Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand





As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.




A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.


“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”


Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.


Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.


The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”


While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.


“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”


Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.


“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”


Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.


“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”


For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.


“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”


“It’s about the cancer, not Lance,” Eddie Bonds said.


That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.


Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.


Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.


“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”


Nienhouse said he had no plans to have the tattoo removed.


As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.


“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”


She also said she did not plan to have her tattoo removed.


“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”


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Illinois corporate tax credits swelled to $161 million 2011









When lawmakers raised taxes on Illinois residents and businesses, they also increased corporate income tax breaks for a select group of companies.


In 2011, businesses were eligible to claim about $161 million in tax credits — double from the prior year — mostly because of the increase to 5 percent from 3 percent in the state's personal income tax rate, which is a factor in determining the value of the incentives. The boost marked the largest increase in the Economic Development for a Growing Economy tax credit program, the state's main economic development program, since its creation in 1999.


Deere & Co., Boeing Co. and Caterpillar Inc., whose leader severely criticized lawmakers for tax hikes, were among dozens of companies that received more robust tax breaks. Some companies' deals also allowed them to be in line to receive tax incentives even while laying off workers or lowering wages.








The EDGE program allows a business to claim a credit against its corporate income tax liability if it agrees to create and/or retain jobs and make an investment in the state of at least $1 million, for companies with fewer than 100 workers, and at least $5 million for larger companies.


Once accepted into the program, which typically lasts 10 years, a company applies on an annual basis for a tax credit certificate, similar to a voucher, which it can claim when it files its taxes.


Marcelyn Love, a spokeswoman with the Department of Commerce and Economic Opportunity, which administers the program, said that under the tax credit program companies make investments and employ workers, practices that otherwise would not have occurred without the credits.


"Both the private investment and the increased employment significantly increase tax revenue collection for the state in excess of the credits given," Love said in an email. Far from adding to the tax burden, she added, these incentives actually generate revenue for the state. "Further, most of these tax credits pay for themselves within two years."


The certificates are the only way to gauge the potential cost and scope of the program, because tax filings are not public. The Tribune obtained the 2011 certificates data, the latest year available, under the state's Freedom of Information Act. Companies have as many as five years to redeem a certificate.


After a deal is finalized, a company has two years to meet its side of the bargain and begin applying for certificates. Thus, the increase in the total value of 2011 tax breaks is also the result of companies receiving certificates for the first time. For example, Ford Motor Co. began applying for its certificates in 2010 from a 2007 deal.


During Gov. Pat Quinn's administration, companies have received increasingly larger deals. Many have been for retaining jobs, according to a Tribune analysis. In 2011, Sears Holdings Corp. was offered a tax credit package worth $150 million over 10 years to keep its headquarters in the state and retain at least 4,250 full-time jobs. The company, which after the deal was announced revealed that it was closing 125 stores nationwide, has yet to apply for a certificate. Five of those stores were in Illinois. State officials have said that during a recession, when few jobs are created, it's important to focus on retaining workers.


Chris Brathwaite, a Sears spokesman, said the company's employment level at its headquarters is higher than the more than 6,000 jobs it had when the deal was approved, but he declined to provide figures.


In general, the value of a certificate equals the number of jobs created and/or retained, multiplied by wages tied to those jobs and the state's personal income tax rate.


That means companies that didn't add one worker and kept wages at the 2010 rate received a 67 percent boost to their 2011 corporate income tax break. Just like individuals, corporations also registered a tax rate increase in 2011. Lawmakers set the new corporate income tax rate at 7 percent, up from 4.8 percent. The increases in breaks partially offset that hike.


The formula under which companies become eligible to receive tax breaks was aimed at encouraging job creation and increasing employee wages. Still, the 2011 data revealed that some companies made deals to allow job cuts and still qualify for incentives, a practice known as "normal attrition."


A case in point is Motorola Mobility. For the past two years, Motorola Mobility has qualified for certificates worth a total of $22.6 million while slowly chipping away at its workforce. Late last year, the smartphone-maker, which was acquired by Google Inc. in May, announced it was laying off 20 percent of its global workforce. Locally, the company cut hundreds of workers, bringing its Illinois head count to about 2,300, a figure that would make it ineligible for a 2013 certificate unless it boosts its workforce before the end of the year.


The Department of Commerce and Economic Opportunity said the EDGE program played a crucial role in keeping Motorola Mobility in Illinois after it was acquired by Google. Its presence, the agency said, is drawing more technology investment and jobs to the state.


A state lawmaker wants the state to end the wiggle room practice, cap at $100 million the annual amount of tax breaks awarded and remove the investment bar so more small and medium-size businesses can qualify for breaks.


"Large multinationals are getting all the breaks," said Rep. Jack Franks, D-Marengo, adding that his focus is to modernize the program and increase accountability.


Franks' House Bill 1336 would also limit the length of the tax breaks to five years and require that companies pay workers at least the median salary of their occupation as determined by federal data. The bill also eliminates the provision requiring companies to make a capital investment in the state of at least $1 million or $5 million, depending on their size. And it creates a nine-member board to oversee the deals, with members appointed by the governor and approved by the state Senate.


Franks said that the Department of Commerce and Economic Opportunity shouldn't promote the program while also negotiating deals with companies, because it creates a conflict of interest.





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Ship passengers describe 'filth,' 'stench,' 'freaking out'








MOBILE, Ala.—





Thousands of relieved passengers poured ashore from a stinking cruise ship on Friday after five days adrift in the Gulf of Mexico with overflowing toilets and stench filled cabins.

Exhausted passengers lined the ship's decks, waving towels and flashlights, cheering and singing "Sweet Home Alabama" as tug-boats pulled the stricken Carnival Triumph into the port of Mobile, Alabama.

Some travelers kissed the ground when they walked off, others disembarked wearing the ship's white bath robes, part souvenir and part protection against a chilly night.

With only one working elevator, it took several hours to get the more than 4,200 people off the ship, Carnival said. Passengers were greeted dockside with warm food, blankets and cell phones to call family and friends.

About 100 buses waited to carry passengers on a seven-hour bus ride to Galveston, Texas, while others buses departed for shorter rides to New Orleans, as well as hotels in Mobile, before eventually flying home.

The end of the saga, documented live on U.S. cable news stations, was another public relations disaster for cruise giant Carnival Corp. Last year, its Costa Concordia luxury liner grounded off the coast of Italy, killing 32 people.

Carnival officials said the Triumph, which entered service in 1999, would be towed to a Mobile repair facility for damage assessment.

The 893-foot vessel was returning to Galveston from Cozumel, Mexico on the third day of a four-day cruise when an engine-room fire knocked out power and plumbing across most of the ship on Sunday.

Passengers described a gut-wrenching stench on parts of the ship and complained to relatives and media by cellphone that toilets and drainpipes overflowed, soaking many cabins and interior passages in raw sewage.

"The stench was awful," said Robin Chandler, a 50-year-old from Dallas who spent her birthday on the ship. "A lot of people were crying and freaking out."

Jacob Combs, an Austin, Texas-based sales executive with a healthcare and hospice company, praised the ship's crew.

"Just imagine the filth," said Combs, 30. "People were doing crazy things and going to the bathroom in sinks and showers. It was inhuman. The stewards would go in and clean it all up. They were constantly cleaning," he said.


Debbie Moyes, 32, of Phoenix told the Los Angeles Times she was awakened Sunday by a fellow passenger banging on her door, warning people to escape.

"That was one of the only points in my life I thought I might die," the mother of four said as she stood in the parking lot.

Soon after, she said some passengers panicked.

"People were hoarding food -- boxes and boxes of cereal, grabbing cake with both hands," she said.


APOLOGY FROM CARNIVAL

Facing criticism over the company's response, Carnival Cruise Lines Chief Executive Gerry Cahill boarded the ship to personally apologize to passengers.

"I know the conditions on board were very poor," he told reporters, sounding shaken in a brief media appearance before he boarded the ship. "I know it was difficult. I want to apologize for subjecting our guests to that," he said.

"We pride ourselves with providing our guests with a great vacation experience and clearly we failed in this particular case," Cahill added.

Operated by Carnival Cruise Lines, the flagship brand of Carnival Corp, the ship left Galveston a week ago carrying 3,143 passengers and 1,086 crew. It was supposed to return on Monday.

Some passengers said conditions deteriorated rapidly on the Triumph earlier in the week, saying people were getting sick and passengers had been told to use plastic "biohazard" bags as makeshift toilets.

"It wasn't a vacation anymore it was like survival mode. Eat what you can. Snack when you can. It was awful," said passenger Tammy Garcia.

Smoke from the engine fire was so thick that passengers on the lower decks in the rear of the ship had to be permanently evacuated and slept the rest of the voyage on the decks under sheets, passengers said.

COMPENSATION OFFER

Some passengers said they tried to pass the time playing cards and organizing Bible study groups and scavenger hunts for the children on board the ship.

Cahill has issued several apologies and Carnival, the world's largest cruise company, said passengers will be reimbursed in full plus transportation expenses, a future cruise credit equal to the amount paid for this voyage, plus a payment of $500 a person to help compensate them.

Chandler, the passenger, scoffed at the compensation offer. "There are lost wages, I've got a baby sitter at home and I had to take off work," she said.

Some passengers said conditions improved on Thursday after a generator was delivered to the ship, providing power for a grill to cook hot food. Passengers said toilets began flushing again on Thursday and the ship served steaks and lobster - a relief after a steady diet of cold sandwiches of cucumber and cheese.

Carnival Corp Chairman and CEO Micky Arison was criticized in January last year for failing to travel to Italy and take personal charge of the Costa Concordia crisis. The tragedy unleashed numerous lawsuits against his company.

He has not publicly commented on the Triumph incident.

"I think they really are trying to do the right thing, but I don't think they have been able to communicate it effectively," said Marcia Horowitz, an executive who handles crisis management at Rubenstein Associates, a New York-based PR firm.

Carnival Corp shares closed down 11 cents at $37.35 in trading on Thursday on the New York Stock Exchange.

The Triumph is a Bahamian-flagged vessel and the Bahamas Maritime Authority will be the primary agency investigating the cause of its engine room fire.

Earlier this month, Carnival repaired an electrical problem on one of the Triumph's alternators. The company said there was no evidence of any connection between the repair and the fire.

For all the passengers' grievances, they will likely find it difficult to sue the cruise operator for any damages, legal analysts said. Over the years, the cruise industry has put in place a legal structure that shields operators from big-money lawsuits.

Reuters and Molly Hennessy-Fiske, Los Angeles Times






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Fat Dad: Baking for Love

Fat Dad

Dawn Lerman writes about growing up with a fat dad.

My grandmother Beauty always told me that the way to a man’s heart was through his stomach, and by the look of pure delight on my dad’s face when he ate a piece of warm, homemade chocolate cake, or bit into a just-baked crispy cookie, I grew to believe this was true. I had no doubt that when the time came, and I liked a boy, that a batch of my gooey, rich, chocolaty brownies would cast him under a magic spell, and we would live happily ever.

But when Hank Thomas walked into Miss Seawall’s ninth grade algebra class on a rainy, September day and smiled at me with his amazing grin, long brown hair, big green eyes and Jimi Hendrix T-shirt, I was completely unprepared for the avalanche of emotions that invaded every fiber of my being. Shivers, a pounding heart, and heat overcame me when he asked if I knew the value of 1,000 to the 25th power. The only answer I could think of, as I fumbled over my words, was “love me, love me,” but I managed to blurt out “1E+75.” I wanted to come across as smart and aloof, but every time he looked at me, I started stuttering and sweating as my face turned bright red. No one had ever looked at me like that: as if he knew me, as if he knew how lost I was and how badly I needed to be loved.

Hank, who was a year older than me, was very popular and accomplished. Unlike other boys who were popular for their looks or athletic skills, Hank was smart and talented. He played piano and guitar, and composed the most beautiful classical and rock concertos that left both teachers and students in awe.

Unlike Hank, I had not quite come into my own yet. I was shy, had raggedy messy hair that I tied back into braids, and my clothes were far from stylish. My mother and sister had been on the road touring for the past year with the Broadway show “Annie.” My sister had been cast as a principal orphan, and I stayed home with my dad to attend high school. My dad was always busy with work and martini dinners that lasted late into the night. I spent most of my evenings at home alone baking and making care packages for my sister instead of coercing my parents to buy me the latest selection of Gloria Vanderbilt jeans — the rich colored bluejeans with the swan stitched on the back pocket that you had to lay on your bed to zip up. It was the icon of cool for the popular and pretty girls. I was neither, but Hank picked me to be his math partner anyway.

With every equation we solved, my love for Hank became more desperate. After several months of exchanging smiles, I decided to make Hank a batch of my homemade chocolate brownies for Valentine’s Day — the brownies that my dad said were like his own personal nirvana. My dad named them “closet” brownies, because when I was a little girl and used to make them for the family, he said that as soon as he smelled them coming out of the oven, he could imagine dashing away with them into the closet and devouring the whole batch.

After debating for hours if I should make the brownies for Hank with walnuts or chips, or fill the centers with peanut butter or caramel, I got to work. I had made brownies hundreds of times before, but this time felt different. With each ingredient I carefully stirred into the bowl, my heart began beating harder. I felt like I was going to burst from excitement. Surely, after Hank tasted these, he would love me as much as I loved him. I was not just making him brownies. I was l showing him who I was, and what mattered to me. After the brownies cooled, I sprinkled them with a touch of powdered sugar and wrapped them with foil and red tissue paper. The next day I placed them in Hank’s locker, with a note saying, “Call me.”

After seven excruciating days with no call, some smiles and the usual small talk in math class, I conjured up the nerve to ask Hank if he liked my brownies.

“The brownies were from you?” he asked. “They were delicious.”

Then Hank invited me to a party at his house the following weekend. Without hesitation, I responded that I would love to come. I pleaded with my friend Sarah to accompany me.

As the day grew closer, I made my grandmother Beauty’s homemade fudge — the chocolate fudge she made for Papa the night before he proposed to her. Stirring the milk, butter and sugar together eased my nerves. I had never been to a high school party before, and I didn’t know what to expect. Sarah advised me to ditch the braids as she styled my hair, used a violet eyeliner and lent me her favorite V-neck sweater and a pair of her best Gloria Vanderbilt jeans.

When we walked in the door, fudge in hand, Hank was nowhere to be found. Thinking I had made a mistake for coming and getting ready to leave, I felt a hand on my back. It was Hank’s. He hugged me and told me he was glad I finally arrived. When Hank put his arm around me, nothing else existed. With a little help from Cupid or the magic of Beauty’s recipes, I found love.


Fat Dad’s ‘Closet’ Brownies

These brownies are more like fudge than cake and contain a fraction of the flour found in traditional brownie recipes. My father called them “closet” brownies, because when he smelled them coming out of the oven he could imagine hiding in the closet to eat the whole batch. I baked them in the ninth grade for a boy that I had a crush on, and they were more effective than Cupid’s arrow at winning his heart.

6 tablespoons unsalted butter, plus extra for greasing the pan
8 ounces bittersweet chocolate, chopped, or semisweet chocolate chips
3/4 cup brown sugar
2 eggs at room temperature, beaten
1 teaspoon vanilla extract
1/4 cup flour
1/2 cup chopped walnuts (optional)
Fresh berries or powdered sugar for garnish (optional)

1. Preheat oven to 350 degrees.

2. Grease an 8-inch square baking dish.

3. In a double boiler, melt chocolate. Then add butter, melt and stir to blend. Remove from heat and pour into a mixing bowl. Stir in sugar, eggs and vanilla and mix well.

4. Add flour. Mix well until very smooth. Add chopped walnuts if desired. Pour batter into greased baking pan.

5. Bake for 35 minutes, or until set and barely firm in the middle. Allow to cool on a rack before removing from pan. Optional: garnish with powdered sugar, or berries, or both.

Yield: 16 brownies


Dawn Lerman is a New York-based health and nutrition consultant and founder of Magnificent Mommies, which provides school lectures, cooking classes and workshops. Her series on growing up with a fat father appears occasionally on Well.

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Facebook's latest revenue trick: Pay to promote friends' posts









Facebook has announced its latest attempt at making money, and this time it involves letting users pay to promote their friends' posts.


The feature lets users pay to have a friend's post show more prominently in other friends' news feeds.


"If your friend is renting their apartment out and she tells her friends on Facebook, you can share the post with the people you and your friend have in common so that it shows up higher in news feed and more people notice it," the company said, citing an example of when this feature could be useful. 





PHOTOS: Tech we want to see in 2013


The feature is similar to another one that Facebook introduced last year that lets users pay to promote their own posts.


The company said Thursday that people have been using that feature to promote posts about charities and causes, publicize events, advertise items they're selling, promote important life announcements or congratulate someone else on an accomplishment.


The cost of promoting a post depends on a number of factors, including geographic location and how many people the post would reach, Facebook said.


Facebook said the ability to pay to promote a friend's post will be rolled out to all users over time.


ALSO:


Google under fire for sending users' information to developers


Mother's 'baby' portraits of 13-year-old son go viral on Facebook


Bandai resurrects Tamagotchi pets just in time for Valentine's Day






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'Blade Runner' Olympian charged with girlfriend's murder









JOHANNESBURG -- South African "Blade Runner" Oscar Pistorius, a double amputee who became one of the biggest names in world athletics, was charged on Thursday with shooting dead his girlfriend at his upscale home in Pretoria.

Police said they opened a murder case after a 30-year-old woman was found dead at the Paralympic and Olympic star's house in the Silverlakes gated complex on the capital's outskirts.






Pistorius, 26, and his girlfriend, model Reeva Steenkamp, had been the only people in the house at the time of the shooting, police brigadier Denise Beukes told reporters, adding witnesses had been interviewed about the early morning incident.

"We are talking about neighbors and people that heard things earlier in the evening and when the shooting took place," Beukes said outside the heavily guarded residential complex.

Police said a 9mm pistol had been found at the scene.

Beukes said police were aware of previous incidents at the Pistorius house. "I can confirm that there has previously been incidents at the home of Mr Oscar Pistorious, of allegations of a domestic nature," she said.

Pistorius, who uses carbon fiber prosthetic blades to run, is due to appear in a Pretoria court on Friday.

"He is doing well but very emotional," his lawyer Kenny Oldwage told SABC TV, but gave no further comment.

A sports icon for triumphing over disability to compete with able-bodied athletes at the Olympics, his sponsorship deals, including one with sports apparel group Nike, are thought to be worth $2 million a year.

South Africa's M-Net cable TV channel said it was pulling adverts featuring Pistorius off air immediately after blanket coverage of the arrest in a country more used to honoring Pistorius as a national hero.

"WE ARE ALL DEVASTATED"

Steenkamp's colleagues in the modeling world were distraught. "We are all devastated. Her family is in shock," her agent, Sarita Tomlinson, tearfully told Reuters. "They did have a good relationship. Nobody actually knows what happened."

Pistorius, who was born without a fibula in both legs, was the first double amputee to run in the Olympics and reached the 400-metre semi-finals in London 2012.

In last year's Paralympics he suffered his first loss over 200 meters in nine years. After the race he questioned the legitimacy of Brazilian winner Alan Oliveira's prosthetic blades, though he was quick to express regret for the comments.

South Africa has some of the world's highest rates of violent crime, and many home owners have weapons to defend themselves against intruders, although Pistorius's complex is surrounded by a three-meter high wall and electric fence.

In 2004, Springbok rugby player Rudi Visagie shot dead his 19-year-old daughter after he mistakenly thought she was a robber trying to steal his car in the middle of the night.

Before the murder charge was announced, Johannesburg's Talk Radio 702 said the athlete may have mistaken Steenkamp for a burglar.

Pistorius was arrested in 2009 for assault after slamming a door on a woman and spent a night in police custody. Family and friends said it was just an accident and charges were dropped.

OLYMPIAN UNDERGOES POLICE TESTS

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Life, Interrupted: Crazy, Unsexy Cancer Tips

Life, Interrupted

Suleika Jaouad writes about her experiences as a young adult with cancer.

Every few weeks I host a “girls’ night” at my apartment in Lower Manhattan with a group of friends who are at various stages in their cancer treatments. Everyone brings something to eat and drink, and we sit around my living room talking to one another about subjects both heavy and light, ranging from post-chemo hair styling tips, fears of relapse or funny anecdotes about a recent hospital visit. But one topic that doesn’t come up as often as you might think — particularly at a gathering of women in their early 20s and 30s — is sex.

Actually, I almost didn’t write this column. Time and again, I’ve sat down to write about sex and cancer, but each time I’ve deleted the draft and moved on to a different topic. Writing about cancer is always a challenge for me because it hits so close to home. And this topic felt even more difficult. After my diagnosis at age 22 with leukemia, the second piece of news I learned was that I would likely be infertile as a result of chemotherapy. It was a one-two punch that was my first indication that issues of cancer and sexual health are inextricably tied.

But to my surprise, sex is not at the center of the conversation in the oncology unit — far from it. No one has ever broached the topic of sex and cancer during my diagnosis and treatment. Not doctors, not nurses. On the rare occasions I initiated the conversation myself, talking about sex and cancer felt like a shameful secret. I felt embarrassed about the changes taking place in my body after chemotherapy treatment began — changes that for me included hot flashes, infertility and early menopause. Today, at age 24, when my peers are dating, marrying and having children of their own, my cancer treatments are causing internal and external changes in my body that leave me feeling confused, vulnerable, frustrated — and verifiably unsexy.

When sex has come up in conversations with my cancer friends, it’s hardly the free-flowing, liberating conversation you see on television shows like HBO’s “Girls” or “Sex and the City.” When my group of cancer friends talk about sex — maybe it’s an exaggeration to call it the blind leading the blind — we’re just a group of young women who have received little to no information about the sexual side effects of our disease.

One friend worried that sex had become painful as a result of pelvic radiation treatment. Another described difficulty reaching orgasm and wondered if it was a side effect of chemotherapy. And yet another talked about her oncologist’s visible discomfort when she asked him about safe birth control methods. “I felt like I was having a conversation with my uncle or something,” she told me. As a result, she turned to Google to find out if she could take a morning-after pill. “I felt uncomfortable with him and had nowhere to turn,” she said.

This is where our conversations always run into a wall. Emotional support — we can do that for one another. But we are at a loss when it comes to answering crucial medical questions about sexual health and cancer. Who can we talk to? Are these common side effects? And what treatments or remedies exist, if any, for the sexual side effects associated with cancer?

If mine and my girlfriends’ experiences are indicative of a trend, then the way women with cancer are being educated about their sexual health is not by their health care providers but on their own. I was lucky enough to meet a counselor who specializes in the sexual health of cancer patients at a conference for young adult cancer patients. Sage Bolte, a counselor who works for INOVA Life With Cancer, a Virginia-based nonprofit organization that provides free resources for cancer patients, was the one to finally explain to me that many of the sexual side effects of cancer are both normal and treatable.

“Part of the reason you feel shame and embarrassment about this is because no one out there is saying this is normal. But it is,” Dr. Bolte told me. “Shame on us as health care providers that we have not created an environment that is conducive to talking about sexual health.”

Dr. Bolte said part of the problem is that doctors are so focused on saving a cancer patient’s life that they forget to discuss issues of sexual health. “My sense is that it’s not about physicians or health care providers not caring about your sexual health or thinking that it’s unimportant, but that cancer is the emergency, and everything else seems to fall by the wayside,” she said.

She said that one young woman she was working with had significant graft-versus-host disease, a potential side effect of stem cell transplantation that made her skin painfully sensitive to touch. Her partner would try to hold her hand or touch her stomach, and she would push him away or jump at his touch. It only took two times for him to get the message that “she didn’t want to be touched,” Dr. Bolte said. Unfortunately, by the time they showed up at Dr. Bolte’s office and the young woman’s condition had improved, she thought her boyfriend was no longer attracted to her. Her boyfriend, on the other hand, was afraid to touch her out of fear of causing pain or making an unwanted pass. All that was needed to help them reconnect was a little communication.

Dr. Bolte also referred me to resources like the American Association of Sexuality Educators, Counselors and Therapists; the Society for Sex Therapy and Research; and the Association of Oncology Social Workers, all professional organizations that can help connect cancer patients to professionals trained in working with sexual health issues and the emotional and physical concerns related to a cancer diagnosis.

I know that my girlfriends and I are not the only women out there who are wondering how to help themselves and their friends answer difficult questions about sex and cancer. Sex can be a squeamish subject even when cancer isn’t part of the picture, so the combination of sex and cancer together can feel impossible to talk about. But women like me and my friends shouldn’t have to suffer in silence.


Suleika Jaouad (pronounced su-LAKE-uh ja-WAD) is a 24-year-old writer who lives in New York City. Her column, “Life, Interrupted,” chronicling her experiences as a young adult with cancer, appears regularly on Well. Follow @suleikajaouad on Twitter.

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American, US Airways announce merger

CEOs Doug Parker and Tom Horton speak to the "CBS This Morning" co-hosts about the merger of American Airlines and US Airways in their first network morning interview.








AMR Corp., parent of American Airlines, and US Airways Group will merge and keep Chicago O'Hare International Airport as a hub, the companies said Thursday.

The merged airlines, to be called American Airlines, would create the world's largest carrier, edging out Chicago-based United Airlines, assuming the $11 billion merger is approved by regulators and U.S. bankruptcy court, where American filed for Chapter 11 restructuring in 2011. The combination is expected to be completed in the third quarter of this year and save $1 billion by 2015.

The merger would likely end a wave of consolidation that has helped put major U.S. airlines on more sound financial footing. The widely expected deal has been more than a year in the making. U.S. fliers would be left with four major airlines, American, United, Delta Airlines and Southwest Airlines, which together would control about three-quarters of the U.S. market.

"We think this merger is the best strategic fit for both companies because it cures each other's ills," said Morningstar analyst Basili Alukos in a note to investors Thursday. US Airways, which he says "is essentially a small domestic carrier" gains a network to compete with the largest airlines, while American benefits from US Airways' "lean operating system and better access to the East Coast."

In Chicago, the two have little overlap. American is the No. 2 carrier in the region, with about 27 percent of the market, 500 flights per day and 9,300 Chicago-based employees. O'Hare is American's second-largest hub, after Dallas-Fort Worth, which will be the headquarters for the merged airline. 

By contrast, US Airways flights account for just 2 percent of the seats flying out of Chicago's airports, and the carrier employs 170 here.

The combined airline would be run by US Airways CEO Doug Parker, while American's CEO, Tom Horton, becomes non executive chairman until next year.

The merger was unanimously approved by the boards of both companies. American said the combined airline would "have a robust global network and a strong financial foundation. The merger will offer benefits to both airlines' customers, communities, employees, investors and creditors."

American said customers of the merged airline would have access to more choices and increased service across the combined company's larger worldwide network and through an enhanced Oneworld Alliance, of which American Airlines is a founding member. The combined airline will offer more than 6,700 daily flights to 336 destinations in 56 countries.

"Our combined network will provide a significantly more attractive offering to customers, ensuring that we are always able to take them where they want to travel, when they want to go," Parker said. 

However, consumer groups have been critical of the merger before its announcement.

"From a consumer standpoint ... individual traveler or corporate travel department -- there are few benefits to offset the negative impacts of this proposed merger that include reduced competition, higher fares and fees and diminished service to small and mid-size communities," said Business Travel Coalition Chairman Kevin Mitchell.

Charlie Leocha, director of the Consumer Travel Alliance, said the merger offered "no discernible consumer benefits."


"Antitrust regulations were created to protect consumers, not to facilitate industry consolidation," he said. "The claim that this merger will provide more destinations is hollow. Whatever new cities are added by a future (American Airlines-US Airways) network are subtracted from the current airline alliance network that US Airways enjoys with United. The net effect is that, overall, consumers are left with nothing new and no improvement to the status quo."

Airlines executives said they were not worried about getting antitrust approval from the U.S. Justice Department because the airlines are complementary and overlap on just a dozen of 900 routes.

Industry analyst Jeff Kauffman from Sterne Agee agreed. "The Justice Department could order assets sales if it finds the deal creates a monopoly in any area. We see this as unlikely given there is little overlap of the respective networks," he wrote in a note to clients.

In Chicago, travelers would be largely shielded from the merger's downsides, experts have said. The region's plethora of flights from O'Hare and Midway, as well as the presence of many discount airlines, should hold fares largely in check on most routes after the merger. 

Route changes are most likely on a few overlapping routes from Chicago to US Airways hubs in Philadelphia, Phoenix and Charlotte, N.C., experts say.

"But most Chicagoans will still have at least four airlines competing for their business on the majority of routes -- and even more on routes such as Chicago to Los Angeles," said George Hobica, founder of Airfarewatchdog.com.

Customers can continue to book travel and track and manage flights and frequent-flyer activity through AA.com or USAirways.com and will continue as usual in the AAdvantage and Dividend Miles frequent flyer programs. At first, there are no changes to the frequent-flyer programs of either airline. Eventually, frequent-flyers will be able to earn and redeem miles on a larger network.

The merger is supported by American Airlines' unions, which separately negotiated contracts with US Airways in anticipation of a merger. "With a strong, proven leadership team focused on partnering with frontline employees, improving reliability and customer service, and expanding our network, the new American Airlines will return to a position of industry preeminence," said Dennis Tajer, spokesman for the Allied Pilots Association, the American Airlines pilot union.

The new carrier would be 2 percent larger than current No. 1 United Continental Holdings in traffic, as measured by the number of miles flown by paying passengers worldwide.

In a note to employees Thursday, United CEO Jeff Smisek said the newly merged airlines would be a "formidable competitor" but that consolidation is good for the airline industry.

"We, our co-workers, our customers and our shareholders have benefitted from the improved financial health that consolidation has brought to our industry," he wrote. "United is a much stronger carrier today than we were before we merged, and we haven't even finished harvesting all the synergies of our merger. Delta, which is two years ahead of us in the merger process, is performing very well as a result of their merger. I'm encouraged by the successes we've seen in the airline industry in recent years."

The merger of the two airlines does not appear to provide clarity toward American and United Airlines reaching agreement with Chicago about completing the runway expansion project at O'Hare International Airport that has dragged on for eight years.

Officials from both United and American have said the new runways covered under the existing expansion agreement are sufficient to handle demand for the foreseeable future, and there is no justification for the airlines to spend more money on expansion now. 

The two largest airlines serving O'Hare have in the past vigorously opposed the city's financing plans for the expansion, saying the city is taking on too much debt through extensive bonding that would ultimately saddle the carriers with unacceptable costs. As a result, Chicago's plan to build the final runways and construct a massive western passenger terminal complex has been in an indefinite holding pattern.  

In 2011, Transportation Secretary Ray LaHood brokered a deal for one new runway, on the south section of the airfield, by offering more in federal funds. Negotiations on completing the O'Hare expansion project, which once totaled $15 billion and was scaled back to less than $8 billion, were suspended until this year, with Chicago officials hoping to nail down an agreement by 2014.  

But no formal negotiations have taken place between the two airlines and the Emanuel administration, sources said.

The prospects for United and American investing in O'Hare expansion in the immediate future appears unlikely. United is focused on smoothing out its recent merger with Continental Airlines. American, whose parent company, AMR, is still working to get out of bankruptcy, will be consumed with its new partnership with US Airways.

In the merged company, Horton would be board chairman through the first annual meeting of shareholders. After that, Parker would take over as chairman. The board would initially be made up of 12 members, three American Airlines representatives, including Tom Horton, four US Airways representatives, including Doug Parker, and five AMR creditor representatives.

Under the merger agreement, US Airways stockholders would receive one share of common stock of the combined airline for each share of US Airways common stock then held. American Airlines stakeholders, including labor unions, would own 72 percent of the merged airline, while US Airways stakeholders would own the rest.

Vicki Bryan, senior high yield bond analyst at Gimme Credit, said in a note to investors Thursday the merger is good news for everybody involved, even fliers after the combined airline gets passed integration issues.

"Under CEO Doug Parker, we expect American will 'straighten up and fly right,' " she wrote.

gkarp@tribune.com

Tribune reporter Jon Hilkevitch contributed.






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Remains found in burned cabin after standoff with rogue cop

The manhunt for fugitive ex-cop Christopher Dorner appears to have come to a dramatic and deadly end at a burned-out cabin near Big Bear Lake, Calif. CBS News' Carter Evans reports.









Like many Southern Californians, Los Angeles police officials nervously listened to radio traffic as a shootout unfolded at a Big Bear-area cabin, a spokesman said Wednesday.

Officers swarmed the wood-paneled structure Tuesday after a man thought to be fugitive former cop Christopher Dorner was holed up inside. Sources described an intense firefight, with hundreds of rounds fired in a "constant barrage of gunfire."


"It was horrifying to listen to that firefight and hear those words 'Officer down,' " LAPD Lt. Andy Neiman told reporters Wednesday. "It's the most gut-wrenching experience that you can have as a police officer."








Neiman provided a brief update on the ongoing investigation into Dorner as officials worked to identify a body found in the cabin, which burned to its foundation Tuesday.


Neiman declined to comment on the San Bernardino County part of the investigation, but said Los Angeles police returned to normal operations late Tuesday. Of the 50 or so families assigned protective details because of Dorner's alleged manifesto, only about a dozen were still under watch Wednesday.


"We have some individuals who are still in great fear," he said.


Neiman said the investigation into Dorner's alleged acts would continue until investigators "make sure that we have covered every base."

"We don't just stop a murder case simply because we think the suspect in that case is no longer with us," he said.


The investigation ordered by LAPD Chief Charlie Beck into the handling of Dorner's disciplinary case — an online manifesto attributed to Dorner complained he had been mistreated by the LAPD and vowed revenge — would also continue, Neiman said.


Beck "wants to make sure that the public has the confidence in this police department that we are operating in a transparent manner and the members of this police department are treated fairly." If the inquiry reveals concerns, Neiman said, "we are going to address it. [Beck] is very clear about that."


As for the $1-million reward offered, Neiman said that issue would be handled by the city attorneys involved. He noted that although information received about Dorner on Tuesday was "beneficial," the reward was offered for his arrest and conviction.


“This is an unusual circumstance,” he said.


When asked about the lessons learned from the situation, Neiman replied: "There are going to be many lessons and we're still learning."


"We're still in a fog from all this," he said.


If the body is identified as Dorner’s, the standoff would end a days-long manhunt for the ex-LAPD officer and Navy Reserve lieutenant suspected in a string of shootings following his firing by the Los Angeles Police Department several years ago. Four people — an Irvine couple, a Riverside police officer and a San Bernardino County sheriff's deputy — have died allegedly at Dorner’s hands.


Police say Dorner's first victims were the daughter of the retired LAPD official who represented him at his disciplinary hearing and her fiance. Monica Quan and Keith Lawrence were found shot to death Feb. 3 in their car in their condo complex's parking structure.


Days later, officials said, Dorner allegedly attempted to steal a boat in San Diego in a failed bid to escape to Mexico. By Feb. 7, authorities said, he had fled to the Inland Empire. In Corona, police said, he fired at an LAPD officer searching for him at a gas station. About half an later, he allegedly opened fire on two Riverside officers, killing Michael Crain, 34, and injuring his partner.


His burning truck was found near Big Bear later Thursday, prompting hundreds of officers to scour the area and conduct cabin-to-cabin checks. That search was scaled back as authorities found no new signs of the wanted man.


On Tuesday morning, two cleaning service workers entered a cabin in the 1200 block of Club View Drive and ran into a man who they said resembled the fugitive, a law enforcement official said. The cabin was not far from where Dorner's singed truck had been found and where police had been holding news conferences about the manhunt.


The man tied up the women and he took off in a purple Nissan parked near the cabin, the official said. About 12:20 p.m., one of the women broke free and called police.


Nearly half an hour later, officers with the California Department of Fish and Wildlife spotted the stolen vehicle and called for backup, authorities said. The suspect turned down a side road in an attempt to elude the officers but crashed the vehicle, police said.


A short time later, authorities said, the suspect carjacked a light-colored pickup truck and took off, only to be spotted by another Fish and Wildlife officer. A gun battle ensued before Dorner crashed the truck and ran to the cabin.


He later shot two San Bernardino County sheriff's deputies, killing one and seriously injuring the other, authorities said. The injured deputy is expected to survive but it is anticipated he will need several surgeries. The names of the two deputies have not been released.


An intense gun battle ensued as authorities swarmed the cabin, people with knowledge of the situation said, adding hundreds of rounds were fired in just more than an hour.


"There were very few lulls in the gunfire," one person familiar with the investigation said.


Just before 5 p.m., authorities smashed the cabin's windows, pumped in tear gas and called for the suspect to surrender, officials said. They got no response. Then, using a demolition vehicle, they tore down the cabin's walls one by one. When they reached the last wall, they heard a gunshot. Then the cabin burst into flames, officials said.


"There would have been a lot more casualties" if officers had to "assault the cabin and make entry," the source said. "There weren't a lot of options."



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Well: Straining to Hear and Fend Off Dementia

At a party the other night, a fund-raiser for a literary magazine, I found myself in conversation with a well-known author whose work I greatly admire. I use the term “conversation” loosely. I couldn’t hear a word he said. But worse, the effort I was making to hear was using up so much brain power that I completely forgot the titles of his books.

A senior moment? Maybe. (I’m 65.) But for me, it’s complicated by the fact that I have severe hearing loss, only somewhat eased by a hearing aid and cochlear implant.

Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins School of Medicine, describes this phenomenon as “cognitive load.” Cognitive overload is the way it feels. Essentially, the brain is so preoccupied with translating the sounds into words that it seems to have no processing power left to search through the storerooms of memory for a response.


Katherine Bouton speaks about her own experience with hearing loss.


A transcript of this interview can be found here.


Over the past few years, Dr. Lin has delivered unwelcome news to those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology and public health,” as he writes on his Web site. The most significant issue is the relation between hearing loss and dementia.

In a 2011 paper in The Archives of Neurology, Dr. Lin and colleagues found a strong association between the two. The researchers looked at 639 subjects, ranging in age at the beginning of the study from 36 to 90 (with the majority between 60 and 80). The subjects were part of the Baltimore Longitudinal Study of Aging. None had cognitive impairment at the beginning of the study, which followed subjects for 18 years; some had hearing loss.

“Compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia over the course of the study,” Dr. Lin wrote in an e-mail summarizing the results. The worse the hearing loss, the greater the risk of developing dementia. The correlation remained true even when age, diabetes and hypertension — other conditions associated with dementia — were ruled out.

In an interview, Dr. Lin discussed some possible explanations for the association. The first is social isolation, which may come with hearing loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is some pathological process that causes both hearing loss and dementia.

In a study last month, Dr. Lin and colleagues looked at 1,984 older adults beginning in 1997-8, again using a well-established database. Their findings reinforced those of the 2011 study, but also found that those with hearing loss had a “30 to 40 percent faster rate of loss of thinking and memory abilities” over a six-year period compared with people with normal hearing. Again, the worse the hearing loss, the worse the rate of cognitive decline.

Both studies also found, somewhat surprisingly, that hearing aids were “not significantly associated with lower risk” for cognitive impairment. But self-reporting of hearing-aid use is unreliable, and Dr. Lin’s next study will focus specifically on the way hearing aids are used: for how long, how frequently, how well they have been fitted, what kind of counseling the user received, what other technologies they used to supplement hearing-aid use.

What about the notion of a common pathological process? In a recent paper in the journal Neurology, John Gallacher and colleagues at Cardiff University suggested the possibility of a genetic or environmental factor that could be causing both hearing loss and dementia — and perhaps not in that order. In a phenomenon called reverse causation, a degenerative pathology that leads to early dementia might prove to be a cause of hearing loss.

The work of John T. Cacioppo, director of the Social Neuroscience Laboratory at the University of Chicago, also offers a clue to a pathological link. His multidisciplinary studies on isolation have shown that perceived isolation, or loneliness, is “a more important predictor of a variety of adverse health outcomes than is objective social isolation.” Those with hearing loss, who may sit through a dinner party and not hear a word, frequently experience perceived isolation.

Other research, including the Framingham Heart Study, has found an association between hearing loss and another unexpected condition: cardiovascular disease. Again, the evidence suggests a common pathological cause. Dr. David R. Friedland, a professor of otolaryngology at the Medical College of Wisconsin in Milwaukee, hypothesized in a 2009 paper delivered at a conference that low-frequency loss could be an early indication that a patient has vascular problems: the inner ear is “so sensitive to blood flow” that any vascular abnormalities “could be noted earlier here than in other parts of the body.”

A common pathological cause might help explain why hearing aids do not seem to reduce the risk of dementia. But those of us with hearing loss hope that is not the case; common sense suggests that if you don’t have to work so hard to hear, you have greater cognitive power to listen and understand — and remember. And the sense of perceived isolation, another risk for dementia, is reduced.

A critical factor may be the way hearing aids are used. A user must practice to maximize their effectiveness and they may need reprogramming by an audiologist. Additional assistive technologies like looping and FM systems may also be required. And people with progressive hearing loss may need new aids every few years.

Increasingly, people buy hearing aids online or from big-box stores like Costco, making it hard for the user to follow up. In the first year I had hearing aids, I saw my audiologist initially every two weeks for reprocessing and then every three months.

In one study, Dr. Lin and his colleague Wade Chien found that only one in seven adults who could benefit from hearing aids used them. One deterrent is cost ($2,000 to $6,000 per ear), seldom covered by insurance. Another is the stigma of old age.

Hearing loss is a natural part of aging. But for most people with hearing loss, according to the National Institute on Deafness and Other Communication Disorders, the condition begins long before they get old. Almost two-thirds of men with hearing loss began to lose their hearing before age 44. My hearing loss began when I was 30.

Forty-eight million Americans suffer from some degree of hearing loss. If it can be proved in a clinical trial that hearing aids help delay or offset dementia, the benefits would be immeasurable.

“Could we do something to reduce cognitive decline and delay the onset of dementia?” he asked. “It’s hugely important, because by 2050, 1 in 30 Americans will have dementia.

“If we could delay the onset by even one year, the prevalence of dementia drops by 15 percent down the road. You’re talking about billions of dollars in health care savings.”

Should studies establish definitively that correcting hearing loss decreases the potential for early-onset dementia, we might finally overcome the stigma of hearing loss. Get your hearing tested, get it corrected, and enjoy a longer cognitively active life. Establishing the dangers of uncorrected hearing might even convince private insurers and Medicare that covering the cost of hearing aids is a small price to pay to offset the cost of dementia.


Katherine Bouton is the author of the new book, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You,” from which this essay is adapted.


This post has been revised to reflect the following correction:

Correction: February 12, 2013

An earlier version of this article misstated the location of the Medical College of Wisconsin. It is in Milwaukee, not Madison.

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