Eugene Lucas, MD

We've understood the health implications of #Vo2Max for sometime now but I'm still concerned that it is not being discussed enough with patients.

@HankFrank Have you tried Bevel? It’s a smartphone app, can pull data from an Apple Watch or Garmin connect.

The problem with WHOOP that nobody is fixing: It's called cadence lock. The wrist sensor picks up your arm swing rhythm instead of your actual heart rate while running. The result? My Garmin reads 124 bpm avg on an easy run. WHOOP reads zone 4 and 5 for nearly 80% of the same run. Same activity. Completely different data. And this happens every single day. What makes it worse? WHOOP doesn't let you use an external heart rate monitor to correct it. You're stuck with the bad reading. Your strain is wrong. Your recovery recommendations are based on a workout you didn't actually do. I've been a member for 3+ years. I've tried every fix. Nothing works. At what point does a "known issue" become a broken product? What am I paying for at this point @WHOOP?

POV, you're a doctor trying to advocate on behalf of your patient for insurance coverage Start 10:30 AM -Wegovy denied by Aetna after being covered and after patient achieved clinically meaningful weight loss. -Authored LOMN which included patient's starting weight, obesity related comorbidities, total weight loss percentage, and rationale for medical necessity (risk of weight regain and health complications if medication not covered, general health benefits associated with maintaining optimal weights). -Appeal on basis of LOMN was denied, only explanation provided --> not medically necessary. -Pt called insurance, was told that the information provided in the LOMN authored and signed by the doctor (me) is generally what they need, but a peer-to-peer (phone conversation with a "doctor" representing the insurance company) is required in order to potentially provide coverage. -I call insurance, provide the patient's information and select number option for appeal, hold for 10 minutes, reach someone, then confirm patient info with them and reason for the call, and the representative tells me I need to call a different number to reach the correct department. -The above happened again with the second department, and then again with a third department -Speaking with 4th department, first person then transferred me to a pharmacist. -The pharmacist (CVS Caremark Rep) said there was no record of the LOMN I authored, I offered to share the reference # provided to me by our pharmacy liaison team, pharmacist said he cannot use the reference # to look it up. -I offered to email (with encryption given HPI) the LOMN, he said it must be faxed. -I faxed it while still on the phone, and requested to stay on the phone while he views the faxed LOMN, he said that is not possible, that he can call me back. -Called patient back and provided these updates. End 11:15 PM. @mcuban

@iruletheworldmo This article summarizes what has been learned since @ezraklein wrote on 3/12/2023 "The coders casting these spells have no idea what will stumble through the portal", tinyurl.com/2fw9exo4. Equal parts fascinating and frightening

An offer i can't refuse

@DeanTTraining What are your thoughts on using this a pec fly machine with one arm at a time and crossing midline at the end of movement. Better sternal head activation that way or not much of a difference relative to two arms at once.

Gonna keep posting good Pec Fly videos every time I see one so I can keep driving home this point: When you are doing these, your objective is to (A) Keep your arms in a FIXED (relatively straight) position & (B) Drive the insides of your elbows together STOP HUGGING A TREE!

@DeanTTraining I explain it to patients with a metaphor. In golf on a single hole, 3 bad shots in a row can be nullified with an excellent 4th shot (chip in from sand). Weight is regulated unfortunately in the opposite.

You can absolutely 1,000% blow your entire weekly deficit in 1 day if you’re not careful Suppose your maintenance calories are 2,500 If you consume 2,000 calories Sunday-Friday and then 5,500 on Saturday, you’re back at net neutral “Who consumes 5,500 calories in a day???” you might be wondering PLENTY OF PEOPLE is the answer Food for thought as we head into the weekend!

Medicare recipients (~20% of US population) did not have coverage for telemedicine appts during the shutdown. In-person appts were covered but transportation can be difficult for those > 65 yo and medical offices can accommodate a limited number of providers on a given day. That was a major healthcare access issue for a vulnerable group of people.

@donwinslow @SenAngusKing @SenatorShaheen @SenatorHassan @timkaine @SenatorDurbin @SenFettermanPA @SenCortezMasto @SenJackyRosen Honest question… I’m sure there are pockets of people who felt it, but did the majority of Americans notice the shutdown other than government employees? @grok

America, You suffered for 40 days for NOTHING. You were suffering to LOWER HEALTH COSTS that would have HELPED your lives. But these 8 people sold you out. @SenAngusKing @SenatorShaheen @SenatorHassan @timkaine @SenatorDurbin @SenFettermanPA @SenCortezMasto @SenJackyRosen

@DrNadolsky LDL skeptics addressing legitimate evidence

The ldl skeptics are not happy right now 😅😅😅

@noodlesli2016 @drwilliamwallac invested-health.com

@drwilliamwallac How to test it

How much oxygen your body can use is one of the best predictors of long-term health This figure shows how cardiorespiratory fitness (VO₂max) - the body’s ability to use oxygen during exercise predicts health, longevity, and physical capacity across life. VO₂max reflects how efficiently the lungs, heart, blood, and muscles work together to deliver and use oxygen. 🟡 Panel A: VO₂max levels across populations Elite endurance athletes reach 70–90 mL/kg/min, while sedentary adults average below 45. Values under 17.5 mark the aerobic frailty threshold, and below 10.5 approach the mortality threshold where daily function and survival are compromised. ➡️ Training can raise VO₂max by 10–20%, while aging lowers it about 7–10% per decade. 🟡 Panel B: Fitness decline and mortality risk VO₂max steadily declines with age but staying in higher fitness percentiles dramatically reduces all-cause mortality. ➡️ People in the “exceptional” fitness range have about five times lower risk of death compared to those in the lowest fitness group. Even being “above average” lowers mortality by over 40%. 🟡 Panel C: The physiology behind VO₂max Every system contributes to oxygen delivery and energy use: Lungs and respiratory muscles draw in oxygen Red blood cells carry it through the bloodstream The heart pumps oxygenated blood to tissues Vessels distribute oxygen efficiently Muscles extract and convert it into ATP for movement 💡 The bigger picture VO₂max is one of the strongest predictors of overall health and lifespan—more powerful than blood pressure or cholesterol. Improving it through regular aerobic exercise strengthens every component of the oxygen delivery chain, protecting against disease and functional decline with age. DOI: 10.1152/physrev.00045.2024

@Wegiveyouhealt1 Counterpoint: Everything in the universe "runs" according to mathematical formulas. Any suggested exceptions are processes that we don't understand well enough yet.

I am eating 2800 calories for last 60 days per day on an average, daily calorie surplus is around 600-650 per day and I lost 1 kg in that period. Calories in , Calories out 🤡. Body is not run by mathematical formulas.

I don't know who this lady is, but yes.

@lime_crush @brady_h @mackinprof Counterpoint, maybe new info relative to your last review. Links: pubmed.ncbi.nlm.nih.gov/27935521/ pubmed.ncbi.nlm.nih.gov/32664648/

@brady_h 🎯 I seem to remember research from @mackinprof showing little or no benefit from amino acid supplements.

Saying protein powders are overrated and then pushing next-to-useless amino acids is such a bold move.

@brady_h Putting gary aside, there's at least a few studies that demonstrate MPS benefit in association with essential amino acid supplements. Review article on the topic: pmc.ncbi.nlm.nih.gov/articles/PMC10…

Use your favorite LLM/AI and ask it to summarize the evidence on nattokinase. I think you'll find that the overwhelming majority of evidence reveals no benefit for reducing risk of defined clinical outcomes (heart attacks and strokes) and its use can cause bleeding. Worth noting that original poster promotes a 20% discount for nattokinase on their linktree page, which leads me to conclude that he has a financial relationship with a company that sells nattokinase.

@BowTiedPhys What is the downside to Nattokinase?

Nattokinase takes ~13 hours to reach peak activity in breaking down blood clots Heart attacks & strokes happen most often in the AM when the body produces higher levels of PAI-1 (protein preventing clot breakdown) NK before bed → max effectiveness during high-risk AM window → dissolve clots + more cardiovascular protection

@SpineNeuro Original post has no basis in reality, ~9000 likes. Corrective response from neurosurgeon, ~600 likes. Misinformation now travels at warp speed and truth still drives a prius.

Neurosurgeon here. This is not correct . Not even a little bit .

-Insurance companies: Give us a lot money regularly, we'll cover services to support your health -Semaglutide & Tirzepatide: We offer more total health improvement opportunities than any other medication class -Insurance: We will do everything we can to not cover these meds

@DiBonaNFL any timeline on a return for Willie Lampkin? @FDuffyNFL

In my opinion, there should only be three options for the Eagles if Cam Jurgens is out: 1) Move Landon Dickerson to center and start Matt Pryor at left guard. 2) Move Dickerson to center and start Sua Opeta at left guard. 3) Start Drew Kendall at center. That’s it.

I love this so much. The kid knows he will likely suffer from his fandom for the next decade or more, but he's still gonna tune in to bravely face whatever misery awaits him. He demonstrates that quite literally in the way he squares up to the interviewer after being taken by surprise. He strikes me as exemplary human and I'll expand upon that. Everyone experiences failure at some point and this can be instructive. As a Jets fan poised to experience years more of losing/depressing seasons, he'll perhaps learn to not expect anything from life other than what he earns. It's an ongoing lesson that may motivate him in other areas of life and drive success. Whether it's genetics or other circumstances beyond our control, we're all Jets fans in some aspect of our life. Turn and face it with the calloused courage displayed by this young man.

TRENDING: All this young New York #Jets fan has known in his life is losing and having a miserable football team. He got interviewed after Sunday’s game: “I hate this team. I was born into this… I hate this team.” (Via dandremac/TT)

So happy he shared this. For anyone feeling nervous about returning to an activity after an extended break, there should be comfort in hearing that even Michael freakin' Jordan was nervous to shoot a free throw after a own hiatus of his own.

@TheBrattPack63 *“mountains”

Man it’s so cool living in New Jersey Wanna go to NYC? One hour Wanna go to Philadelphia? One hour Wanna go to the beach? One hour Wanna go skiing in the mountains? One hour Wanna go ride roller coasters? One hour Wanna go see a show or concert? One hour I love it here man