Saturday, January 6, 2018

Life-Saving Screening Tests for Men

Doctor Talking To Man About Screening Test

Why Screening Tests Are Important

Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they're easier to treat. With early detection, colon cancer can be nipped in the bud. Finding diabetes early may help prevent complications such as vision loss and impotence. The tests you need are based on your age and risk factors.
Prostate cancer cells (SEM)

Prostate Cancer

Prostate cancer is the most common cancer found in American men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop, when treatments are most effective.
Doctor Talking to Patient About Prostate Issues

Tests for Prostate Cancer

Screenings for healthy men may include a digital rectal exam (DRE) and possibly a prostate specific antigen (PSA) blood test. Government guidelines recommend against the routine use of the PSA test. The American Cancer Society advises each man to talk with a doctor about the risks and possible benefits of the PSA test. Discussions should begin at:
  • 50 for average-risk men.
  • 45 for men at high risk. This includes African-Americans.
  • 40 for men with a strong family history of prostate cancer.

Testicular Cancer Exam

Testicular Cancer

This uncommon cancer develops in a man's testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. Some doctors advise regular self-exams, gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes.
Colonoscopy View of Villous Polyp

Colorectal Cancer

Colorectal cancer is the second most common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops, it can invade or spread to other parts of the body. The way to prevent colon cancer is to find and remove polyps before they turn cancerous.
Doctor Looking at Colonoscopy on Monitor

Tests for Colon Cancer

Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon.
Some patients opt for a virtual colonoscopy -- a CT scan -- or double contrast barium enema -- a special X-ray -- although if polyps are detected, an actual colonoscopy is needed to remove them.
Malignant Melanoma

Skin Cancer

The most dangerous form of skin cancer is melanoma (shown here). It begins in specialized cells called melanocytes that produce skin color. Older men are twice as likely to develop melanoma as women of the same age. Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are. Your risk increases as lifetime exposure to sun and/or tanning beds accumulates; sunburns accelerate risk.
Man Checking Skin for Signs of Cancer

Screening for Skin Cancer

The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine checkup. Treatments for skin cancer are more effective and less disfiguring when it's found early.
MRA Scan of Aortic Aneurysm

High Blood Pressure (Hypertension)

The risk for high blood pressure increases with age. It's also related to weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm -- dangerous ballooning of an artery. But it can be treated. When it is, you may reduce your risk for heart disease, stroke, and kidney failure. The bottom line: Know your blood pressure. If it's high, work with your doctor to manage it.
Doctor Checking Man's Blood Pressure

Screening for High Blood Pressure

Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 130/80 or higher, and in between those two is prehypertension -- a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.
Angiogram of Atheroma Plaque

Cholesterol Levels

A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of the arteries (seen here in orange). This increases your risk of heart disease. Atherosclerosis -- hardening and narrowing of the arteries -- can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this "bad" cholesterol and lower the risk of cardiovascular disease.
Tagging a Blood Sample

Determining Cholesterol Levels

The fasting blood lipid panel is a blood test that tells your levels of total cholesterol, LDL "bad" cholesterol, HDL "good" cholesterol, and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce the risk of heart disease, stroke, and diabetes. Starting at age 20, men should be screened if they are at increased risk for heart disease. Starting at 35, men need regular cholesterol testing.
Fundoscopy of Diabetic Retinopathy

Type 2 Diabetes

One-third of Americans with diabetes don't know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), nerve damage, and impotence. This doesn't have to happen. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.
glucose blood test

Screening for Type 2 Diabetes

A fasting blood sugar test, glucose tolerance test, or an AIC all can be used alone or together to screen for diabetes. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.
HIV Virus Close Up

Human Immunodeficiency Virus (HIV)

HIV is the virus that causes AIDS. It's in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. Modern treatments can keep HIV infection from becoming AIDS, but these medications can have serious side effects.
Drawing Blood From Patient

HIV Screening Tests

HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It's possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.
Condom In Wrapper

Preventing the Spread of HIV

Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex -- abstinence or always using latex barriers such as a condom or a dental dam -- is necessary to avoid getting HIV and other sexually transmitted infections. Drug users should not share needles.
Glaucoma Infected Eye


This group of eye diseases gradually damages the optic nerve and may lead to blindness -- and significant, irreversible vision loss can occur before people with glaucoma even notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.
Man Having Glaucoma Test

Glaucoma Screening

Eye tests for glaucoma are based on age and personal risk:
  • Under 40: Every 2-4 years
  • 40-54: Every 1-3 years
  • 55-64: Every 1-2 years
  • 65 up: Every 6-12 months
Talk with a doctor about earlier, more frequent screening if you fall in a high risk group, including African-Americans, those with a family history of glaucoma, previous eye injury, or use of steroid medications.

12 Clues You Might Have Heart Disease

man wearing sleep apnea mask

Sleep Apnea

When your snoring is broken up by pauses in your breathing, your brain may not be getting enough oxygen. It will send signals to your blood vessels and heart to work harder to keep blood flow going. This raises your risk for high blood pressure, abnormal heart rhythms, strokes, and heart failure. Fortunately, sleep apnea is treatable.
orange bumpy rash

Yellow-Orange Bumpy Rash

Extremely high triglyceride levels can make your skin break out around the knuckles of your fingers and toes and on your bottom. A lot of these fats in your blood may play a role in hardening your arteries, and high numbers are often related to other conditions that put you at risk for heart disease and strokes, too.
couple hanging from tree

Poor Grip Strength

The strength of your hand may tell you something about the strength of your heart. Research suggests the ability to squeeze something well means a lower risk of heart disease. If it's hard for you to grasp an object, odds are higher that you have or could develop problems. (But improving your grip strength alone won't necessarily make your heart healthier.)
splinter hemmorage under fingernail

Dark Spot Under Nails

If you haven't banged or hurt your finger or toe recently, little dots of blood trapped under your nail could point to an infection in the lining of your heart or valves, called endocarditis. You can also get these blood specks when you have diabetes, and people with that condition are two to four times more likely to have heart disease and strokes.
spinning globe


Lightheadedness is often a direct result of something wrong with your heart because it isn't pumping enough blood to your brain. Dizziness could be a symptom of an abnormal rhythm, called an arrhythmia. Heart failure, meaning the weakening of the muscle, can also make you unsteady. Feeling woozy is one of the many lesser-known symptoms of a heart attack, too.
unhappy couple in bed

Sexual Problems

Some troubles in the bedroom could mean you have heart disease and a greater risk for a heart attack or stroke. Men with erectile dysfunction may have circulation problems related to high blood pressure or narrow arteries from cholesterol buildup. These blood-flow problems can also lessen a woman’s libido and ability to enjoy sex.
janeway lesions

Skin Color Changes

Blue or gray fingers and toes could be from poor circulation of oxygen-rich blood, often due to a heart defect you were born with or narrowed or blocked blood vessels. A lacy, mottled, purple pattern shows up when bits of built-up cholesterol plaques break off, then get stuck in small blood vessels. You might get bloody splotches just under the skin on the inside of your hands and the soles of your feet when you have endocarditis.
bleeding gums

Bleeding Gums

Experts don't totally understand the link between gum disease and heart disease. But studies suggest that bleeding, swollen, or tender gums may lead to trouble with your ticker. One theory is that bacteria from your gums gets into your bloodstream and sets off inflammation in your heart. Having gum disease, which can lead to tooth loss, may also raise your chances of a stroke.
acanthosis nigricans on womans neck

Dark, Velvety Skin Patches

You may find these thick spots, called acanthosis nigricans, in skin folds and creases such as your neck, armpits, and groin when your body has trouble using the hormone insulin. The patches could have skin tags, too. If you aren't being treated for insulin resistance, metabolic syndrome, or type 2 diabetes, see your doctor for help controlling your blood sugar and protecting your heart.
tired man during run

Trouble Breathing

Feeling short of breath can be a symptom of heart failure, an abnormal heart rhythm, or a heart attack. Tell your doctor if you struggle to catch your breath after doing things that used to be easy for you, or if it's hard to breathe while lying down. Have chest pain, too? Call 911.
swollen legs being massaged

Swelling In Lower Legs

It happens when you stand or sit for a long time, and it's also common during pregnancy. Fluid build-up can also stem from heart failure and poor circulation in your legs. Swollen legs could be from a clot that's blocking the return of blood from your lower limbs to your heart. Call your doctor right away if swelling comes on suddenly.
tired woman rubbing eyes


Don’t always chalk it up to poor sleep. Heart failure can leave you tired and drained, because the muscle no longer pumps well enough to meet your body’s needs. Watch for other symptoms, such as coughing and swelling, too, since feeling wiped out and weak can be a warning sign of many different conditions, including anemia, cancer, or even depression.

Inspirational Quote – January 06, 2018

“Don’t do something permanently stupid because you are temporarily upset.”

I can so relate to this and I expect many of you can too. It is so easy and tempting to strike back in retaliation when we feel we've been attacked. In these days of the internet and global messaging the temptation to put fingers to keyboard, press a button and, hey presto, it’s out there for not just our “antagonist” but the whole world to see. Unfortunately, it’s out there forever and can’t be taken back when we’ve had time to cool down and perhaps realize that, you know what, it wasn’t said or meant in the way we initially thought. However, by then, it can be too late and we may not have just lost the friendship of one person but caused everybody else to look at us in a different, even not very favorable, way. Not easy I know, but in situations like this, take a deep breath, walk away, have a cuppa, go for a walk, anything to give you time and space to look at what’s happened more rationally and calmly. Chances are, you won’t even bother responding………

Fleeing the Mouth of the Shark

Bill Dienst, MD, is a rural family and emergency room physician from north central Washington who has been volunteering for humanitarian medical missions since 1982, when he was a young man in medical school. His first experience profoundly changed his life and he was "hooked," he says, volunteering repeatedly for medical exchange programs in Veracruz, Mexico, the West Bank, and the Gaza Strip. Most recently, he served as the medical coordinator for Salaam Cultural Museum (SCM), a Seattle-based nonprofit conducting humanitarian and medical relief work with refugee populations in Jordan, Lebanon and Greece. In this interview with Moon Magazine, Dr. Dienst offers his unique perspective on the refugee crisis as well as some practical suggestions for how others might help.

Friday, January 5, 2018

How Inequality Thwarts the Promise of College for All

A new book explains how poverty and inequality put students at a disadvantage—and how we can better support them.

Four years ago, a high school senior from an Oakland charter school reached out to me to ask if I could help her apply to college. Jennifer was a first-generation student of Salvadoran and Guatemalan immigrant parents, a conscientious person with straight A’s at school.
Piece of cake, I thought, having already launched two daughters to college.
Over weekly coffees at Starbucks, we decided which colleges Jennifer would apply to and laid out a timeline of application tasks. Just to be sure, I passed her qualifications by a friend who is a professional college counselor.
“Aim for community colleges,” she advised.
Well, that’s a low bar, I thought to myself. Not very optimistic of her.
Jennifer was admitted to all of the University of California schools, and we were jubilant—and vindicated. Little did we know that getting into college was the easy part. Staying in was the hard part.
Jennifer’s student loan didn’t come through in time for her to take the supportive transition course during orientation. She felt unprepared for the overwhelming pace of work, and she suffered “imposter syndrome,” believing that she didn’t belong. She was intimidated by the prospect of talking to professors during office hours. She juggled a work-study job. She moved off campus to save money but had roommate hassles and the added burden of food shopping and preparation. By the end of her first year, she had failed a course and was placed on academic probation.
Jennifer is smart, and she was prepared to learn to navigate a whole new environment. But college was a tsunami of challenge. Fortunately, she found coaches and tutors to help her and continued to work hard. Jennifer will be graduating from the University of California this spring—the first in her extended family to do so.
Still, her earlier struggles were telling. If someone so promising—with so much “grit” and determination—had trouble making it, what does that say about our educational system?
When I read Linda Nathan’s new book, When Grit Isn’t Enough: A High School Principal Examines How Poverty and Inequality Thwart the College-For-All Promise, I had a shock of recognition. Nathan understands exactly how the cards are stacked against students like Jennifer.
Nathan has 38 years of experience in the Boston public schools and was the founding Headmaster of the Boston Arts Academy (BAA). At her school, roughly 80 percent of students are Latino or Black, and 71 percent qualify for free or reduced lunch—but more students apply, are accepted to, and graduate from college than the national average.

Drawing from this experience (more so than research), Nathan’s book is packed with insight and realistic solutions for anyone—especially high school educators, college and university counselors and coaches, vocational mentors, and more—who seeks specific suggestions for helping low-income and first-generation students succeed in college or careers.
I spoke to Nathan recently about her book—and what students need, besides grit, in order to succeed.
Diana Divecha: What prompted you to write this book?
Linda NathanLinda Nathan
Linda Nathan: After I stepped down from my position at the Boston Arts Academy, I interviewed alums of the school. I found that so many of the students didn’t succeed in college despite being so promising. In my first book, The Hardest Questions Aren’t on the Test, I tell the story of Shanita, who graduated top of her class at BAA. She got into her dream college with a full scholarship, but she never went. That has haunted me.
Students are made to believe that if they work hard and play by the rules, they will succeed—a promise that is failing them. Five assumptions or myths emerged from the stories of the students that especially harm low-income and first-generation college applicants: That when it comes to college, money and race don’t matter; that success comes from working hard; that anyone can go to college; and that if you just believe, your dreams will come true. These are just not true for everyone.
And I’m angry. I’m angry that we still haven’t got it right, and we’re asking the most vulnerable among us to figure out how to succeed when there are systemic inequities stacked against them. The privileged should be figuring this out for them. This isn’t a happy book—but all the royalties go back to the Student Activities Fund at BAA.
DD: What are some solutions to America’s failed promise to students?
LN: We’ve defunded guidance counselors in high school, and nonprofits are stepping in to help. But so far, the nonprofits tend to work alone. If they could get together and coordinate to give every rising senior an intensive week in August to help them figure out what they want to do next, to help kids apply to college, and so forth, it could change the course of America.
For college-bound seniors, there could be a week of college and career prep. In the summer between high school and college, nonprofits could coordinate for a week to make sure kids who’ve gotten in to college are actually putting together their packages and getting their last dollar of scholarships. Colleges need to coordinate with high schools to learn what kids need to succeed in the transition. And Thanksgiving is another pressure point; many students decide over the Thanksgiving break that they’ll do one more semester and then not go back. We need to catch them and say, “No, you can do it!”
DD: A lot of your solutions are systemic. What advice do you have for the students themselves who might come from poverty or are first-gen college applicants?
LN: Number one is, don’t you dare go where you don’t get money. You gotta go where the money is. And don’t take a year off—that’s fine for kids who come from privilege, but kids from challenging backgrounds who don’t go right away often won’t go at all. That’s why the service and the career exploration have to happen earlier in high school. At the school where I worked before BAA, kids do a six-week internship in the middle of their senior year.
DD: That’s great, because someone like Jennifer doesn’t have the luxury of exploring an unpaid internship later. She’s got to earn money.
LN: Exactly. That’s what enrages me. She should have had opportunities to explore careers in high school.
DD: In your book, you quote someone who compares “no excuses” discipline tactics—where students’ posture, attention, behavior, and even their dress are controlled through strict measures—to police brutality. What’s the problem with “grit”?
<a href=“”><em>When Grit Isn’t Enough: A High School Principal Examines How Poverty and Inequality Thwart the College-For-All Promise</em></a> (Beacon Press, 2017, 200 pages)When Grit Isn’t Enough: A High School Principal Examines How Poverty and Inequality Thwart the College-For-All Promise (Beacon Press, 2017, 200 pages)
LN: There’s nothing wrong with grit. It’s the way it’s been implemented, especially in charter schools, that’s wrong. The no-excuses movement [which enforces a strict disciplinary code], the SLANT mantra [Sit up, Look forward, Ask questions, Nod your head, Track the speaker]: They’re racist pedagogies, a sort of 1950s behavioral approach that is devoid of context. They make it seem like a student’s success is all individually accomplished, which is, of course, wrong.
You have to take into account race, social class, health, mental health, poverty. Just be grittier?! I’m waiting for the charter management organizations to issue a wholesale apology, to say, “We blew it, and we knew it all along.” Instead we should be helping students embrace their identities and navigate a racist and oppressive society.
DD: To what do you attribute BAA’s high persistence rate (percentage of students admitted to college who go on to graduate from college)?
LN: We do a ton in high school to prepare them for college. We feel it’s our job as teachers, not just the guidance counselor. It’s part of our curriculum to visit colleges, write college essays. We run an August institute to make sure everyone signs up for financial aid—you can’t graduate without it. We hired a retention specialist to support kids between graduation and the start of college. And we do a Thanksgiving program to support kids when they come back for break.
In most high schools, you graduate students and you’re done. And I’m saying to high schools, that’s not good enough.

DD: You question in your book whether college is right for everyone. For whom is it right, and what are the other options?
LN: Career exploration has to be a part of education from middle school on, but, unfortunately, high-stakes testing has narrowed curriculum to a very limited diet of learning. High school should be an apprenticeship for life. It should offer career and technical training, along with opportunities for students to process and reflect on their experiences, so that, by graduation, students can make a decision: Do I want to be a forklift operator and go into construction, or do I want to do lab science which requires more training? Do I want a two-year degree, a four-year degree, do I want to join the military, is it possible to go right to work and make a living, or do I need more education and training?
America has dismantled what was formerly called vocational training. But there are great international examples. Switzerland has created apprenticeship programs for musicians, for child care workers, and for health care workers that are really good, so out of high school you can go the apprenticeship route or the four-year college degree. And it actually works! We could fund our community colleges more and make that route far more legitimate than it seems now.
I don’t think the mantra of “college for all” is right. We want young people to be able to live a decent life, have a living wage, and participate in democracy, and we’ve assumed the only way to get there is a four-year degree. That’s not the only way, and we need to create more paths from school to career.

What Happens When Older Adults Take a Class on Gratitude?

An instructor shares her experience teaching older adults the science (and practice) of gratitude.

This fall, fifteen adults over the age of 50 gathered together in a university classroom to learn about gratitude.
They were students at the Osher Lifelong Learning Institute at the University of California at Berkeley, who had registered and paid to take a module on gratitude from the Greater Good Science Center’s online course The Science of Happiness. I taught the module as a “flipped classroom”: Participants read articles, watched videos, and worked on gratitude practices at home each week, and then came to five live, weekly classes to discuss the content they had studied. 
Before and after the course, we asked participants to fill out surveys about their gratitude and life satisfaction. Over the course of those five weeks, the average gratitude score went up from 5 to 6.6 (out of 7), and the number of people who were highly satisfied with their life doubled. But those results were less impressive than the transformations we witnessed.
At the first session, we answered questions about computer use so that our participants could easily find, open, and view the content of the course on their computers. I also presented an overview of positive psychology, the big scientific field in which gratitude resides.
During our introductions, when students spoke about what drew them to the class, our sole male participant Brian said his wife had made him come. He was not feeling particularly grateful, as he was losing his sight to macular degeneration, but he was willing to see if there was anything in the course for him.
During our first session, our oldest participant expressed concern that the course would be too challenging for her. “Say more about that,” I asked. Abigail said, “I thought you were going to teach me two or three more ways to say thank you. This isn’t that. This is going to require that I think more deeply about my approach to life and I’m not sure I’m up to it.”
At the end of the first class, I said that I hoped Abigail would consider coming back the following week. She responded, “Oh, I’ve already decided I’m going to try to meet the challenge.”
Another woman, Karen, came to our basement classroom in a motorized wheelchair. Getting to class required two different trains and a shuttle bus. She was also one of the most demonstratively grateful people in the course. 
In succeeding weeks, the group learned about keeping a gratitude journal, writing a gratitude letter, and expressing gratitude as a way to recover from a negative experience. Each week, participants chose a gratitude practice they would try between sessions and discussed those practices at the beginning of class. Some of the practices included nurturing current friendships, watching inspiring videos, and appreciating nature. 
As a final project, I asked that each participant plan a gratitude letter. They weren’t required to actually write the letter (though a few of the participants did), but to think deeply about who the recipient would be, what the source of gratitude was, and how they would express that gratitude. The final presentations were inspiring.
Before the last session, we learned that Brian’s wife couldn’t come, which meant that he couldn’t come. I volunteered to meet him at the entrance to the classroom building if his wife could find a ride for him, and she said she would think about it. The following week, he arrived in a wheelchair with a health aide who stayed to hear all of the gratitude letter presentations, including the ones by Brian and Karen (both of whom had attended every single class).
Brian said he would write a letter of appreciation to his secretary, who had made his professional life so much easier and smoother. As a lifelong military officer, he told us that these letters were very important in military files to facilitate promotions and awards. At the end of class, he expressed his own gratitude for the course and for the change it had made in his approach to life. Like Abigail, he had decided to meet the gratitude challenge.
The Osher Lifelong Learning Institute (OLLI) provides high-level learning opportunities, almost entirely live, to its scores of East Bay older adult learners over age 50. OLLI will offer the gratitude class again during the spring with a possible enrollment of 25.