Wednesday, June 29, 2011

Men's Health: A Compelling Quality of Life Issue

It's time to Break It Down!

(Disclaimer: This post contains references that are graphic in nature, and which may be considered offensive; reader discretion is advised).

A couple of days ago I had a Colonoscopy, which is the endoscopic test of the colon and the distal part of the small bowel with a camera.  The procedure is recommended for men over age 50, on a periodic basis; every 10 years if no irregularities are found, and more frequently if non-benign polyps or other issues arise during the test.  Mine was scheduled as a regular sequential step in my Annual Physical regimen, not from any kind of alert or scare.  That is as it should be. 

This is not intended to provide a by blow-by-blow of my procedure.  I am addressing this topic to provide a public service.  I have observed both anecdotally and from numerous data streams, men in general and African American men in particular, are notorious for neglecting our health.  There are too many reasons to enumerate, but a few include:

·         Distrust of doctors (Some black men still reference the Tuskegee Experiment)

·        Fear…of doctors, of medicine, bad news, of pain, of surgery, of anesthesia, the 
      unknown

·         Unawareness of early warning signs

·         No regular doctor

·        Lack of health care benefits (African Americans are more likely to be
      Unemployed or Underemployed, and therefore less likely to have insurance)

·         Misplaced priorities (some men take better care of their homes and/or cars than
      they do their personal health)

·         Good intentions; bad execution (Many of us “intend” to” schedule an appointment
      to see a doctor, but don’t)

·         Procrastination (Delay, delay, delay)

·         Superman complex (The perception that one is young, healthy, and totally bullet
      proof)

·         We are on a super secret suicide mission (No, we just act like it)

Those are 10 of my own very unscientific, totally straight off the top of my head reasons.  After setting them to paper, I decided to look for an expert opinion…OK; I checked to see what a doctor thought.  Not surprisingly (to me anyway), there was a fair amount of overlap. 

Dr.Sharon Orrange, Assistant Professor of Clinical General Internal Medicine at the University of Southern California has weighed in with what she believes are “The 10 Real Reasons Men Don’t Go to the Doctor.”  Since she actually practices medicine, I will allocate more weight to her opinion than mine…though keep in mind, I do have the inherent advantage of being a man.  Dr. Orrange’s 10 most compelling (or real, as she puts it) reasons are:


1.     You are afraid we will pit our finger up your butt.  We will, especially if you are over 40 or have any complaints related to your bowel movements.  Yes, you get a rectal exam after the age of 40 once a year for a feel of your prostate and so we can check your stool for microscopic blood that you can’t see.

2.     You are afraid we will examine your balls.  We will, if you are 40 or younger. The peak age for testicular cancer is 18-40 so guidelines recommend you get a once a year testicular exam. Don't worry it won't hurt at all.

3.     I feel FINE.  I am glad you feel fine, but you can feel FINE with high cholesterol, high blood pressure and elevated blood sugars.  Your mother or wife won’t feel fine when they are taking care of you after you have a stroke.  Don’t wait until you feel awful to come see us.

4.     Going to the Doctor is a chick thing.  Many of you feel this way but remember we live longer than you do.  If doctor visits are a chick thing well, then, nursing homes are a guy thing.  You have to get over this.  It’s true, the waiting room magazines are not for guys but when you come see us you will see that many of the medical assistants, doctors, phlebotomists and medical records folks are men.  Real men go to doctors.

5.     You are embarrassed to talk about what’s going on with you.  The bright red blood on the toilet paper when you wipe, the red itchy rash in your groin and on your feet, the problems you have at times getting a boner, getting up at night a few times to pee, we hear it all the time.  You are not alone and our job is to show you how common this is and help fix it for you.

6.     You don’t find the office hours convenient.  I get this and urge you to find a doctor who is accessible and can work around your office hours.  Seriously though. The average guy watches 16 hours of TV a week, you can come for a 30 minute visit once a year and maybe a couple of follow-up visits as needed.

7.     Going to the Doctor is giving in to your nagging wife.  I had a patient who gave his wife for her 20th anniversary a copy of his Lipitor prescription, thinking this was a GIFT to his wife that he was taking care of his medical issues.  It is true, women rightly so nag their dads, brothers, and husbands to go to the doctor because they are tired of square dancing with women at the assisted living facilities.

8.     You don’t realize we are here for prevention.  You don’t have to be sick to come see us and if you establish a relationship with us you have easy access when you do get sick.  Once a year we can touch base with you to discuss age appropriate screening which we KNOW helps keep you well.

9.     You don’t have a relationship with a physician.  If you are not attached to a regular physician by the age of 40 you are more likely to get in trouble.  Unlike women who need annual pap smears and contraception, you haven’t had to see someone regularly from the age of 18-30.  Find someone your friends use or enlist your partners help to find someone that might be a connection.  You want someone accessible and younger physicians are much more likely to e-mail so look until you find the right match.

10. You think we will pick on you for your habits.  Drinking a 12-pack on the weekends, not exercising and eating bad foods, among other things.  These things are not as uncommon as you might expect.  We will put you on a long leash and let you pick and choose the habits to get rid of as needed.

If you are a Doctor Dodger, the reality is, it is of little consequence whether your reasons for doing so more closely resemble Dr. Orrange’s list or mine.  If your recalcitrance leads to a preventable heart attack, some form of cancer, or a stroke, you will have contributed directly to reducing your quality of life, as well as that of your family members.  Such actions could also lead to premature death.  It really is pretty simple; fear, embarrassment, death (sooner rather than later)…pick one dude!

Let’s be clear here, human beings are not immortal.  Psalms 90:10 advises us: “The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labor and sorrow; for it is soon cut off, and we fly away.”  Proponents of the Bill Maher School of Thought dismiss such biblical advisory as akin to magic, wizardry, or witchcraft.  But I am reasonably certain even Mr. Maher would concede that we all will die.

The point of seeing health professionals on a regular basis is not to live forever; none of us will.  Rather, the idea is to leverage the best possible existence out of our all too brief time here on earth.

As most of us know, women live longer than men.  Once upon a time, this was largely attributable to the rigors of backbreaking manual labor, and long before that, due to the results of men losing too many battles with the lions or other members of the Wild Kingdom, in the quest to determine who would eat...and who would be dinner. 

Neither of those historical tableaus aligns with today’s American reality.  No, the underlying contemporary contributory factors for those of us now living in the USA are that poor exercise habits, irresponsible dietary choices, too much smoking and drinking, and eschewing regular checkups and prevention screenings combine to lead to a lower quality of life (health wise), and ultimately, to a shortened lifespan; on average five years less than for women.

According to a 2007 Harris Interactive survey that included over 1,100 men, the American Academyof Family Physicians found that:

·         Many men go to the Doctor only when they are very sick

·         Before they did, many of these men waited several days to see if they felt better

·         Most of these men had a regular doctor

·         Most had currently active health insurance

·         Most said they felt comfortable talking to their physician

In an even more recent survey, conducted by Esquire magazine in January of this year, researchers found that:

·         Roughly half of American men ages 18-50 had no primary care physician

·         One third had not had a check-up in more than a year

·         More than 40% had never had their cholesterol checked

·         70% had never had a prostate exam

Do you perchance know the leading causes of death in America?  According to the Centers for Disease Controland Prevention (CDC), the latest complete information available is for 2007, and breaks down like this:

 Number of deaths for leading causes of death:

·         Heart disease: 616,067

·         Cancer: 562,875

·         Stroke (cerebrovascular diseases): 135,952

·         Chronic lower respiratory diseases: 127,924

·         Accidents (unintentional injuries): 123,706

·         Alzheimer's disease: 74,632

·         Diabetes: 71,382

·         Influenza and Pneumonia: 52,717

·         Nephritis, nephrotic syndrome, and nephrosis: 46,448

·         Septicemia: 34,828


Based on CDC research, Heart Disease and Cancer, the top two causes of death in the United States in 2007, led to nearly twice as many deaths as the cumulative totals of causes 3 through 10.  In fact, the number of deaths attributable to Heart Disease alone, (616,067), nearly equaled the total for causes 3 through 10 (667,589). 

It is important to recognize that the relative death rate for men is higher than that for women for all of the Top 10 causes.  While there are hereditary factors that contribute to individual proclivity to develop Heart Disease, a timely and committed change in lifestyle in concert with an appropriate medical remediation, prevention, and/or maintenance strategy can help most men (and women) live a relatively normal life.

In summary, this post is a cry for help on behalf of men.  Perhaps, more aptly stated, it is a call for men to step up and help themselves.  As a general rule, ours is an interdependent society.  That means, someone, somewhere relies upon you.  So men, I urge you to unite on behalf of a cause that intuitively selfish, but intellectually selfless.  I entreat you to recognize this undeniable truth; Men’s Health: A Compelling Quality of Life Issue!”  Yes, this is a cause that requires you to think of (and act) for yourself first.  But in doing so, your wife, or significant other, your children, your siblings, your parents, your friends, your co-workers, your career, your civic association, your fraternity, and yes, your state of mind, will all benefit.

I’m done; holla back!

Read my blog anytime by clicking the link: http://thesphinxofcharlotte.blogspot.com.  A new post is published each Wednesday.  For more detailed information on a variety of aspects relating to this post, consult the links below:            























Wednesday, June 22, 2011

"Coded Language: A Road Map To 'Take Our Country Back'"

It's time to Break It Down!

So what does this not so newly minted, now, Right-wing catch phrase really mean?  At first blush, there may be a tendency to ask, “From whom?” Perhaps you are wondering, “Who has misappropriated our dear America?  The obvious, but clearly unintended historical response to this query is, "From the Europeans."  Surely you remember the infamous voyage to the East Indies, the subsequent great discovery, and the resulting misnomer, Indians (Native Americans).  Christopher Columbus, who was taking a supposed non-traditional route to Japan, actually landed in the Bahamas.  In typical hubristic fashion, Chris, who made three additional voyages to the Americas after his 1492 sojourn, visiting the Greater and Lesser Antilles, the Caribbean coast of Venezuela, and Central America, never conceded he missed the mark, and instead gifted the natives of all those lands with the appellation, Indians. Alas, that does not appear to be the intended answer.       

The Tea Party Movement, as they insist upon calling themselves (they don’t have members, you know; only supporters), takes credit for originating the current iteration of this wonderfully metaphoric Call to Arms.  If you listen to a number of the recently declared GOP Presidential Candidates, you could conclude (with a 100% degree of confidence) that they, at least, are convinced it is the Great and Powerful O(z)bama who absconded with our beloved Land of the Free and Home of the Brave.  Moreover, as destiny, or luck, or (could it be) anti-Karma, would have it, the GOP-T Party is here to rescue us from this gruesome plight; which, apparently, is a fate worse than death.

Regardless of the manner in which the mission is stated; the flatly direct, Take our Country back,” the slightly less dynamic and non-inclusive, “Take our government back,” or some other thinly veiled variant, the idea is meant to stir passion and fervor among those activists anointed to promote the cause.  In some corners the phrase is repeated so often, it may just replace the inimitable “God bless America” as the signature sign-off of choice.

Among the frequently parroted (officially sanctioned) replies to the question, “Take our country back from whom” (or from what/or what inspired the cause), you would likely find that most Top 10’s would include several of the following:

  • The far left
  • Tax and spend liberals
  • Big government
  • Health care reform
  • The stimulus bill
  • The bank bailout
  • The auto bailout
  • Anti-immigration
  • Gay and Lesbian marriage
  • Cap and Trade
Far be it from me to suggest that these issues are a roundabout way of saying that the design and desire is to “Take our Country back” from President Obama.  After all, I am a huge proponent of Coincidentalism.  You do believe it was merely a fortuitous happenstance that the Tea Party Movement was created within a month after President Obama was sworn into office…don’t you?  Of course you do!  (Wink-wink).

Relax; this post is not a proxy for the latest Anti-Obama conspiracy.  On second thought, don’t relax; it could be even worse than that.  It could be that we are posing the wrong question, entirely.  It is possible that instead of thinking about this issue in a typical two-dimensional sense (e.g., for or against President Obama), we should add depth and make it a 3-D exercise.  Let’s forget the classic heads or tails argument, and instead, turn this coin on its side. 

In other words, what if the question we should be asking is, not, “Take this Country back…From whom,” but, “Take this country back…Where?”  That’s right, while we are now swept up in the fervid passion of the Tea Party Movement’s Take Back America mantra, the record will show that Howard Dean popularized the phrase as a 2004 Presidential candidate.  Fast forward to the 2008 Presidential Campaign and it was Barack Obama who so artfully turned the phrase.

So then, while it is unlikely most Right-leaning Tea Party types realize they are unimaginatively sullying their mouths with a catch phrase previously bandied about by the very bane of their collective political existence, it is where they want to Take our Country back that concerns me most.  Somehow, I doubt it is “To the future.”  After all President Obama has proposed a prescription to “Win the future,” which in and of itself makes that an unlikely destination.

In fact, given the principal areas of concern frequently mentioned in determining Magnetic North for the Tea Party Movement, I am primarily concerned that the prevailing impetus is to “Take our Country back” to:

  • Tax Policy that lowers taxes on the wealthiest Americans, many of whom pay virtually nothing already, which in turn will result in raise relative rates on the less affluent
  • Foreign Policy that emphasizes isolationism, and encourages America the Exceptional to feel good about itself, but that renders our nation, ultimately, less secure
  • Immigration Policy that exacerbates Xenophobic tendencies, and that serves to destabilize, not secure borders
  • Social Policy that redefines the social contractual relationship between Americans and Social Security/Medicaid; paring significantly the effectiveness and assistance those programs provide
  • Environmental Policy that escalates the use of fossil fuels and resulting negative affects on the environment
In summary, we are inundated and threatened by Coded Language: ‘A Road Map To Take Our Country Back’”…ward!  I’m done; holla back!

Read my blog anytime by clicking the link: http://thesphinxofcharlotte.blogspot.com.  A new post is published each Wednesday.  For more detailed information on a variety of aspects relating to this post, consult the links below:















Wednesday, June 15, 2011

Playing Fast And Loose With The Facts: A Prescription For A One-Term Presidency!

It's time to Break It Down!

The early field of GOP candidates who would be President had their first big date night this past Monday evening.  CNN, self-appointed Most Trusted name in News” conceived, sponsored, and convened a Made-for-TV Debate (aren’t they all?), in conjunction with WMUR, a Manchester, New Hampshire TV station, and The NewHampshire Union Leader, Manchester’s daily newspaper.  The Debate was held at Saint Anselm College, a Benedictine Catholic Liberal Arts college in Goffstown, New Hampshire.  Seven Republican luminaries who have stated their intent to vie to become President of the United States (POTUS) participated, including:

·         Michele Bachmann

·         Herman Cain

·         Newt Gingrich

·         Ron Paul

·         Tim Pawlenty

·         Mitt Romney

·         Rick Santorum

Ms. Bachmann, Congresswoman, serving Minnesota’s 6th Congressional District stated during the event that she filed the necessary Federal Election Commission (FEC) paperwork earlier in the day, Monday, to run for President, and in effect used the forum as staging for a thunder-stealing official announcement.  Of the seven Debate participants, she was the only one not to have already announced her candidacy.

If there was one recurring theme during the evening’s Q & A, it was that the group would collectively eschew intraParty squabbling (at least for the night) in favor of launching repeated broad scale attacks on President Obama.  They made it clear he should immediately contact North American Van Lines (NAVL), or whatever his preferred moving company is, because he will be relocating from the White House in January 2013.  Ms. Bachmann went so far as to vow that as President, she would repeal “Obamacare.” “It’s a promise, take it to the bank, cash the check; I’ll make sure that happens.”  She added, “Make no mistake about it, I want to announce tonight, President Obama is a one term President; we’ll win!”

Her assertions were embraced by the assembly, as they praised each other; Mitt Romney even declared any of the seven candidates on the stage would make a better President than Mr. Obama.  When asked if there was anything President Obama had done right, the group in a stunning display of honesty, if not objectivity, could think of nothing.

The debate, which was moderated by CNN’s John King, included questions on domestic and foreign policy issues, including economic policy, deficit reduction, and the wars in Iraq, Afghanistan, and Libya.

Questions were posed by journalists, audience members, and voters at gatherings across the State, which is home to the first Presidential Primary next year.  Obviously, the area is in close proximity to Massachusetts.  As a result, Mitt Romney, who served as Governor there, is considered the early favorite.

The campaign is in its infancy; a variety of themes are still developing.  One mechanism that gained popularity in the latter stages of the 2008 Campaign season, due to the frequent use of hyperbole, and often misstatements and untruths, is Fact Checking.  This is independent research, typically conducted by an organization not aligned with the candidates.

Even though it’s early, the GOP candidates, perhaps in their exuberance to distinguish themselves, without taking-on each other directly, have already shown a propensity to skew the facts in terms of their claims about Mr. Obama’s record, his policy positions, and in some instances, their own records and accomplishments.

Two sharpen the focus on this pattern of behavior I will single out a couple of last night’s Debate participants.  While each of the seven has put forth egregiously indefensible assertions, I will point out a few notable examples of non-credible claims by two of the candidates. 

Rick Santorum, former Pennsylvania Senator, in announcing his Presidential bid introduced several arguments that wilt under scrutiny.  They include:

·         Santorum: “Thanks to this President, for every dollar we spend, 40 cents is borrowed.”

The Facts – The government does borrow about 40 cents for every dollar spent in the current budget.  However, Mr. Santorum conveniently omits, forgets, or simply ignores the recession, two major George Bush tax cuts, the wars in Iraq and Afghanistan, and other decisions made before Mr. Obama took office.
 

  • Santorum: “The 2010 health care overhaul will result in the government having the power to create dependency on every American.”
The Facts – The 2010 law preserves employer-based private insurances for most people, so they would not be wholly or perhaps even partly dependent on the government for health care.  The President quickly gave up on a government-run, single-payer, universal health care system (incidentally, to the chagrin of many of his staunchest supporters). However, due to Medicare, Medicaid and more, government was an enormous player in health care long before last year’s changes.  Government at all levels was on track to pay most of the nation’s health care costs even absent the President’s overhaul.

  • Santorum: Quoted Mr. Obama speaking of Medicare, Medicaid, and unemployment insurance as saying, “The country is a better country with these programs.  I will go one step further; America was not a great country until these programs.”  Mr. Santorum then went on to counter the alleged quote by saying, “America was a great country before 1965.”
The FactsMr. Santorum misquoted President Obama’s April 13th speech.  Mr. Obama said, “We contribute to programs like Medicare and Social Security, which guarantee us health care and a measure of basic income after a lifetime of hard work; unemployment insurance, which protects us against unexpected job loss, and Medicaid, which provides care for millions of seniors in nursing homes, poor children and those with disabilities. We are a better country because of these commitments. I’ll go further — we would not be a great country without those commitments.”

Mr. Santorum also conveniently neglected to note that the President included Social Security, a popular program created in 1935.

  • Santorum: President Obama “has devalued our currency by pumping Federal Reserve currency, pumping money, inflating our commodities, our food prices, our oil prices, which is a horrible penalty on working Americans.”
The Facts - Presidents appoint the Federal Reserve’s board members. But the members serve fixed terms, and their decisions are not subject to ratification by the president or anyone else. The Fed is subject to congressional oversight. As for the cost of living, core inflation remained low as the Consumer Price Index (CPI) rose 0.4 percent in April and at a 6.2 percent annualized rate over the past three months, according to the Bureau of Labor Statistics.
 

  • Santorum: Under Obama, the nation suffers a “discouragingly high rate of unemployment. Not 9.1 percent, but 14 or 15 percent of people who really want to get work and cannot find it.”
The FactsMr. Santorum is including estimates of part-time workers who want full-time work and discouraged” workers who want jobs but have quit looking. Economists recognize these types of workers. But they are not included in the Labor Department’s monthly unemployment rate, a widely cited statistic that stands at 9.1 percent.

The generally presumed GOP front-runner is Mitt Romney, former Governor of Massachusetts.  Similar to Mr. Santorum, in announcing his candidacy, Mr. Romney resorted to good old-fashioned GOP creatively to characterize several of the President’s positions.  For example:
    
  • Romney: “When he took office, the economy was in recession. He made it worse. And he made it last longer.”
The Facts - A case can be made for and against the idea that President Obama’s policies made the economy worse than it needed to be and that the recession lasted longer than it might have under another president. Such arguments are at the core of political debate. But the President did not, as Mr. Romney alleged, make the economy worse than it was when he took office.     
 
  • Romney: A few months into office, he traveled around the globe to apologize for America.”
The FactsPresident Obama has not apologized for America. What he has done, in travels early in his presidency and since, is to make clear his belief that the U.S. is not beyond reproach. He has told foreigners that the U.S. at times acted “contrary to our traditions and ideals” in its treatment of terrorist suspects, that “America has too often been selective in its promotion of democracy,” that the U.S. “certainly shares blame” for international economic turmoil and has sometimes shown arrogance toward allies. President Obama, whose criticisms of America’s past were typically balanced by praise, was in most cases taking issue with policies or the record of the previous administration, not an unusual approach for a new president — or a presidential candidate. Mr. Romney’s actual point seems to be that President Obama has been too critical of his country.

But there has been no formal – or informal – apology.  No saying “sorry” on behalf of America.  Simply did not happen…period!

  • Romney: “Instead of encouraging entrepreneurs and employers, he raises their taxes, piles on record-breaking mounds of regulation and bureaucracy and gives more power to union bosses.”
The Facts: Mr. Romney ignores ambitious tax-cutting pushed by President Obama. The stimulus plan early in his presidency cut taxes broadly for the middle class and business. He more recently won a one-year tax cut for 2011 that reduced most workers’ Social Security payroll taxes by nearly a third. He also campaigned in support of extending the Bush-era tax cuts for all except the wealthy, whose taxes he wanted to raise. In office, he accepted a deal from Republicans extending the tax cuts for all. As for tax increases, Mr. Obama won congressional approval to raise them on tobacco and tanning salons. The penalty for those who don’t buy health insurance, once coverage is mandatory, is a form of taxation. Several large tax increases in the health care law have not yet taken effect.
 

  • Romney: “The expectation was that we’d have to raise taxes but I refused. I ordered a review of all state spending, made tough choices and balanced the budget without raising taxes.”
The FactsMr. Romney largely held the line on tax increases when he was Massachusetts governor but that’s only part of the revenue story. The state raised business taxes by $140 million in one year with measures branded “loophole closings,” the vast majority recommended by Governor Romney. Moreover, the Republican governor and Democratic lawmakers raised hundreds of millions of dollars from higher fees and fines, taxation by another name. Mr. Romney himself proposed creating 33 new fees and increasing 57 others — enough to raise $59 million. Anti-tax groups were split on his performance. The Clubfor Growth called the fee increases and business taxes troubling. Citizens for Limited Taxation praised him for being steadfast in supporting an income tax rollback.

The foundation of a democracy is an informed citizenry.  The question of whether Americans pass that litmus test is a constant source of debate.  We may soon learn the answer. 

An analysis of the GOP talking points used by a number of the leading candidates seeking the Republican Presidential Nomination could lead one to infer that they believe the winning formula for 2012 is “Playing Fast and Loose With the Facts: A Prescription for a One Term Presidency!”  Of course, an informed citizenry would never fall for the okey doke; will we?

I’m done; holla back!

Read my blog anytime by clicking the link: http://thesphinxofcharlotte.blogspot.com.  A new post is published each Wednesday.  For more detailed information on a variety of aspects relating to this post, consult the links below:

















 
http://www.washingtonpost.com/blogs/fact-checker/post/tim-pawlentys-dubious-economic-assertions/2011/06/07/AGxyZRLH_blog.html