Monday, February 28, 2011

Are pelvic exams going out of style?


Ah, every woman’s favorite. Melinda Beck wrote about this internal exam in the WSJ, Feb 15, 2011.

After you reach a certain age, you have had this yucky exam so many times it is not as horrible as at first. But still. And even if you have no uterus or cervix, they still tell you to have it.

The American College of Obstetricians and Gynecologists, I believe, say you can stop the Pap when you are 65 and have had three normal ones…or two, I forget.

The Pap recommendation is now every two years for women 21-30 with no symptoms or risk factors and every three years from 30 up.

This exam also checks for ovarian cancer with that press on the stomach and press from inside deal (bimanual exam—two hands). This can lead to unnecessary tests, some docs say. If symptoms of cancer appear, ultrasound can be better than this periodic mashing.

There is no need for a pelvic to get the pill—but it is often required.

Still and all, some doctors insist on regular pelvics. See if your doctor will kick this around with you.

There is also a move to make this exam more humane—like warming the equipment. Yeah, that would be good.

Friday, February 25, 2011

ICU: Too much care?


Laura Landro, WSJ, Feb 15, 2011, says some hospitals are rethinking intensive care.

If you get sent there after surgery or with a life-threatening infection or something, you may be heavily sedated or even put in a deliberate coma, not move much, and be poked and prodded while given drugs to make you forget.

Now, researchers think, this may set you up for problems later.

You can get intensive care delirium—maybe increasing your chances of dementia.

A year after a stint in intensive care, half the patients cannot return to work.

The new thinking is to sedate more lightly, regularly assessing for pain. The nurses may awaken patients every so often to see if they can breathe on their own.

Another technique is to sit patients up—or even stand them up.

These approaches come from Vanderbilt’s ICU Delirium and Cognitive Impairment Study.

Since patients may be out of it, family members have to be sure these steps are taken.

As many as a third of ICU patients may suffer from depression after a stay.

If you know someone who ends up in the ICU, ask about this.

Thursday, February 24, 2011

Childbirth--and afterward


Today is my daughter’s 29th birthday. That was a big day for me 29 years ago today.

First, my water broke about 4 am. True to what they said in those weird classes, her father did not seem impressed and went back to sleep.

Now, I watch childbirth shows all the time. I once told her Dad childbirth is a woman’s Vietnam.

In one show—ONE BORN EVERY MINUTE—everyone seems to get pitocin to speed up labor. At least at that hospital—I thought that was kind of rare.

Guess not.

We went to the bank and hardware store before the hospital. For some reason, I made Jell-O, which sat in the fridge for weeks. The doctor said we should have hurried more.

It hurt—no epidural. But the nurses pooh poohed it—said they weren’t “real” labor pains. Yeah, well YOU have them, then.

Finally, I ended up with a Cesarean after 11 hours—fibroid big as a grapefruit (gross-sorry) they had not seen on the sono. She would never have come out. In olden times, she and I would both be taking harp lessons.

So now she’s 29. Not secretary of state, as we used to joke. But she has her moments.

Oh, almost forgot—if you don’t read the book on Cesareans during the class, you will get one. Yeah, I once thought that was stupid, too.

Wednesday, February 23, 2011

Be careful on that human growth hormone deal


Assuming you want to live a long time, you might want to steer clear of fad diets involving HGH—Human Growth Hormone. There are a bunch around where you eat 500 cals a day and take some bogus pill—but the real ones involve injecting yourself.

A lot of the fabulous folk are into this these days.

Scientists didn’t study the fabbies, though—they studied a group of extended relatives (inbreeding?) in Ecuador. They share a mutation that shuts off receptors that process HGH.

This mutation, called E18, helps cause Laron syndrome—a disorder that stunts growth by about 50%.

The people are small with high infant mortality.

But—on the positive side—they don’t get cancer and diabetes.

This played out in mice, too.

This is without HGH, remember.

Scientists may look into suppressing HGH to prevent diseases and help people be healthier longer.

I don’t know—this is based on a small, sort of offbeat sample…But stay tuned.

Tuesday, February 22, 2011

Does this bug you?


Marcel Dicke and Arnold Van Huis, WSJ, Feb 19-20, 2011, says four legs may be out in the protein dept—and six legs may be the new source.

Insects.

I had a eighth grade teacher who brought in choc covered bees—and dared us to eat them. The bee was pretty encased in choc, so wasn’t too disgusting. Just a little.

Still, aren’t shrimp sort of like sea bugs? Crawdads, etc?

In New York, these two say, you can get a taco stuffed with dried grasshoppers for $11.

Water bug caviar may be coming…

Insects are high in protein, B vitamins, and iron and zinc.

Most of the developing world eats the six-leggers occasionally.

Apparently they are sort of catching on in The Netherlands.

Another argument is that unlike cows and pigs, insects like to live all squashed together.

Anyhow—this story points out—we already eat a few bugs. The average person eats a pound of insect parts a year—this much is allowed in other foods. Your next glass of fruit juice could contain 5 fruit-fly eggs.

All together now—ew.

Monday, February 21, 2011

New thinking on chronic fatigue


The largest study ever on this debilitating condition (600 participants), published in Lancet, suggests that “adapting” to diminished energy and strength by taking it easy may not be the best therapy.

Exercise seems to help, the researchers found. It might even reverse some of the symptoms.

You may not need to have CFS forever.

Up to 2% of people worldwide have this. The symptoms are persistent tiredness, muscle pain, insomnia, and memory problems.

The cause is unknown—although some viruses can set it off. The conventional wisdom now is to pace yourself—rest if you can’t do a lot.

The patients tested medical care, psychology to address fears of exercise, drugs for insomnia or pain, or the adaptive pacing strategy.

Behavior and exercise changes helped about 60%. How long improvements will last was not known.

I would say this is a start—not a breakthrough.

Still, if you heard exercise could be harmful, this seems to indicate that it isn't.

Friday, February 18, 2011

Teen-involved


A friend (writersweekly.com) recently posted on a scary car accident her daughter and the daughter’s boyfriend had.

Sue Shellenbarger recently wrote about teen accidents in the WSJ, Feb 15, 2011.

Why should you care? A third of those killed by teen drivers are not in the teen’s car.

Thirty percent of teen-caused fatalities are cyclists, pedestrians, or people in other involved cars.

Half a million people were involved in an accident involving a teen last year.

Teen fatalities actually have been dropping since tougher teen laws came in in the mid-1990s. These laws involve many more hours of supervised practice than before.

Still, almost a fourth of teen deaths are caused by car accidents.

Teens talk on the phone and text—even while driving and even while this is prohibited by state laws.

And their reflexes and sense memory is not as set in to protect them from sudden mishaps.

Bad combo.

In past years, Daddy may have taken the T-Bird away. Maybe now, it should be the cell.

Thursday, February 17, 2011

Is your hubs crabby--or hormonal?


Supposedly, there is such a thing as male menopause—low testosterone.

Ever heard that commercial for “Low T,” that is pharmco cutespeak for low testosterone.

You know—in case you are too stupid to know that. These people!

Anyhow, while women undergo a big falloff in estrogen at menopause, men tend to lose “T” a few percentage pts a month from age 30 on.

Still, this gets blamed for irritability, erectile dysfunction, and low energy. Some men think they may need some big old drug.

For one thing--too much testosterone can also be bad. Look at wars.

If your mate or someone you know is really undergoing a big personality and energy change, maybe a blood test for testosterone might be worth a throw.

Antidepressants, exercise and diet changes could work as well as an expensive trip to the pharmacy, though.

More to the point—what about these lame names for things? I also saw an ad for atrial fibrillation (which I have) with a pop-up book with a paper blood clot heading for a paper brain. Come on—what are we, five?

I need a chill pill.

Wednesday, February 16, 2011

Cutting funding for cancer research


The various proposals to freeze or cut the National Institutes of Health have resulted in a wall of demagoguery as high as the sky.

First, the admin is claiming that more research means more people will live longer, meaning more productivity, which is presumed to be a good thing, even though the smokin’ productivity of the American worker is allowing companies to do the same amount with fewer workers—you guessed it, persistent unemployment.

A physician wrote to the WSJ on this subject, Feb 15, 2011, saying most of the people who die from cancer are retired so productivity at work is not an issue. He also said he has an arsenal of $4 meds for many of his patients with poor lifestyles (I guess he means anti-cholesterol and anti-BP meds). And he further said immunizations have eliminated a lot of other things young people used to die of.

So is cancer research sort of … unjustifiable? Another letter writer said we were increasing life expectancy by one year at a cost of $3.2 trillion. I am not sure how that number was justified.

Yet another letter writer said the govt really wants research that lengthens life to go away because they bend the cost curve the wrong way.

They like to say things like “bend the cost curve” instead of “raising costs.”

What do you think, readers? Or is your head exploding like mine?

Tuesday, February 15, 2011

Sidewalk rage


Things are getting tense. Shirley S Wang, WSJ, Feb 15, 2011, writes that you don’t even need a car now to fly to pieces.

Slow walkers—those have to go! One scientist has even created a Pedestrian Aggressiveness Syndrome Scale to map the outrage.

People get “intermittent explosive disorder.”

Facebook has a site called “I Secretly Want to Punch Slow Walking People in the Back of the Head.” It has 15,000 members.

If you have this syndrome, you may shove around people, mutter menacingly, stare, offer “a mean face,” or tailgate on their heels.

They firmly believe slow people should keep right, stay on one side of the escalator, etc. The world apparently should cater to them.

One guy walked into people all the time—he thought he was walking correctly and they weren’t.

Well, who says?

A study in NY showed that smokers walk 2.3% slower than the average. Tourists walk 11% slower. Cellphone talkers are slower.

Maybe older people (me) and slow walkers (tourists) are giving you a great chance to smell the daisies. Try thanking us.

And—be glad you even have sidewalks—I live in gooberville and would love to walk on a crowded sidewalk again in this life and clog it up!

Monday, February 14, 2011

Dream a little (lucid) dream


The New Scientist, June 12, 2010, says you can make yourself have a lucid dream—maybe.

Lucid dreams are now an altered dream state in which you know you are dreaming but still dream unlikely things. I meet people I have never seen—clear as day. You can control the dream—make yourself wake up by jumping into water or something.

The key, they think is to ask yourself all day if you are dreaming now—and then maybe at night, you will also ask yourself this and get a lucid dream or enter that state.

I don’t know—maybe I dreamed that instruction.

I remember dreams I had as a kid—in one the big roses on my grandmother’s wallpaper looked like burglars in black eye masks—remember those in cartoons in those days? I was scared to death!

If you focus on one thing all day—like a computer game—you are more likely to have a lucid dream.

Another way to have one is to wake yourself an hour early, tell yourself to have one, and go back to sleep. I do have vivid dreams toward morning.

Adolescence is the peak of our dream life. Too late. Well, drat.

The lucid dream I hate is when I wake up, am awake, sit up, and waking up was a dream. The monsters can come back…that’s bad. Once, I thought I was all ready for work, dressed, breakfast, but had to do it all over. That was also bad.

Also I type a lot in my dreams. Jeez, I can’t catch a break.

By the way, did you know kids most often dream of animals? No one knows why. Maybe they like them.

Friday, February 11, 2011

Now here is an argument for income redistribution


It’s official—some people have too much money

While many of us (cough, Arizona, cough cough, Florida and Nevada) are checking under the couch cushions every day, others are lah-de-dahing about the tony organic stuff they use to clean the counters.

Ann Marie Chaker wote about the “pampered countertop” in the WSJ, Feb 9, 2011. First up, Mrs Meyer's Clean Day line.

You guessed it—at Whole Foods. (Some people call it “Whole Paycheck.”)

Mrs Meyer’s costs a third more than the average—but smells like lemon verbena and basil.

Caldea has a $12 sandalwood-riceflower cleaner and a $9 sea salt neroli cleaner. Target carries their Herbs de Provence scents.

Of course, it does.

Remember those earlier “good for you” cleaners and their plain-Jane “simple” packages. They are now into the Green Mandarin and Leaf thing.

One gal pipes up that it’s like aromatherapy for your house.

She must be the average customer for this stuff—income $80K and up, physically fit and loves to treat herself.

Mrs Meyers even plays hardball and engages in brand blocking—making stores put all her stuff in one area, not soap in one, detergent in another, and so on.

Cleaners used to be citrusy or piney—now they are “Scent of Desire.”

Jeez, what was wrong with Febreeze?

Thursday, February 10, 2011

Oh, "belay" this!


Ellen Byron, WSJ Feb5-6, 2011, says advertisers are spinning their brains out to grab that Boomer buck.

They are using “flattery, subterfuge, and euphemism” to waltz us oldies out of our money.

Wait—isn’t this what all advertisers do?

Still…

Those ADT people with the “I’ve fallen and I can’t get up” necklace are told never to remind people that they are old. Yet, the telephone people are told to speak fast and get to the point. Apparently, shaky old people still don’t like patronizing BS. Good sign there.

How about those “adult diapers” we so DEPEND on? Well, for one thing, they are now “underwear.” And they are mixed in with tampons in some stores so people won’t feel like they are going to the geezer aisle.

The investment company Invesco tells brokers offer coffee cups with handles (you know we can’t handle—so to speak—smooth Styrofoam) Put in lamps, not overhead lights, they are told, and turn off the TV—too much glare and background noise for us.

Those grab bars—Kohler renamed those “belays,” trying to evoke mountain climbing expeditions of yore. Yeah, all those mountain climbs—remember them well.

Type is getting bigger, contrasts better.

What’s up with the term “senior citizen.” Many of us are not citizens. Trying to make us feel like part of the society? Well, can it.

Stuff is being moved to convenient shelves in stores, signs are bigger. Some aisles will have chained-up magnifying glasses.

Actually, I welcome a lot of this. Which idiot decided the door to the library should be about a mile around back of the building? Why are there steps everyplace and few curb cuts? Can you say curb cut? Or is it “skateboard access for really really young people”?

Sure, make it easier. I see plenty of young people sitting on the benches in the mall—which reminds me, why don’t all stores have a few damn chairs?

Wednesday, February 09, 2011

Piloxing--I thought you knew what it was


Rose Apodaca, Harpers Bazaar, says Pilates and boxing have mated and produced a new exercise—piloxing.

This was invented by Viveca Jensen, a “sunny, sparkling Swedish woman.”

She started on Pilates and became a certified instructor—but she also had loved boxing since she was 18. Quite a combo. Apparently Joseph Pilates also boxed.

Rose says it’s Bob Fosse mixed with Muhammed Ali.

She puffs through the sunny sparkling routines—until actress Kirsten Dunst slinks out, defeated.

Viveca keeps shouting her mantra, “Sleek, sexy, powerful!”

Naturally, this story ends with Rose slipping back into her pencil skirts and even having a glass of vino.

I would like to powerfully drink some wine. That sounds OK.

Go to www.piloxing.com for more info.

I get the idea that this is sort of Cage Zumba. Not that there’s anything wrong with that.

Tuesday, February 08, 2011

This calories on the menu idea


We went to IHOP for lunch on Saturday. This is hardly a diet joint—pancakes, people! But they have succumbed to the Leave No Fat Kids Behinds Behind or whatever our amusing leaders call their obesity drive.

Or, anti-obesity, I should say. I take it they are against it.

Although when you look at the WH menus of aged beef, brats, ice cream, cookies, buttered lobster (even for breakfast), and other delights, you have to wonder.

Anyhow—back to IHOP. They had squooshed in a ton of tiny type for calorie counts—trashing up the whole mess for people like me who can’t see well.

They had a slogan—SIMPLE and FIT. How can a food be fit? Fit to eat? Barely.

I didn’t order one of the Simple and FIT salads, though—I ordered the Fajita Salad, which used to come with a big yummy taco shell, ground beef, beans, salsa, sour cream, guacamole, etc.

Not any more, babies! Now—it’s rusty scraps of lettuce, a couple of Doritos, a chicken wad baked shoe-sole hard, and a dab of sour cream. I could get this drek at home! I had to ask for salsa…on a Mexican dish.

So-called Mexican.

Well, what do I expect from a pancake place anyhow?

Pretty soon they will have to rename the place International House of Politically Correct Slop.

Monday, February 07, 2011

New thinking about cancer


A friend’s sister recently died of brain cancer. Way before her time. She was trying to get into a study at Duke but didn’t live long enough.

Researchers there, paired with those at the University of Texas MD Anderson Cancer Center, are working on a vaccine for glioblastoma, the most deadly form of brain cancer.

A third of these cancers are fueled by an aggressive cancer genes Called EGFRvIII. Before we get too deep in the weeds here, suffice it to say as one researcher did—these are the worst of the worst.

The work being done involves a vaccine. A cancer vaccine. The study (J Clin Oncology) involved 18 patients newly diagnosed with this cancer and a set of 17 matched patients as controls. Both groups received surgery, radiation, and chemo. The vaccine group began receiving injections one month after radiation and stayed on it as long as it appeared to be working.

Median survival time wwent from the expected 15 months to 26 months in the vaccine group. Progression-free time was also 14.2 mos for the vaccine group, 6.3 months for the controls.

Cancer vaccines of several sorts are being tested these days. Basically they get the body to fight the cancer cells and kill them.

This is a small study. But it does highlight new approaches being explored—in addition to cutting, burning and poisoning the forms of this fearsome disease. Another set of ideas involves getting the body to cut off the blood supply of tumors. Matching therapies to individual genes of the patient is also being done.

My feeling is that in 10 years, what we do now will be considered primitive.

The patients in these studies (note that some did not get the vaccine)--and the tireless researchers--are the warriors of the new frontier.

Friday, February 04, 2011

Some tests are more needed than others


Man, all this prevention, so-called. This testing. Scouring your body to find something wrong, something that COULD go wrong.

This is why I stay away from doctors if I can.

Amazingly, my last round of tests was normal. I am fat. My tests are normal. Oh, come on, surely there must be a lot of stuff wrong with you—more tests.

Now, Consumer Reports has rated tests—just like they would a fridge.

Take cardiovascular disease. Blood pressure and cholesterol tests are justified, they said. Electrocardiograms or c-reactive protein—not so much, at least for otherwise healthy people.

A test that is unnecessary can lead to a cascade of other tests (as I was saying, ahem).

The US Preventive Services Task Force rates these things. They are cooling on yearly mammograms and PSA tests.

Clogged peripheral arteries can also lead to a cascade of procedures. Say your EKG shows “something” is wrong (my last one said I had had a heart attack—news to me). Anyway, that “abnormality” could lead to a CT scan and a ton of radiation. If that is odd at all—how about an angiogram, wires snaking through your body to your heart?

OK, say the angiogram shows a 50% blocked artery. That is not considered significant, but you might want treatment, it might sound scary.

I have atrial fibrillation—and all the therapies almost killed me. Unintended consequences.

So I am not saying don’t get a recommended test—but I am saying ask about it. Make the doctor explain why it’s justified.

Thursday, February 03, 2011

Putting the "cuss" in concussion


Everyone who knows me knows concussion is my hobby. Not getting one--saying I am writing about them. So here goes. Again.

First, concussion is a mild brain injury—brain damage, not a funny little rite of passage. The soft, gelatinous brain surges in the hard skull due to a blow. This upsets thinking, memory, and even how your body works—metabolic function. Ooops. Not good.

The symptoms, which can take hours to develop, include not remembering things up to the hit, dizziness, nausea, and confusion, among others.

Researchers at the Univ of Penn have identified a little test called the King-Devick test that can be given to a player on the sideline. It takes one minute and consists of reading single-digit numbers off index cards. Each player takes it and has a baseline reaction time on file. If he or she takes a hit to the head, they get the test again. Even a 5-sec lapse in time from the baseline can indicate a brain change.

This measures vision, cognition, “with it-ness”, and can show a change.

Usually the treatment is rest. Out of the game! You’re done for today and many places now, until a certified person says it’s OK to come back to practice or play.

Once the brain has been forcibly slopped around like this, the next time, it is even more damaging. Even with a helmet, football players experience hundreds of such blows. Boxers, too. Rest begins not to repair the damage.

Also in concussion news, a reminder that traumatic brain injury was up 21% in the first eight weeks of the professional football season. Think of that on Super Sunday.

A mechanical engineering prof at Villanova is at work on a helmet containing a computer chip that will transmit brain wave analysis for coaches and trainers on the sideline. We could be seeing this—Mindscope (BCILab) software--by 2014.

If you have an hour—check this out… http://www.youtube.com/watch?v=-mB1gFXfOZU

Also there is more info on the CDC website… http://www.cdc.gov/concussion/

A mind is a terrible thing to squoosh—even for millions of dollars.

Wednesday, February 02, 2011

I don't THINK so, nosy parkers


I have a new Medicare Advantage plan—I know our amusing leaders plan to ruin these, but so far, they seemed OK. I figured pretty soon everyone will be ruined anyway, so I went for it.

Then they sent me a GIGANTIC HONKING questionnaire about my health.

After I filled it out and sent it right over, it assured me, they would send a report to my doctor about what I might need—additional services…

Wait a hot second. YOU will tell my doctor? How about if my doctor tells you something that’s wrong with me in order to get reimbursed, and that’s all you need to know?

I like that system better.

Or maybe this could be anonymous—if you need info on your customers. But no—it said no need to put my name, it was coded. Yup—all about me.

I don’t want my BMI in a study, I don’t want noodgy letters about going to the gym or getting my innards snaked (tried--but the doctor could not do it), no nurse needs to call and see if I took my pills. I don’t want to be in a national database of people who can’t get up from a chair (one of the questions).

Bah! Leave me alone! I don’t care if I eat a cookie and get a heart attack right after—you probably took a long run and pulled something I have to pay for.

Now where is that questionnaire—must have lost it. What a shame.

Tuesday, February 01, 2011

Dogs will pounce on dropped pills


There is a show—hand to God—called Your Dog Ate WHAT? It’s..duh…about dogs that eat unlikely objects such as 15 pounds of gravel, a whole ear of corn with sharp little prong-thing attached, a whole leash, the inside of a couch cushion, bait with hooks, 27 baby pacifiers (the family had screaming triplets with pacifiers everywhere), you name it.

Saturday night I watched 3 hours of this for some reason. That remains my personal problem.

Anyhow, according to Sue Manning, Associated Press, the most common thing dogs eat that’s bad is prescription drugs.

I think I wrote about this recently. But now I can add that there is a ASPCA Animal Poison Control Call Center. Call 888-426-4435 in case you need it.

Oh—and this could be bad news—calls are on the increase about purloined marijuana. Don’t let Fido eat your stash. It could increase his blood pressure.

Fido. Does anyone name a dog that—did they ever?