Caitlyn and Jenna dance concert at Ladera Vista


  I used to like him, but my confidence in him has waned...


Yea - I am deplorable...

Carr: Some Quick, easy steps to tell if you’re a deplorable

Howie Carr Wednesday, September 14, 2016

Credit: AP

IN A ‘BUCKET’ OF TROUBLE: Democratic presidential nominee Hillary Clinton waves on Sunday after leaving a 9/11 ceremony early.
Are you a “deplorable,” one of those dreadful Donald Trump supporters who so offend Hillary Clinton’s delicate sensibilities?
As far as she’s concerned, the deplorables are expendable, in order to make room for her “basket” of voters, the despicable and the deportable.

If Hillary hadn’t had that problem with seasonal allergies or overheating or chronic dehydration or pneumonia or whatever they’re calling it now, her “deplorables” slur would be getting a lot more play.
Didn’t Barack Obama say a few months back that a candidate couldn’t insult his way to the presidency? I guess he was referring to Donald Trump. Hillary Clinton, apparently, can.
In case you’ve been wondering which side you’re on, you may be a deplorable if you stand for the National Anthem.
Or if you know all the words to the Pledge of Allegiance, especially, “under God.”
Or if when you go to Market Basket, you tend to buy generic products, because you’re using your own money, not an EBT card.
You may be a deplorable if you just got your car inspected.
If you’re deployable, you’re definitely deplorable.
If you wake before noon, if you call Islamic terrorists Islamic terrorists, if you don’t have an Obamaphone and you don’t believe that global warming is “settled science” — can you say deplorable?
You may be deplorable if your passport, driver’s license and credit cards are all in the same name.
Saying Merry Christmas — Deplorable with a capital D!
You may be a deplorable if you wouldn’t mind showing some ID at the local precinct before you vote.
You are most assuredly a deplorable if you have more than one job.
You may be a deplorable if you’ve never used Western Union to wire welfare cash south of the border.
You may be a deplorable if all of your children have the same last name — and it’s your last name.
Or if while watching the second Monday night NFL game you were less irritated by the streaker than you were by all the fawning coverage of Colin Kaepernick on the pre-game show.
You may be a deplorable if you resent training your H1-B replacement.
Or the fact that the Earned Income Tax Credit is NOT earned.
Nothing says deplorable like the National Rifle Association.
If you liked your doctor and wanted to keep your doctor, if you wear pants rather than pajamas when you leave the house, if you were passed over for the job even though you got a 95 on the civil-service test — you know what you are.
You may be a deplorable if you don’t think you should have to press one for English.
If you lost your security clearance and your job for mishandling classified information, you are deplorable.
You may be a deplorable if you identify as a member of the gender in which you were born.
Or if you drained your 401(k) or took out a second mortgage on your house to pay for your kid’s tuition at UMass while the illegal alien down the hall goes on the arm.
Or if you believe that good fences make good neighbors.
You’re most definitely a deplorable if you have an American flag flying in your front yard.
Or if you’ve never windsurfed with John Kerry on Nantucket, or stood in line with Sen. Warren at your local “cheese shop.”
You are a deplorable if you believe All Lives Matter.
If you’ve never needed a “safe space,” or heeded a “trigger warning” — deplorable.
If you’ve gone to the store and ordered a “Proud to be Deplorable” T-shirt — yes, you know very well what you are.
Listen to Howie 3-7 weekdays on WRKO AM 680.

ObamaCare and the death spiral...

... like it was designed that way or something.

A Scary Obamacare Mystery

Pop quiz: Are the Obamacare exchanges a success? Your answer should take into account three recent pieces of news about the online marketplaces created by the Affordable Care Act:
  • The U.S. Centers for Disease Control's latest report on the uninsured shows that 8.6 percent of the population was uninsured in the first three months of 2016. This is a record low.
  • A survey of Blue Cross/Blue Shield companies, the backbone of the exchanges, indicates that about half their customers in the individual market are buying insurance without subsidies.
  • Arizona has managed to persuade its Blue to sell insurance in Pinal County. That was one of a handful of localities nationwide that faced the possibility of losing all the providers in their Obamacare marketplaces after insurance giants like Aetna announced in August that they were pulling out.
You may be wondering what these three seemingly disparate facts have to do with each other. The answer is, quite a lot. Let me explain.
Conservatives should acknowledge that the coverage expansion is real, it is large (though not as large as we were led to expect), and that while it is not necessarily going to make people much healthier, it is probably going to reduce financial hardship among at least some of the people who have gained coverage. That’s significant, though we can still argue about whether the benefit was worth the cost. (If Obamacare were being voted on today, I would still oppose it).
Liberals, however, should also acknowledge uncomfortable facts. The first is that most of the decrease in the uninsured population came in 2014 and 2015, and is now leveling off. Unless younger and healthier people start buying insurance in much larger numbers, we’re probably not going to see huge improvement. The fact that so few young, healthy people are buying insurance may not only mean that the number of uninsured people stops going down. It could mean that that figure starts going up again.
Why? Because outside of the near-poor, uptake of Obamacare policies is not as high as we’d like. As health insurance consultant Bob Laszewski has written, “Historically, insurers want to see a 75-percent participation rate.” In other words, they want to see three-fourths of the eligible people sign up.
That's because insurers can predict their costs when a representative cross-section of people buys their plans. But when too few sign up, the insurer has to ask, “Who’s declining to buy insurance?” and the most likely answer is, “Healthy people who don’t expect to use it much.” The remaining pool, then, will be sicker. The lower the participation rate, the more likely it is that you’ve got a small group of people who are going to make expensive claims.
This is a phenomenon known as “adverse selection.” And it tends to get worse as premiums rise to reflect the cost of covering this sicker pool, because more people start dropping the ever-costlier insurance, and usually the folks who drop out are the healthiest ones.
Obamacare’s individual mandate was supposed to prevent this death spiral by levying a tax penalty on those who refused to sign up. But the fine appears to be too small to get young folks to buy in.
And that brings us to our second point: the split between subsidized and unsubsidized patients. Because right now, the main thing standing between Obamacare and a death spiral is the fact that subsidies shield customers from the true cost of their plans. So the law’s supporters hope that the second, really vicious part of the death spiral, where rising premiums produce even more adverse selection, will never kick in.
Most of the exchange customers are subsidized; the off-exchange customers are not. But that doesn’t matter, because under Obamacare, insurers have to treat their exchange policies and their off-exchange policies as a single actuarial risk pool, rather than adjusting for the different risks in the different markets. If the exchanges have too many old, sick people on them, and not enough young, healthy ones, those costs will leak over to the unsubsidized off-exchange policies in the form of premium hikes.
That may explain why we’ve seen some insurers pull out of the exchanges while continuing to offer individual policies. That means the older, sicker exchange customers don’t show up in their pools. However, that obviously creates a problem when the number of plans available on the exchanges dwindles. Which brings us to our third data point.
Regulators have tools to combat this sort of strategic withdrawal. They can force all individual policies to be sold through the exchanges, for example, as my own home city has done. But that creates the risk that insurers will simply exit the individual market entirely. Alternatively, the regulators can beg insurers to do them a favor, possibly offering sweeteners in the form of leeway on premium-setting, or favorable treatment in other insurance markets.
But it’s questionable whether this is a viable long-term solution. How many favors can insurance regulators give companies to get them to keep taking losses, year after year? And if the favors come in the form of, “We’re not going to quibble over how much you want to charge people for the insurance you offer on the exchanges,” this will translate into big premium hikes that the subsidized buyers don’t see, but that deliver a nasty shock to the folks in the unsubsidized market. At some point, adverse selection seems likely to set in once again, threatening the gains that reduced the number of uninsured Americans.
The correct answer to the pop quiz, therefore, is “We don’t know yet.” While Obamacare’s grander claims about lowering health-care costs and rationalizing our crazy health-care system have mostly failed to come to pass, the one thing supporters have been able to point to is the falling number of uninsured people. If that number starts to rise again, that argument will become harder to make.
  1. This is complicated because the high deductibles on the plans mean that a lot of people won’t get any benefit from their policies. Sicker people, who are more likely to blow past those deductibles, seem to be much more likely to buy policies.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
To contact the author of this story:
Megan McArdle at
To contact the editor responsible for this story:
Jonathan Landman at


Why Wasted Words Kill Good Ideas And Cost Sales

It’s easy to take the nuts and bolts of our communication for granted. We can all talk and read and write, after all. But as soon as we start to put our own ideas out there – making the leap from reader to blogger, or from consumer to persuader – how we communicate starts to matter. Words become tools. To get a grip on what we’re doing with them, we need to dissect the language that we otherwise take for granted.
This way of thinking holds true for every aspect of promotion – whether we’re talking about a verbal sales pitch, a formal presentation, a blog, or an advert. Everyone communicates, but not everyone communicates effectively.

Marketable messaging: How to stand out from the crowd

Aside from the nitty-gritty of what you are selling, it pays to consider what makes an image chime with a particular piece of writing. You need to learn how to maintain the right tone of voice from one page to the next and from a first introduction to a long-lasting relationship.
Those simple common-sense issues cut right to the heart of what makes a blog (or a website or a sales pitch) hang together effectively. They represent the difference between a recognisable (marketable) entity and something that just takes up space.
The blogging giant Wordpress, which accounts for more blogs than any other provider, haspublished stats showing that their users produce around 69.8 million new posts and 22.2 billion pages every month. That’s quite a crowd to try and stand out from. At the same time, New Yorker Magazine’s Ian Parker has estimated that over $250 million a day are wasted through poor PowerPoint presentations. There are serious costs that come with making a mess of your messaging.

It starts with plain speaking: Keep it short and crisp

As early as 1997, the linguist Jakob Nielsen argued that the language of the internet was not the same as the language of books or newspapers. Web texts share the same basic ingredients in terms of recognisable English words and phrases (WordPress claim that 71% of the posts they support are in English). In most other respects, what cuts it across the web is writing that mimics how people ordinarily speak. Shorter, crisper sentences and simpler vocab generate more vividly striking ideas.

Leaden language: Graveyards for good ideas

This is serious enough when your words are sitting there on a page, but when someone is standing up and delivering a badly written script it’s just plain painful. Just like blogs, presentations are all too often sunk by a leaden use of language. Anyone who has ever spent time in a boardroom has seen how disastrous a bad pitch can be. Bad pitches are graveyards for good ideas.
If you think of every sentence as an ad for your proposition, you’ll be on the right lines. Consider all the great slogans you’ve ever come across: Beanz meanz Heinz, Just do it, It’s the real thing… short, sweet and punchy nails it every time.

Authenticity and Sincerity: At the core of good business

As we’ve said, every sentence counts when you’re pitching, but for every sentence to count you need to consider its context. As an example, Hiscox points out on their small business knowledge hub that pitching doesn’t come in a “one-size-fits-all methodology”. Essentially, if you want your words to have an impact, they need to mean something to the audience you’re addressing.
As you’d expect, every context will have its own unique conditions, but according to Hiscox the main variables stay the same. Outlined in the Hiscox tailored guide on the ‘Four Ps of Pitching’, the basic principles any pitch should cover include: People, Price, Principle and Proposition.
Naturally, there’s a lot more to the advice in the guide than just a way with words. For instance, the importance of humour when it comes to connecting with an audience is emphasised throughout. But if, as their pages insist, authenticity and sincerity are at the core of good business, it only ever makes sense to say so directly.
The BBC Academy is another valuable resource that agrees with the principles conveyed in the Hiscox guide. The BBC might be selling news, but the common sense aspect of how to successfully deliver words that work is just the same. Whether you’re blogging about basket weaving or making a presentation in Dragon’s Den, the words you use will have a direct bearing on your bottom line. How many times have you seen the dragons frustrated by someone talking in circles?

White space and silence: Wasted words are for losers

Concise, scannable, and objective was the mantra coined by Jakob Nielsen. It is a mantra that still holds good and is still being pushed 20 years after it was coined. It is the “be all and end all” of everything that works for a public audience.
If you can stop waffling, you will start seeing what all the fuss is about. When it comes to writing for the web, white space is not the enemy – it is actually a powerful tool to highlight what’s important. In the same way, if you’re on your feet and pitching, silence is a tactic you can use.
Here are some common sense measures you can take to ratchet up your effectiveness.
  • Write snappy – short words work wonderfully well
  • Be happy – we all like being talked to on a one-to-one basis. Sermons are seriously out of fashion
  • Be savage – much as it hurts, taking words out is like weeding the garden. The harsher you can be, the more your ideas will bloom
  • Get straight to the gist – kids like mystery tours, buyers are more brutal
  • Learn to love lists – everyone likes a list
The common sense ideas behind winning people over – whether you’re blogging or pitching – are easy to ignore. If you want to deliver something that’s readable, shareable and marketable, it will always pay not to put excess words in the way.

I pretty much get cramps nightly, and with the nerve damage in my back, I can now understand some of the processes that lead to cramps.

I pretty much get cramps nightly, and with the nerve damage in my back, I can now understand some of the processes that lead to cramps.

Could there finally be a way to prevent muscle cramps?
As long as people have played sports, unexpected muscle cramps have been an Achilles' heel for everyone from aspiring Olympians to weekend warriors.
For decades physicians and other experts in sports medicine have theorized that a cramp was the result of a muscle that was dehydrated, or starved of electrolytes, or suffering tears in its micro-fibers and cell membranes. These caused pain and spasms that could only be alleviated with water and electrolytes, conventional wisdom held.
Now, more experts are beginning to believe we may have been thinking wrongly about cramps all along. A shot of spicy liquid—think wasabi or hot chilies—may be a far more effective treatment than an energy drink or a banana. All it took was a Nobel Prize winner experiencing some untimely cramps while sea kayaking a decade ago for people to begin to understand that the causes of muscle cramps may not have much to do with muscles at all.
“The primary origin of the cramp is the nerve, not the muscle,” said Rod MacKinnon, the kayaker and Nobel Prize winning scientist who studies molecular neurobiology and biophysics at Rockefeller University and has led the new thinking on cramps.
Dr. Rod MacKinnon, left, and friend Jon Sack sea kayak between Chappaquiddick, Mass., and Woods Hole, Mass.ENLARGE
Dr. Rod MacKinnon, left, and friend Jon Sack sea kayak between Chappaquiddick, Mass., and Woods Hole, Mass. PHOTO: BRUCE BEAN
With the Olympics scheduled to begin in Rio in a little more than three weeks, the new understanding of cramps couldn’t be more timely. Athletes spend four years training for their moment at the Olympics, and few things are more frustrating than a freak event like a cramp that can wipe out years of preparation.
Paula Radcliffe, still the world record holder in the marathon, famously cramped up at the Athens Olympics in 2004 and failed to finish the race. Earlier this month, tennis player Madison Keys experienced cramps during the third set of her fourth round match at Wimbledon and lost to Simona Halep.
While both Ms. Radcliffe’s and Ms. Keys’s muscles were indeed taxed, that doesn’t necessarily explain why they experienced the pain we associate with cramps. If muscles cramp simply because they are weary and poorly nourished, why do our muscles cramp when we are lying in bed doing nothing? Why would an elite triathlete like Craig Alexander, a former Ironman world champion, occasionally suffer from leg cramps in the first minutes of a race, when he was fully hydrated and the opposite of exhausted?
“You feel so helpless when it happens,” Mr. Alexander said, “and the explanation flew in the face of logic.”
Dr. MacKinnon’s hands and arms dangerously cramped up a decade ago when he was kayaking with colleague Bruce Bean, a neurobiologist at Harvard Medical School, roughly 7 miles off Cape Cod in Massachusetts. Hydration and electrolytes weren’t issues in that case either.
Nobel Prize-winning molecular neurobiologist and biophysicist Rod MacKinnon, left, and Harvard neurobiologist Bruce Bean, invented a spicy drink to neutralize the nervous system’s excessive firing of motor neurons, which causes muscle cramps.ENLARGE
Nobel Prize-winning molecular neurobiologist and biophysicist Rod MacKinnon, left, and Harvard neurobiologist Bruce Bean, invented a spicy drink to neutralize the nervous system’s excessive firing of motor neurons, which causes muscle cramps. PHOTO: WENDY MAEDA/GETTY IMAGES
After making it back to shore, Dr. MacKinnon and Dr. Bean began hunting for an answer. Rather than focusing on his muscles, Dr. MacKinnon and his friend hypothesized that something might have caused the impulses the nervous system sent to his muscles to misfire and his muscles to cramp. Perhaps, they thought, people might be able to avoid cramps by regulating excessive firing of motor neurons, which they saw as the origin of muscle cramping.
Exercise science isn’t generally an area that winners of the Nobel Prize in chemistry indulge in. Dr. MacKinnon won the Nobel after he and his colleagues provided the first atomic structures of the protein molecules that make electrical signals in living organisms.
LeBron James in June 2014 playing for the Miami Heat. Mr. James has had to exit games due to severe pain caused by muscle cramps. ENLARGE
LeBron James in June 2014 playing for the Miami Heat. Mr. James has had to exit games due to severe pain caused by muscle cramps.PHOTO: CHRIS TROTMAN/GETTY IMAGES
U.S. tennis player Madison Keys suffered muscle cramps during the women's singles match she lost to Simona Halep of Romania this month at the Wimbledon Tennis Championships in London.  ENLARGE
U.S. tennis player Madison Keys suffered muscle cramps during the women's singles match she lost to Simona Halep of Romania this month at the Wimbledon Tennis Championships in London. PHOTO: TIM IRELAND/ASSOCIATED PRESS
Nevertheless, cramps were on Dr. MacKinnon’s mind. After perusing the existing research he and Dr. Bean hypothesized that they could modify the nervous system, including the motor neurons controlling muscle, by applying a strong sensory input and by stimulating receptors in the mouth and esophagus—which is how scientists describe ingesting pungent tasting foods. The pungent-taste overloads nerve receptors, producing a kind of numbing effect.
Or, as Dr. MacKinnon explains it, “The strong sensory input causes inhibition of the motor output.”
Might this be dangerous? Does the pain from a muscle cramp have a purpose, like the pain that makes us pull our hand away from a hot stove?
After considering this possibility, Dr. MacKinnon concluded there is no benefit to a muscle cramp. The debilitating pain we experience doesn’t prevent injury. We experience it not to help us survive but because the human body isn’t a perfectly evolved machine.
New Zealand batsman Mark Richardson has cramped up during cricket matches. Here he plays in a match in the northern Indian state of Punjab in 2003. ENLARGE
New Zealand batsman Mark Richardson has cramped up during cricket matches. Here he plays in a match in the northern Indian state of Punjab in 2003. PHOTO: KAMAL KISHORE/REUTERS
Using himself as a lab rat, Dr. MacKinnon began concocting spicy drinks in his kitchen with varying amounts of ginger and cinnamon and trying to induce cramps with electrical impulses. Over the course of the next decade, he grew convinced his hunch was correct. It was harder to induce the cramps after indulging in the spicy concoctions.
A series of randomized, scientific studies followed. The subjects produced results similar to what Dr. MacKinnon had experienced. Those studies were presented last year at meetings of the American Academy of Neurology and the American College of Sports Medicine.
The great irony of all this is athletes for years had already been trying to avoid cramps not simply with water and bananas but also with pungent liquids, such as juice from pickles, beets or sour cherries. They drank the pickle juice believing its high sodium content would replace an important electrolyte, and they drank the beet and cherry juice because they are rich in antioxidants that athletes thought could help prevent cramping.
The idea was to get those ingredients into the bloodstream and muscles. In some cases, the pickle, beet and cherry juice worked, but in the view of Dr. MacKinnon and a growing number of other scientists, not because the nutrients were reaching their muscles since research showed their blood content was largely unchanged.
“We often find in science we are doing the right things but for the wrong reason,” saidPhilip Skiba, the director of sports medicine at Advocate Lutheran General Hospital in Park Ridge, Ill., who has worked closely with Olympians both in the U.S. and Great Britain to develop training programs. “The sensory experience may have been what was having the effect on the legs.”
Dr. MacKinnon helped develop the Hotshot drink—a mix of ginger, cinnamon and capsicum or spicy pepper plants.ENLARGE
Dr. MacKinnon helped develop the Hotshot drink—a mix of ginger, cinnamon and capsicum or spicy pepper plants. PHOTO: FLEX INNOVATION GROUP
Dr. Skiba said he has noticed a significant number of endurance athletes who are indulging in spicy drinks before races now. To try to take advantage of that, Dr. MacKinnon, working with biotech entrepreneur Christoph Westphal, launched the company Flex Pharma Inc., which went public in 2015.
Earlier this year, the company brought to market Hotshot, a mix of ginger, cinnamon and capsicum—spicy pepper plants—that comes in 1.7 ounce bottles. It is currently available in select stores in Boston, Los Angeles and Boulder, Colo., and can be ordered online.
Dr. Skiba said more testing of Hotshot and other similar products is needed and that the nature of testing the products, or any pungent tasting substance presents an inherent difficulty. Because the taste is so strong, it is very difficult to create a placebo, so subjects invariably know they have ingested something and that can affect whether they experience a cramp.
Even Dr. MacKinnon acknowledges that drinking Hotshot before a stressful workout, especially first thing in the morning, can feel counterintuitive. This isn't ice-cold, citrus-flavored water. The taste is hardly refreshing, and it packs a jolt more commonly experienced around a table covered with South Asian food rather than a training table.
That is the point though. It is about shocking the system, not replenishing it.

good info

Multiple Myeloma Prognosis


Determining Prognosis

The prognosis of multiple myeloma is usually based on the existence of different signs, symptoms, and circumstances. Multiple myeloma prognosis as well as survival rates have improved due to myeloma research. The prognosis of myeloma is also dependent on the stage of the disease as determined by the results of diagnostic testing. Survival rates are sometimes used by doctors to explain a patient’s prognosis; however, many patients prefer to avoid knowing about myeloma survival rates when learning of their prognosis.
In arriving at prognosis for multiple myeloma, several clinical and laboratory findings provide important information. These prognostic indicators help determine how fast the tumor is growing, the extent of disease, the biologic make-up of the tumor, the response to therapy, and the overall health status of the individual. Prognostic indicators may also help determine whenmultiple myeloma treatment should begin, and which treatment is best according to a person’s individual risk for relapse.

Learn more about multiple myeloma prognosis.