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Posts Tagged ‘health’

I have a question I like to ask first time parents: “What’s the most surprising thing you’ve discovered about being a (father or mother)?” When I asked one young dad at a wedding recently, he was stumped for awhile, and admitted no one had ever asked him that question. So he literally asked me to wait while he thought about it; he took his time. His young son was just turning two and he was finishing an MD/PhD program. It was loud and crowded at this reception but eventually he turned to me and said, “His sense of humor!” He never thought he’d be having so much fun laughing at the world with his toddler!

I loved that answer. So we raised our champagne glasses to the new bride and groom, and to laughter!

Well yesterday, after all the amazing speakers and musicians and short films we saw at TEDx, one woman stood out, one woman surprised me. Don’t get me wrong, I had no idea a young man named Kluge, from a formidable Albemarle family, had decided to make dirty water sexy – like the many clean water initiatives throughout the developing world. He started a campaign called “Toilet Hackers” and is determined to make sanitation available to 2.5 billion people. Quite a worthy mission that would impact disease, economic growth and even education world-wide.

But the statistic that surprised me yesterday was 50,000. A beautiful young woman, Dawn Averitt Bridge, walked out on the stage and told us point blank that she had been diagnosed with HIV at the age of 19 in 1988. Normally, this would have been a death sentence, and her doctor told her parents NOT to talk about it or they would risk being ostracized. She managed to qualify for a very early retroviral study, and has devoted her life to fighting the stigma and the spread of this disease. Bridge only teared up when she recounted giving birth to her 2 HIV-free baby girls, and said that tears come every time she talks about that experience. This is her project: http://www.thewellproject.org

With dignity and grace, she urged us all to get tested for HIV, to include testing as a normal part of health screening. Because when we take the stigma out of the disease, when we treat it like any other chronic, blood-born virus, like Hepatitis for example, it loses its power. And the earlier the diagnosis, the better our chance for survival. This made so much sense to me – every year in America 50,000 new cases of HIV infections are reported. Bridge says this is unacceptable. People are taking more risks today, because they are young and think they are invincible, because they think HIV can be controlled now, like any other STD.

And in my opinion, because many states have banned clean needle exchanges for arcane religious reasons – and you know my opinion on mixing ideology with policy…on treating substance abuse as a crime and not a public health epidemic.   http://articles.latimes.com/2013/apr/29/science/la-sci-hiv-screening-20130430

We can distribute nets to halt the spread of malaria in Africa, we can introduce plumbing to the poor in India to stop the spread of dysentery, and in this country we can do one simple thing. We can urge our friends and family to get tested for HIV; and if you don’t want to visit a doctor, you can buy an over-the-counter test at a local pharmacy. Sometimes the most simple intervention, can be the most surprising of all.

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Who can resist a Snickers shaped like a pumpkin masquerading as a Reese’s peanut butter cup?

It’s funny really, I’ve never had a sweet tooth. Never stored bars of candy in a drawer in the kitchen. Maybe that’s why Halloween was so sacred to my kids, and they milked it for as many years as they could. They knew which houses had the full-size candy bars and which gave out bags of raisins. 

The first time I said “No” to my baby Bride was in a check-out line at the grocery store. I was trying to be all “natural mom” back in the 80s. with real diapers and pureeing my own baby food in a Mouli grater. We even joined a food co-op from Vermont! I didn’t think I’d ever have to say the word “No” about anything, after all couldn’t distraction and/or avoidance solve most discipline problems? Turns out, there’s no avoiding that stack of candy within arm’s reach of a toddler determined to get her hands on some gummy bears.

Now put a bag of chips in front of me, and it’s a different story. I’m just a pushover for salt.

Which is fine, since it turns out that Americans ingest about 138 pounds of sugar a year, and that only serves to increase our risk of heart disease. Because a new study in the British Medical Journal suggests that sugar could be worse for us than fat – raising our cholesterol etc. It’s certainly always been good news for dentists,  Sorry Eric. Now we know something I’ve always known intuitively – grass-fed Irish cow butter is better for us than cookies! There, I said it. http://www.independent.co.uk/life-style/health-and-families/health-news/top-heart-doctor-unprocessed-fatty-foods-may-actually-be-good-for-you-8897707.html

Don’t get me wrong. I’d much rather put a little real sugar in my coffee than an artificial sweetener. Sticking with real food can never lead us down that scary grocery aisle with processed homogenized cheese spread. I recently modernized the Flapper’s version of Depression mac and cheese when my Bug was visiting.

Mac and cheese please

Mac and cheese please

Since butter was scarce in the 30s, my Mom used bacon to start her scrumptious recipe and inserted slices of Swiss cheese from the deli. I found some Gruyere and shredded it instead. I can still remember her saying that she made this mac and cheese for my brother Michael, because it was his favorite dish. It turned out he was her favorite child.

And no matter how many times I said it was my favorite dish too, it didn’t matter. So when you watch this video poetry slam by Lily Myers about “The Shrinking Woman,”  “I have been taught accommodation, I have been taught to grow in…to create space around myself.” Think about how we too are entitled to calories, about how we women are worthy of filling that space. And pass the bread and butter please. 

You may have to click over to the wordpress site to watch the video, but believe me, it’s worth it.

 

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This is an addendum to the last blog post, courtesy of the Bride and TN Poison Control Center. I guess this is not such a new recreational drug. She has seen many teens die in the ER and her husband has seen the results as well in Vandy’s ICU. Molly has also been called “bath salts.”

04-04-11 What is in Molly’s Plant Food? (one of the latest recreational drug rages to affect Tennessee’s teens and young adults)

Question of the Week
April 4, 2011
What is in Molly’s Plant Food?  (one of the latest recreational drug rages to affect Tennessee’s teens and young adults)
Molly’s Plant Food is a synthetic hallucinogenic amphetamine marketed as a “plant food” that contains ingredients that produce highs similar to Ecstasy. Molly’s Plant Food is usually purchased at a convenience store and is packaged in a capsule form with a cost of $8-$12 per capsule. The product label warns “not for human consumption”; however it is packaged in a psychedelic colored wrapper and several Internet web sites and chat rooms refer to the product as “legal ecstasy”. The active ingredient is mephedrone, which is not a scheduled (DEA) drug, therefore making it legal.
Over the past six months, The Tennessee Poison Control Center has received an increasing number of calls from emergency departments regarding symptomatic patients who have ingested or snorted Molly’s Plant Food. Clinical effects include euphoria, anxiety, paranoia, agitation, tachycardia, hypertension, delusions, diaphoresis, and weight loss. The treatment is supportive with intravenous fluids and benzodiazepines. Signs and symptoms have lasted an average of 24-48 hours.
This past week brought good news. Under an emergency court order sought by the Tennessee Agriculture Commissioner and the Attorney General, sheriff narcotic detectives have been removing the products from convenience stores in Rutherford County. Since Molly’s Plant Food is titled a “plant food”, it must be registered with the state as a fertilizer (the purported use of Molly’s Plant Food) and clearly list its ingredients. Molly’s Plant Food has neither been registered nor are the ingredients listed on the package.
This question prepared by Marilyn Weber, CSPI, MSN, RN Tennessee Poison Control Center
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This is a morality tale. It’s about trust and medicine and more.

This morning I was trying to figure out what’s happening with Morning Joe? Mika looks mad all the time, and Joe is always elsewhere, thankfully in a split screen from time to time with his audio turned off. When I heard this health writer talk about the rule of 7. He heard a drug rep say that it usually takes 7 visits, face to face, with a doctor in his/her office, before said doctor will trust them…in other words they need to be able to talk about their kids’ soccer games so that the rep can pitch his reasons for prescribing their high priced drug over another. At least that was what I inferred from his use of the word “trust.”

This was an aside, they were talking about the low polling numbers for Obamacare at the moment, but of course Joe had to complain about doctors in general on their iPhones while dealing with patients. About not listening to their patients, about young doctors not looking them in the eyes. Fear and loathing in medicine, that’s the GOP war cry. But let’s extrapolate. If you need to see someone 7 times before they can trust you, maybe a patient also needs to see their doctor 7 times before the patient can trust the doctor?

I didn’t want to write about this, but my MIL Ada thinks I should. She is a lively, active octogenarian. She is still working as a marriage counselor, and traveling the world, but she’s been feeling tired lately, getting leg cramps, and hates to complain. Let it be said, when Ada visits us it’s a whirlwind of activity and her home is usually teeming with friends “dropping by.” So her base level for “tired” may mean she only had one big event this weekend so she decided to clean the refrigerator and invite people over for a pool party. But a recent doctor visit had her worried, her liver enzymes looked high.

So Ada gathered all her drugs in a basket, and went to her pharmacist for a look-see. It turns out, she was double-dosing on a cholesterol medicine. Her internist had taken her off the name brand Lipitor, and prescribed a generic, only Lipitor kept getting refilled right alongside the same exact drug in its generic name!

This, her trusty second opinion doctor/son Bob told her, accounts for the liver problem and her tiredness. And, Bob told her, he sees this ALL THE TIME in the ER. Elderly patients on a cornucopia of drugs complaining of symptoms that to a trained acute care specialist look like drug interactions…and so in ERs all across the country, doctors and nurses are sifting through a patient’s drug record right alongside caring for trauma and stroke and heart attack patients.

I’ve learned that doctors rarely “write” prescriptions anymore – they are emailed to a pharmacy. So where did this system fail my Mother-in-Law? Was Lipitor taken off the doctor’s list of drugs, or did the pharmacist, or pharmacy tech who read the new email Rx just add the generic without thinking? How many other patients are suffering?

Technology is supposed to add fail-safe measures to health care, but how do you build “trust” with a machine? Maybe, just maybe talking and listening to a patient is more important. Here is Great Grandmother Ada, with her “little” doctor.

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You know that part in the Officer Krupke song of West Side Story, when the character says, “Hey, I gotta social disease!”?

O God, why do I think of life as one long musical comedy? Well I guess it’s better than a Shakespearian tragedy. I was listening to all the talk yesterday about how the AMA has now classified obesity as a disease. Here is what they said at their annual meeting:

“RESOLVED, That our American Medical Association recognize obesity as a disease state with multiple pathophysiological aspects requiring a range of interventions to advance obesity treatment and prevention.”  http://www.npr.org/blogs/health/2013/06/19/193440570/ama-says-its-time-to-call-obesity-a-disease

So, supposedly, if insurance company clerks agree with this assessment, they will pay more doctors for actually taking time to sit with patients and counsel them about the dangers of obesity, and how to fix and/or prevent it from happening. Sounds lovely in writing doesn’t it? So of course I had to ask my doctors what they thought…granted, this will apply to mostly family practice docs, but still.

“Probably just they’ll start covering more gastric bypass surgery,” the Bride said. She takes that global, public policy point of view, citing economic and social issues with our American widening of the collective belt.

“It’s good for the health of the country,” Bob says. More people will be able to access treatment and more insurance companies will have to pay for that treatment. One caveat he mentioned was similar to the Bride’s concern for an increase in gastric bypass surgery and lap bands – citing the fact that no surgery can be done without risk. He also wondered aloud if more drug companies will now push their efforts into finding the wonder drug for weight loss; you know, instead of curing cancer or AIDS.

Semantics – it’s all in a word and how we phrase something. Addiction was always thought of as a social disease. Alcoholics and drug addicts just needed to stop, just put the glass or the needle down for good, cold turkey. In this interview with Russell Brand, we get the sense of its (drugs and alcohol) complete and total mind/body control. http://www.spectator.co.uk/features/8857821/fixing-a-hole/

“I cannot accurately convey the efficiency of heroin in neutralising pain. It transforms a tight white fist into a gentle brown wave, and from my first inhalation 15 years ago it fumigated my private hell. A bathroom floor in Hackney embraced me like a womb, and now whenever I am dislodged from comfort my focus falls there.”

The problem with food is that we need it, we can’t just put it down and stop eating. We can join a 12 step group and leave our bar-hopping days behind, but we still need to sit down at a dinner table. In Mika Brzezinski’s new book, she talks about her struggle with anorexia and her friend’s struggle with obesity as if they are 2 sides of the same coin. https://mountainmornings.net/2013/05/07/and-all-that/ So then it makes sense, if anorexia is considered a disease worth treating, why not treat obesity?

On a lighter note, the Love Bug is absolutely perfect! At her latest pediatric appointment (9 and 1/2 months), her  height/weight charting shows her to be at the 68th percentile for weight, and 84th for height. “Yeah, I’m tall, you got a problem with that?”IMG952245

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How to begin? My Mother used to tell me a couple of things, repeatedly, that I’m sure she never said to my brothers: 1) “You have to suffer to be beautiful,” and 2) “You can never be too rich or too thin.”  I’m afraid that while combing and trying to braid my daughter’s wavy, sand-soaked hair at the beach I may have repeated her first message. Here is the Bride and Bug considering beauty products. I hope she doesn’t hear that message about beauty. photo copy 3

But I tried to banish the second from my mind.

In fact you can be too thin, and if you care to read about one woman’s struggle, Mika Brzezinski and her friend Diane Smith co-wrote a book together, Obsessed. It’s like Jack Spratt and his wife; Brzezinski went from a size 2 to a size 6 (and yes, I guffawed at this) and Smith, a fellow TV journalist, lost 75 pounds.

But Mika was honest about how she may be perceived as the mad, “skinny bitch.” They talked candidly about food as an addiction problem, as a public health problem when I happened to tune into their conversation one morning on Morning Joe, and it was enlightening. They were 2 sides of the same coin, a woman’s body image and our country’s dysfunctional obsession with food. It all started when Mika confronted her friend about her weight gain, calling her “fat and obese,” in case she didn’t hear the fat part. Smith called her a “food Nazi.” And then Mika confessed to a life-long struggle with anorexia and bulimia

Mika said, “How I eat, diet, and look has tied me up in knots my entire life, and I know I am not alone. I have been held hostage by food since I was thirteen years old. My body started filling out more than the figures of other girls in my class, and that set off what has become a thirty-year battle with my body image. Food has been my enemy.” http://tv.msnbc.com/2013/05/06/an-excerpt-from-mika-brzezinskis-obsessed/

My psychologist brother Jim has often said that people are either wrapped too tight or too loose. I worried when the Bride went off to Duke. She was surrounded by Type A young women who were wrapped pretty tight with body dysmorphia – exercising too much, throwing up in bathrooms. It was hard not to see it and not to buy into it. But my daughter is a smart cookie IMHO, and moderation was always her approach. I once heard a friend of hers in med school describe some food as “bad,” and I couldn’t help lecturing her about how food can’t be “bad” or good for that matter. Applying a moral code to ice cream for instance is ridiculous. But putting the spoon down before the pint is finished is a matter of choice. And I realize now, it’s much harder for some of us.

I had a dance teacher who used to say, “I only need a taste,” to be satisfied. What will power, what control she had over her hunger. I was always thin, without trying. I would drink a frappe in Boston on my way back from a dance class. But approaching 40, I was unhappy about moving from MA, I had put on about 10 pounds (don’t laugh, I was a size 10 and these things seemed important at the time) and took my anger out on food. I found an aerobic dance class I loved and started restricting food until I got down to 118, a size 6, with my clavicle protruding. Oh, the attention I got. People said I looked so good and yet I was desperate inside. Thankfully, my self-abusive relationship with food didn’t last long. We moved out of a suburb I hated to live close to the beach, in a town that was very much like New England. And I started writing again for another newspaper.

My feminist brain just loves to think – would this ever happen to a man? Do people ask men how they will juggle this new job with a family? Does that shirt make them look fat? So, here is a little play on that Dove commercial about women and body image. Enjoy!

http://www.huffingtonpost.com/2013/05/01/dove-real-beauty-parody-b_n_3191883.html

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The first night in Nashville I left my book club book in the car. Not wanting to go downstairs and back outside in my nightgown, I picked up a little paperback I found on the bedside table, The Spirit Catches You and You Fall Down, by Anne Fadiman. Little did I know how much I would enjoy reading about the Hmong people of Laos…currently living in California.http://www.nytimes.com/books/97/10/19/reviews/971019.19konnert.html

It’s a story about seizure disorder, and about the many ways modern medicine can fail a refugee population. Cultural dissonance is bound to happen when doctors want to order invasive tests for a baby who’s only problem is that her older sister slammed the door coming in and so an evil spirit invaded her body. For the Hmong, animal sacrifices, amulets, and strings around the wrist should cure her, but instead her parents, who speak no English, are supposed to dose her with a varied cocktail of drugs many times a day. You can see where we’re going.

But it’s not all medicine. I’m almost done with the book and I’ve had quite a history lesson on Southeast Asia. I was talking about the book to one of the Bride and Groom’s friends, an academic internist at Vanderbilt. She said it was required reading in her medical school. “Which medical school did you go to,” I asked. “Yale,” she said.

This morning, after working all night, my ER doctor asked me to read this article.
http://www.theatlantic.com/magazine/archive/2013/05/how-not-to-die/309277/

Have no fear, yes, it is about dying. Let’s face it, the spirit eventually does leave us and we all have to think about this stuff, unless of course denial works for you. It’s about a doctor who becomes an educational/documentary film maker. He makes short films that actually show people what advanced dementia (among other maladies) looks like, and he tells us to have “The Conversation” with our doctors:

“In the health-care debate, we’ve heard a lot about useless care, wasteful care, futile care. What we”—Volandes indicates himself and Davis—“have been struggling with is unwanted care. That’s far more concerning. That’s not avoidable care. That’s wrongful care. I think that’s the most urgent issue facing America today, is people getting medical interventions that, if they were more informed, they would not want. It happens all the time.”

Which made me think. Sometimes, even when you speak the same language, you still can’t communicate.
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Don’t worry, I’m not going to get all biblical on you. I have my fond memories of Sacred Heart Church shrouded in purple, singing in the choir, fake green grass in a basket, biting off the head of a chocolate Easter bunny. And later, hiding colored eggs and candy around my friend’s yard so all our friends’ children could come in their little Wellies and hunt for treasure. Spring is in the air, robins are bobbing their heads.

And hospital and health and safety workers are on the job year round, 24 hours a day. For them, pausing for a big family dinner, let alone searching for jelly beans, doesn’t really happen. What happens is saltines and peanut butter at the nurse’s station. The Bride is working, and so is Bob. And here’s what happened at my daughter’s ER.

A man in his 30s walked into the waiting room and promptly collapsed in a chair. He lost consciousness, nobody even heard a chief complaint. When they hooked him up to an EKG it was obvious he was having a major heart attack; I think they call it Vfib? My doctor daughter had the biggest guy in the room, a tech, pound on his chest while she got the paddles ready. The pounding didn’t help, so she shocked him with the paddles, and he converted but unfortunately he got belligerent and pulled everything out, then passed out. She shocked him again.

And he came back to life. He was discharged from the hospital yesterday.

He has a wife and 3 children and probably will never meet my daughter. And it made me think of the husband of a friend of mine in Pittsfield, MA. In his 30s too, he woke up one July 4th morning sweating, and instead of going to the ER, he took a shower. That is where he died, while his wife tried calling his doctor and finally called an ambulance, before 911. She had a new baby and a toddler so I made baked ziti for the shiva. And I helped her collect pictures of her husband for her children, because i know what it’s like to lose a father so young.

On this Easter morning, Christianity teaches that rebirth can happen to all those who seek God, who walk humbly. As my dear friend Eve quotes:

“I cannot help but think, on this Easter morning, of how many times I have been resurrected. Like so many others, I have known moments when I thought my life had entered a tomb. I saw that great stone rolling between me and the hope of any future I could imagine. But then, through God’s grace and healing, I emerged into a garden to find people who cared for me waiting, waiting for me to return to life. I pray, therefore, for all of those who have been resurrected like me. I celebrate this new life with all of you who have stepped out of the grave into the light of Easter.” S. Charleston

Many thanks to all those emergency personnel who are working today, and just a little note to the Easter bunny – really, you need a break?
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If I may, I’d like to give you some tried and true suggestions for raising teenagers in the White House.

!) Keep up the no Facebook policy: I’d like to think if there were such a thing when I had teens it would have been verboten, like MTV. Oh and let them watch more than 2 hours of TV a week, maybe 4 not counting sports?

2) Make them pay half for their first car: I know they probably don’t have a part-time job, like working at Starbucks or babysitting, but make it clear you expect a contribution.

3) Set a reasonable curfew: Figure out when the bars close in DC, and make it an hour before that as long as it’s before midnight. We all know bad things happen after midnight.

4) Make no drugs or alcohol a sacrosanct rule: Destroy all paraphernalia you find immediately and have the Secret Service (SS) deliver any drunken teenage boys they might find on your lawn to their own homes pronto.

5) Make no exceptions to Rule #4, except: Have them sign a contract that states they can call you at anytime if they have eluded the SS and are drunk and need a ride back to the White House; no questions asked.

6) Cellphone criteria: There will be NO sexting, instagram or tweeting. Zero, zilch, none.

7) Dating Dilemma: Have a realistic sex talk please, if you haven’t already. Mom and Dad-in-Chief will have to meet and approve of each date; football games, movies, concerts. Of course the SS will have fully vetted said date, and will accompany them. There will be no dating of bodyguards!

8) Lighten up on Health: We all know body image problems may set in when hormones surge. Eat fewer carrots and more pie. Practice yoga and not spinning. Allow NO permanent body changes (such as tattoos or body piercing) until age 18. Wear less sleeveless shirts, those arms are intimidating.

9) Do NOT hire a college counselor: You are an educated woman, surely you can require the dreaded college essay and application packet be delivered on time. Suggested topic: “How to Elude the SS.”

10) Be Proactive: Invite their friends over on weekends, start a bowling league in the basement or set aside an arts and craft’s room near the Blue Room. Keep their friends close.

I hope you take my suggestions freely and without any mental reservations.
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1) To get serious about yoga

2) To cook more tofu

3) To walk more, even if it’s cold

4) To do something that scares me (Karaoke?)

5) To laugh loudly and often

I’ve never been a New Year’s resolution type. I used to attend the Borough Hall Annual Reorganization Meeting at noon on New Year’s Day and take copious notes through a hangover haze for the newspaper. “Each year at the Reorganization Meeting, the Council adopts a resolution setting the order of business for each Council meeting.” It takes forever, so and so police officer was awarded something; the zoning plans have changed to reflect such and such.

But now I’m only required to attend a hospital gala on New Year’s Eve, to dress to the nines and make merry at a local winery. I can sleep in without children at home or a care in the world…well, maybe a few.

I have a cold. It’s not the flu, got the shot, but some bugs got through to make my nose run and my throat scratchy. Bob is working, so I’m on my own to push fluids and make my own chicken soup. I managed to try my second martini in 40-something years last night, and decided it still tastes like gasoline. I thought it might help my throat, and the 2 sips I took did seem to numb my tonsils.

My order of business for 2013 is staying true to my philosophy of small steps. In order to grow, we must change and challenge ourselves, to do something scary. Notice I didn’t resolve to go to the gym and lose 20 pounds – just to walk… even in the cold and cook tofu. To quiet my mind with yoga and lighten my heart with laughter. The Love Bug is learning to laugh, and just being with her brings me great joy.

I wish you all a peaceful and joyous New Year! We may not be able to influence those in Congress today who are playing games with our country’s reputation in the world, but we can vote them out tomorrow. And we can start the New Year introspectively, as the Dalai Lama says, “The inner peace of an alert and calm mind are the source of real happiness and good health. Our human intelligence tells us which of our emotions are positive and helpful and which are damaging and to be restrained or avoided.”
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