Skin Cancer Strikes Home

When you write about health as frequently as I do, a few things are bound to happen. You start to actually do some of the things experts suggest like shutting the toilet seat lid before flushing so as not to spray your toothbrush with poo water and letting go of guilt and just indulging in that good-for-you dark chocolate (hey! the experts recommend it!). You also start to become something of an expert yourself. An M.D. wannabe who self-diagnoses everyone – family, friends, neighbors, people in the checkout line at Target, and yes, yourself – with every ailment you write about. You know just enough to be dangerous. And annoying.

So it was no surprise that every mole and mark on my body started to look suspicious as I researched and wrote a Family Circle article about women with skin cancer. I take a peculiar pride in staying as pale as possible, but when you log 100+ hours on a bike every week in Colorado, you’re bound to show some signs of sun exposure no matter how many gallons of SPF50 you apply. There’s nothing like interviewing a half a dozen women who’ve had cancer sliced and diced off of their bodies to motivate you to see the dermatologist. In fact, all of us should see a skin doc once a year for skin checks (more often if you have a history of skin cancer). My husband and I were about 4 years overdue.

My neighbor recommended a dermatologist; appointments were made. Then my husband came home from getting a hair cut. “The stylist said I’ve got a brown patch on my scalp. What do you see?” he asked thrusting his thinning salt-and-pepper bulb in front of me. Now, my husband (of course) is a great-looking guy. But he inherited his mom’s moley skin, and that includes moles on his scalp. This patch? It was new. It was brown, kind of scaly looking. It wasn’t right. Unfortunately, my husband also inherited his family’s penchant to worry. They’re masters of the fret. So I didn’t say, “That looks like cancer” (but based on my research and interviews, it did). Nor did I say, “You know, I interviewed a woman whose hair stylist noticed a spot on her ear. It was melanoma.” (It’s in the Family Circle article; read it.) What I said was, “Yeah, I’d definitely have the doctor check that out.”

You know where this is going. That mini-M.D. was right.

Last week, my husband had Mohs surgery to remove basal cell carcinoma (BCC) from his scalp. If you’re going to get a skin cancer diagnosis, BCC is the one you want. Although it can be disfiguring, it’s not a killer like melanoma or squamous cell carcinoma (SCC). The Mohs procedure uses a high-powered microscope to ensure all cancerous tissue is removed during one surgical procedure. There’s a 99 percent cure rate. My husband will be fine (although he’ll be more vigilant about wearing sunscreen and hats, and he will need to see a dermatologist every six months for a while).

The chances that you or I will get skin cancer are high. It will happen to one out of every five adults. Going to a tanning bed? Sigh. Why not just start smoking? They’re both self-destructive. Fake baking makes you 74 percent more likely to get melanoma. It also ups your risk of BCC and SCC. Plus, have you seen the photos of the leather-faced mom accused of letting her kindergartener use a tanning bed? If that doesn’t stop your tanorexia, what will?

Skin cancer doesn’t discriminate. It can and does strike people with dark skin, pale skin, those with freckles, those without, African-Americans, Hispanics, the young and the old. It happens to everyday women like the ones profiled in the June issue of Family Circle. It happens to people like my husband.

Visit the American Academy of Dermatology to find a dermatologist near you.

Playing matchmaker with someone’s life

I recently completed my donor kit for Be the Match. It was so ridiculously fast and easy that I felt awful that the envelope had sat untouched on my desk for close to a month. I guess I thought it would be more involved and that I should set aside time to complete the program correctly. Nope. I should have done it a month ago, and I encourage you to join me (but to do so more quickly than I did).

Here’s the deal: Be the Match is operated by the National Marrow Donor Program. NMDP estimates that at least 10,000 Americans with blood cancers like leukemia and lymphoma, sickle cell and other life-threatening diseases need bone marrow transplants. The closer the match, the better the chance of having a successful transplant (and saving a life). Unfortunately, finding the right match can be a challenge. This is where people like you and I come in. NMDP’s Join Now page walks you through some simple questions about your age, gender, race (the program desperately needs ethnically-diverse donors), and general health. There’s a consent form to sign, some contact info to fill out, and NMDP mails you a kit that includes really long Q-tips (yeah, I’m oversimplifying). You swab the inside of each of your cheeks with these Q-tips, slide them back into the kit and drop the postage-paid envelope into the mail. That’s it!

Now, you go on with your life grateful that you’re not on the other end of the program: waiting for someone to pop up as your lifesaving match. Unless you request to be removed from the program, you’ll be listed on the registry until age 61 (older cells are less likely to be helpful). What are the odds that you’ll be called on to help? About 1 in 540. Younger donors between ages 18 and 44 are 10 times more likely to be needed. And as noted, people of different races are also in high demand.

I can’t tell you what it’s like to donate marrow since I’ve never done it (the cheek-swabbing, though, was painless). NMDP’s site says a hollow needle is used to withdraw liquid marrow from your pelvic bones. Yes, that sounds uncomfortable, but you’re numbed. Or you might be asked to go through a procedure similar to donating blood.

Joining Be the Match is free. Of course, NMDP incurs costs to test every participant, so donations are always welcome. And if you don’t think you could actually go through with donating marrow, don’t waste NMDP’s time or resources. But do consider making a tax-deductible contribution. 

On Mom’s Birthday: The Ultimate Gift

Today would have been my mom’s 65th birthday. She passed away two years ago just five days after turning 63. Her death certificate reads “probable aortic aneurysm.” That’s a bulge or weakening in the lower part of the aorta, the major blood vessel that supplies blood to the body. It’s as good of a guess as any. Mom was sick for years before she passed. In the last month before her death, she spent more days in a hospital than out. I wish I could tell you exactly what was wrong: that she had some sort of cancer or other readily diagnosable problem. But her illnesses (yes, plural) baffled doctors. She would have been a terrific test case for Dr. House.

In addition to type 2 diabetes, high blood pressure (that was a new thing: she, her mom and I all have really low BP, but then mom’s skyrocketed), and the lovely bipolar disorder, docs eventually slapped her with the diagnosis of “mixed connective tissue disease.” I know. What? It’s a mix of various autoimmune disorders including lupus, Reynaud’s and rheumatoid arthritis. Yep, mom had all of those. Steroids were about the only thing that helped, but of course, you’re not supposed to be on those long-term. MCTD didn’t exactly do her in, but it paved the way. When you’re popping a kaleidoscope of pills hoping one will make your day somewhat grin-and-bearable, it takes a toll on your body. Not eating and drinking will do that too, and towards the end, mom was unable to keep much down.

Mom was an organ donor, but in the end, her body was so spent that the only part they could use were her corneas. And her body. Years before becoming ill, mom did one of the most selfless things a person can do: she signed the paperwork that would donate her body to a medical college upon her passing. The fact that mom died in a hospital made this donation easier, but one needn’t be in such a setting to give this gift. Every large state medical college accepts donated bodies (also referred to as cadavers). They’re used to teach residents the ins and outs of the human body (things you can’t learn from a textbook). Sometimes they’re used for research purposes. You can find info about your state’s process by googling the name of your state + body donation. That’s what I did after mom died. In her honor, I’m now a body donor too. I know it’s not for everyone. The way I see it, when I’m dead, I’m done with my body. I don’t want a funeral where people can gawk at my remains. We still had a lovely memorial service for mom after she died; and then, about six months later, the medical school sent us her ashes. There were also several touching services held at the medical school for the families of those loved ones who gave this ultimate gift.  It didn’t cost my family a dime, and I feel certain that her donation has helped several doctors become better at what they do. My mom was a very giving person, so the fact that she did this doesn’t surprise me. I know it can be off-putting to some, which is why I encourage you to learn more about body donation. It may not be the right choice for you, so consider organ donation instead. And the next time you see a doctor, send up a silent thanks to people like my mom who, in the end, really did give their all.

5 Ways to Keep Your Kid Healthy and Safe at the Hospital

One of my sons underwent emergency surgery in March to have his appendix removed. He was in good hands, of course, but still… it was scary. It didn’t help that I had recently written a Parents magazine article about “Eight Medication Mistakes Parents Make.” While that piece focused on blunders made at home, I knew from my research that medication mistakes happen in hospitals, too. In fact, a 2004 Pediatrics study shows that about 4,500 hospitalized children die each year due to medical errors. If your child’s hospitalized, you can lower his risk of problems by following these tips:

1. Speak up. You have a right to question or voice your concerns to anyone involved in your child’s care.

2. Don’t let anyone give your child a medication without first finding out what it is, what it treats, why it’s needed, who prescribed it and what the side effects are. Make sure the health provider is aware of other medications your child’s taking and ask about possible interactions.

3. Find out why a test or treatment is needed, how it can help and when you can expect to get the results.

4. Be sure every health provider has your child’s medical history including her weight and age, allergies, and other medications or supplements she takes.

5. Talk to your child’s doctor and surgeon to make sure you all agree on what surgical procedure is planned, why surgery is needed and what to expect during recovery.

A Tough Pill (for kids) to Swallow

Recently, my 10-year-old son had to take a prescription medication for a week. Because he’s getting bigger, his doc said it would be a large amount to swallow if he wanted the liquid, so we decided to try pills. Now, my son brags that he’s swallowed grapes whole (yeah, I know that’s a dangerous choking hazard; trust me, he’s had the lecture), but hand him a pill the size of a Tic-Tac and he gags up a soggy glob of medicinal goo. It’s exasperating for us both. I checked with his doctor and pharmacist and confirmed that the pill could be crushed and mixed with applesauce (not all medicines can be mixed with food so definitely check before doing this); we had that back-up option. Still, I kept thinking that my tween ought to be able to choke down a relatively small and slippery pill (after all, there are kids who swallow pills on a daily basis – kids with cancer, ADHD, mental illness). The question was how to make this happen.  Most experts say kids can swallow pills starting around age 5, so I started searching to see what tricks I could try with my 10 year old. What I learned is that we were making many mistakes like these:

Wrong way: Place the pill as far back on the tongue as possible.

Swallow success: For some reason, pills go down easier when placed in the middle of the tongue.

Wrong way: Tilting head back.

Swallow success: The NYU Child Study Center suggests keeping the head level though it doesn’t say why. My guess was that a backward head tilt could restrict the flow of liquids through the esophagus, but then I read that the head tilt actually opens up your airway. Pills need to go into the stomach via the esophagus, not into the lungs via the windpipe. The same experts also suggest having your kid lean forward if he’s swallowing a capsule because they’re lighter and tend to float forward in the mouth. Leaning forward actually helps move the capsule toward the back of the mouth.

Wrong way: Doing a dry run.

Swallow success: Have your child wet his whistle before he tries swallowing a pill.

Wrong way: Taking sips.

Swallow success: Your kid should take big gulps of water (at least two or three in a row) to help the pill go down. Another idea: place the pill on the middle of the tongue and have your child fill his mouth with water until his cheeks are full. Or have him take big gulps through a straw.

Some other great tips I learned:

  • Practice with sweets. The NYU Child Study Center suggests using round candy decorations found in cake decorating aisles. Buy various sizes and start with the smallest. Once your child’s mastered swallowing it 5 times successfully, move on to a bigger size until the last thing you offer is a Tic-Tac. I think Jelly Belly jelly beans, mini M&Ms (as well as regular ones) and Skittles could all work well too.
  • Try the under-the-tongue method. Place the pill under the tongue (not on top of it) and then have your kid take several big gulps of water.
  • Blow up his nose. Say what? I know… sounds very weird. But according to the experts at North Shore-Long Island Jewish Health System, blowing in your child’s face (specifically up his nose) may smooth the pill swallowing process.

What worked for us was a combination of techniques. Some days he could get the pill down by placing it on the middle of his tongue and filling his mouth with water. Once, the under-the-tongue method worked. The blow-up-the-nose method made us laugh and that didn’t help the pill swallowing process at all. Some days, I just took the spit-covered glob and mashed it up with some applesauce. The important thing was that he got the medicine he needed.

If you’ve been there/done that with your child, tell us how you helped him/her get the medicine down.

Splish Splash, It’s Swimmer’s Ear

We’re fortunate to live in a community that has 4 rec centers each with an indoor/outdoor pool. During times like these (when temps hover near 100 every day) my boys and I visit those pools often. It’s great fun until one of them starts complaining that his ear hurts. I can’t recall a summer where I didn’t haul one or both kids to the doctor to get treated for an ear infection called swimmer’s ear (aka otitis externa or an infection of the outer ear canal).

You’ll be shocked (not!) to learn that water is the main culprit behind swimmer’s ear. When a kid swims, or even sometimes just from bathing, water can get trapped in the ear canal. Bacteria multiply quickly in this moist environment and infection sets in. Here’s an easy way to tell if you’re dealing with swimmer’s ear instead of the more common ear infection otitis media, which occurs in the middle ear and is often set off by a cold: Tug on your child’s earlobe. If he screams “Ow!” and looks at you like you’re the meanest mom ever, he probably has swimmer’s ear. (Your kid may also complain that his ear itches or feels blocked.) Knowing which type of ear infection you’re dealing with is important because kids with swimmer’s ear need antibiotic ear drops; kids with regular ear infections may get better on their own or they may need oral antibiotics. Either way, they should see a doctor.

One of my kids has had swimmer’s ear once already this summer, and the CDC estimates the infection leads to 2.4 million doctor visits every year. Since I’m trying to prevent another visit, I’m now trying these helpful tips from the AAP:

  • Towel dry ears after swimming and bathing
  • If you can get your kid to agree to it, have him wear earplugs when swimming (alas, mine says no way!)
  • Make a homemade ear drops solution and apply a few drops to each ear after swimming. The AAP suggests a mixture of one-half alcohol and one-half white vinegar (so you could mix 1/2 tablespoon of each and save the remaining mixture for future pool outings). Don’t use this concoction if you think your child’s already battling an infection. The drops wilsting like crazy, and you may indeed be recognized as the meanest mom of the year.

The United States of Obesity

     My home state of West Virginia is once again making headlines. According to a recently released survey from the Robert Wood Johnson Foundation, more than a third of all Mountaineers are obese; only Mississippi and Alabama have more obese residents. West Virginia’s been losing the battle of the bulge for some time now (20 years ago, it was the 4th fattest state), so this isn’t exactly news. It always bugs me when people refer to West Virginia as a southern state (I lived in the northern panhandle which is much more aligned with the decidedly nonsouthern states of Ohio and Pennsylvania; plus, folks from the south still refer to us as Yankees), but the survey lumps W.Va. in with other struggling southern states and I’ll admit that’s a fair assessment. Besides bursting at the seams with fat folks, the heaviest states  – Mississippi, Alabama, West Virginia, Tennessee, Kentucky, Louisiana – have more than their share of poor folks. Not surprisingly, a lot of these people are depressed. Also not surprisingly, most don’t get any help for that depression. Instead of Prozac, they reach for full-fat ice cream or chips and dip. Besides antidepressants, you know what else boosts mood? Exercise. But when you’re living paycheck to paycheck, a gym membership isn’t exactly in the budget. My W.Va. relatives, unfortunately, are doing their part to ensure the state eventually is ranked first in fatties. I grew up there, I get it: As a kid, I rode my bike freely on the road in front of my parent’s rural house. Today, I won’t even walk on the berm for fear of being flattened by coal trucks and gas and oil company rigs. The area has changed. The nearest gym is a good twisty, turny 30- to 45-minute drive away. Finding a way to exercise is a challenge, to say the least.

     Today, my husband, sons and I live in Colorado, the state with the smallest percentage of obese residents of any in the nation. Unfortunately all this really means is that we’re the skinniest of the increasingly fat. Fifteen years ago, only 10 percent of Coloradoans were weighted down with excess pounds; that number’s now doubled to almost 20 percent. As one official said in this Denver Post article, “Being first in a race where everyone’s losing is nothing to be proud of.” Like the rest of the country, Colorado residents are packing more pounds than they should.

     Earlier this month, the USDA kicked its confusing food pyramid to the curb and replaced it with My Plate. The idea is that half of our plates should be filled with fruits and veggies (which are rich in vitamins, nutrients and

USDA’s My Plate

antioxidants) while the other half should be about evenly split between protein (meats) and grains (preferably whole ones). A small circle off to the plate’s side is for dairy (a glass of milk, a cup of yogurt). The nice thing about this redesign is that we can all relate to a plate (that pyramid thing? not so much). The government has given up trying to dictate how many servings we should strive for (we weren’t listening anyways), and instead is giving us a tool to help visualize what healthy portions and meals should look like. Of course, this will only help if people actually familiarize themselves with My Plate and use it. I’m curious, will you use My Plate when fixing your family’s meals?

     Want to see how fat your state is? Take a look at the full report.

Celebrate an Injury-Free 4th of July!

I was about 9 years old and mesmerized by the burst of white fire shooting from the sparkler I held in my hand. My parents had cautioned me not to touch those sparks: They were hot! Get this: I actually listened! However, they didn’t say anything about the sparkler still being hot once the pretty sparks faded away. That’s right: I wrapped my hand around the top part, and quickly found out that yes, it was still hot! I now know that sparklers, a seemingly safe firework for kids, can get as hot as 2,000 degrees Fahrenheit — that’s hot enough to melt gold! Not surprisingly, when something’s that hot, it takes a while to cool. I was at my grandma’s, so I’m sure my burnt palm was slathered with butter, an old-fashioned burn treatment that should never be used because it ups the risk of infection. (Treat minor burns instead with cool water, cold compresses (not ice), and aloe; give ibuprofen for pain.) We were a good 45-minute drive from the ER, and apparently I didn’t need medical attention as no one drove me there, and I seem to recall firecrackers and bottle rockets still being lit as I nursed my throbbing hand. Trust me, I haven’t touched the tip of a sparkler since and I’m very good at reminding my children to keep their paws off.

Fourth of July fireworks are a lot of fun, but they can be dangerous, especially for children. Last year, close to 9,000 people were treated for injuries caused by fireworks. Not surprisingly, most injuries occur during the 30 days surrounding July 4. Of the 2,000 people who suffered firework-related injuries, 800 of them (40 percent) were children under the age of 15. Kids ages 10 to 14 are twice as likely to be injured. Even with adult supervision (like I had) injuries, usually to the hands, eyes and head, occur. Sparklers and similar novelties accounted for a third of fireworks-related ER visits in 2009. The American Academy of Pediatrics recommends leaving the lighting to the pros; families should sit back and enjoy the show. The National Fire Protection Association concurs though their concern is fire danger, something my family’s familiar with since our arid state of Colorado is constantly battling wildfires. In 2009, fireworks caused about 18,000 fires (700 of them to homes) resulting in $38 million in property damage. None of this keeps parents (including yours truly) from buying sparklers, cracker snaps and party poppers in grocery stores for our kids’ enjoyment. It’s an American tradition, after all. Since we’re not going to stop buying, we need to practice these fireworks safety tips:

  • Don’t let children light their own fireworks. Only adults should play with fire!
  • Have constant adult supervision.
  • Keep a bucket of water nearby.
  • Light fireworks on smooth, flat surface away from homes.
  • Don’t try to relight dud fireworks.
  • Never throw or point fireworks at other people, animals or homes.
  • Soak used fireworks in a bucket of water before disposing of them in the trash.
  • Have a phone handy in case you need to call 9-1-1.

That Thingamajig Called Your Thyroid

 

 

My friend is having her thyroid removed today. After numerous biopsies with inconclusive results, her doctor thought it best to remove the gland. It’ll be biopsied to see if she has thyroid cancer, the 5th most common cancer in women. No one wants to have cancer, but this is one of the better ones to have: The 5-year survival rate is about 97 percent.

It seems as though every woman I talk to either has a thyroid problem or knows someone who does. My mom’s thyroid, for instance, was underactive. All that meant to me was that there was a medical reason for her weight problem. I never really understood what this thing called the thyroid was. With my friend going under the knife, it was time to find out.

Your thyroid gland is located on the front of your neck just above your collar bone. thyroidThanks to the Mayo Clinic for this helpful illustration, but now that Anatomy 101 is done, let’s get to the really important healthful stuff like why your thyroid’s important. For starters, it releases hormones that control things like how fast you burn calories and how fast your heart beats. In other words, it’s critical to your metabolism and therefore your weight. For unknown reasons, sometimes your thyroid starts acting wonky, producing too much hormone (overactive thyroid or hyperthyroidism) or too little (underactive thyroid or hypothyroidism). I have a hard time distinguishing between the two types, so I taught myself this trick: Hypo rhymes with low. If your hormones are low, your body functions will be slow so you won’t be torching many calories. Therefore: Hypo = Low (hormones) = Slow (metabolism) = Hello Weight Watchers! If your thyroid’s in hyper-drive, however, it’s revved like a hyperactive kid and using up all kinds of energy, including the calorie kind. As a result, you have no problem sliding on those skinny jeans. Since our country isn’t in the grips of a supermodel crisis, it should come as no surprise to hear that more of us have clunker thyroids than Porsches (about 5 percent have underactive thyroids or hypothyroidism compared to 1 percent with overactive thyroids or hyperthyroidism).

Thyroid cancer is a slightly different animal. According to the American Cancer Society, more than 44,000 Americans (75 percent of them women) were diagnosed with thyroid cancer in 2010. The disease will claim the lives of close to 1,000 women this year. The number of people diagnosed with thyroid cancer is on the rise, though experts say this may be due to new technology that makes it easier to find small cancers early. As I mentioned, the survival rate is very good, though it certainly helps if you know the symptoms of thyroid cancer which include difficulty swallowing, enlarged lumps in the throat, neck swelling, cough, hoarseness or vocal changes. I have a good feeling that my friend’s results will come back benign or noncancerous. Over the last six months, she’s really struggled with extreme fatigue, weight gain and depression. I hope this is the cure she needs to get her back on a healthy track.

Trampolines: Backyard fun or menace?

In middle school, the only P.E. activity I enjoyed was the trampoline. Mrs. J would haul it out along with the balance beam and the uneven and parallel bars. These days, little girls growing up in suburbia tackle these apparatuses with glee. We West Virginia farm girls looked at the equipment with puzzlement and fear. None of us had a clue how to “ride” these critters—except for the trampoline. After all, anyone can bounce. Even Tiggers do it.

Now these school gym-approved bouncers were different than the bulls-eye shaped metal beasts you see squatting in people’s backyards today. For starters, the school’s was a large rectangle and before anyone was allowed on it, you had to adhere to strict safety rules. This meant a swarm of 20 girls hovering around each of its sides, hands raised high to save the bouncer from taking a painful swan dive onto the bone-crushingly-hard gym floor. Flips were banned unless you were harnessed to a system of pulleys and cables. There was never more than one bouncer at a time. The trampoline was an exercise tool: one that could snap you into shape as easily as it could snap bones. It was, Mrs. J stressed, “Not. A. Toy.”

Heh, try telling that to my neighbor whose backyard trampoline sits cockeyed and sagging. That trampoline has been my nemesis since I first laid eyes on it. The latest statistics released in 2007 by Rhode Island Hospital researchers indicate that trampoline injuries send more than 88,000 people (most of them children age 5 to 12) to the ER each year. This May, my 18-year-old niece joined those ranks when she shattered her schnoz while playing a popular trampoline game called “popcorn.” Like a lot of tramp-related bone breaks, this one required surgery. She’s lucky. According to BrainandSpinalCord.org, about 20 percent of all trampoline-related spinal cord injuries occur to the head and neck. Some people become permanently paralyzed. Nets, unfortunately, can give a false sense of safety. In 2006, 5-year-old Ryne Cleary watched as his father, Kevin, failed to land a backflip on the family’s safety-netted trampoline; he’s been paralyzed ever since. In 2010, 11-year-old Tristen Roach died from a trampoline accident at his Virginia home. (I’m not sure whether his trampoline had a net.)

Despite my misgivings (and despite the American Academy of Pediatrics’ stance that home trampolines are unsafe and shouldn’t be purchased), my kids did bounce on their friend’s trampoline. It’s shameful, but I allowed their need for fun to outweigh my parental instinct to protect them. Last week, one of my bouncing boys lost his balance. There was no gym class full of spotters to stop his fall. His landing was hard, the scream heart-stopping, and the relief when he stood, clutched his back and hobbled home, most welcome. It was a hard, scary lesson for us all, and I’m grateful that he (along with my niece) are not permanently injured. Their pain and bruising will subside, but our family’s trampoline ban is forever.

If your family owns a trampoline, do you ever worry about your child or one of their friends getting injured? If you’re a non-owner like me, do you allow your kids to bounce when they’re visiting a friend or relative?