Friday, September 28, 2007

Autism

Autism is still a mystery to the medical community. And, as with most disorders, early intervention is the best bet to helping a child with autism. The problem is recognizing it, having it recognized by the healthcare professional, and then finding the right help for the child.

There’s a huge spectrum among autism; you can have a very high functioning child with autistic tendencies or a child who can barely hold his or her own – and anything in between.

The article about the gut/brain connection is good information but will likely have a lot of people who live with and love autistic children saying “duh…we knew that a long time ago.”

I know a couple of families who have autistic children and both families have adapted their children’s diet. They both find a big difference in their behaviour. One family has their son on a gluten-free celiac disease diet. As long as he is following it, he does quite well. If he goes off it, everyone knows. The other family has eliminated as many preservatives and additives as possible, as well as sugary foods, and they, too, find a big difference.

So many of these autistic children are so bright and could have a great future. Thank goodness we’ve gotten past the days of “it’s the mother’s fault,” but until we know what does cause it, many mothers and fathers do wonder if they did anything to cause it.

News for Today (and lots of it!):
Scientists make gut-brain connection to autism
Study fails to link vaccines to brain problems

Thursday, September 27, 2007

Physician-assisted suicide

Physician-assisted suicide is legal in Oregon, the only state in the United States that allows it. In the Netherlands, it has been legal since 2002, but practiced since the 1980s.

As a nurse who has worked in palliative care and as the owner of two dogs that died of cancer, I have my opinions on the topic. Although it devastated me to lose my two dogs, Rox, a golden retriever, and most recently, Oscar, our greyhound, I knew that I was doing the right thing for them. They were suffering and it was the only thing I could do for them.

When I worked in palliative care, sometimes family members would ask me if there was any way we could help their loved one through the dying process. While most accepted the answer ("no"), some family members and friends got very angry. Their argument was always that we can put our family pets out of misery but we can’t to our loved ones.

I understand that frustration. I remember looking after patients who were just hanging on and suffering for what seemed like forever. I have to say though, that I never had a patient ask me that question – ever.

Am I for physician-assisted suicide? I’m not against it. I feel that if someone is terminally ill and determined to end his or her own life, it would be most humane to allow it to be done properly and with dignity, rather than furtively and with friends or family who are then possibly caught in a legal web.

According to an article from the University of Utah, that some of the fears of allowing physician-assisted suicide were unfounded. The researchers found that not having insurance (in the US) did not increase the number of suicides, nor did economic status, race, ethnicity, or education.

Not surprising to the researchers was the fact that there were more patients with AIDS who opted for physician-assisted suicide than with any other illness: “We’ve known for a long time from studies elsewhere that rates of assisted dying outside the law were much higher in people with AIDS,” particularly in areas with large, supportive gay communities such as San Francisco says the study’s lead author, bioethicist Margaret Battin in the article. Dr. Battin is a University of Utah distinguished professor of philosophy and adjunct professor of internal medicine. “It’s not a surprise to find high rates where physician-assisted dying is legal.”

News for Today:
Stress can hasten breast cancer recurrence: study
Forget technique — know your breasts, Canadian Cancer Society says
Hungover? Don't down lots of coffee with acetaminophen: study
Kaiser Permanente study: Alcohol amount, not type -- wine, beer, liquor -- triggers breast cancer
For some diabetics, burden of care rivals complications of disease
Study shows autism symptoms can improve into adulthood
Study finds post-traumatic stress symptoms in adolescent children of cancer patients
Married oesophageal cancer patients fare worse in some quality of life aspects than single patients
Less invasive lymph node biopsy method could spare thousands unnecessary operations
Doctor-aided suicide: No slippery slope

Wednesday, September 26, 2007

Cancer

Surviving cancer take a huge physical and emotional toll. Alongside the physical work that goes into the fight, someone with cancer has to deal with his or her mortality and that of others with cancer around them.

When you undergo cancer treatment, you meet others in the same situation. Some survive, some don’t. Knowing that someone you’ve met and with whom you’ve developed a relationship is losing the very fight you’re battling can’t be easy to accept.

I’m choosing to focus on the survivors because the dreaded cancer has taken yet another soul. My husband’s friend of many years lost his wife to cancer earlier this week. I only met her a few times before they moved to another part of the country, but I remember her as being the perfect person for this friend. We were so pleased that he found someone and we wished them nothing but the best of luck and lots of happiness in their lives together. They did get the happiness for a while and for that we’re grateful.

To those who win the cancer fight – congratulations. I hope you stay healthy and enjoy your life. You deserve it.

News for Today:
Breast cancer survivors optimistic, yet lack critical information on reducing recurrence
No evidence magnet therapy dulls pain: study
Check credentials for cosmetic surgery: experts
Survey reveals ignorance and confusion about cancer amongst the elderly
Victims of child maltreatment more likely to perpetrate youth violence, intimate partner violence
Under-used colon cancer screening test is effective
Consumption of omega-3 fatty acids associated with decreased risk of type 1 diabetes
Patients with coronary artery disease appear to have increased prevalence of colorectal tumors
Fruits and veggies not likely linked to colon cancer risk

Tuesday, September 25, 2007

Acupuncture, finding a qualified practioner?

Acupuncture is a field that interests me. I have a few chronic painful issues that would greatly benefit from acupuncture, but I have no way of knowing how to go about finding a trustworthy and competent acupuncturist. I mention this because of a new study that reviewed acupuncture for back pain, one of the issues I do have.

I know all the standard ways to find someone, but to me, an acupuncturist isn’t someone you pick out of the Yellow Pages (oops, will we have to change that expression, will our kids even know what the Yellow Pages are?) If I went to one, he or she would have to come recommended by someone I know who has had experience with the acupuncturist.

I think alternative or complementary medicine can play a significant role in health care. I do have a bit of an issue with chiropractics though. I know that many people swear by them and that’s fine – for you. I don’t trust it. I went to have my back adjusted and I do feel that chiropractors can do that and do it well. But then the chiro started talking about how he could heal my asthma and no, I’m sorry, I don’t believe that. Treat my back, yes. Treat my respiratory illness – no.

So, have you ever gone or do you go to an acupuncturist? How did you find him or her? As I said, I really would love to give it a try.


News for Today:
Acupuncture more effective than conventional treatments for back pain: study
MR spectroscopy identifies breast cancer, reduces biopsies
Vitamin D intake should stay the same for now: Health Canada
Too much sleep as dangerous as too little: study
Black patients with asthma may fare worse regardless of disease severity
New study likely to fuel debate over annual physical exams
Hormone therapy in early post-menopause has no effect on memory

Monday, September 24, 2007

Childhood food allergies - New guidelines for milk allergies

New guidelines were issued for the treatment of children who are allergic to cow’s milk. The goal is to ensure that these children are diagnosed and managed as well as possible without increasing the risk of them developing secondary allergies. According to the press release , “Guidelines for the Diagnosis and Management of Cows’ Milk Protein Allergy recommend only extensively hydrolysed (eHF) and amino acid-based formulas (AAF), and the Taskforce’s recommendations warn against the risks of soy and other mammalian milks, such as sheep and goat, in CMA management.”

The release goes on to say that other mammalian milks can increase the risk of more allergies and “milk substitutes based on grains, legumes or nuts, such as rice, oat, pea or almond milk, are to be avoided in infants and young children due to their poor nutritional profile.”

Childhood allergies are frightening. To find out that your child can have a fatal reaction to eating or drinking something, like peanuts, can have a devastating effect and can severely impact family life. If a child is severely allergic, the whole family has to live around that allergy, something that siblings may have difficulty with from time to time.

I did a search on childhood allergies and increasing prevalence, and came across this interesting article that was published in September 2006: Are the Dangers of Childhood Food Allergies Exaggerated?. The article is based on an analysis and comment published in the BMJ article of the same name (BMJ 2006;333;494-496). You can read the full print article here.

One author, Allan Colver makes the following points (copied directly from the article):
- The incidence of severe food allergy reactions in children is small and not increasing
- The risk of death is very small
- Many effective and simple measures are available to reduce risk
- Many children grow out of food allergy, and clinical reactivity should be reassessed periodically
- It is unclear what proportion of children with food allergy should be prescribed an adrenaline autoinjector
- Autoinjectors generate anxiety in children and carers, and they should be prescribed only when a diagnosis of food allergy has been confidently established, usually by oral challenge

The other author, Jonathan Hourihane, makes his points (copied directly from the article:
- Food allergy is common—2% of adults and up to 6% of preschool children are affected
- Deaths are rare but other reactions are almost inevitable over time
- No tests are available to predict clinical severity
- Management consists of empowering patients and providing rescue drugs
- Delay in use of these drugs is associated with a worse outcome in severe reactions
- These drugs are rarely needed by patients who attend recognised allergy clinics but cannot be
withheld because of the medical uncertainty surrounding allergy

For people interested in childhood allergy, it’s an interesting read.


News for Today:
AIDS vaccine fails, Merck halts testing
New guidelines set to improve standard of cows' milk allergy care
Risk of hip fracture higher in vitamin D-deficient women: study
Washing with soap and water best defence against C. difficile: study
Dangerous diarrheal bacterium found on asymptomatic patients
Multiple corticosteroid injections in pregnant women may increase cerebral palsy

Sunday, September 23, 2007

I'm back!

Before I start back on my regular blog posts tomorrow, I have to share something that I learned yesterday. I have to admit, when I read it, I broke down and cried like I've not cried in a long time, and I think I needed it.

I shared Oscar's diaries with some forums I frequent. He became popular in those forums; some people had previous misconceptions about greyhounds, others had never really seen one or known one. His death affected many people.

When I returned from my vacation, I went to one site to post some photos and I learned that a woman in Australia held an Oscar Memorial Garage sale to benefit the Canberra greyhound rescue. I'll let you read her posts. They were part of a "good morning, what's up this weekend?" thread. I'm sharing the information with her permission :

post 1 earlier in the day:
It is already Saturday here and I am waiting for some friends to arrive to set up for the Oscar Memorial Garage Sale in aid of Canberra Greyhound Rescue. We have acquired a lot of good stuff - everything from freerange eggs to televisions and designer handbags and wallets so I hope we make lots of money. At least we have a beautiful day - 1 degree at the moment but fine and sunny and it should be up to 16 by mid morning. That will run until lunch when we will order in pizza and then collapse for the afternoon.

post 2:
Oscar's memorial garage sale made over $700 for greyhound rescue. We had two foster greyhounds there for the sale and they were both excellent ambassadors for the breed and one of them may have a new home - a good day all around.

post 3:
the greyhound rescue group here in the ACT is quite small and new - it was started by the woman who gave me my first rescue dog and another friend - their website is www.forevergreys.com. You can see the lovely Harvey who came to act as Ambassador for Greyhounds on the site - he did an excellent job - many people had never met a greyhound close up before and there were lots of comments about how gentle, friendly and smoochy he is.

I am so touched that my Oscar was able to have such a far-reaching effect. Who would have thought that when I sat down to have some fun writing Oscar's diaries three years ago, that this would be the result?