Healthy Lungs #63

Ed Miller:

There's not a lot of excitement when something doesn't happen, when the water isn't bad or where there's not a food poisoning outbreak. But I think the whole nature of public health is going to be changing and starting to change.

Rebecca Falzano:

And so for this kind of completely uncontrollable thing to happen with no known cause was a real challenge for me and also an opportunity, a learning opportunity for me to figure out how much inner strength someone can have. And also an opportunity for me to slow down and say none of us have control and that's okay, and to embrace that.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and podcast show number 63, Healthy Lungs, airing for the first time on November 25, 2012 on WLOB and WPEI Radio Portland, Maine. Today's guests include Ed Miller, senior vice President of Public Policy for the American Lung Association Northeast, and Rebecca Falzano, lung cancer survivor and advocate for Lung Cancer Leaders and managing editor of Maine Home Design magazine. Most of us spend very little time thinking about the air that we breathe unless we live in a smoggy area. And here in Maine, we tend to think things look pretty clean, so things must be pretty clean. But it's interesting because we are the smokestack of the Northeast and our air is impacted by particles that come all the way from the Midwest. This is something that Ed Miller from the American Lung Association Northeast has been working on for decades, and it's something that the public health world has been working on for decades as well. We're very fortunate to have come as far as we have in this area, but there's still more distance to be covered. So I know you're going to enjoy this conversation with Ed Miller. Our conversation with Rebecca Falzano is pretty interesting for me because it hit home on a number of different levels. Rebecca was young when she was diagnosed with Lung cancer. As a female and a non smoker, this was an unusual diagnosis for her to have and it's something that impacted her life and her young adulthood. She went through a lot. She made it through and coming out on the other side, she really wants people to hear her side of it. And also getting ready to welcome a new baby into her life and the life of her husband, Steve Pogson. She definitely comes across with this message of hope. This is also personal to me because my own grandfather died of lung cancer when my 16 year old was a baby. My Pepere grew up in Biddeford. He lived there most of his life and he wasn't really a cigarette smoker. He had the occasional pipe and he also worked in a fairly industrial town. But it was never entirely clear to us as to what the direct causation was between what he had done in his life and the type of cancer that he had. What was clear was that this was our Pepere, this was our grandfather. And it was very difficult to watch him get sick and die quickly and leave our lives and leave a hole there. I know I'm not the only Mainer who's had this experience. I'm not the only person in the world who's had this experience. But it does give me a lot of appreciation for clean air and healthy lungs. And that's why I'm pleased to be able to offer the show to you today, who are listening Our our show with Ed Miller and Rebecca Falzano. We hope you enjoy it and we hope you learn something along the way. One of the first shows we did on the Dr. Lisa Radio Hour podcast was a show we called Breathe, in which we interviewed Dr. Dora Ann Mills, who was former head of the Centers for Disease Control in Maine, now at the University of New England. We thought it was important to revisit this topic here. It's November and we wanted to talk about breathing in air. So we couldn't think of a better person to come in and talk about this than Ed Miller, Senior Vice President of Public Policy with the American Lung association of the Northeast. Thanks for coming in, Ed.

Ed Miller:

Hi, how are you? Glad to be here this morning.

Dr. Lisa Belisle:

Well, I'm doing great. And part of the reason I'm doing so great is because there's all this lovely clean air that I know that the Lung association has been working on getting out there for the citizens of Maine for quite a long time now.

Ed Miller:

Quite a long time. And we actually go back to probably 40 years ago with the Clean Air act and certainly Clean Air act has a lot of connections to Maine, with Senator Muskie being the primary author of that, and then later Senator George Mitchell doing some significant updates to that. So Maine has been a leader in the fight for healthy air and I think will continue to be. And we have certainly some vested interests in it. We're kind of at the tailpipe of the nation, and without the Clean Air act, we really don't have a tool to keep our air clean. We could shut everything down in this state and still have pollution problems. And that's why we really do need to concentrate on what happens outside of our borders as well as inside.

Dr. Lisa Belisle:

Well, talk to me about the Clean Air act for people who are listening right now. What exactly did that mean? What did it bring about and where did it come from? Why did they think it was important to put that act into place?

Ed Miller:

Well, I think we ought to look to Senator Muskie and his vision. He saw a lot of polluted rivers. He saw a lot of polluted air in Maine from our factories. And this was something that was common across the country. And at the time, people really didn't understand the health impacts. It was more in many ways aesthetic. They didn't like the smell. People. Anybody who lives in the Portland area can remember that there were some pretty nasty smells in the air here 25, 30 years ago, and you don't get those anymore. And the Clean Air act was sort of an interesting law in that it said, what are the health standards that need to be met in terms of the concentration of air pollutants in the air that are not harmful? And so the scientists kind of set what those limits were for carbon monoxide or for particle pollution or for ozone. And then they said, okay, this is the area that we shouldn't exceed. We shouldn't have more than this, any air. And then separate from that, each state had to come up with a plan on how to achieve that if their air was done dirtier than that. And that took into account things like cost benefit analysis and what the most effective way to do that was. And some things that people almost take for granted these days were significantly the result of the Clean Air Act. And the one I like to use sort of most often is the catalytic converter on our cars. And we're at a point today where, quite frankly, our cars are probably cleaner than our lawnmowers and certainly cleaner than our boats in terms of air pollution. And that's something we ought to be proud of. Of. It's been a major advance, and it's been one that has created jobs, created a technological capacity here in this country that's been exported all over the world and has cleaned our air and improved our health at the same time.

Dr. Lisa Belisle:

Now, what is it about Maine that causes it to be what you've called the tailpipe of the Northeast?

Ed Miller:

Well, the prevailing winds are sort of west to east and kind of south to north. And the meteorology of this is such that the air from across the country travels our way. And as much as it might seem impossible, one of the biggest threats to the air quality in Maine are very, very large coal fired power plants in the Midwest, in the Ohio River Valley. And those areas that in many ways have been grandfathered into under the Clean Air act have found ways around cleaning their mess up, delayed as much as possible. They're still doing this today, trying not to clean and go on as long as they can. And we're the recipients of this. We're the ones. This is where the plume kind of drops down, you know. And so from the air pollution point of view, for particle pollution especially, a lot of those coal fired plants are a major source of our air pollution. And then the other source, particularly in the summer, the ozone problem, is one that to a large degree is from motor vehicle exhaust and sunlight and heat. And so that's something that comes to us courtesy of Massachusetts and New York and the whole Eastern seaboard. And so that's where the winds prevail. And you know that we'll get air pollution alerts in the summer when we get three or four sunny days in a row with a southwest breeze. You're going to have air pollution problems in the state.

Dr. Lisa Belisle:

What does ozone do exactly? I know that people, if you're watching the news or you're reading in the newspaper, there'll be an ozone alert. What does that mean to people who are listening?

Ed Miller:

That's a great question. Ozone is a very intense respiratory irritant. We like to refer to it, kind of a sunburn on the inside of your lungs. And it's a good analogy in a lot of ways. One is that it does irritate the lungs and that chronic irritation can cause problems, cause breathing problems in anybody, not just in people with lung disease, but about a quarter of the population are especially sensitive to ozone, whether or not they have lung disease. And so those folks will experience kind of this tightening in the chest. I remember as a kid growing up on the Jersey shore, used to think it was because we were swimming too much. We now know that tightness in the chest was actually ozone pollution that we were inhaling. And so it's an irritant like that. And it's a cause of irritation to existing people with existing disease. But also people that don't have it, that don't have any lung disease or heart disease, still can be affected by it. And just like a sunburn, two of us can be exposed to the same amount and have very different reactions. And I think that's what's important for people to understand. That's why we tell people, if you're a heavy exerciser or you're doing outdoor work, really of any kind during high ozone days, do that early in the day, because our problem here is worse later in the afternoon. So one of the worst things you can do is nice, sunny, hot summer day, go out and bicycle or run at 6 o' clock at night is probably not a great idea.

Dr. Lisa Belisle:

I know that you've spent time with Deb Dietrich, who is part of the public health sort of ground foundational structure for the state of Maine, who works at Maine Health now. She's a friend and mentor of mine. I also know that you spent a lot of time with Gordon Smith, who we interviewed on our Future of Medicine show from the Maine Medical Association. Is it gratifying to see some of the work that you started doing all those years ago start to come to fruition and to have people finally believe in what you've been kind of putting out there for so long?

Ed Miller:

Yeah, it's interesting as I kind of get older in this profession, you know, it's encouraging to see things that really we've been pushing for, for decades, coming into a time where they're more valued. I had to chuckle. I wrote an article back in 1977 on the health benefits of raising the cigarette tax that was published in the Maine Medical Association Journal. And the story behind that was kind of a funny one. Governor Longley was looking for a way first state employee pay increase, but he didn't want to raise taxes. So he asked the commissioner if anyone could show that raising the cigarette tax would have a benefit on health. And so I kind of did some research and found out it could, so wrote up this article on it. And he passed the tax and employees got their raise. But now we know that, for example, raising tobacco tax is one of the most effective and quickest ways to reduce smoking rates, particularly among our kids. And so some of these things have become much more common knowledge, much more common tools in the public health toolbox. But one thing in Maine that's never changed, and I think it's one of the reasons I've enjoyed working here so much is that we work very well together. This is a state where people know each other, they care about each other, and the barriers among the organizations and various agencies and groups are non existent. People really do work very well, and I've come to appreciate that even more as I've worked in other states where people don't play so well together sometimes.

Dr. Lisa Belisle:

Why do you think that is?

Ed Miller:

I think there's a tradition of that and there's an expectation. And just like if you have children and you expect certain things of them and you're consistent in that and people support that, that becomes the culture. And I think it is the culture here. And certainly there's differences of opinion on things and that. But I know my colleagues over many years working, for example with the Medical Society, with the Heart association, with the Cancer Society, with the Health Department. We've worked very closely for many years on things. And I think the issues that we're dealing with are bigger than any one particular organization can deal with. I know our organization, especially our volunteers, expect us to work together. They don't. Public health's not a solo sport. It's really a team sport.

Dr. Lisa Belisle:

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Ed Miller:

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Dr. Lisa Belisle:

Has there been a challenge with trying to get people to understand that the Lung association is more than just lung cancer?

Ed Miller:

Well, you know, it's an interesting question. The challenge for the Lung association is almost I don't even know if people think of us as lung cancer. They may think of the cancer society too sometimes on that. One of our challenges is that we're more than just tobacco. And I think that's been a very interesting thing. The Lung association goes back to 1911. We were formed and unlike the other voluntary health agencies like heart and cancer, we actually formed formed as a result of grassroots organizations getting together to form a statewide organization. There were the major killer at the time was tuberculosis and people fought that, you know, hand to hand combat in communities. And there were every county had a county TB association. They formed the Lung association or at the time the TB association around 1911. And that was a major killer and that was our focus. The name changed a number of times over the year. In fact we were the Lung association was the public health association from 1911, 1920 to almost 1950. And so that shows you our organization always had a Very broad base of concern around public health issues. Then in the 60s, I think we entered kind of into our second phase, which is really tobacco. And we're obviously still into that. We're still into tuberculosis to a degree. We don't just kind of get rid of it. It's an add on. But now I think the era of tobacco, we're hopefully winding down. We're still active in it will continue to be. But our concern right now and the major threat to lung health this state and in the nation is around healthy air. And that's really going to be our focus, I think, for at least the next 50 years in keeping and making sure that the air we breathe is healthy.

Dr. Lisa Belisle:

Talk to me about indoor air quality. You've mentioned some of the things that we think about for outdoor air particulates and ozone. What about indoor air quality and why is this an issue in Maine?

Ed Miller:

Indoor air quality in Maine is an issue for a number of reasons. One is it's cold outside and we spend a lot of time inside. So that's one thing. The second is that we live in a climate where, you know, looking around this fall, we had a lot of rain. We're not in a desert kind of climate. And that kind of climate, particularly when you also have some warm weather, you can end up with some mold problems. And mold is a problem in many indoor environments in Maine and usually the result of leakage into the building or poor design. Another serious problem, in fact, one that we're also working on, is radon. And this is an odorless gas that is harmful to health. It's a second leading cause of lung cancer after cigarette smoking and secondhand smoke. So radon is a big problem. And the good thing about radon is that it's pretty easy to get rid of. You can do a test, you can fairly inexpensively get rid of the radon. And if you're building a new home, it's very inexpensive to put radon protection in that new home. So that's another indoor problem and then one that people perhaps don't think about as much. I guess I should just back up and say a major indoor air pollutant is if anybody's smoking inside the house. That goes without saying. That's probably one of the worst things that people can do. And fortunately, a lot more people in Maine are smoking outside. Even if they're smoking at home, they're smoking outside and not in their house or their apartment or any other kind of building like this. But another area where we have some concern is around wood smoke. And Maine has a lot of old wood stoves that date probably from the 70s when we had the initial energy crisis and people expanded the amount of wood burning. There's always been a lot of wood burning going on, but they expanded that. And part of the problem is these old wood stoves produce a lot of particle pollution inside the house. And it's not even the stuff that you see. It's the very, very fine particles that you don't see that are the danger. So we've been working around the Northeast and we'll hopefully doing some work in Maine on programs that change out old wood stoves for new wood stoves. And the new wood stoves, particularly the pellet stoves, there's a 70 to 80% reduction in the amount of particle pollution inside the house from these. So it's significant. So if people are considering, as we go into winter, changing out their stoves, they're going to have a lot of benefits. They're not just going to have the benefit of less outdoor pollution that they're creating and the higher efficiency and being able to save on wood or pellets, but they're also going to be significantly improving their indoor air. So those are probably the major indoor air problems in Maine.

Dr. Lisa Belisle:

Is there an issue with VOCs, or volatile organic compounds and building materials? Has this been something that you've seen happen?

Ed Miller:

I think people need to be careful about the building materials. They need to be careful about what they put into their homes and how they perhaps renovate their homes. And we've had in the past problems with people renovating around lead paint and actually causing more problems than perhaps they even knew about. Fortunately, these days we're getting a lot more products that are low voc. You can have paints, for example, that it used to be, you'd paint a room and you'd have to evacuate the house for a few days. Now you can paint a room and you could be in that room that evening. There's some products, and I think people are getting smarter about the use of various products indoors. We have a partner organization. We do a lot of work with the main Indoor Air Quality Council. And if people are interested in particularly residential air quality issues and to some degree, commercial as well, indoor air quality, Maine Indoor Air Quality Council is a great resource. They have a great website and people can Google that and find out a lot more in this area.

Dr. Lisa Belisle:

You've described the challenges of being part of a public health organization that focuses on something that's essentially odorless and colorless and something we take for granted because we breathe it into our bodies. Well, hopefully it's odorless most of the time. Yes, yes. But I know that there are some events that the Lung association does to raise awareness. One of them is the Trek across Maine. And that takes place, I believe, in June.

Ed Miller:

In June. Father's Day weekend. Yes.

Dr. Lisa Belisle:

And it seems to have really taken off.

Ed Miller:

It's remarkable. I had the good fortune to have been working on the Trek across Maine for 26 of the 28 years. And I always say that it's way more than a bike ride. This has been a way that the Lung association has been able to recruit volunteers to identify really impassioned people for our mission, to identify and recruit people who work with us year round to really push the mission of the Lung association and be our eyes and ears and boots on the ground throughout Maine and really throughout. Throughout the country. Usually people from 28, 30 states participate in this event. It's a great event. It's a wonderful experience. It's a very emotional experience. Watching people cross that finish line in Belfast and just their accomplishment. This isn't like waking up one morning and deciding you're going to go do a two mile walk. I mean, this is 180 miles on a bike saddle here, going uphill. And despite the fact that the. The subcontext of the trek is from the mountains to the sea, it is not downhill by any stretch of the imagination. You can ask anybody that's done it. But it's been a great way for us to get our message across. It's been a great way for us to influence families. There are a lot of families that do this. We're working now on three generations of people who have done this trek. And it's remarkable. It raises almost $2 million. It's the biggest. It's the biggest fundraising event in the American Lung association nationwide. There's nothing bigger than this throughout the country. So it's really a source of pride for Maine and for the ALA of the Northeast that this event has been going on as long as it has, that it has grown from the first group of 100 people that raised $50,000 and rode the last day, rode 100 miles from Pittsfield to Bar harbor in the rain. And remarkably, six or seven of those folks are still riding with us and have ridden every single ride for 28 years. So that's a testament to the fortitude of people that do this. But it's great because it's an event that raises money, certainly, but it also demonstrates our mission in Many, many ways. So it's been just a great fit. I'd be remiss without tossing out a kudo to Peter King, who was the originator of Trek Across Maine, still here in Maine. But it's been an idea and an event that's had many, many people contribute to its success.

Dr. Lisa Belisle:

You also have an interesting and unique event, I believe, coming up, in which we have done well for the state of Maine. Out of state. Is that right, firefighters? Tell us about that.

Ed Miller:

Well, down in Boston at One Boston Place, which is one of the taller buildings in downtown Boston, which, incidentally, when I mentioned working for public health in the past, happens to be the same building I worked in the 70s when I was in Boston. It's a 41 story building and we do a stair climb there. And it's a timed event. There are teams or individuals that do that and they climb up as fast as they can, 41 stories. And it's kind of two events and one event is for the general public and the teams and they do their thing usually till about noontime. And then following that, there is an amazing, just amazing competition among firefighters from all over New England who in full gear, including the Scott packs, are heading up those corridors up to the roof of that building. And it'. Sand. Anyone who knows fire departments know that they are a bit competitive, should I say? And Portland has been just a great team and they've won a number of years. They're battling the folks from Boston and all over the Northeast at this point. And it's a fun event. It takes place in early February and you can go on our lung site, lungane.org and get the dates and how to participate in it. But it's a lot of fun. There's a lot of people from Maine that go down and do it because it's very unique.

Dr. Lisa Belisle:

And there's also a phone number that people can call to get in touch with your organization.

Ed Miller:

Sure. 1-800-Lung USA is an easy way to get in touch with us. As part of that number, you'll be prompted if you want to talk to our lung helpline. We have a, a live health care professional that's there to speak to you about any aspect of lung disease. It's either a respiratory therapist or a nurse that can answer your questions. And it's a great service. We have people from all over the country that are calling that number and getting information on how to improve their health.

Dr. Lisa Belisle:

We've been speaking with Ed Miller, senior vice president of public policy for the American Lung association of the Northeast. Thanks Ed, for all the work you've done bringing clean air into the lungs of our Mainers. And thanks for coming in and talking to us today.

Ed Miller:

Well, thank you very much for inviting me and having this opportunity to talk with you.

Dr. Lisa Belisle:

As part of our Healthy Lung Show, I thought it would be interesting to bring in an individual that I've gotten to know over the past year as we've taped our show, the Dr. Lisa Radio Hour, in the studio of Maine Magazine. It's also the studio right next door to Maine Home Design. So we have coming in to talk to us the managing editor of Maine Home Design, Rebecca Falzano, who also has a very interesting backstory, very much related to lungs and breathing and lung health. As a lung cancer survivor herself diagnosed in 2010 and current, I guess I'll say advocate for lung cancer leaders. Thanks for coming in and spending some time with us, Rebecca.

Rebecca Falzano:

Thank you for having me.

Dr. Lisa Belisle:

Now, people who are listening won't be able to see Rebecca, but if you've ever read Maine Home Design, you've seen her picture and you know that she's young. You're in your 20s, still.

Rebecca Falzano:

31, actually.

Dr. Lisa Belisle:

Okay, just out of your 20s. Yes. But you were diagnosed with lung cancer in your 20s?

Rebecca Falzano:

Yes, I was 28.

Dr. Lisa Belisle:

So tell me about that. What was that like to get a diagnosis that's usually associated with being older and being a smoker. And you were a young woman and non smoker, right?

Rebecca Falzano:

Well, in 2010 I was 28 and it was, I think five months before my wedding when I was diagnosed and I had never even so much as touched a cigarette. So it really came out of the blue for me. I had Been waking up with this wheeze and a cough and my breathing was just not right. And I had been diagnosed with asthma many years before that, so I just assumed it was that acting up. So I saw an asthma allergy specialist here in Maine and he tried me on every inhaler on the market. And I would just go in and say, you know, I still don't feel right. And this happened for months. This went on for months. And finally he said, we need to send you in for a CT scan. And thank God he did, because sure enough, I had a cancerous tumor on my lung. And it was just, it was just shocking to get this diagnosis. I think cancer is something that no one expects to get. And I think especially at such a young age. And I had all the misconceptions about this disease that so many people have, that, you know, it affects older people, that it's a smoker's disease. And so it really, it really was out of the blue for me and my husband to be. To deal with us.

Dr. Lisa Belisle:

And you had just recently moved to Maine to I think to take this job, is that right?

Rebecca Falzano:

That's right. We moved from New York City for a change of lifestyle. You know, we really wanted the fresh air. I mean, it's kind of ironic because I was diagnosed with asthma in New York and moved to Maine and it got worse, or so I thought it was my asthma getting worse. But so it was, it was definitely a challenge having moved here and we didn't have any family here and just kind of getting our bearings in this new place and then being hit with, with this illness.

Dr. Lisa Belisle:

How did your friends react when you told them that you had lung cancer?

Rebecca Falzano:

I think everyone was pretty shocked as much as I was. They were incredibly supportive. You know, one of the things that my husband and I always say is that we left our families to come here and how much we miss our families, but we've really, our friends here have really become like family to us, our colleagues, our co workers. It's just been incredible. And everyone was very supportive and in a lot of ways it was an opportunity to have this discussion, which I kind of felt like no one was really talking about this disease, especially in terms of women and especially in terms of non smoking people. And so it was an opportunity to have that conversation with friends and just kind of bring some awareness to the issue.

Dr. Lisa Belisle:

As a managing editor, your background is writing and thinking and putting thoughts on paper and maybe this body thing, not as much. So how was that to feel like your body had somehow done Something that didn't really make a lot of sense. It was kind of irrational and you couldn't really put of a lot. You couldn't think through it in some way.

Rebecca Falzano:

I would say that I'm someone who is very much, or at least I like to think I'm very much in control, very type A personality. I'm a researcher. I'm, you know, like you said, a thinker. And so for this kind of completely uncontrollable thing to happen with no known cause was a real challenge for me to try and get my head around it. And also an opportunity, a learning opportunity for me to figure out just how, just sort of the limits of strength or how much inner strength someone can have. And also just an opportunity for me to slow down and say, you don't have control and none of us have control and that's okay, and to embrace that. Of course, at the time I wasn't really interested in embracing it. I was pretty devastated and terrified. But now I have the benefit of hindsight and look back and say that really was an opportunity.

Dr. Lisa Belisle:

What types of things did you do when you felt out of control? How did you, I don't know, manage that sensation?

Rebecca Falzano:

I googled a lot against the advice of all of my doctors. Like I said, I'm a researcher at heart and I just. And a reporter. And I just, I crave information and knowledge. And so I did a lot of late night googling when I couldn't sleep. And that's where I really discovered some of the really startling statistics that I had no idea about. I can just remember lying awake at night and being on the Internet and finding these numbers. First of all, I had no idea that lung cancer kills more people than any other cancer. I just, I didn't know that. And I didn't know that it killed 70% more women than breast cancer and uterine cancer and ovarian cancer combined. I mean, those just shocked me. I think the most shocking thing though was just how underfunded it was. And also that the survival, the five year survival rate has just stagnated. I mean, it's where it was well before I was born. And that just was unacceptable to me. And I remember finding this article online by this guy named Rob Denson. And Rob works for. Actually Rob heads up an advocacy marketing firm in New York and his wife has stage four lung cancer. And he wrote this really moving piece in the Huffington Post about the disease and how it's affected his family. And just kind of talking about the numbers that I had just researched. And I felt, first of all, such a sadness for what he was going through and what so many people were going through, but also this amazing sense of relief, in a way, and hopefulness that he was onto something here. He was paying attention, and his job was to help other people pay attention. So I reached out to him and emailed him and said, what can I do? And so he flew me down to New York and I got to meet his daughter Arielle, who's my age. And it's just incredible what they're doing. I mean, their family has embarked on this campaign called Lung Cancer Leaders, and they've put so much of their own time and financial resources into it, and they just kind of let me in on, you know, on the ride a little bit, and I was so impressed. And so Arielle and I marched down to Times Square and met with any women's health editors that we could get to meet with us at Conde Nast and Hearst and all these big magazine companies and sat down with them and pitched the story and the story of lung cancer and women. And so it was just a really. It was an incredible experience for me. And, you know, I was just so grateful for all the work that they've been doing and continue to do for this community that I found myself suddenly a part of.

Dr. Lisa Belisle:

Describe Lung Cancer Leaders a little bit more for me. What is the main goal of the Lung Cancer Leaders organization?

Rebecca Falzano:

The mission is to reverse the stigma surrounding lung cancer. And that stigma is that that somehow, if you've smoked, you somehow deserve this disease, which is, of course, unfair and not true. And their mission is to raise awareness. And they have three partners that work with them. The National Lung Cancer Partnership, the American College of Chest Physicians, their One Breath initiative, and also Uniting Against Lung Cancer. So with the. These three partner organizations, they have this really great website that's a great resource. There's a lot of statistics on there, videos. There's also a place where you can sign a petition for the Lung Cancer Mortality Reduction Act. There's ways to get involved. And they have a very active and engaged Facebook page as well, which has blown up. I think they're at 50,000 fans now and growing. And these people have shared so many personal stories. It's really a great. Not only a resource, but a place to go to for support.

Dr. Lisa Belisle:

And you shared your story, I believe. I think I saw a video of you doing. I did, yes. And this is available on their website?

Rebecca Falzano:

Yes. Yep. Lung cancerleaders.org how was this for.

Dr. Lisa Belisle:

I know your husband Steve, and I By the time this airs, it'll be very apparent that you're quite pregnant and you're going to have a baby in January. Well, not to the listeners, but obviously people who might see you on the street. How did this feel to him to have a young almost wife and then wife who was going through this really significant, life changing, life threatening illness?

Rebecca Falzano:

Steve, I think was probably more terrified than I was, but couldn't show it. I think he felt he had to be strong for me. And you know, in many ways we've joked that we were married even before we got married because we, our vows played out in the months that preceded our wedding in sickness and in health, all of it. He was an incredible source of strength and support and you know, both of our families alongside him. I mean, they were there every step of the way. And I can't imagine going through that without someone that supportive. So I was so grateful to have that and also to have a second set of ears and eyes when I would go down to these doctor's appointments. I mean, it's such a scary thing and you know, half the time you just don't know what they're saying to you and everything is moving so quickly. So having not only that emotional support, but just kind of like logistically getting me down there and listening to the doctor and being able to digest and translate sometimes and remember questions that I had forgotten. I think having an advocate like that is hugely important when you're going through something like this.

Dr. Lisa Belisle:

And was it also interesting because you weren't quite married yet and you had your family that had always been your kind of caretaker and now you have this guy who isn't quite your husband and he had to almost be a go between at times. Was that interesting?

Rebecca Falzano:

Yeah. I mean, talk about commitment. A test of commitment. You know, we had been together for so long that it was. I didn't expect it to go any other way. I mean, I knew that he would be supportive and wonderful and it would be fine, but it really, especially for someone like me, who again, is very, very much in control. I tend to joke that I'm a control freak having this crazy thing happen. You know, I was not always in the best of places with it. And I mean, there would be moments where the smallest thing would completely launch me into, you know, this hysterical fit. And it really wasn't about the fact that I stained my shirt, for example, or, you know, it was about all of this happening, but it was easier to pinpoint and focus on something small that had happened and get upset about that in many ways than to open up the floodgates of emotion and fear and anxiety about this much greater thing that was happening. So he dealt with a lot of that very well, I might add.

Dr. Lisa Belisle:

And were you surprised when you were finally able to get pregnant? When you finally got to the other side of this and said, oh my gosh, we have a real life, we got married, we're going to have a baby, were going to actually do what we had thought we were going to do in the beginning.

Rebecca Falzano:

It was amazing. The human body is incredible. I mean, the fact that I could have this happen, go through surgery, a few different kinds of surgical procedures, in fact, in addition to major lung surgery, heal, get married, dance at my wedding, and then two years later become pregnant and, you know, with no issue whatsoever was, it was just, it's amazing to me and surprising. I mean, it was just, it's nice to get some positive medical news for a change. I mean, I remember going to our first appointment and Steve came with me and he just looked at the doctor and he had this, he's, you know, I think we both still have a little bit of post traumatic stress from all these doctor's visits and medical things. And, and he just said, I just can't believe that this is, I mean, this is a happy, positive thing. We're here for happy news. So it's an incredible gift.

Dr. Lisa Belisle:

What do you think you'll tell your baby once your baby is old enough to be a little kid or an older kid or about some of the lessons that you learn regarding, I guess this whole miracle of life piece?

Rebecca Falzano:

I haven't gotten that far yet. I'm still, I think, trying to process it myself. I think I go back to this idea that I kind of hesitate to use the word gift because people who are suffering through any kind of illness or cancer, when you're in the middle of it, it is not A gift, and it's a terrible thing. But I have this hindsight and the benefit of health and a good prognosis, so I can look back and say, that was incredibly difficult and scary, but I'm so lucky. And so I think just this gratitude for every day is something that I hope I can impart onto our kids someday. And I hope that I can keep it in the forefront of my head. I mean, it's so easy to get caught up in your everyday life and just getting through the day and what an incredible journey this was, and how lucky am I that I'm here and that I have this great prognosis and it's not the case for so many people with this disease. And so I hope that that is what I can share. And also, you know, I think one of the things when I was going, when I was in the thick of it, and I was certainly not, you know, strong enough or even in the mindset to even think about someday advocating being an advocate for this, I was so grateful to the people who were. Who were fighting the fight and who were, you know, acting as my voice. And so I hope that I can continue to do that, and that's going to be important to me in the, you know, coming years to continue to fight for this, for the people who can't, the people who have lost people or are suffering and are really sick and don't have the energy.

Dr. Lisa Belisle:

Do you think that it is maybe interesting in a bigger picture way that younger people are getting this disease and hopefully getting cured from this disease and can act as more of a voice as opposed to the people who traditionally had gotten this disease, who were older and who didn't have that many years to live and maybe couldn't be advocates for themselves. Does it seem kind of an interesting twist of fate that now this younger generation is able to actually go out there and provide advocacy where it didn't exist before?

Rebecca Falzano:

That's a really good point because part of the. I think part of the issue with lung cancer is that it is such a pervasive disease, so that by the time many people are diagnosed with it, it's too late, and they're in the stages where they don't have the energy to fight. They don't have the energy to be advocates. So in many ways, being younger was an opportunity for me and having, you know, a lesser virulent form of the disease, I was able to, you know, be that, help be a voice for people who. And hopefully, I mean, I certainly hope that I don't Want more and more young people to be getting this, but it seems like that is happening. And so hopefully that will help the movement, you know, put some more energy behind that movement.

Dr. Lisa Belisle:

It was also fascinating to me to hear that the type of cancer that you have is not a type that is very common. In fact, it's kind of, I think you told me it was an endocrine related tumor. And there is this. We know that there's a link between things in our environment and what's going on with our endocrine or our hormonal systems in our bodies. So I'm wondering if you've had any thoughts about environmental health and the health of the air around us and what type of an impact we could be having on that.

Rebecca Falzano:

I think when you're, when you get a diagnosis like this, the first thing you want to do is find some kind of causality or correlation. And that's so hard as, you know. So my immediate thought, and even my surgeon kind of joked, half jokingly said to me, you know, have you been around some pollutants? Like what have you been doing? And you know, I hadn't. And again, I've never smoked and I was never really around smoke. You know, my childhood home was free of radon. That's a huge thing, especially in Maine. So it definitely was. Was on my mind. But you know, there wasn't. We couldn't find any link. And so then of course it becomes, well, could it be genetic? And there's no. It's very hard to tell. And so what I've just tried to do is, of course when my husband and I bought our first house, I immediately had the radon checked. And I mean, but you're out in the world, so I mean, there's only so much you can do. You just have to really be aware of the dangers and do your best to eradicate them. As it turns out, the house that we did buy did have a radon issue. And so we had that mitigated. And I was a little crazy about that, making sure that got done and went to great lengths to get the best kind of system. So I definitely think environment is huge. And it makes you wonder, especially with this happening more and more with young people and non smoking people, what is going on? And I'm hoping that there will be funding there and efforts to really research this and figure it out.

Dr. Lisa Belisle:

One of the things that I noticed because you and I are friends on Facebook and you know, I've known you for actually more than a year now, one of the Things that I noticed is that you were active, actively soliciting money to do a Harvard. And there was a picture that you put up, I think, after the last heart walk of somebody that was close to you that was impacted by heart disease. But it was a surprising photo. It wasn't a photo of your grandmother or, you know, an older person.

Rebecca Falzano:

Yes, actually, two good friends of mine tragically passed away within three months of one another last year, last summer. And. And both of them had just turned 30 or were about to turn 30. And I mean, it was just a shock, completely devastating. One of them was on vacation in Bar harbor and she passed away in her sleep next to her husband. And the other one, a very similar sudden death that were thinking had to do with heart disease. Kind of unclear, but so our friends have rallied around this cause and every year we participate in the heart walk down in Boston and try to raise money for cardiovascular disease. And again, it's one of those things that can affect anyone, like lung cancer. I mean, you. If you have lungs, you can get lung cancer. If you have a heart, you can get heart disease. And it was just. It was so devastating to lose someone to this someone so young times two, in such a short period of time. And they were good friends. I mean, these aren't two separate friend groups. This is in our circle. It was really. It was really hard and eye opening. And again, the whole idea of life is so fleeting. And, you know, I think when you're younger, you tend to think you have this, you know, endless, you know, time. And so for me personally, having this diagnosis coupled with losing two good friends at such a young age was just again, another opportunity to really value every day as sacred.

Dr. Lisa Belisle:

Did it seem strange to you that you had lung cancer and you survived and these two young women had heart problems, heart disease, and they did not.

Rebecca Falzano:

Yes. You know, they had been so supportive of me when I was sick, and so, you know, to lose them so suddenly out of the blue, yeah, it was very hard and very, you know, it just, it never makes sense, you know, why them? And, you know, why am I okay and why, you know, I mean, you just, you can go down the rabbit hole of questioning and, you know, guilt or any number of emotions.

Dr. Lisa Belisle:

And for people who are maybe still stigmatizing lung cancer patients, still expecting they must be smokers or expecting that they must have done something wrong, what would you say and how do you think? What are some words you could use to shift their mindset?

Rebecca Falzano:

I would say that if you have lungs, you can get lung Cancer. And it's as simple as that. I think it's really unfair to ever blame someone going through an illness. There's so many lifestyle decisions people make every day that may or may not contribute to an illness. I mean, you would never say to someone with skin cancer, well, you shouldn't have gone to that vacation in Cancun for three weeks. I mean, you would never. Or someone with any kind of heart disease, oh, did you eat a lot of meat? I mean, that's just.

Dr. Lisa Belisle:

Well, you'd actually be surprised at the number of people who are very judgmental about illnesses in general. I think the point is very well made. But I think lung cancer is especially

Rebecca Falzano:

stigmatized, and it's so unfair. I mean, no one deserves anything like that. And so I would say, you know, I think one of the biggest things is, one of the biggest things I've at least taken away is never ask someone who tells you they have lung cancer, oh, did you smoke? Never ask that. So many people asked me that. And it doesn't matter. I mean, I didn't happen to, but it doesn't matter even if I did. You know, does it make it, does it make a difference?

Dr. Lisa Belisle:

Rebecca, how can people find out more about lung cancer leaders?

Rebecca Falzano:

They can visit LungCancerLeaders.org or find us on Facebook Lung CancerLeaders.

Dr. Lisa Belisle:

And I would like to point out also that people can probably follow your life a little bit by going to the 48 hours main site because I know that you spent some time in Kenny Bungport last spring. It's likely you're going to be doing this again with or without baby, Probably. So I think that it's really, it would be very interesting for people to actually find out a little bit more about you. So where can people find out more about Maine Home Design and Maine magazine,

Rebecca Falzano:

ME home design.com and themainmag.com well, we've

Dr. Lisa Belisle:

been speaking with Rebecca Falzano, who is the managing editor for Maine Home and Design Magazine, sister publication to Maine Magazine, which is where we tape the Dr. Lisa Radio Hour every week. Rebecca is a lung cancer survivor and an overall really inspirational individual. So we're appreciative that you've come in and spent some time with us today.

Rebecca Falzano:

Thank you so much.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle, and you have been listening to the Dr. Lisa Radio Hour and podcast show number 63, Healthy Lungs, airing for the first time on November 25, 2012 on WLOB and WPEI Radio Portland, Maine. Today's guests included Ed Miller, senior Vice President of Public Policy for the American Lung Association Northeast Edition, and Rebecca Falzano, lung cancer survivor and advocate with lung cancer leaders and also managing Editor at Maine Home and Design Magazine. For more information on our guest and for extended interviews, visit drlisabelisle.com this show and all past shows may be downloaded for free through itunes. We also urge you to like our Facebook page and sign up to get our regular fee. As we head into December and the holiday season, I hope that each of you who are listening will take a moment to take a deep breath and enjoy the fresh, clean air in Maine or wherever you are and enjoy the fact that you can breathe and that you're Alive. This is Dr. Lisa Belisle. Thank you for being part of my world. May you have a bountiful life.