September 5th, 2008 by Dr. Val Jones in Uncategorized
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This week yet another study has confirmed that losing weight (and keeping it off) requires more effort than we initially imagined. Apparently, we really do have to “work our butts off” to be fit for life. It seems that half an hour a day is not going to cut it. Obese women in this study had to exercise for at least an hour a day to maintain their weight losses.
One commenter simply said that a better idea would be to not become overweight in the first place. Well, the train has already left that station! Still, parents need to take heed – once a child becomes substantially overweight, he or she is likely to struggle with that weight for a lifetime.
Perhaps it is easiest to intervene at the very earliest stages of our lives. As for me (and the >3000 of us in my weight loss group) it looks like I’ll be trying to get a full hour of exercise in every day! Care to join me?
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 4th, 2008 by Dr. Val Jones in Uncategorized
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This interview is a continuation from part 1.
Dr. Val: How did Simon contract the MRSA infection?
Dr. Macario: That will remain the biggest mystery of my life. No one knows how he picked it up. In Simon’s case there was no entry via the skin – he had no cut or boil or surface evidence of infection. He contracted the community associated strain of the bacterium, which is much more virulent than the kind people get in hospitals. It seems that the MRSA superbug somehow got into his body via his lungs. It’s possible that he touched something with MRSA on it and put it in his mouth and then breathed it in. Unfortunately, there’s just no way to know where he got it.
Dr. Val: How many children die of MRSA infections/year in the US?
Dr. Macario: According to the Centers for Disease Control and Prevention, in 2005, nearly 19,000 Americans died from MRSA infections. During the same year, there were 134 cases of MRSA in children. Actually, more people in the US die from MRSA every year than from AIDS.
Dr. Val: Tell me what you’re doing to promote awareness of MRSA.
Dr. Macario: I have a Ph.D. in Public Health, and when I received the autopsy report stating that Simon’s death was caused by community-acquired MRSA, I was dumbfounded. I hadn’t even heard of MRSA before. In fact, in my career in Public Health I thought that infectious diseases were no longer much of an emphasis because of the terrific job we’ve done in eradicating most diseases through vaccine programs and antibiotics. I assumed that lifestyle issues (nutrition, physical activity, early detection, and safety precautions) would be the focus of my career.
It was a real eye-opener to me to live through the loss of a child to a menace I thought we had under control. Sixty years ago families had large numbers of children, knowing that some would be lost to infectious disease. That just isn’t the way we think anymore. But MRSA is a threat that could essentially take us back to a time when Americans died of infections quite commonly. MRSA is a superbug that is highly resistant to most antibiotics we have. It’s only a matter of time until it’s resistant to everything.
I’ve begun working half-time with Dr. Robert S. Daum at the MRSA Research Center at the University of Chicago Medical Center, Department of Pediatrics, Section of Infectious Diseases (Chicago, Illinois). Not only are we studying how contagious MRSA is (in home and jail settings), we are also studying the most effective way to treat MRSA infections.
Dr. Val: What should doctors know about MRSA and children?
Dr. Macario: There are 506 new drugs approved by the FDA for development… only 6 are new forms of antibiotics. That’s because the antibiotics are not so profitible. Antibiotic customers are short term users – they need the antibiotic for a short time and then they’re healed. Contrast that with a drug like Lipitor, something that people need to take every day for a lifetime, and you’ll see why statins are more of a priority for drug company development than a new antibiotic that could combat MRSA.
Doctors need to realize that MRSA is a growing threat, and we may not have a good treatment for it in the near future. There is a new strain of MRSA (the “community associated” strain) that can be found anywhere – schools, homes, locker rooms, and gyms. This strain is more virulent and more resistant to antibiotics than anything we’ve seen before.
Dr. Val: What advice do you have for parents to protect their children from MRSA?
Dr. Macario: Wash your hands frequently and thoroughly, clean surfaces with bleach, don’t share personal items like towels and razors. Parents should NOT run to antibiotics for any possible illness their child may have. Don’t use antibiotic soaps. Antibiotics should be considered the absolute last resort. If we keep using them for viral illnesses or when we don’t really need them, we’ll just fuel the drug resistant MRSA.
Dr. Val: What’s the most important thing you’d like to tell Americans about MRSA?
Dr. Macario: This new strain of MRSA (community associated MRSA) can affect anyone. Young, old, middle aged, healthy or sick. It can attack a person as healthy as basketball star Grant Hill. It happened to my healthy baby, and it can happen to your family. People must view antibiotics as a sacred last resort to treating disease. If they overuse and misuse them, MRSA and other resistant strains of bacteria will continue to mutate and become even more prevalent and dangerous.
My husband and I are both highly educated, I keep my house immaculate, I vaccinate my kids, and they never went to daycare centers. It doesn’t matter what socioeconomic strata you’re in, race, gender, ethnicity or age – MRSA doesn’t discriminate. It can happen to you.
But to leave this on a brighter note: my husband and I had another son after Simon died. His name is Dylan, and has brought a lot of joy to our lives.
***
For more information about MRSA, please check out StopMRSAnow.org
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 3rd, 2008 by Dr. Val Jones in Uncategorized
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I had the honor of interviewing Dr. Everly Macario about the the tragic death of her young son, Simon Sparrow. Simon was a healthy one and a half year-old baby who came in contact with a deadly form of Methicillin-Resistant Staphlococcus Aureus (MRSA). The bacteria got into his blood stream and ended his life just 2 days later. Everly has become a tireless advocate for MRSA awareness. This is her story:
Dr. Val: Tell me what happened to Simon.
Dr. Macario: Simon was a very healthy, breast-fed baby, born at full term with no history of illness or immune disease. When he was about 15 months old he caught what I thought was a throat infection. He wheezed a bit when he breathed so I took him to the doctor. The doctor reassured me that he seemed to have a mild case of bronchitis, and gave me some albuterol, prednisone and antibiotics.
Simon did well for a few days until he woke up on a Friday morning with a primal terrified shriek (a sound neither my husband or I had heard from Simon before) and a fever. My husband decided to take Simon to the Emergency Room immediately. Once there, the doctors ran the standard battery of tests (e.g., chest X-ray, oxygen-level test) only to speculate that he may be an asthmatic kid.
I could tell something was really wrong given how irritable Simon was… he truly was inconsolable. When my husband came to pick us up, my husband noticed Simon’s lips were blue as we were walking out the ER doors. We went back in and pointed this out to the doctors. They, once again, measured his oxygen level and informed us that he was within normal range. We then went home and gave Simon some albuterol administered via an inhaler. When we did this, Simon’s eyes rolled back into his head in such a way that really alarmed us. But, we said to ourselves, “he’ll be fine, he’s just sick like any other kid his age gets sick, it’s temporary, he’ll be fine….”
That afternoon, Simon vomited the little milk he had had that morning, and lied limply in my arms – something that terrified me as I was used to a more wiggly and restless Simon when he would get ready for a nap. He kept asking for “agua” (water in Spanish) and drank about 4 “sippy” cups of water, only to vomit all of it soon-after. I really panicked when his cheeks and forehead were cold and his lips were turning blue again. His nostrils were also flaring and he was breathing so heavily at this point that his chest was expanding and contracting “in and out” in the shape of a barrel. I called the doctor to have her hear Simon’s labored breathing, at which time she said, “Hang up and call 911.”
As soon as Simon was wheeled in to the ER, doctors hooked him up to everything imaginable (oxygen, nebulizer, IVs for medication and pain relievers). And, I kept hearing, “Your child is very, very sick. Your child is very, very sick.” At this point I became absolutely hysterical – “basket case” would be the technical term. Simon kept looking at me with his chocolately-brown eyes, and long curly eye-lashes, repeating, “Agua, agua, … agua.”I was so completely terrified and felt so utterly helpless that my reaction was to call my parents. I had to leave Simon to call them. As soon as I got off the phone I ran back to where Simon had been, only to learn he had been brought up to the ICU, where he was going to get intubated so that he could breathe more easily.
I was brought into a conference room where one of the pediatric emergency room doctors sat me down and began to tell me that Simon had an infection but the source was yet unknown. Her tone was almost too muted and the pace at which she spoke seemed very slow. From this point on, doctors kept coming in and out of the room with updates – basically, Simon had gone into septic shock and his blood pressure was dropping. One fellow who tried to be encouraging said, “Most kids leave the ICU.” It was this fellow, however, who said later that evening that she “didn’t want to lie, that Simon was going downhill.”
By the time my husband arrived and we were allowed to see Simon, I knew in my soul Simon was dead. Jim and I gathered around the bed on which Simon was lying, along with what seemed like 10 doctors, representing every specialty in medicine. The attending said that they had to get Simon on ECMO (the “heart-lung machine” or “extracorporeal membrane oxygenation”) as this was “his only chance.” I begged the ECMO expert to do what he could to save Simon.
From that point on until Saturday morning, Jim and I desperately and despairingly prayed for Simon to come out of this sepsis state somehow. Doctors came in regularly to update us but we knew the chances were not good when we heard things like, “We’re not sure if your son is going to make it at this point.”
While on ECMO, Simon became incredibly bloated and his skin turned purplish and scab-like.He had solid plasma “tears” coming out of his eyes. He did not look like Simon.
Late morning the next day, Jim and I decided to take Simon off of the ECMO machine, as he was not responding to it at all, and he was pronounced dead at 12:45 p.m. Still no precise cause of death.
Two months later, from the autopsy, we learned, as was suspected, that Simon died from “Methicillin-Resistant Staphylococcus Aureus” (MRSA), probably the “community-acquired” kind versus the hospital-based one. Neither my husband nor I had ever heard of it. MRSA is a virulent antibiotic-resistant bacterium. We have since learned that because of the over-prescription of antibiotics and the use of antibiotics in animals that we eat, we have created an environment that causes “weaker” bacteria to die off, allowing stronger competing strains to survive. MRSA is only treatable with vancomycin, that is assuming you know that is what you have contracted.
It seems unfathomable that a healthy, hearty, and beautiful little boy could have breathed in such a bacterium – one that attacked his organs by releasing lethal toxins – and in less than 24 hours was gone. MRSA took my son swiftly and totally.
***
Please see the next blog post for the rest of the interview with Dr. Macario.
Everly is a spokesperson for STOP MRSA Now.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 3rd, 2008 by Dr. Val Jones in Uncategorized
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I once heard someone say that the primary difference between humans and animals is that humans learn from others’ mistakes. Animals, by contrast, only learn from their own personal experience with their environment. As I reflected on this observation, I realized that we humans certainly do value personal experience, but that we’re also capable of modifying our perceptions of reality with new information gathered from others. And best of all, we have the flexibility to change our minds about our conclusions when we repeat our observations under controlled conditions.
Smallpox is a deadly virus that kills about 33% of its victims, and badly disfigures the rest. In the 1700’s this scourge was greatly feared throughout Europe. Thanks to a keen observation by a British farmer (Benjamin Jesty), a new mechanism of protection against smallpox was discovered. Jesty noticed that people who milked cows infected with a similar disease (cowpox) did not seem to come down with smallpox. He theorized that exposure to pox-infected cows was a key to immunity against smallpox, and his theory was proven correct by physician Edward Jenner about 20 years later. Dr. Jenner created a reliable means of exposing people to the cowpox virus (called a vaccine – “vacca” meaning “cow” in Latin), introducing a tiny amount of cowpox-infected fluid under the skin to confer immunity against smallpox. This whole process of observation, careful experimentation, monitoring results, and further refining procedures led to the world-wide eradication of a deadly disease. Similar principles were applied to other illnesses, further reducing the global disease burden of polio, measles, mumps, rubella, and many other viral infections.
I suppose that one could thank cows for advancing the field of immunology more than any other animal – and thank a certain farmer for being so keenly aware of his cows’ health and their impact on humans (you know I have a soft spot for cows). But the story didn’t end with Jesty’s anecdotal observation – his theory was born out by science. His observations were repeated again and again in successful innoculation trials, and refined to a point where millions could benefit from vaccines.
Nowadays people are very impatient. We have short attention spans, we want instant gratification, and we are prone to jumping to conclusions about pretty much everything, especially medical news. I can’t tell you how many quantum leaps I’ve observed in health reporting – like the case where a scientist noted that breast cancer cells express a different protein in the presence of olive oil extract (in a Petri dish) and then reporters translated that news into “olive oil cures breast cancer.” All this ignited by the instantaneous availability of information via the Internet, curious minds, and lack of proper scientific vetting.
What happens today is that a plural of anecdote becomes “evidence” of cause and effect. These false assumptions then become entrenched, and end up as “public knowledge” long before they’ve been tested for reproducibility. The cart is well and truly before the horse in most health reporting, and this has done incredible damage to us as a society. Our insatiable desire for answers has outstripped our patience for finding truth.
Consider the recent scare about vaccines and autism. A few people noticed that clinical signs of autism occur at around the same time that some vaccines are given to children. They wrongly assumed that vaccines caused autism, and that misconception has traveled so far and wide that parents are actually choosing not to vaccinate their children against preventable diseases. Measles have made a resurgence, and some are warning of the return of polio. These diseases are absolutely preventable – and it’s tragic that we may have to relive these scourges to remind people of the value of vaccines.
The best part of being human is that we can learn from others’ mistakes. We do not have to live through the mistakes ourselves to change our behaviors. I do worry that the anti-vaccinationist movement represents a regression backwards towards animal type thinking. Will it take a wave of paralyzed children to wake us up to the value of vaccines? Will Jesty’s cow have to tell us “I told you so?”
I’d like to think that we’re beyond that. But I guess only time will tell if people will fall for the plural of anecdote in lieu of truth. Our country’s health hangs in the balance as the Internet fuels both science and folly. Hold on to your skepticism, folks. It could save your life.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
August 29th, 2008 by Dr. Val Jones in Uncategorized
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Here’s my weekly list of things that caught my eye in the medical blogosphere:
Vaccines
With all the misinformed parents opting out of vaccinating their kids, could polio make a comeback the way measles has? Dr. Doug Farrago speculates about the new wave of paralyzed children that may be on the horizon.
Bloggers
What kind of person blogs? A new study suggests that bloggers are more likely to be both “open-minded” and “neurotic” by nature.
Drugs of Abuse
Steroid abuse can lead to a severe form of disfiguring acne. KevinMD found this example.
How NOT to forge a prescription for pain medicines. Thank you, Dr. White Coat.
The Healthcare System
Barack Obama says that a government-run single payer healthcare system makes sense for America. Now THAT’s scary.
Thousands wait in line for a free health clinic, staffed by volunteer physicians in Apalachia.
The government clamps down on pharmaceutical gift pens and paper to doctors while welcoming millions in sponsorship from them for political causes. Wow.
Gadgets
How about this new gadget? A clock that you can wear on your thumb nail.
Weird Anatomy
Would you like a vase shaped like your elbow or knee? Why not?
Are men with wider faces more likely to be violent? Dr. Joe presents the latest research.
This artist takes old fashioned anatomical drawings and makes them “joyful.”
Some serious exophthalmos from Happy Hospitalist.
The Cutest Animal Photo EVER
Sorry, I couldn’t resist. Thanks, Medgadget.com
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
