Talking About Health; Why Health Communication Matters

Bite your tongue–but not literally

June 17, 2013

Ahh, the things we do to ourselves and our health. I had a dental check-up. Cleaning. Routine. Or so I thought. But then the dentist came in and said that there was a growth under my tongue that he was worried about. He showed me in the mirror. I really couldn’t see it very well. The dentist made an appointment for me to see an ear, nose, and throat surgeon right away. The surgeon said that it indeed needed to come out. So surgery was scheduled. And it came out. And it was studied. And it was pronounced a ‘ hemangioma’–explained to me as a ‘nest of entangled blood vessels bound up in tissue.’

‘Have seen a similar thing in patients who were in auto accidents where they bit their tongue really hard. Or other events where the tongue got bitten. Don’t know what caused yours.’

Yikes. I do. I had developed the habit of literally biting my tongue. I placed the tip at the back of one corner or my mouth and kept quiet during times when I knew I should keep quiet. But I didn’t want to keep quiet. Broke that habit in one moment. How many other bad habits affecting our health could we stop in an instant if we only knew what they were doing to us?

Women’s health messages and more

June 16, 2013

Sometimes, we have a bit of a summer camp at my house. Here are my daughter and niece making candles. When I get to share time with my three sisters and my sisters-in-law, all their daughters, my mother, my daughter and daughter-in-law, and my granddaughters–I feel grateful and blessed. They all know that I will eventually somehow end up talking about health messages. But they don’t mind. Most of them have read my co-edited book, ‘Evaluating women’s health messages’ [http://www.amazon.com/Evaluating-Womens-Health-Messages-Resource/dp/0761900578/ref=sr_1_1?ie=UTF8&qid=1371768886&sr=8-1&keywords=evaluating+women%27s+health+messages]. And even though it was published it 1996, it’s still relevant because it tells the history of bringing women’s health and medical research onto the political agenda. It was, after all, only 1990 when the Office of Women’s Health was formed. And until that time, it was just taken for granted that funded medical research should systematically exclude women for all the biological reasons that make us women. What research included women focused mostly on their reproductive health, leaving men out of the reproductive equation just as women were being left out of all the rest of the human health equation research–things such as heart disease research, for example.

The gap in health and medical research is still reflected in society’s norms and language. ‘Reproductive health’ as an expression automatically brings up an image of a woman. Just as ‘outdoorsman’ of course brings up an image of a man. So imagine my surprise when I went to do some shopping online at Bass Pro. A store I dearly love, I usually wait for visits to cities where they are located. but yesterday, I googled them and went to their site and was greeted by, ‘Welcome Outdoorsman’–huh?

Yes, I found the contact information and emailed them promptly. And, yes, they answered promptly. Let’s see what happens next!

21st century work-related health outcomes–bone spurs in the neck

June 15, 2013

If you’ve read my book, ‘Talking about health,’ you may remember the narrative about physical therapy as an alternative to drugs and surgery. The story relates to having bone spurs in my neck. And one of the strategies I learned in physical therapy to deal with it and the pain they cause–support the neck. Always. So elbows on the table–not rude, pain-saving. Elbows on arm rests in the car, on the plane, any and everywhere–pain-saving. Even here, as we wait to launch our kayaks. There you see it. Elbows on my hips. And where did these bone spurs come from, you might ask. Too much time leaning into the computer without a break. Yes, the 21st century technology has its own ‘factory-worker’ like syndrome. Try to avoid it with frequent breaks and moving your neck around. If it’s too late, support your neck, lift it off the painful spot and give yourself support to relieve the pain…

What is a patent and what did the US Supreme Court decide about human genes and patents?

June 13, 2014

The US Supreme Court ruled that human genes cannot be patented. A patent is the authority to make, use, or sell something. Myriad Genetics Inc. sought patents regarding genes for which some versions have been linked to breast and ovarian cancer–the BRCA gene mutations. The Court decided that identifying and isolating these genes is not worthy of a patent. On the other hand, Myriad also has created a synthetic form of DNA known as cDNA and that was determined to be worthy of a patent.

For patients, testing for BRCA gene mutations may become more accessible. Until now, Myriad has had the only genetic test for BRCA gene mutations. Perhaps others will now develop testing and contribute to cost reductions, since Myriad does not hold exclusive rights to make, use, or sell products associated with these genes.

Why are bugs sometimes a good thing when it comes to our rivers, streams, and health?

June 12, 2013

Just returning from the annual Juniata Clean Water Partnership river sojourn. This picture was taken in Lewistown, Pennsylvania after lunch yesterday as we started to get back on the water to continue our journey. We are near Memorial Bridge with a railroad bridge beyond that. As always, the sojourn was recreational and educational. For example, in listening to the Partnership’s director talk after one of the educational sessions, I realized once more how important visual communication can be. We had been learning about the importance of having insects as a source of food for fish in the water and the sign of a water’s health being in danger when there are no insects and then no fish. Mike told me, “It is much easier to get folks enthused about water quality when you hold up a mason jar of river water that is thick and orange. It is much harder to make your case when the water appears to be relatively ‘clean’.”

Among the chemicals in river water that cannot be seen are arsenic, mercury, and benzene. Exposure to these chemicals is linked to cancer, developmental disorders and reproductive disorders. Arsenic is tasteless and odorless, and you can’t see it. Arsenic comes from natural rock formations into the river water but also comes from mining, smelting, and other human activities. Mercury is found in many electronic devices and is part of many industrial activities. Mercury is often released into the air and falls to the rivers in rain. For a comprehensive but nontechnical summary about benzene, this paper from the CDC is useful: http://www.atsdr.cdc.gov/toxprofiles/tp3-c1.pdf

Soy products and nutrition and cancer: Conflicting messages

June 6, 2013

One of my granddaughters is allergic to cow’s milk. I saw effects of such allergies decades ago when a nephew was born with severe allergies to cow’s milk and used goat’s milk. My granddaughter used goat’s milk for awhile but seemed to develop an allergic reaction to it as well. Not as severe as cow’s milk but not waiting around to make that happen…

What about soy milk, my son asked. I have read some of the research and debate surrounding soy and phytoestrogens and cancer. But I never read anything specifically about infants. So I searched and read a number of pieces written. I want to recommend this one written by a pediatrician: http://www.babycenter.com/404_is-it-safe-to-give-my-toddler-soy-milk-if-she-wont-drink-cow_1200425.bc

In a nutshell, the author notes various deficiencies in soy milk that need to be address, such as its lack of B12, and the importance of buying whole soy milk to obtain the fats necessary for brain development, and the importance of having soy milk that is fortified with vitamins A & D, as well as calcium.

The pediatrician does not address the phytoestrogen controversy directly but observes that there is no research linking adverse outcomes to children.

Another alternative is coconut milk. While I could not find any research or pediatrician discussing this as an alternative, I did find a site with a pretty complete discussion by moms, including moms who used coconut milk for multiple kids who are into adolescence now and still drink it. Coconut milk has they say a lot of good fats in it but lacks calcium and protein.

My son asked specifically about Asian diets rich in soy and the health benefits. I have worked closely with Asian graduate students over the past two decades and have come to understand that how they consume soy is quite different from what we think of. Our grocery stores offer tofu and soy milk as mainstays in soy products. Soy in Asian diets takes on different forms and is often fermented in miso, tempeh and natto. Soy milk and tofu are highly-processed soy products. So it appears that one part of the conflicting messages relates to the form that soy takes. More processed forms, as with so many food products, do not offer the same health benefits as less processed.

HPV and throat cancer message from Michael Douglas

June 5, 2013

Michael Douglas has been in the headlines because he talked about the connection between throat cancer and the human papillomavirus–HPV. There is a rather complete discussion of the issue here: http://www.cbsnews.com/8301-204_162-57587350/oral-sex-and-throat-cancer-michael-douglas-hpv-report-spotlights-epidemic/.

As with Angelina Jolie and BRCA mutations and breast cancer, Michael Douglas’ celebrity gives him a platform to increase public awareness about cancer causes. I appreciate his willingness to discuss it and to get a conversation going about an increase in throat cancers, particularly for men, related to the HPV.

Talking about Angelina Jolie’s dislcosure about BRCA mutation and surgery

June 4, 2013

With Angelina Jolie’s disclosure about testing positive for the BRCA mutation that strongly predicts the likelihood of developing breast cancer, a lot of media stories have covered her genetic testing diagnosis and subsequent decision to have a mastectomy. A number of important ideas have been included in Angelina’s talk about her diagnosis and decision. She has emphasized that the genetic test is expensive–about $3,000. Perhaps there has been less emphasis on why and when health insurance is more or less likely to pay for the genetic testing, or some part of it at least. Payment is more likely in situations where a family member has tested positive for the mutation or has developed breast cancer at a young age.

The story has focused more on her decision perhaps than on the relative rarity of having the genetic mutation linked to breast and ovarian cancer. The decision to have the mastectomy relates to the 85% or more likelihood that she or anyone with the mutation would develop breast cancer. So this mutation of a gene that we all have is indeed very strongly indicative of a future breast cancer diagnosis. The decision to have breast tissue removed is Angelina’s way of reducing that risk to more like 5%.

Another fact that the stories have not emphasized is the reality that only about 5% of the women diagnosed with breast cancer have a BRCA mutation. For the other 95%, environmental and behavioral factors contribute to the diagnosis. So it is critical that we focus attention on that reality.

Wind turbines and tornadoes in Oklahoma–the precautionary principle

June 3, 2013

In risk communication, an overarching guiding framework is called the precautionary principle. If an activity appears likely to cause harm to humans and/or the environment, even in the absence of evidence to prove it, the decision should be to err on the side of precaution and avoid even the possibility of likely harm I guess no one was thinking about that when theydecided to put wind turbines close enough to a school that one of the blades could fall off and land on the school. See the story here–listen for a bit to get to the wind turbine event: http://abcnews.go.com/WNT/video/deadly-tornadoes-strike-oklahoma-19306599

If there is a place where wind blows enough to generate energy from wind turbines, perhaps it is tornado alley. I don’t know. I haven’t reviewed those stats. But several things are certain. Wind turbines are huge. They come in different sizes but on average, 3 blades weigh about 40 tons, so one blade weighs 13 plus tons–26,000 and some pounds. Yikes.

Wind turbines are manmade. They have a lifespan. Even in the best situation, a blade will come off eventually. So why on earth would someone place a turbine near enough to a school that a falling blade could land on it. Were they counting on children being out of school at the time? It is this type of risk decision-making that requires some precaution.

Creativity and health

June 2, 2013

My husband and I recently had the pure joy of a week long visit from our five-year-old grandson here in Pennsylvania. We were a bit worried since he had never stayed overnight away from home. We have stayed at his house while his parents had an overnight trip. But he had not stayed with us at our home alone.

The adventure began with a plane flight. And the plane flight should have been easy peasy leaving about 8 am and arriving in State College about 4 pm. Recall the two hour time change and that makes for six hours. We had a nice layover in Detroit with plans for lunch and riding the train.

We began to get phone calls at 4 am that our flight was delayed. And delayed and delayed. We went to the airport expecting the flight to leave finally about 10:30. It did not. Mechanical problems. Most other passengers were being placed on other flights but we needed 3 seats with 2 together. Our grandson was a great sport about it all as we got to the airport and watched the flight board inch later and later. The attendants at our gate were also helpful. they provided him with first class passenger goodies. And we all got 25 dollar vouchers for food and drink.

We finally took off about 1:30. Yep. And we did not have a connecting flight now until 9:30 pm…about an hour past our grandson’s usual bedtime. Still, he remained completely enthused. Exploring everything with us in the stops along the way. Enjoying dinner. He did fall asleep on the last flight home and wasn’t too happy about being awakened to get off the plane. Still, the adventure spirit prevailed.

We went to beaches that weren’t open for swimming and parks to feed ducks. We had picnics everyday. But mostly we played in the sand, threw rocks into a frog pond, and built forts. We piled honeysuckle bushes being cut back and climbed to the top of the growing pile.

And we talked. Endlessly. If you haven’t talked with a five-year-old lately, I highly recommend it. They are so boundlessly creative. During one conversation, my grandson announced that he had powers to change me into anything I wanted to be. I said I was fine as I am, thank-you very much. He said, “No, Grammie. You have to pick something and I will change you into it.” I said, “OK, a butterfly.” “Why?” he asked. “Because I could fly and spend so much time among beautiful flowers.” “OK, Grammie” he said. “Then I am making you into a monarch butterfly. You will be beautiful and birds won’t eat you.” That’s mostly true. That monarch butterflies have an ingredient in their bodies that is mostly poisonous to most birds. How thoughtful and creative that my grandson would think of that in our conversation. I hope he can always be so thoughtful and creative. I am sure it will serve him well. A discussion of some of the research findings to support creativity’s boost to well-being can be found at this site: http://www.cnn.com/2012/05/25/health/enayati-innovation-passion-stress