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MEDICAL MAILBOX

Who would ever guess that the handsome, three-time Olympic gold-medal track star Wilma Rudolph is over 35? Or that she's a grandmother? Or that she's been identified as a potential high-risk future cancer victim?

Wilma was one of several who enthusiastically accepted our recent invitation to gather in Indianapolis, board the 28-foot-long mobile cancer-screening unit, and examine its low-radiataion mammography equipment. Several visitors gamely submitted to the freen screening and asked, "Is that all there is to it?" when the simple procedure was completed.

Dr. Pat Harper, well-known among radiologists for her outstanding research on breast imaging, set up the protocols in the mammobile. She assured us that the Thomson-CGR mammography equipment in the mobile van would give the same excellent results as if it were permanently installed in a clinical setting. In fact, the equipment is identical to that she uses daily.

Those who arrived as skeptics went home as confirmed believers, thanks to comments from therapeutic radiologist Dr. Peggie Findlay, who emphasized the startling projection that more than 40,000 deaths will result from breast cancer this year and that early detection permits breast-conserving lump removal rather than breat removal. Findlay was the radiologist in charge of the large randomized double-blind study at the National Cancer Institute in which lumpectomies (lump removals) with radiation and mastectomies were compared. She reported that newly released preliminary results show that lump removal with radiation is just as effective as breast removal and that the survival rate is equally good. Some of these women in the study have been followed for seven years.

Findlay's announcement gives women a great deal of incentive to be mammogramed for early detection. Both Dr. Harper and Dr. Findlay agree that as a group, lumpectomy patients do far better psychologically than mastectomy patients. Mammography can locate a growth three to four years before self-examination reveals it and before a physician could feel it.

U.S. Secretary of Health and Human Services Dr. Otis Bowen added his endorsement of our pilot program: "I regret that my being out of the country has preventd my sharing in this occasion with you. I commend the Saturday Evening Post Society and Mary Kay Cosmetics Inc. for their commitment to women's health and their undetaking this important new program. We are the Department of Health and Human Services are specially pleased to see partnerships such as yours expand al of your efforts in cancer prevention and control."

Dr. Vincent T. DeVita, Jr., director of the National Cancer institute, challenged Mammobile visitors to help the institute reach its objective of administering annual mammograms to 45 percent of peri- and postmenopausal women by 1990, and 80 percent by the 2000.

"We will not be able to reach our goal unless we let women and doctors know of the advantages of mammography screening and make such screening affordableand convenient." Dr. DeVita stressed. "If this nation is to solve the cancer problem, if we are to cut cancer incidence and mortality, if we are to do it quickly, we need more partnerships and programs like this one being launched today."

The Mammobile included a framed proclamation stating, " I, Robert D. Orr, Governor of the State of Indiana, do hereby proclaim Mammogram Awarenes Week in the State of Indiana, and encourage all Hoosier women over 35 years of age who haven't had a mammogram to get one as soon as possible."

Our Society's very special collaboration with Mary Kay Cosmetics Inc. evolved after results from a Saturday Evening Post readers' survey were tallied by the National Cancer Institute. The tabulation indicated that only 15 percent of respondents over 50 years of age--a high-risk group--receive annual mammograms. A staggering number of women over 35 had never had baseline mammograms. Why? Some poll participants insisted their doctors never recommended screenings; other readers assumed that no symptoms meant no screening was necessary; several respondents were concerned about X-ray exposure; and many cited costs as being prohibitive because they weren't covered by their health insurance.

The purpose of the Mammobile is to address these issues. We not only have to increase awareness of breat cancer and emphasize the promise of recovery through early detection, but we also need to dispel stubborn old wives' tales. Take the issue of radiation, for instance. Women who avoid mammograms because they fear exposure must be taught that new mammography equipment is so low in radiation that the risk is practically nonexistent. Any "danger" could be equated to that of smoking half a cigarette. And that was before the Eastman Kodak Company came out just last week with the good news that it has developed a new film that reduces radiation by 60 percent. This development might mean the risk would be less than that of one-fourth of a cigarette...or a mere puff or two.

We hope that the splendid example set by Mary Kay Cosmetics will encourage other civic-minded corporations Mammobile. So far it costs $40 for the radiologists and technicians to complete each mammogram for us. Your Society is providing matching funds with corporate sponsors that will pay for one-half of each mammogram, which we offer free to cause more women to become aware of their great need for regular mammograms. As more mammograms are being given, undoubtedly the costs for this diagnostic procedure will come down.

Urologist Glad to Know about Calcium Citrate Dear Dr. SerVaas:

I hope you still have the questionnaire and research diet available, as you mentioned in the March Saturday Evening Post. My husband has had ulcerative colitis (diagnosed as such) since 1956--also rheumatoid arthritis, and has had five operations for kidney stones, four in the past two years. He is on three diets--low oxylates, low fat, and no milk products in any form.

We are curious about your diet, and if we can help your research project we'd be more than glad to.

Thanks to the Post, he is now taking Citracal. Our urologist was glad to read about it. Citric acid in other forms had upset my husband so he hadn't been able to take it. Genevieve Busse Onalaska, Wisconsin

We are observing that irritable-bowel disease is often a problem for members of our Kidney Stone Formers Club. Your diet is on its way.

Location Problem Dear Dr. SerVaas:

I read the article "Boning up on Calcium" in the April 1986 issue and am interested in trying Citracal (calcium citrate). I have contacted several drugstores, but I'm unable to locate any.

Will you please let me know where I might be able to find Citracal? Violet MacNeilly Chester, Pennsylvania

We have received many requests for further information on calcium citrate under the trade name Citracal.

Calcium citrate is made by Mission Pharmacal Company, 1325 E. Durango, San Antonio, TX78210. You will need to contact the company directly and request a list of outlets in your area, or information about how to get it by mail.

A Rose by Any Name Dear Dr. SerVaas:

I am very much interested in your article on calcium, but I am disturbed by the fact that you refer to it as a "drug." I was recently advised to take OYSCO (calcium carbonate), 1,000 mg. a day. I could not tolerate that much, and would like to try "Citracal," but not if it is a drug.

Please clear this up. Wilma D. Kellogg Sycamore, Illinois

You are correct-calcium would best be called a food supplement rather than a drug. Since the various calcium supplements are produced by drug companies, writers may refer to them as "drugs." Now bakeries and soft-drink makers ae adding calcium supplements to their products.

Sweet Irritant Dear Dr. SerVaas:

I've tried two food supplements, Ensure and Sustacal, and am unable to take either. I'm allergic to milk, and though the Sustacal is lactose free, it caused problems. Both of them contain calcium caseinate. I'm told that is from a milk protein. Is that correct? Gladys Williams Concord, California

Calcium caseinate is made from milk. Food supplements may be lactose free, but they may contain corn sweetener that causes problems for some people. We're sending you a Colitis Club diet. switched to calcium citrate instead of calcium carbonate, and sure enough, all signs of gas and bloating disappeared. Thank you, Dr. Pak!

He further explains that this reaction, more likely to occur in younger persons who still have good stomach secretions, does not occur in those who use a calcium-citrate supplement. Older people also benefit from calcium citrate, because their ability to absorb calcium decreases with decreased acid secretions. Enhanced absorbability with calcium citrate was demonstrated by Dr. Pak's study of healthy individuals with no kidney or bone problems: "...the amount of calcium absorbed from calcium citrate given orally is greater than that absorbed from an equivalent amount of calcium carbonate."

Calcium absorption and relief from bloating are just two important benefits of calcium citrate. If you also happen to be a farmer of calcium kidney stones, Dr. Pak says that the calcium citrate also helps get the calcium you need while decreasing the chances of precipitating it out as a stone. Two circumstances in which calcium citrate is useful, Dr. Pak says, involve stone formers who have irritable-bowel diseases and those who are prone to osteoporosis.

Unfortunately, we haven't been able to find Citracal in our area yet. Mission Pharmacal Company assures us it is working very hard to distribute the product nationwide. You may want to contact the manufacturer directly to find out where it willbe available in your area. The address is shown on page 110.

Vitamins Instead of Sulfites Dear Dr. SerVaas:

We enjoy your lectures on CBN-TV very much.

The last one on sulfites was very interesting. It reminded me of a discovery I made. Vitamin C crystals in a very diluted water solution, poured over lettuce and other green salads, will keep them from getting rust-colored due to oxidation. Also, if you rub the crystals on cut apples or pears they will keep for days in the refrigerator without turning dark.

When we cook fruit we add a half teaspoon of crystals in a quart to preserve the light color. It works on tomatoes, too.

When my eyes itch, I put a pinch of the crystals in a cup of water. I slap it on my eyes and the itching stops.

We are growing lysine corn again this year. Philip H. Faucett Eureka Springs, Arkansas

We'd like to urge restaurants and grocery stores to use Vitamin C instead of sulfites to keep their produce and salads looking fresh.

Lysine Helped Dear Dr. SerVaas:

I am writing about your segment on the "700 Club" in regard to L-lysine.

I have been subjected to cold sores or fever blisters for as long as I can remember. Too much sun will bring them out--nervousness, etc.

After hearing you that day, I started taking L-lysing (500 mg) once every day. I have not had any cold sores! The reason this is such a miracle is that my husband (age 61) had coronary-bypass surgery on January 27, and all through the testing, the changing of medications, the terrible reactions to the changes, the angiogram, and finally the coronary bypass itself (which surely in the past would have produced a "crop" of fever blisters), there have been none. Mrs. Fred W. Zilke Oxnard, California

The Egg and You Dear Dr. SerVaas:

I've tried taking calcium supplements because I know I should. My mother broke her hip from osteoporosis. However, whenever I take calcium, I'm bothered by gas and bloating. It's painful and makes my waistline seem inches larger. Does calcium citrate really make a difference? Where can I get it? Shirley Morgan Grand Rapids, Michigan

I too suffered bloating and gas from calcium-carbonate tablets I was taking. Quite by chance Dr. Charles Pak of the University of Texas Health Science Center told me in an interview of an amazing discovery he had made in a most serendipitous manner. He was watching an experiment at the Franklin Institute Science Museum in Philadelphia, where an egg kept rising to the surface of a bowl of vinear. Eggshells are made of calcium carbonate, he told me, which reacts with the vinegar and causes carbon-dioxide bubbles that float the egg to the surface. It dawned on Dr. Pak then and there why 25 percent of women can't take calcium carbonate. It is carbonate reacting with hydrochloric acid in the stomach that gives off carbon dioxide. The gas does not occur with calcium citrate, he told me. I
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Title Annotation:Indianapolis gets its mammobile
Author:SerVaas, Cory
Publication:Saturday Evening Post
Date:Jul 1, 1986
Words:2087
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