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Is There REALLY a "Chill Pill?"
| Filed under: News, Lifestyle Change, Health and Wellness with 26 words and 213 views
Link: http://www.koco.com/video/21600770/index.html
Before you spend your hard-earned cash on another supplement to help you relax and de-stress, please watch my interview with Channel 5's Jiao Jiao Shen.
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H1N1 Vaccine: the Data Versus the Hype
Link: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-inact-h1n1.pdf
When considering whether to vaccinate your loved ones against H1N1, don't listen to the hype or the nay-sayers unless they can give you real data.
These are the FACTS:
1) Since April, about 6 people of every 1,000 people who have been infected with H1N1 have DIED.
2) H1N1 vaccine is made in precisely the same way the regular flu shot has been made for decades - the only difference is in the type of virus injected into the eggs.
3) The risk of death (or serious side effects) due to flu vaccine is so small as to be incalculable. Large studies in children as young as 6 months old have found no serious reactions.
Unless you have a history of serious allergic reactions to vaccines, there is no reason to deny your family this potentially life-saving vaccine. I'm immunized and personally gave the shot to my children and my nieces in accordance with CDC recommendations. I didn't lose a moment of sleep over it.
If you want the links to the data, I'm happy to respond. Here are a few to start with:
1) Two large scale studies show influenza vaccine to be safe in children as young as 6 months old: http://www.ncbi.nlm.nih.gov/pubmed/17062862
http://archpedi.ama-assn.org/cgi/content/full/158/11/1031
2) Immunizing infants and young children against influenza reduces the risk of hospitalization due to other viral illnesses, especially RSV:
http://content.nejm.org/cgi/content/full/342/4/232
3) The risk of death from H1N1 and who has died of it thus far (data since July 2009 only - before the disease peaked nationwide):
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Watch my interview to know when to treat yourself and when to call the doctor: http://www.newson6.com/global/story.asp?s=11323025
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My Mother-in-Law Broke My Heart Today
First, let me say that I have a terrific mother-in-law. She has welcomed me into her heart and into her life, encourages me in my life and in my relationship to her son, and is a spectacular grandmother. Second, let me say that although she knows I never respond to mass emailings, she sends them my way anyway when she finds that they make her think of me.
Today she sent along an email with photos of abused and neglected children with a gut-wrenching poem describing the hell these kids go through daily, and an imagined heart-cry they must feel when so ill-treated by the very people who should be their protectors and caregivers.
I couldn't read it. I see it too often in real life.
This time, I was motivated to respond, not only to her but to everyone in her email blast - very unusual for me. The text of my response is below. I had to share it with y'all as well...
"Child abuse IS as horrible as the photos and poem describe and it happens DAILY. Violence is the #1 cause of death in children, and Oklahoma leads the 50 states in child deaths due to abuse! I have seen too much of this first-hand as a physician.
Child abuse happens most often because uneducated and unsupported parents have unrealistic expectations of their children's behavior - when a mother tries to force her 9 month old to be potty trained because the family have no money for diapers and "it's the kid's turn to help the family" or a father throws his child against the wall for being unable to communicate rationally at 18 months, it is up to all of us to help! Parents don't do these things because they are "evil," although believing so makes it more convenient for us to shake our heads collectively and passively do nothing. To do nothing is to allow the abuse to continue. And generations of families will continue to suffer as these children do.
This is why I serve on the Board of Directors of Prevent Child Abuse Oklahoma and the Exchange Club Center for the Prevention of Child Abuse. Exchange Clubs (like Lions or Rotary) exist throughout the U.S. and their goal is to provide education and support for parents BEFORE the abuse happens. By identifying at-risk families and bringing social workers into those families' homes to teach proper parenting techniques and provide social support, and through meeting the most basic needs of the families, the center in Oklahoma (and in other states) has proven its success time and time again - the families' stories when we meet are heartwrenchingly beautiful and the families are so thankful to have had the chance not to become abusers! Over 1500 Oklahoma families have been helped so far, and the Center receives referrals daily - from hospitals, DHS, the court system and families asking for help.
I am responding to this email because I feel so strongly about it that I have decided to help do something. If you can volunteer for an organization that helps prevent child abuse or if you are moved to donate, please contact your local Exchange Club. I have also included the email address for our Executive Director in the CC: section. I do not benefit personally from this request and will have no way of knowing if you choose not to respond, but I do want you to know when you see things as emotionally wrenching as this that there are organizations like ours out there trying to help and that these groups need manpower and money to keep the work going.
Thanks for listening,
Rachel Franklin, MD
Associate Professor of Family and Preventive Medicine
Course Director, Family Medicine Clerkship"
Thanks to all of you for reading and thinking about this, too... for more information about how you can help prevent child abuse, please visit any of the following websites:
Prevent Child Abuse Oklahoma http://www.pcaok.org/
Oklahoma Health Department http://www.ok.gov/health/Organization/Office_of_Communications/News_Releases/2009_News_Releases/Child_Abuse_Prevention_Month_3-24-09.html
Prevent Child Abuse America http://www.preventchildabuse.org/index.shtml
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Scenario: Imagine that you are a person who weighs over 450 pounds. You are one of between 5-7% of the American population described as "severely obese." You are at higher risk of heart attack, stroke, diabetes, arthritis, chronic pain, and disability than even a merely "obese" person. You are more likely to live in poverty, and yet your medical costs are almost double what a person of normal weight can expect every year. You find it difficult to keep your body clean from its daily functions, so you sometimes notice an unpleasant personal odor. Add to that the derisive staring and finger pointing you encounter almost daily by passers-by and your quality of life is already much lower than it would be if you were thinner.
Now, imagine being gripped suddenly with the worst abdominal pain of your life. From the floor of your bathroom you drag yourself to the phone to dial 911, knowing you cannot make it any further. What you may not know, however, is that despite the healthcare team's best efforts, your obesity itself may cause you to receive a lower quality of medical care than others who seek help that night. Read on to see how obesity affects our ability to provide the best care for you, our imaginary (but all too often real) patient, and extrapolate how the continued obesity epidemic could affect the future costs of healthcare for all of us. Note: the information presented below is based upon multiple studies discussing the challenges of caring for obese patients - I did not make this up...
TRANSPORT: NO EASY ROUTE
When the ambulance arrives, the crew realize that their normal gurney will not support your weight, and that the two paramedics who came to the door cannot lift you safely by themselves. It will be another 30 minutes before the fire department can come with a crew of strong men and a tarp, and if you live in a big enough city, a "bariatric" transport vehicle equipped for the severely obese patient. You may continue to lie on the floor in pain during that time, because it will be difficult for the paramedics to find a vein into which to place the I.V. in order to give you medicines.
Once you are rolled onto a tarp and lifted into the special vehicle (or onto a flatbed truck - REALLY - if a special vehicle is not available) you will be brought to the Emergency Department. Many hospitals now have beds that can accomodate patients up to 500-800 pounds, so if one is available you'll be placed on it; if not, they'll try to make due with whatever they can find. Beds have collapsed beneath obese patients for no other reason than that a more secure bed was not available.
IN THE EMERGENCY ROOM: LIMITED IMAGING
The ER staff and physicians will begin their assessment of your concern as they would for any other patient, but the abdomen is a difficult area to examine in the skinniest patients, and imaging is frequently necessary to help find the source of your pain. Herein lies your next problem: almost every hospital in the nation has CT and MRI scanners. Most do not have scanners that can accomodate your girth. The limit on most machines is between 300-350 pounds, with very few able to handle a patient weighing 400 or more pounds before the platform buckles under the weight. These machines cost beaucoups, and the hospital has to make business decisions when choosing which machines to buy. Some bariatric surgery centers and outpatient MRI facilities have scanners that could help, but they won't allow an unstable ER patient to be imaged there at midnight. The local zoo might have a scanner big enough, but none of them will allow humans to be imaged there due to liability concerns.
Plain x-rays cannot reliably penetrate your fat with the x-ray beams, and doctors know that you have double the risk of us missing a diagnosis on x-ray because of your size. So, instead of having a quick CT scan of your belly to make sure your appendix hasn't ruptured, you sit in the ER while the physician decides whether to call the surgeon or to monitor you a bit longer. In the interim, whatever is causing your severe pain continues to brew in your belly, and the doctor and nurses are as frustrated as you are with being unable to make a rapid diagnosis. You could be incredibly ill or simply very constipated, but it will be hard for the doctors to know.
IN THE OPERATING ROOM: LIMITED EQUIPMENT
The ER physician speaks to the surgeon and the surgeon decides you need an operation tonight to find the source of the problem. They are again faced with the dilemma of finding a surgical table that will support your weight. You will need to be intubated and placed on a ventilator for the operation, but because of the excess fat around your neck, it will be harder for the anesthesiologist to find your vocal cords and pass the breathing tube. It may be more difficult for the anesthesiologist to calculate the correct dosage of medicine to paralyze you and to put you under because medications are often processed in fat cells, and the more fat you have, the more difficult it can be to fine-tune the process.
Once you are under, the surgeon scrubs and opens your belly. This is normally done laparoscopically, using cameras and tiny instruments on the end of tubes inserted through little holes in the abdomen, which has been inflated with gas so the surgeon can see what she's doing. To hold the holes open and to keep the air inside, tools called trochars are poked into the belly and stay there throughout the procedure. However, most trochars are only a few inches long, and the standard ones are not big enough to penetrate your skin, fat, muscle and abdominal lining, so special - and yes, more expensive - trochars must be found. There are fewer large trochars in the supply room than regular ones, and if the last surgery was also done on an obese patient, you'll have to wait while they sterilize them for your surgery. If your hospital doesn't have larger trochars, the surgeon's job will be more difficult, because she'll have to push on them harder to be able to see what she needs to see, and the tubes will slip out of place frequently. Your surgery will be, by definition, more difficult than surgery performed on a normal weight person and you will have an increased risk of complications despite the doctors' best efforts.
ON THE FLOOR: DIFFICULT RECOVERY
Successfully out of the O.R. after having your appendix removed, you are sent to the surgical ward. Like every other patient, you are likely assigned to a team of nurses and nurse aides who work together to care for you. However, it will take twice the number of staff members to transfer you from the gurney to the bed, twice the number to turn you and provide your basic care needs. You may become frustrated by what you perceive as lack of response to your requests for toileting assistance and other needs, because the staff have to recruit other people away from their other duties to help them care for your concerns. In the best of circumstances, the staff will have access to special machines to lift you out of bed and to transport you, but more often than not, your movements will become part of an elaborate ritual of request, answer, wait for recruitment and difficult response.
You will be in the hospital longer, have more complications (such as diabetes, heart attack, pneumonia, bed sores and blood clots) and be more dissatisfied with your care than a person of normal weight. Your stay will have cost more, and more likely than not, the bill will be paid by the taxpayers.
OPINION: We need to do more to prevent obesity and to treat its causes. As we continue to work toward safe and compassionate care for patients of all ages, backgrounds and weight classes, we must include a discussion of the obesity problem as we debate the future of our healthcare system. And I will continue my efforts to harp on the benefits of healthy lifestyle for myself and my patients.
For more information or to suggest a subject for the blog, please visit my Facebook Page, "Dr. Rachel Franklin" and send me a message. Here's to a better life for us all!
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