Who Is This E@L?

Who is this person staring back at E@L?

The person in the bathroom mirror with the zipper line of scabs peeling from a scar down the middle of his chest. The person with the healing wounds where drain tubes once sucked out blood accumulating in the spaces between his heart and his chest. Who is the person who would submit himself to such surgical ignominy? Certainly not E@L. E@L would never let people hack at his sternum and prise open his ribs, nor let let them stop his heart, nor let them place a clamp on his aorta - the source of oxygen to his entire E@Lness. He certainly would not let them dig arteries and veins from arm and leg. E@L does not know this front-to-back reversed E@L.

Who is he?

What sort of person is he?

What sort of person is this E@L, who decided such violent effrontery was the best idea at the time. This acquiescent E@L, this bowed into submission by logic and research E@L. This E@L who knew that he might die, and comfortably made the choice to take the risk. This E@L who put thing in order: will and testament, bank accounts, password list. 3% is not an insignificant statistic when they do 60 of these a month. This E@L who really thought he was going to be the one in 33 1/3 who died, the one every month and a half. This E@L who shelled out $50k for the promise of staying alive a bit longer. The E@L who wanted to live but knew, in his cramping heart, that he could die: and die easily, quietly, quickly, never waking up. Death. If not now then eventually, and he couldn’t decide which would the be best outcome. The slipping into oblivion, into annihilation and pre-birth emptiness. Peace. Who is he?

Where is the E@L without these battle wounds? The E@L who feared the pain and dependence that would last for months after, should he survive those first few days. The E@L who said “No fucking way.”

Who is this E@L who dismissed the anxiety. Who is this E@L who knew what could go wrong, but shrugged. Who is this E@L who, while on the operation table, agreed to being intubated while still awake, because of his severe apnoea. The E@L who was hit with a massive headache that burst up the large muscle (sterno-mastoid) in his neck next to his skull, that went up into his brain when the central venous line was inserted, and who mentally shrugged and thought (he could still think!), well that’s it, a massive stroke, but whose both hands still felt strong when he squeezed them as he kept testing them.

But the E@L who joked with the anaesthetist about upgrading his ultrasound machine when he came through this, now that sounds like the real

E@L.

Fuck

Exactly what 54yo E@L didn't need to read after 5 weeks of dieting (down 6 kgs) and massively increased exercise regime. From nothing to 1:30hr in the gym four times a week and 1hr+ walking in the off days and 30mins swimming when the sun is shining and he is working from home. Long term benefits, according to this article - fuck all.

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Cardiac Risk: Late repentance is useless

Whoever cuts their cardiac risk factors often believes that they are then on the safe side. Yet this sense of safety is a deception for the middle-aged: according to U.S. authors, five-or ten-year cardiac risk may then be reduced, but over a lifetime period it isn't.

Excess body weight, lack of exercise, stress, smoking and more – in the prevention of cardiovascular diseases, each risk factor that can be eliminated counts. As long as physical changes and damage are not as yet detectable, nothing has as yet happened – a process of rethinking and behavioral changes made towards a healthy lifestyle are the best guarantee of longevity.

This is wrong: such is the opinion of cardiologists working under Jarret Barry of the University of Texas Southwestern Medical Center, because the current approach in the prevention of heart problems is to identify only the short-term cardiac risk. Only a few studies, such as one investigation done in 2006 with participants in the Framingham study, shed some light on the long term risk. Early life decisions might have a major impact on the rest of one's life and this rule would not apply any differently to the heart. Risk factors for the young and middle aged have an impact on one's total lifetime, says one analysis of studies from the scientists published in the New England Journal of Medicine.

Each risk factor counts

Data based on the analysis of the lifetime risks for the heart has been collected from 18 cohort studies making up the Cardiovascular Lifetime Risk Pooling Project. The data is part of a 50-year-long investigation. Risk factors such as blood pressure, cholesterol, diabetes and smoking were recorded for more than 250,000 people – men and women – at 45, 55, 65 and 75 years of age as well as cardiovascular disease status. For each age category, the risk of cardiovascular events was determined.

An optimal risk profile was defined as having cholesterol at <180 mg/dl, blood pressure lower than120/80 mmHg, non-smoking status, and no diabetes. For this optimal risk profile at the age of 55 years, the lifetime risk (up to age 80 years) of dying due to cardiovascular disease, with figures being 4.7 percent for men and 6.4 percent for women, is low. With two or more risk factors present, the risk of death due to vascular disease increases to 29.6 percent in men and 20.5 percent for women. Coronary heart disease or nonfatal heart attack is suffered by 3.6 percent of men and less than one percent of women, when they have no risk factors. For those with two or more risk factors, those figures are 37.5 percent for men and 18.3 percent for women.

Who has no risk factor?

Even more dramatic is the comparison of the risks for 45-year-olds. A man of that age not having risk factors only carries a risk of 1.4 percent of dying up to the age of 80 years from cardiovascular disease. With two or more risk factors, the risk increased to 50 percent. For women, the difference is 4.1 versus 31 percent.

Taking into consideration – as is done in most studies – only the five-or ten-year risks, where the risks for 50-year-old risk factor-carriers then become rather small, is something the study's authors have criticised. In addition, only a slight increase in risk factors – such as slightly elevated cholesterol levels or blood pressure – can increase the risk significantly. Most study participants presented at least one risk factor.

With regard to the prevention of cardiovascular events, the results show that only the avoidance of risk factors in young and middle age was able to considerably reduce cardiovascular disease. When discovered and treated only in middle age, risks can only be slightly reduced and disease only slowed down in progression. [My emphasis]

Dr. Julia Hofmann
Medical Journalist

Fuck.

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Start slim and healthy, stay slim and healthy, and one day you'll be a slim and healthy person with Altzeimers is the lesson here.

This why you don't see a really old fat people. They've had a brilliant life, spared themselves nothing, and got out before the rot set in. Maybe not so much good sex, unless they flash the Charisma card and stock up on the Viagra (headache!) and Cialis, and hence they are a valid target demographic for up-country Thai girls.

E@L

[Precis of the original article available on-line at NEJM.

Blame Anthony Bourdain

I do. Each of my teeth has its own separate hangover. That third martini must have been spiked. I recall jauntily launching myself downhill on the road to my hotel - alone for some reason - when a taxi driver took pity on me and bundled my sorry excuse for a body into his car for God knows how much money.

I also recall hugging the band's guitarist like he was my long lost (Balinese) brother, but I also told the singer she should wear high heels. This was later (how much later, I can't tell you) at a completely empty club I recollect as being called IngSoc, but that maybe due to us talking Orwellian Newspeak earlier in the day. I am feeling double plus ungood currently. We toasted the late great Keith Floyd, goddam him.

My head says eat, but my stomach says no fucking way.

There's a sign on the wall (but you've got to be sure) about Bourdain claiming Nury's BBQ place (candlelit due to a rainstorm) to have the best martini on the planet. Unfortunately, Jeremy told us, this declaration never made it to his (Bourdain's, that is, Jeremy doesn't have one, but do I have his card) TV show. Meanwhile (or later, or earlier) I was explaining the indubitable (I think Adam tried to use that word first, but pronounced it "inbubblable" - he had commenced on the martinis before us) superiority of Frank Moorhouse's book on martinis as I sipped on my second vodkatini (is a vodka martini, strictly speaking, a martini?) when the rational world began to collapse around me. Is Ubud really a martini town, I kept asking no-one in particular.

Somehow, around 1am, I had survived thus far and wisely decided to repair to my hotel in order to repair, which has only partially succeeded thus far. I believe Daryl witnessed my return. He was sitting bemused in a chair in reception surrounded by fuzzy lizard creatures. I may be wrong in this.

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This morning I shocked the gardener into silence by walking out naked to collect my swimming trunks which had been drying on the balcony.

Ungood.

How was your night?

E@L