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May 29th, 2009
10:00 AM ET

Graduating to adulthood

By Val Willingham
CNN Medical Producer

A year and a half ago, I wrote a blog about my daughter when she chose to spend Thanksgiving with a new boyfriend instead of her own family. To say the least, I was pretty upset. It was the first holiday she had been away from home and I went on and on about her decision and how - I felt - her brain just wasn't making the right choices.  I received an enormous  response to that blog– many of the responses came from college students who said I needed to "get a life." Other people, mostly parents, felt I needed to let her go.

A few weeks ago, my wonderful daughter graduated from college. It was a proud moment. Not only for her, but for her father and me. We had journeyed with her as she navigated her collegiate life for four years. It was up and down: changes in courses, majors, roommates and boyfriends. But she made it through, and with very few scars.

When she left home four years ago to attend Syracuse University, I thought it would be a difficult time for me because of separation anxiety and empty nest syndrome. But knowing she was in a campus environment made it easier. Certainly if there were problems, her roommates would call. If I couldn't find her, I could always dial her boyfriend or the dorm's resident assistant. She was never really alone.

But now that she's graduated, that's going to change. Because she is an independent soul and has no intentions of staying close to home, she'll be moving to a different city, where she'll set up a new life, with new friends, and new experiences. And that's freakin' me out.

According to Dr. Charles Raison, assistant professor of psychiatry and behavioral sciences at Emory University School of Medicine and CNNhealth.com’s mental health expert, the end of college signifies the end of my daughter's "childhood". And because she's my only child, letting go is even more difficult. But if I want to have a healthy relationship with her, letting her live her own life - with little intervention - is necessary.

But it is going to be tough.

No longer will I be able to call her just to check up on her. No more prying, inquiring about grades, friends, activities, etc. Sure, I can ask how she is, but if you think kids are closed-mouth in high school and college, just wait until they strike out on their own. I had a friend whose married daughter called her one day and told her that after five years of bliss she and her husband, my friend's son-in-law, had gotten a divorce. No note, no phone call to mom, until after the ink on the divorce papers was dry and ex-hubby was sent packing. What a shocker for my friend.

Psychologists will also tell you, it's all about control. And I am losing it. Even though she's head strong, our daughter has always listened to us. She may not have done what we asked all the time, but she listened; mostly out of love and respect for her parents. But we also held the purse strings: we paid for her phone, her car insurance, her tuition. Now, as a college grad - hopefully an employed grad - my husband and I will no longer have the financial upper hand. We will now be on a level playing field with her and that's going to take some getting use to. Now if she wants to fly to Paris for the weekend with a new beau, I can't put my foot down. That's her call, not mine - and it's driving me crazy.

Many family counselors point out, no matter how wonderful kids turn out, they never live up to their parents’ expectations. In college you hope they'll make the correct decisions and get it right. My child did, but not the way I thought she would. Did she chose the career path I thought she'd take? No. Did she end up with the boy I liked best? Ah, hardly. Is she pursuing the dreams I dreamed for her? Yes and no.

Child psychologists will say there comes a time when parents need to let go of their dreams for their children and live with the decisions their children make for themselves. That's the biggest part of letting go. And that's not so easy, either. It takes time. Parents can't look back and think “what if…” or “how come...” They need to embrace their children's accomplishments, their children's dreams, and move forward with them, all the while giving them love and support as they venture into a new phase of their lives. Once parents do this, they acknowledge their offspring as adults, not just as their sons or daughters. That's when parents can say they have finally let go.

So congratulations to my lovely daughter and all the young adults who have graduated this year! Here's to their happiness. May they be true to themselves and always have the support of a loving family.

Do you have a child who is graduating from college or high school? Are they going out on their own, joining the service, getting married? How are you adjusting to the idea? We'd like to hear from you.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 28th, 2009
12:02 PM ET

How can I keep my toddler safe in the pool?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Thespena in Crown Point, Indiana:

“My son is 3 this year and has outgrown the kiddie pool but I'm nervous about letting him swim in deeper water. I've heard toddlers can drown in water only a few inches deep. Is that true?”

Answer:

Hi Thespena,

Thanks for asking this question. As a parent of three small children, I completely understand and share your apprehension. You want to do everything you can to keep your son safe, but at the same time to give him as many beautiful life experiences as possible, swimming being a great one (especially as we’re heading into summer).

You're correct about the drowning hazards for toddlers. In fact, just one inch of water is enough for a toddler to drown in, according to Safe Kids USA Part of the reason is because their little bodies are top-heavy, so they have a harder time maintaining their balance and getting back up when they fall. Every year, more than 800 kids in the United States under age 14 die as a result of unintentional drowning. For your 3-year-old, his risk rate is double that of any other age group; children 4 and under actually have the single highest drowning death rate according to the National Safety Council.

But that doesn’t mean you have to keep your child out of the pool altogether. The number one thing you can do is to keep a close watch on what’s happening when your child is in the pool. Try to stay no more than an arms-length away. Unlike the way we see drownings depicted in the movies, there’s usually no prolonged flailing of arms and crying out – sadly, it’s usually very quick and quiet, so you can’t just rely on being in earshot. You have to keep your eyes on your son at all times.

Also, don’t rely on floats or any other swimming aid to keep your child safe because those are not meant to replace your own supervision and can give parents a false sense of security. When you feel he’s ready, you should start taking your son to swimming lessons. It’s a great source of exercise and fun for kids, and the sooner he becomes comfortable and skilled in the water, the safer he’ll be as he grows older.

There are some other things that you yourself can do now to protect against the worst from happening. One of them is to learn CPR. You’ll feel more secure - and who knows when you might need those skills in some other part of your life?

Another thing to consider if you have a pool at home is to secure the pool itself. A 2001 study in the journal Pediatrics found that home swimming pools are the most common site for drownings. So, be sure to have a fence around the pool. That alone has been shown to reduce the incidence of pool drownings anywhere from 50 to 90 percent of the time. The fence should surround the pool on all four sides, instead of relying on the house to be one of the sides. You can also install a door alarm to notify you if your child walks out the back door, a pool alarm that detects any movement in the water, or even a self-locking mechanism on the gate so that your child can’t get into the pool area without you being there.

One more thing while we’re on the topic of pool safety. It’s actually something that many parents are really unaware of since it’s a newer development. A recent federal law has been enacted to require all public pools to switch over to a safe drain mechanism. You should have your home pool inspected too. The reason: some drains have a super-strong suction mechanism that can easily entrap a child or adult at the bottom of the pool, causing them to drown. Once you get stuck to the drain, it’s almost impossible to wrest a person away from that powerful force. A replacement drain – one that allows air to flow in between your hand and the bottom of the drain, so it doesn’t create that suction effect - will run you as little as $35 plus the cost of installation. It’s a small price to pay for the security you get.


Filed under: Children's Health • Expert Q&A • Parenting

May 26th, 2009
11:04 AM ET

Should a state's mandate trump religious beliefs?

By David Martin
CNN Medical Senior Producer

Twenty years ago, I went to Mercy Hospital in Wilkes-Barre, Pa., on a January night to cover the arraignment of Larry Cottam for the death of his 14-year-old son, Eric. The boy had starved to death. Arraignments are usually held in courthouses, but Cottam was too weak from malnutrition to leave the hospital. He sat in a wheelchair, an intravenous tube in his arm, his six-foot frame down to 139 pounds as he listened to the charges the Commonwealth of Pennsylvania was bringing against him. It was a strange scene.

His wife, Leona, was also charged in her son’s death. But that would come later. That night, doctors were too busy trying to save her life. She and their daughter, Laura, were elsewhere in Mercy Hospital, receiving treatment for severe malnutrition.

Larry Cottam was a former Seventh Day Adventist pastor and truck driver. He had been without work for months but didn’t believe in handouts for his reclusive family. He thought God would intercede on their behalf. The Cottams withered as they waited in vain at their two-story home on a dead end suburban street. Authorities said Eric ate his last meal 42 days before his death. The 5' 10" teenager’s body weighed 69 pounds.

I thought about the Cottams as I was reading a line in a statement to the media from Calvin P. Johnson, attorney for 13-year-old Daniel Hauser’s parents: “It is a violation of Spiritual Law to invade the consciousness of another without their consent.”

In Minnesota, where Danny was living before he and his mother fled, the state has a law requiring parents to provide necessary care to a child. Danny has Hodgkin’s lymphoma, but his parents do not think chemotherapy is the right treatment for the boy, Johnson said. In fact, Danny thinks chemo will kill him, according to the attorney.

At a hearing, Brown County District Judge John R. Rodenberg said the boy's "best interests" require that he receive medical care to combat his Hodgkin’s lymphoma. Chemotherapy has a 90 percent success rate with this cancer. Without chemotherapy, Danny’s doctor testified there’s a 95 percent chance the cancer will kill him.

Danny and his mother fled the state rather than comply with the court. They returned to Minnesota on Monday.

“This is a case of Love vs. Power. Love gives. Power takes,” Johnson wrote in his news release.

In the case of Larry and Leona Cottam, no one argued that couple didn’t love their children, nor did prosecutors question the sincerity of their religious convictions. But a jury convicted Larry and his wife, Leona, of third-degree murder just the same.

Last year, a Wisconsin girl named Madeline Neumann slipped into a coma and died after her parents chose prayer over medical treatment for the diabetic 11-year-old. The state charged her parents, Leilani and Dale Neumann, with reckless homicide. A jury convicted Leilani on Friday. Dale is scheduled to stand trial in July.

No one likes the notion of the state imposing its will over deeply held spiritual beliefs, but are there times when the government should dictate what care a child receives – no matter what the parents say?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 22nd, 2009
12:02 PM ET

Picking the right sunscreen

By John Bonifield
CNN Medical Producer

It’s Memorial Day Weekend—the unofficial start of summer! I’m hitting the beach and taking plenty of sunscreen with me.

Many of you will be spending hours in the sun in the months ahead. Sadly this year, more than a million of you will also learn that you have skin cancer.

We all know sun blocks can work to prevent burns and disease, but how do you pick the right one?

The American Academy of Dermatology recommends using a broad-spectrum sunscreen. When we talk about sun damage, we’re actually talking about damage to the skin that’s caused by ultraviolet light: UVB and UVA rays.

UVB rays lead to sunburns. When you buy sun block that provides SPF protection, you’re protecting yourself against UVB rays. SPF indicates the level of protection.

UVA rays penetrate deep into the middle layer of your skin. They can lead to wrinkles and age spots. They can also diminish your body’s ability to protect against cancer by weakening the immune system.

Both UVB and UVA rays can cause skin cancer, but not all sun blocks protect against UVA rays. For broad-spectrum protection, you want to buy one that does.

Now, a lot of people wonder about strength: SPF 85 sounds like a lot more protection than SPF 30 or SPF 15, but the difference between them actually starts to get pretty small.

For example, an SPF 15 sun block lets in about 6 percent of the sun’s UVB rays. An SPF 30 lets in only about 3 percentof those rays. An SPF 85 lets in a little more than 1 percent.

So, you’re going to get only slightly more protection with the higher SPFs, but that doesn’t mean you should let yourself bake in the sun longer. The recommended minimum is an SPF 15.

Whatever SPF you pick, be sure to slather on enough sunscreen—a shot glass-full is about right, the recommended one ounce. Reapply frequently, especially after swimming or if you've been sweating profusely.

On “House Call with Dr. Sanjay Gupta” this weekend, we’re kicking off a three-part series called “Saving Your Skin.” We’ll tell you more about picking the right sunscreen.

Also, let us know: what are your skin concerns this summer?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 21st, 2009
10:30 AM ET

Can PTSD be cured?

As a new feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Margaret, via comment on the Paging Dr. Gupta blog

“Do PTSD symptoms ever really go away?”

Answer:

Margaret, thank you for your question. Last week, I sat down with my producer and a flip cam and she started asking me questions about my time in Iraq. I hadn’t prepared for it at all, but the memories came flooding back. There was a hat that I used to wear during my 12 weeks out there. It was a camouflage wide brimmed hat, that was particularly effective for shielding me from the Iraqi desert sun. I brought that hat home, and hadn’t thought about it for a year until one day my wife and I were planning a hike. I pulled out the hat and put it on at the beginning of the trail. Inexplicably, I started to sweat, developed a pit in my stomach and almost threw up. At first, I thought it was something I ate, until I realized it was the smell and feel of that hat that immediately propelled me back to the battlefield. I had found a trigger. And, keep in mind, I was only there for three months, as compared to military personnel that have been on the battlefield for years.

As I researched this I learned the answer to your question. The symptoms of PTSD really never go away. Here is why: There is a profound psychological and physiological reaction to something traumatic. That traumatic event can’t be completely undone, though it can be diminished in the mind. Some of the symptoms include flashbacks, like I had. You may also have frightening thoughts, emotional numbness and depression. Many people will have problems sleeping, concentrating and will experience angry outbursts, to name a few.

The key to your question, I think, is to create a situation where someone who has persistent PTSD is still able to function normally. There are good treatments available, from counseling to immersion therapy. On an individual level, though, maintaining strong relationships with people who support you – they are often the first to notice the signs of PTSD – is very important. Also, talking to people who went through the same or similar experiences can be cathartic. And finally, try and remove things that trigger those memories. For my part, I threw away that hat.


May 20th, 2009
02:43 PM ET

Sir Elton's ashamed he didn't do more

By Matt Sloane
CNN Medical Producer

Growing up, my musical taste was very different from most of the other kids'. While they were all listening to New Kids on the Block and Backstreet Boys, I was listening to the classics: The Beatles, Billy Joel, The Who, Elton John. Not necessarily because my tastes were more refined – it’s just what my dad listened to.

A behind the scenes look after we finished interviewing Sir Elton John.

A behind the scenes look after we finished interviewing Sir Elton John.

I'll never get to meet The Beatles - at least not all four of them - but imagine how cool it was for me when I got to meet Sir Elton John, Tuesday, in Atlanta.

John was here speaking to more than 3,500 biotechnolgy industry experts about a very important global issue: HIV/AIDS. Although he does not personally battle HIV, he has taken on the disease since 1992 as if he had been sentenced to die like millions of others.

The Rocket Man raised more than $30 million last year alone in Oscar party fundraisers, benefit concerts and charity auctions, and it all goes directly to the people who need it most.

"We never really invested in vaccines or in research," he said in that famous British accent. "We left that to amFAR who do a fantastic job. We've always primarily concentrated on direct care and education."

That “direct care and education” goes to organizations like Baphumelele (which built houses for the caretaker of 150 children left orphaned by HIV in South Africa), sex education courses for thousands of kids in the Caribbean, and needle-exchange programs like the Syringe Access Fund.

All of this fundraising activity is going on even as he tours the country from left coast to right; just hours after we spoke to him, John played with another rock legend – Billy Joel – in Indianapolis.

John said he's trying to make up for lost time.

“I don’t know where I was [in the 1980s], and I really deeply regret that, and I try to make up for lost time by being far more outspoken now that I'm sober," said John, in response to Sanjay's question about why he was not more active when AIDS first reared its ugly head in 1981. "I am very lucky in the fact that I am a celebrity and that I can go out and do concerts and raise money for AIDS," he said. "I use my fame and my power and my personality to go there and kind of be like the whore of the organization, if you will."

At least for the forseeable future, this 62-year-old rock icon has no plans to slow down in his global fight to rid the world of HIV/AIDS.

Do you donate your time or money to HIV/AIDS? We'd like to hear about it!

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 19th, 2009
01:49 PM ET

Possible swine flu vaccine whipping around the world

By Caleb Hellerman
CNN Medical Senior Producer

I’d just gotten the kids to bed and was cleaning up the house when the news flashed on my BlackBerry – a Chinese news report that researchers in South Korea, working with a sample from Atlanta, had discovered a potential vaccine against the swine flu H1N1 virus. It was nearly 10 o’clock at night but that’s how this goes – a worldwide, round-the-clock effort for the past several weeks, what some are calling a model of international cooperation.

A few minutes later I was on the phone with Dr. Seo Sang-heui, of Chungnam National University. He told me that yes, he believes he has created a vaccine that could be used against the virus. He’s packed up eight vials of the new vaccine and was waiting for a courier to pick them up and fly them to Atlanta, for testing at the CDC. He figured the courier would arrive in about an hour.

We’re not talking about a usable vaccine, not yet, but this is an important step. Here’s how it works: the U.S. Centers for Disease Control and Prevention isolated the 2009 H1N1 virus in its lab, in Atlanta. It sent isolates to a number of researchers around the world – including, it appears, Dr. Seo. These researchers follow a careful regimen, genetically modifying the vaccine to make it grow well, while keeping the traits that will – we hope – induce a strong immune response. It’s a process of trial and error, but Dr. Seo told me that in the past few days he figured out a way to grow the modified virus in an agar solution. He says he’s doing what any vaccine researcher would do, sending the samples back to Atlanta at no charge, with no conditions attached.

CDC spokesman David Daigle told us that he wasn’t aware of the finding — yet. But assuming the samples do arrive, they’ll go straight to the CDC laboratory for genetic analysis. That’ll tell us, one way or the other, if this is really a potential vaccine. Dr. Gupta and I were at the lab just two weeks ago, peering through the window where scientists were tinkering with the swine flu virus under stainless steel hoods that provide special ventilation, keeping the virus from floating around the room and out the door. The hoods look a bit like big fans over a stove, except for a glass front that lets the researchers see what their hands are doing.

Assuming this finding is the real deal, samples of the candidate vaccine will be shipped to manufacturers around the world. These companies have to adapt the material to their own processes. They have to make sure the vaccine grows well in eggs. Yes, chicken eggs. They have to test various mixtures, to see how well it grows and also whether the vaccine produces a strong immune response in animals, probably mice. They’ll want to see if additives – “adjuvants” – can enable them to produce an immune response using less vaccine – an important consideration if there’s limited supply, and we want to inoculate a billion people. At least one company, GlaxoSmithKine (GSK), says it’s already received notices from several governments that they intend to purchase mass quantities of vaccine, once available. According to GSK, Great Britain has pre-ordered 60 million doses and France, 50 million.

If the vaccine works in animal testing, they’ll test it in people. If that works – and seems to be safe – it’s up to regulators – the Food and Drug Administration, in the U.S. – to give the thumbs-up. If all goes well, the first doses could reach the public in anywhere from four to six months. Of course, the U.S. and other governments might not order mass quantities of H1N1 vaccine. There’s a limited number of eggs, and depending on the final formula, buying more H1N1 vaccine might mean producing less of the seasonal flu vaccine. We’ll be following this closely over the next few months.

There’s a long way to go, from Seoul to a pharmacy near you. And keep in mind, there may be other candidate vaccines discovered. But if the finding we hear about last night is confirmed, it’s a pretty big step. A new strain of influenza can be a scary thing, and it will be a big relief if we have an effective vaccine before the next flu season hits.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 18th, 2009
05:02 PM ET

Can cigarette smoke help allergies?

By Elizabeth Landau
CNN.com Health Writer

Since allergy season began in late March, I have been trying to avoid settings where a lot of people are likely to be smoking. Even outside in Atlanta’s hipster neighborhood of Little Five Points, I found myself coughing uncontrollably last week when walking past a group of people smoking on a corner. Allergists agree that cigarette smoke aggravates allergies.

But a new study recommended by the Faculty of 1000 Biology challenges this conventional wisdom. Researchers at Utrecht University in the Netherlands took mast cells, which play a role in the immune response to allergies, from mice, and treated them with a smoke-infused solution.

They found that the smoke treatment prevented the mast cells from releasing inflammation-induced proteins, which is what normally happens when exposed to allergens. The smoke solution did not affect other mast cell immune functions, the researchers said. This anti-allergy effect would likely hold true for humans, they wrote.

The general idea that smoke would help allergies is surprising, said Dr. Stanley Fineman, allergist with the Atlanta Allergy and Asthma Clinic.

“In humans, we know from the patients that we see that cigarette smoke is very irritating to the mucosa, the lining of the airways,” he said. “People who have allergies tend to have inflamed respiratory mucosa.”

Years of patient work has shown that smoke is detrimental to people with allergies, he said.

Whatever benefits to allergies cigarette smoke may theoretically carry, the costs are hard to ignore: Cigarette smoking accounts for about 30 percent of all cancer deaths nationwide, according the American Cancer Society. About 87 percent of lung cancer deaths, the leading cause of cancer death among both men and women, are caused by smoking. Smoking can also lead to other types of cancer.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


May 15th, 2009
04:20 PM ET

How to save on prescription drugs

There’s no denying that prescription drug costs are in the stratosphere. Combine that with an economy that is in the cellar, and it is no surprise that a recent Kaiser Family Foundation poll found almost 30 percent of adults say they’ve opted not to fill a prescription because of cost. About a quarter of people polled had split pills or skipped doses to make their medicine last longer.

Here are the resources Gerri Willis and Dr. Sanjay Gupta talked about on “House Call” this weekend. Thanks for watching.

Kmart pharmacies www.kmart.com

Costco www.costco.com

Sam’s Club www.samsclub.com

BJ’s Pharmacies www.bjs.com

Drugstore.com

Homemed.com

Familymeds.com

Destinationrx.com

One word of caution here, beware of fly-by-night sites, where your risk of getting counterfeit or tainted drugs rises. Look for sites that carry the "VIPPS" seal (it stands for verified internet pharmacy practice site, and is awarded by the National Association of Boards of Pharmacy).

Also, consider getting a drug discount card. They are available from state government, membership associations, non-profit organizations or for-profit businesses. You may be able to save from 15 to 50 percent on certain medicines. The cards may have annual fees that range from $30 to $60 per family or up to $9 dollars a month.

Pharmacy assistance programs can also help. They are generally run by drug companies. Keep in mind there may be income requirements.

Togetherrxaccess.com

Merckhelps.com

Rxassist.com

Pparx.org

Needymeds.com

For more information of Pfizer’s program, called Pfizer Pfriends, call 1-866-776-3700.

And finally, read the Empowered Patient for more tips on how to save big bucks at the pharmacy counter.


Filed under: Health Care Costs

May 15th, 2009
12:44 PM ET

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.

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