Surviving Cancer

PearlieMae was afraid of the disease that eventually, through complications, took her life. She knew of neighbors who suffered from breast cancer and rather than call the condition to the attention of her doctors she hid the smell of the disease as it ravaged her body. PearlieMae was of the same generation as that neighbor whose religion prevented her from seeking help that might have prolonged her life. We can't speak of PearlieMae's opinion of the neighbor. We do know that she knew of the woman and knew of her condition and her passing.

Cancer is again much in the news due to actor Michael Douglas' treatment. The son to noted actor and stroke survivor Kirk Douglas is considered "cancer-stricken" and like his father shares his' father's fatherhood regrets when career came before family. Now this is a stretch but we included the Douglas' with the neighbor in our story to highlight how knowing information and actually being able to utilize the information are often very difficult tasks.

Michael who may or may not have had to watch his grandfather suffer and die from smoking must have known that his father (Kirk) wasn't a smoker until:

"Hollywood started me smoking, literally putting a cigarette in my hand. Who knows how many moviegoers have started smoking because of what they have seen on the screen? Too many movies glorify young people smoking. It doesn't have to be this way. I have done at least 50 pictures where I avoided smoking. In one film, ''The Brotherhood,'' I played a Mafia character and chewed on a cigar. In a scene from a film I just did, ''The Illusion,'' when offered a cigarette, I say: ''I don't smoke. I have cancer.'' " - New York Times

That is unless career kept father Kirk Douglas from imparting to his son Michael the suffering his grandfather endured and the strength that fueled his ability to quit. The story of which the elder Douglas wrote of and was published in the New York Times.

"After many years of smoking, my father was told by his doctor that he would die of cancer if he did not stop smoking. So he quit cold turkey. Here's how he did it: he always carried one cigarette in the breast pocket of his shirt. When he felt the urge to smoke, he'd take the cigarette out and look at it fiercely. With a growl, he would say, in his Russian accent, ''Who's stronger? You -- me?'' He would glare at the cigarette: ''I stronger.'' And he'd put the cigarette back in his pocket. He did that for a few years, but it was too late. He died of cancer at age 72." - New York Times (May 2003)

Neglect doesn't lead to cancer and we're not trying to suggest such a connection but we are trying to suggest that neglect can lead to repeating what can be avoided and can have disastrous and long term affects that can be repeated in families broken or otherwise. Sometimes stories should be discussed in polite company if only to learn how individuals feel about detection and treatment. Sometimes its just good to know that people, even those whom we see on screens big and small, suffer and prevail.

Jefferson Thomas a "Little Rock nine" member was much younger than PearlieMae. While Mr. Thomas was only briefly on the small screen his passing from pancreatic cancer caught our eye when we read of the latest report in the Journal of the American Medical Association (JAMA). While nothing is written in the story on his cancer struggle it got us to thinking about cancer, secrets, treatment and prevention.

That's when the memory of PearlieMae and the neighbor returned to our memory. We can't rewrite what has been written. Like sharks that can only swim forward, life is a forward journey that each of us must make. Though sharks can only swim forward they, like each of us can also move in a circle. (Thanks to PBS we've learned that sharks don't have to "move or die" some varieties can stand still. We keep mentioning sharks because since 1970 sharks and cows cartilage has been considered for the treatment and/or cure for cancer. While none of the research has been considered successful enough to be commercial viable. The hope still remains. With the big "casino" (cancer) for many hope is all there is.)  We should move forward and forward or upward and onward. We should seek to go where we've never been before. Or so we guess.

The JAMA research found that women having elective mastectomies and

"...women with a genetic predisposition to ovarian cancer may consider preemptively removing their fallopian tubes and ovaries. “Early intervention” can also save the lives of people predisposed to certain types of kidney and thyroid cancers." 

There is a drug for the treatment of prostate cancer, in its early stages or think of it as elective surgery. The down side of treatment is possible hair growth for thinning hair, decreased desire or possible pain in the region.

 "In 2003, the Prostate Cancer Prevention Trial (PCPT), involving more than 18,000 patients, found that finasteride cut the incidence of prostate cancer by 25 percent -- the first drug to do so." Prostate Cancer Foundation (PCF)

The down side is doctor's don't prescribe the drug because they were poorly informed about the drug. While admitted the physicians in the study were in the Veteran's Administration (VA) it is a stretch to assign ignorance to all physicians in every walk of life. However if you learn or suspect prostate cancer a good place to start is with a question concerning the drug treatment before considering surgery especially if caught early.

Early detection whether or not you'd like to go to the extreme and have elective surgery is the key to survival at the very least. While we doubt such an extreme could extend to elective prostate cancer surgery or elective skin removal surgery we're amazed that so much focus has been placed on elective mastectomies. If there was a family history the women stated they'd consider it. The men have a different point of view altogether.

"Other than skin cancer, prostate cancer is the most common cancer in American men." - American Cancer Society (2010) 

Again it just might be this generation or our generation. As for PearlieMae's generation who knew what they considered that makes a woman a woman. Is it because she has her breasts or is she less of a woman if she's had a hysterectomy? As our younger family members deal with their own bouts with the big "C" we'll keep reviewing the research and sharing what we find and what isn't being shared. May the disease never be a part of your family and your life.

The American Cancer Society (ACS)suggests you can prevent cancer by:

1. Eat an abundance of foods from plant-based sources.
2. Limit fat. 
3. Drink alcohol in moderation, if at all.

Eggs Not Us

While the attention is again focused on local egg farmers and the problems of the recall. We would like to remind you as SAFEWAY has posted on the sliding doors as you enter their stores - the recall does not refer to our jurisdiction. So from DC to North Carolina - we're unaffected. We accept for the continuing reports that seem to miss the bigger questions.

There are other questions that need to be asked. You might not remember this but PBS broadcasted a special about our region and pollution runoff. It's how our water supply and how we handle waste, industrial or otherwise, can affect our health. As we become more concerned about the weather, as hurricane Earl approaches and tropical storm Fiona passes water is in our future.

When SAFEWAY addressed the issue finally on their website they didn't just restrict their statement to their Lucerne brand eggs but extended to include all recalls. While the information still isn't on their front page but is pasted old school style on their front doors- it is available.

"One-half to two-thirds of American farmers already inoculate their flocks, according to industry estimates, and that number is likely to increase. While the new federal rules do not require vaccination, they do require testing for salmonella. If henhouses are found to be contaminated, then eggs must be tested. If eggs are tainted, then they would have to be broken and pasteurized, which would mean producers would get much less money for their eggs" - New York Times.(Business)

Poisoned Waters the PBS program is almost two (2) hours in length. It's difficult to view because it addresses our dirty little secret. To get fresh eggs the most efficient and most cost effective businesses get our hard earn income. In times of feast little cottage industries spring up and can challenge the stronghold of the larger businesses. In times of famine, like now, it becomes more and more difficult to be cost effective. Businesses suffer and so sometimes do we, the paying public.

"Low-cost vaccines that may help prevent the kind of salmonella outbreak that has led to the recall of more than a half-billion eggs haven't been given to nearly half the nation's egg-laying hens. The vaccines aren't required in the U.S., although in Great Britain, officials say vaccinations have given them the safest egg supply in Europe." - Associated Press (AP)

The program doesn't deal with any of the businesses affected by the recall nor are our comments specifically directed to the financial decisions made by Hillandale Farms of Iowa nor Wright County Egg.

This isn't an anti-SAFEWAY story. It's a story about processed foods and the dirty little secret that we don't like to admit. To get us the items we need to live someone has to do what we don't want to do. For meat, someone has to kill an animal. For vegetables, someone has to put their hands in manure. We don't like to think about it or talk about it. We certainly don't want to hear it. To provide us with the items we need costs someone money. Which we will gladly pay to get what we want. Men want cheap bargains and women want what they want (if our staff is any indication).

"...vaccinating hens and testing barns regularly for bacteria, has essentially wiped out salmonella on California farms, industry officials say. Yet only nine other states have enacted similar government-sponsored efforts. One reason ... California farmers contend, is cost. Injecting chickens and swabbing cages takes money — not a fortune, but enough to send egg distributors searching for lower-cost sources." - LA Times

We love the Los Angeles Times newspaper but even they don't always answer the most obvious question but for California residents they don't have to. Our question would be what are the other nine (9) states that have testing. Local governments and legislators could prevent the sale of these cheaper and more "risky" foods by making the sale of such product illegal to be sold in our areas. Matters of safety might stand the test of a legal challenge especially during these times of uncertainty.

"Many of the cheapest eggs are produced in the Midwest, where energy, farmland and feed cost less and where regulations are less onerous. 

As a result, Iowa egg operators can undercut the competition. Last month it cost Midwest farmers 53.5 cents to produce a dozen eggs, about 16% less than in California, according to Iowa State University's Egg Industry Center.  

Fullerton wholesaler Michael Sencer, whose company supplies food service firms and chains including Ralphs, Costco and Trader Joe's, bought inventory from Wright County Egg. His customers, he said, liked the low prices and ready supply.  

"It drives the demand for Iowa eggs here in California and everywhere," said Sencer, executive vice president of Hidden Villa Ranch. Those same customers are now scrambling. Wholesale egg prices have jumped 20% in California since the recall, according to the U.S. Department of Agriculture. One key reason: There are 7.5 million Midwest laying hens currently not producing eggs for the nation's breakfasts. But in the Golden State, there are only 19 million hens — enough to meet just 56% of California's demand." - LA Times

Consumer Reports as reported on local WUSA-9 TV in Washington says that the discount chains are considered the best place for bargains by consumers. If you bought your recalled eggs from COSTCO (and we know you didn't) you can always return them for some non-recalled eggs. We personally don't prefer Costco but only because all of us don't have access. We think we can do better than the retailer when it comes to bargains but we must admit. When it comes to food items we've been tempted by the low prices.

"The Food and Drug Administration decided not to mandate vaccination of hens — a precaution that would cost less than a penny per a dozen eggs." - NY Times (Business)

As the PBS program indicates eggs aren't the only problems in these times of financial scarcity that might affect our health and welfare We'll have to be careful and because our concerns will be both costs versus profit what we chose must be fully considered. It just might be a matter of life or death.

Flood Water

There are other questions that need to be asked. You might not remember this but PBS broadcast Poisoned Waters a special about our region south and pollution runoff. It's about our water supply and how we handle waste (industrial or otherwise). How that can affect our health. As we become more concerned about the weather, as hurricane Earl approaches and tropical storm Fiona passes, water is in our future. When Katrina hit the Louisiana leaving "water water everywhere, Nor any drop to drink." Like every major flood disaster the problems that result for the survivors and their ability to recover has much to do with finding fresh water supplies.

We're not trying to frighten you. We're trying to provide context, insight and we're also recently suffered some personal flood damage. Floods that affect our lives generally aren't of the 2012 or Noah's Ark variety. Nor are we likely to suffer a Katrina, Pakistan or Haitian flood variety. Mostly we're likely to suffer the kind of damage we've suffered. This type of loss results in damage to papers and personal effects. We can attest that even a personal loss can be devastating. The suggestions of the federal government would offer no help to survivors of a major catastrophe. But for our particular set of circumstances very appropriate.

FEDERAL EMERGENCY MANAGEMENT AGENCY SUGGESTIONS
1. Safeguard your possessions. (waterproof container)
2. Prepare your house.
3. Develop a family emergency plan. (protect your pets.) (FEMA)

We need more. You might also. We couldn't place all of our possessions in a waterproof container. A fire and the sprinkler system caused soot and water damage to our items. You can't prepare for every possible situation and maybe you shouldn't try. You should prepare for you life and family. Prepare for good health.

"General Assembly declares access to clean water and sanitation is a human right" - July 28, 2010 - UN

Just in time for World Water Week, Sept 5-10,2010 (not to be confused with World Water Day) so we're not that late unless of course you consider their 2003 announcement when:

"...the United Nations has declared that 2003 will be the International Year of Freshwater. We cannot live without water. That is why we have to make sure that everyone can get clean drinking water no matter where they live ....Although fresh water can be found all around the world most of it is either frozen in the polar ice caps, mixed in the soil or deep underground. In fact, less than 1 percent of the world's fresh water is available to be used. That is why we need to take care of it! " - Nane Annan

The nation was worried about the danger to the food supply (seafood) by the BP oil spill, tourism, as well as the damage to the eco-system. We were also concerned about the damage to health and welfare of the gulf residents as well as the nation's seafood. We discovered that while the government (USGS) has been tackling the issue of providing fresh water through desalination of salt water to the nation. No one had prepared for further chemical damage to the already fragile and dwindling nature resource.

"Women, gender equality and water resources in the context of climate change - Climate change has significant impacts on fresh water sources, affecting the availability of water used for domestic and productive tasks. The consequences of the increased frequency in floods and droughts are far reaching, particularly for vulnerable groups, including women who are responsible for water management at the household level." - UN WomenWatch  (Oct 9,2009)

That the could be a gender gap in survival seems only likely because PearlieMae was wheelchair bound and dependent upon the assistance of her family. While many of the canaries from Katrina to Pakistan were PearlieMaes and to feel for these individuals means to make sure, if we can (YES WE CAN), it never happens again. Never again.

"Changes in water availability and extreme events could undermine development, affect human security and livelihoods, significantly impact agriculture and industry, and act as a push factor in population movements and migration. Water scarcity can also trigger conflict. Adaptation to climate change needs to build on conventional hard and soft interventions and may also require a major shift in planning and designing water investments." - UN Chief Executive Board (Nov 22 2007) (PDF)

The problems aren't new and the solutions aren't easy. Most are out of our reach and beyond our control. Our discomfort should be the prelude to our education on the effects and our responses. If not for us then for all of those who will follow in memory of those whom have passed on.

Best Area Nursing Homes?

Though pronounced dead at the hospital which provided her care Pearlie Mae actually died at the nursing home where she for hospice care. The facility did not receive a favorable rating during her "residency." We certainly felt the home was unacceptable for animal care let along the care of a human being. We don't have a high opinion of nursing homes in general. However the ones we do have neutral feelings toward actually didn't score very highly either.

One in five of the nation's 15,700 nursing homes have consistently received poor ratings for overall quality, a USA TODAY analysis of new government data finds. More than a quarter-million patients live in homes given another set of low scores within the past year, according to data released today by Medicare, which first released the star ratings of the nation's nursing homes in late 2008. The ratings are derived from inspections, complaint investigations and other data collected mostly in 2008 and 2009. (USA Today)

It's only because we have experience with many of these local facilities at the time of the ratings that we can support the findings of Medicare. We have from the Medicare site the list for our jurisdictions of the ONLY facilities that you should even consider for housing your recovering or discarded family members. Sorry! That was unnecessarily harsh and we apologize but the subject is still a sensitive one.

Former Frazier co-star David Hyde Pierce had a different opinion and take on the issue when interviewed for the for PBS Series Life (Part 2) stating:

"...[T]hey found a great assisted living place 7 miles from their house, moved him there. It turned out to be the best thing in the world. We usually think of that as a bad second choice. In this case, it was a wonderful choice because instead of being in a house where there were very few people around, 'cause people had to work or be in school, he was constantly surrounded by people. He flourished in a social environment. He was always a very social person. Because of the demographics, he was one of the few men among many women, so that was lovely. And he continued to decline. He never went as far as my grandfather did. My grandfather went the whole route of the disease. My dad was, as we think, mercifully, stricken with the flu and got very sick, and my brother called us all. We were all able to come up there and we were all with him and he still knew us when he passed away." (Science of Happiness, Episode 10)

It took us a few days to analysis the data and find the best of the "poor." These should be the only facilities that you'd even consider for care, however, knowing how a facility fails can help you in either your choice or your lawsuit. The choice to know the devil the government knows or to know what you need to watch out for can also be a great boon to their care.

The Five-Star Quality Rating System was created to help consumers, their families, and caregivers compare nursing homes more easily and help identify areas about which you may want to ask questions. This rating system is based on continued efforts as a result of the Omnibus Reconciliation Act of 1987 (OBRA '87), a nursing home reform law, and more recent quality improvement campaigns such as the Advancing Excellence in America’s Nursing Homes, a coalition of consumers, health care providers, and nursing home professionals. Nursing home ratings are taken from the following three sources of data: Health Inspections, Staffing and Quality Measures. We provide a star rating for each of these three sources, in case some areas are more important to you than others. Then, these three ratings are combined to calculate an overall rating. (MEDICARE)

DC 3 choices (though we only found two (2) worthy of use and our choices are below):

1.  Jeanne Jugan Residence, NE  Stars 5/5/5/2 Medicaid, Non Profit, (40)
2.  The Methodist Home, NW   Stars 5/5/4/4 Medicare and Medicaid, Non Profit, (50)

MD 36 choices (though we only found seven (7) worthy of use and our choices are below):

1. Maria Health Care Center, Baltimore  Stars 5/5/5/5 M and M, Non profit, (60)
2. Crawford Retreat, Baltimore  Stars 5/5/4/5 Medicaid, For Profit, (20)
3. Sacred Heart Home, Hyattsville, Stars 5/5/4/5 Medicaid, Non profit, (102)
4. St. Vincent Care Center, Emmitsburg, Stars 5/5/5/4 M and M, Non profit (46)
5. Garrett County Subacute Unit, Oakland, Stars 5/5/5/3 M and M, Government (10)
6. Hartley Hall Nursing Home, Pocomoke City, Stars 5/5/3/5 M and M, Non profit (70)
7. St. Joseph's Nursing Home, Catonsville, Stars 5/5/3/5 Medicaid, Non profit (44)

NC 47 choices (though we only found four (4) worthy of use and our choices are below):

1.  Chowan Hosp-Snf, Edenton, Stars 5/5/5/5 M and M, Non Profit (40)
2.  Mayview Convalescent Center, Raleigh, Stars 5/5/5/5 M and M, For Profit (51)
3.  Pungo District Hosp Ventilator Unit, Belhaven, Stars 5/5/5/U M and M, For Profit (10)
4.  Wakemed Fuquay Varina Outpatient & Snf, Fuquay Varina, Stars 5/5/5/3 M and M, Non Profit (36)

VA 35 choices (though we only found seven (7) worthy of use and our choices are below):

1. Central Virginia Training Cent, Lynchburg, Stars 5/5/5/5 M and M, Government (104)
2. Little Sisters Of The Poor, Richmond, Stars 5/5/5/5 Medicaid, Non Profit (22)
3. Shenandoah Vly Westminster-Canterbury, Stars 5/5/5/5 M and M, Non Profit (40) 
4. Snyder Nursing Home, Salem, Stars 5/5/5/4 Medicaid, Non Profit (45)
5. Summit Square, Waynesboro, Stars 5/5/5/4 Medicaid, Non Profit (18)
6. Lake Prince Woods, Sufflok, Stars 5/4/5/5 Medicare, Non Profit (40) 
7. Southside Regional Medical Ctr, Petersburg, Stars 5/4/5/5 M and M, For Profit (20) 

• Stars (Overall / Inspections / Staff / Quality Measures) (# of Beds in the facility)

The best nursing home in the District of Columbia can't equal the best Maryland, North Carolina or Virginia facilities according to the Medicare government data. In choosing a better nursing home in the area size matters and the smaller the better - however smaller means fewer available beds. When your loved ones are in need the need from a hospital is immediate. Like David Hyde Pierce whose family interred their Grandfather and then their father in a nursing home while proclaiming the sites good for their relatives. You know if you're a nursing home person.

For us the question is would we want this for ourselves. We certainly wouldn't want to be burden on our families nor bankrupt them financially either. But to quote Mr. Pierce, speaking about his grandfather, on the PBS Series Life (Part 2) episode 10 entitled "Seeking Happiness:"

"The last time I saw him he was in a nursing home in New York State. He was in a wheelchair with his arms tied with straps to the arms of the wheelchair looking at cutout pictures in a construction paper book that some helpful volunteer had put together of flowers. Just sort of happily staring kind of blankly at this thing." (VIEW)

That's not the kind of life or death we'd like for ourselves but that's just us! We say live the kind of life you'd like to die living. For us it's not something we'd like to do alone with strangers but that's how we were raised. If you're raised differently stay in contact with the best places which can transport your loved ones to a facility for specialized care and then return them to the home to convalesce. Beds are few are far between - people are dying to get in.