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Wednesday, March 20, 2013 – Daily News 3B FEATURES Medical bill causes tension Tamoxifen offers benefits if Dear Annie: I am a teenager in the northwest. Recently, I contracted a kidney infection that was painful and needed treatment. I didn't know what I had and wasn't familiar with the symptoms, so the only thing Annie's I said to my parents was that I didn't feel well. After a few days, by Kathy Mitchell it got so bad that I had and Marcy Sugar to go to the emergency room. I was given a prescription and healed, but the hospital bill was $600. When the bill came, my mother read me the riot act for costing her so much. She told me I should have said something earlier and saved them some money. That was true, and I apologized. But the impression I got is that my health is not worth that much money to her. I've never had a good relationship with my mother, but this stung. Why would she insinuate such a thing? What should I do? — Not as Pretty as a Penny Dear Penny: We don't think your mother meant to imply that your health is not worth $600. Have you ever seen a parent yell at a toddler for running into the street? It's not out of anger. It's because they were worried to death by what might have happened. We think this was your mother's reaction. Your illness turned out to be curable, but it could have been something far worse. Becoming angry at the bill was emotionally safer than facing her fears of losing you altogether. Please forgive her outburst. Dear Annie: I was married for 47 years to a man who did not want me making friends outside his family. Unfortunately, his family didn't much care for me. I acquiesced to his wishes (pre-women's rights). When he died, I tried volunteering in order to make friends, but I guess I am programmed to push people away. I correspond via email with a few folks, but no one wants to take the friendship further. I let my son have my house and moved back to my hometown into a Mailbox retirement place that my son convinced me would be beneficial. But they sold him a bill of goods about the activities here. There are none. No one wants to be friends. They say good morning, but even my invites go unanswered. I would like to move, but I can't afford it, and no one will help me pack up. People are full of suggestions — go to the mall, go to church. (I tried that, filled out a visitor card and never heard from them.) I'll be 70 soon, and I feel life isn't worth living if I have to be alone. — Florida Dear Florida: You sound terribly depressed, and this may be part of the reason you have trouble making friends. People are attracted to those who are upbeat and energetic, and those traits are difficult for you to display when you feel so low. Talk to your doctor about an antidepressant. Ask someone in charge whether you could help organize a group outing, perhaps to a movie or a play. Do some volunteer work where your help will be appreciated and you can spend time getting to know others and practicing your social skills. You've spent years being ''programmed'' to push people away. Attracting them won't happen overnight. Consider yourself a work in progress. Dear Annie: This is in reply to ''A Long-Term Care Employee,'' who admonished families for not bringing new clothing to nursing home residents. There is another factor at play here: dementia. My mother wears the same clothes over and over. She has new clothes in her closet. She doesn't recognize them and thinks they are someone else's clothes. I have tried to remove the most worn items, but she stands over me and says, ''No, I wear that.'' This perceived problem is not always what it seems to be. — Kentucky probably DEAR DOCTOR K: encourages I was diagnosed with the cancer to ER-positive breast cangrow larger cer a few years ago. and to My doctor told me to spread. take tamoxifen for five Ta m o x years to prevent my ifen blocks cancer from coming the estrogen back. I recently read that taking tamoxifen Dr. K r e c e p t o r . Because of longer further decreasby Anthony L. es the risk of a cancer Komaroff, M.D. that, it greatly improves recurrence. What the outlook for women should I do? DEAR READER: The with ER-positive breast simple answer is: Ask cancer. Women who are past your primary care doctor if you should talk to a menopause are generally breast cancer specialist, advised to take tamoxifen because it may well be a for two to three years, good idea to continue on and then switch to a difthe tamoxifen. But I ferent type of drug called know you won't be satis- an aromatase inhibitor. fied with a simple This switch reduces the answer, so here's a more chance that the cancer will recur. elaborate one. Women who have not The cells in our bodies are constantly receiving reached menopause (and chemical signals that tell whose ovaries are still them what to do. The way producing estrogen) have many signals work is that been advised to take they attach to something tamoxifen for a full five on or in the cell called a years. A new study (probably receptor. Think of the chemical signal as a key the one you read about) and the receptor as the has found that taking tamoxifen longer than lock the key opens. Breast cancer is divid- five years can further ed into types based on reduce deaths from the whether the cancer cells disease. The researchers have receptors for the studied a group of nearly female hormone estro- 7,000 women with ERgen. If they do, they're positive breast cancer. called ER-positive breast The women were rancancers. Estrogen can domly assigned to stick Annie's Mailbox is written by Kathy stimulate the cells to to just five years of Mitchell and Marcy Sugar, longtime grow and divide, which tamoxifen or to take it for editors of the Ann Landers column. Please email your questions to anniesmailboxcomcast.net, or write to: Annie's Mailbox, c/o Creators Syndicate, 737 3rd Street, Hermosa Beach, CA 90254. Social Security benefits and your taxes Some people must pay taxes on their Social Security benefits. If you get Social Security, you should receive a Form SSA-1099, Social Security Benefit Statement, by early February. The form shows the amount of benefits you received in 2012. Here are five tips from the IRS to help you determine if your benefits are taxable: 1. The amount of your income and your filing status affect whether you must pay taxes on your Social Security. 2. If Social Security was your only income in 2012, your benefits are probably not taxable. You also may not need to file a federal income tax return. 3. If you received income from other sources, then you may have to pay taxes on your benefits. 4. You can follow these taken for 10 years two quick steps to see if your benefits are taxable: • Add one-half of the Social Security benefits you received to all your other income, including tax-exempt interest. Taxexempt interest includes interest from state and municipal bonds. • Next, compare this total to the 'base amount' for your filing status. If the total is more than your base amount, then some of your benefits may be taxable. The three 2012 base amounts are: $25,000 for single, head of household, qualifying widow or widower with a dependent child or married individuals filing separately who did not live with their spouse at any time during the year; $32,000 for married couples filing jointly; and $0 for married persons filing separately who lived together at any time during the year. 5. If you use IRS e-file to prepare and file your tax return, the tax software will figure your taxable benefits for you. If you file a paper return, you can use the Interactive Tax Assistant tool on the IRS website to check if your benefits are taxable. The ITA is a resource that can help answer tax law questions. There also is a worksheet in the instructions for Form 1040 or 1040A that you can use to figure your taxable benefits. For more information on the taxability of Social Security benefits, see IRS Publication 915, Social Security and Equivalent Railroad Retirement Benefits. You can get a copy of this booklet on IRS.gov or by calling 800-TAXFORM (800-829-3676). an additional five years. The study found a significant benefit from remaining on tamoxifen for 10 years: Women were less likely to have a recurrence of breast cancer, and they were less likely to die of breast cancer than women who took the drug for only five years. Be aware, however, that after menopause, tamoxifen increases the risk of uterine cancer. It also increases the risk of blood clots in the legs and lungs in all women. So it's like most treatments: There are both benefits and risks, and you have to work with your doctor to balance them. Without knowing more about your medical history, I can't say for sure whether taking tamoxifen longer than five years is the right decision for you. But based on this study, I'd say it is definitely worth a conversation with your doctor. Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA