 billion people on earth by 2050.  (Currently there are 7.53 billion.)  If we do not achieve the goal of 9.7 billion there will be 1 billion more than that at current growth rates.  This will mean a world with more energy use, building space, food and water needs, waste and transportation problems.  This will be very bad for climate change.

It is important to support Planned Parenthood and other clinics that provide access to contraception and abortion.  Even if you are opposed to abortion, the provision of effective long term methods of contraception is essential to reduce suffering.  Call Northern California Planned Parenthood at 855 - 787-7723.  In other areas, look up your local family planning clinic/Planned Parenthood.
Sadja Greenwood, MD, MPH

What YOU can do about Climate Change with Food

Let's start by quoting Michael Pollan - "Eat food, not too much, mostly plants."  Raising livestock accounts for nearly 15% of global greenhouse gases emitted each year. Some say it's closer to 50%. Cows are the most prolific offenders, generating the potent gas methane as they digest their food. Agricultural land used to grow livestock food is a problem.  In the U.S. and Canada the average per capita consumption of protein is 65 to 90 grams per day, while most adults require 50 grams per day.  This excess protein consumed can be associated with certain cancers, strokes and heart disease. Eating less meat will help you and the planet.  A study from the University of Oxford discussed the economic benefits of a worldwide transition to a plant based diet. Emissions could be reduced 70% through adoption of a vegan diet and 63% through adoption of a vegetarian diet (including cheese, milk and eggs).  Popular author Mark Bittman has written a book called "How to Cook Everything Vegetarian"  Start your own garden if you have the space.  This will ensure that you eat more plants.  Reduce food waste.  A third of food raised or prepared is wasted.  Do not reject food in the market that has minor imperfections. Don't lose track of food in your refrigerator.  Labels saying 'best by' or 'best before' are largely unregulated.  Freeze food that you will not use immediately. If you want fish, buy shell fish such as mussels,  clams or scallops that are designated as green. Consult the Monterey Bay Aquarium for seafood ideas.  Last but not least - support family planning. Fewer unplanned or unwanted pregnancies around the world will make a big difference in global warming.   More on that next week.  Sadja Greenwood, MD, MPH

Diabetes – A New form of Treatment and Reversal

In the U.S. today one in 8 adults have type 2 diabetes and one in 3 have prediabetes.  The number is much higher in those over 65.  (Type 1 diabetes is an auto-immune disease and is not being discussed here.)  News from England is exciting- they have found a way to reverse diabetes, with strict dieting and exercise to induce weight loss.  Patients are given a liquid diet of 800 calories – four daily servings of soup or vitamin rich shakes.  They report reduced hunger after the first few days.  They have a small salad of non-starchy vegetables like tomatoes and cucumbers.  They go off their insulin as the diet begins and are carefully watched by their doctor.  Type 2 diabetes is due to too much fat inside the liver and pancreas.  Losing weight reduces this fat and allows the pancreas to work again by producing insulin. In the English study,88% of those who last 33 pounds or more no longer had diabetes.  In the U.S., the English prescription of diet and exercise is being studied at the Gonda Diabetes Centers at UCLA Medical Center in Santa Monica and Westwood, California.  Anyone interested in trying to reverse their diabetes should work with their primary care doctor.  People stop their insulin when they start the low-calorie diet, which is why you must work with your doctor, who will advise you and monitor your blood sugar levels. Note that the diet and weight loss does not work for 100% of people – depending on how long you have had diabetes, and other factors.  

Scattering the Ashes of Someone who Died

I have had 3 experiences of this which may be helpful to others.  I scattered my mother’s ashes in 1992 in a small town in North Carolina. It was inside a circle.  There were spicules and small pieces, all of which stayed above the ground.  Her husband did not attend the ceremony.  He had started calling himself Charly Big Paw.  My mother did not want to become Mrs. Big Paw.  I afound the ceremony to be serious and meaningful.  I scattered the ashes of my long-time companion Alan Margolis at our home in Bolinas.  Alan had made a plaque when we buried our beloved dog Ladi – the plaque depicted stairs which she would walk to meet him on the other side.  Alan was not religious, but the idea had sad and serious meaning.   I dug a small circular 

trench around the plaque and buried his ashes in it.  I visit it whenever I go back to Bolinas.  Ferns and other native plants surround the site.  It’s good to be able to visit it.  Last week I went to San Francisco with my two sons and stepdaughter to scatter the ashes of their father, my ex, Bob Goldsmith.  Fortunately, Bob and I remained friends after the divorce. We walked up a steep trail to a site where he and his partner liked to look out at the city.  We said the 23^rdpsalm and a Hebrew Kaddish.  It was very meaningful.  It is a place where the group can visit again. This is like returning to a grave.
Sadja Greenwood, MD, MPH

Thanksgiving - how to make it Peaceful, Healthy and Happy

Thanksgiving is a time to give thanks to people who have made life better for you and the world.  Gratitude is powerful - here are my choices.  You will have good ones of your own.  I am grateful for my loving family.  I am grateful for Greta Thunberg, the 16 year old who has brought powerful awareness of the dangers of climate change to youth and adults throughout the world.  I am grateful to Boyan Slat, an inventor from the Netherlands, for the Ocean Cleanup.  They are developing technologies to extract plastic from the ocean and prevent rivers from adding more plastic.  I am grateful for Amory Lovins and The Rocky Mountain Institute for their work on battery technology and indoor cooling, which will be important worldwide.

Here are some suggestions for a peaceful Thanksgiving gathering.  If there is potential discord among  people, ignore politics!  Talk about sports if that will work, or about cooking, and how you made your favorite dish.  Follow the Six Precepts of Tilopa (988-1069) and say very little, letting other members talk while you beam on them.  Here are the precepts - No thought, no reflection, no analysis, no cultivation, no intention, let it settle itself.

When it comes to the Thanksgiving meal itself - more gratitude for the food.  If you want to make it healthy, don't show up extremely hungry. Have some nuts and/or yogurt in the morning ahead of time.  Fill your plate with vegetables and salad first.  If you are eating turkey, go easy on the amount you take.  Be moderate with mashed potatoes and sweet potatoes.  For desert, try small servings of pumpkin or apple pie and even discard some of the crust.  Notice when you are feeling satisfied and have had enough.  Drink water or sparkling water throughout the meal.  Don't drink alcohol if you are pregnant or taking medications that can be affected by alcohol, or if you have cancer.  Otherwise, limit yourself to one glass of wine or one serving of spirits.  At the end of the meal you will feel peaceful and glad not to be overstuffed.  Deal with leftovers the next day in the same way.  Always start with vegetables.
Sadja Greenwood, MD, MPH

Meditation

From the National Institutes of Health

Interesting article:

Meditation and Yoga can Modulate Brain Mechanisms that affect Behavior and Anxiety-A Modern Scientific Perspective

Please go to this link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769029/

Urban Farming in Washington D.C. – an exciting story

Urban Farming in Washington D.C. – an exciting story

You can read the whole article and see pictures of the land and people described here by going to civileats.com. Civil Eats is a constantly interesting website. Gail Taylor, an African American woman has set up the first organic farm with CSA (community supported agriculture) in Washington D.C. She currently has about 200 CSA members, and city farms in seven locations. Rooftop farms are being planned.

 Gail Taylor started out her work in Guatemala, promoting healing for women recovering from the trauma of civil war. Returning to the U.S., she began to share her passion for farming with other African Americans who recognized the power of food production to revitalize their communities. She approached the Oblates of Mary Immaculate, a Catholic order of missionaries with vacant land on their property.  They were able to set up the D.C. Urban Farming and Security Act that allows a 90% reduction in property taxes to owners of vacant lots who create partnerships with independent urban farmers. 

Gail Taylor and her group grow organic vegetables, herbs and flowers.  She plants a third of her farmed areas with oats, rye and crimson clover as cover crops between plantings.  Nearby orchards and farms run by women and farmers of color bring products like fruit, cheese, honey, rice, herbs and eggs.  They donate food to soup kitchens and food pantries.  Gail Taylor calls her CSA ‘Three Part Harmony’ because musicians in her family have created the music and the food together.  

Sadja Greenwood – past issues at sadjascolumns.blogspot.com

p.s. Deaths from vaping in the US have risen to 20.  The number was 6 when I last reported 2 weeks ago.  Do not vape.

 p.p.s. Melania Trump has continued to use and endorse the vegetable garden at the White House started by Michelle Obama.  She invites children to visit, plant and understand how food is grown.  The White House gardeners and kitchen tend to and serve the food daily.  How’s that for good news?

The Dangers of Vaping

The use of electronic cigarettes – e-cigarettes – e-cigs – vape pens – has been increasing among high school students.  Vaping in high schools rose from 1.5% of students in 2011 to 20% in 2018.  Middle schools may also be affected.  This is a serious matter, because of the dangers of vaping. Juul is the brand name for e-cigarettes. Juul has flavored e-cigs that appeal to youth.

In September of 2019 the Centers for Disease Control and Prevention, and the US Food and Drug Administration sent out a warning – urging people to consider not using e-cigarettes and also to avoid buying them off the street.  Currently there have been at least 380 cases of severe lung illness reported from vaping, and 6 deaths.  Unfortunately, more deaths are expected.

Vaporizers heat and aerosolize the nicotine or nicotine plus marijuana meant to be inhaled.  Vaping solutions consist of particles associated with toxicity to the heart and lungs, such as formaldehyde.  Vaping can irritate the lungs and lead to damage. It increases lung inflammation and paralyzes cilia – the hair-like projections in airways that remove microbes and debris. This increases the risk of pneumonia. A new finding has been lipoid pneumonia – the presence of fat in the lungs as a result of vaping. This is a relatively new illness with long term consequences.  Articles in the British Medical Journal and the New England Journal of Medicine have cited cases of hospitalized patients with vomiting, chest pain, shortness of breath, fever, and weight loss.  Recovery can be slow, and complete recovery from lipoid pneumonia may not occur. Vaping has also been linked to seizures and damage to the endothelial cells that line the blood vessels. In one case, the e-cigarette exploded in the mouth of a user.

I think the lessons here are clear.  Do not vape. If you are a cigarette smoker and want to quit, talk to your health care provider about safe methods.  Go to the website of the Mayo Clinic for their suggestions.  You can do it – many have succeeded – be safe, and keep your children safe.  

Sadja Greenwood, MD, MPH

Many Drugs have Dangerous Interactions with Alcohol – Be Aware

Information in this column is based on a newsletter called Worst Pills, Best Pills.  I suggest subscribing to this newsletter (800-289-3787) if you or members of your family take over-the- counter or prescription drugs. You do not need medical knowledge to understand the content of this newsletter, and it can be lifesaving.  

Research from the National Institute on Alcohol Abuse and Alcoholism has shown that many people, especially those over 65, may be incurring a risk by using alcohol when taking prescription drugs.  Alcohol, itself a drug, becomes more intoxicating if the drug taken will block the stomach’s ability to metabolize alcohol.  This is true of commonly used drugs for treating gastrointestinal ulcers such as ranitidine (Zantac and Tagamet), and also true for the smoking cessation drug Chantix.  

People combining alcohol and sedatives, including benzodiazepines (such as Valium or Ativan) and sleeping pills of all kinds, can experience increased sedation, impaired breathing, and be more likely to fall or have serious accidents.  Respiratory arrest can occur.  

Alcohol can impair the metabolism of drugs, resulting in risk of drug overdose.  This could happen with the drug warfarin (Coumadin), used as a blood thinner, and could result in an increased risk of bleeding. Conversely, long term heavy drinking could increase the metabolism of warfarin and increase the risk of blood clots. It is clear that people on warfarin should not drink heavily and be aware of their levels of the blood thinner.

Alcohol can interact with antibiotics, anti-fungal drugs, antidepressants, antihistamines, diabetes drugs, opioids, nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen (Advil and Aleve), and Tylenol.  

People who are used to having a glass of wine with dinner may not experience problems with medications. However, heavier drinking can cause serious problems.  Therefore, the following advice is very important: check with your pharmacist and your health care provider before using alcohol with any prescription or over-the-counter drug. Read the warning labels on the bottle or package.  If it says not to drink alcohol – don’t drink it! 

Sadja Greenwood, MD, MPH