George was a savvy medical customer. He was since more than 60 years as a lawyer in New York - including research serve as executor for the estate of Lou Gehrig's widow, Eleanor, and to ensure that all payments out of the use of Gehrig's image a.l.s. attended Columbia University Medical Center. I originally met George when I research on Lou Gehrig's disease doing it.
George suffered peripheral arterial disease or obstruction of the arteries to feed the limbs.From the outset, it is possible, clogged blood vessels with a balloon again open. but if the disease worsens, blood starved areas typically feet might develop life-threatening ulcers.
By the time I George, met in 2002, a complex combination needed he already prone to ulcers - a result of the flat feet and decades of bad blood circulation - and he of antibiotics, ointments and dressings. I gave what advice could, I refer him to an infectious disease specialist who helped to heal one of largest ulcers.
Things were worse until April 2009. George had require large ulcer that would not heal, to his left foot and was, hospitalizations, and intravenous antibiotics. A surgeon recommended strongly a below the knee amputation of the left leg.
George got a second opinion by Dr. Alan I. Benvenisty, a surgeon and Director of the vascular laboratory at St. Luke's Hospital. In August of hope, a balloon procedures try Dr. Benvenisty sent him a dye study for an angiogram, generates the images of the arteries.But the test showed that a balloon in question.Amputation was the only surgical option.
So Dr. Benvenisty did what any doctor should: he put the possibilities per and Contra.Er told George, that very risky surgery and wounds in about 30 percent of below the knee correctly heal amputations. 704 Such operations, a study published in the archives of surgery 2004 found that patients were at risk for "Significant morbidity and mortality"In George's case, the odds were more: he was 94 and a mild heart attack while his suffered angiogram.
And then there was the very least the Rehabilitation.Am needed George taxation month aggressive physical therapy in a nursing facility.
What was the other option? without surgery Dr. Benvenisty George said, which would probably kill arterial disease him in a matter of months.
I was among the many people who said George.Part of it clearly wanted versuchen.Nachdem all surgery, told me he who will not live?
But he spent even more time to say me why he thought surgery was too risky - and as if it was successful, he endured was away from his frail 90 wife, Dorothy, his rehabilitation to be while."A few months is a long time, when to our age," he said.
George's daughter, Ruth Pappas, reminds himself mixed signals from him first hear: "I don't want to go", but "I haven't given up."
Finally, although George chose hospice care about surgery.Ruth's husband, Tony Pappas, George says told him that even if the operation went well, he thought would complications and his life would not be extended.
George chose home Hospiz.Die Hospice workers helped him go to the bathroom to clean and get in and out of bed.
But he was not in the Hospice for lange.Er had already developed fever and after a few days he was in his bloodstream worse, probably of a foot infection spread hatte.Wenn Hospice doctor an antibiotic proposed, George, refused to say "I want to feel better."Ruth believes that her father's way of saying, was he was ready to die.
He did this later in the night, quiet, in his sleep.
Dr. Benvenisty me that in his experience, the exception to the rule war.Die Forge most patients predicted - even those who have sworn never to amputation and the high risk of dying from the procedure.
I think George done right, and maybe I should have more in this Richtung.Am guide him end but I was glad that he made his own choice.
Dr. Barron H. Lerner teaches medicine and public health at Columbia University Medical Center.
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“Oh, yeah,” she said, vaguely, when questioned about it. “It’s for breast cancer.”
Really?
It’s hard to remember that, not so long ago, the phrase “breast cancer” was not something women spoke aloud, even among themselves. It wasn’t until the early 1970s, with the high-profile diagnoses of the former child star Shirley Temple Black, the first lady Betty Ford and Happy Rockefeller that the disease went public. A short time later, Betty Rollin, an NBC-TV correspondent, published the groundbreaking memoir “First You Cry.” Back then, her grief over losing her breast and the blow cancer dealt to her sex life was greeted with hostility by some critics and dismissed as frivolous. Mammography was just coming into use to detect early-stage tumors. The American Cancer Society was still resisting the idea of support groups for post-mastectomy patients. A woman like Rollin, some said, was supposed to be grateful that she qualified for a radical mastectomy, stuff a sock in her bra and get on with it.
Fast-forward to today, when, especially during October, everything from toilet paper to buckets of fried chicken to the chin straps of N.F.L. players look as if they have been steeped in Pepto. If the goal was “awareness,” that has surely been met — largely, you could argue, because corporations recognized that with virtually no effort (and often minimal monetary contribution), going pink made them a lot of green.
But a funny thing happened on the way to destigmatization. The experience of actual women with cancer, women like Rollin, Black, Ford and Rockefeller — women like me — got lost. Rather than truly breaking silences, acceptable narratives of coping emerged, each tied up with a pretty pink bow. There were the pink teddy bears that, as Barbara Ehrenreich observed, infantilized patients in a reassuringly feminine fashion. “Men diagnosed with prostate cancer do not receive gifts of Matchbox cars,” she wrote in her book “Bright-Sided.”
Alternatively, there are what Gayle Sulik, author of “Pink Ribbon Blues,” calls “She-roes” — rhymes with “heroes.” These aggressive warriors in heels kick cancer’s butt (and look fab doing it). Like the bear huggers, they say what people want to hear: that not only have they survived cancer, but the disease has made them better people and better women. She-roes, it goes without saying, do not contract late-stage disease, nor do they die.
That rubber bracelet is part of a newer, though related, trend: the sexualization of breast cancer. Hot breast cancer. Saucy breast cancer. Titillating breast cancer! The pain of “First You Cry” has been replaced by the celebration of “Crazy Sexy Cancer,” the title of a documentary about a woman “looking for a cure and finding her life.”
Sassy retail campaigns have sprung up everywhere, purporting to “support the cause.” There is Save the Ta-Tas (a line that includes T-shirts and a liquid soap called Boob Lube), Save Second Base, Project Boobies (the slogan on its T-shirts promoting self-exam reads, “I grab a feel so cancer can’t steal,” though the placement of its hot-pink handprints makes it virtually impossible for them to belong to the shirt’s wearer). There is the coy Save the Girls campaign, whose T-shirt I saw in the window of my local Y.M.C.A. And there is “I ? Boobies” itself, manufactured by an organization called Keep a Breast (get it?).
Sexy breast cancer tends to focus on the youth market, but beyond that, its agenda is, at best, mushy. The Keep a Breast Foundation, according to its Web site, aims to “help eradicate breast cancer by exposing young people to methods of prevention, early detection and support.” If only it were that simple. It also strives to make discussion of cancer “positive and upbeat.” Several other groups dedicate a (typically unspecified) portion of their profits to “educate” about self-exam, though there is little evidence of its efficacy. Or they erroneously tout mammography as “prevention.”
There’s no question that many women, myself included, experience breast cancer as an assault on our femininity. Feeling sexual in the wake of mastectomy, lumpectomy, radiation or chemo is a struggle, one that may or may not result in a new, deeper understanding of yourself. While Betty Rollin acknowledged such visceral feelings about breasts, she never reduced herself to them. And in the 1990s, the fashion model Matuschka’s notorious photo of her own mastectomy scar (published on the cover of this magazine) demanded that the viewer, like breast-cancer patients themselves, confront and even find beauty in the damage.
By contrast, today’s fetishizing of breasts comes at the expense of the bodies, hearts and minds attached to them. Forget Save the Ta-Tas: how about save the woman? How about “I ? My 72-Year-Old One-Boobied Granny?” After all, statistically, that’s whose “second base” is truly at risk.
Rather than being playful, which is what these campaigns are after, sexy cancer suppresses discussion of real cancer, rendering its sufferers — the ones whom all this is supposed to be for — invisible. It also reinforces the idea that breasts are the fundamental, defining aspect of femininity. My friend’s daughter may have been uncertain about what her bracelet “for breast cancer” meant, but I am betting she got that femininity equation loud and clear.
I hate to be a buzz kill, but breast cancer is just not sexy. It’s not ennobling. It’s not a feminine rite of passage. And, though it pains me to say it, it’s also not very much fun. I get that the irreverence is meant to combat crisis fatigue, the complacency brought on by the annual onslaught of pink, yet it similarly risks turning people cynical. By making consumers feel good without actually doing anything meaningful, it discourages understanding, undermining the search for better detection, safer treatments, causes and cures for a disease that still afflicts 250,000 women annually (and speaking of figures, the number who die has remained unchanged — hovering around 40,000 — for more than a decade).
As for me, I bear in mind the final statement that a college pal of mine who was dying of breast cancer (last October, in the midst of all that sexy pink) made to her younger brother. She was about to leave two young sons to grow up without a mother; her husband to muddle through without his wife. She could barely speak at the time, barely breathe. But when her brother leaned forward, she whispered two words in his ear: “This sucks.”
Peggy Orenstein is a contributing writer. Her book “Cinderella Ate My Daughter” will be published in February.
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The public will have the opportunity to weigh 36 proposed avatars through 9, 2011.
NEW: R. J. Reynolds is challenging the requirement of courtCurrent tags ignored largely an anti-tobacco advocate says The Federal Government is pushing for ' bolder ' warnings on cigarette advertising and packagesThe new rules will be the biggest changes in tobacco warnings in 25 years
Washington (CNN)--Federal Government unveiled new proposed regulations Wednesday Convention "stringent health warnings" cigarette ads and packaging, according to a new release from the Department of health and human services.
The proposed requirements, described as the biggest change tobacco health warnings in 25 years, include "nine new larger and more significant descriptive alert statements and color images graphics illustrate the effects of smoking, negative health", said the release.
The public will have the opportunity to weigh 36 proposed avatars through January 9. assuming that the plan moves forward as scheduled, food and drug administration officials will select nine statements and images to be used not later than 22 June.
Rules that require the use of new images and warnings for all cigarettes distributed for sale in the United States of America will apply from 22 October 2012.
«Today, FDA is taking a crucial step towards reducing huge toll of disease and death caused by tobacco use, proposing to dramatically change how cigarette packages and advertisements displayed in this country, ' Margaret Hamburg FDA Commissioner said.
"When the rule is triggered, the health consequences of smoking will be obvious when someone receives a packet of cigarettes.... This is a concrete example of how new responsibilities of FDA Regulation of tobacco product can benefit public health. "
Mathew l. Myers, the President of the campaign for tobacco-Free kids, called the proposed changes "the most significant change in American cigarettes warnings." since they were first in 1965 required
Anti-tobacco advocate Richard Daynard praised the new warnings. "It is time," said CNN in an interview over the telephone. "The Canada had similar tags for at least five years and were very effective in reducing consumption there. This is a totally costless way to get information about individuals in a way that would make it attention. "
The law professor at Northeastern University in Boston, Massachusetts and Chairman of the Institute for public health Advocacy said current warning labels "are unread, as for anyone to say ...This would not be possible to ignore new. "
The change became possible, said last year, when Congress gave the FDA broad authority to regulate tobacco products.Prior to that, "what was needed to be done by a vote of Congress."
Stanton Glantz was more blunt about why he had taken so long to effect change in the United States. "It is because the tobacco companies have a lot of muscle, "said Professor of medicine at the University of California in San Francisco in a CNN interview over the telephone."And because they have loads and loads and loads of money to politicians."
According to the current categorisation, the United States "the weakest warning labels in the world," said Glantz.
Glantz, who also directs the Center for Tobacco Control Research and education at UCSF, predicted that some tobacco companies "almost certainly" I am going to sue claiming that publish warnings will prove too costly.
In a statement, Philip Morris USA said it supported several of the initiatives that invokes HHS regarding tobacco issues. "Philip Morris USA participated actively in the FDA rule-making and public comment process and plans to do the same on this proposal, "he said.
But David Howard, a representative of the R. J. Reynolds Tobacco Co., said the legality of which require larger graphic warnings on cigarette packets were already the subject of lawsuits pending filed by the manufacturer of Camel and Pall Mall cigarettes.
The suit alleges that the warnings violate first amendment rights of the company's commercial, freedom of speech, Howard told CNN in an interview over the telephone. "Our packaging, Seizing half devaluing our brands, our contests that, "he said.
If the color was rejected last year in Federal Court in Bowling Green, Kentucky, the company has appealed to the Court of Appeals for the Sixth Circuit, which is expected to take up the matter next year, said Howard.
Tobacco use, in accordance with the Federal Government, causes 443,000 deaths in the United States each year and remains the leading cause of early and preventable deaths nationwide.
An estimated 30 percent of all cancer deaths are associated with tobacco use, health officials say the United States, smokers number 46 million--including 20,6% of adults and 19.5 percent of high school students, according to the Federal Government.
CNN Tom Watkins have contributed to this story.
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