Many of us have already been hit by the H1N1 virus, and many more of us are wondering what the symptoms are, the duration, the recommended protocol.

This article from Harvard Health Journal answers most of our questions:

Your swine flu questions answered

Three times in the 20th century, and many times before that, the world has experienced a flu pandemic that affected the health of tens of millions of people. The world now faces a new flu threat.

The World Health Organization (WHO) has declared a pandemic and is tracking the spread of a sometimes deadly strain of a new influenza virus from its start in animals (pigs and birds) to humans around the world. The virus, officially known as 2009 A/H1N1 influenza (or H1N1, for short), is sometimes called “swine flu.” Unlike ordinary flu, it is more likely to infect young people than people over age 60.

Q: What is a pandemic?

A: An epidemic is an illness that spreads to many people, and a pandemic is an epidemic that spreads around the world. Pandemics typically are caused by a new type of infectious agent to which most people have not yet developed immunity. Pandemics often cause more severe disease than epidemics—but not always.

Q: What is “swine flu”?

A: Flu is a disease caused by the influenza virus. Humans, pigs, birds, and other animals all can be infected by influenza viruses. Typically, influenza viruses can infect only one species, so the influenza viruses of humans are different from those of pigs and birds. However, pigs sometimes can be infected not only with pig influenza viruses, but also with human and bird influenza viruses. Then these viruses can swap genes, creating new viruses that have a mix of genes—from human, pig, and bird viruses. That is what has happened with this new swine flu virus, which contains some genes from human, swine, and bird influenza viruses.

Sometimes this swapping of genes changes a virus from one able to infect only pigs or only birds to one that also can infect humans. When that happens, we refer to the illness as “swine flu” or “bird flu.”

Q: Are swine flu or bird flu viruses dangerous?

A: When swine flu or bird flu viruses develop the ability to spread from human to human, they can be very dangerous: they can cause a pandemic, and they can produce severe disease.

One reason that pandemic illness often is more severe than the regular winter flu is that the virus is so new. The regular winter flu viruses that circulate each year are human influenza viruses and are similar to the viruses that have caused the flu in years past. As a result, most people have some degree of immunity to the latest regular human flu virus. The unusual swine flu or bird flu viruses that develop the ability for person-to-person spread are so different from regular human flu viruses that many people have little or no immunity to them. That is what experts think has happened with the new swine flu H1N1 virus.

Q: How contagious will this virus be?

A: So far, this virus appears to be somewhat more contagious than the usual seasonal human flu virus. About a quarter of people who have had close exposure to someone with swine flu have gotten the virus. However, all flu viruses love cold weather: cold, dry air makes flu viruses both more contagious, and more likely to cause serious illness.

Q: How serious is the illness caused by this virus?

A: The normal winter flu kills about one out of 1,000 people who are infected with the virus. In the United States, that amounts to about 35,000 people every year. Early estimates indicate that the new swine flu virus may kill about two out of 1,000 people, about twice as many as normal seasonal flu. However, there is reason to believe that it could cause more severe disease in the late fall and winter of 2009–2010.

Q: How do I know if I’ve caught swine flu?

A: The initial symptoms of this flu virus are like those of the regular flu: fever, muscle aches, runny nose, and sore throat. Nausea, vomiting, and diarrhea may be more common with this swine flu than with the regular flu. If this epidemic hits your community and you develop flu-like symptoms, it is likely your doctor will take samples from your throat or material you cough up for testing.

Q: How do I protect myself?

A: To protect yourself from catching swine flu from others:

• Wash your hands or use alcohol-based hand cleaners frequently. For a thorough hand washing, use soap, and scrub all parts of your hands, front and back, and between, for about 20 seconds (about as long as it takes to sing “Happy Birthday”).
• Don’t touch your hands to any part of your face: if the virus is on your hands, it can spread to your throat and lungs from your nose and mouth, or even your eyes.
• When you greet people, don’t shake hands or exchange kisses. Instead, bump elbows, wave, or just say “Hi.”
• Avoid contact with people who are sneezing or coughing. To the extent you can do so, avoid crowded situations. Stay at least three feet away from others.
• If you are in public places, remember that when your hands touch what other people’s hands have touched, the virus could be passed to you. For example:
  • On a bus, don’t hold on to an overhead strap or to a pole. Instead, wrap your arm around the pole to support yourself.
  • When climbing stairs, don’t hold on to the railing unless you absolutely have to.

Q: How do I protect others if I get sick?

A: If you develop symptoms that could be swine flu, like those mentioned just above, and if your local health department says there is an epidemic in your community, you should pay close attention to the specific advice of the health department. Our general advice is:

• Stay at home!
• At home, try to stay away from others as much as possible. If you can, try to stay in one room and have others avoid that room. If you have multiple bathrooms, claim one as your own and don’t share it with others.
• If you are coughing and sneezing, don’t sneeze into your hands. Instead use tissue and deposit the tissue in a wastebasket or toilet. Wash your hands immediately after.
• Don’t shake hands with people, or kiss hello.
• If you have to go out, avoid crowded situations—public transportation, movie theaters, and the like.

Q: How long are people contagious?

A: Adults should be considered contagious until at least 7 days after the start of symptoms; with children, it may be 10 to 14 days.

Q: I hear the virus seems to be losing its punch. Is that true?

A: Probably not. The virus did seem to produce more severe disease in Mexico than in the United States and most other parts of the world. But that could be because the weather was getting warmer, and because people in Mexico—not knowing the danger—waited longer to seek medical help. As explained earlier, many experts worry that the virus could produce more severe disease as it spreads in the cold, dry air of fall and winter. That has happened with past pandemics: a summer reprieve was followed by a major outbreak in the fall and winter.

Also, influenza viruses change their genes so frequently that epidemics caused by influenza viruses can change their character quickly. The genetic changes could make the virus cause either more or less serious illness.

Q: Are there vaccines to prevent swine flu?

A: It appears that the first doses of the vaccine will be available in late October 2009. Almost certainly, there will not be enough vaccine for everyone, at first, and so some priority groups will get the vaccine first. In the United States the highest priority groups will be:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated.
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus.
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity.
• Children 6 months through 4 years of age, because they are at higher risk of complications
• Children 5 through 18 years of age who have chronic medical conditions, because they are at higher risk of complications.

If the vaccine supply is more plentiful, then the CDC recommends vaccinating these same groups plus:

• All people from 5 years through 24 years of age
  • Children from 6 months through 18 years of age because many cases of novel H1N1 influenza occur in children and because children are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
  • Young adults 19 through 24 years of age because many cases of novel H1N1 influenza occur in these healthy young adults, because they often live, work, and study in close proximity, and because they are a mobile population; and,
• Persons aged 25 through 64 years who have health conditions associated with higher risk of medical complications from influenza.

Once these people have been vaccinated, then everyone from the ages of 25 through 64 years can begin to be vaccinated. Research shows that the risk for infection among persons age 65 or older is less than the risk for younger age groups, probably because healthy people in this age group are more likely to have some degree of immunity against the virus.

Q: Can you get swine flu from eating pork?

A: Absolutely not. But, as you probably know, you need to cook pork thoroughly to avoid getting other illnesses that can be spread by undercooked meat.
For more information on swine flu and influenza, go to Harvard Medical School’s Flu Resource Center at www.health.harvard.edu/flu.

Swine flu symptoms

For adults, teens, and kids aged 3 to 12, the most worrisome symptoms are:

• Shortness of breath
• Persistent vomiting
• Confusion
• Dizziness

For children younger than 2, the most worrisome symptoms are:

• Very rapid breathing
• Not interacting normally, not eating or drinking normally, being unusually irritable, or appearing unusually sleepy
• High fever and rash
• A bluish color of the lips and skin

The 43-page Special Health Report, Swine flu: How to understand your risk and protect your health, answers questions such as:

• What is an influenza virus, and how does it cause infection?
• What is swine flu, and what is a pandemic?
• What are the symptoms of swine flu, and how are they different from ordinary flu symptoms?
• How serious and contagious could the swine flu epidemic be?
• What has happened in past pandemics?
• Is a vaccine available?
• How is swine flu treated?
• What can I do to protect myself and my family?
• How can businesses prepare for a swine flu pandemic?

Reprinted from Swine flu: How to understand your risk and protect your health, a Special Health Report from Harvard Medical School, © 2009 by Harvard University. All rights reserved.

This is posted on the IDF Web-site and originates from the AAAAI.   This is information for PIDD patients and the Swine Flu vaccine:

September 17, 2009
Flu Vaccine Guidance for Patients with Immune Deficiency
MILWAUKEE, WI – While vaccinations for both the seasonal flu and H1N1 are among the best prevention tools available to prevent complications from the flu, should patients with immune deficiency be given the vaccines?
In general, there are two different types of vaccines. These are usually referred to as live or killed vaccines. Live vaccines contain live bacteria or a virus that has been modified. This means they’ve lost their disease-causing ability or are administered by a route that prevents them from causing clinical disease. Killed vaccines are just what the name says—the bacteria or virus in the vaccine is dead.
The difference between the live and killed vaccines is an important one for those with immune disorders.
Information released today by the American Academy of Allergy, Asthma & Immunology (AAAAI) recommends that live viral vaccines should not be administered to patients with immunodeficiencies. This includes FluMist®, a live viral intranasal vaccine.
Furthermore, family members or household contacts should not receive a live viral vaccine, as they may transmit the live virus to the immune deficient family member. On the other hand, seasonal influenza and H1N1 killed vaccines should be administered because there is no risk of disease from killed or microbial subunit vaccines in patients with immune deficiency.
“Patients with primary immune deficiency, but not patients with severe T-cell deficiency, should receive the H1N1 vaccine. Although the antibody response may be poor or low, the cell-mediated immune response may be a helpful immune response to the virus,” said AAAAI President-Elect Mark Ballow, MD, FAAAAI.
In addition to the immune deficient patient and his or her household members receiving vaccinations with the killed influenza virus, preventative measures such as hand washing should be practiced. If a family member or household contact begins to have flu symptoms, anti-viral influenza drugs should be made available and taken at the first sign of the symptoms.
According to the National Institutes of Health, it is estimated that each year about 400 children are born in the United States with a serious primary immune deficiency. An immune deficiency results in defects in the body’s ability to fight infections. Primary immune deficiency means that there is an inherited problem with the immune system.
Since these patients have a decreased resistance to infections, they often have repeated infections, or infections that are more severe and cause unexpected complications.
The AAAAI offers a comprehensive library of resources on the novel H1N1 virus—especially as related to allergic diseases—including treatment recommendations, vaccine news, case studies and information for patients. Subscribe to the RSS feed to be notified of the latest updates as they happen.
The AAAAI (www.aaaai.org) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has nearly 6,500 members in the United States, Canada and 60 other countries. To locate an allergist/immunologist, visit the AAAAI Physician Referral Directory at www.aaaai.org/physref.

Since may of us have any number of autoimmune disorders, and quite often Celiac disease is one of them, I thought I would post this Newsletter I received from Harvard.  I also have celiac- so keep a very close eye on any articles pertaining to it. 

Getting out the gluten

Gluten seems to be the food ingredient non grata these days. Bakers are coming up with recipes for gluten-free cupcakes and baguettes. Anheuser-Busch sells Redbridge, a gluten-free beer made from sorghum. And, of course, times being what they are, you can easily slip into an Internet swirl of blogs and Twittering about gluten-free foods. It’s not just talk: cash registers are ringing. By some estimates, the sales of gluten-free foods have tripled since 2004.

Gluten-free food has become more popular partly because doctors are diagnosing more cases of celiac disease, an autoimmune disorder whose symptoms are triggered by gluten, the protein content in wheat, barley, rye, and spelt (an ancient form of wheat that’s catching on as a health food). Celiac specialists say the disease isn’t diagnosed as often as it should be. As a result, many people suffer with it for years, often after getting other - and incorrect - diagnoses and useless treatments.

But a growing number of the people dodging gluten fall into a gray area: they don’t have celiac disease but seem to be unable to digest gluten properly. There are no tests or strict criteria for this problem, aside from simple trial and error with a gluten-free diet. Often people self-diagnose. It’s hard to know what’s going on. Some people may be getting caught up in a food fad. But many others probably do have a real problem digesting gluten or perhaps the sugars in some of these grains, a condition akin to the lactose intolerance that makes it hard for many people to digest dairy foods. Their problem is not as well-defined or well-understood as celiac disease but they have a problem nonetheless.

There’s a third group of gluten-free converts: people who are blaming gluten for a wide range of medical conditions, not just gastrointestinal distress. For example, there’s a fairly loud Internet “buzz” about autistic children improving once they’re on a gluten-free diet.

There’s good, solid evidence of an overlap between celiac disease and other autoimmune disorders, particularly type 1 diabetes. And celiac disease and other autoimmune disorders sometimes have neurological effects - peripheral neuropathy, for example, which involves nerve damage that results in numbness and pain.

But based on what is currently known, it’s a big leap to attributing autism and other problems to gluten, and an even bigger one to prescribing gluten-free eating as a treatment. It’s possible that some people benefit from a gluten-free regimen for reasons that have less to do with gluten and much more to do with the structure involved in planning and sticking to such a strict eating plan.

Misreading the situation

Gluten is an imprecise term that shifts meaning depending on the context. Gluten comes, not surprisingly, from the Latin word for glue, and cookbooks define it as the protein-based substance that makes dough resilient and stretchy. If you’re making bread, you want gluten in the dough, so that when it’s baking the walls of the little air pockets formed by yeast expand but don’t burst open. But if you’re making cookies or a pie crust, you want to keep the gluten content of the dough and batter low. Otherwise, your results will be tough and gummy.

In the context of celiac disease, gluten refers to the protein of grains capable of provoking an autoimmune response. Other grains also contain protein, but wheat, barley, rye, and spelt contain varieties that aren’t broken down by digestive enzymes. In wheat, the difficult-to-digest protein is gliadin; in rye, it’s secalin; and in barley, hordein.

These proteins don’t faze the guts of most of us. But in people with celiac disease, when they get absorbed into the walls of the small intestine, the immune system misreads the situation, views them as intruders, and unleashes a furious inflammatory response that damages tissue (see illustration). The inside of a normal, healthy small intestine is carpeted with millions of fingerlike projections called villi that produce digestive enzymes and soak up nutrients. The misguided immune response triggered by the gluten proteins sometimes attacks these villi, so they lose their slender shape and become short and stubby, even flat. When that happens, the villi produce fewer digestive enzymes and absorb fewer nutrients.

Celiac disease: an autoimmune response

Symptoms - classic and non

The classic and most immediately noticeable symptoms of celiac disease are, not surprisingly, gastrointestinal: bloating, flatulence, and diarrhea, sometimes with smelly stools. People who can’t digest gluten or grain sugars may have similar symptoms.

Celiac disease can severely impair the absorption of nutrients. In children, this may lead to stunted growth; in adults, the consequences include anemia (because iron isn’t being absorbed) and weaker bones (because calcium and vitamin D aren’t getting into the body). Anemia causes fatigue and malaise, but some people with celiac disease feel that way without anemia.

Doctors sometimes miss the celiac disease diagnosis because they’re looking for the classic gastrointestinal symptoms, not the vaguer ones that stem for the most part from malabsorption of nutrients.

One major difference between celiac disease and grain-related digestion problems is that when it’s just a digestion problem it typically doesn’t lead to malabsorption and nutritional deficiencies.

Women with untreated celiac disease have higher-than-normal rates of menstrual abnormalities and infertility. A large study published in 2007 found an increased risk of pancreatitis in people with celiac disease. It’s not clear whether a cause-and-effect relationship can be inferred from these associations or if celiac disease and these conditions happen to be consequences of a shared, common cause.

According to some research, several of the nongastrointestinal conditions associated with celiac disease might be caused by an overabundance of antibodies that the immune system churns out, especially those it produces in response to an enzyme in the small intestine called tissue transglutaminase. The antibodies travel to other parts of the body through the bloodstream. Perhaps the clearest example of one of these antibody-related symptoms is a skin condition, dermatitis herpetiformis, which causes itchy red bumps. Less certain is whether the anti-tissue transglutaminase antibodies might get into the brain and cause neurological problems, such as loss of muscle control (ataxia).

A blood test and a biopsy

Compared with other autoimmune disorders (such as Crohn’s disease and rheumatoid arthritis), the diagnosis of celiac disease is pretty straightforward. In the United States, the issue has been getting doctors to consider the celiac diagnosis as a possibility. That’s changing. For example, the guidelines for irritable bowel syndrome were revised to include testing for celiac disease.

The diagnosis begins with a blood test for the antibodies generated by the immune response that gluten provokes. Tests exist for several different types of antibodies, but the one for the antibodies against the tissue transglutaminase enzyme is the most reliable and accurate. If the blood test is positive, the next step is biopsy of tissue from the small intestine to see if the villi have been damaged. Collecting the biopsy involves snaking an endoscope - a flexible tube with a tiny camera on the tip - down the throat and through the digestive tract and snipping out small pieces of tissue that can be examined under a microscope.

Dr. Daniel Leffler, a celiac disease expert at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, says the biopsies show, on average, that over 90% of people with positive antibody tests and celiac symptoms have intestinal damage, and the presumption is that they have celiac disease. But if the biopsy shows a lack of intestinal damage, that usually rules out celiac disease as a diagnosis.

In people with symptoms, judging whether there’s a favorable response to a gluten-free diet isn’t difficult: the turnaround from illness to health can be quite dramatic. But Dr. Leffler notes that many - indeed, perhaps most - people with a positive antibody test and intestinal damage do not have symptoms or have atypical ones that are subtle and vague. These patients raise some important questions. Is this a case of test results in need of a disease, rather than the other way around? And from the patient’s perspective, why bother with a diet that’s inconvenient - despite the growing number of choices - and expensive if you don’t have symptoms?

Celiac disease experts have a three-part answer. First, if doctors and patients were more aware that problems like anemia and fatigue can be traced back to celiac disease, they’d see that a gluten-free diet improves these symptoms. Second, if symptoms are subtle, so might be the improvement. Third, like many so-called silent diseases, celiac disease may not have showy symptoms, but if left alone, it may result in serious problems down the line related to poor nutrition. And some data suggest that the risk of developing other autoimmune conditions (including thyroid disorders like Hashimoto’s thyroiditis and Graves’ disease) may be related to how long someone with celiac disease has been eating gluten.

The super six

We’re often too quick to depend on pills instead of first working to change our diet and exercise habits. But with celiac disease, there’s no pill, and a fairly radical change in diet is the only treatment. Ironically, doctors who treat celiac disease lament the lack of pharmaceutical industry involvement. Drug companies have started to take some interest in the disease, and treatments that would block the absorption of gluten are being investigated, but none so far are close to gaining FDA approval.

Gluten-free eating is a two-way street: getting the gluten out while bringing in healthful - and palatable - alternatives. Some foods are obviously made with wheat and the other gluten-containing grains. Conventional bread, bagels, pizza - they’re out if you have celiac disease. But until you need to avoid gluten, you probably don’t realize how ubiquitous it is. Gluten is used as a thickening agent and filler in everything from ketchup to ice cream. The inactive ingredients in many medications are gluten-based. And even when gluten isn’t an ingredient, it may inadvertently get into a food because a wheat-based food was processed in the same factory, or wheat was grown in a nearby farm field. At home, wooden utensils and toaster ovens are gluten “hot spots.” Oats don’t contain gluten, but many people with celiac disease avoid them because of contamination problems.

The gluten-free diet has traditionally depended on starch from rice, corn, and potatoes. Food makers have also learned how to use xanthan and guar gums to replace gluten’s elasticity: a common complaint about gluten-free baked goods is that they are powdery. But these formulations can also leave diets short of fiber and B vitamins. Melinda Dennis, the nutrition coordinator at the Beth Israel Deaconess Medical Center Celiac Center, encourages patients to eat foods made with unconventional but nutritionally well-rounded substitutes, including amaranth, buckwheat (no relation to wheat), millet, quinoa, sorghum, and teff. She calls them the “super six” because of their high vitamin and fiber content.

Eating out is one of the biggest issues for people with gluten problems, says Dennis. Vegetables get contaminated because they are steamed over pots of pasta water. Fish and chicken are floured to hold seasonings. But many restaurants are beginning to offer gluten-free items. And there are some celiac-friendly cuisines, even if they are not overtly gluten-free. Dennis put Ethiopian (which uses teff), Indian, Mexican, and Thai in that category.

Harvard Health Letter

Volume 34 - Number 8 - June 2009

WASHINGTON, Sept. 15 /PRNewswire-USNewswire/ — The U.S. Food and Drug Administration announced today that it has approved four vaccines against the 2009 H1N1 influenza virus. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks.

“Today’s approval is good news for our nation’s response to the 2009 H1N1 influenza virus,” said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. “This vaccine will help protect individuals from serious illness and death from influenza.”

The vaccines are made by CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and sanofi pasteur Inc. All four firms manufacture the H1N1 vaccines using the same processes, which have a long record of producing safe seasonal influenza vaccines.

“The H1N1 vaccines approved today undergo the same rigorous FDA manufacturing oversight, product quality testing and lot release procedures that apply to seasonal influenza vaccines,” said Jesse Goodman, M.D., FDA acting chief scientist.

Based on preliminary data from adults participating in multiple clinical studies, the 2009 H1N1 vaccines induce a robust immune response in most healthy adults eight to 10 days after a single dose, as occurs with the seasonal influenza vaccine.

Clinical studies under way will provide additional information about the optimal dose in children. The recommendations for dosing will be updated if indicated by findings from those studies. The findings are expected in the near future.

As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal.

People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.

In the ongoing clinical studies, the vaccines have been well tolerated. Potential side effects of the H1N1 vaccines are expected to be similar to those of seasonal flu vaccines.

For the injected vaccine, the most common side effect is soreness at the injection site. Other side effects may include mild fever, body aches, and fatigue for a few days after the inoculation. For the nasal spray vaccine, the most common side effects include runny nose or nasal congestion for all ages, sore throats in adults, and — in children 2 to 6 years old — fever.

As with any medical product, unexpected or rare serious adverse events may occur. The FDA is working closely with governmental and nongovernmental organizations to enhance the capacity for adverse event monitoring, information sharing and analysis during and after the 2009 H1N1 vaccination program. In the U.S. Department of Health and Human Services, these agencies include the Centers for Disease Control and Prevention.

Vaccines against three seasonal virus strains are already available and should be used (see information on the seasonal flu). However, they do not protect against the 2009 H1N1 virus (see information on H1N1 flu). Media Inquiries: Pat El-Hinnawy, 301-796-4763, patricia.el-hinnawy@fda.hhs.gov; Peper Long, 301-796-4671, mary.long@fda.hhs.gov Consumer Inquiries: 1-888-INFO-FDA

SOURCE U.S. Food and Drug Administration

I guess you could say that it’s never a good thing when your Dr. calls you at home over Labor Day week-end, and begins his sentence with ‘Carol, I’m afraid I’ve got really bad news”.  That is what my Monday was like.  It has gotten better since then.

I had a brand new ‘thingy’ removed from my shin the week before.   After I noticed that it had just popped up out of nowhere, I showed it to family members- they all said it looks like nothing.   I watched it for a couple of days, as it grew rather quickly, was uneven with ragged edges.   I called my Dermatologist and got right in (I had a pre-cancerous lesion removed from my lip over New Year’s).   He took a quick look and said- “It looks like nothing”.   Then, he looked under his magical magnifying monocle, and said, it looks kind of unusual.

We’re going to remove it and get a biopsy.  And, they did.

And, it came back as malignant melanoma (Is that redundant)?

When I hung up with Dr- I immediately went on-line to trusted sources to see what I could learn.   I know the best and the worst now.  I spent about 24 hours stressed about this.

Then, I woke up on Wednesday morning, and I knew that I was prepared for whatever the outcome would be.   I am having a larger HUNK of skin, tissue removed bright and early Monday morning.

That will also get biopsied.  I personally feel that I was very vigilant and found it early enough that will be the end of it for now.    For now.

Cancer has gotten it’s hold on me, I’m nearly 61, and I’ve already lost my Dad and my sister to Cancer.   The C word- I never thought I would have to say it about myself.   You could say- OH- It’s just skin cancer- but do you realize that melanoma is the deadliest of all skin cancers?   The most rare too.   Only 2% of all skin cancers are melanoma.  And, they easily  metastasize to lymph nodes and organs. 

We also already know that the incidence of getting cancer is greatly increased by having PIDD.   I’ve heard lots of numbers thrown around - but since they don’t agree- I won’t quote any here.   But, the other thing about PIDD is that we mount a very poor response to fighting invaders= and I guess you could call Cancer – the DEARTH INVADER! 

So, I’m trying to get my house in order this week-end (literally and figuratively) as I prepare for the surgery Monday am.

Why am I doing this- well it beats sitting around and sweating it out.  Plus, being a Type A- it feels better this way.

I’m writing this so that you will also be more vigilant about skin spots- make sure to get them checked.  And, never let something you are suspicious of fester.   Get in to your Dr ASAP.

Very timely information for women.   Read ASAP.

This is from our Department of Health and Human Services

I hope it helps you in your decisions about health care today.

While all Americans shoulder the burden of rising health care costs and increasingly inadequate health insurance, America’s 17 million older women (ages 55-64) and 21 million senior women (ages 65 and older) are particularly susceptible to rising costs. At a time in their lives when access to affordable health care is increasingly important, some older women are having a harder and harder time getting the care they need and deserve.

That’s why, today, I will participate in a roundtable discussion with women in South Portland Maine to formally release and discuss a new report on the importance of health insurance reform for older women and women senior citizens.

The report, Strengthening the Health Insurance System: How Health Insurance Reform Will Help America’s Older and Senior Women, identifies problems with the status quo for older women and women senior citizens and outlines some proposed solutions to those challenges that will result from health insurance reform. A couple of examples that I found especially compelling:

• Senior women spent on average 17 percent of their income on health care in 2005.ⁱ The growth in Medicare Part B premiums from 2000 to 2018 is predicted to cost seniors an additional $1,577 per year out-of-pocket.ⁱⁱ Health insurance reform will reduce overpayments to private plans and clamp down on fraud and abuse to bring down premiums for all seniors and extend the life of the Medicare trust fund by 5 years.ⁱⁱⁱ

• One in five women aged 50 and above has not received a mammogram in the past two years.^iv By ensuring that health plans cover preventive services for everyone, investing in prevention and wellness, and promoting primary care, health insurance reform will work to create a system that prevents illness and disease instead of just treating it when it’s too late and costs more.

Health insurance reform will remove these hurdles to ensure that older and senior women, along with all other Americans, get the quality, affordable health care they deserve. To read the complete report, visit www.HealthReform.gov and share your story or idea about the importance of passing health reform this year.
Thank you for your commitment and support as we work towards creating a health care system that better serves all Americans.

Sincerely,
Kathleen Sebelius
Secretary, U.S. Department of Health and Human Services
______________________________