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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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Varicose Veins - Phlebitis - Thrombosis

Varicose veins are thought to be ugly, and in a way, they are. But as a doctor, I am less concerned with beauty, more with health problems – and varicose veins are not always as harmless as they seem. Thrombosis is a clot that blocks a vein, usually in one leg. Thrombosis may lead to pulmonary embolus and, in rare cases, to a stroke; both can be fatal. The symptoms are swelling and pain and warmth of the affected limb. Physicians order a Doppler scan, to make sure the patient does not have the feared clotting situation. If it is a clot, the patient will be admitted to a hospital and a severe thinning of the blood will be administered with heparin, Coumadin and other anti-coagulants, until the clot is gone or at least stabilized. Often the Doppler test comes back negative – no clot, good news! The patient has “only” phlebitis, an inflammation of the wall of a vein. The symptoms are exactly the same: pain, swelling, warmth. In German phlebitis is generally called “cramping veins” because cramps are also a feature of phlebitis/thrombosis. What can you do against inflamed veins? Phlebitis and thrombosis can have several causes, sometimes combined: A genetic disposition plays a role. Longtime immobility - like sitting on a long trans-Atlantic flight without getting up, or being bed-ridden, especially after surgery – is known to cause clots. Hormone therapy can lead to clotting. Less well known reasons are cancer and food sensitivities, or even just plain food that is not healthy. Nutrition that is less than optimal is known to promote inflammation. That inflammation can show up as different diseases in the body; one is phlebitis/thrombosis. Junk foods with high sugar content, white starches, trans-fats and particularly dairy are highly inflammatory for everybody. Food sensitivities, on the other hand, specific for individuals, can also inflame, but the causative foods are sometimes hard to pinpoint. I have seen reactions to banana, avocado, nuts, beef (it might be more what the cattle ate than the cows themselves) and cherries – but there are endless possibilities; a food diary might help in recurrent cases. Varicose veins frequently occur in people with unrecognized gluten intolerance. Slowly, over the years, the varicosities grow, which is often thought as being just another sign of aging. However, varicosities can be viewed as a sign of chronic inflammation of the body. Pregnancies and much standing can aggravate the condition. What to do in phlebitis: 1. Eliminate all offending foods. 2. Move moderately every day. Don’t sit for prolonged times. Go for a walk every day. 3. Don’t sit with legs crossed – that clamps down of the veinous blood flow. 4. Elevate legs as often as possible. 5. High-dosed fish oil, three capsules three times a day. Fish oil is a mild blood thinner (and could be contra-advised in some conditions) and a strong anti-inflammatory agent. 6. Cold washings and gushes of the legs, cold sitzbaths and barefoot walking in the ocean all are beneficial. 7. In the acute situation, an icepack (not longer than 16 minutes at a time) might bring relief. 8. Wear support panty hose. It prevents the veins to bulge out bigger and bigger. On very hot days cut out the crotch of the panty hose. Wear the support hose also after you are better. 9. Don’t rush into surgery. Phlebitis is often not just a mechanical problem – think about the food connection first. 10. If symptoms get worse with fish oil therapy, you better return to your physician – soon! Read More 
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