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pozorvlak: (Default)
Monday, January 11th, 2016 08:26 pm
 So, you have irritable bowel syndrome?

Yep, since about 2000. My symptoms are mostly low-grade diarrhoea, flatulence, bloating and fatigue, but occasionally I get abdominal pain, or rumbling noises in my abdomen (for which I recently learned the delightful technical medical term “borborygmi”).

Sounds annoying, but not life-changingly awful.

That’s about right. Also embarrassing, and frequently unpleasant for anyone downwind of me.

And you’re on a new diet for your IBS?

Yep, the "low-FODMAP" diet.

Never heard of it. What’s the teal deer?

I have to cut out gluten, dairy, pulses, onions and garlic.

Huh?

And some other things like mushrooms, most fruit, cauliflower, pistachios, cashews and artichokes. And I’m meant to limit my intake of butternut squash, but not other squashes. There are a whole bunch of rules.

You said you have to cut out onions and garlic - how about leek?

Yep. And shallots. And the white parts of spring onions, but the green parts are OK.

And you’re not allowed dairy?

Yep - no milk, cream or ice cream for me. But I’m allowed hard cheese. And Brie and Camembert.

OK, I call shenanigans. You’re making this up.

I’m really, really not. I was told to follow this diet by my doctor.

Oh, your “doctor”, eh? Are they a doctor of crystal Reiki homeopathy? Because this is some “astral quantum chakra”-level enterobollocks.

No, he’s a medical doctor, in a perfectly ordinary NHS surgery. Though he did tell me that he didn’t know much about FODMAPs before handing me a printout and sending me on my way.

OK, supposing - just supposing - you’re not making this up, what the hell are FODMAPs?

Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols.

Say what?

Short-chain carbohydrates which are poorly absorbed by the small intestine, but which make the bacteria in my large intestine go OM NOM NOM DELICIOUS CARBS, causing my enteric nervous system to go “Oh dear! I appear to be full of nasty fermentation products. Better get rid of them quickly!”, and in turn causing me to go “Bloody hell, tummy, I’ve already been six times today and I have a meeting in five minutes, do we really have to do this right n- OK, I guess we do. Dammit, I’d just washed those trousers.”

But gluten is a protein.

Well spotted. The problem is actually with wheat, which has high levels of fructans (one of the two classes of oligosaccharides under the FODMAP label; the other class is galacto-oligosaccarides, which are common in pulses). However, supermarkets and restaurants have “gluten-free” labelling, not “low-fructan” labelling.

Is there any evidence for the FODMAP theory?

Yes! There are peer-reviewed publications demonstrating both the mechanism described above and the benefits of a low-FODMAP diet for patients with IBS.

Is this a revolutionary new treatment, discovered by a mom, that doctors hate?

As previously mentioned, I was told to follow it by my doctor, and AIUI the mechanism described above was already the established one for lactose intolerance (lactose being the disaccharide in the acronym). The FODMAP concept appears to have been devised by Dr Sue Shepherd, a dietician and academic. I don’t know if she has any children.

Is it helping?

It seems to be, yes! I’ve been on the diet for about a month now, and my symptoms are definitely reduced - my bad days now are about as bad as my average days before, and my good days are almost normal. And lapses from the diet seem to be followed by a couple of bad days.

And you think that this may be connected to your utter failure at vegetarianism a few years ago?

Possibly. When I cut out animal protein from my diet, I started eating a lot more pulse-based dishes to compensate, and most of those also contained onion and/or garlic. When I restored meat to my diet, my intake of pulses and alliums went down. That could explain some of the horrible fatigue, lethargy and brain-fog I experienced for those two years, and the dramatic improvement I experienced when I started eating meat again. This theory predicts that my symptoms will be triggered by either fructans or galacto-oligosaccharides, and I'll find that out soonish.

When I saw you last you said you could/couldn’t eat Foodstuff X, but now you’ve changed your mind! What gives?

It’s possible that I was wrong the first time - this is a complicated diet with a lot of rules, I don't always remember them all, and it’s not always obvious what chemicals are in a given food. For instance, lots of surprising foods contain onion powder, which is a major no-no. Or it’s possible that I’ve moved onto a different phase of the diet - in the first two months I’m meant to eliminate all FODMAPs as far as possible, and then over the next few months I’m meant to slowly re-introduce the different FODMAP classes one at a time to see which ones actually cause me problems. Anyway, I realise that this diet makes me a major pain to feed, so thank you for making the effort!

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pozorvlak: (Default)
Wednesday, November 10th, 2010 11:28 am
Here's what I looked like last time I had a moustache:



Haha, fooled you. That's not a picture of me, it's a picture of my grandfather, taken in the Far East in about 1941. As an honest-to-goodness decorated World War 2 fighter ace, moustache-wearing went with the territory. Here's a picture of his CO at the time:



And here's a picture of Grampy with some of his squadron mates a few years after the war, when he was closer to my age now:



He's the one on the left: I think he looked quite a bit like me. My mum does too; it was apparently very weird for her to watch me play the Wing Commander in Chips With Everything at school.

Anyway, this was all by way of introduction to the main event, which is a begging letter. I'm currently growing a moustache for Movember, to raise money for (or rather, against) prostate cancer (which kills one man per hour in the UK alone). If you feel inclined, you can sponsor me here.

Here's what my proto-mo looked like this morning:



Some way to go, obviously...
pozorvlak: (Default)
Wednesday, October 27th, 2010 02:14 pm
Last night a friend of mine retweeted this:
.@marzillk What energy!? Some completely unobservable thing? Energy is simply the ability to do work. Nothing more, nothing less.
-- rhysmorgan
It turned out that this was in response to the following:
@AlabasterC My sister recommends homeopathic aconite and tapping various energy points. It is helping a bit.
When questioned further marzillk usefully clarified:
@rhysmorgan Spleen meridian boosts immune system. It's under ribs on the left hand side - find the sore point, then tap while slow breathing

@rhysmorgan I know it sounds mental but I can genuinely feel it doing something.
Now, there's so much wrong with that that I don't know where to start. But I do know where not to start: by criticising her terminology. I fired off:
@rhysmorgan right now, @marzillk's making observations and you're bitching about terminology. Pop quiz: which is more scientific?
I want to expand on that a bit.

When I went off to university ten years ago, one of the questions I wanted to answer was "what is this thing called energy?" I still don't have a good answer to that, unfortunately; if asked now I'd mumble something about Noether's Theorem and Hamiltonians of closed systems, so I am at least confused on a higher level. But let's accept rhysmorgan's definition "the ability to do work" for the moment (and pretend not to notice that we haven't defined "ability" or "work"). There's still a problem with criticising marzillk's use of the word "energy": the physicist's definition isn't the only possible definition of the term. The OED gives seven definitions, of which only the final two are related to the thing that physicists talk about. Furthermore, the word "energy" has only been in use in the physicist's sense since 1807 (and the following year, someone proposed using it for what we now call "momentum"!) So if the practitioners of traditional Chinese medicine (or anyone else) want to re-use the term "energy" (or, for that matter, "meridian") to refer to something else, I have no problem with that in principle.

What I do have a problem with is the extraordinary ignorance of biology betrayed by marzillk's use of this stuff (and if she thinks that it's irrelevant that she works in educational publishing... well, I'm afraid I disagree). I've encountered a lot of skilled martial artists who claim to find qi (or something very similar) an essential component of the way they think about their art, so I'm not willing to totally write it off (perhaps it could be made to work as a high-level abstraction over some low-level biomechanical details), but really, tapping a point over your spleen to cure a cold? How on Earth does that fit with the (extremely well-attested) germ theory of disease?

But you know what, I could be wrong. Maybe tapping your spleen somehow makes it produce more monocytes or something (would that even help with a viral infection? IANAB). But that's the great thing about science: we don't have to rely on arguments from theory. Instead, we just do the experiment; if the experiment contradicts the theory, then the experiment wins. In this respect, marzillk was being more scientific than rhysmorgan, with her "I don't understand it, but I've tried it and it seems to work", approach. XKCD nailed this one: '"Ideas are tested by experiment." That is the core of science. Everything else is bookkeeping.'

To be sure, it's a pretty dodgy experiment. Only one subject, no control, no blinding, results measured by subjective feelings of wellness. One could imagine a much better experiment, in which a large number of subjects were randomly assigned to two groups: one group would receive meridian-tapping therapy from a trained master of the art, and the other would have random points on their body tapped by actors who could spin a convincing line of bullshit about the mystic significance of what they were doing. Then you measure how long it takes everyone to get better from their colds, and see if there's any statistically significant difference in the recovery times of the two groups.

I had a brief look, but couldn't find anyone who'd done that experiment. A fascinating and well-known 2007 study did what I described for acupuncture and lower back pain, though, and found that the actors had a greater success rate than the acupuncturists!

Contrariwise, this study evaluated "Meridian three-combined therapy" (thread embedding, bloodletting, and tapping/pressing) for the treatment of psoriasis, and found a small but significant improvement in effectiveness compared to conventional treatments. However, I'm assigning that limited weight in this context, because (a) it didn't just measure tapping, (b) it was for a different condition, (c) it was painfully (hoho) obvious to the patients which group they were in, and (d) it was performed in a Chinese cultural context, and we know (from experiments!) that cultural context is very important for the placebo effect.

So, anyone with greater scholarship skills able to find anything more relevant?

Update: rhysmorgan responds "I guess my beef with her referring to it as energy was that her form of energy doesn't actually exist." I take his point, but "existence" is kinda problematic in this context. Physicists' energy is an abstraction, a consequence of the time-invariance of physical laws. You can't measure it directly, nor capture it in a pure form. In what sense does it exist? But the theory of physical energy makes useful predictions: we can do calculations with energy and arrive at correct, numerical predictions of what will happen when we perform experiments. This is the important thing. To take a more abstract example: when you learn about the conventional underpinnings of calculus, you discover that there's no object in the system called "dx" or "dy", and that statements involving them are shorthand for more complex statements about the behaviour of limits. But the theory as a whole allows you to manipulate these non-existent objects and arrive at correct results. Analogously, the important question about meridian-tapping is not "does it refer only to directly observable things?" but "does it give correct predictions?"
pozorvlak: (Default)
Friday, September 4th, 2009 10:49 pm
For the last eighteen months or so, cycling has been causing me mysterious (and apparently untreatable) pain between the legs. This is very inconvenient, given that cycling is my main form of transport¹. It became especially inconvenient when I hurt my foot as well, and walking into town and back became something to be avoided. So, at my urologist's suggestion², I ordered a Moon Saddle:



... and it's been great. I can cycle again! Without pain! Every day!

Fitting it took about twenty minutes, but would probably take much less if you knew what you were doing. You'll need a spanner. Getting the angle right took a couple of goes (pitching it at 20 degrees from horizontal seems about right for me; take great care to get the yaw right, because it's difficult to judge by eye and getting it wrong is uncomfortable). And it took a couple of weeks to get used to riding on it - you feel quite insecure at first. Persevere. It's a bit expensive, at nearly sixty quid, but for me it's been worth it - I'll save the money in bus fares in a couple of months.

In summary: yay for Moon Saddles!

¹ It's definitely the best way to get around compact European cities, like, say, Edinburgh. Faster, cheaper and more reliable than the bus, and better for you. Not ideal in the wet, though - my next upgrade will be a pair of mudguards.
² Kinda. What he actually said was "I can't do anything for you, but I expect some cyclist has invented a special saddle that won't put pressure on the affected area. Have a look on the Internet and see if you find anything." The Moon Saddle recommendation actually came from, IIRC, [livejournal.com profile] nastyicydeath - thanks!