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November 30th, 2009
03:22 PM ET

Tears - Kids have the right idea

By Ashley J. WennersHerron
CNN Medical News Intern

My preschool-age cousin was hospitalized last year for a bad infection. A happy and good-natured kid, she kept her spirits up with visits from family and friends, as well as multiple viewings of “The Little Mermaid.” After nearly a month, she was well enough to go home, as soon as she had her chest port surgically removed.

The surgery was brief, but required her to have general anesthesia. After waking up, she felt sick from the medicine, she felt pain from where her port had been, she felt frustrated by not being allowed to run around and play like normal — it’s a lot for anyone, and it’s even more overwhelming when you lack the ability to articulate all of those emotions. The feelings build up and, often, crying is the result.

Tears show emotion, but we didn’t always have such a clear indicator. According to a study released this spring by the University of Maryland, humans developed to shed tears to efficiently communicate distress, whether it’s grief, fear or frustration. It’s suspected that before we developed the vocabulary to express our emotions, our tear ducts advanced our ability to effectively communicate.

In the study, participants were shown sets of photographs. They were asked to identify the emotions in each pair. The pictures were identical, except tears were digitally removed in one photo per set. The individuals viewing the photographs ranked those with tears as sad and those without tears as less sad, puzzled or confused, even though the facial expressions were the same in every other way. The tears portrayed sadness for those viewing them, but in the photos without the tears, the same message wasn’t as clear.

Children, without the vocabulary to explain a simple emotion or even a need such as hunger, cry. The tears demonstrate that they need attention for something. When we grow up, we can describe what we want or need, but emotion builds up for even the most-level headed person. No, we don’t necessarily cry because we are hungry or tired, but something sad or upsetting can cause the tears to spill.

We use tears to show others a need for understanding and compassion. It’s a cry for help, literally. It’s instinctual, even as infants, we know crying will bring what we need, even if it’s simply attention.

Why do you cry? How do you react when you see others crying?

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.


November 27th, 2009
11:42 AM ET

Alzheimer’s changes family ties

By Rebecca Leibowitz
CNN Medical Intern

It all started one afternoon. “Grandma,” I asked, “how did Karen like my hand-me-downs?” “What?” she responded, “I didn’t know what those clothes were doing in my trunk. I gave them to charity.” We all knew immediately that something was wrong. And there was more to come. Once a skilled, careful driver, my grandmother terrified her passengers when she blew through a stop sign as if it didn’t exist. I would catch her staring at me in confusion, often calling me by the name of my cousin or aunt. My grandmother, like her own grandmother, two brothers and a first cousin, has become one of the estimated 5.3 million people in the United States living with Alzheimer’s disease – the most common cause of dementia.

Our family has learned what many other families know well: Alzheimer’s disease is devastating. We’ve seen our loved ones change into someone entirely different. According to the Alzheimer’s Association, a person develops the disease every 70 seconds in the U.S., and the amount of people living with Alzheimer’s is expected to double every 20 years. The illness’ economic costs are nearly as distressing as its emotional toll. Each year, an estimated $148 billion is spent on Alzheimer’s, including direct costs of Medicare and Medicaid and indirect costs to businesses. This figure, like the burden of Alzheimer’s disease in the U.S., is expected to only get worse.

Alzheimer’s has no cure and its damage can begin decades before symptoms are apparent. The exact cause is still unknown, but tangles and plaques in the brain are thought to lead to symptoms like memory loss, poor judgment, changes in mood or behavior. Without a cure in sight for this disease, what can people like my mom, who is approaching the age when the disease could already be developing, do to prevent or slow the onset of this debilitating illness?

Researchers are convinced that mental activity and socialization can help. Reading, playing board games, playing musical instruments and dancing have all been shown to decrease the risk of contracting any form of dementia. Engage your brain, build up your social networks and you’ll put off getting the disease or possibly avoid getting it altogether.

Other studies have found a link between unhealthy living and increased Alzheimer’s risk. A study earlier this month in the Archives of General Psychiatry concluded that for people with a family history of the disease, high blood pressure in middle age is a significant risk factor for Alzheimer’s in old age. So, what can you do if Alzheimer’s is prevalent in your family? Don’t smoke, eat a well-balanced, heart-healthy diet, stay stress-free and exercise regularly. Not only will these measures decrease your risk for Alzheimer’s, they will improve your overall quality and length of life.

Unfortunately, this information wasn’t around when my grandmother was growing up. But for my mom, her siblings and myself, (as well as the millions of other Americans with a strong family history of the illness), there is hope. Not only can we decrease our Alzheimer’s risk by maintaining a healthy and active brain and body, but researchers are constantly discovering new things about prevention and treatment of the disease. Perhaps one day we will even find a cure.

Do you have a history of Alzheimer’s disease in your family? Are you taking any measures to try to keep from contracting the disease?

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.


November 26th, 2009
11:40 AM ET

Does flying put my family at risk for getting sick?

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

From Connie in California:

"My family will be flying for the holidays. Should we be concerned about being in an enclosed space for five hours?"

Answer:

Connie, more than 2 million people are expected to be flying over this holiday weekend and many have the same concern as you. The Centers for Disease Control and Prevention points out there are not many studies about the spread of flu on airplanes, but anytime people are in close quarters the chance for germs spreading is much higher.

If you are sitting next to someone who is coughing excessively or seems ill, that’s when you are most at risk. According to researchers at Purdue University, you’re most likely to get sick from the people sitting in your row or the row behind you. They actually developed an animation showing how germs move around an airplane. If you’re in this situation, there are things you can do to lessen your risk of getting sick. Point the air vent away from yourself and towards the sick person – that may help push the germs back at that person. Also, turn your body away from the person who seems ill and as we’ve been saying – don’t touch your face. Dr. Julie Gerberding, the former director of the Centers for Disease Control and Prevention, adds that you could ask a flight attendant whether a mask could be given to that person or if that person or you could be moved to another part of the plane. Gerberding also points out that the air on planes is circulated through a HEPA filter, so if you are several rows away from a sick person you’re unlikely to catch his or her germs.

Keep in mind, you can go a long way in protecting yourself by taking some simple steps. I know we talk about this all the time, but wash your hands frequently with soap and water. If soap and water aren't available, you can carry those alcohol-based hand sanitizers. Cover your nose and mouth with a tissue while sneezing and encourage people around you to do the same thing and avoid touching your eyes, nose and mouth. We touch our hands to our faces a lot. In addition, some people might consider carrying a disposable mask, especially if you're feeling sick yourself. Finally, the CDC recommends that you get vaccinated, if you can. That’s sometimes harder than it sounds. For more information, check out flu.gov and CNN’s special report on H1N1.  Have a safe trip, Connie


November 25th, 2009
02:39 PM ET

Drug price gaps can be tough pill to swallow

By David S. Martin
CNN Medical Senior Producer

Talking about health care costs in July, President Obama asked this question: “If there's a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that's going to make you well?”

Many ophthalmologists believe there is just such a blue pill out there. Only the red pill’s not twice as expensive. It costs almost 50 times much: $2,000 compared with about $45 for the alternative. And Medicare covers both.

What are the drugs? The expensive one is Lucentis. The other, Avastin. They’re not pills, really, but a medicine injected into the eye every four to six weeks to treat age-related, wet macular degeneration, a leading cause of blindness in seniors. With monthly injections, the annual cost difference is $24,000 versus $540.

It’s a difference that we, the taxpayers, underwrite. Lucentis cost Medicare $557.3 million last year, according to U.S. Centers for Medicare and Medicaid Services. That’s a figure that could rise as the population ages.

Many retina specialists think Avastin works as well as its more expensive rival, Lucentis, and roughly half of the wet macular degeneration patients are opting for Avastin, according to Dr. David F. Williams, president of the American Society of Retina Specialists.

Not surprisingly, Williams says, Medicare patients with supplemental insurance that covers the 20 percent co-pay are the most likely to choose Lucentis. (Medicare recipients ponied up $142.7 million in co-pays for Lucentis last year, according to government figures.)

Lucentis received FDA approval in 2006. The chemically similar Avastin was originally developed to treat cancer but its off-label use for wet macular degeneration predates Lucentis’ arrival on the market. To make this tale even stranger, both Lucentis and Avastin are made by the same company, Genentech, a division of the Swiss drug giant Roche. Can you guess which treatment the company advocates?

The National Eye Institute, part of the National Institutes of Health, is now conducting a head-to-head comparison of the two drugs. Initial results are expected at the end of next year.

Should the government require patients to choose the less-expensive drug? How about if the clinical trial shows no difference between the two?

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.


November 23rd, 2009
12:48 PM ET

Staying focused on your goals during the holiday season

By Jillian Michaels
Guest blogger

The holiday season is upon us and this time EVERY year I write diet, fitness, and motivation tips about how to not gain weight and let your health spiral out of control. It’s nothing you haven’t heard before so honestly why the heck am I writing about this again?! Did no one listen the last 10 years?

You are not stupid. You know how to be healthy. Eat less and move more. It doesn’t take much to know that a second helping of stuffing and pumpkin pie and yams and biscuits is a bad idea.

You know all the obvious stuff… Eat white meat turkey, not dark. Do whole grain rolls instead of biscuits. Bring fitness DVDs with you if you are traveling so you can workout on the road. Create fun family fitness activities to do together such as touch football instead of sitting around eating or watching TV. And the list goes on…

Let’s get down to the bottom of it. The holidays are a time to be grateful. Grateful for the blessings you have and the ability to create new blessings symbolized by the coming of a new year. However, at a time when we should be celebrating our lives most, we are prone to depression and dysfunction. Eating becomes gluttonous. Family issues become magnified. The gym becomes a distant memory. Stress levels go through the roof and so on.

So how do we create that shift in our thinking, behavior, and overall holiday experience? Desire. The first step is to stay focused in the present tense on the things you want for yourself and in your life. Transformation doesn’t happen in the past or in the future. It happens right now. By focusing on the positive things you crave and deserve, you shift your focus from one of resignation to one of inspiration.

Start by picking a goal. Maybe the one you have been saving for January 1 and begin pursuing it immediately. Every day this season, I want you to wake up and think about that goal and how the actions you take throughout your day will bring you closer to that goal. If holiday parties create temptation for you, avoid them. Find a healthier way to celebrate with your friends like a night on the town dancing. If stressful family reunions throw you off track, set boundaries or stay away. Take a healthy vacation with close friends instead. If the memories of holiday seasons past cause you to feel lonely, channel those feelings constructively instead of destructively. Take them as a sign that it’s time to form new connections. Join a club, support group, or online community where you meet new people and make new friends. And with every decision you make ask yourself this question – “is my choice or behavior in this moment getting me closer to my goals?” If the answer is no, make a different choice.

Some of you are thinking “it’s not that simple. I have to go to my office party. I have to go to my grandmother’s house for dinner where she guilts me into eating thousands of calories. I have to let my in-laws stay with us even though they insult me.” Do you? Do you physically have to? Are you being held at gunpoint to engage in behaviors that upset or hurt you in some way? I bet 99 percent of the time the answer to that question will be no. So stop wasting time and start putting your health first, physically and emotionally. Let’s redefine the holidays as a time of inspiration and possibility one empowered person at a time. And remember, taking care of oneself is a gift to everyone else because everyone ends up having a happier and healthier holiday.

How will you maintain your health goals during the holidays?

Jillian Michaels is a fitness expert and trainer on the TV reality show "The Biggest Loser".


November 20th, 2009
02:51 PM ET

My resolution – be more positive

By Val Willingham
CNN Medical Producer

As the year 2010 begins to sneak up on us, I am already making a list of my New Year's resolutions. There are the usual promises: eat less, exercise more. But I am also determined to adopt a more positive attitude next year and look at the glass as half full. That’s not always easy, especially during a time when friends are without work and the guy down the street can't make his mortgage payments. For some of us this year, the only thing in the glass has been sludge.

But it's time to change the way we look at things and start to appreciate the good in our everyday lives. And we need to spread that joy by taking care of one another, by being there when times get tough, even when the misfortunes are not ours. We need to think that the housing market will do better, employment rates will go up and peace will make its way into the hearts of our world leaders. We must think positively. Research has shown that if we approach the day with an optimistic view, positive things will happen, not only for the good of the world, but for our own heath.

In a recent study published in the journal "Circulation," researchers found that women who were more positive and had a better attitude had a 16 percent lower risk of having a heart attack. Other studies have proved that people who are happier and look at things with a good attitude have lower blood pressure, sleep better and are more active. Doctors also say being more upbeat helps our immune systems, keeps depression at bay and even gives us the ability to cope when things do get rough.

I am a blessed person. I try never to take my fortune for granted. And I try to live by the Golden Rule. But from time to time, when a driver cuts me off, or a clerk messes up an order, I can get irritated – and at times, rather nasty. So next year, instead of slinging terse words at the motorist next to me, or being snippy when checking out at a store, I will try to take a step back, take a deep breath and let it go. I will try to be better to my fellow men and women and lift them up instead of dressing them down. Yes, it's been tough recently, but as we enter into a time of giving thanks, consider all the wonderful things we have in our lives. They may add up to more than we realized. And that’s the most positive thing of all.

Do you are agree?


November 19th, 2009
12:33 PM ET

Nasal vaccine for 14-month-old?

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

From Elaine in New Jersey:

I attended a clinic this weekend for the H1N1 shots, and they administered the nasal spray to my 14-month-old! According to the CDC website it should NOT be administered to children under 2 years of age! I contacted the pharmacy where the clinic was held, and they took my contact info and said we will get back to me. Can you tell me is my child at risk?? I also have a call into my pediatrician. I also contact the CDC and was told they are not medical professionals.

Answer:

Elaine, it is easy to sense dismay and concern from your e-mail, and as a father I can certainly relate.

The reality is – yes – the nasal spray version of the H1N1 vaccine, which contains a weakened live flu virus, should be given only to people ages 2 to 49. We also know that children with conditions such as asthma may not be eligible for the live flu vaccine.

In order to ease your mind a bit, unless he or she has asthma, chances are very good that your 14-month-old will be fine.

The primary reason children younger than 2 do not get the nasal spray H1N1 vaccine is that it has not been tested in, and therefore is not licensed for, that age group. It is that simple. You need solid data to submit to the Food and Drug Administration before a medication can be approved for use in a particular population – that data do not exist for children younger than 24 months.

To ease your mind a bit more, rare complaints among adults and children taking the nasal spray form of the H1N1 vaccine are runny nose, sore throat, and sometimes fever. These symptoms usually go away within a couple of days. If they do crop up for your 14-month-old, you should not be too concerned, but if the symptoms get worse or your instinct tells you to, do see your pediatrician.

On the bright side of your predicament, your son or daughter is now vaccinated against H1N1. There are many parents who are still waiting to have their children vaccinated, so count yourself among the fortunate. Your child should soon have a second H1N1 vaccine dose – this time with the injectable form of the vaccine. And if you have not yet been vaccinated, you should do so – as the caregiver for your baby, you are eligible for these early doses of vaccine.


November 18th, 2009
03:33 PM ET

Are H1N1 fears prompting a run on seasonal flu vaccine?

By Saundra Young
CNN Medical Senior Producer

Every year I get a seasonal flu shot. CNN sponsors flu clinics for employees, so luckily I never have to go "in search of.” My 12-year-old daughter always gets one too.

So the first week in October, I called her pediatrician to schedule a seasonal flu shot. I thought I was ahead of the game. To my surprise, I was told they were out of both the shot and FluMist, but that they were expecting a new shipment mid-October. Since then I have called her office once a week. Nothing. Finally last week they told me they did not know when they would get another batch, and suggested I check with local clinics and other providers such as pharmacies and supermarkets.

I visited a clinic, called numerous supermarkets and pharmacies. Everyone was out, and none knew whether, or when, another shipment would arrive.

According to the Centers for Disease Control and Prevention, as of last week, 94 million doses of seasonal flu have already been distributed. Total production for this season is 114 million doses.

So where did all that seasonal flu vaccine go? CDC Spokesman Llelwyn Grant says the number of people getting seasonal flu vaccine this year is higher than has been seen in previous flu seasons. He attributes the numbers to all the attention given to H1N1. "People are more vigilant in getting vaccinated based on H1N1 activities. They are proactively getting ahead of seasonal flu before it kicks in. Awareness has been higher. That's why seasonal flu vaccine is moving faster than in previous years."

Grant says health officials have not seen much seasonal flu yet. A few pockets maybe, but the majority of cases are still H1N1. He says seasonal flu season generally really starts to percolate around November or December.

Unlike with H1N1, the federal and state governments are not involved in the actual purchasing of seasonal flu vaccine. Whoever orders that vaccine is doing so directly from the manufacturer. So while it may seem like a shortage, the amount of vaccine produced this year is about the same as the last few years. Still, Grant says he understands the frustration. "We are encouraging folks to continue looking. There is more to be distributed. The good news is we have yet to see any seasonal activity really manifesting itself here in the United States. That is the one good piece of news."

So, I find myself waiting for the last 20 million doses to be distributed. Coming soon, I hope, to a clinic near me. Keeping my fingers crossed that I find one with vaccine before the seasonal flu finds my daughter.

I even popped on the American Lung Association's flu clinic locator Web page. Both the CDC and Maryland's Department of Health and Mental Hygiene pushed me to their "find a flu shot site." It didn't help. Most of the clinics that did surface were for H1N1 shots only. The eight that were listed as having seasonal flu vaccine were all in Virginia. Bold type instructed me to "please call ahead to confirm availability."

Is anyone else having this much trouble finding a seasonal flu shot?

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.


November 16th, 2009
04:26 PM ET

Tracking fitness in zero G’s

By Caleb Hellerman
CNN Medical News senior producer

The space shuttle Atlantis lifts off this afternoon, on a mission to deliver spare parts to the International Space Station. I feel an extra connection, because in the past few weeks I’ve been talking to and emailing with Dr. Robert Satcher, an astronaut and orthopedic surgeon who specializes in treating cancer cases. He’s going into space for the first time, and as a preview, he and two of the NASA trainers showed off versions of his spacesuit and the treadmill that astronauts can use to stay fit while spending long months on the space station. (Watch Video)

One twist you don’t see at the gym: Astronauts have to strap themselves to the treadmill with a heavy cable, to keep from floating away when they try to run.

The thrust of the Atlantis mission is maintenance, not medical, but crew members spent a chunk of their pre-mission training, practicing what to do in case of a medical emergency. Satcher also points out that he’s part of “this ongoing tradition of experimentation, human experimentation, what happens to the body when you go into outer space.”

One thing I thought was interesting: On a space mission, you get taller - anywhere from half an inch to an inch and a half. Satcher explains that in zero gravity, fluid is redistributed in the body and the spine gets longer. You also lose bone and muscle mass as the body adapts to the lesser demands of zero gravity. It’s sort of the opposite of what happens when you lift weights at the gym, where your body responds by growing muscle. Astronauts are also prone to sleep disturbances; many crew members take the hormone melatonin as a sleep aid, to try to keep their body clocks adjusted.

In between maintenance work, the Atlantis crew will take measurements to help track musculoskeletal changes, and samples of blood and saliva to try to identify possible changes to the immune system.

Satcher, who likes to be called Bobby, says he’s thrilled to be flying into space for the first time. I hope he can find time to tell us about it, while he’s in orbit.

What would you like to hear about, from a doctor in outer space?

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.


November 13th, 2009
01:46 PM ET

Fight or flight: The chemical motivator

ashleycarBy Ashley J. WennersHerron
CNN NY Medical News Intern

It was the last day of winter break. I was driving to a friend’s house to say goodbye before returning to New York for the spring semester. I was stopped at an intersection when the light turned green. I pushed down the gas and saw a flash of white. Next thing I knew, I was facing the wrong way, toward oncoming traffic and I could feel the January wind rushing in through the driver’s side window I had shattered with my head. My steering wheel was stuck and hitting the brakes did nothing. I hit another car head on and side-scrapped a third. I barreled up a hill, finally stopping just feet away from a row of gas pumps.
ashleycarpicMy airbags had deployed, filling the air with a foul smell and bits of grit. Disoriented and terrified, I thought the burning odor meant my car was on fire. I tore my seat belt open, which was no easy feat. In the impact, I slammed against the armrest, breaking it, which jammed the seat belt buckle. I got myself free, dove through the broken window (my door wouldn’t open), somersaulted to a standing position and ran away from the car I thought was going to blow up. When I reached what I perceived as safety, I collapsed. It felt as if I couldn’t move at all. During my escape, I couldn’t feel the pain, but as soon as I relaxed, I became aware of the extent of my injuries. My head felt as if it were leaking (a result of a concussion and a hairline skull fracture), my ribs were bruised, my leg was banged up and I had shards of glass and airbag dust in my eyes. I could barely answer the paramedic’s questions; how had I managed to perform acrobatic tricks just minutes earlier?

The answer lies in the functions of the autonomic nervous system, a branch of the central nervous system, which is what operates involuntary body functions, including breathing and blinking. The autonomic nervous system operates the sympathetic and parasympathetic nervous systems. The first perks up in a fight-or-flight situation, where danger is perceived. It releases adrenaline, a hormone also known as epinephrine, in response to fear or anxiety. It dilated my eyes and heightened my other senses, allowing for a higher intake of information. It also increased my blood pressure, which let oxygen travel quickly to my muscles and brain, explaining my circus-stunt escape route. Adrenaline powered my body in preparation for an attack or to flee. I wasn’t about to fight my Chevrolet Blazer, so I did everything I could to put distance between it and myself.

As soon as I was safe, my parasympathetic nervous system took over. The norepinephrine (the opposite of adrenaline) slowed my breathing, lowered my blood pressure and relaxed my muscles. My body had entered a long-term state, beginning the process of assessment and healing.

I’m glad to say that despite the severity of the accident, everyone involved was able to walk away. Now, I’m still in physical therapy and I will forever have scars of the accident, but my body took care of me in the moment.

Have you ever experienced unusual focus or strength in the face of danger?


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