Author Archives: Carey Goldberg

What Teens Say Teens Should Know About Sexually Transmitted Diseases

(Planned Parenthood)

(Planned Parenthood League of Massachusetts)

By Joey Boots-Ebenfield
Guest contributor

I’ve gotten used to hearing myths and misinformation when I talk about sex with fellow teens.

And I talk about sex often in my role as an 17-year-old peer educator with the Planned Parenthood Get Real Teen Council (GRTC) — a year-long high school sexual health program for 10th-12th graders who are trained to facilitate sex education workshops and serve as resources for peers, families and communities.

If teens are uncomfortable talking about topics related to sex and sexuality, or don’t have a trusted source of information about their health, it’s easy for all kinds of misinformation to spread. And of course, there’s the Internet, where bad information is often rampant, so it’s not always a reliable place to find accurate health information.

The subject of sexually transmitted diseases (STDs) is no exception. I’ve heard some pretty interesting misconceptions about what STDs are and what it’s like to get tested. One myth is that STDs have obvious symptoms, like localized pain or some other physical sign.

In fact, this is quite the opposite! STDs often show NO symptoms. This myth is especially dangerous because it means that someone can have an STD and not even know it. As a result, many STDs go untreated, which can cause cause some pretty nasty complications. Continue reading

Study: Young Adults’ Casual Marijuana Use Causes Brain Changes

(prensa420/Flickr)

(prensa420/Flickr)

A new study by Boston researchers is believed to be the first that shows that young adults who even occasionally smoke marijuana could be damaging their brains.

The study, just published in The Journal of Neuroscience, found abnormalities in areas of the brain related to emotion, motivation and decision-making.

The researchers say the degree of brain changes appeared to be directly related to how frequently the study’s participants smoked pot.

The authors write in their paper:

The results of this study indicate that in young, recreational marijuana users, structural abnormalities in gray matter density, volume, and shape of the nucleus accumbens and amygdala can be observed. Pending confirmation in other cohorts of marijuana users, the present findings suggest that further study of marijuana effects are needed to help inform discussion about the legalization of marijuana.

The study comes with a plurality of Massachusetts residents supporting the legalization of marijuana for recreational use, and as the state is in the process of opening medical marijuana dispensaries.

Here & Now has more on the study this afternoon.

And hat-tip to The Boston Globe, which has more on the findings.

My Mother’s Surgery And One Doctor’s Substance Abuse

By Karen Shiffman
Guest contributor

USA Today reports more than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction. This wasn’t news to my family.

Some 20 years ago, my mother was mauled by a dog. She was on vacation in Florida and went over to a friend’s house for dinner. To understand what happened next, you need to know a few crucial facts about her: She is afraid of dogs and barely five feet tall. When her friend opened the front door, her daughter’s dog — an Akita- tore out of the house and lunged . My mother turned away quickly. The dog lunged again. Because of her short stature, his teeth sunk into her calf. He all but ripped it off.

(Alex E. Proimos/flickr)

(Alex E. Proimos/flickr)

Blood everywhere. Screams. Tears. Ambulance. Thirty-nine stitches at the ER. She would need a skin graft.

And then there was the drama with the friend. Turns out, this wasn’t the first time the dog had bitten someone. Still, the family didn’t want the dog put down. Eventually, he was. My mother and her friend of 30 years never spoke again.

Back home in Boston, my mother was referred to a plastic surgeon at what is now Beth Israel Deaconess Medical Center. He was kind and I agreed with my mother that he should do the surgery.

The operation went well. I went with her to the post-surgery checkup. We both thanked the surgeon for doing such a great job and for taking such good care of my mother.

So, imagine my shock, in 2008, to read in The Boston Globe that my mother’s surgeon was fired for being impaired in the OR. And that he had been struggling with substance abuse for the past six years. Continue reading

Boston Hospitals Reflect With Pride On Marathon Bombing Response

A Boston Strong banner hangs at the Boston Harbor Hotel on Tuesday. (Bill Sikes/AP)

A Boston Strong banner hangs at the Boston Harbor Hotel on Tuesday. (Bill Sikes/AP)

Early in the afternoon last April 15, Dave Reisman was laughing as he left a meeting to update hospitals around the city about conditions at the Boston Marathon. It looked like a light year for patients. The weather was sunny, but not too hot.

Reisman, an emergency preparedness director at Mass General, told a group gathered Tuesday to review lessons learned the day of the bombings that he will never forget walking out of that meeting, hearing his pager go off, and reading the message.

“Reports of explosive devices in Copley Square: one detonated, another suspected,” Reisman recalled the message saying. MGH treated 97 patients that afternoon, in an emergency room equipped to handle 44.

“The environment in the [emergency department] was intense,” said Maryfran Hughes, nursing director for emergency services. “Many people were arriving and people didn’t know what was going on. The professionalism and compassion of the nurses really transcended their own fears. They didn’t know what was happening out there.”

None of the Boston hospitals, including MGH, lost a patient that day or in the days and weeks that followed, even though the pressure did not let up. Trauma surgeon David King says for hospital staff, it was a marathon week.

Continue reading

Marathon Reflection: How To Raise Secure Children In An Insecure World?

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help injured following the explosions. (Charles Krupa/AP)

Police clear the area at the finish line of the 2013 Boston Marathon as medical workers help the injured following the explosions. (Charles Krupa/AP)

One year ago, on the day of the Boston Marathon bombing, Dr. Gene Beresin shared advice on how to talk to children about the frightening event. Here, a year later, he and Dr. Paula Rauch, a fellow professor of psychiatry at Harvard Medical School, help parents draw broader lessons about how best to help children face such stresses and even grow through them.

By Drs. Paula K. Rauch and Gene Beresin
Guest contributors

For the most affected families, April 15th, 2013 was a life-changing event. For many in our community it produced a lesser, but still significant, set of challenges, and for some facing other family adversity or chronic stresses, it may have seemed like a minor event with little personal impact.

Regardless of how personal or significant the marathon bombing and its aftermath were for you, every one of us will face life challenges within our families and in the larger community. How can we face stressful experiences in ways that support our children’s resilience, and help them grow through those challenges? How do we raise secure, confident children in an uncertain world?

Start small

Children develop confidence and competence by facing new experiences, difficult transitions and unavoidable frustrations throughout childhood. Life continually presents a child with developmental challenges, such as falling asleep alone in a crib, saying goodbye at a new preschool, facing the first day of school with a sea of unfamiliar faces, dealing with a relentlessly annoying peer, being cut from the travel team, and, for some teens, making this month’s tough decisions about college.

It is often tempting as a parent to want to smooth over these challenges, alleviate uncertainty and facilitate a child’s comfort and success. But it is important to recognize that these age-appropriate frustrations and disappointments are essential for building lifelong coping skills. Children need to learn how to manage new and difficult situations, and while parents cannot solve the challenges for a child, they can provide appreciation and emotional support for that child’s efforts. Living through a multitude of such experiences makes the normal feelings of distress more familiar and less frightening.

Face serious challenges together Continue reading

Bittersweet Marathon Anniversary: Lost A Leg, Gained Cherished Friends

Heather Abbott, left, and Roseann Sdoia are both amputees who developed a friendship after last year's bombing. (Jesse Costa/WBUR)

Heather Abbott, left, and Roseann Sdoia are both amputees who developed a lasting bond after last year’s bombing. (Jesse Costa/WBUR)

On the evening before the one-year anniversary of the day that changed their lives, Roseann Sdoia and Heather Abbott met up for dinner. The two women had been acquainted before shrapnel shredded the lower part of Abbott’s left leg and most of Sdoia’s right leg.

Now they’re fast friends who push and inspire each other and offer support and counseling. The close bonds among many of the bombing survivors, first responders and their families are a reminder that Tuesday’s anniversary is mixed.

‘It’s Still Kind Of Surreal’

Abbott was waiting to get into the Forum on Boylston Street last April when the second bomb went off. Sdoia had just stepped out of the restaurant to look for a friend nearing the finish line.

Abbott and Sdoia had come to the Forum with separate groups of mutual friends. The two women didn’t realize they were both amputees until they saw each other at Spaulding Rehabilitation Hospital. They still have a hard time accepting what happened.

“I’m getting a little bit closer, but it’s still kind of surreal to me,” Sdoia said Monday evening.

“Sometimes I’ll wake up in the morning, to get out of bed, and I’ll look down and realize I have to put my leg on,” Abbott said. “And I think, this is never going away.”

Abbott looked down at her left calf and foot. She was wearing a wedge sandal on her dress-up leg. Dress legs come in different heel sizes. There is an adjustable heel, but Abbott said it is not very stable.

“When I inventoried my closet,” Abbott recalled, “four inches was the most popular one, so that’s what I went with.”

Sdoia wore black sandals. The toenails on both feet were a deep purple. Sdoia’s testing a new way to keep the sandal on her carbon fiber foot.

Walking is “not very smooth,” Sdoia said with a laugh. “At any moment, that sandal could come off. I mean it’s velcroed on right now, to the bottom of my foot.”

Sdoia joked about being jealous that Abbott was back into her tight jeans first, wearing heels first and running, again, first. Sdoia, whose amputation is above the knee, has had a more difficult recovery. But each women feels like she’s constantly being fitted for a new socket as her limb shrinks. Abbott has gone through five different-sized sockets and is due for another. Continue reading

After Bombs Hit, Spaulding Moved Front And Center

In this 2013 WBUR file photo, marathon bombing survivor Mery Daniel works with occupational therapist Becky Buttiglieri outside the new Spaulding Rehabilitation Hospital. (Jesse Costa/WBUR)

In this 2013 WBUR file photo, marathon bombing survivor Mery Daniel works with occupational therapist Becky Buttiglieri outside the new Spaulding Rehabilitation Hospital. (Jesse Costa/WBUR)

When the twin explosions hit the Boston Marathon last April, Spaulding Rehabilitation Hospital was 12 days away from moving into its new building at the Charlestown Navy Yard.

Among the first patients on Spaulding’s move-in day were more than a dozen marathon survivors — some just released from acute care hospitals. They’d lost limbs, suffered burns and nerve damage, and some still had shrapnel embedded in their bodies.

“What happens in great places like Mass. General, they save people’s lives that would have otherwise been lost. We like to say once they come to rehab we give the quality of life back after that life’s been saved,” said David Storto, president of the Spaulding Rehabilitation Network and Partners Continuing Care, which includes three other hospitals, as well as 23 satellite facilities.

“People just generally, at the onset of a significant disability, they’re more concerned about the basic things in life,” Storto said. “Are they going to be able to walk again? Are they going to be able to dress themselves again? Are they going to be able to brush their teeth again without being dependent, and requiring support of other people?”

Thirty-two marathon survivors were treated on an inpatient basis at Spaulding  TWEET , including 15 of the 16 who suffered amputations and had to learn to walk on prosthetic limbs. Among them: first-grader Jane Richard, the youngest of the marathon amputees; and Mery Daniel.
Continue reading

Autism: Awareness Helps, But What We Really Need Is Knowledge

The author's 15-year-old son, Sam, after an orchestra concert.

The author’s 15-year-old son, Sam, after an orchestra concert. (Courtesy)

By Ilyse Levine-Kanji
Guest contributor 

April is autism awareness month. Awareness is great. But what really frustrates me and other parents of children with autism isn’t a lack of awareness but rather how little is actually known about the disorder.

For instance, there is no explanation about why the number of autistic children is exploding. Less than a month ago, the Centers for Disease Control released updated data about the public health epidemic of autism. The CDC found that for children born in 2002, the prevalence of autism is 1 in 68, and 1 in 42 boys. This new prevalence finding is roughly 30% higher than just six years ago and roughly 120% higher than the CDC’s findings in 2002 (1 in 150).

I’m incredulous that people still argue that the increase in the prevalence of autism is only due to better diagnosis.  Do we really believe that doctors and teachers 20 years ago simply didn’t notice the devastating symptoms presented by children affected by autism?

Equally frustrating is the lack of knowledge about the capabilities and inner lives of people with autism. When my son Sam was diagnosed at 26 months in 2000, we were told that a primary hallmark of autism is social disinterest and the desire to be alone. Now that Sam is 15, we realize that couldn’t be further from the truth.

Within the first minute of meeting Sam, you know that he is different. He likes to walk up to people he doesn’t know and rapidly blurt out: “What-is-your-name-and-when-is-your-birthday?” He can say this in an unexpectedly loud voice, with his eyes averted and his back or side facing the person he’s addressing, and maybe standing too close to — or too far away from — his intended “conversation partner.” Once the person answers, Sam often simply moves away, without acknowledging the response or following up in any way, leaving the person confused about the unusual interaction.

Connection

While Sam’s social interactions are often quirky and unexpected, Sam has a deep desire to connect with others. He is always willing to go to the grocery store or run errands with me, primarily because he’s excited to see who we will run into. People joke that Sam acts like “the mayor,” greeting everyone he sees by name and with an extremely enthusiastic fist bump. (Again, we were told that people with autism have trouble recognizing others, which also hasn’t been true for Sam.)

What is accurate is that Sam has tremendous difficulty communicating. He speaks in full sentences, but it is often a struggle for him to communicate his thoughts. One way that Sam compensates for this difficulty is that he painstakingly plans out what he is going to say to someone before he sees him or her.

Sam has many rehearsed scripts in his head that he pulls out depending on the person. Continue reading

Opinion: Why Zohydro Ban Is A Tough Call

Update 4/15:

The AP reports that a federal judge blocked Massachusetts from banning the powerful new painkiller Zohydro.

U.S. District Court Judge Rya Zobel on Tuesday issued the preliminary injunction after the maker of the drug, Zogenix, said in a lawsuit that the ban ordered by Gov. Deval Patrick was unconstitutional.

Zobel said in issuing the injunction that Massachusetts appears to have overstepped its authority in banning the drug, which had been approved by the U.S. Food and Drug Administration.

Patrick ordered the ban after declaring a public health emergency in light of widespread prescription drug abuse in the state.

The judge said federal law preempted the state’s order.

By Judy Foreman
Guest contributor

U.S. District Court Judge Rya W. Zobel today disappointed anyone who expected her to quickly strike down Gov. Deval Patrick’s ban on the sale of the new pain reliever Zohydro. She declined to rule on the drugmaker’s request to quickly but temporarily lift the ban, and is continuing to consider whether to lift the ban permanently.

Judge Zobel faces a difficult decision but not because Zohydro, as many media reports have said, is more potent than anything else on the market. It’s not, and we’ll get to that in a minute.

(wikimedia commons)

(Wikimedia Commons)

First, the legalities. It should be up to federal health officials, including the U.S. Food and Drug Administration, not governors, to make decisions about the safety (or lack thereof) of drugs. For better or worse, the FDA, after a long 2013 review, and against the vote of its own advisory committee, did approve Zohydro in October of last year.

Legally, and logically, it also made little sense in the first place – except politically — for a governor to focus on one particular drug when the whole class of drugs to which it belongs — opioids, also known as narcotics – is controversial precisely because that whole class of drugs has such a complex mix of risks and benefits.

In truth, Zohydro is probably not the wonder drug that its manufacturer, Zogenix, claims, nor is it the menace that critics assert. The furor over Zohydro is simply the latest example of how difficult it is to balance the legitimate needs of people in chronic pain who need long-acting opioids and the also-legitimate need to protect vulnerable people from getting their hands on drugs they might abuse.

The unique feature of extended-release Zohydro is that it contains the opioid hydrocodone, and only hydrocodone. Continue reading

Boston Marathon Medical Director: Getting Back To What The Race Is About

 

Medical personnel work outside the medical tent after the Boston Marathon bombing on April 15, 2013. (Elise Amendola/AP)

Medical personnel work outside the medical tent after the Boston Marathon bombing on April 15, 2013. (Elise Amendola/AP)

Last April 15 at about 2:45, Dr. Aaron Baggish was enjoying the sunny spring day and, in his role as medical director of the Boston Marathon, marveling at the low volume of runners who needed his care. Then the first bomb exploded, about 15 feet away from him. It blew out his right eardrum but the crowd blocked much of the force of the blast, and within seconds he was over the barrier and starting to work on the injured.

After the bombing, Dr. Baggish, who heads the Cardiovascular Performance Program at Massachusetts General Hospital, declined requests for interviews, feeling unable to speak publicly about what happened. But as Boston gears up for its next marathon on April 21 and he prepares to help oversee the race’s medical staff once again, he agreed to share some of his thoughts.

As you reflect back on what happened at last year’s marathon, what are you thinking, what lessons do you see?

Basically, I gave up very early on trying to make sense of any of this. There’s no way to make sense of a senseless, horrible act. We’ll never be able to put it into a neat compartment and say, ‘Oh, yes, that’s why this happened.’ No sense can be made of it. So the next step is, what was the impact on me personally? How do I go about some form of healing process? And how do you reconcile the personal trauma with ‘I have a job I have to do’? And we have a job now that we have to do this year, which is as important if not more important than ever: To run the safest, most medically comprehensive race we possibly can.

Are you medical director again?

Of course. You’d better believe it. Nowhere I’d rather be.

Dr. Aaron Baggish (Courtesy MGH)

Dr. Aaron Baggish at work (MGH)

To ask you your own questions, what was the impact on you personally? How do you go about some form of healing process?

It’s been a series of phases, if you will. There was an immediate, necessary phase of blocking everything out and dealing with the professional aftermath: the meetings and debriefings and making sure the volunteers were okay. That lasted for about a month and was more of a business-as-usual sort of feel than anyone could imagine.

But once the media coverage slowed down and Boylston Street was cleared, that’s when the real, hard personal work started. That’s when the concept of PTSD became a reality.

For example?

For example, I was participating in a Triathlon on Lake Winnepesaukee in August. It’s a race I do every year, a half Iron Man, it’s a special day for me, and I was standing on the beach and watching the professional athletes get going, and they fired a cannon for the men’s start. I knew it was coming. What I didn’t realize was that they would fire a second cannon for the women. So three minutes later, they fired a second cannon and I just disintegrated. I had an unbelievable physiological response. I became nauseous, shaking, and it was then I realized that this was a real, deep scar that would be left for a long time. That was a turning point for me; it made me aware I needed to talk about things more, not publicly but with family and friends and colleagues. That was a good step, and over the fall I very actively engaged with people I trust and feel emotionally safe with, to make certain I could start processing some of this. That took some time, and there were some dark moments there. Continue reading