Things You Can Learn at the Chemo Clinic

When, on three Wednesdays out of four, I go to the Knight Cancer Institute at the Oregon Health & Science University (OHSU) for my weekly chemotherapy infusion, the view from my chair is this: (Photo credit: Kristian Foden-Vencil-OPB)

KnightCancer2l

On those days, I'm in the building to the right in this photo overlooking the construction project.

This new, state-of-the-art research facility exists thanks to Nike founder Phil Knight. In 2013, he and his wife pledged half a billion dollars to OHSU to fight cancer and to keep OHSU people like Brian Druker, the scientist who discovered the power of the cancer drug Gleevec, around to continue their research.

But, said Knight, he would do this only if OHSU could match the donation. Half a billion is a lot of money.

In what to me seems a lot like some kind of miracle, OHSU topped the goal. As the Kuni Foundation announced in July 2015:

"Gifts came in from all parts of the community, snowballing into an unstoppable movement against cancer...Children held craft sales and collected cans, sending in shoe boxes of change. Local businesses and labor unions [banded] together sending in funds. The state of Oregon agreed to invest $200 million in OHSU facilities needed to support the building expansion."

Twenty-two months later, with a $5 million donation from the Kuni Foundation, OHSU had met Phil Knight's challenge having raised a total of $508 million. Ground was broken for the new $160 million building in June 2016 and completion is scheduled for next summer.

I know this because doctors and nurses and others at the Knight Cancer Institute have told me the story and I'll get back to that in a moment. First, some smaller things I've learned there from the caregivers at OHSU.

WEIGHT LOSS
Following my Whipple procedure surgery for pancreatic cancer in June, I lost nearly 10 pounds. Well – I suppose some of that weight was half my pancreas, my entire gall bladder, all my duodenum and some smaller bits and pieces the surgeon removed. But most of it was a result of the surgery and recovery.

Plus – I hadn't known this before – cancer uses up more energy more quickly than a body without cancer. The same can be said for chemotherapy. A patient is expected to lose weight during treatment and therefore is encouraged to gain.

God knows I've worked at it. Before now, I spent a lifetime trying to keep off the same 10 or 15 pounds I repeatedly gained back. Even so, it was easier to lose that weight than to put it on this time.

Having at last reached my pre-surgery weight recently, I asked the RN at my chemo treatment last week if she could lay off the admonitions to gain more weight.

Apparently she thought I was kidding. She repeated the need to continue gaining to keep ahead of the chemo drugs' predilection to eat away at my weight.

WRINKLES
Unless one is very fat, wrinkles go hand-in-hand with growing old. I don't much mind them, especially since the cancer diagnosis: something like that strongly focuses one's attention on what is really important, and wrinkles are not.

Even so...

The wrinkles I've had until now came on slowly. A smile line. Increasing number of crinkles under my eyes. That sort of thing over time.

Since the surgery? Wow. I lost enough weight that overnight even my knees became wrinkled. My forearms are crepe-y. My belly is rippled with a long row of wrinkles. So is my butt. These are all new. (No, I'm not showing you photos.)

At the same time, however, it's weird that my waist is bigger than before. It bulges out and that brings me back to what the nurse told me.

Most of the weight I have gained is and will continue to be "unfortunately, fat," not muscle. That's just the way it is in this circumstance, she said.

My whole body has gone soft since I hadn't been able to work out for a long time following the surgery. I finally got back to my morning exercise routine two weeks ago and I'm determined to replace some of the lost muscle. We'll see, we'll see.

CANNABIS
I've been smoking weed since high school but not much in recent years because it makes me cough. The state of Oregon has allowed sale of medical marijuana for quite a while and about two years ago, they expanded to allow sale of recreational weed.

Still, as curious as I am about retail versus illegal sale, I haven't gotten around to visiting a dispensary yet. So at my chemo visit to OHSU last week, when I told the doctor that sleep is a sometime thing for me, instead of a prescription drug, I was surprised when he suggested cannabis, particularly CBD which is, apparently, the part of cannabis that, unlike THC, doesn't get you high.

"What fun is that?" I asked him and we both laughed at how strange it still sounds to hear weed recommended by a doctor.

He explained that CBD is an anti-inflammatory and has a calming effect too that could help me sleep.

Is it as weird to you as it is to me to hear a physician recommend weed? I know that Oregon doctors have issued medical marijuana cards to patients for many years but it still felt odd when it happened to me.

OHSU
Getting back to this, a couple of weeks ago, I posted a list of the many things that, even with a diagnosis as frightening as pancreatic cancer, I am grateful for. There is another I didn't mention then.

That I am being treated at the Knight Cancer Institute at OHSU. My surgeon is one of the world's leading pancreatic cancer researchers and now, with Phil Knight's donation, he is assured of continued resources.

As Nature reported, Brian Druker, who is now director of the Knight Cancer Institute,

"...aims to rapidly hire up to 30 principal investigators, and to provide researchers with a funding cushion intended to free them from the burden of constantly applying for grants...

"The institute will focus on detecting cancers early in their development, when treatments generally have a better chance of success. Druker also wants the institute to take advantage of emerging technologies to develop better tests that would reduce false diagnoses."

Just last week, the Institute hired

"Dr. Gordon B. Mills to lead precision oncology for the hospital. He will be charged with working with his team to try to figure out what combination of drugs is most effective on different kinds of tumors. And he told KXL that he can’t wait to get started in Portland, 'The opportunity to do this at a center that is innovative, flexible, and is really wanting to make a difference, is the reason why I came to Portland.'"

Toward the end of last year, the first time I visited a doctor at OHSU, I felt a sense of pride and dedication from every person I dealt with that wasn't present or, at least, not as apparent with other physicians I've known as it is at OHSU.

I can't help but think all that energy comes from knowing they are part of something big, something special they have been part of creating and know that it took so many other people who believed it them and their goals to donate all that money to make this new research facility possible.

It also helps explain why from the start all these people have made me feel safe in their hands.


ELDER MUSIC: Classical Gas Part 8

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

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This series was named initially by Norma, the Assistant Musicologist, to highlight lesser known composers who are seldom heard on radio or in concert.

JEAN-XAVIER LEFÈVRE was born in Switzerland but spent most of his life in France.

Lefevre

He happened to be in the National Guard when the Revolution broke out and became a conductor for the Guard's band. He later taught at the Paris Conservatoire and records suggest he was excellent at that as many of his pupils gained first prizes.

His main instrument was the clarinet and most of his surviving compositions are for that instrument. That's what I'll be featuring, the third movement of the Clarinet Sonata No. 7 in G minor.

This is a little unusual, as it doesn't have the standard piano or harpsichord as an accompanying instrument; instead it's a harp.

♫ Lefèvre - Clarinet Sonata No. 7 in G minor (3)


FRANZ XAVER SÜSSMAYR is probably best known these days as the person who completed Mozart's Requiem after Wolfie died.

Sussmayr

He was well known in his day which is probably why he got that gig. His musical life began as a member of the choir at a monastery in Austria. When his voice broke he played violin in its orchestra. They also put on operas and young Franz was exposed to the opera composers of the day.

He later wrote quite a bit of religious music as well as secular compositions. One of those is his Divertimento No. 1 in C major. This is the first movement.

♫ Süssmayr - Divertimento No. 1 in C major (1)


NICCOLÒ JOMMELLI was from Naples and spent much of his life in what was then called the Holy Roman Empire (which certainly wasn't holy, it wasn't Roman and not much of an empire either) and France.

Jommelli

Although he wrote cantatas, oratorios and other religious works, he's mostly remembered for his operas - he wrote about sixty of them. One of those is Attilio Regolo (there are various spellings of the name) about a Roman Consul during the Roman Republic.

From Act 1 comes the aria “Par che di giubilo” sung by JOYCE DIDONATO.

Joyce DiDonato

♫ Jommelli - Par che di giubilo (Attilia)


For many years, decades – a couple of centuries even – this next piece of music was attributed to J.S. Bach. Modern scholarship has shown that was actually written by CHRISTIAN PETZOLD.

Petzold

Most of you will be familiar with this, at least those who were listening to pop music during the sixties because a couple of blokes put some words to it and it was recorded by The Toys as A Lover's Concerto. The original was written for the harpsichord, but I rather like this version for violin and piano, Minuet in G Major.

♫ Petzold - BWV 114 115 - Minuet In G Major- violin


WILHELM GOTTLIEB HAUFF was an organist and wrote music for the horn. He lived in the second half of the eighteenth century.

Hauff

That's about the sum total of my knowledge of the man except that his father (with the same name) was also a musician. So, without further ado, let's hear the first movement of his Horn Quintet in E-flat major.

♫ Hauff - Horn Quintet in E-flat major (1)


GIROLAMO CRESCENTINI was most noted during his life as a singer and singing teacher.

Crescentini

He was a castrato (Ooooo!) but that style of singing was already going out of fashion. He wrote some operas when he retired from singing that anticipate the opera style that was to come, particularly Rossini.

He also wrote short pieces, called these days, Italian Ariettas. We have one of those today called Mi lagnerò tacendo, performed by the mezzo soprano MARINA COMPARATO.

Marina Comparato

♫ Crescentini - Mi lagnerò tacendo


ANTONIO BARTOLOMEO BRUNI was born and died in Cuneo, which is in what's now Italy.

Bruni

However, he spent most of his life in Paris. That covered the time of the reign of terror, so it wasn't the safest place to live. But he survived. He was a bit of an archivist and he made a list of all the musical instruments recovered from the noble houses (that included six hurdy-gurdies – I just threw that in for my own amusement).

Tony was also a bit of a composer and most of his compositions were for various small ensembles of string instruments – duos, trios, quartets and so on. An even smaller ensemble is his Viola Sonata in E-flat major, Op. 27 No. 4. This is the third movement.

♫ Bruni - Viola Sonata in E-flat major Op. 27 No. 4 (3)


These days symphonies are thought of as grand, magnificent things, and are often quite long – just think of Beethoven and Mahler. However, before Haydn set to work on them (and boy, did he work – 104 official symphonies and several more works that should be considered) they were little bitty things. The symphonies of WILLIAM BOYCE are prime examples of this.

Boyce

Bill was sort of a link between the Baroque period and the Classical, although he lived well into the latter era. He wrote eight symphonies and I have them all. This is quite easy as they all fit on a single CD. Here is all of Symphony No. 1.

♫ Boyce - Symphony No. 1


The consensus seems to be that CARL ANDREAS GÖEPFERT was a really shy man who was reluctant to assert himself, so he missed out on several important positions. He was considered an honorable, upright and lovable person by all who knew him.

Göepfert

At one stage, he took lessons from Mozart who was so impressed he employed Carl to orchestrate some of his (Mozart's) compositions for various other instruments.

Carl was a virtuoso clarinet player and wrote wonderful music for that instrument. However, I'm a bit perverse and I will feature one of his compositions that doesn't employ the clarinet. It is the first movement for the Sonata for Bassoon & Guitar, Op. 13. An interesting combination of instruments.

♫ Göepfert - Sonata for Bassoon & Guitar Op. 13 (1)


Both Australia and New Zealand claim ALFRED HILL as one of their own. This isn't unusual except it's usually Australia claiming Kiwis rather than the other way round as in Alf's case.

Alfred Hill

He was born in Melbourne and spent some of his early life in New Zealand. As an adult he switched between the two countries as he married a New Zealander. He finally settled in Sydney and played in and conducted several of the local orchestras. He was one of the musical advisers when the (Australian) ABC (TV) began.

Alf wrote music in a number of genres – more than 2000 works: 13 symphonies, eight operas, many concertos for various instruments, piano and choral works and so on. What I think is his high point is the string quartets (17 of them), some of the best of the twentieth century.

His String Quartet No. 5 in E-Flat Major was written to commemorate the victory in World War I, and is named "The Allies". This is the second movement.

♫ Alfred Hill - String Quartet No. 5 in E-Flat Major (2)



INTERESTING STUFF – 14 October 2017

HOW ELDERS ARE GETTING BY IN PUERTO RICO

This week, President Donald J. Trump tweeted that he is ready to abandon the American citizens of Puerto Rico.

TrumpTweetPuertoRico

When he said this on Tuesday, FEMA estimated that 36 percent of the people still have no access to safe drinking water, food is scarce and 90 percent of the island lacks electricity.

On October 6 and 9, U.S. News reporter, Lisa Esposito, spoke by text and iffy phone with Paul Stearns who happened to be visiting his 81-year-old mother on the Puerto Rican island of Vieques when the hurricane hit and is still there caring for her.

Some excerpts from Esposito's conversation with Stearns:

”Since the storm I am surprised [at not seeing] any special attention being given to older adults and other vulnerable populations here on the island.”
”We are eating and [the] grocery store is open but [with] limited options for a healthy and balanced diet. Fresh vegetables have been nonexistent and [we] mostly count on canned foods. Our home and many others have electric stoves so it is difficult for me to make a balanced meal for her. I am currently using a single Sterno with a hibachi grill supported by two cans of corned beef.”
”After the storm there were people who could not get medicine such as insulin and inhalers because they had no cash. The pharmacy refused and it took a local hotel to front the cash. We are an all-cash society now.”
”On the day Maria arrived landline phone service was cut and we had no way to dial 911 and still don't since cellphone service doesn't reach every part of the island.”
”Some people have already left and more are planning to leave until the electrical infrastructure has returned…It is hard for [my mother] to get a good night's rest without [air conditioning] and some days she is overly hot.”
”One other item I'd like to add is with older adults and their pets: The Humane Society is here and I volunteered with them yesterday. I asked what was specifically being done to help these older adults with pets. There seems to be [nothing].”

White House Chief of Staff John Kelly and others have tried to walk back Trump's tweet about abandoning Puerto Rico. We'll see. We'll see.

Read the entire story at U.S. News.

TRUMP “DISGUSTED” AT FIRST AMENDMENT

That tweet (above) was Tuesday. On Wednesday, Trump said in the Oval Office, “It’s frankly disgusting the press is able to write whatever they want to write. People should look into it.” Here is a report about that:

As several reporters have since noted, a 71-year-old native American should know by now that the First Amendment ensures freedom of the press. More at Vox.

TOM TOLES' ON ENDING THE WAR ON COAL AND...

Washington Post editorial cartoonist, Tom Toles, did a masterful job of combining the president's various hints about possible war with North Korea (or some other country, depending on the day) and EPA chief Scott Pruitt's declaration that the “war on coal” is over:

Tometolescoal2

Amanda Marcotte at Salon has a good analysis of the war on coal pronouncement. Some excerpts:

"'The war against coal is over,' [Donald Trump's EPA head] Scott Pruitt announced with great fanfare at an event with coal miners in Hazard, Kentucky, on Monday. 'No better place to make that announcement than Hazard, Kentucky.'

“Pruitt's ostensible reason for this attempted rollback is that the Clean Power Plan was not crafted 'carefully, properly, and with humility,' but he hasn't taken any great pains to hide the real reason he opposes it: The plan encourages states to shift away from coal and towards natural gas or renewable resources to generate electricity...

“'Continuing to prop up the coal industry is bad for the economy, just as it’s bad for the environment,' Michael Brune, the executive director of the Sierra Club, told Salon.

“As Brune explained, the Sierra Club has invested immense resources — 160 of its employees — in the task of monitoring the nation's coal-burning power plants. What they've discovered, he said, is that coal plants are shutting down as other energy sources become 'more accessible and more affordable.' Since 2010, in fact, almost half of the coal-burning plants in the country have either been retired or have a planned retirement date.”

Breathing may become optional thanks to Pruitt.

Whew! That's a lot of hard-to-take stuff. Following is your reward for getting through it starting with

OH NO – HAVING ANOTHER A BAD DAY?

When I check the headlines each morning, I know just how the panda in this gif feels: (Via giphy)

BIRTH OF THE ISRAELI AIR FORCE

Almost every day now I need to find something uplifting or inspirational that restores my faith in the human condition. Here is one.

When Israel declared statehood on May 14, 1948, they had no air force. World War II pilots, mostly Americans, were secretly recruited and trained to help Israel defend itself from the Arab nations and were eager to do so.

The documentary Above and Beyond: The Birth of the Israeli Air Force was produced to tell the story. This is an excerpt.

FALL COLORS PHOTOS

Where I live, the fall color spectacular is in full, gorgeous swing. My friend, Darlene Costner, sent a series of stunning fall foliage photos.

As with most forwarded photo exhibits, there are no credits. This is, of course, no fault of Darlene's. For those of you who do not live near desiduous trees or do live in places on the globe where it is spring, here is a sampling of them.

FallPhoto1

FallPhoto2

FallPhoto3

THE 1940'S/1950'S UK RADIO STATION

An email arrived this week from Jay Lawrence telling me about having found my story on the 1940's recording of Manhattan Tower which will be playing on his U.K. radio programme, The M&M Show soon. (Note my spelling of that word in deference to the origin of the show.)

It is actually two radio stations, referred to collectively as the UK 1940s and 1950s Radio Stations. I had not known of this website before and have been having a fine ol' time listening to songs of my childhood and teen years.

I'm telling you because I'm pretty sure a lot of the people who read this blog would like it too. You can listen live here.

Jay's THE M&M SHOW is broadcast at 6AM & 6PM GMT on the 1950s site. He also hosts a programme titled From Stateside that is heard daily on the UK 1940s Radio Station at 8AM AND 8PM GMT which is where the Manhattan Tower will be broadcast in rotation beginning today.

You can find out what time to listen where you live at this GMT time converter.

CHICKEN FARMER'S SIDE-SPLITTING LAUGH

Frederik van Wijk is a chicken farmer in the Netherlands. Both he and a reporter broke into uncontrollable laughter on camera when the reporter realized that Mr. van Wijk's laugh sounds a lot like a chicken. Take a look:

SAND CAT VIDEO PROBABLY THE FIRST EVER

Sand cats look a lot like your house cat but they are wild cats who live in the extreme weather of the African desert. They are also shy and are hardly ever photographed. This is believed to be the first-ever video of them.

So cute.

The footage was shot by the Sand Cat Sahara Team. There is more to read at the group's Facebook page.

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Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog IF you include the name of the blog and its URL.


Medicare Open Enrollment Begins Sunday

EDITORIAL NOTE: Everyone not living in the U.S. can take the day off from TGB – unless you in developed countries want to find out how lucky you are to have the healthcare systems you have.

The annual Medicare Open Enrollment period begins this Sunday 15 October and lasts through Thursday 7 December – 54 days to make Medicare choices for 2018.

For elders, the enrollment end date has become the equivalent of tax day in April – a dreaded deadline that involves complex decisions that you never feel you have done well or well enough.

Nevertheless, it is important and doing the homework can save you money, sometimes thousands of dollars. So this post is longer than usual, but the basic information is here. Depending on what you need, you can skip around, pick and choose the information you want.

If your needs are more complicated than what I've explained, you may already have an insurance agent who can help or I have included a section on free places to get reliable, informed, personal help.

UPDATE AT 8:50AM PACIFIC TIME: The 2018 Social Security cost-of-living adjustment (COLA) has just been announced. It is 2.0 percent. Over the past eight years, the annual COLA has averaged just above 1 percent. In the previous decade, it averaged 3 percent.

As Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare just emailed:

“The just-announced 2.0% cost-of-living increase (COLA) for Social Security beneficiaries is woefully inadequate. The 2018 COLA translates into a paltry $27 a month for the average recipient, barely enough for a prescription co-pay, a tank of gas, or a bag of groceries. Because COLAs are cumulative from year to year (2016’s was 0% and 2017’s 0.3%), beneficiaries will continue to fall further behind."

More about this in these pages next week.

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WHAT YOU CAN DO DURING OPEN ENROLLMENT
⚫ If you are covered by traditional Medicare, you can switch to a Medicare Advantage Plan.

⚫ If you have a Medicare Advantage Plan, you can switch to traditional Medicare.

⚫ If you have a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan.

⚫ If you have (or choose a new) Advantage Plan without drug coverage, you can choose a stand-alone Part D prescription drug plan.

⚫ If you have traditional Medicare, you can change to a different Part D prescription drug plan.

These are the main choices available during Open Enrollment to the majority of Medicare beneficiaries, and what is being covered in today's post.


WHERE TO GET HELP
MedicareAndYou2018_100 There is a lot of mostly clearly written information in the 2018 Medicare and You Handbook which you have already received in the mail or is available for free download in several formats here.

Medicare: 1.800.633.4227
Open 24/7 with recorded answers to almost any question. Say “agent” at any time for a live person. You can sign up and/or change plans via telephone, all for free.

State Health Insurance Assistance Program (SHIP)
Free one-on-one consultations for Medicare beneficiaries, their families and caregivers. (I've known two certified helpers in this program and they are amazingly knowledgeable.)

Medicare Rights Center
A national nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives. The toll-free helpline for Medicare assistance is 800-333-4114.

Local Organizations
Local organizations such as senior centers, clubs, social groups and even churches sometimes often hold free seminars on navigating Medicare during this open enrollment period. Contact them for information or ask what Medicare help services in your area they know of.


MEDICARE PART A AND PART B
It all starts with this traditional Medicare coverage. Part A is generally free, no premium payment, and covers hospital stays. It's got its own complexities but they don't much apply to what we're discussing today.

Part B covers most medically necessary doctors' services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. We all pay a premium for this coverage which is why I bring it up today.

Medicare has not yet announced the new Part B standard premium for 2018 but expect to pay more than the $109 per month that 70 percent of beneficiaries are paying in 2017, which is usually deducted from Social Security payments. People who fall under other regulations have been paying $134 per month.

How much more Part B will cost in 2018, for most people, depends on the increase in the cost-of-living adjustment (COLA) for Social Security which also has not yet been announced although it is widely believed it will be about just over 2 percent.

There is a “hold harmless” provision which requires that the net Social Security check cannot decrease year-to-year so if the Part B premium increase were to be larger than the COLA, the premium increase - or part of it - would not apply to those 70 percent who are hold-harmless beneficiaries.


MEDICARE ADVANTAGE PLANS
Sometimes called Part C, these are a kind of Medicare version of an HMO that are required to include all that traditional Medicare Parts A and B cover. Many offer such extras as dental, vision and hearing coverage, free gym membership and such.

There are many plans, each with different coverage options and premiums which vary widely in general and in different regions of the country.

And, the options change frequently, so it is important to closely check your coverage for 2018. There are probably other Advantage plans available to you if you see the need.


PART D PRESCRIPTION DRUG PLANS
Traditional Medicare does not provide drug coverage and neither do some Advantage plans so if you do not have Part D prescription drug coverage, it behooves you to think seriously about buying a plan.

Because I took no prescription drugs, until now, for all the 12 years I have been a Medicare beneficiary, I always chose the plan with the cheapest premium and hoped for the best if I needed it. (Yes, this is how it works in the United States: just hope.)

Now, one of the drugs I will need to take for the rest of my life costs about $750 per month retail. That is out of the question for me if I had to pay that full price. I'm lucky now that the cheap plan I chose last year covers all but about $250 after the deductible is satisfied.

But that doesn't mean I'm not going to check all the Part D plans that are available to me and you should do so too. Obviously, I know that my current plan covers my drugs but they have advised me that the premium, the deductible and the percentage co-pays for my drugs will increase in 2018.

Some insurance companies decide not to offer the plan you have now and in that case you will be forced to select a new one. But everyone should investigate whether they can save money with a different plan.

Daniel McFadden and Joachim Winter explain in U.S. News that only 10 percent of Part D enrollees switch plans each year resulting in an average overspending of $373 per person per year and $1.2 billion in excess subsidies by the government. Further, they write,

”In 2015, the average savings for an individual who switched plans was $1,104. Last year the savings was $1,006. One retiree who had a key medication dropped by insurer in 2016 saved $45,768 by switching plans.

“Another retiree, Jerome Walker, 74, and his wife Lora take 14 prescription medicines combined. One year, they saved over $4,000 by switching plans. 'We find that we need to change plans virtually every year,' said Jerome. 'Those who don't choose, lose,'”

The infamous doughnut hole has been closing but it won't be gone until 2020.

For the first time in five years, the average monthly premium for Part D coverage will decrease for 2018, from $34.70 to $33.50. That is a $1.20 reduction. Don't spend it all in one place.


HOW TO CHOOSE A PART D PRESCRIPTION DRUG PLAN
In this section, we are discussing PDPs – stand-alone prescription drug plans for traditional Medicare or Advantage plans that do not provide drug coverage. Follow these steps to select a drug plan:

⚫ Make a list of your prescription drugs including name, dosage, dosage frequency and the current costs to you.

⚫ If you already have Part D coverage, consult the Annual Notice of Change which you have received already from your insurer. Make note of any premium increase, increases in co-pays for any of the “tiers” of drugs you take, and check the formulary (drug list) to see if any of your drugs have been dropped.

⚫ Go to medicare.gov and click on “Find Health & Drug Plans” near the top of the page, white text on green background.

⚫ Enter your Zip Code and other requested information. I suggest that you use the second entry box rather than the “general search” above it so you will get a more personalized list. Click “Find Plans.”

⚫ On this page, you can enter the drugs you use. If you have done this in the past and have saved the list, you can retrieve it here and make any necessary changes. If you do not enter your drugs, you will see a drug plans list but it will not have the correct estimates matching your drugs.

⚫ On the next page, there will be three lists: for people with Original (Traditional) Medicare; for Medicare Health Plans (Advantage plans) with drug coverage; for Medicare Health Plans (Advantage plans) without drug plans. Choose one and click “Plan Results.”

The results shown are ordered by the estimated annual cost including monthly premium, deductibles, co-pays and coinsurance - and star rating. You can sort the results by any of these choices.

When you click the name of a plan, you will get to a page with links to the company's drug formulary and how to enroll, along with other information to help you decide.

One important thing: too many people use only the monthly premium to choose a plan but the other criteria such as deductibles, co-pays, coinsurance and other costs make a difference too and insurers often increase these year to year. So it's important to compare the premium with the overall estimated annual cost.

CHOOSING A PHARMACY
Sometimes it can make a different which pharmacy you use. If you already have Part D coverage, check your new Annual Notice of Change for the list of the insurance company approved pharmacies which are usually a bit less expensive. Some of them may have additional cost-saving plans, and there is usually at least one mail-order pharmacy that can save money too.

The pharmacy list is also included on the individual web pages of each plan that is available to you.

This is a tedious, boring process fraught with stumbling blocks along the way. If we had real single-payer coverage, it wouldn't be necessary, but we don't so we're stuck with this annual ritual. My only suggestions are to start early, move through the process slowly and carefully, and take advantage of the free help listed above if you need it.


Ursula K. Le Guin on Growing Old

TGB reader John Starbuck recently forwarded to me an old issue of Brain Pickings, Maria Popova's weekly blog post of her thoughtful writing on books, art, philosophy, the internet and, over the years, just about anything that captures her interest and attention.

The operative word in that paragraph is “thoughtful.”

TheWaveoftheMindBI recalled that article immediately because it had given me a perspective on a certain essay from a book that sits on my favorites shelf, The Wave in the Mind: Talks and Essays on the Writer, the Reader and the Imagination, by Ursula K. Le Guin.

The book gained favorite status as soon as I read it the first time, when it was published in 2004. The essays go back in Le Guin's life even farther, the oldest having been published in 1988.

On re-reading it this week, what surprised me is that in all the years I've been writing Time Goes By, since 2004, I've have never mentioned the book or – most particularly - the essay that Popova featured in 2014.

To rectify that oversight, I'm going to give you a taste of it today. It is titled, “Dogs, Cats, and Dancers: Thoughts About Beauty” and it is about all those things. All those things and another omitted from the title, growing old.

For some perspective, you should know that Ms. Le Guin is speaking from life, from experience. She was born in 1929; this essay was written in 1992, when she was 63.

Selections from Dogs, Cats, and Dancers: Thoughts About Beauty by Ursula K. Le Guin.

“One rule of the game, in most times and places, is that it's the young who are beautiful. The beauty ideal is always a youthful one. This is partly simple realism. The young are beautiful. The whole lot of 'em. The older I get, the more clearly I see that and enjoy it.”

Le Guin tells us it's hard to look in the mirror, wondering who that old lady is and what happened to her waist. “How large can a knuckle get,” she wonders before it becomes a kneejoint?”

”And yet I look at men and women my age and older, and their scalps and knuckles and spots and bulges, though various and interesting, don't affect what I think of them. Some of these people I consider to be very beautiful, and others I don't.

“For old people, beauty doesn't come free with the hormones, the way it does for the young. It has to do with bones. It has to do with who the person is. More and more clearly it has to do with what shines through those gnarly faces and bodies.”

Further on, Le Guin discusses how, even though children supposedly look forward to becoming adults, puberty isn't always welcome to them. "When I was thirteen and fourteen," she writes, "I felt like a whippet suddenly trapped inside a great lumpy St. Bernard. I wonder if boys don't often feel something like that as they get their growth."

"The change is hard," she writes. "And then it happens again, when you're sixty or seventy."

"But all the same, there's something about me that doesn't change, hasn't changed, through all the remarkable, exciting, alarming, and disappointing transformations my body has gone through. There is a person there who isn't only what she looks like, and to find her and know her I have to look through, look in, look deep. Not only in space, but in time."

Speaking of her mother, who died at age 83, Le Guin wonders how we remember, how we see a beloved person who has died - particularly, as in the case of her mother, one who was, at the end, in pain from cancer, her body misshapen from disease.

”It is a true image, yet it blurs, it clouds, a truer image. It is one memory among fifty years of memories of my mother. It is the last in time. Beneath it, behind it is a deeper, complex, every-changing image, made from imagination, hearsay, photographs, memories.

“I see a little red-haired child in the mountains of Colorado, a sad-faced, delicate college girl, a kind, smiling young mother, a brilliantly intellectual woman, a peerless flirt, a serious artist, a splendid cook – I see her rocking, weeding, writing, laughing – I see the turquoise bracelets on her delicate, freckled arm – I see, for a moment, all that at once, I glimpse what no mirror can reflect, the spirit flashing out across the years, beautiful.

“That must be what the great artists see and paint. That must be why the tired, aged faces in Rembrandt's portraits give us such delight: they show us beauty not skin-deep but life-deep.

“In Brian Lanker's album of photographs I Dream a World, face after wrinkled face tells us that getting old can be worth the trouble if it gives you time to do some soul making.”

You've noticed, I'm sure, that I've left out the dogs and cats and dancers of the essay's title. They are absolutely germane, they enrich the subject further and so these excerpts are not entirely fair.

If you want to read the rest of Ms. Le Guin's essay, not to mention others in the book, it is available at all the usual online sources.


The 21st Meal Weight Loss Plan

On Friday, in a couple of comments and even more emails, readers asked how I lost 40-odd pounds, what my weight loss plan was.

It's been more than five years since I wrote about that so maybe it's time for an update and/or additional information.

* * *

EDITORIAL NOTE: But before I go one word farther, this must be said: what I will tell you today is one woman's successful effort to lose 25 percent of her body weight. Although it is based on well-known, widely-accepted fact within the nutrition, diet and medical professions, it is not a prescription for everyone.

How our individual bodies function differs. In addition, at our ages in particular, conditions, diseases and medications can have an effect along with food allergies and other considerations. So read this only as something that worked for one person; maybe there is a tip or two that might help you and always consult your physician before embarking on a major change in diet.

* * *

A COUPLE OF IRREFUTABLE FACTS
The only way to lose weight is to eat fewer calories than your body uses. Period.

The best short(-ish) overview I've ever read about research into calorie restriction versus exercise for weight loss was published last June at Vox. The conclusion:

”...people who have had success losing weight share a few things in common: They weigh themselves at least once a week. They restrict their calorie intake, stay away from high-fat foods, and watch their portion sizes. They also exercise regularly.

“But note: These folks use physical activity in addition to calorie counting and other behavioral changes. Every reliable expert I've ever spoken to on weight loss says the most important thing a person can do is to limit calories in a way they like and can sustain, and focus on eating healthfully.”

I developed a 45-minute home exercise routine that I followed during the year of weight loss and have continued since then. I don't think it helped in taking off the pounds but it did, and does, help my overall health and strength.

FYI: There are about 3500 calories in a pound of fat so you need to burn 3500 calories to lose one pound.

An average woman needs to eat about 2000 calories per day to maintain, and 1500 calories to lose one pound of weight per week. An average man needs 2500 calories to maintain, and 2000 to lose one pound of weight per week.

Obviously this formula varies from person to person but it is equally obvious that you cannot, as some TV commercials promise, lose 10 or more pounds a week. Well, not without starving yourself.

MY RULES
There is no way to know how many times I lost the same, recurring 10 pounds over my adult life. This time I wanted to end that cycle so I spent a great deal of time planning a weight loss campaign that I could easily continue as a maintenance program. I came up with these four simple rules for myself:

⚫ It doesn't matter how long it takes to lose the 40-odd pounds just so long as the weight is declining week to week.

⚫ Weigh yourself every morning at the same time and keep a chart. Inevitably, weight will fluctuate up and down. That's normal as long as the overall trend is downward.

⚫ Keep a close watch on portion control; don't let it creep up.

⚫ Make sure every meal is wholesome, healthy, and never snack. (I found that if I was feeling hungry between meals, a short walk – as little as 15 minutes – could take care of that.)

At first I used the Harvard Healthy Eating Pyramid to balance the foods I ate:

HarvardHealthyEatingPyramid1024x950

But that graphic is way too complicated and apparently Harvard thought so too because they soon issued their Healthy Eating Plate. This is simple and easy to use:

HarvardHealthyEatingPlate

MY MEALS
BREAKFAST: I tried smoothies for awhile but I don't really like them. I do like oatmeal and that became my go-to morning meal: Stone-ground oatmeal with several fruits (bananas, peaches, berries, etc.) and home-made apple sauce (apples, water, lemon rind – nothing else) stirred into the oatmeal.

LUNCH AND DINNER: Three or four times a week, one of these meals was steamed or broiled fish with a pile of veggies over brown rice or whole wheat noodles, for example. Other times I substituted part of a chicken breast for the fish which I had poached in broth, garlic, white wine and honey.

Because a serving of commercial soups contains almost a day's supply of sodium, I kept a freezer full of home made pea soup, vegetable soup, chowder, etc. for filling meals especially on chilly days.

And then there is Gorilla Salad, named (and as far as I know invented) by my friend Joyce Wadler (who writes a terrific humor column at The New York Times).

It is huge - 10 or 15 different cut-up veggies, pre-cooked - usually roasted - when necessary, maybe some fruit like grapes or melon or some left over chicken breast all held together with homemade dressing.

Always homemade dressing. Commercial salad dressings can be gigantic calorie hogs and the low- and no-fat varieties have an awful, chemical taste. But if you make your own, you can control that. Use good oil, olive or canola, and you can vary the acid – balsamic vinegar, lemon juice, even Japanese mirin work plus any flavorings you prefer.

Keep the dressing portion small. A tablespoon of dressing is about 100 calories. You can use small amounts of dressing if you toss a salad for a long time.

THE 21ST MEAL
I came up with only one trick that was useful to keep me on target. I happen to like vegetables as lot, and fruit and fish so this was a reasonable diet for me but I still wanted to stave off cravings that could derail my weight loss.

So I invented The 21st Meal Diet.

It goes like this: there are 21 meals in a week. It cannot possibly hurt the weight loss program if one meal is devoted to something you like but isn't on the agenda – in my case, usually ice cream or cheeses. So for one meal a week, I gave myself a favorite but disallowed food.

Sometimes it was two or three or even four reasonably-sized wedges of excellent cheeses I had bought especially for the meal. Other times it was ice cream. You do know, I assume, that whatever anyone tells you otherwise, a serving of ice cream is a pint. Right?

Even so, for the 20 other meals, portion size is an important issue. The experts tend to describe one portion as the size of a tennis ball, a small fist, a deck of cards, a bar of soap. All those are about right for one serving. Here's a page that might help further.

Weight loss is a giant topic online; type that phrase into Google and you'll get a quarter of a billion (with a B) returns. A lot of it is junk. Some of it is not.

Here are two website I think are useful: The USDA Food Tracker and the Harvard Healthy Eating Plate. Both are packed with honest, straightforward, proven eating and weight loss information.

Looking back now after keeping off the weight I lost for five years, I think the two most useful pieces of advice to myself were these:

Don't rush it. It doesn't matter how long it takes to lose the weight as long as it is regular and steady.

The 21st meal. That became the big treat I looked forward to each week and helped keep me going.

(NOTE: We're all eager to hear your experience along with any tips that have kept you on pace to reach your weight loss goals in a healthy manner. Just remember, no medical advice and no recommendations of herbs, oils and magic potions "guaranteed" to take off excess weight.)


ELDER MUSIC: Gordie Revisited

Tibbles1SM100x130This Sunday Elder Music column was launched in December of 2008. By May of the following year, one commenter, Peter Tibbles, had added so much knowledge and value to my poor attempts at musical presentations that I asked him to take over the column. He's been here each week ever since delighting us with his astonishing grasp of just about everything musical, his humor and sense of fun. You can read Peter's bio here and find links to all his columns here.

* * *

Sorry, I'm indulging myself this week (yet again) because I've already done a column on GORDON LIGHTFOOT, but he's such a favorite of mine that I think he deserves another.

You could say that I used up all his best songs on the first column but I would disagree - he's written so many terrific ones there's more than enough for another (and probably more).

Gordon Lightfood

In the first column it was a toss-up which of his first two big hits I would include. The one that missed out is For Lovin' Me, so that's the one we'll kick off with today.

This came to my notice because of cover versions by Peter, Paul and Mary and Ian and Sylvia (and many others later). Naturally, I think Gordie does it best. He recorded it a few times over the years but this version is the first time he put it on record.

♫ Gordon Lightfoot - For Lovin' Me


Gordon Lighfoot

Gordie wrote a number of songs about life on the road. He wasn't alone in that regard. Probably the best of them was 10 Degrees and Getting Colder that I featured in the first column. Not far behind that one is Somewhere USA.

♫ Gordon Lightfoot - Somewhere USA


Gordon Lightfoot

From early in his career is a song about lost love; he was a master of that sort of song. This one really nails as far as I'm concerned but you know he doesn't really mean it (I think). I'll Be Alright.

♫ Gordon Lightfoot - I'll Be Alright


Gordon Lightfoot

I managed to get a seat in the front row of a couple of his concerts. Naturally, along with others, I asked for a song. I was the only one to whom he replied. He said he wouldn't play it (in rather emphatic terms). That song is Mountains and Marian.

♫ Gordon Lightfoot - Mountains and Marian


Gordon Lightfoot

A song that just missed the cut in the first column pretty much by the toss of a coin is the next one. Naturally it had to be included this time, and here it is: Never Too Close. It is about friends and lovers who are sometimes the same person. A beautiful song.

♫ Gordon Lightfoot - Never Too Close


Gordon Lightfoot

The album “Don Quixote” is one of the two or three finest albums that Gordie recorded - there's not a dud song on it. Of course, there's seldom a dud song anywhere, but these are a cut above most of the others.

The songs range far and wide: love, lost love (of course), the environment (ahead of its time), ships and the sea, Canada and even a rare protest song. From that album, here is the title track, which really fits none of the genres I mentioned.

♫ Gordon Lightfoot - Don Quixote


Gordon Lightfoot

I've always thought that Rainy Day People is a companion song to Never Too Close. I don't know if Gordie meant it that way, but it seems to me that he's singing about the same people.

♫ Gordon Lightfoot - Rainy Day People


Gordon Lightfoot

Of his first dozen or so albums, "Back Here on Earth" is probably the least regarded. Of course, even an ordinary Gordie album is worth a listen now and then. I have to admit though that the song Bitter Green is the only song from that I listen to with any regularity.

♫ Gordon Lightfoot - Bitter Green


Gordon Lightfoot

One of the best break-up songs, maybe the best (although there's a lot of competition), is Second Cup of Coffee. It's also a really good song about life on the road and the distractions that that life holds.

♫ Gordon Lightfoot - Second Cup of Coffee


Gordon Lightfoot

Miguel is a rather enigmatic song. Different people have quite varied ideas about it. Is Miguel a revolutionary, or just a bandit? Perhaps an illegal immigrant, although crossing the border a hundred times or more may put paid that to that idea. Maybe he just likes swimming. Make up your own mind.

♫ Gordon Lightfoot - Miguel


Gordon Lightfoot

I was going to stop there, but I can't help myself. I'm including a song I used in the first column because it's so beautiful, and check out that wonderful walking bass line.

It continues the theme of Never Too Close to my mind. The song is I'm Not Supposed to Care.

Gordon Lightfoot - I'm Not Supposed to Care



INTERESTING STUFF – 7 October 2017

CHART OF MASS KILLINGS 2013-2017

It's been a terrible week for several reasons, the saddest of which is the shooting in Las Vegas. It may seem like it's a unique event but that is so only in the number dead.

There is a mass shooting in the United States almost every day.

Here is a graphic showing the horrific number of mass killings in the past five years. The gray are people injured in each incidence. The red are the number who died.

MassKillings

SHAG TEAM FROM CAMP HOLLYWOOD

They call it a shag team – that just means swing dancing and it's so much fun. Thank Darlene Costner for this.

CAT LEGENDS THROUGHOUT HISTORY

Pretty much during all the ages of humankind, cats have been mysterious beings, loved or reviled – depending.

Mental Floss gives us 14 ancient legends about cats. Here are some examples:

”A certain sect of Buddhism once practiced in the former kingdoms of Siam and Burma believed that when you die, if you’re holy enough, your soul is transferred to a cat for safekeeping. In this way, special souls lived in a sort of feline purgatory, and when the kitty died, the chaste soul would ascend to paradise.
”In a few different areas of Europe, it was thought to be ill-advised for a pregnant woman to pick up a cat or let it sleep in her lap. In Portugal, it was once said the cat will afflict the baby with a wart or mole, usually a hairy one, and in England, it was thought the baby will either be born with a cat-shaped birthmark or with the face of a cat.”

Kingcat

”Medieval people thought that cats were the Devil’s personal soul courier, ferrying spirits to Hell. The three hairs on the tip of a cat’s tail were said to be 'the devil’s hairs,' which compelled the cat to stay up all night, prowling, when all Christian creatures should be asleep.

“In the American South, it was thought that anyone who drowned a cat would be punished by the Devil himself (for the lesser crime of kicking a cat, he’d just give you rheumatism).”
Many more cat legends at Mental Floss.

HOW SONGS BECOME EARWORMS

A Harvard Medical School psychiatry professor explains a bit about earworms. A couple of excerpts:

"Certain songs are catchier than others, and so more likely to “auto repeat” in your head. When music psychologist Kelly Jakubowski and her colleagues studied why, they found these songs were faster and simpler in melodic contour (the pitch rose and fell in ways that made them easier to sing)."
"In order to get stuck in your head, earworms rely on brain networks that are involved in perception, emotion, memory, and spontaneous thought. They are typically triggered by actually hearing a song, though they may also creep up on you when you are feeling good, or when you are in a dreamy (inattentive) or nostalgic state."
"Some people try to distract themselves from the song, and it works. In one study, the most helpful “cure” tunes were “God Save The Queen” by Thomas Arne and “Karma Chameleon” by Culture Club. Others seek out the tune in question, because it is commonly believed that earworms occur when you remember only part of a song; hearing the entire song may extinguish it."

You can read more about earworms here.

RIGHTS V. PRIVILEGES – ONE REPUBLICAN SENATOR

Watch one U.S. Senator, Ron Johnson of Wisconsin, explain that Americans have no rights except to life, liberty and the pursuit of happiness. Everything else - food, shelter and certainly health care, he says - are privileges reserved for those who can afford them. Take a listen as a high school student asks him this question:

Of the 25 wealthiest nations, only the United States does not recognize health care as a right. Read more at Think Progress.

TREES EATING ARLINGTON CEMETERY HEADSTONES

Arlington Cemetery is hallowed ground, the burial place of more than 400,000 military service people. Recently some of the magnificent trees at the cemetery have been absorbing some headstones:

ArlingtonCemeteryTreeheadstone

Find A Grave puts the count at 11 afflicted markers,” explains Atlas Obscura, “with most of the entombed having served in the Civil War, World War I, or World War II.”

Read more at Atlas Obscura.

ARE WE, HUMANS, A MIND WITH A BODY OR VICE VERSA?

Here is a fascinating TedEd talk about what philosophers have had to say about this mind/body problem.

HOW FLYING MESSES WITH OUR MINDS

Airline flight takes a toll on our minds and bodies in more ways than I would have thought. According to a story at BBC.com:

”The reduced air pressure on airline flights can reduce the amount of oxygen in passengers’ blood between 6 and 25% (hypoxia), a drop that in hospital would lead many doctors to administer supplementary oxygen. For healthy passengers, this shouldn’t pose many issues, although in the elderly and people with breathing difficulties, the impact can be higher.”
”The combination of low air pressure and humidity can reduce the sensitivity of our taste buds to salt and sweet by up to 30%. A study commissioned by airline Lufthansa also showed that the savoury flavours in tomato juice taste better during a flight.”
“'Anxiety levels can increase with hypoxia,' explains Valerie Martindale, president of the Aerospace Medical Association at King’s College London. Anxiety is not the only aspect of mood that can be affected by flying. A number of studies has shown spending time at altitude can increase negative emotions like tension, make people less friendly, decrease their energy levels and affect their ability to deal with stress."

And that's just part of the bad news about flying, especially long distances. Read more here.

DOG AND JAGUAR BEST FRIENDS

This Jack Russell terrier and jaguar are best friends, together 24 hours a day at the Akwaaba Lodge in South Africa. Take a look:

* * *

Interesting Stuff is a weekly listing of short takes and links to web items that have caught my attention; some related to aging and some not, some useful and others just for fun.

You are all encouraged to submit items for inclusion. Just click “Contact” at the top of any Time Goes By page to send them. I'm sorry that I won't have time to acknowledge receipt and there is no guarantee of publication. But when I do include them, you will be credited and I will link to your blog IF you include the name of the blog and its URL.


Cancer Linked to Obesity

During a medical checkup while I was recovering from the Whipple surgery for pancreatic cancer, one of the physicians told me that even though I was among the 10 percent who are eligible for that procedure, they probably would not have done it due to my age, 76, if I had not been as healthy and in as good physical condition as I was.

Based on that information, four years earlier – when I was 72 - they would have rejected me.

Back then I weighed more than 160 pounds (I am 5' 2” tall), couldn't walk up one flight of stairs carrying the groceries without stopping halfway to rest and got no more exercise than trying to climb those stairs or running the vacuum cleaner once a week.

When I realized, after being laid off from work in 2004 that it was unlikely I would be hired again, I sold my home in New York City and moved to Maine. What I also did was allow myself to eat all the things I'd kept to a minimum all my life to help maintain a reasonable weight – wonderful things like ice cream and cheese.

My weight crept up and up and up.

By late 2012, it was sometimes difficult to breathe even when walking on flat ground and I always avoided hills, even small ones. That's when I realized I had to get healthy or become incapacitated in some manner.

I devised an eating regimen that would keep me healthy while losing weight at a reasonable rate – about four to five pounds a month - and a daily exercise routine that combined old-fashioned calisthenics, some ballet exercises, resistance and weight training, flexibility work and tai chi.

A year later I was down to a consistent 120-125 pounds. I could walk for miles, up hill and dale and stairs and my exercise routine kept me strong.

A NEW STUDY RELATING CANCER AND OBESITY
There is a just-released study titled “Vital Signs” from the Centers for Disease Control (CDC) in collaboration with the National Cancer Institute showing an association between obesity and 13 kinds of cancer:

”As many as 40 percent of all cancers are related to obesity, according to the new research, which suggests that these cancers would be preventable if weight was kept under control...” reports Medical News Today.

“The findings are particularly important given the alarming statistics on obesity in the United States. Between 2013 and 2014, the CDC note, as many as 2 in 3 adults were deemed overweight or obese.”

Here are the 13 cancers:

13Cancers

According to The Guardian, deputy director of the CDC, Anne Schuchat, said their research

“'...found an increase in a number of types of cancers associated with obesity and overweight, at a period when the prevalence of obesity and overweight has increased substantially in the middle ages...The prevalence of obesity and overweight is starting to show up in our cancer statistics.'

“...In 2014,” continues The Guardian, “roughly 630,000 people in the US were diagnosed with overweight- or obesity-linked cancer. Two-thirds of those cases were in Boomer-generation adults, between 50 and 74.”

Having lost weight four years earlier didn't seem to affect my getting pancreatic cancer but all cancers are mysterious things. Some researchers I've read have talked about cancer cells living benignly in our bodies for many years, if not all our lives, and then something triggers them to go wild. Maybe, sometimes, obesity? No one knows. Yet.

This seems to be a particularly timely study for old people because so many of us put on excess weight as we grow older.

There are many more details of the study at those two links above, at the Centers of Disease Control and elsewhere around the web.


Blogging and Privacy

We live in an age of oversharing, of what many consider TMI (Too Much Information), of social media websites that make it easy for millions to bestow upon the world the most mundane aspects of their lives as though the rest of us care what they had for dinner last night.

So widespread is the belief that the world is waiting with bated breath for any given person's (usually misspelled) thoughts on watching paint dry that the president is hardly the only one who can be labeled narcissist.

(You can be forgiven at this point if you're thinking now that I fall into the same category, and move on to some other webpage.)

Today's post was prompted a few days ago when a TGB reader and friend named Ann emailed to ask about how my chemotherapy is going, that I hadn't written lately about any cancer developments. She was quick to note too, however, that she believes

“...I speak for many who understand and respect your need to keep the private, private.”

As chance would have it, I had just finished writing Monday's post with an update on the chemo treatments that had taken me awhile to get around to because there was nothing useful to say: it's going well. Next?

But it did get me thinking about privacy and the choices I make about what and how much personal information to reveal on this blog.

It was easy to decide to write about my diagnosis of pancreatic cancer. Such a thing is so shocking to hear, so hard to believe at first, accompanied for awhile by a near certainty someone has made a mistake that there was no room in my brain for anything else.

In that regard. I hardly had a choice. If I hadn't made it public, Time Goes By would have disappeared because I could think of nothing except cancer.

On the other hand, writing about growing old is what I do, it orders my days, and when the initial impact wore off I remembered that cancer is more common in old age than any other time of life. It is one of the "diseases of age", as they say, one of the topics of this blog – or should be - so perhaps my diagnosis and I get to be the guinea pig.

There was more. As I explained to Ann, my silence about the cancer was

”...not about privacy. I don't believe in it. Privacy, that is, although I do believe it is up to each individual to choose how much to say. I long ago learned that if it has happened to me, if I have done it or it has been done to me - so it has been with millions of others.

“And that, for me, pretty well removes any sense of privacy and more, perhaps requires that we DO talk about things many people don't want to mention.

“That thought came to me eight or ten years ago when I wrote about urinary incontinence for the first time. I wrote the blog post and let it sit in the computer for several days because it seemed there was some propriety involved. We just don't discuss such things.

“But it's a common affliction of old age so finally one day, I took a deep breath and hit the publish button. It was hours before I had the nerve to check comments and nearly fell off my chair when I did - dozens and dozens of people talking about their difficulties and/or solutions, pleased that someone had given them permission to talk about it openly.

"So nowadays, I consider privacy only if the subject involves another person whose story or information I have no right to share without permission.”

That doesn't mean my life is an open book. In general, whatever personal information I reveal relates to some aspect of ageing although I've allowed myself to stretch that definition here and there.

The thing about blogs, at least for a former journalist like me, is that they are a hybrid. It is important when I report on Medicare, Social Security, health issues, age-related politics and so on, that it be straightforward, factual and trustworthy.

But TGB is also a personal blog that hardly has a raison d'etre without my opinion of whatever is being discussed which often requires some degree of personal disclosure.

Over the years, finding the balance has been a challenge. In the earliest years, there was hardly anything about me. Nowadays, as in regard to the cancer, my personal experience is sometimes the example from which to expand and explore.

It's not always easy to decide what is or is not going too far with that – I definitely am not writing an autobiography or memoir. The goal here, while still coloring mostly within the lines, is to try to figure out what it's really like to get old.