I live - I live not in the most expensive area of Cali. My yoga studio is not the most expensive one in the vicinity. I have been to much posher yoga studios. Meditation is never free - it is rather costly because it consumes one of the most valuable limited resources - your time. So it better provide very significant benefit! Nothing is free - there is an old saw from the Chicago School of Economics "There is no free lunch". Now you may not subscribe to the ideas of Chicago School of Economics but in this they are quite right - somewhere someone always bears the cost.

Take my migraines. What I currently do is drink drink drink lots of liquid all days long to keep myself REALLY hydrated. My migraines get triggered by dehydration. Drinking helps. It does not prevent all migraines but it lowers their frequency. So I come to work, have a cup of coffee and then begin my "routine" - I take two BIG mugs and make tea (to prevent boredom, I rotate through decaf black and fruit teas). Then when it is cool enough, I drink it - gulp after gulp, two big mugs. Then I IMMEDIATELY make myself two more cups. And this is like a second job for me ALL day long. And of course I have to go pee all the time. This is annoying. But it helps. I still get migraines though, just not as frequently. When I get them, it helps to catch an attack very early on and treat it with Imitrex nasal spray. Yesterday it really took the edge off the pain - really did a good job. Sometimes it doesn't though. It depends. Imitrex costs about $300 a month. Right now I get it for free from the county. I have also asked D. to bring me some from Europe because it is cheaper there by a lot. But if I do not get a permanent job and my supply of European Imitrex runs out, I would have to buy Imitrex out of pocket starting in January when I stop being eligible for free county care. And I would pay $300 because the alternative - a much cheaper Depakote that prevents most migraines - sucks because it causes weight gain and considerable tremor. So I am prepared to make and drink tea around the clock and pay for expensive Imitrex just to have a better figure and a steady hand. So what is it? It is a cost benefit analysis at work - the monetary cost of Imitrex plus the time and annoyance cost of frequent drinking and peeing are justified by the benefits - having a better figure (I have lost weight since stopping Depakote) and not having tremor. My next alternative? Topomax. Prevents migraines as effectively as Depakote but causes a weight LOSS. Luring, no? To kill two birds at once: lose weight and prevent migraines -- surely it is very attractive. But not so fast - many many people report cognitive side effects and I need instant access to my extensive vocabulary in all the languages that I speak or read. I would not be able to live with cognitive side effects. I need to be articulate etc. So the benefits of having a better figure and not having migraine attacks do NOT outweigh the potential cognitive cost of Topomax. So what will I do? I will ask my doctor for Topomax to try and see if it causes cognitive side effects. If it does, I will stop. If it does not, I will continue. Because you never know - you may luck out! I did not luck out on some drugs (Seroquel, Depakote), but I did on others (Prozac so far has been implicated only potentially and only in very slight tremor - per my daughter, "you would not notice it unless you know what you are looking for" - I can live with that, it is not like the tremor I had from Depakote; my sleep aid, Amitriptyline, first caused morning grogginess and an increase in appetite but then my body adjusted and now it causes no side effects; Lithium causes two side effects - acne and thyroid dysfunction, but both side effects are 100% remedied by additional drugs - Tazorac and Levoxyl, respectively - and these additional drugs do not cause any side effects themselves - moreover, Tazorac keeps me wrinkle-free so I am going to use Tazorac for the rest of my life even if I have to pay out of pocket for it ($300 but it lasts many months) so with Lithium everything is manageable and I have perfectly functioning kidneys (well with the amount of water I consume I better do...). Geodon is 100% effective against mania and psychosis but the cost of Geodon - unorgasmia - is not justified even by those big benefits, so I am going to discontinue it. So as you see, it is nothing but cost-benefit analysis applied to every drug or drug combo on an individual basis. Some drugs pass with flying colors while others get discontinued. The benefit of orgasms is enormous so a drug that eliminates them is not justified even it is very effective for mania and psychosis and does not cause a single side effect other than unorgasmia. Exercise (unlike benzos) takes time so there is cost, but there are so many benefits plus for me it is more effective against anxiety so I would use exercise and skip benzos. Standing rather than sitting is hard but I do it because the immediate benefits (being completely free from piercing shoulder pain) plus the LT benefits (prolonged sitting reduces our lifespan by two years) justify the work that I put into standing at my desk. Same thing: cost-benefit analysis. But nothing is free - standing may seem free but it is not - it is hard. Maybe one day it will become second nature but for now it is hard.

Another drug that I am happy with is Metformin. Not only has it probably helped me to lose weight (a bit, and I am not even sure because of the confounding factors - I also stopped taking Depakote), it has also restored my original taste; I do not know what drugs screwed up my taste at some point but I used to be unable to drink tea without sweeteners so I was consuming record amounts of carbohydrates in the form of stevia which was not good for me. On Metformin, I can drink tea just as I did in my childhood - without any sweetener. I returned unopened stevia to the grocery store. Plus, now I will for sure not get diabetes. I was already low risk because my blood sugar was borderline low, but with Metformin it is a surefire deal. And side effects? NONE. No digestive discomfort that is reported so commonly, no nothing. $20 a month (I got it from a private clinic rather than the county, hence it is not free). $20 a month is fully justified by not having to use sweeteners, being for sure free of diabetes and possibly losing weight. The benefit here clearly outweighs the cost.

I really do not know what there is MORE to medicine in the end than cost-benefit analysis.