Off Sick

Haven't posted this week because I've been home ill. I thought it was a cold until my nose started turning red, swelling, and I came down with a slight fever and feeling of nausea. Off to the clinic, was diagnosed with a nasal carbuncle or celluitis, and immediately put on I.V. antibiotics (!!) before being sent home with two other antibiotics and some painkillers. The doctor stressed not squeezing or putting pressure on my nose as it could drive more infection into the bloodstream. 24 hours later the swelling is still there but I was able to sleep well, no fever or nausea issues. I looked online and it said it'll typically take 2-3 days for the swelling to start to subside. So I'm chilling out at home and hopefully by the end of the weekend things will look better.

Obesity Rates in Qatar

My previous post about weight loss shows was a bit prophetic, there's been a recent report that suggests the Government look into a tax on junk food to help combat soaring obesity.

http://dohanews.co/report-junk-food-tax-help-qatar-fight-obesity-raise-money/

Many people think that the United States has the highest rate of obese and overweight people but while it has the highest rate out of the OECD countries there's still a few countries in the world that beat it, a number of Polynesian islands, then Qatar and the other GCC countries. If you Google “obesity in Qatar” you'll see all sorts of articles from the last few years, such as this one from the New York Times.

Estimates appear to vary, but upwards of 60% of Qataris are either overweight or obese. This does not surprise me at all and it is common to see overweight or obese children now. I recall that the rate of diabetes was 17% of the Qatari population, in the US I think it's roughly around 8-9%.

Bariatric surgery appears to be a popular option but I was surprised to see in the Dohanews article that over 900 such operations were done at the main hospital this year. While I don't think all of the patients were Qatari I'm sure a fair number were. I'm not sure this even touches on just how many people are opting for surgery, in 2014 I knew two Qataris who went for bariatric surgery and neither of them had it done in Qatar so it would not be in the above statistics.

So is a junk food tax the answer? Well I don't think it will do much to reduce obesity rates, Qataris have reasonable levels of wealth so increasing the price of junk food and sodas by a few riyal isn't really going to do anything to encourage people to eat less junk food. It might encourage the poorer people in Qatar to not spend money on junk but because the poorest people are low-paid laborers I’m willing to bet obesity is not a widespread problem there. To help the poor people such taxes should also be combined with subsidies on nutritious food like fresh fruit and vegetables. Laborers and other low-income workers will gladly buy nutritious food if it's cheap.

The benefits of the tax will be more on the Government revenue side. Obesity creates all sorts of health issues, and because the Government provides free health care for its citizens, obesity is likely costing the Government hundreds of millions of dollars every year in extra health care costs. A tax on junk food could at least help offset those additional costs. If the Government is also subsidizing unhealthy foods, such as sugar, it should consider reducing or eliminating the subsidy.

As for how to reduce the overall obesity rates in its citizens? I have no answer for that. I know the government has been trying with various programs and promotions to encourage people to exercise but in the end the will has to come from the people themselves to change their lifestyles and eating habits.

Review of Some Weight Loss Shows

As many of you know I've been trying to slowly lose weight. Nothing drastic, just eating less, eating better and exercising more. Over the last six months it has worked out well and I believe I've lost around 7 or 8 kg. Many people have noticed that I lost weight, which is always encouraging. I'm sure thanks to two weeks convalescing at home that I had gained some weight but I hope it's not too much.

For some inspiration (and to pass the time) I went to YouTube and started watching episodes of weight-loss reality shows. Not the American stuff, I'm familiar with those already, instead I was watching British shows that I had never seen before. I actually find them more interesting than the American ones and learnt a few things along the way.


Supersize versus Superskinny

I found this show amusing. Fairly simple concept, the doctor pairs up a supersized person with an underweight person and over the course of a few days the two swap meals. The show hopes to use shock tactics to make the overweight person realize that they can get by on less, and to make them realize just how out of whack their portion sizes and food choices are by seeing the skinny person struggle with their meals. On the flip side the skinny person will hopefully get a wake-up call when they see just how little they eat and learn to eat larger portions and eat a variety of foods.

The struggles can be amusing. Obviously the skinny person can rarely believe the amount of food that they have to eat and most of them soon realize, once they come to terms with the overweight person starving because of the little food they get, that they need to change their ways. Similar revelations occur with the overweight person.

Surprisingly I tended to be more appalled by the skinny person's diet. So many of them were not only undereating but what they were eating was typically junk food. Many of them were using coffee/tea/energy drinks as meal replacements, or just eating a lot of sugary foods just to give them the energy to get through the day. Occasionally the overweight person wouldn't even be able to finish the meals because of how messed up they were (something like breakfast – coffee, lunch – coffee, dinner - fries and two chocolate bars). One lady was a vegetarian yet her diet didn’t contain any vegetables. Some of the skinny people would soon get really apologetic about the lack of food they were giving to the overweight person.

While the program did have some long-term successes I'm not sure if shock tactics are really going to help if there's a more fundamental problem. If the skinny person has a bona fide eating disorder then they need therapy, swapping meals with an overweight person for a few days isn't going to cure them. Likewise if there are emotional issues or food addiction involved with the overweight person then I'm not sure this show will be able to get them to change their lives for good.



Secret Eaters

Either you've said it or you know people who've said it, “I eat a healthy and well-balanced diet and yet I am still putting on weight. I just don't understand why I can’t lose weight.”

Well some of those people have volunteered for the show Secret Eaters. They provide the show with food diaries (which show that they typically undereat or are eating the right amount of calories), have interviews to discuss their eating habits – then allow the show to set up cameras throughout their home to try to get to the bottom of what exactly is going on.

What the subjects didn't know was that the show also hired private investigators to track their movements when they are out of the house.

In the end it's discovered that the people are eating way more calories than they think and of course are eating more calories than they should be and so are gaining weight. It seems to come down to a number of factors:

Denial -- some of the people in the interview swear they eat healthy then surveillance shows them get take-out burgers or Chinese food dinners 1-2 times a day. I know that most people watching the show figure that's exactly what is happening with every contestant but in truth it was not always the case.


Simplistic assumptions – “For lunch I only eat a sandwich”, “Some meals I only eat salad.” We appear to make quick assumptions about the healthiness of a meal based on its title. It's a salad so it's healthy, right? It's just one sandwich! But not all sandwiches and salads are created equal. One person did just have a chicken and vegetable sandwich for lunch, but the chicken was fried and had barbecue sauce, there was a lot of cheese, and it was on a high-calorie flatbread. The one sandwich had just over 1000 calories. Another person's “one sandwich” was essentially a huge donair kebab (kebab meat, fries and cheese rolled in a pita), and well over 1000 calories. One person’s salad had so much tahini sauce it looked like coleslaw -- and had over 600 calories. And they went back for seconds. It’s just salad, right?


Not noticing the little snacks -- that biscuit with a cup of tea, that couple mouthfuls trying out other people's food, the nuts or chips that were sitting in a bowl that you reached for once, it was all adding up. When the people found out just how many calories they been consuming through these invisible snacks it was probably one of the biggest shocks. You just don't notice these things. Cutting these out could probably be one of the biggest changes a person could make towards losing weight but I think the only way to really do it, because you tend to not notice when you're eating them, is to just make sure you never buy them and bring them into the house. Don't keep things like biscuits and chips hanging around.


Not counting the drinks -- people really, really, underestimate the amount of calories they get from alcohol and sodas. Not only do they underestimate how many calories are in those drinks they underestimate just how much they are drinking. One lady's food diary noted she had four drinks over the course of the week, and on the first night of surveillance had at least that many or more. Another guy figured he had a couple of beers a night, which turned out to be more like 3-4, and on a weekend night out with friends he would have more than a dozen. Another guy turned out to be eating just the right amount of calories he needed, but it was topped up with over 1500 calories a week of soda. If you're trying to lose weight you need to seriously cut back on the drinking. Go with diet soda if you can't kick the soda habit (I'm trying to kick it myself but still have the case of diet soda), but in the end you’ll be better off cutting soda out altogether and drinking water.


But for people who are morbidly overweight there is another option, surgery. Which leads us to the third show . . .


Fat Doctor

More like a documentary than a reality show, a morbidly overweight person is scheduled for gastric bypass surgery and the show follows the journey. They have lengthy interviews with the person before and after while the surgeon also explains some of the underlying issues and problems with this type of procedure. The show doesn't pull punches and always shows scenes of the doctor doing the surgery.

A lot of people see surgery has a magical way to simply lose weight but it is a major surgery and has a lot of risks. One of the people didn't recover and died in hospital a few days later (that episode really surprised me). Occasionally a person's heart, already overburdened by the obesity, just can't handle the stress of a major surgery.

I really liked the doctor on this show, he seems to really care about his patients and does not believe this is simply an issue of how fat people should just eat less to lose weight. He talks a lot about the problems surrounding food addiction, yo-yo dieting, and why it is that psychologically so many people struggle with losing weight. He doesn’t think shaming fat people helps at all, in fact it tends to drive them further into comfort eating. He and his fellow doctors at the clinic also host a garden party every year and invite all of their former patients so they can catch up with them and see how they're doing (and so can the viewer, the show has run for multiple seasons so you get to see how people from previous episodes have been doing). Everyone discusses how the surgery was truly life-changing for them and allowed them to get their lives back together.



So if you're thinking of losing weight maybe take some time to go on YouTube and look these shows up.

Recovering

Unfortunately I had to go to the hospital a few days ago for a minor procedure. A quick operation under general anesthesia, couple of nights resting in the hospital, and now I'm chilling out at home. General anesthesia really is strange stuff. It's not like you're sleeping and dreaming, it's more like someone clipped out a section of a film and tied the two ends together. You remember the anesthesia going into you and next thing you know you wake up in the recovery area. Really strange.

Anyway, everything went well and I suppose I should be grateful that it was nothing really serious. I also really appreciate music players and smart phones, which help to get through the tedious days sitting in a hospital bed. I had a book as well but there are times where you just don't feel like reading. Even after two days I was getting anxious to go home. Not that I'm doing much more here, although I do have access to my laptop, but it's nice to be in more comfortable and familiar surroundings.

One advantage of medical care in Doha is that it's relatively quick to get scheduled for a procedure. This was not any kind of emergency yet from diagnosis on a Wednesday I had the surgery on Saturday. No wait list, no having to wait for weeks for the surgery.

It will be more than a week before I can return to work. Lots of people might think that would be great but it's not ideal for me as I'm not one for sitting around relaxing for long periods of time. Even when I go on vacation I'm not a big fan of just sitting by a pool or beach for days on end, I like to get out there and explore. Nothing to be done about it though, I need to do what the doctors say and just relax, take my medications, and recover.

How to Have a Colonoscopy

So I celebrated Christmas Eve with a colonoscopy, not exactly the way most people would want to spend the day. It was just for a colon cancer screening, something I do every 7 years. Since it’s the holidays and lots of people are out of Qatar on vacation this is when the hospitals have space for bookings.

Normally something like this wouldn't be the kind of thing I would be blogging about but I realized that many people are reluctant to get themselves checked for colon cancer. It’s a really important thing, colon cancer is one of the most common cancers, and if detected early the odds of getting through it are very, very good. Colon cancer is definitely one of those things you don't want to have detected after it is in the later stages. So I figured I would blog about the entire process in the hopes that it helps others to not be too nervous about getting a colonoscopy, and then talk to their doctor about whether they should have one.

The toughest part about a colonoscopy is not actually getting it done at the hospital, the annoying part is the preparation. The colon needs to be clean so the doctor can use a small camera to look inside. So to get clean you have to go on a 48-hour strict diet of clear fluids only. Just clear fluids -- no soups with a little bit of vegetables in it, no juices that have pulp in it, no milk, just completely clear fluids. You should also avoid too much red and purple liquids, lest it stain the sides of the colon and make your doctor think it might be cancer.

Here’s pretty much what I had for two days:

Water
Weak tea (no milk, milk makes it cloudy)
Kiwi & lime juice
Ginger ale
Sprite/7-up
Lemon juice that I would put in some of the drinks
Red Bull
Clear gelatin
some clear, hard candies that you can suck on

Yep, not the most impressive things to be “eating” for two days. I think what annoyed me the most about it was that pretty much everything was sugar, sugar, sugar. I've been spending the last six months really cutting back on sugar so I wasn't too happy to be having almost nothing but sugar as my only nutrients. And of course by the second day you're quite tired and lethargic since you haven't eaten any solid food. Caffeine, as well as energy drinks, helped a lot. After a while your stomach goes into starvation mode and you cease even feeling too hungry. I figured by the second night I'd be biting my arm for sustenance but in truth my body was not even craving the sugary drinks.

Some websites mentioned you can do things like a weak chicken broth that's clear. I agree something like that would've been nice to have and would've made a great change from all the sugary drinks. Next time I'll try to make some in advance.

The doctor will also prescribe some type of substance for you to ingest that will really flush out the colon. In my case it was a powder called Movicol, which I had to take 48 hours and 24 hours before the colonoscopy. You stir a whole bunch of this powder into some water and drink it. While the taste was nothing to write home about I didn't have any problems drinking the stuff, just chug it down. Then 1-3 hours later you will need to go to the bathroom as the stuff essentially finishes going through your digestive system. This is no joke, you need to be close to the bathroom at all times after drinking the powder as you will have only a little time to get to the bathroom. After that you should always try to be relatively close to a bathroom, now that your colon is empty all of the drinks you have after that will go through you pretty quickly. At some points I was going to the bathroom every hour or so, especially after my second dose of Movicol the next day.

For the final eight hours before the procedure you must completely fast. No more liquids, not even water. I didn't find that too troublesome, the procedure was at 11:30am so I just went to bed around midnight, slept as long as I could, then woke up and went straight to the hospital.

At the hospital they checked my blood pressure then I was shown to a room where I undressed and put on a hospital gown, then was led to the procedure room. I laid down on my side, the nurse put one of those little oxygen tubes by my nostrils, and then the doctor and the anesthesiologist came in. The anesthesiologist had to put a small needle in my hand for the anesthetic -- this was the only needle I had during the whole procedure. Once he started injecting the anesthetic I think I was asleep in less than 10 seconds.


[This is the only evidence of my colonoscopy]

And then I woke up 25 minutes later and everything was done. Just like that. I don't think it was a strong general anesthetic, I remember dreaming, and given I was only out for less than a half-hour I'm wondering if they also gave me something to wake up but I forgot to ask. I laid there on my side for another 10-15 minutes and then the nurse came by to see if I was feeling dizzy. I wasn't, just a bit lightheaded but I was like that even before the procedure started thanks to the 48-hours without solid food. So she helped me stand up and there was no dizziness. I changed back into my clothes, the doctor told me my results, gave me copies of the pictures, and wished me a Merry Christmas. That’s it. All told from entering the front door of the hospital to leaving it was maybe 90 minutes.

I immediately went to a restaurant to get myself a nice solid lunch. I wasn't feeling that hungry but the moment I started eating my stomach immediately switched back on and I was ravenous. Going to a restaurant was probably a bit of a mistake, because your stomach and colon are empty the liquids still go through you quickly. I was lucky because after lunch I immediately found a taxi to take me home (because of the anesthetic you shouldn't drive for the rest of the day) and it wasn’t until I'd been home for about 10 minutes that I needed to go to the bathroom. I'd hate to think what would have happened if the taxi had been stuck in traffic. My advice to you is after the procedure go home and eat there.

That was it, the colonoscopy was done (and yes, the results were fine). Trust me, the diet is more annoying than the procedure itself. Just prepare yourself for a couple of hungry days and the rest of it is fine.

Please, please consider talking to your doctor about whether you should have a screening for colon cancer. It could save your life.

The Myth of Detoxifying

My sister forwarded an article through social media from the Guardian newspaper. Titled “You can’t detox your body. It’s a myth. So how do you get healthy?” it spells out how products that claim to detox your body simply do not work, because there’s nothing to detoxify.

The claims are typically this, your body has built up toxins somewhere that your body is not removing and these products or diet will remove them. They never say what exactly these toxins are or how it is that they build up in your body (because if they did biologists will be able to point exactly how the manufacturers' claims are wrong) they just use vague and nebulous language about these toxins being inside you. The Guardian interviews doctors and medical researchers who discuss why these claims about toxins are wrong.

It’s a scam. It reminds me a lot of ear candling, where you stick a candle in your ear and light it. It is supposed to draw earwax and toxins out of your ear and you can then break the camel afterward to see the gray or brown “toxins” in the middle of the candle. Of course if you lit the candle on its own without sticking it in your ear the toxins also appear in the candle afterward.

Toxin has become the latest fad word for diets and health products. I’m glad the Guardian decided to finally look into this and call it out.

Eat healthier and exercise everyone. I know, I know, that's more difficult than sticking Detox Foot Pads on your feet and going to sleep but exercising and eating right is the magical way to healthy living.

Doha Clinic Operating Hours

Today I was coming down with some kind of eye infection so I decided to go to Doha Clinic to get it checked out. I was pretty sure it closes in the afternoon so I did an internet search to find their hours. No luck: their website required that I download Java just to go beyond their main page (no thanks), no other website had the hours, and even my Marhaba magazine didn’t have it. Strange. No wonder some people stumble onto my blog searching for “Doha Clinic hours”, it’s hard to find online.

Anyway I went this evening and saw the doctor. On my way out I asked reception what the clinic's hours were. It turns out it depends on the department as the various departments have different hours. So from Sunday to Thursday a department might be open (I'm going from memory here):

from 8am-12 then 4-8pm;
from 8am-2pm then 4-8pm; or
from 8am to 8pm.

I didn't even ask what the Friday hours were but I'm assuming they don't open until, at the earliest, 4pm. I'm assuming the Emergency Room is open 24 hours.

The 8pm is when they accept the last registration for patients to see the doctor that day, the doctors will stay until 9pm or longer to see all the patients who have registered.

So I guess your best bet is to just call to see when the department you want is open: 44384333

So, Speaking of Car Accidents . . .

Today while I was in my car waiting at a light a taxi zoomed up and ran into the back of my car!

Over seven years without an accident and now twice in four months I have been hit from behind while stopped at an intersection. *sigh* This one was bad too, most of the trunk was caved in.

So I called the police. Since no one was injured and the taxi driver agreed he was at fault (it would be pretty hard to argue otherwise, unless I somehow reversed into him at 50 kph) the guy on the phone told me to come to the traffic station in Madinat Khalifa to file a report.

So off to the traffic station, filed a report, then tried to go to the insurance company but they were already closed for the day. So now I have a wrecked car sitting in front of my apartment building. As soon as they saw the car the security guards at my apartment building were asking me what the heck happened -- the rear of the car is pretty smashed up. We'll see what the insurance company says tomorrow.

A couple hours after the accident I realized I was still feeling kind of light-headed. I took a nap and still felt the same. Not in pain, and there’s no bump on my head, but similar to that feeling you get when you oversleep. Maybe I have a mild concussion from my head slamming into my seat when my car was run into. I went for a walk this evening and ate some dinner and felt a bit better but still have a bit of this “fog”. Hopefully I feel better tomorrow, otherwise I'll have to conclude that I did get a mild concussion and so will have to take it easy for the next few days.

Bedbugs

No, my place is not infested with them. As summer approaches it’s the main travel season in Qatar so there is a likelihood that during your travels in Europe or wherever you could pick up unwanted hitchhikers – bedbugs.

I'm always concerned when I travel about staying somewhere with bedbugs, whenever I get an insect bite I'm always thinking in the back of my mind “was this bedbugs?” (in truth I believe it’s always been mosquitoes but I get a bit concerned nonetheless).

While most people grumble about the temperatures in Doha it does provide an excellent way to deal with bedbugs without having to use pesticides or other chemicals.

Insects tend to have very specific tolerances to heat and their “thermal death point”, the point at which the insects will die, varies from species to species but is pretty exact – below that temperature they live, above it they die.

According to this entomology website the thermal death point for bedbugs is:

45 degrees celsius for 90 minutes to kill adults and nymphs
48 degrees celsius for 20 minutes to kill adults and nymphs (90 minutes for eggs)
49 degrees celsius will kill all bedbugs quickly.

I’ve actually seen lower numbers elsewhere (43-46) but "better safe than sorry" so let's go with the higher numbers.

So ensure that no bedbugs will infest your home after you travel by taking advantage of the Doha summer:

1) After returning to Doha, don't put your luggage into the house. Remove any perishable items such as medicines and cosmetics and leave the luggage in the car (or if you took a taxi take the luggage to your car and put it in the trunk). Electronic equipment will usually be fine but if you're worried about laptops being exposed to heat then check them for bugs and then bring them inside. I usually leave my electronics in the luggage but I've never had a laptop with me so I'm not sure about their heat tolerance.

2) Immediately after entering your apartment remove all of your clothing and either run it through the washing machine (making sure to dry them on high heat, it will be more than 49°) or put your clothing in a plastic bag and put it with your luggage in the car. Shoes too.

3) Leave your car out for the day in the sun with the windows rolled up. As you know cars heat up more than the outside air temperature so the car will easily go above 45°. Feel free to use the car for errands and things but try to leave it parked outside in the sun.

4) In the evening retrieve your things from the car, if there were any bedbugs they will all have been killed.

Simply washing all the clothes in the luggage isn’t enough, if bedbugs have hitched a ride they could be hiding in the seams or fabric of the luggage itself so make sure that the luggage as heated as well by leaving it in the car.

I do this trick whenever I travel from the late-spring to early autumn even if I didn't see any signs of bedbugs during my travels, just in case.

Sugar Update

Did word get around Qatar that I was cutting down on sugar? Yesterday I was at Costa Coffee chatting with a colleague when the lady behind the counter came over with a free serving of cheesecake for us. Then later at Tim Hortons, I wish I was kidding, the manager came over and gave me a free white chocolate macadamia nut cookie. What the heck? Apparently it’s the Murphy's Law of dieting, as soon as you go on a diet that's when all the treats come out. I'm expecting tonight to get a phone call inviting me to a chocolate tasting.

Today I stopped by the supermarket to see about low-sugar alternatives. First up was bread. I like bread and I like eating it with meals. I don't want to give up bread. But how much sugar is in the stuff?

Luckily I did find a local bakery that puts the nutritional information on its bread packaging – Qbake.

QBake says on its packaging there’s no added sugar, the ingredient list appears to agree, and one piece of whole wheat pita bread has only 1.4g of sugar in it. Other QBake breads (white pita, sliced loaves) also say there's no added sugar in it. I think 1.4g fits the low sugar diet I'm aiming for so I'm glad that QBake put it on their label. That's not to say it's a wonder food, there's around 140+ calories per pita and maybe around 4 grams of fiber, but it's still a decent bread for an occasional snack or maybe to have one with a meal. It’s certainly better than snacking on cereals.

Okay, that's bread solved, what about yogurt? Surprisingly it varies a lot from brand to brand. Many have added sugar, some have added pectin (a type of sugar), some have aspartame or other artificial sweeteners and a few have no added sugar/sweeteners at all. If the yogurt has added fruit then the sugar content is even higher. I looked at one mango yogurt and a tiny one-serving cup had 21g of sugar. You can find yogurts with <1g of sugar.

So yogurt is okay if you read the label and make sure it doesn't have any added sugar. I also looked at laban and that seemed to be fine too, none of the ones I looked at had any added sugars.

I recall Dr. Lustig was okay with eating fruit as even though it naturally contains sugar it also has fiber, which helps to counterbalance the sugar. I think in yogurts the fruit has been processed enough that I doubt there's much fiber left in it -- better to buy a plain yogurt and add fruit yourself.


The quest for low-sugar continues, we’ll see how easy it is to eat out and miss the sugar.

Cutting Down on the Sugar

A friend of mine sent me a link to a YouTube video he wanted me to look at. The video was by a Dr. Lustig, a pediatric endocrinologist at the University of California and the video appears to be getting a lot of buzz.

The video was an hour and a half long and I really didn't have the time to watch the whole thing so instead I put my critical thinking cap on and did an internet search for Dr. Lustig. I found some news articles, interviews and a youtube video excerpt from 60 Minutes covering his theory. In a nutshell -- people eat way too much sugar so need to cut down sugar intake, especially fructose (which is in a lot of processed foods). Sugar is largely responsible for the current obesity epidemic and as far as he is concerned is essentially toxic in the amounts that we are eating. He also says that the food industry has been steadily increasing the content of sugar in foods to make them tastier and to compensate for removing fat from foods due to the move towards “low-fat” eating. There is also some related items regarding calories and how a sugar calorie differs from other calories but I think that's a secondary concern to the overall call to lessen sugar intake.

Now “sugar is evil” and “processed food is bad” is nothing new and is banded about sometimes by alternative medicine circles who love to go on about the dangers of refined sugar or processed sugar, instead promoting natural alternatives. Given I am not a doctor or nutritionist instead it's better to take a critical look at the quality of the messenger and the message.

Positives

Dr. Lustig is:
• a qualified physician with a lot of experience specializing in a relevant field of medicine related to what he is discussing
• not trying to sell you special treatments, expensive medicines or trips to his clinic
• trying to use evidence-based methods to support his hypothesis (not a ton of studies out there right now but there is some experimental evidence supporting it)
• not recommending extreme measures that can be common in alt-med circles: like discontinuing current treatments or avoiding/distrusting the medical establishment
• not heavily pushing for people to buy his book. Alt-med people might give you a teaser and you need to buy their book to get all the relevant information. Dr. Lustig appears to be giving you the overall information you need and if you want more granular detail or food recommendations you can buy the book. Appears more interested in getting the message out than book sales.
• not recommending banning sugar, just cutting back on it a lot.
• not mentioned by the internet site Quackwatch.

Negatives

One newspaper interview with Dr. Lustig contained a few statements entering into the conspiracy theory area -- that the food industry was hand-in-hand with the U.S. Government and they silenced Michelle Obama or something like that. (If you’re reading this Dr. Lustig my advice is to stay away from this kind of thing, keep the debate focused on the evidence and the medical findings. Conspiracy accusations just allow opponents the ammo to dismiss you as a “conspiracy-kook” instead of looking at the evidence.)

So overall a lot of positives and almost none of the red flags that would generally indicate quackery. Hopefully the lengthy youtube video is similar but the other items I reviewed support the above.

Conclusion: an informed hypothesis that is certainly worth study and debate.


So given that the main thing to do is simply cut back on sugar I figured I would give that a try as part of my attempt to slowly lose weight. I'll admit I've been more focused on calories and fat but don’t see any reason not to be more “sugar mindful”, this is not exactly radical, fad-diet stuff here. I figured I’m on the right track already – I never add sugar or sweeteners to coffee or cereal, in fact I don’t touch a sugar bowl. My cereals are typically high-fiber whole-grain cereals (but I do add a bit of those sugar/honey cereals for flavor, that’s going to stop). I've already been cutting back on desserts as part of trying to slowly lose weight, only drink diet sodas, get juice from a juice stall where it’s blended fruit, and I rarely drink alcohol.

So I’ll cut out the bit of sugar cereal and go off the soda, even diet ones (maybe a psychological thing, I think drinking a sweet drink might make you just want to have sweet drinks more). That should about do it.

Until I read the labels on my food.

What do you know, a high-fiber cereal has added sugar. Why would you add sugar to a high-fiber whole-grain cereal? One of them discloses that for every hundred grams of cereal I’m eating 20 g of sugar (for comparison a banana has 12g and apples around 10g). 20% sugar! Huh? And my healthy Dorset high-fiber muesli? 27.5g! (though it’s likely from the dried fruits in it, there does not appear to be any added sugar).

Um, so I guess I’ll cut the cereal down by half and replace the half with an apple or banana. I think Dr. Lustig won’t have an issue with bananas or apples.

I like breads but apparently many of them have a lot of sugar, and I have no way to know how much since the breads have no nutritional labeling. Guess I’ll reduce the bread intake too.

My favorite “healthy lunch” is a vegetarian pasta dish from Vanellis that has a red sauce – their website indicates the sauce likely has around 6-8g of sugar based on the amount of sauce I get. Okay, that’s not bad, but maybe I’ll try to cut down the sauce even more.

I like low-fat yoghurts but they appear to have added sugars – I’ll see if I can find one that doesn’t.


Suddenly this is looking harder than I thought. But I’ll stick with trying to lower the sugar intake and see what happens.

More Evil Eye

Slowly improving. My eye is almost completely open now and I'm definitely feeling a lot better. Not 100%, but better. Light doesn’t bother me as much as it did before either.

Went out for a short walk this evening, first time I've done any kind of exercise in about two weeks. It is still hot out and unfortunately I have to be careful about over-exerting myself -- can't risk sweating and making things worse. I'm hoping by the middle of next week I'll be able to go out for longer walks.

Prognosis from the doctors has been upbeat but I might be on some of the medications for a couple of months. There is also still a chance I could develop eye damage so I need to be careful. I will find out how things are progressing next week at my next appointment.

The Evil Eye

Still sick but feeling a bit better than I have in previous days. My eye is partially open and I'm hopeful things will improve over the next couple of days. Visited the eye doctor yesterday and apparently there is no damage to the cornea so far, which was good to hear.
The doctor was still not 100% happy and has changed one of my medications to see if that improves things.

Sitting at home is not all that relaxing. Light still annoys me so I cannot watch TV or computer screen for very long (not that it was easy to do with one eye anyway). A lot of time is spent sitting on the couch listening to my music player.

I go back tomorrow to visit two doctors so we'll see how things go from there.

Eye Update

Things started getting worse so I went to another doctor for a second opinion. I won't get into the specifics of what's going on but I walked into the ophthalmology department of the hospital and asked to see a doctor. The lady at the desk apologized and said there were no appointments available today.

So I lowered my sunglasses.

There was a brief pause.

And without saying a word she picked up the phone, "Are there any doctors who can see a walk-in patient now?"

So I got to see a doctor. In the end I got to see four.

I now have a complete change of diagnosis, was told to stop taking my previous five medications, start taking these new four medications, and was given sick leave for another week -- though it might turn out to be for longer than that. I now have two follow-up appointments scheduled. I'm confident that this time the diagnosis is right so it's now a matter of seeing this through. (And it's not like the first doctor was way off base apparently in the early stages this disease is typically diagnosed as conjunctivitis)

Resting at home now but man this sucks.

Pink Eye!

Yesterday my right eye was itching a little and slightly swollen. Figured I was just tired but when I woke up this morning it was slightly worse. Wasn't a big deal, just a little irritating, so I went to work but by the afternoon it got a bit worse so I decided to go to the doctor in case it was an infection or something.

A few tests later confirmed:

-- My vision is great (no glasses for me!)
-- And I have infectious blepharoconjunctivitis (one of the many conditions we commonly call "pink eye"

The doctor then gave me a note for two days off work. I said I felt okay so might not need it but the doctor told me that it is infectious so I need to stay home. Oh, okay then.

So I'm now sitting at home with five medications (two eyedrops, one ointment, and two oral antibiotics). Looks like I'm essentially going to be in quarantine for a couple of days. I suppose it's for the best -- my eye has swollen even more now but at least I've started the medications.

I tried to take a picture of my eye for the blog but unfortunately it kept coming out blurry (or maybe that's just my vision) :-p

Nothing starts the New Year off right like...

An emergency root canal! *sigh*

Remember how I had to have all of my wisdom teeth out? Well the reason I had to have them removed (aside from the fact they were heavily impacted) was because a big cavity had formed where a wisdom tooth was impacting another tooth, and the dentist could not get at the cavity unless the wisdom tooth was removed. So after the wisdom teeth were removed and my mouth had a chance to heal the dentist filled the cavity. It was so deep the dentist said she could see the pulp. So she warned me there was a chance it would get inflamed in which case I would be in real pain, so she gave me her mobile number in case that happened.

After nine days suddenly my jaw started feeling more sore than usual. By Friday I was having the occasional throbbing pain that would last about 3 or 4 minutes, and remember I'm on prescription painkillers for my back. Now I've had a toothache before that required a root canal and I remember the pain well so I knew something was up. I called my dentist and she said to come in Saturday at 5 p.m. as she worked evening shift on Saturday (everything in Qatar is closed on Fridays). I figured okay I can hold out until then because I have the strong painkillers and the pain attacks were annoying but bearable.

By Saturday I was doing little but laying on the couch watching the clock waiting for the time when I could head to the dentist. The throbbing pain was now every 40 minutes or so and would last for around 10 minutes. It was getting agonising even with the painkillers and when an attack came there was little I could do except lay on the couch and close my eyes until the pain passed. I do not even want to know what it would have been like without the prescription painkillers.

Got to the dentist and had a root canal done. Aaaaaaaah, I felt so much better. It is amazing how just a few little nerves in a tooth can cause such trouble. At some points it felt like the right side of my face was being punched repeatedly.

Go back to the dentist again this week to get the root canal finished. After that that should be it for dental problems this year (I hope).

Back Update

Okay so the MRI results came back, looks like I have a slight degeneration in one of the discs in my lower back. It has a lot less fluid than the other discs, which affects the elasticity, which can cause soreness and pinching. Definitely could see it in the MRI -- all of my discs showed up as black with white in the middle except for the troubled disc which was entirely black. So I'm booked for physiotherapy (starting this week), need to lose weight, and try to avoid sitting for long periods of time, which is more difficult than it sounds since I work in an office. If after a few months there is still no improvements I think I can have fluid injected into the disc, but that sounds a little scary. The degeneration is apparently something that can come with age and also with people who sit for long periods of time. I'm getting old! *sigh*

On the plus side booking physiotherapy was a breeze, go down one floor to the physiotherapy department at the clinic, hand them the referral form, and my first appointment is in a few days (provided the insurance company approves it of course). When it comes to wait times for medical service Qatar beats Canada hands-down.

Christmas Eve Medical

While everyone else is gearing up for Christmas (well, the Westerners and Christians anyway) I decided to do something different -- go to the doctor about my back. The blood work and x-rays were ready so I was to see him.

So another meeting with a doctor, another consultation, and another prescription for medications, my third in eight days. I had to spend a minute to ask the doctor which ones of the old prescriptions do I keep taking and which ones do I stop. Oh, and I have to lose weight. Next appointment is on Sunday.

By the time I got home: my back ached, my tooth ached from that cavity I had filled a few days ago, my Repetitive Strain Injury was acting up a little because I was driving around, traffic was lousy, I'm now on a diet, and because of the cavity I can't eat anything hot or cold for a week, and it was still hot outside. I was miserable.

Then, like those corny old Christmas specials on TV, I received a gift. And thanks to this gift everything started looking better again, my misery vanished, and I was back to my happier self...




... prescription painkillers!



Wow, those things work like a charm! It's amazing how much better you feel about things when you're not in pain and discomfort.


Back to health care. When I first saw the back doctor (a neurosurgeon) he wanted me to undergo some blood tests, x-rays, and an MRI. Did the blood tests and the x-ray immediately thereafter, and made an appointment for the MRI, which would be in three weeks. When I spoke to the doctor today he asked about the MRI and I told them I had made a booking for January 11. He immediately said, "no, no that's too long, go back and tell them to get an earlier appointment, if you pressure them they will do it."

I thought that was strange, I thought three weeks for an MRI was pretty good (in Canada it would be). So I went back to the MRI area and told the clerk at the appointment desk that I had an appointment through January 11 but the doctor would like me to have it earlier. So he did a bit of typing on his computer, then said:

"Okay, comeback at 4:30 this afternoon"

So I had an MRI appointment for the same day! In fact, I just got back from it. (Are you reading this Health Canada!?) That's why my next appointment with the doctor is Sunday, to discuss my MRI results.


Now I do not want anyone to worry that I will be spending Christmas sitting in some corner alone in the dark. I'm visiting friends tomorrow morning, and going to another friend's place for Christmas dinner. I have also booked my plane tickets for Canada so in about five weeks time I will be with my family having our usual late-Christmas. And thanks to prescription painkillers I should enjoy it all, even though I will not be eating as much as I would have liked.

Merry Christmas everyone!

My Warranty Has Expired

These past few days has seen me go to one doctor for a problem with my back (doctor suspects it is a joint inflammation between the spine and the hip, test results come back Thursday), and to the dentist to get a deep cavity filled (this was why I needed to get my wisdom teeth out the cavity was between a tooth and an impacted wisdom tooth).

I swear my mother must have a certificate that was given to her when I was born stating that I have a 38-year warranty because, man, am I falling apart! I've been under general anaesthetic three times in the last year and have had two other medical problems besides. Almost everything has been resolved so if this back inflammation can get sorted out then I have to worry about is my repetitive strain injury.

I hope 2010 is way better medical-wise.

Al Ahli Hospital versus Doha Clinic

Okay I'm back from the hospital for the wisdom teeth extraction at Al Ahli Hospital. So far so good, face is not too swollen and the pain has been more like a dull ache that non-prescription painkillers keeps in check, I don't need the heavy-duty painkillers thankfully. The procedure was a little more complicated than a standard wisdom tooth extraction so I needed to be under a general anaesthetic and spent 24 hours in the hospital.

So in the course of one month I have undergone general anaesthesia and a hospital stay in both Doha Clinic and Al Ahli Hospital (AAH). AAH is the newest private hospital in Doha, spacious with wonderful-looking facilities, and most companies purchasing private medical plans for their employees want AAH on the list. Doha Clinic is older, not as spacious, and tends to be more crowded. But are looks everything? Here's my comparison:

Approval for the procedure: Tie. both places sent the request for the procedure to the insurance company and as soon as approval was given my procedure was scheduled within a week.

Initial blood work and admissions procedures: Doha Clinic. I just had to go to the laboratory for the blood tests and there was no waiting or delays processing paperwork. AAH was busier and it took around a half an hour before I could get my blood taken, and I also had to separately go to an admissions office to sort out the room booking, which I did not have the do at Doha Clinic. Good thing AAH had sent a nurse along with me otherwise I probably would have had to ask someone where to go. I know, I know, a half-hour wait for blood work is not exactly an ordeal, but it was still quicker and easier at Doha Clinic so it wins.

Preapproval consultation: Tie. this is a bit trickier because there are two consultations involved, with the surgeon and with the anaesthesiologist. The consultation with the surgeon was definitely longer and more detailed at AAH, but the consultation with the anaesthesiologist was better at Doha Clinic. At AAH the anaesthesiologist consultation was a couple of minutes in my hospital room before the procedure, at Doha Clinic the consultation took place days before at the anaesthesiologist's office and we had a good 15-minute discussion. I will say that much of the information asked by the anaesthesiologist at Doha Clinic was instead done by a nurse at AAH but I feel more at ease talking to the specialist directly. Also, no one at AAH mentioned fasting before the procedure. I fasted anyway because I knew from my operation at Doha Clinic that you should fast before going under a general anaesthetic. It was not until I got to AAH for the procedure that I was asked when I last ate, not sure what would have happened if I'd had breakfast just before going to the hospital?

Hospital room: AAH (by a hair). I was in a private room at both hospitals and the facilities were pretty much the same: rooms were around the same size, extra chairs and couches for guests, a small refrigerator, closet/wardrobe to keep stuff in, TV, etc. So it is down to the small stuff, AAH wins out because: the room is newer, AAH provides a room safe for your valuables, hospital gown was softer, and the small refrigerator is stocked with water and juice for your guests.

Nursing staff: Tie, both excellent. Professional, friendly, and never any problems or delays when I called for them.

Cleanliness: Tie. at both places staff came by to clean the rooms and the garbage frequently

Operation: I was unconscious so what can I say? AAH was more serious about patient identity, every step of the way from admissions, the nursing staff, to just outside the operations room, I was always asked to confirm: my name, what procedure I was here for, and then I would be shown the signed consultation form which detailed the procedure and risks and asked to confirm that was my signature. Looks like AAH was really worried about doing the wrong procedure on a patient. Was it overkill? Can't say. Guess one cannot be too careful with these things.

Food: unfair to make a comparison. I was at AAH for wisdom teeth extraction so my meals were limited to liquids and ice cream while at Doha Clinic I could avail myself of their full menu. Doha Clinic provided me 4 meals a day (breakfast, lunch, dinner, snack) and the food was pretty good, for example one meal was roast chicken on biriani rice, green salad, soup, cooked vegetables, another salad similar to a Greek salad, and dessert. Sometimes I couldn't even finish the meal there was so much food. AAH did ask me if I was having guests pop by and when so that if I wanted they could prepare meals for them (!!), something Doha Clinic didn't ask me about.

Postoperation consultations: unfair to make a comparison. on the face of it AAH was better as the dental surgeon came by when he said he would, checked the wounds, provided an update as to what he thought and asked if I had any questions, at Doha Clinic sometimes the surgeon came by as scheduled, sometimes not. BUT at AAH I was dealing with a dental surgeon while at Doha Clinic I was dealing with a general surgeon who was on call for emergency surgeries. I do not think it's fair to criticise a surgeon who does emergency surgeries for not stopping by my room at a pre-arranged time - he may have had to save a life instead. And given the number of car accidents in Doha I'm willing to bet there are a lot of emergencies to deal with.

Both places also had a Guest Relations person come by to see if everything was okay and if I had any questions or concerns to either let them know or call the nurses.

So there you have it, both places were pretty good. Some people in Doha may be drawn to AAH instead of Doha Clinic because the clinic side of DC is crowded (the hospital part isn't though) and the building is not as new or fancy as AAH, but it certainly did an adequate job and had standards comparable to AAH. I was treated well at both places.