Rhodes understood that for women with dense breast tissue, “the mammogram doesn’t work well at all.”  In fact, as she wrote to me via e-mail, “Breast tissue density poses a higher risk for breast cancer than having a mother or sister with the disease, but 9 out of 10 women don’t know this—or how dense their breast tissue is.”

Breast density is genetically determined.  Rhodes qualifies it as the “culprit” for inadequate readings of mammograms. She explained that two-thirds of women in their 40s have dense breast tissue.  If a mammography cannot detect the early onset of cancer in one out of six women in the age range of 40-49, this is a major issue. Although breast density usually declines as a woman ages, up to one-third of women retain breast density for years after they reach menopause.

How important is it for women to know about their breast density? Very.  You can learn this information from your mammogram report.  Rhodes showed slides that illustrated the four categories of breast density.  There are two groups who are at greater risk for not having a tumor detected.  They are those in the heterogeneously dense group (51-75 percent density) and those in the extremely dense group (over 75 percent density).  Both tumors and dense breast tissue appear as white on mammograms.  For those with fatty breasts there is an 80 percent probability of finding a cancer, as opposed to the 40 percent likelihood of finding a cancer in a dense breast.

There has been little change in the field of mammography since the 1960s other than the development of digital mammography—which is still an x-ray of the breast.  Ultrasound is used, as are MRIs—which are costly.

The aha moment for Rhodes came when she was introduced to Michael O’Connor, a nuclear physicist.  He told her about gamma technology.  Gamma rays are not affected by breast density.  Rhodes and O’Connor, along with a core hub of two radiologists and a bio-medical engineer, have formed the Molecular Breast Imagery (MBI) Research Team at Mayo Clinic. They are currently working on a “dual-head” gamma camera that can detect tiny tumors in dense breast tissue.

For imaging, a patient receives an intravenous injection of a radiotracer, which is then picked up by tumorous cells.  Rhodes explained, “MBI exploits the different molecular behavior of tumors” which is unaffected by breast density.  In addition, unlike the traditional mammogram, the MBI delivers “light pain free compression.”

With chances for a cure dropping off as the size of a tumor increases, finding a tumor at 1 centimeter gives a patient a 90 percent chance for successful treatment.  The work that Rhodes and her group are doing got them a major nod in 2004, when they received a grant from the Susan G. Komen Breast Cancer Foundation.  They were funded to study 1,000 women with dense breast tissue, and compare the results with mammography.  (The women chosen were already in the Mayo Clinic system.)  With mammography, 25 percent of cancers were detected; with MBI, the result was 83 percent.  A combination of the two yielded a 92 percent detection rate.

Concentrating on lowering the radiation dose, they have achieved using an amount that is “equivalent to the effective dose from one digital mammogram.” With this reduction, they have moved forward with their screening study.  Rhodes showed an example of how a 67-year old woman who had received a clean bill of health with a digital mammogram was found to have a 3.7-centimeter tumor with an MBI.

Getting their findings published in the January 2011 issue of the Journal of Radiology has helped them gain traction and exposure in the larger medical community.  Now they need to finalize the screening studies using the low dose.  Protocol demands that the study has to be “replicated” at other institutions.  That could encompass a period of five or more years.

Although the MBI unit has been FDA approved, it is still not widely available.  Rhodes referenced “economic and political forces,” in addition to the science, as contributing factors.

While this technology is continuing to be advanced, Rhodes recommended the following guidelines to women:

• Know your breast density (only the state of Connecticut has mandated that women receive notification of their breast density after taking a mammogram).
• If you are pre-menopausal, try to schedule your mammogram during the first two weeks of your menstrual cycle, when breast density is relatively lower.
• If you notice a persistent change in your breast, insist on having additional imagery screening.
• Have a mammogram every year for women with dense breasts 40 and older.

Via e-mail, Rhodes also expressed what she considered four important features to consider when developing a screening technique that is “well suited to women with dense breasts.”  They are:

1. It has to be better than what we have (mammography—which
works beautifully in women who don’t have dense breasts, but
much less well in women with dense breasts).

2. It cannot generate too many unnecessary biopsies.

3. It has to be safe and comfortable (not too much radiation, adverse
reactions, etc).

4. It has to be affordable.

Rhodes advised that women with dense breasts should discuss all options with their doctors.  For those specifically with “at risk factors” for breast cancer, Rhodes suggested exploring if they are eligible for a breast MRI, which has a higher rate of sensitivity.  She pointed out that not only is an MRI expensive, but that most insurance carriers require that patients meet specific criteria (Typically 20% or greater estimated lifetime risk of developing breast cancer).

A strong believer in women’s self-empowerment through learning about their breasts, she wrote, “I think it is important for women to understand the limitations of a test that they are having year after year – so we can collectively advocate for developing [such] an alternative.”

Rhodes ended her talk at the conference with a final reference to her patient, whose child was now in middle school.  After losing her sister to breast cancer, she made the choice to have a prophylactic mastectomy. Rhodes concluded, “We can and must do better.”

Image courtesy of newsblog.mayoclinic.org

Left: Digital Mammogram Reads Negative Right: MBI Reveals 17mm Cancer

This article originally appeared on the women’s health site Empowher.

A recent visit to an emergency room with my mother and her subsequent hospital stay have absolutely convinced me that many of our young health professionals and, in general, the US hospital system view the health care needs of senior citizens with disdain if not outright contempt.

Democrats/Liberals/Progressives, this is what you need to understand. Many senior citizens are simply afraid of our health care system, and rightfully so.

When seeking medical care, all too often, the legitimate complaints of the elderly are dismissed as senile rantings. Even when a family member or caregiver is acting as an advocate for an elderly person, their voice is often ignored. And let’s face it, most caregivers are women. In fact, since women generally outlive men, most senior citizens are probably women. Is a picture emerging?

As I’ve shared bits of my family’s story over the past week, I’ve heard numerous equally horrific examples of disrespect, callous treatment and in some cases probable medical malpractice. It is enough to make you very afraid to grow old.

Briefly here is what we experienced.

My mother was taken via ambulance to the emergency room of a local hospital at 5 pm on Tuesday, February 16, 2010. I advised both the paramedics and the attending in the ER that my mother was diagnosed with NPH (normal pressure hydrocephalus) in 2005 but recently she had been experiencing a drastic decline in mobility. She had also been complaining of pain in her right ankle, knee and wrist which might be the result of a fracture sustained during a recent fall. In addition, and not in any way related to a diagnosis of NPH, a large unknown mass had appeared on her abdomen

At approximately 1 am, Wednesday February 16, 2010, we were still in the emergency room and I had to repeat the same detailed information again to the admitting resident.

Finally, at 3:30 am, after 11 hours in the ER, my mother was taken to a room. Once again, I provided the nurse with a full description of my Mom’s condition.

Later on Wednesday my mother was seen by a neurologist. In fact, I was able to have a wonderful discussion with him when I visited my mother later that afternoon. So far all was going well. I was very troubled that my mother had had very, very little sleep in over 36 hours but I believed that she was receiving the care that she needed.

I won’t bore you with all of the details so I’ll just skip to 11 am Thursday, February 18. While attempting to determine just who in the hospital was coordinating my mother’s care, I was advised that the attending intern/resident in the ER had failed to note anything on her chart about the abdominal mass or my concerns that my mother may have sustained stress fractures during her last fall. In fact, I have good reason to believe that it was not until I brought the non-NPH issues to the attention of the admitting physician on Thursday that X-Rays of her limbs and a MRI of the abdomen had never been ordered. Needless to say, I was not a happy camper. However, at least now everyone was on the same page and all of my mother’s health concerns would be properly addressed. Or so I thought.

Since the hospital was well aware that my mother suffers from NPH, a disease which affects memory and mobility function, I thought certain that they would contact me on Friday morning with her tests results. Unfortunately, not only did the hospital fail to contact me with my mother’s test results, a doctor making his rounds on Friday morning told my mother (not I) that she was being released that day. My mother called me at home at 2pm on Friday and informed me that she was being released. After confirming this with the nurses’ station, I contacted the hospital’s social services office and, in a very forceful manner, asked that they make arrangements to have an ambulance taken out of their establishment asap. Yes, I ranted and now, of course, those rantings are being chalked up to caregiver burnout.

My mother’s discharge papers simply read:

Discharge Diagnosis: Normal Pressure Hydrocephalus
Follow up with your office in one week
Activity: as tolerated:
Diet: regular
Discharge to: Home

There is no mention of any other condition.

Friends, this caregiver may have been tired before last week but if I’m burned out now it’s because the health care system poured the gasoline and lit the match. Sadly, I am learning this this experience is not at all unusual.

Now this Northeastern, college educated, middle aged, liberal understands why it was so easy for the GOP to sell the myth of “death panels” during last summer’s health care reform debate. And I understand why town hall meetings turned into screaming matches.

If the US health care system already treats insured senior citizens so badly, it isn’t a great stretch to believe that someone, somewhere, in the name of saving a dollar, wants to see them dead. It’s not true of course, but …..

originally posted on Pam’s Coffee Conversation

From “Baker’s Dozen About Obama” by Ellen Keim

Here are thirteen of my “Obamic” impressions, for what they’re worth:

First of all, I hope people can separate what they think of Obama–either his track record or the man himself–from the historical fact of his presidency.

Second, I can’t even imagine how much pressure he feels to be the best for fear that he may ruin the chances for another black candidate.

Third, I never thought he was the “Messiah” as some did, so I never expected him to be super-human. Some people are getting disenchanted because they expected perfection and instant gratification.

Fourth, I don’t think people are giving him enough credit for what he has done, either because they don’t agree with it or because it isn’t their pet project.

Fifth, he hasn’t been President for all that long. Considering the messes he inherited, we should expect fixes to take longer than a year.

Sixth, I don’t think we have seen the positive effects yet of the way he has reached out to the Muslim community around the world.

From Marcia G Yerman, “Thoughts for a New Decade: What I Wish for Women“

As we move into a new decade, I can’t help looking over my shoulder at all the things I would like to leave behind.

VIOLENCE: Number One – Violence perpetrated against the female gender. Whether it is domestic violence behind closed doors in the United States, acid being thrown in the faces of young girls in Afghanistan trying to attend school, or rampant rape as a tool of war…It must end.

DYSFUNCTIONAL HEALTH CARE: I would like to discard health care that doesn’t take into account the needs of women, and policies that don’t speak to the disparities in care for all members of the female community at the local, state, and national levels.

UNEQUAL CHANGE: I would welcome a roll back on the wage disparities between a woman’s paycheck and a man’s, taking into account a gap that is even larger for women of color. Moving forward, I would like more support for women working in the services sector, where wages are lower and benefits are commonly non-existent. More legislated awareness for the work/life balance issues that often drive women to choices based on the need for flexibility, as they seek to mesh family responsibilities with a career agenda, would be helpful.

From Margaret, “Free Speech and Corporations“:

Over the weekend, I posted a link on my Facebook page to a Keith Olbermann commentary on the SCOTUS decision that was issued on January 21, 2010. Now, I’m not a fan of Olbermann as a general rule, but I found what he had to say pretty much nailed what has me concerned about this decision. I don’t often publish anything on Facebook that is politically oriented, but I feel as if this decision has such far-reaching implications that it transcends “politics” and really has the potential to impact my daily life. In short, it scares the living crap out of me.

And from Onedia Hayes Sylvest, “Lifting the ‘Don’t Ask, Don’t Tell’ Policy — Those Arguments Against Sound Familiar“:

I am a retired navy commander. I retired in 1994 just after the Don’t Ask Don’t Tell Policy was begun. I thought it was insufficient then and I thought the reasons for taking such a half-baked (read another word there) stand was a little brass short of what it should have been. I also heard lots of reasons (and some of those are being repeated now by such people as John McCain) that sounded remarkably familiar.

When I first entered the Navy women did not have pants in their uniforms, they had to leave the service if pregnant, their husbands could not be claimed as “dependents” without proof that the navy woman provided at least 51% of his monetary support. We did not have top ranks or positions, there were no women with stars on their shoulders and we were denied access to many jobs/skill areas solely because of our gender. Women could not serve on ships or on aircraft and the primary reasons offered sounded almost identical to those I heard in 1993 and that I am hearing now.

I know that I served with gays and lesbians in the navy. Most were talented and dedicate. Some were not or even disruptive. However, neither the talent and dedication nor the poor performance and disruptive behavior were caused by their sexual preferences. The same traits and performance were equally present in both heterosexual and homosexual service people. In those days if you wanted to get someone eyeballed by the chain of command then feed the rumor of homosexuality. In my early days many people even assumed that women in the military were probably lesbians and if not they were either looking for a husband or were not of good moral character. The environment bred, I think deliberately, some level of hostility to any who did not fit the accepted image of what a sailor, CPO or officer should be. In the 70′ the primary targets were women and homosexuals.

This is just a sampling of what women are saying.

Want to read more? Why not join us and make your voice heard.

Health care costs wouldn’t be so high and there wouldn’t be so much concern about the cost of a public health care plan if so many Americans weren’t so sick.

Right?

On Monday, the New York Times reported on the hundreds of thousands of gallons of toxic waste being dumping into the nation’s water supply by coal-fired power plants. In the article, “Cleansing the Air at the Expense of the Waterways“, Charles Duhigg reported:

“For years, residents here complained about the yellow smoke pouring from the tall chimneys of the nearby coal-fired power plant, which left a film on their cars and pebbles of coal waste in their yards. Five states — including New York and New Jersey — sued the plant’s owner, Allegheny Energy, claiming the air pollution was causing respiratory diseases and acid rain.

So three years ago, when Allegheny Energy decided to install scrubbers to clean the plant’s air emissions, environmentalists were overjoyed. The technology would spray water and chemicals through the plant’s chimneys, trapping more than 150,000 tons of pollutants each year before they escaped into the sky.

But the cleaner air has come at a cost. Each day since the equipment was switched on in June, the company has dumped tens of thousands of gallons of waste water containing chemicals from the scrubbing process into the Monongahela River, which provides drinking water to 350,000 people and flows into Pittsburgh, 40 miles to the north.

‘It’s like they decided to spare us having to breathe in these poisons, but now we have to drink them instead,’ said Philip Coleman, who lives about 15 miles from the plant and has asked a state judge to toughen the facility’s pollution regulations. ‘We can’t escape.’

Even as a growing number of coal-burning power plants around the nation have moved to reduce their air emissions, many of them are creating another problem: water pollution. Power plants are the nation’s biggest producer of toxic waste, surpassing industries like plastic and paint manufacturing and chemical plants, according to a New York Times analysis of Environmental Protection Agency data.”

If the air pollution caused by coal-fired plants has already been linked to chronic asthma and COPD, just imagine the result of ingesting large quantities of the same toxins in your drinking water.

In an article for Care2.com, Melissa Breyer reported on the link between pesticides and Parkinson’s Disease.

A study by eminent oncologists Dr. Leonard Hardell and Dr. Mikael Eriksson of Sweden concludes that there is a link between “the world’s biggest selling herbicide, glyphosate (commonly known as Roundup, marketed by Monsanto), to non-Hodgkins lymphoma, a form of cancer.”

The following video clip is from the documentary “The World According to Monsanto” which took an in-depth look into the bio-chemical companies impact on agriculture, the environment and health.

And while we’re discussing Monsanto we certainly can’t forget their efforts to bury the truth about rBGH (bovine growth hormone) in milk.

There are many, many more instances of links between toxic waste and disease but I think that you get the picture.

Corporations have been dumping toxins in the water, air and food supply with impunity. The American public has grown sicker which has in turn driven up health care costs. Health care insurers are profiting from this illness. And now the corporate lobbyists and insurance industry spin machine are waging a full scale assault on health care reform.

Dear Members of Congress and President Obama,

if you really want to reform health care please take a comprehensive approach to this problem. How can you not pass health care reform with a public option when the government agencies which were supposed to protect the environment, agriculture and public health have failed us so miserably.

The previously cited New York Time article shows that the Riverhead International Coal Plant in Macon GA has been cited for 124 violations, paid $0 in fines and hasn’t been inspected since 1979. 1979 – 30 years ago.

Let the teabaggers and birthers rant, rave and spread lies about “death panels” but don’t give in to the insanity.

Americans can diet, exercise, visit the doctor and take all the pills we want. But if the biochemical and power industries continue to poision the air, water & food, we will grow sicker and sicker. Health care costs will both bankrupt consumers and increase the federal deficit. And in the end, we will die. Those without health care coverage will just die much quicker.

Congress must pass health care with a public option and if you want to reduce costs take on the corporations that have contributed to this crisis. Fine them. Shame them if you have to. Expose them for the greedy, heartless profiteers that they have become.

How dare Wellpoint sue the State of Maine to ensure that it is guaranteed a profit!

Enough is enough.

originally posted on Pam’s Coffee Conversation

Finally, the health insurance reform debate turned its focus — albeit briefly — on women and girls. About time. Women make most of the health care decisions in American families, and because of our longevity we tend to use more health care services as well. Further, because a persistent wage gap deprives many women of fair pay, women also have a harder time paying for health care and health insurance. And, to add insult to injury, insurance is typically more expensive for women. Without commonsense reform, insurance companies could continue the discriminatory practice of gender rating, and women could continue to pay monthly premiums ranging from four percent to 48 percent higher for individually-purchased health care plans than men. FLOTUS Michelle Obama’s first foray into the health care debate was quite welcome, and could not have come at a better time.

Enjoy a clip, and read the full text below.

Below is a DNC video that I recently was sent a link to.  And this is some of how I feel about it…

I don’t claim to have any answers – just questions.  So, here goes.

I could understand the Republicans being against Obama’s healthcare plan if they at least had a plan of their own.  Do they?

Sometimes I wonder if our elected government  has forgotten that they represent The “United” States of America…and that this issue is about LIVES not elections.

Okay, that wasn’t really a question, more like a statement.

And I’m totally NOT for taxing the top 2% of Americans to subsidize the 15% without insurance. But just out of curiosity…

Who are these people?  The top 2% people?  Are you one of them?

And how many of them would be totally against donating some of their wealth or business savvy (at least temporarily) to finding a way to help the uninsured of their own country?

Seriously. Did anyone think to ask? Maybe this population of our country isn’t as heartless and greedy as some people would like us to believe?

Anyway…Here’s the video from the DNC.  What do you think about all of this?  Dare I ask?

Link:  Barack Obama’s “Closing Arguments” Speech

SEE FULL VIDEO OF THIS OBAMA SPEECH HERE

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A few days ago, I posted on my blog, New Wave Grrrl, about the gaps surrounding Sarah Palin’s purported policy priority of addressing the needs of children with disabilities. I questioned the McCain-Palin ticket’s ability to put our money where their mouths have been on the subject of more funding for people with special needs. On October 24th, Palin gave a speech in my home state of Pennsylvania, on just what she and John McCain planned to do in order to better serve children with disabilities.

Although Palin’s speech was heartfelt, and I believe she truly cares about disability issues as a parent and as an aunt of children with developmental disabilities, her speech and the so-called McCain-Palin plan for children with special needs (which comes less than two weeks shy of Election Day) still falls flat, and still lacks any real promise of change in the quality of life for individuals with disabilities.

One glaring reason for this is the complete lack of policies that support people with disabilities beyond childhood. People who live with physical, developmental, cognitive, and multiple disabilities need various levels of care and support services throughout their entire lifetimes, in order to achieve a better quality of life and live fully within their communities. This includes not just vocational services for people with disabilities who can and want to work, but actual Medicaid dollars to fund the programs that provide for independent living in the community and not in State institutions, regardless of the severity of one’s disability.

Palin did mention teens in her speech, within the context of education and transition to adulthood planning, but again, the McCain-Palin approach is fragmented and does not address the current and critical health and human service needs of young people with disabilities. A recent study published earlier this year in the Journal of School Health showed that adolescents in special education programs are more likely to contract Sexually Transmitted Infections (STIs) than their typically developed peers. In adddition, we know that young people with disabilities are more likely to be victims of sexual abuse and assault. Better sexuality education and health services are needed to address these serious issues, and under a McCain-Palin Administration which would continue to fund harmfully inaccurate Abstinence-Only Education programs in schools, it is unlikely that these issues would ever see the light of day.

Palin also mentioned how lucky she and her family are to have such a strong network of social supports, and acknowledged that others who are surrounded by less family or have fewer resources are less fortunate. Wow! But neither Senator McCain nor Governor Palin have track records of supporting family-friendly work policies that would make it easier for families to put together the kind of support networks that Palin referenced in her speech. Their actions of not supporting family leave, benefits for same-sex partners, or pay parity for men and women strongly suggest that they recognize their privelege of having access to services and family supports, but will do nothing concrete to create the same access for others. How is this a populist message?

Last, although it is not funny, I almost have to chuckle to myself when I hear Palin talk about IDEA and fully funding this law, which gives children with disabilities the right to a free and appropriate education that best meets their needs. The Individuals with Disabilities Education Act (IDEA) was originally passed with the provision of the federal government eventually funding 40% of the cost for states in order to provide education to children with disabilities. This act also includes a provision for Early Intervention, a voluntary program that provides therapeutic and educational services to infants and toddlers with disabilities. IDEA has never been funded fully, which has thrown the special education and Early Interventions systems within many states into decades of problems while not being able to serve enough children with disabilities. This story includes Palin’s state of Alaska, which has little infrastructure and one of the worst track records of serving children with special needs in-state.

Moreover, not only has John McCain routinely voted against more funding for IDEA during his tenure in the Senate, but he has also vowed to freeze all federal spending indefinitely if he becomes President. This could likely be disasterous for vital federal programs that serve people of all ages with disabilities, including veterans, not to mention for states which count on federal dollars to make their budgets whole and to provide the most basic of services to the most vulnerable people in our society.

The recent McCain-Palin proposal to address the needs of people with disabilities is not only too little too late, but it is derived from a complete lack of policy knowledge and understanding that has haunted their entire campaign.

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Many people, like myself, feel that the way in which a society supports its most vulnerable or disenfranchised citizens is a critical indicator of how healthy that society is, and where it is headed in the future.

The issue of disability policy and the improvements that are necessary to elevate the quality of life for children and adults with disabilities in this country has rarely made it into the mainstream discourse during this election. Unfortunately, this is not surprising as individuals with disabilities are typically excluded from the larger social and political environments, both by actual physical barriers and by traditional social practices in our society which make them invisible.

Although it seemed that we might actually be treated to a serious debate on disability policy issues when Sarah Palin’s name was added to the Republican ticket and she announced that she has a child who was born with Down Syndrome earlier this year, no such rich or meaningful public discussion has resulted. Palin has vowed to make special needs children a priority in a McCain/Palin Whitehouse, however it is not clear how Sarah Palin, or John McCain, would accomplish this. In addition, given the track records of both Palin as Governor and McCain as Senator, it does not appear that the disability policy issues that will be crucial in the 21st Century, such as greater independence, de-institutionalization, community supports, and funding for special education will be represented by this ticket should they win the 2008 Presidential Election.

For example, McCain has repeatedly been unsupportive of fully funding special education for children with disabilities across the nation, and he does not support legislation to help move more people out of state institutions and into communities. Sarah Palin, as noted in a New York Times article in September, has not so far been an advocate of children with special needs in her state, which has one of the highest rates of out-of-state placements of children with disabilities based on Alaska’s inability to provide them with adequate services.

On the other side of the spectrum, Barack Obama released his plan to empower people with disabilities earlier this year, and it is a comprehensive plan that addresses many of the issues facing people, both adults and children, with physical, developmental, and cognitive disabilities, including health care, education, independent living, employment, and a host of other issues. In addition, Barack Obama supports the movement towards requiring that insurance plans cover mental and behavioral health services, which would positively impact people who are dually diagnosed with both disabilities and mental illness.

On November 4th, many who care about the rights and quality of life for people with disabilities will decide, in addition to other factors and issues, which candidate can best serve to support this population and honor their rights and abilities to live full, happy, and productive lives in American society. Hopefully, you will be one of them! Find out more information on where these candidates stand by visiting the links below:

Senator Barack Obama/ Senator Joe Biden:
Website: www.barackobama.com
Plan: Obama-Biden Plan to Empower Americans with Disabilities

Senator John McCain/ Governor Sarah Palin:
Website: www.johnmccain.com
*Plan: Please note that although McCain does address some disability issues for veterans, he does not have a policy plan for people with disabilities.

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Last November 26 as the race for nomination began in earnest I posted an Open Letter to the Candidates. I think it relevant that I now post it again with a few additions highlighted in bold.

Well, since it is here and easy to step onto, I am pulling out the soapbox this morning. This is an open letter to all the presidential candidates about what I want from my next president. Here it is not in priority order since I don’t want to make this too hard:

1. I want you to begin the withdrawal of troops from Iraq within the first 100 days of office and to provide medical care for the wounded and support for the reserve military to return to their civilian lives.
2. I want you to find a way for everyone in this country to have medical care !
3. I want you to find a way for everyone in this country to have affordable medications.
4. I want you to find a way for every young person to have access to higher education.
5. I want you to improve our schools and get our teachers better prepared and better paid.
6. I want you to find a way to ensure that the people who have entered a tacit agreement to turn over some of their earnings with the understanding that they would have a return as social security annuities will in fact get that return on investment.
7. I want you to behave as a Global CITIZEN rather than as the AUTOCRATIC PATRIARCH telling your global brothers and sisters how to run their countries.
8. I want you to strengthen our relationships with other countries and to broker agreements that will improve our security and our economy and that will reduce barriers and build alliances.
9. I want you to use more diplomacy in dealing with world issues and NOT rush to invade, conquer and quash.
10. I want you to be as concerned about what is happening in Burma and Darfur as Iraq and Iran.
11. I want you to refuse to build a WALL across our border and to develop a considered approach to immigration issues that is not fueled by fear, prejudice and narrow vision.
12. I want you to ensure that religious thought does not dictate decisions such as who may or may not enter into the civil contract of marriage. Such issues are for (of-age) individuals to decide not government.
13. I want you to reduce the availability of automatic weapons.
14. I want you to ensure our environment is protected.
15. I want you to use passion, vision and focus to develop and deploy real alternatives to fossil fuels as energy in this country. Kennedy took us to the moon in a decade … we can do the same to solve our energy problems.
16. I want you to sign the Kyoto agreement and to work diligently to reduce global warming.
17. I want you to immediately take appropriate action to improve our economy for the small towns, the working people and the small business owners of this country not simply for the big cities, the moguls and the financial houses.
18. I want you to be a person of integrity and intelligence and to surround yourself with passionate, dedicated people of equal intelligence and integrity.
19. I want you to do what you said you’d do while trying to get me to vote for you and to not use clever ways of speaking to avoid telling the truth about what you’re doing. (thanks Mary Ann of DSS)
20. I want you to lead us, inspire us, unite us, redefine us.
21. I want you to understand the need for and the way to build consensus when leading change.
22. I want you to promote harmony, to inspire pride and confidence, and to unite us.
23. I want you to protect the constitution and not erode the rights protected by the constitution!
24. I want some sane and reasonable regulations or restrictions on the financial community (or some creative and realistic solution) to restrain the overwhelming greed and corruption that brought us to our current dismal financial situation. I don’t have the answer but creative problem solving that does not simply put a band-aid on a headache can certainly be developed over the next four years. And while you are looking into that, how about reconsidering the federal stance on usury.
25. It is absolutely reprehensible that we as a nation continue to employ land mines in our warfare strategies.We need to change that! See references below.

The Ottawa Treaty or the Mine Ban Treaty, formally the Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-Personnel Mines and on their Destruction, bans completely all anti-personnel landmines (AP-mines). As of 2007, it has been signed/accessioned by 158 countries. Thirty-seven states, including the People’s Republic of China, India, Russia and the United States, are not party to the Convention. (Wikipedia)

Arms Control AssociationI KNOW. These are big expectations, but not unreasonable and they are the goals and expectations that will allow us to be a truly great and powerful nation.