Tuesday, August 31, 2010

Fat vs. Lean

Jack Sprat could eat no fat
His wife could eat no lean
And so betwixt the two of them
They licked the platter clean

Jack ate all the lean,
Joan ate all the fat.
The bone they picked it clean,
Then gave it to the cat

Jack Sprat was wheeling,
His wife by the ditch.
The barrow turned over,
And in she did pitch.

Says Jack, "She'll be drowned!"
But Joan did reply,
"I don't think I shall,
For the ditch is quite dry.".

To figure out if we were fat or not, we used to stand on a scale and slide the bars over. Sometimes we even paid a nickel to have our fortune told with our weight. Then we would let someone guess at a county fair... Doctors made it more complicated and would measure rolls of fat with calipers and give you a stern lecture on eating salads.

Then the Atkins Diet, Grapefruit Diet, and any number of diet fads. After that along came the Body Mass Index and home scales that would tell you how much fat you have. It got complicated. We got confused. Eat vegetables, no fruit, no whole grains, skip red meat, no eat some red meat, follow the food pyramid, they changed the food pyramid, again. We have a country full of confused people and they wonder why we are obese.

But wait there's more. Now they say skip the BMI and pay attention to your percent of body fat. But the best thing is to figure out your waist to hip ratio:

'Or, since abdominal fat is more hazardous, simply take a tape measure around the widest part of the abdomen and another at the hips and calculate the waist-to-hip ratio. For men it should be no higher than 0.90, and for women no higher than 0.83.'

So do I skip weighing myself and find a tape measure or do I ignore them all and have ice cream for dessert as I contemplate just how confused I am?

Monday, August 30, 2010

Its nice to knowI'm not the only one

Recently I have written (or blabbed or bored you) about clinical trials and the drug approval process and how (un)happy I am with it at times where they approve drugs and then withdraw them. Well, it turns out, I am not the only one. There was an article this morning where a doctor at Children's Hospital in Boston discusses possible flaws in the drug approval process. But she also has some plausible solutions for changing the process - and says we aren't there yet. So I'll go on with my fingers crossed that nothing I take will be recalled.

But its Monday morning and I have my forgotten radiation oncologist follow up first thing. Somehow I will be incredibly busy in the next two weeks. Why do I do these things to myself? I have four doctor appointments, two meetings, two big work deadlines, and have to go to work as well. When am I supposed to have fun?

Sunday, August 29, 2010

Paying the price

Today I am paying the price. Yesterday I had fun. I got together with a college friend. She runs half marathons and I don't so she is probably in better shape than I but that, of course, didn't stop me. I went to visit her yesterday. She went for a run before I got there so she should have been tired.

We hung out on the rocks behind her house on the lake. Then we went for a little hike - 3-4 miles through the woods and got caught up on marriages and old friends. After a brief shopping stop, we decided to cool off by floating around her lake on tubes. After successfully flipping from my back to my stomach on the tube and staying dry, I was over confident and assumed I could handle tubing. I erroneously attempted to navigate off the tube and onto the rocks. On my first try, I stayed mostly on the tube but did not get onto the rocks. But of course did not stay on the tube and ended up in the lake with the tube upside down over my head. I did make it on to the rocks eventually but my tube floated away - but conveniently floated over to the beach which was our final destination.

I swam ashore after my tube. Upon successfully retrieving it, I attempted to sit on it while standing in water less than a foot deep. I ended up in the water with the tube floating away - again. I retrieved it. My friend got to laugh at me twice in one day.

I do admit to being tired after all that but decided I should just drive home. By the time I got home, I was wiped out and spent the evening sitting - this meant my husband cooked dinner and cleaned up. I didn't sleep well again last night. Today so far, my back hurts. I am exhausted. I don't have many plans for the day. In fact, my plans include the living room couch, the DVR, and my laptop. I think we will go for a walk as well but it won't be very long.

I think my blog is boring lately. I was going to write something more profound, scintillating maybe, intellectual possibly, or just plain interesting but am too tired. I need to rest up for my doctor appointment tomorrow morning.

Saturday, August 28, 2010

All the fun out of life

So after cancer, life goes on and you return to a new normal - you can never go back to being normal, your are now a zebra. After chemo, your system once again appreciates food, your hair returns, and life goes on. And now they say if you drink, you are more likely to have your breast cancer return.

What if life is a tiny bit more stressful than it was in the past and you appreciate that dinner glass of wine a bit more. But now you can't have it. Here's the choice: (A)don't have wine and feel more stressed because your cancer might return or (B)have wine and feel less stressed because you are slightly relaxed about if your cancer will return. Do you want A or B? (Actually, how about (C) have no cancer in the first place?) They are taking all the fun out of life.

Anyway today I am off to visit a college friend. (I was going to say an old friend but we aren't old.) She and her husband live on a lake. I said I can't kayak or canoe but she offered to tow me with her kayak while I float in an inner tube. That could be quite enjoyable.

Actually today my back is not happy. I woke up in the middle of the night and then I tried lying on my side to get back to sleep and ended up in excruciating pain... But I have drugs and will still be able to float.

Friday, August 27, 2010

How does this work?

The latest medical recall has Johnson & Johnson recalling hip implants. So, if you got one of those and its recalled, how are you supposed to send it back? Do you have surgery to take it out and get a new one?

This is the same thing when they recall medical stents - how do you take it back to the dealer and get a new one? Or do you just walk around with a little time bomb inside you that isn't going to work as expected? I mean if you have a Toyota, you take your car back to the dealer and they fix what was wrong. I don't mean to pick on Toyota but they seem to have recalls weekly - I guess that QA got overlooked there for a bit.

I simplified the salmonella egg problem in our house. I ditched the last of the store bought eggs and bought some from the local farm stand which raises their eggs there. I avoided the tylenol recalls by buying the safe store brands. But if you had a hip replacement, how do you give it back?

I don't know. None of these recalls makes me feel particularly safe and comfy. It goes back to the question should we all be living in a cave somewhere so we can be safe?

Thursday, August 26, 2010

I am not sure how this happened

I forgot about my upcoming radiation oncologist appointment. I mean I knew it was coming but thought it was a few more weeks away. I thought I had more time before worrying about it. You can't visit an oncologist without worrying. You know you are in trouble when you make that first oncologist appointment.

I actually have two oncologists - one radiation and one medical (chemo) oncologist. I'll see my medical oncologist in a few weeks. This is my annual follow up with my radiation oncologist. I think I see her for five years or so after treatment ended to make sure there are not any long term side effects. She is a very nice Russian woman with a long hard to pronounce name so she is called Dr. G by most people. We often compare shoes in addition to talk about how I am doing. But how did I forget about this?

1. Maybe I am less stressed by the cancer business than in the past. Well that is an option and partly may be the cause.
2. I have no brain and just completely forgot about it. This is a definite option.
3. I was ignoring it and thought I had weeks to go. This is definitely part of this as well.

I am going for mostly 2 with a little bit of 1 and 3 in the mix. But now I have to get my little list of questions for her together. Basically it will be a bit of an exam followed by lots of questions. I need to bring her up to date on my other issues - include my lovely, ongoing thyroid adventures (that I am definitely ignoring).

Well today the rain has finally stopped and I am very optimistic that my garden will burst into bloom. We barely had rain for 2.5 months - one night of showers since early June - and my dahlias are very late with other flowers gone dormant for a while. But three days and more than five inches of rain later, it has turned green all over again. I am not able to stay home until my flowers bloom but must go to work all day.

Wednesday, August 25, 2010

I can if I want to

I have a transportation dilemma. I live on the border of two towns. It is just over two miles west to the next town's center and just about two miles east to my town's center. It is relatively flat to both towns. Both towns have libraries, banks, farmers markets, grocery stores, and other necessary stops in life. 90% of my life is contained between these two points. I have many transportation options.

I can drive. I consider myself lazy to drive to one town center or the other for one thing and make an effort to combine trips. Many of my trips don't even require me to go as far as 2 miles so its kind of stupid.

I can take a bus. There is one approximately every 5-10 minutes to my town and once an hour to the next town. Its relatively cheap but it involves standing around and waiting. I usually am too impatient to wait. But on a rainy day, it can be much better than walking.

I can walk. I often do. In fact there is a multi-use bike path parallel to the main road which I can walk on. But then I have to carry things.

I can't bike. My back does not allow me to bike. I have given my niece my bike. I really liked my bike (it was fuschia and mine for nearly 15 years) but with my back issues I can't bike so I gave it up.

I could roller blade but I have a feeling my back would not like it. And then you have to carry a pair of shoes to switch to in stores and other places. How to carry things home?

I could get a motorized scooter. But road traffic is busy and they are relatively expensive, not necessarily green, and may require a motorcycle driver's license which would be a hassle to get. Motorized vehicles are not allowed on the bike path.

I need options. My latest thought (and feel free to disagree - my husband thinks I'm nuts) is a kick scooter. I could use it on the bike path. It would get me places quicker than walking. I could fold it up and lock it at a bike rack, run my errands, hop on and head home. Yes I would have to carry things as if I was walking but I would be vertical for a shorter period of time which helps my back. If I got rained on, I could hop on the bus. It would be green. It would be easy to store.

The problem is what if I buy it and then my back really hates it? I have to ponder that. But I can if I want to.

Tuesday, August 24, 2010

The doctor filter

You have a doctor appointment coming up. To get prepared you come up with a list of all your medications. Then you come up with a list of questions or issues to ask the doctor about - and possibly write them down so that you remember to ask them all. If you are really good you might bring someone to write down the answers.

You get to your appointment and start asking all your questions. Is your doctor taking notes then or are they going to write down their notes after the appointment? I think this is a matter personal preference on the doctor's part. How much are they really writing? What are they saying? What are they disregarding as non important or irrelevant? How much are they filtering out?

I think there is a doctor filter in play. If you say, sometimes you are sore after working out - does that count as a health problem or something that is expected? Or if you ask about allergy issues - runny nose and sneezing - are they just going to write down allergy symptoms or lots of details?

They do need to filter to some degree. I mean sometimes you ask questions that they answer and they don't require further comment or action. Other times, a question may lead to more checking or follow up. It is their professional opinion of what is important and what isn't.

But it is you, the patient, who needs to keep track of the questions and their answers and is the issue now closed for you or does it require follow up? Or was it previously closed and now reopened? Part of your question for the doctor might include 'I had this problem two years ago and it stopped and I was fine but its been back for the past two months.'

I think the doctor filter is further proof that we the patients need to keep track of what is going on with our bodies. The doctors see hundreds of patients, you see yourself. Its your body and you need to be in charge.

Monday, August 23, 2010

Make the world healthier

People are fat and getting fatter in the US, also known as 'Fast Food Land'. People are trying to change their lives and their lifestyles to be healthier and lose weight. But then they go back to their easier old habits as they drive past rows of fast food restaurants and turn into the drive through for the greasy bags passed into their windows. Fast food has turned a calorie free drink - coffee and tea - into a latte, mochas and more that have more than 400 calories each - plus whipped cream. Those coffees used to be special for after a nice meal on a rare occasion, not for every morning.

We can all try individually to do our bests but we need to get rid of the chains of fast food who offer cheap easy food to the masses with little or no nutritional value. What happened to fruits and vegetables? Why can't there be a salad and a bowl of fruit on the value meals? Also, how did they turn a relatively healthy item, grilled chicken, into 10 grams of fat per sandwich?

But I digress. The problem is not with the food but with the way the economy and other factors impact our life styles. The government subsidizes corn and soybeans used for animal feed and oil for fryers and high fructose corn syrup. It also includes the cities without grocery stores forcing reliance on fast food. Why can a burger chain afford the rent but a grocery store can't?

We need to promote access to healthy food and reduce access to bad food. We need to make choices that are not influenced by non stop television advertising for bad foods choices - soda, doughnuts, and fast food. (What if the lettuce growers of America sponsored the Superbowl? It would be very green.) Why is it so hard to buy healthy food at sport stadiums and in airports? Skip that sausage and hot dog and get a salad with grilled chicken. Make the right choice.

There is nothing wrong with fast food restaurants but what if they de-emphasized the greasy food and emphasized the healthier foods? What if the government subsidized lettuce growers so it was cheaper for them to promote salads?

If you stop at the doughnut shop, skip the grease and fancy coffee and get a normal coffee and then something with some protein. And skip the drive through, park your car and walk from your car. Your body (and your waistline) will like you better.

Sunday, August 22, 2010

Being a horse or a zebra

The other day I had a discussion with my therapist about whether I am turning into a hypochondriac and over reacting every time there is something wrong. Do I let the little things (headache, cough, etc) become big things? Should I ignore them or when should I call the doctor? Can I ignore them or should I call the doctor?

The medical profession is also partly to blame as once you have a cancer or other bad diagnosis, they are quick to put you on the fast track for more tests for what otherwise would be minor issue. Once you get a little tag in your file that says 'cancer' or something else nasty, they send you down the little path of tests. Which, yes, you can refuse, but then invitation counts more than the action. (Just like with party invitations you become part of the in-group.)

My therapist made the analogy that in medical school, doctors are trained to look for the zebras in the herds of horses. To most doctors, I am clearly a zebra.

People talk about going back to a new normal after a cancer diagnosis but I was never an adult without a cancer diagnosis. I was 19 the first time so I have spent all my adult life being fast tracked by doctors looking at a zebra. My therapist actually has also had breast cancer but she was an adult when she had it. I think she is somewhere in her 50s and I think she had breast cancer in the past ten years. (I don't know exactly because we talk about me, not her as I am the patient.) She has been an adult before and after cancer so she has a sense of what I am missing.

The question becomes, as my therapist summed it up, as a zebra how many stripes do I want to have? I would prefer to have none and blend in with the horses but am not sure that its possible.

Saturday, August 21, 2010

This is my kind of list

I can handle this list of good vices. Allow me to recap so you don't have to waste time reading a whole article before partaking in any of these.

1. Sleeping
2. Playing hooky
3. Sex
4. Daily chocolate fix
5. A night out
6. Healthy fat food
7. Daily cup of coffee
8. Massage
9. Sunshine
10. Wine with dinner

I've already slept in a little, had coffee today, and my husband massaged the painful knot out of my back. I will be out in the sun today, I'll find some healthy fat and chocolate to eat and have some wine with dinner (since it is now recommended). And since my back hurts I'm giving myself a day off where I will knit/crochet, watch TV with my feet up and hang out with the cat for the most of the day.

Usually health guidelines tell us 'no', 'no', 'no', 'no', 'no', 'no', 'no', 'well maybe a little', and 'no even though we told you yes for decades' so this is my kind of list where it tells you things you can do. A little positive reinforcement once in a while is very much appreciated.

So now that my day is off to a good start, I shall migrate to the couch shortly to begin my day of being lazy.

Friday, August 20, 2010

The Big C

So in its infinite wisdom, Showtime has introduced a new show - 'The Big C'. Its a comedy. It has a love interest for the woman who is receiving treatment. What the hell were they thinking?

Let's start with the beginning. Thank you for reintroducing the euphemism that we have spent generations trying to erase. The Big C was a death sentence. It had no cure. It was whispered by adults so children or anyone nearby wouldn't hear. It was an embarrassment to have a family member with cancer. It was hidden. They called it the big C so they didn't have to say the word. But now Showtime has brought it back into every day language. For this we thank them?

Next, its a comedy. They are trying to find humor in the main character's situation. Granted life goes on and life does contain its humorous moments. You do best while in treatment if you can keep your sense of humor. But its not a funny situation. Losing your hair. Feeling like crap. Having no energy. Nausea. Its not exactly a high point in one's life. If someone going through treatment can see humor in their life that's fine. But its not a situation for a comedy.

Finally, a love interest for a cancer patient? Who's married? Not happening. You are losing your hair. You are trying not to lose your lunch. YOU DON'T FEEL LIKE FLIRTING.

Yes people as a whole are much more open about cancer than in the past. It is openly talked about by many. But it is not funny, in any way, shape or form.

I should point out that after cancer treatment, many find it too painful to read about others with cancer in books. It took me along time to do be able to read a fiction book with a character with cancer. If a new book or movie comes out where a character has cancer, it is discussed in support groups and among cancer friends - should I see it, will I be able to cope? Why would I want to watch someone else going through cancer?

I admit I watched and enjoyed 'The Bucket List' but I watched it after hearing from many friends about it. And it was a comedy. But both main characters were very believable. They may have done a lot but they both were dying and they knew it. They didn't have a 'romantic' interest. They knew the clock was ticking. We were laughing with them. They called it cancer. It wasn't the big 'C'.

I won't be subscribing to Showtime anytime soon. Thanks but no thanks.

Thursday, August 19, 2010

Seeing is believing

So headlines this morning report that the new chief of Blue Cross in MA says that reining in costs is a top priority. Well, that sounds like political campaign words - 'its all about taxes' but in the world of health care, its all about premiums and coverage. Call me a skeptic after decades of jumps in health insurance premiums and decreases or more complicated rules for getting coverage. I will take a wait and see approach on this one.

Just the other day, it was reported that a hospital charged $300 for a $17 device. So you can see why I am a skeptic.

One thing I am not a skeptic on is this new study that palliative care extends the life of cancer patients. Back when I was first diagnosed with breast cancer and had two surgeries and was starting chemo and was a tiny bit stressed, I joined a support group at a local non profit (where I now work) which also offered wellness activities including Reiki. I was a skeptic then but desperate - not sleeping, totally stressed, a tiny bit crabby. I was offered a reiki session and poo pooed it. But then I tried it and felt nothing during the session but went home and took a nap - and actually felt rested.

Now the organization I work for, has expanded their offerings to include reiki, meditation, polarity and all sorts of activities for those touched by cancer - current and former patients, caregivers, and family members.

So maybe my skepticism will change to optimisim if the health insurance rates stop having these giant jumps and over charge for things - just like the government was accused of in the past - the $50 box of paper clips.

Wednesday, August 18, 2010

Who are these people?


- First we have the psuedo friends who say they will help you but never really step up.







Really what we want are the people we know and love to continue to keep treating us the same way with allowances for naps and doctor appointments. My brother, in his infinite brotherliness, at one point asked me if I had run out of body parts they could remove. This is exactly the kind of response I expect from him. I appreciated it in more ways than anyone can understand. My husband still wants me to do everything I can (but he insists on taking out the trash which I am happy to let him do) and is happy to help when I cant.

Tuesday, August 17, 2010

I feel so comfy about this

"Drug Recalls Surge" My bed side table is littered with 11 prescription bottles, one over the counter medication and I have two pill boxes containing the 14 pills I take on a daily basis plus the extras for break through pain. And apparently they are recalling all sorts of medications for manufacturing errors. What are my odds that something I take is manufactured wrong? I feel so comfy - NOT.

Well, I shall do my best to avoid thinking about this - let my inner three year old come through in my mature handling of this issue. I have enough to worry about otherwise. Like why my back hurt last night so that I have been up since (insert drum roll here) 3:30 am. I will say the cat was overjoyed I was awake because that meant he got a drink of water in the middle of the night. But I shall take my perky, overtired self off to the office and be 'charming' to my co-workers.

Now, here's a chance to feel old from my alma mater with their annual Mind Set list

Monday, August 16, 2010

I've been avoiding my health

So now its time for an update on how I am doing. First of all, my back hurts, all the time, and it doesn't matter if I am sitting, standing, walking, or lying down. It hurts. Sometimes it hurts all across my upper back. Sometimes it hurts sharply in a specific place. The only difference is that if I move around, it hurts less in some areas and if I sit down, I can ice it. Currently I am waiting for my back doctor to call me back to find out the next steps - either an office visit or more needles. I do want to talk to him about trying acupuncture.

This week I see by my therapist and my meds therapist. They are the ones that keep my brain connected to the rest of my body and keep me from freaking out over every little medical issue that crops up in a continual sequence in my life. These are conveniently scheduled one day apart so I will have two trips to the same place one right after the other.

At the end of August I have a follow up with my radiation oncologist. She is very nice and quick to order more tests if she thinks they are needed. One time when I had a visit with her, she loved the pair of shoes I was wearing and we talked about shoes as well. She's Russian and rolls her R's so its fun to listen to her as well. I'm not as concerned about seeing her.

I also have scheduled myself for a skin check with a dermatologist. I don't think I have much going on in that area but there is this spot on my leg I would like checked. I don't think its nothing but after a childhood in the sunshine and many sunburns and skin cancer in the family, I would prefer to be checked periodically. I haven't been getting checked yearly as I see far too many doctors.

I am then supposed to meet with the dietitian. I am not sure if I will go back. I do the right things. I lost a few pounds. I want to keep losing more. I am not sure I want to keep going to her at this point. I have enough doctor appointments. She tells me I am doing the right things as well. This is meant to be one last follow up with me. I don't know. I may cancel it.

My next medical adventure is a day where I have thoughtfully scheduled both a dentist appointment and a visit with my medical oncologist. The dentist should be just a cleaning. At the oncologist, I want to talk to her about a bunch of things - perhaps I will even put together a list before then...

Otherwise, my lymphedema seems to be under control. The new exercises I was given at my last visit seem to have helped control it so I have stopped wearing my sleeve (which was a pain in the neck). My ankle seems to be healed. I am supposed to have a December appointment (which somehow is not on my schedule) and I may or may not cancel it anyway if it continues to feel better.

So my medical life keeps chugging along. I still go to the doctor too often. My back pain and residual fatigue are what slows me down more often than not. But I'm still here.

Sunday, August 15, 2010

Pain, pain, pain, pain, pain, pain - to the tune of 'Spam, spam, spam'

Living with pain is so much fun. If I pretend to be a normal person and do something like sit in a chair and cross one leg over the other or do some weeding or go for a walk or sit down or any number of regular every day things, my body reminds me I shouldn't. But the catch is sometimes it hurts and sometimes it doesn't. So its a crap shoot once again, will it hurt or not. Some times I can be normal and sometimes I can't. This morning I am lying in bed, propped up on pillows and my back is killing me and my right hip is hurting and stopping.

Then I read this lovely article about women and pain and depression and decided I need to do something else besides think about pain. Maybe I'll go have some breakfast.

Spam Song Lyrics

Customer: Morning,

Waitress: Morning.

Customer: What have you got?

Waitress: Well, there's egg and bacon,
egg sausage and bacon
Egg and spam
Egg, bacon and spam
Egg, bacon, sausage and spam
Spam, bacon, sausage and spam
Spam, egg, spam, spam, bacon and spam
Spam, spam, spam, egg and spam

(Choir: Spam! Spam! Spam! Spam! Lovely Spam! Lovely Spam!)

Or Lobster Thermidor aux crevettes with a mornay sauce
served in a provencale manner with shallots and aubergines
garnished with truffle pate, brandy and a fried egg on top and spam.

Wife: Have you got anything without spam?

Waitress: Well, the spam, eggs, sausage and spam. That's not got much spam in it

Wife: I don't want any spam!

Customer: Why can't she have eggs, bacon, spam and sausage?

Wife: That's got spam in it!

Customer: Hasn't got much spam in it as spam, eggs, sausage and spam has it?

(Choir: Spam! Spam! Spam!...)

Wife: Could you do me eggs, bacon, spam and sausage without the spam, then?

Waitress: Iiiiiiiiiiiich!!

Wife: What do you mean 'Iiiiiiiiiich'? I don't like spam!

(Choir: Lovely spam! Wonderful spam!)

Waitress (to choir): Shut up!

(Choir: Lovely spam! Wonderful spam!)

Waitress: Shut Up! Bloody Vikings! You can't have egg, bacon, spam and sausage without the spam.

Wife: I don't like spam!

Customer: Shush dear, don't have a fuss. I'll have your spam. I love it, I'm having spam, spam, spam, spam, spam, spam, spam, baked beans, spam, spam, spam, and spam!

(Choir: Spam! Spam! Spam! Spam! Lovely spam! Wonderful spam!)

Waitress: Shut Up!! Baked beans are off.

Customer: Well, could I have her spam instead of the baked beans then?

Waitress: You mean spam, spam, spam, spam, spam, spam, spam, spam, spam, spam, spam, spam and spam?

Choir (intervening): Spam! Spam! Spam! Spam!
Lovely spam! Wonderful spam!
Lovely spam! Lovely spam! Lovely spam! Lovely spam!
Spam spam spam spam!

Saturday, August 14, 2010

And the doctor says 'eat your veggies'

Lots of Americans don't eat their vegetables and there is a growing obesity problem in the US. Now some doctors are prescribing vegetables to their patients. I think this is a great idea. Some people just need a little prompting to try new things and actually follow the advice of their doctors (now there are a lot of people who don't follow their advice but I am sure that's a different blog post).

I think people have a tendency to eat things that are:

- familiar to them - the food they grew up with.
- easy to make or obtain - prepackaged or fast food
- taste good - think chocolate, sweet, french fries

But back up to the healthy criteria. Hopefully the vegetables and fruits and vitamins and minerals are in there somewhere.

You don't have to be a cook to eat healthy in this country - the land of prepackaged everything. Of course, its probably best to organically grow your vegetables and buy everything at the local farmer's markets and make everything from scratch. But because of the convenience of America's food culture, you can go to the grocery store and get a bag of lettuce and some pre cut carrots and celery and then get hamburgers and rolls and there you go - a relatively nutritionally meal. Then go for a walk and you are off to a healthier life.

Friday, August 13, 2010

Ahem, could this be skewing of clinical trials?

Well, not the actual data but the releasing of the data. It turns out that more industry funded trials have better results than those run by non profits or government agencies. Then we learn that results of many trials are not made public, even into standard medical databases.

So if we take fact one that industry seems to be better at running clinical trials at face value - maybe its just because they are better at running trials since they developed the drugs or whatever. Then we take fact two that trial results don't always see the light of day. This has nothing to do with whether a drug is approved or not, the FDA takes the trial results and goes from there. It seems that non-industry run trial results, the ones that are less likely to be full of as many positives, are less likely to be published.

The problem lies in the fact that if the trial results are never published for doctors to read them and then are less likely to prescribe them to their patients. This is where the gap becomes problematic.

I think there should be a standard here. If all clinical trials are run to be a true test of A vs. B or A vs. B vs. C so they are equal. Then shouldn't their results be required to be equally available to all? I mean if a drug is approved for use for treatment for a specific disease or condition, shouldn't all the relevant clinical trials be equally available for doctors to review? And in an equal format so they can be easily reviewed and compared by the doctors. It just seems logical to me.


Now this morning, I am running late. I was tired and I slept in. I wanted to be at the office by 830. Not happening. Well maybe if I rush. But I'm feeling lazy so probably not. I'm trying something new today - I am going to a Chronic Pain Support Group. Just to see what its like. Maybe I'm turning into a support group junkie.

Thursday, August 12, 2010

Not so fast

Yesterday I was working hard (wasting time online) and found this article on how companies and US health insurance companies are looking to save money by sending employees overseas for basic medical procedures. I thought about it and in my case the issues would be cleanliness, medical standards, medical training, and other basics.

I don't doubt that medical care can be just as good outside the US as in the US but I am comfortable with my medical care here where all my doctors can read my giant medical records going back for decades in one place. This even has prevented me from switching to another health care center - I would have to spend a fortune getting all my medical files moved. Digital ones are easy, its the older paper ones, which are expensive. Just think of photocopying all those pages.

Then this morning's news is all about how patients who travel for medical procedures overseas are bringing home this new resistant strain of germs that have a gene which is resistant to all but one currently known antibiotic. So maybe I won't jump on that medical travel bug quite so fast.

It is not surprising to me that a germ has appeared that is resistant to Western medicine. If you think about it, its a completely different germ pool in another city in a foreign company. Local germ pools are developed based on the people who live there. So think if its a city with a relatively local germ pool and you stick some outsiders into it who have different immunities and voila you get new germs with new mutations. I think it doesn't matter to germ pools if the new people are introduced from 100 miles away to 10,000 miles away.

The problems are pinpointed in the last two paragraphs of the second article:

'... "What you're looking at here is like coastal erosion, a gradual winding down of our ability to treat infections. The worry is, as time goes by, infections become a little harder and harder to treat. So much of modern medicine depends critically on our ability to treat infections as they arise."

The Lancet authors say the growing popularity of travel for medical care makes it unlikely that this particular genie will ever be stuffed back in the bottle. But they warn that such travel should probably be discouraged, saying the establishment of NDM-1 carrying strains around the world is a “clear and frightening” possibility.'

If you add in the costs of treating antibiotic-resistant germs against the potential savings gained my treating patients overseas,the savings just may not be there in the long run.

Wednesday, August 11, 2010

A case of the post-vacation blahs

I have a bad case of the post vacation-blahs. I got in late Saturday night. My husband picked me up at the airport - and of course his phone wasn't working so I couldn't call him and say "I'm here" so he drove in circles and I stressed out. But we met on the curb outside baggage claim around 11pm. Upon arriving home, I was tired but couldn't sleep so was up late.

Sunday I got up at a semi normal time and dealt with shopping (I am not sure what my husband ate while I was gone but he didn't leave much behind for me - he even mentioned the lack of vegetables). I also unpacked, did laundry, sort of put things away, watered plants, etc. We did go out for a walk as well. My back wsn't so sure it liked it but I managed to get through it. I did resume my exercises.

Monday I was home by myself. My goal was to work from home for 4-5 hours in the morning. By the time I motivated and got organized it was 1230pm. So much for that idea. I even did my exercises
Tuesday, yesterday, I went to my job at the office and was incredibly busy. I also forgot my anti depressant, and some other pills, so was some what stressed and had a headache by the time I left. I never remembered my exercises either. I was very unsettled last night - just wasn't able to relax and just not feeling that great. Finally I fell a sleep and did sleep well.

This morning, I do need to do some work but also have several errands to run. I did make it through my morning walk and pondered why I feel so out of sorts - I have the post vacation blahs. I need a vacation to recover from my vacation. We relaxed too much. But that's not for another few weeks. In the meantime, I need to start doing my exercises again daily, stop forgetting to take all my damn pills, and even fit in a few doctor appointments. Life returns to normal.

Tuesday, August 10, 2010

What were they thinking?

I don't understand.

1. A Pop-Tarts store in Times Square. Pop-Tarts are not the most nutritiously balanced food available. They have sugar. They have white flour. They have chemicals. But when I was young (before I knew better), I loved the cinnamon frosted ones especially after they were in the toaster. But a Pop-Tarts store - 3,000 square feet of it in Times Square.

2. Teacher's union fights for Viagra coverage in their health insurance. Never mind that the school system is $30 million in debt. Its not normally covered by insurance but apparently its seen as an equality issue. Insurance costs would probably go up if they covered Viagra but apparently the teachers don't care. Its an equality issue and they are more equal than the rest of the country who doesn't have Viagra coverage. (Just think if Viagra was covered by insurance, we would all get less spam.)

3. Don't push your friends into the river if you don't know if they can swim and maybe you should all wear life jackets. This is very sad and very stupid.

Three cases of 'what were they thinking'. I don't know but clearly there needs to be some thought process somewhere.

Monday, August 9, 2010

What does one have to do with the other?

I admit I am a reality cooking show junkie. I watch them all - Top Chef, Next Food Network Star, Chopped, Top Chef Masters, etc. Some I am addicted to, others not so much. I don't like the challenge ones as much.

So yesterday I had to start to get caught up on all my DVR'd cooking shows from vacation where I didn't get to watch any. On one of them, one of the contestants said something along the lines of 'I can cook better than the other guy. I have been through so much more than he has - I've had cancer and four surgeries.' My inner thought is that's half of what I have been through - cancer twice and eight surgeries so shouldn't I be twice as good a cook as the guy on TV? But then he's on TV and I'm not which tells you something right there.

So what does having cancer or any other health ailment have to do with cooking skills? This isn't the first time that someone was saying they were better in whatever it was, because they had cancer previously. I can remember at least two other shows where this has happened. Granted the shows try to play up the personal quirks of contestants to create more drama. But what does cancer have to do with cooking. They never clarify that. I'm not sure it does other than the fact that during chemo, nothing tastes good.

I also watch two different news shows where one of the newscasters has had cancer and was relatively public about it at the time they were going through it but they don't bring it up all the time. Does it make someone better at what they do because they had cancer? Or are they going for the sympathy vote?

Now there are times to play the cancer card (if you aren't sure what this is, go read 'Crazy Sexy Cancer' by Kris Carr for more details). But if you sign up for a competition, you really shouldn't use your your cancer or other health issues as a reason for being better than anyone else. Nor in the workplace. I don't see how one has anything to do with the other.


I'm back from vacation which means there is laundry to deal with, the cat is neglected, the mail is piled up, and my back hurts. Well it hurts all the time, but I will actually do something about it and call my doctor today about it. I need a prescription refilled and if a human answers the phone I will whine about my back as well as get the refill. If I get voice mail, no whining, just a refill. But I am working from home so the cat will feel less neglected and the laundry might get folded.

Sunday, August 8, 2010

Two opposing sides of cancer

First we have the pathological liars, greedy people, deceptive people, and other words I can't use here (without offending) but we'll just call them the *(&)^^%%^$%^&#^$*^&%*(&(^*_)*(^* people like Ashley Kirilow of Ontario, CA who told her whole family and friends that she was diagnosed with terminal breast and brain cancer. People came out of the wood work and raised money for her. She received approximately $20,000 in donations and a trip to Disney World before her own father turned her in. Good for him I say. It must have been a very difficult decision to turn in your own child. But now she is spending the weekend in jail awaiting a court appearance on Monday.

It is unfortunate that people like this make it more difficult for the real worthy charities more difficult to raise money. I will not give money to any charity who calls me on the phone. I insist they send me a letter and allow me to make a decision. Recently on a phone call, they tried to explain to me that they wanted a pledge up front for budgeting purposes. Well, that's their problem not mine. Send me a letter and I'll think about it. If I want to feel pressured I'll go shop for a used car from a guy with a bad greasy comb over.

Now the other side of cancer is taking place around here this weekend (and the weather is cooperating this year). Its the Pan Mass Challenge which raises around $31 million for the Dana Farber Cancer Center. This ride, has varying lengths, and requires the riders to individually raise around $3000(+/-) (which I find an appalling amount but that's a post for another day).

These dedicated people not only train to ride nearly 200 miles in two days but they also spend hours, days and weeks raising the money that provides life saving cancer treatment for thousands of people. Senator John Kerry is even riding in it this year.

So the two sides face off - the dedicated volunteers who donate their time and efforts vs. the woman in jail in Canada (and I hope she spends a fair amount of time there and gets counseling). Who would you prefer to hang out with? I prefer the honest ones myself.

Saturday, August 7, 2010

This is wrong

I find it very wrong that people on life saving medications have to stop taking them for financial reasons. As reported recently in the New England Journal of Medicine, patients were forced to stop taking their life saving medications.

First, I will say the drug in question is relatively expensive - $4500/month. That equals $150/day or $54,000/year. But did the drug company have any ability to provide low cost prescriptions to needy patients? I know some that do (and then the question arises, why can't we all get cheaper drugs - but they need to pay for their overhead, blah, blah, blah. But that will be another post on another day.)

Now the first patient in question had to stop taking the medication due to decreased family income. When it comes to saving the house for all, or saving one person's life, you have to draw the line. But how? Who makes the choices? That would be an awful decision.

The second patient started his own business and couldn't get insurance because of a pre-existing condition. I have lived with a pre-existing condition for 29 years. I have juggled health care plans. (I was very happy when Massachusetts tightened up its consumer protection laws and got rid of the pre-existing loop hole years ago. Its a tough one to juggle. My health is on a need to know basis and if my doctor was telling me you are basically healthy, why should an insurance company say we can't insure you because of your health? But I digress.) This second patient couldn't get health insurance which shows what is wrong with the current system.

The third patient's business failed and he could no longer afford the medication. Again dollars and a human life.

I find it wrong that we are juggling people's lives and dollars. When does a human life get reduced to ability to pay? How wrong is that?

Friday, August 6, 2010

Complimentary treatments & healthy eating

I am all for keeping myself as healthy as possible through eating the right foods (breakfast today was actually hummus, cucumber slices and ciabatta bread), exercising (that damn daily walk thing), getting enough rest, and taking supplements as needed. I am careful about what I take as supplements as I have to be careful about interactions with my medications and some of them have proven to have weird interactions and side effects discovered long after they were on the market. The FDA does not regulate supplements which should be kept in mind before taking them. Also, if you take any supplements, be sure your doctor knows - regardless of whether you are in treatment for anything. When you fill out your medications list at a doctor's appointment, you should list all supplements you take.

Here is a video on Kombucha tea. Kombucha is considered a supplement by the FDA. Its benefits are debatable as there never has been a true clinical trial. It does have side effects. In its brewing process, alcohol is produced (which set off Lindsay Lohan's alcohol detecting ankle bracelet) as well as molds and bacteria. It can be brewed at home or purchased commercially. But it should be noted that Whole Foods (a/k/a Whole Wallet) removed Kombucha from its shelves because the alcohol level is not consistent and can't be always considered non-alcoholic. But my point is, its unproven and should be considered a medical supplement and discussed with your doctor.

Another recent fad was St John's Wort. Did you know it interacts with birth control pills and renders them ineffective? That would be a big problem. That is just an example of the side effects.

My latest thoughts on healthy eating include:

- Dont eat things your grandmother wouldn't recognize - What is in Gogurt anyway? I love that example? A single serving of a chemically altered yogurt in a plastic tube. Why does it make me think of 'Soylent Green'?

- Aim for foods with five or fewer ingredients. Butter vs. margarine. Butter is the clear winner.

- Avoid foods with ingredients you can't pronounce or know exactly what they are.

- Vegetables, fruit, fiber, lean protein.

However there are things I can't find in healthy versions so I suffer with a few chemicals. I try for natural body care products but can't always find them. I really do try. And then I saw this video which is now my newest goal - you can eat anything you want provided it is natural, unprocessed and preservative free. I am not sure how much more I will have to change but I will focus on this now.


This morning I am hanging out in an internet cafe for a couple hours waiting for stores to open - yarn store, consignment, and bead store. I should be working but I am on vacation still. Later today will be lunch, a walk, packing, and one last scrabble game.

Thursday, August 5, 2010

Why does our health make us write?

But first, a minor detour:

I blog. There are probably 1,000,000 other people out their blogging about their health? There are some who are very good and there are some who are very bad. There are those who meant to blog and startd out with 'Today I have another big scary doctor appointment. I'll fill you in later on what they told me' and we are left hanging with no more blog updates - did they give up their blog, did they lose their internet connection, did the scary doctor give them good news, did they get hit by a bus, did they die (it would be nice to have some sense of completion here), or any other number of reasons? But we would like to know and never will.

Some blogs are funny like Baldylocks (watch her new video on the right!) or Babs (I want a Jillie if I ever have to deal with this again) and allow us to see the humor in all this crap we call cancer. Some are heart wrenching - like Emily - she's too young for this. Some just show us the human side of our health and getting our lives backtogether - like Linda. Some are just plain enjoyable reading - like Debbie or Whitestone. And some are inspiring like Jothy. I can go on and on and on. I read any number of blogs each day. (This is one of the many reasons the internet has become a giant time suck for me.)

I also read the health sections of CNN and the NY Times regularly. I find some writers more inspiring than others. Sometimes they write about an ailment that I don't have - yes there are some I do not have. Today I am inspired by both Elizabeth Cohen who writes the Empowered Patient for CNN and by Christopher Hitchens, a contributing editor at Vanity Fair. Elizabeth writes today about why she writes her column - because of the issues she went through after the birth of her child. Christopher writes about his feelings with his diagnosis with what appears to be late stage esophageal cancer (he never says what exactly his diagnosis is - this is my non medical interpretation on what I understand are the facts as he states them).

For whatever the reasons we write or means to write, it allows us to express our feelings as well deal with trauma, stress, our failing bodies, our repetitive trips to the kind doctors who send us off on multiple medical excursions that usually include the words 'its might be a little uncomfortable' or 'you will feel a small pinch' or 'hold still and move as little as possible for the next sixty minutes' (and then your nose itches).

We write because we need to reach out to the outside world and say 'don't forget about me'. Perhaps we also write to inspire others. Or to just say I'm still here and don't plan on going any time soon.

Well, today we are back in southern MN. I slept well last night and am on my own today - which we know always leads to trouble. My friend went to work. I am at her place by myself. We are having her father and his new wife over for dinner so I do need to cook and stuff but this is my to do list I sent to her at work, in no particular order

1. Figure out the damn tv again - every time I shut it off I have to figure it out again.
2. Finish messing up your kitchen - she thinks I'm rearranging it. (she said I could)
3. Finish waking up - not sure if that will be before or after #2
4. make lemon curd - I found the whipped cream attachment for the mixer. maybe make some pureed berries to go in the layers of the trifle.
5. Roast vegetables for soup - worst case, you can't borrow a blender, what do you think the whipped cream attachment would do to the soup? (And find the damn soup recipe we saw in a TV show on line so it might actually be edible.
6. Weeding - do you have any gardening implements that would help with dandelion removal or should I just search the garage? (No she has clippers only.)
7. Go for a walk to the arboretum
8. Nap
9. Do some work.
10. Finish my blog before noon.

So far I have finished #10.

Wednesday, August 4, 2010

Its discrimination















Tuesday, August 3, 2010

Lacking the connection between 'Customer' and 'Service'

We are on vacation and having a grand old time doing all the things we shouldn't - buying too much yarn, clothes, shoes, jewelry and other necessities (we are returning the shoes to allow for our other expenses - this is what happens when you travel with an old friend as opposed to a husband who does not allow for the proper amounts of shopping time and expense).

We found a beach yesterday morning, albeit a Great Lakes beach as opposed to the ocean kind I prefer, and went for a long walk to be followed by a brunch at a restaurant we found. We were very excited about our restaurant choice as its the perfect place to have brunch. They only serve breakfast and close at 1pm. After our walk, we headed there for some needed nutrition.

We walked in and assumed we should seat ourselves because there was no one at the door - but no sign and we were ignored by all the staff. So we seated ourselves and waited a good five minutes, eying the credit card slip from the previous diner on the nicely set table. There were a few waitresses around busily waiting on others. Another couple came in and sat at the counter and were greeted instantly. Finally we gave up and moved to the counter next to them and were instantly greeted by a different waitress.

We placed our orders with the cheerful waitress. My friend wanted a bowl of fresh berries and was asked which kind she wanted - blueberries or raspberries. She wanted to have a mixture of both. The reply back was 'No we can't do that'. What do you mean no? Isn't the customer always right? How difficult would it be to mix up two bowls of berries???? But when they arrived, they were quite yummy and we did eat them all.

The couple next to us ordered their food. The husband ordered an egg thing. But the wife asked for just cranberry walnut toast. They had a big note on the white board advertising cranberry walnut French toast. She just wanted toast toast. The answer was 'No, we can't do that.' Again, how hard was this to do? She just had a cup of coffee instead - how's that for a lost sale?

Sitting at the counter, we were right in front of the window to the kitchen where we could see our food come up. We figured out which was ours and it sat, and sat, and sat, and sat, and sat. We looked around for our waitress. She was busy filling little containers of raspberry jam in the back room. When she finished filling them, we thought she might come bring us our food. But then she had to put the lids on. And pulled out more little containers. Now we know where she was when we first came in. Finally, she realized it might be time to bring us our food.

Then there was the waitress who didn't do anything. Seriously, she just stood around behind the counter and watched things. She was young so maybe in training but we didn't see her receive any training either. At one point she washed something in the sink but the rest of the time we were there she didn't do a thing other than stand there. Maybe she could have filled little containers with raspberry jam.

Needless to say we won't be back there for breakfast. We'll find a place which knows that 'customer' and 'service' are connected.

Monday, August 2, 2010

16 things you didn't know about me

I am jumping on the latest fad band wagon - I have seen several other posts on this so its my turn.

1. I do not like crawly things. I like to garden, I like organic vegetables but they should not have house guests.

2. I am not a cancer survivor. I am a person with cancer or even someone touched by cancer. All I survived is a bunch of doctor appointments (still on going - so maybe I am a work in progress).

3. I do not color my hair. My friends are jealous. Both my siblings have way more gray hair than I (not that I mention it to them much). My hair dresser thinks I have a way to go before being gray. I was gray briefly after chemo but it all came back to the way it was.

4. I cannot parallel park. Some times I have problems with regular parking spaces as well. My husband coaches me or I just leave the car badly parked all the time. We did buy a car a couple of years ago with a tiny turning radius and my husband hoped I would be able to park it but I still cant. (To be fair, when I took my driver's test, oh so many years ago, I hit a trash can while parallel parking but they still passed me.)

5. I believe that everyone has the right to their own opinion but that we just don't have to agree. This means I really don't have time for fear mongerers or hate mongerers.

6. I try to be proactive in taking care of my health issues. I am actually going to a dermatologist later this month for a skin check just because I should. I even go to the dentist and periodontist regularly. Even though I hate the dentist - drills..... eeeekkkk!

7. I like to travel and have traveled to most of the US except some of the western states and Alaska and Hawaii. I have traveled to Canada, England, France, Spain, Japan, and Italy and even went to school in France for a summer term in high school and then a semester in college and a summer term in Spain in high school as well. Next year I want to go to Iceland. Right now I am on vacation up in northern Wisconsin on Lake Superior. In September we are going to Sacramento and Lake Tahoe.

8. I have studied French, Spanish, Italian and Japanese. I don't remember too much of them but
can get by. I was very pleased that I managed to survive in Japan mostly by myself.

9. I love to cook, garden, read, and hanging out with my husband. The best part about cooking is my husband will try anything once and has learned to give his opinion so I make things again that he likes. I rarely follow recipes and measure exactly, sometimes I look at them for guidance and then pour in a little of this and a little of that.

10. I dislike prepared food. I try to follow the rule of no more than five ingredients, no ingredients with words you cant pronounce or eat things your grandmother wouldn't recognize. I do not eat at fast food or chain restaurants unless I can avoid it. I make everything from scratch including soup. I recently learned how to make pasta and bake my own bread.

11. I am addicted to competitive cooking shows - The Next Food Network Star, Top Chef, Chopped, etc. I also watch Jeopardy every night with my husband - and we argue about the clues or the people on the show and what they are wearing.

12. I also like to crochet and knit and am a member of SABLE (Stash Acquired Beyond Life Expectancy) in the yarn category - and added some more awesome yarn yesterday at an yarn store we are going back to today. They had lots of Italian yarns...

13. I used to ski (cross country and down hill), snow shoe, hike, bike, roller blade, ice skate and all sorts of out door sports. Now I am lucky to make it through my daily walk. I do try hiking as long as my husband carries my pack.

14. I am not a late night person. I like to go to bed between 9 and 10 - and have always been this way with the exception of college where I would stay up late - till 2 or later. This is not just because of my stupid health issues. I am a morning person. I like to watch the sunrise - we can see it from our bedroom window.

15. I was 4'8" in fifth grade. For some reason I remember that height. I am now a whopping 5'3.5". I used to be the shortest person in generations in my family. One of my great grandmothers was six feet tall.

16. And finally, I am an internet junkie (as my friend is telling me). I blog. I am on Facebook. I am on Twitter. I update websites as part of my work. I have a certificate in Internet Systems Management. So maybe I am a geek. No not just a geek, I am a COOL geek. (Is that possible?)

Sunday, August 1, 2010

Its on a need to know basis

Apparently many older American's don't understand the new health care law and how it applies to them. Well, I don't either. I mean I understand bits and pieces of how it applies to me and a few little things about the Medicare portion of it. But I don't really understand most of it. I figure I'll pick up what I need to know when I need to know it - its really just on a need to know basis.

The National Council on Aging apparently thinks we need to know now so they have set up a website. Honestly I tried deciphering the results of the survey they did but I need more caffeine to have it make sense. Its kind of like trying to read a word problem in math class and then deciphering how they presented the results. (But that is not just the case with this study, many studies do this - I think this is how statisticians keep their jobs by having to keep clarifying what they did.)

At any rate, if you decipher it you will learn that older people and younger across America are confused. So let's all be confused together until its time to need to know.

Today I am in Minneapolis staying at a very nice hotel with my friend. A question though is if you are in a room with two beds so probably two people will stay there, why do you only have one coffee and one decaf little packets for the coffee machine? Shouldn't there be two coffees and two decafs? This is making the assumption that one person will want one and one the other. We both need caffeine. So plan B is to split the caffeine and buy cups to go in the lobby.

We are off on the next stage of our adventure to head to Bayfield WI. I've never been there. She's been there once, long ago. We have to navigate our way across WI without getting lost. We have a map.

Now how does my back like travel. It doesn't. I got an ice pack when we finally go here - after lunch downtown and a brief trip (and two pairs of shoes later) to the Mall of America. Then I reused my ice pack before bed and at 3 am I took pain meds. Today my goal is take all my pills at their regularly scheduled intervals.

I Started a New Blog
