None of us get out of this alive…

“America is the only country in the world that looks upon death as some kind of personal failure.”

As we age, it is natural to contemplate more often the inevitable consequence of life, our own death. I know that since I experienced a serious brain injury at age 53, with hours of spontaneously moving in and out of consciousness, death has become a fascinating topic for me. I often wonder if unconsciousness is what death feels like. If so, it may not be so bad.

Then as I entered my 60s and personally experienced too many new ailments and disabilities, I wondered again when and of what I would die. I also learned something important about our culture: Even if we Americans don’t see death as a personal failure, we most certainly see illness as one. Ever since I moved from the healthy column to the older, not so healthy column, I have noticed many treat me quite differently. But aren’t I the same person with equal potential?

This all reminds me of a patient I treated in my counseling internship in a rehab hospital. When this elderly woman became ill and ended up in the hospital, the only question on her lips was,

“What did I do to deserve this?”

Do we all “deserve” illness and death? Of course not. We are no better or worse than all the others organisms in our world. We are born by no choice of our own. We live the best we can, and then we die. Then, regardless of the “death industry’s” best efforts, we all become dust in the wind eventually. Big surprise. No secrets here, and yet most of us walk around thinking this simply CANNOT be true!

How can this all mean nothing in the long run?

That has been the realm of religious leaders and philosophers forever. How do we make sense of this thing called life and death? That must be where our judgment of those “failures” who have the indecency to die comes from. When we are still among the living and healthy, it rarely seems likely that we will die someday.

I am reminded of a very cynical MD I met once in Boulder decades ago. I remember him telling a story about one of his healthy patients. The doc was given the unenviable task of telling this person that they had cancer. The patient’s response?

“I can’t have cancer! I run ten miles a day!”

If you like to play the odds game, here are our nation’s death stats:

Top 10 causes of death in the US.: https://www.mdlinx.com/internal-medicine/article/3848

Please note number ten on this list, the rate of suicides among Americans. This rate has risen since these statistics came out in 2017. And speaking of suicide, let’s give Camus the final word on this topic:

“There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy…These are facts the heart can feel; yet they call for careful study before they become clear to the intellect.” -Albert Camus

Learn more about nodules & lung cancer in women!

First the GOOD NEWS: The cancer death rate in the U.S. dropped 2.2% from 2016 to 2017, the largest single-year drop ever recorded, according to the latest report from the American Cancer Society, continuing a longstanding decline that began a quarter-century ago. This decline was fueled in no small part by recent advances which have lowered death rates in lung and skin cancer patients.

This 26-year decline in our overall cancer mortality rate, a 29 percent drop, translates to roughly 2.9 million fewer deaths than there would have been had the rates remained the same. In contrast, less impressive results remain for other major causes of death, such as heart disease, whose mortality rate has slowed; stroke and other cerebrovascular disease, whose rate has stabilized; and accidents, Alzheimer’s disease and suicides, rates which continue to increase.

Unfortunately lung cancer statistics don’t hold up as well among American women. Internationally, screening programs and more effective treatments have helped lower breast cancer death rates. Meanwhile, the number of deaths from lung cancer has already sped past those from breast cancer in the U.S., Canada, New Zealand and other higher-income countries. In the U.S. in 2015, more than 70,000 women died from lung cancer and about 41,000 women died from breast cancer.

In the U.S., smoking rates peaked in women after they did in men. That is why the U.S. is one of the countries where lung cancer rates have stabilized or decreased in men but they continue to rise in women. Men are still far more likely to smoke than women, and this will likely hold true in the future. Research is now underway to investigate whether smoking cessation programs are more effective than lung cancer screening in reducing lung cancer deaths in women.

An X-ray showing COPD

Please let me share a few interesting facts I have learned about lung cancer since discovering I have nodules in my own lungs. Nodules can be seen as a precursor to cancer. In my case they were found by getting a simple chest X-ray. Please get your lungs checked today! But when I recently asked my pulmonologist how common nodules are, she informed me that they are far more common than previously expected. How do we know this? So many more people have received X-rays and cat scans of their lungs in the past decade or so.

I also learned that, like me, as many as 20% of people who die from lung cancer in the United States every year have never smoked or used any other form of tobacco. In fact, if lung cancer in non-smokers had its own separate category, it would rank among the top 10 fatal cancers in the United States. Non-small cell lung cancer (NSCL) is the most common type of lung cancer, yet it’s difficult to detect early on because early-stage lung cancer often has no symptoms and is not detected with a chest X-ray. Positron emission tomography (PET) and CT scans can be more helpful in diagnosing lung cancer.

Researchers continue to make progress in understanding what can cause lung cancer in people who have never used tobacco. A few other causes of lung cancer include:

  • Radon gas. The leading cause of lung cancer in non-smokers is exposure to radon gas, according to the US Environmental Protection Agency (EPA). It accounts for about 21,000 deaths from lung cancer each year.  About 2,900 of these deaths happen among people who never smoked. Radon occurs naturally outdoors in harmless amounts, but sometimes becomes concentrated in homes built on soil with natural uranium deposits. Studies have found that the risk of lung cancer is higher in people who have lived for many years in a radon-contaminated house. Because radon gas can’t be seen or smelled, the only way to know whether it’s a problem in your home is to test for it. A Citizen’s Guide to Radon explains how to test your home for radon easily and inexpensively, as well as what to do if your levels are too high.
  • Secondhand smoke. Each year, about 7,000 adults die of lung cancer as a result of breathing secondhand smoke. Laws that ban smoking in public places have helped to reduce this danger. The American Cancer Society Cancer Action NetworkSM (ACS CAN) – the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society – is working to expand and strengthen these laws to further protect both people who smoke and those who don’t from the dangers of secondhand smoke.
  • Cancer-causing agents at work. Some people are exposed to carcinogens (cancer-causing agents) like arsenic, asbestos and diesel exhaust at their workplace. Work-related exposure to such cancer-causing materials has decreased as the government and industry have taken steps to help protect workers. Still, if you work around these agents, be careful to limit your exposure whenever possible.
  • Air pollution. Researchers have known for a long time that both indoor and outdoor air pollution can contribute to lung cancer. The World Health Organization (WHO) classifies outdoor air pollution as a carcinogen. However, it’s believed the risk of lung cancer associated with air pollution is lower in the US than in many other countries because of policies that have helped to lower the levels of exposure.
  • Gene mutations. Researchers are learning more about what causes cells to become cancerous, and how lung cancer cells differ between people who have never smoked and those who smoke. Understanding how gene changes cause lung cancer cells to grow has helped researchers develop targeted therapies, drugs that specifically attack cells with these mutations.

Do not assume that because you never smoked, you cannot have nodules or lung cancer. Get your lungs checked regularly as you age.

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Restoring our lost intimacy with nature

As many of you know, I have been struggling to understand and express here how living close to nature changes you. Since moving into big sky country over four years ago, I have changed tremendously, to the point where living with a brain injury does not effect me half as much. Why is this? Because nature is slow and deliberate. Nature is in no hurry to explain or understand itself. Nature is so not like the predominantly human world.

This week I read an amazing interview with writer Barry Lopez in the December issue of “The Sun.” Here he explains myself to me well. As someone who grew up in small to medium-sized cities, I rarely experienced the wonder or intimacy of living close to nature. I experienced instead the loneliness and lack of opportunities for true intimacy in the human-made world. I did not even appreciate my own need to reconnect with the natural world completely until my husband Mike talked me into moving to a wide-open space in the high desert of southern Colorado.

As soon as we moved here I felt different. I felt myself slowing down and appreciating each moment much more completely. Each astounding new view took my breathe away. Slowly I began naturally letting go of my past and my future, feeling less alone than I ever have. Nature is deliberate and can be trusted unlike most experiences in wholly human culture. The beautiful silence outside my door each morning provided me with authentic contact with the harmony in a world outside of human existence. Living in such beauty awakens a sense of gratitude for all there is to experience in the natural world. There so much here that most will never experience directly.

Barry Lopez believes that if you asked anyone walking down a sidewalk in a city, “What is it that you really want?” Many would say intimacy. But “you can’t gain intimacy without vulnerability, and you can’t have vulnerability without trust.” Barry finds this lack of intimacy and vulnerability in human culture to be manifested by our lack of intimacy with the land itself. Cities create a kind of competition and divisiveness that can not be found outside of them in the natural world.

Sometimes I think about the darkest moments in my past, moments of depression and hopelessness. I now realize that if I had known enough to escape from cities at those times, I would have found the kind of meaning and peace I needed to find new hope for meeting my next future.

But then we are all on schedule to learn what we must to discover our best life. Trust in that!

My Own Experience With WildFires and Snow Storms

Imagine if this were your town…

My heart goes out to those who lost loved ones in the California Paradise Fire last November. I hope you were able to see Frontline last night, Fire in Paradise. I think it is important that the rest of us understand what some Americans have gone through and what they lost. In less than 4 hours a small fire that started 8 miles from Paradise engulfed the entire town from all directions. Many of the 40,000 residents simply did not believe the speed of this fire. Others tried to get out, but the roads were too jammed up to escape. Eighty-five Americans, most over age 65, died in this wildfire.

I felt a strong need to watch this episode of Frontline because we had our own wildfire here last July, and if not for our wonderful and amazing local firefighters, that town could have easily been La Veta, population 8-900.

The Spring Fire on the evening of June 28th 2018

The night that fire started, I sat in my bed and watched the fire jump from mountaintop to mountaintop across a couple valleys behind us. I could also see our local firefighters out there giving their all to contain that fire. The next day the National Guard was called in along with the Hot Shots and firefighters from around our nation. We were evacuated the next day for a week, as the fire jumped Highway 160 and came towards our new home. Our fire burned a total of 108,045 acres, and was the third-largest wildfire in Colorado history.

The residents of Paradise where not so lucky. They basically had no warning. The fire came flying into their town so fast and only half were warned properly by Code Red. But even then their roads were inadequate to evacuate the entire town in less than an hour. Imagine the fear and anguish.

The weather outside may be frightful, but not like a firestorm!

Like most disasters, news reporters flash on a big story for a day or two and then we all forget, but not me. Every report from California and every single day of our latest series of three snowstorms here in southern Colorado remind me of how lucky we are to still be receiving large amounts of moisture. Yep. Fifteen inches of snow is fine with me!

Finding Health in an Unhealthy World

In a world filled with glaring contradiction, unfairness and stress, where can we turn for comfort? Too many of us turn to food, pharmaceuticals and other forms of self-medication. The possible distractions are endless, but many are unhealthy or even self-destructive.

New research is showing another alternative:

Spending a minimum of 2 hours in the great outdoors (parks, green space, your own backyard) every week boosts both your physical and mental health.

What roles do nature and exposure to natural surroundings play in improving our health? We know that spending time in nature makes us feel good, but does it measurably affect our well-being? Study after study has shown the answer is yes.

In fact, social determinants of health—including where we’re born, live, work, play and age collectively have a far greater impact on our health outcomes than the healthcare delivery system. Healthcare services account for just 10% of longevity, while social and environmental factors account for twice that at 20%, your genetic makeup accounts for 30%, and lifestyle choices and behaviors a whopping 40%. 

Ever since I left suburbia and moved a lot closer to a natural setting, I have been changing. My mental health has improved with ever increasing mindful meditation and peace. My vigilance and fear have gradually diminished, and yet I struggle to explain how this move has changed me. I only know when I return to cities I notice a difference between me and those who struggle with traffic, congestion and overpopulation every day.

Now we have new research proving what I have learned on my own. Sure, this may all seem like a no-brainer, but if you are looking for a new form of tranquility, accept the obvious and find comfort in nature. It’s free and clean!

How our self-image must change as we age

Somehow I never pictured myself with oxygen equipment. For most of my life I have felt strong, healthy and very self-sufficient. That was how I saw myself as I traveled the globe, collecting sometimes difficult but important life experiences and M.A. degrees.

Life certainly has an amazing way of surprising us!

The view from our new solar home!

Ever since I moved down to southern Colorado in 2014 and then up to seven thousand feet in 2015, breathing has been a struggle, leading to many doctor’s appointments, cat scans and even a recent lung biopsy. No, I don’t have cancer, just damaged lungs from decades of bronchitis and bad air. What a great thing to find out as we settled into our forever home near the Sangre de Cristo Mountains.

I fought hard for a couple of years, not accepting that I needed oxygen full-time to live a normal life. I thought I would eventually adjust to our thin air, using all of my inborn stubbornness. If you know me, you know how stubborn I can be! Accepting reality has never been my forte. But finally, twenty tests and a sleep study later, I have resigned to my new reality. I will probably be on oxygen for the rest of my life.

Acceptance releases everything to be what it already is!

Some say just move to a lower elevation. My answer is a resounding NO! Living away from cities, listening to the marvelous natural silence and looking at the mountains constantly has changed me completely in ways impossible to describe to others. I feel so content, safe and grateful here in spite of my breathing struggles.

I know what’s happening in the “world” but I can also completely ignore it here, close to nature and what matters most to me…