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Listing all posts with label patient advocacy. Show all posts.
  1. I recently posted a blog about Yaz that was more popular than I would have at first expected and it made me think that perhaps there is more to say about birth control pills and their effects on the body. So here we go ...

    Everyone's body is different. I'm going on record right now - we are all different. Physiologically speaking we are unique. Similar. Shockingly similar. But definitely individuals.

    I guarantee that no one reading this has ever had a doctor or healthcare professional do a blood workup (more than once) prior to prescribing medication of any kind let alone birth control. I'm not going to get into the importance of it to me - it is enough to know that millions of women and girls (emphasis on not-yet-grown-up women) take the pill. No one is monitoring what their baseline hormone levels are, how they change over the course of their natural cycle and no one is matching the prescription to these levels. Doctors are, intentionally / knowingly or otherwise, in the pockets of big pharmaceutical companies. (I wrote a blog about it because it bugs me so much.)

     

    For this reason sites like Drug Watch exist to try to let people know what's going on. People should be informed and that's why I found some good pix online to help illustrate what a so-called normal cycle should look like and give some info about what the pill is really doing.

    This is what a menstrual cycle should look like:

     

    where menses means menstruation. FSH is follicle stimulating hormone (what literally stimulates a resting would-be egg to mature enough to burst through the surface of the ovary and float down the fallopian tube toward the uterus). LH is luteinizing hormone and when it spikes in production, menses follows.

    Naturally these charts are really simplified and I've included a more accurate one to give an idea of how variable the timing of release is expected to be. 

    Now all 4 of the main hormones interact with each other in complex feedback loops. (Eating 1 oreo causes you to want more oreos - that's a kind of like a feedback loop. I know it isn't a negative one for me. I've never had 1 oreo and thought - well that's going to stop me from eating any more.)

    It's crazy complex and I have no doubt that there's still lots for the 'scientific' community to learn but just for a couple of examples:

    from wiki: "LH receptors are also expressed on the maturing follicle that produces an increasing amount of estradiol", "the oestrogen rise [with follicle maturation] leads via hypothalamic interface to the positive feedback effect, a ... LH surge that triggers ovulation, thereby not only releasing the egg but also initiating the conversion of the residual follicle into a corpus luteum that in turn produces progesterone to prepare the endometrium for a possible implantation."

    from Rocky Mountain Analytical (a hormone detection company): estradiol is needed "for the proper function of progesterone receptors and maintenance of the right balance between estrogens and progesterone" which is "crucial for hormone health."

    Because sex hormones are produced by influencing hormones made in the pituitary gland (FSH, LH, thyroid stimulating hormone i.e. TSH - stimulates thyroid to produce thyroxine and triiodothyronine which in turn affect adrenal function), hypothalamus (thyrotropin-releasing hormone - controls TSH production), adrenal glands (testosterone - which in turn affects estrogen) and ovaries. It is an enormously complex web that the pill disrupts. This little look into the body is enough to tell me that indiscriminately mucking with it is not going to be without consequences.

    And so it comes around again - consequences. Side effects. All prescriptives have them. We tend to ignore them but our bodies do not have that luxury. It is no wonder that late night television is swamped with adverts to sue drug companies. I think that part of this trend is due to a lack of full disclosure on the part of the doctors. Time constraints and the pervasive thought that patients cannot handle the volume or detailed-aspect of the information leads many doctors to gloss over the whole story (as it is known to them, and they may not have all of the most current published info at their fingertips). And so big drugs are specifically targetted for law-suits. Check out these links for details regarding suits against Yaz, Celebrex and Nasonex.

    I write these blogs to put info out there. If it helps someone, that's great. An even better outcome from these posts would be to inspire others to check out the issues they have on reputable websites to better know what they are taking and why. A little information can lead to foolish choices or it can bring about questions. Questions could lead to dialogue and maybe better answers from your doctor.
    Good luck!

    Brought to you by You Get Well Soon.

  2. Recently I was having lunch with my mom after one of her doctor's appointments and like always she was consulting with me. Now just so you know off the top - I am not a doctor. I am one of those people with years of experience in pharmacies, health food stores, medical research and clinical diagnostics but I am no doctor. I vacillate between recognition of their years of intensive study and therefore remarkable knowledge of the body and their easily bought (no, too harsh), influenced choices when it comes to prescriptives.

    Now back to my mom. She's got a whole host of problems which I won't get into but in addition to her previous drug regimen she now needs an additional drug for cholesterol and a different blood pressure drug. The doctor was actually paying attention that day (I mean this literally - she lost nearly 50 pounds which was more than 20% of her body weight and he didn't notice before). So, he went to their stores and brought out a bunch of samples. One of them was a new drug and he explained that it wasn't available as a generic. And a second one was an old drug.

    This all confused my mom and maybe this is weird to you too. Drug companies pay millions to develop new drugs. For that money, they've got the FDA in their pockets such that there will be patent protection for the production of the drug for anywhere from 10 to 20 years. So no generics can be legally made and sold. After I related this to mom, I said that that was why he had mentioned the 'new' drug and was concerned about her being able to afford it.

    With regards to the old drug - I told her that most doctors are 'encouraged' to promote new drugs so that big Pharma can make money. Old drugs make them nothing. And if you've seen The Fugitive you'll remember that doctors are 'courted' by drug companies. They sponsor

    conferences and meetings all over the world to not only help the dissemination of medical information but also as self-promotion. The kind of Old Boys' Club mentality that it would be great to eliminate but given the state of politics (and especially special interest's groups hold on political cojones) is unlikely to happen any time soon.

    And speaking of the negatives of Big Pharma, I was recently asked about vaccinations with respect to my own kiddos. The old argument of vaccines causing autism came up and I had to remind the person I was speaking to that we (in Canada) do not get the same vaccine formulations that other countries do. Our regulations are different and an across the board comparison is not accurate. That stated though, another issue I have with big Pharma is how they have vaccination drives for batches of vaccine that are about to expire. The next time you see a push for a vaccine that should have been delivered en masse already (like an influenza vaccine push after January) it may be due to someone noticing that huge numbers of units are going to be thrown out if they don't get out the door.

    This isn't to say that vaccine campaigns are always suspect. The recent ones for Mumps Measles Rubella and Varicella or Diptheria, Pertussis (acellular, a) and Tetanus are valid and should be seriously considered by all parents. It used to be that a child could not attend any public school until all vaccinations were up to date. Now things are definitely different. With the recent decline in compliance, herd immunity is down and most all of these are making comebacks in the developed world.

    I know this is diverging but I thought I'd include a few pix of what these bad-boys can do.

    In order: Measles - identified by cough, runny nose and red eyes - fever in excess of 39C/102F, rash and sometimes spots inside the mouth. Complicated by diarrhea, pneumonia, encephalitis (swelling in the brain), corneal ulceration/ scarring which would lead to vision problems to blindness. Oh yeah and a fever of 40C can mess up the brain forever.

    Mumps - noticeable and painful swelling of the parotid (salivary glands) and testes (also painful for adolescents or adult males that can in rare cases lead to infertility), fever and headache.
    Both have recently been enormous problems in the western world with outbreaks dominating diagnostics in many countries.

    Rubella - a personal favorite of mine because a schoolmate had it 6 times in 2 years. (And to this day she's mad at me for giving her scarlet fever. sheesh.) Also has a rash, swollen glands, joint pain, headache and conjunctivitis. Mostly a danger to pregnant women as it causes spontaneous abortion and congenital rubella syndrome (heart, brain, eye and ear defects which are permanent, low birth weight, prematurity, anaemia, hepatitis, "blueberry muffin skin lesions" and low platelet levels or thrombocytopenia which causes wound healing problems.)
     

    Varicella - perhaps better known as herpes / chicken pox / shingles. The pic above is shingles because just about everyone knows what Chicken Pox looks like. They're vaccinating for this because of the increased risk for serious Staph and Strep infections of the lesions.
    To note in the shingles pic - the rash is only on half of the body. Usually front and back and there can be limb involvement. This rash is painful in 80-odd% of cases. Really Painful.

    Diptheria is one I won't forget seeing as my mom had it as a small child. It causes sore throat (inflamed neck = bull neck), usually low but in rarer cases high fever, adherent pseudomembrane which may require medical intervention to maintain breathing and can lead to heart problems and death. (My mom was sent home to die 3 times.)

    Pertussis, also known as Whooping Cough. This one is quite common in the north of Canada and causes a type of cough that is so persistent that the person doesn't get much time to breathe - hence the whoop. Technically called a paroxysmal cough. It is so severe that it can cause eye hemorrhages, rib fractures, incontinence, hernia, fainting, inspiration of vomitting and even vertebral artery dissection. If that didn't spell it out - hey, it's serious!

    Tetanus. This one got some press recently when Selma Hayek teemed up with Pampers to distribute vaccines to the third world. This bacteria is of the same parent group that includes botulism (yes, botox), gangrene and an overwhelming intestinal infection known as C.diff. Tetanus causes the muscles of the body to contract (opposite of botulism). It's painful - very painful. Think of a muscle spasm that you may have had in your leg or back and multiply it by all the voluntary muscles of the body. In the industrialized world the fatality rate is about 11% but elsewhere it's more like 50-75%. High fevers, sweating, increased heart rate and blood pressure go with it - but that's no surprise given the muscle contractions. Lockjaw is also a common first sign.

    So vaccines in general good.
    Big Pharma not always good. I think of them like any big business of today (or say the Catholic Church of the dark ages) with so much power - it's easy to be corrupted. And if a church can justify killing thousands if not millions what can a corporation justify doing?

  3. I was approached by a website to do a link exchange. As I've written before - this is nothing too new. The new part was a seemingly directed interest in a certain pharmaceutical: Yaz.
    Personally, I am no fan of birth control. Not for the birth control part. I'm a big fan of exercising control over such issues. Big Fan! I just don't believe that anyone (and by that I also mean any doctor, pharmaceutical company or researcher) has the info to rearrange an individual's body systems for any directed purpose. Especially one as all-encompassing as the entire sexual hormone production of a person. (Like that's not going to have consequences.)

    Now I've attended, worked at and worked out at a university for most of the last 20 years. This means that I see how particularly birth control is marketed to the young women of the university. I have never seen the side effects listed - if at all - in print larger than 10 point. This includes on posters that are more than 2x2 feet in size. They are always an after-thought, as if it didn't matter as long as the 'prime objective' was served.
    Well, as someone who cannot take birth control due to blood clots, I haven't been keeping up with the new types and brands. [I remember getting the usual follow-up at the doctors office and had high blood pressure. I'm thin and eat well and was very young at the time (~20) so there was no reason for this. My cholesterol turned out to be dangerously high. Higher than some of the obese people I knew at the time. Then came the blood clot - behind the knee (one of the most common places to notice leg clots as a layperson) and that was the end of my trials (which included over a dozen different varieties) with chemical birth control.]

    So I was inspired to investigate Yaz. Drug Watch is a site with an interest in informing the public about drugs that have proven to have harmful side effects.


    And Yaz is in their sites.



    In the interest of fairness - I visited the Yaz site. It first wanted me to input the DIN before I could enter. I guess they don't want anyone who doesn't already possess the drug to visit them. (Interesting marketing idea - don't let people make informed choices or bring information to their doctors - no, trust in your sales team to reach every doctor and give out enough samples that people who are interested will already have the drug in their hands.)
    Once you enter the DIN, they ask if you're 14 - the minimum age for usage - that's all that's on the page too. A picture and that question. Then you're into the 'highly informative' yet 'jazzy' site.
    Seriously, they must think every young woman is a moron - or listening to Rush Limbaugh (same thing)- had to throw that one in - what a buffoon. (Hey Rush, not every woman wants to be a 20 year old swimsuit model - for all of time. Just because that's what you want women to look like doesn't mean that's what they want -but I'm sure you don't understand the concept of No Means No either. BTW do you also expect your mom, Mrs. Limbaugh to look like a swimsuit model?)



    When you finally get into the Yaz site - there is nominal information about the product. You have to listen to this ridiculously lame video that states right in it -that all of the side effects and warnings are on the drug pamphlet that you, the viewer of the site, already has. CUTE. What's next, telling me that any adverse effects I might experience are my fault for having the drug in my hand in the first place? (Blaming the doc's now?)

    The site also does another 'clever' thing - they've put all the text in as a picture. That way it isn't search-able. Take a look at the bottom of the screen - I've typed in nausea which appears as the first word under the heading beginning "The most common side effects . . ."


    The blue bar at the side does another interesting marketing thing - it doesn't indicate size. Most such navigational tools show a large or small bar depending if there's a bit more on the page or lots more on the page, respectively. So you have to scroll through the whole thing to find out how much info there is

    .

    And as usual, it's written at a grade 4 level and contains very little actual information. Hence the need for Drug Watch or more local for me C-Health. I like their site too because it gives the facts straight up with just some advertising (Huggies, that kind of thing) and general health stuff too. One of the things I found regarding Yaz was a list of states of being that were incompatible with Yaz:



    They also had an easy to find and read list of drug interactions. I had to zoom out 4 times to get this list as one screen shot. 4 times - how dangerous is this drug? And why is it made out to be - for 'everyone' who is over 14, less than menopausal and a non-smoker. (Good thing most public places are smoke-free. Perhaps that will eventually mean most people are too.)


    I also found an interesting blog post regarding Yaz and hair loss. If the bloating, gas, weight gain and irritability wasn't enough to make you completely unattractive (I'm assuming this is of a modicum of import if the person taking the pills is concerned about birth control) the loss of hair will seal the deal.



    It explains how this young lady had hair loss problems with Yaz - especially after halting the pills. What was more telling to me were the comments. So many not only found the site, read the post but also shared their own stories of horror. And here's just one:

    first off congrats for your progress!!! second...You just described everything that I am going through. I
    don't think I'm losing that much hair as you said in the 300's. I was on yasmin for 5 years and loved
    it except it made me bloated and i'm a normal/thin body type but i didn't really care. I thought my hair
    was started to thin out after my 5th year so I switched to yaz, plus my dr had free samples and coupons
    bc i dont have insurance. i was on yaz for 5 months. it was so horrible with my moods and just not
    well feeling. (plus i was a total bitch and never wanted sex) after the 3rd month of being on yaz i noticed
    my hair started to fall out as i washed it and combed it. It was all over my clothes and weirdly yo
    u could
    see "hair balls" on my clothes after they came out of the washer! so this is my first month off yaz and free
    of bcp all together. let me know everything that you tried bc it is extemely frustrating and i dont have
    the money to be going to drs. I went to 2 diff derm drs who charged me $120 each just to tell me to go
    on rogaine! this is my 2nd month on rogaine and nothing has really changed. im 24 and i eat extremely
    healthy and dont dye or blow dry my hair and had blood work done that came back normal.

    Now I know that birth control is important - even if the Republicans don't. (Check out Freakonomics' take on the government-forced lack of birth control in Romania and what it's


    results were - if you don't remember the rampant stories coming out of Romanian orphanages that is.) Bottom line, women raise children. And, if they don't want them - they won't be raised in a way that benefits those who live among them.  That's all the rest of us.  All  The Rest Of Us.

    There are options - but Yaz doesn't seem to be one of the universally wonderful ones.
  4. This may sound weird but after my mom's trouble with ulcers you'd think that it would be natural to check my dad for the bacteria that causes 90% of all ulcers: Helicobacter pylori. I wrote a blog about this a few months ago and included info about how this little factoid was discovered - and how it resulted in a Nobel Prize for Dr. Warren.


    My dad reminds me in some ways of Dr. David Suzuki. I don't mean in the seriously eco-sensitive, hosts his own TV show, has a foundation to help protect the earth way. You may not have seen the interview with him that disclosed his commitment to his physique but it left a lasting impression on me.
    OK, so in that interview he told a story about how one of his daughters had a bodybuilding magazine out that she was looking at and he offhandedly mentioned that he could look like that. According to his interview, she scoffed as only a teenager could which prompted him to take up bodybuilding. He did end up looking like the guy on the cover of the magazine (see above - wow) but more to the point of my father, they showed some footage of Suzuki building a deck. He was hammering nails into the boards with the speed and accuracy of a nail gun. No fooling. And he was in his 60s at the time. Yikes and Hey - How You Doin'?
    My dad believes in exercise as no one else I've ever known. He devises little machines and routines regularly to improve his physique. The man exercises for a living via his career in home improvements and then comes home to walk the dogs for and hour. Every day. And then proceeds to do his made-up exercises. So when he was having gastrointestinal problems that would not be cleared my mom began to worry. I was asked for some insights and gave the usual answers - watery diarrhea use activated charcoal. But if it's an infection it should clear on its own in 7 to 10 days.
    This didn't happen. He wasn't dehydrated. He didn't have cramping or pains. Just this knowledge that the volume going in wasn't reflected by the volume going out. So my next suggestion was a laxative. This did help with the volume going out. This is good but still this water problem.
    Adding to my mom's concern was that he wasn't active. He was watching TV. Not that he never watches but he sat for more than an hour. This doesn't happen. Ever. He was fatigued. And it wasn't ending. Combine that with the need to use the facilities immediately after eating and that's a combo no one wants.

    Now when my mom was diagnosed with an ulcer back in 2006, I told my mom to get dad checked. They are from a part of the world (middle Europe pre-1960) where the incidence of Helicobacter pylori infectivity is super high. Did he go? Course not.
    But something about these symptoms really bugged me - so I put the bee in mom's ear and she called his doctor's office and forced them to run the test. And finally the results are in - yup, he's got it. So why am I relieved? There is a cure. Even though antibiotics do not work a lot of the time (like a 70% failure rate). There are natural things that can help out with clearing the bug.
    Now I don't know if my dad will be 100% after his treatment regime but if he can get back his energy and not need a washroom every time he thinks about eating - I'll be happy.

    Bottom line - you need a patient advocate.  Seriously, what kind of doctor doesn't think to check the spouse of a known ulcer patient who has tested positive for H. pylori.  This isn't rocket surgery.  It's passed through saliva and hello married people are known to kiss, share food and drinks.  Not to mention the above stated likelihood of his having the bacteria due to location and conditions of his life prior to living in Canada.  The patient shouldn't need to diagnose themselves.  A reminder of your individual situation no matter how difficult it may be to get your healthcare practitioner to listen, may just lead to the diagnosis you need so that you too can be on the road to recovery; like my dad.
  5. I know that I'm not a girly-girl. Never have been. I do have some experience with being in the hospital and I also know that when you're all alone for 20+ hours a day a nice floral arrangement does make you feel better. (It doesn't do anything for me when I'm at home but hey that's me.)

    The thing is there will come a time (and it's here in some places) when flowers won't be allowed in rooms at all. There are already bans in France and the UK and probably more of Europe. The reasoning that's been used has little to do with the real hazards though. So what reasons did they use to create / enforce the ban? Bacteria in the water of flowers, oxygen use (by the flowers and therefore less available oxygen for a compromised patient) and a potential hazard to equipment should they tip. Well these are somewhat valid reasons I suppose. When a patient has very serious and urgent oxygen needs every little bit makes a difference but this won't apply to the vast majority of patients.

     

    Bacteria in the flower water sounds like a possible health risk but it's again unlikely to cause problems. You'd have to drink the bacteria or inhale them. No one's drinking flower water. As for inhaling the bacteria, this sounds easier than it is. The water would have to beaerosolized for that to occur. So it'd have to be put into a spray bottle (and when are those going to be banned in restaurants, etc. Spray bottles cause aerosolization of whatever surface greeblies that are supposed to be cleaned off.) It's unlikely that flower water would end up in a spray bottle. Again, for the very few who would be affected by such a minor number of bacteria of that variety, it would be a health risk but not for every patient.

    Equipment risks - that's the third listed issue for no flowers. This is a real possibility given that there is very little space in hospital rooms and always too much stuff. So tipping them over and perhaps having water get on machinery - that could certainly happen. And here, the hospital wouldn't charge us for such an accident so the hospital would have to absorb the replacement costs.

    Why didn't they use the real reasons: spores, pollen, water molds, multiple chemical sensitivities, nurses have enough to do and look after? Now there's a question. As the sound bites about severe peanut allergies should have enlightened all and sundry, fungal spores are very dangerous. Fatally dangerous to some. This was enough to handcuff parents to never include any peanut-containing items in kids lunches for school. (What lesseconomically advantaged parents do when peanut butter is one of the best combinations of cost, nutrition and kid-appeal; I don't know?) There are fungal spores associated with soil and therefore flowers. And again, we know from the peanut allergypeople who you don't have to have an appreciable number for 1 to get through and cause trouble.

    Pollen. There are tons of people allergic to pollen. Let's face it, if someone's living in a hospital (even short-term) there's something seriously wrong with them. They don't need additional problems. They've got problems already. I encountered this one when I was in hospital. I was there so long that I ended up with more roommates that I could have ever imagined - I think it was 9 in the 17 days I was there. And one of them was allergic to pollen. So I was given a choice, I could ditch the flowers or I could move. I chose to move. It worked out even better for me because I finally ended up with a window. I digress.

    Water molds. I know this is a bit of an odd one and it takes time for them to form but the spores from water molds are very dangerous for those who are allergic / sensitive. My sister has this one (and the next one - multiple chemical sensitivity). You'll know if you have this one if you live where there's snow. Snow has more time to develop molds and so with snow melt - the mold spores are released and physiological reactions ensue.

    Multiple Chemical Sensitivity (MCS) is a very real problem for an increasing number of people. This one isn't an allergy but it is a neurological response to chemicals sometimes including those of flowers. Usually it's triggered by chemicals from personal hygiene items (soap, perfume, hairspray, shampoo, hand cream, laundry detergent, etc.) It's a very difficult issue to manage when in public - and there's pretty much nothing more public than living in a place that gets 10's of 'visitors' every day; from the teams of doctors, nurses, cleaning staff, your personal visitors, everyone else's visitors, deliverypersonnel, and the list goes on.


    Nurses have enough to do. This one is self-explanatory. They do an impossible job and somehow manage to be nice (most of the time) while doing it. They really don't need to watch out for everything that comes into the room that isn't 'hospital equipment'.

    I'll just add one more thing. When I was putting together the inventory for my business (YouGetWellSoon), we needed bags. So we went to our local people for some compostable bags and got into a discussion with the girl at the counter. Turned out she was the daughter of the owners and had been in hospital for a kidney problem. She had received flowers but since she was in the ICU was not able to have them with her. If she craned her head, she could see them sitting on the nursing station table. Not quite what her benefactor had in mind.

    Bottom line - this once stable of the hospital gift may soon be no more. So before your gift gets turned back, perhaps check with the facility or give a gift that is more in keeping with what a patient may want / need. It may be less fun but it'll get through the door.

  6. Nearly ever since the advent of Viagra, there has been a search for a female counterpart. (For a recap on how Viagra saw the light of day - check out The Viagra Story.) Don't get me wrong, many women find Viagra works well to improve their sex life. The drug companies need a new compound to market to women. Since Viagra is so well-known as a treatment for men, there needs to be a separate drug for women. This is just marketing. So which behemoth drug company has come closest to the finish line - Boehringer Ingelheim with their new Little Pink Pill Flibanserin (and I do hope they come up with a more catchy name). Not surprisingly, this drug is not trying to physically 'up' women's sexual responsiveness. Instead it is geared toward the psychological aspects of sexuality.

    Boehringer Ingerheim doesn't even claim to have any expertise or interest in this area of research. Here's a pic from their website:

    Nowhere on this list is anything to do with emotional issues. The only area that comes close to brain function alteration for the purpose of emotional enhancement is Parkinson's - and it's not close enough for my blood.

    Here comes the question - does the medical community know enough about how the brain works to play around with it? And for sex? Really. How many reports have their been that antidepressants led to suicides? Or how about the rampant use of Ritalin. If your kiddo is not paying attention to you or to school - give them a pill. Ritalin is a central nervous system stimulant similar to amphetamines targeting the dopamine neurotransmitter in a manner similar to cocaine. The side effects are numerous: Short-term effects can include nervousness and insomnia, loss of appetite, nausea and vomiting, dizziness, palpitations, headaches, changes in heart rate and blood pressure (usually elevation of both, but occasionally depression), skin rashes and itching, abdominal pain, weight loss, and digestive problems, toxic psychosis, psychotic episodes, drug dependence syndrome, and severe depression upon withdrawal. (Taken from a webpage of Partnership for a Drug-Free America.) How are these Side Effects better than a kid who has trouble focusing? Let's face it - kids don't pay close attention. They just don't. And what's more - with time, they get over it. But somehow we've bought into the idea that it's not only OK but necessary to mess with the developing brains of our children. How do we know that we won't be permanently altering the course of their natural development? And here's the rub - is there any way for us to know this with certainty?

    And so I question, do we really know enough about the brain and it's changes with not only puberty and early development (as is the question with Ritalin) but with the hormonal cycling of female brains (and yes the hormonal cycling triggers do also come from the brain) and menopause / peri-menopause? It seems as though we haven't figured out how best to handle the hormonal changes of menopause - and now we're going to further complicate matters by mucking with women's brains on top of things.

    In a time when a large proportion of the population and even the medical profession is rediscovering the efficacy of natural approaches why are we being bombarded by these 'medical interventions'? Pharmaceuticals are big business. They're so big they can force compliance of governing bodies like the FDA and they can also lure physicians into prescribing drugs when they could be exploring the nature of the problem. If you think I'm off my rocker - do you know someone who is taking 1 or more drugs to counteract the side effects of another drug their taking? Or perhaps you remember the Vioxx scandal - the NSAID that caused heart attacks?

    So yes there will be a Little Pink Pill - backed heavily by Boehringer-Ingerheim with the help of their paid researchers and marketing team - don't believe it - check out Sex, Brain, Body. They even produced a special panel with 6 of 8 specialists supported directly by them. And in the field of research it may as well read - owned by Boehringer. But like big oil - it's up to the consumer to make as many alternate choices as possible and put pressure on our elected officials to ensure that our Best Interests are being addressed - not big business's.

  7. Since I was speaking with my mentor this morning it brought me back my days in grad school and with it the health topic I was most closely associated - meningitis.  Let's start at the beginning; meningitis is an inflammation of the membranes (or meninges) of the brain.  Because the brain is housed in a solid bone cavity, there is no room for this inflammation and if left untreated is fatal.  The symptoms of meningitis are headache, visual or hearing impairments, fever, fatigue and stiff neck.  Most people are aware of these ones.  The one I wanted to focus on (and make a point of bringing up at every lecture I lead on molecular biology) is the rash.  The rash associated with meningitis is very specific and easy to spot.  It is my belief that it is missed due to, of all things, awkwardness.  You see this infection is common in 3 age groups.  The very young are usually infected with a bacteria called Haemophilus influenzae B.  This is the same bug that causes flu but if it accesses the brain of the very young (less than 5 years of age and often younger) it causes meningitis.  Thankfully the vaccination campaign that backs HiB has been incredibly successful and the rates of infant meningitis have all but bottomed out.

    The elderly are also at risk for meningitis but again the causative agent is different.  They are more likely to get meningitis from the bacteria Streptococcus pneumoniae.  This bacteria also causes meningitis in the very young which is also why it is included in the infant vaccine schedule but it is also the cause of otitis media (ear infections), sinusitis, skin infections and pneumonia. 

    The one that I wanted to spend some time on is Neisseria meningitidis.  This one is the cause of most bacterial meningitis in young adults (teens to 30s).  It is particularly an issue for those who live in close confines or those whose behaviour puts them in close contact with others.  What do I mean by that?  People who live in barracks or dorms or find themselves in smokey filled-to-capacity rooms on a regular basis are more likely to be in the kind of contact which enables the transfer of these bacteria.  They do not survive well outside of the body so this kind of transfer is a requirement.  Naturally, contact is not enough to cause the infection to become meningitis.  The bacteria has to not only colonize the individual but also needs to cross the blood-brain barrier. This happens very infrequently.  The human body is exquisitely ordered so that its functions are continuously managed.  Again, there is a vaccine for this bacteria BUT it is targetted to 4 of the 5 serogroups (differentiated types): A, C, Y & W135.  Unfortunately, the 5th one, B, is the cause of 30-50% of this bacterial meningitis in the western world. Vaccine research continues but thus far has been unsuccessful. 

    This bacteria also causes a septicemia which is to say it causes infection throughout the body.  Such infections become very painful but before this symptom is evident, a purpuric rash appears.  This is the symptom that if recognized will save someone's life.  It is a non-blanching (when pressed the color remains) rash of very small red or purple spots (0.3-1mm).  It is found primarily on the trunk of the body which brings me back to my point of awkwardness.  Most people would not dare to ask to see the chest of a teen who is experiencing fatigue, headache, stiff neck and/or fever.  I am not one of those people anymore.  If you cannot do this, get them to look in a mirror and report to you.  This rash is the sign that there is a medical emergency.  Right Now.  Get them to a hospital and before you even let them start up all the forms - show the rash.  You'll get the best service of your life - and it will save your life. 

  8. There are very few medical emergencies but I was unfortunate enough to have one several years ago.  The sad thing is that because everyone thinks that what they are experiencing is an emergency, some life-threatening incidents are overlooked.  As a young adult living in my hometown, I had some symptoms that troubled me enough to go to our family doctor.  He was a fellow who knew me well and took any complaints of mine seriously knowing that I was not one to make waves if I didn't have to.  (He actually had saved my legs years earlier.  I had had an accident and thought the pain I was experiencing with walking and standing was part of the healing process.  3 weeks later, the pain was getting worse and it turned out that I had bone and tissue infection throughout both my legs and was about half a week away from needing intervention.)  At that time, he had told me that if my stomach pains continued to go to the hospital and call him at home.  He also gave me a list of other symptoms to watch for; nausea, a hardness to my abdomen, pain that increases upon release of holding the area below my ribs on the right side, fever, and difficulty walking. The symptoms went away and I did not take any further steps but his concern and advice stayed with me.

    Many years later, I had a return of something similar but much more painful.  I went to my local emergency room and the triage nurse was quite concerned and sent me right in with 2 of 3 indicators of appendicitis.  4 hours and some blood work later, the doctor argued with me about the likely cause and pointed to some bacteria in my urine as the cause of my discomfort.  I tried to explain that this pain was different and I had had many bladder and even kidney infections and what I was there for then was not anything like a bladder infection.  After more arguing, she very reluctantly agreed to have me X-rayed in 4 hours.  Now here's where the story gets personal.  If I had just stayed and been my own best patient advocate, I would have been in hospital for the surgery sometime that day or night.  I did not do that.  I was mad that she wasn't taking me seriously and I left.  I wanted to be right and I wanted her to be right that it wasn't anything too pressing.  Sadly, a couple hours after I left the emergency department, it ruptured.  I didn't know it then but I do now.  How do I know - I felt Better.  What?  That's right - I felt better.  In that moment the pressure of the inflammation was released and I felt much better.  Unfortunately, that's when parts of your intestinal insides are leaking into your abdominal cavity causing all sorts of problems with infectious materials and very damaging fluids. 

    Obviously I am writing this entry so I did get the proper medical care.  Having written this though, that care was delayed by more than 1 day due to my stubborness, inability to adequately state my case and be taken seriously as well as the wrong diagnosis.  That wrong diagnosis caused the ambulance staff to force me to get out of bed, walk down the apartment halls, down the stairs and get onto the stretcher by myself.  (It had been ruptured for about 9 hours by then.)  It also caused the next emergency room to delay testing for an additional 8 or 9 hours.  All in all I waited 20 hours with a ruptured appendix for the surgery to save my life.  The potential consequences were, aside from death, permanent damage to my fallopian tubes and intestinal abscesses.  As it turned out, I went on to have children - so no damage to the fallopian tubes and after just 17 short days in the hospital I went home to spend another 5 weeks recovering.

    The bottom line: be your own patient advocate or get someone who knows you well to be an advocate for you.  As well trained and talented as the medical staff are, they deal with a spectrum of cases and a spectrum of people every day.  Not everyone is honest.  Doctors need to make snap decisions about not only a person's health status but also their personality.  It is not an easy job on multiple levels.  But you know your body better than anyone else.  You've been living in it and with it all your life.  No one should tell you what you feel.  If they are and you feel your concerns are not being addressed you can try to better state your case, have someone help you with explaining yourself, wait for another physician to take the time to hear you or even go to the next clinic or emergency room to find another doctor to repeat your story to.  I know it sounds tedious and it shouldn't be that way but everyone has had a situation where you know you are not going to get what you want.  Rather than beating your head against a wall (which would require more medical attention), keep trying.  I even remember hearing that Oprah was misdiagnosed for over a year.  And speaking for myself, she's got way more money and resources.  If it can happen to her, it can happen to you and it has happened to me.


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