Tag: new york times

California/Health/Lifestyle/Politics & Causes/seniors/USA
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An elder revolution? It's possible

by Fran Johns

If you are over 50, or plan to be over 50 at some future date, you have just been issued a challenge. You might call it a leadership alert.

New York Times columnist David Brooks, who does have a good head on his shoulders, yesterday published an interesting column advancing the theory that real social change will come from the geezer generation. Those at the time of life traditionally perceived as fuzzy, withdrawing and passive. Or at best, the time of life in which most are inclined to let the young folks do the heavy lifting. But those times, Brooks maintains, have changed.

Citing studies undertaken over past decades, Brooks explains that the geezer generation (in which I am a fully accredited member) is now understood to be not so dimwitted and inept as long thought. Beyond new research that shows brains can continue to thrive and develop into one’s late years, people who had been studied over a 50-year period proved to be increasingly outgoing, self-confident and compassionate.

That’s the good news.

The bad news is that we geezers — a population about to boom as the Boomers hit Medicare age — are eating up a way disproportionate share of the GDP. So pensions are going to keep getting money that would better be spent on education, taxes will go to fulfill earlier promises, etc.

Then, though, Brooks turns it all around a new corner:

In the private sphere, in other words, seniors provide wonderful gifts to their grandchildren, loving attention that will linger in young minds, providing support for decades to come. In the public sphere, they take it away.

I used to think that political leaders could avert fiscal suicide. But it’s now clear change will not be led from Washington. On the other hand, over the past couple of years we’ve seen the power of spontaneous social movements: first the movement that formed behind Barack Obama, and now, equally large, the Tea Party movement.

Spontaneous social movements can make the unthinkable thinkable, and they can do it quickly. It now seems clear that the only way the U.S. is going to avoid an economic crisis is if the oldsters take it upon themselves to arise and force change. The young lack the political power. Only the old can lead a generativity revolution — millions of people demanding changes in health care spending and the retirement age to make life better for their grandchildren.

It may seem unrealistic — to expect a generation to organize around the cause of nonselfishness. But in the private sphere, you see it every day. Old people now have the time, the energy and, with the Internet, the tools to organize.

The elderly. They are our future.

We could start by convincing seniors to ignore the scare tactics of their conservative friends and support health reform. Mount a movement for what is morally right: health care for all Americans. Their grandchildren will thank them.

Not being a community organizer myself, I don’t know how to start this campaign. But if you have any suggestions I’ll join the movement.

Op-Ed Columnist – The Geezers’ Crusade – NYTimes.com.

California/General interest/Health/Politics & Causes
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Obama, Pelosi & the health bill yo-yo

by Fran Johns

Invoking the not-so-long-ago proposals of Senators Bob Dole and Howard Baker, President Obama told the Republicans Friday that his health bill is “pretty centrist,” while suggesting they might leave off referring to it as a Bolshevik plot. “People in America don’t believe it’s centrist,” Congressman Jeb Hensarling (R-TX) told PBS NewsHour‘s Judy Woodruff just after the event — “the government defining costs, benefits…”  Hensarling did not sound much like someone ready for bi-partisan cooperation.

House Speaker Nancy Pelosi, meanwhile, said yesterday, in a letter e-mailed to constituents, that “Congress will pass health insurance reform no matter what barriers stand in our way. We will go through the gate. If the gate is closed, we will go over the fence. If the fence is too high we will pole vault in. If that doesn’t work, we will parachute in.” And therein may lie the problem: Obama’s move from health care to jobs as number one issue, and Pelosi’s, well, Pelosi-like determination to get some sort of a health bill through, no matter what. Some of us who agree that jobs and the economy are admittedly number one still believe the disaster that is our current health care system has got to be addressed. (One wonders what planet Virginia Governor Bob McDonnell lives on, commenting during his rebuttal to the State of the Union address that Americans don’t want to mess with “the best medical care system in the world.”)

Health reform, whatever remains of it, has become the yo-yo of the year: it’s up, it’s down, it’s tangling in multiple strings, and the axle connecting it between Democrats and Republicans looks more worn with every loop.

Here are a few of the assessments Friday night pundits were making: New York Times reporter Peter Baker on Washington Week in Review: “It’s become bad politics. There is no option but to slow down.” Also on Washington Week, Politico‘s John Harris remarked, “It’s comatose.”

The President did himself proud with the Republicans, in what was indeed a remarkable event, even if no immediate good will arises. It felt downright civil. But as to the health care yo-yo and whether it now rolls quietly under the sofa to rest a while, a parting thought came from columnist Mark Shields on NewsHour. “President Obama,” he observed, “doesn’t control Nancy Pelosi.”

California/Health/Lifestyle/Medicine/Politics & Causes
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Is marijuana a medicine?

by Fran Johns

Of course it is, to answer this rhetorical question posed by a January 18 headline in the Wall Street Journal. New Jersey is the most recent to recognize that fact, becoming the 14th state to legalize use of marijuana for medicinal purposes. The New Jersey law, signed this week by outgoing Governor Jon Corzine, limits use to patients with specific illnesses such as cancer, HIV/AIDS, multiple sclerosis and ALS (Lou Gehrig’s disease) and specifically forbids grow-it-yourself projects.

What’s needed now are serious studies of how good a medicine it really is, and these aren’t happening very fast. As outlined in a New York Times article this week, getting permission to study the weed is no easy task.

Despite the Obama administration’s tacit support of more liberal state medical marijuana laws, the federal government still discourages research into the medicinal uses of smoked marijuana. That may be one reason that — even though some patients swear by it — there is no good scientific evidence that legalizing marijuana’s use provides any benefits over current therapies.

Lyle E. Craker, a professor of plant sciences at the University of Massachusetts, has been trying to get permission from federal authorities for nearly nine years to grow a supply of the plant that he could study and provide to researchers for clinical trials.

But the Drug Enforcement Administration — more concerned about abuse than potential benefits — has refused, even after the agency’s own administrative law judge ruled in 2007 that Dr. Craker’s application should be approved, and even after Attorney General Eric H. Holder Jr. in March ended the Bush administration’s policy of raiding dispensers of medical marijuana that comply with state laws.

“All I want to be able to do is grow it so that it can be tested,” Dr. Craker said in comments echoed by other researchers.

Marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.

“The more it becomes clear to people that the federal government is blocking these studies, the more people are willing to defect by using politics instead of science to legalize medicinal uses at the state level,” said Rick Doblin, executive director of a nonprofit group dedicated to researching psychedelics for medical uses.

In California, where a mish-mash of laws and enforcement policies can bewilder all but the expert — (and there are many experts) — the Supreme Court ruled yesterday that lawmakers acted improperly in amending the voter-approved legalization of medicinal marijuana to limit the amount critically ill patients might have:

The high court ruled lawmakers improperly “amended” the voter-approved law that decriminalized possession of marijuana for “seriously ill Californians” with a doctor’s prescription by limiting patients to eight ounces (227 grams) of dried marijuana and six mature or 12 immature plants.

The Compassionate Use Act, passed by California voters in 1996, set no limits on how much marijuana patients could possess or grow, stating only that it be for personal use.

In 1997, the state’s Supreme Court defined a lawful amount as enough to be “reasonably related to the patient’s current medical needs.”

The state’s quantity limits were passed in 2003 as part of a voluntary identification card program designed to protect against both drug trafficking and wrongful arrest by allowing police to quickly verify a patient’s prescription.

The court on Thursday let stand the voluntary card program but found that the limits it imposes should not “burden” a person’s ability to argue under the Compassionate Use Act that the marijuana possessed or grown was for personal use.

California Attorney General Jerry Brown said in a statement the decision “confirms our position that the state’s possession limits are legal” as applied to medical marijuana cardholders.

While conceding that marijuana may have some just-for-fun attraction too, I can’t vouch for the recreational weed. Thankfully, since I am addicted to anything that comes down the pike and question the view that marijuana is non-addictive,  it hadn’t made its way to small-town Virginia when I was experimenting with other mood-altering substances. But I do know its medicinal value. My beloved now-deceased sister could have had much suffering relieved with legal pot. Countless friends I loved and worked with during the height of the AIDS pandemic would have suffered less with legal, easily-accessible marijuana.

We are past time to establish, through definitive studies, the medicinal benefits of this natural bounty, and make it legally available to those in desperate need.

California/General interest/Health/Medicine
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The doctor is in… cyberspace

by Fran Johns

Getting health care — whatever happens with the health care bill — is no longer just a matter of getting to the doctor. Issues of comfort, efficiency and cost control increasingly point to the use of telemedicine, which is coming, ready or not. And one recent report suggested the medical profession isn’t ready. Pauline Chen, M.D. , writing recently in the New York Times, cited resistance by doctors and nurses alike to what some consider long-distance health care.

Telemedicine has the potential to improve quality of care by allowing clinicians in one “control center” to monitor, consult and even care for and perform procedures on patients in multiple locations. A rural primary care practitioner who sees a patient with a rare skin lesion, for example, can get expert consultation from a dermatologist at a center hundreds of miles away. A hospital unable to staff its intensive care unit with a single critical care specialist can have several experts monitoring their patients remotely 24 hours a day.

But despite its promise, telemedicine has failed to take hold in the same way that other, newer, technologies have. Not because of technical challenges, expense or insufficient need. On the contrary, the most daunting obstacle to date has been a deeply entrenched resistance on the part of providers.

Tech industry writer/elder care advocate Laurie Orlov thinks those concerns are a thing of the past. Since data was gathered for the study Dr. Chen cited, Orlov points out in her Aging in Place Technology blog, doctors, patients and technology have come a long way. “Forget the JAMA study”, Orlov says, “here come the virtual visits.”

Medical practices, hospitals, clinics are well aware of a much-changed world and consumer health care costs that can be breathtaking. American Well’s virtual visit platform use is growing, as are other virtual platforms discussed in our 2009 Calibrated Care report. They have read about transformation of self-care and virtual visits in Denmark. Given the geographic distribution of people — and the distance required to get to doctors in some states and rural areas, given the availability of technology that was barely known or completely unknown in 2006, these are going to happen, reimbursement has begun, criteria for the use has emerged, and the JAMA study (and its much-syndicated press coverage) is already irrelevant.

On a technologically lower level is the use of PC programs long in place for Kaiser patients. They haven’t asked for a testimonial, but here’s one, with enthusiasm. The e-mail your doctor program allows doctor-patient communication at the convenience of each (my primary care doc, oncologist and other specialists almost all answer queries within 24 hours or less); test results are posted immediately and can be viewed via charts or graphs to show how you’re doing; drug information or other Q&A’s are immediately accessible through personal accounts. All of the above save time, money and patient angst.

Doctors in cyberspace could be good medicine indeed for U.S. health care.

California/General interest/Lifestyle/seniors/teens/USA
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Walking while cellphoning can be hazardous to your health

by Fran Johns

Having raged and ranted about phoning/texting drivers and pedestrian-oblivious bikers, this space would now like to come to the defense of cellphoning walkers. Not, you understand, multi-tasking/app-studying cellphoning walkers, but talking walkers. Noting the attention that has recently focused on the hazards of distracted drivers, New York Times writer Matt Richtel reports on the new hazard:

But there is another growing problem caused by lower-stakes multitasking — distracted walking — which combines a pedestrian, an electronic device and an unseen crack in the sidewalk, the pole of a stop sign, a toy left on the living room floor or a parked (or sometimes moving) car.

The era of the mobile gadget is making mobility that much more perilous, particularly on crowded streets and in downtown areas where multiple multitaskers veer and swerve and walk to the beat of their own devices.

Most times, the mishaps for a distracted walker are minor, like the lightly dinged head and broken fingernail, a jammed digit or a sprained ankle, and, the befallen say, a nasty case of hurt pride. Of course, the injuries can sometimes be serious — and they are on the rise.

Slightly more than 1,000 pedestrians visited emergency rooms in 2008 because they got distracted and tripped, fell or ran into something while using a cellphone to talk or text. That was twice the number from 2007, which had nearly doubled from 2006, according to a study conducted by Ohio State University, which says it is the first to estimate such accidents.

“It’s the tip of the iceberg,” said Jack L. Nasar, a professor of city and regional planning at Ohio State, noting that the number of mishaps is probably much higher considering that most of the injuries are not severe enough to require a hospital visit. What is more, he said, texting is rising sharply and devices like the iPhone have thousands of new, engaging applications to preoccupy phone users.

There is the problem, it’s the apps. It is a solvable problem. Just as it is possible, without inviting death and destruction, to talk to a (non-distracting) passenger while driving a car, it is entirely possible to talk on a cellphone while walking. Many who have managed to do so without winding up in emergency rooms have the solution: don’t be accessing travel agencies and restaurant menus, just talk. Furthermore, do not give your cellphone number to anybody but your children and a few very good friends. They do not create angst while you are walking/talking, and will also understand that you turn the thing off when you get home. Anybody else can darn well call the land line and leave a message. The fact that addiction to electronic wizardry and perpetually multi-tasking with it is a fairly recent phenomenon probably explains another interesting discovery:

Mr. Nasar supervised the statistical analysis, which was done by Derek Troyer, one of his graduate students. He looked at records of emergency room visits compiled by the Consumer Product Safety Commission.

Examples of such (hospital) visits include a 16-year-old boy who walked into a telephone pole while texting and suffered a concussion; a 28-year-old man who tripped and fractured a finger on the hand gripping his cellphone; and a 68-year-old man who fell off the porch while talking on a cellphone, spraining a thumb and an ankle and causing dizziness.

Young people injured themselves more often. About half the visits Mr. Troyer studied were by people under 30, and a quarter were 16 to 20 years old. But more than a quarter of those injured were 41 to 60 years old.

Over 60? Except for the unfortunate gentleman strolling off his porch, we don’t event merit inclusion in the data. This may add up to one benefit of being too old to deal with the technological wonders of cellphone apps, and tending to use the cellphone as a phone. The Times article, highly recommended reading for all ages, is full of interesting factoids and neurological rationale. But much still boils down to the old can’t-walk-and-chew-gum adage.

“Walking and chewing are repetitive, well-practiced tasks that become automatic,” Dr. Gazzaley (Adam Gazzaley, a neurologist at the University of California, San Francisco) said. “They don’t compete for resources like texting and walking.”

Further, he said, the cellphone gives people a constant opportunity to pursue goals that feel more important than walking down the street.

“An animal would never walk into a pole,” he said, noting survival instincts would trump other priorities.

There could be a message here. Perhaps it is that the goal, or at least the top priority, of walking down the street should be to get to your destination in one piece. If you skip the apps and keep your eyes open for texting drivers at cross streets, it is entirely possible for someone of any age to accomplish this task — while talking on the cellphone.

Driven to Distraction – Pedestrians, Too, Are Distracted by Cellphones – Series – NYTimes.com.

California/Education/General interest/Lifestyle/seniors/teens/Women
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Facebook parenting — God help us

by Fran Johns

At the risk of sounding like a grandmother, which I quintupitally am, I have to say I’ve been spending a lot of time in the past several days being thankful I’m not raising any teenagers. This is thanks to the story of Tess of the d’Overmuch and her Facebook quest for relief from being grounded. If you’ve missed this exciting adventure, Susan Dominus summarizes it in today’s New York Times:

They feel her pain. At the Spence School and Greenwich High and Fullerton Union High and Nyack High and Narragansett High, teenagers and near-teenagers, hundreds of them, are waving a virtual flag for Tess Chapin, a 15-year-old from Sunnyside, Queens, who has been grounded for five weeks. A few days after founding the Facebook group — “1000 to get tess ungrounded” — Tess had nearly reached her stated goal, with 806 members by Friday morning; after this column about her quest was posted on nytimes.com, she surpassed it.

This is teenage rebellion, electronic style — peaceful, organized and, apparently, contagious.

So basically, Tess explains on her group page, she made an honest late-night mistake. Her parents flipped, and they grounded her for five weeks — “thats my childhood right there,” she wrote. “please join so I can convince them to unground me. please please please.”

Interesting she should mention childhood. Tess’ groundation, as she terms it, occurred after an honest late-night mistake involving drinking booze and missing a curfew, behaviors that are wisely left until childhood is past, which her parents, if not her friends, understand. To their everlasting credit — and bless their hearts for having to raise what must be a bright and feisty daughter in such a public arena — they seem thus far disinclined to let Facebook group rule.

If your parents didn’t care,” pointed out a sophomore at Ithaca College, “they would have just let you rot.” Someone agreed with Tess that “parents can be stupid.” A friend of a friend expressed hope that she and her parents would take something “grand” away from the experience. A close pal chimed in, “I love you, but your parents are not gonna unground you for convincing 1,000 people to join a group.”

It is to this last theory that Ms. Iselin Chapin (mom Jennifer Iselin Chapin, a fund-raiser for the Natural Resources Defense Council) subscribes.

“What’s your fallback strategy?” she asked her daughter Thursday night, sitting across from her in the living room of their two-bedroom apartment in Sunnyside.

“O.K., one: drive you so crazy that you’re going to unground me,” Tess replied.

Her mother shook her head. “That’s not going to do it, sweetheart.”

Times writer Dominus suggested early on that perhaps another group might be started in support of “Parents Who Believe in Consequences for Serious Lapses in Judgment and Care Enough About Their Kids to Enforce the Rules,” and reported that within an hour a Times Online reader had done just that. And bless that reader’s heart, too.

I think raising kids in the relative obscurity of pre-internet times was infinitely easier and surely effective, for proof of which I offer three excellent grown children, parents of three flawless teenagers and — in the case of son and daughter-in-law who deserve an extra blessing of hearts — two gorgeous girls who won’t be teenagers for another 6 or 8 years.

My eldest granddaughter came across the country to enter college last fall, offering joy and a learning experience to her creaky left coast grandparents. We are diligently learning about what 19-year-old college art students create, wear, enjoy and pierce. She is extraordinarily grounded and gifted and fast approaching the end of child/teenagehood — though she did exemplify the complexities of it all when assuring her mother she was not homesick while asking that she (the mom) please not talk about the dogs.

I have conceded that most of today’s teenagers will miss the pleasure of things like thank-you notes (they don’t write, they Facebook and they text,) and think it’s just as well my own college art major was in the dark ages. We did life drawing and paintings of little arrangements of bottles and fruits for starters. The college art life today is tough. My granddaughter took us on a walking tour of her dorm and its collection of depictions of violence and terrors, which prompted me to remark that there is so much angst in today’s art.

“Well, Gran,” she said with a note of weary indulgence, “we ARE teenagers.”

Big City – Teenager Taps Facebook to Protest a Punishment From Her Parents – NYTimes.com.

California/General interest/Health/Lifestyle/Money/Politics & Causes/Women
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Bone weary in America: contraceptives, celiac disease & other osteo-hazards

by Fran Johns

You might want to start paying attention to your bones.

Even if you’re not an over-50 hard-drinking guy, or a post-menopausal former-smoker gal — even  if you are, say, just a light-complexioned skinny person, your bones want you to understand they might not be able to keep you together forever.

My bones sent that message not long ago by summoning a few other medical markers. Anemia and exhaustion got my attention and lo! we discovered celiac disease. Who knew? Celiac sprue is a genetic condition half the country seems to have, now that it’s gotten half the country’s attention — and confirmed diagnoses are relatively easy to make. Because I am an asymptomatic celiac person, in my case it was just the ol’ bones sending a signal that they would like a little calcium, please.

Yesterday’s New York Times reported another new finding:

Almost half of all women who use a popular injected contraceptive lose a significant amount of bone mass within two years, and researchers now say the greatest risk is to smokers, women who don’t consume enough calcium and those who have never gone through a pregnancy.

A study that followed women who used the birth-control method — a shot of depot medroxyprogesterone acetate, better known as DMPA or Depo-Provera, every three months — found that 45 percent of the users experienced bone mineral density losses of 5 percent or more in the hip or lower spine, researchers said. The study appears in the January issue of Obstetrics & Gynecology.

More than two million American women use DMPA, including about 400,000 teenagers.

Researchers said the bone loss was of “significant concern” because recovering bone mass can take a long time, and the hip is the most common site for fractures in women later in life.

“We can now tell our patients, ‘Don’t smoke, and take your calcium every day’ — those are modifiable risk factors,” said the senior author, Dr. Abbey B. Berenson, director of the Center for Interdisciplinary Research in Women’s Health at the University of Texas Medical Branch at Galveston. “The flip side is that if I have a patient who smokes, I’m going to be more concerned about giving her Depo-Provera.”

Your bones could be aching for attention even if you’re still none of the above. The World Health Organization now has a nifty new bone-health tool called FRAX to help you figure if you’re at risk for fractures. You can visit their site, plug in country and ethnicity for your personal profile. You can also go to KnowMyBones.com (bones people are having a good time with titles and acronyms) and find out more about healthy bones and how to keep them thus.

Dem bones, as long as you help them, gonna walk around.

California/General interest/Health/Lifestyle/seniors/Sports/USA/Women
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Adventure travel for the young — at heart

by Fran Johns

Not long ago I was fond of bragging, with more than a small amount of smug self- satisfaction, about completing Circus 101 class at the San Francisco Circus School shortly after I became eligible for Medicare. Although it was quickly evident that I can’t do upside down any more without tending to throw up, I was more flexible than the muscular hunks and quite good, if I do say so, on the top of the pyramids. I was always the top of the pyramid because nobody wanted to step on the little old lady. Moments of grandeur and glory, those were.

Well, tell that to Ilse Telesmanich, 90. She’ll be hiking in South Africa this summer. Or Tom Lackey, who is into wing-walking over the English Channel at 89. (“My family thinks I’m mad,” Mr. Lackey said in a telephone interview discussing the flight with New York Times writer Kirk Johnson — his 20th wing-walk. “I probably am.”)

Intensely active older men and women who have the means and see the twilight years as just another stage of exploration are pushing further and harder, tossing aside presumed limitations. And the global travel and leisure industry, long focused on youth, is racing to keep up.

“This is an emerging market phenomenon based on tens of millions of longer-lived men and women with more youth vitality than ever imagined,” said Ken Dychtwald, a psychologist and author who has written widely about aging and economics.

And the so-called experiential marketplace — sensation, education, adventure and culture, estimated at $56 billion and growing, according to a new study from George Washington University — is where much of that new old-money is headed.

At the Grand Circle Corporation, for example, a Boston-based company that specializes in older travelers, adventure tours have gone from 16 percent of passenger volume in 2001 to 50 percent for advance bookings this year, even as the average traveler’s age has risen to 68 from 62.

At Exploritas, a nonprofit educational travel group previously known as Elderhostel, the proportion of people over 75 choosing adventure-tour options is up 27 percent since 2004. The sharpest growth has been in the over-85 crowd, more than 70 percent.

At VBT, a bike touring company in Vermont that does rides in countries around the world, the number of bikers over 70 has doubled in the last 10 years.

“Unusual is way more popular now,” said Alan E. Lewis, chairman of Grand Circle, “and with this audience, that’s a major shift.”

It’s not all fun and high adventure — medical insurance with companies such as  InsureMyTrip.com is likely to quadruple, transporting medications can be problematical, and ordinary risk factors (though wiser elders often fare better than macho youngers) remain.

But it’s enough to make me renew my Exploritas membership, hit the par course more often and shut up about circus school.

Seeing Old Age as a Never-Ending Adventure – NYTimes.com.

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