My mother had 2 lumpectomy/reexcision surgeries for her BC and her margins remained positive and so rather than trying another breast conserving surgery, she opted that her third surgery was a mastectomy. Having not the greatest health insurance, she had to bear a 20% co-insurance burden for these 3 procedures which added to the depression she already had over “her body turning on her.”

I’m curious as to the difference between her experience at a regional hospital versus what might be the outcomes of having a better pathology / surgical staff environment at a more metropolitan hospital?

I’m of two minds on this important subject. My first concern is about misdiagnoses. We know, for example, that women heart patients are under-diagnosed (and under-treated even when appropriately diagnosed) compared to their male counterparts.

So if doctors are reading this stuff from the AMA (and other sources), will they be even more likely than they already are now to treat our complaints dismissively? I was sent home from the ER in mid-heart attack (despite textbook symptoms) by an ER doc who told me confidently: “You’re in the right demographic for GERD!” before patting me on the head and sending me away, feeling terribly embarrassed because I’d just made such a fuss “over nothing”.

On the other hand, could I have been his 10th in a row middle-aged female patient with the same complaints that day, who had all shown up in his ER, frantic because they’d been Googling their symptoms and self-diagnosing what wasn’t actually there?

On my blog, and in my frequent community presentations about women’s heart health, I meet many women who are absolutely convinced that they are in imminent danger of heart attack, often despite weeks or months of futile (and expensive) diagnostics that say otherwise. At first, I’m always alarmed that this woman’s complaints may not be taken seriously (e.g. as seriously as you and I know that a male heart patient’s complaints would be taken). But over time, I’ve come to wonder if many of these women are indeed the notorious “worried well”, sucking up medical resources and doctors’ energy, so that by the time a person like me shows up in Emerg — a real live patient in mid-heart attack! — docs are more likely to blow me off, too. There’s actually a name for this unfounded belief you’re having a heart attack: “cardiophobia”.

These people make it hard for those of us who are suffering bona fide cardiac events. It’s hard enough for women, particularly women under 55, to be assessed appropriately with legitimate heart issues, without clogging up the ER with the “worried well”.

I wrote more about this dilemma in “Catastrophizing: Why We Feel Sicker Than We Actually Are” at http://myheartsisters.org/2011/01/05/catastrophizing/

First, if Ms. Deen were just another 64-year old overweight, inactive smoker diagnosed with Type 2 diabetes, we wouldn’t care. But she isn’t. Forbes magazine has estimated that Ms. Deen’s annual income tops $4.5 million from her Food Network cooking show earnings, product endorsement contracts, and book/merchandise sales. She is a hugely popular cooking show celebrity (what we in the public relations field would consider a person of “affluence and influence”.

Instead of attempting to use that influence for good, however, Ms. Deen stayed quiet about her Dx for three years until she’d locked down her lucrative drug company endorsement deal with Novo Nordisk (what we might consider an attempt to cash in on her medical condition).

When interviewed about her news, she attempted to downplay the entire issue of a high-fat, high-sugar Southern diet as a potential contributor to her diagnosis. As you wrote, Type 2 diabetes could largely be “avoided by diet and lifestyle mod­i­fi­cation”. You know it, I know it, I’m guessing Ms. Deen knows it, too. But instead, Ms. Deen told media interviewers that factors like stress and family history were likely to blame as part of a mysteriously vague and complex puzzle. You’re right, her deep-fried cheesecake didn’t cause our current epidemic of obesity, but it sure didn’t help (what we might interpret as disingenuous).

And when the groundswell of public condemnation just refused to go away, Ms. Deen announced that she’d suddenly decided to donate an undisclosed portion of her Novo Nordisk cash to the American Diabetes Association — a move that backfired dismally as critics saw this for what it seemed to be: a desperate ‘too-little-too-late’ strategic move, no doubt recommended by her crisis communications team (what we might consider a ‘Hail Mary’ attempt to turn down the relentless heat).

I like what food writer Kristin Wartman wrote recently about this phenomenon in “Civil Eats”:

“There are three main issues when it comes to the myth of personal responsibility about food choice, and they get at the root of our nation’s health crisis:
1. the public’s confusion about nutrition
2. the lack of time and knowledge about real home cooking
3. the promotion of quick fixes like drugs, diet foods, and fads in lieu of addressing underlying causes

“The Paula Deen diabetes story manages to hit on every single one of these issues.”

Keep up the great work…
cheers,
C.

Don’t grow fast??? Half the rego­rafenib-treated patients were DEAD in 6.4 months. Do you want them to keep taking the drug after that??