Yesterday, in the middle of my crying fit, I had an appointment with my orthopedist. I've mentioned my car accident havent I? If I have you can skip this paragraph. 5 days after I lost my job I had my final epidural. The pain management specialist that I was going to does these epidurals under general anestesia so also owns a car service. It's an insurance deduction for him, you're not supposed to drive immediately after general anestesia. On the day my last injection the car service was driving me home and the driver crashed into another car. I was in the back seat, with my seat belt on, minding my own business reading a book. All of my medical bills have to go through my insurance company. I think that's ridiculous since my car was parked in front of my house at the time (I didnt even have my car keys) but NJ is a no fault state so all my stuff has to go through my insurance, not the car service. Now here's where it gets tricky. According to Allstate I checked the box authorizing my primary health insurer to be my PIP carrier. I dont remember ever checking that box, I looked on my original policy and that box isnt checked. They say I checked it on the next renewal, I dont remember doing that. Since I was laid off 5 days earlier I didnt have insurance. My attorney says that since I had no primary insurance at the time, that Allstate has to pick up all of these bills since they're my secondary insurance. Allstate says otherwise. Anyway, I'm not getting into that mess right now, it makes my head hurt. Let HIM fight that battle, he's getting 33% of my settlement... let him earn his money!
The insurance company says that my primary care doctor has done all he can so they arent paying for any more visits (like it matters.... they're declining all the charges anyway). They say I need to see an orthopedist or a physiatrist. When I saw that independent medical review and the word psysiatrist I went nuts. I called my lawyer screaming "they're saying I'm crazy! I'm not imagining this pain!". He, of course, laughed at me. Psychiatrist's deal with emotional disturbances, physiatrists specialize in physical therapy. Who knew! lol
So yesterday I walked into my orthopedists office, first words out of his mouth are "those shoes are too old, you need new ones". He tells me that sneakers break down after a few months and even though they look in good condition, the insoles break down and they're actually bad to wear. So now, on top of everything else I have to buy sneakers. I go to Sports Authority and see a nice pair of Nike Air Vitalitys. They have my size, and they're on sale. Here comes the salesman "do you need any help?" "nope, I have what I need" "are you sure? we have a lot of shoes here". My son starts to tell him about my back problem and the surgeries and the metal bars and he (the salesman) tells me that I'm wasting my money buying air soles, they break down much sooner than regular sneakers. He shows me these white New Balance, says they're much better than the Nike Air. Says they're 1st choice of nurses and other people who have to be on their feet 10-12 hours a day. I tried them on, they felt ok and were the same price as the ones I'd picked so I get them. I get them home and put them on. 10 minutes later my feet are crying. They're hard to walk in, they dont bend at the toes. Now I get that you have to break them in but I cant have extra pain anywhere in my body until they break in so I brought them back.
I had the original Nike Airs in my hand when I see these Brooks (the picture is the color I actually got)
My neighbor had just been talking about Brooks shoes. He's in the police academy and said the Brooks were the best sneakers he's ever worn. So I tried them on. OMG they're like wearing pillows on your feet!! The ones that I got are normally 95.00, on sale for 60. That's a little more than I intended to spend but I think it was worth it. Can you hear my credit card crying? I think they can hear it in Kansas.
Oh, and if there's a Sports Authority in your area, they have this great deal. For an extra 5 bucks you can get insurance on your sneakers. If they rip, tear or seperate, or the color fades, or the lace holes break or that metal comes off, or ANYTHING ELSE goes wrong with your shoes for 1 year they will replace them. The guy told me in 6 months (when it's time for new shoes) to rip a seam, return the shoes and get new ones for free! Check into it... I think it's a great deal!
What is it about shopping that instantly makes you feel better? I felt like shit all day. Still depressed over yesterdays rejection, still stressed over money. Yet you go into a store and you leave happy. What is that?
I just read the most fascinating article on nytimes.com about weight loss! I'll paste the article below but sum it up here. We have fat cells, brown fat cells, that burn calories faster in the cold. We are born with these brown cells but lose them as our bodies mature and learns to warm iteslf. They put these mice in a cold room for a week and they lost 14% of their weight just by being cold!! I want these fat cells :) I'd live in my refridgerator
April 9, 2009
Calorie-Burning Fat?
Studies Say You Have It
For more than 30 years, scientists have been intrigued by brown fat, a cell that acts like a furnace, consuming calories and generating heat. Rodents, unable to shiver to keep warm, use brown fat instead. So do human infants, who also are unable to shiver their muscles to stay warm. But it was generally believed that humans lose brown fat after infancy, no longer needing it once the shivering response kicks in. That belief, three groups of researchers report, is wrong.
Their papers, appearing Thursday in The New England Journal of Medicine, indicate that nearly every adult has little blobs of brown fat that can burn huge numbers of calories when activated by the cold, like sitting in a chilly room that is between 61 and 66 degrees.
Thinner people appeared to have more brown fat than heavier people, younger people more than older people; people with higher metabolic rates had more than those whose metabolisms were more sluggish, and women had more than men. People taking beta blockers for high blood pressure or other medical indications had less brown fat.
“The thing about this brown fat is that it takes a very small amount to burn a lot of energy,” said Dr. C. Ronald Kahn, head of the section on obesity and hormone action at the Joslin Diabetes Center in Boston.
The fat really is brown, researchers say, because it is filled with mitochondria, cells’ tiny energy factories. Mitochondria contain iron, giving the tissue a reddish brown color.
The hope is that scientists may find safe ways to turn peoples’ brown fat on, allowing them to lose weight by burning more calories. But researchers caution that while mice lose weight if they activate brown fat, it is not clear that people would shed pounds — they might unwittingly eat more, for example. The data on global patterns of obesity are not good enough to say whether living in a cold climate makes people thinner.
The best evidence for the effects of brown fat is from earlier studies in mice, said Leslie P. Kozak, a professor of molecular genetics at the Pennington Biomedical Research Center of Louisiana State University.
Recently, Dr. Kozak put mice predisposed to obesity in a cold room, 41 degrees, for a week. The animals activated their brown fat. As a result, they lost 14 percent of their weight, which constituted 47 percent of their body fat, while eating a high-fat diet with two and a half times more calories than they had consumed at room temperature. “That’s just by going out in the cold, without any drug treatment,” Dr. Kozak said. But, he cautioned, mice, small animals with a comparatively huge surface area, are easily chilled. “Put the mouse in the cold,” he added, “and it becomes a heat producing machine.”
Jan Nedergaard of the University of Stockholm did the opposite of Dr. Kozak. He and Barbara Cannon, also at the University of Stockholm, studied mice that were genetically engineered so their brown fat could not burn calories. The animals became fat.
“Until very recently, we would have said that it is doubtful that differences in brown fat really could contribute to obesity,” Dr. Nedergaard said. Now, he said he had changed his mind, at least for mice.
The key to finding brown fat in humans was PET scans, which pinpoint areas where cells are actively burning glucose. Because brown fat rapidly burns glucose to produce heat, it lights up in the scans. In two of the three studies, investigators also studied samples of brown fat that were removed from a few subjects, confirming that the cells had a protein, UCP-1, that is unique to brown fat.
Brown fat in adult humans was in an unexpected place. Infants have it mostly as a sheet of cells covering their backs. Rodents have it mostly between their shoulder blades, just down from the neck. But in adult humans, it showed up in the upper back, on the side of the neck, in the dip between the collarbone and shoulder, and along the spine.
That may be one reason it was missed for so long, Dr. Kahn said.
“There was an interest in looking at humans 20 or 25 years ago with different scanning techniques, but people were always looking between the shoulder blades,” he said. And since there is so little brown fat — just a few grams of tissue — it can be hard to find, Dr. Kahn added.
His study, one of the three published Thursday, involved 1,972 people who had had PET scans for a variety of reasons. The scans showed brown fat in 7.5 percent of the women and 3 percent of the men — an underestimate, Dr. Kahn says, because the people had not deliberately activated brown fat by getting cold.
Dr. Kahn and his colleagues also examined biopsy samples taken from the necks of two patients. They concluded that what looked like brown fat in their scans was indeed brown fat.
A second study, led by Wouter D. van Marken Lichtenbelt of Maastricht University in the Netherlands, involved 24 healthy young men. Ten were lean, the rest overweight or obese.
The scans showed no brown fat when the men had been in a room that was a comfortable temperature. But after they were in a chilly room for two hours, scans showed brown fat in all but one, an obese man.
A third study, led by Dr. Sven Enerbäck of the University of Goteborg in Sweden, involved five healthy adults. Each had two PET scans — one after being in a room at a comfortable temperature, the other after being in a chilly room for two hours. The investigators saw brown fat in their chilled subjects. Three participants allowed the researchers to remove some white fat and some brown fat to demonstrate that what looked like brown fat in the scans really was that elusive substance.
The studies, investigators say, should stimulate research on safe ways to activate brown fat. It is known to be activated not only by cold but also by catecholamines, hormones that are part of the fight or flight response. That is why beta blockers, which block catecholamines, can suppress brown fat activation.
Epinephrine, or adrenaline, and ephedra, a herbal supplement containing epinephrine, can stimulate brown fat, said Dr. Rudolph Leibel, co-director of the Naomi Berrie Diabetes Center at the Columbia University Medical Center. But, he added, the drugs have too many side effects to be used for weight loss. While caffeine can boost ephedra’s effects, Dr. Leibel said, it is easy to eat your way out of a brown fat effect.
Brown fat, he said, “fits the fantasy — I eat what I want and burn it off.”
That, however, is still a fantasy, Dr. Leibel added.
If a drug that stimulates brown fat could be developed, said Dr. Claude Bouchard of the Pennington Biomedical Research Center, it would be the first obesity drug to affect energy expenditure rather than appetite.
Then there is the notion of simply hanging out in a cold room.
“We’re thinking of opening a frosty spa,” Dr. Kozak joked.
