Happy New Year!!

We wish all of you, our loyal readers, a very Happy New Year. May this year bring you hope, prosperity, and good fortune.

- From the CareTALK Gals

Then and now…

Now that the year is coming to a close, everyone has been working on their lists: top 10 best… top 10 worst…

However, this is also a time to reflect on what changes have occurred—not only in this past year, but in the past 50 years.

The article in The New York Times, "So Many Advances in Medicine, So Many Yet to Come", gives a wonderful description of how medicine has changed in the past several decades thanks to new technology, new research findings, new prescription medicine. So many things changed such as how you treat heart attacks, in vetro fertilization, immunizations to prevent-- at the time-- rampant infections, CT Scans, M.R.I.s, Xrays, etc.

Even the attitude of doctors has changed. As the writer (also a doctor) writes:

At the time, anyone who went into preventive medicine and public health was assumed to have graduated at the bottom of the class. A shingle on Park Avenue was the measure of success, not saving lives in poor countries. Now students are eager to study global health.

Yes, it is now a global world. No longer is it just about us -- how can we help ourselves. Now it's more about how can research can help the world.

Despite all these advances, there is so much more. Technology is advancing at such a fast pace, we can hardly keep up. Everyday, new research findings are published. Everyday, the medical field finds something new. What we have now is just the tip of the iceberg.

We may look back and shake our heads at the simplistic treatments 50 years ago... but "imagine the laughter in 2056 as people look back at the brand of medicine and public health that we consider so sophisticated today. For all that doctors have learned in the last half-century, we are ignorant about far more."

Crisis looming…

We're sure many of you have read articles upon articles about the rising costs of caregiving—whether it's your parent, spouse, child, relative, or friend. But, have you been paying them any attention? Have you really taken a good look at your long term finances or planned for your healthcare when you retire?

If so, great!

Now… have you looked into the long term care expenses for your caregiving charge? You may have enough saved up to cover your long term care needs--- but what will happen if you have to use these savings to take care of your parent, or your spouse, or your other loved ones?

Let's face it…if your mom or dad needs something--- whether it's groceries or home aides—you'll go get it, even if it means borrowing from your 401(k), selling your home, or depleting your savings… or all three, as in the story of one caregiver in The New York Times article “Elder-Care Costs Deplete Savings of a Generation.”

So what do you do? What help is there?

As many of you know by now (or will know after reading this), Medicare DOES NOT cover long term care costs. Yes, President Bush signed into law a bill authorizing $300M in grants to help primary caregivers hire temporary support. However, this is only applicable to spouses. Unfortunately, many of the adult children are the caregivers. It is THEY who also need the support.

At the moment, the best thing is planning. Get long term care insurance for you, your spouse, your parents, even your children (you never know if they will have a horrible accident where they may need care). Also, check with your local governments. Some states (like New York) do provide some home care assistance.

Next month, CareTALK.com will relaunch and we will help you find answers to these problems and more.

PS. A special note to Ms. Marilyn de Leo, a friend of CareTALK—we hope your mom makes a quick and full recovery. Our prayers are with you and your mom.

Doctors are compassionate too.

Reading past articles in The New York Times, we stumbled across a very poignant op-ed we'd like to share with you, "The Most-Avoided Conversation in Medicine" written by a physician who, like many other doctors, "has had difficulty dealing with dying patients."

Many of you may believe doctors should be used to it or that the doctors you've encountered don't seem to particularly care.

Fortunately, this is not the case.

In fact, perhaps the problem, as the writer of this article recounts in her op-ed, is that they don't know how to communicate with their dying patients. It could be fear of acknowledging that they tried their best but couldn't help their patient (as was the case in this doctor's story) or it could be the sheer uncertainty as to how to approach the topic of death with their patient. But the writer does have a great suggestion—when doctors go on their rounds, they should ask each other the question: "How good is this patient's end-of-life care?"

Surprisingly, this is not asked.

Perhaps, changing their attitude towards end of life discussions with their patients, the doctors can be one "step closer to being the compassionate doctors [they] have always dreamed of becoming."

Aging minds want to know…

Will we really improve our cognitive skills with daily exercise of our brain?

Of course! But don't take our word for it. According to The New York Times article, "As Minds Age, What's Next? Brain Calisthenics", several studies have found that yes, brain activities can improve your cognitive skills.

Will this help you remember where you left your car keys, your glasses, or in our particular case, our cell phones? Probably not. (Good thing we can call our cell phones to locate it. Now if only everything else had a locator beeper or such.) Most doctors are being cautious by not stating additional brain activities will prevent -- or even cure-- Alzheimer's and other mental diseases. However, they do state that mental activities may prevent Alzheimer's and other such diseases.

We had written regarding this same topic a few weeks ago, "Don't you hate those 'senior moments'?" and Dr. Ridge had written an entry on the CareTALK Aging & Caregiving blog on Yahoo Health titled "The Bionic Brain." Now, The New York Times has come out with the aforementioned article and an editorial, " "Exercise for your Aging Brain." This is the trend—as boomers age, everyone is looking at the issues affecting boomers — affordable health care (better health care), financing health care, cosmetic surgery, advanced surgery (to put ourselves together again-- ie. a bad knee won't stop us… just get knee surgery!), etc.

In the end, all this research, all these studies will help us all live healthier, longer lives. We just need to do our part and help our body and brain operate to their top capacities – and we can do this by exercising--- exercising both our bodies and our minds. (Sorry, can't get away from it).

Universal Health coverage -- one state at a time

Everyone is predicting that the next two years will be very different, now that the democrats have control of Congress – especially the health care program. If they win in 2008, things will be VERY different. However, states aren't waiting until then to get support from the government regarding healthcare.

According to Wall Street Journal article, "Others Join Maine in Push For Health-Care Change," two years ago, Maine passed into law a universal health-care access program-- and now other states are following suit. The Maine program may have fallen short of its initial goals but the system is currently being reviewed and revised. The important point is that other states such as Massachusetts, Vermont, California, and others have healthcare programs beginning that will offer near-universal or universal health care coverage to its residents. Of course, we all know the state governments are passing these programs mainly to lower the rising health care costs in their budgets – but this also helps its residents.

And yes, it is a good idea for the states to take control of their individual health care costs and not depend fully on the government (as we all know, the federal government tends to move slightly -- ok, very-- slow).

As one research fellow at a Washington think tank said, "the longer he studies the subject, the more convinced he is that states have to customize revisions to their particular needs."

97 years young…

That was the age of Dr. Michael DeBakey when he underwent surgery for a dissecting aortic aneurysm (aka, a torn artery)--- a surgery he created. However, according to the article in The New York Times, The Man on the Table Devised the Surgery, there was much debate among the doctors regarding whether to even operate on him--- given the fact that he was 97, given the fact he had signed a form with a DNR (do not resuscitate)/ do-not-perform-surgery directive, given the fact that he was a pioneer in his space and no doctor wanted to take responsibility should something happen on the operating table.

Was it ethical to go against his directive?

Was it "worth" it to operate on a 97 year old given the probability of complications even though that would be the only way to save his life? Dr. DeBakey had postponed the surgery because "he feared the operation that he had developed to treat this condition might, at his age, leave him mentally or physically crippled. 'I'd rather die' he said." In addition, it would be his family who would have to take care of him, should complications arise.

In the end they performed the surgery.

This story is inspirational (if you have the will to keep going, you can survive and get through anything—no matter what age you are), yet, at the same time shows what good, high quality (ie. expensive) care – pre-op, during op, and post-op- can provide. If you have the means, you can receive the best quality health care thus, giving you a higher probability to live to a ripe old age.

However, one important factor the doctors kept stressing—Dr. DeBakey was a very healthy 97 year old. Had he not been, there would have been no debate— surgery could not be performed.

Bottom line—keep yourself healthy. Who knows, by the time you're 97 you might need surgery.

Wishes from the CareTALK Gals

Happy Holidays! Merry Christmas!

- From the CareTALK Gals

Some relief in sight…

You may not have realized (probably because it wasn't picked up by the media) but on Thursday of this week, President Bush signed a bill into law authorizing $300M in grants over the next 5 years to aid primary caregivers in hiring temporary support.

$300M, in the scheme of things, may not see like much (according to the Wall Street Journal Article, "Caregivers Get Some Relief", it is estimated that $300B/yr is spent on caregiving efforts by American families). However, as the article points out, "the bill's easy passage signals the growing political force of health-care issues amid a confluence of forces: increasing costs, fraying insurance coverage, the aging of the baby boom, medical advances extending life expectancy and legal and cultural shifts leading more families to try to care for relatives at home. The new law also is part of a growing effort by the federal government to encourage home care as a way of saving money in other programs, especially Medicaid, for the high cost of nursing homes."

This is what our tax dollars should be spent on—on helping American families.

The National Family Caregiver Program created in 2000 is good but it is mostly limited to lower income families. Unfortunately, the middle class families also need financial assistance (though at the rate we're going in this economy, more and more families will be moving from the middle income bracket to the lower income bracket). This new federal law "will provide grants to states for funding for all age groups and all income levels, as well as encourage state agencies that provide respite care -- such as aging and disability groups -- to collaborate services."

We applaud the government for this action. And caregivers thank you, Mr. President.

Calling all men…

To all the aging men out there… if you want to slow down the natural decline of your testosterone levels--- exercise! (ok, there are other factors that help slow the decline but getting off your bumpkin is very important.)

According to The New York Times article, "Aging: Lifestyle May Influence Testosterone Level," researchers for a new study has found that "even a fairly small increase in body mass index, for example, is associated with a drop in testosterone like that normally associated with 10 years of aging. And that can put men at increased risk for diabetes, reduced bone and muscle mass and sexual problems." (Wow!)

Therefore, gentlemen, if you're not willing to exercise to improve your health, or to get rid of your pot belly, perhaps you will do it to slow the decline of your testosterone (meaning you won't need the blue pill so soon).

Update:

Just as an update to the entry we wrote on Wednesday titled "Euthanasia," the Italian poet, Mr. Piergiorgio Welby, a great advocate for the rights of the terminally sick to end their lives, passed away "late Wednesday after a doctor sedated him and removed the respirator that had kept him alive for nine years."

This case has been widely publicized on the front pages of the Italian papers (euthanasia-- or even refusing treatment, such as a respirator, that will cause death -- is illegal in Italy). Mr. Welby tried to end his life legally by going through the proper channels in court and even writing the president a letter--- but his request was repeatedly denied.

However, he refused to be quieted regarding his cause and, on Wednesday, was aided to die peacefully---albeit illegally.

Rest in peace, Mr. Welby.

A new way to diagnose Alzheimer's early?

Yes, according to The New York Times article, "New Chemical Is Said to Provide Early Sign of Alzheimer's Disease," a new study has found that a new chemical, called FDDNP is able to detect if a person has Alzheimer's --- even before they develop the disease.

How is this possible?

According to the study, FDDNP "attaches to abnormal clumps of proteins called amyloid plaques and nerve cell tangles that develop in Alzheimer’s sufferers and inhibit messages being processed by the brain."

Of course, further studies need to be had—but don't underestimate the importance of this study. If doctors could find a chemical that detects Alzheimer's before the person shows significant signs, then it's great! With all the Baby Boomers aging, there will unfortunately be many with this degenerative disease. We will need all the help we can get to combat Alzheimer's --- perhaps even find a cure.

"Boomeritis"

How many times have you heard: "For healthy aging you must exercise, exercise, exercise"?

Too many times we're sure. But, the fact of the matter is… it's true!

Even the doctors in The New York Times article "To Avoid 'Boomeritis,' Exercise, Exercise, Exercise" are telling their patients and others that exercise is the best solution to slow down the natural deterioration of muscle, bone strength and agility that comes with aging. One orthopedic surgeon said "Baby boomers are falling apart — developing tendinitis, bursitis, arthritis and 'fix-me-itis,' the idea that modern medicine can fix anything. It's much better to prevent things than to have to try to fix them."

This is very true. We are in a society that looks at surgery perhaps a bit too comfortably. If you don't like the shape of your nose, have surgery and fix it. If you don't like how your toe looks, have surgery and change it. If you want to lose weight, have liposuction. Of course, we are not referring to those who need surgery to treat a disease or treat pain. Even cosmetic surgery is fine--- if done in moderation (for example, don't become addicted like Jenny Lee who is 30 Years old and has already had 32 surgical procedures). However, some people see surgery as a first recourse--- not the last. Some people have liposuction because it's a "quick and easy" way to lose weight (but then continue with their old eating habits). This should not be.

The article gives some very good suggestions for exercises. For example, one doctor "cautioned against 'cookbook recipes' for exercise… 'The key to a good workout is customization,' based on a professional assessment of flexibility, cardiovascular endurance, strength and balance."

Euthanasia

Yes, this is a very touchy subject--- in all countries. The article in The New York Times, "A Poet Crusades for the Right to Die His Way", describes a person's desire to be euthanized--- and the government's refusal to allow such a deed to occur.

This raises the question--- if the person is fully cognizant of his/her thoughts and actions and desires to be taken off artificial life support, why should s/he be challenged? According to the article, "there is a serious attempt in Parliament to pass a 'living will' law that would allow Italians to declare what medical treatments they would accept."

Everyone should have a right to say how he/she should die--- and especially if he/she wants to receive artificial life support to prolong life--- a life that may or may not be the life their used to.

Perhaps one of the issues in this particular case is that everything is being done publicly--- after all, the patient was a central figure to the advocacy of euthanasia in Italy. However, this issue should be made public--- just as in the USA, the case of Terry Schaivo made the importance of a living will front and center.

The miracle of science and technology

We came across a wonderful article written in the New York Times, "With Lasers and Daring, Doctors Race to Save a Young Man’s Brain," which was very poignantly written and portrayed the feelings of everyone involved clearly. The article is about the "first person in the United States to undergo an operation involving the use of an excimer laser to treat a giant brain aneurysm."

However, while reading this article, we noted that the writer mentioned several times this laser is not approved yet by the FDA --- yet it has already been used in similar operations in Europe. In fact, the Dutch neurosurgeon who devised the laser procedure-- and who was present during this operation-- has already performed this procedure in over 300 patients. The extraordinary concept about this new laser procedure used to bypass a brain aneurism is that "instead of cutting a hole in the brain artery and then sewing a vein to it, [the doctor] sews first and cuts later. That way, the artery does not have to be temporarily clamped, and blood flow to the brain is not cut off. A excimer laser is used to make the hole because it can be slipped into a tight space on the tip of a slender tube and makes a clean cut that stays open without burning nearby tissue."

This new technique will not be approved until comparative studies are made and further study and research is done to ensure it meets with the FDA's standards. However, how long will this take? 5 years? 10 year? We understand FDA approval is to ensure all standard guidelines are adhered to (after all, this is what keeps us safe) but we need a speedier (yet thorough and accurate) process of approval. The world’s technology is forever changing and for the better.

We need to take advantage of this in all fields--- but especially in the field of health care. The life saved may be your own.

And Time's Person of the Year is...

YOU.

By now you may have heard Time magazine has chosen as you (and us and the person next to you) as the Person(s) of the Year. It is each individual person who has made a significant contribution to the world -- through the internet. It is you (all of you) that have built online communities, support groups, brought strangers together through shared interests --- just for the fun of it. You have made possible a universe about "community and collaboration on a scale never seen before." As Time magazine describes it in the article, "Person of the Year: You," "it's about the many wresting power from the few and helping one another for nothing and how that will not only change the world, but also change the way the world changes."

We should all be proud Time has recognized something we have all known--- it is the consumer --- you and us and everyone around us--- who yields the power. There is a power in numbers, and we have proven that we can come together to change the way the (virtual) world works. As Time magazine wrote, "we're looking at an explosion of productivity and innovation, and it's just getting started…"

Let's take this power, productivity, and innovation and make further changes -- politically and socially.

Children as venture capitalists?

In yesterday's entry we mentioned that entrepreneurs come in all ages and generations-- it seems venture capitalist investors also see this trend and are capitalizing on it. In fact, they are going one step further -- they're using children (tweens and young teens), not to start businesses, but for advice on what's hot in Web 2.0. As you can imagine, all investors are trying to get in on the next Myspace and YouTube.

The New York Times article, "From the Lips of Children, Tips to the Ears of Investors," describes the venture capital investors as a "notoriously self-assured bunch" who admit "some innovations may be lost on their g-g-generation." (It's good to hear the investors are finally admitting this…. It took a while!). As the article points out, "the trend may indicate the rise of something new in the venture capital industry itself: humility." (It’s about time! They dont call them "vultures" for nothing.)

The main reasoning behind using children to assess the new technological terrain, as explained in the article, is:

"as the investors themselves are aging, the technology — including social networking Web sites and mobile gadgets — is designed for, used by and sometimes built by people half their age.

Young people… may be better equipped than investors, who tend to be in their 30s or older, to see nuances and identify trends."

We agree. This may be a great way to teach children about entrepreneurship and business. However, we do believe there should be other qualifying factors involved in an investment decision—not just the word of a child. Though, we do hope the children are being justly compensated (it's not fair if the investment company makes millions based on the advice of children but the children don't benefit.)

Role Models

We love the baby boomers -- and we have made it very clear on this blog. However, there is much to be said for the younger generation -- Gen X and Gen Y. If you pick up Monday's (Dec. 18th) issue of Red Herring you'll understand why.

The cover story is about 25 young men and women who are CEOs and Founders of their own companies -- and all of them are under 35 years old! The companies are all in different fields--- but they have one things in common--- they would not exist had it not been for today's technology (and of course, these companies are helping to expand the capabilities of this technology).

Take for instance a 19 year old female Stanford student who decided to dropout to start Theranos, a company whose "system includes a handheld device that monitors a patient's blood wirelessly and works by measuring tiny amounts of blood through a biochip to determine if an adverse drug reaction is occurring. " The data is sent electronically to the company's web site (where patients can check the results) and to the physician's PDA.

The great aspect of this… she's only 22 now, leads more than 100 employees, and has obtained over $16M in financing.

Bottom line: Role models come in all ages and all generations.

Don't you hate those "senior moments"?

Don't you ever find yourself going towards the living room (or kitchen or bedroom) only to find out, when you get there, that you've forgotten why you went there in the first place? Some people may call it a "brain fart" or a "senior moment." (Some people might even call it too much stress and not enough rest!) ;- )

All kidding aside, there will be more and more moments like this as we age --- it's a fact of life that with age, our cognitive abilities decline (they don't call it "senior moments" for nothing). In fact, Dr. Ridge, one of our board members, wrote an article, "The Bionic Brain", on the CareTALK Aging & Caregiving blog on Yahoo Health regarding keeping the brain active. He recommended a couple of new products (besides the usually crossword puzzles) -- namely, the new Nintendo Brain Age game and PositScience's brain fitness program.

We're sure you've seen the commercials for the Brain Age game (check one out here and the other here.) AND it's not for the young'uns. It's targeted to the Boomers! (Ahhh. Playing Nintendo again does bring back fond memories--- but then again, that's the point, isn't it? To keep your brain active so you can keep your memories!) According to the Brain Age official site, "Brain Age presents quick mental activities that help keep your DS brain in shape."

Another great product is PositScience's Brain Fitness Program 2.0 which is a workout for your brain --similar to how you would (or let's face it, should) normally work out your body. This program consists of 40 one hour "sessions" – 1 session/day, 5x/week for 8 weeks.

Now that the holiday season is upon us, check these items out. Not only are the good for you, but they are actually fun!

Ranking Hospitals

According to the Wall Street Journal article, "Hospital Rank Doesn't Predict Death Rate", the findings of a new research suggest that "many [hospitals] that are highly rated by government regulators only have marginally lower patient death rates [than those not highly rated]." This study evaluated 3,657 hospitals that are listed on the Hospital Compare utility found on the Centers for Medicare & Medicaid Services Web site. However, one should note, death rates in hospitals aren't the only elements CMS used to rate hospitals. According to the director of CMS's quality measurement and health assessment group, the Hospital Compare utility uses 22 quality measures.

The findings of the study also suggested that "better ways of measuring performance are needed to help consumers make meaningful choices ... Only then will performance measurement live up to expectations for improving health care quality." Perhaps consumers won't have to wait to long (Google, anyone?).

Yes, there probably needs to be more quality measures when comparing hospitals. Perhaps even with these added quality measures there will be studies proving there is little difference between top rated and lower rated hospitals. However, when it comes to a matter of life or death, who would you trust—a study or CMS (which receives performance reports from hospitals nationwide)?

One person can make a difference

The article by Susan Okie in the Washington Post, Teaching Hospitals How to Listen, is very poignant -- and disturbing. Reading the struggle of Ms. Okie's friend, Ms. Sylvia Stulz, to get hospitals to be more aware and responsive to their patients makes one shake their head and say "this should not be." Why should she, or anyone, have to struggle to teach hospitals -- doctors, nurses, staff members --to be responsive to patients and to treat them as human beings -- not as a burden?

This article also points out the courage of one woman who focused her energy -- not on her illness or on a "woe is me" attitude --but on changing the experiences she had gone through in the hospitals so that others can benefit. This is a perfect example of a boomer--- boomers are doers; they are action takers. We have been saying this repeatedly -- as the boomers age and have new experiences --ie. hospitals stays, etc--they will begin changing what is not working (after all, they did stop the Vietnam war, invent the internet, create MTV--- which was originally intended to be a channel for music videos).

This is why CareTALK was started -- because one Boomer mother saw there was nothing available when she became a caregiver for her daughter. This is the reason Google is going into health --- because of the experience Adam Bosworth, a VP at Google and a boomer, had while caring for his mother. There are inefficiencies in the health care system and in the information available for caregivers.

Boomers will change this. You can bet on it.

Want some Cocaine?

No, we're not talking about the powdery drug.

Apparently, in the race to be a recognized energy drink in a booming market, a new energy drink branded itself Cocaine.

Why?

Well, according to the NY Times article, The Energy-Drink Buzz Is Unmistakable. The Health Impact Is Unknown, the founder of Cocaine said "It was always the plan to let negative publicity move us forward. There is an enormous amount of competition out there." We're sure there are better ways to get publicity. He just validates Esther Dyson's comment regarding the "sleezy* marketers" (check out our entry here).

According to the article, "energy drinks are a $3.7 billion industry whose revenues have increased by 51 percent in the past year alone." (That's pretty impressive).

Yet, how safe are all these energy drinks? Granted, we know engineers who drink Mountain Dew or Dr. Pepper or Tab by the cases because of their high caffeine content (more than regular Coke or Pepsi, we're told). But energy drinks have double the caffeine—normally, 2-3 times the amount in a cup of coffee. Cocaine itself claims to have 280 milligrams of caffeine. (Vivarin has 200 milligrams according to the Nutrition Action Health Letter).

Again, is it safe? Experts don't know because "there is little scientific research on how high intakes of caffeine affect adolescents over the long term." In addition, "caffeine is difficult to abuse; unpleasant side effects appear even at modest doses, and toxicity occurs only at very high doses."

A grande latte with a shot of expresso, please!

*(yes, the word “sleezy” is purposely misspelled)

Ever heard of the "Master Cleanse"?

If you haven't, don't worry. You will soon. Apparently, this is "a fast that requires subsisting for 10 or more days solely on an elixir of fresh-squeezed lemon juice, cayenne pepper, maple syrup and water" which has been around for quite some time (actually, it was created in the 40's) and is now making a comeback among those wanting to lose weight very quickly. According to the NY Times article, "I Heard It Through the Diet Grapevine", the fast was originally created "to treat ulcers and other internal ailments. Its fans then were health-conscious types, interested in purging their bodies of impurities and toxins like pesticides and food additives." Now, with society's instantaneous gratification mentality, this diet has been used by many, even celebrities, to lose weight quickly. Staunch believers swear by this diet --- and say it helps in their facial appearance (ie. less acne) and gives them energy.

Many nutritionists caution consumers regarding this diet, though they don't seem to completely denounce it. Fasting for a few days is not harmful for the body, though it may be counterproductive if the sole purpose is losing weight. They say it may "even slow down the metabolism, making it even more difficult to lose weight in the future."

Does this diet work? We don't know. We've never tried it ourselves.

Have you? If so, let us know your thought on this.

Ahh ... the price of fashion

How many of you have sacrificed comfort for fashion? Come on, admit it ... what's a little pain right? Especially when it comes to those gorgeous shoes, or that killer dress, or even that designer oversized handbag that's so in fashion right now.

There are a growing number of cases related to shoulder soreness and neck pain--- and it's mostly (if not all) due to women carrying large handbags (which of course are all the rage now). According to the New York Times article, Ouch! My Bag Is Killing Me, "doctors, massage therapists and chiropractors are tailoring treatments for the bag-obsessed" --- they don't dare tell their patients to ditch their oversized purses. As one doctor put it: "It's like telling a woman, 'You cannot wear Manolo Blahniks.' It's just not realistic." This is so true.

As much as we would like to make light of this, frankly, if you're getting MRI's and cortisone shots to alleviate the pain like one woman described in the article, then perhaps it is time to stop carrying so much. Permanent back damage is a very serious matter.

Though, if you still believe fashion is worth this, there are a couple of tips included in the article such as cleaning out your purse once a week and using "all the pockets so that the weight is dispensed evenly within the bag."

… and more from your friendly "sleezy marketers."

Yep! That's CareTALK, according to legend Esther Dyson (whom we love)!

At the 2006 Connecting Americans to Their Health Care conference, Esther asked the only question that mattered to CareTALK of an illustrious panel (moderated by Josh Lemieux of the Markle Foundation) that included Ted Eystan of Group Health Cooperative, Ed Fotsch of Medem, and Peter Neupert of Microsoft.

The question being (in paraphrased context):

Missing is the bridge to the consumers for the information shared
at this conference. Where are the "sleezy marketers"?

To Esther –
We’re here!! ... along with Google Health and Microsoft.
(Don't worry, next year, we'll be on the panels.)

- The CareTALK Gals.

Adam Bosworth's speech at the Connecting Americans to their Health Care PHR conference

Adam Bosworth, Vice President of Engineering at Google and head of Google Health, was the keynote speaker at lunch during the 2006 national conference: Connecting Americans to their Health Care: Empowered Consumers, Personal Health Records and Emerging Technologies. Here are a couple of highlights from his speech regarding PHRs (Personal Health Records):

• "In general, if you build a place that accepts all data and deliver the value … the standards [to define interoperable ways to move the information] will work themselves out."
• Google does not do things small. Google is transformational.

We'll leave you with that for now… more tomorrow…

Adam, Missy, Roni, Eric, Alex-- we're with you!

- The CareTALK Gals

PS. For Adam's "Thoughts on health care, continued" on the official Google blog, click here.

Catch us at the 2006 PHR conference in Washington DC

The CareTALK Gals are traveling to Washington DC to attend the PHR conference sponsored by the Markle Foundation and The Robert Wood Johnson Foundation. (For those of you who know us: Yes, we’re actually leaving our desks and phones to attend a conference.) However, this isn’t just any conference, this is the 2006 national conference: Connecting Americans to their Health Care: Empowered Consumers, Personal Health Records and Emerging Technologies. (Ok, for those of you who may not be impressed yet, check out who the lunch keynote speaker is for Thursday, Dec. 7th -- That’s right, it’s Adam Bosworth, VP of Google.)

You can draw your own conclusions but we believe it’s a big deal when a VP of Google is giving a keynote at the conference for personal health records just days after he wrote an entry on the official Google Blog (for those who haven’t read it, you can read it here) regarding Google’s goal to help solve some of the issues with the health care system. (Google Health, anyone?)

We wholeheartedly endorse this badly needed, pivotal, collaborative effort and its participants in validating the need for PHR utilities so that caregivers can be empowered to better manage increasingly complex challenges yet to come. Thank you to our friends at the Markle Foundation for facilitating this wonderful conference.

We are proud to collaborate with these initiatives with modern family caregivers.

Check back soon, we will certainly give you our impressions and a recap of the conference!

Check out the Dec 11 issue of New York magazine!

Every Tuesday, we eagerly await our mail (and it's certainly not for the bills and junk mail). Tuesdays are the days when we receive our copy of New York magazine. (Have we ever written how much we love the sensibility and writing of the magazine?) Well, we do!

This week we were not disappointed--- especially since a main section of the magazine was dedicated to elder care! "The Everything Guide to Elder Care" has reviewed several facilities and has listed some of the top facilities in NYC for the aging based on "experts, including geriatric-care managers, watchdog groups, elderly advocates, and government officials." (Oh, and they also visited the facilities themselves).

Many people may not realize this, but New York City is really a city for all—young AND old. According to the 2000 census, there were approximately 1 million New Yorkers over the age of 65--- accounting for about 11% of NYC's population. Why so many elderly? New York magazine explains it best:

You don't need to drive, virtually anything can be delivered, the world's best doctors are here, and … [plenty of] senior-minded outings, clubs, and yoga classes (not to mention the opera, Broadway, and the occasional White Stripes concert for the young at heart).

Yes, that's right… forget Florida. New York City is the place to age-in-place.

The beauty of new technology

Now, there might be a new method to detect breast cancer in women--- without having to get a biopsy. According to the Wall Street Journal article, "Elastogram May Reduce Need
For Biopsy to Detect Breast Cancer," there is a new technique called "elastography" which is an "experimental ultrasound technique that measure how easily breast lumps compress and bounce back."

The results from a small study of 80 women were extremely positive--- there was 100% accuracy in distinguishing benign lumps from malignant ones. If the results hold up in a larger study, this new technique could revolutionize the detection of breast cancer. Some experts laud the technique but believe it will not replace biopsies--- there needs to be much more research and hard evidence. One surgeon said, even if the technique is proven effective and accurate, doctors may have reservations about relying just on this technique and not ordering biopsies ---for fear of a lawsuit. It is a sad but true reality that doctors have to fear lawsuits even when a new technique is proven better than an older method.

For the sake of every woman, let's hope this technique is proven effective, accurate and meets (or surpasses) all the experts' expectations with the larger study. Researchers are already testing this technique to detect other health problems—prostate cancer, thyroid cancer, and even damage after a heart attack.

Aging America

By now we have all read how within 30 years the number of Americans over 65 will double --ie. it is estimated there will be approximately 70M Americans over the age of 65--while the number of younger people able to take care of them is far less. This is the caregiving crisis the Frontline special two weeks ago described. Not enough caregivers to care for these aging Americans.

However, Ken Connor describes another problem we currently have and which will be more prominent with 70M Americans over the age of 65--- the fact that our culture does not respect the elderly. In fact, they are seen as "economically inconvenient." In his article Graying America: An Inconvenient Truth, Mr. Connor states:

Other than the unborn, no single age group in the United States suffers from a diminished view of the value of human life more than the elderly. We have adopted a sliding scale of dignity which depends upon one's functional capacity, quality of life, and level of sentience. Woe be unto the old person who does not score well using this quality of life calculus and who costs more to maintain than they produce.

This is truly horrible. Why is it that, in this culture, we do not respect our elders? Why do we see them as a burden to society? Were it not for them -- their work, their wisdom, their courage-- many of us would not be here. Other cultures revere the elderly and see them as wise advisors that should be listened to and respected.

We don't. We need to change this.

A crying shame

It really is a crying shame when start-ups and small businesses have to worry more about paying for health insurance than any of the other challenges they face. One small business owner was quoted in The NY Times article, "Health Care at a Premium", as saying "It's definitely causing me to consider going back into the job market."

According to the article, the high costs of health insurance is deterring some people from beginning their own business. Who could blame them? You pay high insurance premiums, and you're still at risk of not being covered when you really need it (please read our Sept. 22nd entry). One small business owner said, "When we worked for someone else, life was good. We had plenty of money and health care. Now we live with the constant fear of something. You never know, you just hold your breath. We will probably have one of us go back and get a full-time job at some point." When premiums for small businesses are rising at a faster rate than larger companies, some entrepreneurs have no choice.

However, this should not be.

This is a nation of the American dream, where anyone can start his/her own business--- and should be encouraged to do so. There are already too many challenges for small businesses--- high premiums for heath insurance should not be one of them.

What can we do about this?

Google Health

Many of you may have read today's posting, Health care information matters, by Adam Bosworth, VP of Google, on the official Google blog where he speaks about the challenges of the health care system (which unfortunately are many)—especially the challenges "in supporting caregivers and communicating between different medical organizations"—he observed while caring for his recently deceased mother (our deepest sympathies go out to Adam and his family).

His focus at Google is to help alleviate these challenges. (Who better than Google, right? They are already helping doctors--- and every day readers like you and us—correctly diagnose disease through search.) Some challenges he's focusing on are:

• "People need the medical information that is out there and available to be organized and made accessible to all."
• "Patients also need to be able to better coordinate and manage their own health information. We believe that patients should control and own their own health information, and should be able to do so easily."
• "connect[ing] people with similar health interests, concerns and problems."

Best of luck to Adam and GoogleHealth team for much success. This nation with its severely challenged health care system definitely needs assistance.