The Latest Portait of Dorian Gray

I have recently been reading and hearing about anti-aging medications that are just about to hit the market.  Snake oil has been for sale since currency existed, but now Big Phrama has taken a renewed interest in the concept of arresting and reversing the consequences of aging.  There is an unimaginable amount of money to be made for those that can prove that their elixir of life not only works to prolong the age of mice but also the lives of men.

A decade ago resveratrol was the silver bullet.  Studies showed that mice lived longer after ingesting red grape extract in various dosages but after millions of dollars were spent researching its effects on humans it turned out that people didn't benefit the way rodents did.  Needless to say this will not change my nightly dose of grape extract from the Loire River Valley but the conclusion drawn by Big Pharma and Wall Street is that the magic pill must be proven to benefit humans before being brought to market.  Of course this is no easy task because the FDA doesn't view aging as a disease.  Drugs that treat the symptoms of aging, such as heart disease and arthritis, can gain approval because there is a limited focus, but when a drug claims to address multiple diseases and disorders attributed to the aging, approval becomes a long and expensive task.

Speaking of "the aged" or "the aging" I hate these terms.  It sounds like we are fossils that require carbon dating and tweezers when being dealt with.  Besides isn't everyone aging?

Anyway, there is a drug that has existed since the 1980s that is close to hitting the market, which may be the first FDA approved anti-aging medicine.  The bacterium Streptomyces hygroscopicus  (S.h.) was isolated from a soil sample from Easter Island, of all places (Arthur C. Clark and Leonard Nemoy would feel vindicated), and has been used in various forms under different names to combat numerous ailments. The drug Rapamycin,which is S.h., was manufactured by Wyeth to suppress the immune systems of organ transplant recipients.  A derivative of this same bacteria has been used as a coating on the inside of cardiac stents to prevent blockages from forming and a similar compound has been marketed as an anti-fungal agent.  Extensive testing has demonstrated that this bio-agent postpones the onset of  heart disease, cancer and Alzheimer's and appears to "delay age-related decline in multiple different organ systems." It would seem that using an immune suppressing drug would be problematic for old folks who already have compromised immune systems, but apparently if  S.h. is given in small doses over a short period of time the immune system is improved not diminished.  This sounds remarkable. 

Novartis is the current manufacturer of the new version of S.h. that inhibits cell division which causes the cells to engage in autophagy: a recycling of old proteins left over from cell reproduction.  Instead of generating new cell growth this biological OCD like behavior disposes of harmful waste products.  What is interesting to me is that the same results are acheived through fasting.  Caloric restriction really does seem to be the key to longevity.  The advantage of this anti-aging drug is that you don't have to deal with the inconvenience of being hungry.  There are other drugs in the pipeline which address muscle loss, hearing loss and one that restores cartilage in joints - all potentially beneficial for the aging. 

Again we are on the brink of discovering something our bodies already knew.  Before the age of plenty our well programmed systems expected a lack of food and apparently required it for optimal health.  Now we are looking for another easy path to take us back to where we were but without the inconvenience.

The recurring theme of taking shortcuts to ease discomfort is a disturbing human tendency.  It is a quality that is not without its merits, but we continue to push the envelope without considering the long term consequences.  Because our bodies are so good at adapting to new microbes and we have so little understanding of the role of the millions we currently carry around with us wouldn't it be safer to modify our habits instead of medicating?  The belief that we can gain without effort has recently lead us into war with two countries and by privatizing our forces and eliminating the draft, the majority of us don't have to feel the pain of prolonged combat while we continue to enjoy the ease that fossil fuels afford us.  But there are long term consequences associated with these choices and we are now feeling them.

Novartis' new S.h. drug may be a boon to the pharmaceutical industry and may help thousands of patients in the short term but at some point we have to stop taking pills for conditions we can control on our own through diet, exercise and education.

Please watch President Eisenhower's January 17th, 1961 speech concerning the "military and industrial complex" and substitute "medical and industrial complex" for the former phrase. 





   

Through the Looking Glass

I have experienced migraines all of my life.  At times they have plagued me by both their intensity and their frequency, but thankfully as I have aged they have abated somewhat and they no longer immobilize me the way they used to.  Perhaps this change is due to more consistency in my life: engaging in regular exercise, a healthy diet and striving for adequate sleep over the past several years.  That being said I had a doozy last week that put me in bed for an evening and required four milligrams of dilaudid to compartmentalize the pain.  Several days later I am still not quite right.
 
Over the years my migraines have gone from terrifying to inconvenient - at times a major pain the ass.  The discomfort is nauseating but the aura (the prodromal stage) is surreal and at time dangerous.  Whenever I experience the visual cues that alert me to the fact that shortly I will be experiencing distress my reaction is always the same: "Of course! No wonder I haven't felt myself for the past few days. That is why I can't think straight and words are being trapped in the firewall between my brain and my mouth (otherwise known as aphasia)."

The aura is not the same for all migraineurs but there are shared characteristics for those who experience hallucinations in the prodromal phase. My experience is this:  My vision becomes blurry in a way that is similar to my glasses being unusually filthy so I remove them, see if they are smudged and then look at the exact same person, landscape or object that I was viewing seconds before sans glasses as a test.  If the blur remains then I am in for a show.

If I were looking at your face half of it would disappear and your visage would be framed by a chain of jagged pulsing geometric shapes (usually a preponderance of triangles) that are not unlike the gas light liquor signs found in the window of a corner bar.  The reds and greens dominate the blues  and yellows in this broken picture which accompanies a tightening of my jaw that begins at the occipital bone. The band of tension envelopes the temple on the opposite side of my skull from the eye that is most effected by the hallucination.  This tight polar vice is the precursor to the ice pick ramming sensation that will work its way like a worm from the inside of my rotten apple brain out through my sinuses and the soft palate of my mouth.

Often times there is an overlap between the aura and the onset of the freeze dried number 20 rusty nail driven through my skull.  This is the dangerous time because I can't really see and the pain zaps any meaningful ability to focus.  Driving is out of the question and walking is not much better.  When I was a full-time carpenter and a migraine showed up at work I had to step away from the chop and table saws for fear of losing a finger or a hand.  Once the pain takes hold the aura usually disappears.  If it fades gradually that is good, but it can stick around for the duration or it can leave and come back for a second round.

Migraines are fickle and therefore unpredictable.  In my case they can last for a few hours or the better part of a day but the remnants can be felt for a week.  I have learned much about pain management through migraines.  As a child they terrified me, not so much because of the aura but because of what those shapes and colors portended.  Into my thirties I used to throw-up every time I got one but I haven't done that for several years.  Opioids work well for me because they don't upset my stomach.  The newer drugs don't help and the two times I tried Imitrex I felt like the drug was damaging my nervous system.  The strange thing about controlling the pain is that it doesn't go away, with the right drugs you are able to package it, put it on a shelf and gaze at it.   Migraines have taught me to notice the boundaries of discomfort so that I can make decisions about how to work around them.

Out of body experiences (OBEs) are common amongst migraineurs and I am no exception.  When I experience a migraine I (the me that is not physical) separate from my material body and the more sickening the pain becomes the farther afield I wander from my corpus.  I don't know if this is my body's healthy response to the situation (physiological dissonance/neurological denial) or it is another biochemical result of the cause of the migraine, which has been likened by neurologists to an electrical storm in the cerebral cortex.  This hyper stimulation of the brain, raises blood flow by 300% followed by a below normal flow which sets off a chain reaction that alters serotonin and norepinephron levels throughout the brain.

For days after a headache the thought of chocolate or alcohol, two things I love, makes me ill.  And any time I see an MC Escher print I have to look away.  The first time I walked into the Loebe Library at NYU I thought I was going to throw up.  The first floor (the flooring) of the library is a massive Escher print made of stone inlay. I wonder if he was one of us.  Lewis Carroll (Charles Dodgson) was and apparently Through the Looking Glass and What Alice Found There was migraine inspired. And the hallucinations experienced by migraineurs has a medical term: AWS (Alice in Wonderland Syndrome).

There are two noteworthy books that I have seen excerpts of (and recently ordered on line) discussing the subject.  One is titled Migraine by Oliver Sacks and the other is a compilation of art and essays by migraineurs entitled Migraine Art by Clause Podoll.  If you are curious about the visual experiences associated with a migraine google Migrain Art - there are some disturbingly accurate depictions of an event.

The triggers for migraines are varied and for me coffee plays a significant role.  Last week I  exceeded my caffeine thresh hold by drinking a cup of coffee which is a rare occurrence.  After 50 years I now know that my body has a limit for both caffeine and stress which I cannot overstep without experiencing tangible consequences. Irregular sleep patterns - too much, too little, variations in bed-time and wake-up are triggers as are food, sunlight, smells and travel (probably because it involves the aforementioned).

There is a genetic component to this mystery that causes our ion channels and pumps to malfunction.  Ion pumps and channels are the mechanisms by which our cells ingest and expel select ions across the cell membrane that determine PH balance and the firing of neurons in addition to functions that are too numerous and complicated to discuss here. The migraineur's mind is wired differently (termed channelopathy or malfunctioning ion channels) from those who do not have this anomaly.  Our brains are "hyper excitable," which means that they do not function the same as a non migraine brain even when we are not experiencing a headache.

There is something positive to be gained from a migraine.  There is a true sense of being reborn upon the cessation of pain and visual impairment.  I often feel more creative and amorous following this experience.

So why am I putting this in my blog?  Because our abnormalities are important aspects of who we are.  We all have our issues and although we don't discuss them readily with others learning about them is more important than how much weight we lift .  Our differences are our strengths.  Through acceptance and understanding we become greater than our stumbling blocks and the lessons we learn can be used to face future challenges.  What have you learned from your exceptions?

"And then there's the butterfly," Alice went on, after she had taken a good look at the insect with its head on fire, "I wonder if that's the reason insects are so fond of flying into candles - because they want to turn into Snap-dragon-flies."
Lewis Carroll

Where Shall We Meat?

There is a new meat-like substance in town and it tastes pretty meaty.  I read about the Beast Burger, which is coming to a supermarket near you, in last month's issue of Outside Magazine.  What makes this meatless burger stand out from its tasteless drywall like competitors is that it is purported to taste like beef.  That doesn't sound uncommon: most animal protein-less patties claim to taste something like the real thing but Beyond Meat, a small but rapidly growing company in California (where else?), has apparently done it.

Their chicken -free strips fooled Mark Bittman of the New York Times who thought that the strips not only tasted just like chicken, he thought they were chicken.  I have purchased this product twice  to test it for myself and I was pleasantly surprised by how chicken-y the product was but I am shocked that Bittman mistook it for the real thing.  Perhaps if I were used to eating mass produced poultry I might make the same mistake but my locally raised and slaughtered birds taste and feel like what they are: chicken.  I say "feel" because this is when the English language, again, falls short when it comes to the sensual.  Chicken meat has a particular texture as does good ground chuck.  the problem with previous incarnations of fake meat is that even if the flavor was close, the texture missed the mark.  This globby consistency of meatless burgers is due to the use of gluten as a texturizer.  The people at Beyond Meat, through a combination of determination, science, money and ethics, have come closer to any of their competitors in achieving what has long been a dilemma for health conscious individuals (there are lots of people who think it is unhealthy) and those who have sworn off meat for ethical reasons.  The problem is people like the way animals taste, which includes smell and feel.

Ethan Brown, the CEO of Beyond Meat, started his business because he wanted to change the world's reliance on animals for protein and he believes that he is creating meat from plants.  (An interesting note:  it is now believed that the old theory of taste buds and how they are positioned on the tongue is inaccurate.  Scientists now think that we have taste buds throughout our entire body and they are not sure why, but what is clear is that taste does not end at your gullet. Another digression of note:  We have far more taste receptors for bitter than we do for sweet because poisons are bitter, which is another reason we have made it this far on the planet.)

Most of the animal we eat is muscle, which consists of bundles of columnar and parallel fibers that your mouth recognizes as meat.  At Beyond Meat they have extruded pea and soy protein so that the substance that comes out of the other end of the hopper possesses a similar fiber structure to the real deal.  I can't wait to try the Beast Burger, but currently neither of my two local health food dispensaries carries it, so if you see some pick it up and post your results.

Here is the head to head comparison between the beast and the Beast Burger:
Beef burger:19 grams of protein, 0 grams of fiber, 80 milligrams of cholesterol.
Beast Burger: 24 grams of protein, 4 grams of fiber, o grams of cholesterol and it contains more omega 3s than salmon, is rich in calcium, B vitamins (all statistics come from Mr. Rowan Jacobsen's article, "The Perfect Beast" in the January edition of Outside Magazine.) and it tastes and feels like hamburger.

Now for the ethical portion of the Post:
According to the Worldwatch Institute the annual production of meat (22 billion animals) leads to the release of 103 million tons of methane which is exponentially more damaging to the atmosphere than carbon dioxide.  Fifty-one percent of global greenhouse gases are a result of raising livestock for consumption.  A few other startling statistics that Mr. Jacobsen listed in his article: "It takes 9,000 calories of edible feed to produce 1,000 calories of edible chicken...(and) 36,000 calories (are) required for 1,000 calories of beef."  The sad news for all of us grass-fed junkies is that grass-fed cattle produce more methane than factory raised cattle and leave twice the carbon footprint as those that are raised in pens.

My cognitive dissonance meter is bumping around eleven right now because I am experiencing severe discomfort on multiple levels of my psyche.  The notion of "Franken food," the current term for man-made food leaves a bad taste in my mouth.  Even though Beyond Meat is using all natural ingredients this is a highly processed food.  I don't know enough information about the differences in the types of proteins between the Beast and the boeuf (yes, that's my name), so I can't weigh-in on which is healthier.  The fact that the Beast has no cholesterol is a selling point, but there are many who believe, as you have read in these blogs, that cholesterol is less of a concern than was previously suspected.  And what about moderation?  Would you rather have one stupendous grass fed burger or a couple of these Beasts if given the choice?  But perhaps we, as a species, have entered an era where moderation in all things is no longer the best option when it comes to world food supply.  I will make a few enemies with this statement: There are too many fucking people on this planet (and too many people...) and they have to eat, so the production of their food must not destroy the ability to cultivate more of it.  Therefore, a thoughtful and ethical manufacturing model is a better alternative to killing animals for protein and the collateral damage to the environment that process entails.

The second one is the obvious ethical dilemma I have struggled with off and on for decades.  I love animals.  My dog and cat are my greatest teachers, my best friends, they smell good, they feel luxurious, they are more amusing than anything on the computer, they love unconditionally and they are meat.  In various parts of the world my tender young mutt would make a delicious roast and I kid him about that fact.  My seven year old cat, Alice, on the other hand, would require some tenderizing, which could be achieved through parboiling.  She purrs when I tell her this - probably because she and I both know that while my dog, Ranger, would sit faithfully beside my cold and fetid corpse for weeks she would dig right in. And dear baby Alice has hit the nail on the head, as cats often do: If it is in your DNA to eat meat at what point does your over-sized cranium with well-developed pre-frontal and frontal lobes decide the time has come to buck "nature?"

For millennia we killed for food and many people still need to do this to survive, we would not be here without it, but the world has changed.  No, that's not accurate - we have changed the world, and in order for it and us to continue we must alter our behavior.  Many of us now have the economic resources to make a choice.  It is a decision that runs counter to many cultural norms and genetic wiring, but don't most difficult decisions fit this mold?  Is it O.K. for me to kill for food and how far up the chain can I go?  The more I look at it the answer is "No." But I love the taste, smell and feel of meat, and the ritual of cleaning and preparing it, so I am conflicted and perhaps the Beast Burger is an answer.

I have looked for pithy and provocative quotes from brilliant minds to end this piece but I have found none, largely because they were written a century or two ago when the issue was based solely on the ethics of killing for human consumption.  Of course this issue remains germane but the newer concerns are broader, more tangible and portend greater catastrophe.

So I will end at the other end of the spectrum: "Soylent green is People!  It's People!" (the late and not so great Charlton Heston from the movie Soylent Green (1973).)