Tag Archives: creativity

C-Pap and Apnea

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A month of so ago, I went to see a sleep doctor for my snoring. I got a take-home breathing test that gave me the worst night’s sleep in recent memory. A few days later, I got a somber diagnosis: “You are a walking zombie.” Apparently, I hold my breath for ten seconds or more every minute and a half while sleeping. Normal is supposed to be every 4 to 10 minutes. But by this standard, more than half of all middle-aged men are sub-normal (how is this possible?). As a result of my breath-holding, the wrinkled, unsmiling DO claimed I’m brain-dead now and will soon be physically dead unless I change my ways. Without spending 3 minutes with me, the sleep expert told me that I need to lose weight, and that I need a C-Pap (continuous positive airway pressure) device as soon as possible. It’s supposed to help me lose that weight and get back the energy. With that he was gone. The office staff gave me the rest of the dope: I was prescribed  a “ResMed” brand C-Pap, supplied by a distributor right across the hall from the doctor (how convenient).

I picked up the C-Pap three months later. Though I was diagnosed as needing one “as soon as possible,” no one would release the device until they were sure it was covered by my insurance company. The device when I got it, was something of a horror. The first version I tried fit over the whole face and forces air into my mouth and nose simultaneously, supposedly making it easier to inhale, but harder to exhale. I found it more than a bit uncomfortable. The next version was nose only and marginally more comfortable. I found there was a major air-flow restriction when I breath in and a similar pressure penalty when I breathed out. And it’s loud. And, if you open your mouth, there is a wind blowing through. As for what happens if the pump fails or the poor goes out, I notice that there are the tiniest of air-holes to prevent me from suffocating, barely. A far better design would have given me a 0-psi flapper valve for breathing in, and a 1/10 psi flapper for breathing out. That would also reduce the pressure restriction I was feeling every time I took a deep breath. One of my first blog essays was about engineering design aesthetics; you want your designs to improve things under normal conditions and fail safe, not like here. Using this device while awake was anything but pleasant, and I found I still hold my breath, even while awake, about every 5 minutes.

Since I have a lab, and the ability to test these things, I checked the pressure of the delivered air, and found it was 3 cm of water, about 1/20 psi. The prescription was for 5 cm or water (1/14 psi). The machine registers this, but it is wrong. I used a very simple water manometer, a column of water, similar to the one I used to check the pressure drop in furnace air filters. Is 1/20 psi enough?How did he decide on 1/14 psi by the way? I’ve no idea. !/14 psi is about 1/200 atm. Is this enough to do anything? While the C-Pap should get me to breathe more, I guess, about half of all users stop after a few tries, and my guess is that they find it as uncomfortable as I have. There is no research evidence that treatment with it reduces stroke or heart attack, or extends life, or helps with weight loss. The assumption is that, if you force middle-aged men to hold their breath less, they will be healthier, but I’ve no clear logic or evidence to back the assumption. At best, anything you gain on the ease of breathing in, you lose on the difficulty of breathing out. The majority of middle-aged men are prescribed a C-Pap, if they go for a sleep study, and it’s virtually 100% for overweight men with an apple-shaped body.

I’d have asked my doctor about alternatives or for a second opinion but he was out the door too fast. Besides, I was afraid I’d get the same answer that Rodney Dangerfield got: “You want a second opinion? OK. You’re ugly, too.” Mr. Dangerfield was not a skinny comic, by the way, but he was funny, and I assume he’d have been prescribed a C-Pap (maybe he was). He died at 82, considerably older than Jim Fixx, “the running doctor,” Adelle Davis, the “eat right for health” doctor, Euell Gibbons “in search of the wild asparagus,” or Ethan Pritkin, the diet doctor. God seems to prefer fat comedians to diet experts; I expect that most-everyone does.

Benjamin Franklin and his apple-shaped body

Benjamin Franklin and his apple-shaped body; I don’t think of him as a zombie.

What really got my goat, besides my dislike of the C-Pap, is that I object to being called a walking zombie. True, I’m not as energetic as I used to be, but I manage to run a company, and to write research papers, and I get patents (this one was approved just today). And I write these blogs — I trust that any of you who’ve read this far find them amusing. Pretty good for a zombie — and I ran for water commissioner. People who use the C-Pap self-report that they have more energy, but self-reporting is poor evidence. A significant fraction of those people who start with the C-Pap, stop, and those people, presumably were not happy. Besides, a review of the internet suggests that a similarly large fraction of those who buy a “MyPillow.com” claim they have more energy. And I’ve seen the same claims from people who take a daily run, or who pray, or smoke medical marijuana (available for sleep apnea, but not from this fellow), or Mirtazapine (study results here), or  for electro-shock therapy, a device called “Inspire.” With so many different products providing the same self-reported results, I wonder if there isn’t something more fundamental going on. I’d wish the doc had spent a minute or two to speak to this, or to the alternatives.

As for weight loss, statistical analysis of lifespan suggests that there is a health advantage to being medium weight: not obese, but not skinny. I present some of this evidence here, along with evidence that extra weight helps ward off Alzheimer’s. For all I know this protection is caused by holding your breath every few minutes. It helps to do light exercise, but not necessary for mental health. In terms of mental health, the evidence suggests that weight loss is worse than nothing.

Jared Gray, author of the Alien movies, was diagnosed with apnea, so he designed his own sleep-mask.

Jared Gray, author of the Alien movies, was diagnosed with apnea, so he designed his own sleep-mask.

Benjamin Franklin was over-weight and apple-shaped, and no zombie, The same is true of John Adams, Otto Von Bismarck, and Alfred Hitchcock. All lived long, productive lives. Hitchcock was sort of morbid, it will be admitted, but I would not want him otherwise. Ed McMahon, Johnny Carson’s side-kick, apologized to America for being overweight and smoking, bu the outlived Johnny Carson by nine years, dying at 89. Henry Kissinger is still alive and writing at 95. He was always fatter than any of the people he served. He almost certainly had sleep apnea, back in the day, and still has more on the ball, in my opinion, than most of the talking-head on TV. The claim that overweight, middle-aged men are all zombies without a breath assisting machine doesn’t make no sense to me. But then, I’m not a sleep doctor. (Do sleep doctors get commissions? Why did he choose, this supplier or this brand device? With so little care about patients, I wonder who runs the doctor’s office.)

I looked up my doctor on this list provided by the American Board of Sleep Medicine. I found my doctor was not certified in sleep medicine. I suppose certified doctors would prescribe something similar  but was disappointed that you don’t need sleep certification to operate as a sleep specialist. In terms of masks, I figure, if you’ve got to wear something, you might as well wear something cool. Author Jared Gray, shown above (not the author of the Alien) was diagnosed with Apnea 6 months ago and made his own C-Pap mask to make it look like the alien was attacking him. Very cool for an ex-zombie, but I’m waiting to see a burst of creative energy.

What do we zombies want? Brains.

When do we want them? Brains.

What do vegetarian zombies want? Grains.

Robert Buxbaum, March 15, 2019. In case real zombies should attack, here’s what to do.  An odd legal/insurance issue: in order to get the device, I had to sign that, if I didn’t use it for 20 days in the first month of 4 hours per night, and thus if the insurance did not pay, I would be stuck with the full fee. I signed. This might cost me $1000 though normally in US law, companies can only charge a reasonable restock fee, but it can’t be unreasonable, like the full  price. I also had to sign that I would go back to the same, quick-take doctor, but again there has to be limits. We’ll see how the machine pans out, but one difference I see already: unlike my pillow.com, there is no money back guarantee with the C-Pap treatment.

What is learning?

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It is common to spend the most of one’s youth in school — presumably learning something. The financial cost for primary education is a few hundred thousand dollars, borne by the state, plus 13 years or so of the student’s life. College learning costs another $50,000 to $200,000, borne by the student, plus another 4-6 years of life. The indication that you’ve learned something appears, in many majors by the ability to get a job that pays more than the school financial cost. But there is also a sense that you’ve learned something, and this is perhaps the only reward for students of film, religion, or archeology. My question is based mostly on this part: what is this learning. Is it the same as knowledge, a set of facts, or satisfaction — perhaps you could be as satisfied by ignorance or drugs. How do you evaluate the spiritual payback from 4-6 years of college? I don’t have all the answers, but ask to exercise my ignorance.

It would seem to me that an important standard of learning is that it should develop the mind and not corrupt it. But how do you recognize the difference? it seems to me one should leave with a set of mental skills should be new to you, recognizable to a normal outsider, and somewhat useful, as in the poem “Botany” even if you don’t use it. I’m not sure if the skills have to be true, by the way, or how useful they have to be. Perhaps developing a new confusion is better than having false notions — knowing that you doubt something.

sometimes education is the removal of false notions.

Sometimes learning can be the development of doubt.

If you’ve been educated in music, it seems to me you should be able to make sounds that appear pleasant to a normal listener; if you’ve been educated in mechanics, you should be able to make machines that work, and if you’ve been educated to think… perhaps then you should be able to walk into a discussion about something you once thought was true, and show that it is really false to an extent that others would accept it (and act upon it?). That is, my suspicion is that learning should involve an identifiable change –not only internal satisfaction, and I also suspect learning the new must involve unlearning the old.

Liberal Education may not be useful, or elevating

Education that isn’t useful isn’t particularly elevating

And that leads us to facts and methods: knowledge. Facts are good, they are the fuel and  substance of learning. Without facts there is nothing for the learning to attach to. But facts are often wrong — the ignorance of others, and even when right, they can be  deceptive. If you’ve learned the moon is made of rock, or out of green cheese, it’s pretty much the same unless there is a reason to think the fact you’ve learned is true, and unless you’ve a good understanding of what the fact ‘means.’ I can imagine a rock that is organic (a gall stone) and less solid than some (old) green cheese. The word rock or cheese must mean something to you to be a fact. Similarly in all subjects; if you learn that Shakespeare is a better writer than Poe, you should have a reason to believe it, and a clear understanding of the word ‘better’ in this context.

Turning to the knowledge of methods. It seems to me that learning a new method of thought, action, or argument is a necessary component of learning– one might even call it virtue, but this too seems to have limitations if it is not directed to use. A person is half-educated if he leaves school knowing how to do geometric proofs, but never doing any, or knowing how to run a great business, but never running one. A science graduate should at least be able to use the techniques learned to demonstrate that the world is made of atoms, and that the sun does not circle the earth and perhaps more. An argument can be made for traditional education areas of logic, rhetoric, mathematics, and dialectic. But these seem useless unless they are applied to a worthy end. One should do more with the new methods than to win drawing-room arguments.

There should be some satisfaction to accomplishments, but I'm not sure how it's learned.

Learning should provide satisfaction –in particular religious learning — but it’s nicer if it goes with doing good for someone (not only the poor) and the ability to earn an honest income. 

There should be a moral component of learning too, but here I feel less certain in describing it, or describing how it should be taught. Theodore Roosevelt said that “An uneducated man can steal from a rail car, “but an educated one can steal the whole railroad.” but perhaps stealing the railroad isn’t such a bad thing if it’s done legally. And as I don’t quite know when the honest stock deal is moral, I’m even more in the dark as to how to teach one to recognize the moral from the immoral in these situations. Two thoughts here: a student deserves some satisfaction from his or her learning and (from Aristotle’s Nicomachean Ethics) to be moral, the student has to earn an honest income. One who can not earn a living is bound to steal from someone sooner or later.

A final sign of learning, and perhaps it’s crown, is creativity, the ability to come to new understandings and develop new things. To do this productively requires some knowledge of the past plus an indescribable view of the future. A spark? A divine madness? Schools do not seem to be able to teach that, but it can help or hinder by either encouraging it, or beating it down. If you did not possess this ability when you entered school, you are unlikely to leave with it, even if you just did drugs, but school can teach one to direct the spark productively.

I’ve noticed that our high schools focus little on the above areas, perhaps because they are hard to test. Rather classes aim to the exams, and the exams test (as best I can tell), memorization, aptitude, and exposure. A surprisingly large fraction of our students leave diagnosed as ADHD. Still, strangely, our graduates do better than the Europeans.

Dr. Robert E. Buxbaum, December 29, 2014 (I taught in college). Here’s some advice I wrote for my 16 year old daughter in high school.

Marijuana, paranoia, and creativity

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Many studies have shown that marijuana use and paranoid schizophrenia go together, the effect getting stronger with longer-term and heavy use. There also seems to be a relation between marijuana (pot) and creativity. The Beetles and Stones; Dylan, DuChaps, and Obama: creative musicians painters, poets and politicians, smoked pot. Thus, we can ask what causes what: do crazy, creative folks smoke pot, or does pot-smoking cause normal folks to become crazy and creative, or is there some other relationship. Dope dealers would like you to believe that pot-smoking will make you a creative, sane genius, but this is clearly false advertising. If you were not a great artist, poet, or musician before, you are unlikely to be one after a few puffs of weed.

The Freak Brothers, by Gilbert Shelton. While these boys were not improved by dope, It would be a shame to put the artist in prison for any length of time.

The Freak Brothers, by Gilbert Shelton. What’s the relationship?

When things go together, we apply inductive reasoning. There are four possibilities: A causes B (pot makes you crazy and/or creative), B causes A (crazy folks smoke pot, perhaps as self medication), A and B are caused by a third thing C (in this case, poverty culture, or some genetic mutation). Finally, it’s possible there’s no real relationship but a failure to use statistics right. If we looked at how many golf tournaments were won by people with W last names (Woods, Wilson, Watson) we might be fooled to think it’s a causal relationship. Key science tidbit: correlation does not imply causation.

The most likely option, I suspect is that some of all of the above is going on here: There is an Oxford University study that THC, the main active ingredient in pot, causes some, temporary paranoia, and another study suggests that pot smoking and paranoid insanity may be caused by the same genetics. To this mix I’d like to add another semi-random causative: that heavy metals and other toxins that are sometimes found in marijuana are the main cause of the paranoia — while being harmful to creativity.

marijuana -paranoia

Pot cultivation is easy — that’s why it’s called weed– and cultivation is often illegal, even in countries with large pot use, like Jamaica. As a result, I suspect pot is grown preferentially in places contaminated with heavy metal toxins like vanadium, cadmium, mercury, and lead. No one wants to grow something illegal on their own, good crop-land. Instead it will be grown on toxic brownfields where no one goes. Heavy metals are known to absorb in plants, and are known to have negative psychoactive properties. Inhalation of mercury is known to make you paranoid: mad as a hatter. Thus, while the pot itself may not drive you nuts, it’s possible that heavy metals and other toxins in the pot-soil may. The creativity would have to come from some other source, and would be diminished by smoking bad weed.

I suspect that creativity is largely an in-born, genetic trait that can be improved marginally by education, but I also find that creative people are necessarily people who try new things, go off the beaten path. This, I suspect, is what leads them to pot and other “drug experiments.” You can’t be creative and walk the same, standard path as everyone else. I’d expect, therefore, that in high use countries, like Jamaica, creative success is preferentially found in the few, anti-establishment folks who eschew it.

Robert E. (landslide) Buxbaum, September 4, 2014. The words pot, marijuana, dope, and weed all mean the same but appear in different cultural contexts. To add to the confusion, Jamaicans refer to pot as ganja or skiff, and their version of paranoid schizophrenia is called “ganja psychosis”. I’m not anti-pot, but favor government regulation— perhaps along the lines of beer regulation, or perhaps the stricter regulation of Valium. My most recent essay was on the tension-balance between personal freedom and government control. I was recently elected in Oak Park’s 3rd voting district. My slogan: “A Chicken in every pot, not pot in every chicken”. I won by one vote. For those who are convinced they’ve become really deep, creative types without having to create anything, let me suggest the following cartoon about talent. Also, if pot made you smart, Jamaica would be floating in Einsteins.