Wednesday, February 28, 2007
Tackling cancer with a vaccine is a good thing, right?
If you are like most people, you have probably seen television advertisements for a new vaccine called Gardasil. It is being prescribed to prevent cervical cancer, and according to the FDA, it works pretty well. It works by preventing four strains of a sexually transmitted virus, known as human papillomavirus, from ever taking hold. It is these four strains that cause 70 percent of cervical cancers and 90 percent of genital warts. The message: Take the vaccine early and dramatically reduce your risk of cervical cancer.
As we have been reporting this story, however, I have seen more questions than answers emerge. Let me try and tackle a few. One of the big areas of concern is the age at which girls should get the vaccine. The Centers for Disease Control and Prevention recommends the vaccine for girls 11 and 12 years old, but it can be administered to girls as young as 9. That's young, for sure. But, the research tells us that girls between the ages of 14 and 19 account for 25 percent of all of these infections, which are almost always transmitted sexually. That was a bit of an eye opener for me, a father of two girls. So, the age started to make more sense. What about boys? That was another question. Well, it turns out that a vaccine may be approved in the future for boys as well. The thinking is that if you prevent boys from getting the infection, they are less likely to pass it on to girls, which in turns reduces a girl's chance of cervical cancer.
Not everyone who gets HPV will get cervical cancer. If you do get cervical cancer, though, it is one of the deadlier cancers. Yes, the vaccine does appear to be safe based on an average of 3.9 years of follow-up testing. It does not appear to adversely affect a woman’s fertility in the future.
Where it gets sticky is the call for mandatory vaccination. This may be the most controversial question of all. Perhaps, it is our rugged individualism that makes us question anything that is forced upon us. Perhaps, it is the concern about side effects down the road. Perhaps, it is that we don't necessarily want to have conversations with our 9-year-old girls about why they are getting the vaccine in the first place.
As a doctor, and parent, I would recommend the vaccine for my daughters. I feel the ability to protect them in any way, including from cancer, is my primary obligation. What do you think? Would you recommend or get the vaccine? What are the objections?
Tuesday, February 27, 2007
Going after the Girl Scouts
It's Girl Scout cookie season again, but this year I'm probably not going to buy any. I still have a solid stash of Thin Mints in our freezer at home, right next to the Cherry Garcia, in the "I.C.E. box" ("in case of emergency" - it's just comforting to know they are there waiting for me). I've been buying the crispy, cool confections since college, when we'd descend upon the Brownie troop with its little stand at the video store parking lot.
That's why I initially laughed when I heard that the advocacy group National Action Against Obesity is calling for a boycott of Girl Scout cookies.
When I talked to the group's mother-turned-activist founder, MeMe Roth, this is the point she made: They do amazing work, but "is it OK to raise $700 million a year off cookies if you're a civic-minded organization like the Girl Scouts, in the midst of an obesity epidemic?"
After all, more than 18 percent of kids in the United States between ages 6 and 11 are overweight, according to the CDC. That's a lot of chubby little cookie-munchers. MeMe's solution is to gradually wean Girl Scouts off cookies as the group's main fund-raising tool, sometime over the next five, 10, even 20 years. Yipes! No more Samoas?
The Center for Science in the Public Interest seems to be of the same mind. The non-profit organization recently released a report about junk food fund raisers. Did you know that 67 percent of them use baked goods to help raise money for athletic equipment, field trips, and the likes? Instead, the CSPI suggests book fairs, walk-a-thons and other physical activity fund raisers, recycling events (cell phones and printer cartridges for money), and healthy food sales (granola bars anyone?).
Honestly, I'd be willing to consider replacing the school bake sales with some of those healthier activities, sure. But even Cookie Monster knows "a cookie is a sometimes food," so can't we just leave the Girl Scouts alone? I mean, they even cut out most trans fats from their cookies recently. Should we go after these girls as money-raising cookie-pushers? Or is that just downright un-American?
Monday, February 26, 2007
Air that you can see, smell and taste
Last night, a film starring former Vice President Al Gore talking about global warming won the Academy Award for best documentary feature. If someone would have told you six years ago that the losing presidential candidate would make people care about climate change through a film titled "The Inconvenient Truth," you would have probably thought it was a bad joke. Global warming has become a hot topic (pun intended) over the past few years due in part to Gore's efforts, but also because the effects can no longer be ignored. I am currently in Manila, the capital city of the Philippines. It is one of the most polluted cities on Earth. It is a place where the inconvenient truth is painfully self-evident.
The air is thick here. It sticks to you. The temperature is over 90 degrees Fahrenheit/32 degrees Celsius with 60 percent to 70 percent humidity. I can see a black, smoky haze as I walk on the crowded sidewalk. The layer of grime on the streets is proof that the pollution has caked into the environment and the people themselves. I begin to think of my own skin, my own pores. The bad air is slowly seeping through them. My lungs are acting as a filter for the exhaust fumes that surround me. The cars, jeepneys and trucks chug along spewing black coughs of smoke in the never-ending traffic jam.
The health effects of pollution don't affect only developing countries. The impact on health is well documented. A recent study in the New England Journal of Medicine suggests that women who live in cities with the most air particles, such as Los Angeles and New York, are at a 75 percent increased risk for fatal heart disease. Why women? According to the researchers, air particles are harmful to both men and women, but women may be more vulnerable, because they have smaller coronary arteries.
It doesn't stop at heart disease. According to scientists at the Center for Health and the Global Environment at Harvard Medical School, rising carbon dioxide levels go hand in hand with a long list of ill-health risks, not to mention a large role in global warming. An increase in death rates from heart and lung ailments has been linked to high smog days. There are now stronger, longer, more virulent, allergy seasons. Did you know that mold attaches itself to diesel particles? The diesel/mold combination is deadly. The pair embeds itself more efficiently deep inside your lungs.
The Harvard researchers also point to dust clouds rising from drought-ridden African deserts making their way across trade winds. Those traveling dust clouds result in skyrocketing asthma rates, even in places such as the Caribbean, where asthma has never before been a problem. Coincidentally, asthma rates have quadrupled in the United States since 1980.
If there is one thing that Gore's film preaches, it is the interconnectedness of the planet. The United Nations reports that global temperatures will increase 3.2 to 7.1 degrees Fahrenheit (1.8 to 4 degrees Celsius) by 2100. The main cause? Human activity - specifically, carbon emissions from fossil fuels. Last night, Gore told Hollywood and 1 billion television viewers to care about global warming because it's "not a political issue, it's a moral issue."
Do you care about global warming? Do you think you suffer any ill health effects from global warming and pollution? Do you have any tips on how each individual can fight global warming? Or do you think that global warming and it's impact aren't real?
Editors note: See "Gore defends energy saving efforts" on The Ticker blog for Vice President Gore's response to allegations that he wastes energy at his Tennessee mansion.
Friday, February 23, 2007
Don't let fear keep you from donating
On February 7, my family appeared on CNN to raise awareness about the critical need for minorities to register with the National Marrow Donor Program. February 7 marked the seventh anniversary of my daughter's death. She was 2.
Since 1999, my family has worked to spread the word about the critical need for minorities to join the NMDP. The message is falling on deaf ears.
Hello! Wake up! Are we killing off our own by not stepping up? Are we turning our heads, expecting someone else to do the job?
No one else can.
Because of genetics, you are most likely to match a person within your own ethnic group.
Although Jade died a few months after transplantation, she had a donor and a second chance. Her twin, Jillian, now 9, has had TWO transplants from the same donor. Jillian calls him "hero."
Try to understand the kind of hope donors provide families. Try to imagine having absolutely NO CONTROL, no ability to help your child? To know there's a possibility of saving him or her, but there aren't enough people to help? Explain that to your child.
I have lost one child, watched as my other daughter fought for her life and consoled my son, 12, as he watched his sisters suffer.
I have always believed that if Oprah Winfrey, a household name worldwide, asked minorities to become registered donors, it would happen. Her words are GOLDEN. Her level of influence is unparalleled. It would be amazing - the potential lives saved, the good deeds performed, the energy of gratitude. There would be no tool to measure such an astonishing act, no words good enough to say thank you. It would be life changing.
Get educated. Tell others. Get registered.
Is the past haunting us - fear of the medical community and Tuskegee? We are a very intelligent, determined and prideful race - we have fought for centuries to save ourselves - why stop now?
Online registration: www.marrow.org/join
Accept the challenge.
To see the Pasleys' story, tune in to a special edition of House Call with Dr. Sanjay Gupta - "Your Race, Your Risk" - Saturday and Sunday at 8:30 a.m. ET
Thursday, February 22, 2007
A note on autism
Some of the responses to Dr. Sanjay Gupta's blog about Amanda Baggs raise questions about her diagnosis and whether she is indeed a low functioning autistic. We spoke with her health care providers and reported what they told us. Also, Amanda shared her medical records with us from various providers diagnosing her as autistic. We are not in the business of diagnosing people's medical conditions. But, as in all of our stories, we conducted our own independent investigation, spoke with expert sources and reached informed conclusions.
100 Black Men take on the challenge
If you have ever discussed the obesity epidemic, the discussion probably has come back around to responsibility. Some will blame the government; others may blame the fast-food industry. The medical establishment will most likely take a hit and so will the news media. I have been personally taken to task for not doing enough, and I've tried to respond with my Fit Nation project. Many ask, though, what about personal responsibility? When should we be held accountable as individuals?
The truth is, it's not always easy. There are certainly people who cannot lose weight, no matter how hard they try. They may need to seek medical attention. Still, the vast majority of those who are overweight - nearly 60 percent of all adults in America are considered overweight - probably can do something about it. And, those people are the target of the organization 100 Black Men. They are taking responsibility.
Started as a civic organization, promoting scholarship mentoring, its leaders realized that without good health, little else would matter. David Dinkins, Jackie Robinson and many others were the visionaries that helped start the organization back in 1963. Now with former Surgeon General David Satcher helping lead the charge, they are trying to protect the legacy they worked so hard to build. With African American children twice as likely to be obese as white children, that legacy is certainly in danger.
The program focuses on simple things: making sure you take 10,000 steps each day and eat nine servings of fruits and vegetables. The strategies have worked. As an organization, they consistently lowered blood pressure and blood sugar levels in the groups they targeted. They represent some of the very best grass-roots initiatives that are truly making a difference. Now, they are taking their mission national. In many ways, though, it still raises the original question: Who is responsible for the fact the United States has become one of the most obese countries in the world? Organizations like 100 Black Men will only be able to do so much. What can you do?
Wednesday, February 21, 2007
Who's leading the charge on food outbreaks?
Over the past few months, we have been doing a lot of reporting about food-related bacterial outbreaks. Most recently, BJ's Wholesale Clubs recalled mushrooms. Turns out E. coli was found during routine testing, and a voluntary recall followed. Many think that's exactly how the system should work. There have been no reported illnesses.
Also, listeria has been found in chicken strips and salmonella in peanut butter. And, of course, late last year, E. coli dominated headlines with outbreaks at both Taco Bell and with spinach. More than 200 people became sick and three died because of tainted spinach.
Each year, more than 250 food-borne illnesses are reported in the United States, causing 76 million cases, 325,000 hospitalizations and 5,200 deaths. According to the Centers for Disease Control, the cost of caring for these illnesses is more than $1 billion a year.
What has been most amazing to me, though, is the way these outbreaks are handled. First off, we weren't even sure who was in charge as we started doing our reporting. Was it the Food and Drug Administration or the U.S. Department of Agriculture? It is confusing. The USDA regulates 20 percent of the nation's food supply, while the FDA regulates 80 percent. You could literally have one government agency regulating chicken, while a different agency regulates eggs. And, remarkably, neither agency has the ability to institute mandatory recalls. All the recalls you hear about are voluntary.
No surprise then that there is some push for the Safe Food Act, which would create a Food Safety Administration. Like the Environmental Protection Agency, it would take responsibility for food from the USDA and FDA. Some people say it makes perfect sense to combine all these functions under one agency. Critics charge that, well, it is yet another agency. What do you think? How do we best manage food safety in this country?
Tuesday, February 20, 2007
Behind the veil of autism
Despite the friendly invitations and our lively e-mail banter, Amanda would not look at me when I walked in the room. She wore sunglasses and sat in a wheelchair, even though her legs are fine. She could make some noises, but could not speak. Amanda has what doctors call low-functioning autism. If it were not for a device that synthesizes words as she types on a keyboard, we would not have been able to communicate with her at all.
She taught me a lot over the day that I spent with her. She told me that looking into someone's eyes felt threatening, which is why she looked at me through the corner of her eye. Amanda also told me that, like many people with autism, she wanted to interact with the entire world around her. While she could read Homer, she also wanted to rub the papers across her face and smell the ink. Is she saw a flag blowing in the wind, she might start to wave her hand like a flag. She rides in a wheelchair, she says, because balancing herself while walking takes up too much energy for her to also type and communicate. To an outside observer, the behaviors would seem eccentric, even bizarre. Because Amanda was able to explain them, they all of a sudden made sense. In case you were curious, there is no possible way that I was being fooled. Amanda, herself, was communicating with me through this voice-synthesis technology.
It really started me wondering about autism. Amanda is obviously a smart woman who is fully aware of her diagnosis of low-functioning autism, and quite frankly mocks it. She told me that because she doesn't communicate with conventional spoken word, she is written off, discarded and thought of as mentally retarded. Nothing could be further from the truth. As I sat with her in her apartment, I couldn't help but wonder how many more people like Amanda are out there, hidden, but reachable, if we just tried harder.
I am a neurosurgeon and Amanda Baggs opened my eyes about the world of autism. I am eager to hear what you think of her story and if you have stories of your own.
To learn more about Amanda and adult autism, visit CNN.com/Health.
Monday, February 19, 2007
Just plane scared of flying...
I am sitting on a flight from New York to Asia and I am on high alert. No, not for terrorists - for an entirely different, far more insidious threat: airplane germs. They are lurking everywhere. The kid in front of me refuses to cover her mouth as she coughs up her young lung. The person next to me blows her nose as if she's allergic to the airplane itself. On line for the toilet, the guy in front of me rubs his eyes and touches the latch. I can't escape the infectious bacteria. Five hours into the flight, I'm convinced I feel a tickle in my throat and early signs of a sniffle.
I try to assuage my fears by remembering the scientific evidence. The World Health Organization, backed by a decent list of reputable studies, says there is very little risk of transmitting any infectious diseases on board an airplane. One study from the Journal of the American Medical Association says that the risk of getting a cold or any other communicable illness is no different on an airplane from any other situation where people are in close quarters: a train, a bus, a theater or even in the office.
I try not to think too hard about the air in the passenger cabin. Just how do they clean it? Most airlines, it turns out, recirculate about half the air inside the plane. Viral particles, fungi and bacteria are removed by special filters.
But still, on this long journey, antibacterial hand sanitizer is my best friend. I use it compulsively. I overdose on Airborne and Emergen-C in hopes of helping my immune system fight any nasty germs that make it past the hand sanitizer. I turn on my air vent because some experts think the rush of air can help push away the germs that float into your space. I even consider the benefits of a surgical mask, but realize just how silly I would look.
I realize that there are far more serious problems to worry about. Bloating, gas expansion, dehydration, deep vein thrombosis (known to some as "economy class syndrome"). I get up and walk around every few hours. I am sure to drink as much water as possible, even though I know the flight attendant would prefer that I press my call button just a little less often.
Twelve hours into the flight I know that I have done everything possible to avoid getting sick. I am feeling better, until I look up and see little cartoon figures on the screen. It's cute at first, but I realize they're warning me to avoid contact with birds and bird droppings. They're speaking Chinese with English subtitles. They direct me to watch for persistent cough or flu, within two weeks of my journey. If I notice anything, I should fill out a communicable disease survey form and alert quarantine officers. Oh, and if I experience symptoms, I should be sure to wear a mask, the cartoon squeals in its high-pitched voice. That's just great. Now, I have to worry about bird flu. Maybe, I should have worn a mask after all.
Even though I know I have an infinitesimal risk of contracting bird flu or any other serious disease on an airplane, I gear up as well as possible to lower that tiny risk. What do you do to stay healthy on a plane? What are some of your tips? Do you believe you're more likely to get sick during or after a plane ride?
Friday, February 16, 2007
Imaging the pre-criminal mind
Remember that Tom Cruise movie "Minority Report," where the cops were able to see into the future and then bust people for crimes that they were going to commit, before they committed them? That was science fiction, but what if I told you we're not so far away from a world where reading people's intentions becomes a regular thing?
A team of researchers, led by John-Dylan Haynes at the Max Planck Institute for Human Cognitive and Brain Sciences in Germany, has figured out a way to use functional magnetic resonance imaging (fMRI) technology to decode what people are intending to do in the future. They train their computers to learn what your fMRI brain patterns look like when you have certain thoughts, and then use that knowledge to figure out what you're about to do.
For now, they're only able to read intentions with about 70 percent accuracy. And you can't just grab someone off the street and figure out his or her intentions immediately. First the fMRI machine has to be calibrated to each person, and it's a huge machine so you have to actually bring the person to the machine. At most you can read very binary or "yes-no"-type answers for one thing at a time, and you have to pre-determine what the possible outcomes are going to be. For example, the researchers asked test subjects to decide ahead of time whether they were going to either add or subtract two numbers, and then the scientists trained their computers to recognize what the brain looked like for each of the two results.
Despite the limitations, Dr. Haynes says we're about 20 or 30 years away from having "Minority Report"-type technology, which to me doesn’t sound like much longer. In the next couple of years, as the next generation of more sensitive fMRI machines are developed, we're probably going to see these systems used commonly as more accurate lie detectors, for neuromarketing (detecting consumers' attitudes about products), and for prospective employee screening.
Ethicists are up in arms over all this. We're ushering in an era of using personal medical data in a whole new way, and some of it can feel... scary. Other research has been done using fMRI brain scanning to detect whether someone is having moral or amoral thoughts, or whether his or her brain looks like one of a criminal psychopath or a non-criminal. Scientists have also recognized what the brain looks like when it is able to control feelings of arousal, so there is now talk of using that information to decide whether a sex offender in prison has been fully rehabilitated or not.
Soon it may be possible to read people's future intentions even before they are conscious of them. Do you think we should welcome this brain-reading technology, or are we opening up Pandora's box here?
Thursday, February 15, 2007
My mom sets the pace at 81
One of the things I look forward to every June is the Race for the Cure, held in Washington, D.C. Each year my daughter, my mother and I wake up early, put our race shirts on, pin our numbers on our chests, our "In Honor " banners on our backs and walk the three plus miles downtown It's always a special occasion. That's because we walk in honor of my mother, a 30-year breast cancer survivor. Thirty years!!!! And she still walks every year, even at the age of 81.
It's a thrill to take part in the race for two reasons. One is, obviously, we give thanks for my mother's survival, but the second is even more rewarding. I love to see the look on women's faces when they notice the "30 year breast cancer survivor" written on my mom's back. Many of those walking are breast cancer patients in their 30s, 40s and 50s. And for them to know that someone can survive way into their golden years after breast cancer gives them hope. Many of them hug her; some cry but almost all thank her for giving them a reason to keep fighting.
When my mother's cancer was diagnosed in the early '70s, there wasn't a lot being done for breast cancer patients. She found the lump while bathing. It was the size of a dime. Her doctor figured it was just a cyst, but the biopsy proved him wrong. It was cancer. For a lump the size of a large pea, she had her entire right breast removed. But the physicians said she was lucky. The cancer had not spread to the lymph nodes and she didn't need chemotherapy or radiation treatments. But she did lose her right breast and never had reconstruction. That's just not something they did back then.
She's had a few scares, but she remains cancer free. She's never smoked, eats well, exercises and sees the doctor twice a year. She lives with the knowledge that she will always be a cancer patient, but she knows she's beaten the odds and that she's been sort of a pioneer in the fight against the disease.
Thirty years later, there are so many more treatments, more diagnostic tests for breast cancer, and women are beating it every day. Breast cancer is not a death sentence. There is hope - lots of it. Just ask my mom.
I'm curious to hear about your experiences with breast cancer.
Wednesday, February 14, 2007
Finding the secrets of youth
For the past two weeks I traveled with Dan Buettner of Quest Networks Inc. exploring the secrets of longevity on the Guanacaste Coast of Costa Rica. During the trip we met numerous centenarians like Dona Panchita - all of whom possessed an extraordinary vigor for life and an ability to do what I sometimes completely neglect - to savor life.
Most centenarians seem to have found a healthy balance between work and play - a philosophy that might not be so easy to grasp for the average workaholic. In fact, one of the most surprising contributors to longevity was a factor I had never even considered - family. In many aspects, centenarians are never alone. It's not uncommon, for example, to find five generations of one family living in one neighborhood - or even under the same roof. All of the centenarians we met in Costa Rica made family, friends and religious networks an uncompromising priority.
In the United States, we often get so wrapped up in working, there's hardly any time left for our personal lives. Quality of life is sacrificed for the drive to get ahead on the job. According to Dan Buettner, what Americans often fail to do is get the most good years out of life and the most life out of years. He says what really counts is, "what is my chance to live from this point on."
So what can we do? There's an old saying that "the tragedy of life is not that it ends too soon, but that we wait too long to begin it." Speaking with a person who has been alive for 10 decades certainly puts that phrase into perspective. It's never really too late to begin. As you hustle through another busy work day, take a moment to stop and think, what's it all about? Save some time to spend with family and friends... and you could possibly add several more good years to your life.
I'm curious - what are your secrets for living a long life?
Tuesday, February 13, 2007
Are adoptive parents more attentive than biological parents?
The guest of honor was the size of a Honeybaked ham and just as sweet. After months of fervent prayers and false starts, Doug and Cheryl's dreams of adopting a child had finally come true. They named their son Alexander James, but everyone calls him AJ. At AJ's welcome-home party, I looked around the room. Strangers hugged and family members cried as the little man slept securely in his daddy's arms. I had no doubt love is thicker than blood. AJ was finally home.
From Doug and Cheryl to Angelina and Brad, it seems as if everyone is adopting these days. A recent survey found that up to 4 percent of U.S. households include adopted children. That number is expected to increase, so I was interested to read about a new study that finds adoptive parents invest more time and financial resources in their children compared with biological parents. (See Full Study)
Intrigued, I called one of the researchers, Dr. Brian Powell at Indiana University. He says that, ironically, the challenges adoptive parents face actually set the stage for them to excel in parenting. "Society often tells people that adoption isn't normal," says Dr. Powell. As a result, he says, adoptive parents often spend more time with their children, know their friends and their friends' parents and are more involved with school activities.
Dr. Powell also believes this study could change public policy and the way adoption is handled in the courts. The legal system usually bases its decisions on what's in the best interest of the child. Historically, it's been assumed that in most instances children are better off with their biological parents and that adoption should be considered only as a last resort. These new findings, say Dr. Powell, could change the way the legal system handles international adoptions (for example, by older, single parents) and adoptions by same-sex couples.
I want to know what you think. Do you think adoptive parents invest more in their kids than biological parents? Also, do you think this study will change the debate when it comes to same-sex adoption?
Monday, February 12, 2007
Health awareness days: Mark your calendars again and again
It's February. There are hearts everywhere. Most of them are for Valentine's Day, but some are commemorating American Heart Month. After all, it was just a couple of Fridays ago, February 2, when celebrities around the country, including CNN's own Larry King, Paula Zahn and Soledad O'Brien, helped observe National Wear Red Day. Public service announcements on heart health abound.
American Heart Month is just one of more than 200 official National Health Observances in 2007. Every year, the U.S. Department of Health and Human Services develops a calendar of these awareness days, weeks and months to highlight a particular disease or health issue. Each year, HHS gets dozens of requests to get more issues on an already crowded calendar. In addition to hearts, this month has lesser-known awareness days for low vision, prenatal infection, children's dental health, burns, children of alcoholics, organ donation and eating disorders. Sometimes it seems that the dates assigned to a particular issue are chosen at random. All of them are serious health issues needing attention, but what is my personal February favorite? Today is the first day of National Condom Week and Valentine's Day is National Condom Day. Apparently, February is a good time to talk about hearts and condoms.
A National Health Observance Day can bring much-needed attention and donations to an important health issue. Last year's "Go Red for Women" raised $2.1 million for National Wear Red Day out of a total of $23 million for the year. There is no real way to quantify the effects of these events, but Dr. Elizabeth Nabel of the American Heart Association points out that before National Wear Red Day started in 2004, 1 in 3 women died of heart disease. Now, those numbers have improved to 1 in 4 women.
Breast Cancer Awareness in October and Lung Cancer Awareness in November are other examples of successful health awareness events. The pink-ribbon campaign dates back to 1992, when 1.5 million ribbons were handed out along with self-breast exam instructions at Estee Lauder cosmetic counters around the country. Now, pink is an unmistakable icon for breast cancer. Every November, the American Cancer Society launches the Great American Smokeout. The Quitline and the ACS Web site get the highest traffic of the year around that day.
I think awareness days can be incredibly successful. As a health journalist, I get a deluge of story pitches from publicity campaigns ranging from Colorectal Cancer Month to Jaw Joints/TMJ Day to National Fruit and Vegetable Day. The most successful campaigns usually are marked by a healthy budget and passionate advocates.
Do you think February as Heart Month and October as Breast Cancer Awareness Month make a difference? Do you pay more attention when you find out that today is a day highlighting a particular issue? Which health issues deserve their own days?
Editor's note: CNN Medical Intern Caroline Bray contributed to this blog
Friday, February 09, 2007
Handling a friend's diagnosis
Sitting on my desk is a get-well card. It's addressed and stamped, but the inside is blank. A woman I know recently learned she has cancer. She's not a close friend, but her gentle spirit and beautiful smile always have touched me. I want her to know that if she needs anything, I am her girl, but I don't want to appear too nosy. I also want to be optimistic, yet I don't want to come off as a "Pollyanna." After all, cancer is serious business.
Not exactly sure what to do, I called Christine Miserandino. She is the founder of butyoudontlooksick.com. Christine has lupus and she talks with other seriously ill people all the time. "People get weird," says Christine. "Often they think you don't want to do the same things you did before, like get your nails done or go to the movies... but as I remind people, it's the same me." Christine also offers these suggestions:
1) Forget the flowers - think more practical. "What girl doesn't love flowers?" says Christine. But after a while, the house or hospital room may start looking like a mortuary. Christine suggests buying a gift certificate for something your friend needs, like a maid or grocery-delivery service. Remember when people are sick, energy is low and money is often tight.
2) When visiting, come prepared. Boredom is often a side effect of illness. When visiting, bring something you can do together, like a movie or a game. Christine says she started making scrapbooks and it was a great way to think about happy times.
3) Do your research. Find out whether your friend is on a special diet or is craving a special treat. Also some hospitals don't allow balloons or flowers. Some treatments can also mess with the sense of smell, so before you invest in bath supplies or candles, ask.
4) Call Ahead. Know your friend's schedule, when he or she gets treatment or is sleeping. Also, even if you have made plans, call an hour before, to make sure they are still up for a visit.
5) Get real. When Christine's lupus was diagnosed, it drove her crazy how some people would pussy foot around the diagnosis. "Don't tell me I will feel better. I might not." Christine has a wicked sense of humor, so she designed a shirt with the words "Lupus Sucks." That shirt, she says, built bridges with her lupus brethren and broke the ice with countless other people.
That card is still sitting on my desk, but I now know what I will write.
What are some things you do to support someone who is seriously ill? Have you ever been annoyed by a well-meaning friend when you were sick?
Thursday, February 08, 2007
Cheesesteaks... My only weakness!!
I love cheesesteaks, really more than any other food on the planet. I'm a Philadelphia transplant, so when a restaurant here in Atlanta serves a "Philly cheesesteak" I'm at the head of the line to try it. I'm usually disappointed!
Not surprisingly, in 2001, Philadelphia was named America's fattest city in the country on the annual "Fittest and Fattest Cities" list from Men's Fitness magazine. Naturally, I was outraged. They've got pizzas the size of small cars in New York and Chicago, fried everything here in the South, In N' Out Burgers out in California (my second favorite food). How could Philly be the fattest?
A few years later in 2005, we were picking cities for our first CNN Fit Nation Tour, and Philadelphia kept coming up as a city that was doing things right. So we called Men's Fitness and asked, "What's up?"
Editor-in-chief Neal Boulton had a good answer. He said that magazine staffers were also surprised when the city's new mayor, John F. Street, called and asked them to take a second look. Boulton and his team went, and found out that when he took office in 2001, Street had taken Philly's "fat" ranking as inspiration for change.
The city began sponsoring weight-loss support programs, the mayor himself met with families who struggled with obesity and personally mentored them to better health, and he appointed a "fitness czar." (Full Story)
He didn't mess with the cheesesteak though. That would have been sacreligious.
Just yesterday, Men's Fitness came out with its latest list. Guess what? Philly is No. 20 - on the FIT list!
Las Vegas, Nevada, was named the fattest city, followed by San Antonio, Texas, and Miami, Florida. On the Fittest list, Albuquerque, New Mexico, is tops - up from No. 13 last year. Nos. 2 and 3 are Seattle, Washington, and Colorado Springs, Colorado.
None of those last three had to deal with a cheesesteak addiction. Life can be so unfair.
To check out the full list, go to Men's Fitness Magazine online. The latest issue hits newsstands nationwide this weekend.
Today, I am going to blog about cupcakes. Yes, this surprises even me. There's a story circulating about school districts banning cupcakes and other non-nutritious treats from schools, even for birthdays and other events. Cupcakes, lathered with sticky frosting and rainbow sprinkles... mmm... are under fire. (Watch Video )
The arguments are easy to state on each side. On one hand, childhood obesity rates are killing America's youth. The rates are starting to approach 20 percent, and our junk food diets are a large part of that equation. Add in that cupcakes have increased tremendously in size. They used to be golf-ball sized. Some are now bigger than softballs. If there are around 25 kids in a classroom, and several holidays, all of a sudden you have lots of calories on lots of days. Those who oppose cupcakes say they are non-nutritious and have no place in the schools.
There are, however, plenty of cupcake defenders springing up all over the country. In Texas, Democratic state Rep Jim Dunnam has been one of the most vocal. He sponsored legislation to allow parents to bring in whatever they want. He became involved after one of the schools in his district banned a father from bringing non-nutritious food to his child's class for a birthday. Dunnam's argument is that cupcakes aren't the problem. Instead, it is lack of activity and overall diet.
No doubt, it is controversial, more so than I would've thought. One school superintendent, who chose not to be named, actually received threatening e-mail after her school district supported the ban. What do you think? Is banning cupcakes going too far? Or, is it a logical way to target the childhood obesity epidemic?
Wednesday, February 07, 2007
3G contraceptives (part 2)
Thank you all for your comments and personal stories. To answer one of the more frequent questions, the nine drugs that Public Citizen is taking issue with (Full Story), and that Dr. Gupta listed this morning on CNN are as follows:
- Kariva (Duramed/Barr)
- Desogen (Organon)
- Mircette (Duramed/Barr)
- Apri-28 (Duramed/Barr)
- Ortho-Cept (Ortho-McNeil)
- Reclipsen (Watson)
- Cyclessa (Organon)
- Desogestrel and Ethinyl Estradiol (Duramed/Barr and Watson Pharmaceuticals)
It's important to remember though, that all types of birth control pills contain a risk and a written warning about increased risk of blood clots and those containing desogesterol have an additional warning that the risk for blood clots may be even greater.
In addition, the drug companies say their drugs are safe when taken as directed. Two manufacturers issued statements to CNN:
"The labeling that accompanies the company's oral contraceptive product provides all the necessary warnings and precautions for the appropriate use of the products."
-Statement from Barr Pharmaceuticals
"When used as labeled, Ortho-Cept is a safe and effective birth control choice."
-Statement from Ortho Women's Health & Urology
3G birth control a difficult pill to swallow...
This morning, we reported about a recent petition by Public Citizen about birth control pills. The consumer advocacy group is calling for all third-generation birth control pills (the newest kind) containing desogestrel to be banned. (Full Story) Its concern: These pills can double the risk of life-threatening blood clots. (See the list of medications Public Citizen is concerned about).
The blood clots, besides being painful, can travel to the lung and cause severe shock or death. We found studies dating back to 1995 that validated this increased risk of blood clots. In fact, the FDA publicly announced the higher blood clot risk years ago, yet the drugs still remain on the market.
According to the national prescription drug audit, 7.5 million prescriptions were filled last year. So why are these medications still available? As with most things, you have to dig a little deeper for the answer.
First of all, keep in mind the absolute numbers are very small. The risk of having a blood clot while taking the second-generation birth control pills was about 1 per 1,000 users and went up to around 2 per 1,000 on the third generation (according to a 2001 report in the New England Journal of Medicine). Also, some women find the third-generation pills to be a better pill. They don't get as sick while taking them, compared with some of the older pills.
Public Citizen cites a slightly lower blood clot rate but says there are no additional benefits to the third generation pills compared with the older pills.
So, what is the FDA's role here? Should they remove the pills from the market or is this more a case of buyer beware?
Tuesday, February 06, 2007
Planting the seeds of change
The Northern California fields that produce much of the lettuce and spinach you're likely to eat this summer haven't been planted yet. The seeds go in the ground in less than 60 days - time farmers still need to determine how to best prevent a repeat of last year's deadly bacteria outbreaks linked to their crops. The problem-solving is becoming contentious.
In mid-January, farmers, hoping to control their own fate through self-regulation, met to hash out a plan for better safety standards. A state senator dissatisfied with that plan presented bills last week that would give the state control. The federal government spoke out last week, too. In a highly critical report, the Government Accountability Office described the nation's food safety measures as "inconsistent" and "ineffective." The president's 2008 budget calls for $341 million for the Food and Agriculture Defense Initiative, an increase of $19 million, or almost 6 percent more money compared with 2007 spending.
But how can that be done when farmers and even top scientists don't fully understand how bacteria such as E.coli, which can taint salad greens, operate?
"It's there one minute but it's gone the next," Dale Huss, a grower who helps manage a medium-size farm, said. "We're being asked to build metrics around something that is a phantasma."
A microscopic bio-ghost, but Huss is optimistic, kneeling into his soil to smell the dirt. It smells fresh - the kind, he says, that will grow a good crop. Huss says he knows the dirt is safe because it's routinely tested. But not all farms in California do that - just one example of a system with vulnerabilities and a new planting season looming.
What food safety issues concern you the most?
Faces and races: Maybe we're all a bit blind
What if every face you saw was new to you every time you saw it? That's what face blindness can be like. Also known as prosopagnosia, face blindness is a visual memory problem that makes it hard for some people to remember the faces of people they've already seen. Sometimes they can't even remember the faces of family or they have trouble remembering what they themselves look like.
As many as one out of 50 people might have some form of face blindness, according to the latest studies. That means someone I know probably has the condition - that someone could even be me! Heck, I've been known to forget a few faces, much to my chagrin.
But that statistic also reminds me of a funny scene in "Rush Hour 2" where Chris Tucker accidentally punches Jackie Chan in the middle of a fight with Asian gangsters and then apologetically but exasperatedly explains, "All y'all look alike!" They make fun of something I bet is pretty common: thinking people from another race look similar.
It's happened to me a few times, where someone gets me and another south Asian woman mixed up. I know it's an honest mistake, so I usually just brush it off, but now I'm wondering whether my transgressors could have some sort of ethno-specific face blindness?
When I asked Dr. Brad Duchaine, a face blindness expert at University College London, he said a lot of people who are face blind admit it's harder to recognize faces from other races. But then again, if you're the only one who's of a different race from everyone else, he points out, it may be easier for a face blind person to recognize you. There's not enough research to prove whether some people are more blind to certain ethnicities than others.
While I was researching the subject, though, I learned something about race and physical features that I think is worth mentioning: Humans are 99.9% genetically identical to one another. There's only a teeny tiny bit of genetic variation among us, and about 85% of that variation exists within local groups of people, among Romanians or among Bengalis, for example.
Also, certain facial features thought to be linked to race are actually spread out all over the globe. For example, Germans tend to have nose widths more similar to Arabs than to Norwegians, despite their respective races. So even though genetic differences do exist among us, those differences don't necessarily reflect race. Interesting.
Anyway, let's be honest here - do you sometimes have a hard time distinguishing people from another race? Or, have you been confused with another person from your race? Or both?
To learn more about face blindness, and to take a diagnostic face recognition test, go to www.faceblind.org.
Monday, February 05, 2007
Three questions for your doctor
"Ask your doctor."
You've heard it in a million pharmaceutical advertisements, but do you really know what to ask? Dr. Rick Kellerman, president of the American Academy of Family Physicians, says that in any medical situation, a patient or their family should ask three vital questions:
- What do I have?
- What is the treatment?
- What is going to happen to me?
Simple enough, but too often basic communication breaks down. Consumer Reports just published a survey that asked 39,090 patients and 335 primary care doctors what they like about each other and what drives them up the wall.
The No. 1 complaint of doctors, 59 percent of them, is patients who don't follow the prescribed treatment (No. 1 patient complaint: doctors who keep you waiting). Of course, not following doctor's orders because you didn't understand what he or she said can lead to serious health consequences.
If you're like me, when you finally get through the waiting room, you're tongue-tied. Kellerman suggests keeping a running list of complaints and questions, so you don't forget them at the moment of truth. He also says that to avoid confusion, you should bring in all your medications, in a bag. Consumer Reports suggests bringing printouts of "credible" information from the Internet.
What else to ask? Other doctors gave me some interesting suggestions, from "What tests would be important to check my risk of heart disease, stroke or cancer?" to "How would you treat me, if you didn't have a prescription pad?"
Whatever you want to know, communication flows better with a doctor you know well and who makes you comfortable. That's why Kellerman says it's so important to see a primary care physician on a regular basis. If you do that, the three basic questions are less likely to produce an alarming answer.
What would you really like to ask your doctor?
Friday, February 02, 2007
Battered athletes may suffer the consequences
We see it on the field, in the rink and in the ring. Athletes in high-contact sports suffering concussions - a brain injury caused by a strong blow to the head that can cause dizziness, headache, memory loss, and even a loss of consciousness.
Every year players in the National Football League suffer concussions and risk life-altering consequences, particularly those who experience multiple concussions.
For decades athletes have called them "dings," and some shook them off, "playing through" the injuries that some doctors now link to depression, dementia and even suicide - once an athlete's playing days are over. In a study of nearly 2,500 former NFL players by the Center for the Study of Retired Athletes at the University of North Carolina, the rate of depression for players who had five or more concussions was three times that of players with no history of concussion.
And what about children who play sports? Studies spanning the last 20 years show that nearly 20 percent of high school players - nearly 250,000 kids - suffer concussions yearly, moving experts to call for better education among players, trainers, coaches and parents.
If you've had one concussion your brain needs time to heal because head injuries can cause lasting problems. And we know that a player who has had a concussion has a greater risk of having another one. But if your brain hasn't healed from the first, your next concussion could be fatal.
There's a lot that we don't know about concussion, but with all we do know, do players, coaches and parents need to start taking them more seriously.
Has your child suffered a concussion playing high school sports? How long did you make him or her wait before resuming play?
Thursday, February 01, 2007
A beautiful addition to the family
One week ago, my wife delivered our second child. Up to the point of the delivery, we had no idea whether the baby was a boy or a girl. She is definitely a girl. Very pretty, very mild mannered. Beautiful. We could not be happier.
My wife and I are both pretty compulsive people. Yes, we had a birth plan and everything went pretty much as we anticipated. To prepare, I have been reading tons of books written by friends such as Dr. Laura Jana, who often calls to check in on us. Thanks, Laura. I also have read several books by Heidi Murkoff and Dr Ari Brown, who have both been guests on my show. My wife is partial to "The Girlfriends' Guide to Pregnancy." Without a doubt, there are many great books out there and great resources.
Still, I am not sure any amount of reading can truly prepare you for your second child. It is a very different experience from the first. Truth is, I could write a book about all that I have felt over the last week. My friend and colleague John Vause sent his greetings from China and very correctly stated that we "had gone from being a couple with a kid - to a real family." A real family. Interestingly, one of the most powerful emotions I felt had more to do with my 19-month-old daughter. I was so used to seeing her as a baby, and suddenly she seemed grown up, too grown up. When she offered to go get her new sister's diaper, I was both amused and sad. Wasn't she still our baby too?
It is when your children grow up that you are truly forced to stare into the face of mortality. As I reflect now, I realize that I wasn't quite ready for that. I am sure that it will get better over the weeks and months, and then our new one will suddenly seem too grown up. In the mean time, I want to enjoy our moments.
I typically don't solicit parenting advice, but I wanted to get a discussion going here about what experiences other parents have had, especially bringing their second child home, and wondering whether you raised your second child any differently from your first. And, what advice for me do you have on new-dad bonding?
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