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December 14th, 2009
02:22 PM ET

Grief and guilt

By Ashley J. WennersHerron
CNN Medical News Intern

A friend and colleague of mine died in July, from injuries she suffered when she was hit by a delivery van in Ocean City, New Jersey. Casey A. Feldman was a 21-year-old student with a promising future in journalism, balancing a full course load, an internship and the job of news editor for our school paper. Her family recently endowed a scholarship for communications students, so that others will have the opportunity to intern without monetary worries. Few people applied, despite a simple application, requiring only a recommendation, resume and a 200-word personal statement.

I applied, but I didn’t want to. Only a true need for financial aid (and my mom’s encouragement) pushed me to fill out the application. It sounds irrational, but I do not want to take money that could be going to the girl I knew. Nearly five months after her death, I want the money to be waiting for her and I would feel guilty if I won the scholarship. It feels wrong and disloyal to gain profit from Casey’s death, yet she would want others to have the opportunity to explore internship options and career choices.

It’s survivor’s guilt.

People who lose someone tend to find that, in their grief, they experience a sense of powerlessness. This complete lack of control, in all facets of life, stems from our emotional worlds toppling from the loss.

“When we lose our grandparents, we lose our past,” said Diana Nash, a psychology professor at Marymount Manhattan College and a bereavement counselor. “When we lose a sibling or a peer, we lose our present. If we lose our children, we lose our future.”

The idea of losing my present struck a profound and terrifyingly accurate chord for me. The comfy, college bubble of carefree immortality had been yanked away, leaving an acute void. Where I was once planning and daydreaming about my future, I began simply hoping there will be a future for me and wondering why Casey and her family didn’t get to keep their dreams.

The world loses logic when someone dies suddenly. I entered a mode of complete reaction. I couldn’t actively make decisions or plans — everything I did was in reaction to things around me. I felt as if I had no control at all.

The scholarship was something I had some say in. I could decide to apply, or not to apply. It was my decision, I thought, until I realized how difficult it was to make. Nash explained that even the scholarship itself is a plan for the future, something that was just proven hazy. It’s instinctual to avoid exposing yourself to a situation closely related to the experience that just caused so much suffering. The scholarship is a happy thing in itself, but it is also another manifestation that Casey is still gone, and the guilt doesn’t bring her back.

Have you experienced guilt after the death of a loved one? How did you come to terms with 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.


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 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?


October 30th, 2009
02:05 PM ET

Breast cancer scare an insurance nightmare

By Ashley J. WennersHerron
CNN Medical News Intern

Breast cancer runs in my family; even my dad had it. I routinely do self-checks, always terrified that I'll find some indication of my worst nightmare.

Two weeks ago, I did. I found a lump the size of a pea buried in the skin between my right breast and my armpit. I paled, I cried, I panicked about the future, and then I did the sensible thing. I searched the Internet. Typing "Right Breast Lump and 20-Year-Old Woman" into Google didn't reveal anything. Neither did "Breast Cancer in 20-Year-Old Girl." I fruitlessly searched every site I could think of, turning up contradictory results.

An hour into my self-diagnosis, it occurred to me to call a doctor.

Living away from home and my usual doctors, I called my insurance provider. After 45 minutes on hold, an operator listed four doctors in Manhattan that would accept my insurance. The first three were booked through November. The fourth could see me the week before Thanksgiving.

The thought of not knowing for nearly a month was unbearable. Tears welled up in my eyes and fear was obvious in my voice when I confirmed a time with the receptionist. She must’ve heard how scared I was, she told me that they could squeeze me in early the next day.

The next morning, after arriving an hour early, I was told that the doctor’s office was out of network for my insurance. They’d take me, but I’d have to cough up almost $200 just to be seen, and I’d have to pay out of pocket for testing –up to $3,000.

I was shocked. Something was wrong with me and I was getting it checked. I was being responsible. I had called my insurance company, thinking they would send me somewhere I could afford. Not only was I worried about a potentially serious health problem, I was also concerned that I wouldn’t be able to have it looked at because it was too expensive. It turned out that the doctor’s office was willing to work with me. Maybe they just wanted to get me, crying and hyperventilating, away from their other patients out of their waiting room. But they took me; they didn’t turn me away.

The doctor examined the lump and sent me for a battery of tests.  After being poked and prodded and monogrammed and sonogrammed, I waited.

Eventually, I was told the good news—a benign cyst and an inflamed lymph node. Two completely harmless conditions that I could have agonized over for weeks and weeks, if I hadn’t known what it could have been.

If you are truly concerned that you might be sick, get it checked out.  A lot more doctors’ offices than you might think are willing to work out payment plans. It’s worth knowing what you are facing.

Hopefully, it’ll end up being nothing, but if it is something worse, catch it as early as possible.

Have you ever ignored a health problem, because you thought you couldn’t afford to get it looked at? Are you putting off going to see a doctor because you don’t want to know if you are sick?

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.


October 20th, 2009
10:09 AM ET

Turn that frown upside down!

By Ashley J. WennersHerron
CNN NY Medical News Intern

As someone who frequently speaks with people who are less than pleasant on the phone, I’ve learned to employ an old telemarketing trick of physically smiling to sound happier. As soon as I set my cheek muscles to work, I feel a little happier, and that tends to rub off on others. The happier I sound, the quicker the person on the other end of the line is soothed. You smile because you are happy, but can you be happy because you smile?

According to several recent studies, emotions’ causes and effects work in a circle; one leads to the other. An April 2009 study, conducted by the University of Cardiff in Wales, determined that women with Botox injections are reportedly happier than women without the cosmetic injections. The boost in happiness is not attributed to a higher self-confidence, as there was not a significant difference in how the women ranked their own attractiveness. It seems that the women who’ve had Botox have an impaired ability to express unhappiness and, as a result, feel happier.

The same holds true for frowning and pain. In a study conducted by the University of Wisconsin-Madison in May 2008, subjects held relaxed or controlled faces, or were allowed to facially express displeasure at a painful heat prompt. Those who were allowed to frown and express their hurt reported feeling more pain than those who did not facially communicate pain.

Not expressing pain, and not feeling as much pain, doesn’t mean you are protecting yourself. Research conducted by Judith Grob, a psychologist at the Netherlands University of Groningen, proposes that suppressed emotion can express itself later. Grob subjected her study groups to a series of distasteful images, asking each group to keep its emotion a secret, or to hold a pen in the mouth to prevent frowning, or to express what group members felt. Each group then answered word puzzles. The groups who were allowed to express their emotions filled in missing letters of a word neutrally, while those who were unable to express their feelings created negative words.

Smile when you want to feel happier, but don’t ignore your negative feelings, either. Feelings don’t go away when they aren’t expressed; rather, they tend to emerge in unanticipated ways. Expressions aren’t working to convince others of your emotions, but also yourself.

Do you use facial expression to induce feelings, or do you express what you feel? Do you think there is a difference?

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.


September 21st, 2009
12:44 PM ET

Health care in the real world: duct tape won’t suffice

By Ashley J. WennersHerron
CNN NY Medical News Intern

Come May 2010, I may be forced to trade in my health insurance for my college diploma. The results of the ongoing health care reform debate may determine what happens.

My current insurance carrier, TriCare Standard, is common for military families. I am coverd by them until I’m 23 years old, or until I can no longer classify myself as a full-time student. If I continue through graduate school, I can keep my health insurance for two more years. The problem is that when I finish graduate school, I’ll have to work to pay off any loans. With the current job market, my chances for finding long-term work that provides healthcare coverage, are slim to none. Not only will I have to worry about loan payments, I will also carry the extra concern of finding and paying for a health insurance plan.

My predicament is a familiar one for most college students. About 20 percent of us are uninsured, according to a report conducted by the U.S. Government Accountability Office. For the 80 percent of us with coverage, our insurance will turn to dust soon after we flip our tassels to the right side of our mortarboards in May.

However, we can protect ourselves. We must learn the details of our current plans, and our options for the future. Insurance regulations vary state to state, meaning a plan based out of Virginia may strip me of insurance the day after graduation, but the same plan in Florida may allow me to keep my insurance until the age of 30, as long as no one becomes dependent on me.

President Obama’s health care plan calls for a national age limit of 25 years old before a person is removed from his or her family’s insurance plan, which would provide the time necessary to find a job and make a dent in loan repayments. Students and recent graduates might also consider short-term coverage plans with catastrophic caps, to be used for unforeseeable health emergencies. It’s something, but that type of plan doesn’t provide for the every-day possibility of minor injuries or common illnesses.

Consider moving out of the college dorms the day after graduation: You can accidentally cut your hand with the scissors you are using to cut tape. That’s an out of pocket expense for stitches. You could drop a heavy box on your foot. That’s another expense. The dust you inhale from under your bed may induce an asthma attack. There’s the possibility of an ambulance ride and a hospital stay, none of which is covered in a short-term plan, because it’s a pre-existing condition.

Are you a college student, or a parent of a college student, worried about your future health care insurance options? Are you a recent graduate who can’t find a job that offers health care?

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.


September 7th, 2009
12:09 PM ET

Breast Cancer: Men Can Wear Pink, Too

By Ashley J. WennersHerron
CNN Medical News Intern

October is Breast Cancer Awareness Month, and I usually spend September coming up with ways to bring attention to the fact that men also are at risk. While women are a hundred times more likely to develop breast cancer, the American Cancer Society estimates that nearly 440 men will die from breast cancer in the United States this year. The rarity of male breast cancer, combined with the societal stigma that breast cancer is a woman’s disease, often leads to a late diagnosis for men. This translates to a delay in treatment, which can be detrimental. Just ask my dad.

My father discovered what he thought was a mole a few days after his 36th birthday. He had it removed, but soon discovered another. After six weeks of visiting various dermatologists, my dad ended up in an oncologist’s office. The diagnosis was stage III breast cancer, meaning the cancer had spread to his lymph nodes. Since the spread was significant, he underwent chemotherapy. It was hard on him. The chemo compromised his immune system and he had to live in an isolated clean room for about a month, with minimal physical contact. He wasn’t allowed food prepared outside the hospital, which, combined with nausea caused by the chemotherapy, resulted in a drastic weight loss.

Now, doctors are considering administering chemotherapy to patients who may have only a very slight spread of cancer cells. In a study published by the New England Journal of Medicine, conducted in the Netherlands, it was found that even a few cancer cells floating to the lymph nodes increases the chance of cancer recurrence. Previously, doctors tended to ignore these “micro-tumors,” because they considered them too minuscule to be significant. The side effects of chemotherapy were considered too severe to be worth the benefit of clearing the rogue cancer cells. That’s changing now.

Chemotherapy may be a small price to pay if it means that a future recurrence is less likely. A late breast cancer diagnosis is typical for men. Micro-tumors and further spread of the cancer are more likely for men, but men have the same likelihood of recurrence as women.

I am happy to say that my father will celebrate his five-year remission mark this January. At one point during his treatment, I was told to prepare for the worst. Luckily, hoping for the best paid off. I still worry, though, and with good reason. Breast cancer must be discussed in terms of people, not just women. Diagnoses need to be made early and treatment should be effective in the long-term. My dad’s story ended on a happy note, but how many more men out there think they have only a mole? How many doctors aren’t even considering that their male patients might have breast cancer?

Do you know a man or are you a man who has experienced breast 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.


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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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