Watch HBO's COMA, July 3 at 9PM

National HIV Testing Day

Wednesday, June 27, 2007

Ijeoma Eleazu, PharmD

More than 40 million people around the world are infected with HIV and nearly one million of them are Americans. Our knowledge about AIDS and the virus that causes it, HIV, have grown exponentially over the past few decades but not enough for us to have developed a cure yet.

For this reason a day has been set aside to raise awareness about the need to get tested. June 27th 2007 has been declared National HIV Testing Day in the US but whether or not you reside in the US anyone who knows they may be at risk is encouraged to get tested for the virus. Oh yes, we have heard it said that ignorance is bliss, the truth is that sometimes what you don't know can indeed hurt you (and sometimes others). Just because I refused to check the weather before I left the house and decided instead to dress like it was summertime in the Bahamas...this did not stop the dreary San Francisco fog from rolling in and neither did it prevent me from getting bludgeoned by the cold snaps of wind! I think you get my drift.

Medically speaking, treatment and management of the disease have a come long way and continue to move in a positive and hopeful direction. On a social level, the more people are educated about the disease the better equipped they are to respond to those who are afflicted by it. Getting diagnosed with AIDS or finding out that one is HIV positive can never be an easy pill to swallow but it is a bridge that must be crossed all the same. Get tested.

Photo courtesy of Robert Miller

Thank You Wandering Visitor for Grand Rounds!

Wednesday, June 27, 2007

JC Jones MA RN

Wandering Visitor is an, uh...angelic looking doctor who asked the medical writers in the blogosphere to submit posts that inspire us. I submitted my post Global Healthbeat: Somalia Country of War which she kindly included in the round-up. Check out Keagirl's post on men's obsession with all thing relating to their penis...

World Refugee Day: Bleak Picture for Somalis & Iraqis

Wednesday, June 20, 2007

JC Jones MA RN

June 20 is World Refugee Day and the United Nations wants us all to get informed and get involved in the plight faced by millions. Refugee health is a subject I am particularly passionate about, as I wrote my graduate thesis on it about five years ago. Things started looking better for awhile, but escalations in international turmoil over the past five years have resulted in greater upheaval for many people. Violence in Somalia and Iraq have left nearly 44 million people homeless and on the move. UNHCR High Commissioner Antonio Guterres claims the rest of us are just not paying enough attention. We are not providing support to the most vulnerable people on the planet. This is a public health catastrophe.

Somehow a reader in Somalia found her way to a computer and contacted us for assistance. Right now we are assisting the only way we know how - by sharing information about the dire circumstances of the Somali people. We are asking for help from you, the Healthline community - to give us some guidance, ideas about ways we can expand assistance and awareness.

Medicens Sans Frontieres/Doctors Without Borders (MSF) seems the most direct resource, with information on their website updated this month. They have served continuously in that country for 16 years, no small feat considering there has been no central government since 1991. MSF has 60 international staff members and 800 national members working in 10 provinces in Somalia. Staff members working in the countryside report that those fleeing Mogadishu due to the escalation in violence were being accommodated by family members. They battled a cholera epidemic in April, 2007.

MSF echoes the refrain I have read elsewhere: they don't want to talk so much about crisis aid. They want long term solutions. One in four children die before they are five years old. That has been the reality of life in Somalia for decades. MSF recommends addressing basic human rights:

Food (malnutrition is rampant)
water (dehydration due to lack of access to clean water is rampant)
access to health care (most Somalis lack any access to health care)
education
sanitation

One other detail: Armed protection is required to deliver aid. Two MSF members were shot in Mogadishu June 5, 2007. Their driver, Abdulkarim, was killed.

Labels: Doctors without borders, international health, refugees, somalia

Thank you Nurse Geena at Codeblog for Grand Rounds 3.39!

Tuesday, June 19, 2007

JC Jones MA RN

Guess Geena supported my side of the story on the medical blogging controversy. She included my post Medical Blogging 2.0? It's About Time in this weeks Grand Rounds over at Codeblog: Tales of a Nurse.
It's a round up of the usual suspects in the medical blogosphere, with some good posts. Check it out...jc

New Orphan Drug For Pulmonary Hypertension

Monday, June 18, 2007

Ijeoma Eleazu, PharmD

On Friday June 15th 2007, the Food and Drug Administration (FDA) approved a new drug for the treatment of pulmonary arterial hypertension. Letairis (ambrisentan) is an endothelin receptor antagonist which belongs to a broader class of drugs known as vasodilators.

In clinical studies, Letairis (ambrisentan) was found to improve the capacity for physical activity in affected individuals and also to delay the worsening of pulmonary hypertension. Common side effects include facial flushing (getting red in the face), swollen legs and ankles, sinusitis, and nasal congestion.

Letairis (ambrisentan) comes with a black box warning about potential liver injury and contraindication in pregnancy - the drug is very likely to produce serious birth defects if used by pregnant women. Monthly blood tests to assess liver function are required for all patients who will be using this drug.

Because Letairis (ambrisentan) is used to treat a rare disease (and due to certain other criteria it meets), FDA has granted it orphan drug designation. Manufactured by Gilead Sciences , Inc. in Foster City California, the drug will be available in 5mg and 10mg tablets which will be taken once daily.

Photo courtesy of permanently scatterbrained

Men's Health: Gift of Health with our NEWEST Product Feature

Saturday, June 16, 2007

JC Jones MA RN

Human Kinetics and the American College of Sports Medicine present Healthline’s exclusive new Health Books On-Line.

If you want to get serious about your health and make some lifestyle changes, Healthline wants to be your partner. We make it easy to take control of your life and your health with Healthline's New Action Plan and Fitness Books, for free! Published by Human Kinetics, the authors are all members of the American College of Sports Medicine. These books are filled with activity plans, dietary advice and exercise diagrams to guide you on your road to fitness, health and longer life.

Advanced Sports Nutrition: The hottest sports car in the world won’t run if it doesn’t have fuel in the tank. Find out how to fuel your tank from sports nutrition expert Dan Bernadot. Bernadot was the Team Nutritionist for the 1996 US Olympic gold medal winning women's gymnastic team. He explains everything from ideal body weight to gluconeogenesis.
Action Plan for Arthritis: Limit pain, disability, and expense associated with arthritis. Don’t just survive, thrive with this new Action Plan! Take some time to explore the chapters and images on the pages here at Healthline. Then spring into action armed with the best available information on the web. Physical Therapist A. Lynn Millar provides detailed information on everything from Exercising in Cold Weather to Foundations and Informational Groups.
Action Plan for Diabetes puts you in control of your blood sugar with a complete guide to managing and preventing complications associated with this disease. Author Darryl E. Barnes MD is a family practice and sports medicine expert at the Mayo Clinic. He provides Foot Care Basics as well as some great ideas for changing your perspective to create a new future.
Strength Training for Women: Get the lean muscular look you want without the big bulky look you don’t want. Personal training guru Laurie Incledon explains why our mood, as well as other aspects of our being, lifts as we weight train.

A Google Search will turn up a mother lode of Health and Wellness content on the web, but until now, the best, most reliable Health and Wellness information has been unavailable to consumers. At Healthline, we are excited to bring to our readers information previously available only to professionals and students thanks to our exclusive online distribution agreement with Human Kinetics Publishers.

thank you J.C. Rojas, for use of photo Old Style Swing.

Labels: fitnes, health

Medical Blogging 2.0? It's About Time...

Thursday, June 14, 2007

JC Jones MA RN

With all due respect Dr. Eleazu, and other esteemed blogging colleagues, I think it's about time everyone zipped it. If I wanted to read anonymous rants, I would go to Craigslist Rants and Raves. Sure, we all need to let off steam now and then about stressful situations at work, but when it involves intimate details of the lives of other human beings - we have no right to parade those details in a public forum.

It's about time medical bloggers do a better job of self-censorship. Ranting about patients and their families on blogs is just not right. It is inevitable that someone will recognize themselves, and someone will be hurt. Ranting about people and situations in the institutions where we are employed is just, well, dumb. Why bite the hand that feeds you? We all know health care is a mess. Why not take the time to analyze the root cause of the problem that has irked you, and suggest an improvement in a blog? Do some research, advocate implementation of IT and other solutions to decrease errors and improve quality at your institution. The writers who do this are, to me, more mature and more interesting to read.

Our blog manager Leigh Shevchik reminded me that IT blogging went through this same growing up process a few years ago. Engineers and programmers posted anonymously and gossiped about what was going on in their corporations ("Think Dilbert meets Red Herring"...she says.) "Secrets were exposed, people were outed, ...some lost their jobs." At first the IT companies tried to ban blogging, but soon they embraced it, incorporated it as part of the culture and developed ground rules. Kind of like our community with our Medical Blogger Code of Ethics. We're teenagers now. We have to learn we can't just say whatever we feel like saying.

Thank you Ol.v!er [H2vPk]'s for use of photo mister dilbert vs. mister donut.

Medical Blogging: To Be Or Not To Be?

Tuesday, June 12, 2007

Ijeoma Eleazu, PharmD

That is the question du jour. Due to certain recent happenings in the medical blogging community there has been some debate about this issue. Without re-hashing actual events (do a Google search and you'll be up to speed), the question of ethical issues surrounding blogging in the medical world seems to be at the core of the debate.

Is it right for people who have been entrusted with the health and well-being of others, with their deepest darkest secrets (medically speaking), with their life and death issues (literally), to turn around and share that information with the world? Well of course the basic answer is no. Morally, ethically, legally...that's just plain wrong. Does it happen though? But of course! We (medical professionals) talk amongst ourselves all the time, oh yes, when HIPAA was instituted we had to blanket our conversations under the cloak of "medical professionals involved in the care of the patient" but we still did it, just more cautiously.

Now I'm not saying it is right to gossip about your patients or put all their business out in the streets (or in this case, out on the information superhighway), not at all. What I am saying is that the same benefits we derived from sharing with our colleagues face-to-face i.e. the second opinions, the confirmation that we made the right call (or not), the bouncing off of ideas... On a more personal level sometimes we just needed to vent our frustrations to someone else whom we knew would totally understand and sympathize with us - patients getting angry (not "mildly upset" but rather, enraged) at you because of their insurance company restrictions, you getting angry at the insurance companies as well (don't let me start), being physically assaulted by someone you are trying to help, being held up at gun point (albeit plastic) for the "good stuff" (PS: I'm a pharmacist and I don't mean money...not many other medical professionals get to work behind bullet-proof glass or need police escorts to get them safely home, but, I digress)... Then there are those cute stories you want to share, when you make a visible and marked difference in someone's life, when you get to make a positive impact on someone's health, when you see that baby leave the hospital alive because you caught a potentially deadly drug dose miscalculation, when you prevent a life-threatening drug interaction, when the disoriented mentally-ill parolee asks for your hand in marriage and won't take no for an answer...These are the things you just want to share with someone.

It is easiest to share them with those in the same situation but from time-to-time you find that other people are interested in such stories. Now I will admit I have shared many a work story with friends and family but the people I have told will never in a million years be able to figure out who any given patient in my stories were. That's because I never divulge identities or give anywhere near sufficient information to even try to narrow down the field. The key is to maintain patient anonymity. It's just that simple. Should peoples' right to free speech be squelched just because they wear a white coat, know more than any human being ought to about medications (not me but people I know), respond to "code blue's or red's" or have the power of physical life and death in their hands (okay maybe that's taking it a bit too far but you get my point). I say no, one's career path ought not strip one of their inalienable rights. The key I believe, is just not to strip anyone else of their own rights in the process.

Do I have more to say on this issue? Yes, I do, but I would like it to be a dialogue. If you have any comments please feel free to exercise your freedom of speech rights.

Photo courtesy of hive and mellowbox

Labels: blog, blogging, debate, ethics, free speech, medical blogging, medicine

Men's Health Week: Post-Partum Depression Hits Dads Too!

Monday, June 11, 2007

JC Jones MA RN

While many of us have been led to believe that Post-Partum Depression is due to the fluctuating hormones of pregnancy, studies indicate that just as many men suffer from baby blues as do women. While expectations - and pressures - run so high that having a baby is a joyous experience that will change our lives, the reality can be a little less rosy.

Having a baby means lack of sleep, additional responsibilities, financial pressures, sexual adjustments, changes in the relationship of the partners involved in caring for the baby. Everyone is making big adjustments to this amazing little being who is suddenly the center of the universe. It's not easy, and frankly, it's not for everyone. Post-partum depression in men can begin anytime after childbirth and continue up to a year. Those afflicted may have changes in mood, appetite, sleep patterns, feelings of sadness, hopelessness and intrusive thoughts of harming the baby.

Fathers with greater levels of depression interact less with their babies. Clinicians are not likely to pick up on the problem, men are not likely to seek help for the problem. That leaves it to the tired and frustrated new mother to be a little less frustrated and talk to your partner if you see these signs. Maybe other family members and friends can intervene, get him to talk about how he's feeling, and seek help. We've probably all known more than one "great husband" who abandoned his wife after she had a baby, and maybe this is what that was all about.

Thank you, benjamingettinger, for use of photo Xander & Dad.

Labels: mental health

June is National Scleroderma Awareness Month

Thursday, June 07, 2007

JC Jones MA RN

The Scleroderma Foundation is dedicated to improving the lives of those effected by scleroderma through support, education and research. The Foundation website is a wealth of valuable, in-depth resources about this complex illness.

Research: They encourage advocates to contact members of the US House Labor-HHS- Education Subcommittee in support of bill FY08, providing a 6.7% increase for the National Institutes of Health (NIH). The Foundation is concerned about an "...erosion of the nation's medical research enterprise..."

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (subdivision of NIH), provides most of the funding for scleroderma research, but advocates state this disease is given low priority

The Scleroderma Foundation allots $1 million a year to research dedicated to finding the cause and cure of this complex autoimmune disease:

Support: CarePages "Support & Community for Everyone Coping with Illness". I love this site! There are CarePages Moms, blogs (Stories of Inspiration) by people with various conditions. The only drawback is the site does not allow you to search by diagnosis or condition, so I can't search for the Scleroderma Community pages and provide a link for you...
Education: If your computer supports Windows Media Player, you can view "Living Well with Scleroderma". There is a Get Connected Bulletin Board. There is a contact for the National Registry for Childhood Onset Scleroderma. The site provides links to camps for children with serious skin diseases.

Health Professionals get their own section of the website where links to Continuing Education and CME opportunities are provided. FDA alerts are provided, such as the important FDA MEDWATCH ALERT reporting deaths connected with compounded Injectable Colchicine 0.5mg/ml, 4 ml vials lot number 20070122@26.
One of my very favorite resources, dermatlas.org (Dermatology Image Atlas). As a clinician, you've just got to love it! Almost 10,000 images of skin problems to peruse. Just be patient while they download.

Seven Healthy Habits to Prevent Headaches

Tuesday, June 05, 2007

JC Jones MA RN

The National Headache Foundation is focusing attention on Seven Healthy Habits of Headache Sufferers as we observe the 14th annual National Headache Awareness Week, June 3-9, 2007.

Diet: Eat regular meals, avoid known food and drinks that trigger headaches (for me it's alcohol...)
Sleep: Maintain a regular sleep schedule, even on weekends and vacations. For migraine sufferers, this means avoiding oversleeping, which can trigger attacks.
Headache diary: Keep a log of when headaches occur and what seems to trigger them.
See your healthcare provider: Make an appointment to discuss headaches and ways to manage them effectively.
Stress: Implement stress reduction techniques into your daily routines.
Be an informed participant in your healthcare treatment: read about possible alternative medications or treatments if what you are using isn't working and discuss with your health care provider.
Education: Stay up to date with headache news and treatment options by visiting www.headaches.org.

If you (like me) suffer from migraine headaches, you might want to check out my post, Topamax: I love you! over at Healthline Connects.
Thank you Leo Reynolds for use of photo, headache.

Labels: headache, migraine, Topamax