A Bang Up Fourth!

In 1946 and 1947 my family lived on N.A.D. Hawthorne, Nevada, where my father was the Navy's Fire Control Officer. As the fourth of July approached in 1946, fireworks were in short supply. Even had there been any, it was an ammunition depot! My father set about creating a big Fourth of July at Walker Lake, near Hawthorne. He invited the band from the Marine base nearby, a color guard from the Navy and Marine bases and townspeople. Never willing to celebrate small, he and his men set up canon, rocketry, large caliber guns and shells, some on boats in the middle of the lake. I'm not certain how many of the townspeople were ready for real bombs bursting in air, but it was a bang up success!

In 1943, based on the 1941 State of the Union Address of President Franklin D. Roosevelt, Norman Rockwell painted a series of paintings, depicting four freedoms, four essential human rights, Roosevelt believed should be universally protected. The paintings, featured one at a time, together with an essay on each, by the Saturday Evening Post.  They later toured the country, sponsored by the United States Department of the Treasury, to help sell War Bonds. The paintings now hang in the Norman Rockwell Museum. They are sentimental, and, of course, not stylish or avant guard, but, if you haven't seen reproductions of the paintings or posters for a while, they are heartwarming to revisit. 

http://www.archives.gov/exhibits/powers_of_persuasion/four_freedoms/four_freedoms.html

We look forward to a world founded upon four essential human freedoms. The first is freedom of speech and expression--everywhere in the world. The second is freedom of every person to worship God in his own way-- everywhere in the world. The third is freedom from want . . . everywhere in the world. The fourth is freedom from fear . . . anywhere in the world.

--President Franklin D. Roosevelt, Message to Congress, January 6, 1941

We've progressed to a Universal Declaration of Human rights, ratified by the United Nations. It is on the U.N. website. The link is here: http://www.un.org/en/documents/udhr/ What is the state of our human rights in this country and abroad this Fourth of July? We should be asking, because it is not good enough to give lip service to how grateful we are not to be living in an undeveloped country or totalitarian state.

Here's wishing us all fun! Enjoy the feast, the concerts, the parades the fireworks! As for me, I love band music, and Denver has the oldest municipal band in the country. Of course the State of Colorado has a pretty colorful history of Fourth of July Celebrations. In 1894, in Swan City, Colorado, restless miners, who had asked for fireworks, had never received them. So they went into town, and blew up the United States Post Office. My dad would have loved it, except for the law breaking part. Oh, hell, my dad would have loved it!

In the quiet time after or before the festivities, talk about the universality of human rights, and what it is We The People want America to be.

"Honey, I'm Your Cook, Not Your Doctor"

     I really didn't want to ring in on the current Paula Deen racist controversy, but hearing about her current plight, I recalled one of Deen's appearances on the Oprah Show, to make traditional pound cake. Dropping a block of butter into the mix master, Deen looked at Oprah's expression. Oprah, on a perpetual weight-loss regime, looked horrified. Deen said, "Honey I'm your cook, not your doctor!" It was a funny moment -- I laughed right along with the audience. 

     Some years after the pound cake fiasco, Paula Deen developed Type II Diabetes. Apparently she made changes in her personal food preferences. She also made a deal to endorse Novo Nordisc's Victoza, a drug used for weight loss and blood sugar control. 
     Whether the famous Southern cook's illness prompted her to back away from promoting and preparing drop-dead decadent food,  I couldn't say. The Food Network, however, should have been more concerned about the killer recipes than the possibility Paula Deen used or condoned racist language.

One's philosophy is not best expressed in words; it is expressed in the choices one makes ... and the choices we make are ultimately our responsibility. -Eleanor Roosevelt

     Perhaps, though, the biggest concern is what happened, when Nova Nordisc approached Deen to endorse Victoza. Deen, herself, may have experienced success with the drug, but she is in no way qualified to recommend it. Unfortunately people, particularly Americans, wrongly put stock in anything and everything celebrities say and do. Pharmaceutical marketing directors know this, and use celebrities to aggressively market their products.

     Victoza (liraglutide) is now the subject of controversy and lawsuits. The drug is alleged to have caused acute pancreatitis, even, increased the risk of thyroid and pancreatic cancers, as well as putting consumers at risk for kidney failure and severe allergic reactions.  http://douglassreport.com/2012/05/25/new-warning-over-the-injectable-drug-victoza/

     Paula Deen may have taken lightly, warnings about bad food choices, as she took the occasional racist crack or dirty joke in stride. She chose not tell her brother what to do and say in the context of his business, taking a "boys will be boys" approach to his persona. According to Deen, she tended to her side of  the business, but left her brother's side of the business to him. This may make her a passive sexist or racist, or not. We aren't all proud of our relatives, and we can imagine being too busy to pay close attention, especially with multiple business and financial interests of our own to attend. Paula Deen is a cook, not a doctor. Neither is she a role model of the 21st Century Woman, unless we're talking about being a survivor and a tremendous success. 

     Toxic language, negative attitudes, snide jokes, decadent foods, drugs with deadly potential ... are all there for the taking. We choose constantly and the choice is ours. Will we be the people to promote  change for the better? We can choose that, too. 

If we're to be seeing, hearing or speaking evil, though, let's talk about  pharmaceutical giants. 

Heartburn Girl

Do you know me? I'm Heartburn Girl. Decades ago, a physician diagnosed me with GERD, related to a hiatal hernia. GERD, or gastro esophageal reflux, is miserable, and can be dangerous. It may be associated with infection by a bacterium, H. Pylori, which does require physician-supervised treatment. Although not as dramatic as GERD, acid indigestion, heartburn, afflicts millions on a regular basis. Seniors are at risk, due to changes in the L.E.S., the acid controlling stomach valve.

My physician prescribed a proton pump inhibitor, Prilosec, for GERD. I'd already had tooth enamel eroded by hydrochloric acid, and wanted to avoid esophageal damage. After reading the instructions and warnings, I took the drug, and seemed to suffer none of the listed side effects. At the end of each fourteen-day course of treatment with Prilosec, I was wretched, while off the drug. It was not until much later that I discovered pharmaceutical companies are not obliged to report some side effects.

Eventually I began to experience severe muscle cramps. Later crepitus in my knees became osteoarthritis. Eventually low-level pain in one knee escalated to the unthinkable. The opposite knee became painful. Other joints in my body began to follow suit. Morning stiffness extended to daytime stiffness. A bone density study confirmed osteopenia. I was deficient in Vitamin D, magnesium and, it turned out, Vitamin B12. This was shocking, because I'd always had an excellent diet, rich nutrients.

Doesn't anyone else think it is a most egregious act to advertise medicine directly to the consumer? To sell prescriptions? To provide coupons for drugs? To send people to a website to take a quiz where they diagnose themselves online? Have we all lost our minds, our senses, our morality? -Donna Flagg, Reporting in The Huffington Post

Imagine my astonishment, on reading more and more reports by respected medical, consumer and news publications. The litany of PPI side effects in these reports sounded like pages torn from my life. Although my issues were not provable side effects, I decided to cut my dosage in half. Very soon some of the joint pain and stiffness began to abate. Let's just say, the honeymoon was over between me and proton pump inhibitors. 

Here is a useful link to a 2010 CNN broadcast. http://www.cnn.com/2010/HEALTH/05/26/heartburn.medication.fractures/index.html

The Livestrong and Mayo Clinic sites contain comprehensive information concerning heartburn and proton pump inhibitors. Here is an article regarding strengthening the L.E.S. valve: http://www.livestrong.com/article/346430-exercises-that-strengthen-the-les-valve/.

Remember the joke about the Jewish grandmother, who said  chicken soup might not cure a cold, but it couldn't hurt? An alternate approach to heartburn may cure, and are less likely to  harm!

Right Fighting

The human tragedy is seeing fluid reality as static. We reach for that which is solid and, as we grasp it, the solid object is in decay. Change is upon us, and great conflict comes, when we do not embrace it, or  drag our feet, rather than adapt. This wisdom I am sharing, because I'm no better at embracing or adapting to change than most of my family or friends. Nor, am I great at conflict resolution; the urge to fight or to flee, equally powerful, always get in the way. 

Passion and strife bow down the mind. -Virgil

Still reeling from a miserable week of unexpected conflict and confrontation, I retrieved some useful knowledge from a PBS broadcast. 

Techniques for Conflict Resolution
• Behavioral Techniques
o Don’t negotiate when angry.
o Forget the past and stay in the present.
o Focus on the problem not the person.
o Communicate feelings assertively, NOT aggressively. Express
concerns without blaming the other side.
o Expect and accept another’s right to disagree. Don’t push or
force compliance; work to develop common agreement.
o Don’t view the situation as a competition where one has to win
and the other has to lose. Work toward a solution where both
parties have some of their needs met.
o Build‘powerwith’ NOT ‘powerover’others. 
o Thank the person for listening.
• Negotiation Techniques
o Identify and define the conflict in specific terms.
o Focus on areas of common interest and potential areas for
agreement.
o NEVER jump to conclusions or make assumptions about what
another is feeling or thinking.
o Listen without interrupting; ask for feedback if needed to assure
a clear understanding of the issue.
o Generate alternative solutions.
o Discuss the pros and cons of the alternatives. Listen as well as
state your case.
o Select the best course of action that all can agree upon.
o Implement only the parts of the plan that are in agreement.
Remember, when only one person’s needs are satisfied in a
conflict, it is NOT resolved and will continue.
o Follow-up to evaluate the effectiveness of the plan and make
any adjustments necessary. 

First it is good to know you are in conflict or providing an irritant, not to be blindsided.  My lessons from last week are: sharing information is the same as giving gratuitous advice. Relax deeply, before responding to a surprise attack. For a lifetime, this is the hardest thing for me to do.

If a friend or family member telephones or drops in, to say he or she is suffering, just listen and say, "I love you." Then, however you say goodbye, say it kindly, but say it. If you fail in this part of the mission, keep the conflict resolution methods handy, and read before speaking.

I would not offer you advice, though, my friend.

That Will Be $300 X 10

Do I Bite? Why Do You Ask?

In case you missed it, ugh, colonoscopies are in the news! In fact they are the catchy subject of an expose in the "New York Times". Her is a link to the articlet: http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all&_r=0 

By now we've heard from an army of celebrities the horrors of colon cancer. The medical community touts colonoscopy as "the preferred method" for detecting colon cancer, so we've swallowed the absolue need for testing, just as we swallow the dreaded Golytely. Any resemblance to Holly Golytely is dispelled within seconds of retrieving the prescription. We may choke on it, until we're in the grips of dizziness and nausea, but it's for our own good ... right? 

If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as the souls who live under tyranny. ― Thomas Jefferson

     We're vulnerable, people, driven by fear. We're just not paying attention to the cost of testing we perceive as  definitive and needful. We're not thinking about all the hikes in insurance premiums for providing products and services at exorbitant rates. Big Insurance, money, marketing and standings have taken over our medical care. Back to the marketing aspect ... what's your favorite public service spot for colonoscopy? My favorite was the actress in her hospital gown, propped up on her elbow, riding a gurney with her tiny Yorkshire terrier. I'll attest to the fact she couldn't have better protection from medical blunders than a feisty little terrier.

     If you've read the Times article, you know that, were you to live in another country, your colonoscopy will cost you, your insurer, your government, in the hundreds of dollars. As you live in the United States, however, the cost is in the thousands. Nor, is the federal government's system of "rating" Medicare insurers helping.

     I'll use my current Medicare insurer as an example. I selected Kaiser Permanente, specifically, for its five-star rating. The honeymoon is over, and I'm planning to drop Kaiser, during open enrollment in October 2013. A couple of letters urging me to reply to a managed care questionnaire, I admit, did not compel me to pay attention. Next I started receiving increasingly urgent letters from Kaiser, usually with my name, address, or other information incorrect or missing. From the get go, Kaiser alerted me about such non-events as my missing Social Security number on their records.

     Some Kaiser letters alleged a colon cancer screening test was sent to me, and I'd failed to return the test kit and sample, as instructed. I wrote Kaiser back, stating I'd not received the kit, and that, if Kaiser wanted my shit, they'd have to send me their shit first. Another letter stated my PCP had noted the absence of a panoply of tests. The letter demanded I fast, and report for testing to a designated place at a designated date and time. There was only one problem. I had not selected, had not seen, any Kaiser physician or clinic.

     At one point I did go to a Silver Sneakers exercise class, just to observe. Good God, I thought, have I really reached such an advanced age I can't escape this bad euphemism or break a sweat?

     I've written the Kaiser people off. It's a five star romance gone sour. Admittedly I'd be lax about the periodic ordeals and the team health management concept, anyway. I'm big one having the people who propose to "manage" my healthcare, get my name, rank and serial number right.  I'd like to have the luxury of actually selecting a physician, based on his or her qualifications, experience and other charms.

     Call me crazy, but the government's rating system is all hokum to me. In a time when everyone, from our legislators to our nation's President, throws elders to the wolves, I'd like to see stringent cost regulation in place and enforced. 

P. S. I'm thinking of signing off on my blog posts. What do you think? I vote for What's-Her-Name, Oh-You-Know, the Cranky Buzzardette from Denver.