After suffering a heart attack in 2004, I was directed by my first cardiologist to go in annually for nuclear imaging.  Test after test showed near normal function despite the noticeable but relatively minor muscle damage.  My last scan in 2009 came back with a twist, though.  The heart looked good but a white spot showed up in my chest that looked like a cancer.  This necessitated me going in for a CT scan.  It came back negative (no cancer).  Nevertheless I spent a couple of weeks in a state of high suspense.

Now I’m undergoing underwriting for a key-man insurance policy for my company.  Maybe I will need to go back in for another nuclear imaging.  Although it will be useless to push back on this, my current cardiologist says there’s no need to spend the money and expose me to the radiation so long as I’m not exhibiting any changes in my heart health (I am not).

My point is that one should not assume that it’s always good to get testing, both because of its inherent dangers and because of the chance of false positive results—mistakes that can be very costly for the patients psyche.  Also, the outright costs of over-testing cannot be overlooked.  In this case I got irradiated two-fold by the nuclear imaging and then by the CT’s x-ray bombardment.  (Is it irony that a test for cancer increases ones chance of cancer?)

My friend Rich put me on to this very-informative podcast by Minnesota Public Radio (MPR) featuring a talk, aired on June 30, by Dr. Jerome Goodman and his wife, Dr. Pamela Goodman on how to make medical decisions.  Not only are both partners in this couple outstandingly qualified to speak on these matters, they bring quite different perspectives on how to weigh the risks of tests and treatments versus the potential benefits.

For example, a middle-aged woman is told that her cholesterol being above 200 exceeds the level considered safe for her heart-health.  She is advised to go on statins to reduce the risk of heart attack by 30 percent.  However, some research by this patient uncovers the statistic that women of this age only face a 1% risk of such a catastrophic event whereas 1 to 10% of those going on statins suffer the side-effect of myopathy—a painful and debilitating muscular disease.  As a result of this woman doing her homework, she decides not to take the doctor’s advice.  Does that make sense?

There really is no right answer for any of these medical decisions, but it surely is worth pressing your physician for data on risks versus benefits, doing your own research and, if it’s important enough, getting a second opinion.

As reported here in today’s Wall Street Journal,  Finnish surgeons split 146 patients with meniscus tears into two groups and ‘scoped them all, but only half had their cartilage removed.  The remainder—the control group—underwent all the same post-operative processes and thus remained in the dark that they really did not get the full procedure.  The end results showed that any advantages to this ‘partial meniscectomy,’ which purportedly accounts for $4 billion in annual medical costs on the USA alone, are relatively small and short-lived.

Naturally, an independent orthopedic surgeon asked by WSJ to assess these results did not agree that the arthroscopic procedure might be overdone, even though a previous study showed physical therapy to be just as effective for patients with somewhat similar knee problems.

Without strong affirmative evidence from double-blind studies such as this one, I myself am leery of just accepting any given surgeon’s advice to press ahead with a procedure. As Teppo L.N. Järvinen, co-author of the Finnish experiment, says:

Doctors have a bad tendency to confuse what they believe with what they know.

Tuesday’s Health & Wellness section of Wall Street Journal passed along distressing news for folks like me who like to take a spin on their bicycle.  New research by scholars at University of Bath and Brunel University* suggests that wearing noticeable clothes not only did nothing for getting motorists to back off, but when cyclists wore a “POLITE notice, Pass Slowly” vest, they were more likely to be harassed.

Perhaps wearing camouflage like this fellow shown here this fellow shown here might be the way to go.

*Detailed here by IrishCycle.com

Today’s Science Friday radio show made it known that willpower is a very limited resource.  That’s the bad news.  The good news is that you can build up your willpower by proper exercises, just like you do for toning up muscles.  This is the premise of Florida State University psychology professor Roy F. Baumeister, whom Science Friday host Ira Flatow interviewed.  Baumeister and co-author John Tierney reveal all in their book Willpower: Rediscovering the Greatest Human Strength, chosen as one of the Best Books of 2011 by Amazon’s editors.

Here are a few pointers I picked up from Science Friday that will prevent depletion of your willpower reservoir:

• Do not start in on all of your New Year’s resolutions all at once – pace yourself: Work on one resolution at a time.
• Pick off the easiest resolutions first, such as making your bed every morning or taking your dog for a walk daily.
• Exercise and build up your willpower with trivial things such as sitting up straighter and using your non-dominant hand to mouse around the computer.

For an inspiring demonstration of supreme willpower see this video of the  Stanford Marshmallow Experiment.

http://www.youtube.com/watch?v=6EjJsPylEOY

Unfortunately, according to Professor Baumeister, testing your willpower on something as compelling as a sugary snack can be very perilous, because once you fail it goes downhill from there.  That’s why my goal is to first eat all the Christmas cookies before giving up sweets.

Happy New Year — best wishes for achieving all your resolutions…

Spiritual teacher Jaya Row, a microbiologist by training, provides a simple formula for happiness in this article on Timeless Truths which I saw in The Times of India while vacationing in Aurangabad last month.  Here it is: Happiness Quotient (HQ) equals the number of desires fulfilled divided by the number of desires entertained.  She advises that we focus more on the denominator than the numerator of this HQ ratio.   I interpret this as trying to be happy with less, rather than being greedy for more.

While in Aurangabad I came by the tomb of the Mughal emperor Aurangazeb.  His father, Shah Jahan, built the Taj Mahal – the most beautiful building in the world, in my opinion.*   Aurangazeb was an ascetic who followed a particularly austere from of Sufism.  At the ripe old age of 88 the emperor was buried according to his wishes in a simple tomb purchased with money he earned himself by stitching caps.  Sometimes the apple does fall far from tree.  One wonders who led the happier life – Aurangazeb or his father.  Now I think that the Taj Mahal really symbolizes the desires that never can be fulfilled in anyone’s life, that is, a monument to unhappiness.

Ending on a happier note, I offer up this photo of monkeys scampering along the road to Chand Minar, the Tower of the Moon, built by the Mughal conquerors of what came to be known as Aurangabad.

*Another story: While working for General Mills in the mid-1980s as a purchaser of Indian agricultural products, my agent bribed the guard at this monumental set of tombs in Agra to enable a private tour for my wife and I under a full moon and candlelight. Priceless!