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Saturday, 11 June 2016

Princess Health and June 11th, 2016 To Prove Otherwise. Princessiccia

Princess Health and June 11th, 2016 To Prove Otherwise. Princessiccia

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June 11th, 2016 To Prove Otherwise

I first met Bill at one of my book signings in 2012. He lives in my hometown. I consider him a friend. We certainly don't get together as much as we'd like, but still, we've kept in contact, enjoyed coffee and we've shared in deep intellectual and philosophical conversations about the various elements of transformation. He's one of the most intelligent people I know. He's an attorney and for many years lectured at Oxford University. It is truly an honor to call him a friend. Bill is also someone who has studied this blog closely over the years. His support, wisdom and insights are always appreciated. He also, as you might imagine, has a fascinating transformation all his own.

After my maintenance weigh-day post, I received a wonderful email from him, containing some very interesting information. With his permission, I'm sharing it with you:    

Dear Sean,

I read your blog every day, watching with interest your evolution.

The main thing now is that you are getting a grip on your rest and sleep.  That is so important, noting that there are two variables which you cannot control, which are work related commitments combined with the unpredictability of the weather, and then the family obligations.  Consequently, it requires some flexibility, an approach you are more than able to handle at this point.  Well done.

As you progress with things, the surprise and mystery of how you can eat a higher portion of daily calories and still lose a bit of weight has been on your mind.  

Some months back, while reading my usual international papers, noting the health sections in particular, there was one which crossed my path that was of  interest.  Unfortunately, I cannot remember the paper, and did not bookmark it at the time.  I have been unable to locate it.

However, I do remember the main point.  The breakthrough study found that in the study of weight loss, there came the usual point when people "reached their goal".  What surprised them was the fact that it took 12 full months after the goal was reached for the metabolism to return to normal!

What this means is quite significant.  Essentially, there is a two phase process, with the first being the initial weight loss, and the second being the metabolism recovery.  To return to normal eating of caloric intake prior to the 12 month period of readjustment could very well cause a relapse in itself.  

Interestingly, this reset is something that you are experiencing, which is fascinating because of the precision of your tracking, and it seems to run true to the study I mentioned.

So rather than digging back through your archives, it might be easier if you could look back and determine at what point you reached the goal and went to the 2300 calories.  Has it been a year?  If so, then it would perhaps answer why the loss is occurring now.

If you get a moment, out of curiosity, let me know that date or mention it in your blog, as it will be interesting to see if you are close to the 12 month window.  

More on me later.  Lots to tell, but all well, in a nutshell. 

Cheers,
Bill

I went back into the records and discovered I officially dropped below my initial goal of 230 on June 24th, 2015. That was the day I could say I lost all of the relapse/regain weight-plus two pounds. I weighed 228 that day, just a couple weeks shy of one year ago. I started adding calories slowly at first, then a little more, and a little more, before finally arriving at a maintenance budget of 2300 calories. Throughout this process, it's brought me to where I am today: 203.8

It's all wonderful news, really. I spent many years believing there was nothing I could do about my sloth-like metabolism. I've shattered that old story. It just wasn't true. I never remained consistent enough to prove otherwise, that is, until this transformation started seven and a half years ago. I'm grateful for the changes and absolutely blessed by what's revealed in the study of it all.

Once again, thank you, Bill!

--------------------------
I posted yesterday's blog and rushed off to the rodeo grounds for night two of three, broadcasting from the big PRCA Pro Rodeo. My activity level at these annual broadcasts is completely different than it was for several years. At my heaviest, I hid in the station broadcast vehicle. The lights were on, the station was blasting--but I was hidden inside, only heard on the air. Now, I'm all over the arena--with a spring in my step and a smile on my face. The perspective has shifted. And this is a perfect example of how my physical/mental/emotional transformation has positively transformed my work performance. Now, the perspective isn't, how can I get this over quickly without too much effort? It's, how can I make this a great broadcast?

I had a couple more location broadcasts today--one from a grocery store and then my final rodeo broadcast of the year. My activity level the past two days has been more than sufficient to be considered workouts. I no longer wear a fitbit--and haven't since mine stopped working, but I'm sure if I still had it, the numbers would back up that conclusion. I may get another one soon, I'm still on the fence. I don't necessarily need to see the stats, I just need to get the movement--you know? The activity monitor on my phone works a little--but I don't think it catches everything.

Tonight's broadcast brought to a close one of the busiest two week periods of my entire year.

I'm very proud to be able to say: Through it all, I've embraced the fundamental elements of my plan. I've maintained the integrity of my maintenance calorie budget, I've remained abstinent from refined sugar, I've reached or exceeded my daily water goal and I've stayed connected with exceptional support contacts.   

Tomorrow is a special Noah day. I'm picking up the little guy about 11:30am and we're spending some super-quality time together. I can't wait! We're going to have an absolute blast.

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Thank you for reading and your continued support,
Strength,
Sean

Friday, 10 June 2016

Princess Health and June 10th, 2016 Big Day. Princessiccia

Princess Health and June 10th, 2016 Big Day. Princessiccia

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June 10th, 2016 Big Day

I didn't get as much sleep as I needed or wanted last night, but apparently it was enough to make a difference for me today. I woke feeling rested and ready for a big day.

It's been a really big day, work wise. I've been going non-stop since 6am and it isn't over until just after 8pm. Once again, my activity level will be my workout today. My three hour location broadcast earlier today was in the sun, constantly moving. Honestly, I probably should have consumed more water.

I'm in between location broadcasts at the moment--writing this from the studio.

Having what I need when I need it is imperative on days like today. It takes minimal planning, but it does take planning. My midday broadcast was an event where the client was giving away free hamburgers, hotdogs, potato chips, ice cream and cupcakes. I enjoyed some good food right before and planned on my late lunch not too long after, so I made it through just fine. Had I not planned well, I would have had a harder time getting through that broadcast without feeling the need to blow through a good amount of calories. Staying connected in good support also helps.

I'm about to take off for my broadcast at a big rodeo where I plan to ride a mechanical bull. There will be video, I'm sure.

I'll make it home afterward, grab a decaf, relax--prepare dinner and very likely, go to bed early. Doesn't much sound like me on a Friday night, but that's the plan. Tomorrow starts another busy day with two location broadcasts, including our final turn at the 101 Wild West PRCA Pro Rodeo.

I've maintained the integrity of my calorie budget. I'm remaining abstinent from refined sugar, I'm meeting or exceeding my #watergoal each day and I'm staying connected in support. I feel great about maintaining the fundamental elements of my plan in the middle of such a crazy-hectic schedule.

I received a wonderful email this morning in response to last night's blog post. I'm awaiting approval to share some of the very interesting information it contained.

Have an amazing Friday night!

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Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Ashland hospital expands into wellness and prevention programs. Princessiccia

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By Judi Kanne
Kentucky Health News

Hospitals� basic business is taking care of the sick and injured, not keeping people from getting sick. But more and more of them are getting into wellness and prevention, not only to help their communities but to make money.

King's Daughters Heart and Vascular Center
One of those is King�s Daughters Medical Center in Ashland, which has developed an innovative strategy for building relationships with local employers to help their employees live healthier lives.

King�s Daughters began by focusing on self-insured employers, who can get the most direct benefit from reduced health-care expenses. It used one-to-one employer outreach activities such as a farm-to-table employer lunch, to which more than 126 local employers were invited.

The first question for employers, said Matt Ebaugh, vice president and chief strategy officer at King�s Daughters, is �Do you understand what is driving the cost for your employees?� because �Self-funded employers do not always have the analytics or tools needed to understand where those costs come from.�

King�s Daughters used Strategic Health Services of Alpharetta, Ga., to create a portal for health risk assessment, biometric screening results, claims analytics and personal health profiles of employees.

While the program is aimed at wellness, it also finds new cases for the hospital. �We knew if we did a smart thing for local employers, demonstrated value, and coupled it with good customer service, then when employees needed a higher level of care, they would come to us,� Ebaugh said.

By means of screenings for diabetes, cholesterol, and body mass index, employees become patients.

Diabetes screening can be critical. About 86 million American adults are pre-diabetic, but nine out of 10 people who are don�t know it, according to the federal Centers for Disease Control and Prevention. That can be detected with health-risk assessment lifestyle questionnaires.

Beyond individual screenings, hospitals can examine the emerging risks in a population using claims data. That can also help them show employers what�s driving up their costs. Claims also indicate which employees are most likely to use hospital and pharmacy services.

�We need to find innovative ways to motivate individuals to change old and dangerous patterns,� Ebaugh said, because simple lifestyle changes can dramatically cut the risk for developing diabetes.

But getting healthy may require offering financial and other incentives to get people to participate in wellness programs. The Ashland hospital plans to try gamification, incorporating into the workday a set of programmed games and activities that remind sedentary employees to get up, stretch, and move around.

The idea is to make health and fitness fun, a social experience and accessible to as many members as possible. Gamification programs include computer notifications or other reminders that stimulate sedentary disruption and track activity. In some cases, motivation includes team competition in which employees win points by stopping to stretch.

Ebaugh said such programs have been shown to work and are critical in some cases, because a pre-diabetic employee may not be motivated enough to change eating and exercise patterns. �Knowing is not enough,� he said. �We anticipate the energy and participation with gamification will increase as a result of more engaging activities.�

The hospital first started a wellness program for its own employees, and plans to add gamification to it, Ebaugh said: �It�s important our model work well to show our employers the success we are having with our internal employees.�

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.

Thursday, 9 June 2016

Princess Health and June 9th, 2016 Observing And Analyzing. Princessiccia

Princess Health and June 9th, 2016 Observing And Analyzing. Princessiccia

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June 9th, 2016 Observing And Analyzing

A good friend of mine joked, with a smile, "I can't stand you, Mr. I'm Not Trying To Lose Weight!! I'd kill for 3.2 pounds." 

Yesterday's maintenance weigh-in was truly unexpected. I haven't handled my schedule very well. Instead of me managing it, I've allowed it to manhandle me. My point is, too little sleep and a big bunch of missed workouts, should have translated to a slight gain. It didn't. And I'm not complaining AT ALL. I'm just observing and analyzing. 

I can see where this whole I'm not trying to lose weight thing can possibly read annoying to anyone starting out or in the middle of intense struggle along the way. But before you yell, "shut-up Sean, Mr. I'm Not Trying To Lose Weight," at your computer or device screen, consider--I've been at all points along this road. And some of those places, I hung out for quite some time. 

What this is really proving to me is how the metabolism can effectively be transformed. If you told me I'd be eating 2300 calories per day and somehow, still losing weight, I would have never believed you. I was convinced my metabolism was stuck on super slow. It might have been for a very long time. But clearly, it's different now. I'm blessed and very grateful. But my bigger point is this: There's hope for anyone who believes they're forever in a down position with their metabolism.

I'm not a nutrition expert, obviously. But I think the gradual evolution of my food plan is chiefly responsible for this quicker metabolism.

I eat a lot of, what I call, "one ingredient foods" or "foods without a nutrition label." As in, an egg is an egg, an apple is an apple, natural peanut butter is simply peanuts, an avocado is an avocado, you get the idea. Granted, I certainly eat some processed stuff--but for the most part, it's very simple things. The abstinence from refined sugar for over two years, I truly believe--has contributed in a major way.

My opinion, based on what I've learned from others and the analysis of everything, on the whole--is this: The body recognizes and processes these things I'm eating easier and much faster. I'm not throwing it many heavily processed curve balls or refined sugar--I'm also getting more than enough water every day...and so, the metabolism works more efficiently. 

So what now? Do I add more calories? When I commit to a more structured weight training program (longtime readers, even though I might deserve it--please refrain from bursting out in laughter), I'll need to add a fairly good amount of calories, I'm sure. Even just a more consistent combination of cardio/strength training will require more calories, I'm certain.

If we study this from the right perspective, it offers a tremendous amount of hope for yet another wonderful part of our individual transformations along the way. Perhaps right around the corner for some--maybe further down the road for others. But, it's possible. 

Once again I wasn't able to blog late afternoon instead of last thing at night. That plan is clearly a work in progress.

Isn't everything a work in progress? 

Today, I maintained the integrity of my calorie budget. I remained abstinent from refined sugar. I met my #watergoal and I exercised well with nearly two hours of walking around my location broadcast this evening. I'm dropping in bed at a fairly reasonable hour.

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Thank you for reading and your continued support,
Strength,
Sean
Princess Health and Kynectors, health advocates ask state to maintain staffing and other resources in new health-insurance enrollment system. Princessiccia

Princess Health and Kynectors, health advocates ask state to maintain staffing and other resources in new health-insurance enrollment system. Princessiccia

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As the administration of Gov. Matt Bevin works toward dismantling Kynect, the state's health insurance exchange, health advocates say they worry that the transition is going too quickly to be smooth, risking a loss of coverage for some Kentuckians.

Kentucky Voices for Health, a coalition of groups supporting health-care reform, said June 9 that the administration needs to "keep, hire and train adequate staff," make eligibility decisions quickly, "dedicate enough resources to educate the public on how to enroll," publish its plan and allow time for comment, and "create an online dashboard to measure how well the system is functioning."

The group also wants the administration to extend the transition period, saying that no state has made such a transition so quickly.

�To be successful, we need to take our time and make absolutely sure we�re protecting consumers from gaps in coverage," KVH Executive Director Emily Beauregard said. "By . . . taking more time to complete the transition, Kentucky can keep more of its people covered with access to essential care."

Whitney Allen, coordinator of community development and outreach for the Kentucky Primary Care Association, said in the KVH news release, �These recommendations are key to fostering a culture of continuous improvement focused on the consumer experience.�

Keeping a campaign promise, Bevin decided to shift Kentuckians enrolling in private, federally subsidized health insurance via Kynect to the federal exchange, www.healthcare.gov, and Medicaid recipients to Benefind, the state's new one-stop website for state benefits, by Nov. 1.

This new model for subsidized insurance is a federally supported but state-based marketplace, in which the federal government will handle consumers' eligibility appeals but the state will handle insurance-company grievances and still review insurance plans. The federal government will certify the plans but it will "strongly rely" on state recommendations, Health Secretary Vickie Glisson said in March. Consumer grievances will be handled by a state-federal partnership.

Kentucky Voices for Health said it wants "to ensure that any enrollment system that will replace Kynect works as well or better to ensure all Kentuckians have access to coverage without interruption or barriers."

Bevin's office replied to the KVH release with this statement: "Throughout the process, we have updated stakeholders and listened to their feedback. We appreciate the continued interest, input and cooperation of advocates as they are an important component of our communications and outreach strategy during the transition from Kynect to healthcare.gov. We are pleased to report that Kentucky has met all milestones and deliverables, some ahead of schedule, that were established by the [federal] team in order to proceed with the transition to healthcare.gov."
KVH continued to emphasize the importance of Kynectors, a blanket term used for those who help Kentuckians apply for and enroll in coverage. The state has about 600 Kynectors, but their fate is uncertain.

�Research indicates that Kentucky consumers find insurance overwhelming and confusing, and value the face-to-face assistance they have received to navigate the system,� Dr. Susan Buchino of the Commonwealth Institute of Kentucky, said in the KVH release. The institute, part of the University of Louisville School of Public Health and Information Sciences, calls itself a "transdisciplinary collaborative for population health improvement, policy and analytics."

KVH said the Bevin administration recently agreed to its request to have a diverse, multi-stakeholder advisory committee like the one that helped create Kynect.

The group said its recommendations came from Kynectors and health advocates, "many of whom have hands-on experience with enrollment and consumer assistance." Click here for the full report.

Forbes magazine contributor Josh Archambault wrote June 7 that Bevin is right to end Kynect because it serves mainly as a funnel to the Medicaid program and is funded by a fee on all health-insurance policies sold in Kentucky.

At least part of the fee will remain in place to help pay transition costs, fund the Kentucky Health Information Exchange and cover remaining claims to the high-risk insurance pool for which the fee was originally established. It was transformed into Kynect funding by an executive order from then-Gov. Steve Beshear.

"Kynect�s website will actually be active until the end of 2017, as the site also services small-business plans which have no set open-enrollment season," Archambault notes.
Princess Health and A Serious Challenge to the 2012 Low-carbohydrate "Metabolic Advantage" Study. Princessiccia

Princess Health and A Serious Challenge to the 2012 Low-carbohydrate "Metabolic Advantage" Study. Princessiccia

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Warning: this post will be a bit more wonkish than usual, because I need to get detailed to make my points. To read a summary, skip to the end.

In 2012, David Ludwig's group published an interesting RCT that suggested a substantial "metabolic advantage" resulting from a high-protein, very-low-carbohydrate diet (VLC) (1). In other words, this diet led to a higher energy expenditure relative to a normal-protein, low-fat diet (LF) over a one month period (a low-glycemic-load, normal-protein diet was in the middle and not significantly different from the other two). Resting energy expenditure (REE) was slightly but significantly higher on the VLC diet, and total energy expenditure (TEE) was elevated by a whopping 300+ kcal/day! I covered the study at the time, describing it as "fascinating" and "groundbreaking", and calling for the study to be replicated so we can be more confident in its unexpected result (2).

This finding has been used by Ludwig, Gary Taubes, and others to support the carbohydrate-insulin hypothesis of obesity, although there is no evidence that the effect was mediated by insulin, and also no evidence that it was mediated by reduced carbohydrate rather than increased protein (3).

Since I published that post, my confidence in the finding-- and particularly the common interpretation of it that reducing carbohydrate intake to a very low level increases REE and TEE-- has gradually been eroding. This is partially because other studies have generally reported that the carbohydrate:fat ratio of the diet has little or no effect on REE, TEE, or fat storage (4, 5, 6, 7, 8, 9, 10).

Read more �

Princess Health and Nonprofit says most of the 52 Kentucky hospitals it grades on patient safety got Bs and Cs, and KentuckyOne got five Ds. Princessiccia

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Kentucky Health News

A nonprofit group that rates hospitals recently doled out its hospital safety scores and found that most Kentucky hospitals scored a 'B' or 'C' in overall patient safety, and that five of the six Kentucky hospitals that got Ds are owned by the same hospital system.

The Leapfrog Group, a non-profit organization that rates hospitals, evaluated more than 2,500 hospitals nationwide, including 52 in Kentucky. Most of Kentucky's hospitals were not rated because rural critical-access hospitals don�t have to report their quality measures.

It found that 21.2 percent (11) of Kentucky's hospitals got As, which was much lower than the national average of 31 percent, while 11.5 percent (6) got Ds, more than the national average of 6.3 percent. Additionally, 23 percent (12) got Bs and 44 percent (23) got Cs.

"Once again Kentucky had fewer 'A'-rated hospitals than the national median and more hospitals rated near the bottom with increasing numbers of 'D's. More troublesome is the observation that five of the six hospitals receiving a 'D' are in the same hospital system," Dr. Peter Hasselbacher, emeritus professor of medicine at the University of Louisville, wrote in an op-ed for the Kentucky Health Policy Institute blog.

Except Lake Cumberland Regional Hospital, the Kentucky hospitals that got a D are owned or operated by KentuckyOne Health: Jewish Hospital, Sts. Mary and Elizabeth Hospital and University Hospital in Louisville; and St. Joseph Hospital and St. Joseph East in Lexington.

Richardson
Staffing cuts at the U of L Hospital have made it �unsafe� for seriously ill and injured patients, Dr. J. David Richardson, vice chair of surgery and president of the American College of Surgeons, told the university's top health officials in an email on June 7. He said the public hospital has �never been worse in the 34 years that I have been heavily involved with it,� reports Andrew Wolfson of The Courier-Journal.

"In an interview, Richardson said the problems are so great that the only solution is to 'unwind' the 2013 agreement in which the state turned over day-to-day management of the hospital to Catholic Health Initiatives," Wolfson reports. He said the letter understated the problems, which are making it impossible to conduct academic research at the hospital.

The two University of Kentucky hospitals got Cs from The Leapfrog Report. Pikeville Medical Center is the only Kentucky hospital evaluated that has had straight As since 2013, when the study began. Click here for Kentucky's Hospital Safety Scores.

KentuckyOne Health issued a statement saying University "is an excellent hospital with a dedicated and talented team of professionals that is staffed to meet the patient�s needs. Our focus has always been on quality, safety and patient experience."

On Sunday, June 12, KentuckyOne and the university ran a full-page ad in The Courier-Journal saying they are "committed to ensuring safe and effective patient care" and "Safety and quality are our top priorities." They said they take Richardson's concerns "seriously, and we are committed to reviewing and addressing the issues noted."

In 2012, when management of most of the hospital was given to KentuckyOne, "Officials said it would pump $1.4 billion into U of L health operations over 20 years. But the company has had financial troubles ever since, and in February 2014 announced it was laying off 500 employees in Kentucky," Wolfson notes.

The Leapfrog Group's analysis was developed under the guidance of the nation's leading patient safety experts and the scores were based on 30 measures of publicly available hospital safety data. The ratings are issued twice a year, for errors, injuries, accidents and infections. The report is peer-reviewed and published in the Journal of Patient Safety.

Hasselbacher noted legislation in Congress that would protect some hospitals from Medicare payment cuts if they serve more than average numbers of indigent and poor people.

"Care must be taken that this initiative, lobbied heavily by hospital organizations and their partners in academic medicine, is not interpreted to imply that is it acceptable to provide medical care of lower quality to poor people or in teaching hospitals," he wrote. "The fact that this protection is being considered at all is a tacit admission that our current methods of measuring quality and safety are flawed."

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
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