Health care reform

Of course I need to offer my opinion on the health care reform act. Now that we can stop arguing about whether its legal or not - or you can feel free to disagree with the Supreme Court but I just want the arguments to stop that I can hear.  Whatever your opinion about the law, its a law and we have to live with it until someone comes along who wants to have it retracted or changed.

I'm not calling it perfect by any stretch but I do like it because it represents change to the health care system. The health care system is broken. We all know horror stories about people who couldn't get care, or went bankrupt trying to get care, or lost their insurance for some reason and then got very ill.

Insurance companies are making health care decisions based on their statistics instead of letting doctors make decisions based on what is needed for the patient. People use emergency rooms instead of primary care doctors and often wait until they are very sick to get treatment. If they had insurance they might have gotten wellness care where the ailment could be prevented or caught early so medical bills will be less.

People may not realize the importance of health insurance until they get a nasty ailment, have a car accident, or need surgery. Then they find out they really need it.

So unless someone else has a bright idea on how to fix the health care system now that we will all have insurance we are stuck with this plan for now.

So how was my day? Lovely, I think.

I went into Boston for a seminar on grant research yesterday morning. I memorized the address but since I have chemo brain I thought I would write it down on a little piece of paper as well. But didn't bring the phone number because my phone only works when plugged in - hence its lost its mobility.

I left about 15 minutes later than I wanted because I got side tracked on the evil internet. Traffic was backed up for a good ten minutes to get into the parking garage. So I used that time to look at a map to remind myself of where I was going downtown.

I ran to get the train and when we got downtown I walked very fast to get to the seminar. It wasn't there. There wasn't a #55. There was a 47 and a 63 with a parking lot in between but no 55. After looking around and realizing the seminar would not be held at the parking lot, I looked at my little piece of paper and realized I was on the wrong street.

So I rushed to the seminar again, hoping I wouldn't be late, and when I got there, it was very empty - because it didn't start for another 30 minutes. So I took a seat in a crappy chair and got caught up on some reading. My back did not like the crappy chair and started letting me know very quickly. the chair actually looked pretty comfortable but it didn't have the support my needy back requires. I quickly opted for the pain pill option in hopes that I could suck it up and last through the day.

So I sat in the crappy chair for my extra  half hour of stupidity and through 2 1/2 hour seminar and my back really hurt at the end. Then I did research in the library for another 1 1/2 hours on another crappy chair. My back was not happy. Then I took the subway back to my car and it sat underground for a while on a slant which made my back hurt more.

Then I went to the AT&T service center to remobilize my mobile phone where they told me it would be 30-45 minutes before they could even look at my phone. I took a seat in another crappy chair. After 30 minutes of 'patiently' waiting, they called me. 1.5 hours later I finally got a new phone during which time I told them I was losing my patience as everyone else was gone long before me and most  repairs took about 10 minutes. I took another pain pill somewhere in there but my back really hurts.

I made a quick stop at the store to get dinner because I wanted to make a nice one for my husband who is having a tooth pulled this morning and will be on soft food for a while. I got home after 5. I then tried my handyman skills to figure out why the dishwasher won't drain. Leaning over into the dishwasher was not good for my back either. I needed ice and alcohol to recover. We'll call a repair person tomorrow.

Lunch? You will note there was no mention of eating anywhere during my day. I had some cheese and crackers when I got home to round out the two pain pills I had earlier - does that count?

A bit more about thyroid cancer

If you have breast cancer or one of the 'popular' cancers, there are boatloads of information. Actually there are aircraft carriers full of information on the cancer. Enough information to go to the moon and back a million times.

But if you have an obscure cancer, no one knows about it. Thyroid cancer used to be nice and obscure - 10,000 cases annually. Now it is getting 'popular' and there are expected to be 50,000 cases a year. This means I can actually find information about it that is not in 'medical-speak' or the dreaded 'scientist-speak'.

So here is a nice little article explaining the thyroid cancer. The author of the study (yes another study, because we needed it), says:
“The excellent survival rates of almost all of our patients are predominantly due to the multidisciplinary optimization of their diagnostic and therapeutic management, including advanced molecular imaging techniques, highly sensitive laboratory assays, excellent endocrine surgery, individualized high-dose radioiodine therapy and lifelong medical surveillance.”

Please note the last three words - lifelong medical surveillance. Yep, it has a sneaky habit of coming back decades later. Isn't that nice. With most cancers, five years means the chances of recurrence are lower. Not so with thyroid cancer. It likes to return much later. How fun.

Blah, blah, exercise more, blah, blah

Right up therer with common medical advice - eat right, stand up straight, floss - is get some exercise. When have they ever told us not to exercise? Exercise is good for all sorts of things - we know this. This is why we had gym class in school and were sent out side to play and went for walks all the time.

There are some downsides to exercise - blisters from badly fitting or the wrong shoes. Or, muscle aches and pains for the days when you might 'over do' things by a tiny bit. Or stretching injuries if you perchance are in the slightly wrong position and end up with a very painful knee (not that I would know this by experience or anything).

But there is another new benefit to exercise - reducing your breast cancer risk. Who would have thought? Duh. Exercise is known to be good for us. But, here's the real story:

"Moderate exercise tied to lower breast cancer risk 

...Women who exercise moderately may be less likely than their inactive peers to develop breast cancer after menopause, a study published Monday suggests.

And it did not take a vigorous workout; regular exercise at any intensity level was linked to a lower breast cancer risk, the researchers say.

Still, there are reasons to believe it can, said lead researcher Lauren McCullough, of the University of North Carolina, Chapel Hill.

One possible way is indirectly, by reducing body fat, McCullough said in an interview. Excess body fat is related to higher levels of certain hormones, including estrogen, as well as substances known as growth factors, which can feed tumor development.

Researchers found that of more than 3,000 women with and without breast cancer, those who'd exercised during their childbearing years were less likely to develop the cancer after menopause.

The findings, reported in the journal Cancer, add to a number of past studies tying regular exercise to lower breast cancer odds.

But like those past studies, this latest one can only point to a correlation: It does not prove that exercise, itself, is what cut women's breast cancer risk.

But exercise might also have direct effects, McCullough said -- by boosting the immune system or the body's ability to clear cell-damaging "free radicals."

That is all speculation for now.

But, McCullough said, the findings do support the general health recommendation that adults stay active throughout their lives."

So what does this tell us? Speculation is telling the researchers that exercise can lower your breast cancer risk. So before you adopt a mighty exercise plan to reduce your risk of breast cancer, just remember that it is speculation that is driving this.

This also reminds that all these studies that tell us things like eating spinach is good for us - some is based on science and some is based on speculation because there appears to be a correlation. And it always needs more research to prove anything.

The real reason I fired my primary care doctor

She never really acknowledged my breast cancer diagnosis. Five years later this still irks me. In April 2007, I had my annual physical and she made sure I was scheduled for a mammogram. Which was the bad one. After my diagnosis, I stopped by her office at the hospital while I was there for one of my billion other appointments and left her a note that I had been diagnosed with breast cancer. I never heard from her.

In the next couple of years I never even saw her, I had my physicals with the nurse practitioner. I gave up and found a new primary care. If you are a doctor and you have a patient diagnosed with cancer, shouldn't you care enough to see them?

I was talking to a friend yesterday who is in chemo for a second cancer diagnosis. She told me she fell a couple of weeks ago and ended up in the emergency room. Her primary care insisted she come back in and see her to make sure she is doing okay. I think that is how doctors should be.

I had my annual physical a few weeks ago, my second one with her, and I was pleasantly surprised at how she knew what was going on with me, was glad she hadn't seen me for four months - which means I had not required medical care for that brief period of time (even if I had seen numerous other doctors). She was also happy to talk to my oncologist about a possible prescription. She even seemed like she cares.

Warning - Smart phones are dangerous

"People are risking their health by working on smartphones, tablets and laptops after they have left the office, according to the Chartered Society of Physiotherapy."

No, they don't (think they) they cause brain tumors. Its much much worse! They hurt their..... [insert drum roll]... posture! I first read this article a couple of days ago and still find it intriguing in the sense of overhype of stupid bits of news.

"It says people have become "screen slaves" and are often working while commuting or after they get home.

The society said poor posture in these environments could lead to back and neck pain."

Here's the advice:

"Unions said people needed to learn to switch off their devices."

That's it. Use the off switch. Tell your boss to take a hike and stop bugging you after hours - unless you really have a critical profession and the world might come to an end if you didn't check your email or voice mail or catch the latest Kardashian gossip on Twitter.

The chairwoman of the Chartered Society of Physiotherapy, Dr Helena Johnson, said the findings were of "huge concern".

She said: "While doing a bit of extra work at home may seem like a good short-term fix, if it becomes a regular part of your evening routine then it can lead to problems such as back and neck pain, as well as stress-related illness. 

"This is especially the case if you're using hand-held devices and not thinking about your posture. Talk to your employer if you are feeling under pressure."

The general secretary of the Trades Union Congress, Brendan Barber, said: "Excessive work levels are not good for anyone. Overworked employees are not only unlikely to be performing well at work, the stress an unmanageable workload causes is also likely to be making them ill.

"By the time someone is so overloaded they constantly feel the need to put in extra hours every night of the week at home, things have clearly got out of hand.

"Individuals who find themselves unable to leave their work in the office should talk to their managers and learn to switch off their smartphones."

This is a real article from BBC. I personally find the article a prime example of the decay of modern society (did I really use that phrase?) Well anyway, here's my thoughts on why this is so bad.

1. Overuse of hype. Good posture is a good thing and we all knew that. Our parents always said 'stand up straight'. But I think the problem is a bit overinflated here. Its not a medical disaster.

2. I don't call it a medical issue anyway. Its a management issue. Unless your job requires it and you knew it signing up, you should not be 'on call' in the evenings and on weekends. Its time management for you and management for your boss.

3. I question how newsworthy this is anyway. I mean there's a lot more going in the world - SJC ruling on healthcare, Syria and Turkey, research on the cure for cancer.

Posture is less of a concern to me than cancer. Sorry. Since my smart phone isn't going to kill me off anytime soon and my back already hurts, posture is low on my priority list.

Mammograms and statistics

The AMA has said (finally) that yearly mammograms should start at age 40. Back in 2009, some group of rocket scientists recommended they start at age 50 for women with normal risk factors. That started a big 'To-Do' and everyone (and their brother) had an opinion. They have joined the ranks of the American College of Obstetricians and Gynecologists; the American College of Radiology; the American Cancer Society; the National Cancer Institute; and the National Comprehensive Cancer Network who also say 40, unlike the rocket scientists.

So maybe the AMA is a bit slow here but its nice to see them on the bandwagon with everyone else promoting something that's common sense.

Especially since it has been learned that women who work night shifts are between 30 and 40% more likely to get breast cancer. This last set of statistics proves two things:

1. Lots of things cause breast cancer so we all have a higher risk and therefore all women really need the mammograms.
2. It is possible to reach analysis paralysis with breast cancer statistics, just like any other kind of statistics.

That's enough for today. I'm going to the beach.