Pomegranates Are Healers for Arthritis

Researchers have found that pomegranate extracts may help block inflammation that contributes to arthritis pain.

Pomegranates also help turn off the enzymes that destroy your cartilage, help block blood clots, and fight clogged arteries.

Build the Perfect Snack

I found this in Prevention magazine (January 2009).

"Fiber, Fluid, and Protein: three essential ingredients for a diet-friendly -- and hunger-squashing snack. To create the perfect combo, choose one item from each column below. Our favorites include a pear with a golf ball-size portion of almonds, or an apple and a dollop of peanut butter."

Match one from the fiber and fluid column with one from the Protein column:

Fiber and Fluid
Pear
Baby carrots
Celery
Kiwifruit
String beans
Apple
Red bell pepper slices

Protein
Almonds
Hummus
Almond butter
Walnuts
Low-fat cheese
Peanut butter
Greek yogurt

Book Review: The Art of Aging, by Sherwin B. Nuland

This book was shoved into my hand with an edict to read it. Okay, it wasn't that harsh a movement, but she did give the book to me as a gift, and reading it became almost required. What is there to read about aging, I thought, when you're living it?

But I was surprised by this book, and enjoyably so.

It starts out in a daunting sort of way, however, with medical reasons underlying aging. One thing did catch my eye: the reasons for falling. As we age, we seem to be in danger of stumbling and falling more often, and such accidents really are awful to those of us who are seniors. I thought that there would be one or two reasons for this propensity, but it turns out there are several, according to Nuland. "Falls become an increasingly important source of disability as people get older. Falls happen not only because of decreased strength and coordination but because of a lessened range of joint motion and because of a generally decreased reaction time. All of these factors are accentuated by the kinds of neurologic deficits that sometimes make walking so hazardous."

Nuland has an easy style, but as a surgeon, these words come trippingly off the tongue, I'm sure, but a bit harder for the rest of us to digest. However, after the first long chapter where he tells us how we get older -- as well as what exacerbates that process, including a dissertation on the hazards of smoking -- he spends most of the rest of the book on individuals and how they cope with aging.

And these stories about actual people, how they deal with their spouses passing before they do, how they lead spiritual lives that help them live longer, fuller lives, is the best part of the book. And Nuland seems to suggest that somewhere in their stories is the wisdom and energy that we can borrow to help us with our own journey.

Pneumonia and the Shot

I'm going to the doctor rather frequently these days. It seems she's got me either going for lab tests every two months, or I'm going back to find out the results of the tests. And to get prescriptions refilled.

This last time she told me I needed two shots: pneumonia and tetanus. I had never had a pneumonia shot before. She said she had seen too many people, especially those over 50, come in lately with pneumonia. They'd get a cold, then - wham! come down with pneumonia.

A recent study in the Canadian Medical Association Journal of people at high coronary risk found that those who had gotten the pneumonia vaccine at least a year earlier were less likely to have a heart attack than those who had not. Pneumonia can trigger a heart attack, and apparently the vaccine can reduce the risk of both occurring. The researchers also suggested that younger people with chronic problems (like lung or heart disease, cancer, and diabetes) should get the shot.

I recently came down with a cold, and I'm battling that currently. But at least I know it won't grow into pneumonia.

Cauliflower and Cabbage Prevent Breast Cancer

Cauliflower and cabbage have been known to inhibit breast cancer, but nobody ever knew why. However, new research is pointing the way.

Lee Wilson, professor of biochemistry at the University of California Santa Barbara, and Mary Ann Jordan, adjunct professor in molecular, cellular and developmental biology, have shown the healing power of these vegetables at the cellular level. Co-author Olga Azarenko, a graduate student at UCSB, said: "Breast cancer, the second leading cause of cancer deaths in women, can be protected against by eating cruciferous vegetables such as cabbage and near relatives of cabbage such as broccoli and cauliflower."

To read the whole story, click on this link.

Your A to Z Guide for Feel-Good Foods

Sunset magazine (January 2009) put out a delightful alphabetized list of foods that are good for your health. Or, perhaps I should say, foods that are a better choice than others out there.

A: Almonds. They’re loaded with heart-healthy mono- and polyunsaturated fats, and are the best nut source of the antioxidant Vitamin E. Try almond butter instead of peanut butter in your next PB&J sandwich, or in place of peanut butter when making Thai peanut sauce.
B: Berries. There’s a reason they’ve been dubbed superfoods. Berries help lower blood pressure, increase the body’s level of good cholesterol, and contain potent antioxidants. Use frozen raspberries as the chilling ingredient in a smoothie; add to yogurt, cereal, even salads.
C: Cabbage. Cabbage and its botanical relatives contain potentially cancer-fighting compounds called glucosinolates. Red cabbage is rich in anthocyanins, powerful antioxidants that give it its red-purple color. Add thinly sliced cabbage to soups, stir-fries, and sandwiches.
D: Dates. Medjool dates in particular are wonderful and caramelly that having just one can satisfy a dessert craving – at a mere 66 calories each. Plus, they’re a good source of fiber.
E: Eggs. Eggs developed a bad rap a few years ago as being high in cholesterol. Recent research, however, shows that, for most people, eggs don’t contribute to heart disease and may actually be good for heart health. Eggs are full of protein, are low in calories, and are a fine source of lutein and zeaxanthin (pigments that may keep eyes healthy).
F: Fat. Fat helps the body process carbs and protein, and using mono- and polyunsaturated fat s can be good for you. Some fats (like omega-3) can even be very good for you. Aim for no more than 30% of your calories per day to come from fat, and choose unsaturated olive, canola, and nut oils.
G: Grass-fed. The meat from herbivores such as cows and sheep is lower in fat and cholesterol and higher in beneficial omega-3 fatty acids when the animals are allowed to eat by grazing on grass. Seek out meat labeled “grass-fed” or “pasture-fed.”
H: Herbs. They provide bonus vitamins and minerals, and they’re a great way to add fresh flavor to food without added calories. Try tabbouleh, which is packed with parsley.
I: Identify what’s in your food and where it’s coming from. In this age of food-borne illnesses and questionable food-raising practices, it’s a smart thing to do.
J: Juice. Juiced vegetables – like carrots, spinach, and beets – are a refreshing alternative to fruit juices. Look for 100% vegetable juice in the refrigerator case at your grocery store.
K: Kumquats. These little citrus fruits – sour on the inside, with sweet-tasting skins – are high in vitamin C and dietary fiber.
L: Lentils. They’re high in fiber, protein, B vitamins, folate and iron, but they’re low in fat and cheap. Check out black beluga lentils, a mild, earthy variety that keeps its tiny round shape when cooked.
M: Mustard greens. They have a pungent bite and cook to tenderness in just a few minutes. They’re loaded with vitamins A, C, and K.
N: Nori. A paper-thin, dried seaweed, nori has an intense briny flavor. Researchers are taking note of its omega-3 content, so expect to hear more about nori in the future. Use it cut into slivers and sprinkled on soups or stirred into steamed brown rice to add flavor without lots of additional calories.
O: Oranges. Consider eating sections of a whole orange instead of a cup of juice – nearly as much vitamin C and 9 times as much fiber.
P: Papaya. Cup for cup, papaya has as much vitamin C and potassium as oranges do, with more vitamin A to boot.
Q: Quinoa. Pronounced keen-wah, this grain-like seed is gluten-free, high in protein (12 to 18%), and full of fiber and minerals (folate, iron, magnesium, and manganese). Try it instead of rice of pasta.
R: Raw. Rather than cooking all the vegetables in your side dishes, leave a few of them raw; they’ll add texture and flavor to your meal. Mix cooked pasta or rice with thinly sliced raw vegetables and dress the dish with your favorite vinaigrette.
S: Salad. It’s not just a side dish but also a meal. Rule of thumb: The darker the salad green, the more vitamins it has. Use more romaine, spinach, and watercress.
T: Tea. Drink it freshly brewed from loose leaves or bags to get maximum benefits. Tea may lower the risk of developing Parkinson’s disease, and the polyphenols (a class of antioxidants) in tea may help prevent cancer. Drink it with lemon, which helps preserve its antioxidants.
U: Use a smaller plate.
V: Vegetarian. Eating lots of fruits and vegetables lowers your risk for heart disease, cancer, and diabetes, not to mention being good for your waistline. Try going meatless one day per week.
W: Water. Beyong being essential for life, water helps joints stay lubricated, flushes waste, and lets the body maintain the proper temperature. Add a slice of lemon or cucumber if you want flavor.
X: X this off your list: fad diets. They just don’t work, period. If you want to lose weight, focus on consuming more vegetables, limiting portions, and exercising.
Y: Yogurt. Yogurt is an excellent source of calcium and protein, but many contain as much as 2 tablespoons of sugar per serving. Look for the kind of yogurt that a shepherd would have made – unsweetened and without added thickeners. If you’d like some sweetness, mix in a bit of fruit.
Z: Zinfandel. This red wine is full-bodied and aromatic – and, in moderation, good for you, too. Researchers are looking at a number of antioxidants in red wine, among them quercetin, resveratrol, and catechins, and their positive links with heart health. Pair a glass with sweet-and-spicy toasted nuts.

Inflammation

Excerpts from Diabetes Self-Management, November/December 2008:

We’re just beginning to understand what chronic inflammation does to the body. We know a bit more about what it does to blood vessels, which is where most of the research has been focused: Chronic inflammation stresses arterial walls and is associated with the development of atherosclerosis, the buildup of fatty deposits in arterial linings.

It’s also becoming clearer that inflammation may be behind insulin resistance, the reduced ability of the cells to respond to insulin, which is a cause of high blood glucose in Type 2 diabetes.

Lifestyle habits over time may play a role in chronic inflammation. “The sedentary lifestyle and excess caloric intake that lead to excess weight gain promote this chronic, sub-acute inflammation, which then participates in the development of Type 2 diabetes.”

It’s possible that simply being overweight triggers inflammation. “Maybe lack of exercise (is a cause),” says Dr Trence. “This is an area where there are a lot more questions than answers, and I think people are beginning to recognize that there may be various factors that play a role.”

Whatever causes inflammation in the first place, its presence creates an unfortunate set of consequences in a few very concrete ways. “The immediate contributions are, first, atherosclerosis, heart attack, and stroke; and second, insulin resistance and Type 2 diabetes,” says Paresh Dandona, M.D., Director of the Diabetes-Endocrinonology Center of Western New York and Chief of the Division of Endocrinology at the Medical School of the State University of New York at Buffalo.

As long as 100 years ago, studies suggested that people who took very high doses of aspirin – about ten 325-mg tablets a day – seemed to experience some improvement in diabetes control, but such a high dose of aspirin has unacceptable side effects. …then we realized that there were other salicylates, chemically similar to aspirin, that don’t carry the same risk of bleeding. The drug they’re studying now, salsalate, was widely used not too long ago to treat arthritis, but it got “back-shelved” when other drugs were developed for the treatment of pain and arthritis.

Enrollment in a new, large study began in September 2008. Those interested should visit the TINSAL-T2D (Targeting Inflammation Using Salsalate for Type 2 Diabetes) website.

Cancer Tumors - Where Do they Come From?

The information below is a small part of an article in the latest The John Hopkins Medical Letter (January 2009), but I feel it's important to reiterate.

"All tumors are caused by genetic mutations. Some of these occur spontaneously with age or because of the environment; others are inherited. A hereditary mutation is more likely in people with strong family history, meaning:

* Cancer developed in several relatives across different generations
* One relative was diagnosed at an early age, or
* One relative developed two types of cancer.

"About 10% of people who get cancer have a strong family history; a smaller number within this group were born with cancer-linked genetic mutations that current tests can detect."

The article is entitled: "Cancer Care Expands to Include Genetic Testing." It's really interesting that only 10%, such a small group, have family history of cancer. And, as you saw, less than 10% are born with cancer-linked genetic mutations. This is the group current genetic testing attempts to identify.

More on this later.

New Advances in Fighting Cancer for 2008

A new report from the American Society of Clinical Oncology (ASCO) details 12 "major" advances and 19 "notable advances" across the gamut of cancer prevention, screening, treatment and survival in the past year.

Here's the entire summary report in full from Yahoo Health.

Do You Have Depression?

Over the last few weeks in Oakland, it's been hella cold, rainy and rather dark. Plus, have you noticed how quickly night falls?

I've had a couple of friends tell me that it's this time of year when they feel a little sad. They don't know if it's depression, but that feeling tends to linger.

Yahoo Health has a little quiz to take to see if you're in the throes of depression.

Colonoscopy Is Still Recommended

USA Today had an interesting article about colonoscopy, how it's imperfect but still recommended by doctors.

A study in last week's Annals of Internal Medicine found that, although colonoscopies reduced deaths from cancers found on the left side of the colon -- the part closest to the rectum -- by 67%, the tests did not reduce the cancers found on the right side.

Other studies have shown that colonoscopies often miss flat or indented lesions.

And last week we also heard (see our report below) how pills used to clean out the bowels in preparation for a colonoscopy present their own risks, this time for kidney damage.

Douglas Rex, director of endoscopy at Indiana University, tells us that complications from colonoscopy are extremely rare and that they can prevent 50% to 70% of colorectal cancer deaths.

The American Cancer Society suggests that patients look for doctors who have a lot of experience when they set up their colonoscopy appointment: doctors should have performed at least 200 colonoscopies, and should perform them regularly.

And be sure to follow the directions on the liquid bowel cleansing box. Clear colons provide doctors with the best conditions with which to detect cancerous polyps.

Rex also suggests that patients can ask to see the doctor's notes or even photos documenting the colonoscopy. Rex says it takes skill for the doctor to examine the entire colon, and tumors may be hiding at the very end, which is not always examined. Make sure the doctor documents his or her examination of the end of the colon.

Look here for that USA Today article.

Slow Down to Lose Weight

A recent article in the British Medical Journal, and summarized in today's Parade magazine, says "you're more likely to be overweight if you down your food fast and don't stop eating until you feel full.

"Scientists asked more than 3,000 adults to answer a survey on their eating habits. Those who didn't stop eating until they felt full were nearly two times more likely to be overweight as the slower eaters."

So, if you want to lessen the normal 5 pounds we gain during the holiday because of all the goodies set out at parties, just slow down: think about what you're putting in your mouth, chew thoroughly, pause between mouthfuls, and stop before you feel stuffed.

Look here for the full Parade article.

Broccoli: It's Not Easy Being Green

Broccoli is the blah vegetable. Not many people are singing its praises these days.

But broccoli is a one-stop vitamin rush. In two recent studies of middle-aged adults, broccoli's Vitamin C's anti-oxidants reduced significantly their risks for diabetes Type II.

Broccoli also has sight savers in beta carotene, vitamin E and zinc, not to mention vitamin C. These vitamins and minerals reduce the odds of incurring blindness.

For Yahoo Health's recent article on the the subject, see this link.

Flaxseeds

Much has been written about flaxseeds. Studies suggest that the omega-3 fat they contain, called alpha-linolenic acid (ALA), is great for the heart. They also contain lignans, a type of plant estrogen with potential health benefits.

If you're going to incorporate flax seeds into your diet as a natural source of omega-3, don't eat them whole, according to the UC Berkeley Wellness Letter (December 2008). "Whole seeds tend to pass through the body undigested. In contrast, ground flaxseeds are easy to digest. You can buy them ground, or put the seeds through a food processor, blender, or coffee grinder. Be sure to keep flaxseeds refrigerated. They taste fresher if ground just before using."

You can sprinkle ground flaxseeds on your hot or cold cereal as an easy way to incorporate them into your diet. You can also add them to muffins, pancakes and breads if you prepare them, as well as soups, salads and stir-fries. They're also good in pasta dishes and added to hamburger patties.

For online flax cooking recipes, go to the Flax Council website.

How Many Calories Do You Burn?

This month's UC Berkeley Wellness Letter (December 2008) had an article about metabolism and how to estimate how many calories you burn in a day.

If you're trying to maintain a healthy weight, you need to know how many calories you should consume in an average day. Once you know the number, you can build an eating regime around that.

The below chart gives a very rough idea of daily calorie needs for the average 50-year-old:

-------------------------------------------------
Activity Level Men (175 lbs) / Women (140 lbs)
-------------------------------------------------

Very light 2,150 / 1,635
Light 2,350 / 1,800
Moderate 2,560 / 1,960
Heavy 2,900 / 2,200

NOTE: Very light means mostly sedentary. Light means light activities/exercise a few times a week. Moderate means brisk, moderate exercise most days. Heavy means vigorous exercise and/or manual labor every day.

This chart represents the daily calorie needs for average 50-year-olds, based on how active they are. For people over age 65, numbers would be about 10% lower. For younger people, about 10% higher.

To compute the number for your age, body size, and activity level, go to the Calorie Control Counter.

Colonoscopy Prep Pills Carry Kidney Risk

In 2007, I had one of the three colonoscopies I've had. When the doctor was explaining about the salty liquid I had to drink a gallon of, I started complaining. I had done it before, and threw up halfway through; I never finished drinking the concoction, and so my colonoscopy results the previous year were inconclusive.

He then suggested I substitute OsmoPrep pills, and gave me a prescription for it. With OsmoPrep, I could take one pill every couple of hours, and then follow that with a quart of water. It was a lot easier to digest, mentally and physically.

However, as I urged my friends to get colonoscopies, I wondered why their doctors never gave them the OsmoPrep choice. Each of them liked how it sounded, but, of course, did what their doctor suggested.

This week, the FDA published a warning about OsmoPrep and like sodium phosphate pills for bowel cleansing. These medications should be used by caution with people with the following:

1. Over 55 in age.
2. Those who are dehydrated.
3. Those who suffer from kidney disease, acute colitis or delayed bowel emptying.
4. Those on medication that affect kidney function, such as diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and perhaps even ibuprofen and other anti-inflammatory drugs.

Reports of kidney problems with OsmoPrep first started coming out in 2005. Wise doctors steered their patients away. But since there's a chance I might end up on dialysis if I try OsmoPrep again, I'll be going back to those foul-tasting phosphate liquids this coming October, when I expect to undergo my next colonoscopy.

The Bad News

Last night I got the call. The sister of one of my good friends, Bruce, called to tell me that he had died suddenly Sunday morning. I'm still trying to deal with that information.

She didn't know what killed him, only that it was sudden. He was walking down the steps of his house early in the morning, when he reportedly collapsed. His newspaper delivery man, with whom he had had frequent conversations, called 911 when he found him, but it was too late. I suspect Bruce died of either a heart attack or stroke. He was 63.

Bruce had the exact same medical issues I have: diabetes, high cholesterol and high blood pressure. That information stops me in my tracks, and has made me look hard at my own behavior.

I called some friends last night to talk about Bruce's death. One of them reminded me that I had just gone to the doctor yesterday morning, and had received a good report. My blood pressure was 128/72. My cholesterol numbers from the latest lab reports were very, very good. My A1C, which measures blood glucose, was 6.4, which is excellent.

And yet I knew the last month had not been good. I had been dipping into the candy jar on a regular basis. I have taken up drinking cokes as part of my routine. Horrible behavior for a diabetic.

But I've also been doing good things. I'm exercising more, even as the cold weather approaches. Even though it's been a struggle since my insurance company changed my mail-order pharmacist, I've kept the medication going. So I'm doing some things right.

Although I don't know the exact cause of Bruce's death, it's apparent to me that there's a direct relationship to his lifestyle. He is giving me the inspiration to reduce that relationship in my own life.

Another Reason to Eat Fruits & Vegetables: Reduced Cancer Risk

From an article posted on Yahoo Health today:

"Certain breast cancer survivors who load up on fruits and vegetables, eating far more than current U.S. guidelines, can slash their risk the tumors will come back by nearly a third, according to a U.S. study released on Monday.

"The finding only held for women who did not have hot flashes after their cancer therapy, the researchers said -- a finding that suggests fruits and vegetables act on estrogen."

For the entire article at Yahoo Health, click here.

Load Up on Protein in the Morning

From Diabetes Forecast, December 2008: "Loading up on protein in the morning may make sticking to a diet easier, according to a small new study in men. Study participants who ate high-protein breakfasts felt fuller and more satisfied throughout the day, compared to those who ate breakfasts with normal protein content, about one-third the amount in the high-protein breakfast. The researchers also tested high-protein lunches and dinners, but found the greatest satiety, as determined by self-reporting, came with a protein-laded breakfast. (Remember to check with your health care provider before adding extra protein to your diet, as it can be a problem for some people with diabetes.) Source: British Journal of Nutrition, Sept. 2, 2008"

Cancer Will Be the #1 Killer by 2010

According to the World Health Organization (WHO), "Cancer will overtake heart disease as the world's top killer by 2010, part of a trend that should more than double global cancer cases and deaths by 2030, international health experts said in a report released Tuesday. Rising tobacco use in developing countries is believed to be a huge reason for the shift, particularly in China and India, where 40% of the world's smokers now live."

This prediction is in spite of all the strides that have been achieved in early detection of cancers.

Read the whole article in USA Today.

Protein P53: The Dictator of Life and Death

From an article in Yahoo Health:

"It's a tiny molecule with a nondescript name — "p53" — but it has an awesome responsibility: preventing more than half of all human cancers. Some scientists call it the 'guardian angel,' 'guardian of the genome,' or the 'dictator of life and death.'

"P53 is a protein, a string of 393 chemical units stored in the DNA of most of the body's cells. Normally, p53 works to suppress malignant tumors. When it's missing or mutated, however, it can't carry out its lifesaving mission and lets cancerous cells run amok. Scientists are developing drugs to repair or restore damaged p53 in mice, but so far none of those drugs are ready to treat human cancers.

"Almost 50,000 papers about p53 have been published in scientific journals, but its workings are still not fully understood, and it's little known outside the worlds of biology and medicine.

"P53 is 'certainly the most studied protein in the whole history of cancer,' Magali Olivier , an expert at the World Health Organization's International Agency for Research on Cancer in Lyons, France , wrote in the journal Cancer Gene Therapy this fall.

"...Here's how it works: A normal p53 protein detects a patch of DNA in the nucleus of a cell that has been damaged by accident, a virus, radiation, smoking or other environmental assaults, raising the chance that the cell will turn cancerous. P53 triggers a complex biochemical program that stops the pre-cancerous cell from dividing until it repairs its DNA or commits suicide.

"When p53 itself is flawed, however, it allows other cancer-causing genes (known as oncogenes) to hijack the cell's control machinery and set it free to spread wildly — the hallmark of cancer."

With all the attention being paid to P53, it's only a matter of time before scientists understand it more, and develop an agent that will counterattack its effects.

No Insurance? That's a Killer.

There was an article in Newsweek on November 10, 2008, that reiterated an article that appeared in the October issue of Archives of Surgery, particularly this one sentence: "In brief, insurance represents more than just the ability to pay a bill."

As Newsweek science editor David Noonan recounts in his article, "Of course, what insurance (and the lack of it) often represents, as numerous studies have shown, is the difference between care and no care, between an early cancer diagnosis and a late diagnosis, between properly managing a chronic condition like asthma and waiting until a dangerous attack occurs. For some of the patients in the Archives of Surgery study, which was led by Johns Hopkins trauma surgeon Adil Haider, what insurance represented was nothing less than the difference between life and death."

The study found that, overall, uninsured patients were 50 percent more likely to die from their injuries than insured patients. This conclusion was based on data collected from 700 trauma centers and emergency departments around the U.S.

Quoting from the Newsweek article: "Among white patients, the mortality rate for those with insurance was 4.2 percent, compared to 7.9 percent for the uninsured. The numbers for minorities were worse. Uninsured African-Americans died at more than double the rate of the insured, 11.4 percent to 4.9 percent. And while 6.3 percent of insured Hispanic patients died after traumatic injury, the rate for uninsured Hispanics was 11.3 percent."

The cause and effect implied here is confusing. Is it that the uninsured have underlying conditions due to lack of routine care? Are they delayed in seeking help after trauma? Or -- and this is a possibility we have to study more -- are we treating uninsured and/or minority patients differently?

Here's the entire Newsweek article.

6 Habits of Highly Respectful Physicians

A Science editor, Michael W. Kahn, M.D., devised a simple six-step checklist for doctors to follow when meeting a hospitalized patient for the first time, a procedure that would emphasize good manners and ease the patient:

• Ask permission to enter the room; wait for an answer.

• Introduce yourself; show your ID badge.

• Shake hands.

• Sit down. Smile if appropriate.

• Explain your role on the health care team.

• Ask how the patient feels about being in the hospital.

Read the entire article in the New York Times here.

Cancer Blogs

From time to time, I'll be looking at other cancer blogs, and posting the results here for those I think are worthy of a look-see.

Check out NPR's My Cancer. It's a personal look at how one woman gets through the day-to-day with cancer.

Here's the blurb on the blog:

"After that day, your life is never the same. "That day" is the day the doctor tells you, "You have cancer." Every one of us knows someone who's had to face that news. It's scary, it's sad. But it's still life, and it's a life worth living. "My Cancer" is a daily account of my life and my fight with cancer."

If you have a favorite blog, or one that's worth others knowing about, please let me know.

Calcium the Easy Way

I was visiting a friend of mine in L.A. two weeks ago, and I saw her peel the foil off a little square piece of candy. Only it wasn't candy. "It's calcium," she said, as she popped it in her mouth. "I take 3 a day."

They're calcium soft chews. I was having a tough time swallowing those big, chalky vitamins of Citracal, so I thought I'd try these.

They come in a multitude of flavors. My favorite is chocolate.

Each chew gives you 500 mg of calcium carbonate plus Vitamins D and K. They advise a dose of 3 soft chews a day, which would total 1,500 mg. Most people only need 1,000 mg a day, but I figure, as a woman who's entering an older age, I need more. They advise that you space the chews out over the day.

Here's a link to Viactiv's website. I noticed that Rite Aid also had almost the same version in drugstores, possibly at a cheaper price.

Wal-Mart's $4 Prescription Program

It took an hour, but I finally got a short-gap prescription for the Verapamil pills I need to maintain my blood pressure. After a confusing dance this morning at the clinic, I got the right prescription, and, as she handed it to me, the nurse added: "Go to Wal-Mart or Target to have your prescription filled. They only charge $4."

I was in danger of having prescriptions overlap. My new mailorder pharmacy, Caremark, was about to fill a new prescription for Verapamil. (The 4 refills I had left did not transfer, which heightens my frustration level with this process.) So I didn’t dare fill a new prescription for the same drug, as the insurance company would surely cancel one or the other. So, when I went into Wal-Mart, I told them I had no insurance, fully expecting, like the nurse said, to have to pay $4.

Well, to my shock, the bill came to $41.73. Only drugs on their list qualify for the $4 prescription charge. Verapamil is not on that list.

It’s a good deal if you have no money and/or are underinsured. Always ask how much it cost. (I didn’t bother asking; I had to have the drug order filled regardless.)

There's a list online at Wal-Mart's website of the $4 drugs. They will also hand you a paper list at the pharmacy if you want one. It truly is a great deal if you have no insurance.

Get a Pedometer

In a recent study, researchers from the U.S., Australia, Canada, France and Sweden set new guidelines for recommended daily steps for walking routines.

WOMEN
Age / Steps per Day
18-40 12,000
40-50 11,000
50-60 10,000
60+ 8,000

MEN
Age / Steps per Day
18-50 12,000
50+ 11,000

Source: Journal of Physical Activity and Health, January 2008

Researchers at Stanford University School of Medicine found that people who used a pedometer take 2,000 extra steps than those who don’t. You can buy a basic pedometer in a drugstore for about $6, or a more complicated one that holds seven days of memory for $20.

Winded When You Hike Up the Stairs? Try Fiber.

This is from Yahoo Health:

"Wish you didn’t get so winded when hiking up the stairs? Then start your day with oats. Or bran. Or anything high in fiber.

"It may not give you the lung capacity of Michael Phelps, but it could help you breathe easier. New research shows that dietary fiber may give lungs a leg up.

"In a study, people who ate at least 27 grams of fiber per day had better lung capacity than people who got less than 10 grams. The high-fiber eaters were also 15 percent less likely to develop chronic obstructive pulmonary disease, an irreversible lung condition that makes it hard to breathe. Fiber may protect lungs by reducing tissue-damaging inflammation. The antioxidants in fiber probably help protect lung cells, too. Are you getting enough fiber?"

If you wonder, take the RealAge Nutrition Health Assessment. You'll have to give information like your email address to log in.

The quiz will give you:

* A detailed nutrition analysis with your current intake of fiber, flavonoids, and cholesterol
* Which vitamins and minerals you are missing
* What to eat to make your RealAge younger
* A recommended calorie allowance for your height and weight

Spittin' Mad at Big Pharma

I don't usually get angry. Oh, yes, of course I have on occasion. I don't usually yell in those circumstances; I just walk away.

Well, you can't walk away from your mail-order pharmacy. Although, believe me, I've love to.

I've been with Express Scripts for the past 3 years, and watched them put me in a double-bind several times where I can't get the prescription I need. Usually what happens is I'll see the prescription I need right on the website, and the website tells me I have something like 2 or 4 refills left. I click on it.

Two weeks later, instead of getting the pills, much-needed at that point, I get a letter saying they can't fill the prescription because (1) it's for less than 30 days, and/or (2) it's too old. And there's no one to talk to.

So, on October 26th when I learned that my health insurance was kicking out Express Scripts and signing onto CVS' Caremark, I was thrilled. Well, thrilled until now, right now, today, when I feel like throwing a big truck at them. (What a futile daydream! God knows where these people are, supposing there are people rather than robots.)

I still don't have my I.D. card from them so I can't order anything. I called them up (twice) today, asking that my blood pressure medication be filled. They can't do that, they said: no refills left. I know I had 4 refills on the verapamil before the transfer started....and apparently those numbers are in a deep, dark hole somewhere.

So now I'm stuck. I have five of those beautiful blue pills left, enough for two-and-a-half days. I called the trauma nurse at my clinic today. She's going to get a doctor to sign a prescription for 30 days to get me through the emergency.

And I have to tell you: I don't have any faith that Caremark will come through on filling that one prescription at all.

As if you didn't know, maintaining your health is a part-time job, and sometimes even a full-time job.

WCRC Invites You to "Gifts of Healing" on December 5 at 6:00pm

A Celebration of Art, Music, Flowers & You

Friday, December 5, 6-8 PM
5741 Telegraph Avenue, Oakland 94609
Tickets $25 per person or $250 for a table

Please join us for a stellar evening of good fun, great food, amazing art and music, a silent auction of fabulous gifts and flowers and to celebrate WCRC's commitment to serving women with cancer and the community who loves and supports them.

RSVP: sarah@wcrc.org or call Sarah at 510-601-4040 x105

This event is generously sponsored by VeriFlora and Elephant Pharmacy

The Psychological Challenges of Surviving Cancer

There's an article at Newsday.com today from the Harvard Mental Health Letter (December 1, 2008) that discusses the psychological challenges of a patient after the cancer has been treated.

To quote the first part of the article, "...the most difficult times occurring during transitions... One transition in particular is likely to cause psychological distress: the period immediately following completion of intensive (primary) cancer treatment. For some patients, this transition may be as stressful, if not more so, as undergoing treatment itself.

"Patients, family, and friends understandably look forward to the completion of cancer treatment, especially when the prognosis is good. But when patients complete what may have been a grueling series of daily, weekly, or monthly medical visits, they also lose both the support system and structure provided by regular contact with an oncology team and other patients."

To read the rest of the article, look here.

Water

Water. We’re urged to drink plenty of it, and most sources tell us to drink 8 glasses a day.

However, I’ve heard from other health sources that there’s another formula for how much to drink based on our weight.

Take your weight and divide by two, then divide by eight to get the number of glasses needed daily. For example, for a 180-pound woman, 180 divded by two equals 90 divided by eight equals 11 glasses of water.

I like this next suggestion if you choose to follow this formula: Premeasure your water the night before, and then store it in the refrigerator. Transfer it in the morning to a portable container and take it with you.

Hydration will make you feel full and will curb your appetite. It’ll speed up your metabolism, and make it easier for your body to consume food and ramp up energy.

75 percent of all Americans are chronically deyhydrated. Even mild deydration can slow your metabolism by 3%.

Salmon....or Not?

There's an interesting article in this month's UC Berkeley Wellness Letter (December 2008) with a question-and-answer section about salmon. Is it safe to eat? Here is a portion of what they say.

"Does farmed salmon have more contaminants than wild?
Like wild salmon, farmed salmon is low in mercury. But studies a few years ago found higher levels of potentially harmful PCBs and other industrial pollutants in farmed salmon (particularly from Europe), which was blamed on the feed. When anchovies, sardines and other small oily fish are made into fishmeal, the trace amounts of contaminants in them are concentrated. As a result, farmed salmon are likely to consume more contaminants than wild salmon (which eat a more varied diet) -- and they accumulate more fat, whee the contaminants are stored. Fish chow has reportedly been improved, but more research is needed to determine if farmed salmon today really has lower contaminant levels. PCBs have been linked to cancer, at least in animals, and other potential health problems. To reduce them, you can remove the skin from farmed salmon and trim any visible fat.

"What about canned and smoke salmon: farmed or wild?
Most canned salmon is wild and says so, though more and more companies, including Kirkland (Costco brand) and Bumble Bee, are now using farmed salmon in some of their products (if it's labeled 'Atlantic' salmon, it's farmed). If you want wild salmon, look for canned Alaskan pink or sockeye (also called red or blueback) salmon. In contrast, most smoked salmon is farmed.

"Bottom Line: A Good Catch
The health benefits of eating two or three weekly servings of fish (a serving being four to six ounces) -- whether farmed or wild -- outweigh potential risks. Varying your choices and selecting fish lower on the food chain (small fish such as herring, mackerel, and sardines) will reduce your exposure to contaminants. Here are resources that can help you pick fish that are lower in contaminants and are raised or caught in environmentally responsible ways: Environmental Defense Fund, Blue Ocean Institute, and Monterey Bay Aquarium."

Happy Thanksgiving!

Happy Thanksgiving everyone!

My goal today is to spend time with friends, family, and my extended family. Since our hosts today decided to invite a bunch of students from a local college who have nowhere to go for the holiday, I will also meet new friends.

My secondary goal for today is to watch what I eat and drink, to be sensible about it. Since I'm the designated driver, I don't think the drinking part will be a problem (as long as I stay off the soft drinks). And I really don't think the eating part will be a problem either. I don't care much for turkey, although I'll have a little -- it's the sides that I crave. Mashed potatoes. Homemade cranberry sauce. Pumpkin pie.

I still think it'll be all right. Hopefully all those kids being there will limit what we have to eat so that portion control won't be an issue!

A Guide to Lowering Blood Pressure

What is high blood pressure?

This is from Remedy magazine's website. "Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls throughout the day. When blood pressure stays elevated over time, it’s called high blood pressure.

"The medical term for high blood pressure is hypertension. High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries). It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness." (Read the whole rather lengthy article, of which I paraphrase briefly below, here.)

It took me years to wrestle my blood pressure into normal territory, years I shouldn't have spent. I didn't realize that it takes a whole approach, a whole process, to deal with hypertension. I'm much better off, my numbers are much better, when I exercise regularly and when I eat in a nutritional way. As I exercise more, my blood pressure has lowered and stablilized more.

But I can't kid myself that I could conquer it with diet and exercise alone. I couldn't, and I can't. I am currently on three blood pressure medications, and those, along with diet and exercise, are finally doing the trick.

Remedy's guide to controlling your blood pressure, in short:

1. Monitor your weight.
2. Eat right.
3. Be active (exercise).
4. Less sodium (salt).
5. Manage your prescribed drugs.

Can Breast Tumors Disappear on Their Own?

I've seen this story in several newspapers recently, but I think today's USA Today article is easier to read and understand.

We know that one rare type of cancer found through screening sometimes disappears on its own, but in this study, researchers asked: do more invasive breast cancers found in mammograms disappear on their own?

Researchers in Norway and the U.S. compared the number of breast cancers found in more than 100,000 Norwegian women who were screened every two years with an equal number who received only one mammogram after six years.

They found that 22% more breast cancers were discovered among the women who got more frequent mammograms. This discovery raises the possibility that mammograms found cancers that eventually went away, and thus never needed to be treated.

It's important to note that doctors may more easily find cancers on repeat mammograms, and that most doctors believe that frequent mammograms save lives.

Salt Is the New Bad Guy

There's an interesting article today in USA Today about salt. The article claims that, since trans fats have begun fading from the nutrition network, "there are early signs that 2009's nutrition 'bad guy' will be salt."

Several food manufacturers are looking to reduce salt to boost sales. The below products are a result.

*Pepperidge Farm will be rolling out lower-sodium versions of the eight breads in its 100% Natural line. Most will be down 33% to 40%. The company replaced regular salt with sea salt, which delivers more salt flavor. These moves are expected to boost bread sales by at least 10% in the next year for Pepperidge Farm. Next on the salt-reducing menu: Pepperidge Farm bagels and rolls.

*Campbell's reduced-sodium soups will ring up $650 million in retail sales this year. Campbell announced sodium reduction in 48 of its soups. Overall, 85 of its 230 varieties now are lower in sodium. But its big three (Chicken Noodle, Tomato, and Cream of Mushroom) are still salt mines. A can of classic Chicken Noodle contains 890 milligrams of sodium.

*Frito-Lay recently launched Pinch of Salt, a low-sodium line with 30% to 50% salt reduction in its Lay's, Tostitos, Ruffles and Fritos chips.

*Orville Redenbacher has introduced SmartPop Lower Sodium Popcorn with 30% less than regular Redenbacher popcorn. The rest of the Redenbacher line will have sodium reduced 15% to 30%.

*Beech-Nut recently rolled out Let's Grow toddler meals with a "no junk" claim. This line has 200 or fewer milligrams of sodium per serving, up to 50% less than other brands.

*There's even less salt in salt. Last year, Morton Salt rolled out Salt Balance, a blend of salt and potassium chloride with 25% less sodium than regular salt.

Book Review: "Cancer Is a Bitch," by Gail Konop Baker

This is a very personal book. It's about a woman who discovered that she has breast cancer -- the book starts there -- and what she does about it. But, more than that, it's about who she is, and how she reacts, and how her family and friends react to her and vice versa. Because, let's face it, we don't live in a vacuum. Whether they like it, good or bad, they're along for the ride.

So if you don't want personal, don't read Cancer Is a Bitch.

But if you want an intriguing book, written very well and from the heart, from a professional reporter, this is a good one. If you've been involved with cancer, either as a patient or family member or friend, this will help you understand reactions, at least this woman's reactions.

But although Cancer Is a Bitch is an easy read, it's not an easy read, if you know what I mean. It's linear, it's funny, sometimes hilarious, almost always true, sometimes heartbreaking, and it's the latter times that I found it difficult to continue. I'm glad, however, that I did.

The inside flap reads: "I want to be brave. I want to be big. I want to be gracious and cool. I want to be the Audrey Hepburn of cancer... Gail Konop Baker was a runner, yoga practitioner, and lifelong subscriber to Prevention magazine. As her forty-sixth birthday approached, she looked forward to a time when she could at last take a deep breath, with one child heading off to college and the other two busy with their lives. She finally felt as if she was getting her life back.

"Then, right before Valentine's Day 2006, she heard the words that would forever change her: Just to be safe, I think we should biopsy.

"It was the beginning of her year-long struggle with breast cancer and its fallout."

Cancer Is a Bitch, or, I'd Rather Be Having a Midlife Crisis
by Gail Konop Baker
Da Capo Press
2008
261 pages

Do Glucosamine and/or Chondroitin Help Arthritis?

A new study is out, reports the University of California, Berkeley Wellness Letter (December 2008), that reports whether glucosamine or chondroitin helps slow or prevent the deterioration of joint-cushioning cartilage that is the hallmark of arthritis.

Two years ago, the newsletter reported that, overall, neither glucosamine nor chondroitin sulfate, alone or together, reduced pain or other symptoms significantly better than a placebo. The question remained: do they slow down cartilage deterioration?

The answer is no, according to what the newsletter calls a "large, expensive, well-designed study." The 357 subjects continued treatment of glucosamine, chondroitin, both together, Celebrex, or placebo for an additional 18 months beyond the first study. They then had x-rays to measure cartilage loss as determined by the distance between the ends of bones in the knee. The exams found only insignificant differences in cartilage loss between the groups.

Interestingly, glucosamine and chondroitin, when taken together, did worse. But nothing worked much better than the placebo.

So, the verdict is clear: if you suffer from arthritis, don't waste your money by taking these supplements.

With Sweet Drinks, Even One Is Too Many

This was printed in the November 2008 Diabetes Forecast magazine:

"One glass of orange juice a day may increase women's chance of developing type 2 diabetes by 24 percent, new research finds.

"Other fruit juices studied, including apple juice and grapefruit juice, had similarly negative associations. So did fruit punch, nondiet soda, and low-calorie soda. In contrast, women who consumed more whole fruits and green leafy vegetables demonstrates fewer incidences of diabetes. Researchers suggest that these findings should encourage people to replace juice with whole fruits in their diets."

Five Ways to Keep Alzheimer's Away

I work the little word puzzle every day in the Chronicle. You know the puzzle I'm talking about -- it has five letters or so, and you rearrange it to form a common word. At least I try to work it. I usually give up when I can't get most of the words. But, still, when working the puzzle, I can't help but think that perhaps I'm doing something to help my mind stave off Alzheimer's, a disease that affected my mother late in life.

There's a terrific article from CNN on five steps we can take to keep Alzheimer's at bay. (Thanks to my friend George for forwarding this article.) These are steps anyone can do. The steps include taking supplements, or eating curry, while other steps include doing puzzles, just like the ones I tackle every day.

Walking for My Life

I heard it somewhere. If I walked 30 minutes five times a week, my risk of getting cancer again would be lowered. I couldn't recall where I heard it. I finally did some research online, and found several references.

CVS Pharmacy is my new pharmacy provider, so I thought I'd look on their site. (You can look at their cancer guideline site here.) There it was: "Engage in moderate to vigorous physical activity for at least 30 minutes, five or more days a week (45 to 60 minutes are preferable). Studies show 45 minutes or more of moderate to vigorous activity on five or more days a week may lower your risk of developing colon and breast cancers."

That's been great motivation for the last month. I don't quite know why. I mean, do negative ideas, fears, ever work? Well, in this case, it's working.

And it's more than the idea that my risk is lowered for developing more cancer of the colon. (Although that's plenty; I sure don't need more of that.) But walking helps me in so many ways. It keeps me active. It keeps the pains down to a minimum. It keeps my flexibility up. It helps my aching back, actually warms up the muscles as I get going. And it's a nice social activity if I take along a friend.

I met my friend George at the Lafayette Reservoir today and we walked all around that body of water. My pedometer bit the dust, but I would guess that stretch is about 3 miles, perfect for us. I highly recommend walking to those who can.

Group Therapy Helps Cancer Patients Cope Better, Live Longer

Reuters Health news agency released a new study led by Ohio State University that supports the idea that psychological support groups can help women with breast cancer not only cope better with the disease, but live longer.

Researchers studied 227 women with breast cancer. About half took part in a year of therapy in groups of 8 to 12 patients led by two clinical psychologists, while the others did not.

After 11 years, the women who participated in the group therapy were 56 percent less likely to die of breast cancer and 45 percent less likely to have their cancer return, the researchers wrote in the journal Cancer.

"Survival is kind of the bottom line when it comes to cancer. So we have people being healthy, productive people for longer -- and that's a huge health outcome," Barbara Andersen, who helped lead the therapy groups, said in a telephone interview to Reuters.

The women had Stage II or Stage III breast cancer in which the tumor may have spread to the lymph nodes near the breast or chest wall or skin, but not to more distant parts of the body.

Andersen said the group sessions, among other things, aimed to reduce the women's distress, train them how to relax and improve coping skills, improve their diet and exercise habits and discourage smoking and drinking alcohol.

The improved survival may stem from better immune function resulting from stress reduction, the researchers said.

Do Hand Sanitizers Really Work?

My nephew always carries a little bottle of liquid hand sanitizer in his backpack, just in case he can't wash his hands in a dirty environment or has to pick up food with his hands.

And we all know we should wash our hands frequently to avoid picking up people's germs.

So, my question has always been: do those portable hand sanitizers really work?

The answer was supplied this month in the December 2008 issue of Travel and Leisure:

"'I only use hand sanitizers when soap isn't available,' says Dr. Anna Bowen, medical epidemiologist at the Centers for Disease Control and Prevention. Sanitizers with a minimum alcohol concentration of 60 percent, such as Purell and Germ-X, have been proven to kill germs effectively, but they don't wash away dirt, grime, or certain agents such as the novovirus. 'If you do opt for a sanitizing product,' Bowen says, 'make sure you use enough gel to cover the entire surface of your hands, and let them dry completely.'"

I knew my nephew was smart. Looks like he's right once again.

Pill Can Replace Chemo for Lung Cancer

An article appeared this week in USA Today about a new drug, Iressa. Iressa seems to do less harm to patients, but costs thousands more than standard chemotherapy.

Quotes below are excerpts from that article, based on an article published last week in the British Lancet medical journal.

"Some advanced lung cancer patients already treated with chemotherapy might be able to skip some of the bad side effects of another series of chemo by taking a pill instead, a study suggests. An international study showed patients on Iressa, an expensive, newer targeted treatment, survived about as long as those on another course of chemotherapy.

"'This will provide us with another drug in our armory,' said Dr. Michael Seckl, head of Cancer Research UK's Lung Cancer Group at Imperial College in London. Seckl was not connected to the research.

"Few treatments for lung cancer exist, and most patients die within a few years of diagnosis. Lung cancer kills about 1.4 million people every year.

"In the study, paid for by AstraZeneca, researchers studied 1,433 advanced lung cancer patients in 24 countries, who had already gone through chemotherapy. Roughly half were given Iressa, or gefitinib, once a day. The other half were on docetaxel, a chemotherapy drug given intravenously every three weeks.

"Patients on Iressa survived about 7.6 months while those on chemotherapy survived about 8 months. After one year, 32% of patients on Iressa were still alive, versus 34% of chemotherapy patients.

"'In the patients that respond, it is very dramatic,' said Seckl, who has seen patients live years on the drug. He did not work with AstraZeneca on Iressa, but has consulted with them on other drugs.

"'Though the benefits of prolonging life are modest, patients on (Iressa) get a higher quality of life,' said Chris Twelves, a professor of clinical cancer oncology at Leeds University. "That should swing the pendulum in its favor."

Caring Bridge

I discovered that someone I had met online several years ago had quit her job (which is where I had known her from) due to cancer. Someone very helpfully pointed me toward her website, a website sponsored by Caring Bridge. I was able to post a get well message for Carol, and find out where she was in her treatment.

Caring Bridge offers "free, personalized websites that support and connect loved ones during critical illness, treatment and recovery."

According to the site, "CaringBridge® (www.caringbridge.org) is a free, nonprofit web service that connects family and friends to share information, love and support during a serious medical condition, treatment and recovery. It takes just a few moments for you to create your own personal and private CaringBridge website."

I noticed that Carol was able to post updates on her condition as well as photos. I thought it was a great way to keep in touch in folks, especially concerning her health.

Caffeine Inhibits Cancer

A new study shows that caffeine might help inhibit, and possibly even reverse, damage to skin caused by the sun.

"For some time, we've known that caffeine appears to be able to prevent skin cancer," said Dr. Paul Nghiem. "There's epidemiological data along those lines and the interesting more recent thing is that caffeine appears to be able to do that when you apply it topically."

There have been several studies in recent years showing a preventative connection between caffeine and liver as well as skin cancer. This is the latest in those studies which support this.

For the November 2008 article, click here.

More than one million new cases of skin cancer are diagnosed every year, making skin cancer the most common type of cancer.

National Lung Cancer Awareness Month

November is National Lung Cancer Awareness Month.

The Northern California Cancer Center tells us that lung cancer is the leading cause of cancer death and occurs even in non-smokers. It also occurs differently among ethnic groups.

New data supports the idea that women are more likely than men to have non-smoking-associated lung cancer.

Asian-Americans are found to have lower incidence rates of non-small cell lung cancer than whites, with South Asians having the lowest rates. Researchers have also found that foreign-born Asians have a higher rate than U.S.-born Asians, which may be due to factors other than smoking, especially among women.

What You Can Do:

Don't ever smoke or stop smoking if you do. While it's possible to get lung cancer even if you don't smoke, smoking causes more than 80% of lung cancer deaths.

- NCI Smoking Quitline 1-877-44U-QUIT; TTY: 1-800-332-8615. Call within the US, Monday - Friday 9:00 a.m. to 4:30 p.m. local time.

Avoid exposure to radon gas, asbestos, or areas of high air pollution, including second-hand smoke

Consider getting screened with a chest x-ray or spiral CT scan. If there is a history of lung cancer in your family and you have habits or symptoms that suggest you have a higher risk of lung cancer. As with most cancers, early detection can increase chances for survival.

Support more research of this deadly disease. NCCC Scientists are currently seeking funding to study risk factors for in Asian and Latina women who have never smoked. Identifying risk factors can inform the study of lung cancer in all groups, leading to more effective prevention.

Link to a New Blog

A friend of mine was recently diagnosed with cancer, and she's in an advanced stage. Here's the blog link to My Life in a Tumblr.

She just started taking chemo, and, as you can imagine, is having a tough time of it.

Her blog is very raw, as are her emotions.

Dry Eye and What to Do About It

I've written just a little about another condition of mine: Dry eye.

I had dry eye before my lasik surgery, which was 8 years ago. But after the surgery, I really had it bad.

My lasik eye doctor didn't tell me how to treat the condition, which, in hindsight, is very unfortunate and I would even venture to say, unprofessional. But I have learned a lot since then.

A few years of suffering with intense pain, coupled with talking with friends and coworkers, and eventually getting referred by my doctor to a specialist helped tremendously.

My regular optometrist was no help at all. In fact, I stopped seeing her because of this condition and her inability to even offer possibilities for solutions. However, five minutes with an eye specialist, an opthalmologist, helped me put this problem behind me. And my new optometrist understands the condition and is helping me manage it.

That five minutes was spent in a conversation about what I was doing, and what he recommended I do and not do. This occurred just when the liquigel Systane was having difficulties, having discovered fungus in one of their batches. As a consequence, I couldn't find any more of the Systane liquigel; their regular lubricants didn't help me at all. He suggested the following:

1. Stop taking antihistamines and the like, which further dry out the eyes.
2. Use the liquigels that were then coming out on the market. Refresh liquigel is the best, in my opinion. As I was discovering, the regular lubricants don't even put a dent in lubricating my eyes.
3. Start using Restasis, a prescription medication which comes in the form of drops in one-time use plastic vials.

This last one was the real clincher for me. My partner had tried Restasis, but couldn't continue with it because it causes a burning sensation. As it turns out, the burning is due to the dry eye; once you start taking the Restasis and have continued for months, that burning sensation decreases considerably. (At this point in my usage, it's all but gone away.)

The trick here for Restasis, according to my specialist, is to use it daily. Twice a day. And you won't feel any improvement for at least three months. Restasis acts as an anti-inflammatory, and only works for a percentage of patients; not everyone will enjoy its benefits -- and, of course, the problem is that you have to use it for months to find out if you'll have any benefit. Thankfully, it worked for me.

Since Restasis is expensive, he showed me a little trick: each vial will give two doses if you use it sparingly. I have done so and made my supplies last twice as long.

Two things I've also added to my routine: (1) I have also started taking vitamin supplements containing Omega-3: TheraTears. I take 3 orally on a daily basis. (2) My regular optometrist recommended I put a gel in my eyes at night so that when I awake, it won't feel like my cornea is being ripped off. He recommended Refresh PM gel, and that's what I use every night, a drop under each eyelid.

Thankfully, Refresh liquigel and PM gel as well as TheraTears supplements are now available in most drugstores, Costco, and drugstore.com and are easily available. And my regular GP doctor continues my Restasis prescription.
With this problem solved -- albeit with daily ministrations -- I can go on to deal with more serious problems like diabetes and my general health.

Back to Fiber

From Dawn about a subject that's near to her heart: fiber.

"Again on the FIBER topic.

"Just found Mission Tortillas - CARB BALANCE. They have 11 grams of fiber in each tortilla! This is fantastic! They can be used for healthy dips instead of chips. You can toast them in the oven if you want them to be firm. There are 5 grams of protein and only 7 grams net of carbohydrates. I don't know what they mean by "net" carbs. But it sounds good."

MRI vs. Mammography

Newsweek (November 3, 2008) had a small article on MRI's vs. the mammogram.

It seems that the question about whether MRI's can do a better job than mammograms in the detection of breast cancer has been coming up ever since women learned that Christina Applegate's breast cancer was discovered after her doctor ordered an MRI.

According to Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, most women will not benefit from MRI screening.

The problems with MRI's:

1. MRI's are more expensive.
2. MRI's have more false positive results than mammograms.

However, recent American Cancer Society guidelines (cancer.org) do recommend MRI, along with mammography, for women who are at the highest risk of developing the disease.

As it turns out, Applegate was in that group. She had tested positive for a genetic mutation called BRCA. Also at high risk are those women who have a close relative with the mutation and are untested.

Best bet: talk to your doctor.

Family Stressed about by Alzheimer's

There was a Dear Abby column today where a woman told Abby she was stressed out by her mother's quick ascent into Alzheimer's, and she wondered what to do.

I liked Abby's answer. "Today, an estimated 10 million Americans are caring for someone with Alzheimer's or another dementia. More than 40 percent of them rate their emotional stress level as high or very high, and it is a danger to their health." She pointed families stressed out by parents' Alzheimer's or dementia issues to the national Alzheimer's association. The toll-free number is (800) 272-3900 or visit www.alz.org. The website has a stress test for those affected by the disease.

Cholesterol Drugs Offer Great Benefit

Cholesterol drugs can reduce your risk for heart-attack or stroke dramatically, even if you don't have high cholesterol.

A two-year study recently concluded -- it was originally a 5-year study, but researchers ended it sooner because of the dramatic results -- which shows that those who aren't at risk re: cholesterol received enormous benefit from taking Crestor, a statin.

Crestor was found to reduce heart attacks, strokes, heart-related deaths or hospitalizations, or the need for an artery-opening procedure, by 44 percent.

"We reduced the risk of a heart attack by 54 percent, the risk of a stroke by 48 percent and the chance of needing bypass surgery or angioplasty by 46 percent," said researchers.

The problem, however, is the cost. Crestor costs over $3 a day, which would add up to $9 billion a year if everyone took it. A better possibility is generic forms of other cholesterol-reducing drugs.

For the MSNBC article, look here.

Your First Year with Diabetes

A new book has been issued on what to do when you first find out you have diabetes, or pre-diabetes. It’s called Your First Year with Diabetes: What to Do Month by Month, and is for sale at the American Diabetes Association website, store.diabetes.org, or 800-232-6733. The author is Theresa Gamero, APRN, BC-ADM, MSN, CDE.

If diabetes has left you confused or angry, wondering what to do, wondering how to improve your situation, this book will be a good reference for you.

I haven’t read it yet, but I already ordered it. I could use all the help I can get. Plus, maybe I missed something along the way even though I’m not in my first year. I tell you, I sure could’ve used something like this when I was first told I was pre-diabetic some ten years ago. Gamero says, “Walking 30 minutes a day most days can prevent pre-diabetes from graduating into diabetes.” What important information I could have had!

The ADA says the book is straightforward and easy to read. “Over the course of one year, you’ll learn about medications, exercise, meal planning, and how to handle lifestyle and emotional issues – all at a pace that suits you.”

Say NO to Yoplait?

Yoplait is urging consumers to buy its yogurt and send in the Yoplait yogurt lids to fight breast cancer.

But what consumers have subsequently discovered is that Yoplait yogurt is actually made with milk from cows that have been treated with the synthetic hormone rBGH. And that's not so good for our health.

If you want to tell Yoplait to go rBGH-free, go to the think-before-you-pink website and send Yoplait an automated message.

Do cholesterol-lowering drugs increase memory loss?

The University of California, Berkeley Wellness Letter (November 2008) reported that, "despite anecdotal reports that cholesterol-lowering statin drugs may increase memory loss in some people, studies over the years have not found this link.

"In fact, some research suggests that statins may actually reduce the risk of cognitive decline and dementia. Recently, for instance, a study in the journal Neurology of nearly 1,700 older Latino Americans found that statin users were about half as likely to develop these problems as nonusers over a period of five to seven years."

I had heard that some people have reported loss of memory due to the drugs they were taking. I kind of wonder how they knew which drugs might be affecting them, however, since those who are taking one drugs are likely to be taking more than one.

It's good to hear, though, that evidence is suggesting that there is no deleterious memory effect from statin drugs. One less side effect to worry about.

What You Need to Know About the Relationship between Hormones and Breast Cancer

After skin cancer, breast cancer is the second most common cancer among women. 178,000 new cases and 40,000 deaths occur each year. Lung cancer, however, claims more women's lives each year.

More and more research points to hormones as playing a part.

From the moment we women start to menstruate to the point of menopause, women are exposed to estrogen and progesterone in their bodies.

“These hormones stimulate the breast duct and lobular cells, and it’s that repeated monthly stimulation, where the levels of the hormones go up and down, that can lead to mutations or alterations in the breast cells’ DNA,” says Julie Gralow, M.D., associate professor of medicine, department of oncology, at the University of Washington School of Medicine and associate program head of the Breast Cancer Program at the Fred Hutchinson Cancer Research Center in Seattle. “So if you start menstruating early (before age 12) or stop late (after 52), your risk for breast cancer goes up.”

I'm quoting from an article by Remedy magazine. They go on to say that family history also affects breast cancer risk, and that it's "a solid factor in about 5 to 10 percent of breast cancers. Maintaining a healthy weight through menopause, exercising and limiting alcohol consumption may reduce a woman's risk, says Dr. Gralow." (Most of the below information is from this article.)

But cancer rates fell by 7 percent in 2003. The National Cancer Institute believes this may have been due to two factors: a drop in mammogram screening (and thus a drop in detection of early-stage cancer), and a decline in hormone replacement therapy (HRT) use. The drop in HRT occurred in 2001 after the Women's Health Initiative (WHI) found a potential relationship between HRT and slightly higher breast cancer rates.

My mother underwent a hysterectomy early in life after I was born. She was on hormone replacement therapy, specifically estrogen, for most of her life after 30. She claims she just didn't feel right if she didn't have her estrogen every day. I often wondered why my doctor didn't offer me the option of HRT after I hit menopause. I think I now know.

Obviously, if you're considering HRT, you and your doctor need to look at your risk for breast cancer. If you have a strong family history of cancer, you might want to consider other ways to manage menopause.

The Chocolate Dose

In our continuing discussion of the good things about chocolate and how much to eat, here's another comment from Dawn:

ok, so it looks like 6/7 grams of chocolate daily is the dosage. That's 1/4 oz of chocolate! REALLY REALLY SMALL! But maybe that is good.

Did you read this article?
http://www.webmd.com/diet/news/20030827/dark-chocolate-is-healthy-chocolate

The article says that a 100-gram bar of dark chocolate has 531 calories. So if I did my math right, 6.7 grams is about 35 calories. It seems like a very small number of calories for such good results. I'm thinking that getting a bar of and taking a medicinal dose each night would be a good idea. You list so many advantages!

Chocolate....Deadly or Healing?

Dawn left a comment and question for us:

"This may sound silly, but what's the scoop with chocolate? I hear that it is good for you - minus the sugar. So what exactly is good and does it refer to cocoa beans unsweetened? I like intense flavors and chocolate is intense."


That's a good question. I think we should all recognize that a lot of research has been done on chocolate, but a great deal of that research was funded by the chocolate industry and interest groups, and, therefore, not to be trusted. And we also have to recognize that much of this research did not include "co-factors (i.e., added sugar, corn syrup, milk fats/dairy cream, hydrogenated oils, etc.)," all of the other ingredients in the chocolate, some detrimental. So, conclusions are sometimes conflicting. I also tried to concentrate on research and conclusions drawn recently.

Let's just state a fact and get it out of the way: Unprocessed chocolate has no sugar in it and is really quite bitter.

That being said, what are the good things about chocolate? I mean, besides taste.

1. Its nutrient profile is quite impressive, rivaling more commonplace fruits and vegetables: Vitamins B1, B2, B3, B5, B6, Vitamin C, copper, calcium, phosphorus, iron, magnesium, zinc, manganese, vitamin E, and high polyphenols and flavonoids. The last two are powerful antioxidants that provide significant health benefits. A cup of cocoa contains nearly twice the antioxidants of a glass of red wine, and up to three times those found in a cup of green tea.

2. Dark chocolate is loaded with key neurotransmitters like tryptophan, serotonin, and dopamine. These chemicals can suppress one's appetite and block the pathway that leads to food cravings.

3. In some studies, those who ate dark chocolate had a significant drop in blood pressure (by an average of 5 points for systolic). Those who ate white chocolate did not.

4. Eating chocolate releases endorphins in the brain, which act as pain relievers. Cocoa products also contain stimulants such as phenylethylamine, which have an anti-depressant and amphetamine-like effect. They contain pharmacological substances such as n-acetylethanolamines that are related to cannabis (marijuana), and they have compounds that stimulate the brain to release an opiate-like substance called anandamide.

5. The sugar in chocolate may reduce stress and have a calming effect.

6. Eating chocolate may reduce the risk of heart disease and cancer. Several studies have suggested that the addition of copper through chocolate can protect the body against colon cancer.

7. Studies have shown that consuming a small bar of dark chocolate every day can reduce blood pressure in individuals with high blood pressure. Dark chocolate has also been shown to reduce LDL cholesterol (the bad cholesterol) by up to 10 percent.


The bad things about chocolate:

1. Sugar is a well-known cause, contributing or aggravating factor with a host of medical conditions that includes heart disease, insulin and blood sugar disorders, mood disorders, immune system disorders, leukemia, dental caries, yeast infections, depletion of essential nutrients, osteoporosis, obesity and others.

2. Chocolate has an addictive quality. When drugs are used to block the brain's opiate receptors, the desire for chocolate (and other sweet and fatty foods) disappears, confirming the addictive nature of chocolate.

3. Consumption of high copper sources such as chocolate and cocoa products can aggravate many high copper-related medical conditions and can create new ones.

4. One-third of the fat in chocolate is bad for you. (But that also means that two-thirds of the fats (especially oleic acid, which is found in olive oil) is good for you.)


So, with all this information, what is "healthy" chocolate?

A. It has not been alkalized (dutch processed) with chemicals that wash away the nutrients.

B. It has been cold-pressed rather than heated.

C. It contains at least 70 percent cocoa.

D. It contains cocoa butter instead of milk fats or hydrogenated oils.

E. It contains natural, low glycemic sweeteners.


So, what's a good prescription for eating chocolate, which means, how much and how often?

Science Daily reported last month that "6.7 grams of chocolate per day represent the ideal amount for a protective effect against inflammation and subsequent cardiovascular disease." They cite findings published recently in the Journal of Nutrition, findings from one of the largest epidemiological studies ever conducted in Europe, the Moli-Sani Project, which has enrolled 20,000 inhabitants of the Molise region. The sample of people who have moderate amounts of dark chocolate regularly have significantly lower levels of C-reactive protein in their blood -- in other words, their inflammatory state is considerably reduced (17 percent).

The study suggests that "less than half a bar of dark chocolate (70 percent cocoa) consumed during the week may become a healthy habit." If you want to take a look at that Science News article with the details of the study, look here.