Author Archives: Rachel Zimmerman

Blogger, CommonHealth Rachel Zimmerman worked as a staff reporter for The Wall Street Journal for 10 years in Seattle, New York and in Boston as a health and medicine reporter. Rachel has also written for The New York Times, the (now-defunct) Seattle Post-Intelligencer and the alternative newspaper Willamette Week, in Portland, Ore., among other publications. Rachel co-wrote a book about birth, published by Bantam/Random House, and spent 2008 as a Knight Science Journalism Fellow at MIT. Rachel lives in Cambridge with her husband and two daughters.

Massachusetts Court Upholds $63M Judgment In Motrin Lawsuit

The highest court in Massachusetts has upheld a $63 million judgment against the manufacturer of Children’s Motrin awarded to a family whose daughter developed a life-threatening disease after taking the over-the-counter medicine.

A Superior Court jury ruled in 2013 that Johnson & Johnson failed to provide sufficient warnings about the potential side effects of Motrin.

Samantha Reckis was 7 in 2003 when she was given the ibuprofen product to reduce a fever. She suffered a rare skin disease known as toxic epidermal necrolysis and was blinded.

Continue reading

On Point: Adulthood With Autism, And The ‘Cliff’ As Kids Age Out Of Care

In this May 23, 2014 photo, Colleen Jankovich works with her 11-year-old autistic son, Matthew, who is non-verbal and requires 24/7 care, in Omaha. (AP)

In this May 23, 2014 photo, Colleen Jankovich works with her 11-year-old autistic son, Matthew, who is non-verbal and requires 24/7 care, in Omaha. (AP)

It’s not surprising that this week’s On Point hour on the “stark realities of autistic adulthood” drew a raft of calls from parents: Rates of diagnosed autism in America have risen dramatically in recent years, and now, a whole generation of autistic children are entering young adulthood.

As WBUR’s Martha Bebinger recently reported in a powerful piece titled “Troubled Future For Young Adults On Autism Spectrum,” this is a “pioneer generation” that often lacks supports in place.

Our colleagues at On Point have posted a write-up of the many calls from parents that their segment prompted, including these:

“This is the first time I’ve broken up about this,” caller Lisa from Nashville said. “I have a 21-year old daughter here in Nashville. She has moderately severe autism, severe speech impairment, intellectual disabilities.”

A backlog of applicants waiting for state support in Nashville has led Lisa to leave her state once her daughter ages out of the school-age care currently provided her.

“My plan is to relocate and to leave the state of Tennessee,” Lisa told us. “We’ll be able to provide housing for her, but how can a family that’s not making 300,000 and up provide that 24/7 care that she needs? There is no safety net for these people.”

Other callers, like Maisel in New Orleans, found school-age care for children with autism no better than the nonexistent care for adults. Continue reading

This Blind Man Climbs Every Mountain, And Now He’s About To Run The Boston Marathon

Randy Pierce with his guide dog, Autumn, at WBUR (Robin Lubbock/WBUR)

Randy Pierce with his guide dog, Autumn, at WBUR (Robin Lubbock/WBUR)

In 1989, Randy Pierce was fresh out of college, living in southern New Hampshire and working happily as a computer hardware designer. One day in fencing class, his instructor noticed that his blind spot was oddly enlarged. You need to go to the doctor, the instructor said. Today.

A neurological disease was attacking Pierce’s optic nerve. Within two weeks he had lost all the sight in his right eye, and half the sight in his left. In the following years, he lost the last remnants of his sight, and damage to his cerebellum destroyed his balance, landing him in a wheelchair.

On Monday, he will be running the Boston Marathon.

Pierce, 48, will be running on Team With A Vision, which supports the Massachusetts Association for the Blind and Visually Impaired. He’s running to raise money — and to make a point, about what he calls “ability awareness.”

“I have a disability — I can’t see,” he says. “We all have disabilities, things that we can’t do. I think it’s so much more important to put the focus of our lives on things we can do. And if something is important enough to you, I say anything is possible, you’re just going to have to problem-solve and persevere to get there.”

An example of problem-solving: Last year, Pierce became the first blind American to complete a Tough Mudder obstacle course, and last month he repeated the feat. (See the video below.)

From a platform 25 feet high, he had to leap out about 8 feet, grab a T-shaped, trapeze-like bar, swing farther out and release his grip at just the right moment to hit a remote hanging bell before plunging down into the muddy water below. He used his cane to feel for where the T-bar was, to form a mental image of it, and friends’ descriptions of where the bell was hanging.

The crowd went wild.

“You know, those are just moments — every one of those people out there would have told you this is impossible. Now they won’t,” Pierce says. “They’ll believe me when I say everything’s possible — or they’ll believe in themselves, which is the more important part.”

As for the perseverance Pierce talks about, he used it to fight his way out of the wheelchair that he occupied “for one year, eight months and 21 days — which tells you how I feel about it. Pretty challenging.”

Pierce’s wife, Tracy, says that somehow, his struggles and losses led him to adopt the supremely positive attitude that uplifts him now. Continue reading

Why To Exercise Today: To Promote Cognitive Health (It’s Official)

(Diabetes Care/Flickr)

(Diabetes Care/Flickr)

The venerable Institute of Medicine came out with a report this week on cognitive aging (yes, that means you…) and a few things that can help avert the inevitable. The panel’s No. 1 recommendation? “Be physically active.” Enough said.

To be clear, “cognitive aging is not a disease,” the report notes. “Instead, it is a process that occurs in every individual, beginning at birth and continuing throughout the life span.”

That process impacts the brain like no other body part, the authors say. And while the extent and quality of cognitive aging (read: decline) varies greatly, many older men and women will experience problems related to the speed at which they process information, the ability to problem-solve and make decisions and, of course, memory. (Lost keys, anyone?)

Putting a little silver lining on things, the IOM news release quotes the chairman of the committee, Dan G. Blazer, the J.P. Gibbons Professor of Psychiatry Emeritus at Duke University Medical Center, saying that “…wisdom and knowledge can increase with age, while memory and attention can decline.”

So what should we do about our aging brains? The report is clear:

· Be physically active.

· Reduce and manage cardiovascular disease risk factors, including high blood pressure, diabetes, and smoking.

· Regularly discuss and review health conditions and medications that might influence cognitive health with a health care professional. A number of medications can have a negative effect — temporary or long term –on cognitive function when used alone or in combination with other medication.

The committee also identifies additional actions for which there is some scientific evidence to suggest positive effects on cognitive health:

· Be socially and intellectually active, and continually seek opportunities to learn.

· Get adequate sleep and seek professional treatment for sleep disorders, if needed.

· Take steps to avoid a sudden acute decline in cognitive function, known as delirium, associated with medications or hospitalizations.

· Carefully evaluate products advertised to consumers to improve cognitive health, such as medications, nutritional supplements, and cognitive training.

Continue reading

Wide Hips? Take Heart: Study Finds You Can Run Just As Efficiently

As a woman who describes herself — matter-of-factly, not self-hatingly — as shaped like a cello, I’m deeply pleased by this fascinating marathon-season report from our friends over at Boston University’s Research Website, headlined “In Defense of Wide Hips.” Re-posted with their permission:

Biological anthropologist and evolutionary anatomist Kristi Lewton of BU School of Medicine. (Jackie Ricciardi for BU)

Biological anthropologist and evolutionary anatomist Kristi Lewton of BU School of Medicine. (Jackie Ricciardi for BU)

By Kate Becker

What can you learn from a pelvis? Among the qualities that make humans unique are two physical features: our way of walking and running upright on two legs, and our newborn babies’ very large heads. Those two traits of humanity meet at the pelvis, a set of bones that includes the ilium, ischium, pubis, and sacrum.

For more than 50 years, anthropologists thought that the human pelvis was shaped by an evolutionary tug-of-war between the competing demands of bipedalism and childbirth. Now, a team of scientists that includes Kristi Lewton, an assistant professor in the department of anatomy and neurobiology at Boston University School of Medicine, and colleagues at Harvard University and Hunter College has shown that this so-called “obstetric dilemma” might not be a dilemma at all.

They found no connection at all between hip width and efficiency: wide-hipped runners moved just as well as their narrow-hipped peers.

Humans give birth to very large (“ginormous!”) newborns, says Lewton. While chimps and other nonhuman primate babies emerge from the birth canal with room to spare, human infants must perform a complicated series of rotations to make their way into the world, and the pelvic opening is just barely big enough. If something goes wrong, the lives of both mother and baby are at risk. So, why hasn’t the human body evolved a wider pelvis? Anthropologists have long believed that an evolutionary trade-off was at work; they assumed that a wide pelvis was “bad for bipedalism,” says Lewton. Yet, until now, no one had rigorously tested this assumption.

Lewton and her colleagues set out to discover whether wide hips really do make running and walking less efficient. They recruited 38 undergraduates, including both men and women, and had them walk and run on a treadmill while gauging how hard they were working by measuring their oxygen consumption. While the participants exercised, their motion was tracked by eight cameras trained on infrared markers attached to the participants’ hips, knees, ankles, thighs, and shanks. Lewton and her colleagues estimated the subjects’ hip width using the results from the infrared trackers, and later combined their data with results from a Washington University in St. Louis research team that used MRI to get a direct measure of hip width. (True hip width is defined as the distance between the hip joints, points out Lewton, and is different from what you would measure with a tailor’s tape.)

If the basic assumptions of the obstetric dilemma are right, says Lewton, participants with wider hips should run and walk less efficiently than those with narrow ones. But that wasn’t what Lewton and her team found. Continue reading

Time The Healer Moves Slowly For 2 Boston Marathon Survivors

Marathon bombing survivor Martha Galvis is learning to use a hand doctors are still reconstructing. Here Galvis attempts to pick up a pen off a table after a physical therapy session at Faulkner Hospital. (Jesse Costa/WBUR)

Marathon bombing survivor Martha Galvis is learning to use a hand doctors are still reconstructing. Here Galvis attempts to pick up a pen off a table after a physical therapy session at Faulkner Hospital. (Jesse Costa/WBUR)

It’s just the crumb of a muffin, but Martha Galvis must pick it up. Lips clenched, eyes narrowed, she goes after the morsel, pushing it back and forth, then in circles, across a slick tabletop.

“I struggle and struggle until,” Galvis pauses, concentrating all her attention on the thumb and middle finger of her left hand. She can’t get them to close. Oh well.

“I try as much as I can. And if I do it I’m so happy, so happy,” she says, giggling.

Galvis, 62, has just finished a session of physical therapy at Boston’s Brigham and Women’s Faulkner Hospital, where she goes twice a week. She’s learning to use a hand doctors are still reconstructing. It’s been two years to the day since she almost lost it.

On April 15, 2013, Martha and her husband Alvaro Galvis headed for Cleveland Circle — mile 22 on the Boston Marathon route. This would be the first of three spots from which they’d enjoy the race and the boisterous crowd. Their last stop would be at or near the finish line in Boston. Continue reading

The Complex Interplay Of Genetics And The Placebo Response

Why do some people respond to placebos while others don’t?

One possible answer: genetics.

A provocative new paper introducing the concept of a “placebome” — that is, the complex interplay between genetics and an individual’s response to placebos — raises questions that might ultimately lead to changes in how clinical studies of drugs are evaluated.

Indeed, researchers from Harvard Medical School suggest that genes, and genetic variation, might play a far bigger role in the placebo response than previously thought.

That the placebo effect is an actual physiological response is well established. But the new report, a research review, looks specifically at the placebo response in the context of drug studies, where some participants get the active medication while others get a placebo, or non-active version of the drug.

The new findings, “call into question whether or not the outcomes in a drug treatment arm of a clinical trial are limited to the effect of the drug on the condition,” says Kathryn Hall, an integrative medicine fellow in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, and one of the study authors.

Instant Vantage/flickr

Instant Vantage/flickr

Several neurotransmitters, such as dopamine, appear to be involved in the placebo response, Hall said, and variation in the genes in these pathways appears to change our response to placebo. So different people with different genotypes respond differently to placebos.

But Hall takes it one step further. “When you are in a trial you don’t know if you are getting the drug or the placebo, so not just the people in the placebo arm can have placebo responses. We are curious about the drugs’ effect on the placebo response.”

It’s all a bit tough to wrap your brain around, so I asked Hall to give me an example. Here’s what she said:

In the literature we see several studies in which in the placebo arm one group of people with a certain genotype have a strong placebo response and the other group has a weak placebo response. And when we look at the drug treatment arm, we see the outcomes are reversed, the people who had the strong response in the placebo arm now have a low response and the people who didn’t have a response in the placebo arm now have a strong response. The historical interpretation of these results has been that only one group of people responds to the drug and we’re pointing out that it’s more complicated than that. It’s that one group responded to the placebo and that response is eliminated in the drug treatment arm.

What all this means in the real world is still hard to know. But in their paper published this week in the journal, Trends in Molecular Medicine, the researchers offer these three key takeaways in the abstract:

•The predisposition to respond to placebo treatment may be in part a stable heritable trait.

•Candidate placebo response pathways may interact with drugs to modify outcomes in the drug treatment arms of clinical trials.

•Genomic analysis of randomized placebo and no-treatment controlled trials are needed to fully realize the potential of the placebome.

Continue reading

Sexual Reality: The Checkup Podcast Debunks A Few Myths (Like Size And Age Matter…)

Possibly our juiciest segment yet, the latest installment of The Checkup podcast, our joint venture with Slate, takes on some sexual myths and offers a bit of reality.

We bring you surprises about penis size, stories of great sex over 70 and new insights on how both men and women are lied to about their sexuality. As we have in past segments, Carey and I offer our fresh take on research-based news that could brighten up your life below the waist. Check it out here:

And in case you missed our last episode, “Grossology” (including a look at the first stool bank in the nation and research on the benefits of “bacterial schmears” from a mother’s birth canal) — you can listen now.

And if you want to hear earlier episodes: “Scary Food Stories” includes the tale of a recovering sugar addict and offers sobering news to kale devotees. And “On The Brain” includes fascinating research on dyslexia, depression and how playing music may affect our minds.

Make sure to tune in next time, when we present: “High Anxiety,” an episode on the (arguably) most prevalent of mental health disorders.

Each week, The Checkup features a different topic — previous episodes focused on college mental health, sex problems, the Insanity workout and vaccine issues. If you listen and like it, won’t you please let our podcasting partner, Slate, know? You can email them at podcasts@slate.com.

You Are When You Eat: Study Explores Body Clock Effects On Blood Sugar

(Macro Mondays/Flickr Creative Commons)

(Macro Mondays/Flickr Creative Commons)

You know the old saying (or maybe you should): “Eat breakfast like a king, lunch like a prince and dinner like a pauper.”

A new study in the journal PNAS looks into some of the underlying biology: that our bodies tend to regulate blood sugar better after breakfast than after dinner.

Led by researchers at Brigham and Women’s Hospital, it also helps explain why night shift workers tend to be at heightened risk for Type 2 diabetes.

Says the study’s senior author, Frank A. J. L. Scheer of the Brigham, on Radio Boston today: “What we wanted to explore was whether the biological clock — the internal clock — is playing an important part in this day/night variation, or that it might just be due to the sleep/wake and feeding/fasting cycle.”

The study pinpoints two separate mechanisms at work:

• Our basic body clocks, also known as circadian rhythm, have major influence on our blood sugar regulation: our glucose tolerance is naturally higher in the morning than the evening.

• And, independently, when our clocks are misaligned — when we’re forced to flip our days and nights — that, too, lowers our glucose tolerance.

Bottom line, for those of us who are not shift workers: The same exact meal can lead to more of an increase in blood sugar when eaten at night than when eaten in the morning (and higher blood sugar is considered a risk factor for developing diabetes.) Chalk one up for the writers of old sayings.

On the study: Continue reading

Daughter Born To Widow Of Slain Boston Surgeon

Mikaela Jane Davidson (Courtesy of Brigham and Women's Hospital)

Mikaela Jane Davidson (Courtesy of Brigham and Women’s Hospital)

This poignant birth announcement is just in from Brigham and Women’s Hospital:

Davidson Family Welcomes Baby Girl

Boston, MA – On behalf of Dr. Terri Halperin and the Davidson family, Brigham and Women’s Hospital announces the arrival of Mikaela Jane Davidson, born Saturday, April 4, 2015. Mother and baby are doing well.

Mikaela’s father, Dr. Michael J. Davidson, was tragically shot and killed by a patient’s son at BWH on January 20, 2015, leaving behind his beloved wife Terri, daughters Kate (10) and Liv (8) and son Graham (2). Mikaela was named after her dad and shares his initials – MJD.

Terri said, “Michael was very much looking forward to the birth of this beautiful baby girl. At a time when my children and I are completely heartbroken over the loss of Michael, we are finding joy in Mikaela’s arrival. We have been humbled and touched by the tremendous outpouring of love and support coming from family, friends, patients and all those kind-hearted souls who have been moved by Michael’s senseless death.”

Brigham and Women’s Hospital established the Davidson Family Fund to provide support for the Davidson children.

The press release notes that Dr. Halperin is not otherwise interacting with the media right now.

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

A woman wears a button honoring Michael Davidson at his January funeral service. (Jesse Costa/WBUR)

Related: