Category Archives: on Prevention

Post examining the standard of care as it relates to keeping disease at bay

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.

Got the Blues? Get Screened Online to Be Sure It’s Not Something More Serious

Got the blues? or is it depression?

Ever feel like you are the only one who is sad in a world of happy people? Everyone experiences stress, sadness and anxiety from time to time – it’s part of life. These feelings often happen when you a lose a job, children move away from home, during divorce, with a death in the family, or during retirement. But when changes in mood and behavior interfere with your ability to work, sleep, eat, and enjoy once pleasurable activities, it could be a sign of depression.

Different Kinds of Depression

There are many names for the different kinds of depression. People with recurrent episodes of major depression are sometimes said to have unipolar depression (or what used to be called “clinical depression”), because they only experience periods of low, or depressed mood. Those living with chronic, low-grade depression have what is called dysthymia. When people experience both dysthymia and major depression, they are sometimes said to have double depression.  Mood disorder symptoms also can arise after giving birth (postpartum depression) and they can sometimes be accompanied by psychosis (psychotic depression). Still others who experience a depressed mood during the fall and winter seasons are said to have seasonal affective disorder, SAD.

YOU ARE Not Alone

Research conducted by NMIncite shows that Depression and other mental illnesses are the most discussed health conditions online.

get screened and learn more

Today is National Depression Screening Day (NDSD).   The perfect opportunity to take a free, anonymous questionnaire assessing your risk for mood and anxiety disorders and provides referral information for treatment.  Got the blues? or is it depression.  Take the first steps towards finding out. Visit www.HelpYourSelfHelpOthers.org to find a local organization offering depression and anxiety screenings or take a screening online today.

Disaster Preparedness: Were You Ready?

Last week was pretty trying for those of us living here in the nation’s capitol.  We were literally shaken with fear shaken with fear Tuesday when we experienced the first major earthquake on the east coast in more than 100 years. It measured a noticeable 5.8 on the Richter scale.  As a novice to earthquakes, having lived on the east coast all of my life.  I must say those were the longest 15 seconds I’ve experienced.  We were still assessing structural damage of the National Cathedral and other buildings and infrastructure when the hurricane, Irene in the Caribbean was establishing a clear path up the Atlantic coast. Threatening to make landfall by Friday.

Although Irene was a category 1 hurricane, the expanse of the storm was extremely wide.  While here in DC, we were spared a lot of the flooding suffered by those in NC, New York, and New England, there are still thousands here waiting to have their power restored.  This all begs the very obvious question: WERE YOU READY?  enBloom has compiled a list of resources and steps you want to take to ensure you and your family are prepared in the face of any disaster.

We were blessed in DC that neither natural disaster was as severe as it could have been.  In the case of the hurricane several preventive measures taken by the local and federal governments also served to minimize a disastrous outcome.  Hurricane season is well underway, go ahead and prepare now so your answer is YES! I’M READY when the next natural disaster poses a threat.


MDs Retool for Vaccine Safety Debate

H. Fred Clark and Paul Offit, the inventors of...

H. Fred Clark (l) and Paul Offit (r). Image via Wikipedia

Last month, the National Medical Association convened their Annual Convention and Scientific Assembly in Washington, DC.  In a special Pediatrics Immunization Update, Daniel Salmon, PhD, MPH and Paul Offit, MD presented to physicians and health care providers about current issues in pediatric immunization and managing parental concerns regarding their safety.  This was a timely presentation.  During August, pediatricians see many patients who are preparing to go to school for the first time and their parents who have many questions and concerns.

Sources of Misinformation

Dr. Offit who serves as the Director of the Vaccine Education Center and Chief of the division of infectious diseases at the Children’s Hospital of Philadelphia explained that an increase in parents  refusing to immunize their children correlates strongly with the publication in the medical journal, Lancet of a paper by Andrew Wakefield posing a hypothesis for a link between autism and the MMR (measles-mumps-rubella) combined vaccine.  Though the study has been disproven many times over and a recent British Medical Journal (Jan 5, 2011) editorial characterized Dr. Wakefield’s work as “an elaborate fraud,” parental fear and distrust surrounding the medical need for the standard schedule of childhood immunizations continues to persist.

The Current Challenge

Dr. Salmon who is the Director of Vaccine Safety at the National Vaccine Program Office of the Department of Health and Human Services presented statistics that underscored the immunization refusal trends.  In some counties throughout the country, as many as 25% of appropriately aged children have not been immunized.  On average, however, only about 10% of parents have delayed or refused one or more of the recommended immunizations for their child(ren).  Every state allows exemptions to its laws for medical, religious, or philosophic reasons.  But when you combine these facts with the pervasiveness of unproven or unsubstantiated health information available on the internet, the low health and science literacy of many parents, and poor communication between parents/patients and physicians, it becomes easier to understand how myths and misinformation around childhood immunizations persists.  A dangerous result can be an increase in immunization exemptions to the point where communities can become particularly vulnerable.  When immunization in a community falls below critical thresholds, herd immunity ceases to exist.  There is direct overlap between low prevalence of immunization communities and outbreaks of certain vaccine-preventable disease, such as pertussis (whooping cough).  This was featured in detail in the PBS Frontline broadcast The Vaccine War that we discussed in a previous blog post.

Fear of overloading the immune system, a belief that vaccine-preventable diseases are not dangerous or their children simply are not at risk for contracting the illness are all among reasons why parents refuse to immunize their children.  “We may practice evidence-based medicine, but most parents are motivated by anecdotes,”  Dr. Salmon continues, “It’s important to try to understand the parents’ concerns and what influences them.”

What can be done?

It is imperative that physicians take the time to have productive conversations with their patients (and their patients’ parents).  Providing accounts of patients who were saved because of vaccinations or describing the suffering and complications caused by vaccine-preventable illnesses may prove to be more persuasive and meaningful to concerned parents.  If you are a concerned parent and want to have a meaningful conversation with your child’s pediatrician, consult the Screening Guide for Child and Teen Immunizations on the health guides page before your next appointment.

Read more:

Paulsen, Emily.  Parental Fears Over Childhood Vaccination Must Be Addressed. Medscape Medical News at Medscape.com.

Are We Safe from Vaccine-Preventable Illnesses?

None - This image is in the public domain and ...

Image via Wikipedia

First Friday in First Person.  Imagine having your newborn baby, just over a month old begin suffering from what appears to be a cold with a persistent cough. The situation persists. Over a period of two weeks and several visits to the pediatrician the best diagnosis you receive is the croup or a virus. No remedies resolve the situation and your young daughter is not getting better. This is what happened to Alvaro and Myriam Fontan’s daughter Vanessa. They shared their ordeal in an April 2010 interview in The Vaccine War (a PBS Frontline production). During one particularly severe crisis, young Vanessa stopped breathing and turned blue.

In the emergency call to the doctor, Alvaro exclaimed, ”Tell me that this is normal. I mean, she’s turning blue.”

At the doctor’s advice, the Fontans rushed to the nearby emergency room but it was not equipped to handle pediatric patients so an ambulance had to transfer Vanessa to a children’s hospital where Dr. Cynthia Cristofani was on duty. Immediately she diagnosed the Fontan baby with Pertussis, commonly known as whooping cough. Finally, the Fontans received a diagnosis which had until now eluded them. This is probably because younger physicians are not coming across many vaccine-preventable illnesses during their training or practice. For Vanessa, there remained a long steady road to recovery, after spending nearly a week in the pediatric intensive care unit and another two months suffering through less severe crises as the antibiotics took effect and managed the bacterial infection.

What is Whooping Cough?


Cynthia Cristofani, MD the pediatric critical care physician in Portland, Oregan that treated Vanessa Fontan describes whooping cough. “Whooping cough is a particularly miserable disease. You cough and you cough and cough, and you cannot stop. Eventually you manage to inhale a little air, and that’s the whoop. And if you don’t inhale any air, you may pass out. If you do, you’re likely to make the noise of the whoop and throw up, and then a few hours later or even an hour later you do it all over again. These spells happen many, many times a day, and they’ll also wake you up in the middle of the night. So these people are sleep-deprived, miserable. They never know when the next attack is going to get them. Just the mechanics of the cough will hurt. Adults get rib fractures. It takes a pretty brutal cough to break your ribs. Little kids will get hernias; they’ll get rectal prolapse; they’ll get bleeding around the eye; occasionally they get bleeding in their skull; they’ll bite their tongues. They do all kinds of damage just from the mechanics of the cough, never mind the fact that these people are suffocating and miserable. In the [developing world], this is a huge killer. Somewhere between 200,000 and 400,000 people die a year. In [developed countries], most people don’t die of it, with the exception of very young infants. People who have had no immunizations at all have very poor immune defenses. This is where most of the reported mortality in the United States happens.”

How did Vanessa Get Whooping Cough?


Vanessa was 40 days old when she was diagnosed with whooping cough. According to the immunization schedule of the time, she was too young to have received the vaccination. This left her dependent on the herd immunity that prevents many infectious diseases from attacking communities. Unfortunately, the original childhood immunization for Pertussis did not provide patients of that time with lifelong immunity. This may have played a significant role in the way in which Vanessa became infected. The Centers for Disease Control and Prevention investigation ultimately traced the whooping cough to a student who attended high school with Vanessa’s brother.

Although, vaccine-preventable illness occurs less often in the United States, it does not make these infectious diseases less dangerous. This is particularly true for the youngest and the oldest members of our community who have less robust immune system. Use our page of health guides to check the immunization schedules for 2011.

Learn more:  The Vaccine War on Frontline website at www.pbs.org and The Vaccine War Transcript

5 Topics in Men’s Health

June is Men’s Health Month.  The month when fathers and surrogate fathers are recognized for all that they do is also an ideal time to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys.  After all, the most powerful thing any father can do is maintain good health so that they will have many more Father’s Days to share with their family.  Follow these links below to articles we’ve previously posted on enBloom that are relvent to the health of men and boys.

5 Risk Factors for Colorectal Cancer

Do Race and Ethnicity Affect Cancer Risk?

Do You Have Type II Diabetes?

I’m Not Gonna Need ‘Em When I’m Dead

Doctors Appreciate the Active & Informed Patient

Learn More:  Men’s Health Network and the Blueprint for Men’s Health