A few meditative moments with Icelandic standout Gunnar Nelson. 

thenarcicyst:

Nothing.

jayparkinsonmd:

Back in 2007, I had a patient who was uninsured with a strong family history of breast cancer. At the time, the only place you could get tested for the gene mutations strongly associated with breast cancer, BRCA1 and BRCA2, was this company called Myriad. They had a monopoly on the test. I thought the patient really needed to know her risk (which could be as high as 87% likelihood of getting breast or ovarian cancer). I called up Myriad and asked how much their test would cost a cash-paying patient. They said $4000. I asked if they had some sort of financial assistance programs. They said nope. Of course this made me angry. 

And now it’s 2013. Back in January I joined 23andMe, spit in a cup, sent it off to them, and found that I have none of the three most popular BRCA mutations. And this only cost me $99 cash. So…in 5 years or so, the cost of understanding your risk went from $4000 for testing two genes to $99 for sequencing much of your DNA. And that’s a beautiful thing. 

I applaud Angelina Jolie for being open and honest about her decision to have a double mastectomy to prevent breast cancer. Celebrities can shed a vital light on important and difficult issues to popularize. And she’s done a remarkable job, unlike Jenny McCarthy. By being science and data-driven, you can save lives. By being emotional and scientifically ignorant, you can take lives. 

photo by Martin Schoeller

I had the same thought as Dr. Parkinson, what’s the difference between the personalized genomic sequencing service offered by 23andMe vs the $4000 test? My guess is that the former cuts out the middle man and provides the patient with their genetic susceptibility loci along with studies linking the genetic variabilities with disease, leaving any (expensive) conclusions to be made by the patient rather than the physician. This may seem like a problem but I think in many cases it can benefit the patient. A quick search brought me to this study which found that the much cheaper sequencing package lead to patients asking for the confirmatory test from their physicians as well as notifying at risk family members, thereby bypassing the cost prohibitive option. 

https://www.23andme.com/health/BRCA-Cancer/howitworks/

http://www.huffingtonpost.com/jill-steinberg/testing-brca1-positive-wh_b_776263.html

sherpaa:

It’s hard describing how we do things here at Sherpaa. Stories always help!

So, with every client’s permission, we’re sharing real life stories that happened here at Sherpaa.

We received a phone call from a client complaining of sudden onset shoulder and back pain that was worse upon taking breaths. Based on the series of standardized questions we ask each and every patient with these symptoms, we narrowed our potential diagnoses to musculoskeletal back pain vs. a pneumothorax. A pneumothorax (pl. pneumothoraces) is an abnormal collection of air or gas in the pleural space that separates the lung from the chest wall and which may interfere with normal breathing. It can be a serious emergency and we needed to act fast. We had three options:

• Immediately send this client to the ER

• An urgent care center

• Or directly to the radiologist

We knew the absolute fastest way to determine if this was a pneumothorax was sending this patient directly to the radiologist. So we called up the radiologist and within 30 minutes the patient went to the radiologist and we had the results. Fortunately, there was no pneumothorax. It was just muscle pain and we had the gold standard test to prove it.

If we would have sent the client to the ER or the urgent care center:

• They would have asked the same questions and done a physical exam

• Test: Chest X-ray

• Time: 8 hours in the ER or an hour and half in the urgent care center

• Cost: $1500 in the ER or $500 in the urgent care center

But we asked all the right questions over the phone, skipped the physical exam because the physical exam isn’t the gold standard, and sent the client directly to the radiologist for a $40 chest x-ray saving all kinds of inconveniences and money. And we confidently ruled out something scary. We treated his muscle pain and we’ve been in regular contact with him via email and we’re happy to report he’s now almost all better less than 24 hours later.

We simply rethink how healthcare is delivered and we make it speedier, more convenient, and less expensive.

isms-in-martialarts:

The evidence that Lloyd Irvin runs a team based on deception that is rife with sexual misconduct is so numerous that it’s tough to keep all of it in your head at once. Here’s the run-down I wrote just to keep everything straight in my own head:

• The evidence is overwhelming that Lloyd Irvin…

This is a nice summary of everything that has surfaced thus far in the Lloyd Irvin drama within the BJJ community. I’ve always had a distaste for LI and suspicious of his “mastermind seminar” videos with his many dubious claims. 

The Verge has an in depth profile of internet marketing scams- not to be confused with legitimate internet marketing, which sheds much light on the issue and disrobes Master Lloyd Irvin as the scam “guru” that he is. Recommended reading for anyone who doesn’t want themselves or their less internet savvy friends or family members to get taken advantage of. 

http://www.theverge.com/2012/5/10/2984893/scamworld-get-rich-quick-schemes-mutate-into-an-online-monster

incisional:

How to Direct a Surgical Video 

I have been attempting to learn about inguinal hernia repair and its different approaches as a result of a small research project I am working on. Trying to understand the anatomy by staring at a sea of black squiggles and trudging through jargon became daunting, so I turned to YouTube. Naturally, I believed that watching surgical videos would be a much faster, clearer way of achieving the visual understanding I was working to find. I was wrong. Trying to orient yourself the first time you watch a laparoscopic surgery can be dizzying after all the head-pivoting and brow-furrowing. At least while reading literature, I know where the top and bottom of the page are at all times. Not so while watching these laparoscopic videos. 

I watched a dozen or so videos and let the repetition of patterns sink in. Some were narrated by voice, some by text imposed on the image, some in different languages. Finally, I stumbled upon my favorite video of the lot. It’s tastefully backed by some sophisticated music that surely is in tune with the frequency of brain waves or whatever the alleged association is that makes me listen to Baroque music while frantically cramming for exams. Between the “scenes” of the operation, a tidy bulleted presentation of steps, potential hazards, and best of all, anatomical diagrams orient the viewer. Going above and beyond the call of duty, some of the shots are even labeled as the procedure is being performed. Unlike most of the other videos I watched, we even get to see the patient being sutured, and there is another special surprise at the very end of the film.

Despite the array of detail that distinguish this video from all of the other surgical procedures I’ve seen on YouTube, my favorite part is watching the delicate dissection of fascial layers by the surgeon. There is something very satisfying about the scene at 3:30 minutes in; I guess I prefer surgery’s simple pleasures. My only complaint is that the user, Dr. John M. Clarke, doesn’t have any more videos uploaded.

I need to become more efficient at night time. I’ve realized that if I can work effectively between the hours of midnight-morning, I will gain a significant study advantage. It’s not rare that I take naps after evening workouts which disrupt my sleeping patterns, leading to night time wakefulness, and to waste optimal brain time after midnight is unjustifiable. I find that I have a difficult time studying during late hours because I’ve long been conditioned to relax after midnight. I almost instinctively play a movie, browse to my channels on Youtube or reddit and turn into a couch potato around this time, although my brain is actually in optimal learning mode.

As part of my manifesto to kick my learning into hypergear and reach a new level of studying effectiveness, I will be using ALL of my optimal brain time towards studying and learning new material. Every hour counts, to waste them on passive entertainment is counter-intuitive and will not bring me any closer to success. Now that I’ve made this realization and put it down in text, I need a plan.

Developing a pre-study routine would shift my mind into study mode. A routine that I can use during the day and at night to let myself know that it’s study time, regardless of the hour of day. From Kevin Paul’s book:

Learning environment - “You want to create a space that has associations related only to studying. When you sit down at this place, the subconscious messages that come into your brain tell you that this is where you study, and do nothing else but study.”

Relax to control anxiety and stress - breathing techniques, visualization

Pump up self-esteem - visualization, music

Sharpen focus - visualization, activate memory

Define goals and objectives for each study session - realistic and achievable goals.

Visualization -

A. Visualize past successes

B. Visualize future success

…

So I’m making a playlist for boxing/sparring and I did a quick search online but was disappointed. There were few good suggestions here and there but nothing consistent. Here is my own. It’s a work in progress but I think it’s one of the better boxing playlists available online.

52 songs, 3.4 hours
As We Enter- Nas & Damian “Jr. Gong” Marley
Lions In the Forest (DJ Solo Mix) - D.J. Muggs & Planet Asia
How You Like Me Now (Single Edit) - The Heavy
The Champ - Ghostface Killah
Here Comes The Hotstepper- Ini Kamoze
End Of Line (Photek Remix) - Daft Punk
Kryptonite - Big Boi
So Appalled - RZA, Jay-Z, Pusha T, Swizz Beatz & Cyhi
Ride Like the Wind (Klaas Remix) - Michael Mind
Ice Cream On Blast - A-Trak
Alors On Danse - Stromae, Kanye West & Gilbere Forte
Make Some Noise - Beastie Boys
Not Afraid - Eminem
Da Mystery Of Chessboxin’ - Wu-Tang Clan
The Only Fat Sax - Big Boi + Black Keys
In For The Kill (Lifelike Remix) - La Roux
Dangereux - IAM
Black Bug - Big Boi + Black Keys
Carte Blanche ft. Kid Sister: Do! Do! Do! - A-Trak
Duck Sauce - Barbra Streisand - A-Trak
Green Light (MSTRKRFT Remix) - Andre 3000 and John Legend
Shutterbugg - Big Boi & Cutty
Beware - Big Punisher
Battle - Gangstarr
Go Get Tangerine - Big Boi + Black Keys
Don’t Turn The Lights On (Carte Blanche Remix) - Chromeo
Ca Vient De La Rue - IAM
Replacement Killers (Matrix soundtrack) - Crystal Method
Where The Hood At? - DMX
Work - Gang Starr
No Church in the Wild - Jay-Z and Kanye West
Whatever You Shoot - A-Trak
Jump Around - House of Pain
Shiny Suit Theory f. Jay Z & The-Dream - Jay Electronica
Bring the Pain - Method Man
Scenario - A Tribe Called Quest
Ready for war (Mayweather vs. De La Hoya remix, extended version) - 50 Cent
Can’t Be Touched (CLEAN LYRICS) - Roy Jones Jr
Song for Lisa (Benny Benassi remix)- The Japanese Popstars
Desabafo / Deixa Eu Dizer - Marcelo D2 & Claudia
The Horror - RJD2
Otis - Jay-Z & Kanye West
Natural Blues - Moby
Six Days The Remix - Dj Shadow Feat Mos Def
Public Service Announcement - Paul Nice & Jay-Z
Monster (Teachers remix) - Kanye West
Nirvana - Smells like teen spirit
Stronger (remixed) - Kanye West & Daft Punk
Drop a bomb on em - Eminem
Body Medusa (left field dub mix) - Supereal
B.O.B - Outkast