Friday, October 21, 2016

WHY I FELL - The Risk The Doctor May Not Mention

Many decades ago, a doctor wrote a scrip for Great-Aunt Blanche:  Buy a case of Vernor's Ginger Ale.

They couldn't really afford the gas they burned to drive across the state line to a Vernor's distributor, but at least she had something important to talk about for weeks:  Dehydration.

I remembered that story a few years ago at work, when a fabric rep refused my offer of coffee: "I only drink it in the morning now; coffee is just too dehydrating - it ruins your skin."  (And his skin is fine, worth pampering.)

Not too long after that, at a company outing to a fabulous evening open house, I suddenly felt weak, sunk gracefully to the sidewalk, and passed out for a few seconds.  I was outside in crisp, cool air and hadn't had any symptoms before I fell. The fire dept. EMT made me drink a bottle of water; I got up and walked to the car with no more symptoms.  Turns out half a tiny plastic glass of wine had been no protection against dehydration.  You'd think I would learn.

My writing ritual was always a cup of coffee right next to the computer (part of my inner image as the busy writer, or at work, the busy computer jockey.)  But I don't have the habit of drinking enough water.

Fast forward:  A couple of weeks ago, I felt a bit dizzy and tired at the keyboard, put head between the knees, and all.  Suddenly I knew:  dehydration..  Since my recent bout with pre-diabetes, ginger ale is not an option, so I drink all the coffee I want instead of the water I need. Adding my green tea from the dental protection regimen should make me drink even more water.  Ugh.

I was lucky to have those symptoms.  Aunt Blanche apparently didn't notice symptoms, but her doctor did.  (One thing I'm learning; different writers from the same big hospital may have slightly different opinions on a subject like dehydration.) Alas, several of them agree that getting older may add to the danger; we may not notice thirst and may not eat foods that bring in moisture.

Today I learned that dehydration could also be a factor in my (expletive deleted) chronic eyelid disease!

Why am I telling this:  With summer ending, school will start, days will get colder in most places. Coffee is warm and kind while water is just ... water.  Grownups will head to a place with hot coffee. We will forget summer warnings to drink enough water.  We may get dehydrated from so much caffeine.  Osteoporosis, taking more medicines than usual, or just being sick may increase our danger of falling.

Writing this really makes me want more mid-morning coffee,  It should come with a glass of water. Secretly, I'm buying bottled spring water, but so far not putting it in the coffee maker.  The big pint-and-a half bottle makes me aware of how much I drink.  Or don't.  I need to get some squatty little water bottles that fit perfectly under the dash in my car.  And I must not keep them in the fridge - a splash of icy water on my leg when I brake could cause problems at least as bad as dehydration.

As for the day recently when I felt a bit dizzy at the computer..(and my need for noon naps):

Signs of dehydration in adults include
  • Being thirsty
  • Urinating less often than usual
  • Dark-colored urine
  • Dry skin
  • Feeling tired
  • Dizziness and fainting"
And of course, I'm in TX so summer warnings still apply.  

Wednesday, October 12, 2016

BREASTCANCER - MUST READ. A Doctor advises: before and during treatment: what to insist on.

 If you missed this on TW or in The Detroit News, hope you get to read it.

Dr. Debra Johnson, a professor at UC Davis, gave information new to me about what TESTS to demand so we can assess dangers before chemo and radiation plus effects of chemo and radiation.

I had to paste this title into Google after this moved on in TW.  Worth the work, work the read.

Tuesday, September 27, 2016

LIFE ON A SECOND OPINION midnight special


Read on Facebook stickit2stage4 today the fine 2nd opinion piece from Beth Caldwell  on her new hope for an incredible combination of rough diseases.

Wednesday, September 21, 2016

TAMOXIFEN - What does it really do? How is it really different?

Today I got an e-mail from   a CA Breast Cancer site I once supported.  One issue mentioned in the  "letter" from their Exec Director, was a study on aromatase inhibitors.  I don't take them, but I still glanced at her June 7 post.

She mentions the "San Antonio Breast Cancer Symposium which showed that extending treatment with tamoxifen reduced both recurrence of and death from breast cancer."  and mentions that she wrote about that symposium and the Atlas Study at that time.

I clicked the link to what she had written then.  And was dismayed to find this: "Tamoxifen is an anti-estrogen drug given to women with hormone sensitive breast cancer to prevent spread and recurrence."

 In fact, anti-estrogen is the opposite of  Tamoxifen--   

Pre-menopausal women get Tamoxifen because it does NOT destroy or prevent estrogen.

Here's what Tamoxifen does: 

Cancer Research UK:
Tamoxifen works by locking on to the oestrogen receptors to block oestrogen from attaching to them. The oestrogen cannot then stimulate the cells to divide and grow. "  (bold is mine)  

 For me, this is a very important difference, a vital difference.  At my age, if my body produces a bit of estrogen, I want to consider that that might not be all bad!  

So I refer you to what the Nat'l Cancer Institute says on hormone treatment and what SERMS like Tamoxifen can do. 

 "Most SERMs behave as estrogen antagonists in some tissues and as estrogen agonists in other tissues. For example, tamoxifen blocks the effects of estrogen in breast tissue but acts like estrogen in the uterus and bone."  

PS Even my oncologist mentions now and then that Tamoxifen is thought to have deposited some new bone on hips. And one of my hips is where I'm hoping for a little help with my osteoporosis.  


Tuesday, September 13, 2016

BELOW THE BELT - more about some parts that aren't working perfectly

I once had a need to pee too often.  It wasn't a doctor or nurse who saved me - maybe a book or magazine or friend said a magic word Kegel exercises.  Recently I'm having those urges again.

Why aren't my nurses and my Gyno handing out Kegel info as a sort of preventive move?  You can print it out on Mayo clinic - they tell if Kegels will probably help you and when they might not.

Maybe your complaint is not frequent urination, but something is irritating your perineum, and you don't want to hear about exercises until this is fixed.

In fact, I have both problems. I've learned several things can make our perineum very unhappy.  Mine has been unhappy before. A male doctor (and his nurse) listened to the perineum problem and clued me into what might work.?  They agreed that Clotrimazole OTC might help.  It did.  More recently, a Texas NP wrote me a scrip for a combination cream containing it. She said I could use it anywhere, but I DON"T use it inside the vagina and don't get it near my eyes.  Ever.

Also, isn't it possible that a hard-to-ignore irritation may start if we're taking tamoxifen or meds that completely stop estrogen production -- we've been gifted with our own Second Menopause, and our perineum is getting nothing. Hmm.  Ask your oncologist on that one.  Other patients may have noticed the same thing.

Furthermore - It seems when my perineum is irritated, I feel a need to urinate more often, and my pee-ometer (early warning system) in my head gets confused.

By the way, when more and more women started working, I read some reminders that we should empty our bladders completely instead of rushing back to work too soon.

Finally, As we get older, they say our senses get weaker - doesn't this include the sense that notices we may need to pee soon?  Should be maybe looking for the bathroom locations when we enter the building?

Infuriating hour-long phone conversations with the internet service taught me that I can retain a very full bladder longer than I think I can, if I must.  But I don't risk it for fun.

Ask your doctor.  Then ask her nurse.  Then ask your other doctor.  But ask before you exercise and before you use any medicine.

Wednesday, September 7, 2016


This is from Sunrise Rounds.  I get it on e-mail, but you can go to his website.


Posted by  on Sep 6, 2016 in End of LifeFeatured | 5 comments
An older friend of mine a couple of years ago said before she was convinced to go and live near her daughter:
"I wish I were doing something worthwhile."
Dr. Salwitz knows about this need.  I'm encouraged when even one doctor says he does know.


Wednesday, August 31, 2016

THE TEST FOUND WHAT?! And that, too, and that, and that?

Since I took RETHINKING AGING... out of the library, headlines on overtreatment have been catching my eye.

Twitter led me to this one.
When a Medical Test Leads to Another, and Another

 Yes, it opens up the argument- should patients be told of unexpected things that pop up during X-rays and other tests - things that may be nothings?  Things that may not be dangerous?

The two researcher authors feel we're over the line and giving too much information.

A sidebar gives us some info and a few percentages of what is turning up unexpectedly lately.  Lumbar spine MRI's for instance.  I already knew that my lumbar spine MRI showed a bunch of arthritis that I'm still dealing with.  Or dealing with more often.  Interestingly - it was a 2nd-opinion pain expert who told me about the arthritis.  The spine surgeon never mentioned it.

Also, you might be surprised by the many extra findings during diagnostic tests for colon cancer.

A lot of mention is given to unexpected kidney findings, and how urgent they could become if left for later.

This patient was reading fast, looking for the part where they would mention "immune system.."  Since Prolia arrived in my life, my immune system is on my mind.  Didn't find a mention of it.

Nothing has been solved here, but I am always glad when anyone pokes a stick into over-treatment and keeps it in the spotlight.

I wish you health.