Tossing And Turning

Hello Dear Pinkies. An exhausted Joy here with you today. I was awake in the wee hours of the night, my head spinning with thoughts of all that I must accomplish between now and 2010. I’m making my first Thanksgiving dinner next week, then flying to the east coast that night for an abbreviated trip that will include a dear friend’s wedding and visits with family and friends. I’m also hoping to be certified as an integral coach in January, for which I have pages and pages of cases and book summaries and essays to write by the end of December. And oh, the winter holidays approacheth, don’t they? So many loved ones upon whom I want to shower tokens of my adoration in the way of gifts, even small ones. Not to mention my three year old nephew’s approaching birthday … Auntie’s got to come through there, no excuses.

Such were the thoughts and lists clogging my brain from 3–5am as I tossed and turned, alternately making mental “don’t forget” lists and willing myself to get some sleep in preparation for a busy weekend filled with even more … stuff.

Mind you, all of what is happening in my life right now is absolutely phenomenally fabulous. I want to drink in everything. Swim around in it. Address it. Be with it. Love it. It’s just that, currently, the volume of stuff is bordering on chaos. One might advise me to shave down my priorities, but at this juncture, I am choosing against that option. There are simply too many people to love. Too many dreams to pursue. Too much life to be living.

Letting It All Be

Once I owned that – that everything I’m currently up to is actually serving the bigger me – something dawned on me. The reason that all the STUFF is feeling so chaotic is because I’m trying to get it all under control. My brain was making its biologically characteristic attempt to put things in neat little piles and draw up a blueprint for each day. My poor ego is struggling to get to a place where it can stand confidently in the middle of my life, like a policeman at the scene of an accident, and announce, “Everything! Is under! Control!”

The realization I had today was that that ubiquitous phrase – “everything is under control!” – is an absolute fallacy. Nothing in the universe is within our control. Ever. But we all love those words, don’t we? We get so comforted when we hear them announced in the middle of a crisis on the street or at the office.

The thing is … they’re just words. In truth, circumstances, people, endeavors are all spinning outside of us. Life is dancing its dance, following the natural flow. It is only up to us to dip joyfully in and flow with it, or not.  That decision is the only control we’ve got. And right now, my intuition is telling me to forego the raft and the life jacket, plunge on in there and body surf on down the rapids.

There’s Always An End To The Madness

The coolest thing about this all, though, is that as false a phrase as “everything is under control” is, there is abundant truth in another one of my favorites: “this too shall pass.” Currently the river of life is full and rushing, as after a good rain. However, I know things are going to slow to a trickle at some point. Either that, or I am going to decide that I’ve had enough for now, haul myself up onto the riverbank, and spend some time sunning myself and contemplating the wild ride.

And So, I Flow

But for now, of this I’m sure: nothing is under control, so it’s kind of futile (not to mention a total energy suck) to try to get to that place. I’m going to let go of the handle, let life flow, and participate with every particle of me that there is. As much as I can, I will remember to own joy, not take things so seriously, and savor all the moments of love, connection, chaos, and beauty that await me.

Sure, I’ll forget things. Stuff will slide. Details will get missed. People might be disappointed or I may overcook the turkey. But whatever.  Even if I wanted to I couldn’t control this trip. I’m flowing, I’m feeling, and I’m doing my best.

What about you Pinkies? The holidays tend to be a time when the river is rushing wildly for many of us. Are you jumping right in? Weighing your options? Do you have a life raft of some kind? Do you have Everything Under Control?

Not me …

CANNONBALL!

Joy

Good morning, Pinkies.  I just heard the news (calm down, Lissa. Breathe…) In the wake of the U.S. Preventative Services Task Force’s new guidelines for mammography screening, the American College of Obstetricians and Gynecologists just announced new recommendations that cut back on Pap smear screening. My blood is boiling, Pinkies. WHAT IS GOING ON? Why are we recommending cutting back on women’s health screening? Don’t get me started (yet). Let me fill you in on the news.

New Pap Smear Guidelines:

1. Instead of recommending that Pap smear screening begin after you’re sexually active, new guidelines say that even a sexually active 13 year old should wait until 21 for her first Pap.
2. After 21, Pap smears are recommended every 1-2 years until age 30.
3. After 30, if you’ve had three consecutively normal Pap smears with no history of a seriously abnormal Pap, new guidelines say you only need to do Paps every three years.
4. If you’ve total hysterectomy for benign reasons, new guidelines say you can skip Paps altogether.
5. New guidelines recommend quitting Paps sometime between 65-70 if you’ve had three consecutively normal Paps with no abnormal Paps in the past 10 years.

Why the Change?

There is evidence to support the changes.  The truth is that you’re unlikely to go from having a normal Pap smear to having cervical cancer in 3 years, even if you contract HPV. Because cervical cancer grows slowly, it’s still likely to be precancerous by the time it gets picked up. And yearly screening does increase the number of procedures performed, and some of those procedures- such as cryotherapy and LEEP procedure can affect fertility and pregnancy in rare cases.  Plus, cutting back on Pap smears saves precious health care dollars. And if we’re not saving lots of lives and potentially causing harm by implementing procedures that may not be necessary, why do annual Pap smears?

So these guidelines aren’t positively ludicrous like the new mammogram guidelines that threaten to kill hundreds of thousands of women. I understand why they’re recommending pushing back the age of first Pap smear.  HPV, the virus that causes cervical cancer and abnormal Pap smears, is almost ubiquitous among teens. As such, doing Paps will lead to many abnormal results and require colposocopies, biopsies, and possibly treatment such as LEEP procedures, which can affect their pregnancies in the future, leading to scarred cervixes and preterm labor. And many of those abnormalities, if left untreated, would have resolved themselves without treatment.

I can also see why they’ve said that women who have had a hysterectomy can stop getting Paps. After all, they don’t have a cervix. And while there may be scant cervical cells left at the surgical scar inside the vagina, the risk of cervical cancer is exceedingly low.

BUT (and this is a gigantic BUT) there is a GINORMOUS problem here that carries far-reaching consequences for women’s health, and I can’t keep this quiet. Though women come to the gynecologist under the guise of their annual Pap smear, they actually come for WAY more than that.

Here are some examples of issues I handle under the guise of an annual Pap smear exam:

• Sexual problems that threaten your relationship
• Debilitating depression and anxiety
• Chronic fatigue that prevents you from living vitally
• Pelvic pain, often as the result of sexual abuse you have never confessed to anyone until I hold the sacred space for you and invite you to tell the truth
• Urinary incontinence that causes so much shame and embarrassment that you might not leave the house, much less exercise or pursue your dreams
• Menstrual disorders like hemorrhaging or menstrual cramps that cause you to miss work and other important life functions.
• PMS/PMDD that may be hampering a happy life
• Interstitial cystitis symptoms that make you feel like you constantly have a UTI
• Menopausal symptoms that threaten a woman’s relationships, sleep, work, and life
• Relationship counseling
• Parenting advice
• Losing your mojo

And that doesn’t even include the oh-so-necessary annual breast exam, internal pelvic exam to check for ovarian tumors and such, and the opportunity to make sure a woman is up to date on other cancer prevention procedures, such as colonoscopy in older women, or the HPV vaccine for teens.

Now, ACOG does say you should still talk to your doctor about getting an annual pelvic exam. (Thank you ACOG.)  But are insurance companies going to cover a routine pelvic exam in the absence of a Pap smear?  Are women going to go? So many women will hear these new guidelines and think, “Cool! I can skip the gyno for 3 years!”

By changing its guidelines, ACOG is going against the other main authorities on cervical cancer. The American Cancer Society and the U. S. Preventative Services Task Force both recommend that women get their first Pap test within three years of having sex, or at age 21- whichever comes first.

I respect evidence-based medicine and understand the rationale for these guidelines. I went to Duke and Northwestern and learned all the ivory tower beliefs about  practicing based on evidence, not anecdotal speculation or emotion-based care.  BUT….

What Do I Think?

Hmmm…I guess I think all the guidelines that have come out this week are missing something critically important in medicine.   As leaders in women’s health, what messages are we putting out there? Somewhere along the way, governing bodies in medicine have forgotten the most vital aspect of what we doctors do. When they are reviewing data to make these guidelines, they are focusing only on what “cures” someone. But they have forgotten that there is a difference between healing and curing.

Let’s take a huge leap and assume that cancer screening is completely worthless and doesn’t prevent cancer at all. Is there not some value to the other types of healing work we doctors provide under the pretext of the annual Pap smear? Women don’t make separate appointments to talk about their sex life or whether they’re living as vitally as they might.  They lump those things under the umbrella of a Pap smear.  Many women feel like they’ve been handed a “You’re worthless” card at birth.  I try to extract that card and replace it with a hot pink one that says, “You’re lovable, valuable, beautiful, and worthy.” This kind of work cannot be proven in a scientific study. But is taking away a woman’s excuse to visit her gynecologist taking away that hot pink card as well?

I’m not suggesting we do unnecessary testing or procedures just for the sake of getting a woman in the door. Ultimately, you have to be your own advocate for your health and wellness. But I worry about the far-reaching effects these kinds of guidelines will have for women who misunderstand and fail to hear the part about annual exams still being a critical part of women’s wellness.  What if they get lost in the system? Especially underprivileged women, who may not be educated enough to advocate for their own well-being.

My fear is that cutting back on cancer screening will not only increase a woman’s risk of cancer. It may also limit a woman’s access to the kind of healing good doctors can provide.  For most of my young patients, I am their primary care provider.  The Pap smear is what gets them in the door.  If you hear that you only need a Pap smear every three years, you may go three years without anyone talking to you about whether you’re living as healthfully and joyfully as you possibly can.

And you can be sure that insurance will cut back your coverage. If ACOG says you don’t need a Pap smear, your visit will likely only get covered if you have an ICD-9 code diagnosis like endometriosis or fibroids. And let me tell you- there’s no ICD-9 diagnosis for losing your mojo or cancer prevention.

You may think I’m biased. After all, I’m a gynecologist. It’s my business to have people come in for Pap smears, so of course, I would oppose these new guidelines. But the truth is that most gynecologists lose money by doing a Pap smear. The cost of the visit exceeds what insurance companies will reimburse most of the time. And since Medicare already doesn’t cover annual Paps, we usually eat the cost for older women who want to get Pap smears but don’t have coverage. So trust me, for most gynecologists, this is not about money.  One of my dear friends in San Francisco (a total Pink God) is closing his practice- declaring bankruptcy- because he simply can’t make ends meet with a busy insurance-based practice. It breaks my heart. He is one of those doctors who, like me, practices love, with medicine on the side.  Why does the system not embrace him? Why have we replaced doctors like him with technology, scientific data, and task forces? (*crying now*)

And why are they cutting back on only women’s health screening? Why not PSA testing for men? Not to be all conspiracy-theorist on you, but you can’t convince me that there aren’t some sexual politics caught up in all this. With all the advances we’ve made in women’s rights and women’s health over the years, why are we going backwards? Won’t somebody please stand up and shine the light on the Emperor’s new clothes?

I get that we need to cut back on health care costs. But come on, people. Must we do it at the expense of women? Can’t we focus our energy on tort reform or capping profits for insurance companies. Is this really the way?

For me, it’s all about advocating for holistic women’s health- the big kind, the kind that looks at a whole human being, not just a breast or a cervix. The only way we can help women holistically is to get them into our offices, provide a safe, sacred space for healing, and show up- fully present- to help them get in touch with what their body needs to be whole.

What Will I Do In My Practice?
I think you should be given a choice. The way I see it, it’s my job to present the data and help you understand the risks and benefits of cancer screening. If you want to get a yearly Pap smear and mammograms after 40- Fine. If you’d prefer to stretch out your screening or skip it altogether, no problem. It’s your body- your choice. I’m just here to help you understand your options and deal with whatever comes up.

The Bottom Line
Please, Pinkies, regardless of what you decide to do about your Pap smear or your mammogram, please don’t stop seeing a doctor every year.

Our Broken System

Thinking of how these new guidelines may limit your access to health care breaks my heart.

This system is so BROKEN. Hand me the suture and a needle driver. I want to stitch the fragmented, fractured, hemorrhaging heart of medicine back together again.

Waiting, with hand outstretched- “Suture, please,”

Lissa

Hiya Pinkies! I wrote this post last week, very early in the morning, while I was in Big Sur, and I wanted to share it with you.

Clinging to the Moment

I awoke early this morning to the nature sounds of Big Sur. My husband still sleeping, I threw on a sweater and made my way to outdoor sofa, overlooking the breathtaking view of Big Sur’s ocean cliffs. The sun was just beginning to cast its pink-hued glow on the landscape, and I ran back into the house to find my camera, so I could capture the beauty.  I kept trying, take after take.  But try as I might, my little Canon just couldn’t reproduce what I was seeing with my own eyes. Then I realized I needed to stop. I was trying so hard to freeze the moment in time that I was forgetting to simply enjoy it.  So I put down the camera and enjoyed the sunrise, knowing that the memory of it would exist only in my mind.

But isn’t that always the case? How often to we cling so hard to past memories or future worries that we fail to appreciate what actually exists- which is this moment, right now.  Think of how much time you spend remembering yesterday or planning tomorrow. Even this precious moment, this beautiful sunset, will be gone in moments (in fact, as I write, the pink is fading as a warm golden yellow replaces it).  Like it or not, life is ephemeral. Trying to grasp it is like clinging to a trapeze of shifting sand. If you depend upon it staying the same, you will inevitably fall.

Being Present

I think back to moments in time I’ve tried to attach to- the precious quiet of my father holding my newborn only hours before he died, the snuggled-close feeling of being in a bloody labor bed with my best friend and sister as she awaited the birth of her daughter, the sunset backdrop of my Big Sur wedding to my beloved.  All are precious memories- and valuable as such. Yet, those moments, at the time, were fraught with worry.  How much longer would Dad live? Would Becca’s birth go well?  Would the sun set so fast that we lost light for our wedding? Why do we do this?

What if, instead, we commit to actually living, to being truly present for each moment of our lives, both the joyful ones and the tragic ones?  What if we stop regretting what happened in the past or fretting about what the future might hold?  What would that look like?

Try it, Pinkies. I dare you. Please report back. What does this moment- right now- hold for you?

Living right here, right now,

Lissa

Dear Pinkies, please welcome Eileen Smith, a teacher, healer, channeler, and Posse Blog rockstar here to help us own spirituality, surrender, and our inner voices by giving us permission to meditate OUR way. Ahhh, deep breaths of relief and bows of gratitude to you, Eileen. Welcome, and thank you.

How can I be more psychic?
Meditate.
How can I hear my angels and guides better?
Meditate.
How can do I know I’m making the right choice?
Meditate.
How can I heal my past and boost my self esteem?
Meditate.
How do I (fill in the blank)?
Meditate.

Throughout my experience as a teacher and healer, one of the answers to many of life’s questions and goals can be found in meditation. And invariably, one of the answers I receive back is that people don’t know how to, or can’t meditate.

Meditation is one of the major keys to probably everything we would like to create in our lives. People want the quick, the easy. But meditation can be both of those things once you throw out the “shoulds” and expectations, and find out what works for you. I think a large part of the reason people don’t meditate is the misconception of what it is. Many people believe that you must set aside long periods of time in order for meditation to be beneficial.

Many have visions of a person sitting in a sparse, monk-like room, in the lotus position with empty minds. For most of us in this modern world, this is a rarely attainable situation and certainly hard to incorporate into a daily regime. Effective meditation is, and will be, different for each person.

It is has been said, “Prayer is talking to God, meditation is listening to God”, and I would agree with that. Keeping that in mind, whichever way creates a space within your day and within your being that allows you to achieve that state of focus is meditation, and is effective. Be it for 5 minutes or 60. Do what you can! If you can’t do it everyday, it’s okay. So many people feel guilt if they don’t take the “all or nothing” approach, which creates unrealistic expectations for it to be a part of their life.

Also remember everyone is wired differently, so whatever works for you is what works for you! Don’t compare yourself to others in regards to meditation. For example, some people need quiet to meditate; some people need the room to be dark. Others like the sun, others need music. What brings you to a higher space – to the particular sacred place inside YOUR head?

For example, it is easier for me to meditate with music, but when I first began meditating, I learned to do so with guided tapes. I began mediating in my late teens when I discovered Richard and Tara Sutphen’s tapes. These guided journeys basically taught me, a beginner, how the process took place, and how it felt.

Some people have trouble visualizing, others have trouble with intruding thoughts. If you’re not visual, that is okay – allow for just a sense of where the guided journey is taking you. If your mind won’t stop thinking about the tasks and conversations that are in your day, hearing someone else’s voice in a guided meditation may help you.

We all have the voice inside our heads – the one that keeps thinking about the phone calls we need to make, etc. Some of my students find it helpful to acknowledge it and let it know you received the message and will remember it later — this can sometimes quiet it. Or keep a piece of paper nearby and write down the message the voice wants you to hear so you can go back to meditating.

Keep in mind that walking and other activities that are rhythmic and healthful, like swimming, dancing, or walking, can create a meditative place within you.  I have had some of my best “listening to Spirit” meditative moments walking in nature. I live by a park with trails that allow for a strong connection to the Earth and Nature Kingdom to renew me in body, mind and spirit. Yoga is also meditative for people. Part of yoga’s life-changing effects for those who do it often is this meditative state it creates.

So you see, Pinkies, it simply is a matter of finding what works for you. Throw away the false assumptions, comparisons and expectations. Don’t be hard on yourself, enjoy it. Explore your style of meditation and start listening.

What does work for you, Pinkies? Have you found a meditation style that is most helpful? How long do you meditate? Have you been thwarted up to this point by assumptions and frustrations? How might you explore different ways of meditating?

Communing with Spirit my very own way,

Eileen

© Copyright 2008 Eileen Smith www.whiterosepath.com, The Path of the White Rose

Hiya Pinkies. I already posted something for today, but a bunch of you have come to me begging me to don my white coat and comment on the new recommendations from the U.S. Preventative Task Force about mammography in young women, so here goes.

Mammograms – Not Perfect, But Far From Pointless

My father was a radiology doctor who specialized in mammograms, so I grew up around those machines that take two perfectly good knockers and squash them into Swedish pancakes. Dad used to joke that if women were in charge of medicine, men would have to stick their penises between two plates and get “manograms” after the age of 40.  When I was young, I remember sitting beside Dad in the dark screening rooms while he inspected film after film, hunting for subtle signs that might signal breast cancer. He likened it to reading a Where’s Waldo book. Mammograms may seem like torture, but they also may save your life.

But we all know that. Why am I writing this post? Because the U.S. Preventative Task Force just declared that women in their 40s of “normal risk” should no longer get routine mammograms.  They also say women after 50 should only get mammograms every other year, recommend against teaching breast self-exams for all women, and say no mammograms after the age of 74.  WTF? What changed since they recommended mammograms every 1-2 years in women over 40?

Okay, so mammograms are far from perfect. So we’re gonna throw all progress we’ve made in reducing breast cancer mortality out the window?  What about new advances in digital mammography?  What about my patient who just potentially saved her own life by finding a breast cancer while examining her breasts? What about Mrs. Olivier, my amazingly vital 81 year old patient whose mammogram found an early breast cancer ten years ago and is still alive and kicking after treatment?

Okay. So it’s true. Self breast exam data isn’t stellar. Large studies have shown it to be pretty ineffective, actually. But what about those few women who do detect their own cancers and save their own lives?  Plus, what’s the harm in feeling your boobies for lumps? And what’s with the recommendation against mammogram in women after 74? These are the women at highest risk, for whom mammography screens most effectively. All of the sudden, Grandma is no longer important? Have I just stepped into some alternate universe? I mean, seriously, people.

Why Did They Change The Guidelines?
There is no new data. It’s all about how you look at the existing data. The Mautner Project summarizes the data:
The USPSTF used statistical modeling to predict the impact of screenings found over a 10 year period. It found that if a thousand women beginning at age 40 were screened with mammograms, there were small gains in cancer deaths averted, compared to if these women started at age 50. Specifically, their modeling found that 6.1 deaths would be averted, compared to 5.4. The panel judged that difference to be not worth the expense, biopsies and anxieties.

1,000,000 women 120,000 99,990

Gulp. Personally, I don’t need some patronizing government board trying to protect me from anxiety. I’d rather be protected from breast cancer, thank you very much.

What the Studies Say

Whew…Deep breath, Dr. Lissa. Okay, so mammography for women in their 40s has long been a controversial issue. Truth is, mammography just isn’t a great screening tool for women age 40-49. In our forties, our breasts are more dense, making it harder for X-rays to penetrate breast tissue to see early signs of cancer. Also, because breast cancer is less common in this population, you’re more likely to wind up with false positives, leading to follow up mammograms, breast biopsy surgeries, and enough anxiety to leave you quivering.  So medical societies have been mixed on their recommendations for women in their forties, but most agree that women in their forties should have mammograms no less than every other year.

While they’re not an ideal screening tool for breast cancer, studies estimate that mammograms detect about 75% of breast cancers in women in their 40s and 90% percent of breast cancers in women in their 50s and 60s.[i] Early detection can mean the difference between living and dying. If you’re over 40 and you get mammograms regularly, your risk of dying of breast cancer is reduced by 34%.[ii]

So why the push to nix it altogether when we already know that mammograms save lives? According to Dr. Otis Brawley, chief medical officer for the American Cancer Society, “With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.” Say what? Actually, I do hear what they’re saying. The task force isn’t saying that nobody should get screened in their 40s. They’re saying they should talk to their doctor about risk, but they shouldn’t get screened routinely.  And I hear what they’re saying from an epidemiological standpoint. So maybe it’s not cost-effective. But price can you put on a mother of two young kids? I know we docs aren’t supposed to, but I can’t help getting emotional about this. I’ve lost too many people to breast cancer already…

Others Disagree

The American Society of Breast Surgeons just issued this statement. “We believe there is sufficient data to support annual mammography screening for women age 40 and older. We also believe the breast cancer survival rate of women between 40 and 50 will improve from the increased use of digital mammographic screening…The Society will continue to advocate for routine annual mammographic screening for all women beginning at age 40. Mammography screening reduces breast cancer mortality and saves lives.”  The American Cancer Society and the American College of Obstetricians and Gynecologists agree.

On the flip side, Dr. Susan Love, author of Dr. Susan Love’s Breast Book agrees with the new task force recommendations. She says:

These recommendations are long overdue. Most countries do no support mammography screening under 50 and do it every other year after 50 in their government-sponsored screening programs.  I hope that the insurers will change reimbursement, because it is probably the only way that women will be spared the extra radiation exposure of too many mammograms. Since our system pays the radiologist, hospital, or mammography center and biopsying surgeon by the more they do, there is no incentive for this to come from the medical profession.

Strong words.  Yes. Mammograms have their risks. Applying radiation to a breast in order to reduce the risk of breast cancer may indeed seem counterintuitive. I work at a holistic health center, and many in the holistic health world recommend against mammography altogether, favoring breast thermography, which my patients often choose to use as an alternative to mammography.  And yes, it’s true that mammography is not a great screening tool for younger women.  But what’s a girl to do?

So what do I think?

Well, I’m admittedly biased. Half a dozen of my closest friends and many of the women I’ve worked with for The Woman Inside Project were diagnosed with breast cancer in their early forties, some of them by routine mammography alone. Had they not been screened, would they have survived their cancers? No way to know. How much is one life worth? Also, since Dad was a radiologist, I grew up around stories of breast cancer near misses.  I know that’s not scientific reasoning, but these new recommendations bring up a lot of feelings for me.

My biggest concern about the task force recommendations is that insurance companies may use this as an excuse to deny coverage for women in their forties who wish to get mammograms. If they have to pay out of pocket, fewer women will get screened, and we might wind back the clock to the days when women only got diagnosed with breast cancer after a lump was detected. Why would we want to go backwards? Is this all part of some government plan to cut back spending on the cusp of health care reform? Are our best interests really at heart? I’m not sure. What do I know?

Breast Thermography

Every woman ultimately has to make this decision for herself, assessing her own risk tolerance. At my office, we offer breast thermography as an adjunct to mammography or as a mammography alternative for those who are young or who choose to avoid mammography because of radiation concerns. If mammograms give you the heebie-jeebies and you’ve opted to skip them, check out breast thermography. Thermography, a non-invasive procedure using digital infrared imaging to assess heat in the breasts, may reflect an increase in blood vessels that are commonly seen with evolving cancer. If there’s heat on the body’s surface, this can indicate cellular damage, increased cellular activity, and inflammation- which may be cancer precursors. Breast thermography may be useful for screening young women, and it may even detect changes in the breast before breast cancer arises.

Breast thermography has some great advantages over mammography. Unlike mammography, which does nothing to prevent breast cancer- only death- thermography can actually assess the conditions in your body that may lead to breast cancer. And these changes can be treated- and often reversed- through dietary changes, lifestyle modifications, supplements, and bioidentical progesterone cream applied to the breasts.

Keep in mind that studies to support thermography as a replacement for mammography are limited. But as an adjunct or alternative for those who wish to avoid radiation or fall into that younger age group for whom mammography works less well, it has great promise.

Breast Thermography

Will I get a mammogram?

You betcha. I just turned forty, so I’ll soon be making the phone call to get my hooters mashed between the plates. I’ve got a three year old, a husband, and a beautiful mission to serve. I’ve got a lot to live for, and I’m not going to let some new recommendations get between me and a long life. But I may not do it every year. I may get thermograms in between (and in addition to mammograms), just to reduce my radiation exposure and assess any breast health issues I might be able to reverse. Ultimately, you’ve got to go with your gut. What feels right to you? When there’s controversy among various organizations, it usually means there’s no one right way. Listen to your body. Ask for guidance from the Universe.  Let your boobs tell you what to do…

Freaked out about breast cancer? Don’t be. Fear won’t help. But these tips may (regardless of what the task force says).

Integrative Medicine Approaches to Reducing Breast Cancer Risk

-Practice monthly self-breast exams.

-Eat 5 or more servings of fruits and vegetables per day, preferably raw

-Limit your intake of animal fats, particularly red meat.

-Eat lots of fiber

-Avoid drinking two or more glasses of alcohol per day

-Increase your intake of superfoods high in antioxidants, such as kale, beets, carrots, beans, collard greens, brussel sprouts, and broccoli. If you’re not good about eating your veggies, try Sun Chlorella.

-Drink green juice. It’s a great way to alkalinize your body, and cancer likes acid, not alkalinity.

-Avoid dairy or use organic butter, cheese, and milk, as they are less likely to be contaminated with human growth hormone or estrogen, which is sometimes used to stimulate milk production in cows.

-Use extra-virgin olive oil, raw flaxseed oil, and cod liver oil.

-Expose yourself to the sun. High levels of Vitamin D help fight cancer.

-Exercise. It helps detoxify the body and decreases the amount of estrogen that reaches the breasts. Women who exercise regularly have a 30% lower risk of breast cancer.

-Apply loving energy to your breasts with daily massage. Massage your breast tissue and the area under your arms while you’re soaping yourself in the shower. Close your eyes and visualize healthy breast tissue. Release all fear of breast cancer through a release valve at your root chakra. Dump the toxic energy of fear into the earth’s core and allow the golden light and radiant healing of the Universe to enter through the top of your head. Close your eyes and imagine healing energy extending from your heart, through your arms, to your hands.

-Talk to your doctor about when you should begin mammography and/or breast thermography.

-Be aware of your family history. If you have a first degree family member who was diagnosed with breast cancer before menopause, consider talking to a genetic counselor.

-Limit alcohol intake, and if you do drink alcohol, make sure you’re getting enough folic acid in your diet. If not, take a supplement that includes folic acid.

-If you are at higher risk for breast cancer, talk to your doctor about supplements you can use to reduce your risk.

What will you do, Pinkies? Please share your thoughts.

Loving you and your PINK boobies,
Lissa

PS. Want more? Watch this EXTRA video clip where they interviewed Pinkie survivor Marla Rosner Johson.

[ii] Elwood, M, Cox, B, Richardson, A. The effectiveness of breast cancer screening by mammography in younger women: correction. Online J Curr Clin Trials 1994; 121:385.

The Origins of Pain

I saw a patient today who inspired me- let’s call her Sally.  She suffers from a host of medical conditions that threaten to rob you of your mojo- fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain.  When this young woman walked into my office, she looked like crap. Before looking at her chart, I thought she had cancer.  Gaunt and pale, her skin hung on her skeleton like she was in the last grip of life.  During the first half hour, she didn’t smile once. I felt the anxious tug we doctors feel when we see people like this, the one that says “I’m not going to be able to help this person,” which triggers insecurities and, often, judgments, in our own minds. It becomes about us, rather than being about them. We have a tendency to turn off because we don’t want to fail. But I vowed not to do this.  Sitting in her presence, I was determined to be present for Sally and sit with whatever is true, rather than letting my own stuff get in the way.

What is true for Sally is that she has spent the last decade plagued by pain, fatigue, and a body that is betraying her.  She has been to universities, fancy alternative medical clinics, and specialists. Someone told her that her condition is “incurable,” and somewhere, a while back, she decided to believe them. But she never gave up trying to be well.

When she came to see me for a gynecologic complaint, I heard her words, but what I saw in front of me told me that her condition was deeper than what her words betrayed. This was not about a pain in her pelvis, this was about a core wound.  I listened while she talked about her pelvis, but I focused more energy on watching her, feeling her, being with her in the moment. What rang out loud and clear was this message: “I am not well.” And yet, I could see this glowing, radiant energy beneath the surface, a vision of a vibrant, vital being, leaping in the air and spinning with glee.

Unbidden, she began to tell me about her favorite place, a remote town near Santa Fe, where she owns a vacation house. She fantasizes about quitting her job, living there full time, and spending time with animals in some way. Currently, she owns her own business, selling software to help people maintain their gardens.  She works until 2am many nights, finishing projects and meeting deadlines. A team of people bow to her leadership. Years ago, she gave birth to her company from a place of passion, but lately, she dreads everything about it. It has become her ball and chain, and she suspects it is related to her illness.

The Power to Heal

Last year, fed up with being sick, she considered quitting her job. She went as far as selling her primary residence, with the intention that she would live full time near Santa Fe. With money in the bank to help support her, she settled into a new life. And miraculously, her symptoms disappeared. For two whole months, she felt like a vibrant twenty year old, brimming with energy and vitality.  She hiked every day, ate wholesome food, wrote in her journal, and meditated. “I did everything right,” she said. And her body rewarded her with new life.

Then her mother had a heart attack, and she left Santa Fe to return to California, where she is now caretaking her family. Because she is back in the area, she has resurrected her business. Within days of returning to her old life, her symptoms reappeared. She has been coming to our integrative medicine center almost weekly ever since. Her thick chart belies a series of supplements, laboratory tests, and referral letters that conclude, “There is nothing we can do.”

Yet, to me, seeing Sally for the first time, the answer is obvious. Her body has already told her what it needs to be healed. She needs to release the expectation she has placed on herself to care for her family.  She needs to let go of her business. And she needs to move back to that small village near Santa Fe, where her body knows how to heal itself.  Only I can’t say this to her. It is not my place to give advice.  Advice implies that someone is broken- and nobody is broken.

Instead, I ask her, “What does your body need in order to get better?”

She says, “I need to find care for my mother, let go of my business, and move back to Santa Fe.”

Bingo.

When she says this, I see, for the first time of our visit, a faint smile. I ask her what she will do when she is there. She says, “Hike, ski, paint, play with my dog. Maybe start a new business, something related to animals.” Her smile widens. She begins to talk about the steps she would need to take in order to put this plan in place. Some steps she has already begun, as she has known intuitively what she needs to do. Within moments, she is grinning. I ask her how her pain feels in this present moment- right here, right now, and she says, “It’s gone.”

Then something shifts. A dark cloud wafts across her. She curls her shoulders inward.  Her smile disappears. Her brow furrows. Sally says, “I can’t do this. And what’s the point? My doctor said there was no cure for my condition.”

Healed Versus Cured

I can’t help telling her the story of my father. Dad was diagnosed with a gigantic goomba of a brain tumor when I was 7 months pregnant. A body scan revealed that there was cancer everywhere. A biopsy confirmed metastatic melanoma, which comes with a near certain death sentence. My father, a physician who did his senior thesis on melanoma, knew the facts about his prognosis. So when he called me one morning at 4am to say that he had a vision and that God had come to him to tell him he had been healed, I groaned. “Oh no,” I thought. “The brain tumor is growing. He’s delusional. And he’s in denial.”  I nodded and told Dad I was thrilled that he was healed, but I dreaded the repeat body scan that would tell him the truth. When the body scan showed that the tumors were growing, Dad got quiet. He didn’t speak of his vision again. My heart ached.

A month later, Dad failed to experience any of the expected symptoms of a gigantic brain tumor. He had no headaches, no seizures, no vomiting, no dementia. He was plain old Dad, only with a bald head from the whole brain radiation they gave him.  So when Siena was born and Dad said, “Can I go now?” I wasn’t prepared. What did he mean, “go?” What exactly did he plan to do?  Dad said he was going to quit eating and die a peaceful death. He wanted our permission. Reluctantly, we gave it.

Dad kissed us goodbye, and when I asked whether he was scared, Dad said, “I’m not scared. I’m joyful.” He kissed away our tears, closed his eyes, and died peacefully 48 hours later.

Only in retrospect did I learn a very important lesson- one that has fundamentally changed the way I practice medicine. I realized that, in spite of my skepticism, Dad had been healed- that there is difference between healing and curing. I always thought they were the same.  Now, I realize that you can healed without being cured, and you can be cured without being healed.  I spent 12 years of medical education learning how to cure people, but no one once spoke to me about healing. In fact, we don’t even use the term “Healing” in reference to patients. We might talk about a healing wound, but a healing patient? Nah. Too woo-woo.

The Whole Picture

So when that doctor told Sally that she would never be cured, he failed to look at the whole picture. Yes, there may not be a drug she can take to rid herself of symptoms permanently. But I absolutely believe that she can be healed. Her body has already proven it to her.  The power to heal lies within us all, if only we tap into it.

What about you Pinkies?  What needs to be healed in your body, your soul, your heart, your life?  What would it take to feel better? What steps might you take to put a healing plan into place? How can we support you?

Committed to helping you (and me) heal,

Lissa

Dear Pinkies, please welcome back Mojo Mentor and Pink Lovemuffin Extrordinaire Megan Monique Harner, here today with today’s Mojo Monday exercise and an inspiring piece about her profound experience with home altars. In honor of today’s MojoLIVE session about gratitude, we give thanks to the Universe, not only for the obvious blessings, but for the challenges that help us grow. Bows of thanks to you, Megan!

For as long as I can remember I have always been curious about religion and different acts of faith that bring you closer to God and yourself. I remember my mother looking at my strangely when I was little because I told her I would love to have my very own therapist. To me, having a therapist wouldn’t mean that I was trying to find out what was wrong with me, but it would allow me to view myself from an angle I had not yet seen.

Every year that gets added onto my life is another year in whichI learn more about who I really am, and about things that do or don’t work for me on a spiritual level. Recently I was introduced to home altar building through one of Lissa’s Owning Pink posts with a video from the Home Altar Building Workshop she led with Carmela Carlyle.

The concept of building a home altar was exciting to me although but was unaware of what revelations I would actually experience. I didn’t want to go into building my home altar blind, so I asked for a tool to help guide me through this process and was led to a book, Altars: Bringing Sacred Shrines Into Your Everyday Life by Denise Linn. At first I was taken aback by the word “shrine,” but decided to put my previous judgments aside and give it a go.

This book was just what I needed. It explained what altars are, how they help you, and how to build them. It also gives a vast number of examples of all the different kinds of altars you can build for different occasions in your life. Or maybe you have been struggling finding a way to combine all of your ‘slashes.’ Believe it or not, there is an altar you can build to help integrate the many talents of you and have them all work together in a sacred balance.

Creating Your Altar

Step 1: Decide What Your Altar Will Represent

It is important that your home altar represents who you are and what you live your life for. Whether you are wishing to transition something new in your life, find a new career, a new passion, meet a new significant other, or bring peace to your home, it is important that you are clear around your intentions so that the altar is at its most powerful. You can test this after the altar is created by sitting near the altar as if you were about to pray or meditate, and feel with your heart the energy it is conveys. You will know intuitively if you have completed your space.

Step 2: Pick A Location For Your Altar

The location of your altar is another important decision. Finding the space for your altar is just as important as the objects upon it. Make sure you choose a location that speaks to you — a place where you feel comfortable, safe and secluded. A high-traffic area would not be ideal for a meditation space. If your altar symbolizes bringing wealth to your household, you would place it in the far left corner (as you are looking into the room from the doorway). Love and marriage altars would go on the far right wall; fame, the wall opposite the doorway;  career, somewhere near the door;  self actualization, the near left corner.

Step 3 Choose Objects For Your Altar

I encourage altar building because it is a fabulous way to express your inner most desires, all the while having a blessed, sacred space for prayer and meditation. Depending on what kind of altar you create, you might include a variety of objects, all symbolizing different things. Bells- carry your past mind into your soul, Garlic- offers protection, Apples- health and vitality, Copper- transformation, Jasmine- beauty and joy, Octopus-ancient wisdom, Cedarwood-relaxing,  Green- healing and balance, White- purity, and the list goes on and on. The object doesn’t necessarily need to have a textbook definition – you can create the symbolism yourself.

Where My Home Altar Took Me

It wasn’t until recently that I actually began praying. After creating my home altar, prayer took me to a whole other level. It was as if, when I created my altar, I made a place just for me and God. When I go there, I am attentive and express myself clearly.

I encourage you Pinkies to journey into creating your very own home altars. If you are unsure about what-all it entails (this post barely grazes the surface!), I would recommend purchasing Altars by Denise Linn. She will tell you all you need to know to create your perfect home altar.

Happy journeying Pinkies! Have a great Mojo Monday.

Sacredly yours,
Megan

Dearest Pinkies, Please welcome Christine Reed, blogger, yogi, dancer, and … well … you’ll see. We’re thrilled to have her in the community, and to welcome her and her gorgeous words onto the Pink mainstage. Thank you, Christine, for giving us the opportunity to bear witness to your story. We love you!

Tiny Dancer

I have a very early memory of a small me, dancing in the kitchen of my Great Aunt. She was making us some dinner. I know it was dinner time because of the way the light was coming in the windows, making the dust motes flit like fire-lit fairies through the air.

The kitchen itself was golden and yellow and this added to the magic of the moment.

I was twirling and dancing to my own song, and I remember feeling utter peace and joy, and this was reflected back to me through my Great Aunt’s silent witnessing and big smiles.

I danced, and then …

Through a childhood that wrote large chapters of pain on my body, I danced.

Lost as I entered college, I danced.

Then, for a million reasons and for no reason at all, I stopped.

For the next many years, I struggled, trying to force my body into new containers of movement, experimenting with all forms of yoga until I found Kundalini and thought I was happy enough.

I danced again

Then, suddenly, in my 40th year of life, I went to a friend’s wedding, and I found myself on the dance floor, twirling to ABBA’s Dancing Queen.

“I don’t know the last time I saw you that happy,” my partner said to me later that night in our yellow living room. We talked for hours and then went to bed and got up and talked more.

Before the sobering effects of sleep, dancing felt alive and real to me, but by the next morning, I had an enthusiasm-hangover, and dance felt like a long ago dream, lost in the shadows of poor memory.

“But I am 40 years old!”

That number …

Over the next few months, that sentence would come out of my mouth a lot.

As I ordered my first pair of Capezio ballet slippers since I was about 20. (But I am 40 years old!)

As I stopped spontaneously into a dance supply store and purchased my first pair of high heeled tap shoes. (But I am 40 years old!)

As I danced every single day and started to watch my body respond to this thing that it so obviously was made to do. (But I am 40 years old!)

As I signed up for YogaDance teacher training, imagining I would be the oldest person there. (But I am 40 years old!)

At that teacher training, there were women in their 70’s and my voice of protestation began to shrink.

Validated

At that teacher training, women — dancers, yoginis, and movers of all sorts — women I respect, told me, “This is who you are.”

They witnessed me like my Great Aunt, and I felt myself becoming that little girl again.

I danced in ways I did not know I could in the light pouring in through our practice room windows.

I danced with power.

“I thought the windows might just blow out of the building!” One of those beautiful women told me as I panted, out of breath, and cried, out of my mind with joy.

And now …

Age has no power over me now. Yes, I am 40 years old, and I am a dancer and I am infinite.

What have you Pinkies discovered (or rediscovered) that positively sets you on fire?

Spinning with mojo,

Christine

Hi Pinkies, Joy & Lissa here with some meandering musings on the topic of gratitude in advance of our MojoLIVE session on Monday. If you’re interested in joining us, click here for more info.

I’m not much into the practice of gratitude. I don’t keep a gratitude journal as Oprah prescribed all those years ago, nor am currently I participating in that Facebook thinggie where you post something for which you’re grateful each day from now until Thanksgiving. I mean, I think they’re beautiful ideas, as they help to promote a state of thankfulness in more people who may not otherwise see the blessings in their lives. Really, I’m all for such things. I’ve just never felt particularly drawn to do them.

And it’s not that I’m not grateful. On the contrary, I spend most days in absolute awe of how the world works, how the universe intervenes, the kindness that can be found everywhere, and the power of intention. I am blown away by the vivid technicolor of flowers I pass as I walk my dog around the neighborhood. I look out onto the bay and feel my breath catch with wonder knowing how many phenomenal people surround it. I see two old men – old friends – walking down the street together in silence or conversation, and I get choked up at their unconditional thereness for each other. I pet my cat and feel love bubbles effervescing up my arm.  I witness synchronicity and see people waking up every day to their immense potential as beings. I explode with laughter and shed tears and shake my head, grinning.

On occasion I will plop down on my meditation pillow and utter words of thank you, thank you over and over again, as it is, quite literally, all I can do to express the “YIPPEE!” I feel at being alive in that moment. I’m not sure who the “you” in thank you is … I assume it pertains to the universe, or source, or even myself. But it isn’t part of my daily repertoire to ceremoniously thank the Universe for all that I have, all that I am, all there is.

Why? I don’t know. Maybe part of it is that, even if I wasn’t thanking – in an active, giving forth kind of way – wouldn’t this all be happening anyway? Is it more important to spend my time thanking, or drinking it all in with relish? It’s like the Universe is my grandmother and she just set a dish of lasagna in front of me. What would make her heart swell more – for me to sit there and say, “thank you SO much,” or for me to stick my face in that plate, messily gobble up every morsel, and ask for more?

Yes, of course, if we’re not relishing on a daily basis, deliberately stopping every so often to give thanks is one of the best and easiest ways to get to the good stuff in our lives. I mean, we can’t enjoy it if we’re not noticing it. But to me, gratitude is not so much the act of thanking as in the awareness. It is attention to all of the things in life that remind us of our basic goodness; our highest essence. Giving thanks is a practice of training ourselves, really, to put our attention upon kindness, beauty, innocence, love … all of the stuff that is real. All of the stuff that connects us to our divinity, and to each other.

But there’s something else I’m learning, and that is that everything that happens to us is miraculous. Even hard-learned lessons. Even atrocious mistakes. Even bad news. Even illness. Even death. It’s miraculous because it’s all part of life. Giving thanks for only the “good” stuff in our live precludes a whole chunk of being alive that is no less of a blessing – no less worthy of gratitude. To only be thankful for the sunshine and health and thanksgiving feasts ignores the blessings inherent in rain and illness and solitude, ya know?

But I’m getting ahead of myself. That’s what Monday’s MojoLIVE session is all about- being grateful, not just for the obvious blessings, but for all the little twists, turns, disappointments, and losses the Universe sometimes uses to help us find our truth.  Maybe, if we learn to feel gratitude, even when times get rough, we will open our eyes to all the ways the Universe blesses us.

What about you Pinkies? What comes up for you when you think about gratitude?  What are you grateful for? What disappointments and losses have turned into blessings? How might we reframe the way we think about what happens in our lives?

Feel free to share your thoughts on gratitude here, or bring your thoughts, intentions, and blessings to the MojoLIVE sesh. Check out the MojoLIVE page of the Posse Forum for info and to register.

Seeing, appreciating, and relishing each one of you,

Joy & Lissa

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Hiya Pinkies (said with slightly less chipper tone than usual),

I’ve been having a rough week, as those of you who follow me on Facebook and Twitter may have realized. I’ll give you more details about why soon, but suffice it to say that I think I’m going to have to let go of something I care for deeply. I will have to say goodbye to a dream. I will disappoint people and maybe even piss them off. I am mourning the loss of what I thought could be, realizing that I am attached to the fantasy, but the fantasy is not real. It exists only in my head.

How often do we do that? We love “the perfect guy” in our heads, but he’s not really who we want him to be. We attach to a fantasy about friendships, jobs, even luxuries vacations. Christmas morning leaves us longing because our dream of what it would be like to be home with our families doesn’t come true. We WANT to believe. And yet, deep down, we know that the fantasy lacks any basis in reality.

Right now, I’m in the discovery process- trying to sort out whether it’s definitely time to let go of my dream or whether there’s a kernel of hope to be salvaged. But in my gut, I think I know already. So I cry and sit with the sadness. Letting go is arguably the hardest thing we as humans do, isn’t it?

I am- I know- a pretty positive person.  I feel blessed to have the gift of seeing light in dark places, but we cannot always live in a world of roses and violets. Right now, I’m mourning. And yet, I have faith. I know that this is happening to open up room for something else. My path is forking, when I’m dead set on going straight. But why fight it? Better just to fork, maybe.

Let me tell you the good news. I’ve dropped hints about my sadness, to friends, to Pinkies. And my goodness! My inbox is FULL of loving people sitting silently with my story. Love, support, wisdom, and tears meet me right where I am. I am not alone- and neither are you. What we’re doing here at Owning Pink WORKS! Losing my mojo this week has made me realize just how valuable what we are co-creating is, how beautiful it is to have this place, where loving kindness is our religion. The beauty of realizing that, while we are each unique, we share common threads that weave us together into a tapestry that warms us like a patchwork quilt.  We are shifting something here, Pinkies- something is happening. I can feel it. And this week, I got to receive from Owning Pink what it is we have given birth to here. I can claim no credit for this community. All I did was set the intention- that we would hold a sacred space that would envelope the whole planet with love, safety, friendship, and trust. Everything else has been you. YOU are Owning Pink. And I have had pink blessings heaped upon me this week. I bow at your feet in gratitude.

One Pinkie sent me this, and somehow, I just know that this is meant for all of us.

The Invitation by Oriah Mountain Dreamer

It doesn’t interest me what you do for a living. I want to know what you ache for and if you dare to dream of meeting your heart’s longing.

It doesn’t interest me how old you are. I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.

It doesn’t interest me what planets are squaring your moon. I want to know if you have touched the center of your own sorrow, if you have been opened by life’s betrayals or have become shriveled and closed from fear of further pain.

I want to know if you can sit with pain, mine or your own, without moving to hide it, or fade it, or fix it. I want to know if you can be with joy, mine or your own; if you can dance with wildness and let the ecstasy fill you to the tips of your fingers and toes without cautioning us to be careful, be realistic, remember the limitations of being human.

It doesn’t interest me if the story you are telling me is true. I want to know if you can disappoint another to be true to yourself; if you can bear the accusation of betrayal and not betray your own soul; if you can be faithless and therefore trustworthy.

I want to know if you can see Beauty even when it is not pretty every day. And if you can source your own life from its presence. I want to know if you can live with failure, yours and mine, and still stand at the edge of the lake and shout to the silver of the full moon, ‘Yes.’

It doesn’t interest me to know where you live or how much money you have. I want to know if you can get up after the night of grief and despair, weary and bruised to the bone and do what needs to be done to feed the children.

It doesn’t interest me who you know or how you came to be here. I want to know if you will stand in the center of the fire with me and not shrink back. It doesn’t interest me where or what or with whom you have studied. I want to know what sustains you from the inside when all else falls away. I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments.

Feelin’ it,

Lissa