Monday, November 23, 2015


Despite the many differences that exist among people and families, I suspect that  throughout our lives we all have variations on some basic conversations. These conversations usually take place between the elders and their  younguns.  So, for example, the Easter Bunny, Santa, Boys and Girls and What Happens, disappearing Grandma and Grandpa, Assisted Care (or not),  and Death. 

Say what!? Death? Remember 2007, the year of Sarah Palin's Death Panels? If we pass the Affordable   Care Act, then government panels will decide who lives and who dies. Or variations on that theme from those determined to prevent passage of the ACA. What was proposed back then, and then withdrawn after the shameless efforts of pols like Palin, was that people should discuss with their doctors end life issues and Medicare  should reimburse doctors for the time spent in helping people to formulate an advanced care plan. 

This past summer my  younger sister passed away. When I got to her in the hospital in Florida I found that she had not made out an advanced care directive, but we were discussing what she would do after leaving rehab and without any expectation that  her death was imminent. Well.... we had that conversation anyway and a day or so  before her heart gave out  she filled out an advanced care directive. With her permission, and between visits to her in the hospital, I also found that she had pre-purchased a funeral plan.  Her will was well hidden and was not where  she said it was but I found it in the end. She passed away after about a week, in the morning just as I was leaving my motel to  visit her. As sad as her death was, I cannot easily express how thankful I was to know that she had planned in advance for exactly what happened. 

In September a Kaiser Foundatin poll found that 80% of respondents said that Medicare and private insurers should pay for the end-of-life conversations but that fewer than one in five respondents reported actually having had such a discussion with a health care provider, including only about a third of those over age 75 and about a third of those with a debilitating disability or chronic medical condition.

Many patients and families want to have these discussions, and this past summer the Myth of Death Panels was laid to rest when Medicare authorized such conversations. Under the final rule patients and families can have the discussions when and where they want — before patients become ill, after they receive a diagnosis of cancer or other serious illness, or while they are receiving hospice or palliative care. 

In such conversations, patients could discuss whether and how they would want to be kept alive if they became too sick to speak for themselves. Doctors can advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

The conversation that you have with your  kids and/or your  doctor about the end of your life is  every bit as important as the one you and your kids had about Santa, or  any of those other essential conversations. Please do not put it off.

Thursday, November 19, 2015

Nifty Science: a nano-sized submarine to deliver your prescriptions?


We seniors have certainly benefited from the super advances in drug therapies that have been developed since WW II. Probably all of us are taking one or more on a daily basis for any number of medical conditions. I think though that much of what we may take for, for example, some cancers is a rather blunt instrument. One goal of drug therapy would be to specifically target the site at which the drug should work. How to do that? In a report I read today, scientists at  Rice University have developed a phenomenal 'nanosubmarine,' a single molecule, comprising 244 atoms, that is driven by a kind of propeller (actually a flagella such as is found on some bacteria and other protozoan organisms). The nanosubmarines could conceivably be loaded with medicine and sent up a person's bloodstream for precision delivery, or made to ferry toxic chemicals out of water filters. The paper describing the molecular machine appeared in the journal Nano Letters and was reported by NBC news. It is indeed a brave new world in which we live!

Thursday, November 12, 2015



There is a bunch of good things in this issue. I especially liked Pat's editorial about November. Truly, it is November. Typically it's a 'neither here nor there' sort of month, with cold-ish temperatures, gray sky, some rain and maybe some snow. The colorful leaves are gone. Maybe some golden birch leaves are hanging around but mainly what remains are the brown beach and oak leaves. Surely it's the fastest month of the year. I really do believe there is at least a week fewer number of days in November than in any other month. I mean, Thanksgiving is sort of a week away and the Christmas commercial hullabaloo is in full swing now.  

I like November. Some might think of this somber month as a time of dead but really Thanksgiving is my favorite holiday of the year: your 'responsibility' is to reflect on your (hopefully) many blessings. Just now, even before Thanksgiving, we celebrate and honor those who have gone to war in order to ensure our thankfulness at Thanksgiving. We  honor those guys, men and women, in November. Thanksgiving, unlike Christmas, is not laiden with guilt  about gifts, cards -- 'got to,' and 'should have' stuff. It is no wonder Christmas is, for some, a very depressing season (the whole reason for celebrating the season by many having been overlooked or hijacked by commercial interests: didn't Christ throw the money lenders out of the temple after all? time for us to reconsider what this season is about?). No, I like November and Thanksgiving  My wood is stacked, we've got gas for the generator. Most importantly, the fruitcake fruit is marinating now in good dark rum.

Anyway, back to Seniors Alive!. Read Pat's introduction. Then note that there will be a Thanksgiving feast at the Hillsborough .American Legion on Saturday, 21 November at 1:00. It's free thanks to the Hillsborough Lions Club. 

Note also that the Senior's Bus will make its' monthly trip to Walmart onWedneday, 18 November, leaving from Shaw's parking lot at 10 am. Call Marie Mogavero (603 464 4727) to reserve  your spot.

I wish you all a very happy Thanksgiving!