Tuesday, January 24, 2017

Endowment for the Arts

Idea of the day: The National Endowment for the Arts needs a real endowment.
If 10,000,000 people each gave $100, the NEA would have a real endowment of $1 billion.
This seems do-able. PBS gets donations of this size on average. They have about 1 million donors, just for TV.
NEA supports art, literature and music. 
 This request would be under the duress of Trump not wanting to fund the arts. I think everyone who has anything to do with the arts, either as a book reader, theater goer, concert goer, teacher, or student would donate. Students would probably donate more on the order of $10. 
 Pitched well, I think the companies that donate to PBS would also donate to creating a self-sustaining endowment.

Indian Boyhood Multicultural Book

Indian Boyhood, the True Story of a Sioux Upbringing by Charles Eastman (Ohiyesa) Adapted by Michael Oren Fitzgerald, illustrated by Heidi M. Rasch

I'm happy to recommend a book I received as part of the Multicultural Book Reviews program. Indian Boyhood is a modernized and illustrated (based on footnoted historical art) version of Ohiyesa (Charles Eastman)'s autobiography. Ohiyesa lived as a Sioux for his first 15 years, and moved to Canada after his father received a pardon from Lincoln for his part in the Sioux Rebellion. He had a pet grizzly bear, an uncle who woke him at all hours to learn defense, and a family that made him recite folktales.  Eastman was originally named Pitiful Last because his mother died shortly after his birth.  After he won sporting event, he gained the new name Ohiyesa (Victor). This book gives insights into both the life of a Sioux and the insights of a man who was transplanted into white culture as a teenager. A Delightful book.

You can find more books by Ohiyesa / Charles Eastman at Gutenberg Press.

This book is available here: https://www.amazon.com/Indian-Boyhood-Story-Sioux-Upbringing-ebook/dp/B01N8OQZ6C

Tuesday, January 17, 2017

American Cancer Society supports FIT

If you had a choice of between a test that is life-threatening, time-consuming and requires horrible preparation, or a briefly gross encounter with scooping poop from your toilet, and you were assured by the American Chemical Society that both tests were equally valid, which would you choose? (If the poop test is positive, you can always get the colonoscopy later.)

This letter from the American Cancer Society is worth posting:
"Let me assure you, no organization is promoting stool testing for colon cancer more than ACS and the National Colorectal Cancer Roundtable. You may be aware that the fecal immunochemical tests, (FIT), are largely supplanting guaiac based FOBT - but the idea is of course, largely the same.
One of the centerpieces of our 80 by 18 campaign to achieve 80% colon cancer screening rates by the end of 2018 is to encourage use of FIT or other high sensitivity stool testing. We are clear in our messaging that colonoscopy is not the gold standard and that the best test is the one that gets done.
May I suggest that you visit our website at www.nccrt.org to get the latest messages and tools. I am also finding a time to come to Jeff to meet with leaders there. One of the topics will be how Jefferson can help achieve the 80% goal. Perhaps we can talk when I’m there. Thanks for reaching out.
Richard Wender | Chief Cancer Control Officer
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303
Phone: 1.404.329.4313
cancer.org | 1.800.227.2345"

Thursday, December 22, 2016

Colonoscopy's Proper Use

This is the letter I wrote my GP after my colonoscopy:

When your resident recommended I get a colonoscopy, I asked him for an article that compared colon cancer testing alternatives. He didn’t know of any. The colonoscopy was worse than even I had anticipated.  Since then, I have found the article I wish I’d read in the first place.


Had I seen this, I would have opted for FIT or FOBT and only agreed to a colonoscopy if the FIT or FOBT came back positive.

I will never go for another colonoscopy again, as a regular screening.

The nurse at gastroenterology did not know how to insert an IV.  She missed twice at my elbow, leaving behind two nasty blood clots. Then she took more than 2 minutes of digging and twisting and turning that needle while I screamed. (Nobody came to my rescue, so they must have a policy that says screaming is okay, which also means it is common.) Then she said she was done, gave me a few seconds of relief and went back to digging and twisting for another minute while I went back to screaming.  Again, nobody came to my rescue.

When she finally got it in, and started the IV, my arms started shaking uncontrollably. She walked away. After a while, I got the attention of somebody else who worked there. This person put a heated blanket on my legs. Why my legs?  I tried to pick the blanket up to put it on my arms, but my arms were shaking uncontrollably and I couldn't do it.

After a while I got the attention of another person who brought another heated blanket for my arms. That did help.

I have had surgery with IV insertion 5 times at this medical center. 3 times at Orthopaedic Care, and 2 times at breast cancer surgery.  I have never had trouble with IV insertion or with shaking after the IV started.

I wrote to the hospital president’s office asking that they make 3 changes:

1) a nurse gets 1 miss and then apologizes and finds a more experienced IV inserter to finish the job.

2) if there is screaming, somebody comes to the rescue immediately

3) gastroenterology should find out what IV solution is used at Orthopaedic Care and / or Breast Cancer Surgery and switch to one that does not cause shaking.

Instead, his flack-catcher wrote me that she would investigate and get back with me.

Several weeks later she wrote that she had concluded her investigation and closed the case.  She said she and my nurse "apologize if you experienced any discomfort. But, you should be informed that inserting an IV is uncomfortable."

The words IF and DISCOMFORT and UNCOMFORTABLE do not apply.  This was torture.
And the clear meaning of her words are that they will not be making these three crucial changes.

In addition the preparation solution caused damage.  It was painful on the way out.  The doctor who performed the colonoscopy took a photo of my swollen red anus if proof is necessary. And, even more damaging, it washed out my healthy intestinal flora.  I never used to get headaches.  After the colonoscopy. I started getting headaches. I tried yogurt and kim chi, to no avail.  I tried 3 different brands of probiotics.  Finally, the 3rd brand stopped the headaches. But I'm still gassy, so I've ordered a 4th brand.  In other words I'm still not back to normal, months later.

In summary, I do not recommend the gastroenterology department.
I do not recommend colonoscopy as a standard of routine care.  Most of the warts removed are hyperplastic, which never become malignant.
I suggest that the FIT or FOBT be used as the primary test and colonoscopy only be considered if that test comes back positive.

Monday, December 12, 2016

Monday, September 12, 2016

He said, She heard

This probably explains why I don’t get along well with doctors:

She went to the doctor’s office because of persistent back pain. She gave her birth date as part of the office check-in process.
He came in, looked at the computer screen, and said, “Are you 21 or 22?”
She heard: I have the wrong chart on the screen, and I haven’t bothered to look at you so I haven’t noticed yet.
She said: “I’m 68.”
She thought: When I was 21 or 22, I had 80 years ahead of me. I was just starting out.  This is end game. I have at most 30 years left and I want them to be as active as possible. I do not have the health problems of a 21 or 22 year old.
He said: “I just wanted to see you smile.”
She heard: “I can’t find anything real to compliment about you, so I’m making up something preposterous, just to say something. And I don’t care how stressful your back pain is for you, even though it must be awful or you wouldn’t be here.  I’m just trying to get you onto the surgery conveyor belt.”
He got her dexa scan up on the screen.  “It doesn’t look like you have any fractures.”
She heard: “I haven’t read the report that came with the dexa scan.”
She said: “I read the report. It says specifically No Fractures.”
He said: “We can’t be sure, but it doesn’t look like any. You have low bone density. You are prone to fracture.”
She heard: “I haven’t read any of the clinical experimental literature of the past 20 years.”
She said: “All the research of the past 20 years shows there’s no connection between bone density and bone brittleness.”
He said: “That may be, but you have low bone density and your bones are brittle.”
She heard: I don’t care about anything that contradicts what I was taught in medical school.”
He wrote on her chart: Fracture Risk.
She heard: I was really faking with that 21 or 22 year old nonsense.
She said: I’ve had one broken bone in my entire life and it took a 2-ton car hitting me at 30 miles per hour while I was riding my bike to break it. Lance Armstrong had more damage falling while riding his bike and nobody wrote Fracture Risk on his chart. This injury is not different because he is a young man.
The doctor refused to change his note.
He said: “You need to do weight bearing exercises.”
She heard: I’m not looking at you, so I can’t see the muscles in your arms – muscles that can only develop with weight bearing exercises. Then again, I don’t exercise, so I don’t appreciate muscle development. I don’t even know what to look for.
She decides to start him off easy. “I do push-ups.”
He said: “That’s fine. But you need to do weight bearing exercises.”
She heard: I have no idea what a weight bearing exercise is. It’s just a buzz word that I heard someplace.
She sent him an email listing at least 20 types of weight bearing exercises, including calisthenics. She detailed how she spends over an hour a day doing a variety of them.  He did not respond.
She sent the doctor 4 papers from refereed professional journals detailing clinical research studies, all of which show clearly that there is no connection between bone density and bone brittleness.  He did not respond.
She asked him to remove the erroneous Fracture Risk from her file.  He did not do so.
He did a series of strength and flexibility testing. He gave no feedback. He poked her feet with a pin. He did not ask permission to do something painful. When she told him he should have asked permission he said he thought he had permission to do an examination. He didn’t understand why painful tests are different from other tests, and why he should ask permission to do them. He claimed nobody had ever said anything about painful tests before.
She heard: I don’t care if I hurt you. It’s more important to me to fill out a box on my form than to have your respect and trust.

Three men she knows had recommended this doctor. He never asked any of them about their age. He never commented to any of them about their bone density. He did not write fracture risk on their files, even though they are old.

He tried to talk her into an MRI and tried to talk about surgery.  She asked for PT.  He said: “Surgery usually works better than PT.”
She heard: “I think PT is a waste of time and money. But I’ll write the prescription if it will make you go away.

He wrote the PT prescription, but checked the Fracture Risk box on the top of the form. She thought he meant to deprive her of useful exercises. He didn’t want the PT to work. They made an appointment to meet again after a month of PT.”

She went to PT, did the exercises. Plus she accidentally discovered that lying on a small exercise ball removed the worst of the pain. The exercises worked to enable her to stand longer and walk longer without her pelvis cramping up. She’ll have to do these exercises every day for the rest of her life. This is end game.

She went back to the doctor’s office for a followup visit.
He asked how she liked being 39.
She said: “My children are older than that.”
She wanted to say: “When I was 39, I had both my breasts and both my hips.  I’m not aging well.  That’s why I’m here. My age is no joke. And why in your mind has my age suddenly doubled?”
He said, “I see you don’t like being teased.”
He hadn’t read the research papers.
She showed him the exercise ball that eliminates most of the pain if she lies on it for at least 15 minutes every night.
He said: “I knew about that.”
She heard: “I think this home-remedy stuff is useless. If I actually thought it worked, I’d have told you about it.”
He said: “We never need to meet again.”
She heard: I never want to see you again.
It was mutual.

Wednesday, September 7, 2016

Right/Left Agree on Many Issues about Crime

Just when I thought America was reveling it its right/left division, I came across this website: http://rightoncrime.com/

The right and left have a lot in common when it comes to reducing prison terms, number of crimes, severity of penalties, and treatment of prisoners.

Now, if we could agree on how to eliminate poverty, which seems to be the main cause of crime, we’d be on the road to recovery.