[P]onder This...

• Cigarettes kill more people than alcohol, accidents, homicide, AIDS, car accidents and all illegal drugs combined. 
• Cigarettes contain ionizing radiation. The radiation from a cigarette is roughly equivalent to 10 millirem (mRem)-that of a single chest x-ray, and the average 1.5 pack per day smoker is exposed to the equivalent of about 300 chest x-rays per year!  This radiation is from radioactive polonium-210 (²¹⁰PO), an alpha-emitter, and radioactive lead.  The polonium, which, ironically emits particles that could be stopped by a piece of paper in the outside world, become much more deadly when in close proximity to cells lining your respiratory tree.  Polonium-210 comes largely from fertilizers used to grow tobacco in the same fields year-after-year to make the tobacco more "flavorful."  (Yummy!  I always love some polonium 210 in the morning with my coffee and newspaper.  It must be that great flavor!)  This concentrates in the tobacco leaves and remains after processing.  Smoking deposits the polonium and lead in the bronchi of smokers, where the radioactive particles supply a close, concentrated dose to the cells-much too concentrated for normal DNA repair to take place, which leads to mutation of cells, abnormal cell division, and, oh yes, cancer.  To put things in perspective, the radioactive cesium fallout on plants from the Chernobyl disaster was less dangerous than the polonium-210 residing in tobacco leaves.  Living next to a nuclear plant would be safer, exposing a human to < 0.1 mRem/year! 
• Smoking cigarettes takes an average of 6 years off a person's life.  However, after a certain number of years of smoking, your life expectancy will be reduced by a decade (10 years).  That's 10 years without your significant other, friends, relatives, your kids, or your grandkids.  They'll miss you.  Thankfully, you'll be dead then.  Dead people don't have to worry about anything like their families missing them.  That's one nice thing about being dead.
   

• Smoking Trends: Six states-Alabama, Arizona, Mississippi, Oklahoma, Tennessee, and West Virginia had NO significant declines in smoking prevalence over the last 10 years! http://www.cdc.gov/tobacco/data_statistics/mmwrs/byyear/2009/mm5809a1/highlights.htm
• Smoking is the primary cause for at least 30% of Cancer-related deaths (and that's not all lung cancer, either). 
• The U.S. loses $96.8 billion (that's right, with a "B") in productivity annually from smoking; yet, on a state level, we spend only a fraction (about 325 times less) on tobacco prevention and control programs programs at $595 million (all states combined) as of fiscal year 2007. 
• Smoking is one of the biggest reasons for high health insurance premiums for everyone.  Frankly, we're a bit disappointed that we have to pay for the poor decisions of others, but that's just crazy us.  Perhaps health insurance should be more like auto or life insurance-based on individual risk.   We are perplexed that more informed and intelligent individuals don't question why a healthy family has to shell out the same amount or more than a family full of obese smokers.  There are actually reasons for health insurance companies doing this (they're not pretty).  The bottom line is this: The 80-20 rule (a.k.a. the Pareto Principle, as also referenced in Six Sigma, http://en.wikipedia.org/wiki/Pareto_principle) needs to be applied differently.  This rule states that, generally 80% of the effects come from 20% of the causes.  Use your imagination and try to guess who the 20% are when it comes to healthcare outcomes and risk.  Are you one of the 20%?  If you are, I think your premiums should be higher than mine.  Any argument to the contrary would be...illogical. 
• There's too much money in it for the Government to ban it.  In 2006, our government collected nearly $15 billion  in taxes related to tobacco.  Smoking exists because our Government is too greedy and short-sighted to stop it, and putting a warning label on a pack of cigarettes is like telling a heroin addict "this might be bad for you."  (Actually, all-cause mortality is lower in heroin addicts who don't smoke than for smokers).  But, after all, cigarettes are legal.  How bad can it be if its legal?  Besides, the lobbyists and tobacco execs need bigger yachts this year.  In this country, "legal" means OK to our kids.  If you're a parent who smokes, your behaviors say smoking is OK, too.  Is that really the message you're trying to send?http://en.wikipedia.org/wiki/Tobacco_politics

• Picking your nose is a bad habit.  Smoking is a drug addiction.  Know the difference and it will save your life.  It's the classic tail wagging the dog scenario.  The cigarettes control you.  No matter what the financial or health costs, you will smoke, because the nicotine tells you to, even if it means hauling around a big green tank, looking 50 when you're actually 30, or, sadly, your kids saying goodby to you too soon.  We'll miss you, dad. 
• From the CDC: http://www.cdc.gov/tobacco/
• From the American Lung Association: http://www.lungusa.org/stop-smoking/

• F as in Fat:
• In many studies, the United States is the most obese country in the world (why does that not surprise me).
• Canada has roughly about 1/2 the obesity rate as the United States.  Hmm...maybe switching countries is the answer.  Think about that and get back to me.
• Not a single state's obesity rates went down last year, and 30 states had obesity rates for children at or above 30%.  Furthermore, adult obesity rates increased in 27 states (yikes)! http://healthyamericans.org/reports/obesity2009/
• The state of Alabama was the MOST obese state in 2008 with an obesity rate of over 31%! per CDC statistics. http://www.cdc.gov/obesity/data/trends.html#State.  Watch how fat we've become in the U.S. since the mid-80's on this neat little flash-animated map.
• Look at the scary prevalence of obesity in the Southeast compared to the rest of the country.  Why the Southeast? (Hint: think culture, and you're on the right track).  Can we change culture?  Hopefully. 
• About 2/3 of all adults in the U.S. are overweight or obese.  Ah, the land of plenty!
• Americans spend most of their free time watching TV and sitting around.

• Fact: Well-applied duct tape intermittently removed by a good friend is a cost-effective alternative to bariatric surgery (That's just a joke.  It is true, but we don't really recommend that). 
• Seriously, bariatric (weight loss) surgery is increasingly popular.  There has been about a 600% increase in the procedure over the last several years.  Is it really that bad that we have to pay surgeons to re-route or clamp-off our digestive tracts because we can't stop eating?  Sad commentary, don't you think?  Other people around the world are starving, and we Americans eat ourselves sick.  But, hey, let's make it a real disease so that we can legitimize it and its drastic, sometimes life-threatening treatments.  Besides, "obesity" sounds so much better than "fat."  Name a vice, and we'll eventially legitimize it by turning it into a disease.  I'm sure there's a 12-step program out there that we can all join for our vices (I mean "diseases"). 
• Calorie restriction has been proven to increase life expectancy, and lowers levels of insulin and inflammatory mediators. Seriously, nursing homes are full of skinny old ladies-that's because fat people die before they get old enough to need a skilled nursing facility, and women easily outlive men.  Our seniors are wise.  The unwise usually never get to be seniors. 
• Losing weight gradually, on your own through moderate caloric restriction and exercise is superior to weight loss surgery in most instances except in the case of the super-obese individual who has lost the ability to exercise or self-restrict calories without serious complications.  Marginally obese individuals can and should lose weight through traditional means. 
• Bariatric surgery has a complication rate of up to 20% and a mortality rate of up to 1%.  Complications can include vitamin deficiencies, gallstones (requiring a second surgery), leakage (requiring a second surgery), infections, protein-calorie malnutrition, metabolic bone disease, and hair loss. 
• The strict dietary, nutritional and supplement requirements following gastric bypass procedures are actually more complicated than following a strict, calorie-modified diet to lose weight sensibly without surgery. 
• Obesity in families may not be due to purely genetic factors.  In fact, kids are often victimized unwittingly by their well-meaning parents by forcing them to make unhealthy food choices.  Fat parents breed fat kids.  Instead of blaming the genes, however, we need to blame the unhealthy food choices that parents make for their children.  Are you making your kids fat?  If you are, consider the consequences.  
• Its better to throw food away, than to pack more calories on if you are overweight.  Feel less guilty about not cleaning your plate.  There are kids starving in Africa-just like your mom told you.  They're really skinny.  You cleaning your plate won't save them.  When you come in to my clinic and say you "hardly eat anything" and you weigh 300 pounds, I'm pretty sure you're lying, and you insult the millions of people in the world who really do hardly eat anything.  That's what you should really feel guilty about.  Get real, get a life, and stop lying to yourself. 

Information from the CDC: http://www.cdc.gov/obesity/index.html

Currently a body mass index (BMI) greater than 25 means you are overweight, and a BMI of 30 or greater means you are obese.

 

1. 104,748 U.S. patients are currently waiting for an organ transplant; more than 4,000 new patients are added to the waiting list each month.
2. Every day, 18 people die while waiting for a transplant of a vital organ, such as a heart, liver, kidney, pancreas, lung or bone marrow.
3. Because of the lack of available donors in this country, 4,573 kidney patients, 1,506 liver patients, 371 heart patients and 234 lung patients died in 2008 while waiting for life-saving organ transplants.
4. Nearly 10 percent of the patients currently waiting for heart transplants are young people under 18 years of age.
5. Acceptable organ donors can range in age from newborn to 65 years or more. People who are 65 years of age or older may be acceptable donors, particularly of corneas, skin, bone and for total body donation.
6. An estimated 12,000 people who die each year meet the criteria for organ donation, but less than half of that number become actual organ donors.
7. Donor organs are matched to waiting recipients by a national computer registry, called the National Organ Procurement and Transplantation Network (OPTN). This computer registry is operated by an organization known as the United Network for Organ Sharing (UNOS), which is located in Richmond, Virginia.
8. Currently there are 58 organ procurement organizations (OPOs) across the country, which provide organ procurement services to 250 transplant centers.
9. All hospitals are required by law to have a "Required Referral" system in place. Under this system, the hospital must notify the local Organ Procurement Organization (OPO) of all patient deaths. If the OPO determines that organ and/or tissue donation is appropriate in a particular case, they will have a representative contact the deceased patient’s family to offer them the option of donating their loved one’s organs and tissues.
10. By signing a Uniform Donor Card, an individual indicates his or her wish to be a donor. However, at the time of death, the person's next-of-kin will still be asked to sign a consent form for donation. It is important for people who wish to be organ and tissue donors to tell their family about this decision so that their wishes will be honored at the time of death.
11. All costs related to the donation of organs and tissues are paid for by the donor program. A family who receives a bill by mistake should contact the hospital or procurement agency immediately.
12. Tissue donation can enhance the lives of more than 50 people. Donated heart valves, bone, skin, corneas and connective tissues can be used in vital medical procedures such as heart valve replacements, limb reconstruction following tumor surgery, hip and knee joint reconstruction and in correcting curvature of the spine.
13. In 2008, a total of 14,208 organ donors were recovered in the U.S. Of these, 7,990 were cadaveric donors, which represented a decrease over the total of 8,019 in 2006. Living donors decreased from 6,732 in 2006 to 6,218 in 2008.
14. Donor organs and tissues are removed surgically, and the donor’s body is closed, as in any surgery. There are no outward signs of organ donation and open casket funerals are still possible.
15. Acceptable organ donors are those who are "brain dead" (whose brain function has ceased permanently) but whose heart and lungs continue to function with the use of ventilators. Brain dead is a legal definition of death.
16. Organ transplant recipients are selected on the basis of medical urgency, as well as compatibility of body size and blood chemistries, and not race, sex or creed.
17. Advances in surgical technique and organ preservation and the development of more effective drugs to prevent rejection have improved the success rates of all types of organ and tissue transplants.
18. About 94.4 percent of the kidneys transplanted from cadavers (persons who died recently) are still functioning well at one year after surgery.
19. The results are even better for kidneys transplanted from living donors. One year after surgery, 97.96 percent of these kidneys were still functioning well.
20. Following are one-year patient and organ graft survival rates:

    Organ		Patient Survival Rate		Graft  Survival Rate
    Kidney (cadaveric) Kidney (live donor) Liver		94.4% 97.9% 90.1%		89.0%  95.1%  82.0%

    
    
21. Following is a comparison of the numbers of organ transplants done in 2008 and the numbers of individuals who are on the national waiting list as of November 2009.
    
    

    Organ		Number of Transplants in 2008		Number of Patients on Waiting List* (of November 2009)
    Kidney Kidney/Pancreas Pancreas Liver Heart Heart/lung Lung Intestine Total:		16,520 837 436 6,319 2,163 27 1,478 185 27,965		82,364 2,220 1,488 15,915 2,884 83 1,863 229 107,046

    
    
22. Of the 13,156 single kidney transplants performed in 2008, 5,968 were from living donors and the rest were from cadaveric donors. In addition, 837 kidneys were transplanted in combination with pancreas transplants.
23. Over 2,500 bone marrow transplants were performed in the U.S. in 2004. Marrow is collected from a pelvic bone using a special needle while the volunteer donor is under anesthesia. The majority of bone marrow transplants are done for leukemia.
24. In the United States fewer than 2.5% of patients with end-stage kidney disease undergo transplantation as their first treatment or therapy. The National Kidney Foundation is dedicated to educating kidney patients about the benefits of pre-emptive transplantation - when a person is able to go straight to transplant without dialysis they usually have good health outcomes.
25. 2008 was the first time in 20 years that there was a decline in the number of deceased donors used for transplants. Living donors in 2008 were at their lowest numbers since 2001.
26. Virtually all religious denominations approve of organ and tissue donation as representing the highest humanitarian ideals and the ultimate charitable act. (Source: The National Kidney Foundation).
27. Death row inmates have never been able to donate their organs even if they requested to do so.  Seriously?  There were 3,279 death row inmates as of July 2009.  Each of these persons, if executed today, could potentially provide fifty (50) patients with life-saving organs or tissue.  Let's assume, conservatively, that 50% of these inmates are healthy enough to donate.  Even that 50% could potentially provide organs and tissue for 81,975 individuals needing help.  Conservative estimates have us spending over $137 million per year on caring for death row inmates and carrying out the ultimate punishment.  If the death penalty were abolished in favor of lifetime incarceration, the costs would be reduced to $11.5 million.  We spend over $125 million each year in excess costs to continue this practice.  Furthermore, the death penalty has not been proven to be a deterrent to serious crime such as murder in states that favor such punishment.  Would $125 million purchase some healthcare for those who needed it?  Please help us come up with real solutions!  http://www.amnestyusa.org/death-penalty/death-penalty-facts/the-death-penalty-and-deterrence/page.do?id=1101085.                

This Is Really Interesting...Who's More Likely to Condone Torture?  (You May Be Surprised).       http://pewforum.org/docs/?DocID=156