Recurrent Breast Cancer

Thursday, May 31, 2012

Dr. Clem's Health Blog

Dr. Clem's Health Blog: aoa.org/macular-degeneration.xml
www.aoa.org/macular-degeneration.xml

Yesterday, my wife and I drove a narrow winding road that took me to the fourteen thousand foot summit of Mount Evans.  Fortunately, the breathtaking trip was uneventful because I wore prescription sunglasses.  I wondered how someone could make this challenging drive without appropriate eye protection and prescription glasses. Gradual loss of central and color vision are symptoms of macular degeneration, not uncommon in middle-age people.   For further information, log on to the American Optometry Association regarding this eye disease.  You wouldn't want to drive over the edge.  It's two and a half miles straight down.

Tuesday, May 22, 2012


We often make excuses to keep in touch with those who are special to us. “It’s not convenient right now. Let’s do it later.” Pause and ask yourself, “Why don’t I have the time?”

Much of our day is spent doing what’s important for “us.” Multi-tasking, on-line communication, Facebook, Twitter, email, and LinkedIn are the norm. We avoid talking to neighbors, co-workers, and family.  “Not enough time to spare. I’ll get to it tomorrow.”  

I’ve had a long-time fascination with antique clocks. Swinging pendulums, resonating chimes, church bells, wedding bells, and door chimes all make me slow down. 

When I was a teenager, I watched an intriguing movie. There was an eccentric, elderly clockmaker, Ed, who lived across the street from a clock shop. His employer, Herbert, was as a “Scrooge.” When Ed came to work one morning, Herbert glowered as his employee tinkered with an old pendulum clock. Over time, he noticed that Ed spent more time with this clock than all the other timepieces.
One day, he confronted Ed.  “Do you want to keep your job?  I have to remind you time and again that this is a retail business. You have to care of all the timepieces.”

Ed had no reply, but his eyes sparkled as he polished his favorite clock. “Look at it. Cherry wood casing with swirled carvings, and its chime is as deep and colorful as gold. It reminds me of my younger days. It’s part of me.”

Herbert shook his head. “Silly old man. You’re losing your mind.”

“You don’t understand. It is eternal, but I’m not. When the pendulum stops, I die.”

An hour before closing time, Herbert told Ed to go home. He complied. “Thank you. I need the time to clean our chimney and fix the stove.”

After Ed departed, Herbert moved around the store and stopped all the pendulum clocks. “Lost time is lost profit,” he muttered to himself. He switched off the lights, locked the door, and went home.
Let me now take you to a different time. I was a pre-med student at the University of Kansas in the 1970’s. I kept a small LP record player in my room and enjoyed the music of a rock group, “The Byrds.” One of their songs contained a Bible passage from Ecclesiastes, Chapter 3: “To everything there is a season and a time for every purpose under heaven. A time to be born, a time to die, a time to weep, and a time to laugh, a time to mourn and a time to dance, a time to embrace, and a time to refrain from embracing, a time to gain and a time to lose … .”

My mother was diagnosed with breast cancer a year earlier. She did okay for a year or so after radical mastectomy surgery. Calculus, chemistry, and premed courses kept me busy during my second year at the University of Kansas. I promised my parents that I’d come home for spring break, a month away. 

My brother called me two weeks later on a Monday evening. “Clem, Mom died last night. Come home right away.”

I signed out of the dormitory the next morning and travelled home to attend her funeral. 

Let’s now return to the clock shop. Herbert came returned to his store the next day.  He started up all the clocks.  When he came to Ed’s clock, the pendulum dangled motionlessly. He wound the mainspring as tight as he could and nudged the pendulum. It refused to swing. By then, Ed didn’t show up for work. Herbert called his employee. Ed’s wife came on the line. She sobbed, “Edward didn’t wake up from his sleep. He is dead.”

What is the message here? I believe it is this.  None of us have all the time in the world. We need to take time to appreciate and stay in touch with those who are dear to us. 

When your clock fails to chime, will you be prepared?

Dr. Clem's Health Blog

Dr. Clem's Health Blog      mhmoa@hotmail.com

 


Watch out!  Do you have vision problems?  Macular degeneration is a disorder in which vision gradually deteriorates over time. The “baby boomer” population should have an annual optometry exam to screen for this condition.  You wouldn't want to drive off the road.

For further information, log on to the American Optometry Association, www.aoa.org/macular-degeneration.org.xml

Monday, May 14, 2012

Dr. Clem's Health Blog

Dr. Clem's Health Blog Long term heartburn?  It may be more than acid.
Stomach heartburn persisting over years puts you at risk for cancer of the esophagus.  Ongoing acid reflux from the stomach to esophagus may lead to Barrett's Esophagus, a pre-cancerous condition. About one in five adults diagnosed with esophageal cancer survive for five years.  Smoking, overweight, and lack of vegetables in the diet increase risk.  Acid inhibitors, such as Nexium, mask symptoms but don't treat the problem. The freight train is bearing down on you. Get it checked out. It's no fun having to be fed by a stomach tube the rest of your limited life.
                                                                                

Monday, April 30, 2012

Be Wary of Being Test Weary


Be wary of becoming test weary.  
 Here are seven tests and procedures doctors often recommend.  Are they safe, appropriate, and reasonable?
Electrocardiograms and heart stress tests for people who have no symptoms or history of cardiac disease.
Pro: Cardiac screening tests are reasonable for people with diabetes, hypertension, and family       history of heart disease.
Con: People with low risk of heart disease may have indeterminate or false positive results that lead to expensive and invasive testing.

DEXA (bone density test) scans.  
PRO: Steroids can weaken the bones. People who take long-term prescription steroids for certain diseases, such as severe asthma, adrenal insufficiency, and multiple sclerosis, can reduce fracture risk by having a bone density test to screen for and treat osteoporosis. 
Con: People who take physician prescribed steroids may develop hypertension, stomach ulcers, glaucoma, and diabetes. In these cases, DEXA testing can lead to unnecessary and expensive imaging tests and questionable treatment. The American Academy of Family Physicians recommends DEXA screening predominantly for women over sixty five and men under seventy.

Antibiotics for patients with mild sinus infection.
Pro: Antibiotics are appropriate for bacterial sinus infection.
Con: Viruses cause more than ninety percent of adult sinus infections. Antibiotics don’t kill viruses. Antibiotics can cause diarrhea and drug resistance, which increases risk of life-threatening bacterial infection.

 Over the Counter Anti-inflammatory medicines (i.e., Motrin, Advil, Aleve) for joint and back pain.
  Con:Pro: These medicines are cheap, easily available, and need no prescription.
Adverse effects of anti-inflammatory medicines include decreased kidney function, elevated blood pressure, fluid retention, and stomach bleeding.


 MRI and CT imaging for uncomplicated headache.
PRO: These imaging tests are highly sensitive for diagnosing stroke and tumors.
CON: Cumulative radiation from CT scans increase cancer risk. However, MRI imaging does not involve radiation. Though MRIs show exquisite detail, false positive findings could lead to unnecessary invasive procedures and surgery.
 Allergy testing:
PRO: Allergy testing by IgG (immunoglobin) antibody can diagnose food allergies so that people can eliminate certain foods and feel better.
Con: Presence of IgG antibody suggests a normal immune system.  However, IgE antibody, used in skin patch testing, is more specific for food allergy. Inappropriate dietary restrictions can weaken the bones and immune system.
X-rays, CT Scans, and MRI imaging for low back pain.
1.       Pro: These imaging tests are useful in diagnosing tumors and cancers for people with long-term low back pain.
Con: Chronic low back pain is rarely due to tumor and cancer. Most back pain resolves in six to eight weeks with no treatment.  However, people with long term back pain and weight loss, leg weakness, loss of control of bowel/ bladder, and fever should have further testing.
Source: AARP Bulletin, May, 2012


 Get Off Your Duff and Get Involved
A recent report in Archives of General Psychiatry (vol. 67, p. 304) suggests that having a purpose in life reduces risk of Alzheimer’s disease and mild cognitive impairment (MCI).  Over nine hundred participants greater than age eighty were evaluated by questionnaire in the Rush Memory and Aging Project for a seven year period.  Initially, none had clinical evidence of Alzheimer’s.  At the end of the study, 155 participants were diagnosed with Alzheimer’s.  Participants who had a strong sense of life purpose were 2.4 times more likely to not have Alzheimer’s.  Those participants had a reduced risk of MCI and slower rate of mental decline.  The study concluded that having a goal-directed purpose can lead to improved mental and physical health as well as longevity.
 

Sunday, April 22, 2012

Family Medical History

Imagine that it is four o'clock in the morning of Christmas Eve.You checked in at the Coffeyville, Kansas Holiday Inn after visiting cousins in Wichita, Kansas.  As you are getting ready to go to bed, you have gradual onset of chest pain and shortness of breath. You grab your cell phone and call the front desk. The desk clerk calls the volunteer fire department, which dispatches an ambulance. When the paramedics load you up,  your consciousness fades. A distant voice rouses you. Your glasses are missing. An endotracheal tube, connected to a ventilator,  prevents you from speaking.Your spouse and grandkids are in Germany enjoying a Rhein River cruise and won't be home till the following week. A resident physician pours through your incomplete medical records.  There is an undefined family history of heart disease. A nurse is frantically trying to reach a family member or friend.

How to Compile Your Family Medical History
Family medical history is crucial to assess health and disease risk. Sparse medical history can lead to unnecessary medical screening, inappropriate treatment, and delay in diagnosis.  Here are some recommendations to gather crucial information that may save your life.Compile a list of relatives and their contact information.  Ask about a range of health conditions, including heart disease, cancer, dementia, alcohol abuse, complicated childbirth, and when these were diagnosed.  Keep the records current. They can be stored on-line at familyhistory.hss.gov. Update it periodically and print copies for family and health care providers.  Additional useful websites include cdc.gov/genomics/famhistory and talkhealthhistory.org.  This may save your life.
Source:  HealthSmart; USA Weekend, April 2012.