Tuesday, March 31, 2015

When to Walk Away from the Experts

I was challenged the other day over my decision to go through with Bariatric surgery, when it is entirely possible (in theory) to lose weight the "natural way" through diet and exercise. Indeed before I was approved for surgery, I had to demonstrate that I could lose weight on my own. And even though it sounds counter-intuitive, I will continue to lose weight and increase my strength and mobility through diet and exercise. The surgery is a boost but it is not an answer to significant and sustained weight loss.

I won't go in to all my reasons, but there was a mental switch that triggered, where I had enough of the conventional wisdom. How many times should a gal beat her head against the same wall, before she walks away from the wall?

I am reminded of another story of expert advice gone horribly wrong, in the story of the settling of the prairie dry belt in the book, "Empire of Dust: Settling and Abandoning the Prairie Dry Belt" by David C. Jones. When I was young, I learned in school that prairie farmers were partly responsible for the dust bowl because of poor farming practices. They cut down trees and deep-furrowed the loose soil which then blew away. All through my young life I watched farmers in our parkland, a little farther north from the dust bowl, faithfully plant tree lines around their property. This was the farmer's penance, to compensate for the ignorant practices of the past.

Then I read Jones' book and found out that the deep fallowing farming practices were the prevailing wisdom of the time.  Promoters and agrarian experts alike claimed that bumper crops could be gleaned from a land short of rain, solely on the moisture retained in the soil. Many farming families, hopeful for a new life, answered siren call of free land. The prairies were settled, then abandoned again, in huge numbers between 1909 and 1926.

Imagine a farmer following all conventional wisdom. Some years he experiences success. In dry years he loses it all again. He plants again in hope of a good year. He follows the "Campbell Method" ever more finely, believing it must be somehow a failure in execution. Sometimes he succeeds and he believes again. Then drought follows drought in successive years. Finally he is exhausted, destitute and entirely driven from hope. To save his family, he packs up and quietly leaves, indebted, the fallow land left in the hollow hands of the banker. For the farmer, his former faith is fatally snapped by reality. To survive, he must launch out on his own wisdom, taking an untrod path, and holding his breath that he and his little family will survive.

It boggles my mind that even today, this failure is left resting on the shoulders of the poor farmer, who was simply following the experts.

There's a time to step back and admit when a pet method simply does not work. There is no shame or failure in trying something else. It may be the only way to survival.

When it comes to weight loss, it is possible to simplify the whole process to a matter of Calories In - Calories Out (CICO). It does come down to this. Logically, if a person is gaining at a certain calorie intake, the only way to lose is to reduce the intake or increase the burn. Eventually the energy deficit will reap the expected result, as the body can't be built on air alone. But for some reason, some people seem to be able to eat more and still lose weight, while others struggle. Why some fail is baffling. Are they measuring their food wrong, failing to log all their entries, closet eating, or messing up their metabolism to such a degree that they require a dangerously low calorie intake? The dieter is left to blame.  She follows the instructions ever more finely, believing it must be somehow a failure in execution. Finally she is exhausted, entirely driven from hope.

I smell an expert failure. There are factors at play yet left undiscovered.

Oh, and in case this story has you wondering, I'm hopeful. The surgery went well, I have very few food intolerances, and I am close to achieving a weight target that will take me out of the obese range.

Monday, March 23, 2015

Privacy and Emergency Contacts

The unthinkable happens, and an employee is injured on the job - after hours - and is being transported to the hospital. (Let's call our unfortunate, Fred). In a safety culture, the first goal is to prevent the unthinkable, but if such a thing were to happen, are we prepared to provide support and information in those first critical hours?

I'm talking about personal private information and the workplace. There is an exception to disclosing private information without direct consent in cases such as Fred's accident. Human Resources or Payroll typically collect this information on hire. Exceptions to direct consent are typically written in to the regulations to allow for quick disclosure of this information, to Fred's "In Case of Emergency" (ICE) contacts.

"If a reasonable person would consider that it is clearly in the interest of the individual and consent cannot be obtained in a timely way (for instance, emergency contacts)" - A guide for Businesses and Organizations on the Personal Information Protection Act, Rev. November 2008 (p. 27)

Typically this information is kept on the employee file, and is collected in the first few days on the job. There are a few things to consider, however.

  1. Is there a plan in place (say, annually) to confirm and update the emergency contact information?
  2. Is there a contingency in place to access this information after hours? 
  3. Do the supervisors know about this contingency plan?
  4. Is there continued protection of this information from unauthorized access? 
But what if we asked a broader question; can the employee self-manage their ICE contacts through a tag or on their cell phone, while still protecting their privacy rights? Paramedic Bob Brotchie began promoting the saving of "In Case of Emergency (ICE)" information on cell phones in 2005. His idea gained international attention as a result of the London terrorist bombings that year. The idea is to include emergency contact names in the phone directory (i.e. last name ICE) so that an emergency responder can quickly work out who to call. This has become a little more complicated as most phone screens now lock, but new apps have filled the need. 

The apps available have gone steps further including personal medical information, allergies, and so on. Keep in mind however that for emergency responders, wealth of detail hinders rather than helps their cause. Having an emergency contact to call (who can fill in on existing conditions, allergies) is of primary importance. 

Bob Brotchie has endorsed an ICE tag made in Canada that bypasses apps altogether and provides a durable tag that can be attached to a keychain, backpack, running shoe, or helmet. All that is included on the ICE tag is two contact names with phone numbers. Nothing else is disclosed.  http://iceincaseofemergency.ca/

An employer may offer such a tag to employees who work off-site and after hours, that they could voluntarily manage and update as necessary. This eliminates the privacy, currency, housing, and accessibility concerns of the traditional emergency contact form maintained on the personnel file.

Further reading:

Federal Privacy Emergency Kit

Information Sheet No. 5: Personal Employee Information

Evaluating apps:
When selecting a health-related app, pick one where the developer is open and transparent about their privacy policy, is specific on what information is being collected and how it will be used.  Ten Tips for Communicating Privacy Practices to Your App's Users


With this extreme weight loss it is still a job getting used to my new size, but I am getting there. What seems to help is measuring, putting my stats on a size chart, and looking in the mirror. I am getting used to what am now. 

I am a grandma with lots of spare wrinkles and lumps so I try and look with an uncritical eye; observing but not judging. 

Have you noticed how the thighs have a terrific spread? Sit down in the hot tub and they spread out like mounds of leavened dough, ready for punching and baking. It seems all out of proportion somehow. 

Our legs aren't sticks; they're triangular. Our legs are levers, powered by large muscles.
Speed Skaters have terrific thighs. 

Mathieu Giroux

Strong thighs give me launching power, and propel me out of my chair. No twiggy for me, tottering on stick legs. I've got places to go and things to do.