Health issues - cervical screening

Back to health, 'cos there is always something to write about health, and how many of us have not been through so many similar scenarios? (Although seems not everyone had my exciting operational childhood).

On one post, I said that I believed in my youth that cervical screening was A Good Thing. This was primarily because I knew stuff all about it. I am not saying it is a bad thing, but you really don't need to do 1000 Hail Marys if you choose not to take up a screening appointment.

IMNRHO, cervical screening receives far too much airtime. Why does it receive so much publicity when it is hardly one of the most common cancers? Possibly because it combines two irresistible subjects, cancer prevention and sticking things up women, to put it bluntly. And for all those women out there who have had smears, that is exactly what it is and what it feels like.

However, I shall now add to the airtime, as I find it an interesting topic, not least because of the amount of ignorance out there. I'll start with mine.

I can't remember what or where I first heard about cervical screening. Probably, like lots of other women of my generation, something I read about in a magazine. And my first fuzzy impressions were that it was important to go for one as it would prevent cancer. In case you are already bored - just read one more comment. Cervical screening, in itself, does NOT prevent cancer. Nor is the purpose of the programme to detect it.

So having heard about this strange procedure where someone sticks something up you and it could possibly be slightly uncomfortable, what happens next? Well, again, in my antiquated day, the first experience was usually when you braved the local doctor to ask for a prescription for the pill. My GP was OK to be fair so this is not a criticism of him, more of the system, or lack of it at the time. But ask for pill, and jump on couch, open legs and nasty cold thing is stuck up.

When I had my first cervical smear, there was no organised call and recall programme. Screening was provided by GP surgeries but on a sporadic basis depending who your GP was etc etc. Call and recall (as it's called in NHS jargon) which is the incredibly organised invitation system, was introduced in the late 80s. My mother received an invitation in her early 60s and asked me what to do. I figured a) she wouldn't really like the experience and b) she had managed 60 years of her life without a smear so best leave it alone.

Some years later, I took over responsibility for the local screening programme in my health authority, and we had a call and recall programme up and running. We had merged two districts so we had one running a three year programme, and one running a five year programme. We also had GPs doing their own thing. Nightmare.

First though, a few facts, just in case the women's mags didn't include them, or you don't read the nice leaflets the NHS now provides. Or you don't live in the UK.

1) Cervical screening tests for the presence of pre-cancerous cells. That is, cells that may, or may not, later turn into cancerous cells.

2) If there are abnormal cells, this is described as dyskaryosis. Dyskaryosis can be borderline, mild, moderate or severe.

3) What you want to receive is a normal (negative) result. This is not negative by any stretch of the examination, it means that there are no indications of dyskaryotic cells. Moving up the scale, you can get a borderline one, or an abnormal one (refers to mild, moderate or severe dyskaryosis). Or if it can't be read, you get an inadequate one. Doesn't mean you or the smear are inadequate, just that it couldn't be properly read back in the lab, eg not enough cells, or too much mucous, blood or goodness knows what on the sample.

4) All screening programmes provide false results, usually known as false positives or false negatives. A false negative is when you are given the all clear and a problem is later discovered. A false positive is when you are told there is a problem - and possibly given unnecessary treatment for that - and, you didn't need it.

5) You do NOT have to attend for a smear test, however much pressure your local clinic or surgery puts on you. It is your choice.

6) From 1990, UK GPs got extra money for reaching certain targets for the amount of women they managed to screen. So, if they got half the women on their surgery list in for screening they got one payment, if they topped 80% they got more. Mmmm, ever think your GP has your best interest at heart? Or their pocket? What is the use, in a cash-strapped public sector service, of screening women who are at low risk of developing cervical cancer just to stick more bucks in a GP's pocket?

7) If you want to know more, check out the NHS cancer screening website. Their public information leaflets look awfully like the ones I developed more than ten years ago, but hey ho, these things happen. Seriously, though, I do think there is a lot of good info out there and saves me repeating it all.

http://www.cancerscreening.nhs.uk

And - here is another very good page.

Next up - a few horror stories??

The little things

The other day a friend told us about something another friend had for sale. We agreed to go and look at it, preferably early in the morning over the weekend. Our intermediary was happy with that as he gets up early anyway. He agreed to ring us with a time.

As luck had it, he rang back when we were asleep, and left a message. The next morning - not having checked the answerphone - we were still expecting to go look at the prospective goody. Have you ever sat around waiting for someone to ring you with time and location for a meeting?

Invariably their idea of early is midday and the morning is happily wasted as you sit around getting more and more irritable. Or at least I do, and so does Partner. Just in case there is anyone out there who doesn't know, I am a morning person. By which I mean I get up between six and seven am, like to do things in the morning, start thinking about lunch at midday, do nothing in the afternoon, start feeling tired, have some tea/supper later on, and fall into bed in the evening. Not a night-time person by any stretch of the imagination. Night-time and darkness are for sleeping.

And the second thing to say is, I am probably impatient. I do NOT like waiting around. Even waiting for the bus to school I used to get annoyed when it was late, and timed my arrival at the bus stop a couple of minutes before the expected time, but allowing for the odd occasion when it was early. Waiting at bus stops for more than five minutes was never my thing. All that changed somewhat when I went to India and had to wait days for a train. But waiting around for someone to ring to set a time? And seeing the day disappear in front of your eyes? No. Not my thing.

So I decided we would go out, because we would be back home by mid morning and still able to make any appointment. And off we went. After a few minutes, my 'phone went. Had we got the message on the answerphone? No. The appointment was for 5pm that day as it was the only time the other person could manage. This is the weekend. This person does not work at weekends as far as know. Why are we all hanging around until 5pm? No-one stays in bed that long. And this is a five minute job - go and look at something and decide if we want it. We agreed to turn up for 5pm.

How are we getting there, I asked? Walking? I thought your partner could drive, says our intermediary. Hmmm. Well that poses a problem to start with as it is a van and there is only room for one passenger. Where was I supposed to go? Ah. I get it. Nothing to do with me. So I'm not factored into any of this. Well where is it, I asked? Oh, it's near Such and Such Street, says intermediary. That wasn't even five minutes away from us, no need to drive there thinks me, but strangely and unusually said nothing. We'll ring when we get back in an hour or so, I said and clicked off the 'phone.

When we got back we rang and got directions for this place, although not the actual address. I should say that this goody was a vehicle bit and on the vehicle so all we had to do was spot the vehicle in the right car park and have a look without hassling anyone. Off we went. Gib is not a big place but when you don't have good directions, it's not always easy to find somewhere.

We looked at every conceivable nearby car park but the vehicle we were looking for was nowhere to be found. So we came home. That's enough of the tale without going into really boring detail. Basically, someone who had nothing to do with the proposed purchase was acting as intermediary (no cut involved because it wasn't even an expensive buy) and telling us time, but no location, how to get there ie driving not walking, assuming that we were going to buy it anyway so would put said bit in vehicle, AND thinking that I had nothing to do with this possible purchase. Oh. No. Here we are with the money, to buy something and no-one is fitting around us. Or telling us what we need to know.

Point number three - when I am going somewhere - I like to know where I am going. I want an address and specific instructions. 'It's around Such and Such Street' and 'Go up there and it's in the car park' don't really suit. So people, don't give me orders, don't organise what I am doing, and please provide accurate directions in future. And early morning does NOT mean 5pm. Everyone's weekends are precious time. We want to enjoy ours too.

Babies, kids and all that crap or whatever I called it before Blogger spat out the dummy

Some of my dear friends may already be aware that the maternal instinct thing fortunately passed me by. That's if you even subscribe to the theory of maternal instincts as opposed to cultural gender indoctrination.

Which, put simply, means women are bombarded with endless messages from the moment they are old enough to think, that their main role and function in life is as a breeding machine. Having children is the most wonderful and fulfilling experience ever and that is what we all live for.

Well, I don't and neither do countless others so the propaganda got lost somewhere along the line. I have never found ugly wrinkly babies remotely appealing. Give me a puppy, a donkey, a baby chicken, anything really apart from an ugly wrinkly baby that will grow up into an obnoxious person. Probably an ugly wrinkly obnoxious person. And as for thinking they will look after you in your dotage? Hmmm strikes me as a) amazingly selfish and b) amazingly naive.

As I reached adulthood my views didn't change. I still didn't find babies or young children cute, appealing or interesting. I did however, not dislike the early teens type kid that seemed to suffer all the problems of adolescence. Not young enough to be cute any more but not old enough to be treated as an adult. So I would make time to speak to this somewhat ignored group if they came my way.

I've never understood why people speak differently to children compared with how they do to adults. Hopefully the ghastly talking down to kids thing has decreased over the years. As far as I could see, they were all small people and deserved the same respect and the same type of conversation that big people got. Like big people, if little people came out with smart comments to me they would get one back.

When the first of my university friends finally had a baby I dutifully started knitting a cute matinee coat. If the baby got chance to wear it once I would be surprised as it took me that long to finish it. Even knitting baby clothes was boring as hell despite the smallness of the coat. All in all my friend was pretty good with me when I went to visit and admired the latest designer acquisition. She didn't get annoyed when I called it 'It'. (It was a boy actually). Nor did she bat an eyelid when I screwed up my nose as she efficiently changed a nappy.

Naturally she went on to have a girl next. One of each. We visited her parents one New Year and I spent most of the time playing on the floor with the toddler. As she grew up, I spent time with her in her bedroom, playing with the cat, the hamster and painting our nails together. Mummy was out at pilates or something like that. The young daughter was easy to get on with and I enjoyed her company. No idea what she is like now in her very late teens.

Another couple of friends (again from my university days) had their two - one of each again - somewhat later in life, so when I visited them a few years ago, the two children were still junior school age. They were nice too. Interesting, polite, friendly, well-behaved - and I was asked to read a bed-time story to the boy. I wouldn't have volunteered because there is nothing worse than sticking your nose in where it's not wanted, and being rejected. But always happy to read stories, so that was fun.

On the same trip, I visited other friends. The teenage son was out but the daughter (sixth form) was at home. Again, easy company, loads to talk about, and an interesting and pleasant young woman. None of those friends pushed their kids in my face - at any age. But equally, their children were not ignored while I was there, they were treated with attention and the same amount of respect as an adult. Their parents took time with them, explained things, talked to them sensibly, and from my incredibly inexperienced point of view, seemed to be the sort of parents one would want.

I like my friends, and fortunately - I happened to like their children. Accepting someone's children is a bit like accepting their partner. They are - presumably - the most important people in their world, and you want to get on with them because you like your friend (s). Just like you don't expect your friends to settle with terrible partners, you don't expect their offspring to be vile creatures.

People know I am more interested in dogs than children. For virtually all our married life we have had dogs. If friends don't like dogs they don't need to visit. That includes Mother-In-Laws (Mothers-in-Law?) from hell too. And it is really impressive when someone asks you to stay, and says that you can bring the dogs of course. How totally considerate. Although preferably not to be shut up in a cupboard at night a la MILFH.

Some years ago one of our British friends came to visit us in Spain. He's always had a cat but has been pretty wary of our dogs, or to be more accurate, the German Shepherd. As we sat in the patio, Prince settled down happily next to Andy. "I've never really got this close to him before," said Andy. "Are you sure it's the same dog? He's quite nice really." Give me an old dog before a baby any day.

Allegories?

Promised you all something about - allegories. So here we go.

When I asked for a simple explanation of the proposed American shutdown, I was surprised to get a rather trite and facile explanation of household budgeting. think of it this way: you spent all of your money except for 10 dollars on shoes. You want more shoes, but your husband says you can either buy shoes or eat. You decide to buy shoes and shake down your mother for more money so you can eat, except she doesn't have any money, so you go hungry and blame your husband

Well, anyone who knows me knows that I am unlikely to spend money on shoes. In fact, I can't remember the last time I did, unless training shoes count. Similarly, food on the table always comes first in this home, along with warmth and shelter. And highly unlikely that my husband would tell me how to spend my money.

Moving on .... It's not about that. To go back to using allegory... I'd like a new car. I don't NEED one, my 2001 Celica is great, but hey, a Lexus would be nice. But there are things I need to take care of FIRST -- we prioritize our budget. Take care of the taxes, insurance, utility bills, food, vet care, ETC... then see what's left. Obama and the dems buy the Lexus first, then go into debt. The republicans (who now control the House but not the Senate) are trimming the budget - and Obama is whining that he just won't spend ANY money then, if he can't have his Lexus. Again... it's allegory. But hopefully that makes sense.

Yeah. I have had one new car in my life. A Mini Metro for anyone who is interested back in the 80s at a cost of some £3000+. I saved the money and bought the car. Our oldest vehicle is 37 years old. I really don't give a shit about a new Celica or a new Lexus. So that is the personal stuff out of the way regarding the 'allegories'.

Except ... I think I should add a few points about my ability to manage budgets. I haven't got to 50+ years of age without working out how to add up. 1) Million pound budget manager for cancer services (I mean lots of millions, obviously) 2) Somewhat smaller budgets for managing the chief executive's office 3) Book-keeping for a business for 25+ years 4) Submitting tax returns for same 5) Somewhere in the past I think I can find that MBA - and wait! - I even enjoyed calculating Net Present Value. So do not tell me how to manage a domestic budget. Thank you. Or tell me not to buy a new pair of shoes or a new car. JFC.

Importantly, I do not think the parallel between domestic budgets and the proposed American shutdown is remotely similar. Balancing a budget is one thing - arguing about ethical points is another. So let me provide my scenario. I also think allegory is a totally inaccurate description. allegory noun ( a story, poem, or picture that can be interpreted to reveal a hidden meaning, typically a moral or political one : Pilgrim's Progress is an allegory of the spiritual journey. • the genre to which such works belong. • a symbol.

Ron and Dan live together. Doesn't matter what sex they are before you ask, they are gender neutral names. Every six months they swap around the control of the domestic budget. At the moment, Dan is in charge of the budget and Ron is not working much so relies on Dan. They have agreed that whoever is in charge, pays the basic bills and proposes a plan for capital expenditure (for example).

Ron doesn't like Dan's proposals and starts to complain. Ron gripes about Dan eating tuna sandwiches at lunchtime because Ron likes dolphins. (Yes! I know it is unlikely that Republican Ron would do that but the whole point of this is finding an ethical sticking point, thank you, so read on). Ron wants Dan to stop buying tuna. Dan refuses. Dan says s/he will stop paying the bills and reduce the household services. ..... Dan agrees to buy tuna that doesn't damage dolphins.

And - the budget continues. No problems for anyone. For what it's worth, I think that was slightly more relevant than a comparison with budgetary overspending. The whole point about the shutdown was about making political points about ethical issues. Not whether or not you buy shoes or cars. Or overspend.

Next up, I had thought of writing another um - allegory?? It seemed inappropriate to post on my facebook wall given the sensitivities of my readers. But.. this is my blog and my space (so to speak).

Let's imagine you live in a nice house in a nice street. You are happy in your home but - around the corner in the rather tatty trailer trash area is someone who has something you want. They could be the Beverly Hillbillies with black gold in fact. But you want it and your needs are more important.

Guess what? You go right in, saying they are unsound neighbours. You ask a few friends to help who live a few blocks away and who daren't say no. You don't like the morals/religion/ethics/clothes/anything really of this trash and rip the shit out of them. You take the black gold too. Naturally it is all done in the name of beautification of the neighbourhood. A few lies don't go amiss about what trash they really are because everyone believes you. Once you have what you want, you pussyfoot around for a bit pretending to help and then clear off. As do your poodles.

I hope that was a helpful parallel. It isn't an allegory at all. It is just a different way of portraying American politics. ETA courtesy of the lovely Otter Um allegory - analogy??

analogy noun ( pl. -gies) a comparison between two things, typically on the basis of their structure and for the purpose of explanation or clarification : an analogy between the workings of nature and those of human societies | he interprets logical functions by analogy with machines. • a correspondence or partial similarity : the syndrome is called deep dysgraphia because of its analogy to deep dyslexia. See note at likeness . • a thing that is comparable to something else in significant respects : works of art were seen as an analogy for works of nature. • Logic a process of arguing from similarity in known respects to similarity in other respects. • Linguistics a process by which new words and inflections are created on the basis of regularities in the form of existing ones. • Biology the resemblance of function between organs that have a different evolutionary origin. DERIVATIVES analogical |ˌanəˈläjikəl| adjective analogically adverb ORIGIN late Middle English (in the sense [appropriateness, correspondence] ): from French analogie, Latin analogia ‘proportion,’ from Greek, from analogos ‘proportionate.’

Women don't exist

I have been so busy droning on about internet politics and crap like that to the extent I have ignored world affairs.

Or perhaps there is indeed a link. It is called censorship. As in. You. Do. Not. Exist.

Hillary Clinton will do for starters. As will Audrey Tomason. And why are these two women in the news? Well, strictly speaking in orthodox jewish terms - they aren't.

Check out the links but, to cut to the chase, an orthodox jewish newspaper in New York cut Clinton and Tomason out of the photo where key White House staff were watching an update on the Bin Laden attack.

Let me put on all my hats.

As a historian - messing with history is garbage, and very, very, dangerous.

As a journalist - messing with records is lying and deceptive, and very, very, dangerous.

As a feminist - this is one of the biggest crocks of shit I have heard for some time. Getting rid of women on photos is getting rid of women, because men don't want them to exist. Especially in positions of power. Simple.

And if orthodox jewish men view those women as sexually suggestive that is THEIR problem, not that of the women in government. That's like saying - women shouldn't go out at night in case men want to rape them.

Now here is a comment that I particularly want to criticise.
While I disagree with the altering of the photo, I don't think it is g'neveit daat (GD). GD would be when they are trying to trick people into thinking something not true. The hasidic jews know that there are women in government, including as secratary of state. Also, does it really matter which officials were there or not?


Well, sweetheart, yes it does matter which officials were there. In fact why not get rid of all the men and leave the women in the photo?

In fifty or 100 years time, some of us won't be here. I certainly won't. Which hassidic jews will then know about the photoshopping and which women were in power at the time? Just - why delete the women? Because every single orthodox jew in the world finds them sexually suggestive? I find this horrific.

Any manipulation of data, history, records, images, - is deceitful - although it seems some jews can rationalise this one.

I should say that I didn't realise how incredibly sexist, no - misogynist - some jewish sects could be. My heart goes out to both Clinton and Tomason for the sheer disrespect and offence that they were shown from the jewish community.

rabbijason religion.blogs.cnn news.yahoo.com huffingtonpost

A few other comments. If you scrolled down the comments on one of the links there was a comment about women who cycle. Jesus!! Can't women do anything without being regarded as god-damn sex symbols???

Secondly - Golda Meir was the first thought that came to my mind - no pix of her? Israeli prime minister, third woman pm in the world?? Nope, apparently according to one religious zealot, she don't matter. Well done Golda, you left yourself a great heritage. A jewish community that disrespects intelligent and powerful women.

And - jewish people - if you ever wonder why you alienate yourselves, this is one very good example.

Cloudy netiquette?

Always good to have a little post about netiquette I feel, as it changes by the week, or maybe by the day or the hour. Let's start with dirty linen. It doesn't get washed in public. Or shouldn't. So that means: 1) If you know someone in real life and you have an argument, you don't bore the rest of the forum with the sordid and - in some cases - sexual detail. It may well be amusing to the rest of the world, but you just end up looking a prat. However tempting it may be to tell everyone how horrible your former friend was, you don't make the other person look small, only yourself. 2) On the other hand, if you are on a private forum, ie it is closed to the world and visible to members only, and you have a section where you are free to argue whether on a personal level or about controversial issues, then that is fair game. You can criticise someone on there, and wait for a response, a counter-attack, an apology, or whatever. But even if it is a special section on a forum - you may still find that you lose friends. Being able to insult someone on a forum without being banned does not mean you will win popularity contests. 3) Slagging people off on public facebook pages is puerile. In the extreme. In addition, when you are no longer friends with someone or have blocked them, having a go at them behind closed doors is underhand. Don't deal from the bottom of the pack. They will probably hear about it anyway. And if that's your real intention, why not just email said person? 4) If you find yourself host to some insulting and rude comments, whether on your facebook page or on your blog you have two choices. You can leave the comments as a record of what people said. You may think that is a wise idea, as once something has been said it can't be taken back. Maybe people wrote when they were tired/drunk/stressed/who knows? And, other people may find it upsetting or annoying. Admittedly they can also choose not to read it. However, you can delete comments on blogs and conversations on facebook. The power of censorship on the internet is wonderful. 5) You can fall out and in with people a number of times on the internet. I know, I have done it, believe me. And, do you know what? When people have the courtesy to offer me friendship again after we have fallen out, I am happy and appreciative to accept that friendship. We all fuck up. 6) Facebook is not the most important method of communication on the internet. It may be the most used social network, but there are other places to go. Many of my internet friends use Twitter (unless it has changed, I found it too much like hard work) and Tumblr. Probably a third of my Facebook list comes from forums, another third is from blogging, and the last third is friends of friends of friends of friends who either have German Shepherds, huskies, play Farmville - or all three. There are people who want to know the ins and outs of everyone who they have on their friends list. Are they safe? Who are they? Who do they know? Do your friends know them personally? (Yeah right). Me, I really don't care. So long as they aren't vicious axe murderers/Michael Vick/or similar lowlifes, I'm not too worried about them. 7) You can choose to be open about your views or not, depending on what you are hoping to gain from the internet. You would have to be more than half asleep if you look at my blogs and do not realise what my views are. I see no reason to write in detail on facebook and if you are so interested in what I think you can find my blogs and cheerfully send yourself to sleep reading about my views on the world and their dog(s). Now for those of you who don't know - here is the facebook fallout. In both senses of the word. A month ago I asked about the proposed shutdown of the American government as I hadn't a clue what it was about. When I looked it up, I found nothing helpful on the internet. Here..... Hello US pals. Been reading about your proposed shutdown and don't understand. I gather you had one 15 years ago. But what is it? And why is it? Please can someone explain either a) really simply or b) give some useful links rather than the crass media ones I have found. Even better, what does it mean to people who live there? .....is my question. There was a long discussion. I found it helpful and interesting, and other people also did. Apparently others didn't as the following morning I noticed two 'friends' less. I don't know when I would have noticed, but ironically I was trying to comment on a wall post by one, which was a link to a good dog blog post. But I couldn't comment. Obviously. And then I looked up the other 'friend' who had posted the same sentiments on the shutdown discussion. Yup, also gone. Now while the first one was a relatively recent friend, the second one was a dog blog pal of four years, and a regular blog commenter, and an occasional pm/email friend. Not someone you would expect to drop you like a hot cake. Let's call her Friend 2. The discussion on the proposed shutdown seemed pretty reasonable in the internet scheme of things to me. There was only one rather rude comment (made by the first person I noticed who had defriended me) which was patronising and mocking towards someone else. I doubt either of them lost sleep over it. So. What annoyed me about this? Well firstly, someone I had known - as well as you do in the dog network - for four years, dropped me without even kissing my arse goodbye. More importantly, and I don't know the reason, so I can only surmise, but it followed a controversial political discussion. Do you drop people because you disagree with their point of view or because you host a serious discussion on facebook? Because if that's the case I could reduce my facebook friends to er one, maybe two. Just to be clear, what has really, really, really got up my nose, is what seems to be a deletion based on personal views and opinions. Around abortion and military intervention. (By which I mean US plus poodle allies invading half the world in the name of liberation but in a real quest for oil). Here is a quote from a pm I received: It is totally contrary and bizarre of XXXXX to do this, because it is like she is saying "unless you agree with me, follow my religion and my politics" then you are not to be a face book friend. And the day you delete people because you don't like the way they think, is the way you go down a dangerous road. Actually, you have already gone there. This is a woman who - in the words of another dog blog friend - 'throws friends away like an old pair of shoes.' (Thank you - you know who you are - for allowing me to use that brill quote). Because I wasn't the first to be deleted. Or the second. But at least the third that I know of. And why, might I ask? Because our lives don't fit the ideal role model? Our views are unsound? Mine have been the same for some time. There was just something about this whole thing that freaked me out. Deleting people that you have 'known' for years beacause of a political discussion? Freedom of speech? So long as they are the right freedoms maybe? Or the right speech? Still here, dear reader? I deleted all the people who were friends with Friend 2. Why? Because as far as I could see I had been deleted by someone I considered a friend following a political discussion. That smacks of censorship and fascism to me and if you want to be friends with someone like that - fine by me. But don't expect me to approve you sitting on the fence being friends with everyone, sweeties. Because one day, one day, those same people like Friend 2 will maybe decide they don't like what you say either. They won't tell you though. You will just be - gone. The truth is - you just don't matter and neither do your views. Older people on the internet may have even heard of the Nazis. Perhaps we are all judged by the company we keep?? That's why I changed mine.