Author Archives: Carey Goldberg

Where’s Laurie? When ‘McFitness’ Axes Your Beloved Exercise Instructor

Exercise class members posted this tribute video to instructor Laurie

By Constanza Villalba, PhD
Guest contributor

In the annual survey of fitness trends from Zumba to yoga, one “trend” remains consistently among the top three: the importance of high-quality fitness professionals.

Why are skilled, educated instructors so important to fitness? Many reasons, but one seems to be the relationships they form with the people they teach. One recent study found that people are more likely to remain engaged in their own fitness — and indeed, may even be more satisfied in life — if they have kind, caring exercise instructors who are genuinely invested in the success of their students.

Are Fitness Classes Going The Way Of Fast Food?
– Huffington Post Headline

“The important thing here was the perception of the leader’s interaction and the message they were sending,” says Dr. Theresa Brown of the University of Kansas, the study’s lead author. “Instructors who say, ‘Hey, give it your best effort and focus on your own improvement; don’t worry about what others are doing.’ Those are the instructors whose students stay engaged.”

None of this comes as a surprise to me, or to the roughly 40 people who have joined me in a campaign this fall to bring back a beloved fitness instructor named Laurie, who was fired from our Boston-area gym in August.

When we learned that Laurie had been dismissed without cause, we formed a Facebook group and started notifying other members about the group and the need to coalesce.

We wrote letters complaining to the owners, we wrote Yelp reviews (some of which were removed) condemning the gym’s decision, and several of us even filmed the short video above showcasing Laurie’s skills. Finally, after realizing that the gym’s management had no intention of bringing Laurie back, many of us, myself included, canceled our memberships.

Laurie taught an array of classes, including barbell, step aerobics, power yoga, and kickboxing, all of which were impeccably planned, richly choreographed, and layered so that people of all fitness levels could choose the intensity that suited them. Her skill as an instructor was reflected in the numbers of students she would attract, from 15 to 25 followers for each of her six classes.

We missed her. Many of the gym’s members asked the management about Laurie’s departure. In a public Facebook statement, the new manager said simply that the gym was going in a different direction.

The night I canceled my membership, which I’d had for 14 years, I realized that this “new direction” meant replacing Laurie’s classes — which she had creatively designed and choreographed herself — with prepackaged, so-called “pre-choreographed” classes whose routine is scripted by a corporation that does not allow instructors to vary moves or add personal or creative touches.

A Huffington Post piece by a health coach calls this “McFitness” and asks in its headline, “Are Fitness Classes Going The Way Of Fast Food?”

Grace DeSimone, a group fitness expert, has seen many gyms go through the type of turmoil my gym is going through when they make the transition to pre-choreographed classes. She says people may get unhappy and complain or even quit, but she has never seen class members go to the lengths we did.

Laurie’s style of teaching, DeSimone explains, is called “freestyle,” but that name makes it sound like she’s winging it, which could not be further from the truth. Instead, freestyle is about actively and expertly customizing a workout to the audience at hand, Desimone says.

Desimone understands why gyms shift to pre-choreographed classes. “Even if Laurie has a strong following, the day that she’s out sick or can’t make it in, the gym is stuck,” she explains, “because no one can do it quite like Laurie does.” With pre-choreographed classes, any instructor can take over and teach the same class. Continue reading

6 Mass. Hospitals Collaborate On Ebola Response Plan

An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)

An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)

Updated at 5 p.m.

BOSTON — Massachusetts public health leaders said Friday that while the risk of Ebola remains very low in the state, six hospitals are prepared to handle one patient each, meaning the state could treat six patients at any given time.

The announcement clears up some confusion around which hospitals are ready to care for an Ebola patient if there is a confirmed case in Massachusetts.

The six hospitals collaborating to provide care include Bay State Medical Center in Springfield and five Boston facilities: Boston Medical Center, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Tufts Medical Center and Massachusetts General Hospital.

“Hundreds of people at each hospital have spent incalculable hours in the necessary planning, training and practice efforts that are needed to respond to the challenges posed by this disease,” said Dr. Paul Biddinger, vice chair of emergency preparedness at Mass General.

Boston Children’s Hospital says it expects to join the Ebola treatment collaborative, and UMass Memorial in Worcester may as well.

The other 59 acute care hospitals in Massachusetts would screen a patient, hold anyone who is at high risk or Ebola-positive in isolation, and then transfer the patient, says Public Health Commissioner Cheryl Bartlett.

“By creating this coordinated, collaborative system, we reduce the number of people who have to have that level of intensive training to care for an Ebola patient and this is one of the reasons for our announcement today,” Bartlett said.

Massachusetts hospitals do not expect to take Ebola patients from other states. Bartlett says the Centers for Disease Control has asked each state to be ready to care for its own.

All this costly planning is making some physicians, nurses and other hospital staff nervous.

“We’re fighting fear with facts and being direct with our staff members,” said Dr. Eric Goralnick, medical director of emergency preparedness at the Brigham. “Obviously there is a lot of anxiety around this issue. We’re being aggressive around communications, and listening and listening and listening, and educating, and focused on training, exercising and preparing for this.”

There is no uniform policy for staff who treat Ebola patients in Massachusetts hospitals, but several say personnel could come and go as they would on any shift. Each doctor, nurse or lab worker would monitor their temperature twice a day.

Hospitals that take Ebola patients expect a financial hit as patients avoid “the place that is treating Ebola.” In announcing the collaborative hospital effort Friday, the Department of Public Health stressed the work it has done to prepare for Ebola, but some hospitals say they need more help with equipment, training and the possible loss of business.

More Coverage:

Why Not Scratch That Itch? Study Says Serotonin Is The Reason

(Sarahluv via Compfight)

(Sarahluv via Compfight)

By Nicole Tay
CommonHealth intern

One thing I’ve learned about living in Boston is that the mosquitoes here are vicious. They fly around almost silently, and by the time you notice them, it’s too late; they’ve already made a snack of you.

In one particular case, I was driving home from work and noticed I had an unwelcome passenger. The commute turned into an anxiety-ridden nightmare: lots of swatting while driving and many awkward attempts to lure her out the window. This would not end well, I knew. Sure enough, when I got home, I had bites everywhere. (Apparently, Boston mosquitoes can bite you through tights?!)

The itching comes next. Everyone knows not to scratch bites and itches, but few of us have the superhuman self-discipline to resist the urge. I had even deluded myself into pseudo-scientifically justifying my scratching: “If scratching relieves itchiness, it’s obviously due to some beneficial neuronal pathway, right?”

Wrong. New research from Washington University School of Medicine in St. Louis says otherwise: Scratching can relieve itch by creating minor pain. But when the body responds to pain signals, that response actually can make itching worse.

In essence, when we scratch, the resulting pain interferes with the itchiness and the brain releases serotonin to quell that pain. The serotonin then binds to certain receptors on certain neurons that stimulate the itchy sensation. From the press release:

As part of the study, the researchers bred a strain of mice that lacked the genes to make serotonin. When those genetically engineered mice were injected with a substance that normally makes the skin itch, the mice didn’t scratch as much as their normal littermates. But when the genetically altered mice were injected with serotonin, they scratched as mice would be expected to in response to compounds designed to induce itching.

[To identify the specific serotonin receptor, senior investigator Zhou-Feng] Chen’s team injected mice with a substance that causes itching. They also gave the mice compounds that activated various serotonin receptors on nerve cells. Ultimately, they learned that the receptor known as 5HT1A was the key to activating the itch-specific GRPR neurons in the spinal cord.

To prove they had the correct receptor, Chen’s team also treated mice with a compound that blocked the 5HT1A receptor, and those mice scratched much less. Continue reading

Against Odds, Menino Fought Successfully To Merge 2 City Hospitals

At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)

At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)

In 1996, it took all of Boston Mayor Thomas Menino’s political muscle to pull off what some consider a managerial miracle. Despite intense union opposition, a reluctant city council and concerns about health care costs, Menino fought successfully for the merger of two city hospitals that had been founded in the mid-19th century.

Today, Boston Medical Center stands as an enduring legacy to Menino’s efforts to serve the health needs of the city’s neediest citizens.

On Thursday a steady stream of ambulances, people in wheelchairs and children pushed in strollers entered and left the Menino Pavillion on the Boston Medical Center campus.

“Me and all my children go here. It’s a great hospital,” said Jasmine Vigo, who was leaving the Menino Center with her infant son.

“He was wheezing. I wanted to make sure it wasn’t like a viral infection or something like that. He didn’t,” she said.

Vigo said she had all four of her children in the Menino building.

The eight-story brick building, bearing the former mayor’s name, contains clinics for adults and obstetrics. Its emergency room is the busiest in the Northeast. Meanwhile, its pediatric clinic provides health care to 30,000 kids a year — and that’s just at this one building on the sprawling Boston Medical Center campus.

Continue reading

How The Upcoming Elections Might Shift The National Health Care Landscape

By Richard Knox

Here’s a solid prediction about next Tuesday’s elections: They’ll be crucial to the future of universal health care in America — or at least its near-term future.

For those who believe universal coverage is a good thing, prospects aren’t good, judging from an analysis of 27 national polls scoured by researchers at the Harvard School of Public Health.

Taken altogether, the polls show increasingly negative views of the four-year-old Affordable Care Act among likely Republican and independent voters. That could tip control of the U.S. Senate to the Republicans, enabling them to attack the ACA through the budgetary process — crippling it even if they can’t repeal it without President Obama’s signature.

In this March 23, 2010, file photo, President Obama signs the Affordable Care Act. (J. Scott Applewhite/AP)

In this March 23, 2010, file photo, President Obama signs the Affordable Care Act. (J. Scott Applewhite/AP)

Six states with too-close-to-call U.S. Senate races are unfriendly territory for the Affordable Care Act, the 2010 law that aims to insure nearly all Americans.

In contrast to Massachusetts — where 57 percent support the ACA — fewer than half the voters like the health care law in New Hampshire, Colorado, North Carolina, Louisiana, Kentucky and Arkansas.

“These are states where President Obama is very unpopular,” says study author Robert Blendon. “And Obamacare is not popular in those states.”

The problem, for the president and ACA supporters, is greatly worsened by low turnout. Fewer than 6 in 10 voters are expected to cast ballots, and the polls show likely voters are less inclined to support the ACA than the public at large.

“In a low-turnout election, the voters are disproportionately the core of either party,” Blendon says. “And views on what should happen with the ACA are very polarized” between the two major parties.

Continue reading

The Bionic Mind: Building Brain Implants To Fight Depression, PTSD

Liss Murphy this summer, with husband Brian, son Owen and sheepdog Ned. (Courtesy)

Liss Murphy, who had surgery to implant Deep Brain Stimulation for depression in 2006 and got much better, on Cape Cod in summer, 2014, with husband Scott, son Owen and sheepdog Ned. (Courtesy)

Ten years ago, with little warning, Liss Murphy fell victim to paralyzing depression, a “complete shutdown.”

She was 31, living in Chicago and working in public relations. The morning of Aug. 13, 2004, she had gone in to the office as usual. “It was Tuesday, and I remember the day so clearly,” she says. “The sun — everything — and I walked out — it was about 11 o’clock — and I never went back. The only time I left the house was to see my psychiatrist, who I saw three times a week.

“I have a hard time believing it was depression, in a way, because it was so pervasive and powerful,” she says. “It invaded every aspect of my life. It took so much away from me. And it happened so fast, and it was so degrading — it took everything from me.”

Murphy came home to Boston, and she tried everything — medications, talk therapy, even repeated rounds of electroshock. But she was barely able to get out of bed for months — then years. Her husband and family and top-flight doctors cared for her, but she sank so low she tried twice to commit suicide.

Finally, a psychiatrist told her about a cutting-edge trial to implant stimulation devices deep in the brains of patients with severe depression. She signed up. In June of 2006, she had the operation.

“My greatest hope that day was to have something go horribly wrong and die on the table,” she says. “I didn’t care.”

She didn’t die. Over the next few months, she got better. These days, eight years after the surgery, if you saw Liss Murphy walking her Old English Sheepdog, Ned, or playing with her 3-year-old son, Owen, only the faint silver scars on her clavicles would hint at anything unusual: That’s where the batteries that power her brain stimulator are implanted.

“We’re taking a wall of computers, basically, and putting it into something that would easily fit inside a box of Tic-Tacs.”
– Jim Moran, Draper Laboratory

But though the surgery changed Murphy’s life, “the trial, on average, didn’t work,” says Dr. Emad Eskandar, the Massachusetts General Hospital neurosurgeon who operated on her. “When you pooled everyone together it didn’t work. But there were like five people out of the 10 we did that had remarkable benefits and went into complete remission. We couldn’t continue with the study because on the average it failed, but for those people in whom it worked, boy did it work.”

Now, as part of a $70-million project funded by the military, researchers are aiming to take brain implants for psychiatric disorders to the next level.

Over the next five years, they aim to build a device that can sit inside a patient’s head, pick up the onset of depression or post-traumatic stress disorder, and head it off before it hits. One implant researcher calls it “a moonshot for the mind.” Continue reading

What Depression Stole From Me, What A Brain Implant Restored

Liss Murphy of Boston was one of the first people in the world to be successfully treated for severe depression with Deep Brain Stimulation, an electrical device implanted deep inside her brain. Now, researchers funded by the Department of Defense are trying to bring that technology to the next level, and use it to treat depression and PTSD. Here, she describes her own experience before and after the operation that changed — perhaps saved — her life.

By Liss Murphy
Guest contributor

What is depression?  After all this time, I should know. I don’t.

I know some things about depression, though. Depression is the ultimate subtractor, a thief. It erodes just about everything you are, you were, you have, you want. It takes the promise out of your existence. It destroys any semblance of hope or potential or desire or goodwill. Gone, it just is gone. It is utterly corrosive in a way that I still cannot understand.

Liss Murphy (Courtesy)

Liss Murphy (Courtesy)

Depression stripped my life of many things, of everything I knew at the time. It took away the promise of a normal day; the ability to enjoy and progress in my career and interests and relationships; the ability to think.

What follows is an attempt to make sense of the unknowns, of which there are many.  But also, what follows is a story of sickness, recovery, healing and acceptance.

What was it about August 13, 2004 that made the day what it was?

I have been told that I’d had depression before. Sure, I’d felt lousy, hopeless, tormented. But I was able to function. I could and did go on, as I needed to. It was not a roadblock.

This 2004 episode was different in every possible way. It descended on me overnight, it seems. Yes, I had been tearful and unhappy for a few weeks leading up to my crash, upset that my husband and I had separated. But so what?

It was the beginning of a complete system meltdown — a mental, physical, psychological, physiological meltdown. A total shutdown.

The details are foggy, though some of it seems so clear and vivid. It was a Tuesday, a gorgeous sunny August day. My office had a view of Lake Michigan. I walked out of the office mid-morning and never returned.  My computer was on, my running clothes, sneakers, other personal belongings in my office – waiting for me to return. But I never went back.

One important detail I cannot recall is whether I drove to work or took the subway.  I think I drove but … I am hung up on those details now. Because that day I did not just have a mental meltdown; it was the beginning of a complete system meltdown — a mental, physical, psychological, physiological meltdown. A total shutdown.

I can still see each room in my Chicago apartment as it was back then, as confused as I was. Each day, the rooms got more confusing, more messy, until it all blended into a universal squalor. I see images of brown rice boxes on the kitchen counter, dull steak knives, the tips of burning cigarettes against the hue of a bluish-purple sky just before nightfall. I slept on the couch. I stopped running, started smoking. After that day in August, I only left to see my psychiatrist, three or four times a week, until I came home to Boston.

It wasn’t feeling sad. It was feeling nothing. It was a total void of feeling. For two years, I was basically mute — totally withdrawn from everything. Continue reading

Rat Study Suggests Teen Binge Drinking Could Cause Lasting Brain Effects

sixpacks

(racineur via Compfight)

Remember the neuroscience study this spring that seemed to indicate that even casual marijuana use could cause lasting changes in teen brains? It was, shall we say, a bit controversial — to the point that the Knight Science Journalism Tracker, a leading arbiter of science coverage, questioned both what the study’s authors said and how the media handled it, here: Don’t bogart that joint: Casual marijuana use linked to brain changes?

Now, a new study on rats out of the University of Massachusetts at Amherst and Louisiana State suggests that binge drinking in adolescence can cause long-lasting damage to brain pathways still developing in the young. The press release quotes neuroscience researcher Heather Richardson of UMass:

“Adverse effects of this physical damage can persist long after adolescent drinking ends. We found that the effects of alcohol are enduring.” She adds, “The brains of adolescent rats appear to be sensitive to episodic alcohol exposure. These early experiences with alcohol can physically alter brain structure, which may ultimately lead to impairments in brain function in adulthood.”

She and her colleagues believe their study is the first to show that voluntary alcohol drinking has these effects on the physical development of neural pathways in the prefrontal cortex, one of the last brain regions to mature.

In humans, early onset of alcohol use in young teenagers has been linked to memory problems, impulsivity and an increased risk of alcoholism in adulthood. Because adolescence is a period when the prefrontal cortex matures, Richardson adds, it is possible that alcohol exposure might alter the course of brain development. Rodent models used in this study are documented to have clinical relevance to alcohol use disorder in humans.

Of particular concern: I think of the prefrontal cortex as, well, where I think, the seat of rationality and control, the highest of the higher brain functions. Not a good place to damage — not that there’s any good place in the brain to damage.

On the lasting effects: Continue reading

Pumping In The Girls’ Room: Survey Says Most Airports Don’t Get Nursing Moms’ Needs

(francescomucio/Flickr)

(francescomucio/Flickr)

We can all pretty much agree that air travel, even in the best of circumstances, isn’t fun. But for nursing mothers who must get on a plane for work, air travel can be particularly harrowing.

Now, a survey finds that despite new state and federal workplace laws that require certain employers to provide moms who breastfeed or pump with a lactation room (that means a private space — not a bathroom — with a chair, table and electrical outlet) airports are doing a pretty lame job on this front.

The study, a phone survey of customer service representatives at 100 U.S. airports (that in itself sounds harrowing) found that while 37 percent of respondents reported having a designated “lactation” room, 25 percent of those considered unisex or family bathrooms to fit the bill. The report, published in the journal Breastfeeding Medicine, concludes:

Only 8% of the airports surveyed provided the minimum requirements for a lactation room.

However 62% stated they were breastfeeding friendly. Airports need to be educated as to the minimum requirements for a lactation room.

Caveat: One of the study authors co-owns the breast pump company Limerick, Inc. Still, the findings should be of interest to any mom grossed out by the prospect of pumping in the internationally-germ-laden (just a guess) “family restroom” at LaGuardia. Continue reading

Expert Opinion: Travel Bans And Quarantines For Ebola Could Backfire

New York Gov. Andrew Cuomo speaks during a news conference at Bellevue Hospital to discuss Craig Spencer, a Doctors Without Borders physician who tested positive for the Ebola virus last week in New York City. Along with New Jersey Gov. Chris Christie, Cuomo announced a mandatory Ebola quarantine for health workers returning from treating patients in West Africa. (John Minchillo/AP)

New York Gov. Andrew Cuomo speaks during a news conference at Bellevue Hospital to discuss Craig Spencer, a Doctors Without Borders physician who tested positive for the Ebola virus last week in New York City. Along with New Jersey Gov. Chris Christie, Cuomo announced a mandatory Ebola quarantine for health workers returning from treating patients in West Africa. (John Minchillo/AP)

By Richard Knox

The United States has entered a new phase in its response to Ebola. Call it “officially sanctioned panic.”

Governors from both parties — N.J. Gov. Chris Christie and N.Y. Gov. Andrew Cuomo — declared over the weekend that even symptom-free health care volunteers coming home from Ebola duty in West Africa will be considered infected (and infectious) until they prove otherwise — by not falling ill for three weeks after their return.

Three out of four Americans want to seal the nation’s borders against travelers from Ebola-affected countries in West Africa. Republican members of Congress are demanding it.

But experts say mandatory quarantine of health workers and travel bans are unnecessary and could cripple the global fight against Ebola.

“The only way to buy an insurance policy is to defeat the disease in West Africa.”
– Prof. Alessandro Vespignani

Against this backdrop, I had a long conversation this past weekend with Prof. Alessandro Vespignani. He’s a Northeastern University expert on how humans behave in the face of disease threats. The main takeaways: The key to defeating the outbreak is to get health care workers to West Africa and back, so to the extent a travel ban or quarantines impede that flow, they will be dangerously counter-productive. And travel is so hard to control fully that bans do little to stem the spread of disease anyway.

Vespignani is spending a lot of time these days consulting with the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention and the World Health Organization on how the Ebola situation could evolve over the coming months.

He’s thinking some ominous thoughts, which he says reflect the views of U.S. and international health officials that he talks to. But the scenarios they worry about are very different from those that preoccupy many politicians and voters. Politicians worry more about the small, containable immediate threat to Americans of occasional imported cases than the longer-term and potentially catastrophic Ebola scenario that could affect the whole world — in other words, an Ebola pandemic.

Here’s an edited version of our conversation:

RK: Your group published a paper the other day in the journal Eurosurveillance that would seem counter-intuitive to many Americans. You say that imposing a ban on travelers from Ebola-affected countries won’t do much to prevent importation of the virus to the United States. Why is that?

Vespignani: People think if you have a travel ban everybody from those countries will be kept out. It’s not like that.

It’s important to know that we don’t have direct flights from West Africa. So a travel ban has to be coordinated internationally. There are a lot of people with two passports (whose country of origin can’t be easily tracked). People would try to circumvent the travel ban, and they wouldn’t be trackable — that’s one of the most dangerous things.

You can stop 95 percent of travelers from a country, but it’s very difficult to do 100 percent. And even a 90 or 95 percent travel ban is going to delay the arrival of Ebola (in the U.S.) by only about two months. It’s only buying time.

Already there is almost an 80 percent reduction in travel to the U.S. from that region, so we have already bought some time — about four to five weeks.

So what’s the practical effect of that delay? How much would a travel ban reduce Americans’ risk? Continue reading