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Blog: On Health. On Writing. On Life. On Everything.

To Mammogram, Or Not To Mammogram

About this subject I do write with trepidation – as the right answers are still not known – medicine and science have not advanced far enough to let us make rational decisions. In actuality, regarding mammograms, we are living in something like medieval times. Do mammograms help prevent cancer? No, they don’t. They do find some cancers. But they also “find” an unacceptably high number of “cancers” that aren’t cancers - false positives. For which women then undergo unnecessary treatment. Do mammograms prevent deaths from cancer? The answer is amazingly unclear: For the longest time – basically for the entire twentieth century - namely since the advent of radical mastectomy, breast cancer death numbers didn’t budge. In the last few years, we seem to make a little dent. But it is not clear to me if it comes from therapies, or from better lifestyles that women have adopted - similar to the improvement of cardio-vascular health that happened mostly in the kitchen and the gym, not in the doctor’s office. For thirteen years now I have not done a mammogram. Not because I try to be reckless, but because I have my doubts. In a way, I am sticking my head in the sand (breast cancer runs in my family). On the other hand, I have a history of heavy radiation as a child, and mammogram certainly is adding to my risk to develop breast cancer. You could say that I made a decision rather to die of breast cancer than from breast cancer treatment. You don’t have to follow me here – or rather, I don’t want you to follow me here because I shudder of the responsibility I would take on if I talked you out of mammograms. In reality, I always encourage my patients to have their yearly mammograms – regardless of the personal doubts I am harboring. Because of my childhood radiation history – I had bad tuberculosis as a child with tons of fluoroscopy - my decision not to add any more radiation (I also have myself padded down at airports rather than going through the screening machines) is not applicable to everyone. In addition, I had mammograms since age eighteen every year because of lumps (and twice had lumps removed that turned out to be benign. So, I had an unusual number of mammograms - enough for a lifetime, I think. My doctors, because of my history, are basically waiting for me to develop breast or thyroid cancer. But over the years I came to realize that the real causes for breast cancer - diet, exercise and environmental pollution, including radiation - are not addressed by physicians and authorities. But I want to encourage every woman to come to her own decision. Every case has different variables. Lately I am also changing my thinking about cancer generally - not that one person has it, and the other person doesn't have it. Truth is, at a certain age, we probably are all always having cancerous cells in us, and keeping them at bay as best as we can we good lifestyle habits seems to be much more important. - I also have a body that would react badly to any kind of treatment - so I rather am putting my energy into a good lifestyle. And cancers in later years are often less aggressive than cancer in children and young adults. And a last thought: Medicine is yet is unable to differ between "bad" cancer and "good" cancer - we don't know which one will explode and kill a patient. So we are working with big guns on all cancers. It seems to me that surviving cancer has more to do with which type your cancer is and how good your immune system works than with any treatment. This argument is also very applicable to prostate cancer in men. If I would find a lump, I certainly would have it removed surgically. If I get "exploding" cancer, I hope I will die gracefully. Not knowing if I already have such a time bomb inside me, I make sure I walk every day during daylight to get my daily dose of vitamin D and exercise, I eat my veggies and drink my green smoothie, I keep my animal flesh consumption low (but I don’t advocate vegetarian or vegan lifestyles), I take a daily cold shower or cold sitzbath to strengthen my immune system, and I make sure I sleep long before midnight so that my body can catch bad cells and repair what is broken – before it explodes. The rest is not in my hands. Read More 
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Minimal Exercise Program

Reasons why I keep my exercise program as minimal as possible: 1. Exercise is boring. 2. Too much exercise may easily lead to injuries: We now have a medical specialty called “sports medicine”. If we didn’t overdo exercises, we would not need sports medicine. Using those modern gym machines while watching TV is a mindless enterprise. And as things go around, they come around – you could end up hurting yourself. 3. Definitely, there are more interesting things to do – playing cello, writing a book, reading tons of books, dabble with colors and brushes, being with family and friends, learning Chinese – to name a few. On the other hand, I do have bad posture – inborn (many years of unrecognized gluten intolerance that weakened my muscles), and from years of being bedridden as a young person. Movement creates fire and warmth inside, without which we would not be alive. We need to move yes, but nowhere is it written that we need to jog or overexert ourselves in bad ways. My exercise program changes all the time – I am always on the lookout for something faster and better. You might remember how much I liked the Five Tibetans – until I developed lower back pain. Recently I had to abandon my laps in the unheated Californian pool; the temperature got too low. I still jump in from time to time, just to get the immune-stimulating jolt of the cold water. But I can’t get my exercise that way anymore - danger of hypothermia and ruptured muscles. Of course, back in Boston, I work in the garden and go to yoga classes, and have a house to tend to. Here, in this tiny apartment, I had nothing comparable – so far. Until last week , when I joined tai chi classes – or as it is called in proper pinyin Chinese: tai ji. In German, tai chi is called “shadow boxing” – and that describes well those flowing, artful movements I now try to learn. Emphasis on “try”: This is not my first time; in the past, I always had trouble remembering the sequence of movements. This time around, I will not even try to learn the sequence; I will just mimic my teacher and lose myself in the flow of gestures. Because, in the two more months we will stay in San Diego, how much can I really learn? Not much. But in the first lesson, I already learned an important movement, which I now practice every time I pass by a mirror and notice how bent I have gotten up from my studies. Which makes two little exercises which I do in en-passant, not putting in extra time: 1. This squeezing of my shoulder blades that immediately makes me more upright. Firstly, it is a simple reminder; secondly, the squeezing loosens the muscles of the upper back and prevents that my head slowly vanishes between my shoulders like the head of a turtle in its shell. 2. Standing on one leg – especially while brushing my teeth, or waiting and whiling time away. This is good for balance, and for strengthening leg and pelvic muscles. Imbalance is what kills the elderly: Imbalance – fall – hip fracture – pneumonia – death; we physicians see it all the time. This exercise also increases bone mass in legs and spine, thus counteracting osteopenia and osteoporosis, thus preventing those nasty hip fractures. Standing on one leg is far more interesting and effective than Kegel exercises! Keeps your sex alive! Not everything can be done on the go. So, I have this daily program – and don’t hold your breath! - each of these exercises takes less than a minute, and presently, I am doing six of them, each of them repeated 21 times. Twenty-one: That is the number of repetitions I have kept from the Five Tibetans. You can’t overdo much in twenty-one times, and twenty-one brings me just to the border of utter boredom. 1. Knee bends: Done wrongly, knee bends can hurt your knees. Therefore make sure that you are doing them right: Keep feet and knees together, keep knee caps over your toes, and don’t go deeper than you can easily do, but challenge yourself to go deeper with time. 21 times. Or, in the beginning, you might want to do this by holding on to something stable. 2. Arm exercise: Done with a small heavy ball. I have one of those weighted exercise balls – six pounds. When traveling, I am using my whale of a laptop – has nearly six pounds, too. Fill a plastic bottle with water (this is lighter), or find a heavy book. Slowly lift the ball (or whatever) with both hands and arms out-stretched, and bring it up above your head. Then bend your arms backward and down. Bring up your arms again, over your head and then down in front. Repeat this 21 times. It is good against arm flab, and strengthens the muscles of your upper back. 3. Back exercise: Stand tall. Take the ball in both hands behind you back and lift it upward 21 times. That will squeeze your shoulder blades and improves posture. 4. Swimming on dry: I started this after I had to leave the pool, because I missed the exercise that built up my upper back muscles. Come down on the floor on your belly, lift arms and legs slightly from the ground, and make swimming movements 21 times. A boon is that you are massaging your bowels in this position, which is good against constipation. Getting down on the floor daily acts also anti-aging. 5. Neck strengthening: This I do mornings and evenings in bed: Dig your heels and the lower part of your back head into the mattress. It feels like you arch your back in this position. Breathe in and out. It strengthens all back muscles, especially the upper back. It also works like a charm against a double chin. 6. Tongue exercise: This also helps to eliminate a double chin. Stretch out your tongue, 21 times. One would think that a program this trifling would do nothing for the health of your body. On the contrary – I was never as toned and nimble as I am now, on this program. If however you are already doing triathlons or marathons: Stick with it, don’t listen to me … at least not until you come home injured. Then turn to my gentler method. A big part of why this works is the mindfulness you practice all day: You stand on one leg while waiting for the bus. You get up from the computer and squeeze your shoulder blades. You are in the bathroom and stick out your tongue a few extra times. This program keeps you aware that you have a body, and your body needs attention and pampering, too. Moving your body gently pampers it. Lying down and doing nothing pampers your soul. There needs to be a balance between the two! The other activity we do as often as we can, is walking. Here in San Diego, we have the beautiful Black Beach. If one removes shoes and socks and walks at the water line, in and out of the waves, it is great fun, and another great provocation to the immune system! And by walking and talking we keep our marriage afresh and alive. Read More 
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Sebastian Kneipp Wins – I Lose

Traveling earlier this month in Europe, I missed my daily swimming in the pool so much that I filled a bathtub in the hotel with water to the brim and got in. Now, it happened to be Frankfurt/Main in late fall, and the water was cold. How cold? I don’t travel with a thermometer but it was definitely colder than my Californian pool. But I enjoyed it. I got in to my neck, and stayed for a while. As it turned out, I stayed too long. Although the rest of my body heated up soon after I had toweled myself off, an ice-cold area over my kidneys the size of a football stayed with me – literally for days. Uh-oh! I had overdone it! And Sebastian Kneipp had told me so. He used to warn that one should not exaggerate cold exposure. And as difficult it is to give exact numbers for the time frame of “too much” – if one stays cold in the kidney area for days after, as it happened to me, one clearly has gone too far. Originally, he had cured himself from consumption (tuberculosis) by jumping into the winter-cold Danube River several times a week. When he later tried his method on other people, he quickly realized that not every body was not made for such endurance test: The older people were, and the thinner, the less cold they could handle – and he adjusted his theories to this insight. In Traditional Chinese Medicine “qi” is the life force, and is generated in the “kidneys”, which is actually what we call the adrenals. In Western Medicine it is known that that the adrenals produce a hormone/neurotransmitter called adrenalin, which is an energizer. If you stimulate the adrenals a bit, it will give you that desired energy jolt; if you over-stimulate the adrenals, you get a downer. Now, after two weeks of down time, when I didn’t dare to face the cold again, I swam again in the pool today. The temperature was 15 degree Celsius (59 Fahrenheit). I only swam one lap – wasn’t brave enough for more. One lap might be too short to induce brown fat in my body, but it was exhilarating, and when I got out, my kidneys felt fine! And I restarted in time to strengthen my immune system for the winter. Read More 
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