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Stepping up on awareness of deep vein thrombosis and pulmonary embolism

They are among the lesser known cardiovascular disorders but they are just as dangerous as the others and can cause disability and death.

That’s the reason why the US Department of Health and Human Services (DHHS) published The Surgeon General’s Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism.

Deep vein thrombosis (DVT)

refers to the formation of one or more blood clots (a blood clot is also known as a “thrombus,” while multiple clots are called “thrombi”) in one of the body’s large veins, most commonly in the lower limbs (e.g., lower leg or calf).

These clots can partially or totally block the blood flowing through the vein and can in approximately 50% of all cases manifest in pain, swelling, and discoloration of area affected. The other half of cases of DVT show few or no symptoms and are thus considered asymptomatic or “silent.” More than one third of DVT cases will result in a life-threatening complication called pulmonary embolism (PE).

A PE occurs when a portion of the blood clot breaks loose and travels in the bloodstream, first to the heart and then to the lungs, where it can partially or completely block a pulmonary artery or one of its branches.

DVT may be acute and can go away once treated. It may also be chronic and can recur again and again due to another complication called the postthrombotic syndrome (PTS). PTS occurs when the vein blockage is not cleared completely. The chronic blocking, damages the one-way valves, and results in venous pooling. This leads to,chronic leg pain, swelling, fatigue, and skin ulcers that are difficult to heal.

Every year, about 100,000 people die in the US as a result of DVT and PE.

DVT and PE are preventable and treatable conditions. However, there is a need to step up on awareness of these conditions especially because of the high number of asymptomatic cases. The Office of the Surgeon General, in collaboration with The National Heart, Lung, and Blood Institute (NHLBI) is supporting research work that “focuses on understanding the causes of DVT and PE, as well as safe and effective detection methods, treatments, and preventive measures.”

In upcoming posts, I will discuss more in detail DVT and PE, the risk factors, the preventive measures, and the treatments.. In the meantime, you can check out:

US Department of Health and Human Services. The surgeon general’s call to action to prevent deep vein thrombosis and pulmonary embolism. Available at: www.surgeongeneral.gov/topics/deepvein/calltoaction/call-to-action-on-dvt-2008.pdf.

 

Photo credit: scol22 at stock.xchng

 

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Young Voices: Life With Diabetes

Check this out: Young Voices Unite, national online video campaign, is inviting people affected by type 1 diabetes to submit a 1-minute video message with 1) their personal story and 2) how our next president can help change the future of diabetes. Discovery Health will give the videos national exposure and for each video submission, Novo Nordisk will donate funds to Junior Diabetes Research Fund JDRF (up to $25,000).

The top video will be featured during the World Diabetes Day Young Voices: Life with Diabetes Forum in New York City. Submitting videos is absolutely free, so take advantage of this opportunity to get your desires, attitudes, wishes and needs about diabetes heard! The deadline is October 24th! More information is available here.

“While there are many life-changing experiences during the transition from adolescence to adulthood, teens and young adults who live with type 1 diabetes are confronted with unique challenges and crossroads, such as:, “How do I tell my friends at school?”; “How do I tell my boyfriend or girlfriend?”; “How do I get my parents to trust that I can manage my disease without their constant nagging?”; “Will my parents trust that I will be okay in college?” These are just a few examples of obstacles faced along the road to adulthood.

Discovery Health, Novo Nordisk, Discovery Education, and the Juvenile Diabetes Research Foundation (JDRF) are teaming up to launch Young Voices: Life With Diabetes, a national web-based video campaign allowing teens and young adults to share insights on challenges you face living with diabetes.

Use this site to unite as a community and learn about managing diabetes throughout life’s transitions. Building on the momentum of the upcoming election, record a one minute video message to the incoming President highlighting your opinions, attitudes, wishes and needs for how diabetes care can be improved.
You’ll get a chance to screen many of the videos submitted. We’ll also have a community of young adults just like yourself so you can get connected.”

Check out the promo video here.

Thanks to Shira Silberman and the folks at Novo Nordisk, Juvenile Diabetes Research Foundation, Discovery Health, and Discovery Education for contacting Battling Diabetes with the information on this great campaign.

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No more excuses. No more lung cancer

These are the the promises of the Lung Cancer Alliance, the only national non-profit organization dedicated solely to patient support and advocacy for people living with lung cancer and people at risk for the disease.

Hall of Fame Orioles’ Shortstop, Cal Ripken, Jr. is the honorary spokesperson for the Lung Cancer Alliance, joining forces with the organization in the Face in the Fight campaign. Ripkin is working with the Alliance to help reverse the stigma surrounding the disease. It isn’t about blame but about support and compassion.

Read more

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A Rant About Home Health Care Workers

Okay, you will forgive me for the rant, but I ran into an old friend this past weekend and she is struggling as she cares for her mom who has Alzheimer’s disease. We shared and compared war stories. It was therapeutic for both of us.

She had some of the same issues that I did. Why is it so hard to find good help? From a Medicare perspective, you must always have a backup plan. Well, I’m thinking, if I had a backup plan, I wouldn’t need a home healthcare worker to come. I’d use my backup.

Then there is the issue of the dependability (or lack thereof) of the home health workers. I mean, once I was heading out of town for a speaking engagement. The aide was to show up at 6:30. 6:30 came and went as did 6:40 and 6:50. Finally, at about 6:55, I called the agency only to find out that the aide was not coming. How nice it would have been to have gotten a phone call. I was so angry that I told the person who answered the phone that SHE needed to come and stay with my mother. Of course, she told me that I was to have a backup, which sent my blood pressure THROUGH the roof. Like I said before, if I had a backup, I wouldn’t have needed their services.

Unfortunately, this happened a lot. Over the course of the time that I cared for my mom, I used four different agencies. All made great promises during the sales and intake period, but in the end, they didn’t differ that much.

Now, we did have a few good Aides. Ms. Florence was one of my favorites. She was always on time, she never, that I can recall, just didn’t show up and if she was going to be a few minutes late, she always called.

I don’t mean to badmouth ALL home health care workers. There are probably some good ones out there. So, let’s do this. Please tell me your GOOD stories. Show me that mine was an isolated experience. Tell me about the angels that are helping you to care for your loved one. I know they are out there and I think it would do us all good to hear something positive as we battle this monster called Alzheimer’s disease and all that it brings with it.

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Your job and your blood pressure

Increase in blood pressure has been associated with psychological and emotional stress. But how does stress in the job affect blood pressure? This has been the subject of numerous research studies over the years but the results are conflicting. In this post, I am reviewing 3 studies on 3 different types of workers in Japan.

 Managers

In Japan, the number of managerial employees suffering from cardiovascular disease is said to be higher than any other type of employee. A study of Japanese employed managers and retired managers showed that these people in the management suffer from masked hypertension. The disadvantage of masked hypertension as compared to sustained hypertension is that it often goes undiagnosed so that the people affected are not taking preventive measures or early treatment.

The author concludes that

“job stress seemed to be one of the main causes of masked hypertension…that more frequent measurements of  [blood pressure] at the work place are necessary to identify subjects with masked hypertension.”

Factory workers

This study looked at 352 male factory workers in Japan to evaluate the relationship between “job strain and subclinical indicators of arteriosclerosis.” Subclinical indicators are early indicators before the actual symptoms are actually observed in the clinical setting. The researchers measured these in cerebral artery, the aorta, and the carotid artery. The results show that job strain was associated with the indicators but the association was not significant.

Shift workers

This study which looked at Japanese male employees suggests that shift work may elevate both systolic and diastolic blood pressure – in other words increased risk for hypertension.

That’s what industrialization is all about – 24-hour, non-stop operations in factories and manufacturing plants. To keep companies running, employees have to work in shifts day and night. It is estimated that about a quarter of Japanese companies operate on shifts.

The researchers studied 3963 day workers and 2748 alternating shift workers working in a Japanese steel company. All the workers were male and had annual health check ups between 1991 and 2005.

Looking at the relative increases in blood pressure, the researchers reported that alternating shift workers have significantly higher systolic and diastolic blood pressure than their colleagues working during normal day hours.

The authors conclude that

“[the] study in male Japanese workers revealed that alternating shift work was a significant independent risk factor for an increase in blood pressure. Moreover, the effect of shift work on blood pressure was more pronounced than other well-established factors, such as age and body mass index.”

Photo credit: Workers by createsima at stock.xchng

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An Anticancer Diet

Battling Cancer is fortunate to have another excellent guest post by David Servan-Schreiber, MD, PhD,
author of Anticancer: A New Way of Life.

I am happy to forward any of your comments or questions to him.

Diet is one of the major risk factors for cancer in Western societies. But it’s not just about what we eat too much of. It’s also about the foods we should learn to add to our table every day.

In his $40M laboratory at the University of Montreal, Dr. Richard Beliveau used to test new drugs that may help treat cancer. One day, tugged by children with leukemia who stopped him in the corridor of the hospital to ask if he had something new for them to use, he started experimenting with simple food extracts. Beliveau discovered that many simple food extracts had anticancer properties as powerful as many of the drugs he had been testing for the past 30 years.

Lenny, one of his friends, learned that he had pancreatic cancer. His wife begged Beliveau to help her design an anticancer diet. She fed Lenny, every day, three times a day, with foods that all had been tested for their anticancer properties. Lenny lived five years beyond his prognosis.

Today, the MD Anderson Cancer Center, the largest cancer research institution in the world, is also exploring this avenue. Long used in Ayurvedic medicine in India, the common spice turmeric (one of the main spices in curry) has been found to contain the most potent natural anti-inflammatory ever described — the molecule “curcumin”. Researchers at MD Anderson have shown that it inhibits cancer growth by not only reducing inflammation (necessary for invasion of neighboring tissues) but by inducing cancer cell death (“apoptosis”), slowing down the growth of new blood vessels necessary for tumor expansion (“angiogenesis”), and increasing the efficacy of chemotherapy. This research was recently reviewed in the Journal of the National Cancer Institute (2008).

Researchers at the Karolinska Institute (which awards the Nobel Prize) in Sweden have also shown that the polyphenols of green tea inhibit the progression of cancer. It can increase, too, the efficacy of radiotherapy. Women in Japan who drink more than three cups of green tea per day reduce their risk of breast cancer relapse. Men reduce their chance of seeing prostate cancer advance to a dangerous stage.

Eating at least five fruits and vegetables per day contributes greatly to the reduction of cancer risk.

The World Cancer Research Fund confirmed in its October 2007 report that 40% of cancers could be avoided with a more adequate diet and a bit more physical activity. And that these same life-style choices should be an integral part of any treatment of cancer. It stated as a goal no more than 12 ounces of red meat per week. The current American diet is close to 11 ounces per day.

The single most important feature in an anticancer diet is to reverse the proportions of a typical American meal: make the core of your plate vegetables (and fruits), and use meat only to enhance flavor. Legumes (peas, beans, lentils, etc.) and soy (tofu, tempeh, miso, edamame etc.) offer the same proteins as meat but combined with cancer fighting phytochemicals.

It’s also important to replace desserts (refined sugar) with fruits as often as possible. Berries, for example, contain anthocyanidins that directly help kill cancer cells and reduce the growth of abnormal blood vessels. Tangerines and their special flavonoids also act against cancer cells. All brightly colored fruits contain flavonoids that contribute to slowing down cancer growth. Agave syrup (which does not raise blood sugar or insulin) is a wonderful way to replace sugar for those who can’t do without the sweet taste.

All omega-6 oils (soybean, corn, sunflower) should be reduced or eliminated and replaced with olive oil, canola oil, or flaxseed oil. Omega-3 butter or margarine is also acceptable.

Animal products (meat, dairy, eggs) should be grass-fed or labeled “omega-3 rich”, and preferably organic so as to avoid growth hormone (that can stimulate cancer cell growth too).

Organic vegetables and fruits are preferable to non-organic, but, as Dr. Beliveau likes to point out, “it’s better to eat broccoli with a few residues of pesticides on it than to not eat broccoli.”

And benefits from an anticancer diet are immediate. Within months, we can see our blood sugar go down, our waist thinning, our blood pressure improve, and we feel more energetic and less afflicted by little pains of life we had started to take for granted such as heart burn and joint pains . . . It’s not just about cancer. It’s about nourishing life in us.

©2008 David Servan-Schreiber, MD, PhD

Author Bio

David Servan-Schreiber, MD, PhD, is a clinical professor of psychiatry at the University of Pittsburgh School of Medicine and cofounder of the Center for Integrative Medicine. He lives in Pittsburgh, Pennsylvania, and Paris, France. He has been a cancer survivor for 16 years, and is the author of the International Best-Seller Anticancer: A New Way of Life, released from Viking, September 2008.

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Recipe For Life – The Absolutely Amazing Apple

Apples have long been touted as a wonder food. Remember the old saying, “An apple a day keeps the doctor away?” That may not be far from the truth. I hope as you battle the monster, Alzheimer’s disease, you will take time to enjoy these recipes and get the wonderful health benefits from the amazing apple:

According to Pat Crocker, author of The Smoothies Bible, “Fresh apples help cleanse the system, lower blood cholesterol and aid in digestion.” (p.124) In addition, apples are a great source of vitamin A and contain some vitamin B and C and Riboflavin as well as pectin and boron, two very important phytochemicals.

Furthermore, In one study, women who consumed at least one apple serving per day had a reduced lung cancer risk while a study from Hawaii showed apple intake was associated with a reduced risk of lung cancer in both males and females.

In fact, in the Hawaiian study, apples (along with onions and white grapefruit) reduced lung cancer risk by 40-50% in both men and women while no protective associations were seen for red wine, green or black tea. Source, www.haveanaussieapple.com.au

So, now, let’s get to some recipes for life that are guaranteed sure to be simple, inexpensive and absolutely delicious.

Apple Pie in a Glass (adapted from The Smoothies Bible, Pat Crocker)

This smoothie has all the flavors of apple pie, but you drink it!

• ¼ cup apple cider
• ¼ cup silken tofu (try it, you’ll LOVE it!)
• ¼ lemon peeled and seeded
• 2 apples peeled and cored
• ¼ tsp. ground cinnamon
• 1/8 tsp. ground nutmeg
• pinch ground ginger (optional)
• ½ cup applesauce

Combine all ingredients in blender and process till smooth.
Makes 2 servings

Apple Salad With Honey Mustard Dressing

• 4 stalks celery (leaves included), sliced thinly
• ½ cup walnuts (I use about ¾ cup)
• 4 large apples (combo of granny smith and fuji is nice)

Salad Dressing

• 3 Tablespoons fresh lemon juice
• 2 tablespoons mustard powder
• 1 clove of garlic (chopped finely)
• ½ teaspoon sea salt
• 1 Tablespoon Olive Oil
• 2 Tablespoons honey

Instructions:

• Chop celery and place into bowl of cold water, refrigerate
• Prepare salad dressing: In small bowl, whisk together all ingredients
• Chop apples into bite sized pieces and place into medium sized bowl
• Chop walnuts into bite sized pieces and combine with apples
• Drain celery on paper towel and mix with celery and apples
• Pour salad dressing over apple, celery, walnut mixture and enjoy!

Both of these recipes use FRESH, RAW apples. So, the vitamins and nutrients are still in tact. I hope you’ll try these recipes and when you do, please let me know.

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The lifestyle of the young is not good for the heart

The trend is disturbing. More and more children and young people are having cardiovascular problems. And the causes can be traced to unhealthy lifestyles.

Lack of proper nutrition

Project EAT, a study conducted by the University of Minnesota looked at 2,500 teenage girls over a 5-year period. Their findings show that 62.7% of female teens engage in unhealthy weight control strategies which include taking diet pills, laxatives, drugs that induce vomiting, as well as regularly skipping meals. The use of diet pills is especially popular. Ironically, these weight control behaviour can actually produce the opposite results. Girls who engage in such strategies are 3 times more likely to be overweight. This creates a vicious cycle of dieting, weight gain and eating disorders.

Lack of exercise

How many hours do your children in front of a screen – be it a TV screen, a computer screen or any other game console? Canadian researcher Dr. Ian Michael Janssen tells Reuters that adolescents nowadays “spend more hours daily in front of a screen than they do in a classroom in a given year.” This translates to lack of physical activity that leads to rising rates of obesity among adolescents. It is estimated that about 50% of Canadian children aged 5 to 17 years old do not get enough exercise. 26% of these children are overweight or obese. Excess weight and obesity are risk factors for heart disease and type 2 diabetes.

Lack of sleep

In this study funded by the National Institutes of Health (NIH), researchers found a link between poor sleep quality and shorter sleep duration in teens and elevated blood pressure. Poor sleep quality or low sleep efficiency is defined as having “trouble falling to sleep at night or who wake up too early.”

The study looked at 238 adolescents (123 boys and 115 girls) ages 13 to 16 years old. Data on sleep habits and blood pressure were collected. Adolescents with less than 85% sleep efficiency had nearly three times the likelihood of having elevated high blood pressure.

Researchers say the culprit is technology present in bedrooms, be it in the form of phones, music, computers and other multimedia gadgets.

Childhood hypertension shouldn’t be underestimated, ignored or taken for granted. The likelihood of it developing to a full blown adult hypertension and then a serious cardiovascular disease is very high.

The study authors recommend:

“Adolescents need nine hours of sleep. Parents should optimize sleep quality for their family with regular sleep and wake times and bedrooms should be kept quiet, dark and conducive to sleep.”

 

Photo credit: nookiez at stock.xchng

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Legal Resources For The Caregiver

A while back I did a post that asked the question, “Do You Need an Elder Law Attorney?”

Today, I want to give you some resources to help you navigate caregiving from a legal perspective. For me, the legal issues were a necessary evil. I needed to be able to make decisions for my mom, so I got Durable Power of Attorney. I took care of mom’s financial matters, so that the very little she did have would not prevent her from getting “tuition assistance” for adult day care.

I got copies of her medical records because I moved her to another state and wanted to have everything at my fingertips.

Fortunately or unfortunately, she didn’t have lots of assets, so we didn’t have to contend with that, still, as I look back, I probably could have benefited from having a professional to help me to navigate some of the situations I faced.

Most of these are web-based resources, but each state has resources for the elderly as well. Senior centers, some churches and some states have a 211 human services information line.
All you need to do is pick up your phone and dial 211. You will be connected to an operator who will help direct you to the right place.

Elderlawanswers.com

This is a great site. You can be part of a blog, read and submit questions for the question and answer section, get information about elderlaw for a variety of different states and they will also help you to find an elderlaw attorney.

Elderissues.com

This site offers memberships at various levels to help you get your caregiving organized. The silver level is free and provides: emergency online information, emergency card, refrigerator envelope, access to resource links, monthly caregiver tips, and access to Lifeledger™ library. The platinum level offers more bells and whistles, and is available for $4.95 per month.

Department of Social Services (Your State)

This is where you will find all the information that is specific to your state. You will be able to determine, what if any, financial services your loved one qualifies for. The department of social services will be able to provide a list of senior centers and adult day care facilities in your area.

United Way

United Way services vary by state, but it is definitely worth giving them a call. From free or reduced price legal services to trips to the mall, United Way provides a myriad of services. Your local United Way may even have some services to help lighten your load as a caregiver.

Caregiving is challenging enough without trying to play attorney too. Even if you feel like your situation is not that complicated or feel as if you can’t afford an attorney, at least consider using some of the resources above to help you through these trying times as you battle the monster, Alzheimer’s disease.

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Know your medications: anti-cholesterol drugs

It’s Cholesterol Awareness Month.

So I think it’s only right that I tackle the topic of drugs used in controlling our cholesterol levels. For a review of the basics of cholesterol and what out cholesterol numbers mean, check out this resource post. In the same post, I have tackled lifestyle changes strategies that can help lower and control cholesterol levels. In today’s post, let us take a look at the pharmacological therapies for high cholesterol levels.

The main types of cholesterol-lowering drugs are summarized below.

Statins 

Statins also known as HMG CoA reductase inhibitors, are the most popular of currently available anti-cholesterol drugs. They act on the enzyme that regulates the rate at which our body produces cholesterol. They are known to be most effective in lowering LDL levels (20 to 55%) and triglycerides to a lesser extent.

Statins currently available in the U.S.include:

• Atorvastatin (Lipitor®)
• Fluvastatin (Lescol®)
• Lovastatin (Mevacor®, Altoprev^TM)
• Pravastatin (Pravachol®)
• Rosuvastatin Calcium (Crestor®)
• Simvastatin (Zocor®)

Statins are also available in combination with other classes of drugs, namely Advicor® (lovastatin + niacin), Caduet® (atorvastatin + amlodipine), and Vytorin^TM (simvastatin + ezetimibe).

Ezetimibe

Selective cholesterol absorption inhibitors reduce the amount of cholesterol absorbed in the intestine. Ezetimibe (Zetia®) is the first inhibitor to be approved. It has been shown to lower LDL levels by about 18 to 25%., moderately lowers triglycerides, and increases HDL levels.

Resins

Resins (also known as sequestrant or bile acid-binding drugs) bind with cholesterol-containing bile acids in the intestines and facilitate their elimination in the stool. These class of drugs can lower LDL levels by about 15 to 30%.

Resins currently available in the U.S. include:

• Cholestyramine (Questran®, Questran® Light, Prevalite®, Locholest®,  Locholest® Light)
• Colestipol (Colestid®)
• Colesevelam HCl (WelChol®)

Niacin

Nicotinic acid also known as niacin is actually a water-soluble B vitamin that can lower LDL levels (5 to 15%) and triglycerides and increase HDL levels. However, its positive effect on out lipid profiles is only achieved in doses higher than when taken as just vitamin supplement. For cholesterol control, niacin should only be taken upon doctor’s orders.

Fibrates

Fibrates or fibric acid derivatives are mostly effective in lowering triglycerides and moderately increase HDL levels. However, they don’t effectively lower LDL levels.

Fibrates currently available in the U.S.include:

• Gemfibrozil (Lopid®)
• Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide^TM)
• Clofibrate (Atromid-S)

[Sources: The National Heart, Lung, and Blood Institute (NHLBI); American Heart Association (AHA)]

As with almost all medications, these drugs should only be taken after discussion with your doctor. Currently, there are no avalaible OTC drugs to control cholesterol levels. There may be drugs sold over the Internet but these offers should be approached with extreme caution (see previous post on this). However, aside from taking medications, lifestyle changes are also necessary in the fight against cholesterol and heart disease.

Coming soon: alternative products and supplements against cholesterol.

Photo credit: drugs by sarej at stock.xchng

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Diabetophobia

Diabetophobia or fear of diabetes.

What exactly is a phobia?

From dictionary.com:

“a persistent, irrational fear of a specific object, activity, or situation that leads to a compelling desire to avoid it.”

Perhaps something occurred in your life that stuck in your subconscious mind that triggers a fear of diabetes.

So what is fear?

Again, from dictionary.com:

“a distressing emotion aroused by impending danger, evil, pain, etc., whether the threat is real or imagined; the feeling or condition of being afraid.”

There are many facets to the diabetophobia. It can include fear of becoming a diabetic. Fear of hypoglycemia. Fear of needles. Fear of diabetic complications.

It often includes denial.

Denial is my personal favorite. And hey, if you are reading this…I am probably preaching to the choir.

You probably have the numbers memorized, right?

But for everyone else here they are again from the CDC press release dated June 24, 2008.

Diabetes now affects nearly 24 million people in the United States, an increase of more than 3 million in approximately two years, according to new 2007 prevalence data estimates released today by the Centers for Disease Control and Prevention (CDC). This means that nearly 8 percent of the U.S. population has diabetes.

In addition to the 24 million with diabetes, another 57 million people are estimated to have pre-diabetes, a condition that puts people at increased risk for diabetes. Among people with diabetes, those who do not know they have the disease decreased from 30 percent to 25 percent over a two-year period.

How do you deal with diabetophobia?

The best way to diffuse fear is with knowledge.

Knowledge brings not only the tools to deal with fear but also a calm acceptance that you will be able to handle your future.

A few months ago I shared a simple risk test to assess your risk for diabetes from the American Diabetes Association. Turns out ADA offers an even more in-depth risk assessment called Diabetes PHD.

“Diabetes PHD (Personal Health Decisions) is a powerful new risk assessment tool. It can be used to explore the effects of a wide variety of health care interventions, including losing weight, stopping smoking, and taking certain medications.”

Another personal favorite assessment tool that I love and hate is RealAge.

“Your RealAge is the biological age of your body, based on how well you’ve maintained it.”

If you suffer from diabetophobia you’re probably already having some anxiety.

Relax. You aren’t alone.

I took the simple diabetes risk test and faced the scary realization that I need to make some changes. I haven’t had the courage to take the PHD yet.. I will, I promise. I will.

And RealAge. Haven’t done that in a few years. A little nervous here.

See what I mean about denial? I told you, you weren’t alone.

Elizabeth Kubler-Ross’s five stages of grief from her 1969 book, On Death and Dying, explains the stages which apply to any life changing event. The stages are not simply about death, but reflect the loss of life as you know it. A diagnosis of diabetes or pre diabetes is a life changing event.

1. Denial–refusal, either conscious or unconscious to accept the facts

2. Anger–at self or others

3. Bargaining–compromising with others or a faith system

4. Depression–a period of sadness, fear and regret

5. Acceptance–dealing with the facts

The important thing is not how you move through the stages, but that you continue forward momentum. That momentum is individual, bringing you to a place of coping and to a place of re-evaluation.

Right now I’m transitioning through a few of these stages as I realize I am a pre diabetic (family history, borderline gestational diabetes, weight struggles). I realize knowledge gives me the tools to do something about this and I am trying, albeit struggling, to make the necessary changes in my life.

What about you?

Where are you? What facets of diabetophobia are you dealing with?

Where are you in the grieving process?

More importantly how will you obtain the knowledge needed to overcome diabetophobia?

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Cancer Apparel and other thoughts…

So what’s your take on cancer apparel?

I’ve got mixed opinions on the topic.

This blog is, after all, called Battling Cancer, so obviously I concur with the philosophy that often dealing with any kind of cancer is a battle. Besides the mental and medical armor there are the breastplate and helmet of the physical.

I’m happy to wear that armor for those I love and support. One year a group of friends all had red shirts made up for the MS walk as one of our writing pals has been diagnosed with MS. We had witty clever, writerly things put on the shirts. It was great fun while dealing with a very serious topic.

There are more cool, chic, trendy cancer apparel items available than I can possibly share with you today. But I will share some of my favorites.

Cancer apparel has multiple purposes:

• support for a cause that has touched you
• raising funds for research and other related issues
• awareness

But if I (me personally) were actually battling cancer, would I display my battle on my chest, on my hat, or would I be private in my battle? As private as one can be dealing with the treatment and side effects issues.

I don’t know the answer to that. Obviously this is a personal choice.

This topic was discussed in one of my early posts called The Defining Moment.

Here is an excerpt:

I have observed a unique phenomenon over the years–patients diagnosed with cancer who make a very personal decision to hide the diagnosis from anyone outside a very select circle of perhaps only one or two people. They generally only reveal the information if it becomes necessary.

I was on the support team of a mail carrier who came to our facility for in-patient treatment. He took large chunks of accumulated vacation time for each cycle of his chemo and recovery. This continued for several rounds of chemo, and in the course of my interaction with him he shared that no one at his place of employment knew of his cancer diagnosis. He had not only accepted his diagnosis but he was determined his diagnosis would not define him.

I’ve thought about this often.

Does diagnosis define you? Are you your diagnosis?

Does the world treat you different once they know you have cancer? Do those you once interacted with change as they become unable to cope with your reality? Is it fear of loss or confrontation with their own mortality? Perhaps it is both.

Once the point of acceptance is reached it is your choice how you will deal with the diagnosis. As a caregiver, friend, loved one or family member, I believe it is merely our responsibility to respect that decision.

A final thought. Do you treat you differently? Have your priorities shifted outside of the diagnosis? Once you reached that moment of acceptance how did you begin to see the world around you? Defining moments tend to be the sifters and sorters of life. People and events trickle through the sieve and everything is re-evaluated.

If you have a chance, let me know what you think. In the meantime, here’s a selection of items to show your support, or to select as your trendy battle gear.

IT’S YOUR CHOICE!

Read more

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Genetics in heart disease treatment and diagnosis

We are in the age of genomics. It is now possible to have our genome checked for predisposition to genetically-linked diseases such as cancer, Alzheimer’s, and yes – cardiovascular disease.

According to a review paper in 2005:

“Genetic studies provide new insights into the pathogenesis of coronary artery disease and myocardial infarction. Future studies will focus on identification of new disease-causing genes and susceptibility genes, exploration of the molecular mechanisms by which mutations cause coronary artery disease/myocardiaI infarction, and gene-specific therapies for patients.”

It’s been three years. Are we ready yet for genetic-based treatment of heart disease? Let’s take a look at what the latest research on genetics say.

First gene therapy on trial

The first clinical trial of gene therapy for the treatment of heart failure was launched earlier this year.

Gene therapy is a technique for correcting defective genes responsible for disease development by inserting genes into a patient’s cells and tissues. In most gene therapy studies, a “normal” gene is inserted into the genome to replace an “abnormal” disease-causing gene.

In this therapy developed by researchers at the New York-Presbyterian Hospital and Columbia University Medical Center, the gene SERCA2a is injected into the patient with the hope that gene facilitates the replenishment of enzymes necessary for efficient heart pumping. In patients with heart failure, SERCA2a is depressed, leading to insufficient pumping of the heart and eventually heart failure.

Genetic fingerprinting for cardiomyopathy

Dilated cardiomyopathy is a condition where the heart is abnormally large so that the heart cavity is enlarged and stretched. This weakens the heart, making pumping inefficient and can eventually lead to heart failure. 36% of all cases of dilated cardiomyopathy is due to excessive alcohol consumption. However, distinction between alcohol-induced and non-alcohol induced cardiomyopathy is not an easy task. Because denial is one of the most common symptoms of alcoholism, self-reported evaluations are not reliable sources of data for prevention, diagnosis and control.

Researchers at the Boston University School of Medicine may just have found the answer. They report that they identified the “genomic ‘fingerprint’ for alcohol-induced heart failure.”

According to the authors,

“now that we have this diagnostic marker or fingerprint, clinicians will be better able to monitor the progress of a patient who is being treated either medically or simply self reporting a cessation of drinking.”

Genetic markers for heart disease

In recent years, the search for genetic markers for human diseases has been stepped especially in the fields of oncology, neurodegenerative disorders, and cardiovascular medicine. Recent studies report about promising candidate genes that are strongly linked to the development of coronary heart disease and heart attack. However, these techniques are mainly experimental and still not part of standard clinical practices to diagnose and treat cardiovascular disorders.

How much more time do we need till we get there? It’s hard to say. It seems that medical science is making progress but progress is not that fast. Let’s touch base again in a couple of years.

Photo credit: DNA by clix at stock.xchng

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Worth Repeating: No Such Thing as a Safe Tan

Last week headlines across the globe shared the same note on the notion of safe tanning. All headlines seemed to agree.

There is no guarantee that indoor tanning is safe.

From WebMD, September 18, 2008. Healthy Tanning Beds? Experts Say No

While tanning bed are less likely to cause burns there is no doubt that UV radiation still leads to melanoma and the side effects of premature aging (wrinkles and drying of the skin), eye damage and immune suppression.

The FDA states the following:

• There is no such thing as a safe tan. The increase in skin pigment, called melanin, which causes the tan color change in your skin is a sign of damage.

• Once skin is exposed to UV radiation, it increases the production of melanin in an attempt to protect the skin from further damage.

• Getting a tan will not protect your skin from sunburn or other skin damage. The extra melanin in tanned skin provides a Sun Protection Factor (SPF) of about 2 to 4; far below the minimum recommended SPF of 15.

So consider these facts:

The American Cancer Society says that people 35 or younger who used tanning beds regularly had a melanoma risk eight-fold higher than people who never used tanning beds. Even occasional use among that age group almost tripled the chances of developing melanoma.

What is melanoma?

Melanoma is a type of cancer that forms in the melanocyte cells, which are the cells that form the melanin or pigment of the skin. Melanoma is less common than other skin cancers, but is the most serious type of skin cancer. Like other skin cancers, it is often curable in the early stages. It can occur anywhere on the skin, but most likely occurs in the trunk of men and the legs of women. The face and neck are also common sites. Melanoma can spread to other parts of the body.

Prevention can be as simple as understanding the UV light index for your area, limiting UV exposure (including tanning beds), wearing sunglasses, protective clothing and sunscreen and. Mole inspection and removal is another important facet of the prevention of melanoma.

The National Cancer Institute estimates that in the U.S. in 2008 there will be 62,480 new cases of melanoma and 8,420 melanoma deaths.

Is it worth the risk?

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Tea for Two

Let’s talk tea.

I’m basically a java girl but I keep plenty of tea around for those tea occasions. Ginger tea after meals to aide digestion, green tea in the evening, and of course chamomile (honey vanilla chamomile) before bed.

Let’s dissect my favorite teas.

Ginger tea:

Used for centuries to aide digestion, ginger also helps with gas and bloating. Ginger tea is also considered an aide for motion sickness. Talk to your doctor if you are taking warfarin (coumadin) which may be affected by ginger consumption.

A lovely Lemon Ginger Tea recipe from The Daily Green

SERVINGS
4-6

INGREDIENTS
6 cups water
4 teaspoons sugar
1 inch fresh gingeroot, thinly sliced
8 pieces lemon peel, strips
6 green tea bags

PREPARATION
Read more

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More on Guardians and Conservators

Yesterday, I talked about how courts/judges make decisions regarding who might be awarded conservatorship/guardianship. Today, I want to look at the process and what it takes become a conservator or guardian.

Remember the terms conservatorship and guardianship are used interchangeably in some jurisdictions, and in others they have slightly differing meanings and functions. I use the terms interchangebly.

You realize that aunt Ruth cannot take care of herself or her affairs. What now? Here are the steps you should take:

1. Call a meeting of close family and friends; specifically, those that might be willing and able to care for Aunt Ruth
2. Determine what Aunt Ruth’s needs are.
• Does she have other medical conditions in addition to Alzheimer’s disease? What are her living arrangements? What is the status of her estate? Does she own a home? Does she have other properties? Does she have assets? Is the plan for her to stay at home or move into a long-term care facility?
• Determine who is best able (and willing) to expend the time and energy to care for Aunt Ruth. Because the courts are involved, the conservator is responsible to periodically report to the court and keep fairly detailed records regarding expenses incurred and care provided.

3. Be aware of the scope of responsibility of the conservator/guardian

Below is a statement by the Department of Human Services regarding the duties of a guardian/conservator

What are the duties of a guardian/conservator?

A guardian/conservator must maintain contact with the protected person to become familiar with the protected person’s needs and limitations, and only exercise their decision- making authority to the extent required by those limitations. The guardian/conservator must respect the fact that their relationship with the protected person is a confidential one, and should encourage the person’s participation in decision-making to the extent possible. Obviously, the guardian/conservator must always act in the best interest of the protected person, and never become involved in a situation that might give the appearance of a conflict of interest. Finally, the court does require that the guardian/conservator provide some information to the court, including information pertaining to the protected person’s finances and personal inventory, and an annual personal status report.

The other very real issue to consider is that, because conservatorships require court intervention, they can be costly and quite time consuming.

Finally, families should consider conservatorships as a last resort. Durable Power of Attorney is an easier, less expensive, less time consuming and more “friendly” process. It also enables the person in question to have some say in who will handle their financial and medical affairs.

Are you a conservator or guardian? Share your experience.

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Know your condition: heart murmurs

Last year, one of my sons was diagnosed with a heart murmur, and as expected, this declaration from the doctor triggered an alarm in the mother inside me. Inspite of the doctor’s reassurances that most heart murmurs are harmless, that kids simply outgrow them with time, that no additional tests are necessary, I needed to a thorough research for my peace of mind. And some of the fruit of my research I share here with you.

What is a heart murmur?

A heart murmur is an unusual sound during a heart beat. They are heard by a doctor through his stethoscope during auscultation. Murmurs are described as “whooshing or swishing” noises which may be soft or loud.

Is a heart murmur a symptom of heart disease?

A heart murmur is not necessarily a sign of heart disease. According to the National Heart Lung and Blood Institute, there are two types of heart murmurs: innocent or harmless murmurs and abnormal murmurs.

Innocent heart murmurs

According to the American Heart Association

Innocent heart murmurs are sounds made by the blood circulating through the heart’s chambers and valves or through blood vessels near the heart. They’re sometimes called other names such as “functional” or “physiologic” murmurs.

They may occur when blood flow in and out of the heart is faster than usual. A person who has a harmless heart murmur exhibits no other symptoms of heart disease and is perfectly healthy. This type of murmurs is quite common among healthy children. They come and they go. Like our doctor said, it is most likely that my son will outgrow his murmur as he grows older.

Children with innocent heart murmurs do not any medication. They are not suffering from any form of heart disease. They shouldn’t be treated as cardiac patients and their activities and diet shouldn’t be restricted. They are perfectly healthy and normal. However, it is always prudent to keep to a healthy, nutritious diet.

Abnormal heart murmurs

Heart murmurs are deemed abnormal and may be symptomatic of a heart problem when the patient exhibits other cardiac symptoms. Abnormal heart murmurs may be due to several things.

• Defective heart valves. They are the most common reason behind heart murmurs. A heart valve, for example, cannot open completely because it has a smaller than normal opening. A valve may also be unable to completely closed, causing a backflow of the blood. Defective valves in children are usually due to heart defects at birth or congenital heart defects.
• Surgery. Sometimes, murmurs appear after heart surgery such as valve replacement or heart bypass. These murmurs may or may not be cause for concerns until further tests are peformed.
• Diseases such as thyrotoxicosis (overactive thyroid gland) or anemia.
• Infections
• Aging

My research confirmed what our doctor told me. Not that I didn’t trust him. It’s just I wanted to see for myself. I still have to keep an eye on my little man though. He’s healthy and active and going strong. But you know what they say – the mommy in us never sleeps.

Photo credit: heart by lusi at stock.xchng

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Update on World Diabetes Day

World Diabetes Day is almost here.

This November 14, 2008 event, celebrated world wide to encourage awareness of diabetes, includes the 200 member organizations of the International Diabetes Federation and 160 countries, all members of the United Nations.

The date, November 14, was chosen to mark the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1922.

The closer we get to the November date the more exciting the domino of events across the globe.

First check out these ten landmark buildings are on board the challenge to light up the world in blue:

• Banting House National Historic Site, London, Ontario, Canada
• Round About, Tortola, British Virgin Islands
• Swan Bell Tower, Perth, Australia
• Kings Park Gum Trees, Perth, Australia
• Jet d’eau, Geneva, Switzerland
• Shree Swaminarayan Temple, Cardiff, UK
• Soldiers’ and Sailors’ Monument, Indianapolis, USA
• Indira Gandhi Statue, Gorakhpur, India
• City Hall, Nicosia, Cyprus
• City Hall, Brussels, Belgium

See the entire map of currently listed monuments, ready to be lit up in blue as the challenge moves towards its 500 building mark.

World Diabetes Day and YOU!

Register yourself and your diabetes event on the WDD site so that global activities can be counted.

The WWD site suggests these activities:

There are many ways to join in:

• Get a local monument to participate in the World Diabetes Day monument challenge.
• Organize an event with local politicians to mark World Diabetes Day and draw attention to the theme.
• Organize or participate in a community activity such as a walk, cycle ride, a human circle event, or a school-based activity.
• Participate as an individual and lend your support to the global campaign.
• Why not illuminate your home in blue or light a blue candle for World Diabetes Day?
• Fly a circle. Get a blue diabetes circle (which is like a frisbee) and fly it.

More on the Diabetes Flying Circle:

Flying circles are available in packs of two from the online store. Register it online!

More on Lighting a Candle or Lighting a Virtual Candle!

Give your visitors the opportunity to join the global diabetes awareness campaign and light a virtual candle.

If you own a website, you can place a virtual candle or a World Diabetes Day banner on your site.

Want to go one step further? Bring diabetes to light on 14 November by purchasing and lighting a World Diabetes Day candle in your home, workplace, or other setting of your choice.

Get your candle today and show your support for diabetes awareness!

You can check out the other World Diabetes Day merchandise, like posters, pins, flags, refrigerator magnets and more.

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Prostate Cancer Awareness Month

National Prostate Cancer Awareness month is a chance to bring awareness of a disease that is the most common cancer in men after lung cancer, affecting one in six men in the U.S.

Did you know?

• The prostate cancer patient is rarely under the age of 40, usually over 50 and in fact two-thirds of all cases are diagnosed in men over 65.
• 60 to 61% of the time it is diagnosed in an African American male.
• A male is twice as likely to be diagnosed with prostate cancer if he has/had a father or brother with the disease.
• There is also an inherited gene for prostate cancer, affecting 5 to 10 % of all diagnosed cases.
• While research into genetic testing is promising, it is not yet available.

August 5, The U.S. Preventative Services Task Force (USPSTF) released its recommendations regarding prostate cancer screening.

Summary of Recommendations:

• USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years.

• The USPSTF recommends against screening for prostate cancer in men age 75 years or older.

What is the USPSTF?

“The U.S. Preventive Services Task Force (USPSTF) , first convened by the U.S. Public Health Service in 1984, and since 1998 sponsored by the Agency for Healthcare Research and Quality (AHRQ), is the leading independent panel of private-sector experts in prevention and primary care. The USPSTF conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the “gold standard” for clinical preventive services.”

Current American Cancer Society Guidelines recommendations for screening:

Both the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy.

Screening will begin with:

• Digital Rectal Exam-part of a regular yearly physical to exam the gland for changes.
• PSA-Prostate Specific Antigen blood test-higher than normal levels may indicate a problem.

And may proceed to the following if your DRE and PSA indicate the need.

• Ultrasound-A small probe inserted into the rectum will take pictures of the gland using sound waves.

All About Choices:

Is prostate cancer screening right for you?

The decision is yours.

To help men aged 50 years or older understand both sides of the issue. The CDC has several helpful booklets to assist in the prostate cancer decision process.

• Prostate Cancer Screening: A Decision Guide presents a balanced approach to the pros and cons of prostate cancer screening and enables men, their families, and physicians to make a decision that is right for them.
• Prostate Cancer Screening: A Decision Guide for African Americans targets African-American men. At all ages, African-American men die of prostate cancer more often than other men do. The reasons for the variation among groups are unknown, making it critical that African-American men know the facts about prostate cancer and the available screening tests.

Read more

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Guardianship and Conservatorship Who Has First Rights?

It’s obvious to you, other family members and even friends that something is awry with your loved one. It’s serious enough that you and others have begun to think about taking over the financial and medical affairs of the one who is showing serious signs of dementia and is clearly unable to independently handle day to day responsibilities.

To make matters worse, your loved one does not have a living will. Nor does anyone in the family have Durable Power of Attorney, which gives the legal right to handle financial and medical issues on your loved one’s behalf.
This is where the legal terms Guardianship and Conservatorship come in. Let me give you definitions before we go any further.

Guardianship— A Court-ordered relationship between a person (called a Guardian) who has been appointed to care for the financial (Guardian of the Estate) and/or personal (Guardian of the Person) matters of another (called a Ward). (www.legalhelpmate.com)

www.Elderangels.com provides insight on conservatorships:

Conservatorship—There are two types of conservators. Conservator of the Person and Conservator of the estate.

Conservatorship of the Person:
The conservator arranges for the client’s care and protection, determines where he or she will live and makes appropriate arrangements for health care, housekeeping, transportation, and personal needs.

Conservatorship of the Estate:
The conservator manages the client’s finances, locates and takes control of the assets, collects income due, pays bills, invests the client’s money, and protects the assets.
Conservatorships are also court-ordered relationships. In many circles the terms are used interchangeably.

Here’s a question from a reader:

“I would like to know who would be considered first to be given Guardianship or Conservatorship of a person with Alzhiemer’s? Would it be a family member or a girl/boyfriend?”

Great question. The simple answer is that it varies by state. Most states have laws that actually provide a pecking order, if you will, as to who gets first shot at becoming legally responsible.

According to www.seniorhousingnet.com here’s how Judges select conservators.

When a conservatorship petition is filed in court, a judge must decide whom to appoint. Often, just one person is interested in taking on the role of conservator — but sometimes several family members or friends vie for the task. If no one is suitable is available to serve as conservator, the judge may appoint a public or other professional conservator.

“When appointing a conservator, a judge follows certain preferences established by state law: Most states give preference to the conservatee’s spouse, adult children, adult siblings or other blood relatives. But a judge has some flexibility; he may use his discretion to pick the person he thinks is best for the job. Without strong evidence of what the conservatee would have wanted, however, it is unlikely that a nonrelative would be appointed over a relative. Because of this, conservatorship proceedings may cause great heartache if an estranged relative is chosen as conservator over the conservatee’s partner or close friend.”

As you can imagine, it can get pretty ugly. That is why I continually and not so gently URGE you to act BEFORE it gets to this point. Have the difficult conversation and get the living will or Power of Attorney in place before you have to take drastic measures like filing for conservatorship or guardianship

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