MotherThoughts

Bad timing

2012-01-21T10:09:00.005-05:00

So this whole bar mitzvah thing...the timing seems to be off.

This is my problem. When J was a little kid, he loved all the Jewish stuff. He loved Shabbat at preschool. He loved the wine, the candles, the challah... He loved saying the blessings. He loved being the Sabbath King. He loved Chanukah. He loved Purim. He loved the seder at Passover.

So we sent him to Jewish day school because we loved how seamlessly his preschool had moved between our two worlds, the American/secular world and the Jewish world. And he loved kindergarten, and he learned to read English, and then in first grade he learned to read and write Hebrew, and he learned some Hebrew words. He liked the bible stories, and he liked learning the morning prayers. He liked the Hebrew songs and Israeli dances. And we went to temple, and he liked the kids' services. And it continued this way, through about fourth or fifth grade.

But now J is 12-1/2, in sixth grade, in middle school, on the brink of adolescence. Currently, he loves 1) basketball 2) x-box 3) his friends, especially if he is playing either basketball or x-box with them. (And playing basketball on x-box with a friend is the ultimate.) But what he isn't really interested in anymore is school, or Judaism. Those things are, to quote J and all his friends, are "boring."

And now it's time to prepare him for his bar mitzvah. He's not resisting, but he's not really into it, either.

So here we are. Now what do we do? How do we make this meaningful at this time in his life?

Non-adherence and mail orders

2012-01-13T08:41:00.008-05:00

I've always been somewhat peeved by the term "non-adherence," as in "the patient is non-adherent to his/her medication." It puts the blame squarely on the patient. It's as if someone is saying: "Why won't you just take your medication? I told you it's good for you! I told you that you need it! What is wrong with you?"

So here's a little story...

I take two medications, one prescribed by my PCP and one prescribed by my oncologist. For some reason, my PCP will not give me a prescription for a year, and insists on giving me a script for 6 months or even 3 months. (This is a medication I've been on for years. It's not like something is going to change.)

My new job has a mail-away drug program, and you can get 3 months of your prescription for a slightly lower cost than ordering it from the local drug store. So the last time I was in to see my PCP, I asked her to send the prescription to the mail-away drug program. She assured me that it would go through quickly and that I'd receive the medication in a few days.

I checked the mail-away drug program's website and my prescription didn't appear there. After about 10 days, I heard from my PCP's office: there had been some problem with getting the mail-away drug program to accept my prescription. They think it has been resolved.

Next, I get an automated call from the mail-away drug program, asking me to confirm my zip code and address. They say that the address in their system and in the PCP's system don't match. I'm starting to realize that my doctor's office probably has my zip code entered incorrectly (there are 2 zip codes in my town and people tend to confuse them). This has caused all this delay.

So now the prescription is on the website, and everything looks okay. Except it hasn't been filled or mailed.

What the hell is going on? And my medication supply is dwindling.

Probably a week later, I get another automated call from the mail-away drug program. There has been a delay in my order (no explanation for the delay). Am I running out of medication? If I am, I should call them.

So by now I really am running out of medication. I call my PCP's office. Since I'm calling about a prescription, they transfer me to the nurse's voice mail. I explain the situation and that I need a refill from the local pharmacy because the mail order one is being delayed. The voice mail says that if you are running out of a prescription, you should call the pharmacy and have them fax a request to the PCP's office.

I call the pharmacy, and they tell me that they can fax a refill request to my PCP's office. So I have them do that. And then I leave another message at my PCP's nurse's voice mail.

Finally, I take my last pill. Now I am starting to get very nervous because if I miss these pills for more than a day, I'll start getting side effects.

I decide to call the mail order drug program. (I don't know why I am protecting them: Medco is the company.) A very polite woman says that my prescription was sent 2 days ago and should arrive soon. I tell her that I am now out of medication. She offers to authorize a "bridge" prescription of my medication, but...my PCP has to authorize it before the drug store will fill it. Also, since I've already run out of medication, do I want counseling?

Counseling? No, I want my prescription. Thank you very much.

I call my PCP's office again. This time I am able to talk to a human being who discovers 2 interesting things while looking at my record: 1) my zip code is incorrect in their system (as I suspected) which caused the delay in the first place with the mail order company, and 2) the nurse did indeed already call the prescription into the local drug store. I am relieved, and plan to pick up the prescription at the drug store when I get home.

When I get home from work, the medication has arrived from the mail order company. I take my pills. All is well with the world.

Or is it?

Why did I have to jump through all these hoops just to get my prescription filled? This is absolutely ridiculous.

So back to where we began: non-adherence. It's easy to see how people get off-track with their medications when you have to deal with #$%@ like this. Sure, some folks probably don't take their medications for other reasons. But I'll bet that a lot of the non-adherence now-a-days is due to ridiculousness like this. It just isn't right.

P.S. As a final nail in the coffin, I just tried to pick up my prescription at the local pharmacy. The emergency prescription that was supposed to hold me over in case my mail-order prescription didn't arrive soon enough? It was denied by the insurance company.

Chanukah: done

2011-12-19T17:59:00.004-05:00

Listening to the Manic Mommies complain about Christmas preparations (via podcast) on my ride home today, I couldn't help but compare their preparations to my own. My Chanukah preparations. (You can stop laughing now.)

I have attempted to buy presents for my family, I really have. I requested a list from both my husband and son: no lists have appeared. J will periodically (i.e. daily) tell me about this or that thing that he wants me to buy him, but he does that even when it isn't Chanukah. A just says he doesn't want anything, as usual. So I've been trying to find some creative things for them. I've been somewhat successful - we'll see when I actually give them the presents. The stress is that you are supposed to give something every night. And J doesn't want small things anymore. So what are you supposed to do?

I sent my parents a small gift. I need to send something to my niece and nephews. That about does it.

And tomorrow night is the first night of Chanukah. I need to get out the Chanukah menorahs, dust them off, and dig out the wax from last year (if you are Jewish, you know what I mean...). I need to make sure we have Chanukah candles...I'm pretty sure we do, as we tend not to use them all, for some reason. We have a box of old Chanukah decorations in the attic - I should get that down, although many of those things are too child-like for J now. And I should make sure I have potatoes so I can make latkes tomorrow night. And...that's about it. Chanukah: done.

Too soon

2011-11-29T13:23:00.002-05:00

J attended his first bat mitzvah party last Saturday night. All the kids from his class were there. The girls were dressed in party dresses, some in heels, some in strapless outfits. They looked beautiful, and very grown up. The boys were mostly wearing button-down shirts, some had on ties, some even wore jackets. They looked good -- handsome, even -- but vaguely uncomfortable.

This party came right on the heels of J's first middle school dance last week. Most of the bar/bat mitzvah festivities for J and his friends will take place in 7th grade, but there are a few kids having celebrations in 6th grade. So this party, and the dance, are the first time these kids have been in this situation. I'm thinking they may be a smidge too young for this sort of thing. Most of them are barely in puberty. Or "pubertized," as J likes to say.

But there's another issue, too. With these dances and parties, J is being asked to look at the girls differently than before. They are supposed to now be objects of desire. But he doesn't feel desire for them. They are the same girls he's gone to school with since kindergarten. They are friends. How is he supposed to make this transition?

"Slow dancing is stupid," he commented. "All you do it put your arms around the girl's waist, and move back and forth. It's boring."

Well...yeah. Until it isn't.

Trouble is, he's just not there yet. These kids are 12. Some are still 11. This is too soon.

Maybe next year.

Sperm donors and ethics

2011-09-16T10:38:00.003-04:00

I can't stop thinking about an article I read in the Globe yesterday. It was about a lawyer in his 30s who was a sperm donor for about 3 years while he was in law school. Now he finds out that his sperm was used to father 70 children. 70! And because people are so much more connected these days, many of the families have connected with each other and with him online. So now he has a dilemma: what is his relationship with his biological children supposed to be? It's fascinating, and scary. You can read the whole article here.

What I don't understand is: why isn't there a limit to a number of times that a single sperm donor's sperm can be used? If a woman is an egg donor, is there no limit there, either? I can't believe that no one has thought of this before.

The thing that fascinates me is that kids really do have a need to know where they come from. I'm seeing this more and more with J as he gets older. He was thrilled to meet a bunch of cousins in Chicago this summer who share his last name. I think it helped him feel more grounded, connected. So I can understand why the kids, whose fathers are nothing more than a sperm donor number, are interested in learning about these men.

I tried to bring this topic up at breakfast this morning, and A gave me a look. I think he knew where it was going before I did.

I explained the situation to J, and he thought about it a minute. He wasn't at all interested in the ethical dilemma.

"How does the man get the sperm out of his penis?" he inquired.

A looked at me.

"Um, he masturbates, and then the sperm comes out," I replied somewhat vaguely. J has recently learned about masturbation, although I don't think he fully gets it. Yet. At least I didn't mention the pornographic magazines offered at the sperm bank.

"Where does the sperm go?"

"Um, in a cup. Then the sperm bank saves it and uses it if people want to get pregnant and for some reason they don't have sperm."

J thought it was pretty funny that men would go somewhere to masturbate into a cup, but he was impressed to find out that they could get paid for it. I'm afraid my discussion of the ethical issues of sperm donation didn't go very far.

Oh, well. I tried.

Life on the fifth floor (part 4)

2011-08-17T15:17:00.004-04:00

Many, many years ago -- I guess it was probably around 1986 -- I was just out of grad school and temping at Emmanuel College, and a friend was going to school at Harvard Medical School. I remember meeting him on "the quad" one day, and thinking: this is lovely! It's a huge field of green grass surrounded by stunning, impressive, white buildings with enormous columns.

Now it's 2011, and here I am. It's still beautiful.

On Wednesdays during the summer, there is music (see the little white triangle?) in the quad for everyone to enjoy, put on by Berklee students.

This is the email that goes out on Wednesdays:

... take a break from your research, patients, paperwork and other tasks to enjoy a series of concerts on the HMS Quad and in the Kresge Courtyard. The concerts, featuring musicians from Berklee College of Music, take place on Wednesdays from 12:30–1:30 pm. Sit back, relax and enjoy some music with your colleagues.

Today's concert wasn't spectacular, but it was nice to sit in the sun for a few minutes. There's a nice focus on "quality of life" here. I like it.

Life on the fifth floor (part 3)

2011-08-11T12:04:00.006-04:00

My new project -- and Harvard in general -- uses a lot of acronyms. A LOT. Some of them absolutely crack me up.

KFC. What does that mean to you? Well, to me it means Kentucky Fried Chicken. Here, it means "Key Function Committee." But every-time someone says KFC I think of chicken.

CHIRP. What does that mean to you? To me, it's the sound that a bird makes. Chirp, chirp, chirp. Here, it is (embarrassingly) the name of my program. Community Health Innovation and Research Program. CHIRP. Not sure how we will ever get anyone to take us seriously with that name.

R-Nav. Pronounced "ar-nav." It probably doesn't mean anything to you -- yet. It's actually a pretty cool thing. The Research Navigators (or R-Navs) are "PhDs who serve as scientific liaisons to facilitate clinical and translational research." They connect people to each other and to research opportunities. There are 4 R-Navs, and they are very nice. And very smart.

Translational. What does that mean to you? Here, it isn't about translating something into another language. It means translating a scientific discovery into something that can be used by people. Everyone's always talking about translational this and translational that.

TAP is the tuition assistance program. HUGHP (pronounced "hug-up") is the Harvard University Group Health Plan. PeopleSoft is where you log your time, and ASPIRE is where you apply for a new job (if you ASPIRE for a job...get it?). PMP is the performance management process. Although at the Med School, we do PPR - Performance Planning and Review.

And now...back to the 5th floor. Here is a photo of my wastebasket. Have you ever seen anything like that? It's a little teeny tiny waste basket that is hooked onto the side of a blue recycle bin. The message is: recycle most things, throw away just a little. Of course what I end up doing is completely filling the little tiny waste basket, and not putting much of anything into the recycle bin. I guess I'm lucky, though. My friend, K, over at the School of Public Health, doesn't even HAVE a wastebasket. None. At. All. They take recycling very seriously over there.

Life on the fifth floor (part 2)

2011-08-08T12:01:00.004-04:00

There is a hierarchy to the floor plan on the 5th floor: there are those folks with offices (and windows), and those with cubes (and generally, no windows). The important people (directors, managers) get the offices and the windows. The working people (myself included) get the cubes. The cubes are quite small, and there is absolutely no privacy. None. If you make a phone call, everyone can hear. And you can hear everyone else, too. If someone chooses to talk on speaker phone, it's really, really distracting.

Some of the folks in the offices don't have a ton of privacy either, to be honest. My boss shares an office with another person. Whenever either person has a meeting or talks on the phone, the other person can hear every word. I guess privacy isn't something that is needed now-a-days. Transparency in everything, right?

Turns out that several programs in the office are moving to a new location "across the quad" in a few weeks. This will probably reduce the density of the office somewhat, although I don't think I'll score an office quite yet. Sounds like once the programs move, I'll be moving to a cube closer to my two main co-workers.

So back to the library. There are some amusing aspects to the library, one of which is the recent introduction of Cooper, the Countway Therapy Dog. Yes, a dog. In a library. On Tuesdays and Thursdays, you can "check out" Cooper, a registered therapy dog, for a half hour of doggie deliciousness. You can play with him, take him for a walk, or just snuggle with him. He really is very cute. Take a look at this face.

Life on the fifth floor

2011-08-02T14:53:00.011-04:00

My friend K is writing a blog about her experiences at her new job, and another friend, A, suggested that we write "dueling blogs," as it were, about our experiences. I like how K is writing about the small details of her new work-life, so I'm going to try it here. Here goes.

My office is on the fifth floor of a medical library, this rather nondescript building to the left. But every day when I get off the elevator, I walk right into an exhibit of old medical paraphernalia which is formally called the Warren Anatomical Museum. The exhibit consists of old medical instruments -- some of which are very scary looking -- and also skulls, anatomical models, statues, and all kinds of weird things. A co-worker just informed me that there is a tray of gallstones. Ugh. Every day, people come up to look at the museum. Groups of students. Little kids and parents. People who are clearly tourists.

Click here to see a photo of what it looks like right outside my office suite.

On the walls of the fifth floor, there are also some strange formal portraits of men who must have been physicians a long time ago. Perhaps some of the founders of the medical school. Several of them have rooms and buildings named after them. But the real question is, why do you think this guy looks like this?

He looks very uncomfortable, doesn't he?

Here is another view of the library, a view of the staircase winding its way down.

It's getting better

2011-07-21T13:59:00.008-04:00

The new job is getting interesting. I'm currently working on topics as varied as medical uses of marijuana, chlamydia, food policy councils, and something called "hospital community benefits offices". I'm meeting different professors in the school of public health, physicians in the area hospitals. I'm meeting with folks in the state and city departments of health. I'm starting to feel a bit more confident. I'm starting to remember the names of the people in the office. I'm getting used to the commute (which actually isn't so bad, in the summer, at least). I have a friend on campus who just started here a few weeks ago, and we meet for lunch about once a week - so nice! Harvard is kind of an amazing place to work. There is so much here. And the work environment is very humane. I think I'm going to like it here.

Being new is hard

2011-06-09T14:37:00.007-04:00

It's not that I'm not grateful. I am so very grateful for this new job. It came at a great time, just when my old one was about to end. The new job is at a great institution, I found convenient parking, everyone seems very friendly and very smart, I've pretty much settled into my little cubicle (no office for me here, no door, no window, no privacy).

But I just feel so awkward.

I don't really know what I'm supposed to do yet. I'm getting an idea of what my new project is about, but I don't know exactly what to do. Is that crazy?

Let the party begin!

2011-06-01T14:53:00.003-04:00

Well, I've thought about it, ruminated on it, worried about it, ignored it, been distracted by it, and thought about it some more, but now it's here. It's June 2011. In 25 days, I'm turning 50. The big 5-0. There is no denying it, and no turning back.

One way I'm dealing with it is by making plans. I have things planned for each weekend (and more) this month. I'm going to a ballgame with A; having brunch with some of my women friends; going to NYC with two close women friends to see plays, go to museums, eat wonderful food, and experience that which is New York City; and on the actual day of my birth, I'll be with my birth family for the start of a week-long vacation on the Cape.

In addition, I'm ending my current job, and starting a new one.

Let the party begin!

JAMA!

2011-05-20T08:31:00.004-04:00

As promised, here is the link to my essay that was published this week in JAMA (Journal of the American Medical Association)! It's very exciting!

Unfortunately, JAMA will not provide you with the full article, unless you happen to be at work and your work has a subscription to it. So if you want to read the whole thing, and you can't find a hard copy of the journal (usually the public library has it), send me an email and I'll send you a copy!

Random thoughts

2011-05-05T13:05:00.000-04:00

I'm sorry I haven't been posting more on my blog. It's not that there hasn't been a lot going on...

Yesterday I had jury duty. I spent 3 hours in a court room on a very hard wooden bench as part of the jury pool. The judge and the two lawyers spent this entire time questioning potential jurors in order to pick 14 for the jury. They picked one, excused one, excused two, picked one. When they had 14 jurors selected, and we all heaved a sigh of relief. Then the lawyers conferred and excused 4 of the seated jurors! Back to questioning potential jurors. It seemed like an inefficient process, but I guess that's how it works. It was a very long day.

* * * * *

I just learned that a good friend has an abnormal mammogram, and has to go back for an additional mammogram and an ultrasound. This made me very sad. Hearing about more and more people dealing with cancer diagnoses and potential cancer diagnoses is just...awful.

* * * * *

J and some of his friends are suddenly interested in the show Jersey Shore, and he's been watching it, so I've been watching some it, too. It is, by far, the worst display of human behavior I have ever seen in my life. Period. The cast members curse, fight, call each other names, go to clubs late at night, pick up strangers, make out with said strangers, bring them back home, have sex with them, and then do it all again the next day. I think J is trying to figure out what adults do, and that's why he's so fascinating with it. It's so awful it's actually funny. I hope J isn't scarred for life after watching this.

* * * * *

I have an article coming out in JAMA (The Journal of the American Medical Association)! It's not a research article; rather, it's an essay I wrote about working on the end-of-life study. It comes out on May 18th in a section called A Piece of My Mind. I'll put something up on the blog once it's officially published!

Unacceptable

2011-04-14T15:23:00.004-04:00

There are two kinds of cancer: the type you get better from, and the type you really don't.

I was lucky. I had the first kind.

But lots of people aren't lucky. They have the second kind.

I subscribe to a blog called Mothers With Cancer, and this is what popped up today:

Some Things
A year ago when I was rediagnosed with breast cancer I was diagnosed with stage IV Metastatic breast cancer. which basically means my cancer had spread outside my chest area to other parts of my body. I kept this pretty private to the girls and tried to make it as easy on them as possible only making some details known to them, to protect them in a way.

Lately my scans have been good I have had some set backs but I believed I was on the up swing. I had another round of scans last week and my scans reviled a shadow that my doctor wanted to check out a little closer. So I had a brain scan on Friday morning, by two o’clock my doctor called me with the results. The cancer has spread to my brain in one spot on the right side in the back of my head. I also had questionable spots throughout my brain.

So this has been really hard to soak in. It’s not an easy thing to process. Yes I have cancer, in my brain what will happen to me? So I start radiation to my head tomorrow, and they will treat me for two weeks everyday. Then we will work on the spot of cancer if it needs to be treated. they will stop my chemo until then, they don’t like to mix the two together.

So that is what we are facing right now, it’s hard and scary and I hate sharing it all with you, but you are all a big part of me and my recovery and my blog has pulled me through some really tough times. So I thought I could share this with all of you.

Thank you so much for all of your prayers and support

Sarah

Eleven people commented on her post on Mothers With Cancer, and 121 commented on her personal blog (so far). Lots of people are praying for Sarah. I don't know Sarah, although I've been following her story for a few years. The truth is, she isn't going to get better. She doesn't know how long she has. She probably doesn't have very long at all.

This is unacceptable. There has to be a better way.

That's why I'm focused on prevention.

Cans

2011-03-30T13:59:00.004-04:00

I just made some lunch, which consisted of a can of Trader Joe's tuna in olive oil, mixed with cornichon pickles and Goya chick peas, also from a can. Yum.

My place of work just sponsored a month-long Can Drive and collected over 500 cans of protein (tuna, ham, etc.) to donate to a local food pantry. Hooray!

And I received an email this morning from the Breast Cancer Fund:

We know BPA is all around us, and the CDC tells us the chemical is in almost 95 percent of us. And we know that laboratory studies have linked BPA to breast cancer, along with a whole host of other serious health problems. But what is the leading source of the BPA that contaminates our bodies? If we removed that source, how much would our BPA levels drop?

The Breast Cancer Fund and Silent Spring Institute conducted a study, published today in Environmental Health Perspectives, to find out. We enlisted five families for a week-long investigation. First, the families ate their normal diets. Then, we provided them with three days’ worth of freshly prepared organic meals that avoided contact with BPA-containing food packaging, such as canned food and polycarbonate plastic. Finally, the families returned to their normal diets. We measured their BPA levels at each stage.

While the families were eating the fresh-food diet, their BPA levels dropped on average by 60 percent. Those with the highest exposure levels saw even greater reductions: 75 percent.
These groundbreaking results tell us that removing BPA from food packaging will eliminate our number one source of BPA exposure.

Scary, isn't it?

The email continues:

That means you can make changes right now to reduce your family’s levels of this chemical linked to breast cancer. It's as simple as cooking at home with fresh foods and making some very basic changes in your kitchen, such as limiting canned foods, choosing glass and stainless steel food and beverage containers, and not microwaving in plastic. You might also consider eating fewer meals out—especially at places that don't use fresh ingredients.

But how about those 500 cans of food we just donated to the food pantry? Is it better to eat something that might have BPA in it, or not to eat at all?

I think this is an important study, and it certainly will help raise awareness of BPA and its connection to the food supply. But I also feel that this issue is bigger than us. The email continues:

But while we can take steps to reduce our BPA exposure, we need big-picture solutions to ensure that everyone is protected from this chemical. Together with you, we are working tell industry and government that we want safe, non-toxic food packaging now.

So now what? I will continue my work with MBCC to continue to fight for reducing chemicals in our environment. I will continue to prepare and serve fresh veggies as much as possible from our CSA, from our garden, and from the grocery store. Will I stop using canned food altogether? Not sure. Not yet.

Here is a link to info about that study from the Silent Spring Institute
Here is a link to info from the Breast Cancer Fund

Rules, guilt, and seders

2011-03-25T13:29:00.002-04:00

I listened to the latest podcast of Vox Tablet recently as I drove a short distance from my office to pick up some lunch. Vox Tablet is the audio arm of Tablet Magazine, "a daily online magazine of Jewish news, ideas, and culture." While I don't read the online magazine that often, I do listen to the podcasts frequently. I like the host Sarah Irvi. She's smart and spunky.

So this week's episode is about Cokie Roberts, of NPR fame, who -- surprise! -- is married to a Jewish man. Cokie was raised Catholic, and married her culturally-but-not-at-all-religiously-Jewish husband Steve Roberts in the 1960s. Trying to figure out a way to integrate Judaism into their home, Cokie was the one who decided that they should have a seder. And the rest, as they say, is history. They just published a new book, a haggadah actually, called Our Haggadah: Uniting Traditions for Interfaith Families.

Back at the office, I'd eaten my lunch, and I was strangely annoyed. And trying to figure out why.

These are my thoughts. It's one thing to say -- I'm culturally Jewish, and I'm going to have a Passover seder, and that's all I'm going to do -- and keep it to yourself. But to put it out there as a model of what people should do? It feels unfair to me. Judaism is a lot more than conducting a Passover seder. How about all the laws, all the rules, all the guilt? (especially all the guilt?)

I don't know. This whole thing sounded like a white-wash, if you will, of what Judaism really is. Judaism isn't just a Passover seder, for goodness sakes. Sure, a seder is a good thing. But what about cleaning for Passover? Changing the dishes? Buying the Kosher for Passover foods? Purging the house of all the chametz? And so on? Passover is huge, and takes a month or more of preparation. It isn't just a seder.

I realize that this is ironic coming from me, the one who breaks all the rules. But is it better to break the rules knowing what they are, than to blithely do some rituals, not even knowing about the rest?

Or here's another example that I vaguely remember from my past: is it better to eat a cheeseburger knowing that you are breaking the rules of kashrut (and having decided to break the rules) than to do it unknowingly?

That's the issue.

I found a baseball in the backyard today

2011-03-11T13:40:00.004-05:00

I found a baseball in the backyard today
It had been covered by a layer of snow
(Five layers, actually)
We had five snowstorms this year
Each layering on top of the other
Like layers of sedimentary rock

But today
The snow is almost gone
A plastic bag, a candy wrapper, soggy pieces of paper
And the baseball
Appear in the yard
The baseball is soggy, dirty, but intact

If I move the wet layer of leaves
I can see the first signs of daffodils
Pushing green out of the cold ground

Yet somehow
The baseball is an even
More hopeful
Sign of spring.

Not for children

2011-02-25T19:31:00.004-05:00

I love listening to This American Life, and while on a plane heading home from Florida yesterday, I plugged in and started listening to a recent episode. The theme was people who delay doing things, which sounded innocuous enough, although there was an odd warning before the first piece. Don't play this in front of your children. Okay, I wasn't playing it in front of children. And then the piece started.

It was about a reporter who decided to kill the man that, as a teenager, had raped him at age 7. Not fondled him, not touched him inappropriately: raped him. Then threatened him, and he never told anyone. Until now. You can read the piece in full here, if you'd like. Or maybe you'd rather not.

The piece was fascinating and horrifying. And somehow familiar. Oh, yeah. Scott Brown.

Last week, our illustrious senator started promoting his new book by appearing on TV shows. Turns out that he was molested by a camp counselor when he was 10. He never told anyone about this, until now. Didn't even tell his wife. Didn't even tell his mother.

And then, in today's paper, a vivid article about a physician at Boston Children's Hospital who apparently molested young boys for years under the guise of providing medical care to them. He was about to be charged. He killed himself.

In the This American Life story, the mother reads an old childhood diary and finds out about the rape years later. She actually calls and confronts the family of the rapist. I guess this was the part of the story that spoke to me: what would I do if I found out that this happened to my child? And how do I make sure this never happens to my child?

But the other mothers -- Scott Brown's, the mothers of the boys molested by the physician -- never had a chance to do anything. The boys didn't tell them what had happened. They were too ashamed, too confused. They didn't have the words. They didn't feel that they had any power.

As frustrating as I find my son some days, I am glad that he has a strong sense of self, and is able to express when someone does something to him that seems unfair or unjust. I hope that if something terrible like this happens to him, that he will come to me and let me help him. But really, I hope something like this never happens.

The trouble with school

2011-02-08T09:19:00.006-05:00

J isn't in love with school these days. I think he enjoys parts of it, but overall, school --and homework -- just gets in the way of his free time. I don't think this feeling is atypical of 11-year-old boys. But it's becoming somewhat of an issue.

Last week, I received two emails on the same day (one from each of his two main teachers) about things that he wasn't doing. He didn't finish an assignment. He didn't do an assignment. He did poorly on a test. He isn't trying. He isn't showing effort. And so on.

So A and I talked with him very seriously about it. We took away video games during the week, to reduce distractions. We told him to make sure to write down all his assignments, not just some of them. And we are checking more to make sure he does what he needs to do.

But in addition to the things that he is and isn't doing, I think the teachers are pretty cranky, as well. I know that some of the 5th graders are very silly, and I'm sure it's hard to teach when kids are laughing and joking all the time. Apparently yesterday J and a friend were sent out of class for laughing. They met with an administrator, who not only chastised them for their behavior, but also chastised J for not being as good a student as his friend. It took J a while to tell me this story, but he finally did, and he cried. "My grades should just be between me, my teacher, and my parents! He shouldn't have told my friend." He was right.

We dealt with it, and the administrator has apologized, but I'm still left feeling...sad. I want J to feel empowered in school. I want him to feel good about school. He actually is a smart kid, very insightful, intelligent. His writing skills are excellent. His math skills are better than mine. His Hebrew is much better than mine was at his age. But his teachers are focusing on his deficits more than on his strengths, and it's wearing him down. It's wearing me down, too.

D'var Haftarah for Mishpatim

2011-01-29T22:27:00.005-05:00

This Shabbat was Sisterhood Shabbat once again at my shul. I was not on the planning committee this year, which meant much less angst for me. The day went very smoothly, and the guest speaker, Galeet Dardarshti, was wonderful. One of my roles was to deliver a "d'var haftarah" - a Haftarah introduction. This one was not easy to write, but I think it came out well in the end. Enjoy!

* * * * *

This week’s Haftarah is from the book of Jeremiah. Like most Haftarah portions, it was chosen because it echoes some of the themes of the Torah portion. In the Torah portion that we just read, you might recall, there were a number of laws about the treatment of slaves. The Haftarah portion deals with a very specific instance of keeping and freeing slaves.

But let’s back up a little. What is all this about owning and freeing slaves? It is important to understand, first of all, that during biblical times, slavery was something that was accepted as common practice, even though it seems abhorrent to us today. In addition, there were different categories of slaves. Hebrew slaves were treated differently – and better – than non-Hebrew slaves.

So why would a Hebrew become a slave? Sometimes this was legislated through the court, to pay for a crime – or to pay off a debt – or even to escape poverty. In this case, the person would become a slave – really more like an indentured servant – and there was a time limit on this, six years. At the end of six years – in the seventh year – they would become free once more. Again, this practice sounds very strange to us, but clearly was common and acceptable at that time.

The laws in Mishpatim, in the Torah, actually are revolutionary in that they create a system of laws around how a master treats a slave, something that wasn’t found in other cultures.

So now back to the Haftarah. In this Haftarah portion, the upper class Hebrews of Jeremiah’s time were not following these laws we just discussed. They weren’t letting their slaves go after 6 years of service. Also, the city of Jerusalem, ruled by King Zedekiah, was about to be attacked by Nebuchadnezzar, King of Babylon. What happens next is very interesting The text reads:

King Zedekiah had made a covenant with all the people who were in Jerusalem, to proclaim freedom to them; That every man should let his manservant and every man his maidservant, a Jew and a Jewess go free, that none should hold his Jewish brother as a slave. Now all the princes and all the people who had entered into the covenant hearkened that every one should let his manservant and everyone his maidservant go free, no longer holding them in slavery; then they obeyed and let them go. But afterwards they turned and brought back the manservants and the maidservants whom they had let free, and forcibly made them into manservants and maidservants.

Two questions come to mind here: Why would the king decide to have the people free their slaves? And why would the slave owners then force them back again into slavery?

In my research for this talk, I found two explanations for freeing the slaves. The first explanation is practical: since the Babylonians surrounded Jerusalem, laying siege to the city, King Zedekiah released the slaves in order to increase manpower: the slaves could help defend Jerusalem from the Babylonians. Another explanation – more theological - is that the slaves were released – as they should have been anyway after 6 years - to appease G-d, to persuade G-d to be merciful during the attack by the Babylonians. Once the siege was lifted, however, the slaves were forced back into slavery.

Jeremiah reminded the people that just as they made a covenant with the King Zedekiah to release all of their slaves, God made a covenant with their ancestors after God freed them from slavery in Egypt. By taking their slaves back, the people renege on their covenant with Zedekiah, and on the covenant that their ancestors made with God.

The issue – here – isn’t the fact of slavery. It’s that the people didn’t follow G-d’s law of releasing slaves after 6 years, and that they broke their covenant. The fact that they refused to follow the law, and then went back on their promise is what made G-d so angry. And G-d is really really angry. A litany of bad things – which you can read for yourself in the text - will befall them for what they have done.

This is an interesting Haftarah alongside the Torah portion because it shows that setting down the laws (Mishpatim) are one thing, but actually following the laws is something else. The Torah sometimes shows an idealistic view of things, and we imagine the Jews in biblical times living a very moral life, following all the laws that are presented. In reality, following the laws wasn’t easy. The people in Jeremiah’s time didn’t want to give up their slaves every 6 years. They probably didn’t EVER want to give up their slaves. Jeremiah had to remind them of the covenant they had made, and threaten them with very harsh punishment if they didn’t obey.

Sources:
MyJewishLearning.com
The Jewish Study Bible
The Women's Haftarah Commentary
and others

25 years ago

2011-01-21T18:05:00.007-05:00

An article in today's paper reminded me that 25 years ago, on January 28, 1986, the Challenger Shuttle exploded and Christa McAuliffe, the first teacher in space, lost her life.

This happened half my life ago, and I can remember that moment exactly.

I was a working at the New England Telephone building in downtown Boston. I was fresh out of grad school (the first time) and I couldn't find a job in my field, so I was temping to bring in some money. Turns out that my typing skills were more valuable (job-wise) than any of the other skills I gained during college and grad school.

So I was typing, at my temp job, and suddenly the news spread that the shuttle had exploded. Televisions were turned on, and everyone was watching the news on TV. It was true. That lovely teacher with the small children at home had died. It was horrible.

Also around that same time, my mother called to inform me that she had breast cancer and that she was having a mastectomy. The winter of 1986. My mother was 47, just about to turn 48, the same age that I was when I was diagnosed breast cancer. I remember getting permission to call her from work to find out how she was doing after her surgery. Waiting to hear if her lymph nodes were clear (they were). That's about all she ever said about her cancer. The case was closed after that.

1986. Half my life ago. A lot happened that year.

Delurk!

2011-01-15T17:13:00.002-05:00

Yesterday was the official Delurking Day 2011, and I missed it by one day. Lurking, in the blogging world (for those who don't know), means those who read blogs but don't comment on them. I don't mind, really, if you read but don't comment. I do it myself. On the other hand, I'd love to hear from you! If you are so inclined, please post in the comments!

Follow-ups

2011-01-14T13:34:00.001-05:00

I won't bore you with the details of last Friday's mammogram. It was pretty much the same as the other times. Lean into the machine. Lean more. More. That's it. Relax. Don't breathe. Hold it. Hold it. Okay, now you can breathe.

The only thing different this time is that after my mammogram, they kept me waiting in the waiting room (watching Nate Berkus, and then The View) for over an hour. Still not sure why that was. And I had an appointment at the surgeon's after-wards. It made for a very long morning in the hospital. I'm still a bit cranky about that.

Anyway: here is the official result from the radiologist:

INDICATION: History of right breast cancer.
GE DIGITAL BILATERAL DIAGNOSTIC MAMMOGRAM WITH ICAD:
COMPARISON: July 2008, January 2010, and January 2009.
The breasts are extremely dense and nodular, severely limiting sensitivity of mammogram for detection of masses. A focal area of architectural distortion is noted in the right retroareolar region, consistent with prior surgery. This is marked with overlying scar marker. Surgical clips are noted in the lumpectomy bed. There are multiple microcalcifications seen scattered in both breasts which remain stable. Microcalcifications scattered in the right lumpectomy bed also remain stable since January 2010. Microcalcifications in the right upper-outer breast, posterior to the lumpectomy bed, remain stable dating back to 2009.
No spiculated masses or unexplained areas of architectural distortion.
IMPRESSION: No evidence of new or recurrent malignancy. Findings discussed with the patient.
BI-RADS 2 - benign findings.

So, believe it or not, this is a good report. She didn't find anything in particular that concerns her. Although this is the part that kills me: "the breasts are extremely dense and nodular, severely limiting sensitivity of mammogram for detection of masses." What this means is: we really can't see anything.

Dense breasts are a risk factor for breast cancer. So far, no one has been able to tell me how to make your breasts less dense. I think as you get older, the become less dense. One good thing about aging...

What's ironic is that yesterday, I received a report on this mammogram in the mail. This is what it said:

The mammogram you had on JAN 07, 2001 was NORMAL. That is, the mammogram did not show any evidence of cancer...Mammograms are useful in detecting breast cancer but will not find all breast cancers.

So first they tell you that it's normal. Then they tell you that it didn't show any evidence of cancer (but could the cancer be there without evidence?) and then they tell you that mammograms don't find all breast cancers.

Great.

Today, just to add to all the fun, I had a follow-up visit with the radiation oncologist. That's where I had my radiation treatments 1-1/2 years ago. I saw the nurse, who is lovely, and one of the radiation techs. Everyone there is very kind.

The radiation onc checked me, asked a few questions. Everything looks good. See you in a year.

I actually said to her: "so the radiation is supposed to prevent a recurrence in my right breast, and the Tamoxifen is supposed to prevent a new primary cancer in the left breast. Is there anything else I should be doing, except waiting?"

The reply: "that's all you can do."

So that about sums it up.

Top Twelve

2010-12-29T17:12:00.007-05:00

A lot of bloggers are posting their favorite top ten-ish posts of the year, so I thought I'd go along and do it, too. Well, there are twelve.

First Mammogram Since Surgery The machine is hard: metal and plastic. My breasts, my body, are soft. The technician keeps telling me to relax.

Poem One day I am a person | The next day | After knowing fingers find a | Lump |I am a patient.

Spring Children run and shout| Like convicts escaped |Throw balls | Ride bikes |Grow in the sunshine

Breast MRI Fun at the Hospital "There is no graceful way to do this," admits the technician. She indicates that you should climb onto the table. "Your breasts go here, and your face goes here."Say what?

Don't chew on your mama's tefillin Two poems (not mine) about different women's experience of Judaism, juxtaposed

Incidentaloma There is a new terminology out there -- incidentalomas -- for things that are discovered accidentally during a test for something else.

High holiday wandering My earliest high holiday memory involves big white tents.

The story of a man This is the story of a man I know.

Puberty, pimples, and cups J recently turned 11, and at his yearly physical shortly after his birthday, the pediatrician opened up a discussion about puberty.

On breast cancer (a version of which was printed in our local paper) There is strong, growing scientific evidence that the cause of breast cancer is environmental, i.e. chemicals in our food, water, air, and soil.

Friends in cyberspace And sometimes, people you know only from cyberspace die.

Oy, Chanukah (a version of which was posted in the OnBeing Blog) What does it mean to be Jewish during a prolonged, public, and pervasive holiday season?

And here are some other bloggers' top posts: the Velveteen Rabbi's top 12; Scary's Mommy's top 12 (and others posted in the comments section): top White House food stories of 2010; I'll add more as I find them. Enjoy!

Entering data

2010-12-21T01:45:00.002-05:00

I'm at work, entering data into an Access database. It's not very difficult, and it can be a bit soothing to enter data. I don't have to think too much. But entering this data always gives me pause. I'm entering the data that represents a child, a child who progressively became sicker and sicker, and ultimately -- always -- died at the end. Entering this data makes me feel... strange. Sad. Grateful that I have a healthy child. Sad for the families that have to go through this. Amazed and so appreciative of the folks who work in this field and do this work every day.

Even after four years, it's hard for me to talk about the study I'm working on. Improving end-of- life care in the pediatric ICU. The study is about making the end-of-life experience better for very sick kids and their families. True, this is a very small minority of kids. Most kids get sick, and get better. But some kids -- 55,000 a year in the U.S. -- don't. And most of these kids die in the PICU. So here I am.

I start out typing in very basic information. The child's date of birth. The date they entered the hospital. The day and time of their first vital signs. Often, these children are very young. Often, they enter the hospital soon after birth. These are the kids with very serious birth defects: problems with the heart, with the digestive system. Sadly, some of them never get to see the world outside the hospital. This is where you start to think about quality of life, for the child, for the parents. Does it make sense to keep them alive for a few months in the hospital, only to die a few months later? Is a few months of life worth the pain and discomfort that the baby experienced? The parents? No easy answers.

The next page has information about the diagnosis. Often I don't understand these, but sometimes I do. Kids in the PICU tend to have serious diseases. Usually chronic diseases. Cancers, genetic issues, cystic fibrosis, muscular dystrophy. Occasionally, there is something acute, like a car accident, a drowning, being hit on the head.

Next page is about the involvement of different care givers, such as social workers, chaplains, and so forth. Most of the time, there is support offered by some of these services to the child and the family. This seems like a good thing to me. After that, there is a chart that lists the different family conferences that took place. These are interesting because they tend to follow a progression: at first, the family and the doctors discuss the prognosis, and decide to continue supportive care. The next day, they consider withdrawing or withholding treatment. And finally, they decide to withdraw or withhold. One thing that I've learned from working on this project is that the acceptance of a child's death is a process. Parents need to see that everything that can be done, has been done, and if they see that and see that their child is still not improving, then they can start to consider the end.

The next pages deal with all the possible interventions that a child can have in the PICU, from differing types of feeding, hydration, medications to bring up the blood pressure, different types of mechanical ventilation, and different medications that relieve a child of pain. It's interesting to see that, again, this tends to follow a pattern. The child often receives lots of interventions at first, and as the days go by, they tend to drop off.

There is a question called "ability to communicate" and most of the time, the child in the PICU is comatose. At least they aren't aware of what is going on. Most of the time, they aren't feeling pain at all, either.

The final page describes the child's death. Who was with them, was there an autopsy, was there a decision for the child to be considered as an organ donor, did the donation actually happen? And that's it. The chart abstraction is over.

Another child has died. Another family is crushed. I exit out of the chart. And sigh.

What I don't like about winter

2010-12-20T20:18:00.003-05:00

My hands are SO DRY right now that there is actually a crack in my right thumb (and it hurts)
Having to put on a scarf, long coat, and gloves every time I go anywhere
Cannot find the ice scraper
Have lots of gloves and mittens without mates -- for some reason, only the left ones remain
It gets dark at 4 pm
I'm sleepy by 7 pm
It's really dark in the morning, too
The first official day of winter is TOMORROW
At least 3 more months of this?!?!?!
Why do I live in New England anyway? Oh, yeah: the change of seasons is so beautiful...

It keeps changing

2010-12-10T19:00:00.001-05:00

Let's review.

During the summer of 2009, my onc suggested/recommended/insisted that I switch antidepressants because there was some research that showed that the type of antidepressant I was taking might affect the functioning of the Tamoxifen, which is supposed to prevent cancer from coming back. Here's a post I wrote about that.

So I tried several of the antidepressants that were supposed to be better for women on Tamoxifen, and none of them worked. In fact, about a year ago, I was feeling pretty crappy. Here's a post I wrote at that time.

Ultimately, I got off the new antidepressant, off the ovarian suppression study, and back onto my old antidepressant (that I know works for me). Here's a link to that post.

I thought I wrote more about it on the blog, but I guess I didn't. During that time, I read a whole lot of research about the connection between Tamoxifen and something called CYP2D6, which is an enzyme in your liver. Supposedly some people metabolize Tamoxifen differently, and this can impact how well the Tamox works to prevent future cancers. Some women took this research to heart, and had the CYP2D6 test and based their decision whether to take Tamox or not on that result. My onc wasn't convinced, so I didn't have that test. That was fine with me, because I wasn't convinced either.

Then, someone looked at antidepressants, which also are affected by the CYP2D6 enzyme in the liver, and decided to look at whether women who take certain antidepressants and Tamoxifen are more likely to have a recurrence. However, reading the research, I wasn't convinced. They were using data sets from health care corporations, with records based on women filling their prescriptions.

I looked at everything I could get my hands on, and decided, based on what I read and how I felt that I had to have good quality of life, and that was more important than a possibly reduction in efficacy of the Tamox.

So today, here's some news from a large breast cancer research conference (the San Antonio Breast Cancer Symposium):

The CYP2D6 test, also called the “tamoxifen resistance” test examines a gene called 2D6, which produces the enzyme CYP2D6. This enzyme is necessary for the body to metabolize a number of drugs, including tamoxifen. Tamoxifen has to be metabolized to endoxifen in order to work. This is done in the body by enzymes. Some people have variations in these genes that result in them making less endoxifen, and there has been some data suggesting that these people don’t do as well when they take tamoxifen. This was noted at the 2007 San Antonio Breast Cancer Symposium, when researchers presented data that showed that women who inherited a certain variation of the 2D6 gene were almost twice as likely to have their breast cancer recur, even though they were more likely to complete their tamoxifen treatment.
To explore this question further, researchers took advantage of two large studies that were done to look at the benefit of tamoxifen versus an aromatase inhibitor (which is metabolized differently, and is not affected by CYP2D6). Their findings refuted the previous data, showing that the presence of common mutations in the genes that control the enzymes that metabolize tamoxifen did not have an effect on whether women were likely to have a recurrence. They also found that antidepressants that are thought to inhibit CYP2D6 actually had no effect on whether women taking tamoxifen had a recurrence. In sum, the researchers concluded that for postmenopausal patients with hormone-sensitive early breast cancer, CYP2D6 testing is not justified to determine whether to give tamoxifen. They also found that, in contrast to what has been suggested, the presence or absence of hot flashes should not be used as an indicator of whether tamoxifen is effective. (link back to original article by Dr. Susan Love)

So, as usual, I'm both relieved, and angry. Relieved because I really didn't believe the initial research that showed that the antidepressants impacted the Tamoxifen. Angry because lots of women went ahead and changed their antidepressant because of this research. Also, some women took the CYP2D6 test to see how they "metabolized" Tamoxifen and made treatment decisions based on this test. So now what do they do?

This breast cancer business is a moving target. You try to make decisions based on the latest information, but next year, it might change. Argh!

Discontented

2010-12-10T11:02:00.001-05:00

This was the Chanukah of J's discontent (apologies to Shakespeare and to Steinbeck).

I'm not kidding. The kid really wasn't happy this year.

Here's the back-story. J received an X-Box 360 (a video game system) recently as a joint birthday/Chanukah gift from his grandma. He also purchased a bunch of games that he wanted to go along with it (sports, only sports). He really doesn't need anything else.

So for Chanukah this year, we gave him the following: a t-shirt with a cute basketball saying; note cards with a cute basketball saying (okay, I know not very kid-friendly, but he needed note cards for thank you notes); a year-long membership to X-box Live; a year-long subscription to Sports Illustrated Kids; a Needham duffle bag filled with a Nike hoody and athletic pants (he liked those gifts a lot); Celtics sweat pants; an iTunes gift card; and a photo book I'd made of this birthday party this year. I also attempted to buy him a Snuggie but I bought the wrong size and had to return it, and I attempted to buy him a Miami Heat calendar (he loves the Heat) but it didn't have the Big Three in it, so that didn't work out either.

Not so bad, right?

Wrong. Terrible.

What he wanted was: a cell phone, an HD TV for his X-Box that lives in the basement, a Kinect for his X-Box, another expensive Celtics or Heat shirt (he already has MANY)....he just "wanted something good" (spoken in very whiny, privileged tone of voice). What we gave him "wasn't good."

Also, according to J, "Chanukah this year wasn't as fun as it used to be." It wasn't exciting. Lighting the candles wasn't exciting. Singing the songs wasn't exciting. The presents weren't exciting.

Sigh.

Welcome to the real world, kid.

Oy, Chanukah

2010-11-30T12:23:00.005-05:00

Chanukah begins on Wednesday night this year. Tomorrow night. December first. Yes, it is confusing. Even we Jews are confused. Why – everyone is wondering -- does Chanukah coincide with Christmas some years, and other years, Chanukah arrives weeks before?

The answer is that the Jewish calendar is different from the secular calendar. The Jewish calendar is lunar, and the secular calendar is solar. Since each Jewish month is only 28 days long, and the secular months are 30 or 31 days long, after a few years, the Jewish calendar and the secular calendar become out of sync. The Jewish calendar corrects this by actually adding an extra month every few years in order to get things back to normal. This spring, there will be an extra Jewish month (Adar II) added, and by next Chanukah, Christmas and Chanukah will coincide once more.

But I’m getting ahead of myself.

Chanukah is really a very minor holiday in the Jewish year. The Jewish holy days of Rosh Hashanah, Yom Kippur, and Passover are much more important than Chanukah. But due to its (sometimes) proximity to Christmas, Chanukah has become much more important than it was originally intended to be, especially in the U.S. And then, of course, there are the presents. Eight nights of presents.

Growing up in a mostly Catholic neighborhood, the only way my parents could convince us that celebrating Chanukah was a good thing compared to our neighbors’ exciting Christmas celebrations was by giving us eight presents: one for each night of Chanukah. Yes, our neighbors had the Christmas tree. Yes, they had Santa Claus. Yes, they hung stockings by the fire with care. Yes, they had Christmas carols. Yes, they had the beautiful decorative lights hung on the bushes and trees. But we had eight nights of presents.

In general, Chanukah traditions are much simpler than Christmas traditions. You light the Chanukah menorah. You sing some songs. You spin the dreidle (a special top). You eat chocolate gelt (coins). You eat potato latkes (pancakes). You get some presents. You give some presents. Repeat for eight nights. End of story.

Christmas traditions seem much more complicated and stressful to me. Procuring, transporting and putting up a live tree in your living-room. Decorating the house, inside and out. Buying expensive presents for everyone in your family. Cooking a special Christmas meal. Traveling to be with family. The whole Santa Claus thing.

On the other hand, Christmas takes up a huge chunk of space in the American consciousness. It’s really really hard to be left out of the Christmas festivities when all the radio stations are playing Christmas music, everyone other TV show is about Christmas, houses are decorated with Christmas lights, every store is loaded with Christmas paraphernalia of all kinds, everyone wishes you Merry Christmas, etc. As a child, I really really really wanted to celebrate Christmas. In spite of the eight nights of presents. I wanted a tree. I wanted a stocking. I wanted Santa. I wanted all of it.

Now that years have passed and I have a child of my own, I think things are somewhat better in our multi-cultural, pluralistic, internet-connected world. My son is interested in Christmas, but he doesn’t seem quite as jealous as I remember feeling growing up. We generally celebrate Christmas with a close family friend, and after decorating her tree and exchanging presents, he seems to have had enough of Christmas for one year.

But the “December dilemma” remains. What does it mean to be Jewish during a prolonged, public, and pervasive holiday season? It becomes even more complicated for interfaith couples, now a large proportion of Jewish families. Do they buy a Christmas tree even though they are also celebrating Chanukah? Do Christmas ham and potato latkes go together? Can Santa visit as well as Judah Maccabee?

I’m not sure if we will ever solve the “December dilemma” here in the U.S. Meanwhile, I’ll sing along to Christmas carols on the radio, enjoy the pretty lights around town, wish my neighbors Merry Christmas, light the candles, spin the dreidle, eat latkes, and hope that the next generation does it even better.

P.S. I'm happy to announce that this post was published last week in the "Being" blog, which was the inspiration for it being written in the first place.

Chemicals are in us

2010-11-21T21:30:00.000-05:00

I recently became aware of a podcast series put out by the friendly folks at Environmental Health Perspectives (a monthly journal of peer-reviewed research and news on the impact of the environment on human health, published by the National Institute of Environmental Health Sciences). I started listening to some of these podcasts today. Very. Scary. Stuff.

Here is one about long-term effects of in utero exposure to BPA. A quote from the scientist who was interviewed:

NEWBOLD: BPA is still a compound that we just don’t know that much about, and we really need to be concerned about this, because we know from studies from the CDC that over 90% of the population actually has been exposed to BPA because we’re picking it up in the urine. We also know that it’s in a lot of different plastics, so the potential for exposure is quite high. So we need to know the long-term effects—if there are truly any adverse effects. And right now the animal studies are leaning toward that direction.

Here is one on flame retardants, know as PDBEs

AHEARN: So they’re in almost 100% of Americans. How did they get there? How did they get into our bodies?

STAPLETON: That’s a big area of research that scientists are still trying to understand. We know for a fact that PBDEs are ubiquitous. They are found in a lot of our food products. They’re found in the air in our home. They’re found in the dusts in our home at fairly high levels relative to levels in the outdoor environment. There is definitely an exposure pathway from the presence of these products in our home and through our diet. Research definitely shows we’re getting exposure from both avenues.

Here's a third podcast, on breast milk:

Ernie Hood: Dr. Goldman, what do you recommend that we do to make human milk even safer than it is today? Are there actions on a macro level that we can take to reduce the presence of these contaminants we’ve been discussing?

Dr. Goldman: Yes, I think so. I think on a macro level, what we need to do is develop policies where we are much more vigilant about avoiding the use of persistent chemicals and pesticides. We do not want to have anything that’s persistent and going to build up in the environment or in our bodies in our food supply, in the air we breathe, in the water we drink. Because we’ve learned over and over and over again that these persistent substances, if they do have adverse health effects, then over time there’s very little we can do about them. So, many of the chemicals that are found in human milk are no longer used today. Many of them were banned as much as 20 or 30 years ago and yet we still find them. And yet when these chemicals are persistent we can’t simply dial down the exposure levels, because some of them have half-lives that last many, many years.

Um...yup. That's the problem in a nutshell.

Chanukah mood

2010-11-18T09:30:00.000-05:00

Thanksgiving is still a week away, and Chanukah comes shortly after, on December 1st. I'm trying to find that Chanukah spirit, so I'm turning to the internets for a little inspiration...

The candles sing Mi Y'Malel (interactive: click on the candles and see what happens!)

Hanukkah Hey Ya!

Hanukkah Hey Ya! Flash Mob (from last year, still great!)

John Stewart's Can I Interest You in Chanukah?

A Jewish Christmas Rap

A very young Adam Singer sings the Chanukah Song

Onc appt @ noon

2010-11-17T11:20:00.002-05:00

The sun is shining, and the birds are chirping, and the squirrels are busily searching for things to eat, and the day is unusually warm for November...and I have an oncologist appointment at noon. I am inexplicably sad about it. There is really nothing to fear. It's just a check-in. We'll exchange pleasantries, and she'll ask me how I'm doing. I'll tell her I'm doing just fine now that I'm off the study drug and the sleeping pills, and now that I don't have hot flashes and can sleep. I'll tell her that my periods finally came back. Not sure how she'll take that news. And she'll do a physical exam, and all will be well. But I still don't like going. It reminds me of everything that happened, and even though I feel like I'm pretty much past that now...it's still there. And I keep hearing about women being diagnosed with breast cancer, women having recurrences of their cancer, women with stage IV cancer, women dying of cancer. And I'm still scared. And angry.

Published!

2010-11-16T10:25:00.002-05:00

I'm proud to announce that an article I wrote on the connections between breast cancer and the environment, similar to something I posted here on the blog in October, appeared in our local newspaper last week. If you'd like to take a look, here it is.

I'm pretty happy with the article, and I've received some nice feedback on it. Many people are surprised to learn that breast cancer has anything to do with the environment. I'm always surprised to learn that people are surprised: it seems so obvious to me. Clearly, there is still a lot of work to be done.

Still here

2010-11-02T11:27:00.005-04:00

So we made it through October. Breast cancer awareness month is over.

(Deep sigh of relief.)

Football players wore pink gloves; the White House was lit up in pink light, as were the walls in Jerusalem. Yogurt lids were pink, and just about everything else you could imagine was pink.

But breast cancer is still here.

A cousin's sister was recently diagnosed with breast cancer. A friend who is a breast cancer survivor recently experienced a scare when a breast MRI showed something, leading to ultrasound and biopsy. Turned out to be only scar tissue, but scared my friend to death. RivkA, of Coffee and Chemo, died a few days ago. She lived with breast cancer for 5 years. 1,000 people attended her funeral in Israel.

Meanwhile, today is election day, and the politicians continue to be jerks. There is no intelligent discourse. Just sound bites and accusations and yelling.

It seems like more attention in general is being paid to the connections between breast cancer and the environment, but I'm not sure if anything substantive is being done.

There is legislation -- for example, the Toxic Chemicals Safety Act of 2010 -- which basically just asks companies to test their chemicals before releasing them into the world. Although I just read that this act is dead now. Too bad, maybe next year.

This time of year makes me feel a little sad. I'm still sad that the summer is over (!) and I still haven't accepted that winter is coming. Not my favorite time of year, although it has been a pretty fall.

P.S. Damn! I just realized that November is NaBloPoMo! (national blog posting month) I'm supposed to be doing a post a day! Argh!

Friends in cyberspace

2010-10-29T09:00:00.001-04:00

The internet is a funny place. Some of the relationships you have are with people you actually know in real life, and some are with people you only know in cyberspace. Sometimes you get to know people pretty well in cyberspace, especially if they write frequently in their blog. And sometimes, people you know only from cyberspace die. And it is really, really sad, even though you have never actually met them in person.

RivkA was one of those people.

I follow a number of "Jewish" blogs of various types, and one of them is called A Mother In Israel. When that blogger read about my struggles with breast cancer, she connected me with RivkA. I've been reading her blog for several years now, and was always amazed at her energy and ability to live fully in each moment, even while dealing with her serious and ultimately, fatal breast cancer.

An example of that is a post here from her blog from just a month ago:

Last week, for the first time, I had such a difficult time teaching swimming that I wondered if I would be able to continue. Given how weak I felt, I did not know until this morning if I would be up for teaching today. Even if I could manage to teach, I worried that it would take everything out of me and leave me like a rag again.

In the end, I felt OK, so I decided to teach, and I am so glad!

I had amazing classes!!

My beginners all accomplished a new step forward and we were all so excited!

My advanced swimmers worked hard and had a very productive lesson as well.

Of course I felt tired afterwards, but I also felt great!

I love teaching and days like today make all the efforts worthwhile!!

RivkA leaves a husband and 3 teen-aged children. Breast cancer is not fair. Some people do fine, and others die.

I remember when I first started reading RivkA's blog, in spite of her optimism, I realized that this brave person would likely not make it. Her cancer was spreading. She had some time, but not a lifetime.

Hearing of her death makes me renew my commitment to work to end this disease. To figure out how to prevent breast cancer before it begins, so other families will not have to suffer the way RivkA's family surely is.

May her memory be for a blessing.

Confusing

2010-10-18T13:20:00.003-04:00

As much as I'm all for understanding environmental exposures and their connections to breast cancer and other cancers (and other diseases), I'm not entirely comfortable with the idea that we personally can avoid this and that product, and somehow save ourselves and our family from cancer. I just don't buy it.

My feeling is that the chemicals that are causing the problem are so ubiquitous that we really can't avoid them. These chemicals are in the soil and water, in our homes, and even in our bodies (even the President's Cancer Panel Report admits that "babies are born pre-polluted"). I don't think that making small changes in our lifestyles will really make a difference. But others feel differently. They feel that by eating organic food, avoiding microwaving in plastic, using natural cosmetics, etc., that they are at least doing something.

So I received this email today:

Dear Adena,
What's orange, yellow, and pink all over? The month of October! Fall's here with orange pumpkins, yellow leaves-- and the "think pink" campaign of Breast Cancer Awareness Month. Everything is adorned with pink ribbons, from yogurt cups to NFL football helmets. But our friends at the Breast Cancer Fund know that it's not enough to just be aware of breast cancer. We need to start preventing this disease and protect our families from cancer!

Please join MomsRising and the Breast Cancer Fund for a free and important webinar briefing to learn about practical ways to protect your family from cancer causing toxins. We’ll talk about how parents can make safer purchases and choices for their families and participate in a larger movement to protect children from toxic exposures.

This hour-long, web-based presentation, based on the Breast Cancer Fund’s report "2010 State of the Evidence: The Connection between Breast Cancer and the Environment," will emphasize the newest science connecting exposure to unsafe chemicals and radiation to increased risk of breast cancer. This important report catalogues the growing evidence linking breast cancer to, among other factors, synthetic hormones in cosmetics and meat; pesticides in food; solvents in household cleaning products; BPA in food containers; flame retardants in furniture; and radiation from medical treatments. We know exposures early in life are linked to breast cancer later in life and other health concerns, which means it’s especially important to protect children from environmental chemicals and radiation.

See what I mean? I agree with them up to a point, but then, I don't agree with the idea that we have the ability to "protect our children from environmental chemicals and radiation." I just don't think we are that powerful. I think much bigger changes -- in manufacturing practices, in lawn care practices, and so on -- will be needed to really change things. Sorry, I don't mean to be a downer, but that's how I feel.

On breast cancer

2010-10-01T14:05:00.003-04:00

Well, it's October 1st. It's national "pay attention to breast cancer" month. I'm not really happy with the pink nausea, everyone telling you to buy this yogurt or that pair of jeans and the company will donate 10 cents to this fund or that fund... But, regardless of my feelings, here we are.

Here are some things that I feel are important:

There is strong, growing scientific evidence that the cause of breast cancer is environmental, i.e. chemicals in our food, water, air, and soil. You can see some of this evidence in the Breast Cancer Fund's report The State of the Evidence 2010. Another important source of information is the President's Cancer Panel's recent report, Reducing Environmental Cancer Risk: What We Can Do Now. Also, be sure to read the Silent Spring Institute's fact sheet on breast cancer and the environment. The point is to figure out how to prevent breast cancer before it begins. Mammograms can (sometimes) find breast cancer once it's already there - improved treatments are great for those who are already diagnosed - we want to prevent breast cancer before it even starts!

The Love/Avon Army of Women is a wonderful group put together by Dr. Susan Love, a leader in the breast cancer arena. The "army" is aiming to recruit 1 million American women who are available to take part in numerous research studies, with the goal of preventing breast cancer. You can easily join the Army of Women by clicking here.

Another wonderful organization, if you are local to Massachusetts (or even if you are not) is the Massachusetts Breast Cancer Coalition (MBCC). I recently joined the board of this organization, which is dedicated to challenging all obstacles to the eradication of breast cancer... and believes that compelling research exists linking environmental toxins to the dramatic rise in breast cancer incidence over the past several decades. The MBCC started an amazing research organization called the Silent Spring Institute, which does research on the links between the environment and breast cancer. Currently, the MBCC does education and outreach to spread the word about breast cancer/environment links. You can read more about their work here.

There are a few other great organizations worth mentioning. These include Breast Cancer Action, an agency on the West Coast that challenges assumptions about breast cancer, and which created ThinkBeforeYouPink. There is also the National Breast Cancer Coalition that has just set a 10-year "deadline" to end breast cancer, and which has an interesting white paper laying out the reality of the situation: Despite years of campaigns to raise awareness, ever expanding screening programs, and increased fund raising and research, breast cancer incidence has increased and mortality has not changed dramatically. It is time for a radically new approach.

For breast cancer information, BreastCancer.org is a wonderful resource, and the discussion boards there are particularly amazing and supportive. For people under 40 with cancer, I2Y (the I'm Too Young for This Cancer Foundation) is fantastic, and they have a weekly radio show/podcast called The Stupid Cancer Show, which I love. I also love anyone who writes truthfully and irreverently about breast cancer. For example, author Barbara Ehrenreich has a great post entitled Not So Pretty in Pink.

The bottom line is, women are still dying from breast cancer. It's not okay. I follow the blogs of women whose breast cancers are not going away, such as Coffee and Chemo, and Mothers With Cancer. These women are just trying to live their lives as mothers, wives, friends, workers, people, and they have to battle cancer as well. This is not okay.

We can do something. Click on the links. Learn more about the environmental causes of breast cancer. Join the Army of Women. Give to some of these fine organizations. Do something. Don't give up. And don't give in to the pink.

The story of a man

2010-09-28T09:11:00.002-04:00

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.

Fine.

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.

Turning pink

2010-09-27T15:25:00.002-04:00

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.

Making nothing into something

2010-09-17T08:38:00.006-04:00

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?

Ridiculous.

Puberty, pimples and cups

2010-09-15T09:45:00.001-04:00

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....

Babies who lunch

2010-09-02T14:46:00.005-04:00

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.

Restoring honor

2010-08-31T10:25:00.006-04:00

One of my pet peeves is when people who are supposed to be reporting the news decide to make their own news. This phenomenon -- which is happening more and more these days -- drives me CRAZY. It goes against all the principles of good journalism.

So this whole Glenn Beck thing -- "Restoring Honor," I believe the rally was called -- is driving me crazy. Glenn Beck is a conservative commentator. He makes money by stirring people up. He is also rich. According to a piece in the New York Daily News,

Between his gig at Fox News, authoring best-selling books, and hosting a radio show and GlennBeck.com, Beck pulls in $35 million a year, according to Forbes, which puts him 43rd on its Celebrity 100 power ranking list.

See, the thing is, I think that, with the election of Obama, we already restored honor to America. We now have a president who is intelligent and thoughtful. The world community respects us more. He is working, slowly, surely, at solving all the problems we having in this country. It takes time to solve problems. Beck and those of his ilk are into stirring people up and making them angry. This is not useful! Also, we certainly don't need more religion mixing into politics, as Beck is proposing.

I feel that politics these days have become very confusing. Even if you are trying to do something good, someone on the other side just talks about it and disparages it and makes it bad. Everyone's memory is short. No one wants to remember that much of the trouble we are in right now (economic, etc.) is due to policies of the Republicans. Somehow, everyone wants to blame Obama.

The whole thing just makes me feel sad, and discouraged. We started out with so much hope. And now...

P.S. Maureen Dowd from the NYTimes also wrote (very eloquently) on this theme. Take a look.

Rosh Hashanah in video

2010-08-28T16:23:00.002-04:00

The first, an interesting take on the story of "the binding of Isaac":

The second, just for fun:

Eleven!

2010-08-19T13:38:00.004-04:00

Happy Birthday, J-Man! (this is not our dog, by the way)

High Holiday Wandering

2010-08-18T15:30:00.000-04:00

My earliest high holiday memory involves big white tents. No, I wasn't actually wandering in the desert during the Exodus. It was the '60s, and Temple Reyim in Newton was under construction, so services took place outside the synagogue, in tents.

The next high holiday memory I have is on the steps at Temple Emanuel in Newton. Emanuel's community was so large during the '70s that there were two sets of services: an early morning service in both the sanctuary and the social hall, and then a late-morning-early-afternoon service in both locations. But what was most fun was when the early-morning service let out and the late-morning people were arriving, and the two sets of people would crowd onto Ward Street and meet on the steps of the synagogue. This was a great place to meet friends, eye cute boys, and generally see what the community was up to.

My family then moved to Florida, and I remember several high holidays spent in giant theaters. The rabbi was very very very far away. I guess we were in the nose-bleed seats.

Then came the wandering years. In college, I went to services at various Hillels in Boston, Ohio, and Pennsylvania. The service that impressed me the most was a creative service at Brandeis University that featured a cello playing Kol Nidre. It was extremely powerful and moving.

When I moved back to Boston after grad school, I still wandered for a while. I remember going to a family member's shul where I was horrified to discover that I was supposed to bring my own machzor. I'd never heard of such a thing! How was I supposed to pray without a machzor?

Next came Boston's Young Adult High Holiday services. This was the first time I encountered anything that could be considered "creative" in a religious service. The services were developed by young(ish) rabbis and young adults from the community, so they tended to include meditations, guided visualizations, discussion, etc. This is also around the time I met my husband, so I have fond memories of the Young Adult High Holiday scene.

After our son was born, our high holiday wandering took on a new question: what do we do with a baby during those long, long services? We continued to attend the Young Adult High Holiday services for a few years, and I remember nursing my son in the women's room during his first high holiday season. When he was two (or possibly three), we signed him up for babysitting and he surprised us by allowing us to leave him for a few hours to join the adult service. By the time he was four, we had joined our current temple, and over the years we've attended a variety of babysitting groups, pre-schooler services, and school-age services there with him.

Which brings us to today.

I guess you could say that we've stopped our physical wandering, but I feel that spiritually, I am still looking for my high holiday home. I find high holiday services to be kind of nerve-wracking. From the insane parking, to the crowds of people, to making sure my son gets to his service on time, to finding a seat in the crowded sanctuary, and then trying to stop and relax and pray and connect...it's all really quite too much. But maybe this year will be different. I can always hope.

It's just not right

2010-08-17T14:22:00.004-04:00

I often take a walk around the block at work to clear my head. It takes about 10 or 15 minutes, maybe a bit longer. I listen to my iPod, stretch my legs, get a little exercise. It's all good.

Yesterday, I noticed a snazzy little logo that I hadn't seen before on a building that I passed. Health Talker. It sounded kind of interesting, so I decided to look it up when I got back to my desk.

So it turns out that Health Talker is part of something called "word of mouth marketing." Basically, working for the pharmaceutical industry, they encourage patients who use a particular medication to tell others about this medication, using social media networks. The goal of this is for the pharmaceutical industry to sell more drugs. From what I can see on the website, Health Talker does not appear to pay the patients for providing this service. So the drug companies are getting free advertising.

Here's what they do in their own words:

Our innovative word of mouth (WOM) marketing programs mobilize patients and caregivers to spread the word. We help you build greater brand loyalty and grow your market share, one conversation at a time.

Am I naive to be horrified by this? I'm all for social media. I love it. I use it. I've found wonderful support on the discussion boards of a great website called Breastcancer.org. But the thought that drug companies are somehow using the information that people are discussing online in order to better market their products...ugh.

There's even an organization, WOMMA, the Word of Mouth Marketing Association, that supposedly has "ethical standards" for this type of work. Unbelievable.

Any thoughts out there on this topic? Any marketing or advertising folks care to chime in? I remain stunned. I'll just sit here quietly.

Tomatoes + Summer = Love

2010-08-16T19:25:00.005-04:00

It's tomato time in the garden and on the farm, and I've been making some amazing things with these tasty little red orbs.

Here are some of my recent favorites:

Moosewood Gazpacho (still, and always, my favorite)

Panzanella (Italian Bread Salad) - this isn't the exact recipe that I'm using, but it's close enough

Bruschetta

and my new favorite, Pan Bagnat (a yummy, spicy, drippy sandwich - great with a side of gazpacho)

The only downside to all this tomato-y goodness is that soon all the fresh tomatoes will be gone, and we'll be back to the yucky, tasteless store-bought ones for another year... so sad...

Pokemon!

2010-08-13T10:45:00.005-04:00

We are way beyond the Pokemon phase, but J's group at day camp did a fantastic rendition of the Pokemon Theme Song in the all-important lip sync contest, so I'm going to post it here for everyone to see...

If that doesn't work for you, click here for the link.

Gotta catch 'em all!

Ready or not...Rosh Hashanah is coming!

2010-08-11T17:08:00.003-04:00

Today is not only Rosh Chodesh Elul (the celebration of the new month of Elul), the month leading up to Rosh Hashanah and the rest of the High Holidays. It is also the first day of Ramadan, a month of daytime fasting, prayer, and reflection in the Islamic tradition. I wonder how often these two holy periods align?

I've heard that the Hebrew letters of Elul (aleph, lamed, vav, lamed) can be thought of as representing the words "ani l'dodi v'dodi li" - I am my beloved's, and my beloved is mine - standing for the relationship between G-d and Israel.

Whether you buy that or not, Elul is a time for reflection and "warming up" to the High Holidays. It is difficult here in the U.S., where summer (for many) is still in full swing, and there are only hints of fall and school days to come. But like it or not, Rosh Hashanah is coming very early this year, and on Wednesday night September 8th, Rosh Hashanah will be here.

I just found something to help me get into the mood, if you will, for the High Holidays, and I'm going to share it with you. It's called Jewels of Elul, and it's something new to think about each day for the 29 days of Elul.

The creator of this idea, Craig Taubman (who is also a musician), says:

"There is a great Jewish tradition to dedicate the 29 days in the month of Elul to study and prepare for the coming high holy days. The time is supposed to challenge us to use each day as an opportunity for growth and discovery.
While conceptually the notion is noble, it was clear that acting on it was a bit more challenging. Enter . . . Jewels of Elul. For the past six years I have collected short stories, anecdotes and introspections from some fascinating people."

To sign up, click here, and a Jewel will be sent to your e-mail in-box each day. I think it's a great idea!

Incidentaloma - Part 2

2010-07-28T19:49:00.008-04:00

I'm back in this room again in the hospital: the waiting room for mammograms and related breast things. I was here the day I found out I likely had breast cancer, and I was here 6 months ago for my first mammogram since my surgery. Today, I'm here for a breast ultrasound.

The women still sit in their incongruous blue pajama-like gowns. The TV blares. The women read, fill out forms attached to clipboards, stare off into space. There are still no keys to lock the clothes cubbies. The magazines are still out of date.

Someone calls my name. Surprise! I'm getting a mammogram, too. The tech is kind, but it hurts. At least she doesn't pretend that it doesn't hurt like some of the techs; I appreciate her honesty.

After more waiting, a different woman calls me in for the ultrasound. The ultrasound tech tells me that she loves her job. She uses warmed gel on my breast; she covers me with a blanket. She points out muscle, fat, and milk ducts in my breast. Fascinating. My breasts are dense, she says. What do non-dense breasts look like? I ask. "They are clear, like a clear day; yours are cloudy," she replies. I always wonder if I should apologize for having dense breasts.

The radiologist is young, Asian, very friendly, and handsome. He explains things well. Nothing untoward found today. Come back in 6 months for more. Any questions?

Now I have an hour to wait until my liver ultrasound. They don't do livers here in the breast clinic, so I have to go someplace else. I'm hungry because I'm not supposed to eat before the liver ultrasound. The coffee at Starbucks smells amazing...Everyone is eating lunch.

I walk over to the other Radiology department. They are able to take me a bit early. This technician is younger, chewing gum. I don't have to take anything off or put anything on. She just rolls up my shirt, and squirts more warm gel on my belly. She says "take a deep breath, hold it" and then "okay, you can breathe." She says this about 30 times. She takes a lot of pictures. She tells me about the liver. It is quite large, and has a lot of lobes. "What are you looking for?" I ask, trying to engage her. "The two lesions they found on the MRI," she says bluntly. Oh, yeah.

When she is done, she goes off to talk to the radiologist. I wipe the goo off my belly. Soon, she returns. Everything is benign, she says. The two lesions are hemangiomas, and there was another one she found that is just a cyst.

Well, okay.

I call A to tell him that everything is fine, and go off to find myself some lunch. I'm tired, hungry, frustrated to have to go through all this, but relieved that the news is good. Now, onto the rest of the day.

Today's agenda

2010-07-28T09:17:00.003-04:00

Let's see, what's on for today:

drop of J at basketball camp
take recyclables to the dump
do laundry
wash floors
go to hospital for ultrasound of left breast and liver
go grocery shopping
pick up J from basketball camp
make dinner

Sounds like a fun day, doesn't it?

Sometimes Judaism drives me crazy

2010-07-17T20:43:00.005-04:00

This morning, I was driving to our Conservative Egalitarian shul. I was giving the d'var torah (congregants give the d'var in the summer when the rabbi is away), and also helping to set up the kiddush (the Sisterhood sets up the kiddush in the summer as well). From the sublime to the mundane, I know.

So on the way, I passed a group of about ten young Chassidic-looking men, walking along the road, looking very hot and tired. Hmm, I thought, why is a group of ten Chassidic men walking through our town? It's just not a common occurrence.

I thought about it a bit, and realized that they were probably walking to the Chabad House in our town for Shabbat services.

Then I thought about it a little more, and realized that they walked right past our shul on their way. Did they even notice it? And if they had, would they have even considered praying there? I think not. You see, our Conservative Egalitarian shul would not meet their standards. We don't have a mechitza. We allow women to participate fully in services, to have aliyot, to read Torah. So no, they would not have felt comfortable at our services.

And that makes me very uncomfortable.

So then I get to shul, and I go into the kitchen, and of course the lights aren't on, so I have to turn on the lights in the kitchen, and in the social hall, which I'm sure you aren't supposed to do on Shabbat, but did I have a choice? And then K and I started pulling things out of the freezer and putting table clothes on tables, and pouring wine and juice, and cutting things up and putting things out...And the question is, we aren't supposed to be working on Shabbat, but how come it's okay for us to be doing all this work to set up the kiddush?

It just drives me crazy. The hypocrisy. The contradictions.

But in the end, the d'var went well, the service was fine, the kiddush was tasty, and a good time was had by all. Even the Chassidic men probably made it to the Chabad house and were happy. Just another Shabbat in our little town.

Incidentaloma

2010-07-14T17:32:00.003-04:00

There is a new terminology out there -- incidentalomas -- for things that are discovered accidentally during a test for something else. I've actually read two articles recently about them: here is one by Kevin MD, and here is one from the NYTimes.

The problem with incidentalomas is that sometimes you find something important, say a malignant tumor, and save someone's life, but often -- very often -- you find something that you would never had found and which would never have impacted that person's life. But now that you know about it... you have to find out more, and make sure it's nothing. So you test more. You scan. You biopsy. You may even do surgery.

And to what end?

So...guess what? My breast MRI found an incidentaloma. Actually, two. There are some "lesions" on my liver (which -- I had to check an anatomy chart -- is located just below my breast, so I guess that's why the liver was even in the picture). Also, there is an "area of non-mass-like enhancement " in my left breast. They want to do ultrasounds of my liver and my left breast "just to be sure" or, in medical speak, "for further characterization."

Great.

I spoke to several people yesterday, and everyone agreed that MRIs are very sensitive, and often pick up things that aren't anything important. Everyone said "don't worry." So I'm trying not to worry.

But the larger problem, as these two articles point out, is that finding and characterizing incidentalomas can cause well people to become, well, sick people. The NYTime article's author, Dr. Peter Libby, had this to say about it:

"Yet all invasive procedures entail some risk. If only a small fraction of the procedures occasioned by incidental findings lead to a complication, the overall burden of disease unwittingly induced by investigation may be substantial. In many cases, the “incidentaloma” proves benign, or is better left untreated. Thus, the unintended consequences of screening by imaging can make a well person ill."

I am hoping that I am not one of those people.

Don't chew on your mama's tefillin

2010-07-09T10:00:00.001-04:00

I've always loved this poem by Merle Feld, We All Stood Together, and how it describes what the experience of standing at Sinai may have felt to the women there. Especially compared to the men's experience.

We All Stood Together
-by Merle Feld

My brother and I were at Sinai
He kept a journal
of what he saw
of what he heard
of what it all meant to him

I wish I had such a record
of what happened to me there
It seems like every time I want to write
I can’t
I’m always holding a baby
one of my own
or one for a friend
always holding a baby
so my hands are never free
to write things down

And then
As time passes
the particulars
the hard data
the who what when where why
slip away from me
and all I'm left with is
the feeling

But feelings are just sounds
The vowel barking of a mute
my brother is so sure of what he heard
after all he's got a record of it
consonant after consonant after consonant

If we remembered it together
we could recreate holy time
sparks flying

Times have changed...but they haven't. Judaism -- or some strands of Judaism -- are more inclusive of women, but there are still those pesky verses of the bible or of prayers that, even with interpretation, are hard to swallow. That's why I was thrilled that Rachel Barenblat -- the Velveteen Rabbi - wrote a poem that is what I consider to be a corrective to Feld's piece. Read, and enjoy.

Another mother psalm: bringing the baby to morning prayer

MOTHER PSALM 7

-by Rachel Barenblat

Don't chew on your mama's tefillin
I say, dislodging the leather
from your damp and eager grasp.
We play peekaboo beneath my tallit,
hiding your face and revealing it
the way God is sometimes present
sometimes not. You like the drums,
the fiddle and clarinet.
You bang your rattle on the floor.
As we sing "Praise God,
all you elders and young children"
you bellow and and we laugh.
During silent prayer your yearning
opens my floodgates.
When the Torah is carried around
I waltz you in my arms, my own scroll.
All my prayers are written
in your open face.

(click here to link back to Barenblat's blog)

Breast MRI fun at the hospital

2010-07-07T16:04:00.009-04:00

You are confronted with a large tube-shaped machine and a flat cot-like table. On the table are two pillows, and a few other strange contraptions.

"There is no graceful way to do this," admits the technician. She indicates that you should climb onto the table.

"Your breasts go here, and your face goes here."

Say what?

You are lying face down on the table, with your face in one opening, and your breasts hanging into another. The tech puts a pillow under your knees and tries to make you comfortable.

"What do I do with my arms?" you ask.

"They go over your head." Great. My favorite position.

"Here are some earplugs," says the tech. "The machine can be noisy."

Uh...okay.

Noisy doesn't begin to describe it. But I'm getting ahead of myself here.

You feel your body moving (on the table) and you feel wind rushing around you. You are afraid to look up. You sense that you are inside the tube.

"Okay, the first session will be 2 minutes," says the tech.

The machine starts to make clicking noises. Then noises like machine gun fire. It is LOUD. You start to recite prayers to get your mind off the noise.

Deep breaths. Uh, oh...didn't she say no deep breaths? Shallow breaths....

Time passes. Every few minutes the tech announces another interval. "This one will take 6 minutes. This one, 3 minutes." You start to lose track of time. You lose the feeling in your arms. You can't feel your hands. Shallow breaths...

Finally, it's over. How much time has passed? Will I ever feel my arms again? And what will the results show? She says I'll hear from my doctor in 24-48 hours. Great! Can't wait.

P.S. This will help you understand what the MRI sounds like.

Cancer prevention tips from EWG

2010-06-24T11:28:00.004-04:00

The Environmental Working Group works to "expose threats to your health and the environment, and to find solutions." I don't agree with everything that comes out of the EWG (more on that at a later date), but much of what comes from them is useful.

You may recall a few months ago I received an email from the American Cancer Society about cancer "prevention" that angered me. I received a similar email today from EWG, but this one is much more useful. Here's what it said:

Dear Adena,
You may have heard that the President's Cancer Panel issued a landmark report last month suggesting that public health officials have "grossly underestimated" the extent of environmentally-induced cancer among the in 1.5 million Americans diagnosed with the disease annually.
While we were not surprised by this high-level acknowledgment of the environmental connection to cancer, we know that hearing news like this can raise questions. So we put together nine practical tips for consumers like you to reduce the risk of environmental cancer. They're easy and could make a difference.

So here are the tips. Or you could read the original article here. What I like about EWG's tips vs. ACS's tips is that EWG's have to do with actively avoiding things in the environment that can cause cancer. I feel strongly, however, that we can't avoid everything that causes cancer because these substances are already in the air, water, and earth, but perhaps some of these things are in our control.

1. Filter your tap water. Common carcinogens in tap water include arsenic, chromium, and chemical byproducts that form when water is disinfected. A simple carbon tap-mounted filter or pitcher can help reduce the levels of some of these contaminants. If your water is polluted with arsenic or chromium, a reverse osmosis filter will help. Learn about your tap water and home water filters at EWG's National Tap Water Database.

2. Seal outdoor wooden decks and play sets. Those built before 2005 are likely coated with an arsenic pesticide that can stick to hands and clothing. Learn more from EWG.

3. Cut down on stain- and grease-proofing chemicals. "Fluorochemicals" related to Teflon and Scotchgard are used in stain repellants on carpets and couches and in greaseproof coatings for packaged and fast foods. To avoid them, avoid greasy packaged foods and say no to optional stain treatments in the home. Download EWG's Guide to PFCs.

4. Stay safe in the sun. More than one million cases of skin cancer are diagnosed in the United States each year. To protect your skin from the sun's cancer-causing ultraviolet (UV) radiation, seek shade, wear protective clothing and use a safe and effective sunscreen from EWG's sunscreen database.

5. Cut down on fatty meat and high-fat dairy products. Long-lasting cancer-causing pollutants like dioxins and PCBs accumulate in the food chain and concentrate in animal fat.

6. Eat EWG's Clean 15. Many pesticides have been linked to cancer. Eating from EWG's Clean 15 list of the least contaminated fruits and vegetables will help cut your pesticide exposures. (And for EWG's Dirty Dozen, buy organic.) Learn more at EWG's Shopper's Guide to Pesticides.

7. Cut your exposures to BPA. Bisphenol A (BPA) is a synthetic estrogen found in some hard plastic water bottles, canned infant formula, and canned foods. Some of these chemicals cause cancer in lab studies. To avoid them, eat fewer canned foods, breast feed your baby or use powdered formula, and choose water bottles free of BPA. Get EWG's tips to avoid it.
8. Avoid carcinogens in cosmetics. Use EWG's Skin Deep cosmetic database to find products free of chemicals known or suspected to cause cancer. When you're shopping, don't buy products that list ingredients with "PEG" or "-eth" in their name.
9. Read the warnings. Some products list warnings of cancer risks -- read the label before you buy. Californians will see a "Proposition 65" warning label on products that contain chemicals the state has identified as cancer-causing.

Rachael, and Michelle

2010-06-14T20:28:00.006-04:00

I've been a fan of Rachael Ray's for years, and now I love her even more. She is working on a great new initiative with Michelle (Obama, that is), to involve chefs with schools to encourage healthier eating for kids. Here is the article, and the video is below. So cool!

Fourth grade poetry festival

2010-06-10T21:00:00.000-04:00

J's fourth grade class had a poetry festival today. Each child read an original poem that they had created during the year, and then, classmates commented on each poem. The child's parent or parents had a chance to make a comment, and then the teacher commented. It was incredibly touching. There was something about the kids making supportive, insightful comments about each poem, and then the teacher doing the same, and praising each child for his or her growth this year...it was really moving.

Some of the poems were funny, some were sad, most were very descriptive and surprisingly emotional. It is such a different side to these kids who we usually see being silly and running around.

They are growing up.

They also each recited a poem that they had memorized. Most of these were funny poems, and they used props. Here is J reciting the poem Toucan Tour Guide by Deborah Ruddell. The words follow, in case you can't understand him.

I was touring Peru in a silver canoe
And my guide was a toucan named Zeke
A talkative fellow with splashes of yellow
And green on his eye-catching beak

The river was cold, the sunlight was gold,
We were feeling as free as could be
When something I said made Zeke turn his head
And the tip of his beak hit a tree

So we stopped for the night at a vine-covered site
And Zeke made a fire by our tent
I tried not to peek at his curious beak
But to tell you the truth it was bent.

Makes me laugh every time!

Weather man

2010-05-27T10:55:00.004-04:00

J and I discussed the weather this morning on the brief ride to school. Yesterday my car thermometer read 105 steaming degrees at one point, and this morning it was at a cool 60.

J stated that he loves it when it's about 70 or 75 degrees. I agreed.

"Wouldn't it be neat if we could just order the weather we wanted?" I asked.

J thought about this for a moment, and then started making up his own prayer -- in Hebrew -- asking G-d for nice weather.

Sometimes he amazes me.

Random thoughts

2010-05-25T09:37:00.007-04:00

There are a number of thoughts rolling around in my head (think, marbles...or bowling balls) so I thought I'd write about them here.

In local news, Paul Levy, the CEO of BIDMC (whose blog Running A Hospital is in my blog-roll) had an "inappropriate" relationship with a younger woman whom he "mentored" for many years. This has been written about in the media ad nauseum, but I am not satisfied. Did he actually have an affair with her, or not? Somehow, I need to know this before I can really judge the situation. Does anyone else feel that way?

The warm weather has definitely put me in better spirits. I'm starting to wonder if New England weather isn't all that it's cracked up to be...

Not being nauseous has definitely put me in better spirits, too. Ditto for no more hot flashes. I almost feel normal again.

Since writing on this blog, I haven't been doing as much other writing. Is the blog sucking away my writing energy? If I ever want to get something published (in Brain, Child magazine, for example), I'm going to have to start writing again, for real...

Still haven't decided about Ritual committee and what I should do. Should I continue my involvement, and feel frustrated? Should I end my involvement? Should I send A in my stead and see if he can have any impact on them (he has offered to do so)? Argh.

This time of year always reminds me of when we first brought J to daycare at (what used to be) Gan Yeladim. There is some plant that gives off white fluffy stuff that blows around near Gan and near J's school (which is right near Gan) and it was doing it NINE years ago when we first brought him there, and it's doing it now...

J is still a very intense kid. Just the way he was nine years ago. Or, almost 11 years ago...

This time of year is always a bit bittersweet. The end of another school year, the beginning of summer. J, on the other hand, is very ready to be done with school. I think the entire school year has just interfered with his sports activities. He is ready to close the door... Also he is very excited about summer camp. He loves camp.

I guess that's it for now. Maybe more later...

Pushing for prevention

2010-05-17T14:54:00.004-04:00

In today's Boston Globe :

Q. What is needed now in breast cancer research?

A. There needs to be an open dialogue between researchers and public policy makers and women with breast cancer on how research dollars are spent. Every day our congressmen make decisions about our care. Right now they are the biggest funder of breast cancer research. We should have a say in how those dollars are spent.

Q. Where do you think the focus should be?

A. Looking at ways to prevent breast cancer, where we tap into the Silent Spring model of an environmental connection to breast cancer, is an urgent need right now. A big example is the whole idea of exposure to toxins, to poisons that act like estrogen in our body. The problem is that industry is allowed to put bad things into our environment that could be harmful, with very little data before they expose individuals to the poison. It should be reversed. It shouldn’t be up to consumers to prove damage. It should be investigated first before it’s put into our environment.

Q. Your organization doesn’t do walks or promote pink ribbons.

A. The work we do is different. I get tired of hearing about “breast cancer awareness.’’ We’ve been hearing about breast cancer awareness ever since I can remember. What the heck has it gotten us?

You can read the full article here. I am so excited about how this topic -- the connections between the environment and breast cancer -- is making its way into the news almost daily!

P.S. Just had to add this article about possible connections between pesticides and ADHD. Also very important!

Dandelions or not?

2010-05-13T14:13:00.001-04:00

The dandelions are growing fiercely this year in my town, and there is a striking difference between the well-manicured lawns of those using a lawn service (and chemicals to kill the weeds) and those who choose to do their own (haphazard) lawn service (without chemicals). As I walk around the neighborhood, it's easy to see who has chosen to use herbicides on their lawn and who haven't. The long arms of the dandelions tell the tale.

This year, the well-manicured lawns are making me sad. Don't their owners realize that the herbicides can poison their children, themselves: all of us?

Sandra Steingraber's weekly essay is about this very topic, so I'm re-posting it here. Or you can read it on Steingraber's website.

Canadian Bylaws; American Lawn Flags - May 11, 2010

DDT is now so universally used that in most minds
the product takes on the harmless aspect of the familiar.

~ Rachel Carson, Silent Spring

Harmless aspect of the familiar was the phrase that leapt into my mind when I watched a scantily clad woman—the day was hot and sunny—lie down in a green sward of grass in front of the Women’s Center on the campus of DePauw University in Indiana. Next to her waved a small yellow flag that warned passers-by to keep off the grass as it had just been sprayed with pesticides.

I guess the word irony might also have applied. On the other side of the flag, a card table was piled high with copies of my book, Living Downstream, which, among other topics, discusses the dangers of lawn chemicals. The books were for sale. I was positioned up on the porch, encouraged by my faculty host to chat with students, drink punch, and sign books as part of an informal reception before my all-campus Earth Day lecture.

Yes, I intervened. The reclining woman seemed bewildered by my concern for her, pointing out that the yellow flags are so ubiquitous that no one notices them. She reluctantly promised to shower and launder her clothes before attending the evening’s lecture.

No flags wave from the lawns in many parts of Canada. Ontario, Québec, New Brunswick, and Prince Edward Island—and many cities across the rest of the nation—have expressly outlawed the cosmetic use of pesticides. Within these provinces and municipalities, the use of synthetic pesticides to improve the appearance of lawns and, in some places, gardens is now illegal.

Indeed, Earth Day 2009—one year ago—was the deadline for hardware and garden stores across Ontario to remove approximately 250 chemical bug and weed killers from their shelves. Beginning on that ceremonial day, as part of a commitment to decrease toxic exposures to chemicals linked to cancer, residents of Ontario could no longer use pesticides on lawns and gardens, and stores could not sell them.

And just how are the organically managed lawns of Canada faring? During my last visit to Toronto, I can’t say I noticed any barren, grub-infested yards or playgrounds abandoned to thistles—my grandfather the farmer called them Canada thistles for a reason, right?—and I’m happy to report that all the French-style gardens still looked lovely.

What I did notice is that the legislation outlawing lawn chemicals has become familiar enough to Torontonians to merit an offhand mention in the complimentary magazine in my hotel room. This lushly illustrated guidebook not only trumpeted the city’s best restaurants and hottest nightclubs, it also welcomed visitors with the following reassurance:

All green spaces are pesticide-free. In 2004, Toronto became the largest municipality in the world to ban cosmetic use of lawn and garden pesticides. The Sierra Club of Canada reports a clear link between pesticide use and breast cancer; many other studies have shown the dangers to children from chemical exposure to pesticides.

That is precisely the worrisome body of evidence that I review in Living Downstream. When I speak about leukemia and lawn chemicals here in the United States, people in my audiences sometimes tell me that the subject matter is too depressing for them to even contemplate. But in parts of Canada, doing something about it is a selling point for tourism.

The Canadian and U.S. governments have the same scientific evidence available to them—indeed much of the data on children’s exposure to pesticides and its possible contribution to pediatric brain tumors were generated on this side of the border. So why have so many jurisdictions in one nation chosen, as a response to that data, abolition of cosmetic pesticides while jurisdictions in the other rely on dinky yellow flags?

In Canada, the ban on nonessential uses of pesticides began with old-fashioned citizen activism in the small village of Hudson in Québec. (This story is documented in the documentary film A Chemical Reaction.) Upheld by the Supreme Court of Canada, that city’s ban was replicated in other communities. Such bans are supported by the Canadian Cancer Society (a counterpart of our American Cancer Society) and by the Ontario College of Family Physicians. Research partially funded by the OCFP concluded, in 2007, that the weight of the evidence indicates a “positive relationship between exposure to pesticides and the development of some cancers, particularly in children. ...The authors of the research recommend that exposures to all pesticides be reduced.”

Benefit of the doubt goes to children, not to chemicals.

By contrast, federal agencies, mainstream cancer charities, and physicians’ organizations south of the border have been more circumspect about the role of involuntary exposures to inherently toxic substances in creating health threats. Why the demurral? Is it because the impulse in the United States is to treat public health threats as issues of personal choice? Thus, lawn flags instead of bylaws?

I don’t know the answer here. Let’s ask. The mothers of children with leukemia can go first. (A 2009 study found higher levels of household pesticides in urine samples collected from children with leukemia and from their mothers than in the urine of mother-child pairs living in households unaffected by leukemia. Not all of the mothers of these child cancer patients used pesticides themselves. In fact, most did not.)

When it’s my turn, I’d like to pose the following query to the American Cancer Society, the National Cancer Institute, and the American Medical Association: I spent a lot of time this spring walking by yellow flags planted in the green lawns of college campuses, on my way to Earth Day lectures. When I pointed the flags out to my student escorts, most of them just shrugged. Meanwhile, to the north, 77 percent of Canadians already benefit from pesticide bans, Environment Minister Sterling Belliveau introduced a bill last week to ban the sale and use of nonessential pesticides for lawn care in Nova Scotia, and momentum grows for a province-wide ban on lawn chemicals in British Columbia. Why can't we do things like this?

Sandra Steingraber is the author of Living Downstream, newly published in second edition by Da Capo Press to coincide with the release of the documentary film adaptation. This essay is one in a weekly series by Sandra - published at www.livingdownstream.com - exploring how the environment is within us.

More on the environment and cancer

2010-05-07T08:40:00.002-04:00

Coincidentally, two articles in the NYTimes appeared right after my most recent two posts about cancer and the environment.

New Alarm Bells About Chemicals and Cancer
The President’s Cancer Panel is the Mount Everest of the medical mainstream, so it is astonishing to learn that it is poised to join ranks with the organic food movement and declare: chemicals threaten our bodies.

The cancer panel is releasing a landmark 200-page report on Thursday, warning that our lackadaisical approach to regulation may have far-reaching consequences for our health.

I’ve read an advance copy of the report (says Nicholas Krisof), and it’s an extraordinary document. It calls on America to rethink the way we confront cancer, including much more rigorous regulation of chemicals. (italics mine)

You can read the report, or parts of it, yourself here.

So of course, the very next day, here is the headline:

U.S. Panel Criticized as Overstating Cancer Risks

A dire government report on cancer risks from chemicals and other hazards in the environment has drawn criticism from the American Cancer Society, which says government experts are overstating their case. (italics mine)

I guess it's not surprising, given the American Cancer Society's stance about what causes cancer. I don't think the government's report is dire or overstates their case. But that's just me...

Living downstream

2010-05-04T14:30:00.000-04:00

There was once a village overlooking a river.
The people who lived there were very kind.
These residents, according to parable, began noticing increasing numbers of drowning people caught in the river’s swift current. And so they went to work devising ever more elaborate technologies to resuscitate them.

So preoccupied were these heroic villagers with rescue and treatment that they never thought to look upstream to see who was pushing the victims in.

This film is a walk up that river. The river of human cancer. --Sandra Steingraber

I went to an event last week to see a screening of the film Living Downstream, which is based on the book by Sandra Steingraber. Steingraber is a scientist who is making the connections between cancer and the environment, connections that I feel are critically important.

One image that sticks with me from the film is archival footage of people spraying DDT and other pesticides while children are playing nearby and even in the chemicals. It's horrifying.

Steingraber points out that after World War II, there were so many stockpiles of these chemicals left over from the war, that companies had to figure out something to do with them. So using pesticides became part of what was being marketed to American households as, basically, cleaning supplies. Take a look at these images from actual ad copy. Really horrifying.

The bottom line is, there has to be a reason for the increase in incidence of cancer over these past 40 to 50 years. There are many chemicals being used in industry, farming, etc. that haven't been tested well, and whose impacts on animals and humans are unknown. So do we continue to close our eyes and pretend that we are immune to these chemicals? Or do we face the truth, and try to do something about it?

This makes me so angry

2010-05-04T12:40:00.005-04:00

Just received this in my e-mail box:

Dear Adena,

As a valued American Cancer Society supporter, we want you to be among the first to know some very exciting news.

Today, we are launching Choose You, a new national movement that inspires women like you to put your health first to stay well and help prevent cancer. As wives, moms, professionals, and caregivers, we are all SO busy. But nearly half of all cancer deaths could be avoided if we did what we know works - live healthier lifestyles, quit/avoid smoking, and get our cancer screenings. And as the chief medical officers of our homes, we have the power to make it happen if we take the time. Taking better care of our ourselves will not only help us save lives and create more birthdays, but it'll give us more energy to take better care of our loved ones and be healthy role models for our kids.

Um...No, actually that is not the case. Living healthier lifestyles (whatever that means), quitting smoking, and getting cancer screenings isn't going to prevent us from getting cancer. This is such a bunch of bull&%$#.

I haven't even had time to finish the post I started writing last week about Living Downstream, the film based on Sandra Steingraber's book that talks about actual things that we can do to prevent cancer. I will finish that soon, and post it next.

Meanwhile....American Cancer Society...you have officially pissed me off.

A text and the pill

2010-04-27T16:48:00.006-04:00

Two interesting articles in this week's Time Magazine:

The first is about an innovative health education program to try to reach hard-to-reach pregnant moms called text4baby. Basically, the thought is that lots of low-income women don't receive prenatal care, but do receive text messages. So women are being encouraged to text "baby" to a certain number (511411) and then enter their due date. Then they receive texts geared toward the development of their baby.

You know, it's a nice use of new technology, and I'm all for technology. I have two problems with it. One, it's really generalizing and stereotyping to say that low-income women use their cell phones but don't get prenatal care. It makes them seem, well, stupid. Also, I wonder how effective random text messages can be as health education. If the text says to do something, will a woman stop and do it necessarily? Just wondering.

So I haven't seen any evaluation yet of this program. Okay, I found something about an evaluation that's currently being done. Why can't I get a cool job like this one? I'll be curious to see what the results show. Call me cynical (you are so cynical!) but having worked in health education for many years, I just don't see this having the impact that they are expecting. It's cool, but I'm not sure it's really going to work. Will women really access prenatal care, stop smoking, etc. due to these texts? We'll see...

The second article is about the Pill: yes, the Pill has been around for 50 years. Almost for as long as I've been alive (gulp). The article makes some interesting social commentary. Was it the availability of the Pill that lead to changed roles for women, dramatically shifting the social fabric of the U.S.? For example:

In later years, commentators claimed that the Pill changed everything for women. But real social change required the meeting of means and opportunity. "If there were no opportunities out there, it would just be another contraceptive but not revolutionary," argues Elaine Tyler May, author of America and the Pill: A History of Promise, Peril and Liberation. "The revolutionary potential of the Pill could never have been achieved without the opportunities that came about because of women's activism."

And here's another take on the issue by a commentator at Reproductive Health Reality Check.

Enjoy!

Let's pretend

2010-04-16T12:00:00.000-04:00

This train of thought has been spinning around in my head for the past few days, since I attended a meeting at our Temple earlier in the week. It goes something like this...

Most people who belong to our Conservative congregation--this is an educated guess, mind you, I have no hard data on this -- do not keep the Conservative-style mitzvot (Jewish laws) outside of the synagogue proper. Some of them have Kosher homes, but some of them don't, and many of them eat non-kosher outside the home. Some of them regularly (or occasionally) attend Shabbat services, but most of them do not keep Shabbat. Many of them drive on Shabbat. Some of them work and shop on Shabbat. Most of them likely use electricity on Shabbat. Lots of the kids do sports on Shabbat.

There is a kind of fiction going on. A "let's pretend". Let's pretend that people are more observant than they actually are.

So when an issue comes up, like, should we allow instruments to be played on Shabbat as part of a way to increase spirituality and connection in the Shabbat services, my issue is: who is going to be offended? The rabbi? A few congregants? Or, really, does a large portion of the congregation really not care in the least? And if there is more to be gained than there is to be lost: why not do it?

Spring!

2010-04-05T19:28:00.003-04:00

Forsythia bursts like strings of popcorn
Daffodils, happy trumpets

Children run and shout
Like convicts escaped
Throw balls
Ride bikes
Grow in the sunshine

Pink buds fold out of gray pods
Green stems rise out of muddy earth

Every year I am amazed
Again
By the miracle
That is
Spring

Health care, abortion, and fear

2010-03-24T16:39:00.001-04:00

So health care for all (or at least, health care for most) passed and was signed into law yesterday in the U.S. It's not perfect, but it's something. This take on it by Kevin M.D. is a great summary of the reality of the situation.

The thing that amazes me, though, is how abortion has suddenly become the hot-button issue in the health care debate. The Republicans -- hell, even some of the Democrats -- wanted to be extremely sure that no taxpayer money would be used to fund abortion.

Funny, no one ever asked me what I'd like my taxes to be used for before. I don't particularly support the wars going on in Afghanistan and Iraq, but no one has offered me the choice of not having my tax money go towards them.

Somehow abortion is different. It's like a code word for something so evil, so wrong, that people automatically give in when someone utters the word. "It's not going to be used for abortion, is it?" "Oh, no, never..."

As I've said before, abortion is a procedure that happens in a context. Something happens: birth control fails, a fetus develops a defect of some type, there is a change in a woman's life... and suddenly, abortion is the right option. Yes, you can love babies, and yes, you can love life (whatever that means), but abortion is necessary to protect women's health. Doing away with abortion, or making it harder to obtain, isn't going to stop abortion: it's going to drive it underground, and we know what happens with that.

Somehow, in this whole health care debate, abortion has (pardon the pun) taken on a life of its own. It symbolizes something other than what it actually is: a medical procedure. It seems to represent all the fears that Conservatives have about women, being out of control, sexuality run amok.

I truly hope now that health care reform has passed and been signed into reality, that this strange abortion thing will go away. Although I doubt it.

Connect the dots

2010-03-17T10:15:00.009-04:00

I read with interest an op-ed "entitled Politically Exhausted," in today's Boston Globe. It starts:

Here's how the current narrative goes: Americans are fuming. They are fed up with Washington, Wall Street, the stimulus package and banking bailouts, the attempts at health care reform, pretty much everything. The Tea Partiers are all the rage because they seem to channel this fury and threaten to reshape the contours of the political environment through their anger.
It’s a pretty good story. But it is not the real story. What is significant is not that a group of extremists are protesting the government. What is really significant is that the majority of Americans aren’t involved, energized, or even angry. Quite the opposite. They are enervated, afflicted with an overwhelming sense of political exhaustion, dispirited over how wrong things are and uncertain that they can ever be made right. Simply put, they’ve given up. (emphasis mine)

I think the writer of this article, Neal Gabler, has a good point here. This past year, which started out with such promise, has just become worse and worse, and it's worn people down. Speaking for myself: it's worn me down. Government just seems so complicated and well, political, that nothing can really get done. It's much easier to just watch TV or surf the Internet and ignore what is going on, because we feel like we can't do anything about it.

Reading on, I found this article (Cancer costs more than double since ’90),

The rising cost of cancer research and care, which helped reduce death rates by 16 percent over 40 years, is straining the US health system and needs to be restrained, commentators said in a special edition of the Journal of the American Medical Association...The reduced death rates result from anti-smoking campaigns, early disease detection, and new drugs, which can cost individual patients up to $100,000 a year (note nothing mentioned about preventing cancer in the first place)...Cancer remains the second-leading cause of death in the United States, killing 562,000 people a year, according to the American Cancer Society...There has been “remarkable progress’’ in the treatment of certain types of cancer, the report said, including breast, Hodgkin’s disease, and testicular..."We’ve made progress, but people are still dying at too high a rate...’’

And reading still further (I had time today), I found this article (State honoring companies that detoxify manufacturing)

Since 1993, MD Stetson has cut its use of glycol ethers, often used as solvents, by nearly 60 percent, and today much of its product line is “green.’’ For that, the company was honored Monday by Massachusetts legislators and officials who administer the state’s 20-year-old Toxics Use Reduction Act, which aims to reduce the use of toxic substances.

Officials plan to highlight more than a dozen companies that, like MD Stetson, have cut toxic chemicals out of their manufacturing processes, helping to curb chemical use in Massachusetts by 41 percent since the law went into effect. Those companies include Millipore Corp., which has a research and development facility in Bedford, Lightolier in Fall River, and PerkinElmer Optoelectronics of Salem.

Jason Marshall, laboratory director at the Toxics Use Reduction Institute at the University of Massachusetts Lowell, where MD Stetson’s cleaning products were tested independently, lauded the Randolph company for “making Massachusetts safer.’’
“They did the right thing for the right reason,’’ Marshall said. “They said, we know the chemicals we use may not be the best for someone’s health.’’

To me, it's very simple to connect the dots between these three articles. It's important to feel angry (as I do) that people aren't focusing on preventing cancer (instead of just finding it and possibly curing it), and one way to do that is to encourage companies to reduce (or eliminate) the toxicity of the chemicals that they spew into the environment. I just wish there were more people who connected these same dots.

Just write!

2010-03-03T13:15:00.000-05:00

I haven't been posting much lately. I'm sorry. I think I've been spending all of my energy on just getting through the days: getting to work; making sure J does his homework (but not always); getting dinner on the table (but not always); making sure the house isn't a total pit; trying to meet Sisterhood and Temple obligations; trying to stay focused at work (not always succeeding); trying to exercise a few times a week. I'm feeling pretty good today, but I've been dealing with nausea for over 3 months now, on and off, as well as some other annoying symptoms, and I just haven't felt like myself. In addition to my little struggles, it seems that the world is falling apart. I can barely read the newspaper anymore. Earthquakes, weird weather in all parts of the world, wars, increased conservatism all over the world, not to mention a sense of utter frustration with both the economy and the government here in the U.S. There is very little good news these days.

Now this is getting depressing.

On the plus side, I have been feeling better for the past few days; spring is trying very hard to arrive here in New England; J's basketball team is playing really well as they go into the finals; did I mention that spring is coming?

One chance

2010-02-12T07:51:00.003-05:00

I've been watching the American Idol auditions again. Look, it's winter, there isn't a lot to do. Anyway, they are somewhat amusing, somewhat excruciating. The producers manage to find the requisite heart-rending stories of contestants with sick kids, former inmates, people who've never been out of their small town, etc. etc. There are the requisite tears, fights, tantrums. Occasionally, the singing is good.

Anyway, what's been driving me crazy this year is this line, said over and over by the contestants who are eliminated: "This was my one big chance, and I blew it." These are young people, in their teens or twenties. I keep thinking: there are very few things in life -- maybe nothing -- for which you have just one chance. Most of the time, you have a lot of chances. You will go on, and if you are supposed to become a singer, you will become a singer. If you are good enough to be a star, you will be a star. This isn't your only chance.

I realize that they are trying to amp up the drama factor, but I feel that this show is sending a bad message. You only have once chance, and if you blow it, that's it. That's not really how life works. Real life isn't like TV. In real life, you make decisions, you re-visit them, you leave, you go back, you try to work it out. In real life, there are second chances. At least, that's my opinion.

Maybe they should put me on American Idol as the counter-point.

Poem

2010-02-05T19:31:00.004-05:00

One day I am a person
The next day
After knowing fingers find a
Lump
I am a patient.
Doctors examine the lump
First with x-rays, then sound-waves
Then they take a piece of it
Test the lump
The lump is bad.
Now I am neither a person or a patient
But instead someone with cancer.
Transformed by a lump.
Surgeon cuts the lump out.
Someone tests the lump: not enough.
Surgeon takes out a bit more.
Everyone is satisfied
As far as the lump goes.
But for me, the story has just begun.

Someone recently sent me some poetry that they wrote while dealing with their own breast cancer, and I was inspired to try to write some of my own. This is my first attempt.

Judaism and control

2010-01-31T09:32:00.005-05:00

I do not feel as good about Sisterhood Shabbat this year as I did last year.

I had the strongest feeling that we were entering into a world of men, and that we were playing at doing the things that the men do. It was not a good feeling.

Maybe it had to do with the three men - regulars - who arrived first, and who were chatting in the sanctuary with smirks on their faces. I do not think I imagined it. They were smirking, as if to say: these silly women, taking over our service for a day, what will they screw up today?

Judaism belongs to all of us. The Temple belongs to all of us. The bimah, the ark, the Torah. We should feel comfortable taking part, leading, doing an honor. The service is not just the purview of the men, the regulars, the Rabbi. It belongs to all of us.

The rigidity, the need to control, "it has to be done a certain way"...this is really starting to rub me in the wrong way.

I know that control is a big issue of mine. Feeling like others are controlling me. It's always been a big issue of mine, as long as I can remember.

Here's another example. Last night, we were at a program at J's school for the fourth grade. The kids sang some songs in the gym, then everyone moved to the classrooms. They did some things in the classrooms, then we moved back to the gym. There was a lot of: stop, wait, line up, do this, do that, don't do that yet. The whole thing made me very uncomfortable. It was so rigid, it had no spontaneity.

Maybe Judaism is just -- at its core -- about things being done a certain way. It's not particularly spontaneous. It's about order and control. Maybe that's why I feel always feel a bit uncomfortable at temple, with certain Jewish practices. I'm always resisting that control.

Hmm. Why has it taken me so long to figure this out?

Decision

2010-01-21T14:14:00.005-05:00

So I've made a decision. I'm going to drop out of the research study.

I've been getting shots (triptorelin) that make me menopausal since last May, and I've been in pseudo-menopause since about August. I'm not sure what regular menopause is going to be like, but this kind of menopause, in short, sucks.

Since being on this study, I've had insomnia, which I've never had before, and a constant sense of tiredness and lack of energy, even when I do get enough sleep. Hot flashes... don't even get me started. "Flash" doesn't even begin to describe it. Then there has been the whole changing my anti-depressant thing, which has been a disaster. In addition, for the past few months, I've had some other uncomfortable symptoms like rapid heartbeat, and a need to eat very frequently or I feel nauseous. I don't know for sure if the study is causing these symptoms, but no one seems to be able to figure out what else is causing them, and I've been feeling kind of awful. It just makes sense to me to try to return my body to its natural state, instead of the state it's currently in, which is hyped up on 4 or 5 different medications.

So I'm not going to get my shot next week, and I'm going to wait for my body to get back to normal, whatever that is. Tampax, I'm comin' back... did ya miss me?

Old

2010-01-20T11:14:00.000-05:00

The place I'm really noticing it is in the eyes. The sagging. "Hooding," it's officially called. I call it "I no longer have a place to put eye shadow."

Also under my chin. There's a kind of puffy strip under my chin that wasn't there before.

And my hands. Can these be my hands? So many age spots. So dry.

I don't know if these changes are just changes that would have happened anyway, or if being in artificially-induced menopause is pushing them along. But I don't like them. Not at all.

On restrictive abortion laws

2010-01-15T12:43:00.001-05:00

This is done so straight and so well...You just have to see it.

New Law Requires Women To Name Baby, Paint Nursery Before Getting Abortion

Living with uncertainty

2010-01-06T11:41:00.005-05:00

I received the official report from yesterday's mammogram today. Here it is:

FINAL REPORT
GE DIGITAL BILATERAL DIAGNOSTIC MAMMOGRAMS WITH COMPUTER AIDED DETECTION:
INDICATION: History of right breast cancer, status post excision and radiation therapy in January 2009. First post-treatment mammogram.
COMPARISON: Presurgical mammogram from 2009 and printed copies of digital mammogram from 2008.
The breast parenchyma is heterogeneously dense. There is new focal architectural distortion in the right upper central quadrant and retro areolar region at the site of recent surgery. Bilateral scattered calcifications remain stable. No new spiculated mass, suspicious clustered microcalcifications are seen.
IMPRESSION: Interval right breast postoperative changes. A six-month followup right diagnostic mammogram is recommended to assess stability/resolution of the postoperative changes. Findings were discussed with the patient.
BI-RADS 3 - probably benign. Short-interval followup with six-month right diagnostic mammogram is recommended.

I find this pretty hard to understand, and somewhat scary. Suspicious what? Probably benign? Luckily, I know someone who is a radiologist, and he read the report and reassured me that a) the changes mentioned on the report are normal after a surgery, and b) that the fact that the micro-calcifications are scattered and on both sides is a good thing. So they are in fact not suspicious.

Now I have to follow up every 6 months with a breast MRI or a mammogram. Every 6 months.

So I guess you are supposed to live your life, and then get scared just every 6 months. I'm starting -- just starting -- to understand why some women choose the bilateral mastectomy. Because of the "every 6 months."

First mammogram since surgery

2010-01-05T18:02:00.006-05:00

The machine is hard: metal and plastic. My breasts, my body, are soft. The technician keeps telling me to relax. "Turn your head, bend at the waist, put your shoulder down, relax!" How can I relax when I'm pushing my body against this hard machine? She pulls my breast, squeezes it between plastic plates. I don't feel pain, exactly, but it's uncomfortable. "Don't breathe" she commands, and takes the x-ray. I try not to breathe. Seconds pass. "Okay, now you can breathe."

Next is the waiting. I sit with six other women, all dressed in pants, winter boots, and incongruous light blue dotted hospital gowns. We all read magazines about the beautiful lives of movie stars. I really have to pee. I wonder: Do the stars have mammograms? Do they mash their beautiful breasts in between plates of plastic? Do they have to wait?

One by one, the women are called in for their turn with the machine and the technician. One by one, the women are called in for their results.

Finally, it is my turn. "Everything looks fine, but I'd like to see you again in 6 months," the radiologist reports. I guess that's reassuring. Kind of.

Dancing is the thread

2009-12-25T10:44:00.007-05:00

I've always been a dancer of some sort or another. I was enamored with "Tina the Ballerina" and "The Nutcracker" as a little girl, and spent quite a bit of time doing pirouettes around the house. As I grew older, I became interested in Israeli folk dancing. I was a member of our Temple's youth Israeli folk dance group for several years during high school, which meant multiple rehearsals per week, practicing in bare feet on egg salad and tuna fish (left over from Saturday morning kiddush) and taking part in a dance competition and also a regional performance.

Twelve years later, I was back in Boston, and I found Israeli folk dancing again (or it found me). This time, I started dating a man, was introduced to a whole new group of people who became good friends, and spent several years dancing two or three times a week. I was even part of a performing group for several years.

Fast forward a few years, I was still dancing, and I met my husband, A. He wasn't an Israeli dancer, although he enjoying coming to dancing with me and socializing. Ultimately, we did an Israeli dance as the first dance at our wedding.

So... last night, at the annual (Christmas Eve) Israeli Dance Marathon (6 pm - 4 am, and no I didn't stay there the whole time), I saw my life pass before my eyes. There was the man I dated when I did Israeli dancing in high school; there was the man I dated when I did Israeli dancing in my late 20s; there was the man (well, my husband) who I married. It was kind of surreal.

And dancing is the thread that holds it all together...

Hair

2009-12-24T15:18:00.003-05:00

J and I were standing at the JCC today, watching some older teens and men play a pick-up game of basketball. They were playing "shirts vs. skins," so half the men had removed their shirts. Most of them had pretty typical male chest hair, although of course some of them were hairier than others.

Jordan was commenting about their body hair. He really didn't like it.

I pondered this for a while, and realized that his obsession with professional wrestling has given him the false impression that adult men have little or no body hair. I'm pretty sure that the wrestlers shave their entire bodies, and oil them, too. Here's an example of what they look like: John Cena, who is J's favorite and a "good guy," and Randy Orton, who is a "bad guy." The point is: J is getting a really distorted view of what adult men look like. Hairless, very muscular. Tend to jump on each other, and hit each other with tables.

I've been patiently waiting for J's obsession to wear off, and I think it is, somewhat. But this aspect of it is somewhat surprising. I've heard of girls getting the wrong idea from airbrushed images from magazines, but I never expected to have this sort of issue with a son. Silly me.

A year ago

2009-12-19T11:54:00.000-05:00

It all started exactly a year ago, December 19, 2008. I went to my doctor for my bi-annual breast check. We were laughing and chatting. Then she felt the lump.

I didn't believe it at first. It just felt, well, lumpy, and not unlike other things I'd felt before. I even went back to have her check a few days later. No, it was really there. She wanted me to have it checked out.

I tried very hard not to be concerned about it for several weeks, until my imaging appointment. Then on January 2, I had a mammogram and an ultrasound at the BIDMC downtown. They were definitely concerned. Funny, the doctor wouldn't say it, but the ultrasound tech did: it looked like cancer. But they wouldn't say for sure until the biopsy. That was the day I really knew.

That was a Friday, and I had the biopsy on the following Tuesday. The results weren't ready until noon the following Friday. Friday January 9, 2009.

Invasive Ductal Carcinoma.

And the rest, as they say, is history. I had 2 surgeries in February to completely remove the lump; I spent part of March dealing with an abscess (unrelated to the cancer) and with oncology decisions; I had radiation treatment in May and June; I started hormonal treatment and a research study after that; I have monthly shots as part of the study, and I've been dealing with side effects of medications ever since. I feel like I've aged 10 years. I'm in menopause. I don't have my stamina back yet. I'm very emotional. My family feels the stress, too.

It hasn't been a great year.

I'm really hoping that 2010 is better.

Falling through the cracks

2009-12-16T14:09:00.005-05:00

Been having some uncomfortable side effects lately from one or more of the medications I'm taking. Anyway, I did what you are supposed to do, which is to call your doctor. Well, my doctor is on maternity leave. So I called her replacement. She seemed very nice, and told me to call the appointment desk. They made an appointment for the following week. Then the nice doctor had a family emergency, and had to cancel the appointment. So I made another appointment for the following week. Then the nice doctor got the flu (today). So I made another appointment for the following week.

It has now been over 2 weeks, and I still haven't seen this doctor. My new appointment is for a week from now. I'm not feeling great, but imagine if I was really in trouble. Would a person with serious issues be able to communicate to these people that they really need to see someone NOW? I'm starting to understand how people fall through the cracks. You can do everything you are supposed to be doing, and still not get the help you need.

Okay, I'm going to try to call them again...

An idiot

2009-12-16T08:49:00.003-05:00

Interesting discussion on the ride to school this morning. J's class is learning about the Sumerians and the Mayans. Apparently the Mayans sacrificed human beings. This led to a discussion about Abraham and the almost-sacrifice of Isaac. J pointed out that this was only a test, and that G-d wasn't really going to let Abraham sacrifice Isaac.

J: "If G-d let Abraham do that, everyone would have thought that G-d was an idiot."

Interesting.

Chanukah 2009

2009-12-12T10:40:00.005-05:00

Not feeling very ready for Chanukah this year...but here are a few links that make me smile:

The candles sing Mi Y'Malel

Orrin Hatch (?!) wrote a song about Chanukah

Hanukkah Hey Ya!

my favorite this year: Hanukkah Hey Ya! Flash Mob

Sacred work

2009-12-09T09:33:00.001-05:00

I read this post, The Audacity of Goodness, on several websites yesterday, and I found the video that it refers to -- Every day, good women choose abortion -- to be very moving. Take a look.

I'm afraid that my fertile years are now past, but if I needed to have an abortion in my lifetime, I only hope that I would be privileged to have had a provider as kind and considerate as this one.

Also, I love this quote that is mentioned at the end of the article:

“If one woman told the truth about her life, the world would split open.”
--Muriel Rukeyser

Very, very true.

Thinking about Chanukah

2009-12-04T11:58:00.007-05:00

and smiling....(lyrics are below the video)

Hanukkah Hey Ya!
By Eric Schwartz (smooth-e)
© 2003

My dreidel just spins around
and then falls to the ground
as we light the candles (oy!)

I love to light menorahs
and the matzah balls are cooking on the stove (mmm!)

Flames high to light the ceiling
but the candle dripping's burning me right now (ow!)

Thank god for mom and dad
for teaching jewish culture
'cause we are so proud (l'chaim)

[chorus]
Hanukkah
Hanukkah
Hanukkah
Hanukkah

Those fluffy latkes,
oh those fluffy latkes
they're hot i want to eat 'em 'till there's nothing at all

We get the presents, oh we get the presents
and eight is always better than three from santa claus

And what they say is "we're the chosen people"
then what makes, what makes, what makes, what makes
us the exception?

Don't know why, know why
o-y, o-y, o-y (oy!)
Run and call your rabbi so that you can celebrate this year
oy is just yo backwards

[chorus]
Hanukkah (why don't you meet my rabbi)
Hanukkah (he isn't such a bad guy)
Hanukkah (it wouldn't be a bummer)
Hanukkah (if you want to wear yarmulke)

Manischewitz, schewitz, schewitz, schewitz, schewitz, schewitz, schewitz and a kosherized pickle
Maniscewitz, schewitz, schewitz, schewitz, schewitz, schewitz, shevitz and potato knishes
Maniscewitz, schewitz, schewitz, schewitz, schewitz, schewitz, schewitz and the kasha varnishkas
Maniscewitz, schewitz, schewitz, schewitz, schewitz, schewitz, suburbanhomeboy.com...challah

The trial of G-d

2009-11-22T20:23:00.005-05:00

I was waiting in a doctor's office this week (so what else is new?) and I came upon this story in a yoga magazine. It fascinated me. I found a version of the story online, and I copied excerpts of it here. Turns out the original story is actually a play by Elie Wiesel. The article that I read was very close to the version I've copied here.

Three rabbis, all prisoners in Auschwitz and witnesses to the daily death machine of the Nazis, decided that it was time to place G-d on trial.

They formed a rabbinic court (Bet Din), and conducted the trial completely in accordance with Halakha (Jewish Law). They gathered evidence against G-d, building a strong case against the “Holy One Blessed Be He.” The trial lasted several days, with the judges giving all those who wished a chance to speak their minds. Witnesses were heard, painful personal testimonies were given, and in the end, none of the witnesses even remotely defended God.

It was time to issue a ruling, and the rabbinic court pronounced a unanimous verdict: “The Lord God Almighty, Creator of Heaven and Earth – guilty of crimes against creation, against humanity and against His own Chosen People of Israel.”

Soon after this painful judgment was pronounced, the rabbi presiding over the rabbinic court looked up to the sky, saw that the sun had set, and that the darkness of night was upon the world. This rabbi, who had just indicted G-d and pronounced Him guilty of crimes, looked towards the silenced crowd and said “Come, my friends, we have a minyan – it is time to pray Maariv (the evening prayer service).” The other members of the rabbinic court, together with the witnesses and the onlookers, all gathered around the rabbi to join in their evening prayers to G-d.

This story appeals to me, in all my not-knowingness and all my frustration. The idea of a group of people realizing that G-d has really not done a very good job in the situation of the Holocaust, yet praying to G-d anyway; it's just fascinating, and well, just so Jewish.

Memories and divorces

2009-11-18T11:13:00.009-05:00

I've been humming a song sung by Achinoam Nini, better know as the Israeli singer Noa, for the past few days. What's strange is, humming Noa's songs reminds me of going to a few of her concerts in years past with my friend and her husband. What's even stranger, is that my friend and her husband recently announced that they are getting a divorce. I'm not going to get into the divorce here, but rather on how it affects people on the outside.

So I have this memory of going to this concert with A and this friend and her husband, and loving, loving the music, and now this memory is kind of...well...ruined because I was with my friend and her husband and now I'm kind of pissed off at her soon-to-be-ex-husband and he's in my damn memory! How do I get him out?

The same thing happened a few years ago when another friend had to divorce her husband because of a whole bunch of issues. A and I had socialized with this friend and her husband in better times, and I have a memory of an amazing dinner that we had prepared in A's old condo by a real chef. We had invited this friend and her husband (I don't think they were married at the time) and the chef brought all the ingredients and prepared an amazing dinner for us (I think we'd won it in an auction). I remember enjoying it so much. And again, this memory is sullied by the ex-husband who turned out to be a jerk, but there he is, in my old memory of that day.

Ugh.

I guess it goes to show you that relationships really do have far reaching effects, and the formation and maintenance and dissolution of relationships affect many people: even ones you don't expect.

New mammography guidelines

2009-11-17T10:05:00.009-05:00

This is the best analysis I've seen on the new mammography guidelines and what went wrong:
A tone-deaf message on mammograms by Ellen Goodman

and you've just got to love Barbara Ehrenreich's view:
Not So Pretty in Pink: The Uproar Over New Breast Cancer Screening Guidelines

Here are some other excellent articles on the topic:

Does Mammography Screening Save Lives? Let's Talk About It by Barbara Brenner of Breast Cancer Action

The New Guidelines for Mammography by Susan Love, MD, of the Dr. Susan Love Research Foundation

Making Sense of the New Mammography Recommendations, Breast Cancer News, Susan G. Komen for the Cure

New Mammogram Guidelines Are Causing Confusion, But Here’s Why They Make Sense by Our Bodies, Ourselves

I keep adding articles as I see them.

More on Stupack

2009-11-16T11:25:00.003-05:00

As I'd anticipated, health care reform is really in turmoil now. Either you side for health care, or you side for women's reproductive rights. The Stupack amendment is even worse than I feared. It makes it illegal to pay for abortion from any money that the government touches, which of course, includes a lot of the new health care programs (the public option and the health care exchange). This, of course, will affect primarily poor women. Sound familiar?

I did a little research on my own last night about abortion. Turns out that a first trimester abortion costs about $350-900, depending on where you live. For some of us, that amount of money seems trivial. To others, it's rent or food money, and it's absolutely out of the question. I found many websites that help women pay for abortions. So clearly, there is a need out there.

The other thing that I discovered is that when you put the words "abortion" and a place name into a search engine, a lot of anti-abortion sites come up immediately. Which says something else about the times that we live in.

Take a look at what Dr. Nancy Snyderman has to say about this: awesome!

It's beginning to look at lot like....NOT

2009-11-15T14:20:00.007-05:00

Went to a local mall yesterday, and I was horrified to discover that it was completely decked out in Christmas, including Christmas carols over the loud-speakers. Only problem: it doesn't feel at all like Christmas yet. We are having unusually warm weather, which is not entirely unwelcome, but it makes it difficult to get into the Christmas/Chanukah/winter holiday, or even the Thanksgiving, mood.

Most of the leaves have fallen, but there is still some beautiful fall color in the yard. Here's a sample:

My online life

2009-11-13T09:40:00.002-05:00

It's occurred to me recently, as my time has been literally sucked up by the computer and the Internet, that sometimes my online life is out of control. It is very easy to spend one's whole day on the internet: checking Facebook to see if anyone posted anything interesting, checking the blogs I follow to see if anyone wrote any interesting articles, checking the news, checking my email, checking, checking, checking...And before I realize it, hours have passed, the laundry isn't done, the carpets haven't been vacuumed, the groceries haven't been bought...

It's so easy to become consumed by the Internet. You never know what you are going to find, but you always find something. Thinking back to my intro psych course, this is called a variable schedule of reinforcement (scroll down a bit for the definition). And it maintains a behavior beautifully...

Now I must get off the computer.

Health care or abortion?

2009-11-10T12:03:00.003-05:00

So now it seems that health care reform is going to hang on the issue of abortion. The bill, which just passed the House, now has an amendment (aptly named the Stupak amendment) which excludes the use of any federal monies for abortion.

Now this situation puts people in the difficult position of supporting the bill as a whole (which is a good thing) or not supporting the bill (and remaining pro-choice). It is a tough, tough decision.

You really can't single out one legal medical procedure and say that federal money won't pay for it. In my opinion. We'll see what happens...

Busy

2009-11-06T09:45:00.004-05:00

Life has been so busy lately that I just haven't had the time or focus to post anything here. I miss writing, and I miss having time to reflect. Things are a bit too hectic for my taste.

Here's a sample:

Work has been insane. There are ongoing issues that I don't feel comfortable getting into here, as well as planning for and executing an important training earlier this week. I am very relieved that the training is over, and after all my angst, it went well.
Thanksgiving is in 3 weeks (!) and it looks like we are hosting this year. I'm trying to clean up our messy house, and I'm finding it very depressing. No matter how much I clean or remove things, it just seems like there is an endless amount of dust and clutter.
Fourth grade means much more homework for J, in addition to soccer (which is ending) and basketball (which is just beginning). And keeping him fed is a full time job. He eats a lot!
Temple commitments: for some reason I joined the Ritual Committee this year, which I don't really have time for, in addition to my regular Sisterhood commitment, and Sisterhood Shabbat needs to be planned.
Everyone else I know is equally crazed. No one has had time to get together. I managed to get together with my friend B for about 1/2 an hour last week for coffee and a bagel. Is that crazy, or what?
We are having a joint 10th birthday party for J three months late with another friend. Since he and his friend basically have the same friends, it kind of works out well. But still need to finalize a few plans for the party.
We don't have plans for winter vacation. Yet.
They are already showing Christmas and Chanukah candy, etc. in the stores. I am not ready to even think about the holidays!

I guess I'll stop there. This will give you a sense of what's been going on. I will try to post more regularly. It is NaBloPoMo after all!

This joke isn't funny

2009-10-30T18:14:00.005-04:00

G-d is currently playing some kind of cosmic joke on me. And I don't think it's very funny.

It all started last week. I've been planning a big training for work, and I've been trying to stay focused on it. Then, things started happening that kept keeping me from my training preparations. Suddenly there was a large report due (that hadn't been there before) and I had to spend 2 days working on details for that. Then, just as suddenly, the report was not needed. So I got back to my training.

Then, my boss got sick. Like: flu sick. I kept on planning and prepping for the training, and my boss got sicker. Mind you, I'm supposed to be doing this training WITH my boss. You know where this is going, right?

Now my boss is too sick to come to the training (it's on Monday). Five people are FLYING here from all across the country for the training, and my boss is too sick to attend. So I have to do it. I was supposed to be second string, and now: I'm the string.

Come on. Where's the joke?

Life and death

2009-10-27T14:11:00.000-04:00

Since the health care reform debate began (and its accompanying myths and untruths), I've come across many articles lately in the blogosphere about medicine and its relationship to "the big questions": questions of life and death.

Some of these include questions from the beginning of life: when does life really begin? when is it okay to have an abortion, and when isn't it? and who gets to decide? why is a fetus of a certain age viable and worthy of medical treatment when others aren't? what of informing parents that their baby has Down Syndrome? should they be counseled to continue the pregnancy or to end it? or should they be counseled at all?

And the converse, questions from the end of life: when is it time to die? should we do everything we can to save someone who is clearly dying? when have we tried enough, and we need to say "let nature take its course"? How do we best spend the end of our lives? in a hospital bed? at home? in hospice? and who gets to decide?

My own recent medical experiences have made me realize that while doctors know a lot, they don't know everything. Medicine is still often more of an art than a science. Many decisions rely on the experience of the doctor, and even on their gut feelings about a case. Given that, do we want doctors making these sorts of life and death decisions for us? Or worse, do we want legislators making these decisions?

The reality is that these sorts of life and death decisions are often made without clear guidelines. If we are lucky, we have doctors, nurses, counselors, or others to help us through these difficult decisions. But often we are left alone. Or we are left with the legal system, which isn't always a very empathic friend.

It's ironic that two of the major sticking points of the health care reform debate -- the so-called "death panels" and public funding of abortion -- have to do with these very issues. I guess everyone feels some discomfort when confronted with these gray areas.

Wendy, a fellow Oberlin alum, wrote a very poignant piece about this issue in Newsweek last year. She says:

As I reflect on this experience (the death of her father), I keep thinking that with some small changes in how we as a society approach death and dying, we could make this a better experience for everyone. In school, we should teach not just about health but about the changes to the body that accompany death and dying. Give students words of comfort and acknowledgment. They will surely have opportunities to use these words with friends and family members, even in childhood.

We are a death-denying culture and by not being open about death and dying, we leave ourselves unprepared to face other deaths and, ultimately, our own.

P.S. I wrote this about a month ago, and since I seem to have no time to post these days, I'm finally posting this one. More soon, hopefully.

Crisis of faith

2009-10-22T11:27:00.006-04:00

The High Holidays tend to throw me for a loop, faith-wise, as I've mentioned before. I end up feeling so disconnected and uninspired that I need to go to a bunch of regular services for a while, just to get back in the swing of things.

This year, however, I'm having some trouble getting back in the swing of things.

I've been thinking about Judaism, and how (at least in Conservative Judaism) the emphasis seems to be on "doing what you are supposed to do according to Jewish law" as opposed to feeling connected or inspired or uplifted. It's about doing, not feeling. Or as the saying goes, do first, and the feelings will follow. But right now: it's not working for me.

Right now, for whatever reason, I'm not satisfied with my religious experience. I don't want to just go through the motions. I want to feel something. Maybe this is part of my recovery from cancer. Or maybe it's something else.

I'm tired of the old, boring translations in the siddur. I'm tired of the fast, rote repetitions of prayers in minyan. I'm tired of being told what I should do, what I should feel, what I should believe.

Not sure what it's going to take to get me out of this religious funk. But I hope something gets me out of it soon.