Lessons Learned from My Cardiac Problem

Listen to your Body


OpEd in MetroWest Daily NewS, December 8, 2013.


NO LONGER ON LINE, SO HERE IT IS

Listen to your Body … Please                                                                                                  911 words

Martin G Evans

I didn't.

I first felt mild chest pains when walking in the old square in Wroclaw, Poland. It was an August  afternoon  after my lunchtime nap  On this walk, my aim was to go through the square and under the highway to see and take some photographs of the Renoma art deco shopping center which was about 15 minutes away. By the time I had walked for five minutes from the hotel to the post office on the South East corner of the square I was experiencing some chest pains. Oh, I thought, it's that food and beer I had had  for lunch – attributing, incorrectly, the cause to indigestion.

This seemed to me to be the issue because we had had a strenuous, at least compared to my typical sedentary life, two weeks in central Europe during which I had no problems at all despite long walks in Budapest, Krakow, and Wroclaw.

I sat down and rested and ,after a while,the pains went away. I continued my walk going through the underpass under the main road that circles Wroclaw old town. I got to the department store complex and some slight pain returned. I rested, took my photographs, and then returned to the square for an afternoon snack and then the hotel.  During this time I experienced some discomfort but was able to complete my self-imposed assignments

The next day, the same thing happened at the same time. The morning walking around went without any problem. But after lunch and a nap and soon after I sallied forth for some more photographing: this time another art-deco building.  As soon as I had crossed the square, I began to have chest pains. These behaved the same way as their predecessors, easing when I rested and returning as I continued to walk.

That evening, I casually mentioned that I thought I had some heartburn with all this heavy Polish food..

The next two days were symptom free. On the first, we had a road trip to Dresden so most of the day was being chauffeured around with only a couple of hour of walking. I had no problems at all. The following day we left for Boston. In the morning we walked round the old town for the last time. In the morning, the distance walked that would have triggered chest pains on previous days left me untroubled.  The heavy lifting of luggage at the airports and the heavier lifting of our duty free purchases had no impact on my activity, neither did the six hour flight. I got home without incident.

The next day, Sunday, we then loaded the car for our trip to the my wife's family cottage in central New Hampshire. We arrived at Alton soon after noon. Our daughter and her children were delighted to see us.  We took the new kayak out of its chrysalis; loaded it on top of the car; drove down to the beach; unloaded the kayak. All without any problem.

It was later at the beach that I had my next and most severe chest pains. I started to swim out to the raft, about half way out, I experienced severe chest pains and, if my memory serves, I think they spread to my shoulders. I managed to get to the raft and hung on for a while. I rested. I then started to swim back. Several times I tried to stand so as to rest my arms; but the water was too deep until I had gone a good way to the shore. Stupidly, I did not think of turning on my lack to propel myself with leg kicks. Accordingly I made my painful way to land using my arms. I was worried that I might have had more difficulty but there were lots of people around who could have helped me.

I didn't mention the pains to my wife. That is one of my big regrets. I should have told her. She had a right to know. These pains were an important signal; but I did say that last summer I could swim to the raft and then swim some more parallel to the shore and that I couldn't do it this time.

On Monday in the afternoon I had to go down to the crawl space under the cottage and was crawling around in pretty unusual kind of position; again I felt some pains in my chest. That night at dinner, after the main course was over and the kids had vanished somewhere, I allowed that maybe I had a touch of angina and explained when I had experienced it. Before I could finish speaking, my daughter, an ER physician, had packed me into the car and was driving us to the local hospital in Wolfeboro.

There, after many tests, the medics found out that I had cardiac problems. This was a complete surprise to me as I have had low levels of bad cholesterol all my life and even though both parents had, had heart problems, I thought that their influence on my health would work through the cholesterol level and not through other genetic routes.

I was transferred to the Catholic Medical Center in Manchester for surgery.. They found several blocked arteries. They put a stent in one and since that time I have felt quite well; though, of course, I have changed my eating and exercise habits. Thanks to Medicare, my out of pocket costs have been minimal.

My lessons:

• Listen to your body.

• Act on its messages immediately. I know now that I should have done that in Poland, but I find the idea of being in a hospital where I don't understand one word of the language absolutely terrifying. 

• Tell people about what is going on clearly and precisely – especially your loved ones.

Flaws in Obamacase

Mr. Sununu is right. Obamacare is flawed (Obsmacare fail isn't the site --it's the law. Boston Globe, November 25, 2013).

The flaws are due to the compromises that had to be made in order to get the big insurance companies on board so they wouldn't destroy it as they did the earlier Clinton proposals.

A flawless plan would have been to expand Medicare for all.

I would like to hear what Mr. Sununu would propose. It has been over 50 years since universal health care was introduce in Britain after World War II. Over 50 years for the magic of markets to bring universal health care to all Americans. Clearly markets have failed. What is Mr. Sununu's solution?




Sent to Boston Globe

Fixing Social Security

I am a progressive but I do not take a hard line about making changes in Social Security. I just object strongly to the changes that the President has proposed (Paul Krugman, Expanding Social Security. New York Times, November 22, 2013).).

Although Social Security does not contribute to the deficit, it is not yet on a firm financial basis.There are several ways to improve its finances but the one proposed: adopting the chained-CPI is the one that will harm the poorest recipients most. Chained-CPI does not reflect the reality of price changes that affect seniors. It severely underestimates them.

A better change, on the input side, would be to remove or raise the cap on Social Security earnings.

Paying out, we could change the tax treatment of Social Security earnings. Rich Americans only pay income tax on 85% of their Social Security income. One hundred percent of Social Security income should be included in gross income. The impact on low income seniors would be negligible; on rich Americans it would be a modest increase in taxes.

Paying out, we can also look at the payout rate. Despite being regressive at the paying in stage, Social Security is quite progressive when paying out.  Right now the Social Security formula for computing one's pension depends on Average Lifetime Earnings (ALE). Each year's earnings are converted into constant dollars and then a monthly average is calculated. Based on this, Social Security pays you:

- 90 percent of the first $767 of monthly ALE

- 32 percent of monthly ALE between $768 and $4,624,

- 15 percent of monthly  ALE above $4,625 to the cap of $9,475.

Changing the breakpoints, increasing the number of breakpoints (say new breakpoints at $3,000, at $6,000, and at $8000), or reducing the percentage payout at the highest level would maintain payouts for the poorest in our society, but reduce expenditures to those who can most afford it.

Both of these would affect higher income recipients while leaving the poorest unscathed.


Sent to New York Times

Failed Tax Incentives

 Boston Globe letter

They cut it way back.
This was my original:

I rarely agree with Mr. Jacoby, but his column today was right on the money (The bitter pill of failed state tax incentives. Boston Globe, November 6, 2013: A15).

Giving tax breaks to big business (like BioTech firms, Theatrical Producers, Movie Makers, Insurance Companies, etc.) to encourage them to locate in a given area is a beggar-thy-neighbor proposition. Often, as in New London, CT, the jobs never materialize, or they last only a short time as in Devens, MA and Providence, RI.

Some years back, the legislature passed an inter-state compact (National Popular Vote) to bypass the Electoral College to ensure that the President is elected by all the people. We urgently need an inter-state, inter-city, inter-town compact that will disallow these ridiculous handouts to the wealthy top managers of corporations seeking tax breaks.

Alternatively, perhaps the Federal Government could ban the practice nationwide by invoking the Commerce Cause.

It is past time to say "No" to the corporate welfare bums (Quote from former Canadian New Democratic Party leader, David Lewis).

There is a role for adjuncts in the academic community. When the University's local environment contains a person with a special expertise. In such a case, the education experience of the students is deepened by having such a person teach a course in her/his specialty.

However the practice of employing adjuncts as major contributors to the University's teaching function is appalling. As well as the economic and psychological divide described by Mr. Hoeller (New York Times, November 13, 2013: A26) there are two other dysfunctional consequences.

First there is a smaller pool of talent on campus to draw on for administrative duties. However, those who think that the University has too many administrators would probably not see this as a disadvantage if it resulted in a reduction of he administrative echelon.

Second, the University is in the business of creating as well as disseminating knowledge. Have a large number of faculty whose responsibilities do not include research diminishes the research production and hence the development of intellectual seed corn for the nation's future.

We mus return to the days of specialist adjuncts rather than those who are generalists even if they are better teachers than the tenure stream faculty.



Sent to New York Times

Efficient Markets and Food Labels

You are wrong to endorse the voluntary disclosure of Genetically Modified ingredients in the food we eat (Labels for Controversial Ingredients. New York Times, November 8, 2013: A28).

The underlying condition for effective markets is full information.

Consumers need to be told in order to make an informed choice. That is what the free market demands.



Sent to New York Times

Moral Equivalence? Hunger.

Charles Blow (October 26: A19) reports that one in four American children live in poverty.

Reporting from North Korea, Choe Sang-Hun (October 26: A4  )tells us that "more than one quarter of North Korean children under age 5 live with chronic malnourishment."

This is certainly not a time to cut Food Stamp funding.


Sent to New York Times