Category: Lifestyle

California/General interest/Health/Lifestyle/Religion/seniors/USA/Women
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More on mortality: living strong, dying well

by Fran Johns

It’s hard to think about the death of my sister Jane (below) without thinking of another death we faced together.

Our father, in his 90th year on the planet and his 20th year of widowhood, started putting the pressure on Jane and me to come to see him one Thanksgiving. As we were in different states and had families and other things needing attention, getting to Virginia required some doing. Our dad had two daughters in between Jane and me, but she was the executor of his estate and I was the one who brought comfort because I closely resemble my mother. We four daughters usually visited at different times in order to stretch out the audiences for his story-telling and generally keep an eye on him. This time he was adamant. He wanted the two of us there together.

In mid-January we got it worked out. Jane and I met in Atlanta, having to spend the night there because the Richmond airport was snowed in. We managed to get on the first plane to land in Richmond the next morning. After picking up a rental car for the drive to Dad’s home in Ashland we took him to lunch at the only place open in town. He was impatient to get back home. Once there he did his traditional monologue about his 12 flawless grandchildren, a reassurance, of sorts, of his posterity. Then he shuffled off to his room for a nap.

And that’s where we found him when he didn’t answer a call to dinner. Keeled over, on his knees at the head of his bed, where he had said his prayers for 90 years. Having  departed this realm in the midst of a conversation with God, all arrangements complete. He and God had long maintained a strong, conversational relationship.

Not all of us can engineer our departures so efficiently — you had to know my father. Or so gently as Jane’s closing days with her family around, singing hymns. But there are millions of such stories (some of which are in the book, Dying Unafraid, that was motivated by the first story above, if you’ll pardon a little blatant self-promotion here; it’s still in print.) The great majority of those stories happen not because the central character had an unshakable faith in some deity or other (although that does tend to help matters) or because he or she had mystical powers or superhuman strength and determination, but because the central character accepted his or her mortality. We’re born, we live, we die. The facing of, and preparation for, its eventual end often makes dying better and always makes life richer.

That’s the lesson of these two stories. Dying unafraid tends to happen to people who live unafraid. And who talk to their families and friends, and complete their advance directives, and make it clear what their choices are. This is equally true for the young and the old, the fit and the infirm.

What are you waiting for?

California/General interest/Health/Lifestyle/Money/Politics & Causes/USA
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Anthem Blue Cross 'doing the right thing'?

by Fran Johns

In testimony before the California Assembly Health Committee yesterday, Anthem Blue Cross President Leslie Margolin said of her company, “I think we do the right thing, and we try to do the right thing every day.”

What that means is, turn a profit for the company every day. If you are in business to make money, that is the right thing to do.

On the other hand, when Margolin says the company’s goal is to provide “care, comfort and coverage to those in need,” that is simply not true. Physicians and health care professionals provide care and comfort. Anthem provides coverage which sometimes pays for these things and often does not, if they can help it.

Is there no way to connect those dots? Care and comfort for those who need and deserve it — i.e., every human being — are not going to happen until we get the coverage people out of the equation.

OK, not going to happen any time soon. It could happen in California, except for Governor Schwarzenegger‘s probable veto. It should happen in Washington, except for the money and muscle of the coverage people. In lieu of those realities, a health bill that takes a tiny step in the right direction would be welcome.

California/General interest/Health/Lifestyle/Medicine/seniors/USA
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You can go home again — but should you?

by Fran Johns

Yearning to go back to your childhood? It may or may not work.

For many of us, memories of what seems such a carefree, safer time are linked to a place. And now, thanks to Google Maps and other sites, we can find – and sometimes physically revisit – those houses and territories at the center of a powerful, nostalgic pull. But, like adoptive children searching for birth mothers (and vice versa), the adventure carries risk. That site at the end of the rainbow might be psychological gold – or it can turn out to be a pot of mud.

Saturday’s Wall Street Journal featured a ‘Journal Report’ article and related story about the going-home phenomenon, including one particularly fascinating segment:

When John Beebe, a Jungian analyst in San Francisco, was invited to speak at a conference in China, he decided he would try to find the house he had lived in there as a child. His father had been a military attaché in the 1940s, and Dr. Beebe remembers living in a “rather grand” house before the family was evacuated and before his parents divorced.

But when he finally found the spot, the house was gone. It had been replaced, in his words, by “drab communist housing.” That visit—and watching “Empire of the Sun,” a World War II movie about a boy separated from, and then reunited with, his parents—triggered overwhelming feelings of grief, Dr. Beebe recalls. “Twenty-seven years of Jungian analysis, and I didn’t mourn my childhood until then,” he says.

“A lot of people haven’t fully left home,” Dr. Beebe says. “Some people need to go back [in order] to move on.” Others, while claiming to be “just curious” about seeing their childhood home, may have a deeper motive, he suggests: a desire to reconnect to the way they felt as a child before life—school, careers and families—required so many compromises. “In adapting to the world, we all lose some of our soul,” Dr. Beebe says. “When we make the journey back, we find some of our soul again.”

As the eminent Dr. Beebe happens to be a friend of this space, that sent us to the telephone to ask for free advice to pass along to readers about the pros and cons of returning to childhood in this manner. (Before signing off on the advice, Beebe said he “wanted to put in a plug for the amazingly good writer Kathleen A. Hughes” who authored both stories referenced above, proving out his own reputation as both acclaimed analyst/speaker and genuine nice guy. This space hereby strongly recommends you go out and buy Saturday’s WSJ.)

As far as the potential benefits of revisiting childhood space go, Beebe says that “for all of us, particularly as we get older, withdrawing the projections we make onto things that interfere with right relationships” can be very good. In other words, perhaps “our parents were not as tall as we thought.” Or that room so huge or that shadow so all-encompassing. “We all have a subjective relationship to childhood,” he explains, “and it kind of ties us to unreality. When we see where (our memory) was right, and where it was wrong, it somehow sets the soul at rest.”

As to the potential pitfalls of geographical/psychological returns, Beebe says that “memory is powerful, but so is reality. Certainly I was more upset than I’d imagined in China. In a way, I hadn’t grieved enough. These returns tend to stir things up; it can be shocking to be flooded with emotions and I didn’t expect this. I was taken by surprise, but ready.”

Making the return, and dealing with possible impact, may be something you don’t want to undertake all by yourself. “As they used to say about psychedelic drugs in the 60s,” Beebe comments, “it’s better to have someone around to guide you through the trip. It’s not good to be alone.”

In my 60s I returned to my birthplace in Porto Alegre, Brazil, where the tales and photos I’d grown up with showing idyllic hillsides overlooking the bay turned out to be a jumble of rooftops and high walls. In my 40s I returned to the site of my earliest memories, the Nashville, TN house in which I remembered running merrily up and down the length of a giant kitchen. It was, in reality, roughly 6′ x 8′. Today Google Maps tells me it’s gone, replaced by what seems to be an educational facility for the church (same old church) that was two doors down the street. As there are too many metaphors here even to begin considering, if I do any further revisitation I may invite John Beebe to go along.

What about you? Any more going-home-again stories out there?

California/General interest/Health/Lifestyle/Medicine/seniors/Sports
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Breaking news on broken-down joints

by Fran Johns

There’s old news — joint replacements for athletes are downright commonplace, seniors in their 80s and 90s are getting new hips — and now there’s good news. Researchers at the University of California San Francisco, led by sports medicine chief C. Benjamin Ma MD, are finding that damage to the cartilage connecting the foot bone to the ankle bone to the leg bone etc might not have to be permanent.

As almost anyone with a series of sports injuries may know, cartilage damage is permanent. In the words of Dr. Benjamin Ma, chief of sports medicine at UCSF, “cartilage is just lazy” — it doesn’t like to regenerate, so when it gets damaged or worn down through use or injury, it won’t come back on its own.

But Ma and his research team have discovered that given very specific circumstances, cartilage will, in fact, regenerate. The team has been taking knee cartilage from subjects and placing it on a matrix and under some very specific conditions, it is forced to regenerate.

“Cartilage cells are very lazy. They don’t like to grow if they don’t have to,” he said. “So we fool them by doing this particular maneuver and they feel they have to grow, and they form new cartilage. Then we glue it back into the knee.”

The new method has proved to be safe and it helps improve function, and now it is undergoing Phase 3 clinical trials to see whether it in fact works better than microfracture surgeries currently used to treat cartilage injuries.

Down the road, Ma and his team hope to see if there is an application of this method that could help people suffering from arthritis, which is also a cartilage disorder.

That cheer being heard across cyberspace is coming from millions of amateur athletes and the entire population over 50, almost every one of whom could use a little newly invigorated cartilage.

Read more at the San Francisco Examiner.

California/General interest/Health/Lifestyle/Medicine/USA
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Medical marijuana benefits proven

by Fran Johns

Surprise. Medical marijuana really helps. What millions of us have known ever since friends with AIDS proved it more than a decade ago is now affirmed. San Francisco Chronicle writers Victoria Colliver and Wyatt Buchanan broke the news today:

The first U.S. clinical trials in more than 20 years on the medical efficacy of marijuana found that pot helps relieve pain and muscle spasms associated with multiple sclerosis and certain neurological conditions, according to a report released Wednesday by a UC research center.

Dr. Igor Grant, a UC San Diego psychiatrist who directs the center, called the report “good evidence” that marijuana would be an effective front-line treatment for neuropathy, a condition that can cause tingling, numbness and pain.

The results of five state-funded scientific clinical trials came 14 years after California voters passed a law approving marijuana for medical use and more than 10 years after the state Legislature passed a law that created the Center for Medicinal Cannabis Research at UC San Diego, which conducted the studies.

California’s Proposition 215, passed in 1996, allows patients with a valid doctor’s recommendation to grow and possess marijuana for personal medical use. It is one of 14 state laws legalizing medical marijuana. But the federal government still says pot is illegal and without medical benefit. Perhaps that may now change.

“This is the first step in approaching the (U.S. Food and Drug Administration), which has invested absolutely nothing in providing scientific data to resolve the debate,” said state Sen. Mark Leno, D-San Francisco, who noted that marijuana showed benefits throughout the AIDS epidemic in helping people afflicted with neuropathy and other ailments.

Dale Gieringer, a Berkeley resident who is executive director of the California branch of the National Organization for the Reform of Marijuana Laws, agreed.

“This is finally the evidence that shows that the (U.S. Drug Enforcement Administration) stance that marijuana does not have medical use is just wrong,” he said. “It’s time for the Obama administration to act.”

The bad news is that funding for research that could further confirm the potential medical benefits of marijuana may soon run out.

The Center for Medicinal Cannabis Research has approved 15 clinical studies, five of which were completed and reported Wednesday, and two are in progress. While researchers said more studies are needed, the future of the center is in doubt.

The center has spent all but $400,000 of the $8.9 million in research funding it started with in 1999. Leno said the state doesn’t have the money to continue funding it.

“It may be close to the end of its life unless there’s foundation money to continue the work,” Leno said.

If we could just combine the savings that could accrue from getting the feds out of the pot-prosecution business and the taxes that would accrue from legalization of medicinal use, a lot of that work could continue. And a lot of suffering could be alleviated.

California/General interest/Health/Lifestyle/seniors
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Can geezer drivers get safer? How about texters & cellphoners?

by Fran Johns

Just how risky are distracted drivers? Texters, geezers, cellphone users? Recently, Secretary of Transportation Ray LaHood has cranked up the heat on a major campaign to end distracted driving. Well, more power to him… except LaHood’s dsitracted campaign seems to equate driving while talking on a cell phone with driving while tripping on LSD. LaHood’s overkill has raised the ire of The Weekly Standard’s senior editor Andrew Ferguson, who rather eloquently protests what Ferguson (and a lot of others) see as one more good example of government’s overreaching foolishness.

Over the last several months LaHood has mobilized his vast and lavishly funded ($70 billion) department behind a high-minded goal: “to put an end to distracted driving.” Those are his words—not curtail, not discourage, not even reduce by 50 percent. No: Put an end to. In its ambition and method, LaHood’s initiative is a kind of textbook example of how government guys create work for themselves, manage to keep themselves busy, and put the rest of us on our guard.

Meanwhile, with LaHood overreaching and manufacturers of front-seat computer equipment over-promoting we will all have to remain on guard. Against cell phone talking drivers, texting drivers, Big Mac eating drivers and…. geezer drivers.

I, a certified geezer driver, am at risk for a crash. This is a daunting discovery when one is the only driver in a household that occasionally needs to be driven somewhere. My preference — being a resident of the beautiful, walkable city of San Francisco — is always either to walk or take the Muni, but let’s face it, there are times I need to be behind the wheel. And I hate to put you at risk. Or myself, or my passenger either, for that matter.

So you and I are about to get safer. With no help from Ray LaHood.

This all started with a recent post about geezer drivers, texting drivers and other hazards. Steven Aldrich, CEO of PositScience, commented on that post. PositScience makes brain-training software and I am not on their payroll. But I did take the “What’s my crash risk” test which you are also hereby invited to take. I whizzed through the tutorial with a whole bunch of “That’s right!” responses, then set about taking the Evaluation and promptly flunked. After a phone conversation with Aldrich and one of his software experts I am conceding that the problem is not with their software but with my geezer brain. (Try it yourself. Let me know if you fail, please, I would appreciate some company.) Here’s the deal with the test:

The Crash Risk Evaluation measures your “useful field of view”—how much your brain notices in your peripheral vision in a brief glance. Studies show that the size of a person’s useful field of view is closely correlated with car crash risk.

Useful field of view tends to shrink with age because the brain takes longer to process what it sees. As a result, in a single glance it only has time to take in what’s in the middle of a scene—not what’s in the periphery. A smaller useful field of view makes it less likely that you’ll notice potential dangers—like a car swerving into your lane or a dog running into the street—in time to avoid them.

Having had my performance on the Crash Risk Evaluation indicate that my useful field of view is smaller than average, I am deemed risky. I reserve the right to at least some suspicion about tricky tests — there is a product for sale here and clearly it wouldn’t sell if everyone passed with flying colors — but I do have a geezer brain.

Therefore, thanks to the generosity of PositScience, I am now in possession of the DriveSharp program which I’m starting tomorrow. It’s 10 hours, for heaven’s sake, so don’t look for safer roads in San Francisco this week.

This space will report on your improved road safety as my DriveSharpness progresses. Got any ideas about texting drivers?

California/Environment/General interest/Health/Lifestyle/Women
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Goldsworthy sculpture sends spirits soaring

by Fran Johns

Just when you think there is no good news, anywhere, any more, comes wordSpire sculpture this morning that Andy Goldworthy is considering a new sculpture in the Presidio National Park. His last work, Spire (left), created a monument to nature out of the trunks of 37 cypress trees. Like most of Goldsworthy’s works, Spire evokes a sense of reverence and peace. And, also like many others, it will eventually disappear as surrounding trees grow up to and past their silent neighbor.

The serenely beautiful film Rivers and Tides introduced many Americans to the creative Scottish sculptor a few years ago. My 40-something children loved it. Their teenage children loved it. Preschoolers love it. What’s not to love about Rivers and Tides? Goldsworthy art has a way of inching into your soul and making thinks okay. The new piece in the Presidio — that gorgeous chunk of land you and I now own — would be a band of eucalyptus branches snaking along 350 feet of Lover’s Lane, in the southeast corner of the 1,491-acre park. It may not leave the ground, but it still promises to soar.

Goldsworthy’s best known works in the San Francisco Bay area include his Stone River at Stanford, and Faultline at the de Young Museum

You’ve not met Andy Goldsworthy? Treat yourself. It’ll make your day.

California/General interest/Health/Lifestyle/Women
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'Lesbian Health 101' seeks to open doors, minds

by Fran Johns

Years ago a lesbian friend, who would soon die of uterine cancer, told me how she hated going to her gynecologist and consistently postponed it. “I’m sitting there in the middle of all those bulging bellies and beatific smiles,” she said, “like some sort of an alien.”

How I wish she were alive, so I could send this clipping from the San Francisco Chronicle:

When Dr. Patricia Robertson held the first lesbian health clinic at San Francisco General Hospital in 1978, she decided to cover the “family planning” signs in the lobby – she didn’t want to deter patients who thought gynecologists were only for dispensing birth control and helping women get pregnant.

“We wanted to put together evidence-based research that would support clinical guidelines, so when we talk about why lesbians are different from heterosexual women we can back that up,” said Robertson, who is a professor in the UCSF department of obstetrics, gynecology and reproductive sciences. “Doctors are going to be able to legitimize their advice after they read this book.”

The article points out that although progress has been made in health care since then, “lesbians are more likely than straight women to suffer depression and drug and alcohol abuse. They may be less likely to get regular health screenings like pap smears and breast exams.

With those disparities in mind, Robertson and Suzanne Dibble, a registered nurse with the Institute for Health and Aging in the UCSF School of Nursing, have put together the first textbook on lesbian health care. ‘Lesbian Health 101’ was released this month.

The textbook is written in medical language and designed for doctors, nurses and other health care providers, although Robertson and Dibble say they’re encouraging lesbians to use it as a resource for understanding their own health issues. Most of the chapters were written by health care providers who are also lesbian.

Chapters in the nearly 600-page book focus on a wide variety of health issues, from heart disease and breast cancer to partner violence and how to decide which woman in a relationship should get pregnant.Some sections focus on the risk factors that affect lesbians more than straight women – higher smoking rates, for example, or what effect not having children might have on breast cancer risks – while others address how doctors can best meet the particular needs of lesbian patients.

Many of the health issues that affect lesbians can be tied to stress related to their sexual orientation, Dibble said. Discrimination, the stress of coming out to family and friends, or feeling ostracized and alone can all lead to health problems.

Dr. Erica Breneman, an obstetrician-gynecologist with Kaiser Permanente in Oakland, said she’s pleased to see such a textbook available to doctors now, even if it’s troubling that the book is even necessary.

“In a perfect world, we wouldn’t need this,” Breneman said. “A woman who happens to be gay shouldn’t need much that’s terribly different than a woman who is straight. But the reality is, because of the particular demographics of lesbian women, they do have other health issues.”

Perfect worlds, it seems, are slow in coming.

‘Lesbian Health 101’ seeks to open doors, minds.

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