January 31, 2013

Tips on Blood Pressure Monitoring

I used to visit my internist for my annual physical, roll up my sleeve, have him take a blood pressure reading (or two), and listen for the numbers. That was my blood pressure.

Recent research suggests that BP readings aren't as accurate as they should be. As a result, many people are easily misdiagnosed. Usually mistakes skew to the high side, so people are sometimes put on medication unnecessarily, or given doses that are too high.

Our BP fluctuates throughout the day. Evaluating it is like shooting at a moving target. All sorts of things can cause BP to rise or dip. Did you know, for example, that you shouldn't smoke, exercise, or drink caffeine for the 30 minutes before being tested?

The possible variations don't matter too much if you're clearly hypertensive, or clearly normal. But most of us are in the middle "gray area."

Recommended Guidelines
A standard way to measure BP has been recommended by the American Heart Association. Here's a summary:

January 30, 2013

What My Doctor Would Label Borderline or Actual Hypertension May Be Just What I Need

I've been talking for the past week about the need to break away from the "one-size-fits-all-medicine" that's practiced these day in favor of more individualized treatment -- http://bit.ly/WstYeM.  An example is my blood pressure readings.

I check my blood pressure at home once or twice a day. The readings vary greatly, but most are in the range of 130/75 to 145/90. My internist who practices standardized medicine would see this as cause concern. But a growing number of medical authorities would say the numbers are just fine, using the more individualized guidelines under which higher numbers are acceptable, and even desirable, for the elderly.

Blood Pressure Guidelines: One Size Fits All
The standardized medical advice on blood  pressure is as follows:
  • Normal blood  pressure is 120/80 (The first number is your systolic pressure; the second is your diastolic pressure.
  • You have hypertension (high blood pressure) when your average systolic number is 140 or higher and/or your average diastolic number is 90 or higher.
  • If your systolic number falls between 120 and 140 and/or your diastolic number is between 80 and 90, you have  pre-hypertension, which puts you at an elevated for eventually developing full-blown hypertension.
Blood Pressure Guidelines: Different Strokes for Different Folks
Finally medical authorities are beginning to realize that the standardized medical care treatments aren't appropriate for older people. A panel convened by the American College of Cardiology (ACC) and the American Heart Association (AHA)  recommended the following measurements for "older people"
  • Age 65 to 75: 140/90 or less
  • Age 80 and older: 140/90 to 145/90

January 29, 2013

Shaywich’s Healthcare Trends for 2013, #3: Industrialization of Drug Discovery

In recent posts (below), I’ve commented on several healthcare trends predicted for 2013. Today, I focus on the third and last: the industrialization of drug discovery. This trend concerns Big Pharma, the behemoth often described with slightly villainous attributes. It’s hard to imagine that anything could short-circuit the continuing power of the giant drug companies. Here are just a few reasons why.

Cost
These days, regulation by the Food and Drug Administration (FDA) requires complex and lengthy testing before any new drugs become available. Nobody I know wants to make this process less safe for consumers, but here’s what drug trials now require:
  • Phase 1: Screening for safety
  • Phase 2: Establishing the testing protocol
  • Phase 3: Final testing
  • Phase 4: Postapproval studies
In Phase 1 trials, researchers test an experimental drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

In Phase 2 trials, the experimental study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.


January 28, 2013

We Need Not Accept Cheesecake Factory Medicine

Last Friday, I reported on the second of Dr. David Shaywich's three health-care tensions for 2013: the one that exists between the relentless standardization of medical treatment and the need for more individualized care.

Shaywich compared visiting a doctor's office today with going to lunch at the Cheesecake Factory, where everybody ends up getting pretty much the same thing. I've talked about this issue often. Shaywich calls it "Cheesecake Factory" medicine; I call it "one-size-fits-all" medicine. Same complaint.

Bell Curve and Cheesecake Factory Meals & Medicine
It helps me to envision the standard bell curve (above). The Cheesecake Factory offers a menu that (let's say) 2.15 percent of the populace (the yellow segment on the left) thinks is the best ever... 68.2 percent (the blue segments in the middle) considers good but not great... and another 2.15 percent on the right (including me) are happy to avoid altogether.

When it comes to medical treatment, even the best doctors prescribe medications and treatments that provide nearly miraculous results to the 2.1 percent on the left. Those therapies may work reasonably well (and with few side effects) for the 50 percent on the left of the midpoint. But they yield declining benefits (and increasing side effects) for those to the right. When you reach the 2.1 percent on the far right, treatments aren't helping at all, and patients are dealing with serious adverse effects from drugs or therapies.

Here's the problem: too many medical providers think that the experience of the 50 percent on the left side is the full story, leading to the Cheesecake Factory's "one-size-fits-all" overly standardized medical treatment.

January 25, 2013

Shaywich’s Healthcare Trends for 2013, #2: Relentless Standardization of Medicine

On January 22, I discussed Dr. David Shaywich’s first healthcare “tension” for 2013: preventive healthcare vs. excessive medicalization. Today, I want to consider his second healthcare trend for the new year: the relentless standardization of medicine.

The Cheesecake Factory School of Medicine
Shaywich describes a trend he finds alarming: seeing one’s doctor these days resembles going to lunch at the Cheesecake Factory. You go for a reason; you have a brief conversation with the employee, based on a standardized menu of options; the employee feeds your comments into the computer; you get the very same product delivered to you that every person in every other location receives who said essentially the same thing you did to the employee.

Some might say the Cheesecake Factory approach represents progress. There’s a gigantic database of medical info now available; why not rely on it more regularly? There are wacky practitioners out there who act capriciously; why not pull them into the mainstream? There are thousands of studies that point the way to treatment for your symptoms; why not utilize the data and – based on what has worked for the greatest number of patients like you – do the same thing? Our medical history and records are now pretty much computerized; why not plug a few new bits of info – the patient’s latest comments -- into the data, hit “enter,” and act according to the results of the recalculated algorithms. Bingo!

January 24, 2013

Iatrogenics: Medical Treatments vs. their Risks. LESS IS MORE!

Yesterday, I posted the first of a three-part report on healthcare "tensions" we're likely to see in 2013. Dr. David Shaywitz made the predictions on his popular The Healthcare Blog. The first tension vibrates between our expanding options for preventing / treating disease and the risks that often accompany these options.

I like Dr. Shaywitz's observations, because they accord with what I find in "aging and Parkinson's and me."  In his discussion of treatment options and their risks, Dr, Shaywitz sprang a new word on me, "iatrogenics," the inadvertent adverse effect or complication resulting from medical treatment or advice. 

I've given lots of thought to this subject in the past year and reported on it frequently here. In fact, my experience and research led me to a new mantra for 2013: "less is more."

Almost every time I researched a disease or ailment on reputable sites, I found cautions about the use of prescribed medications and over-the-counter dietary supplements. Invariably, the best recommendations called for:
  1. Exercise
  2. Diet
  3. Meditation
The trouble for most of us is that this triumvirate requires more effort than popping a pill or getting an injection. Yesterday, I was working with my physical therapist on core strengthening exercises designed to alleviate lower back pain, my #1 health concern for over a year now. I told her I was scheduled to go to Sibley Hospital's pain center on Thursday for a follow-up steroid shot, also designed to ease the back pain.

January 23, 2013

Shaywich’s Healthcare Trends for 2013, #1: Preventive Health vs. Excessive Medicalization

In a post on his popular healthcare blog, Dr. David Shaywitz recently predicted three “tensions” we’d see in 2013:
  1. Preventive health vs excessive medicalization 
  2. Relentless standardization of medicine, and 
  3. Industrialization of drug discovery 
They’re interesting trends, which I’d like to consider one at a time. Today, the first: preventive health vs excessive medicalization.

In this first “tension,” Shaywich means that our current efforts to prevent disease – greatly enhanced in recent years through science and technology – so often carry risks which may not be worth taking. Patients now undergo many more screening exams (like mammography) than ever to “get a jump” on possible future health problems. Based on their doctors’ recommendations, they willingly alter their own body chemistry in the hope of reducing risk factors not yet apparent. They take aspirin to reduce risk of heart attack or stroke; they take powerful medications to lower blood pressure and cholesterol to decrease heart attack risk.

While these exams and preventive strategies have a legion of supporters among doctors and patients, there is no question that they also carry risks… risks we don’t yet fully understand.

January 22, 2013

Two Inauguration Weekends, Two wedding Celebrations -- 56 Years Apart! --#1 - 2013

Lachhita Neupane and Raghav Chhetri
Mallika Neupane and Dipesh Karki


This photo was taken on Friday, January 18 at the Hindu Temple, where these two lovely couples were married. Lachhita and Mallika are sisters who live in Reston, Virginia. Raghav and Lachhita did their undergraduate studies at Truman University in Kirksville, Missouri. They are close friends of my housemate Nimesh Thapa, another Truman graduate.

The Friday wedding was followed by a Saturday night reception for about 200 friends and family. I was privileged  to be one of the invitees. I've learned over the years that Nepalese love to party with nonstop singing and dancing. This occasion was no exception.  

Before dinner, entertainment was provided by many of the couples' young Nepali friends. Much of it involved terrific dance routines. My housemates Nimesh and Bhawana provided a change in pace by singing a popular Nepali song. 

Here's a video I took with my i-Phone. It was my first venture as a cinematographer, and I'm pleased with the result. I'm even more pleased with their performance and the reception it got. As you'll see, toward the end, the bridal couples got so caught up in the music that they got out on the dance floor and then persuaded their parents to join them. It was a high point of the celebration.







Two Inauguration Weekends, Two wedding Celebrations -- 56 Years Apart! -- #2 - 1957


WEDDING CELEBRATION
SATURDAY, 1/19/1956
Diana LeBlanc and John Schappi


I'll explain the reason for this introductory video a little later.

We've heard a lot of talk from pundits this past weekend about the relative unimportance of the second inauguration of a two-term president. That may well be true from the perspective of American history.

But for me, the second inauguration of President Eisenhower included the most important day in my life -- Saturday, January 19, 1957.

Background
In 1957, Diana LeBlanc and John Schappi were editors on different publication staffs at the then 100% employee-owned Bureau of National Affairs, Inc. (BNA). That employee ownership continued until last year when BNA became Bloomberg BNA.

We'd been dating for over a year but had tried to keep our relationship from becoming scuttlebutt at BNA.  Both of us were active in the Newspaper Guild which represented BNA's editorial employees.

Just as with the Obama inauguration this year, the January 20 date for Eisenhower's second inauguration fell on Sunday, so the "official" swearing in of the president on Sunday was followed by the public ceremony on Monday. The Newspaper Guild had proposed that BNA make that day a holiday for the employees, but management rejected the proposal.

January 18, 2013

Are Your Vitamin Supplements Killing You?

That question is a take-off on the title of a book I reviewed last yearAre Your Prescriptions Killing You? I ask it based on an article, The Myth of Antioxidants, that appears in the February 2013 issue of Scientific American I just received today.

Do Vitamins Keep Us Young?
For years, the popular belief was that oxidative damage causes aging: highly reactive molecules called free radicals damage cells and interfere with the functioning of tissues and organs. According to the theory, this rampant oxidation mangles more and more lipids, proteins, snippets of DNA, and other key components of cells. Eventually, the entire organism is compromised.

The early thinking was that isolated antioxidants, like vitamin C or beta carotene, would combat this process and prevent chronic diseases. The marketing hype for antioxidants escalated; today the word pops up on the labels of countless dietary supplements, and in countless TV ads and websites.

As a result, 52 percent (!!) of Americans take antioxidants daily, mostly as multi-vitamin supplements.

New Research Challenges the Antioxidant Myth
The article notes that recent experiments show that the increase in certain free radicals correlates with longer life, not shorter. In some circumstances, free radicals seem to signal cellular repair.

January 17, 2013


"You Only Live Once"

I loved this cartoon from the January 13 issue of  The NewYorker.  But I'll admit I had to Google the "YOLO" caption to find out what the acronym meant. 

That doorway looks much like mine. Hmmm. 

Adhering to my 2013 mantra -- Less Is More -- I'll stop right here. 


"BIG" Exercises for Parkinson's

Shortly after my Parkinson's diagnosis in late 2009, my neurologist gave me a prescription (the needed pass for getting my sessions covered by Medicare) for the BIG exercise program, designed for people with Parkinson’s by the same organization – Lee Silverman Voice Treatment (LSVT) – that developed the LOUD speech therapy for people with PD. The BIG program incorporates some of the features of the voice program, like shouting out your exercise counts in a strong voice. If you are interested in finding someone to work with on either of these programs, go to the LSVT home page and click on the “Find a Clinician” button.

The BIG physical therapy program is pretty intense and probably works best for those in the early stages of PD. It also requires a commitment of four weeks, with one-hour training sessions twice a week.

I was doing fine with this programs, and stuck with it because I could clearly see it was a BIG help. Then came the August 2011 car crash and the resultant lower back pain that still troubles me. I used that discomfort as an excuse to stop taking my daily walks and doing my BIG exercises. I paid a big price for the neglect.

Fortunately, my neurologist at my regular November checkup gave me a new physical therapy prescription, suggesting I use it for a refresher course on the BIG exercises and to strengthen my core muscles. I'm just a few weeks into the new PT program, and I'm already seeing BIG results.

My physical therapist suggested we use my iPhone to record the BIG exercises. Then I'd transfer the videos to my computer for future reference.

January 16, 2013

Hugh Yarrington on Dying But Mostly on Living


A life celebration for my friend Hugh Yarrington was held last Sunday at his home in Williamsburg, Va. The invitation from his daughters, Ashley McKee, Jill Jones, and Elizabeth Yarrington (seen above) read:
As many of you know, Hugh passed away on Tuesday, November 20th, 2012 after a 15-month long fight with Multiple Myeloma. He lived life to the fullest, and would never have wanted his family and friends to mourn him -- he always talked about wanting a party, not a funeral.  So, in keeping with his wishes (and his personality!), we're holding a celebration of life party to honor him. We hope you will be able to join us.  His friends and family meant the world to him, and we know he would love to see us all together, remembering the good times we had with him.
And a great party it was.  Hugh would have loved it.
-----------------
Hugh was a great pal (and drinking buddy) of mine during the years we worked together at BNA (now Bloomberg/BNA). I remember those times fondly. But what I will remember and treasure most is our renewed friendship in the past year after we learned that we both were dealing with progressive diseases. I would have long lunches with Hugh talking about death and dying (among many other things) and always come away feeling happy and re-energized. His emails were inspiring. Here's a sampling:  

Hugh on Our Fear of Death
I think our culture suffers from its fear, or even rejection, of death as a natural part of life. In other cultures, where it happens frequently and in the midst of daily living, people learn from childhood that this is the natural way of things and they build that into their world view in a healthy way. I think our own culture tries to deny death as a part of life that must be accepted and dealt with in the normal course. It's as silly as thinking runway models represent the ideal  female form, but we are constantly pulled in that direction, aren't we.

Hugh on Euthanasia
On the end of life decision,  think you are absolutely correct to say that we can't really say how we will deal with mortality until it is an immediate issue, as opposed to an intellectual one made at a distance from the ever present fact of one of our basic life forces - preservation of our existence no matter how difficult or painful. Let's see. I can't say what I will do when the time actually comes, if it does (and we all have to reckon with a sudden turn for the worst that robs us of the choice). As a reasoning, rational person, I naturally prefer choosing my time and place as opposed to a few months in agony and putting my family through all the emotion of watching a loved one suffer and die. I've made my plans and know how it goes in every detail. It is acceptable in that sense and preferable from any rational perspective I can see, but, you are correct to point out the obvious ... most people do not choose that course when push comes to shove. But, my guess is that many never made arrangements to be able to make the choice, and I suspect that simple suicide by the standard means is beyond most of us, especially when we are sick and surrounded by caring friends and loved ones. Well, let's not think too much about it now. With luck, we are both quite a ways off from such extremities! :)

January 15, 2013

Coconut Oil Confession: I Use It, Inside and Out

For months, I've criticized the unsubstantiated hype from Pat Robertson and Dr. Mary Newport that coconut oil can cure Alzheimer's. But now, a confession: I've recently started putting a tablespoon of coconut oil into my first cup of morning coffee.

I'm not a closeted Robertson/Newport believer. I've been using coconut oil as part of yet another experiment by this novelty-seeking neophiliac. I began this new regimen after seeing reports that the traditional low-cholesterol, low-fat diet is a mistake, and that a low-carbohydrate, high-fat diet is better, especially for seniors. A recent Mayo Clinic study found that people 70-plus who consume lots of protein and fat relative to carbohydrates are less likely to suffer cognitive impairment.

January 14, 2013

Coconut Oil Update: Newport and Robertson Return, New Voices Speak

A major thread running through my 2012 blog posts was an examination of the claims for coconut oil as a treatment for Alzheimer's disease (AD). These claims, which have created huge interest, had their origins in a video promoted by Pat Robertson's Christian Broadcast Network that featured Dr. Mary Newport, a Florida clinician who described the dramatic improvement in her husband's Alzheimer's symptoms after she began giving him daily doses of coconut oil.

I posted about the original Newport/Robertson video last February, but unfortunately didn't check the claims being made. I later added several posts on the lack of scientific evidence for these claims, culminating in a here's the bottom line post in October. I thought this quote from the Spring/Summer 2012 Research Update of the Alzheimer's Association summed it up well:
Every day we hear magical claims of products promising relief. Coconut oil, for example, is touted by a physician in Florida as having a miraculous impact on her husband. While the ketones in coconut oil are being widely studied for dementia and are a key ingredient in an FDA-approved food product for memory loss, there is no scientific evidence that coconut oil helps with Alzheimer’s. 
The coconut oil promise has been around for more than three years. If the administration of coconut oil was, indeed, beneficial, it would be shouted from every mountaintop. (emphasis is mine).
The Return of the Hucksters
Now Pat Robertson has started 2013 with a new report (video below) on Dr. Newport's claims. Robertson reports that 5 million viewers watched the original CBN report, making it the network's most-watched report in 2012.

January 11, 2013

A Song with a Cautionary Message for You Blog Readers



This classic song and rendition are terrific and have come to mind frequently in the past few years as I find "my way" to deal with aging and Parkinson's and life in general. But the lyrics and the performer have a bit too much "Ain't I Great!" flavor for my taste.

Don't get me wrong. I like Sinatra. After all, the combination of his In The Wee Small Hours album (LP, not CD) and martinis led to my marriage.

All of this is by way of making a couple of points that I've been thinking about as I research health issues and write this blog.
  • I'm not touting "my way." The more I explore Parkinson's and other health issues, the more aware I become of how idiosyncratic each disease is. And the same goes for the different ways each of us responds to particular medications and therapies. Yet most of us have tried a medicine, dietary supplement, new diet, or a "new age" therapy based on nothing more than a few anecdotal reports or a media appearance by a product huckster. In reading any of my reports on something that seems to be working for me, don't assume it will work for you. Check it out if you think you might want to try it, and get your doctor's OK. But it's almost certain you won't have the same reaction I did. I don't want this blog to turn me into another Mary Newport. She's the Florida doctor who saw dramatic improvements in her husband's Alzheimer's disease after feeding him lots of coconut oil. Her video and book have been promoted by Pat Robertson's Christian Broadcast Network, launching the coconut-oil-can-cure-AD craze: http://bit.ly/T4Dpv3).
  • "My way" is evolving.  "My way" today is the result of a lifetime of hyperactivity, borderline attention deficit disorder, and neophilia (novelty-seeking). A couple of  friends have said they sometimes feel guilty reading my blog posts because they aren't nearly as active as I seem to be. Relax. There's a lot to be said for a more contemplative life and for taking the time to savor life slowly and deeply. I'm moving more in that direction as I age. I'm beginning to relish "the joy of quiet." Interestingly, as I begin planning the Mediterranean cruise with my family this summer, I look forward to the quiet times sitting on my suite's balcony at night much more than the daily tours of the cities along the way.

January 10, 2013

Workflowy: Silly Name Notwithstanding, It Works for Me

My housemates often comment on how well-organized I am. I'm always looking for ways to bring some order into the chaos that at times seems ready to overwhelm me. So I naturally clicked on a link I came across on a Harvard Business Review report to "Eight Apps To Make You More Productive."

HBR had polled some of its most productive and tech-savvy bloggers to ask what apps they use to stay on track. No. 2 on the list was workflowy.com.

Workflowy is an online tool that helps me organize myself, first by making a list of high-level topics and tasks and then breaking them into smaller pieces. For example, I started with just two major headings: Blog and Personal. Under Personal, I've created sublists like:
  • To phone or e-mail
  • To check
  • To do
  • Shopping list
  • Amazon list
  • Possible activities
  • Travel plans
  • Movies to see
Then I can subdivide each of these topics almost indefinitely. One nice feature is the Workflowy sends me an email every morning reminding me of the latest entries I made. This serves the double purpose of also reminding me to check the list at the start of the day.

January 9, 2013

Exercise Grows Brain, Reduces Alzheimer's Risk


In its short life, this blog has developed several themes. Among them: 
  1. Exercise really matters, and 
  2. I fear Alzheimer’s. 
Now, a recent article in Alzheimer’s Weekly reports on a study that demonstrates how I might use theme #1 to address theme #2. The story’s title: “Energetic Lifestyle Builds Brains by 5%.”

Using 20 years of data about 876 adults (whose cognition ranged from normal to impaired) with an average age now of 78, researchers at UCLA learned that active people create – build – 5% more gray matter in their brains. Here’s the important part: that additional size and activity helped prevent the dementia of Alzheimer’s.

That data had already been collected as part of the Cardiovascular Health Study. It included people from four different locations across the country, and provided information about body mass index and lifestyle habits.

The lifestyle factors the team measured included recreational sports, gardening and yard work, bicycling, dancing and riding an exercise cycle. The specificity of the assembled statistics allowed researchers to estimate energy output in weekly kilocalories.

January 8, 2013

Little Things That Make A Big Difference to Me

I thought I'd start the new year with a brief (remember: Less Is More) photo post on a couple little things I came up with last year to help me and my receding memory. Here goes:

Pill Splitter and Reminder
With one exception, I do all my pill popping when I get up, or when I go to bed. It's easy to remember to take these pills. With the same one exception, it really doesn't matter much if I forget and skip a pill.

The one exception is Sinemet (generic: carbidopa-levodopa). I'm supposed to take this pill four times a day at about six hour intervals. After my "joy of quiet" meditation hour, I try to keep this pill schedule: 5am, 11am, 5pm, and 11pm. The first and last are easy to remember. But I was having trouble with the two middle pills: remembering to take them in the first place, and then remembering IF I'd taken them. Messing up the Sinemet schedule carries consequences: skipping the 11am pill, for example, would would create serious balance problems for me by mid-afternoon.

I finally found a system that works for me (shown below). At bedtime, I set up my pill splitter for the next day. What you see in this photo is the four daily carbidopa-levodopa pills. The white pills are the two halves of a 1mg Azilect tablet. Azilect is usually prescribed for people with Parkinson's in addition to the carbidopa-levodopa therapy. As with most of my meds, I've found that cutting the pill in half seems to work as well as taking a whole pill. So at 5am the next day, I'll start off with one-half of an Azilect and one of the four carbidopa-levodopa pills.


January 7, 2013

Reflections on the Blog's 2012 Hit Parade

I started this blog a few years ago, thinking it might become an online info exchange for people, like me, with questions about their health. I hoped it might help others, as well as myself, and I love the process of researching and learning new stuff along the way.

But the blog, like me, has been changing. I’ve sensed a little seismic shift this year. I find I'm writing more about personal things. I'd been reluctant to do that initially, figuring others would be more interested in the latest medical research than my babbling about life. Then, I noticed I was getting as much or more traffic and feedback on the personal postings. Of course, I usually get the most traffic on posts that primarily feature photos. Reminds me why I liked and now miss the old Life magazine.

So for the coming year, I'll continue a mix of the personal views and research-based reports on issues that concern us old folks.

January 4, 2013

Happy Old Year - #1: My Trip to Nepal Brought A Life-Enricihng Return



2012 was a very good year, and I'm planning a few "Happy Old Year" posts to remind me. Heading the  "Best of 2012" list is my March return to Nepal for the wedding of my housemate Nimesh to Bhawana. It was a joyous event. But, for me, an even greater joy has come from its aftermath: Bhawana joining our DC household. 

Normally, I would now provide some extensive background information. But adhering to my 2013 mantra of "Less Is More," I'll just suggest that if you want to learn more about my 10-year love affair with Nepal and its people, simply go to the "Blog Archive" at right and check the March posts from Nepal.

My Personal Favorites in the Wedding Photos
My favorite photos involve me. Surprise!

I was very honored to join Nimesh and his sister Sona for the ride to Bhawana's house on the wedding day.

.
One of the highlights of the trip was the rapport Nimesh's grandfather and I established, even without any common language.


March to September Transformation
Looking through the blog posts and photos from 2012, one thing that struck me was the contrast between the March wedding photos of Nimesh and Bhawana in Nepal, and the photos of them a few months later here in the U.S. The pictures don't do full justice to Bhawana's amazing adjustment and transformation. Before the March wedding, Bhawana hadn't traveled outside Nepal, aside from the last two years she'd spent in Mumbai (Bombay) India getting her MBA. Today, she could easily pass for a Nepali-American who was born here.

January 3, 2013

My Mantra for 2013: Less Is More

I'm not much on New Year's resolutions (yesterday's post notwithstanding). But I am a big believer in the importance of slogans, sayings, and mantras. Even though I haven't attended an AA meeting in years, its slogans keep popping up as I deal with problems and often are a big help -- "one day at a time," "easy does it" and, of course the always useful Serenity Prayer:

God grant me the serenity 
to accept the things I cannot change; 
courage to change the things I can;
and wisdom to know the difference.

Another less well-known AA saying that I dial up when I find myself brooding about past events is "it's OK to look back, just don't stare."

For a lot of reasons, I've decided I need to focus on one slogan in particular for this year.

Less Is More
This saying is attributed to several sources -- a poem by Robert Browning... the minimalist furniture designs of Mies van der Rohe. It probably came to my attention first as sound advice for writers and journalists. It was reflected in Mark Twain's famous quote:
I didn't have the time to write a short letter so I wrote a long one instead.
I've thought about it often recently in connection with my medical/health issues. I've found that most of my prescribed meds work just as well -- and with fewer side effects -- if I cut them in half (http://bit.ly/VPyCPB) After popping many dietary supplements over the years, I now am happily down to three (http://bit.ly/U0wkxm).

January 2, 2013

A New Year's Resolution for All of Us: Live 2013 As Though You Have a Progressive Disease (or Two)

When I first started attending Alcoholics Anonymous meetings 35 years ago, one of the things I had trouble with (in addition to the God talk) was members introducing themselves by saying, "I'm Jane, a grateful recovering alcoholic." I'd think, "What nonsense!"

Within a few months, I was introducing myself the same way. My alcoholism had certainly given me lots of trouble (like being kicked out of Cornell Law School in March of my last year) but it had brought me to the fellowship of AA and a set of principles for living that turned me in a new and positive direction. I am a grateful recovering alcoholic!

I have a similar view now about my prostate cancer and my Parkinson's disease. Of course, these differ from my alcoholism. While, one day at a time, I can be a recovering alcoholic, I'll never, barring some miraculous medical breakthrough, be recovering from my cancer or PD.

Nevertheless, I am grateful for what has accompanied both diseases.
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