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What’s wrong with these questions?

February 12, 2011

“What are you doing in your free time?” “What do you guys eat?” “Do you have a problem eating healthy?” “Why is tanning so important to you?” “Do you have an eating disorder?” “Do you think you have a problem with eating healthy?” “Do you choose white or whole wheat bread?” “How were you raised?” 

Each of these questions has the potential to seem critical. Asking someone what they do with their free time…could be a friendly rapport-building question in the mind of the person asking the question. But it also has a risk related to seeming to imply that there might be a right or a wrong answer. And if that is true, if you ask me the question, I am going to want to appear to be the kind of person who spends my free time doing things that fit my sense of self. I don’t think of myself as “lazy” and so if I tell you that I like to watch “Survivor” or “American Idol”–will it seem like I am lazy?    

And asking me what I eat–when, yesterday, today, over the holidays, when I eat alone, when I am at work? Again, there are so many ways to think about that question and how my answer may say something about me that I don’t want it to say. So, how about if I just say, “It depends,” is that helpful in suggesting how to guide my eating habits?

And what about tanning? I heard that you need some sunlight to get enough vitamin D to help avoid osteoporosis. So why shouldn’t tanning be important to me?

The questions and our answers are likely to be linked to telling us to change our behavior, and we have some instinct about that as well. Most of us like to make smart choices. So a little bit of coaching can go a long way toward helping… But, just telling us “to stop tanning,” or “don’t eat junk food,” or” find more time to exercise…” –well, we’ve heard it all before.  

When we talk about health, it helps to think about the fact that most of want to be liked by others or at least to have a chance to show how what we do matches who we think we are…most of the time.

…saying ‘good-by’ to a woman whose life was…well lived…

February 8, 2011

Ruby Brown died this weekend. She was the mother of one of my sister’s husbands…and mother and grandmother and great-grandmother to dozens of others. She lived on a farm in Missouri. She lived on that farm until her death. She was strong and resourceful. She grew a garden with enough fresh produce to share…with my sister and her family who lived next door, with another of her children and that family who lived behind my sister…

She had flowers that bloomed with the extra big blossoms hanging over the entry into the side door of her home and flowers that wound up on the sides of the barn. Her hobby was sewing doll clothes. It was fun for her to go to garage sales and buy discarded dolls, bring them home, and clean them up and make repairs, and then sew a wardrobe and wait for the just right child to give each to…

Ruby talked to her family about her life and her death. She wanted no heroic measures. We have talked here before about having an advance directive [http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=226&action=edit]. And so, when she suffered a serious stroke on Friday, her family gathered and they were with her as she let go her earthly body… Thank you, Ruby, for all the love you lived…

Have you heard of black bean powder?

February 7, 2011

I love to try new foods. I particularly like spices. I like the smell of ground cloves and cinnamon…I love a fresh tomato out of the garden. I love peppers and grow several kinds each summer. I love the smell of fresh herbs and grow them as well. I dry oregano for use in my own cooking and to give as gifts. And as luck would have it, these things turn out to be good for you…

Research links consuming cinnamon to improved glucose levels and less likelihood of diabetes, as well as improved cholesterol [http://care.diabetesjournals.org/content/26/12/3215.abstract]. Dried oregano works as an antioxidant… Cloves may prompt recall… 

One of the graduate students in our health communication program brought me a gift when she returned from Korea after the break–black bean powder. .. I love black beans, especially when they have been cooked with some of the spices I like best and served with tortillas. I also have experimented with making black bean brownies… But I hadn’t heard of black bean powder. It provides a very easy way to add protein to a meal, even breakfast. Add to a glass of milk with a little honey and–presto–a healthy breakfast or other time power drink. Make your own black bean powder [http://www.soy-beans.org/soy-powder.html].

It’s fun to talk with friends and family about good food… and to make and share it… especially when you know it is good for your health, too.

What did Dr. Oz say about genes and health, and what did his guest doctor say about viruses causing cancer that left me talking to the TV–and not in a happy voice?

February 4, 2011

Aieeeeeeeee. Dr. Oz had some visiting doctors on his show again today. As they were wrapping up some of the discussion, Dr. Oz said, “Genes load the gun… The environment pulls the trigger… I want you to remember that.” What?! We have discussed the importance of family health history in this forum before. So the role of genetics is one that is an important topic when talking about health.

But I wonder how many viewers really got the idea that it was family health history they should be thinking about with his expression–“Genes load the gun.” This is an old metaphor for the role of genes for health and has not been very effective. Add to that, the conversation that Dr. Oz was having about genetic mutations on the show. It all got mushed together…

“The environment pulls the trigger.. I want you to remember that.” Really? What does it mean? Again, the meaning of environment in this metaphor has many interpretations. Environment for most people is about where they live, the climate, the neighborhood, pollution… those things all matter when it comes to our health and interact with our family health history. But environment includes our personal behavior and our social environment–friends, family, and culture. What we eat, for example, is part of the ‘environment’ that our genes live in… But I am not confident that this meaning is clear when talking about genes and health with this metaphor… 

Then there was the conversation about viruses–that cause cancer. HPV was one of the two examples discussed. I think that this also was not a good way to discuss the issue. If I have cervical cancer, you cannot ‘catch’ it from me. Cervical cancer is not a virus that can be passed from one woman to another. Cervical cancer is often caused by the lesions that form from genital warts caused by HPV–the humanpapilloma virus. So there is a virus that causes a condition that may be the cause of cancer…and not just cervical cancer but also penile cancer and throat cancer and head and neck cancers… So we may pass a virus between us that leads to genital warts that sometimes do not heal and may cause some changes in our cells and become cancer…

So let’s focus on understanding that increases our health literacy and not shorthand expressions that don’t… And let’s look toward spring and the daffodils that will replace the frozen icy tundra in my woods today…

What didn’t Oprah know about drug use and sperm quality and women’s health that Pam Grier told her?

February 3, 2011

Wild horses… well, not exactly. More like tame pets… A few images from our fall camping trip to Assateague…where ‘wild’ horses live on the beach, walking among the campers and even sharing our water and facilities…

And then, there was Oprah’s show today… [http://www.oprah.com/oprahshow/The-Original-Foxy-Brown/4]

Pam Grier talked about her life–today and during the period of time when she had starring roles in such shows as Foxy Brown. She also talked about relationships she has had, including with Richard Pryor.

As the Oprah show revealed, “After a gynecologist visit, Pam says she discovered Richard’s vices were affecting her too. She writes candidly about the experience with the hope of informing women who may be at risk. “There was an epidemic of a lot of people doing cocaine,” she says. “And it accumulated in the body and often in the prostate gland. It would come out during your sexual activity and [end up] inside a woman.”

Pam’s doctor cautioned her about the dangers of having unprotected sex with Richard. “[The cocaine] could harm the woman’s internal organs,” she says. “So I had to tell Richard, ‘You’re going to have to wear a raincoat—a condom.’ And he had an issue with that, and I said, ‘Well, it’s my life. You have to understand.’ So I chose me.”

Oprah said, “I did not know that–” in response to the revelation about the drugs ending up inside the woman…  We have discussed such matters before http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=295&action=edit 

We can’t talk about ‘women’s reproductive health without talking about men’s reproductive health… and we can’t talk about men’s health without talking about women’s health…

Why did Dr. Oz introduce Dr. Nemeh on his show today?

February 2, 2011

Well, with all the winter weather slamming the nation, I thought a picture to remind us of spring was in order…

Dr. Oz discussed healing through faith on the show today [http://www.doctoroz.com/videos/man-faith-healer-pt-1]. This is one of my favorite topics in health communication. Dr. Oz introduced Issam Nemeh who was very comfortable answering all kinds of questions. For example, “Couldn’t the lung mass have really been a virus that cleared up on its own?” “A biopsy showed it to be a mass… It was there and then it wasn’t.”

My favorite phrase used several times during the show by several people, including the host and the guest–“it isn’t ‘either’ — ‘or’. It can be both” They were referring to…healing through faith and Western medicine…working together.

In ‘Talking about health’, Tina Harris tells the story of her brother when he was young and the years that her family dealt with his breathing difficulties. Her brother had many hospitalizations and saw many doctors over almost five years. During all of that time, they prayed for a healing of Ken. Then, the family found a doctor who shared their faith. The family prayed with him. The comfort they had based on the shared faith guided them to feel comfortable with scheduling a surgery with the doctor, believing that God would use the doctor’s own faith and skill to improve their son’s health. Then, the miracle they had been praying for happened. Ken was healed. He no longer needed surgery…and as Tina said, her brother sings the Lord’s praises every week in church…

Tina and I have explored the topic of the role of religious faith for beliefs about genes and health. We find, of course, that some people do not believe in God. Religious faith is a strongly held value. In a nation founded on religious freedom and among citizens who largely claim to be religious, openly declaring one’s own lack of religious faith is not a declaration likely to be done with little thought behind it. But expressing belief in God is also not a declaration done with little thought, and finding a way to make a space for either in conversations about health is important…to health and healing…

What did Dr. Besser say about the HPV vaccine?

February 1, 2011

Today, on ‘Good Morning America,’ Dr. Besser–the show’s medical expert and reporter–talked about recommendations for vaccines that older teens should get. http://abcnews.go.com/GMA/OnCall/video/new-vaccine-guidelines-for-older-children-teens-12810738 He recommended three vaccines, including one to prevent whooping cough,meningococcal booster to prevent meningitis, and a hepatitis B vaccine.

Dr. Besser was talking about the American Academy of Pediatrics new recommendations for older teens. The Academy recommended other vaccines as well, including the HPV vaccine.    http://abcnews.go.com/Health/w_ParentingResource/vaccinate-child-time/story?id=12806514&page=1 

Interestingly, Dr. Besser did NOT recommend this vaccine…for teen boys specifically, saying that he wouldn’t, “get it for my sons.”  When asked why, he said for boys, it is a preventive for genital warts which are he noted “easily treatable.” When pushed for more information, he added, “It’s very expensive.”

Interesting. We  have discussed HPV in this forum before and in the past week, had quite a discussion relating to HPV. http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=376&action=edit  That discussion built on an earlier one.  http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=33&action=edit

It is important to remember the limitations of the vaccine for females and cervical cancer prevention noted on the National Cancer Institute’s site, “The vaccine tested in this study has several limitations, noted NCI’s Hildesheim. For one thing, the vaccine offers no protection against other types of HPV that can also cause cervical cancer. In addition, it’s unknown whether the vaccine’s protection against HPV-16 is long-lasting. Finally, it does not prevent HPV-16 infections already present at the time of vaccination from progressing to cancer.” http://www.cancer.gov/clinicaltrials/results/summary/2002/cervical-cancer-vaccine1102

Let’s not forget an important message then… still get a pap test as an early detection strategy for cervical cancer…

What do stories about Amy Chua and ‘tiger moms’ have to do with communicating about health?

January 30, 2010

I have been surprised by one of the media’s most used excerpts to discuss Amy Chua’s book, ‘Battle hymn of the tiger mother.’ The example is about one of the author’s children saying that she hated math. The mother then decided to make quizes and drill the daughter, which improved her skills, and in a short period of time, the daughter like math.. even loved math. My own daughter reached an age where she, too, told me she hated math. I feel lucky that I had a friend and colleague who was studying how students learn math. She had reached the conclusion that girls and boys learn math differently.

Martha Carr “studies first-graders, and has found that girls use different strategies and have different motivations to do math. ‘Boys,’ Carr says, ‘tend to use memory to retrieve sums and are motivated by a sense of competition to get the answer fast, even if they sacrifice accuracy. Girls care less about speed than accuracy and more often rely on “manipulatives” — counting on their fingers or a counting board. Girls will use manipulatives even when they might be able to retrieve [the answer],’ says Carr. ‘They need an added push that boys don’t need to start using cognitive strategies.’ That’s important because while using manipulatives is an excellent strategy when students first learn math, it slows them down as problems get more difficult. In fact, in a study that followed students from second grade through fourth grade, Carr found that becoming fluent, and therefore faster, at basic math is directly linked to math performance. The study also found that girls were less fluent than boys. ‘If we make sure all children are fluent [in math facts], we will eliminate most gender differences,’ she says. http://www.apa.org/monitor/2010/07-08/gender-gap.aspx

Because I had heard Martha present some of her research findings, when my daughter decided she didn’t like math, I looked for a female tutor to balance her male classroom teacher’s approach. It didn’t take the tutor long–several weeks–before my daughter decided that she again liked math because she was performing well again and feeling more confident about it. She went on to become her high school’s ‘physics student of the year’–an award that would be unlikely to be earned by someone who didn’t like math and felt anxious about it. Today, she is a high school science teacher…  So, yes, I believe we really do need to listen to our children’s reports about difficulties experienced in the classroom at the earliest ages possible and see if there is a way to improve their experiences…

I talked about math anxiety in March of 2010  http://whyhealthcommunication.com/whc_blog/wp-admin/post.php?post=162&action=edit. I emphasized the importance of having math skills to be able to make health decisions. These range from simple decisons such as how to calculate when to take a medication that you should take three times a day to deciding whether the research about benefits for a specific treatment add up to a longer life or a more quality life as each of us would define it.  

I haven’t read Chua’s book and am unlikely to do so. It was interesting to note, however, that another book on this topic was written a number of years ago and comes up on the search at Amazon for ‘tiger mother’… The title includes ‘tiger mother’ and ‘dragon father’ and introduces a philosophy for raising children that may have some parallels to Chua’s underlying philosophy but apparently did not include the ‘mean mom’ actions that Chua used to actualize the approach…  http://www.amazon.com/Confucian-Disciplined-Respectful-Children-ebook/dp/B004J4VYYO/ref=sr_1_2?s=books&ie=UTF8&qid=1296407014&sr=1-2 It really is in the communication process that these differences come to light…

How does bad news about our health affect us?

January 28, 2011

One of the blogs I follow is Belinda Brasley’s, ‘Losing vision, Gaining insight…’ http://losingvisiongaininginsight.wordpress.com/2011/01/27/to-blog-or-not-to-blog/ Her journey with low vision is so parallel with my own that it is at times uncanny…. She puts into words my own experiences, including how she feels about low mobility training, using a cane, and other aids to adapt to losing one’s eyesight. Today, her post addresses how she felt at the news of having lost even more vision after being stable for some period of time. It made me think about how any kind of bad news about our health can drain us emotionally and physically.

In part, we go through a number of stages when dealing with bad news about our health. It takes some time to understand and it can make us angry. We need to grieve about what we have lost. We need to understand what it means for all the other parts of our lives, including relationships and plans we had for the future–work and play. Gilotti, Thompson, and McNeilus wrote about how bad news delivery is perceived in a 2002 article in Social Science and Medicine http://www.ncbi.nlm.nih.gov/pubmed/11999499. In short, it is not a good time for small talk. And it is probably not the best time to go into a lot of information about the situation. As I said, it takes some time… Being ready for all of that information will be an important part of managing the bad news.

How does Martin Luther King relate to communicating about health?

January 17, 2011

“When most of us think about the legacy of Martin Luther King Jr., what comes to mind is his role in the real progress toward racial equity that this country has achieved over the 38 years since his death, in areas such as employment, voting rights, housing, and education. Despite the major racial and ethnic gaps that still exist in each of these areas, concrete, measurable gains have been realized, and as a nation we should be justly proud.

“We should be equally humbled and chagrined by the vast racial and ethnic disparities and inequities that continue — 42 years after passage of the Civil Rights Act of 1964 — in Americans’ health status and access to health care…”