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When Hand, Foot And Mouth Disease Sweeps Through: What To Know

(Bob Reck via Compfight)

Veronica Thomas
CommonHealth Intern

Summer is not only the season for watermelon and zucchini. It’s also the time for Hand, Foot and Mouth Disease. Typically found in younger kids, it’s a contagious viral illness marked by a fever and rash — either skin or mouth blisters.

Hand, Foot and Mouth swept through several WBUR employees’ families recently, so we checked in with an expert: Dr. Clement Bottino, a pediatrician at Boston Children’s Hospital in the Division of General Pediatrics who sees a lot of the illness in the Primary Care Center. “Nothing unusual,” he says, “just the summertime viruses.

“Viruses are kind of like vegetables,” he explains. “There are winter and summer varieties. The winter ones cause illnesses like the common cold, while those in the summer cause fever-plus-rash-type illnesses, like Hand, Foot and Mouth.”

Hand, Foot and Mouth typically affects children under the age of 5, but older children and even adults can catch it as well. Symptoms can vary. Some children may only have a fever and mouth blisters, while others have the characteristic rash without other symptoms. The rash may present with classic red bumps on a child’s hands and feet, or a more diffuse rash that includes the diaper area.

Some people, particularly adults, may show no symptoms at all, but they can still spread the illness to others. Hand, Foot and Mouth is transmitted through direct contact with saliva, mucus or feces. Daycare is notorious as a hotbed of activities for spreading infection: hugging, sharing cups, coughing and sneezing, and touching infected objects. While patients are most contagious during their first week of illness, they can spread the virus for weeks after the symptoms fade.

According to Dr. Bottino, the most important thing for parents to know is that the virus is mild and “self-limited,” meaning it usually goes away on its own, causing no scars or lasting problems. Most patients feel better in seven to 10 days without any treatment at all. I asked Dr. Bottino what else parents should know about Hand, Foot and Mouth Disease. Our conversation, edited: Continue reading

Project Louise: Exercise Every Single Day? Says Who?

(Bjørn Giesenbauer via Compfight)

(Bjørn Giesenbauer via Compfight)

This is getting interesting. One week into the challenge laid down by Editor Carey and Coach Allison — to exercise every single day before 7 p.m., and to post a comment reporting that I did so before 11 p.m. — I have made several discoveries.

  1. Carey was right. Exercising every day makes you feel better.
  2. The sweatier the exercise is, the better you feel.
  3. I hate being told what to do.

Let’s focus for now on No. 3, because we all know that Nos. 1 and 2 are true. Right? We do know that, yes? We just don’t do it because … well, because of No. 3.

At least that’s what I’m concluding about myself. Even though I signed up for Project Louise of my own free will, and even though I did it because I really, truly want to change my habits for good and live a longer and healthier life, and even though I know that Carey Goldberg, Allison Rimm and all the other wonderful people who are helping me on this journey are truly here to help, not to push me around, a huge part of my brain reacts to all this support and encouragement and expert advice with a simple, all-too-familiar refrain:

You’re not the boss of me.

Yes, this is the week when I’ve been getting in touch with my inner child. Or, more precisely, my inner brat.

As soon as I wrote that, I realized that I have heard that phrase before — from a wonderful woman named Pam Young, who has written a lot about this idea that we all have an inner “brat” whom we need to learn to love. Because it’s that little bratty voice that keeps us from doing all the good, mature, responsible things we all know we should do. And as long as you keep fighting the brat, you’re going to lose — as any mother of a 2-year-old can tell you.

Likewise, as that same mother can tell you, the secret to success is to persuade the 2-year-old that what you’re telling her to do is actually fun — to make her want to do it, and even to make her think that it’s her own idea. Continue reading

Project Louise: Lose Ugly Belly Fat Fast! Yeah, Not So Much

(Photo: TORCH magazine via Compfight)

(Photo: TORCH magazine via Compfight)

By Louise Kennedy
Guest contributor

I had an epiphany of sorts over the weekend: I hate my belly.

Actually, you can’t really call it an epiphany if it’s something you’ve felt for just about your entire life. And ever since I got a little chubby in second grade – a chubbiness that lasted until puberty, returned with the classic “freshman 15” in college and has waxed and waned ever since – I have gazed down at the extra flesh between my navel and my hips with a mixture of shame, disgust and self-loathing.

And let’s just say that passing the 50-year mark hasn’t helped with any of this. Here’s how we know Mother Nature has a sense of humor: Just when your body stops being capable of pregnancy, it starts looking as if you’re already about 4 months along. Permanently.

But that’s no reason to hate myself, is it? Sure, I’d like to lose the weight. But if I don’t, I don’t want to carry around this toxic mix of negativity along with the extra pounds.

So here’s the real epiphany: I don’t want to hate myself anymore, not even one imperfect part of myself. I don’t have to love my belly; I just want to stop hating it. I want to make peace with my body.

My, that sounds sane. But you may come up with another adjective when I tell you what I did next: I Googled “belly fat.”

Here’s a quick tip: Don’t do that.

Oh, go ahead if you want to. But I can save you the trouble. Here’s what I learned: Continue reading

Project Louise: Beginning To See The Light

By Louise Kennedy
Guest contributor

Well, I did it. I got the damn thing done.

When you create a vision of your ideal life, it's easier to see what fits in and what has to go.

When you create a vision of your ideal life, it’s easier to see what fits in and what has to go.

For those just tuning in: Last week, I attended a workshop run by my strategic coach, Allison Rimm, in which she promised to help all of us develop a vision for our lives and start to create the strategic plan that will make that vision a reality. Since I’ve been promising Allison for months that I would write my vision statement and then somehow not quite doing it, I figured the workshop would, if nothing else, make me get out my pen.

And it did.

What’s interesting is that I had been thinking about my vision, off and on, for all these months – but there is something about actually putting it down on paper that is energizing, exciting, and very motivating. When you take the time to describe, in detail, exactly what you want your life to look like, it becomes more tangible – almost as if you can see it. (Gee, I wonder if that’s why it’s called a vision.) And once you see it in all its glory, you really, really want to make it happen.

Which is where the next part of the exercise comes in: figuring out what you need to change in your current life to make it resemble your ideal life. I was reassured to realize that many parts of my life are already working pretty well. I have healthy and happy children, one of my top priorities; I generally love my job, and I have wonderful friends.

As for the other elements – financial stability, personal writing projects and a few more things – well, now that I’ve identified those as a central part of my vision, I can start to build feasible steps toward achieving them. With a full-time job and the aforementioned children, I don’t have a lot of time to write outside of work. But because it’s truly important to me, I decided to commit to spending 30 minutes a day at my desk, every day. That, I can do. And it’s already making me happier.

Allison’s workshop gave me a couple of tools to help find those 30 minutes – and maybe some more time, as I get better at comparing my daily choices to my long-term vision. She had each of us fill out a calendar outlining a typical weekday; a take-home part of the exercise, which I haven’t completed yet, invites me to do the same for a typical week and then a typical month. But even just looking at a single day was useful. Continue reading

‘I’m Not Stupid, Just Dyslexic’ — And How Brain Science Can Help

Sixth-grader Josh Thibeau has been struggling to read for as long as he can remember. He has yet to complete a single Harry Potter book, his personal goal.

Growing up with dyslexia: Josh Thibeau, 12, imagines his brain as an ever-changing maze with turns he must learn to navigate. Here he is with his mother, Janet. (George Hicks/WBUR)

Growing up with dyslexia: Josh Thibeau, 12, thinks of his brain as an ever-changing maze with turns he must learn to navigate. Here he is with his mom, Janet. (George Hicks/WBUR)

When he was in first grade, Josh’s parents enrolled him in a research study at Boston Children’s Hospital investigating the genetics of dyslexia. Since then, Josh has completed regular MRI scans of his brain. Initially, it seemed daunting.

“When we first started, I’m like, ‘Oh no, you’re sending me to like some strange, like, science lab where I’m going to be injected with needles and it’s going to hurt,’ I’m like, ‘I’m never going to see my family again,’ ” says Josh, who lives in West Newbury, Mass.

Josh and his three biological siblings all have dyslexia to varying degrees. Pretty much every day he confronts the reality that his brain works differently than his peers’. He’s even shared scans of his brain with classmates to try to show those differences. Some kids still don’t get it.

“There was a student that said, ‘Are you stupid?’ Because my brain was working in a different way,” Josh says. “And I’m just like, ‘No, I am not stupid…I’m just dyslexic.’ ”

The Pre-Reading Brain 

On average, one or two kids in every U.S. classroom has dyslexia, a brain-based learning disability that often runs in families and makes reading difficult, sometimes painfully so.

Compared to other neurodevelopmental disorders like ADHD or autism, research into dyslexia has advanced further, experts say. That’s partly because dyslexia presents itself around a specific behavior: reading — which, as they say, is fundamental.

Now, new research shows it’s possible to pick up some of the signs of dyslexia in the brain even before kids learn to read. And this earlier identification may start to substantially influence how parents, educators and clinicians tackle the disorder.

Until recently (and sometimes even today) kids who struggled to read were thought to lack motivation or smarts. Now it’s clear that’s not true: Dyslexia stems from physiological differences in the brain circuitry. Those differences can make it harder, and less efficient, for children to process the tiny components of language, called phonemes.

And it’s much more complicated than just flipping your “b’s and “d’s.” To read, children need to learn to map the sounds of spoken language — the “KUH”, the “AH”, the “TUH” — to their corresponding letters. And then they must grasp how those letter symbols, the “C” “A” and “T”, create words with meaning. Kids with dyslexia have far more trouble mastering these steps automatically.

For these children, the path toward reading is often marked by struggle, anxiety and feelings of inadequacy. In general, a diagnosis of dyslexia usually means that a child has experienced multiple failures at school.

But collaborations currently underway between neuroscientists at MIT and Children’s Hospital may mark a fundamental shift in addressing dyslexia, and might someday eliminate the anguish of repeated failure. In preliminary findings, researchers report that brain measures taken in kindergartners — even before the kids can read — can “significantly” improve predictions of how well, or poorly, the children can master reading later on.

Implicated in dyslexia: The arcuate fasciculus is an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language (left). Researchers found that kindergarten children with strong pre-reading scores have a bigger, more robust and well-organized arcuate fasciculus (bottom right) while children with very low scores have a small and not particularly well-organized arcuate fasciculus (top right). (Zeynep Saygin/MIT)

Implicated in dyslexia: The arcuate fasciculus is an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language (left). Researchers found that kindergarten children with strong pre-reading scores have a bigger, more robust and well-organized arcuate fasciculus (bottom right) while children with very low scores have a small and not particularly well-organized arcuate fasciculus (top right). (Zeynep Saygin/MIT)

Pinpointing The White Matter Culprit

Using cutting-edge MRI technology, the researchers are able to pinpoint a specific neural pathway, a white matter tract in the brain’s left hemisphere that appears to be related to dyslexia: It’s called the arcuate fasciculus.

“Maybe the most surprising aspect of the research so far is how clear a signal we see in the brains of children who are likely to go on to be poor readers.”
– MIT neuroscientist John Gabrieli

“It’s an arch-shaped bundle of fibers that connects the frontal language areas of the brain to the areas in the temporal lobe that are important for language,” Elizabeth Norton, a neuroscientist at MIT’s McGovern Institute of Brain Research, explains.

In her lab, Norton shows me brain images from the NIH-funded kindergartner study, called READ (for Researching Early Attributes of Dyslexia).

“We see that in children who in kindergarten already have strong pre-reading scores, their arcuate fasciculus is both bigger and more well organized,” she says. On the other hand: “A child with a score of zero has a very small and not particularly organized arcuate fasciculus.”

She says we’re not quite ready to simply take a picture of your child’s brain and say “Aha, this kid is going to have dyslexia,” but we’re getting closer to that point. Continue reading

Project Louise: Clearing The Clutter, In Both Closet And Brain

OK, so maybe cleaning a closet isn't a huge workout. But it does wonders for the mind. (Derek Jensen via Wikimedia Commons)

OK, so maybe cleaning a closet isn’t a huge workout. But it does wonders for the mind. (Derek Jensen via Wikimedia Commons)

By Louise Kennedy
Guest contributor

Wow, two weeks in a row where something works! Maybe I really did turn the right corner this time.

Once again I committed to exercising on Sunday, and once again I did it. Inspired by Carey Goldberg’s playground workout, I lunged and planked and pulled myself up, in between pushing my daughter on the swings.

Then, when my son finished mowing the yard and asked me to rake up the grass clippings for him, I saw it as another great chance to keep moving – and challenged myself to do it as fast as I could. Yeah, I got a blister. But I also felt great.

I think this is the key: I don’t much care for working out. But I do like to work. And I like to play even more.

The thing about my Sunday activities is that I was actually accomplishing something – not just getting some exercise, but spending time with my kids and making the yard look better. So the exercise I get along the way doesn’t feel like time stolen from things I’d rather be doing, but rather like an integral part of those very things. Continue reading

Could Medical Marijuana Help Stem The Opiate Addiction Crisis?

Marijuana is touted as a treatment for chronic pain, multiple sclerosis and anxiety — and some say it may be a way to help alleviate Massachusetts’ opiate crisis. But that idea is causing some tension in the addiction treatment community.

A Less Potent Alternative? 

Shelley Stormo is a clinical psychologist at Gosnold, the largest addiction treatment facility on Cape Cod. She has secured provisional approval to open a medical marijuana dispensary in Fairhaven called Compassionate Care Clinics, and the state is now verifying her application. Stormo hopes by this fall, she’ll be able to help patients avoid opiates by using marijuana.

“I’m changing my efforts a bit to really focus on how to prevent addiction,” Stormo said. “Through offering the medical use of marijuana as an alternative to potentially much more harmful and deadly opioids.”

Stormo says marijuana is safer for several reasons.

“Marijuana does not have the physical addictive components that opiates do,” she said. “It does not have the propensity, as opiates do, for overdoses. There’s no documented death by overdose of marijuana.”

Although Stormo does not advocate using marijuana to treat addiction, other medical marijuana professionals say the so-called gateway drug may one day be used as part of an exit strategy.

Continue reading

Can Brain Science Help Lift People Out Of Poverty?

Five years ago Lauretta Brennan was a single mom on welfare with a pack-a-day smoking habit, stuck in a “bad” relationship and living in the South Boston projects where she grew up.

Now, she’s still living in the projects with her young son, but the bad boyfriend is gone and Brennan’s got a job as an administrative assistant after receiving a business management degree. And she quit smoking.

Her childhood in the projects was marked by alcoholism and violence all around, Brennan said; “having no adult role model was the norm, being with a man who’s ignorant, that was the norm.”

Lauretta Brennan graduated from Bunker Hill Community College with an Associates Degree in Business Management in June 2013 (Courtesy)

Lauretta Brennan graduated from Bunker Hill Community College with an Associates Degree in Business Management in June 2013 (Courtesy)

But now, thanks to a novel program that uses the latest neuroscience research to help women dig themselves out of poverty, Brennan says: “I don’t want to live off welfare. I want to make money and be around people who work and go to school. In five years, the program got me to think more like an executive — I have goals, I’m an organizer managing my family well. I’m not scared anymore.”

This shift in thinking — from chaotic, stressed-out, oppressed and overwhelmed to purposeful and goal-oriented — may not sound like brain science. But it fits into an emerging body of research that suggests that the stress of living in poverty can profoundly change the brain: it can undermine development and erode important mental processes including executive function, working memory, impulse-control and other cognitive skills.

To fix that damage, the new thinking goes, people must engage in activities and practices that strengthen this diminished functionality and, exploiting the brain’s ability to change (plasticity in neuroscience lingo) re-train themselves to think more critically and strategically.

“Poverty whacks executive function and executive function is precisely what’s needed to move people out of poverty,” says Elisabeth Babcock, chief executive of the nonprofit Crittenton Women’s Union, a Boston-based group that draws on the latest brain research to help families achieve economic success. “What the new brain science says is that the stresses created by living in poverty often work against us, make it harder for our brains to find the best solutions to our problems. This is a part of the reason why poverty is so ‘sticky.’”

In a recent paper, “Using Brain Science To Design New Pathways Out Of Poverty,” Babcock makes the case that living in an impoverished environment “has the capacity to negatively impact the decision-making processes involved in problem-solving, goal-setting and goal attainment.” In other words, this type of stress can “hijack” the brain.

As other researchers, including Jack Shonkoff, director of the Center on the Developing Child at Harvard, have noted, this chronic vise of pressure — to pay the bills, function at work, raise the kids, and simply survive in an atmosphere rife with social bias and harsh living conditions — “places extraordinary demands on cognitive bandwidth.” Babcock writes:

“The prefrontal cortex of the brain — the area of the brain that is associated with any of the analytic processes necessary to solve problems, set goals and optimally execute chosen strategies — works in tandem with the limbic system, which processes and triggers emotional reactions to environmental stimuli…When the limbic brain is overactive and sending out too many powerful signals of desire, stress, or fear, the prefrontal brain can get swamped and the wave of emotion can drown out clear focus and judgement…”

How does this play out in real life? Chuck Carter, senior VP of research at Crittenton Women’s Union, explains:

“One of the things the brain science brings is something of an ‘aha’ in terms of why things are sometimes harder than we expect them to be. When you’re looking at a family that is struggling and making decisions that you don’t really understand, having that research helps you reassess…it adds another perspective. A lot of nonprofit organizations look at the social determinants [of poverty] but not a lot look at the science that says, ‘What else is at play?’

“I think that, on the ground, it gives us creative ways to think about the work and how we might approach it…Often families are in a lot of crises…and they feel they need to do things ‘right now.’ So, for instance, we’ve got a family, and they’re in a hallway and they’ll have to talk to the case manager ‘right now.’ And we ask whether it’s a true emergency, and if not, can we talk about this the next morning, and not in the hallway. It’s a problem with executive function and poor impulse control, but we can help them slow down and figure out the right time to figure this out and what information do they need. It’s about not responding so impulsively in other parts of their lives. So, in thinking about what to do with money, it can be a question of, ‘Do I buy cigarettes now or save the money for some new furniture when I move?’”

So how do you begin to fix all of this?

I asked Babcock a bit about the science behind her organization’s Mobility Mentoring program, in which low-income — mostly single — mothers apply to get training, professional mentoring, financial and other support for three to five years, in hopes of attaining economic independence.

Here, edited, is our discussion:

RZ: What does the research say about how poverty changes the brain? And how does a “hijacked” brain function compared to a brain not experiencing intense, chronic stress?

EB: Poverty hits what scientists call our executive functioning skills: our ability to problem-solve, set priorities and goals, juggle and multi-task, focus and stick to things. And it does this in at least two very important ways. First, the stress of dealing with new problems every day and never having enough to make ends meet overwhelms our heads and swamps us. It overloads the circuits in our brains and compromises our decision-making in the moment. Continue reading

Project Louise: Going For A Ride — And Going For The Fun

Not only did Louise ride 20 miles, but at the end, she was in a tent with Tom Brady. Oh, and hundreds of other people. Still ... fun! (Best Buddies)

Not only did Louise ride 20 miles, but at the end, she was in a tent with Tom Brady. Oh, and hundreds of other people. Still … fun! (Best Buddies)

By Louise Kennedy
Guest contributor

This whole health thing? It’s like riding a bike.

That’s what I’m thinking this week, anyway. Once you learn how to do it, even if you stop for a really long time, when you get back on the bike, you’re amazed at how simple it is.

And this week, I got back on the bike.

Dedicated readers (I love you, wherever you are) may remember that, way back in March, I decided to sign up for the Best Buddies Challenge bike ride on the Cape. I figured having a goal would encourage me to go to the gym more often, and going to the gym more often would make the ride both easy and fun.

So … it did not make me go to the gym. At all. But it did feel like a firm commitment, and so on Saturday, I went for a bike ride. A 20-mile bike ride. Continue reading

Pregnancy Woes: Why Did The Price Of My Progesterone Skyrocket?

(Photo: Rekha Murthy)

(Photo: Rekha Murthy)

By Rekha Murthy
Guest Contributor

Update: KV Pharmaceutical changed its name to Lumara Health, two days after this post was published.

I’m 34 weeks pregnant and working hard to keep this baby inside me for as long as possible. As with my last pregnancy, there’s a real risk that the baby could come too early. But we’re both holding on so far, thanks to a combination of luck, modified bed rest and medical science.

The science is my biggest concern right now. I will spare you much of it because, man or woman, you will instinctively cringe and close your legs. However, one critical medical intervention that has been proven to work for countless women and babies is again under threat, and I must speak up.

Every week, my husband injects me with 250 mg (1 ml) of 17 alpha-hydroxyprogesterone caproate (“progesterone” for short). Leaving aside what this does to an otherwise tender and loving marriage, these injections have been found to significantly lower the risk of preterm birth.

Two weeks ago, my insurance co-pay for progesterone went from $5.50 per dose to $70 per dose. Just like that. For those without insurance (or with a deductible), the medication went from $32.50 per dose, according to my local compounding pharmacy, to…wait for it…$833 per dose, according to the new pharmacy my insurer is now requiring me to use.

$833. Per. Dose.

Pricing varies somewhat across pharmacies and insurers, but not enough to make this price change any less breathtaking. In fact, the drug’s list price is $690 per dose.

The 12-fold leap in my co-pay sent an epic shock through my (natural and synthetic) hormone-laden system. I immediately called both pharmacies, my insurer, and my doctor, and started digging around online. I soon learned that the price increase came from a new requirement to buy expensive brand-name progesterone, instead of the affordable compounded version I had been getting. A disturbing picture came into focus. Continue reading