Fitness Training 27FEB18

I have started to write about fitness and my back problems several times. Always there was a nagging shadow of pain that continued to follow me.

My Provision Living trainers could make we feel real good, but progress on the back pain was leveling out again. I signed up the in-house physical therapist and a chiropractor. Again progress was great and then slowed.

Last Tuesday, a week ago [a month ago!], the chiropractor “graduated” me down to one session a week. He also found and treated two trigger points near my shoulder blades.  Now my shoulders are free to rock back and forth.

I also have an exercise shared between the physical therapist and the chiropractor. Stand with your back against a wall. Hold your hands, with their backs against the wall, and your arms straight by your sides. Now “snow angel” with the back of your hands remaining against the wall.

Start

Several Days Later

 I could not even get my arms and hands above my shoulders, to start!! Just move my hands away from the wall a few inches and there is no problem raising them up to where my hands can meet.

It took the physical therapist to train me to stand properly while doing this exercise. She could do this, but I needed to learn to do it properly on my own.

For most of two years now, I have been slowly learning to recognize muscle groups that I have had no sense of feeling. How can I do what is called for if I cannot feel what is going on? [muscle cells do not have sensory cells like on your skine.]

“Stand up straight,” but without over compensating!!! “Relax,” and really relax!!! Doing things wrong does not improve things.

It was failure to do those two things that I now know were the basis for my failure to progress after a few weeks of many exercises I learned from the Internet and the Provision Living fitness classes. I plan to write more on the details later.

Yesterday we went for a walk at 3:00 instead of working in the Fitness Center. The fitness director said, “Better sit on the bench,” when he noticed, but I had not, that my shoulders were bending over.

I knew my back had started hurting. He knew that a short rest reversed this so if I carefully stood up “straight” I could walk on without pain for some period of time and distance.

A bit farther, “You are holding your right arm out. Relax it.” And farther on, the residual back pain began to fade away. I need to walk more outside, away from all the stuff in the air in the building?

We visited the edge of the milkweed plantings on the Monarch Butterfly Sanctuary, that borders the walking park. Soon I will get lots of exercise again spraying and cutting weeds.

The chiropractor has loosened up my joints and relaxed muscle trigger points so the physical therapist can help retrain my muscles that the fitness director can strengthen and coordinate for better balance.

Basically I have finally experienced being at the point where I should be, when under their direct attention. Now to practice, practice, and practice until this becomes a habit, muscle memory; or my conscious attention remains on the job until I master the fine art of walking correctly.

Conscious attention costs a lot less than building muscle memory in 60-minute gentle therapy sessions.

[I have been very busy organizing people needed to eliminate third hand tobacco smoke exposure in memory care. I had a productive one-hour meeting with the executive vice president Thursday.]

Tobacco PLUS Store

Missouri has developed a unique market for cigarettes. It is possible for public health, and tobacco shops and convenience stores (TSCS) to work together for the common good!!!

Missouri has low cigarette prices (about $1.00 per pack below the average of all states) and the lowest cigarette tax ($0.17 per pack or 1/10 the average of all states).

Missouri ranks near the top in the portion of people smoking (about 1/5 rather than 1/10). Residential health care facility caregivers are drawn from a low paid group where well over 1/5 are nicotine addicted.

They desire to adjust their blood nicotine level during their shift at work. This practice yields third hand tobacco smoke that is carried into no smoking areas in their hair, clothing, and bodies.

Over 1/3 of in-store sales at convenience stores comes from cigarettes. Over 80% of life time smokers become addicted in their teen years.

The CVS drugstore chain dropped a two billion dollar per year tobacco business and Wall Mart in Canada announced the same this week (14 March). That will drive the market even more into tobacco shops (20) and convenience stores (61 in the Columbia area by Google).

Public health wants to prevent illness and early death. Tobacco shops and convenience stores (TSCS) want to maximize profit in today’s market.

Big Tobacco knows that the transition, from supplying addicted smokers with nicotine in a toxic smoke, to safe alternative sources (lozenges and toothpicks), is now well underway. The sale of cigarettes to well-to-do and educated people continues to fall.

Tobacco PLUS creates a win/win situation for public health and TSCS. Sell each pack of cigarettes ($5.00 each, for example) with a prize. Price a pack of cigarettes PLUS a prize at $8.00.

We now have the price barrier that public health needs to reduce teen experimentation. The $3.00 prize can be anything marked in the store (food, drink, a discount) or items near the checkout.

There is a profit to be made on both the pack of cigarettes and on the prize. At 10%, that is a minimum profit of $0.50 plus $0.30 or $0.80 per pack of cigarettes. The maximum profit can be well over a $1.00 depending upon the prize display.

Display a “Tobacco PLUS’ sign with “responsible marketing of tobacco.”  The signage can be a part of the new licensing being created for Columbia. 

Addendum: The fact that Columbia was the first city in Missouri, in 2014, to raise the minimum age from 18 to 21 years of age to sell (not to buy) cigarettes will reduce the effectiveness of Tobacco PLUS marketing within the city limits.

Columbia charges a $0.10 per pack tobacco occupation license tax and is looking for money to enforce a new tobacco retail license. Kansas City charges the same without an additional tax for license enforcement. 

This is not a tobacco excise tax. Only the state can collect the excise tax ($0.17 per pack). Tobacco Plus keeps the money in town until the state excise tax is increased to an effective rate as to reduce teen smoking.

The Tobacco Master Settlement Agreement,1998, requires manufacturers to contribute $0.0188 per cigarette ($0.376 per pack) into an escrow account to pay states, for ever, for their Medicaid tobacco illness expenses. [This does not count billions of dollars paid by private pay and insurance companies.]

These fees, well below $3.00 per pack, have little effect on reducing cigarette sales. Reduced cigarette sales reduce the federal and state tax collections. This conflict of interest continues to require more public health education.

Second Hand Tobacco Smoke Kills Now

The final scientific research to establish the killing power of tobacco smoke had to wait for “natural” research opportunities. No one can design scientific research on the large scale effects of tobacco smoke on human beings (unethical and costs) .

Scientific research requires large numbers of participants, divided into never smoked and forced to smoke (control and treatment) groups.

For the last few years about 440,000 died in the US, with 11,000 in Missouri, each year, as the result of Big Tobacco marketing and addiction.

Then progressive communities passed clear air ordinances and watched the change in hospital admissions and deaths from heart attacks and strokes.

Addicted people paid for the cigarettes; no research costs. The lure of charismatic Big Tobacco brought in the “treatment” group; no ethical research decisions were needed.

Pueblo, Colorado, restrict smoking in 2002 with a three year study. A comparison of the number of heart attack hospital admissions before and after the law was passed showed a 27% decrease in the number of heart attacks.

A study, between 2007 to 2014 (published last year) in Indianapolis, Indiana, showed a 25% decrease in hospital admissions for acute heart attacks. “Among people who never smoked there was a 21% decrease in heart attacks.”

[Half way through the study, clean air was extended to bars because of the number of lives being saved during the first years. This is good public health practice.]

There is no safe level of tobacco smoke exposure. This includes third hand tobacco smoke from a smoker’s hair, clothes, and body.

Smokefree legislation saves lives. The stronger the law, the fewer hospitalizations and the lower the health care expenditures for a wide range of diseases. For maximum benefit there should be no exceptions in tobacco smoke exposure laws.

[Frequent exceptions have been prisons, hotel and motel rooms, and residential establishments such as long-term care institutions and rest homes!!! These are all places where there is no need for the effect tobacco smoke has on intensifying many illnesses.] 

Second and third hand tobacco smoke not only kill but kill now; any time that a blood clot is caught in the brain or the heart. That includes memory care residents.

The Composite Corpse

The Composite Corpse

We normally think of a dead body as one dead body. One thing killed the body: cause of death in the corner’s report. One person is responsible in the case of a crime. Case closed.

The perfect crime is not solved. The person responsible is not found.

How then can thousands of people be killed each year by people who are clearly identified? The killers kill only a little bit of many persons.

Each cigarette shortens a smoker’s life by about 11 minutes. There is no safe level of tobacco smoke exposure. This is a matter for public health.

The result of selling cigarettes to nicotine addicted persons is well enough known that the result is premeditated: 11 minutes lost per cigarette; 10 years off a normal life time.

Now to catch the murderer. We know the time. Take 10 years off the end of a life time. Take 20 years off the start; before a life time smoker gets fully addicted to nicotine.

That leaves a 50-year market in which to sell cigarettes to an addicted person. Addiction now drives the sales. Some 70% of smokers would like to quit.

How many cigarettes are needed to kill the equivalent of one composite body?

Fifty years x 365 days x 24 hours x 60 minutes = 26,280,000 minutes.

Now 26,280,000 minutes/11 minutes =                   2,389,091 cigarettes.

And 2,389,091/20 =                                                    119,454 packs.

And 119,454/10 =                                                         11,945 cartons.

And 11,945/50 =                                                                239 cases.

No one person can smoke that many cigarettes. A pack-a-day smoker would need to buy 365 packs x 50 years = 18,250 packs; 1,825 cartons; 36.50 cases.

Therefore a minimum of 239 cases/36.5 cases or 6.5 (7) pack-a-day smokers would be needed to buy this many cigarettes. Half would be expected to die early enough to result in a composite one-life-time loss of life.

The sale of 239 cases per year kills one equivalent person (20 cases per month).

It takes a lot of cigarettes to kill the equivalent of one person. It is a messy way to kill people. There are over 30 times as many made ill. Tobacco companies can avoid liability until this statistical, composite, public health, view is commonly accepted: Sell 20 cases per month and pre-meditatively kill one equivalent person.   

Until then, half of all life time smokers will continue to die from tobacco related causes.This does not include those who die or are made ill from exposure to their second and third hand smoke.