Mot Juste

Self-Inflicted

Check out this op-ed piece by Nicholas Kristof in the New York Times.

Cancer From The Kitchen 

"What if breast cancer in the United States has less to do with insurance or mammograms and more to do with contaminants in our water or air

-- or in certain plastic containers in our kitchens?"

More here at his blog - Kristof Blog

Red Tailed Wonder

For years I have had this incredible awe of raptors.  There's so many things about these creatures I find fascinating and its almost as if they have superpowers.  Not only can they make aerial dives at 120 MPH and snatch a mouse up in a single talon, they seem to have bionic senses.  Imagine waking up one day and finding you could suddenly see and hear eight to ten times better than any other person you knew. We'd immediately need ear plugs and glasses just to cope - but that's what these flying wonders can do.  Hawks have the greatest density of vision nerve receptors than any other living creature.  Other than detecting small movement a hundred yards away, raptors also have a built in weapons system.  We need tools because humans aren't well designed enough to have something built in to bodies that protect us and help us obtain food.   My  fascination with raptors was further heightened several years ago when our homeschooling group toured the Raptor Rehabilitation Project at the University of Missouri School of Veterinary Medicine.  To see so closely what I had only watched from afar was a wonderful experience.  And who knew vultures were so cool??

Owls happen to be my all time favorite raptor and we've been fortunate enough around our house to enjoy two spotted and a great horned owl living in the woods near by.  They frequently begin "talking" to each other around two to three in the morning.  I've become so accustomed to their conversations, they're almost reassuring on those nights I decide to be a "night owl" myself.  During one of those late nights while the rest of the house slept, I was making tomato sauce and needed more basil.  I strolled out to the herb garden and while I didn't see him nor did I hear him - I felt him.  He swooped in like a stealth, just feet above my head and glided over me in the darkness.  While I was momentarily startled, I felt more reassurance than fright.  My friends were there, out on night watch and all was well in the world.  I have since gained a better awareness of them, and can frequently spot them in the late evenings, looking down on us from the trees.

Tonight Cameron was walking our dog and came upon a large, dead bird in the yard.  She's the wildlife specialist in the family but it was dark and she couldn't make out what it was, so she she came in for a flashlight.  We discovered it was a red-tailed hawk, not long dead, lying next to our vegetable garden.  It had no obvious injuries, no blood - almost as if it had just landed there and laid down to die.  Over the years, I have found many dead song birds and was saddened to do so - but there is something particularly unsettling about finding such a majestic and beautiful creature, dead in your own back yard.  As the daytime counterpart to his nocturnal cousin, it was sad to see this raptor would no longer be soaring the skies.

We put on gloves and brought it to the garage in a cardboard box.  Its wingspan was well over three feet and we were amazed by its talons.  We reverently discussed how both dinosaur and human-like they were, holding them in our gloved hands.  How amazing this animal was - its no wonder they hold a special place in the Native American cultural beliefs.  Because they can fly so high, they represent a special connection to the sun and sky.  Some legends say the hawk is a visionary and messenger and claim if one lands near you, he is bringing a message from the Great Spirit.  According to The Rosemary Tree, it is also "a symbol of illumination and peace. In the Pomo tribe Red Tailed Hawk was a symbol, along with the Great Horned Owl, of protection and a sure defense against enemies both seen and unseen."

After talking with someone from the Raptor Project, we found out that it is not uncommon for them to succumb to West Nile Virus.  Since they are a federally protected species, we may also talk to someone at the Missouri Department Conservation.  Following that, we plan to give it a proper resting place beneath a tall tree, thinking perhpas of Keats - "A thing of beauty is a joy for ever: Its loveliness increases; it will never Pass into nothingness; but still will keep."

The Mammogram Controversy - Reflective of a Much Deeper Dilemma

Many women and physicians across the country are crying foul over the report released today by the U.S. Preventive Services Task Force.  According to an article in the Los Angeles Times the task force concluded "that risk of breast cancer is very low in women age 40 to 50 and that the risk of false positives and complications from biopsies and other invasive procedures is too high for the procedure to be used routinely."  The article draws attention to eight "gold standard" studies which have examined how mammography has influenced breast cancer deaths, though some say the results are controversial.

The task force, physicians and scientists who support the findings of the task force are urging people not to overreact to the headlines.  Many say it is merely a new way to approach mammography; that the female standard "oh I'm forty, so I have to" and the "one size fits all" approach is no longer valid.  They're advocating that the decision should be made by a woman and her physician.  The predatory politicians have already moved in to use the debate and the surrounding emotions for their self-serving  purposes.  Meanwhile, women don't know if they should look for the underlying conspiracy or cancel their screening appointments.

The problems lie in several pivotal areas -

1) Not all tumors are created equal and the screening does not change the tumor. 

Its very possible that many women who believed mammography saved their lives may have lived without both the mammogram and the accompanying treatment.

As Dr. Heidi Nelson explains in Newsweek -

"We’ve come to a point where the ability to detect precancerous cells has outpaced our ability to understand how these cells operate. In many cases women are treated for breast cancer based on precancerous lumps that are only rarely deadly. A better test for certain genetic markers might help researchers understand which precancerous lumps are most likely to turn into a fast-moving cancer, says Nelson,  but no test like that exists.  For now, doctors treat lots of tumors that may not kill anyone, and women are subjected to a battery of tests that don’t provide many answers. “We can’t advise people at this stage,” says Nelson. “We can only find things.”"

Dr. Michael Cohen of Sloan-Kettering Cancer Center in New York explains that ductal carcinoma in situ accounts for 5 to 60 percent of all tumors in women in their 40s, "It may stay there a woman's whole life and never invade surrounding tissue, but we don't know how to tell the one that won't spread from one that will.”

When looking at mammography and studies that indicate benefits, we have to consider lead time bias and length time bias.

My own mother died in her 59th year of breast cancer.  Early on when asked about her death, I often wanted to respond, "I'm not exactly sure when my mother died.  I only know it wasn't March 23rd."  That response certainly brought about some quizzical looks but what I really meant to say was that the mother I knew did not die that spring morning in 1992.  Although that was the day she took her last breath, the cancer and its treatment stole her away by bits and pieces during the three year of treatment.  Since age forty, she had never missed a mammogram.  The tumor and the aggressive cells it contained appeared like magic, a little over eleven months after her previous screening. 

We've steadily improved on how to handle the side effects of radiation and chemotherapy so retrospectively, it is difficult to say what early screening did for her.  I cannot help but wonder if her cancer was such that it would have been better not to have known.  I wonder - would it have been better to treat the effects of metastasis palliatively once they appeared, perhaps shortening her life but increasing its quality?  We will never know.  Either way, her mammogram only served as the harbinger of her suffering and death.

2)  In order to give everyone a clearer picture of the available information and a better chance at informed decision making, we need to change and clarify the terms we use in reporting and describing cancer. 

The sad fact of the matter is - when we are told that early detection saves lives we can't always be sure exactly what that means.

The term survival rate has always infuriated me.  Say that term to most anyone and especially a newly diagnosed patient or their family and they hear the word cured.   A ninety percent survival rate simply means the 90 out of 100 people are still alive five years after diagnosis.  It can't tell you if 45 of those people died in years six or that another 45 were dead by 10.  It doesn't tell you if anyone in that number is still being treated or was pronounced in remission.  And it certainly doesn't tell you anything about the measures required to maintain that life.

The terms disease free survival or progression-free survival provide only a bit more clarity.  Disease-free sounds like it should mean just what it says, but it doesn't.  Disease free means achieving remission and remission means having no signs of cancer for a period of time although it may be still in your body.  Progression-free means the individual still has cancer but it is not getting worse.  It can include those who have had some success with treatment, but still have obvious cancer requiring aggressive treatment.

The bottom line is this - you can't make good decisions on a consumer level, as a cancer patient or as an advocate when the terminology obscures the information you need to know.

3)  We should focus in on the real target. 

There's something really cool about watching my sisters in a sea of pink solidarity, seeing the ribbon hang from the White House or participating in a Komen event in memory of my mother.  I find meaning in that and I'm sure others do too.   Mammograms may offer us some comfort through a sense of control and we may feel accomplished and empowered by raising awareness, but if we spend too much energy advocating and accepting an outdated screening method we're not really sure about, we're not only being lulled - we're being sidetracked away from the more important challenges in saving women's lives. 

In the world of detection, we need something much better than what we've been given.  We need to be able to identify more aggressive forms of cancer in its earliest stages.  Most of all, in the world of tumors, we need to better identify and understand the bad boys on a molecular level; including the biology of stem cells, the contributing tumor environment as well as finding more effective chemoprevention strategies.

I'm not settling for less and if you believe in the pink, neither should you.

One nation, under illusion - The Boston Globe

One nation, under illusion - The Boston Globe

Posted using ShareThis

For those of you that profess to love your country, do you love it enough?  Do you love it enough to get beyond the pompous put-on?  Do you love it enough to call out the politicians who peddle this self-defeating arrogance?  Perhaps we need to be free and brave enough to see things in a honest light.  Only then can we undertake the work to improve and make it that much more something to love.

If You Just Don't Get It, Here Are Some Clues

Ok, I'll admit I was a bit slow on the uptake. My first thought was 'huh?' when I heard that President Obama had won the Nobel Peace Prize.  Distracted by other things in the everyday of mum, I didn't throughly read the news reports and commentary right off the bat.  What finally made me stop and learn more was the whacked out commentary from the ridiculous right.

Now don't get me wrong, I have many friends who identify themselves as conservative.  I like them and I respect and sometimes agree with their opinions.  The difference is - they are thinkers.  They're not interested in parroting one-liners they once heard on Fox.  While they may chuckle at an anti-Obama joke and intelligently disagree on policy, they don't resort to spewing the ridiculous trash relished by so many of their lower IQ brethren.  The thinkers and intellectual conservatives are not a part of this post.  The trash-talking, projectile brain vomiting ones are.

There.  Now that we have that out of the way ...

While I was still in my initial moments of bewilderment regarding the Nobel and perusing the latest news, I saw a post on Facebook from someone I had known since childhood.  They had never been the brightest crayon in the box, but this Facebook post, as well as some previous ones, confirmed that their intelligence hadn't increased over the years.  It took a great deal of self control not to respond, so I merely "un-friended" them.  To tell the truth, we were never that close in our younger days and its more than obvious she is no one I'd be interested in being chummy with now.  On her wall she was promoting "the no-bull peace prize".  It was a group that sold medals because "these days it doesn't really matter what you have done ..."

Wow.  Talk about incredulous.  Talk about a deep divide.  Talk about a bunch of pea brains blinded by hatred politics. { I think they used to call it petty politics, but its way past that now.}  I could go on and on about how any American should be proud when a fellow American wins the Nobel PEACE {that's right folks, spell it carefully, P-E-A-C-E} prize but I won't.  I don't think they're the type of people to get the obvious.  The politics of hate doesn't exactly encourage intellectual discourse.

It doesn't take a rocket scientist to figure out why our President won.  He was elected our leader when America {or most of us anyway} decided to rise up out of the dark and one of the most shameful periods in modern history.  We decided we didn't want to be lied into a war ever again; we didn't want to be responsible for the deaths of thousands of innocents and call out our sons and daughters to die for us based on a manufactured, manipulative agenda.  We wanted a leader who demonstrated to the world that we were truly what we professed to be -  a people of benevolence and peace - not of lies, war, torture and death.

When Barrack Obama was elected the President of the United States I saw videos from all over the world, people cheering with tears running down their faces, clapping, hugging, jumping up and down.  Frame after frame demonstrated nothing but pure joy.  When in history has the world ever done that for one of our presidential elections?

"The award marks America's return to the heart of the people of the world."

I'm sure Sarah Palinites in all their mindless wonder would like to explain that video footage away by claiming they were all a part of the worldwide-liberal-nazi-terrorist-socialist-anti-American cabal.  But they weren't.  They were people who cared about the United States; who want us to return to noble and moral leadership.

French President Nicholas Sarkozy has been very critical of President Obama in the past.  He has called him, "immature," an "empty suit," and "weak" among other things.  However, when it came to the awarding of the Nobel Peace Prize, no one explained it better than Sarkozy.  He said,  "The award marks America's return to the heart of the people of the world."

Thank you, Mr. President, for helping to lead us there.  It's good to be back.

Parenting by Wishful Thinking

According to Wikipedia, wishful thinking is the formation of beliefs and making decisions according to what might be pleasing to imagine instead of by appealing to evidence and rationality.  No where have I seen more evidence of this than in the debate over infants and safe sleeping.

I’ll explore many aspects of the debate in later posts, but one in particular that has always baffled me is the inappropriate promotion of “evolutionary parenting” and/or “biological imperatives.”  While these concepts are completely legitimate in anthropological study, they lose a lot of validity and add to wishful thinking when applied to modern night time parenting and infant sleep. 

 One of the most important tenants of evolution is that order to survive and prosper, organisms must adapt to changing environments.  You need not be an expert in evolutionary theory to realize that sleep environments have changed radically over time and that a behavior from 5000000 years ago may not be necessary or desirable today.  It also doesn't take a lot of brainpower to see how behaviors in one environment can actually be detrimental in another.  In early times, having an infant close in order to quickly flee a warring tribe or to keep it safe from wild animals may have been an advantageous behavior for the species but today our challenges are different.  If the concepts surrounding evolutionary parenting have any application in this 21^st century debate, it’s the lesson that survival is dependent on the ability to adapt to a changing environment.  Our challenges today are a plethora of adult behaviors beget in modern society as well as mattresses, pillows, duvets, blankets and comforters.

 The concept of “biological imperatives” is also completely inappropriate in the context of modern, nighttime parenting and sleep safety.  While many parents are being sold this wishful, touchy-feely bill of goods, they aren’t told that “biological imperatives” exist in a hierarchy of importance with survival as top dog.  A “biological imperative” model could be particularly troublesome for the pro-bedsharing group.  Placing your infant in an unsafe environment could be labeled as “maladaptive” behavior.

 I have a friend who I knew did not agree with the concern over bedsharing.  After several discussions, she said to me, “For me, it’s an issue much like the Patriot Act.  I’d much rather see babies at risk of death than I would the government or an organization telling me how to care for my child.”  As shocking as that statement may seem for some, it is the most honest statement I have heard in over 20 years from those who advocate bedsharing.  She had enough intelligence and objectivity to know the research evidence was there; she didn’t try to twist or re-frame it or package it in fallacies to justify her choices.  There was no wishful thinking.  She zeroed in on the fact that she valued autonomy and was very uncomfortable with someone/something telling her she was wrong.  While I was initially taken back at such a bold statement, I quickly realized that I have much more respect for her than I do many in this debate.  Disclosing that you’re willing to risk your baby’s death is much more honest and accurate than claiming the evidence against bedsharing is illegitimate or deluding yourself into believing you’ve made an “informed choice.”  For better or worse, at least her point of view is based in reality.

There has always been a fringe movement that advocates a more “natural” approach to living.  In the last decade, in what some call the greening of America, the idea has gone more mainstream and continues to grow.  Overall, I think it is a good thing – but I would never be so naïve to believe that all things natural are good. 

There is a certain comfort in believing that bedsharing is a part of an ubber-attached, exalted connectedness.  Certainly every mother would like more influence and control over their child's well-being and to think you can come closer to that achievement through such little effort while sleeping makes it even more appealing.  For most babies and their mothers, it works well.  The problem is the one morning you wake and that illusion, as well as your soul, is fractured into a million pieces.

 The natural world of ancient man was not filled with wistfully, wonderful things.  Mother Nature is far from all warm and fuzzy and can be cruel to a standard that few would find acceptable today.  It’s been estimated that through most of recorded history, 30 to 50% of babies born never lived to see their first birthday.  No doubt early man found the losses greater still.  The death of children was a very real, expected and natural thing.  I doubt most parents today would so willingly offer up half of their children to the altar of a “natural” or an evolutionary pie-in-the-sky.

Parenting shouldn’t be a robotic job always based on some sterile, rational behavior – but neither should it be completely commanded by our own desires of a perceived ideal.  We need a balance; one where we can determine when our intellect should take the helm and when we can allow our imagination and spontaneity to explore new ideas.  If those things are to be prioritized, what better impetus is there to guide us than the very life of our child?

 

 

For God's Sake

~

 

"For God's sake, in the West you must realize this: no education for women," she said.

"You are going to destroy an entire generation. ...

Your next 9/11 will probably be from Swat."

a Pakistani woman who fled her home because of the Taliban

While American troops battle them just across the border, the Taliban is presented with the keys to the Swat Valley region in northern Pakistan.  CNN has reported that on Monday, the Pakistani government agreed to allow the Taliban to rule the Swat region, despite the fact that the US has given Pakistan millions of dollars to help combat terrorism.  

Rudy AKA "Shake-Down" Giuliani

I don't know what the hell the former mayor of New York has been smoking, but it must have been laced with some out of this world shit - something that causes major disruptions in cognitive processes.  According to CNN, Rudy, aka "Shake-down" Giuliani defended the massive corporate bonuses, saying they were needed so that the executives could continue go out to dinner as accustomed and continue to go shopping.  Giuliani wants us to believe that sales clerks and waiters will lose their jobs if taxpayers don't hand over an estimated 18 billion for bonuses to the fat cats so they can continue to live in style.

Rudy, Rudy, Rudy - you are too funny.  Most of all, shame on you.  Not only do you insult the intelligence of the American public, your claims reek of exaggerated desperation and blackmail.

Kudos to our very own Senator Claire!  Sing it to them sista.  See the video below or here

Bedtime Basics

For the last ten years, I've observed those on the net battle it out on the issue of parents bed-sharing with their babies.  I've sadly watched some very astute mothers be sucked into this impassioned maelstrom and lose nearly all their ability to reasonably analyze information (I won't even go into the ones whose abilities were lacking to begin with  ::shudder::).  It's no huge surprise - if you really want to see an ordinarily savvy and intelligent woman go witlessly berserk, just hint they are not taking proper care of their offspring.  It ranks right up there with telling them their children are ugly.  You won't be well received.

In 1999, I wrote that one of the saddest aspects of this issue were those individuals and organizations who seemed intent on fostering the mindset of "it's us against them."  Their mission seemed much more about drawing lines in the sand than a concern for lives of infants.  As someone who seemed to have one foot in both worlds, I saw the battle coming and it brought me immeasurable sadness.

Like many of my areas of interest, you'll see me post on this topic often.  I hope that I can provide some clarity to those with questions and an impetus for honest consideration and self-appraisal for those who hold rigid beliefs.  I will always welcome questions and comments posted respectfully in the interest of furthering understanding.

Several years ago, I was involved in the production of an educational website addressing sleep safety issues.  Here's the latest and greatest from First Candle/SIDS Alliance.  They've done it much better than I ever could.

Loads of info and supporting scientific research.

Bedtime Basics

Uncomfortable Truths

In the last week, I've had two male friends make comments with regard to environmental concerns or pesticide use.  One, a farmer, declared that agricultural chemicals were not a real concern because of the low amounts that end up in the food.  I didn't take him to task because I knew my energy would be wasted.  We can debate the pros and cons till his cows come home, but the scientific evidence is more than clear.  That truth might make him more than a tad bit uncomfortable and I have no doubt it is disparaged in the circles he runs in.  The older I get, the more I am amazed at how powerful cognitive dissonance is.  Yet if we are to grow as human beings and as a society, we sometimes have to force ourselves to think outside our present state of knowledge; to go beyond our comfort zones and push ourselves to examine previously held beliefs.

Some of my more conservative friends find comfort in traditional beliefs and the status quo.  I'll be the first to admit that outlook has merit in certain instances.  At the same time, I don't want them to be blindsided and come to full awareness with the illness of a beloved grandchild or be shocked with their first realization and outrage while watching the suffering of a friend.

“every day, 610,000 children ages one through five eat a dose of neurotoxic organophosphate insecticides (OPs) that the government deems unsafe. Some 6,000 of these children exceed the government’s safe daily dose of these pesticides by a factor of ten or more.

In an article for Healthy Child, Jane Shepard writes -

"The fruits and vegetables that are so crucial to health are compromised by ongoing pesticide contamination. If you eat conventional food you are eating combinations of pesticides known or suspected to cause brain and nervous system damage, cancer, and disruption of the endocrine and immune systems. The Environmental Working Group (EWG), a non-profit research organization, analyzed government pesticide records and food consumption data and reported that “every day, 610,000 children ages one through five eat a dose of neurotoxic organophosphate insecticides (OPs) that the government deems unsafe. Some 6,000 of these children exceed the government’s safe daily dose of these pesticides by a factor of ten or more. More than half of the 610,000 children exposed to an unsafe dose of OP insecticides each day, get that dose by eating an apple, apple sauce or apple juice. Some apples are so toxic that just one bite can deliver an unsafe dose of OPs to a child under five.” Another analysis showed that every day, more than a quarter million American children ages one through five eat a combination of 20 different pesticides. More than one million children ages one through five eat at least 15 pesticides on any given day.13 "