HEALTHMAN_By Keith Torkelson MS_UCD Educated Pathology: Double XX – Nutrition – Celery Diet – Digital Appointment

Source Document

11_REN_Nutrition_17102306-Celery Diet V2018
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Feature Image – “Scale”

Blog – HEALTHMAN
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Blogger Title

Double XX – Nutrition – Celery Diet – Digital Appointment – By Keith Torkelson (2018)
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Google Plus Information

Central City Community Health Center – Energy Metabolism - Review of Findings – EQR - MSG Pathology for AVEY (201809)

Charter Date – 20180907-F

Authorship – KE Torkelson MS UC Davis Pathology

Editor – AVEY (MSG-2018)

Partners

Update Celery Diet

Table – CaseNotes – Sample of Doctor Errors - Needing Correction

Routine Yearly Physical Examination with Chester D Mojica MD (CDM)

Celery Diet Update V Diabetes (Doctors Impressions)

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Declarations About	CDM (MD)	Actual
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Weight	Says you’ve “gained weight” Your weight is problematic	Exam Day 20180927-TH Nurse weighs us at 142 Pounds Actually our target weight for 2018 is 145
A1c	Says A1c is 6.1 and problematic Says we are “pre-diabetic”	Most recent A1c 20180809 Quest Diagnostics Report A1c = 5.3 Well within normal range <5.7

Table – CaseNotes – Needing Correction – Encounter Physical – 20180927-TH – Last Reviewed: 20180928-F:

Treatment Plan for Pre-diabetics

Doctor Mojica is now tying us some of our meager resource with a treatment plan for Pre-Diabetics. It is in our best interest to follow up in order to get the erroneous records CDM referenced corrected. For now we will busy ourselves about both Treatment Plan and corrective actions. This nutrition aspect of ours was supposed to be a slam dunk. We did not expect him to make fall allegation. We were ready to give CDM one of our best reviews yet. We pretty much have little “Confidence” in him anymore. You might wonder why we don’t seek to be referred away. There is method to our madness to stick it out with doctor CDM.

Abstract – Executive Summary

After we publish this report we will be 2/6 or 1/3 of the way through what we planned to publish as a digital appointment. The date of our Physical Exam is scheduled for September 27 2018. This will be our 6^th Physical with our Primary Care Physician Doctor Chester D Mojica. In this report we focus quite a bit on Managing our Blood Glucose Level (BGL) and A1c. As of 20180809 our BGL as reported by Quest Diagnostic Lab is 97 mg/dL. This value puts us at a High Normal for BGL. On the same lab report dated 20180809 Quest Lab offers us up a 5.3% of total Hgb for our A1c. This value puts at a High Normal. During the last year 2017/18 we get credit for a manual Health Information Transfer (HIT) requested by our Ophthalmology provider. The HIT was from Ophthalmology to PCP. In this report we also address an online utility (APP) called RealAge. RealAge takes into consideration many of one’s health related shortfalls and delivers an adjusted age or RealAge. On 20141221 we last tested our RealAge. Our calendar age was 55 years. Our RealAge that was reported back to us via the internet was 63.9 RealAge Years (RAYs). As of 20180902 our weight as measured by a bar scale is 142 Pounds.

New Feature Scales – Health Habits Forming

We are proud of our weight in response to Behavioral and Nutritional changes. For this study we derived two (2) assessment tools. Our Health Habits Forming Tools, one for nutritional habits (HHF-N) and the other for behavioral habits (HHF-B). On 20180201 (TH) we gave both a try. Our HHF-N score was 100% while our HHF-B score was 81%. High scores are promising. On 20180831 (F) we took another go at it. . Our HHF-N score was 83% while our HHF-B score was 69%. High scores are promising. Near the end of this report are some worksheets to collect: Measurement outcomes, health Indicators, test results etc. We are preparing to update our RealAge Profile. Last here in the summary we address an MSG Concept - Health Related Engagements (HREs). We participate in two types of HREs. The first type is in-network engagements. Basically if our insurer, Brand New Day (BND) is involved we classify the appointment or whatever as an in-network engagement. All else that involves health related dialogue or monologue of an hour or more we classify as an out-of-network HRE. As of 20180905-W we have attended to 40/40 in-network HREs. Up next and possibly the last report in this year’s Physical Health Digital Appointment Series is our investigation about and into COPD.

Units

“mg/dL” - Milligrams per Deciliter

“mmol/L” - Millimols per Liter

Tables - Acronyms/Acrocodes (0-Z)

Table - Acronyms/Acrocodes (0-L) – Table 1 of 2

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Acrocode	Meaning
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A1c	Variant of Hemoglobin
ACV	Apple Cider Vinegar
APP	Application
BGL	Blood Glucose Level
BMOH	Behavioral Markers Of Health
BND	Brand New Day
BP	Blood Pressure
CALC	Calculation
CBC	Complete Blood Count
CCCHC	Central City Community Health Center
CDA	Celery Diet Approach
CMP	Comprehensive Metabolic Panel
COPD	Chronic Obstructive Pulmonary Disease
DRP	Data Reported Previously
EM	Emergency
FAV	Favorite
FE	Fully Executed
Hbg	Hemoglobin
HHFS-B	Healthy Habits Forming Score (Behavioral)
HHFS-N	Healthy Habits Forming Score (Nutrition)
HIE	Health Information Exchange
HIT	Health Information Transfer
HPE	Health Promoting Efforts
HRE	Health Related Engagement
HRE-IN	Health Related Engagement – In Network
KES	Key Event Summary
LNV	Low Nutritional Value
LT	Left
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Table - Acronyms/Acrocodes (0-L) – Table 1 of 2

Table - Acronyms/Acrocodes (M-Z) – Table 2 of 2

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Acrocode	Meaning
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MOH	Markers Of Health
MOMM	Markers Of Mental Health
MSG	Mentalation Solutions Group
ND/NR	Not Done/Not Reported
OCT	Optical Coherence Tomography
PCP	Primary Care Physician
PHR	Personal Health Record
POMH	Markers Of Physical Health
POV	Person Of Vintage
PRN	As Needed
RAT	RealAge Test
RWV	Red Wine Vinegar
RX	Medication
STR	Structured Temporal Reconciliation
SUS	Sustained
UCD	University of California @ Davis
UCSD	University of California @ San Diego
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Table - Acronyms/Acrocodes (M-Z) – Table 2 of 2

Table (2) - List of Tables – Matrices – Figures

Tables - Acronyms/Acrocodes (0-Z)

Table - List of Tables – Matrices – Figures

Table - Digital Physical – Article Format

Table – Digital Physical - Blog Format - Related Blogs Associations – Physical Cluster

Table - Our Goals 4 Our Celery Diet (Brief)

Figures – Lab Results – Carbohydrate Metabolism - Time Series (08/09/2018)

Table – Key Events – Inception - Celery Diet

Table - Doctor List - Pertinent

Tables (3) – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Table - Carbohydrate Metabolism Related Labs – Transformed Results

Tables (3) – Nutrients and Other Consumables

Table – Glycemic Indices

Table – Roizen MDs 80/20 Rule (16 Hours Awake) – Applied

Matrix - Calculation Helper @ “endmemo” - Just 4 Fun (J4F) – Micronutrients

Matrix - Weight Summary – Lifetime History – Keith Torkelson

Matrix – 20-Month Weight Change Summary – Keith Torkelson

Figure – RealAge Report (12-21-14)

Table - Nutritional Changes between Glucose Tests

Table - Behavioral Changes Between Glucose Tests – Health Habit Forming

Table – Nothing is Easy - Risks and Complications

Appendix – Work Sheets for RealAge (ShareCare) Update

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Table - Digital Physical – Article Format

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Article	Primary Blog	Fully Executed
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Hub	AnimaCules
Celery	HEALTHMAN	20180907-F
COPD	BND
PHR/Patient Portals	HEALTHMAN
Tests	Clozapine RX	20180831-F
HRE	AnimaCules
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Table - Digital Physical – Article Format – Last Reviewed: 20180902-SUN:

Table – Digital Physical - Blog Format - Related Blogs Associations – Physical Cluster

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Blog	Primary - Post	Secondary - Post
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Animalcules (Hub)	Homepage	HRE
BND	Portals
Clozapine RX	Lab Testing
HEALTHMAN	Celery	COPD
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Table - Related Blogs Associations – Physical Cluster – Last Reviewed: 20180831-F:

Qualification (Partial)

[INSERT NUTRITION PERFORMANCE]

Table - Our Goals 4 Our Celery Diet (Brief)

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##	Goal	Status 20180904-TU
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01	Avoid Pharmacologic Intervention(s)	Yes
02	Control A1c	Good
03	Control BGL	Progress
04	Find save and cost effective fiber source	Yes (Celery)
05	Fit in old clothes	For most part
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06	Make in easier to sustain our PE programs	No
07	Move our BMI into normal range	Yes
08	Not have to self-test BGL	Yes
09	Positively impact our CBC results	Progress
10	Promotion Vehicle	WorldWafers
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11	Reach/Sustain our target weight	Yes (145)
12	Reduce fatigue	Progress
13	Reduce waistline	40 à 34 à 30 à 29 Fully Executed
14	Stay Vision Problems	“Excellent”
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Table - Our Goals 4 Our Celery Diet (Brief)

History of Celery Diet (Brief)

Our Celery Diet idea began over ten (10) years ago when we were looking for a cost effective natural source of fiber. As a kid we on and off ate peanuts in the shell whole. About ten (10) years ago we experimented with whole peanuts again. In our Avian Nutrition course we remember the instructor saying that peanut shells could be toxic. “Aflatoxin is the name for a group of toxins (carcinogenic compounds) that are produced by two fungi called Aspergillus flavus and Aspergillus parasiticus. These toxins occur naturally and have been found in a wide range of commodities (including peanuts) used for animal and human consumption." When examining the inside of the shells, a good proportion of shells have a blackening inside. Aflatoxin can damage you liver. We set our fiber pursuit aside for a while.

Began Celery Component – Summer 2017

Looking back in our notes we began our Celery Diet Experimentation (CDE) just over a year ago. Our motivation was that we wanted to control our Glucose Toxicity issues. We wanted to protect our vision. As an incidental we lost a few pounds.

Special Topic - Featuring Our (MSG’s) Celery Diet

Metadata à TTS_Digital_Appointment_17072006_F2F 4 Energy

Our new and improved Celery is not just eating celery. Celery is central to quite a few nutritional modifications that brought our Blood Glucose Level (BGL) under control within about three (3) months. We achieved satisfactory BGL without the need for any pharmacological intervention. We were reading on ShareCare, an online medical information broker, that we made have been too aggressive. They indicate it may be OK to cheat 20% of the time. Dr. Roizen (ShareCare) calls this 80/20. We decided not to give away our detailed Celery Diet Approach (CDA) at this time. Below are measures that indicate our CDA was efficacious.

Celery Diet

On 12/27/2016 we weighed 165 pounds. On 10/23/2017 we chartered our “Celery Diet”. As of 8/21/2018 we weighed in at 143 pounds (un-calibrated scale self-measure). Our proximate purpose for dietary (behavioral) changes was to get and keep our Blood Glucose Levels (BGLs) under control. Our distal purpose for dietary changes is to protect our vision.

Metadata à 11_Global_Health_Weight_Related_18080803_Data

Metadata à 11_REN_Nutrition_17102306-Celery Diet V2018

[INSERT QUEST ABOUT BGL]

Figures – Lab Results – Carbohydrate Metabolism - Time Series (08/09/2018)

Figure – Lab Results - Glucose (Blood Glucose Level (BGL)) (08/09/2018)

Figure – Lab Results – Hemoglobin A1c - (A1C) (08/09/2018)

Special Topic - Polygenic Carnivore

In the beginning (1960s) eight (8) of eight (8) of our family members were carnivorous. Our carnivore trait has undergone many tests. In 1996, the United States Department of Agriculture (USDA) hired us on. Our role was a “Slaughter Inspector”. One day while working "Beef" we were asked to stay after our shift to observe the purple ink USDA Inspected stamping. Twenty-five (25) or so sides of beef and smaller cuts were hanging in the chill room. After touring about the smaller cuts, we went home with an appetite for beef. We have a belief that when you perform research on live animals and you sacrifice them – it is wise to eat the meat. In 1986 we performed research using live turkeys. After the experiment was done and the muscle tissue was wholesome we packaged breasts and thighs for others as well as us to enjoy. Makes sense huh (Judge Fusion, 2018).
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Table – Key Events – Inception - Celery Diet

Metadata à TTS_Digital_Appointment_17072006_F2F 4 Energy

Celery Initial: 20171023-M:

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TimeStamp	Item	Theme	Note
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20170623-F	Onset of Left Eye Problem	Detached Retina
20170722-SAT	Lipids – Lipid Panel	Effect of Statin	All in Range
20170722-SAT	Blood Glucose	Result - 103 mg/dL	>99 mg/dL Elevated
20170722-SAT	Behavioral Changes
20170722-SAT	Change in Weight
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Table – Key Events – Inception - Celery Diet

Table - Doctor List – Pertinent - In Scope

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Doctor	Specialty	Note
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Bera, Rimal B	Behavioral Health	New January 2018
Boyce	Ophthalmology	Cataract Survey
Inman, Ann	Optometry
Mojica, Chester D	Family Med/PCP	Physicals (2012-2018)
Roh	Ophthalmology	Retina Surgery
Taban	Ophthalmology	EM Exam
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Table - Doctor List - Pertinent – Last Reviewed 20180905-W:

Tables (3) – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Table – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Table – Doctor List – Associated with (LT) Eye Crisis (2016 & B4)

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Time Stamp	Event	Note
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197812	LT Eye Blunt Trauma	Student @ UCSD Pre-disposition set up
2016	DX Cataract

20160920	Boyce - Cataract Surgery	Increase Risks for LT Eye Vision Problems
20160920
20160921	Boyce Exam	HIT Manual Requested Boyce to Mojica
20161010	Boyce Exam
20161108	HIT Handed to CDM
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Table – Doctor List – Associated with (LT) Eye Crisis (2016 & B4)

Structure Temporal Reconciliation (STR)

We here at Mentalation Solutions Group (MSG) have been developing a promising practice we call Structures Temporal Reconciliation. It is a form of psychological reframing. We came across and article, Structured Case Analysis (SCA), in a legal journal. One SCA element is that the paralegals develop a chronology. The anchor for our STR is the Time Stamp (Temporal Component). The timeline above and that follow were generated while practicing STR. One of the features for STR is re-discovering lost facts. Here the fact that we were looking for was our initial motivation for implementing and sustaining our Celery Diet.

Table – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Table – Doctor List – Associated with (LT) Eye Crisis (2017)

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Time Stamp	Event	Note

20170606	Inman Exam	Floater & Instructed Decrease Vigilance
20170623	Self	Onset LT Eye Problem
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20170624	Self	Onset of Blindness Can’t Drive Car
20170627	Drs Taban > Roh	EM Exams
20170628	Roh	EM Retina Surgery
20170706	Roh Reports	“Really Fantastic”
20170707	Self	Learn to Drive Again
20170831	Roh Exam	Inc OCT Scan
20170908	Self	First Long Drive Fallbrook
20170913	Physical Lab (?)	Results
20170914	Team Martha	Pre-physical
20171010	CDM	Physical
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Table – Doctor List – Associated with (LT) Eye Crisis (2017)

Table – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Table – Doctor List – Associated with (LT) Eye Crisis (2018)

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Time Stamp	Event	Note

20180426	Roh	Post Op Exam Outcome of Retina Concerns
20180710	Inman	Optometry Exam
20180725	Inman Ofc Glasses Specialist 1	Wrong Glasses
20180827	Brand New Day (BND)	Glasses Denial Notice
20180828	Inman Ofc Glasses Specialist 2	Computer Glasses
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Table – Vision - Key Events Summary (KES) – Issues About Left Eye (STR)

Correlation – Physiology – Glucose Diabetes and Vision

Facts About Diabetic Eye Disease

https://nei.nih.gov/health/diabetic/retinopathy

“Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults. Keyword: Diabetic Macular Edema (DME)."

Into Eyes?

The above online National Institute's of Health (NIH) webpage above is really informative. We wholeheartedly recommend it!

[INSERT NIH EYE LOGO]

Table - Carbohydrate Metabolism Related Labs – Transformed Results

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Time Stamp	Group	Test	Outcome	Method

20150908	CMP	Glucose	97 mg/dL High Normal	Paper Report
20170307	CMP	Glucose	95 mg/dL High Normal	Paper Report
20170307		Hbg A1c	Not Run	Paper Report
20170706	CMP	Glucose	103 mg/dL A Bit High	Paper Report
20170706		Hbg A1c	No Report

20180101	Note			Quest Charters E-Reporting
20180209	CMP	Glucose	104 mg/dL A Bit High	E-Report
20180809	CMP		97 mg/dL High Normal	E-Report
20180809	Stand	Hbg A1c	5.3% of total Hgb High Normal	E-Report
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Table - Carbohydrate Metabolism Related Labs – Transformed Results – CMP is Comprehensive Metabolic Panel - Last Reviewed: 20180905-W:

Tables (3) – Nutrients and Other Consumables

Table – Nutrients and Other Consumables - Primary

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Menu		Remarks [PENDING]
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1-LNV - Celery
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Carbohydrates Low Glycemic Index
Carbohydrates High Glycemic Index
Fiber
Fluid - Water
Fruit
Lipids
Omega Fatty Acids
Protein – Animal
Protein – Plant
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Table – Nutrients and Other Consumables – Primary – LNV Is Low Nutritional Value

Consumption Strategies & Dinosaur Skin

Until we can become a “Human Autotroph" we are a Consumer. “How much food do we eat in a year? Since the average human eats about 4 pounds a day, How much does a person eat in a year? Well, last year, the average American ate a total of 1,996 lbs. Feb 2, 2015"

[INSERT HUMAN AUTOTROPH PICTURE]

Looking Back

We have been fortunate enough to have a meal every day of our lives! When we met with Professor Pran Vohra back in 1982 he exclaimed: You have had wonderful nutrition! You should thank your parents. PhD Doctor Vohra had grown up around India. While growing up he suffered a niacin deficiency. In 1982 he was an Avian Nutrition specialist at UC Davis. He gave us a job feeding his Japanese Quail “Flock". This was our first experience with what Vohra called “Purified Diets". In memory of him we promote our "WorldWafer" idea. Also "WorldWafers" would give us a credit with Professor Calvin Schwabe for acting locally while thinking globally.

1 In 9 (2018) – “percentage of people starving"

“Some 795 million people in the world do not have enough food to lead a healthy active life. That's about one in nine people on earth. The vast majority of the world's hungry people live in developing countries, where 12.9 percent of the population is undernourished.”

Protein First Method

We practice what we here at MSG call the “Protein First Method (PFM)". In other words we focus on getting the best quality protein (muscle tissue) on a daily basis. Since 2012 we have consumed some of the lowest quality protein of our lives. For most of the time during any given month we “Fast". For 1-3 occasions per month we “Feast". We think feasting may be in our genes as a Scandinavian. Aside: “Broxton is a small town in Caddo County, Oklahoma in the United States of America. Thor, after his rebirth, had recreated the City of Asgard close to the town about a couple of miles out, making it the new home to the Asgardians for some time." We hear rumor (urban legend) that there is some mighty good eating in Asgard. Once a month we have an all-you-can-eat Chocolate Day. We associate large quantities of sugar including chocolate with migrating cramps. Cramping is a pretty good deterrent to lay low about Chocolate most of the time.

[INSERT SUSHI PROTEIN PICTURE]

Feature – Jicama

Back about the year 2000 we took a Botany course at Saddleback College with doctor Jane Horlings (PhD). Due to extra credit elements we scored an overall of 106 average points where 100 would be perfect. Since Physiologic Chemistry (Circa 1985) at UC Davis we have excelled in Carbohydrate Chemistry. In 2000 Doctor Horlings had we pupils bring some produce items to Botany Lab. We selected various mushrooms. The last half of the lab was to sample as many food stuffs that you could. Another classmate submitted Jicama. When we ate the Jicama we knew we had it from time to time as part of a mixture such as a salad. We found Jicama mighty tasty and were hooked. For us, chewing Jicama delvers a pop in your mouth. In association with our Blood Glucose Level research (Circa 2017) we asked a friend to use his portable BGL test system. The day before our self-test we had eaten a whole Jicama. We tested ourselves the morning after before eating anything. Our BGL was very high. We blamed the Jicama. As of today (September 2, 2018) we haven’t eaten any Jicama. We told our cousin who seems to know much about Food V Glycemic Index that we have cut out Jicama due to its’ effect on BGL. She says we are wrong. Aside: How often have you had a family member state that you are wrong.

Jicama In The Literature

Jicama appears to be “a veggie high in fiber, jicama also has a low glycemic index, is a great starchy vegetable choice for anyone struggling to balance blood sugar or who has diabetes, and can be helpful with losing weight fast, too. Jicama is not any fiber. Jicama's fiber is infused with oligofructose inulin, which has zero calories and doesn't metabolize in the body. Because it has a very low glycemic index, jicama is a great food for diabetics, and low in calories for those interested in weight reduction.” Yeah! We gather that Jicama is back on our menus. September 5, 2018 (W) we plan to purchase Jimaca this afternoon on the way home.

FYI à Define – Glycemic Index

https://www.webmd.com/diabetes/guide/glycemic-index-good-versus-bad-carbs

What Is the Glycemic Index?

“Glycemic index is a number and a system that ranks foods on a scale from 1 to 100 based on their effect on blood-sugar levels. It gives you an idea about how fast your body converts the carbs in a food into glucose. Two foods with the same amount of carbohydrates can have different glycemic index numbers.”

Table – Glycemic Indices

The smaller the number, the less impact the food has on your blood sugar.

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Index Value	Interpretation	Correlation	Note
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0 (Zero)	Super Low		Fiber? Styrofoam?
55 or less	Low	Good	Vegetables? Whole Grains?
56- 69	Medium
70 or higher	High	Bad	Chocolate?
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Table – Glycemic Indices

FYI – Jicama à

http://sarvodaya.stanford.edu/healthy/2009/11/ill-take-side-of-jicama-please.html

Table – Nutrients and Other Consumables - Secondary

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Menu		Remarks [PENDING]
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Fluid – Coffee		Drug Of Choice (DOC)
Fluid - Other		Mostly Tap Water
How is it Lipids?
Iron Supplement Experiment		2012 Too Much – Toxic Hospitalized
Milk		1 Glass/Day Max
Minerals		Periodic Supplements
Unknown Nutritional Factors
Vitamins – Fat Soluble
Vitamins – Water Soluble
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Table – Nutrients and Other Consumables – Secondary

Table – Nutrients and Other Consumables - Tertiary

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Menu		Remarks [PENDING]
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Experimental
Fluid - Alcohol		6-7 Years Plus Avoidance
Lard		Cooks Are Using Less
Lithium as Micro-mineral As is Selenium		Notion CALC Below
Melatonin		Sleep Alterative Study
Acetic Acid		Control Inflammation AMB WBCs
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Table – Nutrients and Other Consumables - Tertiary

Special Topic – Experimental -Vinegar - Stress

During our lifetime we have experimented much with Vinegar (Acetic Acid). Our FAV is Glacial Acetic Acid (GAA) for clearing the sinuses. Second to GAA would fall Red Wine Vinegar (RWV). Last month via a feed: You Tube was promoting five (5) benefits of ingesting minor amounts of Apple Cider Vinegar (ACV). The benefit we are looking for is that ACV may give your immune system a break. We routinely have elevated White Blood Cell (WBC) counts. Our Acetic Acid Experiment (AAE) is our next step to pin down what kind of stressor is bullying our WBCs around. On August 17 (F) 2018 we began our ACV trial. ACV for us is not the tastiest form of Acetic Acid. We were always partial to Red Wine Vinegar (RWV). On September 1 (SUN), 2018 we retired our ACV trial and began warming up to RWV. Unfortunately, if we change too many stress variables it is hard to delineate association and causation.

Table – Roizen MDs 80/20 Rule (16 Hours Awake) – Applied

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##	Variable	20%	80%
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01	Aliteracy [SPELLED]	Non-literary Creation	Read & Write & Sleep
	Break in Reliance on Car	Bus
	Break Nutritional Discipline
	Chocolate
05	Discretionary Budget for Disabled People	+/- $200/Mos	Rent, Meds, Food
	Gap in Symptom Awareness		OCD
	Kinesthetics	Walk, Run, Flex
	Medications Cleared from System	Around noon each day	Atorvastatin may not clear daily
	Others As Needed (PRN)	In network Health Related Engagements
10	Poor Sleep	Actually 20% is too much
	Problem Management
	Problematic Side Effects	6 Hours per Day
	Respite	1 every 2 months
	Sex and Intimacy	20% is a bit too much
15	Stand Up Workstation	Tustin Office/Annex
	Stoicism	Peak relief with massage
17	Work	Probably unrealistic
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Table - Roizens 80/20 Rule (16 Hours Awake)

Basic 80/20 Theme

Whether you are addressing deficits or strengths you can get exhausted with the monotony of sustaining perfection (OCD). One requires a conscious break whether it is two hours a day or one day a week. If you find it nearly impossible to get back going after the break you really probably needed that break. Again, we here at MSG operate with a feast/fast nutritional strategy. Usually once per month we treat ourselves to a high protein all-you-can eat feast. In passing Roizen MD our media doctor suggested taking 20% break time from your disciplines.

[INSERT ALL EAT PHOTOS]

Feature – Digital Presence

Who is Doctor Roizen? – What is RealAge

Michael Roizen, MD | Cleveland Clinic

https://my.clevelandclinic.org/staff/6161-michael-roizen

“In 2007, Dr. Roizen was named Chief Wellness Officer at Cleveland Clinic, the first such position in a major healthcare institution in the United States. Dr. Roizen also serves as Chairman of the Wellness Institute at Cleveland Clinic.”

[INSERT DIGITAL PRESENCE – DOCTOR ROIZEN]

Roizen - Huge Digital Presence

Doctor Roizen has what we call here at MSG a huge digital presence. We ran across Roizen when we looked through YOU: The Owner's Manual a book co-authored by Dr. Mehmet Oz and Dr. Michael Roizen. We call Oz Roizen’s Partner In Crime or PIC. One or both also support an online assessment tool they call RealAge

[SHARE ALSO WITH LITHIUM STUDY]

Matrix - Calculation Helper @ “endmemo” - Just 4 Fun (J4F) - Micronutrients

FYI à http://www.endmemo.com/chem/massmolarconcentration.php

Chemistry – “ng/mL to mmol/L” Conversion (EndMemo)

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Consumable	Range Unit Given	Using Given	CALC
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Selenium	70-150 ng/mL
Selenium CALC		100 ng/mL	0.0012664640324215 mmol/L
Lithium	0.6-1.2 mmol/L
Lithium CALC		0.9 mmol/L	6246.9 ng/mL

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Matrix - Calculation Helper @ “endmemo” – Last Reviewed: 20180905-W:

Interpretation

For quite a while we have been interested in Lithium Toxicity. Back around 1989 the paramedics misread our situation when they concluded that it had ingested a toxic level of Lithium. We had not, yet they pumped our stomach anyhow. Having one’s stomach pumped is no fun! When we set out to do our calculation above we predicted that Lithium must be more toxic than the micro & essential nutrient Selenium. For now, we don’t place big money on our numbers since we could find no cheat table to confirm them with. Yet our preliminary findings indicate that Selenium is more toxic than Lithium. Our hypothesis is: Lithium is a micronutrient such as Selenium is.

Better or Worse - Lithium

We have been interested for quite a while to determine the comparative toxicity between Selenium and Lithium. For us ingesting Lithium is rather innate. Early on it had debilitating and stigmatizing adverse effects about our Activities of Daily Living (ADLs) as a UC Davis Veterinary Medical student (Circa 1989).

Matrix - Weight Summary – Lifetime History – Keith Torkelson

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Age Class	Meaning	Low (Lbs)	High (Lbs)	Note
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Child	01-12	Normal	Normal
Teen	13-15	130	135	Compared with Lambert and Grenier We were “Pudgy”
Transitional Age Youth (TAY)	15-25	135	140
Young Adult	26-30	120	130	Major Rigorous Fitness Routine
Adult	31-59	140	200
Older Adult (OA-POV) [Person Of Vintage]	60 or More	Pending	Pending	Cutoff @ 60 Years Old
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Matrix - Weight Summary – Lifetime History – Keith Torkelson

Subject – AVEY’s Part

The subject of the report on Marking With Health (MWH) is Keith Torkelson. More or less Keith has been satisfied with his weight numbers. There was a period when Keith reached as all time high of 200 pound back around 2003. Keith transferred from UCSD to Orange Coast College (OCC). At Orange Coast Keith began his OCC-Build-1981 fitness program. He carried what he learned to UC @ Davis (UCD) in 1982. Keith quit smoking cigarettes in 1983 and he made substantial fitness gains. Eventually in Davis Keith was a practicing Tri-athlete. In 1983 Keith was asked to substitute on an Ultimate Frisbee Team in the finals. Keith played two games for them and the team won the UC Davis Intramural Ultimate Frisbee Finals. When the photos were taken Keith thought that he looked “Pudgy”. Unfortunately after three (3) years smoke free Keith relapsed back to smoking. Keith still smokes and abuses cigarettes. (AVEY, 2018)

[INSERT UCD ULTIMATE PHOTO]

Matrix – 20-Month Weight Change Summary – Keith Torkelson

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TimeStamp	Weight (Pounds)	Note
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12/27/2016	165	Baseline

01/27/2017	160	2017 Baseline
10/10/2017	147	Physical Day - BP 126/71
10/23/2017		Initialize Prototypic Celery Diet
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12/27/2017	144	@ CBC
01/24/2018	145	@ CBC
08/21/2018	143	Self @ CCCHC @ CBC
09/02/2018	142	Self @ Gym Scale
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Matrix – Results - 20 Month Weight Change Summary - Results/Record of Weight for Keith E Torkelson: Last Update: 20180831-F: Associated with MSG’s Celery Diet

Slope Calculation - Rise 165 – 145 = 20 | Run 20 months

Our numbers indicate that we have been losing on average about one (1) pound per month. Now what we would like to do is lose 1 pound of fat per month and replace it with one pound of muscle. We have shied away from upper bodywork because we still have some upper body (shoulder) injuries that limit us.

Biggest Physical Endeavor - Jogging

About two (2) years ago we took up Brand New Day's (BNDs) offer for their subsidized 24-Fitness membership. It has taken much to come back from the physical losses we incurred back in 2012. For Fall Quarter 2011 we enrolled in and completed a Core Abdominal Training Class at Cypress College. Keith was the oldest male in the class to finish. Keith lost most of his gains during a Year For Catastrophic Loss – 2012 (Y4CL). Bouncing back for Keith has been slow doing. Since 2017 one of Keith’s FAV workouts at 24-Hour is his weekly Yoga Class with the awesome Kamara Y (Teacher). In order measure the impact that yoga has him we track the nature of our Jogging. Coming into Fall Quarter (2018) Keith is planning to make a more concerted effort to jog.

Markers Of Health (MOHs)

The two marker systems we here at MSG are most interested in are the Markers of (Physical) Health (MOHs) and Markers Of Mental Health (MOMH). Here we focus on physical MOHs. As a ProSumer the process of our yearly Physical drives our writing this report. For the most part we accomplished our goal to gather our health indicators (health & fitness numbers) up in on place. Now we are ready to address the new and improved ShareCare RealAge APP. The disparate sources we have for our records are as follows: Planners, Calendars, Summary of Visits, Medical Records (other), Surgical Exams, Patient Portal, and Lab Reports. We also are trying to find the impact that our Arestin (antibiotic) dental treatment has on our White Blood Cell (WBC) count. We may have changed too many variables to strongly associate Arestin with anti-inflammatory changes in our WBC count.

Applying Markers of Health Information - FYI – ShareCare (APP)

Back 2007 an employee of ours introduced us to the online APP – RealAge by Sharecare. We accessed it answering some odd fifty (50) questions to the best of our ability. The results, our RealAge that came back were not very promising. In 2007 our calendar age would have been 48 years old. We have misplaced, for a third time, our official results yet we believe our Real (Physical) Age came in about 58 years old. On December 20, 2014 we updated our RealAge (Calendar Age 55) and we earned 63.9 for our RealAge. Ever so slowly our Markers Of Health (MOHs) as indicated by RealAge are improving. Recently we tried to update our RealAge just to find that ShareCare updated their APP making it more difficult. They now ask for exact values for things like Blood Pressure and Blood Glucose Level. In the end the materials tabulated in this report will be applied to update our RealAge. RealAge promises that they can provide Expert Health Advice. We get ShareCare information feeds on our cell phone (Smartphone) of which only about half are helpful.

FYU – Link à https://www.sharecare.com/

“Health and wellness engagement platform that provides you with personalized resources to live your healthiest life.”

Figure – RealAge Report (12-21-14)

Figure – RealAge Test Results for December 20, 2014 (SAT)

Table - Nutritional Changes between Glucose Tests

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#	Change	2017 August	20180201 (TH) SUS	20180831 (F) SUS
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1	Peanut Butter and/or Orange at Bedtime		Yes	Yes
2	Replace soda with water at dinner time		Yes	Yes
3	Replaced Jicama with Carrots and Celery	Fresh Vegetables	Yes	Yes
4	Stopped dessert		Yes	Yes
5	Goal: 7 days chocolate down to 2 days	Down to 1 in 15	1 In 15	1 in 15
6	20170920-W: Flax Oil per Whim		Yes	No
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	CALC (SUM/Items) =		6/6	5/6
	Healthy Habits Forming Score (HHFS-N) =		100%	83%
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Table - Nutritional Changes between Glucose Tests – Last Reviewed: 20180831-F:

Metadata à 15_REN_Diet_Program_18020205-Celery (MSG, 2017)

Table - Behavioral Changes Between Glucose Tests – Health Habit Forming

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#	Change	2017 August	20180201 (TH) SUS	20180831 (F) SUS
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1	BND Sponsored Swimming		No	No
2	BND Sponsored Yoga Class		Yes	SoSo
3	Eating Less Chocolate		Yes	Yes
4	Incidental Weight Loss (Measure)	Huge! To be in the 140s again	Yes	Yes
5	New Medication Lipitor (Atorvastatin)	Semi-irrational decision	Yes	Yes
6	Semi-Intentional Weight Loss		Yes	Yes
7	Sustained Walking	Decreasing now that our eye (retina) has been “Saved”	SoSo	No
8	Swapped out sugar drink for water at dinner		Yes	Yes
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	CALC (SUM/Items) =		6.5/8	5.5/8
	Healthy Habits Forming Score (HHFS-B) =		81%	69%
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Table - Behavioral Changes between Glucose Tests – Health Habit Forming – Last Reviewed: 20180831-F:

80/20 Rule – Revisited - Health Promoting Efforts (HPEs)

Earlier we discussed the “80/20” (Roizen) Rule. Basically we interpret 80/20 to mean concentrating to the best of your efforts for remaining in line with Health Promoting Efforts (HPEs) eighty (80) percent of the time. Letting off a bit and live twenty (20) percent of the time. A good example for us is sleeping. Each night we religiously begin our Clozapine divided dose regimen at 630pm. We take our last dose at 8am and expect sleep about 9 pm. Yet once a month or so we let it hang loose and go Karaoke until near Midnight. Due to dizziness we cannot drive the car while on any Clozapine. Thus on Karaoke nights we don’t start our Clozapine until we are safe at home or safely in another's car driving us home. We usually get home about 11pm on Karaoke nights.

Updates

20170918-M: Reward for weight loss – Ice Cream all-you-can-eat (AYCE). 80/20 Sugar – In Practice: We avoid simple sugars like the plague for more that eighty (80) percent of the time. Yet about once a month or so we let it hang out and indulge in AYCE chocolate based ice-cream. 20180404-W: How is it that we lost momentum? The one area that it is hard to sustain momentum is attending our weekly yoga class. When we go it is well worth our while and leaves us feeling all endorphin-like. Fall quarter for us is just around the corner (September). We are rethinking our 24-hour based fitness program.

Table – Nothing is Easy - Risks and Complications

Behavioral Markers Of Health (BMOH)

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Risk or Complication	Note	Detail
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Clozapine	Disappointing Changes	Re-adjusted
Contingencies for Clozapine	If it becomes problematic	Need Sound Alternative in the Amalgamation
Determination	Refused Clozapine as Prescribed	Re-adjusted
Family Engagements	Some Healthy Some Challenging	Family members that drink alcohol
JMB (Matriarch)	Excessive Criticism
John Sleep	Sleep - COPD Noises	Interferes with sleep
K_Y	A New Hope
Medi-Cal Redetermination	Spend Down Required	Able to afford on time only dental work
Move Preparedness	Redistribute Property	Promoting OCHCA Housing Advisory Board
OCHCA	Let go as Technology Advisor	Replace Time-spent with work on Housing
Rimal B Bera MD	Orienting a New BHD	Adjusting expectations
Rochester Sleep	Sleep - COPD Noises	Interferes with sleep
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Summary - Feature - Markers Of Health (MOH)

March 2018 CIM – Issues for Behavioral Health Doctor (RBB)

As with most complex endeavors our Physical Health does not operate in a vacuum. There are some challenges that we would like a coordinated effort between our PCP and Behavioral Health Doctor (BHD). From 201707-201809 these are some of the hurdles we faced.

Assessment Development – Beta Versions

We are in the process of developing assessment tools to capture the Markers Of Health (MOH) experience. Our two priority instruments are: Markers Of Physical Health (POMH) and Markers Of Mental Health (MOMM),

Define Markers of Health

A marker of health might be defined as trait, condition, etc that indicates the presence of, or a probable increased predisposition towards, a medical or psychological disorder. Here we focus on traits or distinguishing qualities or characteristics. Most of the qualities we address in this report have been reflected in our lab work. We began seeing doctor Chester D Mojica (PCP) back in 2012 when we were in pretty bad shape. Now after six (6) year of service nearly all of our problematic Markers Of Health (MOH) for our physical health have improved.

Metadata à11_Markers_Of_Health_MOH_18090203_Notes

Appendix – Work Sheets for RealAge (ShareCare) Update

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Table – Measurements – Tests – Indicators – Overlap with Markers Of Health (MOH-Physical)

Collecting Marker of Health Information – Working Complete Collection Table

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Measure/Rule	Measure	Values	Interpretation
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Blood Pressure	Sphygmomanometer	2/21/18 121(S)/79(D)	Pre-High Blood Pressure
Heart Rate	Sphygmomanometer		ND/NR
Weight Change Table	Scale		DRP

Table – Measurements – Tests – Indicators – DRP is Data Reported Previously - ND/NR is Done/Not Reported

Feature – Blood Pressure

“More than 120 over 80 and less than 140 over 90 (120/80-140/90): You have a normal blood pressure reading but it is a little higher than it should be, and you should try to lower it. Make healthy changes to your lifestyle.”

[INSERT TABLE]

http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Appendix – Work Sheets for RealAge (ShareCare) Update

Table – Measurements – Tests – Select Labs – Overlap with Markers Of Health (MOH-Physical)


Measure/Rule	Measure	Values	Interpretation

Blood Glucose Level	Unknown Methodology	8/9/18 97 mg/dL	65-99 mg/dL Goal = 80 or Less mg/dL)
Hemoglobin A1c	Most Likely a Column of some sort	8/9/18 5.3% of total Hgb	<5.7% of total Hgb

Table – Measurements – Tests – Select Labs – Overlap with Markers Of Health (MOH-Physical)

Direct Efficiency

For the present time until we figure out how to directly migrate our MyQuest Lab Results we find it most efficient to print them out as a hard copy. Since 2012 Quest Diagnostics has been our primary lab. In 2018 Quest made available to us their MyQuest Patient Portal. Before 2018 we had to formally using paper request lab results from Quest. We have tried various means to migrate our Quest results directly without Transformation into our Mentalation Solutions Group (MSG) AVEY Database system. Once again, the reason we are laboring over Test Results is that we wish to update our RealAge (ShareCare) profile. In return ShareCare will report back to us free of charge their single numerical result or our RealAge (RA). As of September 5, 2018 our Calendar Age is 59 Years 6 months. We hope our RealAge this time around will come back as 59 RealAge Years (RAYs).

[INSERT ROIZEN AND OZ]

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Table – Quest Lab Testing Analysis - Report Date 8/9/18 (Indexing)

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Test (Cluster)	Stratified # Values	Business As Usual
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Complete Blood Count (CBC)	20	SoSo
Comprehensive Metabolic Panel (CMP)	19	SoSo
Lipid Panel, Standard	6	Yes
Microalbumin, Random Urine (W/Creatinine)	3	Yes
Urinalysis, Complete	16	Yes
Hepatitis C AB W/REFL to HCV RNA, QN, PCR	2	Yes
Thyroid Stimulating Hormone (TSH)	1	Yes
Prostate-specific antigen (PSA) Total	1	Yes
Hemoglobin A1c	1	SoSo

20150908 – HIV 1/2 Antigen/Antibody, Fourth Generation W/RFL	1	Non-Reactive Yes
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Table – Quest Lab Testing Analysis - Report Date 8/9/18 (Indexing) – Last Reviewed: 20180905-W:

Appendix – Work Sheets for RealAge (ShareCare) Update

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Table – Indicators – Overlap with Markers Of Health (MOH-Physical)

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Indicator	As Measured By (AMB)	Number	Note
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Appetite	Weight	Normal	Feast/Fast
Sleep	Sleep Interference Rate (SIR)	August
Attendance	Health Related Engagement (HRE-IN) - Count	9/2/18 40/40	Necessary Health Related – In Network
In Motion	Smartphone APP	>1 Mile/Day
Intimacy	Number of Days Kissing 2015	1/Week Minimum	Partner Moved to Colorado
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Table – Indicators – Overlap with Markers Of Health (MOH-Physical)

Appendix – Work Sheets for RealAge (ShareCare) Update

[HOLD BACK AS ACTIVE DATA COLLECTOR PLACE WITH MOH]

Table – Measurements – Overlap with Markers Of Health (MOH-Physical)

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Parameter	As Measured By (AMB)	Number	Note
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Weight	Scale	144 Pounds
Height	Legacy	5’ – 7.5”
Waist	Tape Measure	2’ - 6” (30”)
Hips	Tape Measure	2’ - 7” (31”)
Body Mass Index (BMI-CALC-Method-1)	Online Calculator-1	22.7	Normal
Body Mass Index (BMI-CALC-Method-2)	Online-Calculator-2	24.0	Fit
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Smoking [HELD OVER FOR COPD STUDY]	COPD Risk	20/Day	Resistant to Solution
Alcohol	Lifetime Risk	6 Years in Remission	Protections Exceeded Risks
Problematic Side-effect(s)			[HELD OVER]
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Table – Measurements – Overlap with Markers Of Health (MOH-Physical)

[INSERT CALCULATOR RELATED]

Appendix – Work Sheets for RealAge (ShareCare) Update

Table – Applied “Summary Of Today’s Visit” – Output Date: 8/21/18

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Medicine - Preventive	Date(s) MRA	Values	Interpretation
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Spirometry	9/14/17	89%	N
Audiology	9/22/15		ND/NR

Immunization - Pneumococcal	11/8/16		Protected
Immunization - TdaP	9/22/15
Last Flu Shot	10/3/17		Protected
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Depression Screening (PHQ-9)	1/24/18	0-4
Depression Screening (PHQ-9)	1/3/18	2	RBB Intake Self CALC
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Fecal Occult Blood Test (FOBT)	3/71/8		NEG
Lipid Profile	9/14/18	(68/159/104)
Prostate-Specific Antigen (PSA)	9/14/18	(1.0,1.1)
Purified Protein Derivative (PPD)	6/8/12		NEG omm
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