Preventive Medicine or Too Much of a Good Thing

When do we draw the line for preventive medicine? The latest ASCO guidelines for high risk, post menopausal women to prevent breast cancer recommend proactively taking Evista, Aromasin, or Tamoxifen to reduce risk. I had already heard about Tamoxifen but not Evista or Aromasin.

When I first read this the first thing that jumped into my tiny chemo-fogged/fibro-fogged brain is this a big ploy by the pharmaceutical companies to generate millions of new patients? That would be a huge conspiracy theory that I immediately pushed away.

The next thing that leaped into my tiny chemo-fogged/fibro-fogged brain is that its getting to be that we need to stop enjoying ourselves and live preventatively with no fun? The guidelines end with:

"If you have a higher-than-average risk of breast cancer, it makes sense to do everything you can to keep your risk as low as it can be. There are lifestyle choices you can make, including:

• maintaining a healthy weight
• exercising regularly at the highest intensity possible
• limiting or avoiding alcohol
• limiting processed foods and foods high in sugar
• eating healthy, nutrient-dense food
• not smoking"

I felt this is getting to the point of  ridiculousness. I mean 'healthy, nutrient-dense food' - can you please define that? I am sure it does not include chocolate or ice cream. If I went to the grocery store and asked for 'healthy, nutrient-dense food', I think they would look at me like I was crazy.

And exercising regularly at the highest intensity possible? This is getting to be too much in my book. Just tell me to live healthy and I can handle that.

I am not dissing ASCO here. They are a wonderful organization but I think that this is overkill.

Yes preventive medicine is a good thing but this is too much. I'm sorry.

Living with pain

Every day my morning starts with 'ouch', 'ow', 'owie', and more. And my husband looks at me and says are  you sure you are are okay for whatever my day is planned. I say yes and suck it up. And maybe take a pain pill.

Yes, that's my life. I don't ask for pity. I cope. I take steps to work on my pain.

I have upped my arthritis medication and go back to my rheumatologist in July. I also have a 'procedure' (which involves sedation and lots of needles) on at the end of June which will alleviate a lot of back pain. I see my primary care (well her nurse practitioner becuase she will be on maternity leave) also in June where I will talk about my hand pain from the stupid (untreatable) ganglion cyst and my knees' general lack of cooperation with my desire to live a pain free life.

All those fancy pain medications you see advertised won't help me much. I have already tried the fancy ones for fibromyalgia and they haven't done much for me. And the other fancy medications, the biologics, for rheumatoid I can't take because of my cancer history, blah, blah, blah.

I am being honest here. I usually am honest in my blog but sometimes I elusively play with the truth and am not as open about some topics. What I do is I withhold the truth until I want to talk about things.

I mean living with pain is not like living with cancer or anything but it does kind of suck in a way. I do get all the good drugs.

But as I said before I am not asking for pity. And if I anyone says 'I'm sorry' to me about this post, I'll be sure to smack you silly next time I see you.

 

This is an ad for a CNN Special called "Escape Fire: the Fight to Rescue American Healthcare" which premiered last night (after my bedtime so I recorded DVRed it and will watch in the next few days).

It was included with this article titled US Manages Disease, Not Health which states that though Obama care represents change and has the goal of helping more Americans get health insurance and access to health care. But tjhat is the wrong question to answer.

They claim the real question that healthcare reform needs to answer is: "How can we improve medical care so that it's worth extending it to more people? In other words, how can we create a health care system that helps people become and stay healthy?"

Personally I would like to believe that both questions should be answered. We need everyone to have access to health insurance and health care and we need a better medical system that helps people become and stay healthy.

As this article claims more focus needs to be on prevention and keeping people healthy where treatments are less expensive and less arduous. We do need to focus on healthier life styles. More exercise - go for a walk instead of watching tv. Provide better food - meaning less processed food, fewer ingredients.

I have seen changes which help make Americans healthier by offering free annual physicals as a preventative measure. There has also been a movement coupled with the recent recession where people are eating healthier, farmers markets are showing up everywhere, and there has been public awareness of the dangers of obesity.

But we have a long way to go. We need health care reform, we need to focus on keeping people healthy, and we need financial reform in the way doctors, medical centers, and insurance companies pay and charge fees.
 

How to be a (un)healthy person

As I used to be a healthy person but can probably safely say I am no longer a healthy person, I must be highly skilled at being an (un)healthy person.

• I can easily put myself in pain by doing basic things - bending over, stretching, moving the cat, looking for things, picking up my laptop. I no longer rush to get to the phone because it can be painful (the rushing part).
• My bedside table collection of medications and supplements has been relocated to my closet shelf - as it has outgrown its original space. And is still growing.
• I carefully plan my activities to try to limit pain levels. My husband recommends on activity per day and I am reluctant to admit he might be right. Yesterday I attempted two activities and spent three hours in bed after the first one so I never made it to the second.
• Doctor appointments and phone calls get first priority in the scheduling of my life.

As a result of my current (un)healthy state, I think the world should make the following changes to accommodate me (because I am the most important):

• Those little grocery carts everywhere. I can't push around traditional grocery store carts because they make my back hurt. I cant carry a basket of stuff because of lymphedema and hand, elbow issues. I need a little cart or my husband to come with me if I can get more than a couple items.
• Special working hours so I can sleep in at least one morning a week. I cant get up more than a few days in a row with the alarm. I get really tired and need to sleep in - at least until 730 - a few days a week. Last week I had to get up six days in a row and was really dragging.
•  Cooking lessons for my husband. He cooks better and better these days because he has been getting plenty of opportunities to practice. He is pretty good and just needs encouragement for the nights I am simply too tired.

Today I have carefully planned my time. I made and ate breakfast (organic Greek yogurt and pineapple). I will start the laundry (after it is carried down stairs) and we will walk down to Walgreen's, drop off one prescription, go for a short walk while it is filled and pick up the four filled prescriptions (three for me). I even feel I know the pharmacy staff at this point. Then I will go to a friends for brunch and then back home to recover. A phone call with a friend this afternoon as I finish laundry. How's that for an exciting day?

Tomorrow I really want to sleep in as I am working from  home. I hope to make it to the gym or for a walk with a friend.

The life of an (un)healthy person requires lots of rest and medication. I will keep practicing.

I'm feeling very healthy these days

In fact I'm feeling as healthy as a horse on the way to the glue factory. It seems every ailment I have had in recent years (except cancer) has come back to haunt me. You name it - sprained ankle - check, sore knee - check, tennis elbow - check, bursitis hip - check, sore back - check, lymphedema - check. I feel awesome - ouch, owie, yow, every time I move.

I had my annual physical last week and the consensus is I'm not going to die of any known cause anytime soon. But I have to wear my wrist brace day and night for a month to see if my tennis elbow/possible carpal tunnel will quiet down. I also had an ankle x-ray to see if I really or only slightly redamaged my ankle. I need to talk to my pain doctor about more injections for my bursitis. And I need a fasting blood test in the next couple of weeks.

I'm feeling so healthy that with record high temperatures forecasted for today, I am going hiking with some friends this morning. How smart is that?