Sunday, November 29, 2015

Have a pill . . . or not.

It's so widely known now that overuse of antibiotics has created a scary situation. More than one scary situation, actually: Not only has it led to drug-resistant superbugs, but it could permanently destroy a person's good bacteria.

Still, so many doctors keep prescribing them for viral infections--or, more accurately, infections that are far more likely to be viral in nature than bacterial. Antibiotics do nothing for viral infections. Why do they persist in doing this?

The most common excuse I've read is that patients expect a pill, usually an antibiotic. So what? Is there something in the Hippocratic Oath that says "Give 'em what they want?"

Sick all week with a sore throat and sinus infection, and beginning to develop a cough, I woke up feeling so thoroughly infected yesterday morning that I visited an urgent care center to have my lungs listened to and get an opinion on whether or not to go to my daughter's for our family Thanksgiving dinner.

The Physician's Assistant, who looked all of 18 and sounded so cheerful she practically chirped, offered me an antibiotic. If she'd given me a good reason why I should take it, I might have. But she didn't. She said, "Well, you came here, so that means you want to take something, right?" Wrong.

Later, I remembered she was the one who offered me an antibiotic for a rash on my eyelid that turned out to be shingles.

It bothers me that this obviously goes on all the time there, and probably in countless other facilities across the country. Perhaps the only way to stop it, or at least slow it down, is for the medical consumers to speak up. Of course we don't want to turn down antibiotics when we really need them. But when they're offered, it wouldn't hurt to ask why.

Tuesday, November 17, 2015

Is Nothing Ever Simple?

I ordered two items from a website I've used before. Most of their stuff doesn't appeal to me, but they have some good sales occasionally. The two things I ordered were a winter face mask to give as a gift and a pair of slippers for me.

An email acknowledging the order said I was entitled to a free magazine subscription. I've gotten these from them before, and it's a good deal. I usually give away the subscription, and this time I wanted to order a technology magazine for my son. But the website neglected to give me the code necessary to place the order, so I emailed their Customer Service. "Raquel" replied, telling me the code had been sent.

"I never got it, Raquel."

Next, "Jerome" said he'd sent me the code.

"It didn't arrive, Jerome."

We went through this with "Patrick" and "Olivia" before I finally got the code.

The winter face mask arrived without a problem.

I was eager to get the slippers, and happy to see a package in my mailbox yesterday. But instead of dark brown slippers, inside the box was a pair of white plastic Crocs. So I wrote to Customer Service again.

"Nadine" responded immediately. I explained that I wanted the slippers, so I would return the Crocs. She said she had arranged for the return, and attached a label for me to print out. The label said I was returning the winter face mask.

I wrote back. No, I said, the winter face mask was fine. I received a pair of Crocs in error. I want to return them so I can get the slippers I ordered.

That's okay, the reply from "Horace" said. He explained that he had arranged for the return, and attached a label for me to print out. The label said I was returning the slippers.

Politeness be damned. "NO NO NO!!" I wrote. I wrote a few other things, pointing out that it was their mistake that had landed the Crocs in my mailbox instead of the slippers I fervently wanted. (Well, I didn't say fervently. I thought it might be misinterpreted.)

So "Adam" wrote back and said I should use the label Horace sent. He said it would be fine, but added that they couldn't guarantee my slippers were still available.

I printed out the label, which states in bold letters that the slippers are being returned. A photo of the slippers is on the label too. I slapped it on the box containing the Crocs, and sent it on its way.

Monday, October 19, 2015

A long, hard look at mammograms

I just recently became aware of a 2014 report on a 25-year study involving almost 90,000 Canadian women to determine the benefits of mammograms. The researchers wanted to know if there was any advantage to finding breast cancers when they were too small to feel. The answer was no.

They also found that screening with mammograms can be harmful. One in five cancers found with mammography was not a threat to a woman’s health, yet the women received unnecessary chemotherapy, surgery, and/or radiation.

Approximately half the women were assigned to have regular breast exams by trained nurses, and half were given regular mammograms in addition to the breast exams.
At the end of the lengthy study, the number of women who died from breast cancer was 500 among those who had mammograms, and 505 among those who did not.

A quote from a NY Times article about the study:  “Many cancers, researchers now recognize, grow slowly, or not at all, and do not require treatment. Some cancers even shrink or disappear on their own. But once cancer is detected, it is impossible to know if it is dangerous, so doctors treat them all.”

This reminds me of something I once read about prostate cancer—that it’s unwise for men to be screened at too early an age because screening is likely to pick up cancers that will grow so slowly that they’ll never become a problem.

In Switzerland, the Swiss Medical Board has advised that no new mammography programs be started, and that those already existing  be limited in duration.  One member of the Board said mammograms were not reducing the death rate from the disease, and they led to false positives and needless biopsies.

Mammograms are big money-makers. In the U.S., about 37 million mammograms are performed annually at a cost of about $100 per mammogram. I guess it’s not surprising that although the results of the Canadian study came out last year, mammograms are still promoted in the U.S. as far as I can tell.

In discussing the potential harm done by mammograms, I have to mention radiation. My only known risk of breast cancer is from having my adenoids removed via radiation when I was 6 years old.  It has never made sense to me to expose myself to more of it, so I’ve had only two mammograms in my lifetime.

Another quote, this one from Dr. Russell P. Harris, a screen expert and professor of medicine at the University of North Carolina at Chapel Hill:  “The decision to have a mammogram should not be a slam dunk.”

Wednesday, October 07, 2015

Trash Talk

For our first 39 years in this house, only one garbage service was available. They offered 1-, 2-, and 4-can service, and you had to supply your own cans. Recycling was not part of the deal.

In recent years I started taking my recycling, as well as recycling from my son and his family, to a single-stream recycling center 25 miles away. I could have brought it to a township 5 miles away, but that would have meant separating everything: different metals, different colored glass, etc. And I'd have to bundle the newspapers with twine and probably do other things I've forgotten. Plus only one kind of plastic was acceptable. They were very picky.

It always bothered me that recycling wasn't made more convenient for people. I feel strongly about plastic in particular. With the typical "out of sight, out of mind" mentality, we've been filling up our oceans with plastic (among other things), and marine life is suffering the consequences. So are we, probably. And yet people in my rural area had to make an effort if they wanted to recycle. That was okay, but there were so many people unwilling to make the effort. We needed to make recycling easy (or mandatory) so everyone would do it.

This year I learned that single-stream pick-up had become available on my road. The service provides two very sturdy rolling receptacles, one for trash and one for recycling, and everything can go in the recycling bin, from cardboard and junk mail to plastics of all kinds. The monthly fee was $1 less than the non-recycling service. Still, judging by the trash cans I see alongside the road, most residents still use the non-recycling service.

Before I signed up for recycling pickup, I called the non-recycling service to make sure I hadn't misunderstood what they offered.

"Do you pick up recycling?" I asked.
"Yes, we do."
"You do?" I was surprised, to say the least. "Where do I put it?"
"You put it in the cans with your regular garbage."
"I do?" I was starting to feel a little slow on the uptake.
"Yes, it all goes together," she said.
"Then how do you separate it?"
"Oh, we don't," she said. "We put it all in the landfill."

Thursday, September 17, 2015

Hat, Mr Finger!

One of my European cousins posted something in German on Facebook, and I clicked Translate. Now I'm remembering why I don't do that very often. No doubt this was a serious issue, so I hope I don't get karma demerits for laughing, but sometimes translations create comedy where none existed before. Here goes:

We congratulate mr finger, for his commitment of mr gross will be awarded. Mr finger had to pay for this honour difficult. He was mayor of lion and Councilman Karl Brock, tortured and director on janitor downgraded, "as writing a book, not in the contract of employment was allowed". He was treated as in gdr-times; it is unbelievable that something like this can happen today and not by the district will be combated. Hat, Mr finger! 

To Karl Brock, we prefer to say nothing, except that he should resign his mandate. If he's guests in the castle as a "pig piglets" response and out throws (present was a cryford type-journalist) because they are, however, that he is a stasi-in as a city council and mayoral election-committee votes, and the city councils to try it on lawyers Ban it, that is, an informed he has in the castle Creedmore nothing to look for it. Now know mr gauck where Mr Brock Lives-in a city where the city council not it considers to be necessary, to be audited. Mr Gross should ask themselves why. Now support you, dear Mr Gross City Council, please.

Monday, August 10, 2015

1953: I've got mail.

From a letter my dad wrote to me when I was 10. It was the summer after my mom died, and I was staying with our cousin Peggy in Monterey, Massachusetts, while he was home in Queens. I think this first part of the letter is so funny. His mother (my grandmother "Lucky") had been an opera singer, and one of her favorite songs was the Joyce Kilmer poem set to music.

Dear Susie, Mother and I got home Saturday at 12:30 p.m. We had a lovely trip, all except Mother and her "Trees." "Only God can make a tree."  And then to make matters worse, she began to sing about the trees. I was praying for the time we'd reach the parkway where trees were not so numerous.

Saturday, July 18, 2015

1982: Two Poems by My Daughter Gillian, Age 7

Thears a green mommey
I said to myself
and there's a red mommey
and there's a purple mommey
and there's a tan mommey
and there is a my mommey

I gave her the first line, "I'll never tell you," and this is what she wrote:

I'll never tell you
wate I have not even
when you are bad
not even when you are good
So do not beg me