North Pole Weather

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The sun rose this morning at 5:49, long before I did, and will set over 16 hours later at 9:52 this evening. It’s only 3 more days until we lose astronomical twilight, and the sun never dips more than 12° below the horizon.

The last of last year’s local carrots. They’re a good inch through, but so tender I can eat them whole.

It’s finally warmed up and started to feel like spring, or as much as it can with over 20” of snow still on the ground. But we have icicles and puddles, and the birch tree outside my north window is surrounded by seeds dropped onto the snow. Natural selection in action: birch trees that hold on to their seeds until they can drop them on the snow have the snow melt faster around them, which in turn means the soil warms faster. Smart birches!

There are more signs of spring. The Farmers’ Market is taking applications for vendors, and the first market is scheduled for May 11, though of course the first week or two will be mostly handicrafts, not produce! Even garden starts are likely to wait until it warms up a little more. I’m thinking of trying Horse Power in CreateSpace, both to learn what’s involved and to have it to sell this summer at the market.

It will likely be well into July before carrots show up, though, and I’m eating the last of last year’s, bought at the Christmas Bazaar put on by the market. I don’t know how they got them to keep that long, as they must have been harvested in September at the latest. I’ve just kept them in the refrigerator, and they are still crisp and far sweeter than any I can buy at the supermarket. Alaska grows really good carrots; it’s too bad our season is so short.

Chocolate

Happy Valentine’s Day!

Food and Drink in the Jarnian Confederation

This post is part of the World Building Blogfest. Click on the logo to find other participants.

Food

As a purely practical matter, food is very important to R’il’noids using their esper talents. These talents are not used without effort. In particular, the laws of conservation of energy, conservation of momentum, and conservation of angular momentum apply to levitation, telekinesis, and teleportation. Although much can be accomplished by counterweighting (moving an external mass in such a way that the net change in energy, momentum and angular momentum are zero) the energy required for esper work is considerable and R’il’noids and the R’il’nai are notorious for always being hungry. This is particularly true of Healing, where the energy used cannot be offset by counterweighting. The rule is “carbohydrates before intense esper work; protein after.” Failure to comply can lead to hypoglycemia (insulin shock) and loss of consciousness. Espers normally carry tubes of honey.

Physical meetings of the Inner Council are always accompanied by high-calorie finger food. Tastes vary, but the food usually has plenty of sugar or honey, often combined with fruit, cream and pastry. After a meeting, some kind of rich soup is in order.

Most food preparation is automated, but there are restaurants with human-prepared food, and experts who develop new dishes and the programs to prepare them.

Individual planets vary greatly in their cuisine and the ingredients available. Marna on Riya lived mostly on wild fruit and nuts, fish, and the produce of her garden. Several of those plants (tika berries, haro nuts, pala fruit, frostberries) were later introduced to Central. Falaron (Terraformed form Earth during the Pleistocene) offered auroch steak and roast peccary. Ethnic restaurants from all over the Confederation abound on Central, while the people of Eversummer, where all imported animals died off very early and the native animals are toxic, live mostly on yams, legumes, cassava, fruits, nuts and grains. (They also eat their dead as a religious rite, and Marna suspects that this developed partly because their diet lacks complete proteins.)

Drink

Non-alcoholic beverages include a wide variety of fruit juices and herbal infusions, some with considerable caffeine. (This includes what we would call coffee and tea, both imported from Earth.) Chocolate was imported from Earth quite early, and is used in a variety of beverages. (I know, chocolate is not native to Africa, but the people who followed Jarn found possible food plants on a number of continents.) Milk and cream from a variety of mammals is used in beverages as well as sweets. Of course water is drunk almost everywhere, though in some places (such as Eversummer) pretreatment is needed.

Alcoholic beverages are even more varied. Just about anything with carbohydrates can be used to make an alcoholic beverage, and is on some planet or other. Wine from grapes is probably the most popular among the R’il’noids, and here a peculiarity of their metabolism must be mentioned.

Most R’il’noids have an enzyme in their saliva that breaks down alcohol even before it can be swallowed. Alcohol taken by mouth literally cannot intoxicate them, though most enjoy the complex flavors and aromas of fine wine. In fact, alcohol serves as an excellent fast energy source.

At the opposite extreme some ethnic groups completely lack the ability to metabolize alcohol. One such is the Clan, a starship-based culture spending their entire lives on starships, and making a living by trade. Clan members are notorious for having no head for drink, and can become addicted to alcohol very easily. I have one character from this group, and his taste for alcohol is part of the plot of Tourist Trap.

Weight Gain

“Calories in – calories spent = weight gain.” Sounds simple and rather obvious – conservation of energy, right? But as applied, it makes some rather bad assumptions. And as many will testify, it doesn’t seem to work.

To start with, caloric input is NOT the same as the calories you eat. To some extent this is recognized. Cardboard has calories, but there is no way a human body can use them. While fiber (cellulose or soluble fiber) is often excluded from calorie counts, even digestible calories may not always be digested. The true caloric input is the calories your body is able to turn into glucose and lipids in your blood stream. I suspect that people vary quite a lot in how efficient their digestive systems are, and that may even vary with time for the same person. Certainly variation with time could help explain the “set point” for body weight.

Inefficiency in our digestive system? There are digestible calories in what comes out the other end, and not just in diabetics who lose sugar in the urine. Pigs and dogs scavenge human feces, among other things, if given a chance. It is the difference in calories between what we eat and what comes out that is the important energy input, and there has been very little study of how much that form of energy out might vary.

Then there is energy usage. Certainly exercise, even walking, burns more calories than simply sitting. But it takes energy to keep our body temperature up, our heart beating, our lungs expanding and contracting, and especially to keep those big brains operating. Sitting as quietly as you can in a cool room may burn a good many calories, though I wouldn’t recommend it as a way to lose weight. (It is, however, recognized as one of the reasons people working in the cold may need more calories. If your body is very efficient at all these “housekeeping” tasks (low basal metabolism) you may need fewer calories to maintain constant weight than someone whose basal metabolism is higher.

For that matter, some people may use their bodies in exercising more efficiently than others.

I strongly suspect this is an oversimplification of what seems to be a near-epidemic of excess weight. I certainly wouldn’t argue with the idea that something in our environment (including our food environment) is tinkering with the efficiency of our digestive processes, though I suspect serving size has a lot to do with it. But why don’t we ever consider calories out? It would be simple enough in test animals, if not in humans.

Guest Blog #IAN

A very quick note. I have a guest blog up on But What Are They Eating about some of the foods my characters eat–and why those using esper talents must eat so much to avoid low blood sugar.

Three Approaches to Health Care

There are three ways of approaching less than optimal health: prevention, treatment and cure. All have their strong and weak points; all are political hot cakes at the moment.

I think most individuals and societies would agree that the best solution is to stay in good health. It is also a solution that is not always possible. It is, however, the approach that is responsible for the dramatic drop in childhood death in developed countries.

Prevention measures are generally lumped as public health. Clean drinking water, proper sewage disposal, nutritious food, clean air and immunizations all fall into this category. So do measures intended to reduce accidental injury or death (such as seat belts) and those encouraging a healthier life style. Prevention would also include such highly controversial measures as not passing on genes known to have a deleterious effect on health.

In general prevention measures are good for the population, but affect individual choice. They may also affect the bottom line of corporations with a great influence on public policy, such as the food industry.

Some of what I need for treatment of diabetes. I want a cure!

By treatment I refer to ongoing treatment — the pill (or shot) for everything or treatments such as dialysis which must be repeated regularly for the life of the patient. Certainly it is better to have a treatment than not! I am alive today thanks to insulin. But treatment is generally expensive and is often lifelong. Further, treatment of this sort almost always has undesirable side effects. In my case, insulin can produce hypoglycemia which can kill. It should be noted that some “cures,” such as organ transplants, may then produce a condition in which lifelong treatment (anti-rejection drugs) is needed.

A cure implies a return to normal health. In some cases (such as the common cold) a cure is mainly a matter of time, with supporting treatment to prevent secondary infections or ease symptoms. Some cancers are curable with surgery, especially if caught early. Broken bones or other traumatic injuries can often be cured, especially in the young. A number of conditions, however, have no cure. Research on cures is ongoing, but the profit from a true cure is usually not as great as from lifelong treatment. Given that most health research today is profit-driven, research on cures tends to take a back seat to research on treatments.

I’ll probably return to this in the future, looking at one of the three approaches at a time. For right now, how would you order the importance of the three approaches?

Contuous Glucose Monitors

Continuous Glucose Monitors (CGMs) are a relatively recent development in diabetes control. They are still controversial with many insurance companies, though prevention of even one high-cost ambulance trip to the emergency room should make them cost-effective. But they do have problems.

There are three devices that I am aware of, worldwide, and others in development. The best, according to users, is the Navigator – but it has been withdrawn from the US market. This leaves the Dexcom and the Medtronic sensors. My own experience has been entirely with the Medtronic sensor, but all three work in basically the same way, on interstitial fluid, and all are subject to the same problems of time lag.

Medtronics transmitter (white) and the visible part of the sensor (clear) with a U.S. quarter for scale. I use IV 3000 to hold everything in place.

The sensors available today consist of some kind of reusable transmitter, a receiver, and a disposable needle which injects a small disposable sensor under the skin. The sensor is then connected to the transmitter, which lies against the skin.

The sensors are expensive. The price today at the Medtronic store is $42 a sensor, with an official life of 3 days. (Most people actually manage to use them longer, and in fact I find they are most accurate on days 3-5, though I rarely get one that lasts more than a week.) The big advantage of the Medtronic system is that the Medtronic insulin pump (the kind I have) acts as the receiver, though separate receivers are available. The official life span on the Dexcom sensor is 7 days, though I understand they are correspondingly more expensive. Comments from users of the Dexcom are solicited!

A continuous sensor is extremely useful in that it allows you to see how your blood glucose varies between finger sticks, and also allows you to see whether it is rising, falling or staying reasonably constant. The Medtronic sensor allows you to choose whether to see a 3-hour, a 6-hour, a 12-hour or a 24-hour graph of your blood sugar, or download values about 5 minutes apart to a computer, and I believe the Dexcom sensor is similar. On the negative side, CGM accuracy is highly variable, and it needs regular calibration with a finger-stick meter. There is a further problem (at least with the Medtronic system) with alarms.

I used to eat protein bars for breakfast. They had a good balance of protein, carbohydrate and fat, they took no weighing, and they were consistent day to day. They also produced a considerable spike in blood sugar in the hour after breakfast, easily identified on the CGM graph but missed in finger-stick testing. When I switched to Greek yogurt with fruit, also a good balance of protein and carbohydrate but without the fat, my blood sugar graph leveled out. In fact, the CGM has allowed me to identify many regular meals as causing spikes or delayed rises in blood sugar. (The fat in the bars was not the problem; in fact fat delays the absorption of carbohydrates, but much of the carbohydrate in the bars was fast-absorbing sugars.)

I am not alone in finding trends more useful than absolute numbers. A high blood sugar (within reason) is not really a problem if the blood sugar is decreasing, nor is a moderately low reading with an upward trend. On the other had, a high reading going up or a low reading going lower is cause for immediate finger-stick confirmation and treatment if the reading is confirmed. A low reading at night or if I’m planning to drive is always reason for finger-stick confirmation.

What the sensor actually measures is a slight electrical signal, and this must be calibrated with a finger stick measurement to get the actual blood sugar reading. The calibration constant changes over the life of the sensor, and can drop very fast toward the end of sensor life. Consequently the sensor must be calibrated a minimum of twice a day, preferably when your blood sugar is fairly steady, and may give a lot of false low alarms near the end of its life.

Another problem is that the sensor measures the glucose concentration in the interstitial fluid, that is, the fluid between the cells. While this follows blood glucose, there is a significant time lag. My blood sugar can drop very rapidly, especially during exercise, and as a result CGM measurements during exercise can be much higher than my actual blood sugar. This time lag alone makes me very dubious about using this type of sensor for any closed-loop artificial pancreas.

My biggest complaint with the Medtronic system is the alarms. Ideally, to be most useful the CGM system should wake you up if your blood sugar starts to drop. In fact, the alarm is so low in volume and so high in frequency that I almost never hear it unless I am in a very quiet environment and there is only a layer of cloth between my ears and the pump, not a down comforter. This is partly my hearing, as others will sometimes point out to me that I am beeping. Yes, it does start vibrating eventually if I do not respond, but I feel the vibration only if the pump is tight against my skin. I usually feel it driving (well after I start going low) but often not at night.

Is it worth it? Yes, for me. But it definitely needs some improvements.

Measuring Blood Sugar

Back in the middle of the 20^th century, long before I had diabetes or even thought much about it, I saw a magazine ad that talked about diabetes. It might have been an insulin ad. What I do remember was that it featured a Russian troika – a three-horse hitch – and likened controlling diabetes to driving a troika. Three things have to be balanced: insulin, food and exercise, and misjudging any of the three can throw you to the wolves.

That balancing act is hard enough today, with all the tools we have to help. It was a lot harder 42 years ago, when I was diagnosed. And I hate to think of what it must have been like at the time of the ad.

The key is being able to keep track of your blood sugar. Really high, and you need insulin – exercise may actually push you higher. A little high, and aerobic exercise may bring you down. Too low, and you need food, preferably fast-acting carbohydrates. But at the time of the ad, measuring blood sugar meant several hours of lab work, and you might hear back from the doctor the next day. In order to utilize food, insulin and exercise optimally, you have to have some idea of what your blood sugar is right now, and whether it is rising or falling.

There are some symptoms. Sweating, shaking, blurred vision, and tingling lips can all be symptoms of low blood sugar. They can also be due to other things. (I was put on hormones at menopause primarily because I could not tell the difference between a hot flash and low blood sugar.) But those symptoms tend to decrease with years of living with diabetes.

Symptoms of high blood sugar are even subtler. I may start feeling a little odd when my blood sugar is three or four times normal, but my feelings were certainly not enough to tell me when I was high. Anyway, in those days doctors normally prescribed a fixed amount of insulin and a fairly rigid diet, and pretty much ignored exercise.

My current glucose monitor

What was desperately needed was a way for diabetics to find out what their blood sugar was, preferably without slashing their fingers with a modified razor blade. (That’s how they used to get blood samples.) Eventually, and over the initial objections of some physicians and regulatory agencies who were afraid that patients would self-treat, glucose monitors were developed. From the point of view of most diabetics, the objections were just plain silly. We have to treat ourselves. We give ourselves shots of insulin (which cannot be taken by mouth because it would simply be digested.) We exercise. We eat. Doesn’t it make sense that the more we know about which of the three we need, the better?

The first monitors were reportedly large, clunky and slow. They improved rapidly, and by the time I got my first one, in the late ’80s, they were pocket sized (if you had large pockets.) My testing kit today fits easily into the belt pouch I use as a purse. I still have to poke my fingers many times a day, but I get results in five seconds. One important thing is not covered, though – I can’t tell whether I’m going up or down from an instantaneous reading.

There is also a problem of expense. Tight control means testing before each meal, at bedtime, before you drive, regularly during driving, and every 20 to 30 minutes when exercising. Test strips are not cheap, and there is a real problem getting insurance companies to cover enough strips.

I’m not the only person with diabetes to feel this way, and there’s been a good deal of research on continuous glucose monitors. The first one I tried was the glucowatch. This used a patch sensor on the arm or wrist, and gave the blood sugar on the “face’ of the watch. It could also be read by a computer. Drawbacks? Many. First, it would only operate for 12 hours, and took a while without readings to initialize. Second, the patch was very irritating to my skin. I invariably had a major welt that lasted a week or more when I removed the watch and patch. Third, any sweat made the readings unreliable – and sweating is a symptom of low blood sugar. The watch did confirm that I was having low blood sugars at night and that I responded by “bouncing” high – a fairly common reaction, and much better than staying low with possibly fatal results. But the combination of problems led me to stop using it.

Modern continuous glucose monitors are much better, though by no means perfect, and I’ll talk about them, and the problems with getting insurance companies to cover them, in the future.

Jarn’s Journal Day 360

Day 360

I am beginning to wonder just who rescued whom.

I am not an explorer. I have never, before this year, had to cook my own food. Oh, I knew that cooking would make the nutrients more available, and that fire could be used to cook food as well as frighten away animals. And it was no problem, once I found stands of trees and dead wood, to teleport wood to the vicinity of the shelter, where I have a fairly substantial pile. I even found a straight stick of the right length to allow Songbird to hobble around while her leg is healing.

But I know just one way of cooking. That is to hang the item to be cooked over the fire. This results in food that is raw inside and charred outside. Songbird put up with this for about three days. The fourth day, she dug a hole in the ground and lined it with large leaves. When I came back with a large fish for our dinner, she grabbed it and demanded the knife I’ve been cleaning my catches with.

She proceeded to clean the fish, a good deal faster than I do. She then stuffed it with a number of plants I didn’t get too close a look at, and told me to transfer about half of the coals from the fire she’d started – I’d shown her how to use my sparker – into the pit. Next thing I knew, she was lowering a muddy package into the pit, scooping the rest of the coals on top of the package, and piling hot rocks over it.

“That was our supper!” I sputtered.

“Good,” she agreed. “Sun touch trees.”

By the time the declining sun had almost reached the trees on the horizon, the odors seeping from the pit had my mouth watering. Nor was it a vain promise. When Songbird uncovered her muddy package, it had hardened into a shell around the best fish I have tasted since I crashed here.

“Good?” she asked.

“Very good,” I replied.

She looked as pleased as Patches with a fresh bone. “I cook. I can’t hunt, but I prepare. You hunt? Bring plants I need?”

“Tell me what you need, and I’ll find it,” I assured her. I wouldn’t know her words, but as long as she visualized what she wanted, I was confident I could find it.

Nor was pit-roasting her only way of preparing food. Today she took a gourd, filled it with leaves, berries, tubers, bones and chopped meat from last night, and then dropped hot stones in to heat the water. Again, I had doubts, which were rapidly assuaged by the odors rising from what she had prepared.

Tomorrow I have to ask her why she was left alone. Surely they could have done something for the leg other than abandon her!

Fairbanks Weather 8/29/11

The sun rose at 6:18 this morning, and will set at 9:24 this evening, for just under 15 hours of potential sunlight. The sun is not quite 35° above the horizon at noon, but it now gets almost 16° below the horizon at solar midnight. Patchy clouds today, but there is still no frost in the forecast. Not that I haven’t gotten out the row covers, or that I’m not keeping a careful eye on the forecast nighttime temperatures!

The wax beans (the ones planted first) are growing faster than I can harvest them, as are the beets. The green beans, the ones I planted late, are in blossom and are showing their first tiny beans. If the frost just holds off for another couple of weeks, I might get a harvest from them. Zucchini? I think another trip to the food bank is in order. At least it’s not like one year when they refused to take any more zucchini!

On their way to the food bank. Those are 8"x16" pavers, for scale.

I really need to take some time off from the internet and trim up and fertilize the plants I plan to bring in for the winter. I have several pots and hanging baskets of geraniums, a hanging basket of fuchsias, and that “Arizona” rose to bring in. And I need to clean up the plant room, too. Funny how retirement (and trying to market two books) leaves you with so little time.

P.S. at 1:30: the sky is clear blue without a cloud in sight, and the obscenely large zucchini (Hey, how much can one person eat?) are on their way to the food bank.

P.P.S. 5:00: I knew I shouldn’t have said without a cloud in sight. Cumuli are building up all around, though it’s still clear overhead. The food bank was happy to have not only the obese zucchini, but several empty boxes I wanted to recycle. If your garden is overproducing, consider your local food bank.