Tag Archives: Robert Buxbaum

C-Pap and Apnea

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A month of so ago, I went to see a sleep doctor for my snoring. I got a take-home breathing test that gave me the worst night’s sleep in recent memory. A few days later, I got a somber diagnosis: “You are a walking zombie.” Apparently, I hold my breath for ten seconds or more every minute and a half while sleeping. Normal is supposed to be every 4 to 10 minutes. But by this standard, more than half of all middle-aged men are sub-normal (how is this possible?). As a result of my breath-holding, the wrinkled, unsmiling DO claimed I’m brain-dead now and will soon be physically dead unless I change my ways. Without spending 3 minutes with me, the sleep expert told me that I need to lose weight, and that I need a C-Pap (continuous positive airway pressure) device as soon as possible. It’s supposed to help me lose that weight and get back the energy. With that he was gone. The office staff gave me the rest of the dope: I was prescribed  a “ResMed” brand C-Pap, supplied by a distributor right across the hall from the doctor (how convenient).

I picked up the C-Pap three months later. Though I was diagnosed as needing one “as soon as possible,” no one would release the device until they were sure it was covered by my insurance company. The device when I got it, was something of a horror. The first version I tried fit over the whole face and forces air into my mouth and nose simultaneously, supposedly making it easier to inhale, but harder to exhale. I found it more than a bit uncomfortable. The next version was nose only and marginally more comfortable. I found there was a major air-flow restriction when I breath in and a similar pressure penalty when I breathed out. And it’s loud. And, if you open your mouth, there is a wind blowing through. As for what happens if the pump fails or the poor goes out, I notice that there are the tiniest of air-holes to prevent me from suffocating, barely. A far better design would have given me a 0-psi flapper valve for breathing in, and a 1/10 psi flapper for breathing out. That would also reduce the pressure restriction I was feeling every time I took a deep breath. One of my first blog essays was about engineering design aesthetics; you want your designs to improve things under normal conditions and fail safe, not like here. Using this device while awake was anything but pleasant, and I found I still hold my breath, even while awake, about every 5 minutes.

Since I have a lab, and the ability to test these things, I checked the pressure of the delivered air, and found it was 3 cm of water, about 1/20 psi. The prescription was for 5 cm or water (1/14 psi). The machine registers this, but it is wrong. I used a very simple water manometer, a column of water, similar to the one I used to check the pressure drop in furnace air filters. Is 1/20 psi enough?How did he decide on 1/14 psi by the way? I’ve no idea. !/14 psi is about 1/200 atm. Is this enough to do anything? While the C-Pap should get me to breathe more, I guess, about half of all users stop after a few tries, and my guess is that they find it as uncomfortable as I have. There is no research evidence that treatment with it reduces stroke or heart attack, or extends life, or helps with weight loss. The assumption is that, if you force middle-aged men to hold their breath less, they will be healthier, but I’ve no clear logic or evidence to back the assumption. At best, anything you gain on the ease of breathing in, you lose on the difficulty of breathing out. The majority of middle-aged men are prescribed a C-Pap, if they go for a sleep study, and it’s virtually 100% for overweight men with an apple-shaped body.

I’d have asked my doctor about alternatives or for a second opinion but he was out the door too fast. Besides, I was afraid I’d get the same answer that Rodney Dangerfield got: “You want a second opinion? OK. You’re ugly, too.” Mr. Dangerfield was not a skinny comic, by the way, but he was funny, and I assume he’d have been prescribed a C-Pap (maybe he was). He died at 82, considerably older than Jim Fixx, “the running doctor,” Adelle Davis, the “eat right for health” doctor, Euell Gibbons “in search of the wild asparagus,” or Ethan Pritkin, the diet doctor. God seems to prefer fat comedians to diet experts; I expect that most-everyone does.

Benjamin Franklin and his apple-shaped body

Benjamin Franklin and his apple-shaped body; I don’t think of him as a zombie.

What really got my goat, besides my dislike of the C-Pap, is that I object to being called a walking zombie. True, I’m not as energetic as I used to be, but I manage to run a company, and to write research papers, and I get patents (this one was approved just today). And I write these blogs — I trust that any of you who’ve read this far find them amusing. Pretty good for a zombie — and I ran for water commissioner. People who use the C-Pap self-report that they have more energy, but self-reporting is poor evidence. A significant fraction of those people who start with the C-Pap, stop, and those people, presumably were not happy. Besides, a review of the internet suggests that a similarly large fraction of those who buy a “MyPillow.com” claim they have more energy. And I’ve seen the same claims from people who take a daily run, or who pray, or smoke medical marijuana (available for sleep apnea, but not from this fellow), or Mirtazapine (study results here), or  for electro-shock therapy, a device called “Inspire.” With so many different products providing the same self-reported results, I wonder if there isn’t something more fundamental going on. I’d wish the doc had spent a minute or two to speak to this, or to the alternatives.

As for weight loss, statistical analysis of lifespan suggests that there is a health advantage to being medium weight: not obese, but not skinny. I present some of this evidence here, along with evidence that extra weight helps ward off Alzheimer’s. For all I know this protection is caused by holding your breath every few minutes. It helps to do light exercise, but not necessary for mental health. In terms of mental health, the evidence suggests that weight loss is worse than nothing.

Jared Gray, author of the Alien movies, was diagnosed with apnea, so he designed his own sleep-mask.

Jared Gray, author of the Alien movies, was diagnosed with apnea, so he designed his own sleep-mask.

Benjamin Franklin was over-weight and apple-shaped, and no zombie, The same is true of John Adams, Otto Von Bismarck, and Alfred Hitchcock. All lived long, productive lives. Hitchcock was sort of morbid, it will be admitted, but I would not want him otherwise. Ed McMahon, Johnny Carson’s side-kick, apologized to America for being overweight and smoking, bu the outlived Johnny Carson by nine years, dying at 89. Henry Kissinger is still alive and writing at 95. He was always fatter than any of the people he served. He almost certainly had sleep apnea, back in the day, and still has more on the ball, in my opinion, than most of the talking-head on TV. The claim that overweight, middle-aged men are all zombies without a breath assisting machine doesn’t make no sense to me. But then, I’m not a sleep doctor. (Do sleep doctors get commissions? Why did he choose, this supplier or this brand device? With so little care about patients, I wonder who runs the doctor’s office.)

I looked up my doctor on this list provided by the American Board of Sleep Medicine. I found my doctor was not certified in sleep medicine. I suppose certified doctors would prescribe something similar  but was disappointed that you don’t need sleep certification to operate as a sleep specialist. In terms of masks, I figure, if you’ve got to wear something, you might as well wear something cool. Author Jared Gray, shown above (not the author of the Alien) was diagnosed with Apnea 6 months ago and made his own C-Pap mask to make it look like the alien was attacking him. Very cool for an ex-zombie, but I’m waiting to see a burst of creative energy.

What do we zombies want? Brains.

When do we want them? Brains.

What do vegetarian zombies want? Grains.

Robert Buxbaum, March 15, 2019. In case real zombies should attack, here’s what to do.  An odd legal/insurance issue: in order to get the device, I had to sign that, if I didn’t use it for 20 days in the first month of 4 hours per night, and thus if the insurance did not pay, I would be stuck with the full fee. I signed. This might cost me $1000 though normally in US law, companies can only charge a reasonable restock fee, but it can’t be unreasonable, like the full  price. I also had to sign that I would go back to the same, quick-take doctor, but again there has to be limits. We’ll see how the machine pans out, but one difference I see already: unlike my pillow.com, there is no money back guarantee with the C-Pap treatment.

Detroit emerges from bankruptcy. Not quite.

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missing homes Detroit

While Detroit’s central core comes back, surrounding, homes burn at 220+/month, leave Detroit streets looking like the teeth of an aging hillbilly.

Detroit went bankrupt last year, the largest US city to do so since New York in 1970. As with New York’s bankruptcy, Detroit’s was used to cancel old debts and rewrite ill-thought contracts. Detroit also got to jail some crooked politicians including mayor Kilpatrick, described as “a walking crime wave.” But the city and county have no easy path out of bankruptcy as both city and county are likely insolvent. That is, they spend more than they take in despite massive out-state funding, and high taxes, 10% above the state level. To make matters worse, they are losing population at the rate of 1% or so per year. It’s hard to fund a city built for 2 million on the tax revenue of 1/3 as many, especially when they are mostly unemployed. Unless a lot changes soon, another bankruptcy is almost inevitable — likely this time at the county level.

We got in this state, largely as a result of a 50 year war between the black, solidly Democrat, somewhat anarchist, political establishment of Detroit, and the white, stayed, mostly Republican out state. The white population fled following the riots of the 60s and the richer black population soon followed. The remainder stayed, trapped in slowly decaying neighborhoods as the city went broke. White flight allowed the black community to develop its own, Motown culture, but except for the music industry, it has not benefitted from this culture.

Detroit's murder rate, 45/100,000, is the highest in the US. It's coming down but not that fast.

Detroit’s murder rate is the highest in the US. It’s come down 10% in the last 2 years, but has far to go.

Detroiters have poor health, poor savings rates, high murder rates, and a fire rate of about .22% per month, 2.6% per year. The city lacks basic city services like reliable fire fighting and street plowing. Police at one point erected signs that said, “enter at your own risk.” There is a lack of small businesses and the services they would provide too: laundromats, grocery stores, and taxis (though no lack of bars and marijuana maintenance clinics). Employment in the auto-industry is down. And it’s not being replaced by home-grown small business – perhaps hampered by the low savings rate. A surprisingly large fraction of the Detroit homes are in foreclosure, see map, and with it a high abandonment rate and a high fire rate. As pheasant and dear return, non-core Detroit is beginning to look like farm country.

Detroit foreclosures near me. Blue is occupied homes, red is unoccupied, yellow unknown, and green is destroyed homes or vacant, foreclosed land.

Detroit foreclosures near me. Homes in dark blue are occupied foreclosed, red is unoccupied, and green plots are destroyed homes or vacant, foreclosed land.

It’s not clear what political leaders should do. The city council would like to return to their pre-bankruptcy ways where they could borrow as much as they felt they needed and spend on whatever they saw fit — often on fast friends, fast cars, gambling, and vacation homes outside of the city. But the out-state population has been reluctant to give them the credit card. Is this racist or is it prudent — probably both, but this can not continue. The city and county pension funds were ransacked for ill-advised investments and consulting fees to cronies and their power-lawyers. Either the money is replaced from out-state or there will be some unhappy retirees in the not-too-distant future. My guess is that the state will have to pick up the tab for this mismanagement, but that they won’t want to hand over management control afterwards.

Rand Paul, a potential GOP presidential candidate, has proposed rebuilding business and property values by a method that the city will almost certainly reject. His solution: cut services to low-population density areas and cut taxes on business and earned income. While this would likely bring in new people and new businesses, the people would likely be white, and the businesses white-owned/ white-serving. Black-Detroiters have too little savings, organization and income to directly benefit from this plan. Detroit’s Democrat politicians will claim, not without merit, that this is welfare for rich whites: a way for them to become yet-richer while doing nothing for the poor blacks of the burning neighborhoods. They are likely to demand control as the elected officials of the town: regulating business and raising the minimum wage to create “equality.” I suspect this is a bad idea.

Detroit hunger games

Detroit suffers from two populations and a divide.

To some extent we’re already seeing the return of white-owned, white-serving businesses. Classic buildings in the core of the city have been purchased by white developers – notably Dan Gilbert of Quicken Loans leading to gentrification and an influx of single, white hipsters. The newcomers are viewed as half-saviors, half-carpetbaggers. They dwell in a whiter city core with hipster bars and expensive restaurants. Does a poor city with massive debt, crime, and unemployment benefit from a core filled with high-priced, gourmet coffee and fern bars?

The author, Robert Buxbaum, enjoys a day at an artificial beach in central Detroit.

The author, Robert Buxbaum, enjoys a beer at an artificial beach-cafe in central Detroit with some, few black folks, none poor. Is this good for Detroit?

The new hipsters put a squeeze on city services too — one that’s hard to deal with fairly. Detroit can not afford to plow all the streets after a snow. Should the new high-tax white folks get plowed streets, or should they suffer equally with everyone else? Detroit education is abysmal, but the high tax-bracket folks want better. Should they get it, or suffer equally? They want extra street lights and police protection. Should they get it, or suffer equally? Is this the way up?  A solution I’d proposed some while ago was to divide the core city from the now-rural outskirts so that each could be managed more sanely. It’s not a grand a solution like Rand’s plan, but less likely to be rejected. One way or another, we seem destined to have a Detroit with a rich core and abandoned neighborhoods. I suspect it might as well be managed that way.

Robert E. Buxbaum, February 10, 2015. I don’t have solutions, but write about the city’s problems, and the partial solutions I’ve heard as a way to clarify my thinking — and perhaps yours too.

Physics of no fear, no fall ladders

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I recently achieved a somewhat mastery over my fear of heights while working on the flat roof of our lab building / factory. I decided to fix the flat roof of our hydrogen engineering company, REB Research (with help from employees), and that required me to climb some 20 feet to the roof to do some work myself and inspect the work of others. I was pretty sure we could tar the roof cheaper and better than the companies we’d used in the past, and decided that the roof  should be painted white over the tar or that silvered tar should be used — see why. So far the roof is holding up pretty well (looks good, no leaks) and my summer air-conditioning bills were lowered as well.

Perhaps the main part of overcoming my fear of heights was practice, but another part was understanding the physics of what it takes to climb a tall ladder safely. Once I was sure I knew what to do, I was far less afraid. As Emil Faber famously said, “Knowledge is good.”

me on tall ladder

Me on tall ladder and forces. It helps to use the step above the roof, and to have a ladder that extends 3-4′ feet past roof level

One big thing I learned (and this isn’t physics), was to not look down, especially when you are going down the ladder. It’s best to look at the ladder and make sure your hands and feet are going where they should. The next trick I learned was to use a tall ladder — one that I could angle at 20° and extends 4 feet above the roof, see figure. Those 4 feet gave me something to hold on to, and something to look at while going on and off the ladder. I found I preferred to go to or from the roof from a rung that was either at the level of the roof, or a half-step above (see figure). By contrast, I found it quite scary to step on a ladder rung that was significantly below roof level even when I had an extended ladder. I bought my ladder from Acme Ladder of Capital St. in Oak Park; a fiberglass ladder, light weight and rot-proof.

I preferred to set the ladder level (with the help of a shim if needed) at an angle about 20° to the wall, see figure. At this angle, I felt certain the ladder would not tip over from the wind or my motion, and that it would not slip at the bottom, see calculations below.

if the force of the wall acts at right angles to the ladder (mostly horizontally), the wall force will depend only on the lever angle and the center of mass for me and the ladder. It will be somewhat less than the total weight of me and the ladder times sin 20°. Since sin 20° is 0.342, I’ll say the wall force will be less than 30% of the total weight, about 65lb. The wall force provides some lift to the ladder, 34.2% of the wall force, about 22 lb, or 10% of the total weight. Mostly, the wall provides horizontal force, 65 lb x cos 20°, or about 60 lbs. This is what keeps the ladder from tipping backward if I make a sudden motion, and this is the force that must be restrained by friction from the ladder feet. At a steeper angle the anti-tip force would be less, but the slip tendency would be less too.

The rest of the total weight of me and the ladder, the 90% of the weight that is not supported by the roof, rests on the ground. This is called the “normal force,” the force in the vertical direction from the ground. The friction force, what keeps the ladder from slipping out while I’m on it, is this “normal force” times the ‘friction factor’ of the ground. The bottom of my ladder has rubber pads, suggesting a likely friction factor of .8, and perhaps more. As the normal force will be about 90% of the total weight, the slip-restraining force is calculated to be at least 72% of this weight, more than double the 28% of weight that the wall pushes with. The difference, some 44% of the weight (100 lbs or so) is what keeps the ladder from slipping, even when I get on and off the ladder. I find that I don’t need a person on the ground for physics reasons, but sometimes found it helped to steady my nerves, especially in a strong wind.

Things are not so rosy if you use a near vertical ladder, with <10° to the wall, or a widely inclined one, >40°. The vertical ladder can tip over, and the widely inclined ladder can slip at the bottom, especially if you climb past the top of the roof or if your ladder is on a slippery surface without rubber feet.

Robert E. Buxbaum Nov 20, 2013. For a visit to our lab, see here. For some thoughts on wind force, and comments on Engineering aesthetics. I owe to Th. Roosevelt the manly idea that overcoming fear is a worthy achievement. Here he is riding a moose. Here are some advantages of our hydrogen generators for gas chromatography.

yet another quantum joke

Why do you get more energy from a steak than from the same amount of hamburger?

 

Hamburger is steak in the ground state.

 

Is funny because….. it’s a pun on the word ground. Hamburger is ground-up meat, of course, but the reference to a ground state also relates to a basic discovery of quantum mechanics (QM): that all things exist in quantized energy states. The lowest of these is called the ground state, and you get less energy out of a process if you start with things at this ground state. Lasers, as an example, get their energy by electrons being made to drop to their ground state at the same time; you can’t get any energy from a laser if the electrons start in the ground state.

The total energy of a thing can be thought of as having a kinetic and a potential energy part. The potential energy is usually higher the more an item moves from its ideal (lowest potential point). The kinetic energies of though tends to get lower when more space is available because, from Heisenberg uncertainty, ∆l•∆v=h. That is, the more space there is, the less uncertainty of speed, and thus the less kinetic energy other things being equal. The ground energy state is the lowest sum of potential and kinetic energy, and thus all things occupy a cloud of some size, even at the ground state. Without this size, the world would cease to exist. Atoms would radiate energy, and shrink until they vanished.

In grad school, I got into understanding thermodynamics, transport phenomena, and quantum mechanics, particularly involving hydrogen. This lead to my hydrogen production and purification inventions, what my company sells.

Click here for a quantum cartoon on waves and particles, an old Heisenberg joke, or a joke about how many quantum mechanicians it takes to change a lightbulb.

R. E. Buxbaum, July 16, 2013. I once claimed that the unseen process that maintains existence could be called God; this did not go well with the religious.

 

Robert Buxbaum is now on the board of a new charity

I’m now on the board of directors for two non-profits (lucky me), plus for my own hydrogen company, REB Research. My first charity seat is for The Jewish Heritage Foundation; it’s really one rabbi who takes donations to make tapes about topics he finds interesting. He then gives away or sells the tapes. We meet once a year to go over the finances and decide what his salary ought to be — basically we rubber stamp.

The second board seat, one I’ve been elected/appointed to just this week, is with a group call “The First Covenant Foundation” they’re semi-religious, trying to get people to behave decently. The first covenant is the one with Noah — God won’t destroy the earth but we have to behave sort-of OK. It’s certainly worthwhile to get people to keep to this minimal standard: no murder, no bestiality, don’t eat the limbs off of living creatures… Then again, if God has trouble keeping folks to this standard, I’m not sure how effective the 1st covenant will be. So far they’ve done nothing illegal or immoral that I’ve seen, so that’s good. Unlike with my first my board position, my contract with first covenant includes a sanity clause. They’re more inclusive that way; as expected, the Jewish heritage group didn’t believe in any sanity clause.

As for REB Research, our aims are simpler: to make and sell good hydrogen-related products, to make money, to pay our workers and creditors, and to develop our workers through training associated with the making and selling of good hydrogen products. Simple enough. My board meets 3 or 4 times a year over pizza; the salary of board members is the pizza. So far we haven’t done anything illegal either, that I know of — and we’re even making money.

Here are the Princeton PhD group of 1980. I’m the hairy bearded fellow at right who’s looking the wrong way. My thesis advisor, Ernest Johnson is the suited fellow just left of center. Dave Ollis is in front of me, and Joe Calo is in front of him, etc. Visit my Facebook page to see how my friends tagged themselves. 35 years ago!
Princeton Chemical Engineering Grad-students, late 1970s. My thesis advisor is the tall fellow at center; I'm the bearded fellow at right looking the wrong way.

Princeton Chemical Engineering Grad-students, late 1970s. My thesis advisor is the tall fellow at center; I’m the bearded fellow at right looking the wrong way.