It’s some kind of commentary on my current lack of intellectual energy that I just spent about thirty minutes in Photoshop making a Christmas tree out of a photo I took of ibuprofen and dextromethorphan capsules. I’ve been trying to read the whole of the recently revised mammogram guidelines, also known by its intimate friends as “Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.” So far, all I can tell you is, if you are someone for whom the very thought of these new guidelines causes insomnia and palpitations, actually reading them will cure you. Not because you’ll discover that all the kerfuffle over them was for nothing, but because you will fall asleep wading through all twelve pages of the statement. And that’s just the beginning. Then there is the supporting article (fifteen pages), the evidence review (seventeen pages), the evidence synthesis (a whopping ninety-five pages), the clinical summary (a mere two pages), the definitions of the terms used in the website statement (two pages), the website statement itself (two pages) and the summary of the previous 2002 guidelines (two pages). And that doesn’t include all of the research articles that were reviewed to come up with these documents. Zzzzzzzzzz……
I promise you, I am contrary enough to wade through all this and write you a post about my thoughts on this thorny and weighty subject. But not just yet. I’m a little tired. Something new! Not. Different reason though. I’m tired because I haven’t been breathing very well lately.
I am a little further along in finding out why, however. I saw my pcp yesterday. He listened to my lungs. They were not noisy, which is good, just a little “squeaky” when I coughed. My pcp is not above using words like ‘squeaky.’ That’s one of the reasons why I like him. I also got a chest X-ray, which was negative for anything acute and obvious, thank god. Yes, I know!! Amazing — results the same day, faxed to my doctor and everything! Hey, I know all the cool places to get stuff like chest X-rays. The radiologist did recommend that I get a CT scan should my symptoms continue. After the X-ray, I got some blood drawn for lab work. This morning, I picked up a prescription for prednisone. I took some today, 60 milligrams. Plus my albuterol inhaler. Plus some cough suppressant. So far, I’m not feeling any better. Call me impatient. When you haven’t been able to draw a deep breath for several weeks, you get a little testy.
Good golly, don’t you all get bored reading this drivel?? I’ll tell you what. I’m getting bored living this drivel.
So, I don’t really have a diagnosis for my coughing and shortness of breath. There are names for my symptoms, but they don’t really ‘splain anything. My feeling is, if it looks like a duck and quacks like a duck and coughs like a duck, it’s a duck, whether it shows up on an X-ray or not. Besides which, pneumonitis is not big and obvious, it’s diffuse and subtle, and I probably don’t have a bunch of it, so it would be easy to miss, in my humble opinion. Besides which, there really isn’t any other obvious reason why I should develop this instant and constant asthmatic irritation. The only thing that’s different in my life is cancer and surgery and radiation and treatment after-effects. So, I’m calling it radiation pneumonitis until someone proves me wrong. Guilty until proven innocent. That’s my story and I’m sticking to it.
In the meantime, I will slowly slog through the USPSTF’s justification for causing a big ol’ media sh*t storm about mammograms during the closing days of Pink Month. So far, my favorite summary of the new guidelines comes from this month’s issue of The Medical Letter, Volume 51 (Issue 1327/1328) December 14/28, 2009. You can’t read it online yet without a subscription. But I have sistahs in high places, so I got to read the article on mammograms. The one-page summary describes quite succinctly the imperfect research and faulty reasoning employed by the USPSTF to draw up the new guidelines, summing up the eye of the storm with these words:
- Not offering routine mammography to women 40-49 years old would save many women from radiation exposure, unnecessary surgery, pain, anxiety and expense, at the cost of some lives.
That’s the closing statement on this page of The Medical Letter. The opening statement is “Happy New Year.”
Makes your blood run cold, don’t it??
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