Maintaining My Dignity

  I've never really cared about maintaining my dignity before I was diagnosed with Stage II A Breast Cancer in 2010, but now after all of the changes my body's gone through, I find myself worrying about it. At the beginning of March 2014 I went through my breast reconstruction surgery, which brought about more changes in my attempt to look "normal" again.
   "How will I fool everyone today?," I asked myself as I tried on clothes that I hoped would disguise the bandage, drain and medical bra I was instructed to wear until my follow-up appointment a week after my surgery, knowing I'd need a large enough shirt to cover everything, but mindful of the 80 degree temperature outside and my personal comfort. After a lot of deliberation, I chose a navy-blue sailor top, which I planned to layer over a grey t-shirt, and a pair of denim cut-off shorts. As I went through my day, I found that despite the soreness and pain I was still experiencing, I felt and looked cool, calm and collected. Through the magic of clothes and makeup, or oversized sunglasses and red lipstick, I've discovered that it's possible to throw caution to the wind and put on whatever I want even though I see scars and war wounds where there was once smooth skin. When I do I find my dignity replaced with a lack of inhibition that allows me not to care. At those times I can dance around in my underwear and fedora like Ann Reinking in "All That Jazz". I'm my old self again and my scars don't matter or exist any longer.
   Pre-diagnosis, I always worried about what other people thought of me, but now I don't care, since I've been through the worst. It's no loss if I lose a friend or support system because I've already lost so much with cancer that to lose in the traditional sense doesn't matter any more. I can always begin again. When one door closes another one opens and in places I rarely expect. After I had my first chemo treatment, I got so sick I had to be placed in the Neupogen ward of the hospital, totally withdraw from school, quit my job and stay out of public places once I was released. At first I felt very lonely and isolated until one of my nurses told me about a website for writers, www.hubpages.com. I started writing for them about three years ago, and in addition to allowing me a chance to connect with others via the internet, I also learned how to blog and started my own blog, www.keepinupwithvicqui.bravejournal.com.
   While dealing with my reconstruction, I've also continued my job search, which hasn't proved any less frustrating, than when I started it after leaving the work force in 2010. I wish I could say I enjoy sending out resumes, making cold calls, filling out applications and going on interviews, but I can't. In this case I have to fight to maintain my dignity and relevance as a viable citizen who still has something valuable to contribute to society. Part of my frustration comes from my lack of direction and focus, so I'm torn in a lot of ways. Dealing with cancer, and my other health issues, don't help either.
   To combat this, when I do go out, I select clothes that will allow me to look as dignified as I try to feel, even if they come off of the sale rack at "Ross" or "Goodwill Thrift Store". In January I had to move unexpectedly so I was forced to scale down my wardrobe, and take only what I thought I'd be able to store in my new place, and put the rest in storage. That meant planning how I wanted to dress and using my imagination in new ways. So far, I've been able to coordinate outfits that project my image as a L.A.-based fashion/feature writer, satisfy my taste level, and inspire me to remain positive as I face all of my current challenges.
   In my previous pre-cancer work life, my style wasn't as important or consistent, as it is now and I sometimes tried to tone it down, conform and not make waves by being different, but now that I've learned that being true to myself has given me strength no matter what, it's become a significant part of me. That's not to say that the question of dignity won't remain a struggle throughout my life, but as I move into the future, I hope to always find a way to have it.

YOU MIGHT PAY A LOT MORE THAN $95 FOR SKIPPING HEALTH INSURANCE

2014 is the first year most Americans will have to either have health insurance or face a tax penalty.

But most people who are aware of the penalty think it's pretty small, at least for this first year. And that could turn into an expensive mistake.

 "I'd say the vast majority of people I've dealt with really believe that the penalty is only $95, if they know about it at all," says Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service. "And when people find out, they're stunned. It's much, much higher than they would expect."

In fact, "the penalty is the maximum of either $95 or 1 percent of taxable income in 2014," according to Linda Blumberg, a senior fellow at the Urban Institute's Health Policy Center. "For people with higher incomes, it can be much more sizable than $95."

Blumberg says that even for people with more moderate incomes, it's important to remember that the flat-fee penalty will be assessed for every family member who lacks health coverage.

"So if it's a two-adult household and both are uninsured, it's twice $95 — $190," he says. "Then if there are any children in the family that are uninsured, the penalty for each of them is half of the $95."

The flat-fee penalty maxes out at $285 next year. To help people figure out what they might owe, the Tax Policy Center, jointly run by the Urban Institute and the Brookings Institution, just posted an online calculator. And Jackson Hewitt has its own "How much is my tax penalty?" worksheet.

Haile says it's important to remember that even if most of the family has insurance, having just one uninsured member can trigger the penalty.

"If you've got someone who comes home to live, it could cost you much more than a spare bedroom," he says. "If you claim that child as a dependent, or could claim that child as a dependent, then you suddenly become liable for penalties if that child lacks minimum essential coverage."

The 1 percent penalty, for those hit with that, also has a cap, but the penalty can still get pretty big. The cap is tied to the cost of the national average bronze-level insurance plan. This year's top penalty could be about $3,600 for an individual, and $11,000 for a family of four.

As Deadline Nears, State Insurance Exchanges Still A Mixed Bag

 If you're uninsured and earn enough to be potentially liable for penalties, you have to sign up for coverage by the end of this month in order to avoid them.

"Your only chance to buy insurance, unless you have a special qualifying event, is during this open enrollment period," Haile says, "which makes March 31 an incredibly important date for avoiding the penalty. If you want to avoid the penalty, you need to get in and sign up for coverage now."

That's much different from how things were before the law's implementation. But the Urban Institute's Blumberg says it's because of the new rule that protects people with pre-existing health conditions.

"Now the insurance companies can't say no, even if you've had serious health problems in the past, or have a serious health problem today. They can't deny you," she says. "And because of that, people are restricted to obtaining coverage during the open enrollment period or during some other open enrollment period where they've had a change in their family status or income."

Indeed, changes to family status — a birth, divorce or job change — will allow you to buy or change your coverage outside the open enrollment period. And if you're eligible for Medicaid or your kids are eligible for the Children's Health Insurance Program, you can sign up anytime.

There are also lots of exemptions from the penalty itself, Blumberg points out, even for people who remain uninsured. The biggest is for having income below the tax filing threshold.

This year that's roughly $10,000 for a single person and $13,000 for a head of household. If you don't have to file income taxes, you won't have to pay a penalty. You also can get an exemption if the cheapest available insurance would cost more than 8 percent of your income, if you have unpaid medical debt, or for any of several other reasons listed on the HealthCare.gov website.

But for most people with incomes above the poverty line, time is running out to either get insurance or prepare to pay up instead.

To see article in original source: http://www.npr.org/blogs/health/2014/03/12/288712831/you-might-pay-a-lot-more-than-95-for-skipping-health-insurance

YOUR ALLY AGAINST OSTEOPOROSIS: UCLA HEALTH NEWSLETTER

Check out this UCLA Health Newsletter article about the benefits of OSTEOBALL®.

http://www.bonefitness.com/consumer/press/ucla_healthyyears.html

CSC will be offering a unique exercise program using the OSTEOBALL® 
 
Beginning with an introductory talk on Wednesday, March 19, 2014 at noon, and the opportunity to sign up for 6 subsequent, weekly classes, Terese Miller, ACE, ACSM, IDEA, Audrey Chernofsky, BS, PT, and Karen Hunt, BS, DT of The Swezey Institute will provide you with knowledge about how to "Get Back to Activity the Gentle Way."  Call 310-314-2555 for more info.

Terese Miller is a Gold Certified group exercise leader, Audrey Chernofsky is a licensed physical therapist who specializes in Post Rehab Exercise and Breast Cancer Rehab and Karen Hunt is an Osteoporosis and Bone Fitness Educator at The Swezey Institute and an expert in the field of bone densitometry technology.

UCLA STUDY ON FRIENDSHIP AMONG WOMEN

 

 

March 8 is International Women's Day!

 

CSC has a free-of-charge program for those affected by cancer of support, counseling, education, mind-body classes and social activities.  Photo is by Krista Kennell and is of CSC Celebration Circle led by Carol Kurland & Abby Brown.  Check calendar for dates and times. http://bit.ly/CSCSocial

 

 

 

 

 

Melissa Kaplan's
Chronic Neuroimmune Diseases
Information on CFS, FM, MCS, Lyme Disease, Thyroid, and more... Last updated January 1, 2014         

An alternative to fight or flight

©2002 Gale Berkowitz

A landmark UCLA study suggests friendships between women are special. They shape who we are and who we are yet to be. They soothe our tumultuous inner world, fill the emotional gaps in our marriage, and help us remember who we really are. By the way, they may do even more.       Scientists now suspect that hanging out with our friends can actually counteract the kind of stomach-quivering stress most of us experience on a daily basis. A landmark UCLA study suggests that women respond to stress with a cascade of brain chemicals that cause us to make and maintain friendships with other women. It's a stunning find that has turned five decades of stress research---most of it on men---upside down. Until this study was published, scientists generally believed that when people experience stress, they trigger a hormonal cascade that revs the body to either stand and fight or flee as fast as possible, explains Laura Cousin Klein, Ph.D., now an Assistant Professor of Biobehavioral Health at Penn State University and one of the study's authors. It's an ancient survival mechanism left over from the time we were chased across the planet by saber-toothed tigers. Now the researchers suspect that women have a larger behavioral repertoire than just fight or flight; In fact, says Dr. Klein, it seems that when the hormone oxytocin is release as part of the stress responses in a woman, it buffers the fight or flight response and encourages her to tend children and gather with other women instead. When she actually engages in this tending or befriending, studies suggest that more oxytocin is released, which further counters stress and produces a calming effect. This calming response does not occur in men, says Dr. Klein, because testosterone---which men produce in high levels when they're under stress---seems to reduce the effects of oxytocin. Estrogen, she adds, seems to enhance it. The discovery that women respond to stress differently than men was made in a classic "aha" moment shared by two women scientists who were talking one day in a lab at UCLA. There was this joke that when the women who worked in the lab were stressed, they came in, cleaned the lab, had coffee, and bonded, says Dr. Klein. When the men were stressed, they holed up somewhere on their own. I commented one day to fellow researcher Shelley Taylor that nearly 90% of the stress research is on males. I showed her the data from my lab, and the two of us knew instantly that we were onto something. The women cleared their schedules and started meeting with one scientist after another from various research specialties. Very quickly, Drs. Klein and Taylor discovered that by not including women in stress research, scientists had made a huge mistake: The fact that women respond to stress differently than men has significant implications for our health. It may take some time for new studies to reveal all the ways that oxytocin encourages us to care for children and hang out with other women, but the "tend and befriend" notion developed by Drs. Klein and Taylor may explain why women consistently outlive men. Study after study has found that social ties reduce our risk of disease by lowering blood pressure, heart rate, and cholesterol. There's no doubt, says Dr. Klein, that friends are helping us live longer. In one study, for example, researchers found that people who had no friends increased their risk of death over a 6-month period. In another study, those who had the most friends over a 9-year period cut their risk of death by more than 60%. Friends are also helping us live better. The famed Nurses' Health Study from Harvard Medical School found that the more friends women had, the less likely they were to develop physical impairments as they aged, and the more likely they were to be leading a joyful life. In fact, the results were so significant, the researchers concluded, that not having close friends or confidants was as detrimental to your health as smoking or carrying extra weight. And that's not all. When the researchers looked at how well the women functioned after the death of their spouse, they found that even in the face of this biggest stressor of all, those women who had a close friend and confidante were more likely to survive the experience without any new physical impairments or permanent loss of vitality. Those without friends were not always so fortunate. Yet if friends counter the stress that seems to swallow up so much of our life these days, if they keep us healthy and even add years to our life, why is it so hard to find time to be with them? That's a question that also troubles researcher Ruthellen Josselson, Ph.D., co-author of Best Friends: The Pleasures and Perils of Girls' and Women's Friendships (Three Rivers Press, 1998). The following paragraph is, in my opinion, very, very true and something all women should be aware of and NOT put our female friends on the back burners. Every time we get overly busy with work and family, the first thing we do is let go of friendships with other women, explains Dr. Josselson. We push the m right to the back burner. That's really a mistake because women are such a source of strength to each other. We nurture one another. And we need to have unpressured space in which we can do the special kind of talk that women do when they're with other women. It's a very healing experience.   Taylor, S. E., Klein, L.C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A. R., & Updegraff, J. A. Behaviorial Responses to Stress: Tend and Befriend, Not Fight or Flight" Psychol Rev, 107(3):41-429. (Full text of article in PDF format) Geary DC, Flinn MV. Sex differences in behavioral and hormonal response to social threat: commentary on Taylor et al. Psychol Rev 2002 Oct;109(4):745-50; discussion 751-3 Cousino Klein L, Corwin EJ. Seeing the unexpected: how sex differences in stress responses may provide a new perspective on the manifestation of psychiatric disorders. Curr Psychiatry Rep. 2002 Dec;4(6):441-8. A Note from Melissa Kaplan: I have been unable to locate Gail Berkowitz, the author of this above article, so please don't write me to ask me how to contact her - you can Google or Yahoo her as well as I can. I also have no information on the studies referred to in the article; to find information on them, you can get reprints of the above referenced journal articles (Taylor, et al., Geary and Finn, Cousino Klein and Corwin) and ask the authors any questions you may have regarding study participants, methodology, etc. In the case of Taylor, et al., , read the abstract online and download the full text PDF of the journal article). To view article in original, visit http://www.anapsid.org/cnd/gender/tendfend.html

THE BREAST CANCER RACIAL GAP

 The Well Column March 3, 2014, 5:23 pm     By TARA PARKER-POPE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Photo by Ruth Fremson/The New York Times

Debrah Reid, who has breast cancer, at home in Memphis, where mortality risk is greater for blacks.

 

A troubling racial divide in breast cancer mortality continues to widen in most major cities around the country, suggesting that advances in diagnosis and treatment continue to bypass African-American women, according to new research.

 

An analysis of breast cancer mortality trends in 41 of the largest cities in the United States shows that the chance of surviving breast cancer correlates strongly with the color of a woman’s skin. Black women with breast cancer — whether they hail from Phoenix or Denver, Boston or Wichita, Kan. — are on average about 40 percent more likely to die of the disease than white women with breast cancer.

 

In some cities, the risk is even greater. In Los Angeles, a black woman with breast cancer is about 70 percent more likely to die from the disease than a white woman is. In Memphis, black women face more than double the risk, according to the research, published on Tuesday in Cancer Epidemiology.

The findings were compiled and analyzed by the Sinai Urban Health Institute in Chicago and the Avon Foundation for Women, which also funded the research. The analysis builds on a series of studies that have identified a startling racial gap in breast cancer mortality.

 

In 2012, a widely publicized study of the 24 largest cities examined the racial gap in breast cancer from 2005 through 2007. The new study takes a longer view and includes breast cancer deaths from 1990 through 2009 in 41 cities.

 

The more comprehensive analysis shows that in most cities 20 years ago, black and white women faced about the same mortality risk from breast cancer. But starting in 1990, the death rate among white women began to drop rapidly in many cities while death rates among black women fell only a little.

 

“It’s absolutely startling and very dismal, because there is hardly any health measure in the United States that hasn’t improved in the last 20 years,” said Steve Whitman, director of Sinai Urban Health Institute and the study’s senior author.

 

Notably, death rates for black and white women with breast cancer declined over all during the two-decade study period; however, the death rates among white women decreased twice as much as those among black women.

 

The researchers said the difference is explained by lower access to screening, lower-quality screening, less access to treatment and lower-quality treatment among black women.

Dr. Whitman said the larger question is why the health system appears to discriminate against black women with breast cancer.

 

“It’s undeniable that this is systemic racism,” he said. “I don’t mean that a bad person is at the door personally keeping women out, but the system is arranged in such a way that it’s allowing white women access to the important gains we’ve made since 1990 in terms of breast health, and black women have not been able to gain access to these advances.”

 

The research also dispels the notion that black women face a higher risk of breast cancer because of genetic differences. While they are at greater risk for some types of breast cancers, that doesn’t explain the widening mortality gap developing in a relatively short period of just two decades.

“Mathematically, it can’t be anything genetic,” Dr. Whitman said. “How could genes change in 20 years?”

 

The next step is to begin to study differences in the racial gap across cities in hopes of identifying the factors that contribute to the problem. The cities with the largest disparities are Memphis, Los Angeles, Wichita, Houston, Boston, Denver, Chicago, Phoenix, Dallas and Indianapolis.

In New York, the gap is far smaller. While black women are still 19 percent more likely to die of breast cancer than white women, over all both white and black women with breast cancer fare better in New York than in many other cities.

 

“New York is the largest city in the country, yet it only has a nominal disparity compared to Los Angeles or Chicago or Houston,” said Marc Hurlbert, executive director of the Avon Breast Cancer Crusade and one of the study authors. “No disparity is acceptable, but New York is doing something better than other cities.”

 

Dr. Hurlbert said factors like the city’s public hospital system and an extensive public transportation system probably play a role, increasing access to breast cancer care regardless of income level. However, more research is needed to home in on the factors that are contributing to the racial divide.

“Can we help cities with a wide gap learn from the cities that are doing better?” Dr. Hurlbert said. “Now that we have the data and understand what is going on, we’re going to move to trying to solve the problem.“

A version of this article appears in print on 03/04/2014, on page D6 of the NewYork edition with the headline: The Breast Cancer Racial Gap.

To see in original go to:

http://well.blogs.nytimes.com/2014/03/03/the-breast-cancer-racial-gap/?_php=true&_type=blogs&_php=true&_type=blogs&ref=health&_r=1