Tuesday, September 28, 2010

The story of a man

This is the story of a man I know. This man is over 50, and has been receiving PSA (prostate specific androgen) tests for the past few years, as do many men over 50. PSA tests are controversial because an increase in PSA doesn't necessarily mean that something is wrong. It's a screening test. And as we know, screening tests are often problematic (see: mammograms).

So about a month ago, this man came home from the doctor and said: my PSA is higher than it was last time, the doctor wants me to go to a urologist for follow up.


So this man goes to the urologist for follow up, and the urologist does a DRE (digital rectal exam) and says, hmm, your prostate is possibly enlarged, but I don't really feel anything abnormal, but I think we should do an ultrasound of your prostate and possibly a biopsy.

The man schedules the ultrasound and biopsy for 2 months in the future.

The man thinks about this, and it starts to drive him crazy. So he decides to reschedule the procedure to one month in the future.

And then he tries to forget about it.

Life goes on, the summer ends, school begins, the holidays come, and now it's time for the procedure.

The man has to do some unpleasant things in preparation for the procedure, but he does them, and goes in for the ultrasound and biopsy. The urologist does the ultrasound, says he doesn't really see anything untoward, but does the prostate biopsy anyway. Twelve tiny samples.

The urologist says the results will be back in a week.

The man waits.

Now, there is a large gap between "you have an elevated PSA level" and "you have cancer," but to the man and his family, this gap was getting smaller by the day.

There were really only 2 possible options: "you have prostate cancer," or "you don't have prostate cancer."

The man's wife works in the health field and keeps looking at articles online. This just isn't right, she complains. It says that if you have a PSA increase, that it could be due to something else. It could be a false positive. It says to follow up with DRE. If that is troublesome, you then go to ultrasound. If that is troublesome, you then go to biopsy. Why did they go straight to biopsy?

The man didn't know, and told his wife that he didn't really want to talk about it until he got the results of the biopsy.

So they waited.

And waited.

They kept thinking about the worst, and the best, and everything in between.

And they waited.

And suddenly, out of the blue, the urologist called the man one afternoon and said: there is no cancer. And the man called his wife, and said: there is no cancer. And they were very very happy.

But the man's wife was still angry. Happy, but angry.

And this is not the end of the story.

P.S. I keep finding more and more articles about cancer screening and how tricky it is. Take a look here and here.

Monday, September 27, 2010

Turning pink

I first realized that it was coming while perusing the yogurt section of our local grocery story recently. I suddenly realized that almost all of the yogurt containers had turned pink... see here and here for some examples (cups of hope? really?).

Next, the town newspaper promises to actually turn pink for the month of October. Yes, they will print the newspaper on pink paper. Not only is it difficult to read -- it looks terrible.

Little pink ribbons are fluttering around like tiny pink birds...

Yes, my friends, Breast Cancer Awareness Month - PINK month - is upon us.

Oh, I really do not like pink.

ThinkBeforeYouPink.Com helps explain why.

You know, breast cancer is something that happened to me. I'm really not very happy about it. I don't feel it was due to something I did or didn't do. I truly believe that estrogen-like chemicals in the environment that I was exposed to as a child and probably as an adult led to the overgrowth of cells in my breast that was cancer.

Breast cancer -- any cancer -- is a horrible disease. Half of all Americans will experience it in their lifetime.

I don't want to see companies touting products and acting like they really care, when all they are trying to do is make money. I don't want to hear any more sob stories, and how "cancer made me stronger." I don't want to hear it.

I want to hear about prevention. And I want to hear about it NOW.

Friday, September 17, 2010

Making nothing into something

Yesterday, I read the Jewish Advocate (Boston's local Jewish paper), as I do every Thursday, and I was puzzled to read an article about some middle school students from Wellesley who visited the Islamic Center in Roxbury who apparently bowed during the prayer services. They bowed during prayer services. This is news?

You can imagine my surprise this morning when I opened up the Boston Globe and there, on the front page of the Metro section, was a similar article.

Talk about making nothing into something.

The article in the Jewish Advocate was somewhat different from the article in the Globe, however. In the Advocate, it stated that some of the boys bowed down to the floor during the prayer services, and in the Globe, it stated only that they bowed their heads. In any case, there was bowing going on.

Who cares?

Jews bow at the waist during different parts of the prayer services. Catholics kneel. Muslims bow to the floor. It would be an interesting exercise to try out all three types of bowing, and see how what feelings each brings up.

But my point is, bowing during another religion's prayer service doesn't mean that you are in some way becoming a part of that religion. Are we so fearful of people leaving Judaism that we think one visit to a mosque and one bow to the ground will cause our children to leave the fold?


Wednesday, September 15, 2010

Puberty, pimples and cups

J has a funny little routine he does sometimes while he lounges in the tub (yes, he still takes baths - he loves them like his momma). He'll look down at himself, feign surprise, pretend that he sees a pubic hair, and declare: "For the love of G-d, it's Puberty!"

This has been going on for quite a while. J has always had a healthy (I hope) curiosity and interest in sex, reproduction, kissing, boy-girl relationships, gay relationships, etc., etc. As a former sex-ed teacher, I think I've done a pretty good job keeping up with him and giving him the right info at the right time. Also, J loves to watch Degrassi on TV, and that is also giving him plenty to chew on.

J recently turned 11, and at his yearly physical shortly after his birthday, the pediatrician opened up a discussion about puberty. Just the basics, your body is going to be changing in the next few years, muscles, sweat, pimples, yadda yadda yadda. But J was very impressed that the doctor had discussed this with him. Very impressed. As a matter of fact, he told a friend's mother later that day about the incident. Also, he's mentioned to me that, while he isn't really interested in girls yet, he doesn't dislike them as much as he used to, either. Hmm....

So, on the heels of all this, I decided that there were probably a few things I hadn't told him about. He knows the basics about sex and reproduction, but what changes would he be encountering in the near future? Oh, yeah. Those changes.

So I sat him down at the dining room table and told him about wet dreams, and about erections (G-d help me!). I still haven't gotten to masturbation yet...still saving that one for the "right time." Or maybe I should pass that one onto A. And I haven't gotten to birth control yet, although he claims to know what condoms are. And I haven't talked about STDs or any of that.

Shortly after all this occurred, J got his first pimple. It really was a pimple, right there on his chin. No idea why suddenly it arose: but it did.

Also, J is playing fall baseball this year, and A bought him his first athletic cup. I helped him put it on one day, and wouldn't you know, I had it turned upside down? Stupid mom.

Finally, I bought him a book: Linda Madaras' What's Happening to My Body? Book for Boys. I actually heard Madaras speak many years ago when I worked in family planning, so here I am now, buying her book for my own kid! J immediately turned to the section on bisexuality. Good grief. This is going to be very interesting....

Thursday, September 02, 2010

Babies who lunch

J and I went out to lunch today around noon. It was a very hot day, and it was hot inside the restaurant. It was also crowded. Three moms, each with two children (one 3 or 4 year old , one baby around 1 or 1-1/2) had pulled two round tables together, and were seated around the perimeter of the tables with their six offspring. The babies were crying, squirming, and trying to run away. Silverware was being flung off the table every few minutes. Food was raining down from the table onto the floor. The wait staff were clearly annoyed. Other customers seemed less annoyed, but the noise level in the restaurant had clearly risen since the arrival of these folks.

I watched with a mixture of fascination, annoyance, respect, and thankfulness.
  • Fascinated to watch how other moms deal with their kids' misbehavior (they were pretty nonplussed by all the chaos)
  • Somewhat annoyed to listen to all the crying and chaos during lunch
  • I respect that they tried to go out to lunch even with kids in tow, something I really did very rarely when J was a baby or toddler
  • I felt very thankful that I'm no longer at that stage...J knows how to sit at a restaurant, order his food, and eat it. We might even have a conversation. Amazing, I know.