Thursday, March 29, 2012

Review: Which Comes First - Cardio or Weights?






Tuesday, March 27, 2012

Sleep Apnea: The Noisy Killer

My previous post on Fitness had people asking me about Sleep Apnea.

Sleep Apnea occurs because our throats are a design compromise. In order for you to be able to speak well and articulate well, your throat should be as flexible as possible. However, in order for you to breath well, your throat should be as stiff as possible. Natural selection ended up with a compromise: your throat muscles hold your throat stiffly when you are awake, which means that the throat can be flexible enough so you can speak well. Unfortunately, when you're asleep, the muscles will relax, allowing the throat to collapse, which would cause an interruption of airflow. This is known as an apnea event if the interruption of airflow lasts longer than 5 seconds. A normal adult human would have less than 5 apnea events an hour. (In other words, if you have less than 4 events an hour, you don't have Sleep Apnea) Other than the throat collapsing, it's possible that your brain simply forgets to breath. That's called central sleep apnea, as opposed to obstructive sleep apnea.

The problem with being Asian is that Asians have smaller throats and smaller jaws. This leads to a higher probability that the muscles relaxing would cause a complete interruption of airflow. One doctor I spoke with told me that if you're Asian, it's not a question as to whether you'll have sleep apnea, it's a question as to when you'll get it. Women tend to have milder symptoms than men, and often don't develop serious symptoms until their 40s.

How do you know whether you're at risk? The big warning sign for me was my snoring. Snoring is basically your body pushing air through your throat in order to get air, vibrating the soft tissues and therefore making noise. My snoring was so loud that friends the next building over could hear my snoring when we were at Lucia. Otherwise, I was completely asymptomatic. Other people who've spoken to me about sleep apnea said they suffered the following symptoms:
  • Hazy and dazy in the morning.
  • Difficult to wake up or get up.
  • Lack of energy, lethargic, difficult to stay alert.
  • Grumpiness, especially in the morning.
  • Unusually rapid aging
Note that I had none of those symptoms when I was diagnosed, something my doctor said was common among Asians, especially fit ones. That's why I was not diagnosed for so long. It took a full on sleep study to discover that I really had 50-60 apneas an hour. (By the way, if your spouse is a snorer, you're should track these symptoms) The standard therapy for obstructive sleep apnea is CPAP (Continuous Positive Airway Pressure). Essentially, you wear a mask that pumps air into your throat to keep it open all night. Modern machines have algorithms that back off the pressure when you breath out so you don't feel like you've been pumped up like a balloon in the morning. You might also opt for surgery, but it's not for the faint of heart: they essentially break your jaw, move it, and stitch it back together, leaving you sucking food through a straw for a bit. I checked with one of the renowned surgeons in the area and he looked at my chart and said, "You respond really well to CPAP, you should try it before considering surgery." Now, if I had been symptomatic before, I'd have been super motivated to use CPAP. The overweight, obese, symptomatic people I've spoken to love their CPAP from day one, because for them, it feels like the fog in their mind was cleared away. For me, it actually seemed to make my sleep worse, and I woke up often with blisters on my nose where the mask chafed against my face, so I ignored it for almost a year. My doctor, however, got very concerned and called in the help of a sleep psychologist, who persuaded me to be more active about using CPAP therapy like this:
"Sleep apnea is like boxing. If you take a couple of hits in the face, it's no big deal. You'll recover and won't even notice. However, if you keep taking hits every day, it's all going to add up and you'll become slurry in speech and be unable to think well. Think about Mohammad Ali when he got old. In addition, it increases your risk of stroke, heart disease, etc."
That struck home, because my father had a stroke for no apparent reason in his early 50s. Ok, after that I became very motivated to use my machine. My sleep psychologist also helped a bit with finding the proper mask. Unfortunately, all the sleep studies seem to be done on Caucasians, so there're very few masks that will properly fit an Asian face, and custom masks just aren't done. And yes, I use the machine even when cycle touring, because I actually do spend a significant amount of my life doing this (or did before I had a baby). Now, if you have kids and you were diagnosed with sleep apnea, then you might be able to correct your kids' facial structure as they are growing so they don't end up with sleep apnea. It turns out that you need to start fairly young (at 1.5 years when you first take them to see a dentist is when you have to start thinking about it). Apparently it's like having braces, but for your jaw instead of just your teeth. The process can increase the airway area so collapse doesn't completely stop airflow. Which means that if you suspect you have apnea and have kids (or plan on having them), you really want to get yourself checked out. So that's as much as I know about sleep apnea. If you want to know more, let me know and I'll try to answer questions. And by the way, sleep apnea is one of those pre-existing conditions that cause you not to be able to get health insurance in California. Since about 10% of middle aged men have sleep apnea, that's a lot of people who would need Obamacare or some sort of group health plan in order to be covered.

Monday, March 26, 2012

PSA: United is now a suitable airline for flying with bicycles

I used to fly United Airlines with my bike all the time. But in 2008, United and Lufthansa jointly raised bike carriage fees to $250 each way. What that meant for me was that I stopped flying United on my bike tours. I wrote a letter in 2009 to United that it cost them 4 $1000+ plane tickets to Japan to continue this policy, but to no avail.

Well, this year, United merged with Continental airlines, which means that they've revised their bike carriage policy to be fairer to cyclists. Bikes now count as one piece of baggage as long as they fit in under 50 pounds and under the linear inches rule.

I've flown United often with bicycles, and they were not the best, but far from the worst. They frequently also had the lowest fare, so I'm glad to have them back in the "good for bicyclist" column on the airline.

These frequent changes in baggage policy is one reason why Independent Cycle Touring doesn't list specific airlines that are bike friendly or not. That information properly belongs to the internet and my blog.

Kudos to Arturo Crespo for telling me about the United merger and the impact thereof.

Sunday, March 25, 2012

Fitness: Optimal Experience

A few years ago, a friend of mine told me that she was really really out of shape. "I'm so out of shape that I get out of breath just going up one flight of stairs." Like many Asians in their mid-twenties, this person was skinny, looked great, and obviously didn't have any trouble partying all night. So I put it out of mind. After all, I remember being too busy in college holding down two jobs while carrying a full time class load to bother with exercise.

I recently thought about this, because perhaps for the first time in years, I haven't recently been in optimal condition. Now, I'm well past my physical peak, where in 2005, I did 2 back to back 100 mile days in Italy, and then went on to do 3 more strenuous days of cycling in the Swiss Alps. I think at least once in your life every person should experience at least one period of peak conditioning, just to understand how it feels.

It feels like being Superman. During that period, I could wake up and ride 100 miles or 10000' of climbing, eat like a king, sleep like a log, and wake up the next morning ready to do it all over again. Every piece of your body works well, and I don't recall being even a little bit sick. The only possible problem was that I'd occasionally feel a little cold because I had too little body fat. And One of my tour companions would complain, because I had a pace that was far faster from all the conditioning that I did. Of course, I was suffering from low bone density during that period, so I was even faster since even my bones weren't contributing as much to my body weight. I felt alert all the time, waking up in a great mood and raring to go. My mind was sharp and I never missed details, such as when navigating across Italy with a paper map in the rain sans GPS. The effect of aerobic exercise on your brain is well documented --- John Medina spends an entire chapter of Brain Rules on its effectiveness.

Since then, while I've lost quite a bit of fitness, I've actually gotten healthier. I've been forced to work out in the gym, and add calcium to my diet. The interesting bit is that the shoulder muscle cramps I used to get in my mid-twenties (when I wasn't nearly as fit) have practically disappeared.

I recently read The Longevity Project, where the authors pointed out that to gain an optimal lifespan, you quickly hit diminishing returns when exercising, so the best use of your time is to be a couch potato and exercise 20 minutes 3 days a week. I think they're ignoring the quality of life difference when you're fit, not prone to aches and pains, and deal with the challenges of the day without pain. If you're Asian, it's more important than you think to be fit, because Asians have a genetic disposition to have Sleep Apnea. My sleep apnea went undiagnosed for years because my circulatory system kept my blood O2 level well above 98% even as my apnea was triggered 50-60 times an hour! Without it, I would have lost a lot of brain cells to my apnea.

I'll end with this quote:
“If exercise could be packaged in pill form, it would immediately become the number one anti-aging medicine, as well as the world’s most prescribed pill.”

-Dr. Robert Butler, International Longevity Center at Manhattan’s Mt. Sinai Hospital

Saturday, March 24, 2012

Review: Career Warfare

I was lamenting to someone about the lack of a book on how to be a good office politician for engineers. That friend said, "There is one. It's called Career Warfare." With that, I was off to the library to pick up the book.

I'm glad I read the book, though I don't think it's actually very usable for engineers. It's clear to me that the kind of people who make CEO might be born, not made. For instance, D'Alessandro has this story from when he was 6 years old:
One winter day, Tony decided to revolt against my tyranny. He said, "I don't want to play with you any more. I'm going to play over here." And in the revolt, he cleaved off four kids into his own little gang.
I was very upset about these defections. But within a few days, Tony's gang wanted back into my gang. They said it wasn't any fun playing with Tony because there weren't enough kids.
Did I welcome them back? Absolutely not. They were out of the gang for the rest of the school year. I was 6 years old, but I froze them out without mercy. I already knew that banishment or death was the only reasonable punishment for traitors.
Clearly, A'Alessandro did not need a mentor to teach him about office politics: he arrived at the office to do battle, and most engineers having to deal with as consummate a politician as he is would probably fail.

Nevertheless, the book can benefit many engineers. The section on what managers want from you and what to expect from your managers in a quid pro quo is priceless. For instance, what does loyalty mean between manager and employee? What kind of bosses should you avoid working for? When should you be a whistle blower?

The book's filled with fantastic anecdotes, and worth reading just for those alone. I therefore recommend this book. Just don't expect that you'll be capable of applying those stories with the same amount of ruthlessness to your job.

Wednesday, March 21, 2012

Reread: Brain Rules for Baby

It probably wouldn't surprise you if I told you that I read 90% of all the books I review for this book out of the library. Most books aren't worth reading more than once, and more importantly, if I bought every book I read, I'd be spending a ton of money. However, Brain Rules for Baby is an exception. I read this book last year as the first parenting book, and since then I've read a lot of parenting books, most of which aren't reviewed simply because I could not bring myself to finish them! Parenting books are in general badly written, have little or no scientific backing, and never say something in 5 words when 5,000 words would do. I have no idea why they're so badly written, but there you go. When I saw that the Kindle edition of the book was now $8.10, I remembered the book so fondly I went and bought it for my Kindle.

In short, if you are a busy parent to be or a parent of a kid zero to five, Brain Rules for Baby is the only parenting book that's worth your time! Heck, if you're considering being a parent, do yourself a favor and read this book so you'll know what to expect.

On the second re-read, I nodded and laughed at the stuff he was telling me that would happen that indeed happened. Yes, marriages get strained with the introduction of the little guy. Yes, expect your wife to throw up during the first trimester. Expect sleep deprivation. Human babies were never meant to be brought up by just one couple, so expect to get help and take as much of it as you can. Expect to be charmed by the little one's first smile (Medina calls it the "Megawatt smile.") Expect to have to work extra hard to overcome the social isolation that could set in inevitably if you don't pay attention. I'm very grateful that at least for us, we've been very lucky and have the opportunity to eliminate many of the usual stressors associated with having a child, but I shudder to think what the typical American family goes through.

In re-reading this book, I keep finding little nuggets of information. For instance, kids learn to lie at 3, and they tell a lie every 90 minutes by the time they're 4. I enjoy reading the segments about empathy and how to teach kids to read emotions. (I'm an incredibly un-empathetic person, so this is going to take serious work)

In any case, there are many parents I believe who should read this book, and every parent-to-be or parent-wanna-be should read this book. As usual, the people who most need to read this book won't, but hey, there's nothing YOU can do about that. Heck, even if you never want to be a parent you should read this book. It's just that good. Highly recommended I really should have named it the book of the year last year.

Friday, March 16, 2012

Review: The Best American Science Writing 2008





Sunday, March 11, 2012

ASA Catamaran Certification

I signed up for the TradeWinds Catamaran sailing class last month. I had thought about learning how to sail Catamarans for a good long time, but the impetus to do so finally came when I finally organized a second BVI trip (upcoming), and could only find Catamarans to charter.

Normally, the class would take 2 days and be run for 4 certification candidates. However, this time, nobody signed up. Normally, Tradewinds would just cancel the class and ask students to come for the next month, but given that my BVI trip was upcoming at the end of the month, Matt at Tradewinds accomodated my need for certification by concentrating the 2-day class into a 1-day intensive training session. Since my crew needed training as well, Matt was happy to let Larry, Cindy, and Arturo tag along for the training so they too could learn the joy of sailing a Catamaran.

Catamarans sail, dock, and undock very differently from monohulls. In many circumstances, "different" usually means "worse", but I was very pleasantly surprised to discover that in this case, "different" means "better." Docking and undocking, for instance, is made a lot easier by having twin engines and twin propellers that essentially allow the boat to turn on a dime. The fact that the vessels are so long and wide means that you aren't likely to be able to dock in a slip, but because of the nature of the twin screws, docking and undocking become essentially a skipper/helms-driven affair, with the crew helping by essentially releasing or setting up lines as appropriate. There's no dashing about or coming off the beam of the boat to set lines forward and aft while the boat is in motion. As skipper, you have to nail the stern of the boat so crew can step off, but once that's done you can pivot the boat one way or another to get the boat aligned with the dock. If this sounds more demanding on the skipper's ability to stay calm and assess the wind and current correctly, you're right. But in many ways, it's also liberating as you no longer have to worry about crew jumping and landing wrong, slipping into the water, or other such antics. We spent plenty of time practicing in order to get this nailed down.

Once the boat is underway, sailing a Catamaran almost doesn't feel like "real" sailing, as you're missing the heeling sensation you get on a monhull. This is great: there's less scrambling, more relaxation, and appreciation of the views, and the prospect of taking a family with children out on the water suddenly seems doable. In particular, Dan Siefers' catamaran, "Caprice" has a self-setting jib, which meant that the crew could essentially watch as the skipper says, "Ready about", and "Hard a' Lee". That took a bit of getting used to. Jibing is surprisingly similar to a monohull.

And then there's the speed. We effortlessly sailed past monohulls carrying big sails without really even trying (I was being distracted trying to learn the material for the written exam).

Finally, when we got to the docks, I realized something: I wasn't fatigued! I had originally intended to spend the night at Tradewinds and then challenging the written test the next day, but decided that I had enough brain power left to challenge the written test right away, so I did that and emerged a certified 114 Catamaran sailor by the end of the day.

I would like to give a shout-out thanks to my crew, Larry, Cindy, and Arturo. Furthermore, Matt's willingness to help accomodate my need to get a catamaran certification by my trip deadline is commendable, and Dan was an excellent and patient instructor. Recommended. I should have gotten myself catamaran certified ages ago. (One thing I did learn today was that in the Mediterranean, the charter companies require that 2 members of the party have sailing certificates, not just one --- so if you've been thinking you could piggy back on my certification at some point, I'm afraid you're going to have to get one yourself as well or a Greek sail would be out of the question)

Friday, March 09, 2012

Review: Logitech C270 Webcam

We recently had to do a few video calls with people we were planning to exchange homes with. Rather than make do with the crappy 1.3MP camera that came on the Lenovo X201, I picked up a Logitech C270 at a Logitech scratch and dent sale.

I've had poor experiences with some Logitech webcams in the past, mainly from balky software that never seemed to install correctly. I was relieved to see that most of this has been resolved: the camera sits happily on top of the monitor, plugs into a USB port, and the logitech drivers seem to integrate nicely with Google chat and Skype.

The picture quality is great! By contrast, I could always tell when I was skyping with somebody who was only on an iPhone, or some other crappy laptop built-in webcam. The face follow feature seems to work, but I mostly turn it off because usually when we're skyping with another family, it's a multi-face affair. Perhaps if I was a Google Hangouts addict I would turn on the face follow feature.

Given the low price and the great picture quality, I'm pleased with it and can recommend it. Even voice seems to work well despite how far the camera is from my face when I talk.

Review: The Longevity Project

The Longevity Project is a statistical study of the so-called "Termites", about 1500 high-potential Californians chosen by Professor Terman to follow over their lifetimes. The authors draw conclusions based on personality and life-events versus longevity.

Based on the data, they conclude several items of interest:
  • Conscientious people live the longest. A lot of it is because conscientious types actually follow doctors' orders and take their pills when they're supposed to and so on.
  • Social types actually don't live longer, because the benefits of having a stronger social network is offset by picking up bad habits like smoking and drinking. That means engineers and scientists actually live longer than the sales types.
  • Mild worriers actually live longer than the happy types, because they'll be proactive about health problems rather than ignoring them.
  • Starting school early is predictive of a shorter life, while skipping grades has no effect on longevity. They speculate that the loss of unstructured play time is really harmful.
  • Parental divorce takes 5 years off your life. In fact, it's better that one of your parents died than that they got a divorce. The exception is that life at home is so bad that all the damage has already been done.
  • Maintaining or increasing your activity levels through midlife is predictive of a longer life. The authors note that if a you spent 2 years over your life time exercising and gain 2 years of longevity, you only broke even from all the exercise. So the best deal is if you mostly became a couch potato and only exercised just enough to get maximum benefits.
  • Being married gave you the longest life, but only if you didn't get a divorce. Divorce is so traumatic that it reduces your life span. Even getting remarried later doesn't help as much. For women, it's better to stay single than to get a divorce and then remarry.
  • Being a top dog and high achiever causes you to live longer.
  • Religion makes you live longer, but mostly because of the social connections and having an active social life, rather than the prayer and meditation.
All in all, this is pretty impressive. Unfortunately, the authors fail to point out many of the obvious flaws in the study:
  1. The study pretty much consists of middle class, white Californians. That homogeneous sample means that if you're Asian, Black, or other ethnicity, the results might or might not apply.
  2. The study shows correlation. The authors do a great job of trying to tease out the underlying cause, and in some cases, they're quite believable, for instance, with respect to religion. For other parts of the study, correlation does not mean causation and you'd have a really tough time figuring things out.
  3. The study was a longitudinal study covering many decades. However, during that time, technology and social norms evolved. It could very well be that conclusions based on people who were born at the beginning of the 20th century would not apply to people who are born now, or who were born in the middle of the 20th century. For instance, do the conclusions about marriage apply to gay marriage? Are no-fault divorces as devastating to the spouses? This study couldn't answer such questions.
  4. Is 1500 people enough of a sample to truly draw such conclusions? The authors don't actually go into sufficient technical detail about their statistical methods to make me feel comfortable with their conclusions.
I'm happy to recommend this book as food for thought, but take their conclusions with several tablespoons of salt: I'm fairly sure they're not as cut and dried as the authors claim they are.

Sunday, March 04, 2012

Review: The Best American Science and Nature Writing 2011

While I don't usually pick up anthologies, when the Kindle had The Best American Science and Nature Writing 2011 as a gold box deal for $1.99, I figured I'd be willing to take the risk.

I started the book and was blown away by how good it is. If you're a fan of science writing for the lay man, you should really stop reading and buy it now, even at the full price at $7.99.

The big draws to this book are the big names like Atul Gawande, Stephen Hawking and Oliver Sacks. But in my reading of all the essays there's no a single dud in the entire book. Gawande's Letting Go is easily worth the price of admission all by itself, and if it encourages you to have a discussion with your family about what should go into the Advanced Health Directive, you'll be glad you read the book/article.

Other articles cover the nature of invasive species into the Americas (Asian Carp is a huge problem, believe it or not). There's one on fermentation and the new food movement. Others cover brain imagery, cancer treatments, and the existence of organic molecules in the universe. There's one about the shooting of songbirds in Europe. There's of course, the famous article about Gay Albatrosses. The last article will probably make you never want to visit SeaWorld again.

Every article was entertaining, and none of them was a waste of time. I felt like I learned something from every article. This could easily be one of the best books I've read this year. While you could plausibly hunt down every article and read it for free on the internet, many of them are long form and benefit from reading on the Kindle or in paperback format rather than on the web.

Highly Recommended. Buy it now!