Sean Meets the Face-Blindness Live and In-Person

I’ve written before, many times, about my horrible face-blindness.

My son Sean recounts a recent misadventure:

Our first La Mirada Disc Golf Saturday trip this year began with Dad and I making our ritual trip to McDonald’s for sweet, sweet Egg McMuffin action. The drive-through line was packed, and time was running out, so we ran inside.

I go to the fountain to fill my soda while Dad received our food, and I turn around to see him holding our bags and looking around, as though I had vanished into thin air (not an unfamiliar expression). I approach him with a wave of my drink hand, and start to say something as I get within I-know-you range of him. He gives me this look, like, you’re way too close to me; you are probably a crazy person in McDonald’s, and pushes me aside. He marches to the soda machine, puts his hand on the shoulder of a young 5’7″ half-Asian guy with short brown hair, a tee-shirt and shorts, says “Hey, boy, ready t… oh I’m so sorry, I thought you were my son,” as the stranger gives him the now-familiar you are probably a crazy person in McDonald’s look.

Now, admittedly, I am young, have short brown hair, and was, at the time, wearing a tee-shirt and shorts. But, he had to push the real Sean Chappell out of his way (waving a drink!) in order to confuse/distress this vague half-Asian approximation of me. Dad immediately realized that the weirdo he’d been recently accosted by was probably the next best guess as to where Waldo was, so we very quickly scrambled out of there.

Dad had, in the past, shared his harrowing tales of picking me up from school and having to guess at the identity of every vaguely-me person walking in his general direction (okay, he’s about Sean’s height; he’s walking right towards me, Sean would do that; he’s saying ‘Hi Dad’, there’s no one behind me; he’s probably Sean).

I never fully understood/believed these stories until that McDonald’s incident, but to Dad’s credit… I’ve known him my whole life and it took me this long to see the face-blindness rear its ugly head, so that’s pretty impressive coping.

In my defense, I think Sean must have been approaching me from my blind side (because I have some actual-blindness in addition to the face- kind, and I just literally didn’t see him as I brushed by him to accost his half-asian Doppelgänger. But yep, that’s my life, 24/7.

On The Bike Again

…after too long off it.

16 miles, riding in the hills near my house in Sunland on Sunday, took my pulse rate up to 163 beats per minute, almost 98% of my theoretical maximum (which, if you’re not too familiar with typical pulse meter readings, is more or less stunning).

My breathing has been stellar the last few days, so I’m guessing that the high pulse rate is due to:
    (a) 13 months off the bike, and
    (b) the recent ALYX blood donation, which takes a double-dose of oxygen-carrying red blood cells. I’ve read complaints from athletes that it makes a noticeable difference, compared to a normal donation.

I’m lucky to have these lovely hills so close that I can literally step out of the house, hop on the bike, and be among them just a few minutes later.

I didn’t have any problem actually climbing the darn hills; the only limiting factor was some lower-back pain, and then last night, some leg cramping, both of which definitely have to do with lack of practice.

On Big Tujunga Canyon road, an evil hill
On Big Tujunga Canyon road, an evil hill.

Next up: a longer ride later this week!

Flowers and Blood

I went to buy some flowers yesterday (having taken Good Friday off), because I have some nice vases at home, and I decided that I liked having some cut flowers around the house.

I picked out a few loose flowers, including one of Sylvia’s favorites, the Stargazer Lily, and had them make up a nice arrangement for about $25:

Good Friday Flowers

…and then while I was at the flower shop, I saw a bloodmobile ad for a blood drive at the church where I go to vote, so I went down there to check if they could fit me in, and they said, “Sure!”, so I made an appointment, took my flowers home and came back and donated.

It was the first time that I’d given blood where they take a double-size donation of red blood cells, separate out the plasma and return it to you for you to cherish.

Here’s a picture of the ALYX machine, separating my blood into flavors. It has three pouches on the left, and you can see the whole blood going into the right-most pouch of the three, the red blood cells being accumulated in the middle pouch, and the plasma on the left waiting to be fed back into me. Technology!

ALYX Blood Donation

They do it all with just the one needle in your arm, and an automated blood pressure cuff. First the cuff presses down, and the right-hand pouch fills maybe quarter-full or so with whole blood, and ALYX works on separating it into parts into the other pouches, and then at some point the cuff lets up, and you feel a chill as the left-hand pouch is emptied and the plasma is returned. Then it repeats for maybe four or five cycles. Takes about 10 minutes longer than a regular donation, but with all the paperwork and waiting and so forth, it’s a huge win all around to get what is effectively a double donation in so short an additional time.

Seriously, though, I can’t imagine (or can barely imagine) thinking about that problem and saying, “Sure, we could build that!”

Explanation For ‘Face Blindness’ Offered

From ScienceDaily.com:

For the first time, scientists have been able to map the disruption in neural circuitry of people suffering from congenital prosopagnosia, sometimes known as face blindness, and have been able to offer a biological explanation for this intriguing disorder.

…[U]nlike that of normal brains, there was a reduction in the integrity of the white matter tracts in the brains of individuals with congenital prosopagnosic. Moreover, the extent of the reduced white matter circuitry was related to the severity of the behavioral impairment.

…People with congenital prosopagnosia are not able to recognize faces, while the ability to recognize other objects may be relatively intact.

…So far, few successful therapies have been developed for affected people, although individuals often learn to use feature-by-feature recognition strategies or secondary clues such as hair color, body shape and voice. Because the face seems to function as an important identifying feature in memory, it can also be difficult for people with this condition to keep track of information about people, and socialize normally with others.

[T]hese individuals appear not to be able to compensate for their inability to recognize faces even though they have had ample opportunity to do so over the course of development,” said Marlene Behrmann, a professor of psychology at Carnegie Mellon.

Behrmann said the team was excited by the possibility that the failure to propagate signals between different regions of the brain might provide a biological explanation for this perplexing disorder.

So distressing to have myself and my face-blind peers around the world referred to as “[T]hese individuals”, and have our brains presented in stark contrast to “normal brains”.

On the other hand, you’d have to say that normal people, when picking up their son at school, wouldn’t have to stare into the crowd on Day 3,000 and wonder if that kid was the one. And really, on balance, it’s a relief to know that there’s a real physical reason for it, and not me just being goofy.

Read the full article in Science Daily.
November 28, 2008

As well, here’s something that made me laugh out loud when I saw it used recently on a forum: someone had posted a message about some subject (as it might be, face blindness), and someone else had posted a reply, asking for a link to more information on the topic. In short order, a link had been posted in a reply, along these lines:

“Sure, it’s here.”

Oh, that made me laugh and laugh.

Eye News #11 – Nothing to See Here

I got around to going to my retinal specialist again yesterday (oog, it’d been 2.5 years since the last time), and everything was pretty stable: the interocular pressure was 17-left, 24-right, just about exactly where it had been the last time, and my vision was still fine, although my left eye (the one that exploded in 1976) has a tiny, cute little cataract, which has gotten vaguely worse over the eight or so years that we’ve been tracking it, to the point where my best vision is in my evil, Y2K-explody eye — though I’m still totally legal to drive, on the strength of the left (worst) eye alone.

My retinal specialist said that things were so stable that I could cut back to seeing him annually, which would still be about 2.5x more often than I’ve been going.

Oh yeah, and the staff at his office made a huge fuss about how much weight I’d lost, more than 65 pounds since when they knew me well:

“You look…fantastic!”

Study: SSRI’s Not Much Better Than Placebos

I don’t have a horse in this race, but this study is just especially delicious, for one facet of the result.

First, the main result: after a meta-analysis of data from several past studies, the authors found that Selective Serotonin Reuptake Inhibitors (SSRI‘s), such as Paxil, Prozac, and Zoloft, are really not much better than placebos, except for the most severely-depressed patients.

The delicious part is why severely-depressed patients fared better than the less-depressed: it wasn’t because the drug worked better (on the severely-depressed, than on the not-as-severely-depressed), but that the placebo worked less well (on the severely-depressed, than on the not-as-severely-depressed).

I don’t know why, but there’s something about that that just makes me smile — grin, even.

This may have something to do with why Industry Figure Ray Norberte once told me,
    “Tom, you’re almost a nice guy!”

Read the Full Study at the Public Library of Science – Medicine.
“Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration”
February, 2008

Urgent Care for Craig

E-mail from my sister Jan about her son Craig, last seen chasing a Fed-Ex plane:

I got a call from Craig Saturday night. It began, “The good news is that the ring is off and I get to keep my finger.” He broke his finger playing basketball on Thursday night and didn’t take off his wedding ring.

By Friday he was at the Urgent Care using all ten of their saw blades to saw through his titanium band. They got it cut through one side and relieved some pressure, but he still couldn’t get it off. He hit jewelry stores the following morning and found someone able to saw and pry off the other side (only ruining 2 saw blades this time).

He plans to purchase his replacement band (gold, this time) from the helpful jeweler.

The moral, too important to leave unsaid:

“Never use titanium for something designed to be skin-tight.”

Study: Fat People Cheaper To Treat (‘Why?’)

From the Netherlands, a study showing that fat people (and smokers!) spend less on health care, and cost less to treat, even for systems with socialized medicine.

And can you guess why?

Oh, it’s because they die way sooner. Those pesky thin non-smokers just live and live; they’re very annoying.

The researchers found that from age 20 to 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.

On average, healthy people lived 84 years. Smokers lived about 77 years, and obese people lived about 80 years.

The point of the study being to debunk the myth that reducing obesity will reduce national health care costs: “We are not recommending that governments stop trying to prevent obesity, but they should do it for the right reasons.”

Read an article about the study, from the Associated Press.
“Fat people cheaper to treat, study says”

Read the study itself, in the Public Library of Science.
“Lifetime Medical Costs of Obesity: Prevention No Cure for Increasing Health Expenditure”

“They’re cheaper! Isn’t that splendid? I think that’s splendid!”

Good (and Short) Taubes Article on Cholesterol

There’s a good article by Gary Taubes (author of Good Calories, Bad Calories) in today’s New York Times (run, I was amused to see, as an Op-Ed), discussing the belatedly-published Vytorin trial results, which touches on one of the issues that he raises in his book, but about which I’ve been too lazy to blog about, as yet — the distinction between low-density lipoproteins (LDL), and the cholesterol carried inside of them.

Though there has been reason to think, for 50 years now, that problems with the LDL lipoproteins themselves were a more important risk factor than the cholesterol they carried, measuring the former wasn’t diagnostically practicable, because of the difficulty and cost, whereas measuring the latter was easy and cheap. In the battle against heart disease, an army of researchers went to war, not with the tools that they might have wanted to have, but with the tools that they had.

In 1977, the researchers reported their results: total cholesterol turned out to be surprisingly useless as a predictor. Researchers involved with the Framingham Heart Study found that in men and women 50 and older, “total cholesterol per se is not a risk factor for coronary heart disease at all.”

The cholesterol in low-density lipoproteins was deemed a “marginal risk factor” for heart disease. Cholesterol in high-density lipoproteins was easily the best determinant of risk, but with the correlation reversed: the higher the amount, the lower the risk of heart disease.

These findings led directly to the notion that low-density lipoproteins carry “bad” cholesterol and high-density lipoproteins carry “good” cholesterol. And then the precise terminology was jettisoned in favor of the common shorthand. The lipoproteins LDL and HDL became “good cholesterol” and “bad cholesterol,” and the lipoprotein transport vehicle was now conflated with its cholesterol cargo. Lost in translation was the evidence that the causal agent in heart disease might be abnormalities in the lipoproteins themselves.

The truth is, we’ve always had reason to question the idea that cholesterol is an agent of disease. Indeed, what the Framingham researchers meant in 1977 when they described LDL cholesterol as a “marginal risk factor” is that a large proportion of people who suffer heart attacks have relatively low LDL cholesterol.

The article is well-written, dense with information, difficult to synopsize (or at least, I’ve found it so), and is, as I’ve already mentioned, short, and worth reading in its entirety.

Read the Full Article in the New York Times
“What’s Cholesterol Got to Do With It?”
by Gary Taubes

Half-Time Show: Forty-Two!

In 1985, I was trim and fit (not to mention 20 years younger). I was walking every night, riding my bike at lunch, and I was down to 179.5 pounds. I am over six feet tall, and that was a good, good weight.

Let us fast-forward to 1999, about 14 years later. Somehow, I had ballooned up to 265.5 pounds!

(Click on the photo to make me even larger)
A (Staggeringly-Fat) Tom Chappell, alongside a Perfectly-Reasonable John Blackburn
Industry Figures Tom Chappell (250 pounds) and John Blackburn, 25 April 2004.

Let’s see, that’s, geez Louise, a gain of 86 pounds. That is not the gain of a pound a year that is so often bruited about in the media; it’s about a 1/2 pound a month. Still not very fast, in the grand scheme of things, as long as you don’t keep it up for 14 years.

Worse yet: ideally, I should really be down to around 165 pounds, a loss of over 100 pounds from my high of 265. That sounds like a ridiculously low weight to virtually every American I’ve mentioned it to, but it gets me down to a BMI of 22, which is about in the middle of the normal range, cuts the diabetes risk like you wouldn’t believe, and might even get rid of the sleep apnea.

And I’m getting there. Here I am, at 207.0 pounds, half-way between my March, 2007 weight of 249 and my goal of 165, and quite a bit more than half-way between my all-time high of 265 and 165:

(You can still make me larger by clicking on this photo, but it won’t be as satisfying)
Tom Chappell and Stephen Newell
Industry Figures Tom Chappell (210 pounds) and Stephen Newell, 29 December 2007

I’ve lost a pound a week, since March, 2007, and I’m going to keep on doing it for as long as I can.

If I can keep it up, then in a little less than a year, I’ll (finally) have arrived at the promised land.

So many people, myself included, have tried and failed to get weight off, or to keep it off once they’ve gotten it off. So far, for me, it seems to be going all right, and it’s worth reviewing: what did I do differently this time? What’s working?

  1. I only try to lose a pound a week. If I get more than a few pounds ahead of the pace, I go out and have something a little wicked, maybe a mini-pizza and a beer, or whatever, which is a nice change of routine. This keeps me from feeling crazy deprived, and just falling completely off the wagon. On the other hand, I really try to hit that target weight every Monday, and actually am happiest when I’m a few pounds ahead of the game.
  2. I limit carbohydrates. This one is unbelievably important. Like practically all overweight people, I’m fairly insulin-resistant, so no other course of action makes sense. I’ve already written extensively, starting here, about why this is absolutely vital, and the totally solid science behind this. Whatever level of carbohydrates you can manage to limit yourself to, the fewer carbohydrates you eat, the leaner you will be.
  3. I check my blood sugar levels. Every morning, I use one of the glucose test kits sold in drug stores to see where the previous day’s rampages have left my blood sugar levels. You can’t lose weight if insulin levels are high, and high blood sugar levels mean high insulin levels, so lower is better (up to a point, of course). I used to cruise at about 105, solidly pre-diabetic, but for the past 5 straight weeks, I’ve averaged 92, which is great, and this week I’ve been averaging an 86, in the fabled Smug Bastard range. I also use them to check to see what an unfamiliar meal does to my blood sugar levels.
  4. I don’t particularly limit dietary fat or protein. I don’t suffer from gout, so I don’t have problems from eating too much muscle flesh. And I haven’t seen a lot of compelling evidence that higher dietary fat dramatically increases all-cause mortality, though I stay away from trans fats. These foods help slow down the carbohydrate rush, keep me from feeling starved, and keep my metabolism revved up.
  5. I exercise a lot more. Exercise is said to reduce insulin resistance, reduces blood glucose levels, helps keep HDL levels high, and blood pressure low. You can lose weight without a lot of exercise, but exercise provides a broad range of benefits, so I exercise.

    Furthermore, a recent study found (University article, journal abstract) that exercising for longer periods is more helpful for reversing the Metabolic Syndrome than is exercising more vigorously for shorter periods, so a great deal of my exercise is just walking around.

    My general routine is two 40-minute fast-paced walks per day (one at lunch, and one later in the day), and 40 minutes of cardio workout after work (alternating at 80% and 60% of my maximum heart rate), every day. Yep, two hours a day. And that’s not even counting the 50-mile bike rides that I often do on the weekends, which themselves are training rides for the 100-mile one-day century rides that I do once or twice a year, mostly for the bragging rights.

    I didn’t start out at that level; I built up to it. I currently shoot for 1,000 calories of exercise per day, though my median in the last nine months of 2007 was 744 calories/day.

    My New Year’s resolution was to increase my amount of strength training (hence the personal trainer), which will probably cut into the existing routine somewhat.

    Note that the bulk of my exercise is in 40-minute chunks, which gives me time to get warmed up and then still do a noticeable amount of exercise, doesn’t require me to bring along special food for the exercise, and doesn’t leave me craving a snack after the exercise. I’ve also had good results going for a walk after dinner, which gives me something to do away from the refrigerator and helps cut down those post-prandial blood glucose levels.

  6. I exercise with a buddy. My carpool partner, Industry Figure Larry Helmerich, is right at my side for almost all of my workouts. We have a small gym at work, a fantastic benefit, and it’s just routine for us to stop and work out at the end of the day, before driving home. And then my long weekend bicycle rides are with some combination of fellow Alcatel-Lucent cyclists Ron, Carlos, and Vincent. It’s easier, and more fun, with a buddy.
  7. No food is actually forbidden, in moderation. If I find myself feeling resentful about not being able to have a food, I make a point of having a small portion of it right then, because constant, unrelenting deprivation makes you crazy. I don’t eat out often, but if I am eating out with my friends or family at, for example, Romano’s Macaroni Grill, where they have amazing bread, I go ahead and have a little, especially if I’ve got a few pounds in the bank. I usually limit it to 1/4 of one of their loaves, rather than the whole loaf or so that I used to eat, and dip each mouthful in the olive oil that they provide, hoping that the olive oil will slow down the carbohydrate uptake from the bread.
  8. I brown-bag lunch, or have a small lunch at the cafeteria at work, 4 times a week. This makes lunch so fast that I have time to do one of my 40-minute walks after eating, which gets some exercise in, and helps to lower my blood glucose level after the meal. But then once a week we go out for lunch, which is a nice treat.
  9. I eat more fruits and vegetables (though not starchy vegetables like potatoes). They’re filled with micronutrients, give my stomach something to think about, and if nothing else, lengthen the meal a bit to give my body enough time to realize that it’s full. And nowadays, you can almost always get restaurants to give you some broccoli or asparagus instead of mashed potatoes.
  10. At home, I cook most of my own meals. Growing up, we basically never ate out — it was all healthy meals, prepared at home, rather than crazy meals like a double burger, fries, and a milkshake. Making your own meals gives you a lot more control over what, and how much, you eat.
  11. At home, I use slightly-smaller plates and bowls. Just about an inch smaller in diameter, which translates into 20% smaller surface area, and arguably more like 25% less usable space. There are a million little ways in which your brain can be fooled into just accidentally eating a little more, or a little less, and I try to set up the things that make me accidentally eat a little less.
  12. I get a good night’s sleep. As I mentioned recently, getting too little sleep has been shown to dramatically worsen insulin resistance.
  13. I drink coffee, tea, and wine “moderately”. Coffee drinkers have, as a group, a lower risk of Type 2 diabetes than non-drinkers. At least one mechanism explaining why this should be so has been identified, and successfully tested, too. (Coffee inhibits the enzyme 11β-hydroxysteroid dehydrogenase type 1 from re-activating the stress hormone cortisol from existing serum cortisone, if you want to know.) The important ingredient isn’t the caffeine, either, so go ahead and have decaf, if you prefer that. Of course, I’m not sure how many doctors would call my 2 to 4 mugs of coffee a day “moderate”, but I call it that, so at least someone does.

    I also drink 2 to 3 cups of tea (which has its own advocates), and drink fractionally more than three 5-ounce glasses of wine a day. (American doctors don’t call that “moderate” wine drinking, but British and French doctors do. French doctors even say that men can have 5 glasses of wine a day, bless them.) What everyone agrees on, though, is that some drinking is better for your health than no drinking or a lot of drinking; you’ve got to draw the line somewhere.

  14. I obsessively track my progress. This one wasn’t here until Stephen posted his comment, but I’d actually thought of it while driving home tonight, too. Absolutely! I measure all sorts of things, pretty much daily: weight, BMI, fasting blood glucose, morning b/p, evening b/p, number of glasses of wine per day, calories spent exercising per day. And then weekly, I measure my waistline. I’ve got graphs that I could show you, because I’m a monomaniac! Eh, it’s working for me.

    Seriously, though, measuring your waistline is fantastically important, because muscle weighs more than fat, and when you start exercising, or even right in the middle of your diet, you might find that you’re gaining weight, or not losing it, but your waistline is shrinking every week.

    If that happens, cut yourself a break, even if it goes on for weeks or months — you’re trading body fat for muscle. Eventually you’ll start losing weight again.

Forty-Two Pounds To Go. Easy!