Torisel Approved for Renal Cell Carcinoma Treatment

Torisel (Temsirolimus) was yesterday approved by the FDA for use in the treatment of renal cell carcinoma, a form of advanced kidney cancer.

Common adverse reactions associated with this drug include edema, loss of appetite, nausea, mouth sores, fatigue, and rash. The drug can also cause some abnormal lab test results, including high blood sugar, lipids and triglycerides, low red blood cell, white blood cell, and platelet counts, and elevated liver and kidney function tests.

Torisel is manufactured by Wyeth Pharmaceuticals and will be available in July 2007.

Photo courtesy of striatic

Labels: cancer, kidney, renal cell carcinoma, torisel

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WHO Observes World No Tobacco Day

The World Health Organization (WHO) states that tobacco is the second major cause of death in the world. 650 million people in the world today smoke, and eventually they will be killed by their habit. Equally as sad are the hundreds of thousands of people who breath second-hand smoke (involuntary smoking) who will develop serious heart or lung disease or cancers as a result.

Protecting children from second-hand smoke in homes and cars has become a major initiative for the US Environmental Protection Agency (EPA). Children who live in homes where people smoke get sick more often with asthma, ear infections, colds and breathing problems. Involuntary smoking has also been linked to Sudden Infant Death Syndrome (SIDS). People in countries around the world are observing World No Tobacco Day activities today.

But those of you who read me regularly, especially some of my posts over at Healthline Connects, know I can be a bit of a contrarian, so bear with me here while I explore some ritual uses of tobacco. Nicotinia tabacum is a perennial herb with large leaves. It has been used for ages in healing and shamanic practices. I personally had the opportunity to witness and participate in some of these tobacco ceremonies in my travels while studying indigenous healing practices at the turn of the millennium. Tobacco is a most important herb to the tribes along the Amazon River, although rather than smoking it recreationally, compulsively, or addictively as in our culture, it is ground and used as a poultice or chewed. When the smoke is used, it is used to purify or ritually cleanse the body and spirit along with prayers and offerings.

North American Indigenous People are promoting the traditional use of sacred tobacco. They promote using the herb less than once a month in ritual ceremonies of healing and prayers with others. I can't help but wonder if a lot of society's problems with addictions could be alleviated if we could regain a sense of the sacred. If we could but find a way to gather with others and share our sorrows, our failings, our hopes, our fears. If we could find a place in our world for these plants that have been with us forever and most likely do, as the elders say, have Good Medicine for us. But maybe that's just a smoke dream...


Thank you Mickki, for use of photo, Tobacco Plant.

Labels: involuntary smoking, second-hand smoke, smoking, tobacco

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FDA Approves First Period-Free Oral Contraceptive - Lybrel

On May 22nd 2007 the Food and Drug Administration approved the first low dose combination oral contraceptive (OC), Lybrel. This drug offers women the opportunity to gain period-free status over time i.e. women who use it over a period of time may eventually become cycle-free. Lybrel is for women who want a form of contraception and are interested in putting their menstrual cycle on hold. By lowering the production of hormones that make pregnancy possible, the drug stops the body's monthly preparation for pregnancy.

The active ingredients in Lybrel, levonorgestrel and ethinyl estradiol, are not new and in fact are available in other OC's currently on the market. The difference is that other OC's have either a pill-free period or some placebo pills that last anywhere from 4 to 7 seven days, during which time the menstrual cycle is prompted. With Lybrel, the active pill is taken for 365 days (366 in a leap year :) ) with no placebo or pill-free period. Even though women who use this medication may have no scheduled period, they may experience some breakthrough bleeding or spotting (most likely to occure during the first 3 to 6 months of use). When discussing whether or not to use this medication with their healthcare practitioners women should carefully weigh the inconvenience of having unplanned episodes of breakthrough bleeding and spotting against the convenience of not having a regular menstrual period. The incidence of unscheduled bleeding during the clinical trials decreased over time in most of the women who continued to take Lybrel for a full year. Lybrel did not appear to affect a return to menses nor did it appear to delay a return to fertility during the clinical trial period.

Another issue to be aware of for women who use this drug is that because there is no monthly bleeding during use, pregnancy may be difficult to recognize. Women who suspect they may be pregnant or have symptoms of pregnancy like unusual breast tenderness, or nausea and vomiting, should take a pregnancy test AND contact their healthcare provider.

Lybrel is not for every woman. Women who have had a heart attack, blood clots, stroke, certain liver diseases or cancers, unexplained vaginal bleeding and those who are or may become pregnant should NOT use Lybrel, or any other OC for that matter. Per a warning on the manufacturer's label, cigarette smoking increases the risk of serious cardiovascular side effects from the use of OC's.

Lybrel, manufactured by Wyeth Pharmaceuticals, is available by prescription only and is expected to hit pharmacy shelves in the U.S. in July 2007.

Photos courtesy of Emuishere Peliculas and Katie Tegtmeyer

Labels: birth control, birth control pill, contraception, lybrel, oral contraceptive, pregnancy, pregnant, the pill, wyeth

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Tuberous Sclerosis Alliance

The Tuberous Sclerosis Alliance asks us to observe Tuberous Sclerosis Month in May. The disease affects about 1 million people worldwide. A genetic disorder characterized by an abnormal growth in the brain that looks like a root or tuber, this disease is also known as adenoma sebaceum and Bourneville's Disease. It is a neurocutaneous illness because of extensive involvement of both the nervous system and the skin or integumentary system.

Skin involvement are patches of depigmented skin, raised bumps with orange-peel texture and red lumps on the face filled with blood vessels (these are the adenoma sebaceum). Neurological involvement can manifest as seizures and mental retardation due to the growths in the brain.

Although it is an inherited disease, it sometimes appears as a new genetic mutation, meaning there is no family history of the illness. Bertalan Mesko, a Hungarian medical student and one of the luminaries of the medical blogosphere, writes an excellent science/health blog, ScienceRoll. One of his most recent posts is a "directory" of all of the best resources about genetics and genetic diseases available on the Web today. Anyone with a genetic illness or an interest in this field will find something of interest in his blog.

Thank you Breno Abreu for use of photo Glass Alpha Helix.

Labels: genetic, ScienceRoll, tuberous sclerosis

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Surviving Teenage Denial of Chronic Illness

It is Asthma Awareness Month, but for parents of kids with asthma, every day is a ritual of "Do you have your inhaler with you?" as you send them off to school. By the time they transition from elementary to middle school, they are fairly self-sufficient, and you no longer have to ask.

Until they turn 13. Suddenly, they become immortal and start "forgetting" their inhaler because they "forget" they have asthma. Running day is the day the Physical Education (PE) teacher enforces running a mile or two each week. It's a great idea to combat childhood obesity and increase fitness in our young. Running day raises the heart rate of parents of asthmatics - we hope we don't get a call from the school stating our kid has had an asthma attack on the field. So the morning ritual is, "Do you have your inhaler with you? Don't forget to take it before you run."

My 13 year old daughter is a very fit, healthy ballerina. Last week, on Running day, I learned on the way to school that she had left her inhaler at home. I turned the car around and drove back and waited while she ran in to get it. It was the typical busy morning. I had an 8:20 ferry to catch and a 9:30 meeting to make it to. After dropping her off at school, I looked at the front seat and saw the inhaler hadn't made it from the car into her backpack. It felt like one of those tests from the Great Spirit or whatever higher power you believe in - are you going to put your kid first again today in this moment? I turned around and drove back the school. I stormed into the office and asked them to page her. No way I was letting the office staff hand it to her. "I need to yell at her," I explained. We can love someone and still be angry at them, right? To her credit, my daughter stood quietly and took it while I demanded to know "If you have an asthma attack out on the field while you are running, and don't have your rescue medicine with you, what am I supposed to do far away at work? What can the school do for you?" I kissed her, hugged her and said "I love you, " and off I went to work. I made it to my meeting and she survived another Running day.


Things didn't go as well this week, a busy week of rehearsals and two evenings of performances. The last thing I said to her as we left the house the day of opening night was "I put your inhaler in your lunch bag." A friend's mother picked them up at academic school and took them to ballet school for warm-up classes. I left work early, armed with food and drinks to get them through afternoon rehearsals to the evening performance. Another student's father chaufeured them to the theater. I went back to work, oblivious to the drama unfolding in the theater, 5 blocks from my office. My kid had an asthma attack between the dress rehearsal and the 8 PM performance. She didn't have her inhaler. She confessed later that night (2 AM, wheezing again) that she had thrown it away with her bagged lunch. She tried to reach me on my cell phone, but with all the calling & coordinating, the battery was dead. In all the commotion, she had missed the information that I was patiently sitting at my desk at work, and for some reason thought I was at the movies (?). It is just as well she couldn't reach me. If I went searching through her backpack for the non-existent inhaler...Long story short, another mother, pediatrician, was backstage with a disposable inhaler and came to her rescue, but not without major drama.

My daughter made it through the performance and I, blissfully unaware of the problems, was outside the stage door with the traditional bouquet of flowers to hand off lovingly to my little star. I was beside myself with anxiety when I heard the story. She came into my bedroom wheezing at 2 AM, "Mom, don't be mad..." and confessed she didn't have her inhaler because she had thrown it away at school. I dragged out the nebulizer machine and gave her a treatment. Two hours later, still awake, I embraced the fact that, as a teenager, she feels immortal. As a teenager, she doesn't want any reminders of any chronic illness or any thing that makes her different. She is in a phase of denial about her asthma. In those hours, I embraced the fact that for 13 years, as a former ICU nurse, I was able to avoid hospitalization for her. I accept that she may, sometime over the course of the next seven years, end up in the hospital due to non-compliance. I am no longer in control of every aspect of her life, including her disease management. I went to the pharmacy first thing the next morning and got her new one. I hugged her hard, as I handed it to her. "If you die, I'll kill you," I said, laughing through my tears. I didn't want to, but I had to let her go. She has to breathe.

Thank you Bobcatnorth for use of photo, Sugar Plum Fairy in the Nutcracker.

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New FDA Safety Alert for Avandia (Rosiglitazone)

There's a new warning out by the FDA regarding the diabetes medication Avandia, generic name Rosiglitazone. Avandia is an anti-diabetic medication that increases the body's sensitivity to insulin in people who have Type 2 (Non-Insulin Dependent or Adult-Onset) Diabetes Mellitus. If you are taking Avandia now you probably already know this and may have heard the new warning all over the news but what does it mean to you?

Well let's start with the facts. Here is the actual warning, "Safety data from controlled clinical trials have shown that there is a potentially significant increase in the risk of heart attack and heart-related deaths in patients taking Avandia". This is where most of the reports on TV, etc stop, but it goes on to state that other studies, some of which have been published and some with publication still pending are showing contradicting results about the risks. The real issue here is weighing all the evidence objectively. Naturally, if a study shows no additional risk this doesn't make headlines but in the spirit of erring on the side of caution the FDA is issuing this warning so that people who use the medication can discuss with their healthcare providers what the best course of action for them is now. Also for healthcare providers to use caution in their prescribing practices.

What makes this so significant is that clinical trials done by the drugs manufacturer, GlaxoSmithKline, showed a 30-40% increase in the risk of heart attacks and other heart-related events in people who were using Avandia for 6-months when compared to those who weren't. The trials only lasted for 6 months so we don't know what the numbers are for those who have been on the medication for longer or shorter periods of time than that. Other than heart attacks, the other "heart-related events" include such things as fluid retention, congestive heart failure, and edema.

There is another drug in the same class as Avandia known as Actos (Pioglitazone), but it is not known at this time whether it poses the same, greater or less of a risk as Avandia for heart attacks or heart-related deaths. The FDA is not making this a Black Box warning, again because of conflicting studies and also because other clinical trials are currently being done to get more conclusive information.

The most important thing is that you NOT stop taking your medication without first discussing it with your healthcare provider and coming up with an alternative plan. There are problems associated with not taking your medication and also with switching to a different medication so this is not something you should even consider doing on your own.

ADDENDUM: 6/6/2007-FDA announced that The Endocrine and Metabolic Drugs and Drug Safety and Risk Management Committees will meet on July 30th 2007 to discuss the heart-related risks of Avandia and other anti-diabetic drugs in it's class.

Photo courtesy of kitchaboy

Labels: actos, avandia, diabetes, fda warning

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Asthma & Allergy Awareness Month: Prenatal Fish & Apples May Lower the Risk

The Allergy & Asthma Network Mothers of Asthmatics (AANMA) is a busy organization, providing education and advocacy for families with asthma and allergies. May is Awareness Month for these health issues, and AANMA's website is very well-organized and chock full of valuable information, like tips on how to work with your child's school officials and P.E. teacher to manage respiratory problems at school. AANMA provides some good spring cleaning tips to help your little asthmatic sleep through the nights, like washing comforters, blankets and pillowcases every two weeks in hot water to kill dust mites. Once a year, take all the food out of your kitchen cabinets and wipe them out. Throw away food that has expired or give away what you will never use.

A new study out of Europe suggests that prenatal consumption of apples and fish may decrease the risk of children developing eczema and asthma! Researchers reported no protective effect was found from any other food except apples and fish...And guess what, they suspect the fish effect might be due to the omega-3 fatty acids!
(See my earlier post over at Healthline Connects: Omega-3 Fatty Acids: Can't Hurt, and They Might Help - with a lot of things...

The list of things omega-3 fatty acids help with grows longer, and the old Apple a day saying seems to be valid, not just for ourselves, but for future generations. Other tips for prenatal health:

• Don't smoke & abstain from alcohol & drugs
  
• Take prenatal vitamins with folic acid supplements
• Eat a balanced, healthy diet

Thank you ohmomof1 for use of lovely apple photo.

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Bike to Work Week - May 21-26, 2007

If you live in the San Francisco Bay Area like I do, having a whole week dedicated to biking to work seems somewhat redundant. It is already an everyday occurrence...not for me personally, but it is a way of life for lots of people out here.

That said, May 21-26 2007 is officially declared Bike to Work Week by the League of American Bicyclists. Nowadays, with gas prices being such as they are, the benefits of biking to work for a week could very well extend beyond just the cardiovascular, weight, and general health benefits to financial benefits as well! The thrill of the adrenaline rush from saving money can be just as addictive as the endorphins released after a good workout.

Cycling is an aerobic exercise, and this type of exercise is the most effective for promoting good health. Riding a bicycle helps to reduce the risk of heart disease, obesity, diabetes, and high blood pressure. Biking helps with weight management and can also improve and elevate your mood. When you ride a bike you develop good (or at least better) balance and coordination and muscle strength which in turn reduces the risk of injuries associated with falls, particularly in the more "mature" population.

To make bicycling a part of your life joining a biking group or getting a biking partner can help keep you on track, plus it's more fun (and safer) than riding alone. For tips on how to select a good starter bicycle, there is a plethora of information out there but you can start here. Also, don't forget to get a bike lock and helmet too!

Photo courtesy of Charles Haynes

Labels: bicycle, bike, commute, critical mass, transportation

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May 17: National Employee Health & Fitness Day

National Employee Health & Fitness Day is a national health promotion observance sponsored by the National Association for Health and Fitness (NAHF). Workplace health and fitness promotion programs are win-win propositions, and we're all about that:

Win for Employees:

• Improved health and fitness
• potential weight reduction
• decreased stress
• increased stamina
• improved self-esteem and sense of well-being

Win for Employers:

• Decreased lost time due to absence or illness
• decreased health care costs for work-related and non work-related injuries
• enhanced employee productivity
• enhanced employee job satisfaction and problem solving skills

Other snippets of related news & ideas:

1. The British Journal of Sports Medicine reports that a "walk and work" computer station on a treadmill helps workers lose up to 60 lbs. (30 kg) per year.
2. As little as 10-15 minutes of daily exercise promotes heart health
3. The World Health Organization (WHO) has identified the workplace as a priority setting for health promotion in the 21st century

Thank you, *clairity* for use of photo Lunch on the Boston Common.

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MIND your Health: Mental Health Month 2007

Mental Health America observes Mental Health Month in May of each year, and this year's theme is MIND your Health. Mental health and illness have been on my mind a lot this month, and I have written about it over at Healthline Connects:

• AJ Hits the Skids: Men and Depression
• Bipolar Spectrum Disorder Updates

And if you have read some of my previous posts,

• Asians and Mental Illness: National Minority Health and Health Disparities Month
• The Human Brain as a Deadly Weapon: Privacy Laws vs. Protecting the Public

you know that there are a lot of unanswered mental health issues swirling in this busy brain of my own. Like many of us, I cried and watched the CNN coverage of the VT tragedy earlier this spring. But I was especially intrigued by the quiet urgency with which a man named Pete Earley spoke when interviewed by Anderson Cooper. He is the parent of a son with bipolar disorder and a former Washington Post Reporter. I picked up his book, Crazy: A Father's Search Through America's Mental Health Madness and have been reading it during my morning commute, but it's enough to make me seasick on the ferry. For starters, I feel really guilty that journalists, not health care people are doing all the research, analysis and reporting on problems like the fact that American society has criminalized mental illness. I felt the same uneasiness about reading The River: A Journey to the Source of HIV and AIDS by Edward Hooper and when the Abu Ghraib debacle was exposed. Edward Hooper is a journalist whose findings, while controversial, are nonetheless, exhaustive and provocative, as all good science should be. As to the prisoners in Guatanamo and Abu Ghraib, there have to be doctors, nurses and psychologists particpating in some aspects of torture - who are they? why aren't they speaking out? how can they allow themselves to participate?

Back to Earley's book: I'm only on Chapter 3, and already I am looking at the homeless differently. Mental Health America is running a campaign to create awareness about insurance discrimination for those with mental illness. Given that depression strikes a majority of the population at some point in their lives, that is an important issue. Earley does a great job of documenting how Smith Kline's wonder drug, Thorazine prompted a dramatic shift in public policy toward mental illness as well as psychiatric treatment in the 1960's. State run mental institutions were emptied out, and the mentally ill were supposed to be treated by community mental health centers, funded by $3 billion. The mental hospitals emptied out and closed down. The problem was, the money was siphoned off into other causes (VietNam war) and the community health centers were never built. The mentally ill started getting arrested for loitering, vagrancy, and other charges. They started treating themselves with street drugs. We now know addictions are also due to brain changes and are therefore an illness, not just a the mark of a person with a lack of will power.

So that's why I look at the homeless differently now. That filthy person covered in rags pushing a cart of junk muttering nonsensically, and yes, likely on some type of street drug, is most likely mentally ill. It's enough to make your head spin.

Thank you Lee Dryburgh for use of the photo Homeless by American Flag by Colin Gregory Palmer.

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It's About Time: Chad Finally Demobilises Child Soldiers

As a mother, a nurse, and a woman, few reports have caused me more anguish than those of children as young as seven years old, dragged off to fight in wars they can't possibly understand. It is Safe Kids Worldwide Month to promote prevention of accidental injury. This is to promote awareness of 1 million children who die needlessly each year due to preventable accidental deaths and many more who are permanently disabled. More children age 1-14 die from accidents than any other cause. This is a worthy goal for most children who grow up under the auspices of caring adult guardians.

Sadly, there are too many children around the world with no one to look after them, and they at the mercy of adults who exploit them. The world got a little better today, with the news that the government of Chad has signed a deal with the United Nation's Children's Fund (UNICEF) to begin demobilising children out of its national army. For the longest time, the Chad government denied UNICEF's charges. UNICEF estimates that 300,000 children under age 18 are involved in 30 armed conflicts around the world today. They are used to cook, to fight, as messengers and as sex slaves. They are abducted, stolen, sold, usually live in combat zones, have limited education and may lack other options for survival. In conflict zones characterized by total chaos and lack of government structure, like Somalia, it is difficult for UNICEF and other agencies to figure out how many vulnerable children are being used.

The people of Chad have their work cut out for them, but admitting they have a problem and getting NGO's involved to help kids and families reunite and heal is a huge step for the country, the continent, and the world.

Thank you, matthew john berry for use of your photo of children in Gulu, Uganda.

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First Ever Patch for Treating Parkinson's Disease Symptoms

Okay, the photo might be a blast from the past for some but you'll get the connection by the time you get to the end of this post!

Today the FDA approved the first ever skin patch for treating the symptoms of early Parkinson's disease. Neupro (Rotigotine) belongs to a class of drugs known as dopamine agonists. The patch, manufactured by Schwarz Pharma, delivers a continuous dose of the medication through the skin over a 24-hour period and will need to be replaced every day.

Common side effects of the patch include reactions of the skin at the application site, nausea, vomiting, dizziness, drowsiness, and insomnia. All these side effects are not uncommon for this particular class of drugs. Outside of these more common side effects some potential safety concerns include the possibility of hallucinations, sleep attacks (suddenly falling asleep while performing routine activites such as driving or operating machinery), and a drop in blood pressure upon standing up.

Neupro will be available in doses of 2, 4, 6, and 8mg per 24-hour patches in a silicone base.

Photo courtesy of carla216

Labels: dopamine, michael j. fox, parkinsons, patch

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Thanks TBTAM For Hosting Grand Rounds

Once a week Grand Rounds - a carnival of health-related blogs - is hosted by a medical blogger who sifts through multiple entries from the medical blogosphere to find the best posts to share. The posts are featured in the host's issue of Grand Rounds on their blog. This week it was hosted by The Blog That Ate Manhattan and is very well organized into different categories for your reading pleasure. This week the host also paid a special tribute to a former member of the medical blogosphere, Barbados Butterfly...think "acronyms". Enjoy!

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May 8 is World Red Cross Red Crescent Day: Are You Prepared?

This weekend as we witnessed another natural catastrophe obliterate a community on our continent, I realized my Disaster Planning just isn't good enough. I imagine many of us are in the same boat. Living in the Bay Area, I have an earthquake kit with 5 gallons of water. I have medical emergency and food supply kits in the house and car for myself and family. The Red Cross is there for everybody, but in recent years natural disasters have clearly escalated to natural catastrophes and we each have to be ready to fend for ourselves and those who are dependent upon us for up to five days.

The Red Cross advises:

1. Make a Plan
2. Make a Kit
3. Stay Informed
   

In addition to having emergency supplies, the Red Cross recommends each family have a Communications Plan. Communications, like cell phones, are usually disrupted during natural disasters and emergencies. Do your children know what family in the community they are supposed to stay with until you can get to them? If a loved one is in a residential center, do you know the evacuation plan for that center? Is it adequate for the frailest members of the community? Select an out-of-state person to be a contact because the Red Cross advises it is sometimes easier to make long distance calls.

The Centers for Disease Control (CDC) is preparing for a response in case of an Influenza Pandemic. The CDC emphasizes the most important advice during outbreak of any disease which can be transmitted human-to-human is to avoid contact with infected persons. While the natural response is to buy and wear masks, there is no scientific proof to support the practice. The best practice is to avoid crowds, i.e. Shelter in Place. It is not a bad idea to equip your self and family with both masks and respirators, however. Masks are the usual surgical masks worn in clinical settings. A respirator is a filtering facepiece designed to protect against inhalation of very small particles. Neither device provides complete protection from the flu.

Finally, a note for women. Have a pair of steel toed or water proof hiking boots in your car and at work in case of the need for evacuation. Women's lives are lost in disasters due to clothing and foot wear that is inadequate for emergencies. As a dear, wise friend of mine advised me, "Hope for the best, but prepare for the worst." This weekend, I looked around and realized I had never imagined a worst case scenario involving the entire town I live in flattened by wind. Every year I need to readjust my thinking about just what the worst case scenario is.

Thank you pingnews.com for use of 1981 NOAA photo.

Labels: emergency preparedness, natural disasters, Red Cross

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Huntington's Disease Awareness Month

Huntington's Disease has been on my mind a lot lately, and you can read a previous post, Unraveling the Mysteries of Neurodegenerative Diseases for some of my musings. But how do people and families who have the disease cope with it while waiting for a cure?

The Huntington's Disease Society of America (HDSA) has a motto: The cure starts here. The caring never stops. Huntington's disease, also known as Huntington's chorea, is an inherited neurodegenerative disorder that does not appear until middle age. Victims exhibit involuntary body movements, dementia, and psychiatric problems. They are not able to function or care for themselves. Parents who carry the disease have a 50% chance of passing the gene to their child. Symptoms are treated with physical therapy, medications, occupational therapy. There is at present, no known cure. HDSA also provides a list of Movement Disorder Clinics and Neurologists who specialize in treatment of dementia. Patients live with deteriorating symptoms for 15-20 years after diagnosis, so coordinating supportive care and financial resources is imperative. Applying for Social Security Disability Benefits (SSDI) can be daunting, and the good folks at HDSA are there to help you through the appeals process. Sad to think that you will likely have to appeal before you even get started, but HDSA can help refer you to an attorney who specializes in these claims.

Prenatal testing is available, and HDSA provides a list of facilities in the US. A new technology called Preimplantation Genetic Diagnosis (PGD) allows a family at risk to eliminate the gene from their family line, forever. Families work with genetics counselors to resolve the ethical dilemmas encountered with in vitro fertilization (IVF), PGD and the production of multiple live embryos to produce a disease free live birth. Genetic counselors are professionals who help people understand and work through the medical, psychological and family implications of inherited diseases.

Some people with a history of the disease are conflicted about whether or not to have the screening test to learn if they themselves carry the disease. A new development in the field of PGD is Non-disclosing Preimplantation Diagnosis of HD, a way of doing PGD without telling the patient whether or not they are a carrier of the HD gene. Some people who are at risk do not want to know their status, not only for psychological reasons but, according to HDSA, "...they may have a well-founded fear of being denied insurance if the test for HD comes back positive. HDSA states this treatment is only available at this time in Fairfax, VA.

This month is Huntington's Disease Awareness Month. Personally, I would recommend anyone who has the disease, or knows someone with the disease request that a Medical Case Manager be assigned to your case to help navigate the confusing and overwhelming maze of medical, financial and social services. A case manager can be your advocate, help you understand what you need and make sure that you get it, whether it is benefits, services or Durable Medical Equipment.

Thank you Lao Wai for use of the graphic.

Labels: Huntington's Disease

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New Warnings for Young Adults on Antidepressant Medications

Today the FDA made a propsoal to all manufacturers of antidepressant medications to update the black box warnings on their products to include warnings about the increased risks of suicidal thinking and behavior (aka suicidality) in young adults between the ages of 18 and 24 during initial treatment.

First of all, what is Black box warning? Well, it literally is a black box on the package insert of a drug. According to the FDA, it is used to highlight special problems, and in particular, those that are serious and is meant to give healthcare professionals a clear understanding of any potential medical complications associated with a drug. The whole point is to enable practitioners to prescribe the medication in a way that maximizes the benefits and minimizes the risks of the drug. Secondly, what time period is considered the "initial treatment" phase? Again according to the FDA it is generally the first one to two months of treatment.

The scientific data which this new warning is based on did not show this increased risk in those over age 24 and that adults 65 years of age and older who were taking antidepressants have a decreased risk of suicidality. What does all this mean to people taking these medications. Well first off, don't stop taking them without first consulting your healthcare provider and if you have any concerns you should definitely notify him or her.

For a list of products involved in today's action click here.

Photo courtesy of Emuishere Peliculas

Labels: antidepressants, depression, paxil, prozac, ssri's, zoloft

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May is Better Sleep Month

It is a common experience that a problem difficult at night is resolved in the morning after the committee of sleep has worked on it. ~ John Steinbeck


Who doesn't love their sleep? Yes I know there are those morning people that jump out of bed every morning and are already in love with a new day...I'll try not to hate even the thought of that too much. Then there are those who savour sleep as a wine connoisseur does wine or the cigar aficionado does cigars. These people love their sleep, coming between them and a good night's rest or a lazy afternoon's nap would be akin to cutting off an appendage.

Well sleep lovers unite! May is the month for you because it is Better Sleep Month. Yes, that's right, Better Sleep Month. If you thought you knew how to do sleep well before, then you need to check out The Better Sleep Council. In a nutshell, they are sleep advocates (supported by the mattress industry). From their better sleep guide to mattressology, yes that's right, mattressology, (don't expect to see this word in Merriam Webster anytime soon though), you'll find all kinds of nifty information about all kinds of sleep-related stuff.

What about those who would like to have a good relationship with sleep but for whom sleep does not come easily? Well there are things you can try, for example here are 10 tips for better sleep from the Better Sleep Council. If all else fails, and this should really be a last resort, there are medications that can be used to help induce and/or maintain sleep. I would also caution anyone thinking of using these medications to read my post on the new FDA warnings for these sleep medications...not to toot my own horn or anything, but this is information you need to know.

A good laugh and a long sleep are the best cures in the doctor's book. ~ Irish Proverb

Photo courtesy of antian

Labels: bed, bedtime, dream, insomnia, mattress, May, month, sleep, sleeping

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