Evidence

Posted by Liz on May 19, 2014 in menopause | 0 comments

A few weeks ago, I found myself in the midst of a discussion about the value of acupuncture for a variety of diseases. And I quickly realized that there was no value in continuing the dialogue as the person who had started the discussion had no interest in hearing anything but his own point of view.

This is commonplace in allopathic, or Western Medicine.

There is a word that is thrown around a lot in scientific circles: evidence. If something has not proven beneficial according to scientific standards that rely on a specific framework of measures, then it has no value. However, in my small circle, value is defined a bit differently and evidence, taken as a grain of salt because not everything can be explained away by science. Or by a clinical trial that creates an artificial environment to evaluate benefit. And practitioners who rely on nothing but this artifice, I posit that perhaps it is their patients who suffer the most, the reason being that even the standards aren’t truly standardized.

Several years ago, Mike Clarke from the School of Nursing and Midwifery at Trinity College in Dublin wrote a great article  about the need to standardize results of studies for a specific disease ( in this case, rheumatoid arthritis). He defined the problem as follows:

“Every year, millions of journal articles are added to the tens of millions that already exist in the health literature, and tens of millions of web pages are added to the hundreds of millions currently available. Within these, there are many tens of thousands of research studies which might provide the evidence needed to make well-informed decisions about healthcare. The task of working through all this material is overwhelming enough without then finding the studies of relevance to the decision you wish to make…”

So what do you do? A few key points:

• Consider that every study has the potential for bias. Perhaps researchers are using 7 instruments to measure depression and only highlight findings from 3 of these in order to preserve the most positive or significant results. Clearly, the reader is being led towards certain outcomes and away from others. And regardless of what one believes, statistical analyses do not always reveal the truth.
• Study designs, types of patients studied, age of patients studied, gender, you name, can differ so it’s difficult, if not impossible to draw definitive conclusions when comparing results of one to another.
• Another issue of great interest to practitioner of Western medicine is whether or not a study is controlled. This means that two groups are compared that are identical in every way except one group is given an experimental treatment and the other, a placebo or standardized treatment. Note that often, real world conditions are often recreated rather than conducted in a real world setting and many studies are not controlled, meaning that the science behind the findings is questionable. And, what is often missing in these studies is the individualization of treatment – no one patient responds the same way as the other. Importantly, Eastern medicine recognizes this and adjusts treatment accordingly.
• I can’t emphasize this last point enough: alternative and complementary medicines are still incompletely understood among many practitioners of Western medicine. What’s more, agents are not regulated carefully and manufacturing practices may vary. Consequently, studies of these agents or modalities are often inconclusive. And of course, often underfunded and under-appreciated.

I’ve written several times about the importance of consulting a practitioner or medical expert before embarking on any regimen for peri- or postmenopausal symptoms. In fact, you should consult several and then compile the information to devise a plan that works best for you. You may need to try different combinations before you find the key to your individual health. Yet, if you only see someone once, at least that dialogue may be useful for initially defining a regimen that may work best for you and what you’re going through. For those of you who live off the beaten track without access to a good practitioner,  excellent resources like Medline or the American Botanical Council may be be of help in discerning what’s what.

The short answer is that there are no short answers. But with careful guidance and a bit of prudence, you may just be able see the light and smooth out the bumps on this rollercoaster ride we’re all on.

Guyside: what the Michael Sam backlash teaches us about us

Posted by Bob LeDrew on May 14, 2014 in Guyside, men, relationships, sexual desire, Uncategorized | 0 comments

If it hadn’t been for two men kissing, I doubt I would have taken any notice at all of the NFL draft last week. While there are lots of people in Canada who are big NFL fans, I’m not; frankly, if I’m watching football, I’m watching the Canadian game, with its bigger field, fewer downs, and more freewheeling style. But I’m not here to talk about our superior game.

The big story out of this year’s NFL draft was the selection of Texan Michael Sam by the St. Louis Rams. Or, more precisely, the big story was the video of Sam sharing a celebratory kiss and hug with his boyfriend Vito Cammisano (who, Wikipedia tells me, is also an accomplished athlete.)

Miami Dolphins safety Don Jones tweeted the word “horrible.” Others criticized ESPN for broadcasting the display of affection, saying “kids are watching.” A former Ole Miss basketball player tweeted that he was boycotting ESPN because his 7 and 11-year-old brothers were exposed to the video clip, then after being subject to a large backlash, said that his tweets had been part of a friend’s psychology project.

Suffice it to say that there was a lot of shock and horror that this athlete would engage in a display of same-sex affection on camera, and that it would be broadcast.

My friend Joe wrote about how he talked with his daughter about this, and it got me thinking about us heterosexual guys and our complicated relationship with gayness. When I was a kid, the worst thing that you could call another guy was one of the pejorative terms for “gay:” fruit, faggot, fairy. And certainly in my world of popular culture in the 1970s and 1980s, there were very few examples of gay men. It was known that Elton John was gay. There were rumours about David Bowie. But certainly there were no out gay men in my world, and I never met someone who was out until I went to university in 1983.

Things have changed since then. I now count many GLBT people as both casual and deep friends, and I’m part of one of  city’s major events for the GLBTQ community. So what have I learned? First off, none of that has led me towards changing my sexual orientation. I’m as straight as I was in my teens, or even back further than that (if you can have a sexual orientation at that age.)

Second, I can’t imagine a set of circumstances that would turn me from a guy who likes women to a guy who likes other guys. And that lack of imagination has led me to believe that it’s unlikely circumstances exist that would change a woman who loves other women to a woman who loves men, etc. So I can’t get behind the idea that someone (child or adult) seeing two men kiss on television is going to be “twisted,” “scarred,” etc. I also don’t see how it’s difficult to explain that behaviour to a kid — “Those guys? They love each other, so they’re kissing. Some guys love other guys.” Apparently, I’m not the only one.

Third, objecting to something does not mean you get to be insulated from that’s thing’s existence. Nobody has the right to tell you that your opinion on gay men is wrong. But you don’t have a right to never see or be exposed to gay men in your life, and it would be a lot easier for everyone if you can say to yourself and others “The Bible tells me that homosexuality is wrong.”

Finally, we straight guys have to get past the double standard that seems to exist around gay men. I don’t think I need to tell you that there’s a lot of attention paid to women kissing women — and men watching them. But when it comes to men kissing men, there’s what many would say is a visceral reaction of revulsion. I believe that reaction is learned and reinforced by society.  (And to be clear, I have no evidence to support that beyond that of my own life.) We are taught to be revolted by it. We then write scripts to justify it, that often involve either direct damage (based on the broadly-debunked belief that homosexuality and pedophilia are related) or psychological damage or scarring (based on the broadly-debunked belief that gayness can be “taught.”)

We need to accept people and things and behaviour at face value. Two guys kiss? Yup, they kissed. No more than that. A guy likes guys? Yup. As men, let’s get past the taunts and the immaturity that we grew up with around this stuff.

What’s it all about, Flashfree? The Lowdown on Estrogen

Posted by Liz on May 12, 2014 in estrogen | 0 comments

I spend a lot of time and energy discussing the role of estrogen in menopausal symptoms. However, it occurred to me recently that readers might not truly understand the distinction between pre and post menopause and how estrogen levels interact with the body to cause a host of issues.

A few months ago, the Endocrine Society sent me an infographic that does a great job distilling this topic down to an understandable level. While I typically stay away from infographics, I like this for a number of reasons, including the fact that it is from a reputable source — the Hormone Health Network.

Skin cancer, driving and technology

Posted by Liz on May 9, 2014 in appearance, skin cancer | 0 comments

It’s Skin Cancer Awareness month, an important reminder to use sunscreen.

Indeed, according to recent estimates, skin cancer accounts for half of all cancers in the U.S. More than 3.5 million cases of basal or squamous cell skin cancer are diagnosed yearly; these types of skin cancer are generally found on the base or surface of the skin and can be cured if treated early enough. Melanoma — the most deadly of all skin cancers that affects the melanocytes, or cells that create skin pigmentation — accounts for more than 2/3rds of skin-cancer related deaths; this year, more than 76,000 cases are expected to be diagnosed. And, one person dies of melanoma in this country every 57 minutes. 

In other words, skin cancer is not something to mess around with.

If you are like me, a child of the 60s and 70s, catching rays meant baby oil and tin foil. My father, who is in his late 80s, grew up on the beach and has spent the last 20 years having patch after patch of skin cancer removed. His body is a veritable skin cancer harvester, and he has even been permanently disfigured due to a botched procedure to freeze cancer cells below the surface of the skin on his nose. He’s lucky; he’s still alive and catching those cancers early enough.

I can’t emphasize it more: wear sunscreen. Moreover, wear it when you are in the car!

A study in last June’s issue of the Journal of the American Academy of Dermatology demonstrates that sun protection while driving is sorely lacking, despite the fact that driving evidently constitutes the largest percentage of total time spent outdoors, more than exercise or gardening. Moreover, on average, the majority of people in this country spend 80 to 100 minutes of their day in their cars.

Mind you, this is a retrospective study, which means that the researchers look back at events that have already occurred; this case, they mailed surveys to 675 patients who had previously attended a surgical clinic for skin cancer. Of all of these patients, 90% had a history of at least one type of skin cancer and 30, of malignant skin cancer.

Ironically? A majority did not believe that they needed to wear sunscreen while driving regardless of whether or not the windows were open or closed, although 53% of people with a prior history of skin cancer thought that they should wear it with the windows open. Real life use of sunscreen was different; about a third of these people reported wearing sunscreen “most of the time,” while only 15% used it while driving. What’s more, about a third of the people who reported wearing sunscreen most of the time while in a vehicle did not apply it to their arms or hands.

Additionally, having tinted car windows didn’t seem to provide additional protection. An equal percentage of people with or without tinted windows developed non-malignant skin cancer (85%); the only difference was the side of the body the skin cancer resided.

Here’s what you need to know:

• Automobile glass does not contribute to skin cancer equally. Important factors include the type of glass, the degree of tinting and the presence or absence of lamination or UV-absorbing film.
• In one study, clear auto glass transmitted 62% of UV radiation whereas dark-tinted glass transmitted 11.4%.
• Windshields are made from laminated glass that allows, on average, 2% transmission of UV radiation. Conversely, your side and rear windows are typically non-laminated and allow up to 80% of UV radiation. This means that the shoulder, arm and hand closest to the window needs to be protected because they are receiving the highest exposure to UV rays.

But, there’s a silver lining too!

Researchers at the University of Strahclyde in Glascow, UK have developed a monitor for preventing risk of overexposure to the sun. The device, which is called “Smartsun” is a waterproof wristband that changes color according to your amount of ultraviolet (UV) radiation exposure.

As exposure increases, the wristband turns from yellow to pink.  

The change in color is created by an acid-release agent that detects UV light and a dye to responds to pH levels.

Smartsun is currently available through UK retailers but global shipping is available through echemist. I don’t know about you but this seems like an easy way to keep track of sun exposure, even while driving.

Don’t mess with skin cancer. Wear sunscreen. And check out Smartsun!

Guyside. It’s spring! (It’s spring?!) Take advantage.

Posted by Bob LeDrew on May 7, 2014 in diet, exercise, Guyside, health, general, Inspiration, men, physical fitness | 0 comments

These t’ai chi practitioners in Beijing have the right idea about spring – get outside and let it buoy you up.

I am not a giant fan of winter. So even a spring as tentative and tantalizing as 2014’s is a welcome thing. You can feel the sun’s warmth on your face, and maybe even on your bare arms. Things begin to bud out in the gardens, early flowers show themselves, and everything seems new again. It’s wonderful.

If you feel the way I do, why not take this opportunity to make a fresh start on some personal care? Here are some ideas:

• I have a fairly substantial bike ride coming up, so that means that I am getting out on the road more and more to get the legs in shape. In my city of Ottawa, there are lots of 12-month cyclists, but I’m not one of them. I ride inside, but that’s never quite the same as being out on the road.
• I also find myself walking to places that a month or two ago I would have driven, because it’s not boneshatteringly cold out and it’s pleasant. Are there types of exercise that winter makes more difficult that you can start doing (or restart?)
• We’re lucky enough to have a garden and a patio, so don’t discount the raking, hauling, sowing, weeding, gopher-chasing, and other outdoor things that you have to do to get your garden started. If you’re reading this where things are far beyond our early garden phase: I hate you.
• If you’ve been relying on comfort foods and root vegetables (or worse, sports on TV and chicken wings!) to get you through the winter, start thinking about finding leafier greens to eat, from the closer the better. Farmer’s markets start opening up this time of year, offering us fresher produce and the opportunity to revisit our diets.
• Relax. Whether it’s on my own patio or whether I’m at a coffeeshop or pub, patio season is a wonderful thing. Take opportunities to sit, unplug from the devices, be with yourself. Or be with other human beings, enjoying the time of year. Make the most of the season as an excuse to resume social life.

The businessman Sir John Templeton was once asked when the best time to invest was. His answer was “when you have money.” The best time to invest time and energy in yourself is when you have time and energy. Let the changing season fill you up with some of that energy, and make the time. You’ll be thankful.

Photo: creative-commons licenced by Flickr user Faungg’s Photo

There’s a new wine in town…

Posted by Liz on May 5, 2014 in hot flash | 0 comments

I love wine. I drink it regularly, even if it tends to promote a bit of heat of the hot flash variety. And, while I am certainly not a oenophile, I take great pleasure in exploring different wines from different regions and countries.

So, I was dumbstruck when I started researching a topic for this week’s posts and ran across Hot Flash Wines. 

There’s a new schtick in menopauseland and it’s wine, that is, ‘A Wine for your Mood at the Moment.’ Let’s take a sampling of the selection, shall we?

• Mood Swing Merlot $18.99/bottle
• Covers Off Chardonnay $16.99/bottle
• Zin-O-Pause $18.99/bottle

That’s a pricey way to drink away the menopause or as the founder of the company, Mollie Openshaw would position it, celebrate, laugh at and make fun of menopause. I applaud Mollie and what she is trying to do; while Skinny Girl takes away the calories, Mollie and friends basically turn their backs on that nonsense and have a glass or two of vino. Their philosophy? Embrace who you are and what you’ve been given, and  living healthy is about loving life! Great messages, right?

But, here’s the rub. It strikes me that there is a recent history of appealing to female consumers through the label and admittedly, I am wary of marketing driven wines. I consider myself a wine drinker, not a gender-driven wine drinker and I care more about what’s inside the bottle than what’s slapped on the bottle. It’s unlikely that I’ll even pick up ‘Mad Housewife’ or ‘Rude Girl’  or if truth be told, ‘Hot Flash.’ Having never tasted a Hot Flash, I can’t say much about the flavor or quality of what Mollie is selling but for a hefty pricetag of $17-$19/bottle, let’s hope it’s better than the schtick because the act can only go so far before people lose interest and put their money literally where their mouths are.

Let’s celebrate being women who are in midlife before we start selling ourselves short, one bottle at a time. Hot Flash Wine? Hmmm. Not too psyched about this one.

Guyside: How old = not giving a crap anymore?

Posted by Bob LeDrew on Apr 30, 2014 in anxiety, Guyside, Inspiration, men, musings | 4 comments

Portrait of an artist not giving a crap

When I was a kid, I was a shy kid. Not shy enough to be tortured by loneliness. But a bit shy in specific contexts. I was fine playing saxophone in a concert band or in a marching band. I was cool with speaking in public or being part of the debating society. I would speak up in class, even crack a joke from time to time.

But there were things that just hit all my buttons. I first took guitar lessons when I was about 11. But other than an awkward and brief performance to get my one and only Cub Scout badge (before I quit for unrelated reasons), I went through YEARS where I only played in my room. And I NEVER sang.

That years was actually decades. And then, things changed. Why? Well… the summer I turned 40 I got diagnosed with bladder cancer. That was not a good summer. And one of the things that I decided to do to follow my heart a little more, to stop putting off ’til someday, was to start hosting house concerts. Those are gatherings in which you invite a professional musician to perform a show in your house, then invite friends, neighbours and colleagues to come and pay the performer for his or her or their work.

Once we decided to do that, we set a date in February, my partner’s birth month. And then I decided to open the show with a couple of songs. Which I had never done before. Not an open-mike night, not a house party, not a campfire.

It was one of the most frightening experiences of my life. I stood in front of my partner, some of her and our friends, her colleagues, with a guitar and an amp and a microphone in front of my mouth and tried to get through two songs. It was petrifying.

I still struggle with stage fright. But I’ve done a fair amount of playing in front of other people since then. A few years after that, we were on our way to a friend’s cottage for a long weekend. “Bring a guitar,” he said. “We’ve never had a guitar at our cottage!”

One afternoon that weekend, I found myself on the dock, sitting in a Muskoka chair, noodling around and singing, my eyes closed against the sun’s rays. When I stopped and looked around, our host’s two teenage daughters and their friends were clustered around me. I then realized why smarter teenage boys than me played guitar in PUBLIC, and not in their rooms.

So what’s the point of all this? Well, for the last few weeks, I’ve been raising money for a two-day cycle trip that raises money for cancer research. As part of my fundraiser, I’ve been thanking people who donate more than $100 by finding a song with their name in it, learning it, and recording a Youtube video of it for them on ukulele. That’s led to a story in the local paper, and now to me being asked to do a 15-minute set at a local club as part of another fundraising concert. At a club that calls itself legendary. Yerk.

I still get stage butterflies, and probably always will. But I mostly don’t give a crap. I acknowledge the feelings of anxiety and the fear that I’m going to screw up onstage so badly that I’ll make an ass of myself as simply that — feelings and fears. And it’s happened, for sure. I just give much less of a crap about that possibility.

I have had some help learning those lessons, because the fear of screwing up catastrophically has run through other aspects of my life and led to some bad mistakes. But part of it has just been getting older and realizing that in a lot of cases… it doesn’t matter if you screw up. If I get the chord changes wrong or forget a line at Acoustics for Cancer Awareness, is someone going to ask for their money back? Will they think I’m a horrible person? Probably not. And if they do, imagine what a jerk that makes them!

And the greatest irony of giving less of a crap? Usually, the performance is better. I don’t mean to say we should not strive for excellence, or that we shouldn’t care about performance. But sometimes you just gotta do it and — at least beforehand — stop caring about the end result. Since we’re all getting a bit older, why don’t you join me in giving a crap about fewer and fewer things? It’ll do you good.