MCN | Medical Consultants Network

The Power of a Second Look

Home / MCNTalk / Tag: Lifestyle and habits

Viewing items tagged:

Lifestyle and habits

Sixteen years into the vaccination/autism myth

In 1998 Andrew Wakefield published a paper claiming a link between the measles-mumps-rubella (MMR) vaccination and autism – reporting on a total of eight children who developed symptoms of autism within a month of receiving the vaccine.

In the past sixteen years there have been multiple studies – at least 14 worldwide – and books published debunking the paper, which was initially rejected by four of the six reviewers who were asked to judge it. And yet the myth continues to have tragic effects worldwide as more deaths are reported from outbreaks of preventable these diseases here in the United States and abroad. Why? In part thanks to celebrities like Jenny McCarthy, actress, Playboy centerfold, co-host of The View, and since 2005 anti-vaccine activist. Read more…

How Doctors Rate Patients: What’s Your Activation Level?

More hospitals, health plans and employers are scoring patients on how engaged they will be in their care using an assessment called the Patient Activation Measure, or PAM. Scores make it easier to customize information, coaching and other interventions.

The aim is for patients, rather than feel overwhelmed by instructions, to become confident that they can change their own behavior.

Another aim: To reduce costs incurred through additional patient visits. Hospitals are using PAM to tailor support they give patients at discharge to avoid readmissions. Patients with low activation scores have nearly twice the risk of 30-day post-discharge hospital admission as patients with higher activation, according to a study last fall in the Journal of General Internal Medicine.

PeaceHealth, of Vancouver, Wash., used PAM at a primary-care practice in Eugene, Ore., and found over 18 months a 42% decline in average quarterly emergency and urgent-care visits. Read more…

Smoking Proves Hard to Shake Among the Poor

 

This article provides a stark description of the socioeconomic aspects of smoking and nicotine addiction. While rates of smoking in the US has plummeted, the actual rate varies widely by socioeconomic levels. The majority of today’s smokers took up the habit after the dangers of tobacco use were clear, and warning abounded. A choice for some became an addiction, as well as an expensive habit. Even at the $5.00 per pack cited in the article as the price in Clay County, this adds up to $150.00 per month for a pack a day smoker – a considerable expense for those with limited income and prospects.

A Preview of “Life, Animated” by Ron Suskind

This Sunday’s New York Times Magazine published an except of Life, Animated: A Story of Sidekicks, Heroes, and Autism, by Ron Suskind, a Pulitzer-Prize winning journalist with the Wall Street Journal. And father of Owen, who at age 3 was diagnosed with regressive autism.

The excerpt is beautifully written and moving, and provides a candid, eloquent glimpse into the twenty-year struggle of one family to communicate — through Disney characters, movies, and their themes — with their son. Well worth the read, as are the on-line comments.

Toes are Overrated (and other Post-Plague Observations)

“You’ve got to play the hand you’re dealt,” says Paul Gaylord. This doesn’t sound like a loaded remark, but it is when coming from a man whose hands were, literally, dealt quite a blow; after a bout with bubonic plague he lost eight fingers (and all of his toes, and nearly his life — his recovery came after doctors had discussed with his wife when to remove him from life support after his 27th day in a coma).

MCN processes a lot of reports related to disability claims. As we address questions of causality and medical improvement, it’s important to remember that each claim is not just a report, but that it represents a person, and human suffering, and is also just a very small glimpse into a person’s life. This article is striking in its outlook, and a refreshing reminder not to confuse a misfortune in a life with an unfortunate life. Certainly Gaylord doesn’t.

“I say I’m actually a 1-year-old because I got a second chance at life,” he said. “I can do almost anything I could do before.”

Undoubtedly Gaylord has struggled immeasurably with recovery and adjusting to his new body and all that he had to learn how to do differently. But as the article notes, the Gaylords have a sense of humor about the whole thing, and Debbie Gaylord said her husband has always had a positive outlook about it.

There are numerous studies which show that an injured or sick person’s outlook and attitude are major components not just of how well they will recover but whether they will recover at all. But a study, like a report, is not a human life; and sometimes it is from that individual life that we learn. Certainly there is something to learn from Paul Gaylord and what he has chosen to share with us: that a disability or an illness does not mean that life stops. “Toes are overrated,” Gaylord said. “And I can do a whole lot with just these thumbs.”

More News on Childhood Obesity

Occasionally my mother comments on my daughter’s weight, which strikes me as out of line since my daughter is only four years old. I don’t want to her to start having body image worries. Aside from the fact that both my daughter and her brother are on the thin side (note that my mother never comments on my son’s weight),  my mother might just (inadvertently) have a point.

For many obese adults, the die was cast by the time they were 5 years old. A major new study of more than 7,000 children has found that a third of children who were overweight in kindergarten were obese by eighth grade. And almost every child who was very obese remained that way.

Some obese or overweight kindergartners lost their excess weight, and some children of normal weight got fat over the years. But every year, the chances that a child would slide into or out of being overweight or obese diminished. By age 11, there were few additional changes: Those who were obese or overweight stayed that way, and those whose weight was normal did not become fat.

“The main message is that obesity is established very early in life, and that it basically tracks through adolescence to adulthood,” said Ruth Loos, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study.

Read more…

Spike in Harm to Liver Is Tied to Dietary Aids

This past November we blogged about herbal/dietary supplements and asked, “and is it a problem?” The answer to this question is clearly a resounding “yes.” According to this recent article in The New York Times, dietary supplements now account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from just 7 percent a decade ago.

Americans spend an estimated $32 billion on dietary supplements every year, attracted by unproven claims that various pills and powders will help them lose weight, build muscle and fight off everything from colds to chronic illnesses. About half of Americans use dietary supplements, and most of them take more than one product at a time. Read more…

Secret to Winning a Nobel Prize? Eat More Chocolate!

The 2013 Nobel prizes were awarded in October, but as this is the time of year when many of us are surrounded by treats — holiday gifts and celebration goodies — we thought we’d ease a little guilt on holiday consumption and maybe add a little perspective to common New Year’s resolutions.

Why would the sweet treat be linked to winning the most prestigious intellectual award, you ask? In the New England Journal of Medicine, Dr. Franz H. Messerli, a cardiologist at St. Luke’s–Roosevelt Hospital in New York City, writes that cocoa contains flavanols, plant-based compounds that previous studies have linked to the slowing or reversing of age-related cognitive decline. (You can also get flavonols in green tea, red wine and some fruits.) Read more…
Read

Dogs on a Plane

Last month, to the consternation of a few readers, we blogged about emotional support pets, citing an article in The New York Times which noted pushback against pets riding for free on planes with no systematic standards as to what constitutes emotional support and medical necessity.

Psychiatrist Dinah Miller, who has been in the position of reviewing such use, chimes in to discuss the criteria involved and her thought process:

Like most things, defining the lines of what it is to “need” an animal on a flight and what training should be required for “support” pets won’t be a problem until someone is bitten or distressed, or until a passenger announces they must bring their emotional support snake aboard a flight where someone has a phobia. In the meantime, I’ll contend that I like seeing an occasional cute dog on planes, but this isn’t a psychiatric issue.

Nelson Mandela – the passing of a truly great man of the ages

by Brian L. Grant, MD

I don’t make a habit of sharing views on world events with the company. But the passing of Nelson Mandela has deeply moved me and compels me to write.

I believe that Mandela is the greatest and most impactful statesman and leader in my lifetime to date and I believe in yours. I was born in 1952, a few years after the death of Gandhi, who might have been a rival for this distinction, from whom Mandela learned a great deal, and who by chance or not, spent his formative years in South Africa as well.

His memorial in several days will be a major world event, attended I am sure, by most significant world leaders and many more. I will watch it in his honor and as an observer of a major piece of world history. You should as well. His life deserves study and familiarity by all. Perhaps this note might cause a few of you to learn more about him.

I was a boy in the civil rights era, and had one memorable experience when driving with my family from Detroit to Florida, of stopping in a southern town for gas and seeing segregated bathrooms and drinking fountains. I will never forget it. Growing up in Detroit, I was also well aware of the de-facto segregation of much of the community, and the prominence of race in our lives, though it was unofficial rather than the official policy of many areas of the country until the 60’s. I recall my city burning in 1967 during the famous race riots.

The system of apartheid that Mandela confronted in South Africa was profound and all-encompassing for everyone there, regardless of color, but the deprivations were great for the black majority.

I hope that you will take the time to learn about Mandela, in the many tributes, news coverage and articles on him. Here is The New York Times Coverage. And President Obama’s statement was meaningful and moving to me.

I have had the privilege of 3 visits to South Africa in recent years, first with my son when he graduated high school – taking a long drive from Johannesburg to Cape Town, and seeing some great wildlife along the way. Then I returned twice when my daughter and her family lived there for two years until this past June, working as teachers. It is a vibrant and modern country that really changed my stereotypes of Africa. It has been remade socially and economically since the end of Apartheid, largely flowing from the work of Mandela.

He, his party, and the black majority of that country could have easily justified revenge for the deprivations, abuses and deaths flowing from the years of white minority rule. Many would have died in violent retribution or spent decades in prison. The whites would have fled and the country could easily have been more like Zimbabwe, the country next door with a dictator, and a history of oppression and economic failure following its “liberation” from white colonialism. In my trips to South Africa I see a proud place of 50 million or so people, many ethnicities, 10 or so official languages, and a love of human rights. Far from perfect, and in need of more economic gains for the many poor there, it is still the jewel of Africa, a vibrant democracy and an example in so many ways to others who may be cynical about the capacity of people and nations to change.

But where Mandela has made his mark on the world and on me is not only as a statesman and national leader, but in showing individuals that there are different and effective ways to deal with conflict and with one’s enemies that do not involve revenge and violence. His concept of reconciliation through truth and justice (http://en.wikipedia.org/wiki/Truth_and_Reconciliation_Commission_(South_Africa) ) is revolutionary and could and should be studied and imitated in every conflict or potential conflict. He basically embraced his enemies and showed a new path. He has inspired me in small ways to consider and adopt alternatives to anger and revenge in the face of the various mishaps, real or perceived abuses that one faces in life. Adversaries are best treated with respect, and hate – a very costly emotion, should be used sparingly if at all. Hatred destroys the hater more than the person who is the object of hate. When one moves on from difficult or destructive people with neutrality, indifference, or even a form of love and humanity, it elevates us to something better than we were before. Mandela’s legacy has been adopted by families of and victims of violence including murder, who have engaged in reconciliation with the wrongdoer. This is not an act of stupidity or pity, but one of self-respect and preservation for people whose lives could otherwise be destroyed.

His 27 years in prison on Robben Island and the humanity he practiced with his guards and fellow inmates is an inspiration. And the struggles that he, his people and so many others in the world have endured and are enduring as this is written should bring pause to any of us who may complain about our lives.

Thank you Madiba for changing the world. Your passing, while anticipated for some time, will allow the world for a moment or more to think about other possibilities that you have demonstrated are real.