Thursday, November 19, 2009 at 08:47PM Cat's Cradle
{My wish for you}
Many strong arms
to surround you
and hold you up
and cradle you in love;
a web woven by all who have come and gone
lingering
with
memories:
dew-drops of magic
and wonder
and joy,
and dripping in peace;
all warmed by the rising sun
in the promise of a new day,
a beautiful, cloudless, crisp blue day.
we love you, jeanna.
friendship Tuesday, November 17, 2009 at 11:38PM So... I guess I need to warn you that this is not a typical post for me. It's probably gonna be long. But I hope you'll hang with me because it's really important. It's one of my soap-box issues. And it just might get ugly... I've worked almost 25 years to tame this she-beast within, but oh! When her feminine sensibilities are disturbed, she oozes from my pores and I'm helpless to contain her.
And maybe I shouldn't.
I'm just sayin'.
Some things are worth getting... ummm... ugly... about.
I first caught wind of this news from a blogging friend {my blogging friends are not only hip to good music, but are on top of medical issues, too!}... and today, I heard more on this in the news.
I guess I should preface with the fact that in another life, I was a physical therapist. Well, I still AM a physical therapist, just not practicing. This is important only because the graduate school I attended was so BIG on basing information on proven.scientific.facts. Like, don't even have a thought unless you can site a reputable source that publishes only well-organized research that withstands the scrutiny of well-known peers and professionals in the scientific community. This means a whole lotta stuff, but I'm afraid that if I go into it, I might loose you on account of boredom. Yawn.
Also just as important to know is the fact that I'm a mother {yes, I know you knew that! I'm just sayin'.}, and by default, this makes me an advocate for women. All women. Because someday, she will be a woman.
It's just that right now, she's very busy being a little girl. So I'll worry about this big stuff.
This is what I heard in the news today:
The average woman does not need to have mammograms until she is 50, and then, only biennially.
And also? Those breast self exams we've been encouraged to do for the last, I don't know, 20 years? Don't do those, either.
Hmm.
So... Yes. I heard this on CNN's Headline News. And, Yes. This IS typically my news source. Only because they give me what I need to know quickly. Like, in little quippets. I no longer have the time to listen to 30 minute dissertations on a story, or to hear two opposing super-gurus debate the topic, or to flip back and forth between the conservative and the liberal news stations so that I can form an opinion on my own. I don't have time for that. Any more. I am not in any one place long enough to do that! So, HLN it is.
But this just didn't sit right. I came home and researched. And researched. And researched some more (click on the links to see my sources - I've been properly trained.) And again, yawn, to save you the time and interest, I'm putting it to you as the thoughts came to me. It's a little more digestable that way.
First, though, this is my mom.
She would probably be pretty upset to know that I published a photo of her from Christmas morning... without make-up, or her hair properly done, because she is my southern mama. But I wanted you to meet her. She used to smoke a pack of cigarrettes a day... but she went cold turkey... about 18 years ago. I never told her, but I am so proud of her and her strength, to be able to do this after 33 years of smoking!
Back to the news story. My thoughts kinda went like this:
~WHAT?! WHO said that?
Why, it was the USPSTF*. That would be the 'United States Preventive Service Task Force' which is sponsored by the Agency for Healthcare Research and Quality, and it is not to be confused with the United States Government. Even though it says United States at the beginning. Kinda like "natural flavoring" that is not at all natural, but a chemical that is called "natural flavoring". {Get my drift??} You can read more at that link, but know this (taken directly from the above site):
"The USPSTF reviews the evidence, estimates the magnitude of benefits and harms for each preventive service, reaches consensus about the net benefit for each preventive service, and issues a recommendation.
The Task Force grades the strength of the evidence from "A" (strongly recommends), "B" (recommends), "C" (no recommendation for or against), "D" (recommends against), or "I" (insufficient evidence to recommend for or against)."
Also important to note: this task force is weighing the 'magnitude of benefits to harm' of the said procedures... ie: is it WORTH it? And they specifically mention "for the average woman". We ALL think we're average, don't we? Who is the average woman? This average woman subject is never described.
~Well, who EXACTLY makes up this task force??
Private sector physicians and other health care providers, though it seems they all work in an educational setting. Prestigious educational settings. Like Cedars-Sinai, John Hopkins, Darmouth, and Mount Sinai to name a few.
~WHAT exactly did they do? How was their research conducted? Did they use scientific method? Were there control groups?
It seems, I think, that they reviewed literature, though it's not exactly described and no articles are sited.* HOWEVER, this paper, the results of their endeavors, is published in TODAY's Annals of Internal Medicine. HeLLLo?? A well-respected publication in the medical community.
Hmmm.
Well... then... all that sounds ... reputable. Proven. Scientifically. Except for what they actually did. And except that grading thing. What exactly is THAT?
"The Task Force grades the strength of the evidence from "A" (strongly recommends), "B" (recommends), "C" (no recommendation for or against), "D" (recommends against), or "I" (insufficient evidence to recommend for or against)."
Recommendation against annual mammography for average women 40-49 {that's me, btw}: grade C. See above... "no recommendation for or against". ?? So, I guess that means that a recommendation FOR annual mammography for these same women, based on the review of unsited literature, can be made with the same strength.
Recommendation for biennial mammography for women 50-74: grade B. Hmm.. a little stronger than neutral.
Recommendation against health professionals teaching women breast self-exams (BSE): grade D. See above... "recommends against". So, they make a recommendation and then recommend against that??
It's all unclear at best.
And by the way, here's a picture of my sister:
She's 42, and a school teacher. She loves my children, and my other sister's children like her own. She lives near my parents, the only one of the three of us who does, so she is a daily part of their lives. {And btw, she also would not be too pleased with my publishing her undone Christmas morning picture-you'll keep my secrets, won't you??}
And here's my baby sister {also on Christmas morning... kinda got in a groove here!}:
She's 39 and married to her high school sweetheart. They have two beautiful little boys who are 9 and 6 years old. She loves to cook, and they live in a beautiful historic farm house in Main. She gardens, too. In this picture, she's hugging the automatic garage door opener that her husband gave her for Christmas because it's what she really wanted. This kind of luxury when you live in snowy cold Main is indescribable!!
Also, the reasons sited to NOT have an annual mammogram or to do self-exams is because they found too many false-positives. A false-positive is when you falsely get a positive result. So, assume a woman finds a lump on BSE, but upon further testing, is found to have only fibrotic tissue. The lump found on BSE would be a false-positive for breast cancer (but places that woman into a higher-risk category for developing breast cancer, and thus alerts her and her care providers to take necessary precautions). The USPSTF suggests that these false-positives create too much stress, and lead to unnecessary biopsies and other medical procedures.
Ummm. Sorry. Would rather stress over possibly having breast cancer and find out that I don't, than to not test and find out that I do. Just SAYIN'. And the biopsy... the pinch of a needle to tell me: yes, you do; go get treatment, or no, whew! PLLLLeeeeaaasssse.
Here are my real concerns:
-Other busy moms like me heard "No need for mammograms 'til you are 50, and then, only do it once every 2 years!!" and "DO NOT do those self-exams anymore!!"
-Insurance agencies are going to grab this info, and tell us, "Sorry. No need for this anymore because this very professional-sounding, government-sanctioned-sounding task force said you.don't.need.it. Not medically necessary, so therefore, we ain't payin'." And even though this report STATES that it is up to the individual woman "and her values" as to whether or not she should have mammograms, she may not be ABLE to if her insurance stops paying for it.
*****
The American Cancer Society responded immediately to the USPSTF recommendations with this awesome article - worth reading. They continue to recommend annual mammography exams and clinical breast exams (CBE) for women aged 40 and above.
They estimate that 40,170 women will die from breast cancer in 2009. That's 4.58 women per hour. Every hour. Every day.
Get your annual mammogram. Do your own MONTHLY self-exams. Become familiar with your body so that you can notice changes (this includes changes in your skin), and discuss these changes with your gynecologist or family physician (or dermatologist).
If you dread going for your mammogram, do something to make it fun. I go with a friend and we make a day of it... including lunch and shopping.
Go during the off-season :)... spring. It takes me 20 minutes from my parked car to my parked car! October (Breast Cancer Awareness Month) and November are the busiest times of the year.
Think of your daughter... your mother... your sisters... your friends. Don't believe everything you hear. Do your research. Take care of yourself.
ADDENDUM (11/18/09): Because this has been all the news today, I went back and reviewed the USPSTF article. I found their list of 32 references. All articles can be found, and many read in full through the link for the Annals of Internal Medicine above.
Also given toward the end of the article, and don't know how I missed this at 2am last night while sipping on my wine to calm my inner she-beast, the USPSTF lists recommendations by quite a few well-respected agencies in the medical field. The American Cancer Society (2003) recommends annual mammograms beginning at age 40. So does the American Medical Association (2002) and the National Comprehensive Cancer Network (2009), but these two organizations also recommend BSE. The American Academy of Family Physicians recommends annual mammorgrams beginning at age 40. The Canadian Task Force on Preventive Health Care (2001) and the American College of Obstetrics and Gynecology (2003) recommend mammography every 1-2 years beginning at the age of forty. These include ALL AGENCIES the USPSTF reported on with the exception of two. Information is not given on the recommendations of the other two agencies for women between the ages of 40-49.
Patty
ADDENDUM (11/1809): Though I personally haven't had the time to read all 32 research articles reviewed :) , some critics of the USPSTF's recommendations state that African-American women are under-represented in the trials reviewed by the USPSTF, so it's not appropriate to make these recommendations to this group of women.
breast cancer, healthcare, she-beast Sunday, November 15, 2009 at 07:41PM "C'mon, mama! Get up!"
I looked over at the clock and saw that I had not quite an hour to get ready-and that included finding her dance uniform... an improbable task. But the headache was gone, and that was good. There is a lot to do today.
First, I had to drop her off for rehearsal at the dance studio. They had their first performance as a team at our annual fall festival. She would go from dancing in the streets, to a dance team fundraiser, to the Haunted House again... a 13-hour day for her, but she loves it.
And although I found her costume, it was cold, so they wore their sweats over it... and the right jazz shoe still lies in wait somewhere in my house. I hope.
I stole a few moments and walked through the festival. Nothing like a fall festival in the south...
And how I wished for time to blog about it!
And yes, it's really cider, and not the other juice they make in other kinds of presses here in the mountains of East Tennessee.
Oh, those beautiful apples...
If not for the styrofoam cup!
The sites and sounds and smells were a feast for my senses, and I wanted nothing more than to run home and blog all about it.
When I finally did get home, stuffed from some honest-to-goodness kettle-cooked corn {oh yum!}, I found him here, rescuing her. Who knows how long it took him to catch her and free her from the confines of the garage.
And time is one of those things of which he has so little. What a great post it would make - to write about his love of nature, and his compulsion to fight for and defend those in need. And I thought, I should blog about that.
We spent a few "free" hours trying to catch up on chores, running the boys to where they needed to be, grabbing dinner. Night descended, and we made our way through her Haunted House. I found my beautiful daughter looking like this:
She had been transformed into a hot-dog eating, scary baby toting, graveyard orphan.
She loves to perform. Since she was two, I would find her in front of any reflective surface - a glass door, fireplace screen, turned-off TV - dancing or singing or pretending... who-knows-what imaginary fantasies have played out in her mind. And as I remembered catching her dancing or singing or pretending in all those different places, I thought, I should preserve those memories and blog about that.
It's been a busy fall, and a crazy life. But it is also a satisfying life that has generated memories I wouldn't trade for anything, not even for more time to blog.
And still, I notice the sunrises...
The leaves changing...
The sunsets...
And the moonrises...
And Sunday, I wake up, and go to Sunday school, thankful that after twentysome years, my husband has decided to come with me these last few months. He wants to learn, and he believes that going to church together is "good family building". That would make another great post.
I run downtown to help clean up the Haunted House, pick up one son, and then run the other to his soccer game an hour away.
And as I drive back, each of us lost in the music, I realize I can't do it all. I can't be in all of these places and accomplish all of these tasks and take care of all of these responsibilites and blog about it, too. And this causes great conflict because this is what I want to do. So I decide that
I will do what I can do.
If the time is too short one week, I will let it go. And while I miss you when I can't be here, I still think of you and your blogs, and wonder how you and your children and lives are. And if you need to leave while I'm away, I understand, but I hope you will check in now and then, and let me know how you are.
these days Monday, November 9, 2009 at 09:22PM Ba-boom!... Ba-boom!... Ba-boom!... My heart pounded as I ran down the hall to the garage to see who could possibly be lifting and dropping the garage doors like that, making that crashing noise. But when I got there, all three doors were closed and still. I could still hear it, Ba-boom!... Ba-boom!... Ba-boom!... I made my way back down the hallway and when I reached that part that opens to the bright, sunny living room, I felt like I had run into an invisible wall. I squeezed my eyes closed and dropped to my knees. The pain of the light was excruciating. As I tried to open my eyes and pull myself into wakefulness, I thought, No, please. Not today. I have too much to do today to have a migraine. And in that semi-wakened state, I realized that that crashing noise was my own heartbeat, violently forcing the blood through the vessels around my eyes and temple and brain. Ba-boom!... Ba-boom!... Ba-boom!...
I sat up slowly in my bed and let the pain settle. The increased sharpness of it told me that this originated in my sinuses, and for that I was grateful. That meant that with some Tylenol-laced pseudophed, a hot, steamy shower, and a little more sleep, I might conquer this foe before she became too strong for me. It was still dark, and the blue numbers on my clock told me that it was only 5:20. Good. Enough time to do battle.
I slipped back into bed with my wet head, and felt the warmth of his body. I just wanted to roll over next to him, and let the heat of him wrap itself all around me, but I knew with what was left of my foe, I needed to prop myself up to almost sitting and let my sinuses drain. It was part of the healing ritual. I glanced back at the clock, and then at yesterday's newspaper aglow on my night stand.
I smiled to myself as I remembered my hectic Thursday. Along with my regular mom-schedule of gym classes, dance classes and soccer practice and football practice, I spent the day setting up for our Spirit of Women {SOW} annual event, and the night {wo}manning a booth. SOW is part of a national marketing organization and is associated with a local hospital. Its mission is to improve the health of all women through fun, educational events. I serve on this advisory board with an amazing group of women... women of all ages and backgrounds and experiences. The event was a huge success, and in the end, a life was saved. An attendee had a massive heart-attack, but because she was surrounded by women who knew how to recognize the signs, she was in the ICU with her cardiologist within 26 minutes of first experiencing symptoms. I know that hers might not have been the only life saved that night. There were so many opportunities for women to learn about their health, and choices that they can make to better their quality of life. Life can be so much better when we are healthy. And as I drifted back to sleep, I thought, I should blog about that.
I reached over to touch him, but only felt the coolness of the sheets where he had slept. I looked left, and saw that he was gone, and just as I did, he kissed me on my right cheek and pulled the covers up over my shoulders and whispered in my ear, I'm sorry you have a headache. Go back to sleep. Love you. He turned and left our bedroom-letting me sleep late, because he's like that. And as I sunk down into my pillows, free from pain, I thought, I should blog about that.
Friday had been as crazy-busy as Thursday. After dropping the kids at school, I ran some home-made chicken tortilla soup {and all the fixins!} to a friend who had had surgery, and then headed straight to her dance school. She's dancing on a competitive dance team again, and part of that requires me to decorate her school for a haunted house fundraiser.
I left early from decorating to ride with a friend up into the mountains to hike the 5.6K trail that we would race the following weekend in the "Navy Seals Off-Road Challenge". No doubt it was here that my pain-provoking foe dropped her seeds of allergens on me. It was drizzling a bit, but it was beautiful up in the Smokys that day. I looked forward to doing this race with my husband and 14 year old son, and knew that I would blog on it some day.
We hurried home to get the kids from school and transport them to their respective activities. She would be at the haunted house for seven and a half hours that night, and my younger son was spending the night at his friend's. My freshman son had his first varsity football game, but we would miss it because we had a fundraiser for their school.
Around 8:30 that night, as we made our way through the silent auction {where one of my photo books sold for $165 - woo-hoo!}, my cell phone started buzzing with texts. He had recovered a fumble! I told my husband, He's so lucky! Where does he get that? There are players that play for four years and never have the opportunity to recover a fumble. He's put in in the last few minutes of the game, and the ball falls right in front of him. He's lucky, AND he works soooo hard. I thought, I should blog about that, but I already have. :)
...to be continued...
these days 
