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By Elaine Schattner, MD, on January 13th, 2012
Before Christmas last month, a lymphoma patient and a leukemia patient’s mother connected about a “cancer Barbie” idea. They set up a Beautiful and Bald Barbie Facebook page, and it’s growing steadily.
Several tweets yesterday alerted me to this trending story. The idea is to pressure Mattel, Barbie’s manufacturer, to provide a model that kids getting chemo can relate to. According to USA Today, as of a few days ago the toy company hadn’t responded to the group’s request.
Not surprisingly, a parallel Facebook group calling for a Bald and Brave GI Joe has surfaced.
I’m not sure what to make of all this. Should there be limits to cancer awareness campaigns? Then again, I suppose if a child has cancer, or a sibling has cancer, this kind of doll could be instructive and emotionally helpful.
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By Elaine Schattner, MD, on January 9th, 2012
Yesterday’s Times offered two distinct perspectives on weight loss. One, a detailed feature on gastric surgery by Anemona Hartocollis, details the plight of a young obese woman who opts for Lap-band surgery. In this procedure, surgeons wrap a constricting band of silicone around the stomach so that patients will feel full upon eating less food than they might otherwise. Allergan, the company that manufactures the device, admits to these complications on its website.
The other, a discussion of resolutions and will-power by John Tierney, considers strategies for sticking to diets, exercise regimens and other good intentions for the new year. Within this piece lies a distracting story of an obese (375 pound) hedge fund manager whose gastric band failed to keep his appetite in check. When he landed a project in Las Vegas and feared regaining weight, he aimed high – to lose 100 pounds, outfitted his hotel suite with a gym, and hired a personal trainer to stay
See more Weight Loss Strategies — What Should Doctors Say to Patients?
By Elaine Schattner, MD, on January 2nd, 2012
The December issue of Wired Magazine profiles David Kirchhoff, CEO of Weight Watchers, in a story on new ways to measure calories and food. It’s an interesting piece, with several points worth contemplating at the start of the year.
Kirchhoff, who gained some 70 pounds in his years after high school, writes a blog about the ups and downs of his physical self. When he first came to Weight Watchers, it was a regular points-minded participant. Now, as a fit CEO, he’s changed the plan. In December 2010, the company adjusted its algorithm for counting points. Among the revisions, a banana and other fibrous fruits are relatively encouraged relative to other, less nutritious foods with similar amounts of calories.
The two main points I took away from the Wired story by Jeffrey O’Brien, supplemented by reading of his and sources are these:
1. The effectiveness of Weight Watchers derives largely from its method of peer-to-peer support.
Earlier this
See more A Healthy New Year’s Resolution with a Social Twist
By Elaine Schattner, MD, on December 20th, 2011
 Dear Readers,
Your author will be traveling soon to a mysterious place, somewhere south of NYC. Before departing, she needs complete some ordinary tasks like errands, paperwork and packing. So she is signing off, until January.
Have a great holiday if you celebrate, and happy new year to all!
ES
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By Elaine Schattner, MD, on December 16th, 2011
The author is saddened to learn that Christopher Hitchens died late yesterday evening at the age of 62, roughly a year and a half after receiving a diagnosis of esophageal cancer. He was a prolific and articulate man; I respected him for his words.
His essays on the language and cancer might be of particular interest to some readers of this blog.
The NCI reports there are some 17,000 new cases of esophageal cancer in North American each year; it’s not a common tumor, and most cases arise in men. The annual number of deaths from esophageal cancer approaches 15,000 in the U.S. These numbers are telling: it’s not an easy disease to have, or to treat.
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By Elaine Schattner, MD, on December 13th, 2011
Is a question I ask myself almost every day. When I started this blog, it was partly a response to what I perceived an unbalanced attack on the value of breast cancer screening by the mainstream news outlets. Why it’s continued is, mainly, that I find it liberating and, in a strange way, fun. As I’m no longer practicing, this wide-open world of shared facts, some questionable, and new ideas keeps me alert and, maybe, in-touch.
Today several physicians tell of the benefits of social media for physicians. One post by my colleague Kevin MD is titled Bury Bad Doctor Reviews With a strong Social Media Presence. Kevin has, previously and elsewhere, described the potential value of blogs that encourage nuanced discussion of health care news. What he reveals, today, is that blogs can be a way for doctors to put forward a positive image of themselves and their practices. Closer to home, orthopedist Howard J. Luks, MD writes to the
See more Why Should Physicians Blog or Use Twitter?
By Elaine Schattner, MD, on December 5th, 2011
Over the weekend I developed another bout of diverticulitis. Did the usual: fluids, antibiotics, rest, avoided going to the ER, cancelled travel plans.
One of my doctors asked a very simple question: is this happening more frequently? The answer, we both knew, was yes. But I don’t have a Personal Health Record (PHR) that in principle, through a few clicks, would give a time-frame graph of the bouts and severity of the episodes over the past several years.
The last time this happened, and the time before that, I thought I’d finally start a PHR. Like most compulsive patients, I keep records about my health. In the folder in my closet in a cheap old-fashioned filing box, the kind with a handled top that flips open, I’ve got an EKG from 15 years ago, an OR report from my spine surgery, copies of lab results that the ordering physicians chose to send me, path reports from my breasts, a skin lesion or
See more A Good Personal Health Record is Hard to Find
By Elaine Schattner, MD, on November 30th, 2011
 The other evening I stayed up watching Frida, a 2002 movie about the Mexican artist Frida Kahlo. She sustained debilitating spinal injury in a trolley accident as a teenager and had many surgeries. Among other interesting things about her life, she had a tumultuous marriage to the then-more-famous muralist Diego Rivera, and if this movie be true, a brief affair with Leon Trotsky.
Her story is one of pain, psychological and physical, and of a beautiful woman who uses art to express what that’s like. She’s astonishing, still, if you ask me.
Speaking of pain, or “algia” in Greek, as some of reviewed on Twitter yesterday -
Today I came upon a blog, Pain Sufferers Speak, put together by an on-line friend, Liz Hall. Liz maintains a related Facebook page, a LinkedIn network for pain sufferers, runs Tweet chats @painspeaks and more. There’s a “Facebook Pain Family Group with NO judgment and NO criticism PLUS Unconditional Love plus 24–7 support for
See more A Blog About Pain
By Elaine Schattner, MD, on November 23rd, 2011
 Dear Readers,
I’m going to take a break from blogging for the holiday and possibly a while longer. For tomorrow, there’s lots in store, with family and old friends.
Macy’s Thanksgiving Day Parade, Times Square, Nov 25, 2010, photo attribution: asterix611 (Flckr)
I wish everyone a wonderful Thanksgiving and long weekend!
ES
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By Elaine Schattner, MD, on November 22nd, 2011
A neat story in today’s Times points to the paradoxically increasing smallness of our world, in the digital and, maybe, personal sense. We’re getting nearer, one to one another. Or at least some of us are through Facebook and other technologies.
Our average degree of separation is said to be only 4.74, according to a new study posted on-line yesterday, where else but on Facebook? According to the Times report on the Facebook work:
… The researchers used a set of algorithms developed at the University of Milan to calculate the average distance between any two people by computing a vast number of sample paths among Facebook users. They found that the average number of links from one arbitrarily selected person to another was 4.74. In the United States, where more than half of people over 13 are on Facebook, it was just 4.37.
The caveat, of course, is that the study examined connections
See more New Math in a Digital World: Implications for Patients?
By Elaine Schattner, MD, on November 21st, 2011
A short note on Cutting for Stone, a novel I’ve just read by Dr. Abraham Verghese. He’s an expert clinician and professor at Stanford. The author uses rich language to detail aspects of Ethiopian history, medicine and quirks of human nature. The book’s a bit long but a page-turner, like some lives, taking a strange and sometimes unexpected course.
For today I thought I’d mention one passage that haunts me. It appears early on, when the protagonist, a man in middle age reflects on his life and why he became a physician:
My intent wasn’t to save the world as much as to heal myself. Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound.
The point is, a physician may be immersed in his work in a manner that he is, in
See more ‘Cutting For Stone,’ and Considering the Experience of Practicing Medicine
By Elaine Schattner, MD, on November 16th, 2011
Yours truly, the author of Medical Lessons, is listening to music while she writes. A live version of the Stones’ “Silver Train” has just come on, and she’s happily reminded of something that happened 30 years ago. Distracting? Yes. Calming? Yes. Paradoxically helps to keep me on track? Yes.
My iPod keeps my mind from wandering further. And it lifts my mood.
And so here, on my blog, which is not peer-reviewed or anything like that, I put forth the medical concept of “iPod therapy.”
“When you’re weary, feeling small…” Music can help.
Today’s news reports that 1 in 5 Americans take drugs for psychiatric conditions. That sounds like a lot to me, but I’m no pharmaceutical surveyor. Of course many people need and benefit from medical help for depression and other mental illnesses.
But, in all seriousness, I wonder how many people might use music like a drug to keep them relaxed, happy, alert…
Why not prescribe music? It
See more iPod Therapy — Why Not Prescribe It?
By Elaine Schattner, MD, on November 14th, 2011
A funny thing happened at my doctor’s appointment on Friday. I checked in, and after confirming that my address and insurance hadn’t changed since last year, waited for approximately 10 minutes. A worker of some sort, likely a med-tech, called me to “take my vitals.”
She took my blood pressure with a cuff that made my germ-phobic self run for self-regulation, i.e. I stayed quiet and didn’t express my concern about the fact that it looked like it hadn’t been washed in years. I value this doctor among others in my care, and I didn’t want to complain about anything. Then the woman took my weight. And then she asked if she could take my picture, “for the hospital record.”
I couldn’t contain my wondering self. “What is the purpose of the picture?” I asked.
“It’s for the record,” she explained. “For security.”
I thought about it. My picture is pretty much public domain at this point in my life,
See more Thoughts, on Getting My Photo Taken at a Medical Appointment
By Elaine Schattner, MD, on November 9th, 2011
 Last week Forbes ran a photo-feature on the 7 most powerful ‘foodies’ in the world, according to author Michael Pollen.
Michael Pollen, Forbes, Nov 2011
So who made it onto the short list?* with annotation by ML:
1. Michelle Obama (First Lady, mother, organic farmer-in-chief and Let’s Move! fitness enthusiast)
2. Marion Nestle, Professor, New York University (a neighbor, I’d like to meet!)
3. Josh Viertel, President, Slow Food USA (need to learn more)
4. Will Allen, Urban Farmer (ditto)
5. Jack Sinclair, Head of Grocery, Wal-Mart (who knew they’re the largest vendor of bananas in the US? I did! by listening to the Brian Lehrer show, some time ago.)
6. Ken Cook, Executive Director, Environmental Working Group (sounds reasonable)
7. Mark Bittman, Columnist, The New York Times (he’s on Twitter).
It seems to this homemaker/mom/physician that this group may indeed influence how, where and what we eat. The public health implications of their work may prove unmeasurable, but be large and very real, nonetheless.
I recommend
See more Seven Powerful ‘Foodies’ on Forbes, Influence on Public Health?
By Elaine Schattner, MD, on November 7th, 2011
On Friday I visited the Scar Project exhibit at Openhouse, on Mulberry Street just south of Spring. Photographer David Jay offers penetrating, large, wall-mounted images of young people with breast cancer.
The photos reveal women who’ve have had surgery, radiation, reconstruction or partial reconstruction of the breasts. Some are strikingly beautiful. Some appear confused, others confident. Some look right at you, defiant or maybe proud. Some, post-mastectomy, adopt frankly or strangely sexual postures. Others hide a breast, or turn away from the lens.
This collection is not for everyone. The photos of ravaged bodies of women with cancer might be upsetting, if not frankly disturbing, to some who look at them. Not everyone chooses to do so.
The women’s scars and expressions are telling. Though not representative, these images reflect wounds not often-shown in medical journals, or elsewhere.
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By Elaine Schattner, MD, on November 4th, 2011
Few BC news items irk some women I know more than those linking alcohol consumption to the Disease. Joy-draining results like those reported this week serve up a double-whammy of guilt: first — that you might have developed cancer because you drank a bit, or a lot, or however much defines more than you should have imbibed; and second — now that you’ve had BC, the results dictate, or suggest at least, it’s best not to drink alcohol.
The problem is this: If you’ve had BC and might enjoy a glass of wine, or a margarita or two at a party, or a glass of whiskey, straight, at a bar, or after work with colleagues, or when you’re alone with your cat, for example, you might end up feeling really bad about it — worse than if you had only to worry about the usual stuff like liver disease and brain damage, or if you could simply experience pleasure like others, as they choose.
The
See more On Alcohol and Breast Cancer, Guilt, Correlations, Fun, Moderation, Doctors’ Habits, Advice and Herbal Tea
By Elaine Schattner, MD, on November 2nd, 2011
 A curious diagram appeared in the most recent NEJM, in a perspective on U.S. dietary guidelines. It’s a USDA food wheel from the early 1940s. With Twitter-like style, it says: “For Health…eat some food from each group…every day!
The details are rich: “butter and fortified margarine” constitute 1of the 7 groups. Further inspection-worthy, IMO.
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By Elaine Schattner, MD, on October 28th, 2011
I read Your Medical Mind in hard cover, the old-fashioned way.
This book, on how patients think, offers a penetrable, informed and anecdote-riddled discussion of how people make health-related decisions. It’s co-authored by a husband and wife, Drs. Jerome Groopman and Pamela Hartzband.
The two are experienced physicians: Groopman’s an oncologist and familiar author; Hartzband’s an endocrinologist. He says he’s a “believer” in modern medicine, although his faith’s been challenged since suffering untoward effects of back surgery. She’s a “doubter” and tends to wonder about other doctors’ directives. One thing I like about the book is its dual authorship; underlying its course lie communication, mutual respect and, in all likelihood, some compromises.
The book resembles a travel narrative of sorts, starting with an overview of the planned medical decisions “tour.” The pair sets out to interview “scores of patients of different ages, in different parts of the country, of different economic status, with different
See more Two Minds on Medical Thinking
By Elaine Schattner, MD, on October 27th, 2011
 This story, shared today by Debbie Woodbury, warrants ML Annals of Pink inclusion:
The Arizona Republic reports on a divided community in Gilbert, AZ. At issue is the high school cheerleading team’s plan to wear pink tee shirts with the slogan: “Feel for lumps — save your bumps” on the back. The group’s intention was to raise awareness and funds for the Susan G. Komen Foundation.
The school’s principal said no to the controversial outfits due to their “unacceptably suggestive” content.
What strikes me, among other interesting aspects of this story and what it reflects about BC awareness in 2011, is how the arguments (so needless!) about fundraising play out so differently, depending where you live and the newspapers you might read.
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By Elaine Schattner, MD, on October 20th, 2011
With or without CDC updates on Listeria, and especially when I travel to other countries with less ES-friendly water systems, I pretty much always assume a fruit’s surface bears bacteria that might make me sick.
A rough-skinned melon like cantaloupe is essentially unwashable. You can try, but here’s how I cut melon to reduce the odds that germs on the outside will enter my lunch:
1. Put the melon on a cutting board. Cut it into quarters with a sharp knife.
2. Scoop out the seeds in the center with a clean spoon.
3. Use another knife to shave off the exposed fruit edges of each section, starting from the fleshy fruit center and pressing downward toward the melon’s rind. Stop each cut before reaching the skin, so that the knife remains “clean.” This knife should touch only the fruit’s interior.
4. Carve out the melon slices from within each section, again without letting the knife touch the rind.
See more How To Prepare a Melon
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