Gayle Madwin (queerbychoice) wrote,
Gayle Madwin
queerbychoice

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Health! Bicycling! Hammock-Sitting! Not Dying!

I bought a thing!

And I assembled the thing! From about 50 different parts! It took about two hours, and the tools that it came with were not really adequate to the job, but I found adequate substitutes and made all the pieces cohere into a single unit!

And then I used the thing!

It is a FitDesk. A stationary bicycle desk. So I can continue to have a job that involves sitting at home typing all day and yet not die young from the ill effects of sedentary lifestyles. Though it might have made sense to wait until the end of this month to see whether my temporary contract at work actually gets renewed or not. But hey, the price dropped substantially, so I went for it.

The odometer tells me I absent-mindedly bicycled 25 miles during my workday today. Which is fairly meaningless since there are vastly different tension settings to choose from. I had it set to 4 out of 8, but that's still meaningless unless you have a stationary bicycle of your own that has exactly the same tension settings. However, meaninglessness aside, it sounds impressive to my own ears! I've never bicycled while editing before. Also I seriously doubt that I've ever bicycled 25 miles in one day on an actual moving bicycle, because moving bicycles were always determined to hurl me onto the pavement before I got that far. Stationary bicycles are much better because it is much harder to crash them into things. Probably not even I can manage to crash this one.

I more often hear about treadmill desks than bicycle desks, but I think bicycle desks are a better option. Mainly because they're substantially cheaper, but also because I think it's probably easier to read and type while seated and pedaling than to do so while walking. Typing while bicycling worked surprisingly well for me. You definitely need to stop pedaling if you're doing something like drawing pictures and need to be very precise about cursor placement, but I doubt that's any surprise to anyone. Also, the computer screen does vibrate slightly if you're pedaling, so if you're trying to very closely proofread a large block of text and verify the placement of a lot of tiny punctuation marks, you might again need to stop pedaling to be able to focus your eyes well enough. I stopped pedaling a lot and just didn't worry about it. The placement of the meter so that it's hidden behind the laptop tends to take the focus off the pedaling anyway; pedaling is just something you can occasionally do absent-mindedly when you feel like it, not something you need to worry about trying to achieve any specific goals on.

Mostly I just wanted a way of exercising that cannot be derailed by smashed toes, sprained ankles, blistered heels, 110-degree weather, or any potential 60-hour workweeks that might arise again. This will serve for all of the above purposes.

fitdesk.jpg


Then after work I brought my laptop outside to type this LiveJournal entry in my hammock on my patio, looking out over my freshly mown lawn (well, mown two days ago), playing music (which I verified was completely inaudible at all fencelines, because I am a considerate neighbor unlike some people), enjoying the scent of blooming southern magnolia and Confederate jasmine (the American South theme is the previous homeowners' doing, not mine, but it smells good), watching a hummingbird visiting the Ithuriel's spear flowers in the patio pot where my blueberry bush is planted, and looking forward to another plant sale in Oakland this weekend (I think this will be the last of them until fall) and to meeting q10 in Berkeley on Monday.

And it is lovely.

hammock.jpg


In other health-related news, The New Yorker has an article this week by Atul Gawande about unnecessary medical care and how it damages people's health. Some of it is about cancer, and in the extremely tiny part of it that is specifically about breast cancer, he throws his lot in with practically every popular medical writer everywhere in advocating for fewer mammograms on the basis of data showing that mammograms do not save lives. I like Atul Gawande, and there's certainly no question he knows plenty more about medicine than I do, but I don't think he or any of the many who agree with him are giving adequate respect to the pro-mammogram side of the argument.

I am one of the people whose cancer treatment was arguably unnecessary. Current U.S. guidelines call for women to have their first mammograms at age 40, unless their personal or family medical history puts them at special risk. Many people (the vast majority of popular medical writers) call for pushing back the age of first mammograms to 50. I got mine at 37, for no good reason whatsoever, simply because my doctor misinterpreted the medical guidelines and thought my family medical history put me at special risk when it didn't. The mammogram did for me exactly what the anti-mammogram people complain that mammograms tend to do: it found a tiny cancer that might have just gone away on its own if left untreated. This means that treating it might have been unnecessary. And the data show that treating these cancers early makes no significant difference in the death rate: I could have gone without any mammograms and remained undiagnosed until it developed into a palpable lump that would get my attention even without a mammogram, and my risk of death would not have been significantly altered by this delay.

However, if I had waited that long, I would have needed chemotherapy. (Chemotherapy is necessary if the cancer is invasive; it's unnecessary if the cancer is pre-invasive, because if it's pre-invasive it's definitely trapped in one small area and there's no need to treat any other part of the body.) I would have felt much less free to refuse to take tamoxifen. I probably would have needed a more major surgery and might have lost some of the use of my right arm. Death itself is not the only thing to try to avoid here; quality of life also matters. I would not have gotten the same enjoyment from lying in a hammock watching the hummingbird if I'd been suffering through chemotherapy, tamoxifen, and lymphedema. I would have been too busy worrying about my health to pay as much attention to the freshly mown lawn and the scent of the flowers. I probably wouldn't have felt well enough to plan two trips to the San Francisco Bay Area within the next five days.

Of course, I don't know whether my cancer would ever have developed further at all. It might have just gone away. Or then again, it might not have. Medical science has not yet developed far enough to be able to take much of a guess about what my cancer would have done, and this makes it quite difficult to figure out how to weigh the risks and benefits of bothering with various treatments. I do not have any magical answers for anyone; people all have to weigh their own individual situations for themselves. I got more treatment than some would advocate for and less treatment than others would advocate for. I'm satisfied with where I drew my personal line, for the moment.

And I don't mind that medical writers are questioning the usefulness of mammography and other diagnostic tests that detect large numbers of very early-stage cancers. That is a conversation that very much needs to happen. And I do not have any opinion at all as to whether women should get their first mammograms at age 40 or at age 50; I do not feel qualified to have an opinion on that topic.

But I do ask that the conversation should not focus narrowly on death rates alone. I think Atul Gawande is doing readers a disservice by citing death rates alone in arguing that breast cancers, thyroid cancers, and prostate cancers are excessively screened for and excessively treated in their early stages. I don't know whether they're excessively screened for and excessively treated or not, but I do know that being alive or dead is not the sole measure of good health. So please, please, stop judging certain forms of health care as "unnecessary" solely because not receiving those forms of health care doesn't tend to actually kill people.
Tags: cancer
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