It’s a fucking nightmare unfortunately.
I might as well swallow a skittle as pepcid. Omeprazole (prilosec) is a wonder drug for me. Gotta check your kidney function every few years, though.
MM MD
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I’m on Prilosec. But like Hobbes said you don’t want to be on it forever so they were trying me switching off between a prilosec and pepcid every other day. Didn’t work. Back on pure prilosec.
I find that when I eat like shit for a few days, I start getting heartburn every day. When I switch back to eating healthier, it goes away almost immediately. Have you tried mixing in a good amount of veggies, suzzer? That might make a big difference. Especially the ones that are anti-inflammatory and non-acidic.
For 20 years nothing has made a difference, until Mexico. Then I didn’t eat a Tums for 2 months. Explain that.
Heartburn comes in, heartburn goes out. Can’t explain that.
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You did better in Mexico? You’re having trouble now and you’re back in the states, right?
It’s likely related to over processed garbage food. Almost everything we eat that’s in a package of any kind likely has HFCS, a bunch of additives, MSG, etc… Our food is way less healthy than the food in most other countries.
For example, in Spain I ate dessert after lunch and dinner and never felt like I chose a healthy meal. I lost weight on the trip. I did a ton of walking, which certainly played a big role, but I also wasn’t getting heartburn or anything like that - my body felt healthier.
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Are you just checking eGFR?
For 20 years nothing has made a difference, until Mexico. Then I didn’t eat a Tums for 2 months. Explain that.
Try an elimination diet?
I think it was mostly caffeine/coffee. But maybe gluten or something.
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Yeah there’s also people getting weird diseases from gut bacteria transplants. I think I’ll let others be the alpha testers on this brave new technology.
I did lose 10 lbs. doing 200-150-100-50 g of carbs for 10 cycles (40 days). But the second cycle completely stalled out despite me sticking to it just as well. Could have also been the stress of playing too much live poker and running real bad. I’ve backed off that. Stress sucks. I am soooooo ready to quit office jobs forever. Counting the months.
Can confirm this is not conducive to diet, exercise and/or eliminating heartburn.
My understanding is that there could be two different mechanisms in play. One is the effect on hunger and satiety. I think that’s what you’re talking about. For instance, suppose you were to consume 100 kcal snack of Mystery Substance X. Maybe you’d feel full, but a person with a suboptimal gut microbiome may not produce “normal” levels of (e.g.,) GLP-1 and/or peptide YY during digestion, limiting satiety. So they inhale another fun size bag or three of MSX.
The other mechanism is a change in energy conversion and transport itself, specifically fat storage. It’s fairly plausible given what we know about glucocorticoid effects on enzymes involved in fat metabolism. So it may be that Mystery Substance Y produces similar levels of hunger and satiety in both affected and normal people but is very efficiently converted and stored as fat in the former group. This is all a rather infantile area of research afaict. For example, see:
The mice they generated seemed unremarkable while eating a normal chow diet. However, when the researchers fed the mice a high fat, high sugar diet similar to one commonly consumed in the United States – they found something very different.
“We call it the junk food diet. I describe it as like driving through a fast food restaurant for a burger and fries and then stopping off at the donut shop,” she said. “Most mice on that diet become obese. To our surprise, those that had no HDAC3 in their intestinal lining were able to eat a high fat, high sugar diet and stay lean.”
Seems like a decent surrogate. I’d back away from the prilosec pretty if I had to though.
MM MD
This sucks for a bunch of reasons, but it’s easy to blame the evil nursing home operators and ignore the fact that Medicaid type programs in a lot of states pay so little and so slowly that if you try to operate a facility with any significant percentage of that type of patient you’ll go quickly broke. So your option as an operator is to refuse Medicaid patients, which gives them nowhere to go, or take them, go broke and close your doors, which leaves them nowhere to go.
And I’m not saying that there aren’t some awful operators - there are. But even completely reputable nursing homes have this issue.
MM MD
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Or not run basic public servies such as old people homes as a profit making exercise.
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There isn’t much profit to be made running an old folks home. Some, sure, but it’s mostly used by the healthcare industry as a delivery mechanism.
I don’t think old folks homes are going to stop being for profit even under single payer honestly.
They should be. The way they exploit the elderly and the halfassed service they provide is shameful. See ‘Life And Death In Assisted Living’ from Frontline.
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My wife works in the industry and gets to actually see the financials. They aren’t that good… which is a decent chunk of why they are pretty bleak places to live. We pay the front line employees who care for the elderly peanuts and we don’t pay the nurses much better. The business that employs them is lucky to eke out a 10% gross profit margin.
Most of the money goes out to third parties who service the facility and sell it stuff. Medical device manufacturers, drug companies, and doctors pocket the vast vast majority of these people’s medical spend. The facility is usually trying to figure out how to keep the lights on. That’s why most of them suck so much honestly.
If the entire healthcare industry operated on shoestring margins like assisted living and skilled nursing facilities we’d all be bitching about healthcare a whole lot less. But they aren’t. It’s super normal for a nurse to dispense six figures in medicine to his/her patients in a day or two making 40k a year while caring for 30-40 patients at a time.
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