Health and dis-ease

I have an ax to grind into the backs of cinema make-up professionals and directors.  I don’t require gratuitous ugliness, but some of these films are as unrealistic as the way my siblings and I were at pretending games at age five.  If we played cowboys and Indians, or World War II combat, or cops and robbers,  the person getting killed clutched the chest dramatically and fell over stone dead.  Healthy one moment, suffering two seconds, then dead.   

Therefore, this is an incomplete commentary on the portrayal of cancer in three movies.

The Calendar Girls        

Excellent.  Not only is it a great story; the cancer patient actually LOOKS and ACTS like a cancer patient.  In this case it is a husband who progresses from “normal looking” to puffy-faced to only able to sip a few drops from a child’s juice box straw.    That is the cancer with which I am acquainted.

Y Tu Mama Tambien       

(Do not read this if you are planning to see the film and don’t want it ruined for you.) 

This film is meritorious on many levels and I do recommend it.  A Latino buddy of mine went to a lecture at Harvard in which the film was touted as a disguised means of showing the extreme poverty in Mexico.  Also, it is an engaging coming of age story, conflict between the socio-economic classes story, and more.  However, there is an extremely attractive woman in her twenties who trots around in her bikini and serves as a sexual mentor for two teen boys.  One learns at the end that she has bleepin’ terminal cancer.  Oh, come on!  All bouncy, all perky and energetic, yet has reason to know she has cancer?  Bah, humbug.

 The Bucket List       plus

Alright, I am schizophrenic on this review.  The scenes in the first part of the film occurring in the hospital are pretty respectable.  The only possible improvement I could suggest would be to change the skin color of the patients to a pale-purple-brown chemo-induced yuckiness.   That is minor.  The movie did a fine job, until…the two patients learn they have no hope in hell and only three months to live.  Then, they are blessed by the fountain of healthy youth.  No problems, tons of energy, no need for naps or moving slowly, eating and drinking like 30-year-old playboys.  It is a fantasy.  In fact, the whole movie is a pleasant, light fairy tale which is a metaphor for the poem “Gather Ye Rosebuds While Ye May” or “carpe diem.”  So, thumbs up AND down for this flick.

Comments welcome.  I can’t remember details of Love Story and other movies which you may want to add to this list. Thanks.

Curves is a franchise of very small gyms for women only.  Its set-up is exercise stations, about thirteen, arranged in a circle. Stations alternate between weight resistance and aerobic exercise. Every 30 seconds, within the inspiring background music, a signal is given to change stations.  After doing the circuit twice, you follow a chart of stretches to cap it all. Additionally, Curves provides incentives such as drawings for T-shirts based on attendance and contests for weight loss or weight maintenance.

Simple movements. Straightforward machines. But I also get :

Exercises change before I get bored.  At Curves, you can’t get bored because you switch stations before a minute is up. A variety of music tapes and the daily brain-teaser also feed my mind.

Incredibly warm, personal interest and support from staff.   The staff members learn your name and greet you every time you walk in the door. They ask about your life as you are doing the circuit and generally everyone has a good chat. When you have packed up to go, someone always calls out a personal good-bye.

Entertainment.   The fellow exercisers are a HOOT!  Curves has a light-hearted atmosphere. Some of these gals could be doing stand-up comedy. So, of course, I will be more likely to go to the gym if I can look forward to some good laughs.

Networking.  The amount of knowledge among the club members is formidable. They have their fingers on the pulse of anything happening in our community.

Incentives to do well.  Knowing that I have a monthly weigh-in truly helps me with my eating (or over-eating). I don’t want to see my progress graph go in the wrong direction. Furthermore, I will make the effort to get in three sessions a week in the hopes of winning the drawing for a T-shirt. It’s hokey and I know it’s hokey, but it still motivates me. Additional contests help members not gain over the holidays or maintain great attendance.

If you are a female who needs to get started moving and stick with it, you might consider Curves .

Bottom of Form

In these modern times, most of us work for pay, benefits, and Social Security credits.  Usually our paid work is performed outside the home.  This, obviously, means we must travel to the job.  Once the trip gets beyond fifteen minutes one way, I call that a commute. (I know the New York City workers among us are guffawing.) There are positive and negative possibilities in commuting to work.

To me, the positive benefits for one’s mental or physical health are more easily gained if public transportation (or car pool) is the travel mode.  If you aren’t the driver, you can sleep.  This would be very helpful to most of us sleep-deficit Americans.  Reading is also a bonus for the non-driving commuter.  Even if one is the driver, a work commute can be the time for mental restful activities: listening to books on CD, prayer, or winding down.  Furthermore, if you are one of the lucky few whose commute is made by biking or walking, you receive cardio-vascular benefits of exercise.

The negative aspects of a commute to work may be more obvious.  One has the stress of driving and the extra stress when normal routes are unavailable due to accidents, road work, snow, ice, or flooding.  Alternately, there can be stress in making mass transit connections.  This is exacerbated when a train or bus breaks down or the entire line is off-service.  The worst part, however, is the amount of time lost – the lost opportunity for you to do healthful or restorative activities.

So, you have pluses and minuses if part of your life is spent traveling to your job.  See if you can increase the positives. 

Recently, I completed training for Red Cross certification in CPR and AED.   CPR stands for cardio-pulmonary resuscitation (restoring heartbeat and breathing) and AED is the acronym for Automated External Defibrillator (how to operate).  What seriously daunting responsibilities. 

CPR in the Red Cross method differs slightly for adults, children, and infants.  The number of compressions and rescue breaths remain the same, regardless of the patient’s size or age.  However, the depth of the compression and the way it is administered vary.  On an infant, one uses a few fingers, not two full hands, to press the breastbone down about one-half an inch.  For a child, the familiar two-handed straight arm push is used to compress one to one and a half inches down.  Adult compressions must be a whopping two inches into the chest.   Although that requires much force on the part of the responder, the infusion of adrenalin in such an emergency should help considerably.

The AED devices are called idiot-proof.  It was quite comforting to hear all the instructions given by the mysterious voice inside the machine.  Nonetheless, skill is required to assess whether an AED is needed.  Furthermore, one must possibly perform CPR while the device powers up.

I found these to be somber, but quite useful skills.  I think it would be very worthwhile to eliminate some of the Algebra 2 from state “no child left behind” tests for high school graduation and replace it with competencies such as these.

Part Two

My partner had two rounds of a Rituxan-Fludara chemo combination and now is on a different chemo treatment.  He is receiving Treanda, a trade name for bendamustine.  It was developed in communist East Germany in the 1960’s and recently was approved by the FDA for use in treating CLL. 

This is the chemo that is acting like all the fearsome chemos people dread.  On the two days of the month when he gets the infusion, his skin becomes burning hot, although he doesn’t have a fever.  He has lethargy that mimics (in my eyes) mononucleosis.  He has had weight loss due to nausea and lack of appetite.  Although he hasn’t vomited, he is queasy and dizzy.  In addition, his sleep is totally disrupted.  Mostly, he contends, he is not sleeping at all.  However, he does lie in a chair in a semi-comatose stupor trying to sleep.  I have seen him sleep for short 20-minute periods.  I suspect, though, that whatever sleep he “accomplishes” never reaches the REM stage.  This lasts the entire month through to the next treatment.

His oncologist has added a post-chemo injection of Neulasta.  This or Neupogen are used to combat neutropenia, a condition of having a dangerously low number of neutrophils (one of the types of white blood cells). A neutropenic person is highly susceptible to becoming ill from the normal bacteria carried on his own person.  

It is so blastedly ironic.  Leukemia is a disease of too many white blood cells, yet in treating it the patient may suffer from too few.

Do you want to know what bravery is?  Bravery is the willingness to go back for three more cycles of this.

Part One

My partner has had two rounds of a chemo cocktail and now is on a third chemo treatment with an entirely different drug.  His reactions and side effects have been poles apart.

The first mix is known to us insiders as “RF.”  The trade names for the drugs are Rituxan and Fludara. The Rituxan is a monoclonal antibody.  This means it attacks a specific marker and leaves other normal cells alone.  This chemo mix is an “easy one” according to his oncologists.  And, so it was, broadly speaking.   However, any chemical agents on the warpath the way chemotherapeutic agents behave are going to hurt the patient in some manner.  On his very first day of treatment he had an alarming, but potentially expected drop in blood pressure.   The nurses were forced to stop chemo and give Benadryl.   My partner slept the rest of the day.

Otherwise, after that first knee-jerk reaction to the treatment, he drove himself to chemo on many of the treatment days (although not all).  His first round consisted of infusion lasting about 6 hours for five consecutive days and then he had three weeks off.  He had no nausea, no change in appetite, no change in weight.  He would be tired and faint on the first day.  Also, for first few days his skin color got that purple-brown-gray awful color.   A few years later, he had the same drugs in a second round.  The infusions for this were on Monday,Wednesday, and Friday and then 3 weeks off.  The same non-side effects marked this treatment.

(to be continued)

In many parts of the USA, it is the season of sharing.  We share gifts, festive foods, religious holiday rituals, and, oh yes, germs.  For those of us with significantly colder weather upon us, indoor time increases.  One feature of our indoor time is tightly closed windows to economize on heating expenses.  Therefore, while our inside air stays warm and re-circulates, so also do our leech-like buddies, viruses, bacteria, and other wreakers of dis-ease.

My germ du jour is Montezuma’s revenge.  Therefore, my desire to eat and what I select to eat are considerably altered.  No chicken soup for this ailment.  No, I go with the BRAT diet.

B-R-A-T is the acronym for Bananas, Rice, Applesauce, and Toast.  Some of you may be protesting in horror: no fruit, no fruit!  A Wikipedia.org entry on the BRAT diet states that rice may offer anti-secretory benefits and that amylase-resistant starch in bananas may be good for gastrointestinal mucosa and reduce water and electrolyte loss.  I have also heard the notion that bananas contain pectin, another beneficial chemical for diarrhea, but I have not substantiated that.  Pectin in a no-fiber jelly on the toast is good.

Oddly, some texts on the BRAT diet caution that it is not for daily use and does not supply all needed nutrients.  I don’t think this was ever suspected.  The BRAT diet gives a few calories and a little nourishment to sick people.  The moment they can start adding normal foods, honey, they do!

As Carnegie Mellon professor Randy Pausch acknowledged, having cancer “stinks.” Amen to that. Although I have known one or two people for whom cancer was actually a blessing – a wake-up call to change their lives – most people agree with Randy. My friends who regard it a blessing had curable cancers. On the contrary, CLL, chronic lymphocytic leukemia, is slow-growing, but incurable.

While the CLL patient remains symptom-free, life should be enjoyed. However, when the time comes to better educate oneself about the CLL condition, there is a must-have book that explains it all. This book is Adult Leukemia: A Comprehensive Guide for Patients and Families by Barbara Lackritz.

Adult Leukemia is published by O’Reilly Media, Inc. It is not available through Amazon except as used books through their affiliate sellers. I have seen good deals on eBay.com, however. New books can be ordered on-line from O’Reilly .

This book has many worthy attributes. It contains 500 plus pages that read easily in 19 chapters which follow a logical progression. Currently, there seem to be several inspiring books written as narratives about the heroic struggles of adults with the acute leukemias (particularly AML). However, you need to know dispassionate facts about your chronic leukemia. This book meets that need.

The author, Barbara Lackritz, has also been known by the CLL community as Granny Barb. She worked indefatigably during her lifetime serving her community. She was intelligent, yet plain-spoken; a competent researcher, therefore knowledgeable; and served in the role of a caregiver of a family member with illness and as a leukemia patient – therefore had dual perspectives.

To obtain answers about the meaning of blood tests, resources available, and more obscure considerations, check out Adult Leukemia: A Comprehensive Guide for Patients and Families by Barbara Lackritz.

In Woody Allen’s 1973 movie, Sleeper, viewers chuckled as Woody, a health food store owner from the 1970’s, confronts notions about healthy eating in the year 2173.  To Woody’s horror, citizens of the future are praising the health virtues of steak, cream pies, and hot fudge.  In contrast, the thinking of his era valued wheat germ, honey, and a vegetarian regimen.  Funny, it did not take 200 years for nutritionists to return to extolling dark chocolate.  Nonetheless, whatever the current research-driven trend may be, there will be persons for whom diet recommendations become a quagmire.

Some individuals have health profiles which cause consternation regarding dietary impact.  A person may have Condition A whose treatment requires certain foods.  However, if this person also suffers from Condition B, the  latter malady may be absolutely exacerbated by those same foods. 

A case in point: an individual tries to follow dietary recommendations for anti-cancer and heart health goals.  He eats : dark chocolate for antioxidants, nuts for healthy fats and MUFA,  caffeine in moderation to  speed up cognitive function and to stimulate dopamine, a pleasure-making hormone.  Furthermore, this person avoids meats and eggs to reduce his cholesterol.

However, let us imagine that he also has a skin ailment.  His skin condition has these dietary recommendations: elimination of chocolate and nuts because they are high in arginine, elimination of caffeine because it stresses the immune system, and loading up on lean beef and chicken and eggs because they are high in Lysine, an amino acid.  Lysine is alleged to benefit collagen and keep skin healthy.  What’s a person to do?

In real estate the mantra about property is “location, location, location.”  In health care it evidently needs to be “balance, balance, balance.”  Hopefully, a temporary shift in diet can bring about a quick fix, while the long-term practice mandates a common-sense compromise to care for all systems.

Robert Bruce is a metaphysical mystic from Australia.  He is highly regarded and generously shares his learning.  Many things have naturally revealed to him.  But, as my drumming teacher once said to me, “thank you for sharing ‘your truth.’”  God or the Higher Power, Jehovah or the Great Kahuna, whatever you want to call the superpower of goodness, reveals truth or insight to each person in a unique way.

Robert Bruce states in the video biography on his website, http://www.astraldynamics.com/biography, that  “at the highest level we are all a part of the one energy.” His revelation about attaining higher spiritual levels includes the belief that “every person around you…   that is another you there.  That is another part of you.”  My impression is that he means this literally, not figuratively.

I have trouble wrapping my brain around this concept.  I am not saying that Robert Bruce is wrong.  Nor am I saying that he is right and I am stupid.  Each of us has our own understanding of the truth that God shows us.  He is at his point and I am at my point.

But….

If every person is another me, WHY have so many of them been so mean to me?  Think of it.  All of us have experiences with humans who have been fair to us or unfair, kind or cruel, empathetic or insufferable clods.  If we are all the same being, what’s up?  Why don’t we have some psychic intuition about this self-ness that puts the Christian Golden Rule on autopilot for us? It is a very puzzling notion.  Indeed.