Author Archives: Carey Goldberg

Project Louise: Eat Like A Teenager? Not Anymore

A mere snack for Louise’s son, but more than she can handle anymore. (O’Dea via Wikimedia Commons)

By Louise Kennedy
Guest contributor

Ah, school vacation week. Or, as I like to call it, National Eat Like a Teenager Week.

This started last year, when my son and I took a road trip to Dayton, Ohio.  (Not that one needs a reason to choose such a dream destination, but I grew up there. Thanks for asking.) It quickly became clear that as long as I was taking him to Dayton, I really couldn’t fail to introduce him to one of my childhood haunts, Vic Cassano’s Pizza King. And, of course, if I was actually at Vic Cassano’s Pizza King, there was simply no way I was not going to eat the pizza.

All this was before Project Louise, but I was still trying to eat more or less sensibly. But I really, really wanted that pizza. And thus National Eat Like a Teenager Week was born.

So now here we are again, and once again I’m on a road trip with my son – only to the Cape this time, so I’m safe from Signore Cassano … for now. But I’ve still been tempted, most recently this morning, to abandon all restraint and eat as if I were a 16-year-old boy, with the metabolism to match.

Only here’s the thing: I can’t. Continue reading

A (Frozen) Boost For Fecal Transplants To Treat Nasty Bacterium

Bottles of frozen human stool for fecal transplants at the nation's first stool bank, OpenBiome (Gabrielle Emanuel for WBUR)

Bottles of frozen human stool for fecal transplants at the nation’s first stool bank, OpenBiome (Gabrielle Emanuel for WBUR)

By Gabrielle Emanuel

Last month, we reported on the first national stool bank and its struggle to survive. Today, a pilot study, published online in Clinical Infectious Diseases, gives the stool bank a helpful boost.

The study found frozen stool from an unrelated donor to be as effective in treating patients as fresh feces taken from the patient’s family member. It also found that the transplant can be successfully administered through the nose.

Before you stop reading, here’s some background: A stool bank is just like a blood bank, but instead of collecting, testing and distributing blood, it works with fecal matter. The main beneficiaries are patients with recurrent Clostridium difficile (C. diff). C. diff is a nasty bacterium that causes such bad diarrhea it can completely disrupt a person’s life. Over the course of a year, it sickens half a million people and kills about 14,000 people in the U.S.

Luckily, there is a very effective treatment: fecal transplants. This is when you take stool from a healthy donor and put it into the gut of a sick patient; the good bacteria then outfights the C. diff. Studies involving animals and fresh fecal material show that this procedure works 90 percent of the time.

“It’s been remarkably successful and gratifying,” said Dr. Elizabeth Hohmann, an associate professor of medicine and infectious diseases at Massachusetts General Hospital and Harvard Medical School, and the study’s senior author. “There aren’t that many things we do in medicine that are over 90 percent effective.”

Despite such a success rate, many doctors are unwilling to do the procedure. One of the main reasons is that finding and screening donors takes a lot of time and can be expensive.

When Mark Smith, a PhD student at MIT, heard about this he decided to partner with some friends and start a stool bank. The thought was that if they provide prescreened, frozen stool, the procedure would be way easier and, thus, boost its availability. Their stool bank has been fully operational since early October.

But the FDA was more cautious. Continue reading

Mass. Gov Seeks More Restrictions On Controversial Painkiller

State House News reports that Gov. Deval Patrick is trying once again to crack down on the controversial pain medication Zohydro:

After a federal judge struck down the governor’s emergency ban on Zohydro, Gov. Patrick moved on Tuesday to impose restrictions on prescribing the powerful new painkiller that include mandatory risk assessments for patients.

(Wikimedia Commons)

(Wikimedia Commons)

The Patrick administration announced late Tuesday afternoon that doctors would be required to complete a risk assessment and pain management treatment agreement before prescribing any drug like Zohydro, which is a hydrocodone-only medication that state public health officials say is not yet manufactured in an abuse-deterrent form.

Zohydro only hit the market in March after the Food and Drug Administration approved the drug for commercial use in October. Other states such as Vermont have taken similar steps to protect against the potential abuse of Zohydro by making it more difficult for doctors to prescribe.

The Board of Registration in Medicine voted to approve the new restrictions on Tuesday, and Department of Public Health Commission Cheryl Bartlett issued an emergency order requiring physicians to utilize the state’s Prescription Monitoring Program before prescribing Zohydro, which is a way for state authorities and prescribers to track where patients are getting their drugs. Continue reading

Your Brain On Junk Food: ‘Making Us Crazy’ — But Might Fish Help?

By Suzanne E. Jacobs
CommonHealth intern

An urban planner and a biochemist walk into a seafood restaurant.

Okay, that joke’s going nowhere, but last week an urban planner and a biochemist did walk into a classroom at MIT. In a talk titled “Junk Food and the Modern Mind,” the unusual duo explained to a room full of people how seafood’s effects on the human brain could bridge their seemingly disparate fields.

The urban planner was Lynn Todman, a visiting scholar at MIT. Todman has spent the past nine years working to improve mental health and reduce violence among residents of some of Chicago’s roughest neighborhoods.

(Wikimedia Commons)

(Wikimedia Commons)

Last year, Todman held a focus group with adult men in Chicago. At one point, she recalled, one of the men said, “This food is making us crazy,” referring to the unhealthy options common in urban food deserts. Having read up on studies linking nutrition and aggression, Todman took what he said seriously.

“Now, I’ve been doing community based work for a long time, and I know that residents often understand social realities long before we do in the academy, and even though their understanding might be shaped by a series of anecdotes strung together to suggest a trend or pattern, I attribute very real meaning to what residents say about their communities and the observations about the world that they live in,” she said.

Enter Capt. Joe Hibbeln, the biochemist.

Hibbeln, who is also a psychiatrist, works at the National Institutes of Health as a nutritional neuroscientist and is one of the world’s leading experts on the role of fats in brain development.

His claim: a diet rich in omega-3 fatty acids and low in omega-6 fatty acids can make people happier and less aggressive. Continue reading

Report: Disabled Mass. Residents Face Major Health Disparities

health disparities

A new report highlights the many ways in which Massachusetts residents with disabilities “fare worse” than those without disabilities when it comes to their own physical and mental health as well as access to quality medical care from doctors sensitive to their needs.

This phenomenon isn’t new. Previous research found that many barriers still exist that prevent disabled patients from accessing specialty medical care. And for those with developmental and intellectual disabilities, sometimes finding a doctor willing to treat even common medical conditions can be difficult.

The latest report, by researchers at UMass Medical School’s Disability, Health and Employment Unit working and the Health and Disability Program at the state Department of Public Health, also suggests that the state could do more to ensure that disabled patients have access to health care providers who both understand and can help with the specific medical challenges of this population.

I asked the researchers, led by Monika Mitra, PhD, assistant professor in UMass Medical School’s Department of Family Medicine and Community Health, to lay out the key messages of the report. Here are some of their findings:

• 24% of those with disabilities are current smokers compared to 16% of adults without disabilities.
• Both men (7%) and women (24%) with disabilities were more likely to report lifetime sexual violence compared to men (4%) and women (19%) without disabilities.
• Adults with disabilities (64%) were twice as likely to report being overweight as those without disabilities (34%).

In addition, people with disabilities surveyed in the study reported the following health-related concerns:

• Affordable housing (77% of respondents reported this was a problem);​
• Adequate dental care (64%);
• Adequate mental health services (62%);
• Finding a doctor who is sensitive to disability issues (55%);
• Transportation to doctor’s appointments (54%);
• Communication supports, such as large print, Braille, Computer Assisted Realtime Translation (CART) readers, etc. (52%);
• Managing chronic conditions, such as diabetes (50%);
• Paying for prescription medications (48%);
• Finding a doctor who accepts public health insurance (48%); and
• Accessible gyms (45%).

Continue reading

Heat Takes Marathoners By Surprise

It was hotter than expected on Marathon Monday, and there may have been more charity or first-time runners than usual. Both these things could help explain why almost 4,000 runners and a few spectators walked or were wheeled into a medical tent along the course.

The Mecca Of Marathon Medicine

As temperatures rose above 70 degrees and the sun blazed, Clyde Dickey, from Rockwall, Texas, said he downed too much Gatorade.

“I just threw up a little bit, and I felt faint” as I crossed the finish line, Dickey said. “I thought I had heat exhaustion. I gave [the race] all I had, but the heat just got to me.”

Clyde Dickey from Texas tried for a personal record, pushed too hard and was treated for heat exhaustion. (Martha Bebinger/WBUR)

Clyde Dickey from Texas tried for a personal record, pushed too hard and was treated for heat exhaustion. (Martha Bebinger/WBUR)

Dickey was underground, waiting for the T when the bombs went off last year and regrets that he wasn’t able to help those wounded. He added Boston TV stations to his cable package so he could watch all the specials in the year since.

“I love coming here,” Dickey said. “This is the mecca of marathons.”

And perhaps the mecca of marathon medicine. So when a guy from Michigan, who trained all winter in 20-degree weather, collapsed at the finish line, a volunteer scooped him into a wheelchair and had him on a cot with an IV in his arms within minutes. Another volunteer caught a woman from Washington, D.C., who started spinning as she slowed down.

“I wasn’t quite expecting it but today we saw quite a bit of hyperthermia, people overheating,”
said Dr. Pierre d’Hemecourt, one of the marathon’s medical directors. He said the tents, which were larger with more staff and equipment than last year, were busy most of the day.

“Most of [the activity] being relatively minor, dehydration, things like musculoskeletal complaints,” d’Hemecourt said. “So overall it’s been a pretty good day.”

Which, in contrast to last year, was a relief for many of the doctors, nurses and other volunteers who staffed the medical tents. Continue reading

OBs: No Link Between Labor Induction And Autism

The nation’s most influential group of obstetrician-gynecologists concludes that there’s no connection between labor induction and autism. Earlier reports suggested that there’s was a possible link, but even that research, published in JAMA Pediatrics, was complicated and somewhat murky.

(popularpatty/flickr)

(popularpatty/flickr)

Here’s ACOG’s latest guidance on the matter, from the news release:

Current evidence does not support a conclusion that labor induction or augmentation causes autism spectrum disorder (ASD) in newborns, according to a new Committee Opinion released by the American College of Obstetricians and Gynecologists (the College).

While some studies have suggested an association between ASD and the use of oxytocin for labor induction or augmentation, available evidence is inconsistent and does not demonstrate causation, according to the opinion, which also found important limitations in study design and conflicting findings in existing research.

Given the potential consequences of limiting labor induction and augmentation, the College’s Committee on Obstetric Practice recommends against changes to existing guidance regarding counseling and indications for, and methods of, labor induction and augmentation.

“In obstetric practice, labor induction and augmentation play an essential role in protecting the health of some mothers and in promoting safe delivery of many babies,” said Jeffrey L. Ecker, MD. Dr. Ecker is chair of the Committee on Obstetric Practice, which developed the new Committee Opinion. “When compared with these benefits, the research we reviewed in assembling this Committee Opinion, relative to the utilization of oxytocin, had clear limitations. Because of this, these studies should not impact how obstetricians already safely and effectively use labor induction and augmentation when caring for their patients.” Continue reading

Can You Run Hard While Weeping? Some Boston Marathoners Will Find Out

On the eve of the Boston Marathon, some runners said this year’s race may be as taxing emotionally as it is physically.

Tom Pfleeger, of Gulfport, Miss., finished the marathon about 40 minutes before two bombs went off last year, having completed what he thought was a perfect race. Then, the euphoria was snatched away.

“You went from the top of the mountain to lowest, low,” Pfleeger said, to being “so sad for all the people who were killed and injured.”

Carrie Lundell (left) and her niece Becky Anderson have been crying a lot as today's race approaches, but hope to keep tears at bay while they run. (Courtesy Carrie Lundell)

Carrie Lundell (left) and her niece Becky Anderson have been crying a lot as Monday’s race approaches but hope to keep tears at bay while they run. (Courtesy Carrie Lundell)

Pfleeger is one of many runners who say they are back to take care of unfinished emotional business. Beverly Dwight, from Belchertown, Mass., is running her first Boston Marathon. Last year, she was a volunteer at the finish line.

“I was able to walk away from what happened,” Dwight said slowly. “Not a day goes by where I don’t think about those who are much less fortunate.”

Dwight is prepared to cry while she runs.

They “could be tears of joy,” Dwight said, “just joy to be part of it and a sense of kind of one with the city of Boston.”

Some runners worry about becoming overwhelmed.

“It’s going to be insane. I’m hoping it doesn’t tip me over to the emotional part because it’s super hard to run when you’re like feeling verklempt,” said Carrie Lundell, from Orange County, Calif. She clutched at her throat, using the Yiddish word that means “choked with emotion.”

“I just need to take it right up to that level, but not over until we cross the finish line, and then there’s going to be a lot of tears,” Lundell said.

Lundell will be running with her niece Becky Anderson from Eagle Mountain, Utah. Anderson ran the marathon last year, finishing 15 minutes before the first explosion. Continue reading

Aid-In-Dying Loophole: Advocates Want You To Know You Can Stop Eating And Drinking

Lee J. Haywood/flickr

Lee J. Haywood/flickr

By Nell Lake
Guest contributor

One sunny day in the spring of 2012, Kathleen Klein sat in a car by the California coastline with her 84-year-old mother, Jackie Wilton. The two women had been quietly gazing at the view, watching seagulls along the shore. “I’m ready to go,” Klein recalls her mother saying. “Not go home…Go.”

Klein didn’t need the clarification. Her mother had been speaking of wanting to die for years, ever since Wilton was diagnosed with an unspecified dementia a few years before. Wilton’s memory had become significantly impaired. But even before her diagnosis, Wilton was clear: She wanted to die before she became severely incapacitated.

Not long after the conversation by the water, Wilton asked Klein explicitly for help in ending her life. In interviews and a recent blog post, Klein remembers wanting to help her mother, but of being unwilling act illegally.

Even if Wilton had lived in one of the five states with an aid-in-dying law, she would not have qualified for such aid from a physician. That would have required a doctor’s determining that she would likely die within six months. Given the usual course of chronic, progressive dementia, Wilton would likely have lived much longer.

So Wilton needed another option for ending her life. Soon Klein heard a radio interview about “the possibility of helping someone die by letting them stop eating and drinking,” she wrote. “The way I understood it, it was the only legal form of assisted suicide.”

Klein mentioned the scenario to her mother. Wilton said she would think about it. A few days later, Wilton again mentioned wanting to die. “I asked her if she remembered the idea I had run by her. She didn’t, so I told her again. I suggested we give it a try (a ‘dry run,’ we called it) for a day and see if she wanted to continue.”

Wilton began the “dry run” on April 28, 2012.

No Food, No Drink

Most often referred to as VSED — voluntary stopping of eating and drinking — the practice of giving up food and drink in order to hasten one’s death is being increasingly publicized by aid-in-dying advocates as a legal alternative to physician-assisted suicide.

VSED is legal everywhere, even in states without aid-in-dying laws, and in cases in which a person, like Wilton, would not qualify for assistance with dying even in those states.  Compassion and Choices, a leading “death with dignity” organization, is beginning to more actively promote VSED as an option because “it’s something that patients can openly pursue, in open dialogue with their physicians, with the support of hospice,” says Barbara Coombs Lee, the group’s director. “We do want to make it more public. We want to make it more visible because it upholds the truth that ultimately patients should be and are in charge. That’s kind of a consciousness-raising task. Continue reading