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Ebola and ISIS and the Psychology of Fear

October 14, 2014 Leave a comment

Ebola

There’s nothing like a good, sensational Ebola scare. Sure, Americans have virtually zero chance of contracting the disease. But that doesn’t keep 40% of the public from calling it a serious or moderate health threat. ISIS scares the bejesus out of us too. Some 70% of Americans in a CNN poll says ISIS has the capability of attacking the United States, even though you’d be hard pressed to find a single military analyst who would agree with the notion they’re anything more than a regional threat.

Here, the facts- the things you are way more likely to die of than Ebola or ISIS:

Being in a car: 30,000 people die every year in car accidents. If that many people were killed every year by terrorism, we would have built a gigantic moat around the entire nation and invaded 73 more countries.   According to the National Safety Council, what are the odds of dying in a motor vehicle accident in the United States? It’s 1 in 112.

Odds of an American getting killed in a terrorist attack: 1 in 20 million (Washington Post). Odds of an American who has not traveled to western Africa getting Ebola? Virtually zero (Bloomberg.com).

Being legally executed:  What are the odds you’ll be convicted of a felony and then be put to death?  Way more probable than getting Ebola.  The National Safety Council says there is a 1 in 96,203 chance you will die from legal execution.

The Flu: Though safer than driving in a car, 23,000 Americans die every year from the Flu. But- Oh My God…where can I get a vaccine for that? Anywhere and for free, if you have a health insurance card.

Falling Down: Yup- there’s a 1 in 152 chance you will die by falling down. About 2 million times the chance of getting killed in a terrorist act or by Ebola.

Unintentional poisoning by and exposure to noxious substances: Chances of dying this way are 1 in 119. Right up there with car accidents.

Intentional Self-harm: 1 in 103.

Chronic Lower Respiratory Disease: It’s the second largest killer in the country- there’s a 1 in 29 chance you will die of lung disease.

Heart Disease and Cancer: The #1 killers in America. One in 7 will die from heart disease or cancer.

In an excellent article in the New Yorker, James Surowiecki, summarizes the odd, but quite common psychology we all fall victim to:

At work here is the curiously divergent and inconsistent way most of us think about risk. As a myriad of studies have shown, we tend to underestimate the risk of common perils and overestimate the risk of novel events. We fret about dying in a terrorist attack or a plane crash, but don’t spend much time worrying about dying in a car accident. We pay more attention to the danger of Ebola than to the far more relevant danger of flu, or of obesity or heart disease. It’s as if, in certain circumstances, the more frequently something kills, the less anxiety-producing we find it.

Facts, are, indeed, stubborn things. Fear, however, is both stubborn and widespread.

Goodbye Chemo Pills- Hello Life

February 21, 2014 3 comments

Xeloda

I still find it hard to believe I received a cancer diagnosis almost a year ago. The tumor that was discovered in the stomach was surgically removed last May and there are no signs of any return of the disease though I suppose you’re never really certain enough to declare victory over such a thing, pretty much ever.

One of the courses of treatment you take to prevent the return of cancer via the bloodstream is chemo therapy in pill form- a much more civilized, seriously less horrible alternative than the kind of chemo you get intravenously. It’s called Xeloda and it’s a rather amazing drug. When used to actually attack tumors, it has an excellent track record of shrinking if not annihilating them. And for preventive purposes, as I used them, there is strong statistical evidence they do the job as well.

They are no picnic. Extreme fatigue is one of the effects, along with nausea and uncomfortable things that can happen to your hands and feet. I started taking them July 1st and they gave me weekends off to recover.

I take the last of the pills tonight and I’m done which is worth celebrating- but also kind of scary. As long as you take them, you feel like you’re doing something proactively to keep cancer from coming back. When you’re done with them, it is apparently quite normal to feel like you’re operating without a safety net.

Except you‘re not. My doctors at Georgetown tell me there is new research that indicates that minimal, regular exercise, to the tune of 45 minutes a day of even casual walking, has just as strong a statistical correlation for cancer prevention as chemo-therapy. About a week after they told me this, there it was in the Washington Post- same research-same conclusion.

This is good news for me as I don’t own a car and I actually already walk 36 minutes a day back and forth to the subway. Hopefully, the weekends I was using to physically recover from the effects of the chemo drugs will now be filled with more energy and a little less couch potato action.

This is the last time I intend to blog about this whole thing. It was, honestly, very helpful to me to write about this journey from fear to good health. It’s been a long path, but one that need not be revisited. I continue to be incredibly grateful to my friends, family and colleagues for the tremendous support, love and prayers, all of which worked remarkably well. Thank you all.

And now on to the business of living.

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RGIII- A Future of Pain and Sorrow

November 8, 2013 2 comments

NFL- Baltimore Ravens at Washington Redskins

Clearly, the kid only has one speed and it’s no longer fun to watch.  Without an offensive line to protect him, a defense that defends and a play-caller who is sane enough to know you run when you have a lead, Robert Griffin III is taking the entire team on his shoulders and taking a physical beating.   It’s not his re-built knee that’s in danger – it’s his brain and his very life.

We now know those impressive hits we see in the NFL cause permanent harm.   Former Cowboys running back, Tony Dorsett, is but the latest in a long line of players who have suffered permanent brain injury from the thousands of hits they‘ve absorbed through their college and NFL careers.  Every time RGIII incurs a brutal blow, as he did at least a dozen times in the most recent Redskins’ debacle against the Minnesota Vikings, his brain is literally crashing against his skull and creating the scar tissue that eventually causes memory loss, suicidal thoughts and severe depression.

Someday, when he’s no longer a kid and turns, say 50, will he be able to walk?  Will he remember to take his kids to school?  Will he shoot himself in the chest like Junior Seau did, in order to preserve his brain for clinical study?

I know this sounds sick and extreme.  But it is the reality for NFL players.  It’s why watching this sport is getting to be increasingly uncomfortable.  It’s why I feel very little joy and actually a great deal of sadness when I see this poor kid playing his heart out for a team that cannot protect him and a coaching staff and owner that could care less if they literally break him again and again, only to leave him to recover enough in the off-season to take next year’s beatings.

As you look back at it and understand the frighteningly consistent dysfunction of Daniel Snyder’s Washington Redskins for well over a decade, it makes you wish someone had told this intelligent, charming and supremely talented young man to RUN-  far, far away from Landover and the clutches of the Snyders and the Shanahans.   They’re not only using you, RG- they may very well be killing you.

$2900 for a Room- $75 for a Sponge

July 24, 2013 4 comments
The Brazilian penthouse suite  at the Copacabana Palace in Rio de Janeiro

The Brazilian penthouse suite at the Copacabana Palace in Rio de Janeiro

The good folks at Georgetown University Hospital sent me a document the other day informing me of the charges incurred for a recent major operation. It was a long procedure, mind you, but in a country where it costs an average of $16,000 to deliver a baby, would it really come as a surprise that the total cost for the surgery and one-week stay came to $83,000? Hell, I’m not sure I’m worth half that.

My part of the bill, thanks to the insurance I get through work, was only $500 and even that was covered by my flexible spending account. I cannot even imagine what the uninsured go through. Anyway, in order to make my claim, Georgetown had to provide me an itemized, highly detailed account of how we got to $83,000.

Turns out my semi-private room was $2,900 a day. Just the bed. I started thinking. If I need to go through this sort of thing again maybe I can make a deal with the hospital. After I wake up in the recovery room, they can tell me how it all went and then call a car service and send me directly to the penthouse suite at the Ritz-Carlton in Pentagon City. I’ll do green Jell-O for the first three days then switch over to the buttered lobster.

By the way, a hilarious thing happens when you google “hotel rooms for $2,900.” You get dozens and dozens of hits for the following headline:

Justin Bieber & Selena Gomez Share $2,900 A Night Suite In Brazil.

That’s right, a penthouse suite at the Copacabana Palace in Rio de Janeiro, Brazil costs two celebrities as much as one night’s stay in an American hospital.

Then there were the sponges. I saw three of them used for the procedure and each one cost $75. Again, here is another opportunity I can have to make a deal with the hospital. The night before the surgery, I will, personally, go to the local CVS and buy 6 sponges for $4.99. As I hand them to the surgeon the next day (still wrapped, of course) I will explain that these sponges have the very same sponge-like qualities as his special sponges. They absorb stuff.

Just for the record, I have absolutely nothing against Georgetown Hospital; to the contrary, I see them as a magic, healing collection of wise and skilled shaman who happened to save my life and hundreds of other lives every week. But it does seem to be a strange and arbitrary health care system we have where one hospital charges $5000 for a CT-scan and another will charge $8000. Where lying prone in a bed automatically costs you the equivalent of a penthouse suite and where sponges sell for $75. It’s the business side of the health care system and it’s kind of shocking, should you ever have the chance of seeing it.

Here’s to you not having that opportunity anytime soon 🙂

Hi Ho Hi Ho- It’s Off to Work We Go

Seven-Dwarfs-cover-art1

It’s been an interesting journey to say the least but I am officially back at work at NPR today. So far so good. My colleagues have been so very kind and welcoming. I did not wilt in the heat. I did not get hit by cars in the street. My Dr. Seuss imitation will not be beat.

It’s been 7 weeks since the big cancer surgery. It feels like it’s my very first day at school. I went through the checklist before I left the apartment in the morning. Metro card- check. Reading glasses without which I would be blind- check. Cash- check. Sharpened #2 pencils- not necessary but you know what I mean.

My son, Charlie came up from Nashville and visited me over the weekend. “So how do you feel about going back to work, Dad?” The appropriate, manly, puritan work-ethic response would be, “Can’t wait!” The reality is that it’s another transition in a series of them.

First, a day before surgery you prepare yourself as best you can for uncertainty and what will be a long period of recovery. Psychologically, it’s like you get in the fetal position, let them do what they need to do and then just deal with it. I got through my 7 days of indignity at the hospital. The nurses and docs were all great, but it is just not possible to lie in bed with a tube attached to your nose that goes into your stomach or wear flimsy little hospital gowns and maintain any sense of decorum.

Then there’s the transition home and recovery. It’s a tricky business. You need to rest and sleep. You also need to walk and stay active. Too much rest and you just turn into a tub of Jell-O and your aches and pains get worse not better. Too much activity, and you get ashen-faced and literally hope you didn’t just bust a stitch.

A big transition, frankly, is when they take those stitches out. It’s hard to feel normal when you look down and see 36 metal staples holding your stomach together. After those puppies are gone, you start feeling a little less like Frankenstein.

And what did you do with all that time off, Robert? Well, I’d like to say I did research into the mating habits of Bonobo monkees or wrote a paper that helped to further define Einstein’s theory of general relativity. But, no. I read some great books. I watched three entire seasons of the Walking Dead (because who doesn’t enjoy eviscerating zombies) and two seasons of the Sopranos (which explains why I was overly distraught about the demise of James Gandolfini last week). I walked just about every day. Took in a couple of Nats games because, really, what an honor to be able to watch the worst offense in baseball in the past 30 years. And I completed a 5K walk in memory of my late colleague, Brenda Box, and in the process, raised a little money to fight pancreatic cancer.

And mostly, I attempted to accustom myself to the new rebuilt me. I call it Garcia 3.0. They took out a whole lot of my stomach so eating is a different kind of thing now. I can pretty much consume whatever I want, just smaller quantities, more often. I’m sometimes on the edge of nausea but it never lasts long. It happens if I don’t eat enough, eat too much and this is really interesting- when people get repetitive and annoying, particularly people on cable TV.

Next week, I start taking these chemotherapy pills. Hugely better than having to get infusions. The strategy as I understand it from my doctor, is to take 2 pills in the morning, 2 pills at night, Monday through Friday and do the best you can. You get weekends off to recover. On Fridays, they tell me, I’ll be beat and worn to a nub. But this particular regimen rarely results in either nausea or hair loss. Should I be the rare exception and lose my hair however, I’m telling you right now- I’m getting an earring.

So you take as much of this as you can for a minimum of four months, preferably six. Japanese doctors have their stomach cancer patients take the pills for a year. And when completed, presto! Cancer stays gone and 5-year survivability rates increase from 50 to 70%.

Next transition- getting home from work!

Walking All Over Cancer

June 4, 2013 1 comment
The one and only Brenda Box

The one and only Brenda Box

I am so psyched and happy to say that I’ve signed up to participate in a 5K Walk, June 15th, benefiting Purple Stride, an organization dedicated to fighting pancreatic cancer, which claimed a much beloved colleague and friend earlier this year.

Brenda Box was the afternoon editor with NPR’s Newscast unit.  A kinder, warmer, funnier, sharper, smarter journalist-human will never be found.   Here is a tribute to Brenda from a few months back.   Accomplishing this 5K for her and in her memory is going to be very special to me.   As Brenda’s health deteriorated last year, I developed a few complications of my own.  It bonded us a bit more than most, I think.  The very day I had an endoscopy this year that would find the cancer in my tummy that I’ve had to deal with, was also the day of Brenda’s memorial service which I proudly, if woozily, attended (they put you out for an endoscopy).

I walk about a mile a day now.  Basically, to complete a 5K you take about 4,800 to 5,000 steps.  I can easily handle about 2,400 currently.  But I’ve got two weeks to build up to it.  I can do this.  It’s one hour of walking, for Christ’s sake.

One of the reasons for 5K walks like this, of course, is to raise money for the cause.  Here’s a link if you would like to sponsor my walk.  The group I’m with at Purple Stride is called the Boxtops.  I would be very proud to raise money for any organization dedicated to the fight against any cancer.

I’m doing this for Brenda because I will always love her.  And I’m doing it for me so I can prove to myself that I can take 5,000 steps six weeks after major cancer surgery.  In some silly way, I feel like I’m taking the torch from Brenda, and having been given the gift of a curable cancer, that I am literally finishing the race for her.  That will be her gentle push at my back.  And her prankster foot I dodge in her ill-fated attempt to trip me.  I’m on to you, Brenda.

 

 

 

 

 

Notes from Recovery-ville

May 27, 2013 1 comment

Takes a Village

I don’t mean to turn this blog into a personal medical site, but God apparently did, so….

We’re just past the halfway point of the short side of the theoretical recovery period after most of my stomach, a piece of my liver and my gall bladder all sacrificed themselves in an effort to annihilate a 5cm tumor that turned up in my stomach 14 years after receiving unnecessary radiation in that vicinity following a bout with testicular cancer.

OK, with the background out of the way, what’s it like to recover from major gastro-intestinal surgery?  Meh.  Some days are better than others.  Some days are high energy, some days are low energy.  What is a constant is sleep.  This is the magic potion of healing.  I can drop a 2-hour nap in a New York minute (I know- that sentence must be a gross metaphorical violation of some sort).   The trick is getting 10-12 hours of sleep a day but not turn into a piece of the living room furniture.  You have to get out.  You have to walk.  You have to get in the sun.  You have to breathe the air.  Sometimes easier said then done.

A few days ago, I made my first distant foray from home besides the hospital to take in a Nationals game that reliever, Drew Storen tried to ruin for me but it’s not really his fault- he didn’t know I was sick.  The point is that when I mentioned my outing on Facebook, a friend noted “great you should be feeling so well to get out and about.”  In fact, without going into any detail, I will tell you categorically that was the single worst day of my recovery that I have had.  And that is precisely why I pushed on and decided it was imperative to get out and get TO the ballgame.   And it worked.  The field, the wind, the night air, the best game ever invented in the history of mankind- all conspired to make me feel vibrant and alive.  It did wonders.  Thanks to Drew, I got to leave after the bottom of the 8th and beat a lot of the subway crowd so even the Metro experience was pleasant.

This is about pushing the limits of your physical and mental boundaries.

One of the things I’ve done mentally, is divorce myself from the news within reason.  I am in the news business so it goes against instinct.  But I’m sorry, there is just too much conflict, violence, blood, natural disaster, evil, ego, banality, superficiality, celebrity-worship and general bullshit out there for it to possibly be healthy in any way to consume in large quantities at this time.  I’ll catch up later.

One of the larger adjustments is in the area of nutrition, appetite, food.  After leading a life, like most others I think, in which meals are defined by their taste, all bets are off now.  Foods that I used to secretly crave (and which are advertised more than any other) like cheeseburgers, french fries, fried chicken, have lost their appeal.  Food just tastes different.  With a smaller stomach, I also eat much smaller amounts.  And my appetite is all over the place.  Sometime I have one, sometimes I don’t.

The trick now (and this is too funny for words) is keeping my weight up.  After years of trying to watch my weight, I am currently losing about 4 pounds a week.  Add it to the weight loss that occurred after surgery and a week of hospitalization and we’re talking nearly 30 pounds.  Eventually this has to stop but right now, it feels great to be lighter.

In a couple of weeks I begin a discussion with my doctors about chemotherapy.  They seem to be all gung-ho about the poisonous little cocktails they want to give me to prevent any return of cancer.  They are going to have to convince me with science, research and logic.  The white coats and air of authority will not be enough.  Don’t get me wrong.  I love my doctors.  They have saved my life.  I just don’t want a repeat of 14 years ago when the prevailing medical orthodoxy was to radiate the crap out of people.  It’s one of my own doctors who tells me he is now constantly running into patients with tumors who received radiation 15 and 20 years ago.  A debate for another day.  For now, a few more weeks for healing from the sharp, steely knives.

They say God works in mysterious ways.  I do believe the dude has tried to kill me several times in order to make me stronger and healthier.  Eventually, this time, I think it’s going to take.