Archive for October, 2009

BY GARY FRANK, M.D.

Medical Director, Quality and Medical Management, Children’s Healthcare of Atlanta

Drug reactions in children may be more common than you think. A recent study published in the journal Pediatrics revealed that more than half a million U.S. children see a doctor each year after experiencing a reaction to a medicine. While some of these reactions are severe enough to require medical treatment and hospitalization, the most common types of reactions are rashes and stomach upset. The study also showed that antibiotics are the most common type of medicine to cause a reaction resulting in a doctor visit.

Allergic reactions

If your child has known allergies it is especially important to read the label or ask your pharmacist about the medicine’s ingredients.

Allergic reactions can be serious, even life threatening. Call 911 or go to the nearest emergency department right away if your child shows any of these signs:

• Hives
• Swelling of the mouth, eyes or …

Continue reading DOCTOR IS IN: Know your child’s medicine »

BY PAULA SPENCER OF CARING.COM

Bereaved people often brace for the so-called stages of grief, only to discover their own grieving process unfolds differently. The stages of grief — popularized from earlier theories put forth by Elisabeth Kübler-Ross in her 1969 book On Death and Dying, and later modified by others — initially described responses to terminal illness: denial, anger, bargaining, depression, acceptance. While some find those responses relevant to coping with death, psychologists increasingly believe that the idea of “stages” oversimplifies a complex experience. And grieving survivors seem to agree.

“When we’re confronted with emotional chaos, we yearn for clarity, and the Kübler-Ross stages of grief serve as a kind of road map,” says Robert Neimeyer, a professor of psychology at the University of Memphis who studies grief. “But it’s more accurate to think about phases of adaptation rather than stages of grief. And they overlap rather than fall in sequence.”

No two …

Continue reading AGING & CARING: The new stages of grief — 5 tasks, no timeline »

BY CAROLYN O’NEIL

Was it something you ate?  Chances are that bout of indigestion or full-blown stomach cramps wasn’t caused by a “touch of the flu.” Food-borne illness caused by harmful bacteria or other pathogens is a common occurrence. Statistics reported by the Centers for Disease Control and Prevention estimate there’s 76 million cases of food-borne illness in the U.S. each year.

While no one knows how many of those cases were caused by restaurant foods, a CDC analysis of national food-borne outbreak surveillance data shows that 52 percent of outbreaks reported between 1998 and 2004 were associated with restaurants, delis, cafeterias and hotels. Of course the restaurant industry is all for reducing these numbers and has stepped up efforts to train employees in food safety. And with government sanitation inspection scores on display for customers to see, it’s good business to get good grades, “I wouldn’t eat anywhere with a sanitation score lower than an A,” says noted …

Continue reading HEALTHY EATING: Being safe while dining out »

Q: How effective is Tamiflu against this H1N1 influenza bug? Are there any risks to taking this drug preventively?

I am thinking of asking my doctor for a prescription since I will soon have to take a couple of airplane trips. I do not want to come down with the flu because the person next to me is coughing in my face.

A: It highly unlikely that your doctor would be willing to write a prescription for Tamiflu for a healthy person. Public health authorities are discouraging widespread use except for people at high risk of complications — young children, pregnant women, people with chronic conditions and the elderly. People who need hospitalization or those who develop pneumonia from the flu should also get antiviral medicine.

That said, Tamiflu remains quite effective for preventing as well as treating the type of flu circulating this year. It has not yet developed resistance to the drug. Side effects include nausea and vomiting. The Japanese have reported psychological side …

Continue reading PEOPLE’S PHARMACY: Tamiflu’s an effective flu fighter »

Q: Last year, you answered my question about air pollution and its effects on the athletes competing at the Beijing Olympics. Can you comment on a news story I just heard on how air pollution right here at home can increase our risk of heart attacks? –S.K., Philadelphia

A: The news story you heard are the findings of a University of Michigan study just published in the September issue of Hypertension.

The deleterious effects of air pollution on our lungs are well known; now researchers have shown that the microscopic particles in air pollution can get into the bloodstream, causing a rise in diastolic (resting heart) blood pressure and an impairment of endothelial function (critical factors that help arteries to relax or dilate to allow maximal blood flow).

Roughly one-third of Americans have high blood pressure, a known risk factor for stroke, heart attacks, congestive heart failure and chronic kidney disease. For those with underlying coronary artery or peripheral vascular …

Continue reading ASK DR. H: Bad air can increase risk of heart attack, stroke »

BY SHARMILA MAKHIJA, MD

Georgia Cancer Coalition Distinguished Cancer Scholar and Associate Professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, and Director of Gynecologic Oncology for Emory Healthcare and Emory Winship Cancer Institute

Ovarian cancer may not be the most common cancer in women, but it may be the most feared by women. Each year in the United States, about 21,550 women are diagnosed with ovarian cancer. It is the eighth most common cancer among women, and one for which there is no known cause. The estimate for new cases of ovarian cancer in the United States in 2009 is 21,550 and estimated deaths are14,600, according to the American Cancer Society.

Ovarian cancer forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell …

Continue reading DOCTOR IS IN: Understanding risks and symptoms in ovarian cancer »

BY PAULA SPENCER OF CARING.COM

If a parent or other family member has started to show signs of dementia or possible Alzheimer’s disease, you may feel overwhelmed and unable to figure out what to do. Your most important priority is to get a diagnosis. The earlier you can put a name to the problem, the easier it is to organize a care plan.

There’s no single test for Alzheimer’s disease or most other dementias. In fact, a definitive diagnosis can only be made after death, by examining brain tissue for telltale changes. But doctors can make a probable diagnosis of Alzheimer’s with as much as 90 percent certainty. Start here:

1. Create a record

It’s almost always family members, more than physicians, who spot the first signs of Alzheimer’s disease. Start by writing down observations that you and others make of the person you’re concerned about. You’ll be better able to notice patterns or changes in the frequency of certain behaviors than if you keep a mental record. This evidence …

Continue reading AGING & CARING: Six steps to diagnosing Alzheimer’s »

BY CAROLYN O’NEIL

You don’t have to be a vegetarian to eat like one. The health benefits of eating a plant-based cuisine may be the main motivation, but taste buds are rewarded, too, with dishes such as eggplant torta with goat cheese or Acapulco chili with kidney beans and cannellini beans topped with fresh chives over steamed brown rice.

“The big surprise when we introduced the new vegetarian menus was the number of nonvegetarians who signed up to receive the meals,” said Elston Collins of Good Measure Meals (www.goodmeasuremeals
.com), an Atlanta-based company that provides fresh gourmet meal plans that are calorie-controlled and nutritionally balanced.

Customer demand for vegetarian meals prompted the company — which donates all profits to Open Hand, a nutrition program for senior citizens and the chronically ill — to hold focus groups to find out what was important to vegetarians and to start testing recipes to fit nutritional guidelines. Vegetarian menus for breakfast, …

Continue reading HEALTHY EATING: Meal plan adds vegetarian menu »

Q: I’m a 35-year-old mother not interested in having any more children. I don’t want to use an IUD or take birth control pills. My husband does not want to have a vasectomy. I saw my ob-gyn last week and she mentioned a new procedure called Essure that she says is much easier to do than a tubal [ligation] and can be done right in her office. I didn’t think to ask her how effective it is compared with a tubal [ligation]. Do you recommend the Essure procedure? — T.M., Marietta

A: Essure was approved by the Food and Drug Administration in late 2002 as a minimally invasive way of performing permanent, nonreversible female sterilization. Unlike a tubal ligation, it does not require general anesthesia and can be performed in your doctor’s office.

The technique is rather simple: Thin, flexible metal inserts are placed into the fallopian tubes using a catheter. Once these inserts are in place, they induce tissue to grow in and around the micro-insert to form a permanent barrier that …

Continue reading ASK DR. H: Essure is a minimally invasive form of birth control »

Q: When directions for medicine say take with food, do I take it before I eat anything, at midmeal or following the meal?

A: Unless there are instructions to the contrary (such as “take 30 minutes before eating”), a medicine to be taken with food can be taken at any point in the meal. The idea is to reduce stomach irritation and, for some drugs, improve absorption.

Joe Graedon is a pharmacologist and Teresa Graedon is an expert in medical anthropology and nutrition. They can be reached at peoplespharmacy@gmail.com.

Continue reading PEOPLE’S PHARMACY: When instructions say ‘take with food’ »