Mary Ann Sorrentino's Open Salon Blog

Risky Businesses

Sun, 6 May 2012 20:05:39 -0400

Seattle’s KPLU sports commentator Art Thiel observed recently that, "More than 1,000 NFL retired players are suing the league now over what they claim is neglect of the issues of head trauma to long-term brain function consequence.” Athletes with long histories of repeated head traumas and mental or physical pathology-- which may or may not be related-- will now fuel another long debate. Multimillionaire football players, active and retired, will line up for even more money because football players risk getting their heads bashed every time they play.

Is such a risk a surprise? They are, after all, professional athletes in a sport that involves tackling, kicking, running, jumping, and finding oneself on the bottom of a pile of other players, all of whom weigh hundreds of pounds. When they took that $5 million signing bonus did the dangers of this dream job somehow elude them?

Frankly, in today’s economy, it is difficult to justify more and more compensation for occupational hazards that ought to be obvious when workers choose the job in the first place. Cops risk being shot, stabbed and otherwise injured or killed because their workplace is often a crime scene.

Firefighters will get burned, or suffer smoke inhalation injuries or death because their job is to run into burning buildings, carry people out, knock down burning walls etc. Professional athletes, sports car drivers and players of so-called “extreme games” get rich by putting themselves at high risk in what can be death defying situations.

(Take boxing for example: two grown men get paid to punch each other until one falls down unconscious. Why is this entertainment?)

Then, when a race car driver crashes and burns to death on a speedway, or an extreme game star suffers a paralyzing brain injury after driving a motorcycle off a bobsled run, everyone seems surprised.

Want less risk? Sell cars, teach philosophy, do landscaping, write poetry, or become a computer geek and invent a new Facebook.

Most football (and other) players now earning millions to throw balls and endorse sneakers-- if sent back to wherever it is they come from-- would barely be earning a living doing whatever it is they do when hitting a ball with a stick or running down a field with a ball tucked in their armpit isn’t an option.

Next time you drop a mortgage payment to take your kids to a game, think about why those game tickets cost a fortune.

Art Deco Round the Globe

Tue, 1 May 2012 21:05:18 -0400

Here's my latest travel piece for Yahoo....enjoy!

(See more here )

Abandoned by Our Government

Sat, 28 Apr 2012 21:04:40 -0400

The April 23, 2012 issue of TIME magazine shows a collegial image of President Obama in the White House gardens with President George W. Bush on one side of him and President Bill Clinton on the other. The three look genuinely friendly and Obama has his hands placed warmly on the backs of each of his predecessors as they walk forward.

I doubt I’m the only American old enough to remember past presidents going back to Eisenhower who wonders how accurate the sentiment of the TIME photograph really is. Though we’d like to imagine that all our living presidents support the man currently in the White House, the political realities we witness in Washington every day cast some pretty hefty doubts on that being the case.

Can a man like George W. Bush, the titular head of the Republican Party as its last elected president, really wish Obama well? After all, Bush’s top advisor and friend, Karl Rove, heads up the PAC whose only expressed raison d’être is to get Obama out of the White House. Beyond that, the daily congressional drill since Obama took the oath of office has been the most extreme partisan divide of our political lifetime. Republicans in both the House and the Senate seem determined not to support the president, whatever the cost to the nation, its troops, its children, elders, poor, sick and disenfranchised.

Democrat Bill Clinton, meanwhile, has risen from not having “had sex with that woman” to statesman. In fact his numerous tag-team charitable and diplomatic efforts with former president George H.W. Bush have given Clinton the ultimate bi-partisan icon portfolio. Rumors of Clinton-Obama friction linger, despite Hillary’s fine performance as secretary of state, and the former president’s occasional willingness to question the current Commander-in-Chief’s motives or policies defies the usual partisan rule never to publicly criticize a member of one’s own gaggle.

All of these thoughts, generated from this one photograph, speak to the dilemma of today’s voters who—perhaps for the first time—doubt that politicians of any party really give a damn about them. Washington seems to care little about our sense of abandonment and every day we in the 99% witness more and more evidence that we hardly matter at all.

What would the TIME cover look like, I wonder, that translates those sad sentiments into a photographic essay?

Diet, Exercise, and Hold the Statins, Please

Thu, 22 Mar 2012 14:03:44 -0400

Just when I thought they were going to put statins in the water supply since everyone I know is on them, my friend Dr. Barbara Roberts writes a book that urges us to take a closer look at the whole question of cholesterol management.

Barbara is so great in her field of cardiology, that Miriam Hospital (one of Providence's premier facilities) built an entire women's heart health unit around Barbara's skills.

So here's the summary from the publisher (Simon & Schuster...not exactly chopped liver) and the link to grab this important new paperback before it actually hits the bookstores in a few weeks.

________________

THE TRUTH ABOUT STATINS: RISKS AND ALTERNATIVES TO CHOLESTEROL-LOWERING DRUGS

Synopsis by Dr. Barbara Roberts

Statin medicines to lower cholesterol were approved in the United States in 1987. Over the last few decades, I have been prescribing statins for my patients when it was indicated, and, initially, these medicines seemed safe and reasonably well tolerated. But the more I have learned about statins, both from the experiences of my own patients and in the medical literature, the more concerned I have become. As more and more people have taken statins, there have been more and more reports of serious and sometimes fatal side effects. Now that statin use has accelerated, I feel compelled to share the results of my research into this powerful class of medicines.

Every day, in my practice I see patients who cannot tolerate statins. Some of them complain about muscle aches and weakness, or tendonitis, while others struggle with frightening memory loss and difficulty concentrating. These side effects may not be as rare as we’ve been led to believe.

Some people can take statins and not develop side effects. But how necessary are statins in the first place? Do they really help prevent strokes and heart attacks? Nowadays, doctors are advised to knock down their patients’ cholesterol to very low levels with high doses of statins. But cholesterol, far from being the villain it’s said to be, is a vital part of every cell in our bodies. This waxy fat, produced primarily by the liver, is absolutely crucial for the normal functioning of muscles, nerve cells, and the brain. It’s also the building block that our bodies use to manufacture many hormones, including the reproductive hormones estrogen and testosterone. How will our muscles, brain cells, and nerves react if they are chronically starved of a chemical that is so necessary for their proper functioning?

These and other important questions about statins need unbiased, scientifically valid answers. Why do women seem to derive less benefit from statins than men do? Why do women report more side effects from statins? What questions should you ask your doctor if he/she wants you to take a statin? How solid is the science that is used to justify treating people with statins? What is now at stake for the pharmaceutical industry (Big Pharma), the US Food and Drug Administration (FDA), the medical profession, and, most importantly, the people who take statins?

In researching these issues, I pored over the studies that were used to justify treating people with statins. I spoke to my own patients who’d experienced side effects from the drugs, and to other people who’d heard of my interest in statin side effects and contacted me. I educated myself on the interactions among Big Pharma, the FDA, and the medical profession.

The FDA is responsible for reviewing and approving any new prescription drugs that pharmaceutical companies want to sell to the American public. The FDA not only certifies all new prescription drugs but also must approve any new use of existing drugs. However, once the FDA approves a drug, physicians can prescribe it for anything they choose. Unapproved indications are called off-label uses of a drug. Doctors can prescribe, but pharmaceutical companies cannot advertise, off-label uses of a drug.

Statins are approved to treat high levels of low-density lipoprotein (LDL) cholesterol (so-called bad cholesterol). In most cases, they are prescribed for people with high levels of cholesterol or with built-up fatty deposits called plaque in their arteries: those who either have or are at risk for atherosclerotic cardiovascular disease (ASCVD). Several scientific studies found that statins lowered the risk of cardiac events in people with established atherosclerosis. (“Events” is the neutral term we doctors use for really bad outcomes like heart attacks and death.) However, the benefit was modest and was less in women than in men. Furthermore, despite statin therapy, people with ASCVD still had a high residual risk, that is they had an increased risk of heart attack and stroke even when their LDL cholesterol was brought to very low levels. There were also studies that showed benefits of statin therapy in people without cardiovascular disease but with elevated levels of LDL cholesterol. This benefit was found only in men, however, not women.

In February 2010, based on a study called the JUPITER trial, the FDA expanded the indication for statin use. It now included healthy men ages fifty and older and healthy women ages sixty and older—even those with normal levels of LDL cholesterol—if they have evidence of inflammation in the body (indicated by elevated levels of a substance called high-sensitivity C-reactive protein, or hsCRP, in the bloodstream), plus one other risk factor for developing heart disease, such as smoking or high blood pressure. This new indication for rosuvastatin (Crestor), the statin used in the trial, could add six and a half million healthy people—who exhibit no evidence of ASCVD and have normal cholesterol levels—to the number taking statins.

The trial recruited close to eighteen thousand people who were free of diagnosed heart disease. It included healthy men ages fifty and older and healthy woman ages sixty and older who had normal levels of LDL cholesterol but elevated levels of hsCRP. Half were treated with rosuvastatin and half received a placebo, or inactive “dummy” pill. The trial was scheduled to last five years but was stopped prematurely “for benefit” after an average follow-up of just under two years. This means that the investigators felt that the benefit of the statin in lowering the risk of cardiovascular events was sufficient to end the trial before it was scheduled to end. So based on the results of this study, the FDA approved wider use of rosuvastatin.

The JUPITER trial was paid for by AstraZeneca, the pharmaceutical company that makes Crestor. The principle investigator, Dr. Paul Ridker, developed the blood test that measures hsCRP, and he receives royalties from its use. Both AstraZeneca and Dr. Ridker stand to make a fortune as this new indication for statin use is implemented.

But are the results of this study all they are cracked up to be? Might the findings have been different if the JUPITER trial lasted five years, as originally specified? Was the FDA correct in approving this new indication for rosuvastatin? Were there differences in the results for women compared to men? The answers to these questions may shock you and make you question your physician if he or she wants to put you on a statin.

In exposing the shoddy science that underlies many of the “guidelines” that doctors are told they must follow in treating their patients, and in exposing the rampant conflicts of interest among the FDA, Big Pharma, medical scientists, medical centers, and professional medical organizations, I risk being declared a pariah in the medical community.

But this story must be told. If you or someone you love takes a statin, please read this book. It might just save your life.

_____________

Click on this link to pre order this important new book.

http://books.simonandschuster.com/Truth-About-Statins/Barbara-H-Roberts/9781451660975/

graphics from wikicommons

ABORTION: Real Women, Tough Choices, Personal Freedom

Sat, 17 Mar 2012 15:03:59 -0400

Though I wrote this book in 2006 when it was published by Gadd Books, today's horrifying anti-choice initiatives have made it quite suddenly prophetic and "new."

Here is one of the chapters I called "Snapshots" in the book. This one about how one good man dealt with a girlfriend's abortion choice, before abortions were legal.

The snapshot of Matt has also been adopted by the theater troop "Words of Choice" which performs nationwide. Cindy Cooper would be happy to bring her troop to your next meeting, church gathering,college class, or annual meeting so that the message of reproductive freedom can be spread.

The book can be purchased on the web at Amazon, Gadd Books, and a number of other vendors, or check out your local library. Since its publication, it has also been made part of the curriculum in a number of Women's Studies courses across the country. This is gratifying because I want to bring the message of urgency to young women who have grown up in a world where abortion choices have always been available to them

I hope Matt inspires you to do all you can to make sure our daughters and granddaughters-- and the men who love them-- are not forced to go back to the middle ages on such an urgent and private human choice .

___________________

Snapshot of Matt

When I was in the throes of thinking through the premise for this book, I found myself discussing it at with the husband of a friend.

He gave me good advice when he said, “Don’t forget the men.”

Too often, in the passion of putting a face on the difficult discussion of abortion rights, we forget the many faces of the men who love the women at the center of the discussion.

Matt is a square man, now past 50 and gray-haired, but once sporting a full head of thick blonde locks. His skin is fair and his cheeks ruddy. He has smiling eyes and a familiar gaze.

Matt’s story speaks of those men who come from a generation when back alley abortions were the only ones available. As the responsible partners of the pregnant women of those times, these men had their own sad stories to tell.

In Matt’s case, he was just 20, living in a southern state where there was little if any support for abortion as a legitimate consideration for any pregnant women. He came from a Catholic, middle-class family and says his father never really spoke with him about sex or contraception. In fact, he says, “…He died and never told me he loved me.”

But just as they existed in other places, individuals with varying degrees of medical training profited from the desperation of some women and offered illegal, clandestine and often dangerous abortions for exorbitant amounts of under-the-table cash.

A Marine veteran, Matt had returned to the university in his home state and was partying in his fraternity house in those days, as many sophomores tended to do. At one party, he got drunk with a coed who also had too much too drink and they ended up having sex. This pattern wasn’t, and isn’t, unusual at all.

These kids hardly knew each other: they were not in love, just acting on the alcohol fueled hormones of their age.

After that night, they saw each other on campus, chatted, but never really dated. Matt says there was an awkwardness between them because they were both, in some way, uncomfortable with what had happened at the party.

A few weeks later, the 18 year-old Maryelle, called to say she was pregnant. They were in a state where 21 was the age of majority and abortion was against the law, though illegal operations were available.

Maryelle came from a wealthy family, had traveled widely and was more worldly than Matt. As his mind scrambled with the news and he wondered aloud what they would do, she informed him point blank that she was going to have an abortion.

Her sorority, interestingly enough, had an abortion fund, even then in 1972. They loaned her $200 and she said she had another $100 of her own, but she needed $200 more from Matt to pay the doctor.

Matt says now that in those days a young man in his position was expected to either marry the woman or pay for her medical care, whatever she decided. He sold his stereo and a prized camera he had bought in Japan to come up with the money and Maryelle made all the arrangements for the abortion.

Matt says now he wasn’t even sure what was involved in an abortion. He was embarrassed to ask anyone but he did ask Maryelle what he should expect after the surgery since they would have to drive three hours in a car to get to the office where the surgery would be done. Maryelle told him to get a room since she doubted she would be able to travel for a while, so he did.

I wondered what the three-hour ride was like, and Matt said it was awkward since these two young people were thrown together by their own youthful bad judgment but, beyond that, they didn’t really know each other. He says now that he passed much of the time with her in the car asking her technical questions about what she was about to go through.

“The moral questions never became an issue,” he says. Maryelle was clear about her decision, and he never questioned it. They were both, he now observes, just “trying to get through it so they could get on with their lives.” It was clear to both of them that they were in no position to consider having a child together and marriage seemed absurd given the distance between them without alcohol and a party for a backdrop.

Maryelle asked to be left at the medical building and told Matt to fetch her three hours later. She never asked him to come in with her and he never volunteered.

He spent the next few hours hanging around this strange town and returned a little early to get Maryelle.

They went to the hotel room and she rested, but she was bleeding quite heavily.

A few hours later, Matt noticed she was getting gray and he thought she was hemorrhaging. He finally convinced her they had to go to a local emergency room.

Maryelle was covered by her father’s health insurance and, as a minor, she knew the ER was about to blow her- and Matt’s- cover.

Within a few hours, Maryelle was in the recovery room after a necessary follow up procedure to stop the bleeding. Shortly thereafter her parents arrived.

Matt says now that the mother went right to her daughter’s side without a word to him, but the father immediately took his fists to the young man and was beating him up so badly the ER staff intervened and suggested Matt leave the clinic so calm could be restored.

The Vietnam vet was relieved in a way, he offers, since he wasn’t sure he couldn’t be arrested for this illegal abortion complicity. This was another matter his pride had prevented him from seeking information about. He knew it was against the law but didn’t know what his or Maryelle’s punishments might be.

In the weeks that followed, Matt tried to telephone Maryelle at home, but those answering the telephone there would not put him through to her. Finally, one day, he reached Maryelle’s mother.

To his surprise, the woman thanked him for saving her daughter’s life.

“If you hadn’t done what you did and brought her to the hospital, she would be dead today,” she said. She also apologized for the father’s rage as expressed in the beating but said,” He was only acting the way father’s react…”

Matt sheepishly allowed that he certainly understood how the parents must feel about the situation.

After that, he and Maryelle saw each other on campus, but Matt noticed, “it was hard for us to look at each other, and neither of us wanted to keep remembering” the nightmare they had shared. Interestingly, he felt they bonded around the abortion in a way they hadn’t before that situation threw them together in such an intimate way.

The epilogue to this story is as interesting as the story itself. Now, three decades later, Matt says that if he had known more about what abortion involved and if he had thought about the potential for human life inside Maryelle, he would have had a harder time dealing with his Catholic faith at that time. His ignorance allowed him to go forward, but he now feels pregnant women and their partners should have the kind of full disclosure and counseling most responsible abortion clinics build into their services.

No one should have regrets later because of ignorance about the procedure itself. But Matt cautions that informed consent is different from trying to dissuade or persuade the woman one way or another. In the end, he still believes it is the woman’s choice and hers alone.

The fact that Matt continues to be thoughtful about the fact that he and Maryelle had created the possibility of a child had the pregnancy gone to term is not evidence of psychosis: it is simply the predictable conclusion of one rational, thoughtful person who has been in this situation.

Matt says this abortion story became the second most life-altering experience of his growing up. The first was Vietnam.

Years after he and Maryelle had gone their own ways, Matt married a woman whose professional life eventually led to a position in a medical setting where abortions were also provided. He says he felt so supportive of her work because he never wanted his nightmare- and Maryelle’s- to be a part of his own daughters’ lives.

In the end, Matt’s perspective on the three-hour ride into that great unknown abortion scenario he knew nothing about, and which ended so badly and could have ended even more tragically, made him committed to women’s choices despite his personal reservations based on his faith and background.

I asked him frankly if he felt he could ever drive his own daughter to an abortion clinic one day if she asked him, pointing out that that would mean the termination of an eventual grandchild?

“It always has to be up to the woman,” was his clear and unhesitating response.

The feelings of the men in abortion decisions are often overlooked. This happens because of the fear that if too much attention is paid to those feelings, the men will be empowered to override a woman’s decision to terminate. More important, the woman is the patient and her health and decisions must be primary.

Matt’s story proves that some partners, despite their own ignorance of the procedure or their personal reservations about the decision, can come to understand the necessity for this choice to exist and the need for women to control their own reproductive destinies.

By the end of our interview, Matt isn’t looking at me, I notice. His gaze is in the distance, focused on one dark night, and one bleeding woman whom he felt responsible for saving.

All these years, one marriage, and two grown children later, that night is still as real for him as it was when her blood was flowing onto his jeans as he carried her to the car.

“Don’t forget the men,” he warns.

I realize we mustn’t.

________________________________