Category Archives: on Learning

Post addressing issues in health and science literacy

Have You Checked Your Neck?

January is Thyroid Awareness Month

It’s midway through the first month of the new year and I have one powerful question for you…Where do you stand with your New Year’s Resolution(s)? Truth be told, many of us resolve at the beginning of the year to eat right, exercise and generally take better care of ourselves. Unfortunately, the challenges to truly changing behavior results in abandoned resolution.

My purpose is to have you stop for a moment and examine your situation. Consider your thyroid before proceeding or resuming your personal health improvement plans. Why? you ask. Because the thyroid is responsible for a myriad of functions within our bodies and when your thyroid isn’t working properly, then neither are you.

What You Should Know

  1. Thyroid disorders are more commonly found in women.
  2. Thyroid disorders tend to run in families.
  3. Fatigue is a common complaint for under and overactive thyroid conditions.
  4. Many symptoms such as weight gain, forgetfulness, anxiety/nervousness and insomnia are not specific to Thyroid disorders.

What You Can Do

During you regular annual exam with your physician, discuss you concern about the way your thyroid gland is functioning.  Ask your physician if s/he believes measuring your TSH levels is indicated.  Generally the presence of any of the following support TSH screening:

  1. Type 1 diabetes, or pernicious [per-NISH-ous] anemia
  2. A first-degree relative with autoimmune thyroid disease
  3. A history of neck radiation of the thyroid gland
  4. A prior history of thyroid surgery or dysfunction
  5. An abnormal thyroid examination
  6. A psychiatric disorder(s)
  7. Prescription medicines that may affect the function of your thyroid
  8. An elevated cholesterol level
Sources:
D. Cheung, MD.  Thyroid Gland: Too Slow or Too Fast? at http://www.empoweryourhealth.org/issue-1/Thyroid-gland accessed January 15, 2012.
J. Garber, MD.  When You Should Know Your TSH Level at http://www.empoweryourhealth.org/issue-1/When-You-Should-Know-Your-TSH-Level accessed January 15, 2012.

10 Diabetes Myths Demystified

Logo for the World Diabetes Day

Image via Wikipedia

From the time I was quite young, I remember being aware that my cousin, Esther was a little different. She had (Type 1) diabetes. Early on, I simply understood this as “cousin Esther has to give herself shots…Wow, isn’t she brave!” Often, when we gathered for holiday dinners, she would ask my mother if she remembered to make unsweetened ice tea. To those of you who are not from the South, it may come as a surprise but all ice tea in a southern home contains sugar and sometimes lots of it. That is the very definition of ice tea. But I digress. Because of my cousin, I was made aware of just how serious an illness diabetes was.

Later during graduate school, I became frustrated to learn that a lot of the research into successful treatments for diabetes was not finding its way from the labs of NIH and the CDC into the practices of primary care physicians across the country (or the world for that matter). So I pursued an independent research project to develop a brief questionnaire to measure health-related quality of life in diabetics. I thank Esther. Her life-long challenges with diabetes and her discipline to manage her illness kept me educated and empathetic.

Unfortunately, as diabetes (especially Type 2) continues to increase in prevalence worldwide, a number of myths surrounding this chronic illness continue to persist. The following were found by the American Diabetes Association to be the most persistent.

  1. Myth: Diabetes is not that serious of a disease.  Fact: Diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke.
  2. Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.  Fact: Being overweight is a risk factor for developing this disease, but other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.
  3. Myth: Eating too much sugar causes diabetes.  Fact: No, it does not. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors. Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories, whether from sugar or from fat, can contribute to weight gain. If you have a history of diabetes in your family, eating a healthy meal plan and regular exercise are recommended to manage your weight.
  4. Myth: People with diabetes should eat special diabetic foods.  Fact: A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone – low in fat (especially saturated and trans fat), moderate in salt and sugar, with meals based on whole grain foods, vegetables and fruit. Diabetic and “dietetic” foods generally offer no special benefit. Most of them still raise blood glucose levels, are usually more expensive, and can also have a laxative effect if they contain sugar alcohols.
  5. Myth: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.  Fact: Starchy foods are part of a healthy meal plan. What is important is the portion size. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. The key is portions. For most people with diabetes, having 3-4 servings of carbohydrate-containing foods is about right. Whole grain starchy foods are also a good source of fiber, which helps keep your gut healthy.
  6. Myth: People with diabetes can’t eat sweets or chocolate. Fact: If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more “off limits” to people with diabetes than they are to people without diabetes.
  7. Myth: You can catch diabetes from someone else. Fact: No. Although we don’t know exactly why some people develop diabetes, we know diabetes is not contagious. It can’t be caught like a cold or flu. There seems to be some genetic link in diabetes, particularly type 2 diabetes. Lifestyle factors also play a part.
  8. Myth: People with diabetes are more likely to get colds and other illnesses. Fact: You are no more likely to get a cold or another illness if you have diabetes. However, people with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who do get the flu are more likely than others to go on to develop serious complications.
  9. Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly. Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.
  10. Myth: Fruit is a healthy food. Therefore, it is ok to eat as much of it as you wish. Fact: Fruit is a healthy food. It contains fiber and lots of vitamins and minerals. Because fruits contain carbohydrates, they need to be included in your meal plan. Talk to your dietitian about the amount, frequency and types of fruits you should eat.

Every chronic disease requires vigilant and disciplined self care but diabetes happens to be one of the most powerful examples of this fact.  Our lifestyle choices have a powerful impact on our health.  Diabetes continues to remind us of this fact.  If you are diabetic share with us some of your self care routine. Happy World Diabetes Day to all.

Are you an ePatient?

Tech Term Tuesday.  Yesterday, I had the pleasure of attending SXSH: Sharing. Exchanging. SocialHealth. A summit of professionals from a diverse cross section of disciplines coming together with patient advocates to understand and better utilize the tools of social media for advancing healthcare and wellness. One of the keynote speakers was Dave deBronkart, a cancer survivor, patient advocate and blogger who is known in the webosphere as “ePatient Dave.” His formal presentation was then followed by a more informal (unconference, if you will) breakout discussion facilitated by two talented patient bloggers, Jenni Prokopy and Kerri Sparling. The session quickly evolved into a lively discussion and good-natured debate on what it means to be an ePatient and how physician-patient communication can be improved. This all raised the very obvious question in my head, “Exactly, what is an ePatient?” According to Dave deBronkart, the late Dr. Tom Ferguson “said e-patients are empowered, engaged, equipped and enabled.”

ePatients are active and participatory where traditional patients are passive. Image by jscreationzs.

After my day at SXSH and perusing searches of #SXSH and #ePatient on Twitter, I’d like to add my own take on the definition of ePatient. It’s a  double entendre that refers to electronic patients (or patients in the webosphere) but it also refers to empowered patients. Patients who, through their education and engagement in communities of patients both online and in the real world are empowered to take an active and participatory role in their healthcare.  I would therefore refine Dr. Ferguson’s definition— e-patients are educated, empowered and engaged. The key here is education. What are you doing to educate yourself so that you can be an active participant in your healthcare? If you need help getting started, refer to any of the health guides on this site.

Why does the herd have immunity?

Tech Term Tuesday.  When a significant proportion of a community (or herd) is immune to a contagious disease through prior illness or immunization, the remaining members of that community (such as newborns, the chronically ill, the elderly and those otherwise not immunized) also receive some level of protection. This is because the likelihood of coming in contact with an infected individual has been substantially decreased.

History and Epidemiology of Global Smallpox Eradication. From the training course titled "Smallpox: Disease, Prevention, and Intervention". The CDC and the World Health Organization. Slide 16.

Herd immunity begins to fail when immunization rates in the community fall below critical thresholds and the community is exposed to new members who are infected (such is the case with individuals travelling from international regions with a high incidence of vaccine-preventable illnesses). As a result, the choices of individuals can harm the broader community.

Sources: CDC Online Glossary and Merriam-Webster Medical Dictionary

Learn More: Herd Immunity Animation at The History of Vaccines website

Alonzo Mourning Wants You to Become An Organ Donor

Howard University Hospital located at 2041 Geo...

Image of Howard University Hospital via Wikipedia

This is the 15th observance of National Minority Organ Donor Awareness Day. An event founded by noted transplant surgeon Dr. Clive Callender of Howard University Hospital. Despite this national effort to raise awareness around the number of minorities who disproportionately suffer from end-stage organ failure, the need continues to rise. Watch the video below featuring kidney transplant recipient, Alonzo Mourning discussing this issue. Then go to organdonor.gov to find your state’s online donor registry.

5 Barriers to Minority Organ Donation

National Minority Donor Awareness Day is celebrated annually on the 1st of August. MOTTEP, the Minority Organ Tissue and Transplant Education Program created this observance day in 1996 to focus on education and increasing minority organ donors. In this video, How Do You Say Thank You? African American donor families and recipients tell their poignant and inspiring stories about organ donation.

There are five barriers commonly cited by minorities as their reasons for not volunteering to be an organ donor.

  1. Lack of Information and Awareness. Many minorities may not realize that of the more than 100,000 people on the UNOS Wait List, more than half (51%) are minority. Minorities, in particular African-Americans disproportionately suffer from hypertension and diabetes which can and often does progress to end-stage renal failure. Of the 27% of African Americans on the UNOS Wait List, the majority awaits a kidney.
  2. Religious Myths or Misrepresentations. Many minorities believe that their religion may prohibit organ donation or that it will not be possible to have an open-casket funeral service. The truth of the matter is that all major organized religions approve of organ and tissue donation because it is an act of charity. Removal of organs is done through a non-disfiguring surgery that does not change the appearance of the body for an open-casket funeral service.
  3. General Distrust of Healthcare Providers. (see Fear)
  4. Fear. Many minorities fear that they will be declared dead prematurely, that every medical intervention will not be pursued if they are organ donors. This is simply not true. Hospitals must follow any advanced directives have in place. Additionally, an increasing number of states have developed strict laws and protocols for declaring brain death and how to proceed.
  5. Racism in the Healthcare System. Often minorities believe that all donated organs go to white patients. Truthfully, the UNOS match system is designed so that the recipient with the greatest biological compatibility for the organ receives that organ. Studies reveal that the best matches often occur between individuals of the same racial/ethnic group.

Organ donation is an incredible act of charity. A single donor can extend the lives of 5 individuals with their organs alone and many more if they also choose to donate tissue as well. It is the ultimate gift—the gift of life. Another inspirational story of organ donation is shared in the book III Gifts. Check it out or share your own story about organ donation by leaving a comment.