February 17th, 2008 by Dr. Val Jones in True Stories
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As many of my regular readers know, my dear friend and Revolution Health administrative assistant (Seton) was diagnosed with stage IV colon cancer after giving birth to her first baby. She is doing well on chemotherapy, and working hard to shrink the liver tumors to a size that will allow her to have them cut out, and possibly be cured. On March 9th she’ll be participating in a Race for Colon Cancer walk/run in Central Park, and I’ll be joining her. This weekend I came to New York to practice the 4 mile run with a girlfriend of mine (Karen). Here’s what happened…
As I set out to meet my girlfriend at the southwest corner of Central Park, I became keenly aware that my light windbreaker/t-shirt combo was ill equipped to protect me against the icy wind chill. It was 8:30 in the morning, and as I bowed my head in the face of frigid temperatures, tears streamed down my cheeks while urban grit blew the very moisture out of my eyes. “Whose idea was this?” I asked myself, marveling at the occasional onlooker, bundled head to toe with hats, mittens and face masks. “Oh, yeah – mine. What was I thinking? Why didn’t I look at the weather report?”
About half a mile between my departure point and destination, I began to realize that my ears were in danger of freezing off. “I’ve got to find a hat” I thought… glancing at Citibank headquarters to the right and Meryl Lynch to the left. Where could one find a hat at this time of day, and in this neighborhood? Hmmm… a 24 hour pharmacy perhaps? As I marched towards what appeared to be a distant pharmacy I began thinking of ways to make a hat from cotton strips, Ace bandages, or maybe a shower cap. Severe cold can make a desperate mind exceedingly creative.
As I temporarily thawed myself in the warmth of the pharmacy, I began my search for a head covering. A fleeting moment of triumph gave way to disappointment when a hot pink Santa’s “little princess” elf hat (buried in a discount bin) proved to have the inelastic circumference suitable for a very small child or canine companion. But if there’s one kiddie hat in here, there must be others, I thought. So I combed through the drug store stock with a hopeful eye.
Ah-hah! I discovered a virtual treasure trove of kiddie hats, pinned to the backside of a pillar near the deodorant aisle. Of course, they were each painfully pediatric – with neon colors, gold stars, and little plastic Hello Kitty and Barney type effigies. But, I could see that they were stretchy, and came with some tiny gloves created to be a “one size fits most.” Worried that my girlfriend would have to wait in the cold for me, I hurriedly made my purchase, tore the tags off the hot pink hat and forced it down over the top half of my ears. The gloves covered my four fingers and half my thumb.
I arrived at our meeting place just in time. My girlfriend approached with a quizzical expression, noting the large “Strawberry Shortcake” girl (inside a plastic heart) emblazoned on my hat. I could see that she wondered if my fashion sense had taken a turn for the worse since my move from NYC to Washington, DC two years prior.
I assured her that I had no intention of wearing the hat again, but that desperate times called for desperate measures. She stood in front of me in a full running suit, complete with a layer of long johns, ear muffs, and two layers of Goretex. I felt utterly unprepared in my light cotton shirt and Lycra pants – but at least now that my head was half-covered, I figured that running would keep me from freezing to death outright.
And so we set off on a 4.5 mile jaunt, a hilly distance that neither of us had run in over a year. I had tried to prepare for this day with elliptical training, but wasn’t sure that my cardiovascular reserves would handle this new form of exercise.
Much to our surprise, the icy wind quickly numbed all sensation in our legs, allowing us to jog without much awareness of potential pain or exhaustion. We soon settled into a nice, slow jogging rhythm and took turns catching up on one another’s news. My uphill breathlessness tended to shorten my usually animated description of life-events, reducing me to caveman-like accounts. “Me take new job at hospital. Good.” Though I did much better on the downhill stretches.
In the end my girlfriend and I felt quite triumphant about the fact that we made it the full 4.5 miles without a break. We both knew that another 3 weeks of training should put us in good standing for the Colon Cancer Challenge, though my friend suggested that if I wore the Strawberry Shortcake hat again, she might pretend that she didn’t know me.
Today, of course, all my leg muscles are sore – but it’s nothing compared to what Seton is going through with her chemotherapy. I wish her all the best in her fight against cancer, and hope that my participation in the Colon Cancer Challenge will provide her with some encouragement, if not comic relief.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 14th, 2008 by Dr. Val Jones in Uncategorized
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Happy Valentine’s Day folks – hope you have some great plans tonight with your significant other… but if not, [insert hopeful grin], why not join me, crzegrl and Jenni from Chronic Babe at the Dr. Anonymous show tonight (Feb 14th from 9-10pm EST)? We’re going to be talking about gender differences in medicine, romantic patient stories, and the importance of good relationships. There’s a live chat feature, a call in number, and a video feed of our host, Dr. Anonymous.
I hope to see a few of you there in the chat room or calling in! If you can’t make it, check out the podcast link tomorrow on Dr. Anonymous’ website.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 10th, 2008 by Dr. Val Jones in Uncategorized
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I am so excited to see that we now have more than 1000 people working together to lose up to 20 pounds by spring. Why are people flocking to this group? Here are my thoughts:
1. People want to lose weight (this is my “no, duh” point)
2. Support groups help people with accountability – the Hawthorne effect (people work harder when they’re being watched) is powerful and we’re using it to our advantage.
3. The people in my group are really cool – they have creative ideas and are always encouraging one another to strive harder.
4. The activity tracker is fun – you can fill out a daily check box regarding your diet and exercise compliance.
5. I can offer medical information and guidance when necessary, plus I’m an enthusiastic cheerleader.
6. It’s free and really easy to use.
7. We’re using the American Heart Association fitness guidelines as part of a comprehensive weight loss strategy.
At this point in the year, at least one third of people have given up on their New Year’s resolutions… but the trick is not to wait another year to get back on track. If you’re struggling with weight loss goals, why not join me and 1000+ other motivated people who want to make long term habits that will get us all to a healthier place? We have weekly challenges, and share everything from recipes to pet photos. Come on in, the water’s warm!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 8th, 2008 by Dr. Val Jones in Expert Interviews, News
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Much to the dismay of scientists, policy makers, and health care administrators, good medical decision making is not always black and white. I understand and sympathize with our desire to distill complex disease management issues into specific, easily measured variables. But unfortunately, the human body is exceedingly complex, and willfully resists reductionist thinking.
The recent ACCORD trial (which was designed to quantify the value of aggressive glucose management in a diabetic population) actually demonstrated a higher mortality rate in the intensive treatment group. What? That’s right, people were more likely to die if they had been randomized to the group that used all means necessary to keep blood sugars in a near normal range.
Now, this does NOT mean that it’s a bad thing for diabetics to keep tight control of their blood sugars, but it MAY mean that if they have to take high doses of multiple drugs to get them to that aggressive goal, the negative drug side effects may collectively outweigh their benefits.
I spoke with Dr. Zachary Bloomgarden, a renowned diabetes expert, to discuss his interpretation of the trial results. Here is a snippet from our interview:
My feeling is that this study shows that there is an art to medicine, and that patients can’t be managed via cookbook methods to treat their disease. If a person can control their blood sugar to an A1c of 6.0 without using too many medications, then that might be a good goal for him or her, but if you have to take high doses of several pills to get to that same goal (and therefore experience all the unfavorable additional side effects from taking them like weight gain, fluid retention, and potential arrhythmias) then it might not be appropriate in that case.
Ultimately, it takes a personalized approach by an experienced physician to determine the best treatment plan for an individual patient. One size doesn’t fit all – that’s part of my
take away from this study. We still
certainly want all people with diabetes to do as well as they can with blood
sugar as well as blood pressure, cholesterol, and the myriad other markers of
control of the disease.
And so my plea is that in our race to ensure “quality care for all” in this country, we take a moment to consider that real quality may not be about getting every patient to the same blood test target, but to get every patient to a primary care physician who can apply evidence based recommendations in a personally relevant way. Cookbook medicine is no substitute for good clinical judgment. Let’s invest in our primary care base, and make it financially viable for them to spend the time necessary to ensure that their patients are on individually appropriate therapeutic plans. I hope our next President will appreciate the critical role of primary care in a healthy medical system.
Addendum: a like-minded fellow blogger weighs in on the study
.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 7th, 2008 by Dr. Val Jones in Uncategorized
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Valentine’s Day is one week from today. Since I’m a bit of a blog geek (ok, my husband calls me the “bloginatrix” – go ahead, you can laugh), I can’t think of a better way to spend MY Valentine’s eve than with Dr. Anonymous and 3 other lady bloggers: Crzegrl, Chronic Babe, and Emergency Em on a special Blog Talk Radio feature show! The idea for the show came up when I was complaining to Dr. Anonymous about the fact that most of his guests were male, and that the conversations inevitably degenerated into viagra and cialis debates by the end of the full hour. I suggested that a little bit of estrogen should be added to the testosterone-focused show, then the ladies in the chat room piped up with an enthusiastic, “Let’s have a lady’s night – we’ll call it Estrofest!” And the rest is social networking history.
So please mark your calendars – join me for “Estrofest” on a special Valentine’s Day radio podcast on the Dr. Anonymous show, 9-10pm EST, February 14th. You can call in and chat with us ladies, or just listen in to what we think about medicine, dating, and life in the blogging fast lane. I’m going to do my best to keep this PG-13, but with fellow guests like crzegrl, I’m not sure it’ll be entirely within my control.
Hope to see you at the show!
P.S. Don’t fall for the pressure of Hallmark et al… you can be “romantic” any night of the week… postpone your Valentine’s Day plans with that special someone, and join us at Estrofest!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
