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P age A6
A i ta si 14, 1996 - T he P ori land O bserver
Science
Creating mental cages
by
D r , C harles W. F avlkner
♦ 7 cannot control m y eating
Every tim e that I begin to worry, I
becom e ravishm gly hungry "
♦ " I w ill never be able to control
m y stress because I a lw ays g e t a n ­
g ry w henever / th in k a b o u t m y
boss. "
♦ These p eo p le m ake m e lose
control o f m y se lf every tim e that I
am around them le a n t s ta n d them
That s the w ay it is a n d th t's w ay it
will alw ays be. "
These statements indicate the psy­
chological cages into which the peo­
ple who make them have locked them­
selves. Not only do the statements
describe the way that people fell in
certain situations, but they indicate
other equally important points:
1. They indicate the w ay that
people expect to feel w henever the
situations present them selves.
2. They indicate that the victim
will take no conscious steps to stop
his or her behavior from taking place
because the behavior is considered
to be natural and inevitable.
3. The victim ized person w ould
feel unusual if the particular behav­
ior did not present itself.
4. The individual has resigned him­
se lf or h erse lf to certain “ uncontrol­
lable” aspects o f behavior.
5. T he victim expects to observe
his or her behavior, as if observing a
m ovie in w hich he o r she w as the star,
w henever certain stim uli occur
People who perceive them selves
as having a certian unavoidable be­
havior, in effect, regularly initiate
their own behavior. T hey actually
m ake it occur.
Raymond is an example. Raymond
felt that he would becom e nervous
whenever he was preparing to speak to
a group o f strangers. He had felt this
way for years and could recall the
torment ofhis nervousness during many
previous speeches. He did his utmost
to avoid participating in such activi­
ties, but the worse was to happen.
His boss scheduled R aym ond to
address a group o f new em ployees.
The very thought o f this endeaver
traum atized Raym ond. W hen he was
Bess Kaiser site sell-off begins
on the stage w aiting to be intro­
duced, R aym ond began to observe
his ow n behavior: “ W hen w ill I b e­
gin to trem ble? W hen will I stam ­
m er? W hen will I begin to forget my
speech? W hen will the audience
recognize my nervousness and b e­
gin to laugh at m e? I know that it wil I
happen s o o n - I can alm ost feel it
beginning now. As soon as my name
is m entioned, I will begin to shake.
It alw ays has happened and it will in
a couple o f seconds. T here it g o es... I
can feel it hap p en in g .”
T he above statem ent is ex p res­
sion o f a person w ho has given up. It
represents the internal conversation
that takes place w ithin each o f us
w henever w e expect to becom e ner­
vous in an endeaver.
T h is co n v e rsatio n p rec ed es a
breakdow n in behavior. T he person
speaking could be nam ed Jane, Jack,
Jean or Joseph. T he cause o f the
nervousness could be w alking up a
steep flight o f stairs, flying an air­
plane, m eeting a stranger, bein g rep ­
rim anded o r taking an exam ination.
Melanoma: Where Are We Now?
Ten years ago, doctors predicted
that by the year 2000 the average
Am erican would have a 1 in 150 risk
o f developing skin cancer. T hat pre­
dicted risk was ten tim es the inci­
dence rate in 1930 when one in 1500
American developed skin cancer.
Today, despite years o f public
education cam paigns about the im ­
portance o f sun protection for skin,
the predictions are worse, not better.
By the year 2000, derm atologists
now say, the average A m erican will
have a 1 in 75 chance o f developing
a skin cancer, tw ice as high as was
thought ten years ago. In 1996, alone,
more than one m illion people will be
diagnosed with all types o f skin can­
cer, and more than 7,300 will die of
their skin cancer. In fact, the m ost
deadly form o f skin cancer, m alig­
nant melanom a, is increasing in inci­
dence faster than any other type o f
cancer in the world.
W hat’s behind the rising rates o f
skin cancer? D octors point to m any
potential causes. On the bright side,
doctors and patients are more adept
now at recognizing skin cancers, so
detection o f skin cancers have im ­
proved, and with better detection
come higher incidence rates. H ow ­
ever, im proved detection alone does
not explain the rapid rise in the rate o f
developm ent o f skin cancers. “M ost
of the incidence records are based on
data collected on patients seen in
hospital outpatient clinics, and m ost
skin cancers are cared for in private
doctors' offices w here they usually
do not get into the reporting system ,”
says Howard Koh, M .D., Professor
of D erm atology at Boston U niver­
sity School o f M edicine w ho spoke
on this subject at a recent m eeting of
the American A cadem y o f D erm a­
tology. "There-fore, although d etec­
tion has im proved and this will co n ­
tribute to a higher skin cancer rate,
underreporting o f skin cancer m ore
than offsets the im proved detection.
We are, in fact, facing a m elanom a
epidem ic.”
a more likely explanation for the
rise in the incidence o f skin cancers
and particularly m elanom a, is that
time is finally catching up with us.
Skin cancers can take decades to
develop. As today’s "B aby B oom er”
generation ages into their forties and
fifties, they are heading into the peak
years for skin cancers to arise. “ It’s
quite possible that people being di­
agnosed with skin cancer in their
forties and fifties are paying for the
sunbathing they did in their teens and
twenties," says N icholas Lowe, M.D.,
Clinical Professor ot D erm atology at
UCLA School o f M edicine.
Key to Survival: Early D etection
In addition to your personal sun
exposure history, having a family
history o f m elanom a also increases
your own risks for the disease, as
does a personal history o f m oles,
particularly large, irregularly shaped
moles called “Dy splastic Ne vi.’’ Y our
chances of surviving m elanom a are
greatest if you spot the lesion early in
its developm ent. T he best w ays to do
this are with regular skin exam s by
your derm atologist, and m onthly self
exam ination o f the skin using tw o
m irrors (one o f them hand held) to
view all parts o f your skin. E xam ina­
tion is obviously easier if you have a
p artn erex am in e your skin, too. W hat
are you looking for? C hanges in ex ­
isting m oles or new lesions with ch ar­
acteristics best sum m ed up by the
w ell-know acronym , the A B C D s o f
m elanom a...
A. is for A sym m etry. In ordinary
moles, an im aginary line draw n dow n
the m iddle o f the lesion will produce
two equal halves. In m alignant m ela­
nom a the tw o halves arc likely to be
uneven.
B. is for B order irregularity. M oles
have rounded, w ell-defined borders;
m elanom as are irregularly shaped
w ith poorly defined borders.
C. is for color. T he co lo r o f m oles
is usually uniform ly brow n. M elano­
m as tend to have m ore than one color-
tans and brow ns m ixed w ith black,
red, pink, w hite or blue.
D. is for D iam eter. M ost m oles are
no bigger than the size o f a pencil
eraser. M elanom a m oles tend to be
much larger, usually m ore than 5
m illim eters in diam eter.
will not interfere will its plans to use
Bess K aiser for outpatient services
once inpatient services are closed in
late N ovem ber 1996. “W e estimate
this interim use will last until the sum ­
m er o f 1 998, which is when we expect
to com plete construction o f a new
medical services building at our North
Interstate cam pus,” said Barbara west,
Kaiser Perm anente’s Regional M edi­
cal Services Administrator. The new
building will provide 24-hour em er­
gency care and after-hour urgent care,
along with other services.
K aiser Perm anente is w orking with
the O v erlo o k N eighborhood A sso ­
ciation throughout the process.
Stroke symptoms
S troke sym ptom s require fast ac­
tion.
S trokes are a loss o f circulation
to the brain caused by a closed
artery o r by a blood clot that has
m oved from the heart o r large arter­
ies in the neck.
Ruptured blood vessels in the
brain can also be a cause, said Dr.
Jam es K illian, a n eu ro lo g ist at
B aylor C o lleg e o f M ed icin e in
Houston.
A n y o f these sym ptom s w arrants
an im m ediate trip to the em ergency
room :
♦ Loss o f strength in an arm, leg
or both.
♦ L o s s o f sp eech o r slu rred
speech.
♦ S u d d e n , se v e re an d u n e x ­
plained headache.
O ther p o ssib le stroke sym ptom s
m ay n ot require em erg en cy treat­
m ent but do not w arrant an im m e­
d ia te ca ll to a physician:
♦ N u m b n ess or odd sensations
on one side o f the body or face.
♦ T em porary loss o f vision or
double vision.
♦ D izziness or loss o f balance.
Foot care for diabetics
For diabetics, there is no side­
stepping foot care.
“ Fifteen to 20 years into the dis­
ease, poor circulation and nerve
dam age can threaten the limbs, “
said D r. G lenn C u n n in g h am o f
B ay lo r C o lleg e o f M ed icin e in
H ouston. “ Bui preventive m easures
can help avoid infection, gangrene
and am putation.”
C unningham urges diabetics to
practice p ro p erfo o t care, including
♦ W earing shoes with good arch
support and proper fit.
♦ W earing clean socks or hose.
♦ A voiding walking barefoot.
♦ C hecking inside shoes for peb­
bles, tacks or tears.
♦ Cutting toenails straight across
to prevent ingrown nails.
♦ Buffing down corns o r callus­
es with a pum ice stone or emery
board. Do not cut them or use a
chem ical corn remover.
Kaiser Perm anente’s decision to
close Bess Kaiser rather then under­
take expensive upgrades and other
needed improvements occurs at a time
o f rapid change within health care.
Improved surgical and medical tech­
niques mean many more surgeries are
perform ed in medical offices. And pa­
tients w ho are still operated on in the
hospital can leave sooner, resulting in
shorter stays and more em pty hospital
beds.
In Portland, the average hospital
occupancy rates have fallen more than
17 percent since 1989. On average,
half (more than 1,500) of the licensed
hospital beds o f unused each day.
Plan to
fight H.I.V.
Have an opinion on services for
people living with H IV? W ant to
m ake your voice heard?
Be a part o f the 1996 N eeds A s­
sessm ent o f HIV Services, and have
an impact on how federal funds are
being spent to provide services to
people living with H IV/AIDS.
They w ant to hear from people
living with HIV, their providers,
caregivers, and family m em bers to
find out how service needs are being
met in the six-county area of: C lacka­
m as, C olum bia, M ultnom ah, and
C lark County in W ashington.
D u rin g A u g u st an d S e p te m b e r,
you m ay be ask ed to:
♦ f i l l out a survey, and/or
♦ be a p a rt o f a fo c u s group, or
♦ participate in aprovider/caregiver
fo ru m .
T o co m p lete asu rv e y ; be included
on list o f possible participants for
fo c u s g r o u p s o r th e p r o v id e r /
caregiver forum; or receive a sum ­
mary o f the results (available N o­
vem ber, 1996), please call the HIV
Services Planning Council office at
(503) 306-5730 for inform ation
The first American medical school was opened in Philadelphia in 1765.
FDC
PORTLAND
l)EVELOPME,Vf
COMMISSION
COMMISSION MEETING
Date: August 21,1996
Place: PDC
1120 SW 5th Ave., Suite 1100
Commission Conf. Room
Portland, Oregon
Time: 9:00 a.m.
Commission meetings are open to
the public. A complete agenda is
available at PDC or by calling
823-3200. Citizens with disabilities
may call 823-3232 or TDD 823-6868
for assistance at least 48 hours in
advance.
PDC is the City of Portland's urban
renewal, housing and economic
development agency.
At a world-record pace.
Through careful management of
his serious lung disease,
superathlete Tom Dolan was
able to break the world's record
for the 400-meter individual
medley. Through your support,
our education programs and
research can help millions with
asthma and other breathing
problems. Help the American
Lung Association help us all
breathe a little easier.
W hen you can’t breathe,
nothing else m atters/
t
A lso pay attention to the elevation
o f pigm ented lesions. Increased thick­
ness and a lesion that looks m ore
raised than it once did can be signs o f
m alignant changes in a mole. U lcer­
ation and crusting o f a lesion are
signs o f advanced stages o f m ela­
nom a that require im m ediate m edi­
cal attention.
C urrent and Future T reatm ents
W hen caught early, m elanom as
are relatively easy to treat and have a
high cure rate. So-called “ in situ ”
m elanom as, that are less than 4 mm
in size and that have not spread be­
yond the skin, can usually sim ply be
excised, although the patient should
be closely m onitored for recurrence
o f the tum or. H ow ever, m elanom as
that are g reater in size or that have
spread to regional lym ph nodes or
beyond carry a m uch higher relapse
rate and risk o f death from the m alig­
nancy. T he treatm ent o f advanced
m elanom as involves not only removal
o f the tum or and regional lym ph
nodes, but also potentially treatm ent
with chem otherapy drugs or im m u­
nological agents such as interleukin-
2, o r com b in atio n s o f different skin
in the skill o f application.
A fter com pleting studies w hich
looked at potential uses for the Bess
K aiser M edical C enter property, Kai­
ser P erm anente has decided to divide
the site into tw o land parcels. It will
keep one and sell the other.
T he health m aintenance organiza­
tion (H M O ) will retain the A dm inis­
trative O ffice building, adjacent park­
ing lot, and land to the north, which
includes tw o houses ow ned by K ai­
ser Perm anente.
Kaiser Perm anente has identified
several criteria w hich will help ensure
that future use o f the site will add value
to the neighborhood. It will also re­
quire that transition to a new ow ner
AMERICAN
LUNG
ASSOCIATION.
1-800-LUNG-USA
1
•S ome
b o o - b o o s , a kiss can ' t fix .
Polio. Measles. Diphtheria. Whooping
Cough. The fact is, once a child contracts a
scary disease like this, there's not much a par­
ent can do. It's up to the doctors. And fate.
Which makes it inconceivable that 33% of
Oregon children still aren't fully immunized
by the age of two.
Yes, School Law requires they be immu­
nized by kindergarten. But unfortunately, that
law also creates the perception that it's okay to
wait until then. People don't realize that wait­
ing puts their infants at risk, llnimmunized
infants are not protected. Therefore, they are
more likely to get diseases and to have severe
side effects from them.
Truth is, 80% of all vaccines can be given
by age two. Safely. All it takes is four quick vis­
its to the doctor. Meaning you must follow
through with all the shots. They don't have to
cost a lot either.
Most important, don't be afraid to ask your
doctor, nurse practitioner or health depart­
ment questions. And keep track of your child's
immunization schedule Aftpr all, thp one who
can best take care of your baby is you.
Free or low cost immunizations available.
For more information call 1-800-SAFENET (1-800-723-3638)
or in the Portland Metro area call 306-5858.