vendredi 30 décembre 2016
As both a patient and physician, Dr. Marlene Beggelman wondered: Why didn’t my doctors recognize the side effect? Why didn't they choose a safer drug? Why didn’t I do my homework before agreeing to this medication?
jeudi 29 décembre 2016
From scrubs outside the hospital to Vitamin K for babies to the man who embodies the antidote for bummer weight loss news, here are CommonHealth's 10 most clicked-on stories of the year.
Year In Review: Opioid Death Rate Continues To Climb, Officials Strengthen Prevention And Treatment Efforts
The latest numbers from the state indicate that in 2016 almost five people a day died in Massachusetts because of an opioid overdose.
mercredi 28 décembre 2016
Dr. Annie Brewster spoke with Daniel, who was molested by a teacher in middle school. She writes: "He is a survivor of trauma, and so much more. No one part defines him. In this acceptance, he is whole."
mardi 27 décembre 2016
"We estimated that if families didn't provide this care, it would cost between $11.9 billion and $35 billion per year to have others come into the home to provide that care," says senior author Dr. Mark Schuster, of Boston Children's Hospital and Harvard Medical School.
vendredi 23 décembre 2016
If you want to get yourself to exercise more in 2017, "The Magic Pill" podcast highlights a cutting edge of exercise motivation science: It's all about shifting your mindset from seeing exercise as a chore and a pain, to seeing it as a gift, a treat, even a joy.
2016 was another turbulent year for Joey. He overdosed for an eighth time. He entered detox. He relapsed. Through it all, Joey, the survivor, remains optimistic.
jeudi 22 décembre 2016
"No one ever said we had to be in complete agreement to enjoy each other’s company," write two child psychiatrists. "Divided houses are not easy to mend. A divided country is even harder. But all politics are local. "
mardi 20 décembre 2016
A growing percentage of home health care workers and nursing assistants in Massachusetts are foreign-born, and that reliance on immigrant labor for health care is only expected to increase.
lundi 19 décembre 2016
Says the study's senior author: "Despite that backdrop of lower salaries and less academic promotion, we're finding that not only are women physicians just as good, in fact we're finding that they're a little bit better."
vendredi 16 décembre 2016
Next year, you may notice that your young doctor looks even more sleep-deprived than usual -- if the council that oversees American medical residencies approves a proposal allowing first-year residents to work 28 hours in a row, instead of the current limit of 16.
From Angelina Jolie to Ben Stiller to John Wayne to Michael Douglas, celebrity cancer revelations can be a double-edged sword, an expert says: They inform the public, but without expert insights, they can promote wrong ideas.
We go to the state's largest town to find out how heroin and fentanyl end up in the hands of users, and how police battle the problem.
jeudi 15 décembre 2016
It doesn't appear that the spike in the number of women tested for BRCA gene mutations led to more detection. The rate of women who had the test and then a mastectomy declined.
lundi 12 décembre 2016
A study finds that just about one-fifth of people cost "the lion's share" of public money, from welfare benefits to hospital stays, and most showed signs of brain trouble even at age 3.
vendredi 9 décembre 2016
An ethicist and father whose daughter could have been killed by contaminated heparin worries that, while the 21st Century Cures Act could indeed lead to new cures, it could also compromise the FDA's protection of patients.
Featuring larger-than-life photographs with personal stories of people struggling with mental illness, the exhibit is designed to shed light on a topic often kept in the dark.
jeudi 8 décembre 2016
Listen to "Radio Boston" and "Radiolab" explore the wild finding that light flickering at a specific frequency could help fend off Alzheimer's -- in mice, at least.
CommonHealth honors the memory of Marie Colantoni Pechet, who wrote beautifully about life with cancer -- and just life -- in posts that were a privilege to publish.
mardi 6 décembre 2016
"Working in a community health center in Lynn, which, like many small New England cities, is ravaged by the opioid crisis, I have not met a single primary care provider who has decided to start opioids for a patient. Rather, we are dealing with the 'inherited' pain patient, who has been prescribed opioids by someone else."
lundi 5 décembre 2016
"When the winds blow against science, it’s all of our responsibilities to defend science and promote fact-based reasoning and rationality," Stephen J. Elledge said in accepting the Breakthrough Prize. "I ask each of you to rise up to meet that challenge."
A patent litigation expert says the battle royale over CRISPR -- the revolutionary gene-editing technology coming before a federal patent court this week -- could take years.
vendredi 2 décembre 2016
The outgoing secretary general apologized to Haiti but didn't admit that it was U.N. soldiers who triggered its cholera epidemic. That omission will make it harder to raise money to help, advocates say.
jeudi 1 décembre 2016
Dr. Carolyn Sax writes: "Price's positions are repugnant to me and to every other physician that I know."
mercredi 30 novembre 2016
Is soda food? Should it be exempt from the state sales tax? Soda tax measures just passed in several cities, and a Massachusetts lawmaker plans to propose one again.
mardi 29 novembre 2016
Tom Price has helped lead the charge to repeal Obamacare, and he supports major changes in programs that cover the elderly and the poor.
State health officials say they hope the site will help residents better understand the effects of the epidemic and help policy makers determine how best to deal with it.
vendredi 25 novembre 2016
Michael Botticelli, director of the White House Office of Drug Control Policy, believes that fighting opioid addiction has strong bipartisan support.
The new study offers an explanation for how the controversial sweetener aspartame may lead to -- rather than prevent -- obesity and diabetes.
An intelligent patient who stopped her crucial blood pressure medications on her friend's advice raises the broader question: How can such misinformation persist despite the evidence? And what can we – as doctors, as citizens – do to help counter it?
mercredi 23 novembre 2016
A judge has denied a request for an injunction to halt construction of a new $1 billion clinical building, which will result in the demolition of the half-acre healing garden.
mardi 22 novembre 2016
The task that lies before many of us at Thanksgiving is not unlike the task that faces us as Americans: How do we connect across painful differences?
One doctor's relief for former Speaker Sal DiMasi "is tinged with sadness that the very institution he once presided over, the State House, has not allowed other prisoners the same chance."
lundi 21 novembre 2016
Boston-based researchers pinpoint the protective genetic effects of having two X chromosomes as part of the explanation for why men get cancer so much more often than women.
vendredi 18 novembre 2016
One Massachusetts General Hospital doctor says she can't rely on her usual questionnaire to check for depression, because so many patients feel "down, depressed or hopeless." Sleep troubles, anxiety, stress eating -- doctors and patients don't usually discuss politics, but the election and its effects are coming up at a lot of medical visits in Massachusetts.
jeudi 17 novembre 2016
Thousands of doctors have signed a post-election letter laying out principles that include the tenet that health care is a basic human right, regardless of immigration status.
'Great Deal Of Money At Stake': Expert Says Mass. Health Model May Weaken If Obamacare Changes Under Trump
Massachusetts Health and Hospital Association President Lynn Nicholas explains the fears associated with possible changes to Massachusetts health care services as a result of President-elect Trump's promise to alter the Affordable Care Act.
mercredi 16 novembre 2016
"Unless we speak up," Dr. Aline Zoldbrod writes, "we could be incubating a whole new generation of boys and men who think it is fine or funny to talk about women and women's bodies as Donald Trump has."
lundi 14 novembre 2016
But there's actually no need to rush. An Obamacare expert say any birth control coverage changes will likely take months or years.
vendredi 11 novembre 2016
Join CommonHealth host Carey Goldberg on Sunday, 11/13, at 3 p.m. for an Old South Church concert to benefit medical care for victims of the war in Syria.
Sleep disruption, gut trouble, palpitations -- a stress expert sees the election and its aftermath affecting many of her clients, and suggests some coping tips.
jeudi 10 novembre 2016
If a child is anxious in the wake of the Trump victory, how to help? Suggestions range from civics lessons to simple reassurances of safety.
mercredi 9 novembre 2016
This sign, the one over this big table, this table to which every single person who lives in this country has been invited and perhaps even mandated to attend, would say only one word: “Enough.”
mardi 8 novembre 2016
Massachusetts law enforcement agents are reaching out to patients who've overdosed, but they are desperate to reduce the flow of fentanyl.
lundi 7 novembre 2016
Seventy-four percent of men and women who died in July, August and September as a result of an opioid overdose had fentanyl in their system.
The internet allows eating disorder therapist Jean Fain to help clients from afar. But sometimes, email becomes the problem.
vendredi 4 novembre 2016
An obesity specialist responds to a doctor who has largely stopped telling her patients to lose weight: "We should be willing to treat obesity as the disease that it is. And that means we start by talking about it."
jeudi 3 novembre 2016
Kevin Turner's brain was "riddled with CTE," a BU researcher said Thursday.
mercredi 2 novembre 2016
"Typical Halloween candy isn’t food, it’s junk, despite marketing ploys suggesting otherwise. A few nuts doesn’t counterbalance the sugar in an Almond Joy."
We look at the science behind the claim in three areas: addiction or dependence, disease, and death.
lundi 31 octobre 2016
Dr. Martin Kaminski, raised in Massachusetts, writes about the revelations of returning home to practice medicine.
vendredi 28 octobre 2016
"There have been multiple near-misses and near-launches," Dr. Matt Bivens writes. "Do we really want to trust anyone with this situation?"
"Rising prison populations constitute a major threat to public health and I believe the costs of incarceration for patients and communities simply outweigh the dangers of marijuana."
jeudi 27 octobre 2016
The magazine Undark chronicles how flawed research led to faulty recommendations that likely hurt many patients with chronic fatigue syndrome.
mercredi 26 octobre 2016
While a new report finds that the cost of health insurance premiums is growing slower, that growth is still outpacing income growth -- which means a larger percent of our incomes are going towards health care costs than a decade ago.
mardi 25 octobre 2016
You may have wondered nauseously in the midst of a post-trick-or-treat binge: Just how much of this stuff would it take to actually kill me? The American Chemical Society has done the math.
lundi 24 octobre 2016
Letitia Browne-James struggled with epilepsy-induced seizures and brain fog until she was 31. Then a surgeon removed a small piece of her brain. In the four years since the operation, she hasn't had a seizure, and relishes the new clarity of her mind.
vendredi 21 octobre 2016
As attitudes toward marijuana shift, a leading expert on psychosis warns about heavy teen use and concern that it raises the risk of later schizophrenia from about 1 percent to 3 percent.
jeudi 20 octobre 2016
The plan has been controversial because of concerns about rising health costs and because the expansion will result in the demolition of the beloved Prouty Garden.
mercredi 19 octobre 2016
They're the 'unbefriended,' patients lacking the mental capacity to make medical decisions and relatives to do it for them. As this population grows, so does the urgency of how to treat them.
vendredi 14 octobre 2016
A doctor worries that counseling her patients to slim down could harm them: These brief conversations don't work, writes Dr. Elisabeth Poorman, and could encourage patients to try dangerous methods of weight loss.
A doctor worries that counseling her patients to slim down will harm them. These brief conversations don't work, writes Dr. Elisabeth Poorman, and could encourage patients to try dangerous methods of weight loss.
jeudi 13 octobre 2016
Doctors are not immune to emotional trauma when things go wrong at work. Some hospitals offer help: another doctor who's been there.
mercredi 12 octobre 2016
In 2010, one in 20 organs donated in New England was from an overdose patient. Now, it's more than one in four.
mardi 11 octobre 2016
We often feel exhausted and excluded from the conversation about breast cancer prevention and detection, Carol Chaoui writes.
lundi 10 octobre 2016
The "coming out" and coming together of people with trichotillomania -- compulsive hair pulling -- and related "body-focused repetitive disorders" could be critical to the quest for better treatments.
vendredi 7 octobre 2016
Should you be scared of surgical scrubs? And why are people wearing them outside the OR anyway?
jeudi 6 octobre 2016
The Stop A Suicide Today site is intended to give people a sense of urgency and treat it as a medical emergency, just as if the loved one were having a heart attack.
mercredi 5 octobre 2016
Rates of depression and suicide are strikingly high among doctors, and The National Academy of Medicine wants to help the profession talk about it.
mardi 4 octobre 2016
On certain politicized health issues -- abortion, marijuana, gun safety -- whether your doctor is a Republican or a Democrat may affect how they treat you. So should you be able to look that up?
The geneticist is known as one of the most brilliant scientists in the world, and he's eager -- unlike many scientists -- to talk with the public about the powers we're gaining to engineer life itself.
vendredi 30 septembre 2016
There are roughly 3,000 foreign-trained doctors in Massachusetts, not licensed to practice in the U.S., according to a 2014 report.
An impending plan to ban the herbal painkiller kratom is drawing major pushback.
The $1 billion project has been the subject of much public debate, largely because the building is set to be constructed on the site of the beloved Prouty Garden.
jeudi 29 septembre 2016
Supporting breastfeeding "is something we should be doing to support women for their own health," says the author of a new study. "This is not about who is a better mother."
mercredi 28 septembre 2016
If you've ever been to a high-school reunion, you know that biological age can differ dramatically from chronological age. (Especially the older you get.)
vendredi 23 septembre 2016
A study found that 1 million to 2.5 million women are using custom-compounded hormones, yet many are unaware that these medications not been evaluated or approved by the FDA.
jeudi 22 septembre 2016
Meet one of your gut's good microbes -- E. Faecium. Researchers report on how it fights a bad infection in worms and mice, and it may hold promise for probiotics for humans.
mercredi 21 septembre 2016
Clearly, the two are no couch potatoes; they are frantically busy campaigning. But still, it's a fail. And not a trivial one, considering that Americans spend well over a trillion dollars a year on health care that better lifestyles could prevent.
Clearly, the two are no couch potatoes; they are frantically busy campaigning. But still, it's a fail. And not a trivial one, considering that Americans spend well over a trillion dollars a year on health care that better lifestyles could prevent.
mardi 20 septembre 2016
Please join us on the morning of 9/28 for a lively HUBweek discussion of the state of brain science and the gap between the science and current treatment and policy.
vendredi 16 septembre 2016
An expert on the brain-gut axis says your trillions of gut microbes are in constant cross-talk with your brain, and there’s mounting evidence that they may affect how you feel — not just physically but emotionally.
Prescription drugs may fuel the epidemic, but heroin and fentanyl are more closely linked to overdose-related deaths.
jeudi 15 septembre 2016
The changes, according to state health officials, build off of lessons learned during the first three years of experience with medical marijuana in Massachusetts.
mardi 13 septembre 2016
People searching for help with addiction can now be connected to services in Boston by dialing the mayor's 311 hotline.
lundi 12 septembre 2016
Over the weekend nearly 200 counselors, coders, architects, doctors and current and former addiction patients gathered to come up with and pitch new ideas for tackling the opioid addiction crisis.
vendredi 9 septembre 2016
Many survey respondents consider incontinence a fate worse than death -- but there's a big difference between an imagined disability and a real one.
jeudi 8 septembre 2016
Coming Sept. 15: Launch of WBUR's "Narrating Science" section, for people who work in science and want to write about it for a general audience.
mercredi 7 septembre 2016
This is the second year in a row that Massachusetts missed the self-imposed goal that took effect in 2013.
mardi 6 septembre 2016
The chair of the medical committee for the Paralympics talks about role models and "no excuses."
lundi 5 septembre 2016
The high-handed way that the insurers treat me -- and other providers, and patients, too -- drives me mad, writes psychologist Ellen Holtzman.
vendredi 2 septembre 2016
Can you make a profit without taking advantage of a community?
jeudi 1 septembre 2016
CVS will require its pharmacy staff in Massachusetts to check the state’s Prescription Monitoring Program before filling prescriptions for "commonly misused opioids."
mercredi 31 août 2016
Confirmation of a cognitive benefit "would be a game-changer," according to a commentary piece accompanying the Nature paper.
mardi 30 août 2016
Radiologists are surprisingly good at detecting even subtle cancers in just a split second, a study finds.
lundi 29 août 2016
More than two-million health care practitioners in Massachusetts and across the country will get a letter in the next few days from U.S. Surgeon General Vivek Murthy.
vendredi 26 août 2016
A Harvard evolution expert says we're so hard-wired to avoid exercise that the university should bring back a physical education requirement to help students move more.
Theme of an upcoming Hubweek event: As medicine becomes increasingly dependent on technology, patients have fewer opportunities to tell their stories and similarly, clinicians are less likely to hear their stories.
mercredi 24 août 2016
There's been a push recently among medical professionals to investigate how long, stressful hours for medical residents affect their well-being.
mardi 23 août 2016
An admiring remembrance of Kate Granger, the terminally ill British doctor probably best known for using Twitter to push to humanize medical care.
"Sex on alcohol was commonly reported as being more casual and less emotional," according to the study. "Sex while high on marijuana was commonly described as being more compassionate ..."
vendredi 19 août 2016
UN Secretary-General Ban Ki-moon says the UN "has a moral responsibility to the victims."
Depression in doctors-in-training seems to be not the exception but the norm, writes Dr. Elisabeth Poorman.
Boston's teaching hospitals are "conducting joint focus groups, collecting common data elements and will be identifying an issue to address together over the next few months," the authors write.
jeudi 18 août 2016
Moral of the story: If you're told you have a gene that means you have a serious disease, look into it very carefully -- and stay informed about the rapidly evolving state of gene science.
mercredi 17 août 2016
While I have no reason to think my daughter would become addicted, my thought has been, Why take the chance? Still, no parent wants to see their child in pain.
lundi 15 août 2016
For 79-year-old Tony Swartz-Lloyd, a diagnosis of Parkinson's didn't end his lifelong passion for music -- it sparked it.
vendredi 12 août 2016
Athletes who transition from male to female must demonstrate that their testosterone levels are low enough. That threshold is under debate.
A personal pondering for this election season and beyond: Is it a doctor's duty to stay out of the political fray? Or, sometimes, step into it? What if doing so might hinder the doctor-patient relationship?
It's been standard medical care for over 50 years, but a small and possibly growing contingent of parents decline the Vitamin K shot for newborns.
jeudi 11 août 2016
In return for tax-exempt status, all 12 Boston-based nonprofit hospitals are required to invest in charitable activities that benefit the communities they serve. The authors argue the hospitals should coordinate these efforts.
Maternal mortality is still rare, but the increase is "a national embarrassment," said one author of the study.
mardi 9 août 2016
Harvard announces that prominent stem cell scientist George Q. Daley will lead Harvard Medical School.
While testicular cancer is curable for most patients, even when it has spread, delaying treatment can lead to more advanced, and potentially fatal, disease, researchers write.
vendredi 5 août 2016
With so many Olympic athletes sucking down energy gels, how special are they, really?
"My miracle isn’t that I walk out of here and I get cured. My miracle is that I got 13 years of a Stage 3C diagnosis," said Colleen Lum.
jeudi 4 août 2016
Researchers say their model suggests that Zika is a very slow-moving virus and that its spread is highly varied depending on location.
More promising news on a potential vaccine against the Zika virus: Researchers report that three different kinds of vaccine worked well in monkeys, and call for human trials as soon as possible.
mercredi 3 août 2016
The facility on Milk Street is the seventh dispensary in the state.
More men and women died after an unintentional overdose in the first six months of 2016 than during the same period last.
Numbers released Wednesday by the state Department of Public Health offer no sign the epidemic is slowing down.
Researchers found that people who ate nuts five or more times a week had about 20% lower levels of the measured biomarkers.
Nearly four years after medical marijuana was approved by Massachusetts voters, the first Boston dispensary opens Wednesday.
A Boston doctor says a set a guidelines, called Enhanced Recovery After Surgery, is transforming surgical practices.
mardi 2 août 2016
Other factors that affect Body Mass Index, like genetics, may be responsible for the risk of heart attack and death, one researcher said.
lundi 1 août 2016
The Massachusetts Legislature voted overwhelmingly to override Gov. Baker's veto on a bill requiring health insurers to cover long-term antibiotic treatment for Lyme disease.
Researchers find that nanoparticles show promise for fighting tooth plaque -- in rats, at least.
No one seems to know why. But there is some agreement about possible explanations.
vendredi 29 juillet 2016
Dr. Donald Berwick, a former Democratic candidate for governor of Massachusetts, assesses Hillary Clinton's proposal to allow Americans to opt in to Medicare beginning at age 55.
Professor Wayne Westcott offers an uplifting antidote to the news that the TV show's contestants tend to gain back all the weight and burn fewer calories.
The rating is based on 64 measures including patient-reported hospital cleanliness, infection rates, how often Medicare patients are readmitted for heart failure and how often those with pneumonia die.
jeudi 28 juillet 2016
Gov. Charlie Baker vetoes a bill that would have mandated health insurance coverage for long-term antibiotics for Lyme disease, and proposes an alternative.
A "Shark Tank"-like incubator, based in Boston, aims to speed up the development of new antibiotics and other weapons against superbugs.
mercredi 27 juillet 2016
A study finds two probable carcinogens in e-cigarettes, at levels that vary depending on the heat and age (and gunk level) of the device.
mardi 26 juillet 2016
A new study in mice finds a connection between gut bacteria and Alzheimer's disease: Mice given a long course of antibiotics had fewer "amyloid plaques," a hallmark of the disease.
vendredi 22 juillet 2016
E-cigarettes could have huge health benefits as cigarette substitutes in adults and long-term smokers, one researcher argues. But they could also be useful in harm reduction in teens.
Researchers have linked three genetic risk factors associated with Alzheimer’s disease to an immune cell dysfunction in mice, shedding light on a biochemical mechanism behind the genes.
jeudi 21 juillet 2016
Powassan virus is rare, experts say, but about 10 percent of people with the most serious form of the disease die, and survivors may have long-term health problems.
mercredi 20 juillet 2016
American doctors struggle to have time to talk with patients about their end-of-life wishes, the author writes. A video series may help.
Researchers have developed biocompatible threads that can sense everything from temperature to pH to physical strain. So far, the work is just in mice.
Now it's Martha's Vineyards' turn to consider a cutting-edge proposal by an MIT biologist to fight Lyme disease by modifying mouse genes. He presented last month on Nantucket as well.
lundi 18 juillet 2016
The PRESTO study is trying to tease out the factors around fertility that people can actually modify.
vendredi 15 juillet 2016
Dr. Lee Cohen, the Director of Massachusetts General Hospital’s Center for Women’s Mental Health, who was not involved with the research, is very optimistic about the trial.
The system for assigning donor hearts to patients leaves doctors facing an ethical dilemma: Do you ramp up your patient's treatment, even if it's not called for, in order to bump them up the list?
jeudi 14 juillet 2016
Until this week, many beers did not disclose calorie counts or ingredient lists on their bottles.
mercredi 13 juillet 2016
A huge new study finds that excess weight is not "protective" -- the more overweight people are, it finds, the higher their risk of premature death, including from heart disease and cancer.
The strategies more than 40 governors pledge to implement are modeled after steps taken in Massachusetts.
Researchers had to find a way to turn off the disease-causing protein without turning off the protein essential for life.
mardi 12 juillet 2016
Researchers conclude that women physicians earn, on average, $20,000 per year less than men.
lundi 11 juillet 2016
The letter responds to do-it-yourself-ers who zap their scalps in hopes of benefits ranging from improved math skills to relief from depression.
jeudi 7 juillet 2016
The Broad will help build the infrastructure to share data that could lead to new treatment discoveries.
In case you were hoping to vote again on the "Death With Dignity" ballot initiative that failed in a squeaker in 2012, you can't -- it's not on the ballot this year.
This year orientation for new residents at BMC includes a workshop on what's known as social determinants of health.
mercredi 6 juillet 2016
For three months of the year, Dr. David Shaye operates and teaches in Africa.
mardi 5 juillet 2016
A new app helps doctors -- and patients -- calculate the potential risks and benefits of taking baby aspirin, a sometimes-complicated decision recently updated by new guidelines.
vendredi 1 juillet 2016
I want to find an endocrinologist who will agree to monitor my nodule, rather than insist that I get my thyroid out. Boston is a health care mecca. Surely there are doctors who are up on the latest watch-and-wait approach. It's complicated.
Brigham and Women's hospital is testing an app that tracks a patient's activity and tone of voice to see what it could tell them about anxiety or depression.
jeudi 30 juin 2016
Sometimes, the very act of creating a symbolic tribute to a deceased relative provides some level of comfort.
mardi 28 juin 2016
"We hope that news will galvanize the vaccine effort against Zika virus," says Dr. Dan Barouch of Beth Israel Deaconess Medical Center and Harvard Medical School.
lundi 27 juin 2016
Today, the Supreme Court set a new standard for the role that evidence should play in judicial analyses.
dimanche 26 juin 2016
The tentative agreement still needs to be ratified by the full Brigham and Women's nurse membership.
vendredi 24 juin 2016
The hospital says it has 700 temporary nurses ready to care for patients if its union nurses walk out on Monday.
Heartening new data finds that older Americans are not just living longer but spending less time disabled.
jeudi 23 juin 2016
mercredi 22 juin 2016
We hear from Maureen Bisognano about the challenges facing hospitals and their staffs as a strike looms for Brigham and Women's Hospital nurses.
Thanks To Efforts Of 4 Moms, Broad Institute Launches Initiative To Better Understand Food Allergies
Four mothers were fed up with all the unknowns surrounding their children's food allergies. So they raised close to $10 million to launch the Food Allergy Science Initiative at the Broad.
lundi 20 juin 2016
An MIT evolutionary biologist lays out his proposal for Nantucket and Martha's Vineyard to consider genetically modifying mice to fight Lyme disease.
A column in The New York Times offers a sweeping -- and overwhelming -- roundup of the health benefits of exercise.
vendredi 17 juin 2016
Researchers say men are biologically wired to be fathers -- and children are innately and uniquely responsive to their fathers.
jeudi 16 juin 2016
The reason for this likely hinges on the importance of naturally occurring chemical compounds and hormones in the “encoding of memory,” researchers report.
mercredi 15 juin 2016
Check out the pilot episode of The Magic Pill, a new exercise podcast in development at WBUR that aims to give you a daily dose of get-up-and-go. (Why The Magic Pill? Because exercise is the closest thing we have to one -- but every day, there are forces working against you...)
At the Supportive Place for Observation and Treatment (SPOT), drug users could ride out their high under medical supervision.
vendredi 10 juin 2016
New research is fueling questions about the origins and trajectory of the brain disorder.
jeudi 9 juin 2016
I thought I loved Judy Collins because her voice was ineffably crystalline, because her songs were the soundtrack of my youth, because her “Who Knows Where The Time Goes?” becomes ever more relevant as I get older.
But now that I’ve heard her converse with Here & Now host Robin Young, I understand something more: that infusing her inimitable voice were the pain and the power that come from a life that has included glory but also rock-bottom despair: alcoholism, depression and the 1992 suicide of her son, Clark.
Not that she has kept any of her travails secret. Now 77, she has written and spoken about them so publicly that this week she received the McLean Award from McLean Hospital for “her work to increase awareness about mental health through her many interviews, compelling memoirs and advocacy efforts.”
“She has courageously and very publicly shared her experience with depression, alcoholism and the struggles she faced following her son’s suicide, thus helping dispel the stigma of psychiatric disorders,” says the award’s text. “She has reached countless people with her message and is a true champion of mental wellness for all.”
Here’s some of her conversation on Here & Now, lightly edited:
RY: What was it like? You became sober, I’m sure still, in some part of your heart, mourning your father, the alcoholic, and then having to watch your son…
JC: The worst, the worst. He committed suicide in relapse. I don’t know how I got over it, really. You don’t get over it. I shouldn’t put it that way. You get through it, however. And people reached out to me — people were so kind. There was a kind of cluster of women — Mariette Hartley and Iris Bolton, Joan Rivers.
Joan called me one night from Las Vegas, while she was in the dressing room, getting dressed, and she said, “I know” — it was about four days after his death — she said, “I know you want to stop working.” I said, “You bet, I’ve already canceled everything for the next year.” I said, “Bury it. I don’t even want to look at it.” She said, “You can’t do that because you won’t recover unless you keep working.” And she knew that because she’d lost her husband to suicide.
You said at the time, “His suicide has both ruined my life and probably saved my life, because I have to live through it, I have to get through it.”
You have to. I was determined. Then I had to learn, how do I not kill myself today? And it happens for a lot of issues in terms of our lives. “I just won’t do that for today.” And I think that’s part of our search for mental health, the ability to stabilize your own, sometimes-erratic emotions. If you know where you can finally wind up — I’m in AA, I’ve been in AA for 38 years. I will never not be there, because that’s where the recovery is. And we have had, over the past 10 or 15 years, a kind of revolution in our attitude about this. This is not a secret. This is not a big, terrible, dark secret.
There is a change now, viewing it as a disease.
We now have a man who’s the head of the drug and alcohol commission — Botticelli is his name. I saw him on television the other day when he said that the moment he walked into a meeting and he got it — his eyes teared up. I said, “That’s right.” Mine did too, when I heard him say that because when you understand that there is a solution — you said it was like wrestling with a jellyfish.
We were talking earlier, and I said mental illness is like wrestling with a jellyfish.
I will quote you from now on, because it is. However, there are many solutions. And frankly, human contact with other people who are awake is a big start. I’m very happy that my life is one of sobriety and of living a day at a time, and of working — and I’m so grateful that I’ve been able to work. I have this brand new album, which is to me like a lifeline, and a new world. It’s about the continuity of creativity, and you know you cannot do that when your head is buried in a bottle. I do not believe that what happens when we’re completely out of it doesn’t kill the things in us that are alive and happy and joyful and able to spread the word.
Does it help at all, or maybe even propel you, that while you couldn’t do it for yourself for a long time, you were doing so much for everybody else [with your music]?
Well, I was also keeping myself alive and thriving, because the music, and the artistic aspects of everything in my life, were there. I’m the first person that gets the benefit of all that, so I was staying on the planet and there was a lot of beauty and wonder and extraordinary experience in those years. And until I really went down at the end of ’77 — and I really thought it was all over, because I couldn’t sing, either — in many ways I was thrilled, of course, with the life I had and I was ecstatic much of the time — when I wasn’t passed out. But you cannot keep that up. You cannot.
I’m wondering if we hear any of those early struggles — your son, when he was taken in the custody agreement — do we hear any of that in the music you wrote?
I don’t think that there’s so much a biography, but I think art takes over and makes out of what you are living something that is of you, but it doesn’t have to be autobiographical. It tells the story. I think the voice may tell it. I think you may hear it in the quality of the voice, more than anyplace else. I believe that.
A chicken claw. An FDR pin. A crucifix. A toy sheriff’s star.
Those are some of the weird items that have been removed from kids’ throats, nostrils and ears by doctors at Boston Children’s Hospital and are included in a macabre, yet important, display.
A visitor’s first reaction might be to laugh at the framed collection of dozens of items that dates to 1918 and hangs at the entrance to the hospital’s ear, nose and throat department, but it’s also a reminder to the parents who walk past it every day to remain vigilant.
“It is definitely something that catches the eyes of parents and makes them think twice about what their kids are exposed to,” said Dr. Anne Hseu, a head and neck surgeon at Children’s who has removed Christmas ornaments, toys, carpet tacks and other items from young patients.
One of Hseu’s colleagues removed a rosary bead that had blocked a boy’s breathing passage. The boy might have died, but the bead lodged vertically, so he was able to get air through the bead’s threading hole.
Disc-like button batteries are among the more commonly swallowed items these days, and particularly dangerous because the chemicals in them can burn esophageal tissue in a couple of hours, Hseu said.
Latex balloons, magnets and colorful laundry detergent pods are also frequently swallowed, said Dr. Sarah Denny, an emergency department pediatrician at Nationwide Children’s Hospital in Columbus, Ohio, who has extracted a cellphone button from a teenager’s ear and a gum wrapper that was stuck in a child’s nostril for a couple of weeks.
The Boston collection, which also includes a screw hook, a tiny doll hand and a sardine tin key, is a tribute to late Children’s Hospital physician Charles Ferguson, who worked there for 35 years and removed most of the items himself.
Thousands of children a year are treated for sticking stuff they’re not supposed to in their mouths, noses and ears, Denny said. Parents need to keep small objects out of the reach of toddlers and make sure toys are age appropriate.
Besides the obvious hazards of choking — brain damage or death — ingesting a foreign object can lead to infection.
Pain, a chronic cough or even recurring pneumonia could indicate a child has swallowed something they shouldn’t have and needs a doctor’s attention. A foreign object can often be removed without surgery using an instrument that doctors call a “peanut grasper,” Hseu said.
mercredi 8 juin 2016
When a friend recently finished her grueling year of breast cancer chemotherapy, she received warm congratulations from her health care team and was invited to ring a special bell set up in her doctor’s office. Another friend, cancer-free for a year, is rewarding herself by taking part in a bike ride fundraising for cancer research. Me? Now that I have been on maintenance chemo for two years, I am celebrating by getting a mammogram.
Let me explain. Cancer survivors need continued specialized health care to assess for late side effects from the treatment and the cancer, and specialized preventative care. For example, girls who have received radiation therapy need mammograms at
a far younger ages than their peers, and children who have received brain radiation need a yearly hearing assessment.
One way to assess and treat cancer survivors is through Survivorship Clinics. These are places where patients get multidisciplinary appointments and where survivors meet with, for example, specialized health care providers, mental health care providers, nutritionists and physical therapists.
Research presented this week at the American Society of Clinical Oncology describes the value of such clinics. Care of survivors is especially important in children: Over 80 percent of children with cancer survive and need a care plan to guide surveillance for late effects of cancer therapy.
In the study presented this week, the authors randomized patients to either attending a Survivorship Clinic or receiving a customized survivorship care plan to use with their primary care provider. The authors found that the participants in the Survivorship Clinic were much more likely to receive recommended testing and more likely to have late effects of treatment identified. In fact, out of about 50 patients in each group, the authors found previously unidentified late effects of cancer — including obesity, high lipids, hypothyroidism, neuropathy, osteopenia, restrictive lung disease, substance abuse and anxiety — 21 times in the Survivorship Clinic group, but only once in the group that that received a written care plan.
The study didn’t explore why the Survivorship Clinics were better. My guess is that it was, in part, because most primary care doctors don’t get trained in long-term care of cancer patients. But I think the bigger benefit of these clinics — as with multidisciplinary clinics for diabetes and cystic fibrosis and other chronic diseases — is that having a number of people with varied expertise working together, focusing on one person in one place, is an ideal way to think about a patient. These clinics focus on the whole person, not just on a patient’s disease.
To be sure, Survivorship Clinics can be expensive and are usually located only at big hospitals in big cities. And only one-third of cancer survivors go to Survivorship Clinics. Many people don’t want to go to a Survivorship Clinic because it reminds them of their cancer — of what they’ve survived, and what they might not have survived.
When I was first diagnosed with metastatic colon cancer 2013, the care plan involved intense chemotherapy — oxaliplatin, bevacizumab, irinotecan and capecitabine — every other week. I was taking prednisone and aprepitant for the nausea, lidocaine cream for the injection site pain and pegfilgrastim for the decreasing white blood cell count. My other regular intake included scrambled eggs, Ensure, meat and white bread. Preventive care — like mammograms, pap smears and regular exercise — was not part of the care plan.
Last week, two and a half years after my cancer diagnosis and two years after I started maintenance chemotherapy and went back to work, I went to Survivorship Clinic. My doctors didn’t recommend it — a friend did. My primary care doc and my gynecologist are both great doctors, but when I have asked questions about preventive care related to my cancer (like, “Should I get re-vaccinated?”) they both acknowledge their ignorance and emit a bit of fear of making a mistake. My oncologist’s job is to worry about wandering cancer cells. All three of them do an outstanding job — I am still here, after all — but they are not experts in the long-term care of the cancer patient.
At first I didn’t want to go to Survivorship Clinic. I feel a little like a faker being called a cancer survivor. Both because I still have plenty of cancer in my abdomen (it just hasn’t gone anywhere for two years) and because I am doing really well.
It turns out that people with cancer are considered survivors the day after we get our diagnosis. Whether we have survived one day, one year or 10 years, people use the word survivor to describe our status. I am not sure I agree with the use of the word this way and to be honest, I probably went to Survivorship Clinic to please my friend and because I thought the physical therapist might give me stretching exercises to do after I jog. Not because I identify as a survivor.
Over two hours, I met with a nutritionist, a physical therapist, a social worker and a nurse practitioner. The nurse practitioner had meticulously reviewed my chart, checked into all my prevention needs, and made recommendations with full knowledge of my cancer status.
“You need to get a mammogram,” she told me.
What woman hears this and thinks to herself, “Great news”?
Preventative health measures — including mammograms, pap smears, good nutrition and regular exercise — are important for people who are going to live for 10 years or more. For the same reason that women in their 80s don’t need these things — something else is likely to kill them before a small breast or cervical lesion — people with metastatic colon cancer don’t need them either.
Until they do.
Apparently I am doing well enough that I need to get back on that bandwagon of preventive care. So long, as-much-chocolate-cake-as-I-want-because-I-have-cancer. Hello, mammogram.
And having heard the rest of the recommendations for me from Survivorship Clinic — balance exercises, hearing test, eating well and exercising — I am a believer in the specialized clinic and maybe even calling myself a survivor.
A pediatric oncologist friend of mine, knowing she won’t get everyone to Survivorship Clinic, throws a survivorship picnic for her pediatric patients and their families every summer. Near the bouncy house, there are tables of information on eating well for cancer survivors. Next to the balloon stand there are places to sign up for hearing tests. There are trivia games and cooking lessons. And 400 people come every year. It’s not quite personalized follow up for a cancer survivor but it’s a start.
As more and more of us survive, primary care docs will become better versed in our care. Until that point, we need specialized follow up care that reminds us to exercise, eat our vegetables and yes, get mammograms.
Marjorie S. Rosenthal is a pediatrician at Yale and a 2015-’16 Public Voices Op-Ed fellow.
mardi 7 juin 2016
Pressing for the same or nearly the same limits on opioid prescriptions is one of the ways New England’s Republican and Democratic governors are working together to address the drug epidemic.
The six regional governors gathered in Boston Tuesday for an opioid panel.
There are some signs that efforts to slow the surge of opioid overdoses are working, but the death toll is grim. Narcan or Naloxone, the drug that reverses the effects of many overdoses, is becoming more widely available — and that’s a good thing, says Gov. Charlie Baker.
“We lost 1,500 people in Massachusetts in 2015, but my own speculation, based on the data I’ve seen, makes me think the number without Narcan would have been north of 5,000,” he said. “And it has a ton of, still, negative momentum.”
Baker and his five New England colleagues agree on a few ways to try and stop that momentum.
More Coverage Of The Opioid Addiction Crisis In Mass.
- Insurers Step In To Fight Crisis
- Mass. Sober Home Certification
- Who Is Overdosing In Boston
- Drug Cocktails Fuel The Crisis
- Plans For Heroin ‘Safe Space’
One is requiring that doctors limit their use of opioids (such as Oxycontin or Vicodin) to treat acute pain. But just how low should they go? Massachusetts and Maine recently imposed seven-day caps on first-time opioid prescriptions. A new law in Vermont sets a lower limit, in the range of just 10 pills.
Rhode Island Gov. Gina Raimondo says the governors are trying to coordinate these regulations.
“So, for instance in Rhode Island, we’re making a sure [of] a five-day limit for an initial prescription and you heard from other governors they’re going in the same direction, since a lot of people cross borders and we want to be as coordinated as possible,” she said.
The governors spoke to an international conference of physicians who prescribe or study opioids and urged them to reduce opioid prescribing on their own.
Dr. Paul Sloan, a conference co-chair is professor of anesthesiology and pain medicine at the University of Kentucky. He says doctors are thinking about the minimum amount needed to cope with acute pain.
“We as physicians have to work with that, that’s the environment which we’re in when we’re trying to deal with a public health issues, there’s just no way around that,” he said.
The Massachusetts Medical Society says just under 5,000 physicians (4,872) have taken new online courses on responsible opioid pain management since the beginning of the year. But there are lots of stories about doctors or dentists who are still sending patients home with a 30-day or greater supply of opioid pain killers.
New Hampshire Gov. Maggie Hassan says patients need more non-medical options, like acupuncture or physical therapy, for treating pain
“We need to find a way to make sure that people can get the right kind of pain treatment,” Hassan said. “This is a real challenge: Find that right kind of pain care that isn’t the delivery of an opioid.”
The New England governors are also pledging to increase efforts to stop the street supply of heroin, fentanyl and other addictive drugs. But for Vermont’s Peter Shumlin that’s a more difficult problem.
“We should keep doing all the things we can to slow down illicit drugs into this country, but no one’s figured out the silver bullet for how to get that done,” he said. “I do believe I have the answer for reducing this crisis. It is to stop passing out opiates like candy.”
Shumlin blames pharmaceutical firms and the FDA for making opioids widely available. He says the next president should fire everyone at the FDA who has signed off on increasingly powerful pain drugs.
In response to Shumlin’s critique, an FDA spokesperson sent a speech in which the agency commissioner talks about the difficulty of balancing a drug’s pain benefit against its potential for misuse, and about the FDA’s legal obligation to approve most generic versions of a drug.
vendredi 3 juin 2016
Come in to the Family Health Center of Worcester for just about any reason and, if you’re a woman of child-bearing age, you’re all but certain to be asked “the one key question.” In Portuguese, if that’s what you speak, or Albanian or Vietnamese — or English:
“Are you planning to become pregnant in the next year?”
If you’re not, that’s an opening for a conversation about birth control options. Vietnamese medical interpreter Annie Huynh says that after just a few months of those conversations, she’s already seeing a dramatic shift away from the many accidental pregnancies she was seeing a couple of years ago.
“Now, I hardly ever hear [it’s] an accident anymore,” she says. “It’s something either they plan for, or they don’t get pregnant anymore because of the education I got that I’m able to pass on to them.”
That education includes training on how to talk about birth control, says Jennifer Averill Moffitt, the clinic’s prenatal services manager.
“Whereas before, perhaps the counseling was, ‘Here are these 12 methods, choose which one is best for you,’ ” she says. “Now, we’re saying, ‘Here’s the most effective method, and here are some other choices. Choose what’s best for you.’ ”
The most effective method is long-acting birth control. That includes intrauterine devices, or IUDs, and the Nexplanon hormonal implant — a matchstick-sized rod that’s implanted in a woman’s arm and prevents pregnancy for three years. They’re not for everyone, but for typical users, both have failure rates of well under 1 percent, compared to an annual pregnancy rate of 9 percent for women who take the pill. (That’s due mainly to user error: Pills are easy to miss, while the long-acting methods are “set and forget.”)
The long-acting methods are on the rise nationwide — about 12 percent of women on birth control now use them — and they’re getting a lot of the credit for the recent drop in unintended pregnancies to a 30-year low. But the rate is still strikingly high: Forty-five percent of all American pregnancies are unplanned.
So why aren’t even more women using IUDs and implants, especially now that Obamacare makes them much more likely to be covered?
For one thing, they’re not always easy and quick to get — particularly for low-income women, whose unplanned pregnancy rate can be five times the rate of high-income women.
Enter Upstream USA. It’s a nonprofit that aims to remove the health care system’s remaining barriers to long-acting birth control.
“There are many health centers we work with that are literally not offering IUDs and implants at all. Period. So literally zero percent of women are getting access to these methods,” says Mark Edwards, the Boston-based co-founder of Upstream USA.
“From our point of view, that’s unconscionable,” he adds. “This is a method of contraception which research studies have shown is actually 20 times more effective than the pill in terms of real-world use, and yet health centers are not making these methods available. In any other form of medicine it would just be an outrage. If we had a stent that was 20 times more effective than another stent, it would be an outrage that we weren’t offering them.”
Upstream goes into health clinics like the Family Health Center of Worcester and helps them up their birth-control game. That means training just about the entire staff on birth control counseling, from the medical assistants and interpreters to the schedulers.
“Having a culture shift — that says, ‘This is important enough that everyone who works in a health center should have this education’ — is huge,” Moffitt says.
It also means back-end work on medical paperwork and billing so the center doesn’t lose money on long-acting birth control. And training more medical staff to be able to insert the devices.
Plus, there’s workflow: A woman who wants an IUD or an implant often has to come back for at least one additional appointment — and that can take weeks. She may not come back, or by the time the appointment rolls around, it may be too late.
“That’s what happened with me, actually,” says Angelica Rodriguez, who books appointments at the clinic and is also a patient there, with a wry laugh. After she went through the Upstream training last year, she decided she wanted a Nexplanon implant. She booked an appointment to get one.
“But the appointment was one month after, and then, when the appointment came, it was June something, I was already pregnant,” she says. “When I found out I was pregnant I was like, ‘This is not what I wanted!’ But still I had the baby.”
Rodriguez was in shock at first, she says, because her other son was only just over a year old, But she loves her four-month-old son, planned or not. And, she notes, it’s faster now to book appointments for long-acting birth control.
These days, she’d only have to wait a week or so — and Moffitt says the Family Health Center of Worcester will soon have same-day IUD and implant appointments.
The clinic doesn’t have data yet on whether its Upstream training has cut the unintended pregnancy rate, she says. But she expects the rate to drop, as it has repeatedly in demonstration projects that gave teens and low-income women better access to long-term birth control.
“When we give women the choice, hopefully our number of unplanned pregnancies can plummet,” Moffitt says.
How far they can drop remains to be seen. Experts point out that unintended pregnancy is complicated. Unplanned doesn’t necessarily mean unwanted, says Megan Kavanaugh, a senior researcher at the Guttmacher Institute, a leading think tank on pregnancy and birth control.
And, she says, many factors go into a woman’s choice of birth control: Not all women will or even should use an IUD or implant.
But, she says, there have long been barriers to long-acting birth control, and “for women who really want to use these methods, and who now have access to these methods, that’s a huge accomplishment. That’s a great coup, I’d say, for the family planning field.”
Upstream USA is working at a half dozen sites around the country these days — including a statewide project in Delaware — and its budget, funded by donations, has gone from $1.7 million last year to over $10 million this year.
Edwards, the company’s co-founder, says he hopes Upstream will become obsolete someday.
“As a nonprofit, our goal is really to be out of business in about 12 years,” he says. “We see no reason we can’t be — that we can really change the face of unplanned pregnancy in this country in that period of time.”
He doesn’t expect an end to all unintended pregnancy in a dozen years, of course. But, Edwards says, if any American woman can get an IUD or implant whenever she wants one, that would be a major step forward.
Readers, have you encountered barriers to getting an IUD or an implant? Sarah Kliff of Vox wrote about some here.
jeudi 2 juin 2016
The Worcester Board of Health has unanimously voted to increase the minimum age for purchasing tobacco products in the city from 18 to 21.
The Telegram & Gazette reports that the new regulation, which goes into effect Sept. 1, was among several tobacco proposals the board had been discussing internally.
Local retailers opposing the measure say the new minimum likely won’t have much of a difference on teens who seek out tobacco products.
Chairwoman Abigail Averbach says it has long been a mission of the board to limit Worcester residents’ exposure to nicotine.
Dr. Lester Hartman, co-founder of the Tobacco 21 movement, says the new age restriction creates an important “social distancing” effect where young teens can no longer count on fellow students to buy them tobacco.
mercredi 1 juin 2016
I got a call from the school nurse this week: my daughter had an itchy rash on her arms and neck and red blotchy patches around her mouth.
“My best guess is it’s allergies,” the nurse said, suggesting Benadryl and hydrocortisone cream. “This is a particularly bad season. Kids who never had allergies are coming in. Kids who take Zyrtec or Claritin in the morning are still coming in — their eyes so inflamed and irritated.”
Mention allergies these days and you’re sure to get a story: a colleague left Cape Cod early this weekend, because her allergies got so bad. “The pollen was everywhere,” she said. “It was even on my dishes.”
Micheline Maynard, a senior producer at Here & Now, sent me an email detailing her own allergy hell:
Last week, I had a bout of allergies that had me weeping in the newsroom, and sneezing and coughing. (I was apologizing to my colleagues and saying, “I’m not crying!”) Claritin did nothing, and I took half a Sudafed 12-hour, which helped a little.
I went to Michigan over the weekend, which is basically the same latitude as Boston, and enjoyed a problem-free weekend. I slept with my windows open, I did things out in the garden, and felt completely recovered. No coughing, sneezing, no headache.
Within an hour of getting back to Boston on Monday, my head was completely stuffed up. I was sneezing and coughing, and feeling generally blah… I actually Googled “severe allergies” because I’d never experienced anything like it.
Dr. Elisabeth Poorman, a CommonHealth contributor and third-year medical resident at Cambridge Health Alliance, said she’s experiencing bad allergies this year, “and [I] never have since moving from Atlanta, where pollen is a way of life.”
So is this season truly the most awful for allergy sufferers — the worst one ever — or, as one doctor suggests, do a high percentage of reporters and their friends just happen to have allergies, hence the outcry?
Dr. Anna Kovalszki, M.D., clinical director in the Allergy & Inflammation division at Beth Israel Deaconess Medical Center, offers a reality check: “I think this year is not as bad as last,” she said. “This year is definitely causing symptoms — like other years in the past. But every year I have patients who say, ‘this is the worst year ever.’ ”
Last year, when the thaw finally came following that freezing, snowy winter, “everything started to bloom,” Kovalszki said, and that led to extreme allergy symptoms that felt like they’d come on overnight.
She said patients were arriving last year with their eyes swollen shut, for instance, and due to such intense symptoms, she prescribed strong medications that she normally doesn’t, like oral prednisone — a steroid typically reserved for asthma sufferers.
This year, she says, due to the mild winter, the allergy season seemed to start earlier. And right now “tree pollen is the worst, but the grasses are starting to come up too so there’s a double whammy: if you’re allergic to both, you would have some cumulative symptoms.”
Dr. Mariana Castells, M.D., an allergist at Brigham and Women’s Hospital, agreed that last year allergy sufferers exhibited more severe symptoms that came on abruptly.
But this year, she said, there’s a “prolonged” allergy season that started earlier, with patients having “progressive” symptoms since March. Extreme temperature shifts didn’t help, she said, noting that the season could drag on: “There will be pollen very, very late in the season.”
“At this moment there’s a lot of tree pollen in the air and a lot of grass pollen in the air. Also, with the rain, there’s a lot of mold, so mold spores are something people can be allergic to,” Castells said, noting that the most common symptoms include itchy eyes and nose, nasal congestion and sneezing, post nasal drip, sinus pressure, and coughing.
If you suffer from allergies, though, it doesn’t much matter which season is the worst. Right now, it seems, there’s no escape, with pollen visible everywhere: in the yard, on the car and, at least for my colleague, on the dishes.
And in general, seasonal allergies may be getting worse, doctors suggest. It could be due to overall warming temperatures, or other factors. Kovalszki said that epidemiologic studies looking at food and peanut allergies suggest that incidences are rising.
“I suspect the environmental allergies are as well, there are certainly studies suggesting this with pet dander and also pollens,” she said.
Why? “The most discussed theory is called ‘hygiene hypothesis‘ as to why it is happening: we aren’t exposed to enough microbes, dirt, etc. and hence our bodies are finding something else to attack,” Kovalszki explained.
It’s tough to get a full and accurate picture of allergy sufferers around the region. The state Department of Public Health doesn’t track seasonal allergies, for instance.
The illness trackers at HealthMap, a group based at Boston Children’s Hospital that posts reports on disease outbreaks, says there’s nothing in the data worth noting this year about seasonal allergies.
“Maybe it’s not worse, but just longer given our mild winter?” suggests HealthMap’s Colleen M. Nguyen. “Actually [I] went to the allergist last week, and it was quite busy in the office.”
Readers, tell us your allergy story. Are things worse this year? Better? And how are you coping?
About 50 medical researchers from around the country converged on Boston Wednesday, as they prepare to launch a massive seven-year study into the brain disease known as chronic traumatic encephalopathy, or CTE, in July.
CTE is a degenerative disease similar to Alzheimer’s. It’s only found in people who’ve played football, boxed or taken part in other contact sports.
The researchers are recruiting 180 former NFL and college football players to study their brains. The goal is to develop ways to diagnose CTE in people when they’re alive. The only way to diagnose it right now is by studying the brain after death.
One of the lead researchers is Robert Stern, Ph.D. He’s a Boston University School of Medicine professor of neurology and neurosurgery and director of clinical research at BU’s Chronic Traumatic Encephalopathy Center.
Helping Stern champion the research is Tim Fox, a 62-year-old former NFL safety who played for the Patriots, Chargers and Rams. He thinks he has CTE.
Fox and Stern spoke with WBUR’s All Things Considered host Lisa Mullins about the disease. Stern says while much of the focus has been on concussions, CTE is caused by something that can seem more benign.
Audio from the interview will be added to this post after it airs on All Things Considered.
On diagnosing chronic traumatic encephalopathy:
Stern: “The only people who have ever been diagnosed with it after life, which is the only way to diagnose it, have had a history of repetitive hits to the head. It’s never been seen in someone without that kind of history… It’s a disease that gets set in motion from having repetitive hits … regardless of whether they are symptomatic concussions.”
Fox: “For me, the symptoms are difficulty recalling names, events, issues — even in common speech. I have trouble sometimes grasping what I want to say. It affects your personality. It’s a very frustrating situation when you can’t recall things that you’d like to recall. And I don’t know whether that leads to a much shorter fuse. You know, I don’t have the patience that I once had … and from my perspective it’s looking down the barrel, to me, of a ticking time bomb, because I see all these things in players that have been diagnosed after death, and I look at those symptoms and it’s eerily similar. I would very much like to see them succeed in being able to diagnose this while you are living. I don’t want to have to die to be confirmed that I’ve had issues for the last 10, 20 years of my life. And once they can definitively diagnose it, then we can more accurately, I would assume, definitively treat it.”
Stern: “We have to figure out what the risk factors are for CTE. We know that there’s a necessary risk factor, and that’s getting your head hit over and over again. But obviously not everyone who hits their head a bunch gets this brain disease. So we need to figure out why one person gets it, and another person doesn’t. Is it something about the number of hits, the age of hits, the type of hits? We’re trying to figure that out. But is it also something about genetics? And so we’ve got these incredible geneticists involved with this project to be able to start answering questions about who might be at increased risk based on their genetic kind of make-up. But one of the things we know about these types of brain diseases is that if we can detect it early on and implement some kind of intervention that modifies the disease course, then in a way, that’s prevention. By changing the course of the disease, slowing it down enough, at a time before there’s too much brain destruction, that’s the ultimate goal.”
On a congressional report that found the NFL improperly tried to influence the research and withdrew funding for the study because it felt Stern is biased:
Stern: “I don’t talk about funding issues. It’s just not the thing to do in science. I’m absolutely thrilled that the NIH decided to fund this project. And I’m just really focused on moving the science forward.”
Fox: “The NFL is scared to death of CTE because it can affect their bottom line. And the reality is the NFL is all about making money. They’ve got 32 owners that want to protect their income source. And this is a dramatic threat to the game itself. It’s a dramatic threat to Pop Warner. It’s a threat to high school football. It’s a threat to college football. And as people stop playing at those levels, they will not have the same level of interest in the NFL. So the NFL has consistently dragged their feet in terms of trying to recognize that they have a problem, and they will only admit they have a problem when they’re backed into a corner or they say something by mistake. And so the example of taking the funding away from a project that they had pledged — where they said there would be no strings attached — and then backtracked and took the money back, is just another example of that.”
mardi 31 mai 2016
Today’s topic: stress. Psychologist Tu Ngo looks out at a small group of veterans seated around a classroom table. “Why would we be talking about stress when we’re here because of your pain?” she asks seriously, then smiles. “Lil’ pop quiz now.”
A man who’s sitting near the door, in case his PTSD flares up and he needs to leave, is ready with an answer. “Stress may increase your anxiety, the anxiety may increase your feeling of pain,” says Tom Schatz, “the feeling of pain may increase depression, etc. etc.”
“Very good, that’s a great description of the vicious cycle we know happens when you have pain,” says Ngo, who heads the pain program at the Bedford VA Medical Center. “Pain is a stress response, it’s a signal to the brain saying, ‘Hey, there’s something wrong.’ “
This is Pain School — a five-week, 15-hour course that covers more than a dozen parts of daily life that can make pain better or worse. The classes cover nutrition, sleep, exercise, breathing, visualizations, relaxation and, yes, stress.
“What happens in your body normally when you get stressed?” Ngo asks, urging her students to think about the specific ways stress may increase pain.
“Your muscles tense up,” answers Jasmine Navarrete, a disabled Navy veteran, “your respiratory rate has to increase.”
Other veterans mention a hike in temperature or blood pressure. “Right, yes,” Ngo says. “Then in usually about 20 to 30 minutes, your body comes back down again to what we call baseline.” But many of these veterans never can get down from the feeling of being on guard or ready to flee.
“If you have chronic pain, your system is in overdrive all the time,” Ngo says.
Constant pain can impair memory or concentration and make a veteran more anxious or irritable.
“But,” she offers, “there is something you can do to try and turn that stress response off.”
Ngo hands off to Kalin Clark, who outlines the antidote to stress: the relaxation response.
It begins, Clark says, with slow, deep breathing “and learning to control our heart rate with our breath.” Clark asks for a volunteer, someone willing to demonstrate the connection.
Navarrete’s hand shoots up. The Navy veteran — who deals with nearly constant back, knee and other joint pain — walks to the front of the room and sits down in front of a computer.
Clark slides a monitor onto Navarrete’s left index finger. That’s her dominant hand.
“See if you can follow this pacer. Take a slow inhale and slow exhale, and let’s see what that does to your heart rate,” Clark says, watching the computer monitor.
Navarrete’s belly rises and falls. Her shoulders drop. But waves on the screen jump. They’re not smooth. Clark looks at Navarrete’s hands, lingering on her shiny pink nails.
“It could be a nail polish issue,” Clark says, somewhat under her breath, “because I turned it on me and it was…” Her voice trails off.
While someone else takes a turn, Ngo tells the class that regulated breathing is one of many tools veterans will be introduced to in Pain School. It’s part of a pain management program the VA has been developing for almost two decades. It assumes patients will need help at many stages of coping with pain.
Losing That ‘Security Blanket’
One goal is to help veterans reduce or stop using opioids and other drugs to control pain. Ngo says Bedford currently has the third-lowest opioid prescribing rate among VA medical facilities in the country.
“We’re not curing your pain, we are not taking it away, but it’s a way of helping you to manage your pain and live your life and function better,” Ngo says.
Many veterans don’t buy it. Each time Ngo offers the Pain School, about half of the students drop out before it ends. We tried to reach some of the veterans who did not find this approach worthwhile, but no one would comment for this story.
Ngo says many veterans are scared to try something besides pain medications. “People are afraid to lose their security blanket as much as they know it isn’t working for them,” she says.
Research shows opioids relieve acute pain, but the Centers for Disease Control says there’s little evidence that they ease chronic pain, defined as pain that continues three months after an initial injury or ailment.
Some veterans who stay in Bedford’s Pain School know the limitations of opioids firsthand.
“The side effects were just too much for me to deal with, I couldn’t function at work,” says Robert, who asked that we not use his last name to avoid consequences on the job.
Robert injured his back several times during a dozen years in the Navy. When the pain is bad, he wakes up 10 to 20 times a night and can’t walk short distances — like from the car to the grocery store. Robert reached what he calls a breaking point a few years ago.
“You know, the thoughts that this is never going to go away,” he recalls with a deep sigh, “that this is my life from this point forward. That’s a pretty devastating realization.”
For Robert, it was time to try something other than opioids.
“The VA has been great about accepting that and not saying, ‘Here’s a pill, this is our only solution for you,’ ” Robert says.
At Pain School, Robert and the other students set weekly goals, activities to both manage their pain and push past it. Robert has pledged to take yoga classes and use an app that tracks calories to control his weight. He goes to physical therapy. He’d like to try acupuncture or one of the martial arts, all of which are offered through the Bedford VA.
“So far everything’s been really good,” Robert says. “The only thing that didn’t work was the medications.”
Pain Management Programs ‘Few And Far Between’
Bedford is one of 67 VA Pain Schools across the country, up from 33 in 2010. Through the schools and options such as hypnosis, chiropractic services, massage and tai chi, the VA is trying to shift the way patients think about pain.
“Right now, many patients feel like it’s a mechanical model of pain, where if you just take the part out and replace it or suppress the pain in the brain, that takes care of it. But it doesn’t,” says Dr. Rollin Gallagher, the national pain management director for the Veterans Health Administration
A better strategy, according to Gallagher, is pulling together a team that includes the patient, their primary care doctor and specialists to craft a plan that puts the patient in charge of managing their pain.
“Once you sit down and explain what pain is and how it works, what makes it worse and better, and how an individual can manage that interaction between mind, body and brain, I think it really does help them,” Gallagher says.
Gallagher says the consequences of ineffective pain treatment can be devastating: depression, disability, addiction and sometimes suicide. Veterans are even more at risk. Veterans report chronic pain at nearly twice the rate of Americans overall.
Gallagher says there’s some proof the VA’s approach is working. He points to opioid use, which is down 7 percent among all veterans in the latest three-year period.
Structured pain schools and the range of non-medical pain management options available through the VA are not available to most Americans.
“Pain management programs like the VA’s are pretty few and far between,” says Mara Laderman, senior research associate at the Institute for Healthcare Improvement. She says there are several reasons why. “Physicians have been trained to prescribe opioids for chronic pain, they’re slammed with packed schedules, and there aren’t a lot of physicians who are trained in pain management.”
But Laderman and others agree: Money may be the main reason most doctors, clinics and hospitals focus on medicine to relieve pain.
“We typically reimburse for the things we do to patients, and that means prescribing a medication, doing a procedure or surgery,” says Dr. Sean Mackey, professor of pain medicine at Stanford University. “We don’t reimburse for these types of programs. I provide a large number of these at Stanford, quite a large number of them, but I give them away for free.”
Mackey co-chaired work on a National Pain Strategy released earlier this year that calls for more research and education on the different types of chronic pain and effective treatments.
At the Bedford VA, nutritionist Joanne Maddock wraps up Bedford’s Pain School class with information about foods that provoke headaches or constipation. She says fish, dark chocolate and ginger protect against inflammation.
And remember, Maddock says, excess weight can increase pain.
“If we’re carrying around too much weight it’s a lot of stress on our joints, so if you can get to a good healthy weight you might feel better,” Maddock says. Veterans, she reminds the students, have higher obesity rates than do Americans as a whole.
A pharmacist will be in for the last class, to talk about how to balance pain medicine with all the other techniques students have learned. Some veterans will take more in-depth classes on stress or meditation, realizing there’s a lot to learn about pain.