Man Injects Dog, Etc.

My friend Richard sent me this NY Times article on human cancer drug trials for dogs. I guess I've never really considered the crossover of human drugs into veterinary use, other than the over-use of antibiotics and growth hormones in industrial farming. But I wasn't surprised to find that this drug use is regulated by the federal government. Central to the government's focus is the American Medicinal Drug Use Clarification Act, or AMDUCA.

The US Food & Drug Administration has, in fact, a Center for Veterinary Medicine. And the US Department of Agriculture regulates "vaccines, bacterins, antisera, diagnostic kits, and other products of biological origin" at its Center for Veterinary Biologics.

Stress is placed on the therapeutic use of human drugs in a standard veterinary/client relationship, where drugs are administered only under the care and advice of a vet. In a perfect world, the American Veterinary Medical Association guidelines for antimicrobials would be followed to the letter. But that's sometimes countermanded by our seemingly universal guideline, "If one is good, two is better" that governs such things as the application of home pesticides, or sharing Grandma's medicine because it works for her ...

The emphasis on regulating drugs entering the food chain is a good start. We often seem prone, however, to allowing a drive for profit or personal satisfaction to override both common sense and the law. I guess that's why the "duh" principle is seen at work, when the FDA must issue a guideline prohibiting the use of human anti-influenza drugs in poultry, in the face of avian flu epidemic scares.

Thanks for What?

We all have things in our lives that are untidy, or unpleasant, or unplanned. I can think of several things of the "woulda/coulda/shoulda" variety that might have made my life turn out differently. But, I can look at them positively too.

- I got married the first time at 21 and knew 6 months into it that this was probably a mistake. We still stuck it out together for 10 years. I learned a lot about myself; I acquired patience; I think I got stronger. I don't know what the ex is doing and haven't known for 23 years. I can hope that his life turned out as happily as mine has.

- I didn't see eye-to-eye with my boss at my first professional job. I hadn't realized how bad it was until he presented me with a no-increase salary renewal. In public. With a smile. I was motivated to get out of what had become a rut, try new things professionally, and move on with my life. I got to develop new skills and grow with, rather than away from, my profession.

- I developed renal cell. Yep, that sucks. In the meantime I have gotten closer to my friends and family, I treasure my time here, and I think everything I do is worth doing.

So Happy Thanksgiving, everyone!

Thanksgiving Comes Early

Yesterday, Saint H and I were in Cleveland for tests and appointments. The C/T scans were quite good - no appreciable growth, stable disease state. So far I've had 4 successive scans over 8 months showing stable disease. Given that I'm on a half dose of Nexavar, that's very encouraging. If I were on higher doses, would I see shrinkage? Perhaps, though there's no guarantee of that, and I can't imagine living with the side effects. No tradeoff of misery for longevity, please.

Dr G adjusted some of my medications (one less blood pressure med, hooray) and added a new prescription for an iron supplement. We're trying to fight the anemia and fatigue with this. So, that's minus 4 daily pills for the blood pressure, plus 2 daily pills for the supplement; net -2 pills. (Gosh, no, it doesn't take much to amuse me!)

And life goes on; Dr G and his wife have a baby girl, their first child. I found out they were expecting at my September appointment, and took this sweater along. I love making baby things - small projects, lots of scope for trying new stitches and techniques.

"Do You Poop??!?"

Saint H's work takes him into daily contact with 120 kids up to age 5. During a fire drill this summer, a gaggle of 4-year old boys confronted him with that question. Imagine the words piping clearly across a playground at a child's high pitch, accompanied by manic giggles from onlookers. You get the picture.

It's not exactly "polite conversation" under most circumstances, is it? But it seems to be one of the dominant topics at our support group meetings. Almost all of us live with diarrhea and lower g.i. problems due to our medications. I carry Immodium and Pepto with me everywhere I go, and friends are used to me disappearing during, or after, meals to hit the restroom. I watch what I eat, keeping away from rich foods, but sometimes that doesn't matter; I still have to make a run for it regardless. I have stomach cramps on a regular basis. It's a hell of a way to lose weight, I'm afraid. (But I haven't given up ice cream yet) There's no way to predict what will trigger an explosion.

We talk about it so much at our support group that a pharma company representative, who often comes to our meetings, recently handed out little cards giving hints on how to take Immodium to control the diarrhea. I haven't seen a writeup on this yet but suspect that it won't be long before some scholarly treatise appears.

Oh, yes - that question. Saint H, with considerable aplomb, responded, "Well, what do you think?" and walked away quickly. No fool he!

Civics Lesson

Well, at last. It's midterm election day, and time for all those campaign ads to go away. Time for citizens to get out there and vote. Time for politicians to start raising money for the next - oh, no, wait. Time for politicians to start doing the job they've been elected to do.

Remember the 1968 Democratic convention? I was horrified by the muscle tactics in Chicago; I was appalled by the "business as usual" approach to machine politics. I was 16 years old.

Remember the Twenty-Sixth Amendment? Passed March 23, 1971, it gave the right to vote to 18 year olds. In fall of 1972, I got my first chance to vote. I was a sophomore in college and lined up with crowds of other, eager first-time voters at the IU Auditorium to cast my first ballot.

To me, those are hallmarks of a democratic process that we should all cherish: The political process is imperfect but we have the chance to make changes. We must take our responsibility seriously. I've missed a few special elections and a couple of primaries in the past 34 years but I'd say I've gotten out to vote at least 85% of the time. I've volunteered for candidates, worked polling places, and tried to learn as much as I can about issues before I make my decision.

Never have I seen such undignified squabbling, such vindictive partisanship, such supercilious arrogance, such blind impotence on the part of our "elected leaders." How many of these people have a spine? How many have a conscience? How many have conviction (as opposed to "convictions", which is different)? What has happened to dialogue? What has happened to compromise? What has happened to honesty?

I've tried to do my duty over the years. Time for politicians to do theirs.

An Ode to My Left Big Toe

Well, not really. Perhaps you remember I was complaining about a sore spot on my left foot at the end of September. I've been to the podiatrist twice, to find out what it was and for additional care.

What it was, was a giant blister. About 3 weeks later, the top skin had finally abraded, and then it started to hurt again. Back to the podiatrist - he removed some dead skin and sent me on my way, with instructions to keep it clean, dry and warm, and to keep an eye on it.

Clean and dry I can do, keeping an eye on it, I can do - but warm? Me, the ice-cold bloodless wonder?? I puzzled about that for a while, then came up with what has been a good solution so far. I am an occasional spinner (fiber, not bicycle); as a fiberholic I have collected more roving than I can hope to spin, were I to spin 24 hours a day, seven days a week, for a month. Roving is a great insulator. So, every morning I take a 6-inch strip of roving, open it out and fluff the fibers, and wrap it loosely around my toe. It's warm, it's great padding, and I suppose it could even be considered stylish! Today's fashion take: 50% mohair/50% wool hand-dyed in shades of moss and olive green and golden yellows, called "Olive Garden," provided by White Creek Wools, Deford, MI.

Why worry so much about a stupid blister, you may ask? A knitting friend with diabetes ignored a blister on her big toe until it turned gangrenous. She lost her toe, and has had multiple surgeries on her foot since then. Anti-angiogenic therapy drugs have a reputation for causing problems with patients' extremities. I don't want to find out the hard way that the same rules apply to me, thanks. I've never learned to dance but I'd like to have fewer strikes against me beyond normal klutziness and lack of rhythmic sense.

I don't know how long I'll have to keep this up. But I can always use an excuse to buy more roving!

The Staff of Life -- Or Is It??

A report published online in the International Journal of Cancer [October 10, 2006] has caused a flurry of blog activity on renal cell carcinoma. I quote the article abstract here:

"Although nutrition and diet have been related to renal cell carcinoma (RCC), the role of specific foods or nutrients on this cancer is still controversial. We evaluated the relation between a wide range of foods and the risk of RCC in an Italian case-control study including 767 patients (494 men and 273 women) younger than 79 years with incident, histologically confirmed RCC, and 1,534 controls (988 men and 546 women) admitted to the same hospitals as cases for a wide spectrum of acute, non-neoplastic conditions, not related to long term diet modifications. A validated and reproducible food frequency questionnaire, including 78 foods and beverages, plus a separate section on alcohol drinking, was used to assess patients' dietary habits 2 years before diagnosis or hospital admission. Multivariate odds ratios (OR) were obtained after allowance for energy intake and other major confounding factors. A significant direct trend in risk was found for bread (OR = 1.94 for the highest versus the lowest intake quintile), and a modest excess of risk was observed for pasta and rice (OR = 1.29), and milk and yoghurt (OR = 1.27). Poultry (OR = 0.74), processed meat (OR = 0.64) and vegetables (OR = 0.65) were inversely associated with RCC risk. No relation was found for coffee and tea, soups, eggs, red meat, fish, cheese, pulses, potatoes, fruits, desserts and sugars. The results of this study provide further indications on dietary correlates of RCC, and in particular indicate that a diet rich in refined cereals and poor in vegetables may have an unfavorable role on RCC. © 2006 Wiley-Liss, Inc."

This report was picked up in the national news, with headlines that "bread causes cancer". And it's now being hailed as proof that low-carb diets are the one true way to longevity and health. Isn't that going a little far, though?

The investigators seem pretty cautious in their conclusions. I agree that diet is a contributing factor in everyone's health, and this probably will lead to additional, more conclusive research studies. But given what isn't known about renal cell carcinoma, I'm reluctant to point to one thing amongst many and shout, "That's him, officer! He's the one!!!"

Easily-reached conclusions and sweeping statements make me pretty skeptical. Hmmmmm. Maybe I've gotten jaded due to 3 months of "talking point" political ads here in Battlefield Ohio. Ya think??