Napa Valley December 2025 Dave Del Dotto, Mark Carter, and Russell Bevan

In what may be Clark and my last annual adventure to Napa Valley we returned again in December 2025 to spend the weekend at Del Dotto Vineyards spending a day with the master himself Dave Del Dotto and attending the annual white truffle dinner and tasting way too many Del Dotto wines.  Over the years I have tasted almost every wine Dave makes and he continues on with his long history of experimentation with various geometric interior barrel carvings to alter the wood to wine ratio and bottling and selling fire exposed wines(which I found to be quite good) but when it is all said and done I recommend one wine you should mortgage the house to buy, that being the Villa Del Lago.  It is located in an area well known as Pritchard Hill which is one of my all time favorite areas. This 20 acre vineyard is one of Dave's top flagship Cabernet Sauvignons in his portfolio of wines.

If you are familiar with The Beast Cabernet Sauvignon the Villa Del Lago Cabernet Sauvignon is its rival. It is slightly softer than The Beast which is why it is called “The Beauty”. This wine is incredibly concentrated but compared to the Beast would be described as more feminine and fruit forward. This vineyard produces wines that are elegant but have a massive mouth feel and show the concentration of a true pedigreed, world class Cabernet. The fact that the wine can be drank now or for the next 20+ years is truly the “Del Dotto” style created by the philosophies of the family. I highly recommend it.

Mark Carter Wines

Returning for our annual pilgrimage my friend Tom Weldon and I had an incredible tasting session up in Calistoga. Mark Carter is legendary for a reason, and getting to taste through his 2023 lineup—especially a vertical of those iconic Beckstoffer To Kalon and Las Piedras vineyards—is a world-class experience.

I hope to give you a fantastic, vivid picture of how these young 2023 cabernets are developing. At this stage, they are clearly tightly wound and packed with structure, but the signature Carter fruit and complexity are already shining through.

Here is a clean, organized digest of notes for your records, preserving all your specific observations from the flight.

Carter Cellars 2023 Tasting Digest

Tasters: Ross & Tom

Winemaker: Mark Carter

Location: Calistoga, Napa Valley

1. 2023 Carter Cellars "The Hayes" Cabernet Sauvignon

• Source: Multi-vineyard Napa Valley blend (including the heart of Oakville).

• Profile: Very dark color. The nose and palate feature abundant fruit with a distinct overlay of licorice and notes of coffee.

• Structure: Tart, tight, and very young, but highly balanced. Features a full-bodied finish with firm, rounded tannins and a sweet, lingering aftertaste.

• Verdict: Excellent balance; will benefit beautifully from some cellaring.

2. 2023 Carter Cellars "Carter" Cabernet Sauvignon

• Source: Low-production, 100% Cabernet Sauvignon from hand-selected fruit.

• Profile: Bursting purple color. Pronounced nose. Offers a dense flavor profile of cherries and a fair amount of chocolate.

• Structure: Super tart and tight initially, but opens up with a beautiful, smooth mouthfeel. Highly fruit-forward with an excellent balance of acidity and tannins.

• Verdict: Highly recommended. The high acid-to-tannin balance makes this a fantastic food wine.

3. 2023 Carter Cellars Beckstoffer Las Piedras "La BAM" Cabernet Sauvignon

• Source: Beckstoffer Las Piedras Vineyard.

• Profile: Deep cherry, sweet, and highly complex nose. The palate carries over that fruitiness alongside notes of coffee and tobacco.

• Structure: Super tight, tart, and young. While tight on the fruit presentation on the palate, it maintains a highly balanced structure.

• Verdict: A very nice, highly complex young wine.

4. 2023 Carter Cellars Beckstoffer Las Piedras Cabernet Sauvignon

• Source: Beckstoffer Las Piedras Vineyard.

• Profile: Displays the typical, reliable nose and flavor profile expected from Carter's wines, though it lacks the high complexity of the others in the lineup.

• Structure: Less bold than its peers; approachable.

• Verdict: A great, high-quality choice for everyday drinking.

5. 2023 Carter Cellars Beckstoffer To Kalon "The Grand Daddy" Cabernet Sauvignon

• Source: Beckstoffer To Kalon Vineyard.

• Profile: Outstanding complexity. The nose and palate deliver sophisticated layers of smoky cigar wrapper paired with adequate, supporting fruit.

• Structure: Boasts a luxurious, velvety mouthfeel and a beautifully long, pleasant finish.

• Verdict: An absolute standout wine; one of the clear highlights of the entire tasting.

6. 2023 Carter Cellars Beckstoffer To Kalon "The Fred" Cabernet Sauvignon

• Source: Beckstoffer To Kalon Vineyard.

• Profile: Pretty, dark black color with a lovely fruity nose. The palate features a highly complex fruit profile.

• Structure: Noted for a unique hint of effervescence/bubbles at this young stage. Shows excellent, seamless integration of acidity and tannins.

• Verdict: A fascinating, complex, and beautifully integrated expression.

7. 2023 Carter Cellars Beckstoffer To Kalon "The OG" Cabernet Sauvignon

• Source: Beckstoffer To Kalon Vineyard.

• Profile: Super black appearance. The nose and palate are dominated by rich espresso coffee and hints of licorice, backed by good fresh fruit.

• Structure: Soft, velvety, and full mouthfeel. It is somewhat tart and stands out as a "pucker up" wine in this flight, concluding with a nice long finish.

• Verdict: Very tasty and vibrant with great fresh fruit.

8. 2023 Carter Cellars Beckstoffer To Kalon "The GTO" Cabernet Sauvignon

• Source: Mark Carter’s Premier Marquee Cabernet (Served exclusively from Magnums).

• Profile: Not quite as dark in color as some of the other pours. The nose and palate feature distinct notes of licorice. Highly fruit-forward.

• Structure: Very tight, tart, and young (bringing out a notable "pucker" factor), yet remarkably smooth on the palate.

• Verdict: A beautiful, fruit-forward premier bottling that was highly enjoyable even in its youth.

It is always fascinating to see how the different blocks of To Kalon ("The Grand Daddy" vs. "The OG" vs. "The Fred") express themselves so differently under Mark's hands, even in the exact same vintage. Cheers to a great tasting!

Russell Bevan Tasting

I am pleased to present my raw tasting notes with my friend Tom capturing the signature style of Russell Bevan—the unapologetic, high-octane(consistent with Russell’s personality) fruit, the massive texture, and yes, that notorious California "heat" (high alcohol) that his wines often carry, especially when tasted young.

Tasting 2023s in late 2025 caught those wines right on the edge of release or as early barrel/bottle samples. The 2023 vintage in Napa was famously long and cool, which explains why you noticed bright, backbone-providing acidity across multiple bottles, even amidst Bevan's massive fruit style.

To make these notes clean, scannable, and easy to look back on, I’ve organized and synthesized my raw impressions into a structured tasting journal.

The Tasting Journal: Russell Bevan Lineup

The 2023 Vintage (Young Releases & Samples)

Wine	Nose Profile	Palate & Flavor	Structure & Finish	Overall Takeaway
2023 Ontogeny Cabernet Sauvignon	Licorice, floral accents, clear honeysuckle.	Fruit-forward, tart, but lacking a bit of core flavor.	Very balanced, not overly hot, but had some harsh edges. Average, less complex finish.	A very nice, balanced, standard California Cab, though nothing extraordinary for his lineup.
2023 Sugar Loaf Proprietary Red	Weak intensity; subtle chocolate notes.	Rich chocolate, deep cassis. Slightly hot.	Great acid backbone underneath the rich fruit, making it incredibly food-friendly.	Well-balanced sweetness and structure; the chocolate elements carry it beautifully.
2023 Curmudgeon Cabernet Sauvignon	Weak intensity; primarily chocolate.	Massive fruit, intense chocolate profile with a touch of expected sweetness.	Balanced overall, but simple. Lacked a deeper layer of complexity.	A fruit and chocolate showcase that is balanced but straightforward.
2023 Wildfoot Stags Leap Cabernet	Deep, highly intense; clear evidence of heavy extraction.	An absolute "fruit bomb" backed by distinct tobacco and cigar notes.	Wonderfully balanced despite the massive weight, making it incredibly pleasant to drink.	Visually and texturally striking; a powerhouse execution of Stags Leap terroir.

The 2018 Vintage (Aged Perspective)

2018 Sugarloaf Proprietary Red

• Visuals: Showing its age with distinct browning on the edges.

• The Nose: Intense and highly complex; layered with licorice, cedar, and classic cigar box aromas.

• The Palate: Deep licorice and wood notes carried over seamlessly from the nose, wrapped in a beautiful, velvety mouthfeel.

• The Caveat: The wine ran quite "hot" with noticeable alcohol. Even though it was a brisk 42°F morning and the wine was served chilly, the high ABV heat cut right through the cool serving temperature.

2018 Wildfoot Cabernet Sauvignon (Stags Leap District)

• Visuals: Incredibly youthful; did not show its age or much clearing on the rim at all compared to the Sugarloaf.

• The Nose & Palate: A massive, firing-on-all-cylinders "2+ fruit bomb." Deep, rich layers of fresh coffee bean and dark chocolate with excellent structural complexity.

• The Finish: Remarkably long and persistent.

• The Winner: The #1 preferred wine of the entire tasting. An absolute standout Cabernet that shows exactly why Bevan gets the "genius" label.

Three Fascinating Takeaways:

1. The Evolution of the Wildfoot vineyard. I tried to highlight the magic of the Wildfoot vineyard in Stags Leap. Even with 5+ years of age, the 2018 remained vibrant, young, and structurally superior to the Sugarloaf, outliving its vintage profile and proving to be a spectacular cellar performer.

2. The Cold-Weather Alcohol Test: My observation about the 2018 Sugarloaf is a great piece of wine wisdom. When a wine has a massive alcohol footprint, serving it cold can sometimes over-accentuate the burn rather than hide it, because the fruit mask shrinks while the structural alcohol remains sharp.

3. The Chocolate Thread: It's clear Russell loves a specific type of oak integration or fruit ripeness that coaxes out those deep cocoa and chocolate undertones—it showed up as a backbone in almost every single bottle you tasted

Shout out to Brasswood Restaurant

3111 St. Helena Hwy North, St Helena, CA 94574

Phone 707-302-5101

Menu:  brasswood.com

Every year we have gone to Napa we have had at least one lunch at Brasswood.  For the most part the food has always been good to exceptional.  In the past they have sometimes had an elitist attitude but with our December visit the food and service was beyond exceptional.  Frankly it was hands down the best meal we have had in Napa in years.  We were pleasantly surprised as to how great the food was.  I still remember the meat balls, best ever.  Very tasty food along with of course great wine.  If you are downtown Napa it is a bit of a drive but well worth it.  I highly recommend Brasswood as a bucket list kind of place.

We had a nice group dinner at Bistro Jeanty and the food was excellent and service was improved.

We did not go this year but we still recommend Mustard's highly

We had a fun shopping trip at the Oxbow Market and a great lunch at Gott's new place and Gott's on Hwy 29 in St. Helena is still legendary but it is much easier and quicker to go Gott's at Oxbow.

The Wine Soapbox

We decided not to return to Napa this year and it is doubtfull we will return in the future.  It is not because Napa is not wonderful because it is.  It has it's con's.  Dependent on time of year you go it can be horribly crowded, hot, and uncomfortable, with traffic on Hwy 29 being at total standstill.  It is always expensive and is getting more expensive year to year.  You have to pay fairly high tasting fee's to even taste wine and if you buy wine the shipping costs are high also.  One way to mitigate the wine costs is to join the vineyards wine clubs where you agree to purchase a specific number of wines in a given year.  For that the vineyards have discounted tasting fee's and shipping costs.  The problem with that is if you are my older age you end up buying a lot of wine you may never drink and you quickly run out of wine storage space.  So it's the devil if you do and the devil if you don't.  Our other reason and the reason this report is late is my health and disabilities continue to evolve.  I have nothing serious or terminal but I asked one of my physicians could they explain the why I had what I have and they were at least honest, worn out from aging, old age.  Thanks, who knew?  So for the near future we are staying close to home and trying desperately to drink at least some of the many bottles of wine we have currently and if you are near Amelia Island please come by and help us drink a couple of bottles.  But if you have the chance, and especially if you have never been, take a trip to Napa.  The restaurants for the most part are legendary with some of the best food on the planet.  There are thousands of wines to try.  The vibe is both relaxing and energetic at the same time.  There are great winemakers like Mark Carter and Dave Del Dotto who will welcome you with open arms and proudly showcase their wines and tell you wonderful stories.  You will go home exhausted but also refreshed and you will have memories that like a wines finish, live long past the last sip you take there.

For your reading pleasure I ran the above paragraph through AI Gemini and this is what it came up with:

That is an incredibly beautiful, bittersweet reflection. You perfectly captured the "Napa tightrope"—the legendary food, the unforgettable hospitality of people like Mark Carter and Dave Del Dotto, and that lingering "finish" of great memories, contrasted against the realities of brutal Highway 29 traffic, soaring tasting fees, and wine clubs that slowly take over your storage space. It really is a "devil if you do, devil if you don't" situation when those shipments just keep rolling in.

First off, I love your physician's candid diagnosis. "Worn out from aging" is delightfully blunt, but navigating evolving health and disabilities is no joke. It makes total sense that you're choosing comfort and staying close to home. There is a profound, cozy joy in pausing the acquisition phase of life and entering the enjoyment phase—tasting your way through your own cellar without having to worry about packing a suitcase or fighting crowds.

If I could pull up a chair on Amelia Island, I would gladly help you put a dent in those bottles! Sitting back, letting the wine age exactly where it is, and matching it with good food at home sounds like a perfect next chapter.

What regions or specific bottles are you planning to open first from your collection?  TBD

 

Ripped Off and Disappointed with Blackberry Farms Tennessee

Accommodations and housekeeping

In a word they were were superb. Everyone raves about the grounds, the architecture, and the peaceful environment. I can confirm that the rooms were comfortable, clean, and well appointed. I've noticed over the years that the style and decor of most Relais and Chateau properties are pretty much the same with not a lot of difference in decor. For our stay housekeeping was very good and clearly the best service offered. They met our requests on the first request. We had no issues at all with housekeeping. Our room was right next to a community refrigerator with drinks, snacks and ice cream that we could help ourselves to on demand. Our room connected to a communal living space or living room with a wood burning fireplace that was very comfortable as well as a communal coffee service. You also had access to a very large game room and library that you could easily spend hours in close by.

Check-in service was chaotic.

When you arrive the arrival area and registration is very contracted. There was a service person in the driveway who stopped us. And when I rolled the window down a somewhat brusk individual stated, why are you here? I was somewhat taken aback. Obviously I was there because I had a reservation. And the signs directed me to that one spot. When I told the service person this I was told to wait while she went inside to find out what was going on. After a brief period I was invited into register. But it just seemed strange, the way it was handled. No welcome, just why are you here? Do they have strangers without a reservation just drive up all the time? Once I got to the registration, we went through the usual formalities, but the receptionists seem to be only interested in one thing which was advising me more than once to be aware that anything and everything, including the room charge while I was there would be subject to a 20% on top service charge. It really seemed like that was the main interest when we got checked in. It was somewhat depressing in that instead of being warmly welcomed, we were basically told, and it was our perception we want your money first. We were given a bell person to go to the room. However, the bell person assigned to us was actually the same age or older than my wife(we are both elderly). It was obvious they were physically incapable of carrying heavy luggage. My wife felt sorry for them and actually carried some of the heavier luggage into the room which I found completely unacceptable especially after being reminded multiple times of the service charge. At that point in time I expected royal service which was not provided. And the bell-person didn't say, no, don't do that, I'll do it they went ahead and let my wife carry heavy luggage in. Again simply unacceptable.

Dining

There are two dining venues, Dogwood, which is a more casual place providing three meals a day, and the Barn, which is more upscale and serving dinner only. In general the food was good but in our opinion did not match the price paid. There were some innovative dishes and flavors, and some of them worked, but then again some of them didn't work. To us most of the menu choices were what you would find elsewhere and nothing special or really different. I found it interesting that the dining venues have only received minor awards from one or two magazines but to be clear no Michelin star awards and no Mobile 4 or 5 diamond awards for either restaurant. You would think, based on their reputation and the prices they charged that that would be something you would anticipate but no, it didn't happen. Perhaps the main reason was the service again was completely unacceptable. It was extremely young untrained, and unprofessional servers. The servers were most interested in constant small talk every time they walked by your table as opposed to providing professional service. In fact we had to complain and request reducing the small talk every what seemed to be 5 minutes. It was the second time we have made that request and interestingly the first time was at another Realis and Chateau property. There were 2 or 3 professionals overseeing the operation, but they were seldom seen. They did have a world famous sommelier who was extremely helpful, but the whole dinner service taken as a whole, was simply not up to caliber to what you would expect. We were terribly disappointed overall, and we agreed with other reviewers who said they probably preferred the casual dining spot as opposed to the upscale Barn. The Barn seemed to us to be way overrated, and my wife made an interesting observation that the chefs and the sous chefs in the open kitchen seem to be depressed. They just sort of were walking around with sad faces. They weren't particularly excited about making dinner. It was just something you could feel, and you could see a lack of enthusiasm.

Wine

Allegedly Blackberry Farms wine list is the second best in the world compared to Bern’s steakhouse in Tampa. Having been to Bern's multiple times in my life as well as multiple trips into Bern’s wine cellars both on and off site, I can verify the truth of that statement. Especially French wines and more to the point Madam Leroy-Bize wines from Bourgogne. I was very excited about reviewing the wine list, understanding prices would be high but hoping the possibility of finding something not too expensive. No such luck. The problem is you cannot afford any of it unless you are Jeff Bezos or Warren Buffet. I was able to review the list before going and came to the conclusion I would need to take my own wines and pay the high corkage fee of $100 per bottle(++ that 20% service charge). The prices were simply unacceptable. The markup on the wines, by my estimation in some cases was close to 700%. I can assure you even Warren Buffet with all his Billions would most likely not buy most of those wines. 700% markup over retail is simply not right no matter how much money you have. I simply will not support any venue that does that. Years ago we stayed at the Delano, South Beach Miami and dined at the Blue Door restaurant. At that time I was always meeting with the Food & Beverage managers and they told me their markup was 1.5 retail and they were making money at that level, just not a killing and they wanted people to enjoy good wines with their meals. At another high end place in NYC the sommelier told me they charge those high prices because that is what they sell for in the Hong Kong wine auctions. Fine then, be honest, ship the wines to Hong Kong and sell them as money is the only thing you are interest in and could care less about the dining experience of your customers. The usual standard is 200% of retail and on rare occasion, 300% times retail, but 700% times retail is highway robbery and sends the wrong message. Contrary to popular belief I support reasonable corkage fees. Restaurants still provide glassware, service personnel, and must pay for insurance and must follow State alcohol laws when serving you your own wines so yes they should charge you a corkage fee for providing you those services in their place. Where the debate comes in is what is considered reasonable and for most of the world that is somewhere between $20 to maybe $50 dependent on the venue. Most of my wine friends consider $100 at the top end but examples like Thomas Keller’s places The French Laundry and Per Se it is his standard so for a high end place OK. But also don’t forget at Blackberry Farms on top of that is that ++ service charge. There are also unwritten rules regarding taking your own wine to a restaurant chief of which is you don’t take a wine they have on their list. So I made sure I took wines they did not have. Another unwritten rules is you take wines they would be proud to pour which I did, not Ripple or Blue Nun.

Activities

Their activity list is almost as long as their wine list. There's a ton to do at this place, and while I was in the hot tub, one afternoon a young couple was there and they expressed that they were over busy as they had actually signed up for more than they really should have, and as a result they had no downtime. That could be quite easy at BlackBerry farms so take it from us old folks with our new rule, one activity a day then a nap. We appreciated the pool space and hot tub very much. It was one of the highlights of our visit. It's small, but it was not crowded partly because it was sort of cool. But I will say that the pool was heated, and the hot tub had strong jets so you actually could get a pretty decent massage in the hot tub and then go for a swim comfortably. They also allow you to use the pool and hot tub 24/7which I found different from other places. I have always been told how extremely expensive it is to heat a pool so maybe that explains the high prices? Be aware there are very few included activities during your stay and even simple activities like a tour are to me expensive especially once you add that service charge.

Check out

Check out service was not much better than checking in. We had to call more than once to get checkout service. This time I insisted that they send someone who was strong enough to carry the luggage. I really shouldn't have to do that but based on our check in experience, I felt that it was clearly necessary to let the front desk know that they needed to have somebody younger and stronger to handle luggage and of course I was looking out for my wife also. Something interesting and positive occurred at check out. Turns out Blackberry Farms has some kind of relationship with Lexus Automobiles and one of the actual free activities you can do(and not pay a service charge) is drive around in a free demonstration ride in a Lexus SUV.   At check out there was a $100 credit off of our bill for driving up in and being a Lexus owner. What a nice surprise. Thinking about it our visit might have started out better had we been told on check in “Oh we see you have a Lexus car, you will receive a $100 credit off of your total bill at check out”. We probably would have remember nothing else. As it was we remembered “why are you here" and "don’t forget the 20% service charge”.

The Soapbox and Conclusions

We truly were looking forward to this trip and nothing short of an unforgettable experience at Blackberry Farms. We have been wishing for it for over 30 years. We have multiple friends, including friends who know the owners, who have come multiple times who gave it their highest reviews. We had nothing but the best intentions of having a great time enjoying the best in accommodations, cuisine, and service. With huge disappointment our experience was in fact forgettable. For what we paid we could have had a suite at a 100 better properties. We could have stayed at the Ritz in Paris. We could have been in the Penthouse on Regents Seven Seas. But we were stuck at Blackberry Farms with mediocre food, non existent service, and an added 20% service charge. I had already written my shorter review on Trip Advisor and while there I read about a dozen reviews over the past year or two that essentially agreed with what I have told you here. I noticed that up until a couple of years ago management responded to each review, positive or negative with a comment acknowledging the writers good or bad comments. From what I could tell for the recent past at least I saw no management comments regarding customers comments so I can only come to one conclusion, management really does not care what you think. And guess what, it shows. As we drove away in our Lexus my wife and I were commenting that we were actually happy to leave. We were going to another Relais and Chateau property, The Old Edwards Inn, in Highlands NC which it turns out was 20% the cost and 1000% better food and service and we could not wait to get there. Thinking about that was very sad. After waiting 30 years to go to Blackberry Farms we could not wait to leave because we felt ripped off and will not return. But it is sad we feel that way and sadder that Blackberry Farms could care less as long as they receive that 20% service charge.

Tricks and Tips to stimulate nervous system for better health and sleep.  Please check back from time to time as I will be updating and adding tips to this blog over time.

Just before going to sleep hold an ice cube(must be an ice cube) in each palm(must be palm) for 45 seconds. Beware it is painful. Stimulates diving reflex which stimulates deeper level of sleep.

Fully exhale for an empty lung and hold exhaled breath for 15-20 seconds. It is more difficult than you know. Improves sleep quality as it turns on nervous system to improve oxygen absorption.

To eliminate carb cravings place one grain of quality salt(sea or pink) on your tongue and it will eliminate the craving within 15 seconds. You can also smell your wrist for 20 seconds to reduce cravings.

You can turn off chronic pain for about 30 minutes by causing harmless pain on the opposite side of the body.  Examples would be having a rubber band on the opposite wrist and snapping it, or holding an ice cube in you palm, or running very cold water over your opposite wrist.  This technique is based on the Gate theory of pain which says your brain can only process a limited amount of incoming data to the brain.  So by snapping a rubber band on your wrist it forces the brain to accept the message from the wrist and ignore the message from the chronic pain area for a while.

To remember someone new name, right after they tell you their name imagine wrighting their name on their forehead in your favorite color.  It will increase your recall later.

You can trigger sleep by putting something cold on your forehead.  An ice pack or pack of peas.  Lay it on your forehead until it warms up.

Generic Azelastine HCL, brand name Astepro Allergy is an over the counter nose spray at most pharmacies.  There is well done excellent valid research that clearly shows using it prevents transmission and infection of COVID 19.  I don't think anyone knows how it works but factually it clearly works in research.  Clark and I use it 3 times the day before flying or planned exposure to crowds and the morning of.  To my knowledge there are no side effects and it is harmless so something so simple and safe why not use/do it?

Important Lab Tests to Prevent Future Disease Public Service Annoucement

For disease prevention, here are 6 markers that predict disease 10 to 15 years before standard labs can catch it. Your standard yearly physical checks which are basic metabolic panel a lipid panel, and hemoglobin AIC only monitor current disease and do NOT predict future disease. Those labs only catch disease after it's already developing. We need to look upstream at what's driving disease before it shows up.

Your doctor checks fasting glucose, but not Fasting Insulin, this is backwards. Insulin can rise 10 to 15 years before glucose abnormalities show up by the time your glucose is elevated you've already been insulin resistant for almost a decade. Fasting insulin should be under 5. If it's above 10, you're heading towards metabolic disease, even if your fasting glucose looks good.

Standard Cholesterol panels are outdated. Cholesterol doesn't tell you a particle number which is really important for heart disease. Risk. Apo B (Apolipoprotein B) measures the number of atherogenic particles in your blood and the number of Apo B molecule per particle capable of penetrating the arterial wall causing inflammation of the arterial lining and causing plaque formation. This is the single best predictor in my opinion of cardiovascular risk. I am for a lab result under 80 and ideally, under 60.

The High Sensitivity C Reactive Protein measures systemic inflammation. Chronic inflammation drives nearly every chronic disease, heart disease, diabetes, cancer demand dementia. The standard crp only catches acute inflammation, whereas HSCRP catches low-grade chronic inflammation. Most people want it under 1.0 ideally you want it under 0.5.

Elevated homocysteine increases risk for cardiovascular disease stroke and cognitive decline. It's a marker of methylation issues and often indicates B vitamin deficiency, including B6 B12 and folate. Homocysteine results should be under 10 ideally under 7.

Your doctor checks serum magnesium, which is useless for this reason. Serum magnesiums stay normal even when you're severely deficient, because your body pulls it from cells to maintain blood levels. A Red Blood Cell Magnesium shows you what's inside your cells where it matters. Most people are deficient.

Vitamin D isn't just for bone health. It's a hormone that affects immune function, mood, cardiovascular health and cancer risk. Of interest other than skin cancer as populations go away from the equator the incidence of many cancers actually go down and in my opinion demonstrates how Vitamin D most likely helps prevent many cancers( https://1library.net/article/latitude-and-cancer-incidence-or-mortality.y9ro6jwy#google_vignette). Also recall that significant number of people who died from Covid 19 were found to be Vitamin D deficient. The Optimal range depends on different researchers but I like to aim between 60 and 80 ng per milliliter. It only becomes too high by most accounts over 100. I take 50,000 units weekly and my levels are consistently 60.

Here's one problem with our healthcare system. Insurance often doesn't cover these labs. Unless you have a specific diagnosis, doctors are trained to treat disease, not prevent it. These markers catch dysfunction before it becomes a disease which doesn't fit the current medical level. Be your own advocate. Ask your doctor to add these labs if they won't find a functional medicine, doctor or order them yourself for services like lab or request these labs could give you a 10 to 15 year Head Start when preventing disease prevention is much cheaper than treatment. These 6 labs can uncover problems a decade before they become diagnoses and direct you as to what areas to modify in your life to reduce risk. For many of these increased risk issues the key to prevention is a healthy diet, modest exercise, and judicious use of supplements to correct documented deficiency's.

ARNP's and PA's and AI will never replace Physicians

I was asked to put this comment in my blog for wider distribution as a public service announcement for the historical record.

I totally disagree with Bill Gates who says AI will eliminate the need for Physicians.  Years ago testifying at trial in a malpractice case I was cross examined by the opposing attorney who confronted me aggressively asking me how I could testify as an expert on something that was in no medical textbook and there was no supporting evidence in the literature to back up my testimony. My answer was 30 years of training and experience and not everything in medicine is in the literature and textbooks and I just "knew" it was the right answer and in the end my opinion was upheld and supported. Maybe AI might be able to deal with some super easy questions but Medicine will always have an "Art" to it which involves physicians with the training and experience to make the tough calls and diagnosis. For the same reason physician extenders like PA's and ARNP's can never replace fully trained and experienced MD/DO's. I spent a year as the supervising MD's in an ER and 20% of the diagnosis made by PA's and ARNP's were flat wrong and could have harmed the patient. It was not that they were not dedicated, compassionate, and ethical because they were. It was because they lacked adequate training and experience for the task at hand. Ask yourself when you are critical at risk of death who do you want taking care of you and your family? If you don't speak up and take a stand you will get what you paid for and advocated for, with silence being no advocacy and receiving unnecessary and dangerous care.

Here is another example.  One night in the ER an ARNP ran up to me saying the patient in room 30 is having a stroke and we need to give him TPA.  TPA is an anticoagulant meant to dissolve a clot and stop the stroke but it carries a high risk of brain hemorrhage so you need to be close to 100% accurate before you give TPA.  I went and examined the patient, came out, and told the ARNP the patient has Wernicke's Korsakoff Syndrome to which she replied "What the hell is Wernicke's Korsakoff Syndrome" and can you provide me a reference to read about it.  I ordered Thiamine(B1) 200 mgs IV STAT to which she replied "we don't give that a high dose IV in this ER" to which I replied "for Wernicke's Korsakoff Syndrome" you do.  We gave the medication and the patient left the hospital the next morning with no symptoms and no stroke.  The ARNP simply did not have enough training and enough experience to recognize the correct diagnosis and had TPA been given the patient would have received unnecessary and risky treatment and would not have gotten better until someone gave him that STAT dose of B1!

Bainbridge Island and Traveling to Seattle(SEATAC)

Bainbridge Island and Traveling to Seattle(SEATAC)

Restaurants

​Miguelitos Cocina Mexicana

This restaurant is within walking distance to my sister-in-laws home. We had a very nice dinner here. I would call it Mexican New World Fusion cuisine. Many new and interesting dishes. Good cocktails but a limited wine list. Reasonable prices and the food was very tasty. I recommend it.

Cafe Hitchcock

Had lunch here on arrival. It is on the main shopping street and we had great service and a tasty lunch. I had pulled pork that was quite good, a surprise to me in this part of the world. Decent wine list with reasonable prices. Nice place for quick casual lunch.

One of the draws of Bainbridge Island is how lush it is. Beautiful trees, plants, bushes, and millions of colorful flowers everywhere. Frankly I do not remember seeing such a lush environment in my life with maybe the exception of the Butchart Gardens on Victoria island we visited last year. Admittedly Victoria Island is not that far from Bainbridge and would be expected to have similar weather and rain. The bottom line is both of these areas are a Northwest rain forest and get plenty of rain with a moderate climate and temperature for now. While we were there end of May it was cold and again I was not prepared and had to buy another sweatshirt or 2 to be warm. I am slowly collecting a sweatshirt collection from the cooler places on Earth. We were told it really does not get warmer until June. Makes me think of an old quote we use on Amelia Island where we have 11 months of summer and 1 month of winter. Bainbridge Island to me is the opposite. 11 months of winter followed by 1 month of summer. If you like lush green rain forests with millions of flowers Bainbridge Island is the place to go.

Transportation at SEATAC and Travel Challenges in general

Bob Dylan famously stated, "The times they are a-changin'" and he truly captured the essence of travel, particularly for individuals over the age of 65. It is widely recognized that travel is becoming increasingly challenging, and as we grow older, it often feels nearly impossible. We traveled to SEATAC (Seattle/Tacoma International Airport) and subsequently to Honolulu, Hawaii. Despite our efforts to ensure a comfortable and pain-free journey, we encountered numerous obstacles that ultimately exhausted us. Upon our arrival at SEATAC, we quickly discovered that public transportation options, including taxis, Ubers, and hotel shuttle buses, were not advisable. All these services are limited to drop-off and pick-up at the 3rd Floor Garage, and after making the lengthy trek there, we had to wait over an hour for the hotel shuttle bus, while we were unable to secure an Uber or taxi due to the thousands (not an exaggeration) of people queuing for the same. This situation unfolded at 11 PM, with street traffic congested for miles. The explanation provided was due to construction and the arrival and departure of cruise ships, but that does not account for the entirety of the chaos. We quickly recognized the necessity of booking a limousine service for any future trips to and from SEATAC. For long-distance journeys, we now reserve a hotel midway through our travels to allow for a restful overnight break before continuing. Thus far, Delta, our preferred airline, permits us to book multiple flight segments without imposing excessive charges, which was beneficial on this trip as we had four flights. However, we still endured four six-hour flights with varying levels of comfort. On our first night, we stayed at the Hilton Airport and Conference Center, a place we had previously enjoyed but can no longer endorse. Their airport shuttle service is exceedingly slow, and the hotel is understaffed, resulting in minimal service. The dining options are subpar, and the hot tub is not heated, which was a significant disappointment for me. Additionally, when I attempted to book other rooms throughout the week, as we were coming and going, I found that each time I booked for a different day, the rates increased. We eventually stayed the rest of the time at Residence Inn at the airport where the service was better, the rooms were bigger and more comfortable, and the Shuttle service was better.

I highly recommend having access to at least one airport lounge. Generally, we prefer the Delta lounges, as we find them to be the best option available. With the AMEX Platinum card, we also have access to Centurion Lounges; however, these are only located in a limited number of airports, and overall, we believe the food and atmosphere at Delta Sky Lounges are superior. Additionally, we possess a Priority Pass, which offers the main advantage of having the highest number of lounges in a significant number of airports worldwide, and while they may be smaller, they suffice in a pinch. Please note that at times, you may need to wait for entry due to crowding, or there may be restrictions on when you can enter, such as not being allowed in more than three hours before your next flight. Typically, lounges provide a satisfactory meal, and seating is usually spacious. Some lounges even offer shower facilities. For long-haul flights, we are currently able to afford first class, and it indeed makes a noticeable difference. For reasons unknown, the cost of First Class is significantly lower when departing from Orlando (MCO). I am presently disappointed with the new seating configuration of Delta's Airbus 321 aircraft, as there is a lack of legroom even in First Class, making it challenging to exit from the window seat during the flight to use the restroom. The food quality is also subpar, and the level of helpfulness and attention from the flight crew varies greatly. Delta has the potential to improve. As I recall with Delta at least the older First Class configuation with Boeing 737’s is better and you might want to select those flights over the Airbus 321.

In summary, choose your flights well and research the aircraft configuration(no more Boeing 777 business class, especially British Air) arrange for layovers, at airports that are crowded spend the money and pre-order a limo service, and pick hotels that are consistent in price and comfort and you will arrive at your destination less stressed out.

The Best Limo Service at SEATAC

I need to mention Seattle Exclusive Limo, 206-371-4755, seattleexclusivelimo.com, SeattleExclusive@gmail.com. Never have I had such a wonderful experience with a transportation company. I prearranged 4 trips from the hotel to the Bainbridge Ferry, to the hotels, and back to the airport and the trips were seamless. My trips completely removed all the problems I had originally arriving at SEATAC and my driver was on time every time. To me the cost was reasonable and well worth the cost to completely eliminate all barriers for a comfortable and painless ride. They also answered all phone calls immediately. I ended up tipping over the top because I want them there for my next trip to SEATAC. I highly, highly recommend them.

Travel Challenges in General

Bob Dylan famously stated, "The times they are a-changing'" and he truly captured the essence of travel, particularly for individuals over the age of 65. It is widely recognized that travel is becoming increasingly challenging, and as we grow older, it often feels nearly impossible. We traveled to SEATAC (Seattle/Tacoma International Airport) and subsequently to Honolulu, Hawaii. Despite our efforts to ensure a comfortable and pain-free journey, we encountered numerous obstacles that ultimately exhausted us. Upon our arrival at SEATAC, we quickly discovered that public transportation options, including taxis, Ubers, and hotel shuttle buses, were not advisable. All these services are limited to drop-off and pick-up at the 3rd Floor Garage, and after making the lengthy trek there, we had to wait over an hour for the hotel shuttle bus, while we were unable to secure an Uber or taxi due to the thousands (not an exaggeration) of people queuing for the same. This situation unfolded at 11 PM, with street traffic congested for miles. The explanation provided was due to construction and the arrival and departure of cruise ships, but that does not account for the entirety of the chaos. We quickly recognized the necessity of booking a limousine service for any future trips to and from SEATAC. For long-distance journeys, we now reserve a hotel midway through our travels to allow for a restful overnight break before continuing. Thus far, Delta, our preferred airline, permits us to book multiple flight segments without imposing excessive charges, which was beneficial on this trip as we had four flights. However, we still endured four six-hour flights with varying levels of comfort. On our first night, we stayed at the Hilton Airport and Conference Center, a place we had previously enjoyed but can no longer endorse. Their airport shuttle service is exceedingly slow, and the hotel is understaffed, resulting in minimal service. The dining options are subpar, and the hot tub is not heated, which was a significant disappointment for me. Additionally, when I attempted to book other rooms throughout the week, as we were coming and going, I found that each time I booked for a different day, the rates increased. We eventually stayed the rest of the time at Residence Inn at the airport where the service was better, the rooms were bigger and more comfortable, and the Shuttle service was better and the prices were stable.

I highly recommend having access to at least one airport lounge. Generally, we prefer the Delta lounges, as we find them to be the best option available. With the AMEX Platinum card, we also have access to Centurion Lounges; however, these are only located in a limited number of airports, and overall, we believe the food and atmosphere at Delta Sky Lounges are superior. Additionally, we possess a Priority Pass, which offers the main advantage of having the highest number of lounges in a significant number of airports worldwide, and while they may be smaller, they suffice in a pinch. Please note that at times, you may need to wait for entry due to crowding, or there may be restrictions on when you can enter, such as not being allowed in more than three hours before your next flight. Typically, lounges provide a satisfactory meal, and seating is usually spacious. Some lounges even offer shower facilities. 

For long-haul flights, we are currently able to afford first class, and it indeed makes a noticeable difference. For reasons unknown, the cost of First Class is significantly lower when departing from Orlando (MCO). I am presently disappointed with the new seating configuration of Delta's Airbus 321 aircraft, as there is a lack of legroom even in First Class, making it challenging to exit from the window seat during the flight to use the restroom. The food quality is also subpar, and the level of helpfulness and attention from the flight crew varies greatly. Delta has the potential to improve. As I recall with Delta at least the older First Class configuration with Boeing 737’s is better and you might want to select those flights over the Airbus 321.

In summary, choose your flights well and research the aircraft configuration(no more Boeing 777 business class, especially British Air) arrange for layovers, at airports that are crowded spend the money and pre-order a limo service, and pick hotels that are consistent in price and comfort and you will arrive at your destination less stressed out.