Wednesday, April 29, 2009

"Animal Vegetable Miracle" by Barbara Kingsolver

I don't remember when I first heard about this book. I do know that it was not an unfamiliar title last summer when my mother was reading it and told me that she loved it. I made a mental note to get around to reading it sometime...
A month ago I saw it on the rental shelf at our little library (they have a program where they can rent recent or popular books for less than buying them, so there is a decent rotating collection there), so I snatched it up.

I should probably warn you that if you are pregnant and craving fresh fruit and vegetables (especially if you live in a rural corner of Alaska and cannot get them no matter how much you want them), and it's the end of a long winter where none of the produce is very good even if you could get it, and you haven't had your own garden in three years and you miss it terribly...then this book may leave you feeling very very hungry and dreaming about things like farmers markets and hoeing weeds and canning peaches. Of course, I still heartily recommend it.

Animal Vegetable Miracle follows a year in the life of Barbara Kingsolver, her husband, and two teenage daughters. They decided that they wanted to be 'locavores' for a year, as a sortof social experiment. They did make one exception per family member--dad got his coffee (organic and fair trade of course), one daughter got hot chocolate, mom got her spices...but other than that they ate locally. They planted a massive garden, raised their own chickens and turkeys, went to their farmers market religiously, and almost everything they consumed that year was produced within their own county (I think the most distant item came from two states away). The book tells not only their story of learning to eat locally (and in season!), but also includes several essays from Stephen Hopp (her husband, a professor of environmental studies), essays from the elder daughter Camille Kingsolver, and a mouthwatering collection of recipes that follow the 'in season' rule (in other words, nothing calls for mixing produce from one season with produce from another).

Here are a couple of my favorite quotes from the book:
"[O]ur vegetables have come to lack two features of interest: nutrition and flavor. Storage and transport take predictable tolls on the volatile plant compounds that subtly add up to taste and food value. Breeding to increase shelf life also has tended to decrease palatability. Bizarre as it seams, we've accepted a tradeoff that amounts to: 'Give me every vegetable in every season, even if it tastes like a cardboard picture of its former self.' You'd think we cared more about the idea of what we're eating than about what we're eating."
"Each plant part we eat must come in its turn--leaves, buds, flowers, green fruits, ripe fruits, hard fruits--because that is the necessary order of things for an annual plant. For the life of them, they can't do it differently...
"Waiting for [some foods] is harder. It's tempting to reach for melons, red peppers, tomatoes, and other late-summer delights before summer even arrives. But it's actually possible to wait, celebrating each season when it comes, not fretting about its being absent at all other times because something else good is at hand.
"If many of us would view this style of eating as deprevation [only getting foods when they are in season], that's only because we've grown accustomed to the botanically outrageious condition of having everything, always."
"Waiting for foods to come into season means tasting them when they're good, but waiting is also part of most value equasions...It's hard to reduce our modern complex of food choices into unifying principles, but this is one that generally works: eating home-cooked meals from whole, in-season ingredients obtained from the most local source available is eating well, in every sense. Good for the habitat, good for the body...
"That's the sublime paradox of a food culture: restraint equals indulgence."
"It's interesting that penny-pinching is an accepted defense for toxic food habits, when frugality so rarely rules other consumer domains."

I found the book at once riveting, thought-provoking, and inspiring. It's not just about eating organic foods (though Kingsolver clearly feels strongly about that, and explains why); it's not just about eating local foods (though she obviously feels strongly about that too); it's not even wholly about eating in season (although that comes closer to the mark). No, Animal Vegetable Miracle is about mindful eating. About choosing our foods--and preparing them--with conscientiousness and thought.

Tuesday, April 28, 2009

On Cooking from Scratch

"When we traded homemaking for careers, we were implicitly promised economic independence and worldly influence. But a devil of a bargain it has turned out to be in terms of daily life. We gave up the aroma of warm bread rising, the measured pace of nurturing routines, the creative task of molding our families' tastes and zest for life; we received in exchange the minivan and the Lunchable. I consider it the great hoodwink of my generation."

~~Barbara Kingsolver, in "Animal Vegetable Miracle" pg 126

Wednesday, April 22, 2009

Belly One: Week Eleven

While we were taking the haircut pictures on Monday we got the first belly picture too.

photo @ 10weeks 5days
(just a little bulge!)

I'm 11 weeks pregnant today.
Baby is about two inches long; approximately the size (if not the weight!) of my thumb!
I am solidly into maternity clothing because my regular clothing won't fit, but I do have to stick with the adjustable ones that can be snugged down a bit, because the non-adjustable things fall down! This is probably the most frustrating part of pregnancy: I look bigger, but not obviously pregnant, so unless I wave a sign most folks probably just think I've gained weight. I am starting to feel better (which is nice) but I can't feel movement yet, so I don't have any kind of ongoing assurance that all is well.
Meanwhile, here's a little more from baby-gaga about what the littlest wild thing is up to right now:
The little one is already starting to explore their body, focusing most intently on touching their head, and especially their face and mouth. Their mouth in particular will provide them with hours of entertainment. This happens not only because your baby is gaining coordination, and is therefore able to move a hand on command, but also because their palms have gained sensation and can actually “feel” what it touches.They're also developing their swallow reflex this week. And lastly, your baby's smelling and other olfactory senses will begin developing this week, which when combined with the maturing taste buds, will provide your baby with their first experiences of taste and smell.

Tuesday, April 21, 2009


My hair has been long (to some degree) my entire life, and I like it that way. Last summer I decided that I wanted to grow my hair out to terminal length (the length at which it breaks off rather than growing any longer). I anticipated that my 'ideal' length was about my tailbone--36" long--but since it had never gotten that long before, I wasn't sure whether it could get that long, thus the goal to find terminal. It grew quite fast for the first few months, but has slowed a lot since the new year. I presumed this meant I was approaching terminal, and while it hadn't quite stopped, it was definitely feeling like this was about all there was.
In addition, in the last few weeks I had realized that my hair was longer than what I like. It's been getting in my way and has been noticeably thinner at the end. I have concluded that my ideal length--my perfect length--is right about my waist (in the 28-29" range). Having reached that conclusion, when Hubby asked me to cut his hair last night, I asked him to cut mine too. He asked how much, and I said "well, cut it to wherever strikes your fancy; I like it around my waist, but it can always grow." He enjoys the variety as much as the length, so I figured he'd cut it a little above my waist. He took all my hair in a big handful and cut it in one big SNIP (remember how I have thin hair? Yeah, not difficult to cut it all at once!). Then he let go and discovered that it was pretty slanted, so he had to even it up a bit, and voila, now I have short hair.

Before: 33" long

After: 25" long
Ok, so it's short to me anyway! It's just going to grow. But this time, rather than making every effort to reach terminal length, I'll probably just get it out to my waist and then keep it trimmed there.
Or maybe not.
That's the fun thing about hair: so long as you take care of it, you don't really have to commit to a length, because it will keep growing. ☺

Friday, April 17, 2009

5 years ago

This year the dates of the year happen to fall on the same days of the week as they did five years ago in 2004. So April 7 was a Wednesday again, and Sunday, April 12, was Easter again.
I suppose for most people this is no big deal, but for me this Resurrection Day was a sharp reminder of the poignant Easter I had five years ago.
Five years ago, on Wednesday April 7, my first pregnancy ended in my first miscarriage. I held my first angel baby in my hand and mourned his departure.
Five years ago, on Sunday April 12, I went to church and listened to the choir (with whom I had rehearsed but with whom I was too weak to perform) sing about resurrection and sacrifice and perfect love.

We parents of angels often refer to ourselves as being "in the club that nobody wants to join," and while it's true that I wish I'd never had to join, I must say that if you do have to join, there is no time like right before Easter.

Thursday, April 16, 2009

Update on Life

Tonight Hubby is on a plane to Anchorage to go to a teaching job fair there this weekend. He has turned in his official letter of resignation here in Pelican, and we intend to leave this town on the ferry a week after school lets out at the end of May...but we don't know yet where we'll go from there. We have been hoping and praying for a job in the Anchorage or Kenai area, and would appreciate your prayers on our behalf.
We know that we cannot stay here another year--I can't have a baby here, Wolf's school situation is not good, Wolf and I are both battling depression and loneliness, there are no opportunities for our family here (music lessons, sports, cub scouts, playgroups, oh yeah, and church!) With that said, it is unsettling to know that we are leaving but not yet know where we are going to. We have been told by several school districts as well as teachers up there that there are lots of jobs to be had, and that one just needs to show up to the job fair. We know that Hubby is well qualified--being certified in both math and English and with experience in all subjects and grades 6-12. Now we just need someone to offer him a contract. We dare not go to another tiny rural town like this one--it would have all the same problems that we are having here. We have even considered moving back south but we really love Alaska and feel like this is home. So we're just asking for your prayers (wishes, good karma, lucky chants, spells of employment, whatever you do!) that his efforts this weekend will produce at least one job offer that we can accept.
I will keep you posted of course...but in the meantime I'm doing the single parent thing (again) for a few days, and between that and the morning sickness I don't tend to post much. The one thing I have been trying to do is post lots of new stuff over in my etsy shop, and that's been going pretty well! I don't want to move piles of fabric if I don't have to, so I'm trying to get a lot of stuff sewn up (and hopefuly sold!) over the coming weeks. I've sold some of my fabric yardage to fellow diaper sewers, and have been running sales in my shops which of course always helps to keep things moving through. Check it out!

Oh yes, and on the pregnancy front:
10 weeks along; I feel fat--I do actually have a developing pooch but most people probably don't notice it; last weekend I had two days where I didn't feel very sick and I wasn't sure whether I should be thrilled or terrified (feeling better has often come right before miscarriage for me, and with Bear I didn't get to feeling better until week 15) I took my last pregnancy test to calm my nerves. Very very pregnant (and I feel sick again too).

Sunday, April 12, 2009

Happy Resurrection Day

I love this Easter song (appropriately titled "Easter Song"). It's written by 2nd Chapter of Acts, and here performed by one of my favorite acapella groups, Glad.

(for those who can't see it embedded, here is the direct link to see it at youtube)

Friday, April 10, 2009

Patronizing Parenting

patronize: to adopt an air of condescension toward

I have been noticing recently how many parents treat their children in what strikes me as a very patronizing manner. Phrases like "because I'm the mom, that's why" and "good boy!" and "what do you say, dear?" are all pretty condescending. When my child asks why he has to do something, I tell him--now this doesn't mean that he doesn't have to do it (and sometimes he needs to do it now and I'll explain later), but I think asking 'why' is entirely valid. (Sometimes it makes me question why I am asking this of him, and I can evaluate whether it's really something important or if I'm just being bossy...if "because I'm the mom" is the only reason I can think of, then I know I shouldn't really have asked it of him.) When I ask my son to do something, and he does it, I say "thank you," not "good boy." He is a person, not a dog. My children have learned through example to be polite, but when Bear forgets and says "mommy give me cracker" I repeat to him "give me a cracker please?" and he repeats it more politely. I belive that if I treat him respectfully, he will learn more from that example than from any amount of nagging, reminding, or patronizing parenting.

I started thinking about these things when I read "Unconditional Parenting" [the link goes to my blog post about the book]. The author, Alfie Kohn, has plenty of flaws (for starters I'm told that he's somewhat of a moral relativist, meaning that he doesn't believe in an ultimate 'right' and 'wrong,' and therefore believes that any one's perception of right is just as valid as any one else's...obviously i disagree), BUT, I think he does make a valid point when he says that we should treat our children as fellow people. No, they are not tiny adults--their understanding and perceptions are not as complex as ours--but they do have needs, desires, and opinions--all of which are real, and which we should accept as valid. Children are not animals to be controlled; they are people, and should be taught with respect.

ETA (Edited To Add)
Several commentors have said that Kohn is not so much of a moral relativist as I had heard. I have only read one of his books, and like I said, it got me thinking, but I definitely felt that it was imperfect. My intent with this post was not so much to talk about him, or his theories, or even per say my feelings about him or his theories...just to express my perceptions about patronizing parenting (which happen to have been influanced by his theories).

Thursday, April 9, 2009

In the End

In the post I'm delving into death, specifically mine. So if that makes you cringe or whatever, well, stop reading now.

I'm really not a morbid person, but from time to time I do think about my funeral. It all started when I was 16, in my first college writing course, and we were assigned to read Jessica Mitford's essay "Behind the Formaldehyde Curtain," which describes embalming at some length. It was disgusting and fascinating all at the same time. Not long ago I I read this post over at Chocolate Chip Waffle and decided I might as well post about this, so I started a draft so I'd remember...then of course I just read "Stiff," so I finally sat down and finished the post. Like I said, I've been thinking about it (on and off) for years. ☺

Hubby has said he'd like his body to be donated to science. I think that's fantastic--do something useful with your dead self, you know? Well, Hubby never was big on modesty or clothing, but I am, so I'm not sure if I'm comfortable with laying around naked for lots of pre-med students to study, or for surgeons to practice on, or for forensic scientists to study my patterns of decomposition on the Body Farm. I just don't like the idea of public nudity, even when I'm dead.

I DO heartily support organ donation (yes, I'd support it by donating my heart if my heart could be of use to someone). I have no desire to be kept alive on machines, so if I'm brain-dead then by all means use my insides to fix up somebody elses. Hubby and I have already discussed this and know each others wishes on the matter, so there won't be any delays to get familial approval. If I don't need it any more then by all means it should be helping someone else. (It's a little sad to me that around 50% of families of brain-dead patients are not willing to let the organs be given to those in need.)

But once I'm past the point of being helpful, when the useful stuff is gone and it's just a dead body, I lean more toward the 'green burial' notion...dump me in the ocean please...or stick me in a plain pine box and bury me in the woods. Alternately, I like the book's suggestion of being composted. Freeze me, use ultrasound to blast me into tiny organic bits, then use me to fertilize a tree. What a fabulous way to go!! It sure beats cremation, not only in price but also in eco-friendliness and practical usefulness of the residual matter (and I confess that cremation has always turned my stomach a little bit. Go figure.)

In any case, please don't bother with an expensive funeral, or that embalming junk. Seriously. I have read at some length about the embalming process, and there are two things you should know:
1--you will still decompose (did you know that? The embalming process is mostly designed to keep you pretty and non-stinky through the funeral, that's it. Many of the enzymes that eat you come from the inside out, not the outside in, so even in a sealed casket you're gonna get gross).
2--I honestly believe that pumping a corpse full of formaldehyde is pretty much as damaging as letting critters gnaw on it. In other words, your body is going to be thrashed before the resurrection anyway, and I'd rather be doing some good in the world via feeding little critters, you know?

So there you have it. I want to have my organs given to other people, and then be eaten by critters.
I guess a certain degree of nudity is inevitable, but this is a less public option than, say, the body farm... and I never was fond of chemicals. Really, I think if I'd posted a poll first, most of my regular readers could have guessed that I'd go for composting. ☺

Wednesday, April 8, 2009

Water, it Does a Body Good!

By the time you notice your mouth feeling dry, or your lips feeling chapped, you are already dehydrated. The average American walks around dehydrated most of the time. This is partly because of our cultural affinity for dehydrating beverages such as coffee and soda (yes, if you didn't know that, you did hear correctly--some things actually leech water out of your system, even though they are liquid...evil, isn't it?!)
The recommendations for water consumption vary, but pretty much everyone agrees that we need to drink more water than we do. One common recommendation is 8 8oz glasses of water per day (that's 64oz, or a half-gallon). Since every body is a different size though, I find that a better guideline is to drink 1 oz of water for every 2 lbs of body weight. 100 lbs = 50 oz, 150 lbs = can do the math for you. ☺

Being sufficiently hydrated helps metabolism. It improves skin clarity and elasticity, and tends to help control overeating (many people do not know how to differentiate between hunger and thirst, so they eat when they should drink...if you learn to drink more water, you'll probably eat less, and will very likely lose some extra weight). You will probably get less sick less often, and recover sooner.
Dehydration in pregnancy increases the likely hood of tearing at delivery (remember that skin elasticity part?), and slower healing afterward. It may increase the likelihood of stretchmarks (though that is mostly genetic). It exacerbates nausea, and can lead to weak contractions, long labors, and maternal exhaustion in labor. Along with poor diet, it can increase the risk of gestational diabetes. And remember all that stuff I mentioned before about how your blood volume increases by 50% during pregnancy? Guess what, you need water for that too.

SO, assuming that you are now convinced of the need for more water in your daily regimen, here is a list of ideas that can help you increase your water intake:
  • Drink a glass of water before every meal. This can help those wanting to control portion size, but it's also a good way to get in some extra water every day. (A commenter noted that drinking with meals is actually bad if you have problems with heartburn--so try drinking 30 min before the meal, or saving a little room and drinking afterwards.)
  • Rather than just rinsing, drink a glass of water when you brush your teeth.
  • Carry a water bottle around with you at work/school. Take a drink every time you remember it. Make a goal to empty a certain size bottle each up to bigger/more bottles until you are drinking the amount you should be.
  • Keep a cup in the bathroom. Every time you empty your bladder, drink a glass of water. (This has the added benefit of being cyclical, as the extra drinking will have you making extra potty trips, and thus drinking all the more...but don't worry, the extra potty trips will ease off within a week or two as your body gets used to finally having enough water in it.)
  • Use a big cup! The average person will drain their glass, so use a bigger one for good liquids (like water) and a smaller one for other drinks (like soda or juice).
  • Stop drinking other things. When you are thirsty, regardless of what you think you want to drink, get a glass of water first, or instead. (I actually find that I no longer crave milk, and I usually find fruit juices too sweet. I can handle about two swallows of soda pop. When I want a drink of something, I almost always drink water.)
  • Try establishing a water-drinking habit by going for a week with no other drinks--just water.
  • Do you have other tips? Leave them in the comments and I'll add them to the list!

See more WorksForMeWednesdays here.

Monday, April 6, 2009

Book Review: Stiff

I just read the book "Stiff: The Curious Lives of Human Cadavers" by Mary Roach. Those of you who enjoy the Reader's Digest might recognize her name...she writes the monthly humor column "My Planet," wherein she explores conundrums of everyday life, such as losing car keys or recycling. She approaches things in a matter-of-fact yet tongue-in-cheek way, and I really can't think of anyone more qualified to take on the topic of, well, dead people.
"The way I see it, being dead is not terribly far off from being on a cruise ship. Most of your time is spent lying on your back. The brain has shut down. The flesh begins to soften. Nothing much new happens, and nothing is expected of you.
"If I were to take a cruise, I would prefer that it be one of those research cruises, where the passengers, while still spending much of the day laying on their backs with blank minds, also get to help out with a scientist's research project..."
I will say right off the bat that this book is NOT for everyone. There are some parts which are decidedly gory, even macabre; however as a whole it was a fascinating, couldn't-put-it-down sort of book. The book begins with the more well-known cadaver careers such as anatomy classes, surgical practice, organ donation, and forensic studies at the Body Farm. It then moves into some of the less-known facts, such as bullet testing, and the truth about embalming. Near the end is a chapter about ways in which bodies have been eaten (yes, by other humans) for medicinal purposes...that was the one chapter that I actually found a bit disgusting, although the latter half of it asked some very interesting (and I think valid) questions about why cannibalism is so taboo. The penultimate chapter discussed composting as an alternative to burial or cremation, and the book concludes with the author's own thoughts about what she wants done with her body, now that she really knows all the options. (I have thought about the options before, and felt pretty certain in my conclusion--having read about the choices, I now feel very firm in my decision. But that is another post!!)

In any case, I recommend it without hesitation to my dad and my first sister (who loved poking around at the cadavers in her anatomy lab so much that the next semester she TA-ed for the class)... I don't know who else I'd recommend it to, because it's just not a book for everybody...however if you are fascinated by bodies and or science, and don't get to queasy over unbodied beating hearts, freshly guillotined heads, body snatchers, or decomposition in general, then by all means go for it!

Friday, April 3, 2009

Friday Feel Up & RDs take on Cancer Screenings

It's the first Friday of the month, time for your monthly feel-yourself-up self breast exam. Go ahead, go get it done right now while you're thinking about it. I'll wait. ☺

And for those who may have forgotten, yes you should do them even if you are pregnant or breastfeeding. ☺

The Reader's Digest had a very interesting article in the current issue (April 09) about cancer screenings, so I thought I'd share from that this month. (It's particularly interesting in light of the mixed reviews I found when I wrote about mammograms a few months ago.) Please note that the screenings this article is talking about are the ones done in the doctor's office--the kind that find things you would not notice on your own. Obviously, if you have symptoms (such as a lump in your breast) you should get it checked out. Of course you should still do self-exams. All this is questioning is the wisdom of doing screenings (such as mammograms and colonoscopies) if you have no other symptoms...
So here I quote from them at length.
It's hard to believe, but some researchers [say] that yearly mammograms are not nearly as effective at reducing the risk of dying of breast cancer as most women think, and that mammography leads many women to get unnecessary treatment -- especially those diagnosed with DCIS [ductal carcinoma in situ]. The problem is bigger than just mammography: They say the prostate-specific antigen (PSA) test may do men more harm than good if they don't already have symptoms of prostate cancer. And they have similarly grim things to say about other widely used cancer screening tests.

Their view stands in stark contrast to the message being put out by groups like the American Cancer Society and even the federal government, which say that finding and treating tumors as early as possible is the surest way to avoid a cancer death. But a growing group of scientific heretics -- published in highly respected medical journals, working at some of the most august institutions -- strongly believe that it's time to rethink our whole approach to cancer screening.

That's because screening tests pick up many small cancers that would never have caused any symptoms. "Screening for cancer means that tens of thousands of patients who never would have become sick are diagnosed with this disease," says H. Gilbert Welch, MD, codirector of the Outcomes Group at the Veterans Affairs Medical Center in White River Junction, Vermont, and a leading expert in cancer screening. "Once they're diagnosed, almost everybody gets treated -- and we know that treatment can cause harm." Tamoxifen for breast cancer can trigger life-threatening clots in the lungs, for instance. Surgery for prostate cancer leaves 60 percent of men unable to have an erection. For that matter, some of the screening tests themselves carry risks: Up to 5 out of every 1,000 people who get a colonoscopy have a serious complication, such as a colon perforation or major bleeding.

Most people diagnosed with cancer undoubtedly see these risks as the price they must pay to avoid dying of cancer. "The reality is not so simple," says Dr. Welch. Screening tests are very good at catching tumors that would never bother us, he notes, but they're actually pretty bad at catching the fastest-growing and most deadly cancers in time to cure them. The bottom line, says researcher Floyd Fowler, Jr., PhD, president of the Boston-based nonprofit Foundation for Informed Medical Decision Making: "Screening's power to cut your risk of dying has been wildly overinflated."

How Cancer Can Fool a Screening Test

The idea that getting tested for cancer might be useless or even harmful may strike you as completely wrongheaded. After all, smaller cancers are easier to cut out. They're also less likely to have metastasized, or spread to other parts of the body -- and metastasis is generally what makes cancer deadly. Sure, it's possible for a tumor to kill without metastasizing: A brain tumor, for example, can cause devastating harm when it grows big enough to squeeze healthy tissue inside the skull. But most cancers threaten life only after a few cells break free and travel through the bloodstream or lymph fluid to set up shop in another part of the body. Once that's happened, a surgeon can no longer cure a patient by removing the tumor. And even powerful chemotherapy drugs are often unable to kill every last errant cell.

Physicians used to think that a tumor needed to get to a certain size before it would spread. But that's not necessarily so, says Barnett S. Kramer, MD, associate director for disease prevention at the National Institutes of Health. "Some tumors spread extremely early," he says. They begin metastasizing when they consist of only a few million cells, which sounds like a lot but is smaller than the period at the end of this sentence -- too small to detect with most screening tests. By the time this kind of cancer is big enough to be seen on a mammogram or other test, it's already sent seeds to other parts of the body.

The flip side of this problem is that many screening tests do a great job at catching cancers that would never have caused problems and could simply have been left alone. This notion violates most of what we think we know about cancer, says Dr. Kramer, because most of what we know is based on the tumors that cause harm. If you think of all the different varieties of cancer as making up an iceberg, cancers that cause symptoms represent only the part of the berg above the waterline. For most of human history, these were the only tumors we knew anything about: the breast cancer that had grown big enough to feel, the lung cancer that was causing shortness of breath.

Screening allows us to look under the water, at the tumors that haven't yet become symptomatic. We assume they will eventually cause symptoms, but increasing evidence suggests that's not always the case. Evidence from autopsies, for instance: In one study, postmortem exams showed that nearly 9 percent of women of all ages who died of any cause other than breast cancer had undiagnosed DCIS. Among women from Denmark, where mammography is not as common as it is here, a whopping 39 percent of middle-aged women who died of other causes had undetected breast cancers. Similarly, says outcomes researcher Dr. Welch, a 1989 study found that 60 percent of men over age 60 have undetected prostate cancer -- yet only about 3 percent of deaths in men are due to prostate cancer.

The Damage Screening Can Do

Forget the fact that unnecessary therapies for cancer are a tremendous drain on our health care budget, already strained to the breaking point. "Many oncologists would probably tell you that they've had patients who suffered serious side effects, even death, from treatment that they might not have needed," says William C. Black, MD, a professor of radiology at Dartmouth-Hitchcock Medical Center. No one intentionally prescribes unnecessary treatment, of course. But it's often difficult to know if a patient really needs to be treated, so the tendency is to be aggressive, just in case.


Does Screening Save Lives?

For many people, even serious side effects [would] be worth putting up with if the treatment reduced their risk of dying of cancer. That's the point of getting screened, isn't it? Yet only one cancer screening test, the venerable Pap smear, has truly slashed the risk of death. Between 1955 and 1992, according to the American Cancer Society, Pap smears cut the death rate for cervical cancer by 74 percent, and deaths have continued to decline each year.

Mammograms also offer a smaller benefit than many patients -- and doctors -- assume. Mammography's effectiveness has been hotly debated, but a carefully conducted 2005 analysis suggests it cuts the risk of dying of breast cancer by 15 percent, says the NIH's Kramer. That means a 60-year-old who gets regular mammograms shaves her risk of dying of the disease in the next decade from 7 per 1,000 to 6 per 1,000.

[This section also contained specifics about the effectiveness--or lack thereof--of colonoscopies and prostate cancer screenings...]

To Screen or Not to Screen

The fact is, there's no single answer. It depends on many factors, including how old you are, what other diseases you have, and what you value most in terms of your health...

Eventually, researchers and doctors hope, better screening tests will be able to distinguish between cancers that need to be treated and those that don't. But until then, many experts believe, the decision to get screened should rest on an individual's values and his or her ability to handle uncertainty. "We have come to fear dying from disease more than dying at the hands of overzealous doctors," says Dartmouth's Dr. Black. The fact is, both are risks when we get screened for cancer.

Check out these books, which help with decisions about testing and treatment:

Their conclusions about whether or not to get screened were in a sidebox in the magazine, but I don't see them on the website, so I will copy them here:

Screening might be right for you if:
  • You have a family history. If you have close relatives with cancer, your own risk of developing it may be above average. Generally only immediate relatives (mother, father, sibling, child) count toward your family history.
  • You know you have a risky mutation. The BCRA1 and 2 mutations are known to increase the risk of breast and ovarian cancers. Other mutations have been tied to colon cancer.
  • You've already had cancer. One bout slightly increases your odds of developing another, unrelated cancer.
Think twice before getting screened if:
  • You have another serious illness. Having heart disease or suffereing a stroke increases the odds that you'll die before an undetected cancer could cause symptoms.
  • You're under 50 or over 70. there's less evidence to support getting screened in your 40s, when cancer risk is low. After 70, the possible benefit from early treatment should be weighed against the chance that it will make life less enjoyable or more painful.
  • You're frail. If you can't withstand treatment, it may not be useful to undergo a screening test.
  • You're particularly afraid of being harmed by treatment you don't need.

Wednesday, April 1, 2009

8 Weeks (the truth about barfing, and other secrets of early pregnancy)

For anyone who remembers my April Fool's post last year on this day ("two pink lines"), well, it occurs to me that this year I should have waited for today to make my announcement, and it would have been really darn funny. Oh well!!



"Woohoo! You've got one whole inch of baby inside of you! Your little embryo has finally reached the one-inch mark (30mm). And if it were possible to take a peek, you could actually see your tiny baby without a microscope! What’s more, your baby is finally starting to take on some very distinct human features. For starters, their little tail (really just the spinal cord) has disappeared completely. It’s nice to know your baby can no longer be mistaken for a sea creature! Their eyes and ears are the most visible features on their head. Additionally, both their toes and fingers are prominent with very little, if any, webbing. Upper and lower limbs all show recognizable joints (elbows and knees) and the lower limb bones are starting to ossify. But don’t expect your baby to resemble either parent quite yet. You also have some variation on a boy or a girl at this point, although their genitals won’t be visible enough to determine which color cigars you’re going to buy until around the 16th week. Right now, your baby’s head is disproportionately larger than the rest of their body--making up almost half of your little one’s height and weight!"

Three weeks of morning sickness down, probably about 4-5 weeks to go. Morning sickness gets a reputation for causing daily barfing episodes, but that is actually the minority of cases. As many as 20-50% of women don't experience morning sickness at all (yeah, I know that's a big range, I don't know who thought it could be as high as 50%, because my experience leads me to think that it's probably more like 10-20%, but whatever!). In any case, some women feel queasy for two weeks, and some are on bedrest with IVs for 8 months. All things considered, I guess I get a pretty mild version of morning sickness.
In my first few pregnancies I lost a meal or two, but with the last one (and this one so far) everything that goes down stays's just that I feel like I'm going to barf all the time. If I believed that it were inevitable, I'm sure I'd have made a few rushed trips to the bathroom by now, but I really really hate throwing up, so I do my darndest to avoid it...and so far so good. The thing about morning sickness is that it's not like having a stomach bug. When you have a stomach bug, and you barf, there is some relief...when you are morning sick, and you barf, you still feel just as sick as ever, only now you have to try to eat again because otherwise you'll feel all the sicker. It's a crazy vicious cycle. I'll have to post about morning sickness helps. ☺

So, the littlest wild thing is an inch long now. Some people are able to hear the heartbeat at this stage, but I know better than to try. I have a retroverted or 'tilted' uterus (10+% of women do) and it simply means that my uterus tips back rather than forward. So if you're trying to listen through my belly, well, the baby is deeper in there than on the majority of women who tilt forward, so it's harder to hear. Most women can hear their baby's heartbeat around 10 weeks, but for me it's at least 12...this was deeply distressing to me when I didn't understand the reason, but now that I know it's no big deal. (I'm actually contemplating avoiding the doppler altogether this time. By the time I get to my first prenatal visit, I should already be feeling movement, so what's the point, you know?)

Meanwhile my belly has a distinct 'personal bubble.' I can't stand to have anything snug around my middle, so I sag my jammie pants like a rapper and two weeks ago I stopped zipping up my jeans (even though I technically still could) and have been wearing them unbuttoned and held up with a homemade bella band instead. A lot of charts and books suggest that I might have gained a pound by this point, but I haven't--I didn't gain any weight until 22wks last time though, and I'm not in the least bit worried. The pounds will come when they are ready to come. I was starting to wear some of my smallest maternity clothing at 9wks last time, and I'm more than a little relieved that Hubby was able to pick up my stuff while he was stuck in Salt Lake this week, because while I may not need it at 9 weeks, I am not going to make it till May!

Linked Within

Related Posts Plugin for WordPress, Blogger...