Wednesday, July 8, 2015

Healthcare in the USA

This is a collection of links around the 'net about problems with healthcare in the US.

The problems are best articulated by some of the posts by Karl Denninger.  He points out several examples where services in the US cost between 5 and 10 times what they cost in other developed countries.  Given that the patient typically has a copay for that amount, it means that if the services were being billed appropriately, one would not need insurance.  Sadly, this same model is being exported to all countries where healthcare is not socialized.

In addition to a complete lack of transparency; i.e. not knowing how much a service will cost until after the fact, there are often billing errors resulting in overcharging due to mistakes by both providers and insurance companies.  This speaks to the complexities of the whole system.  Most doctors' offices need dedicated staff to handle billing.

Sadly, despite the costs, misdiagnosis and incorrect treatments are very common.  See this article and this one.

An interesting documentary about healthcare is Sicko by Michael Moore.  Things have only gotten worse since this documentary from 2007.  In fact, medical bills are the biggest cause of bankruptcies in the US.   Health, literally, is wealth--it is one's biggest asset, and lack of it could potentially be one's biggest liability.

Increasingly, because of the complexity of dealing with insurance companies, primary care doctors are converting to concierge services where they charge an upfront fee for all services during the year and provide a higher and easier level of access to healthcare.

Personal anecdote about cost of services

This is an excerpt of a bill I received for recent blood tests.  The total charge by the company providing services is $983.78.  This is what someone without insurance would have paid.  With insurance, the negotiated rate is discounted by $892.00.  That is a 90% discount off the list price!  Why are medical providers allowed to gouge people without insurance?  This is pretty typical of almost all services I receive whether it is doctors office visits or surgery.  It pretty much means that these prices are never actually paid because those without insurance most likely will not be able to afford to pay for these services anyway.  These are oppressive business practices and I am surprised and disillusioned to see that they are allowed to affect something as necessary as healthcare services in a country as progressive as the USA.

This also points to the shape of things to come in developing countries as insurance companies take a stronger foothold.

Billing errors

Over the last few years, I have personally witnessed a significant increase in billing errors both by doctors offices and insurance companies.  First off, the bills are extremely cryptic and it takes tremendous effort and focus to cross check between the explanation of benefits, the bills from the service provider, and reimbursements from the flexible savings account.  I have spent hours on the phone sorting out billing issues.  This is like rubbing salt on a wound -- the services are already too expensive for what is received, the insurance deductibles and co-pays are way high, and to top it off we now have to deal with billing issues going back and forth between the insurance company and the provider and undoing incorrect, automatic reimbursements from the flexible savings account.

The phone systems are typically quite bad and disconnections are very common.  Each time you dial in, you have to go through the sequence of prompts and re-verify yourself with the agent (name, SSN, address, etc.) and re-explain the whole problem from the start.

If we make any mistakes (like forgetting to pay), these corporations will come after us by sending the payments to collection and creating all kinds of legal hassles for us.  But we must simply put up with their poor service because we only have a very limited choice of providers through our employer.

If you are not already sick, you will be sick by the time you're done dealing with this!

Over marketed

Another problem with healthcare in the US is that it is over marketed.  Everything from the quality of care to the outcomes of treatment are over-exaggerated by commercials.  Many doctors choose less treatment over more when it comes time to make a choice for their own treatment because they understand the nature of over marketing.

Cost of snake bite treatment

Here's a classic case.
When dad got the bill he almost needed to go to the hospital because it was over $1 million. The exact amount $1.188 Million Dollars! 
Additional reading

Sunday, July 5, 2015

What I learned appliance shopping - Washers & Dryers

Washers

There are basically 3 types of washers.
  • Top loader: These are traditional washers with an agitator.  These are slowly being phased out in favor of high efficiency models.  They tend to use more water and they are harsh on clothes; e.g. you won't find one of these with a gentle "hand wash" setting.  (Edit: This is not true per one of the commenters below.)  On the flip side, these tend to be workhorses and some brands like SpeedQueen are known to last very long.  These usually range about 3-4 cu ft in size.
  • High efficiency top loader: These ones usually don't have an agitator.  They typically have a load sensor to determine the amount of water to be used.  The drum bobs up and down and this is how it tends to wash.  Because there's very limited movement and no agitator, many users report that they do not clean as well as traditional top loaders.  They are also very susceptible to loads making the drum go unbalanced.  When unbalanced it gets noisy.  Some machines try to "auto balance" the load which involves adding water and trying to move things around.  In this case, part of the efficiency is given up as more water is utilized in trying to rebalance, sometimes without success and requiring manual intervention.  These can go as high as 5+ cu ft in size, but users report it's hard to balance the load when the machine is filled and so it can't really be filled to capacity.
  • Front loaders:  As the name suggests, these washers have the opening on the front.  Once closed, the unit is sealed shut.  One typically cannot add clothes mid cycle.  They offer the best cleaning performance as the drum rotates using gravity to move clothes around.  While it is possible to get an unbalanced drum with this, they are relatively rare compared to HE top loaders.  Many of these come with a gentle "hand wash" setting.  The main downside with front loaders is that water can become trapped in the seals and can eventually cause mold.  Suggestions to prevent mold include leaving the door open after a wash so that it has time to dry out and using a cleaning cycle with bleach.  Additionally, some newer machines have a drum that is tilted forward (and thus water is less susceptible to stagnating) and some have a fan to blow air to speed the drying process.  Still, despite all of this some users report problems with mold.  (Mold is never an issue with top loaders.)  Additionally, since the opening for loading the machine is in the front, these machines are amenable to stacking.  Even when not stacked, their tops can be used as counter space.  These can range in size from compact (~ 2 cu ft) to full sized 5+ cu ft.  The general rule with front loaders is that you can load them up as much as possible as long as one is able to shut the door.
One of the key specifications to look for is size of the drum.  I have seen sizes from < 2 cu ft to > 5 cu ft for most home machines.  Even for size, there are 2 ratings -- there's the IEC rating and the DoE rating.  The DoE rating is typically smaller and corresponds to the actual usable size.

Sizing works different for top load machines vs front load machines.  Front load machines typically hold more laundry than a top load machine of the same size.  For example, on a recent visit to a laundromat, I found that while the top load machines were rated for a single load, their smallest front load machine was rated at 3 loads.

Sometimes washers are rated in lb.  For example, a 20 lb washer is capable of holding a load equivalent to that of two standard top loading machines with an agitator.  The 2.83 cu ft (DoE) Asko washer is advertised as handling up to 24 lb, while the smaller 2.12 cu ft (DoE) Asko washer is advertised as handling up to 18 lb.

The size of the drum does not tell the entire story.  Depending on how the machine is designed, it may or may not perform well when heavily loaded.

Features to look for when buying a washer:
  • The size of the drum.
  • The location of door hinge and if it's reversible.
  • Water and energy consumption.
  • Internal water heater.
    • When equipped with an internal water heater, washing machines can wash with significantly higher temperatures than what is possible from the home's heater, which is usually set to a lower temperature to reduce the risk of scalding.
  • Wash programs and especially programs such as hand wash.
  • Warranty.
  • For front loaders, the design of the door seal and whether it is prone to mold.
  • Whether the washer can be interrupted to add clothes after a cycle has been started.
  • Material used for construction of the drums (inner and outer) and the guides/impeller in the drum.
  • Delayed start.
    • Useful when you want a program to start running just before you get home.
  • How the unit is powered.
    • 110v, 240v, must plug into matching dryer, etc.
Dryers

Dryers are a lot simpler than washers.  There are 3 basic types of dryers.
  • Vented dryer: This is the most common type and is what one would expect to find in the average US home.  As the name suggests, the dryer has to be hooked up to a vent.  Hot air is sent to the vent.
  • Condensation dryer: These units are made specifically for homes and apartments that do not have a vent.  With machines of this type, hot air is released into the room after the moisture has been removed from it.  Condensation dryers typically take a lot longer to dry the clothes, and some folks find the release of hot air into the room annoying.
  • Heat pump dryer: This is the latest technology for condensation dryers.  With dryers of this type, instead of the hot air being released into the room, the hot air recirculated back helping lower the energy consumption.
Many dryers offer the option of running on gas or electricity.  The ones that run on gas typically cost about $100 more.  But because they run on gas, and gas is typically cheaper, they can help lower the utility bills.  However, some utility companies have cheaper electricity and some homes are equipped with solar panels, so the economics starts to dull.

Perhaps the most interesting feature in a dryer is a moisture sensor.  This allows the dryer to sense the remaining moisture in the clothes and either extend or shorten the drying time.  Without a sensor, one would have to manually check if the clothes are dry, or risk "cooking" the clothes.

The matching dryer for any given washer is typically a little larger because dried clothes take up more space than wet ones.

Features to look for when buying a dryer:
  • Size of the drum.
  • Whether it has a moisture sensor.
  • The type of dryer.
  • How the dryer is powered -- gas or electric, if electric whether it is 110v or 240v.
Brands

As with refrigerators, there are the usual brands.  Most of the European brands only make compacts.
  • Asko: A Swedish brand now owned by a Slovene company called Gorenje and manufactured in Slovenia.  A cool innovation with their washers is they have figured how to build a front loader with no rubber seal in the door opening (instead there is just a small rubber seal on the door itself), making it less susceptible mold.  These are less pricey than the Miele, but more expensive than the other brands.
  • Blomberg: A German brand that is owned by Arcelik, a Turkish company, and the units are now manufactured in Turkey.  Also only make compacts.  Their prices are much lower than Miele and even Asko.
  • Bosch: A German brand, but they only make compacts.
  • Electrolux.
  • GE.
  • LG.
  • Miele: A German brand, and they only make compacts.  You buy these from a dealer, but they are delivered and installed by Miele.  The build quality is great, but they are expensive (about twice the price for half the washer).  This was Steve Jobs' preferred brand for a washer (see the discussion at the very bottom of the page).  Most people that have these like them, but at 2 cu ft, they fall in the compact category.
  • Samsung.
  • Speed Queen: These are made in US, and seem to have good reliability based on reviews.
  • Whirlpool family: These include Whirlpool, Amana, Maytag.  These are "assembled" in the US, meaning that final assembly is done in the US, but many parts are imported.

Thursday, July 2, 2015

Self help courses

In addition to things like meditation and life coaches (there seem to be an enormous number of these nowadays), I have come across several organizations that claim to be able to help one get over all sorts of problems in their life and lead more fulfilling lives.  I haven't tried any of them yet, but I'll use this post to list some of them and discuss my opinion on them.

I have only tried meditation and after a little over a decade of regular practice, I still struggle with the same issues that brought me to it--anxiety attacks and various, most likely stress-related, health issues.  Has it helped at all?  At the time I started, I was quite hopeless.  It gave me a lot of hope for a while, but the last few years have been particularly challenging and have made me question its efficacy.  I also know a number of meditators who face similar challenges and who give up meditating altogether.  But given that I was in that situation even before I started meditating, I know for sure that meditation by itself hasn't caused it or made it worse.

Back to the topic of this post, here's the list of several courses I have become aware of over the years.  My main concern with these, based on limited research on the 'net and from talking to a few folks that have participated in them, is that they tend to be cultish and often involve a lot of money and/or ongoing commitment to the program.  For these reasons, I have chosen not to participate in them.
Then there's also techniques such as the Law of Attraction popularized by the book and movie The Secret, and Abraham Hicks, and also teachers like Teal Swan.  A lot of information about these is available for free.

Tuesday, June 16, 2015

What I learned while appliance shopping -- Refrigerators

I recently had to go shopping for a refrigerator and have learned quite a lot over the last couple of weeks.  I thought I'd put some of these learnings in a post.  In general I was disappointed with what I found because most fridges are loaded with features that I will never use but have questionable durability.  About 5 years seems to be the average life nowadays before one is faced with a cost-prohibitive repair.

Style
  • Free standing or built in:  The average house can only accommodate a free standing unit.  Most of the premium brands (e.g. Miele, Sub Zero) only offer built-in units.
  • Door style: Can be 2 door top freezer (the old style), 2 door bottom freezer, side-by-side (fridge on one side, freezer on the other), french door with one or more freezer drawers, and 4-door french door (both fridge and freezer have french doors).
  • Finish: Can be white, black, stainless, or other color.  Some of them offer finger-print resistant finishes.  Only high end refrigerators have the sides finished in stainless steel.  Most run-of-the-mill fridges have plastic sides even though the front may be stainless steel.  High end refrigerator will often offer the option of wood paneling on the doors.
  • Depth: Can be counter depth or standard.  Counter depth models won't jut out but are pricier even though they are smaller.  Go figure.
Features
  • Air filter: Keeps the air fresh getting rid of any odors (including that of the plastic that the fridge is made of).  No need for baking soda or "airing out" the fridge.
  • Water filter: Needed especially with those that are equipped with a water dispenser, however some models use a water filter when creating ice.
  • Lighting: Most used energy efficient LED lighting.  Lighting may or may not be offered in the freezer.
  • Easy open handles on freezer drawers: Like the name suggests, these make it easier to open the freezer drawer.  I have only seen these on Samsung and LG units.
  • Automatic pulling out of top freezer drawer: This partially pulls out the second-to-bottom freezer tray.
  • Folding shelves: This allows the creation of space to store tall objects.
Quality of construction
  • Hinges: Really only different on very high-end built-ins.
  • Drawer operation: Smoothness of opening and closing drawers.
  • Bins: Quality of the plastic used for the bins
  • Shelves: Glass or plastic and ease of adjusting.
  • Odor: The odor of the plastics used in the interior.
  • Noise: The ambient noise of the unit.
Reliability
  • Consumer Reports magazine.
  • JD Power & Associates.
  • User reviews on the manufacturer website and/or dealer sites.
Brands

Most of the mainstream stores sell several brands.  Most of the brands are made by a small handful of manufacturers.  Think of the cereal box model--there is an illusion of many choices, in reality there are only a few.

Here are the various manufacturers, the brands they make, and my thoughts on them as I shopped for a french door with single drawer bottom freezer.
  • Whirlpool.
    • Makes Amana, Whirlpool, Maytag, KitchenAid, Kenmore, Bosch.
    • Overall decent quality.  Assembled in America.  This means final assembly was done in the US using imported parts.  
    • The quality is good but most models lack an air filter.
  • Electrolux.
    • Makes Electrolux, Frigidaire.
    • A European brand that makes most of its units in Mexico.  
    • Makes some of the best looking fridges.
    • Lots of options with air and water filters.
    • The quality of the interior was lacking--cheap plastic and the drawer mechanisms.
    • For some reason, most sales folks tried to steer me away from this brand.  It also seemed to have higher than average negative reviews.
    • Luxury end is Electrolux Icon.
  • LG.
    • Makes LG, Kenmore Elite.
    • The units are made in either Korea or China.
    • Overall a great product, but very limited options with an air filter.
  • Samsung.
    • The units are mostly made in Korea.
    • Similar to LG in terms of quality and features, but I felt the LG was slightly better designed.
  • GE.
    • Recently acquired by Haier.
    • Felt like quality inside and out, but could not find a model that had an air filter.
    • Luxury end is GE Monogram.
At the high end, there are brands like Miele (German), Liebherr (German), Sub-Zero (US), Thermador (German), Viking (US).  I didn't spend much time researching these because they were not suitable for installation in my house.

Getting questions answered

Misinformation abounds with most floor sales folks.  They either don't have the information or haven't bothered to look it up, but emphatically provide their best guess.  For models they do not have on the floor, you typically get incorrect answers for country of manufacture and various other features.  Sometimes the information can be gleaned from the manufacturer website.  But if not, it's unlikely that contacting the manufacturer will yield anything useful.  Emails to their customer service often go unanswered.  Calls to them usually receive a response of the type "the only information we have is what is on our website" or "please contact an authorized sales center for that information."  And authorized sales center doesn't have that information.  So trying to get information can be an exercise in frustration.  The best way I found of getting accurate information is through discussions in various online forums.

This, by the way, is not something limited to refrigerators.  The same is true of most appliances and even other products.  Why is this so?  My conjecture is that the people fielding these questions have no interest in the product.  They are in jobs that are likely short term roles and they are trained to look up whatever information may already be on the company website and no more.  Unfortunately many of the company websites have flaws--links to download documents are stale, information about authorized sellers is outdated, etc.

This is perhaps the most frustrating part of appliance purchases.

Monday, June 8, 2015

How I ended up being an engineer

Every now and then, as I go through my mid life crises (getting older and taking stock of what my life has been about), I wonder how I ended up an engineer.

As a kid, I never thought of being an engineer.  Originally, I wished to be pilot.  I'm not sure what inspired me to want that.  But I developed myopia early in life and was told that becoming a pilot would not be possible as one needed perfect vision.  After that, I never really thought of what I wanted to be.  Since my father was a businessman, that's what I thought I end up as.

At school, I was a fairly average student during my early years.  Something changed when I was in the 7th grade and I started doing well.  This continued as I started doing even better in the 8th grade and continued to maintain that.  After the 10th grade in India, we usually have to choose between science, commerce, and arts.  I had always thought I'd take commerce, but because I did well at school, and because most smart kids took science, I decided to take science.  I reasoned that I could always fall back to commerce or arts, but going in the other direction (from commerce to science) was darn near impossible.

In high school (11th grade in India) I didn't particularly care for biology because of the way the teachers taught it (felt kind of disorganized and dry).  Fortunately, an option showed up to drop biology and German (the latter being another subject that I didn't particularly enjoy at that time) and instead opt for electronics.  That option was quite a relief.  I continued to do quite well through high school.  After high school, the best options (i.e. the ones that the smartest students pick) are either medicine or engineering.  Since I dropped biology, medicine was not an option and so I "chose" engineering.  Among the engineering specialities, the students at the top usually opted for electronics, followed by the various other disciplines, with civil engineering at the bottom.  Since I did well enough, I was able to opt for any branch, but "chose" electronics.

In college, I didn't really enjoy electronics but I was able to do reasonably well anyway.  As we got to the 3rd and 4th year, more and more subjects around digital systems started appearing and I had a natural interest in those.  I found them very easy to absorb and internalize compared to earlier subject matter that I tended to just ingest and memorize.

I really enjoyed my first job as a programmer and then subsequently applied to graduate school to focus on computer engineering.

In graduate school, I once again had to focus on basic electronics to get through the qualifying exam.  But once that was done, I was able to spend all my time studying and researching computer engineering subjects.  What I didn't like about graduate school was the pressure and uncertainty around research and getting the research published.

Since graduating I have worked in the field of computer networking.  I sometimes wonder if I picked the right career.  How might my life be different if I had picked a different path in high school, something like economics or business?  I guess these are the questions that come up during a mid life crisis.  Yet pondering such questions is a waste of time, because I am where I am.

Monday, May 25, 2015

Post purchase surveys are badly flawed

Every time one buys something expensive like a car or a house, one is usually told by the salesperson that they will be receiving a post purchase survey and that anything below the perfect score is a failure for them.  They usually convey this thought at the very end of the transaction and tell you "do let us know if there is anything I can do for you."  This after treating you with distrust and playing with your mind all through the process.  And this is the same no matter where you go...it's just an ugly part of the sales cycle for big ticket items.  They play with your feelings of guilt -- "I'm just the little guy, please don't do anything to hurt my job" -- yet at the same time, all through the process, the only feeling that I get is that they are out to get your money.  They are full of distrust and fear that the deal will fall through.  Once it is done, other than the courtesy call which is again something that is asked about on the survey, you will never hear from the salesperson.

Basically, you have a robot salesperson that tries to do everything they can to make sure the survey questions are all covered without actually caring about the buyer.  In other words, they will say all the right things to make you feel they care about you, but they really don't.  All they care about it making the transaction go through successfully.  The flip side is that customers often have to create dramatic lies in order to back out of a deal (health crisis, moving job, etc.).

Now giving a perfect score on the survey for what was clearly service that could be improved on would be lie (at least for me).  So there are two options--don't respond to the survey at all, or fill out the survey in a genuine fashion and risk seeing an unhappy salesperson should you ever run into them again.  I'm not sure which option is better.

The whole experience is reminiscent of growing up in a dysfunctional family, where you're told about how everyone loves you, but you feel none of it, rather feeling oppression and abuse, because the actions don't match the words.

There was a time when sales people stayed at a job a long enough time and creating trusted, working relationships mattered.  Those days are gone.  The credit score determines whether or not one can be trusted for a loan.  Other than that, it's pretty much pleasantries and bonds (sign copious amounts of paper work to keep you from backing out of the deal).

There was a time in my life when I cared more about other people's feelings than I did about my own.   At such times, I would have filled out such a survey offering a perfect score to the salesperson.  But I'm slowly changing that and realizing that I too am a person and that I too deserve to be treated right.  And that it's important to point out any shortcomings or they will never be addressed.

Saturday, April 25, 2015

Panchakarma with Dr. Sunil Joshi

This post details my experience with panchakarma under the supervision of Dr. Sunil Joshi assisted by his staff at his clinic in Albuquerque, New Mexico from April 18-25, 2015.  Panchakarma can be though of as cleansing/purifying of the body and mind according using methods detailed in Ayurveda.

Booking

Normally, they won't let someone sign up panchakarma unless Dr. Joshi has had some success treating them with herbs and lifestyle.  The lifestyle part (see the bottom of this post for details) is particularly hard to follow because it involves a very restricted diet (almost no processed foods), specific meal times, daily oil self-massages, taking herbs, and breathing and physical exercises.  I had been consulting him for the last 9 months and had made 3 visits to Albuquerque just for consulting him.  I had already seen some minor improvements to my health over that time through just taking herbs and managing my lifestyle, although the improvements have been far from anything significant.  I had followed the prescribed protocol perhaps 50-60%.  

There were 6 or 7 others signed up during the same week as me.  Many of the people I have met at the clinic during my earlier consultations and during the panchakarma have been seeing Dr. Joshi for years (even 10+ years).  Folks had come for treatment not just from all parts of the US, but also from overseas.

Consultations and monitoring

One of the best things about all of the consultations at this clinic is that they involve no forms other than a consent form.  Dr. Joshi assesses out what is happening with the patient's body and mind by reading the pulse and performing a physical examination, and confirms his findings with the patient.

Before treatments are prescribed the he performs a thorough initial consultation in which he checks the pulse and does a physical examination.  Additionally, he performs the oil or herbal bastis daily on all patients, and also monitors the progress based on a brief daily report written by the patient before treatment each day.

Treatments

Treatments varied by day and by person.  The goal of the treatments is to loosen the toxins and eliminate them via peeing, pooping, and sweating.  The treatments last about 1.5 to 2 hours.

In my case, the following were the treatments for each day.
  • Day 1 -- Initial consultation, abhyanga, hand-steam, nasya, steam box, shirodhara, oil basti. 
  • Day 2 -- Abhyanga, hand-steam, nasya, pinda svedh, neck and lower back basti, shirodhara, herbal basti, left knee lepa. 
  • Day 3 -- Abhyanga, hand-steam, nasya, heart basti, shirodhara, herbal basti. 
  • Day 4 -- Abhyanga, hand-steam, nasya, pinda svedh, shirodhara, herbal basti. 
  • Day 5 -- Abhyanga, hand-steam, nasya, neck and lower back basti, herbal basti. 
  • Day 6 -- Abhyanga, hand-steam, nasya, pinda svedh, heart basti, shirodhara, oil basti. 
  • Day 7 -- Virechana (purgation) consultation, pizichil, nasya, steam box, shirodhara.  Virechana is performed during the night of Day 7 by taking some herbs.
  • Day 8 -- Exit consultation, rest.
Abhyanga - Full body oil massage by 2 practitioners.
Hand-steam - Steam applied to the body using an insulated hose attached to the top of a pressure cooker.
Heart basti - A trough made over the heart area with dough and herbal oil is poured in it.
Herbal basti - Enema done with herbal tea.
Lepa - An herbal paste is applied and the body part is bandaged up for a few hours. 
Lower-back basti - A trough made over the lower-back area with dough and herbal oil is poured in it.
Nasya - Face massage and herbal drops put in the nose.
Neck basti - A trough made over the neck area with dough and herbal oil is poured in it.
Oil basti - Enema done with herbal oil.
Pinda svedh - Warm milk massages over the body with a ball made out of a cheese cloth filled with cooked rice and herbs.
Pizichil - Oil massage with a cheese cloth filled with cooked rice and herbs.
Shirodhara - A steady stream of oil is dripped on the center of the forehead just above the eyes.
Steam box - Sit in a steam box with herbal steam for 3-5 minutes.
Virechana - Purgation to cleanse the small intestine.

During the initial consult, we are given herbs and medicated ghee.  The medicated ghee needs to be taken each morning and evening in increasing doses over the days.  The purpose of the ghee is to prepare for virechana.

Meals

For breakfast, only fruit is recommended.  Lunch and dinner were provided and typically consisted of rice, split yellow mung daal (sometimes cooked as a soup separately with or without spinach, and sometimes included in the rice), and a couple of vegetables from the following -- carrots, zucchini, yellow squash, red/orange/yellow bell pepper, broccoli, garnet yams, cabbage.  On Day 7, to prepare for virechana the dinner was potatoes and red bell peppers (with rice and daal).  On the night of Day 7, special herbs are given to induce virechana.  On Day 8, both meals were provided -- meal #1 was rice porridge and meal #2 was rice with some herbs.  The food on Day 8 is supposed to calm the system after virechana.

Accommodation

They do not provide accommodation so patients have to stay at a nearby hotel.  There are a couple of reasonable options within a 5 min walk from the office/treatment center.

Summary

The benefits of the treatment are harder to see immediately but I was assured that I had responded well to the treatment and that it would show its effects over the next few months.  I guess I'll just have to wait and see.

Diet & lifestyle recommendations
Update 11/26/15

I saw a reasonable improvement in my health and so I attended another session from 11/19 - 11/26.  The treatments were similar to the first session as was the food.