Category: Health

California/Health/Lifestyle/Medicine/physicians/teens
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Medicinal pot, Yes. Legal pot, bad idea

by Fran Johns

Wafting around California these days is a lot of rhetoric about legalizing marijuana, a proposition (#19) that will be on the ballot in November. Californians being Californians — I’m one; I know — and pot being pot, there is no shortage of heated opinion. Here is one more.

Countless Americans suffer from chronic or short-term conditions which could be relieved by marijuana. To deny them such relief simply makes no sense at all. The sooner everyone wakes up to the logic of marijuana as comfort care, and it becomes universally legal and available, the better.

Legalizing the weed for recreational delight, though — essentially making it available to all comers — makes very little sense at all. It’s an addictive substance, folks. It messes with your mind. All we need is a whole new population of messed-up folks to add to the messes we already have.

This is just one addict’s opinion. But if one addict’s opinion is only anecdotal, some others, below, are worthy of serious consideration. They were offered by the California Society of Addiction Medicine in an op ed piece by the Society’s president, Dr. Timmen Cermak, in the San Francisco Chronicle, August 22. The Society is taking no position on Prop. 19, Cermak explains, “but we wish Californians would look at the research before they make up their minds on how to vote.” This space applauds that suggestion.

The Society of Addiction Medicine is made up of “the doctors who specialize in the treatment of drug abuse; we work every day with people addicted to drugs, including alcohol,” Cermak writes. “We are a diverse group of doctors committed to combining science and compassion to treat our patients, support their families and educate public policy makers.”

Since very few of the Society of Addiction Medicine’s 400 physician members believe prison deters substance abuse, legalizing marijuana would have that small, back-handed benefit. “Most (of us) believe addiction can be remedied more effectively by the universal availability of treatment,” Cermak writes. “When, according to the FBI, nearly half – 750,000 – of all drug arrests in 2008 in the United States were for marijuana possession, not sales or trafficking, we risk inflicting more harm on society than benefit. Prop. 19 does offer a way out of these ineffective drug policies.”

But other research should raise alarm bells. Cermak’s essay is excerpted below, with a few points worth pondering bold-faced:

“Two-thirds of our members believe legalizing marijuana would increase addiction and increase marijuana’s availability to adolescents and children. A recent Rand Corp. study estimates that Prop. 19 would produce a 58 percent increase in annual marijuana consumption in California, raising the number of individuals meeting clinical criteria for marijuana abuse or dependence by 305,000, to a total of 830,000.

“The question of legalizing marijuana creates a conflict between protecting civil liberties and promoting public health… between current de facto legalization in cannabis clubs and revenue-generating retail marijuana sales… The society wants to make sure voters understand three basic facts about how marijuana affects the brain:

“– The brain has a natural cannabinoid system that regulates human physiology. The flood of cannabinoids in marijuana smoke alters the brain’s delicate balance by mimicking its chemistry, producing a characteristic “high” along with a host of potential side effects.

“– Marijuana is addicting to 9 percent of people who begin smoking at 18 years or older. Withdrawal symptoms – irritability, anxiety, sleep disturbances – often contribute to relapse.

“– Because adolescent brains are still developing, marijuana use before 18 results in higher rates of addiction – up to 17 percent within two years – and disruption to an individual’s life. The younger the use, the greater the risk.

“Marijuana is a mood-altering drug that causes dependency when used frequently in high doses, especially in children and adolescents. It’s important that prevention measures focus on discouraging young people from using marijuana.

“Prop. 19 erroneously states that marijuana “is not physically addictive.” This myth has been scientifically proven to be untrue. Prop. 19 asks Californians to officially accept this myth. Public health policy already permits some addictive substances to be legal – for instance, alcohol, nicotine and caffeine. But good policy can never be made on a foundation of ignorance. Multiple lines of scientific evidence all prove that chronic marijuana use causes addiction in a significant minority of people. No one should deny this scientific evidence.”

So we could use the tax revenues from legalized pot. But it may surely be worth thinking twice about what the concurrent costs will be, in illness and crime and human lives.

Gun control/Health/Healthcare/Lifestyle/seniors/Women
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The curious world of cyberspace

by Fran Johns

Disappearing from cyberspace is a little like being a tree that falls in the forest. A very small tree. Having disappeared from cyberspace myself for a couple of weeks, I am comforted by the fact that the forest is very large.

It’s not that this space disappeared, just that Boomers and Beyond disappeared. Boomers and Beyond is a blog primarily about issues critical to over-50 generations, and it came to pass on  True/Slant.com a couple of years ago. It dealt with health care and fitness and housing choices and brain exercises and driving safety, and often diverted into rants about gay rights and abortion rights and gun control and other miscellany — because the True/Slant folks were a free-wheeling bunch and why should anybody quit worrying about rights and justice when they turn 50? All those profound words are archived in this nifty blog (this WordPress one right here) created by incredible friend-of-B&B-&-this space Mary Trigiani, so that if anyone stumbles into the forest and wants to study a small bush those twigs — OK, enough with the metaphor — are there to be read.

True/Slant didn’t actually disappear; it got bought by Forbes, and is gradually reappearing (as a New And Improved Forbes blogsite) there. Boomers & Beyond is reportedly going to reappear thereon, as soon as a contract appears. In the interim, it is just sitting there inert, and after several watchful readers noticed its inertia (posting anything new isn’t an option at True/Slant any more) I decided to venture once more into cyberspace.

It’s pleasant to meet you here. I hope we’ll meet again soon.

California/Health/Lifestyle/Medicine/New York/seniors/USA/Women
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Early cancer tests, surgeries questioned

by Fran Johns

Was this mastectomy necessary? It’s a question few breast cancer survivors want to ask, and one that few are likely to answer absolutely. But after years of aggressive emphasis on early diagnosis and treatment, some previous imperatives are being called into question. Noting that breast biopsy has long been considered the “gold standard,” a report in today’s New York Times addresses the new rethinking:

As it turns out, diagnosing the earliest stage of breast cancer can be surprisingly difficult, prone to both outright error and case-by-case disagreement over whether a cluster of cells is benign or malignant, according to an examination of breast cancer cases by The New York Times.

Advances in mammography and other imaging technology over the past 30 years have meant that pathologists must render opinions on ever smaller breast lesions, some the size of a few grains of salt. Discerning the difference between some benign lesions and early stage breast cancer is a particularly challenging area of pathology, according to medical records and interviews with doctors and patients.

Diagnosing D.C.I.S. “is a 30-year history of confusion, differences of opinion and under- and overtreatment,” said Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville. “There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin.”

Much of the current finger-pointing is toward pathologists, where their money comes from, whether they are ‘certified’ or not and in general, how good a job they do.

In 2006, Susan G. Komen for the Cure, an influential breast cancer survivors’ organization, released a startling study. It estimated that in 90,000 cases, women who receive a diagnosis of D.C.I.S. or invasive breast cancer either did not have the disease or their pathologist made another error that resulted in incorrect treatment.

After the Komen report, the College of American Pathologists announced several steps to improve breast cancer diagnosis, including the certification program for pathologists.

For the medical community, the Komen findings were not surprising, since the risk of misdiagnosis had been widely written about in medical literature. One study in 2002, by doctors at Northwestern University Medical Center, reviewed the pathology in 340 breast cancer cases and found that 7.8 percent of them had errors serious enough to change plans for surgery.

This space has argued occasionally for reconsideration of yearly mammograms and for longer, stronger consideration of other options before a mastectomy is performed. Especially in the case of older women.

Would I insist on further studies or opt for less radical treatment if I were diagnosed with breast cancer today? Probably. Can I undo the mastectomy I had at 72? Not exactly. Second-guessing is beside the point for someone who is healthy and fit, but asking questions won’t ever hurt.

Earliest Steps to Find Breast Cancer Are Prone to Error – NYTimes.com.

California/Health/Lifestyle/Money/seniors/USA/Women
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Death wish for boomers & elders?

by Fran Johns

Reaching for the hemlock in order not to be a burden…. this seems a little farther than most of us want to go. But the idea is crossing more than a few aging minds, reports CNN intern Sachin Seth on a recent blog.

Rather than burden their children with the daunting task of caring for them as they age, some baby boomers may be considering an extreme form of “relief.” Suicide.

Psychiatrist Mark Goulston says he’s been approached by some middle-aged patients who say they’d rather “take a bottle of pills” than inconvenience their children.

Dr. Goulston blames the problem on the impatient nature of “millennials” – the offspring of baby boomers – a trait he says was passed down from the boomers themselves.

Adding to their angst is their own experience of taking care of elderly parents, which sometimes leads to feelings of resentment. Baby boomers don’t want their own children to grow to resent and begrudge them when they get old and feeble.

There’s a video exchange between Goulston and CNN’s Don Lemon that’s worth watching, but won’t lift your spirits much.

Add to this don’t-be-a-burden dilemma — and it IS a dilemma that crosses the mind of everyone over 60 and most folks who have a parent over 60 — the bizarre situation of estate taxes right now and the whole business of dying gets seriously complicated. It was okay last year, when you knew estate taxes were magically going to disappear on January 1, 2010, so the focus was on staying alive until then.

California/Environment/Health/Lifestyle/Politics & Causes/seniors/USA
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Cellphones, antennas, towers… radiation happens

by Fran Johns
cellphone antenna pole in Wimsheim, Germany
Image via Wikipedia

Radiation from the A-bomb test witnessed by my then-Marine husband in the early 1950s was registered on a small badge worn around his neck. They double-timed from foxholes toward the site of the blast. As far as we and the U.S. government know, all of those guys went on to lead long and healthy lives — and we went on to deadlier bombs anyway. We do now know a little more about those sorts of radiation damage.

We don’t know much about the tiny emissions from cellphones, iPhones, cellular antennas, texters, Skypers, whatever. The suggestion that any of those cyber-issues could possibly cause harm draws scoffs and derision and denials, but the truth is we simply don’t know. Some folks would still like to find out; maybe even find out before harm is done rather than after. An ongoing mini-battle in San Francisco is typical of such citizen struggles everywhere:

The increasing popularity of smart phones is pitting companies looking to expand their coverage against city residents concerned about the dangers presented by a growing number of cellular antennas.

Nearly every week, the city Planning Commission hears from a company looking to add to the thousands of cellular antennas already in the city. And, like clockwork, local residents turn out to fight the plans.

“These towers should be away from residences, away from schools and away from other vulnerable populations,” said Doug Loranger, who, as founder of the San Francisco Neighborhood Antenna-Free Union, has been fighting the cellular companies for a decade.

That’s not easy to do in a city as densely packed as San Francisco, where hills and tall buildings have long made radio transmission a challenge.

The crowds that jammed local stores looking to buy the new Apple iPhones last month demonstrate another part of the problem. San Francisco has a reputation as one of the most tech-savvy cities in the country, and the people buying the various new smart phones want fast and easy access to the Internet on their handheld devices, which means more demand for service.

This demand for service drives the rush to install more antennas and modify the existing ones. As long as they meet emission standards set in 1996, they are deemed fine, and cannot be challenged on the basis of health, a frustrating reality for potential challengers. Because that actually is the issue: whether — or at what point — emissions can indeed become damaging to one’s health. And though radiofrequency radiation emitted by the antennas has not been proven to have any damaging effects, activist Beverly Choe, whose children attend school near one such installation says, “it doesn’t seem prudent to add more radiation until we’re sure of the effects.”

“People want service where they live, where they work and where they play,” said Rod De La Rosa, a spokesman for T-Mobile. “We’re trying to roll out more high-speed data transmission by increasing the size of the pipe and not just for voice.”

T-Mobile is just one of the service providers looking to boost their presence in San Francisco. Just last week, Clearwire, a new company providing wireless data service only, came to the Planning Commission with requests to add antennas to existing sites in Bernal Heights and by San Francisco General Hospital.

“Starting last year, we’ve had a big increase in requests for modifications (of existing sites) and for new antennas,” said Jonas Ionin, who oversees cellular antenna requests for the city’s Planning Commission. “What we’re finding today is that the increases aren’t necessarily based on voice traffic, but on data downloads.”

The city already is home to 709 cell sites, some with as many as 12 separate antennas. Although many of the recent requests have been for upgrades and additions to those existing sites, there is also a growing call for new spots for cellular antennas, which means more battles to come.

Those continuing battles have one interesting aspect that other battles can’t always claim. No one is waiting to find out who’s right. “The funny thing is that people call me on their cell phones to complain about the new installations,” said Diego Sanchez, a city planner. We may all be addle-brained from telecommunicating before we find out where it’s coming from. A lot of us grew up in asbestos-infused schools and homes, and we’re probably all eating mercury-infused seafood (not to mention drinking petroleum-infused water); life is hazardous to one’s health.

Tension over cellular antennas mounts in city.

California/Environment/Health/Law/Medicine/Politics & Causes/seniors/USA
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Supreme Court leaves 'Healthy San Francisco' program to its own success

by Fran Johns

Healthy San Francisco, the city’s healthcare-for-all program, remains firmly in place after the Supreme Court’s dismissal of a suit by the Golden Gate Restaurant Association last week. It may or may not be the model for everywhere else, but a lot of reassured folks here are happy with it. Many are also healthier in the bargain. PBS NewsHour correspondent Spencer Michels talked with several Healthy SF participants for last night’s report, while outlining how the program is working.

Until recently, San Francisco, a diverse city with a population of nearly 800,000, had more than 60,000 adult residents with no health insurance. They were not poor enough for Medicaid, nor old enough for Medicare.

While the nation struggled with reforming health care, this city began a program of its own that so far has enrolled more than three-quarters of its uninsured. It’s called Healthy San Francisco, and it is not, strictly speaking, health insurance. Rather, it’s a way to provide health care, but only within the city limits.

The plan was not particularly radical. It used mostly existing resources, like city clinics and nonprofit hospitals, to supply and coordinate care. Instead of flitting from one clinic or emergency room to another, enrollees choose a medical home, one of 30 public or private health centers in the city, where they go for low- or no-cost health care.

Once you choose your “medical home,” you can’t walk into another and get treatment. But the two Healthy San Francisco participants this writer asked (along with the patients and clinic directors Michel featured on the PBS show) indicate that customer satisfaction with the system — and with their one medical home — is high.

As to the costs, and who covers them, most San Franciscans other than the restaurant owners are fine with the plan. Restaurant-goers have gotten used to the friendly, small-print message at the bottom of the menu that lets them know an amount added to the tab goes to help pay for Healthy SF.

Each patient in Healthy San Francisco costs the city about $300 per month. That’s in line with insurance costs. It totals $126 million a year.

Depending on their income — and most are below the poverty level — enrollees pay nothing or from $20 a month up to about $200, plus co-payments. But that doesn’t pay for it all. The city has mandated that businesses with 20 to 100 employees spend at least $1.23 an hour per worker for health care, and that larger companies pay more.

That money can be used to reimburse employees for health care costs, to buy them health insurance, or it can go to Healthy San Francisco.

The Restaurant Association’s argument before the Supreme Court was not on Constitutional grounds, but rather that the city’s mandate that employers pay into the program violated federal law. The Court declined to deal with it all; the mandate stays. Susan Currin, CEO at San Francisco General, says emergency room use is slightly down. Director Hali Hammer of San Francisco General Hospital Family Health Center (one of the more popular medical homes) says they have hired new providers and expanded hours. The number of participants is growing at about 700 per week, and the Kaiser Family Foundation recently found that 94 percent of those participants are satisfied with the program. Paying that small extra amount for dinner out makes at least a few of us occasional diners-out feel a slight good-citizen glow. Something’s working.

San Francisco Ramps Up Care for City’s Uninsured | PBS NewsHour | Oct. 12, 2009 | PBS.

California/Health/Holidays/Lifestyle/seniors/Sports/USA/Women
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Running for fun & medals: it's been (and still is) a long, good race

by Fran Johns
Sunset Runner
Image by joshjanssen via Flickr

We’ve come a long way since Chariots of Fire, as Denver runners, coaches and serious peak-performance guys Jon Sinclair and Kent Oglesby point out in a report for Coloradoan.com.
Their column was inspired, in part, by the FireKracker 5K which was part of the weekend festivities in Ft. Collins. As commonplace as it now is to see joggers and runners on the trails, in the parks and (sometimes noisily, I regret to say) on the urban sidewalks just below your bedroom window at 6 AM, it was not always thus.

Everyone stand up. All of you that began running after 1976 can sit down. Those that still are standing can smirk proudly at those sitting.

I’m (Jon) sure there aren’t many of you standing. For us “pre-boomers,” or pbers, the current state of running is amazing and we should all feel happy about it.

Pbers, remember when there wasn’t such a thing as a running store? We bought our running shoes at the sporting goods store, which usually was manned by some guy named Al or Bill and the selection consisted of two to three different shoes. The guy selling those shoes was (absolutely, definitely) not a runner and knew nothing about the sport but made some money off of the local high school kids who ran track.

Not only were the shoes different (and under $50), Sinclair and Oglesby point out, but the timers and timing devices were different, the attitudes (sneers from onlookers, not runners) were different and the races were few.

In the early 70s, the entire yearly road racing schedule for the Denver area could be easily printed on an 8.5-by-11 piece of paper. Really, all of it. In summer, there might be two or three races per month. That’s why to a pber, any race older than 30 years, should be treated with great respect. Pre-boomer races weren’t certified and most were measured with some guy’s old pickup … accurate to within 400m. Oh, and no meters or kilometers back then either; we used good old miles. Races in Denver might attract more than 100 runners, but a field like that was out of control big.

But about this “pre-boomer” business. This runner/writer was delighted to discover the designation. There is even a pber who blogs regularly on pbers. And all this time I thought we were just Children of the Depression, or, in a word, Geezers.

By whatever term, some of us who were running before 1976 had experiences that are a little hard to imagine today. Especially the distaff side of the aisle — we were few and far between for some time there.  Once, following a neighborhood 10k in Atlanta, I hung out watching the awards ceremonies. I was still in the high school PTA mode, feeling myself both fit and acceptably chic. “Oldest Male Finisher” was called to the front for his plaque, a balding, gray-haired gent on rather wobbly, spindly legs. We clapped loudly. Then they called out the “Oldest Female Finisher” plaque and — you guessed it — my name. Last year I paired it with my lady geezer award from the Rabun Ramble 5k, about the same time I decided a brisk walk beats running these days. The Rabun Ramble people (OK, my daughter Sandy started this nifty Lake Rabun, Georgia charity event) wised up after a few years of too many medals, too little time. My award is a generic medal on a blue ribbon proclaiming Best in Class. I’ll take it. Some things never change: runners are pushovers for prizes.

Sport of running has traveled a long distance since the ’70s | coloradoan.com | The Coloradoan.

California/Health/Lifestyle/Medicine/seniors/USA/Women
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Live longer, healthier: prospects ahead

by Fran Johns

More news just in on the health and longevity front. At the University of California San Francisco medical center, which I can see from my studio window but that’s about as close as I will ever come to claiming kinship, a clinical trial getting underway will investigate the telomere factor. You haven’t been worried about your telomeres? Get used to them. It hasn’t been so long since cholesterol and genomes became household words.

Bay Area women who volunteer for a clinical trial at UCSF will be among the first people in the world to learn the length of their telomeres – the protective caps at the ends of chromosomes that regulate cell aging and may help people live longer, healthier lives.

Research has shown that the length of people’s telomeres is related to their “cellular age” – the health and stability of certain cells in their body. Because telomere length helps determine cellular health, it’s also been identified as a possible biomarker that can reveal information about a person’s overall health. Short telomeres have been linked to health problems like heart disease and diabetes.

UCSF researchers say it’s possible that identifying a person’s telomere length someday could become as common as checking cholesterol levels. A handful of private companies already have started advertising telomere testing to individuals. In fact, two of the researchers involved in the UCSF study are looking into starting their own company to test telomere length.

The study, reported by Erin Allday in today’s San Francisco Chronicle, will concern such issues as what relationship your telomeres’ length have to health and aging in general, and whether you even need to know a lot about the little cellular-ites. “The idea of telling people their telomere length is totally new and somewhat radical…,” said Elissa Epel, an associate professor of psychiatry at UCSF and one of the lead researchers in the telomere study. (On a purely personal, though relative note: you just try not to worry about it all when you are overage — they want women 50 to 65 — for an aging study and the lead researcher looks like she’s about as old as your granddaughter.)

Medical ethicists say the UCSF study makes sense – as more attention is drawn to telomere length as a potential marker of overall health, doctors should understand whether it benefits their patients to get that information or not.

If people can’t change their telomere length, there may be no point in telling them. Telomere length may be similar to some types of genetic testing that tell people whether they’re at increased risk for Alzheimer’s disease or certain types of cancer, said Arthur Caplan, director of the University of Pennsylvania Center for Bioethics.

Some individuals may decide they want that information – but it’s not always an easy decision to make, he said. “You might find out that you seem to be a premature or rapid ager, but whether there’s anything anybody can do to stop it or reverse it, that remains to be seen,” Caplan said.

How much our telomeres will tell us, what use we can make of it all, and whether you and I really want to know — these issues remain to be seen. Or at least, to be discovered in  the coming study. I have absolute trust in the folks at UCSF. If you do too, and you fit the parameters (female living somewhere in this lovely part of California, between 50 and 65) and want to volunteer to be a part of it all, whip off an e-mail to knowyourtelomeres@ucsf.edu.

UCSF to look at new longevity, health marker.

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