Tuesday, December 30, 2008

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.

Monday, December 29, 2008

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

Saturday, December 27, 2008

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.

Thursday, December 25, 2008

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.

Wednesday, December 24, 2008

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.

Tuesday, December 23, 2008

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.

Monday, December 22, 2008

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.

Sunday, December 21, 2008

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.

Saturday, December 20, 2008

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.

Friday, December 19, 2008

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.

Thursday, December 18, 2008

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.

Wednesday, December 17, 2008

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.

Tuesday, December 16, 2008

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.

Monday, December 15, 2008

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.

Wednesday, December 10, 2008

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"

Tuesday, December 9, 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.

Monday, December 8, 2008

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.

Saturday, December 6, 2008

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.

Thursday, December 4, 2008

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.

Wednesday, December 3, 2008

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.

Tuesday, December 2, 2008

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

Monday, December 1, 2008

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.