Blog Posts

Iron Overload

July 20th, 2020

Every year, Americans observe Hemochromatosis Screening and Awareness Month in July, and this year is no exception. Hemochromatosis is a big word for a disorder in which you absorb more iron from the food you eat than your body needs for optimal function. It’s essentially iron overload.

Everyone needs some iron. It’s an important nutrient that helps the hemoglobin in your blood carry oxygen to your body’s organs and tissues. But if you absorb too much, it stores up in your joints and organs, particularly your liver, heart and pancreas. If hemochromatosis goes untreated, your organs won’t be able to handle the extra iron. They can become damaged and eventually fail.

There are two types of hemochromatosis: primary and secondary. Primary hemochromatosis is caused by a defect in the genes that control how much iron is absorbed from food. Secondary hemochromatosis results from another disease or condition such as thalassemia, an inherited blood disorder, anemia or chronic alcoholism. The primary type is much more common and the focus of this blog.

Hemochromatosis is one of the most common hereditary disorders in the United States, affecting more than one million Americans. It is more common in Caucasians of Northern European descent.

Symptoms typically appear in men between the ages of 30 and 50. They generally do not appear in women until after age 50, or after menopause, because women lose iron from the blood loss of menstruation and childbirth.

Chronic fatigue and joint pain are the most common complaints of people with hemochromatosis. But diagnosis is usually not made right away because these are symptoms of many other disorders as well. Pain in the knuckles and middle finger, referred to as the Iron Fist, is the only symptom specific to hemochromatosis.

Other symptoms of hemochromatosis include lack of energy, abdominal pain, loss of sex drive, heart flutters, weight loss, memory fog, weakness and an abnormal coloring of the skin. It may appear gray or bronzish.

Diagnosis begins with a detailed medical history. Your doctor will ask if anyone in your family has had the disorder or carries the defective genes. A thorough physical examination, including a check of the liver and spleen for swelling, is also completed. Your doctor will likely order blood tests to determine the iron level in your blood. Your doctor may recommend genetic testing to search for the defective genes.

Treatments for hemochromatosis include therapeutic phlebotomy, iron chelation therapy, dietary changes and treatment for complications. Phlebotomy is a procedure that removes blood – and as a result, excess iron – from your body. The process is similar to donating blood, but is typically done at more frequent intervals until your iron level is stabilized. After that, maintenance phlebotomies are completed on a routine basis

Iron chelation therapy uses medication to remove excess iron from your body. This is an excellent option if you’re unable to routinely have your blood removed. The medication can be injected at your doctor’s office or taken orally at home.

Since iron is absorbed from the food you eat, changes in your diet are necessary to limit the amount of iron you consume. Iron-rich foods include red meats such as beef, venison, lamb and buffalo; blue fin tuna; organ meats; and fortified breakfast cereals.

Finally, any complications that result from too much iron in your organs, including liver disease, diabetes and heart problems, can be treated as neededour prognosis depends on the amount of organ damage that occurred by the time you were diagnosed. Early diagnosis and treatment may help prevent or sometimes reverse complications of hemochromatosis. With early intervention, a normal lifespan is possible.

If organ damage has already occurred, treatment may prevent further damage and improve life expectancy, but it may not be able to reverse existing damage. If hemochromatosis is left untreated, it can lead to severe organ damage and even death.

If someone in your family history has hemochromatosis, consider getting a genetic test to screen for the defective genes. Having the genes doesn’t mean you’ll definitely develop the disorder, but at least you’ll know if you can pass on the genes to your children.

Youth at Risk

July 17th, 2020

As the summer rages on, coronavirus infection rates continue to climb across the country. States such as Texas, Arizona and Florida are seeing record spikes on an almost daily basis. As of July 15, there were more than 3.41 million infections and at least 134,000 deaths from the virus in the US, and it’s not done.

Unfortunately, in the midst of all this bad news another negative trend is emerging. Some states are seeing an increase in the number of young people being admitted to the hospital for COVID-19. That flies in the face of a commonly held belief that young people don’t get seriously ill from the coronavirus.

It remains true that the majority of people being hospitalized for COVID-19 are older Americans, and the death rate in the younger population is still very low. But the new reports from hospitals across the country are proving not only that more young people are getting infected but that they’re also getting sick enough to require hospitalization.

At one Arizona hospital, six COVID-19 patients in their 20s were admitted by a physician during one shift on Sunday. Most of those patients, the physician noted, were young, healthy individuals before contracting the virus. Across Arizona, people between the ages of 20 and 44 make up 20 percent of currently hospitalized COVID-19 patients.

At a Houston hospital, more than 60 percent of the patients hospitalized by the coronavirus in March and April were over the age of 55, while about 20 percent were under 55. In June and July, the percentage of patients under 50 climbed to 40 percent.

The rising infection rate in younger people may be explained by the fact that a high percentage are overweight and have a history of smoking or vaping. These risk factors can contribute to the development of a severe illness from the coronavirus. Young people are also more likely to gather in large crowds, attend parties and shun social distancing, believing they are immune to the virus.

And then there’s Florida, one of the worst coronavirus hotspots. According to a report released July 10, at least 31 percent of children who were tested for the coronavirus recorded positive. As part of a state initiate, 54,022 Florida residents under 18 were tested and 16,797 tests came back positive. The positivity rate for Florida’s entire population is approximately 11 percent.

This report comes as Florida, along with many other states, debates the risk of returning students to school this fall. According to the American Academy of Pediatrics, children and adolescents are “less likely to be symptomatic and less likely to have severe disease” from COVID-19 infection. But they can still carry the virus and infect others.

In May, the US Centers for Disease Control and Prevention issued an advisory about a severe inflammatory condition discovered in children believed to be associated with the coronavirus called MIS-C. Florida’s pediatric report notes there have been 13 cases of MIS-C in children under 18 in the state.

To be fair, not all states have experienced a rise in infections and hospitalizations of younger patients. Some states, such as Colorado and Idaho, report that their age distribution has remained fairly flat. In California, the average age of patients hospitalized with COVID-19 has decreased, but only slightly, from 64 at the beginning of the pandemic to 57 in early July.

Another key finding in the ongoing fight against COVID-19 is that the most disproportionately affected young people are those of color, especially those who have underlying medical conditions. And young people of color are more likely to experience chronic health conditions associated with poor COVID-19 outcomes.

Common chronic conditions affecting minorities include diabetes, obesity, asthma, hypertension and heart disease. These conditions increase the risk of severe illness and hospitalization from COVID-19. They affect people of color, including young people, at higher rates than non-Hispanic whites, putting them at higher risk for serious COVID-19 infections.

For everyone’s sake, continue to practice the recommended safety precautions: Wash your hands frequently, wear a mask in public and stay 6 feet away from others.

Boning Up on Sarcoma

July 14th, 2020

Summer is now in full swing and some of us are looking for creative ways to beat the heat. Here’s an opportunity to take a break and get a little education at the same time.

July is Sarcoma Awareness Month, so sit back and read about this form of cancer that accounts for only one percent of all adult cancers but is rather prevalent in children, accounting for about 20 percent of all pediatric cancers.

The Sarcoma Foundation of America states that sarcoma is cancer that arises from connective tissue, “or the cells that hold the body together.” These include cells of the muscles, nerves, blood vessels, bones, fat, tendons and cartilage. The Foundation reports that there are hundreds of different types of sarcomas that arise from different types of cells.

Sarcoma can be divided into two broad categories, non-soft tissue sarcoma, including bone sarcoma, or osteosarcoma, which is soft tissue sarcoma. It’s estimated that in 2020, about 13,130 people will be diagnosed with soft tissue sarcoma and about 5,350 people will die from it. In addition, an estimated 800 to 900 people of all ages will be diagnosed with osteosarcoma. About half of those will be children and teens.

The most common types of sarcoma found in adults are undifferentiated pleomorphic sarcoma, which most often affects the arms and legs; liposarcoma, which involves malignant tumors of fat tissue, and leiomyosarcoma, which is cancer that starts in smooth muscle tissue.

The most common type of sarcoma in children is osteosarcoma. Other common sarcomas in children include rhabdomyosarcoma, tumors of the skeletal muscles, and Ewing’s sarcoma, cancer that occurs principally in the long bones of the arms and legs, the pelvis and the ribs, but can also occur in soft tissues.

In general, sarcoma doesn’t cause any outward symptoms until a noticeable lump, or tumor, develops that causes pain. Sarcoma affecting the gastrointestinal tract can lead to blood in the stool or black, tarry stools. Osteosarcoma tumors can cause certain symptoms including localized pain in the affected bone, radiating pain in the area surrounding the affected bone, swelling, limping if the leg is affected and reduced mobility.

The cause of sarcoma is unclear, but there are certain factors that put a person at greater risk for developing sarcoma. Previous radiation therapy in high doses has been found to contribute to the development of sarcoma in some people.

Exposure to toxic chemicals used in herbicides, wood preservatives and plastic manufacturing is a risk factor as well. Certain inherited diseases are also associated with an increased risk. The human herpesvirus 8 is known to cause a type of sarcoma called Kaposi’s sarcoma, which mainly affects the skin but can occur in other tissues.

Diagnosing sarcoma begins with a complete personal and family medical history followed by a thorough physical examination. Your doctor may order imaging tests such as x-rays, CT, MRI or PET scans to get a better look inside your body. The doctor will likely take a biopsy of the tumor to confirm that it is cancerous and to establish the stage and grade of your cancer. This is done to help guide treatment decisions.

Treatment for sarcoma may include surgery, radiation therapy, chemotherapy and targeted drug therapy. These treatments may be performed alone or in combination for the best results. Radiation therapy and chemotherapy may be used either before surgery to try to shrink the tumors or after surgery to kill any remaining cancer cells after the tumors are removed.

Targeted drug therapy attacks the parts of cancer cells that make them different from normal, healthy cells. The drugs used for this therapy are different from the drugs used for standard chemotherapy and have different side effects. Targeted therapy drugs affect the way cancer cells grow, divide, repair themselves or interact with other cells.

As with other types of cancer, the outlook for people with sarcoma is better when the cancer is found and treated early. There are no screening tests for sarcoma, so the best thing you can do is see your doctor immediately if you begin to experience any of the symptoms. This way, treatment can be started right away.

Always be mindful of changes in your body, and don’t be shy about bringing them to your doctor’s attention.

Safe Under the Sun

July 8th, 2020

A few precautions can keep your skin safe this summer.

Summer is here and with it comes an increased desire to get out of the house and do something outdoors. That desire may be even stronger this year, what with so many isolating themselves at home in an effort to avoid contracting the coronavirus.

Before venturing outside, though, it’s always smart to take into account the risks associated with exposure to the sun and its potentially harmful ultraviolet rays. That’s why July has been named UV Safety Awareness Month.

UV light is a form of radiation emitted naturally by the sun, which produces three different UV wavelengths. One of those wavelengths, UVC, is blocked by the ozone layer that protects the earth’s atmosphere.

But the other two UV wavelengths, UVA and UVB, can not only pass through the ozone layer but they can penetrate deep into a person’s skin and cause everything from sunburn to wrinkling of the skin and skin cancer.

That’s why it’s so important to protect the skin from overexposure to the sun, which is hottest between 10 a.m. and 4 p.m. This is also the time when UV levels and radiation levels are highest, especially at the beach, where the sun’s rays can easily be reflected.

If at all possible then, it’s best to plan outdoor activities for the early-morning or late afternoon hours. No matter the time of the outdoor activity, though, it’s also smart to take a few simple precautionary measures to reduce your risk of suffering skin damage.

Those measures include wearing a hat, preferably a wide brimmed hat; wearing lightweight, light-colored loose-fitting clothing and sunglasses. The latter is a step endorsed by the American Academy of Ophthalmology, and rightfully so.

Because overexposure to the sun can lead to the early development of cataracts and age-related macular degeneration, the AAO recommends wearing sunglasses that are labeled UV400 or come with a label saying they block 100 percent of UV rays.

When outside, it’s always best to spend as much time in the shade as possible, but it’s important to keep in mind that the sun is so powerful that it can still cause skin damage even on a cloudy day or when someone is in the shade.

It’s also important to remember that reflective surfaces such as a white sandy beach, the water in a pool, lake or ocean, even snow on a bright sunny day in the winter, can intensify the sun’s ability to damage skin through UV exposure.

That’s why one of the most important precautionary measures is to wear sunscreen. But not just any sunscreen will do. For the best protection, the US Food and Drug Administration recommends using waterproof sunscreen with a sun protection factor (SPF) of at l5.

And don’t be conservative with it. When applying sunscreen, it’s best to apply at least an ounce (which amounts to about a palmful) every two hours and to apply it even more frequently when sweating or swimming.

Another step that can be taken to ensure your safe under the sun is to check the UV index for your area prior to going outside. By simply typing in your zip code, the Environmental Protection Agency (EPA) can give you a UV forecast.

This forecast will give you a number from 1 to 11 that will help you determine just how dangerous the sun is that day and how much protection is needed to avoid serious damage from UV rays. The lower the number, the less protection you’ll need.

Summer is a time for outdoor fun and adventure, but assuring you and others are safe under the sun is one way to ensure you won’t regret you venture outside.

Extra! Extra! Read All About It

July 5th, 2020

Most of the news we’ve been reading about COVID-19 lately seems to be bad news: New cases are spiking across the country. Hospital ICUs are filling to capacity with seriously ill patients. And experts are warning of escalating infection rates in the coming months.

But if you look a little closer, you can find some tidbits of good news as well. Here’s one story I came across recently that gave me hope. On July 1, the pharmaceutical giant Pfizer and its partner the German biotech company BioNTech announced that its experimental COVID-19 vaccine has shown promising results in early testing.

The initial clinical data from the study revealed that volunteers who took low or medium doses of the vaccine in two injections about a month apart developed immune responses to the virus in the range expected to be protective.1 In fact, their immune defenses were stronger than those of the average recovered COVID-19 patient.

The study involved 45 healthy volunteers. Twelve received a 10 microgram dose of the vaccine, 12 received a 30 microgram dose, 12 received 100 micrograms and nine received a placebo. The main side effects were fever and injection site soreness. The 100 microgram dose caused fevers in half of patients receiving it, so a second dose was not given to those patients.

Pfizer’s experimental vaccine generated antibodies against SARS-CoV-2, the virus that causes COVID-19, and some of those antibodies were neutralizing. That means these antibodies may prevent the virus from functioning.

The level of neutralizing antibodies in the study volunteers were 1.8 to 2.8 times that found in recovered COVID-19 patients, but researchers aren’t sure yet if higher antibody levels lead to virus immunity. Pfizer is planning large-scale studies to prove that people getting their vaccine are 50 percent less like to become infected. Those studies are set to begin this summer.

For its vaccine, Pfizer used specific genetic material called messenger RNA, or mRNA. This mRNA contains directions for making a certain protein used by the virus to invade human cells. The mRNA is taken up by the body’s cells, which then follow the directions and make the protein. The body’s immune system recognizes the protein as foreign and make antibodies to disable it if the virus tries to invade.

The vaccine in this study is one of four candidate vaccines being developed by Pfizer. The company reported that additional information from this particular trial will help it to pick a leading candidate and dose level for a much larger study. Based on the initial trial results, BioNTech and Pfizer hope to progress to a larger US trial involving 30,000 participants.

Pfizer notes that if its vaccine proves safe and effective, and is approved, it expects to make up to 100 million dose by the end of 2020 and “potentially more than 1.2 billion doses by the end of 2021.”

The good news is there. But you might have to look beyond the front page.

Go Purple on the Longest Day

June 18th, 2020

Alzheimer’s Association Seeks to Raise Awareness.

The longest day of the year, also known as the summer solstice, is the day with the most light. Not coincidentally, it is on that day each year that the Alzheimer’s Association strives to bring the most light to its efforts to fight the darkness of Alzheimer’s disease.

That day falls on June 20, a Saturday, this year, and while the impact of the coronavirus may force a few changes in plans, the Alzheimer’s Association still hopes to have thousands of people celebrate its efforts as part of Alzheimer’s and Brain Awareness Month.

The Association’s goal is to devote the entire day to the cause by creating a day-long sunrise-to-sunset event that signifies the challenging journey that those with Alzheimer’s, their family members and caregivers face each and every day.

As part of the program, the Association is asking people who know someone with Alzheimer’s disease to wear purple to honor that person, and already, a long list of celebrities have signed on as Alzheimer’s Association Champions to help get the word out.

The list of personalities includes current and former professional athletes such as Pro Football Hall of Famer Terrell Owens, actors such as Samuel L. Jackson and Olympia Dukakis and television hosts such as Leeza Gibbons and Vivica Fox.

Their goal is to use their faces and voices to challenge 5 million Americans – one for every American living with Alzheimer’s disease – to learn more about the disease and become Alzheimer’s Association Champions themselves.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and eventually robs people of the ability to perform the simplest of daily tasks such as bathing, dressing and eating.

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease will afflict one out of every 10 people 65 and older this year, and it is the only leading cause of death that cannot be prevented, cured or even slowed.

To alter that situation, critical research is needed. That’s why the Alzheimer’s Association is encouraging people to participate in or hold fundraising efforts of their own and is even providing tips and tools on how to hold such a fundraiser.

The Association suggests building a fundraiser through sporting events, community gatherings and hobbies such as painting, dancing and arts and crafts. Almost anything thing can be turned into a fundraiser to bring awareness to the cause.

And for those who are unable to participate or hold a fundraiser, awareness can be brought by simply wearing purple on the 20th of June or by purchasing and wearing some of the purple gear that is available through the Alzheimer’s Association’s website.

It is through the Association’s Go Purple venture that many of the celebrities involved in the fight are making their voices heard by telling stories of friends or loved ones in their lives who have or are struggling with the disease.

The Association is encouraging others to do the same by sharing their stories through social media and through the Association’s website and using the hashtags #ENDALZ and #The Longest Day in their posts.

To learn more about The Longest Day, events associated with Alzheimer’s and Brain Awareness Month or information on how to participate in a current fundraising event or start one of your own, you can call 800-272-3900.

Sounding Off on Scleroderma

June 9th, 2020

Scleroderma is a chronic autoimmune disorder that replaces your body’s healthy connective tissue with thick, hard tissue that’s full of extra collagen, a protein that serves as a building block for connective tissue. Connective tissue is fibrous tissue that supports, protects or gives structure to other tissues and organs in the body.

Scleroderma is an unpredictable disease. Sometimes, it’s mild and affects only your skin, which is made up of connective tissue. But other times, scleroderma involves multiple organs and can be potentially fatal. The disease varies from person to person, but up to one in three people with the condition develops severe symptoms.

Fortunately, scleroderma is rare. Fewer than 500,000 people in the United States have it. It is more common in women than in men. It’s estimated that six out of seven people with scleroderma are women. It most often develops in people between 35 and 50 years old, but it can affect young children and older adults as well.

Normally, your body’s immune system battles disease and infection by releasing germ-killing chemicals and cells and by triggering disease-fighting processes. With an autoimmune disorder, your immune system mistakes your body’s own cells and tissues as foreign invaders and initiates the process to destroy them.

If you have scleroderma, your immune system triggers your protein-producing cells to make too much collagen. The extra collagen builds up in your skin and internal organs, causing them to become thick and hard. In this condition, your organs can’t function properly and symptoms appear.

One of the first symptoms of scleroderma is thickening of your skin, primarily on your fingers and hands. Swelling of your hands and feet and red spots on your skin may also develop. Other symptoms may appear if additional organs become involved. These include joint pain and stiffness, persistent cough, shortness of breath, heartburn and other gastrointestinal issues, difficulty swallowing, high blood pressure, constipation, weight loss and fatigue.

There are two main forms of scleroderma: localized and systemic. Localized scleroderma, the milder form, primarily affects your skin, but it may also affect your muscles and bones. There are two main types of localized scleroderma, morphea and linear. They differ mainly in the appearance of the thickened patches of skin and the areas affected.

Systemic scleroderma affects the entire body. This includes the blood vessels and internal organs, especially the kidneys, esophagus, heart and lungs. There are two main types of systemic scleroderma. They are limited, sometimes referred to as CREST syndrome, and diffuse.

Limited scleroderma primarily affects the skin on the hands, feet, face, and lower arms and legs, but may also affect the blood vessels, lungs and digestive systems. One of the main symptoms of CREST syndrome is Raynaud’s phenomenon, color changes in the fingers and sometimes toes after exposure to cold temperatures. Raynaud’s occurs when blood flow to these areas is temporarily reduced.

Raynaud’s phenomenon is a common symptom of scleroderma. More than 90 percent of patients with scleroderma have Raynaud’s. But you can have Raynaud’s and not have scleroderma.

People with diffuse scleroderma, the more serious type, typically have skin thickening in the area from the hands to above the wrists. The diffuse type can affect many internal organs as well, hindering digestive and respiratory function, and causing kidney failure. It can become serious and sometimes life-threatening.

The cause of scleroderma is unknown. Researchers believe there are genetic and environmental factors involved in its development, but these theories have not been proven. It is known that scleroderma is not contagious.

Diagnosing scleroderma can be challenging because its symptoms are similar to those of other autoimmune diseases. Diagnosis generally requires consultation with rheumatologists and/or dermatologists. Blood tests and a variety of other specialized diagnostic exams are used depending on which organs are affected.

Currently, there is no cure for scleroderma. Treatment for the condition is aimed at controlling and managing symptoms, minimizing damage and maintaining function. The approach used is typically a combination of medication and self-care. Physical therapy may be recommended to keep your muscles and joints functioning at their best.

Scleroderma can affect many areas of your body, so living with the disease can be quite challenging. It may result in physical limitations and pain, but there are a few things you can do to improve your situation and make your life a little more comfortable. Consider the following tips:

  • If you experience digestive issues, eat multiple small meals throughout the day instead of three large meals.
  • Keep your skin well-moisturized to lessen stiffness.
  • Be careful during activities such as gardening and cooking so that you don’t injure your fingers.
  • Dress in layers to keep your body warm. Wear socks, boots and gloves, and avoid very cold environments.
  • Exercise to ease the stiffness in your joints. Ask your physical therapist for safe exercises.
  • Maintain relationships with your family and friends to create an emotional support system.
  • Seek professional help if you struggle with the psychological consequences of living with a chronic disease.

Convalescent Plasma Therapy for COVID-19

June 6th, 2020

Even as you read this, researchers are feverishly working to uncover potential treatments for COVID-19, the highly infectious illness caused by the SARS-CoV-2 coronavirus. One of the treatments being studied is the use of plasma from people who’ve recovered from COVID-19 on currently sick patients. It’s called convalescent plasma therapy.

If you had COVID-19 and recovered, your body developed natural defenses against the disease called antibodies, which are located in the liquid portion of your blood called plasma. Convalescent plasma, which is donated by people who recovered from COVID-19, contains disease-fighting COVID-19 antibodies. In theory, once convalescent plasma is transfused into sick patients, the antibodies battle the active virus and help the patients get better.

The use of convalescent plasma therapy is not a new concept. It dates back to at least the time of the Spanish flu of 1918. It has also been used to fight measles, severe acute respiratory syndrome (SARS), Ebola and other lesser known diseases.

There are several risks associated with convalescent plasma therapy. The treatment is given by transfusion, so blood-borne germs can be transmitted to the recipient, which can cause infections. Another risk is transfusion-related acute lung injury, or TRALI, in which the transferred antibodies damage blood vessels in the lungs.

Transfusion-associated circulatory overload, or TACO, is another risk of convalescent plasma therapy. TACO occurs when your body can’t handle the added blood volume from the transfusion, which can be up to half a liter of fluid. Both TRALI and TACO lead to difficulty breathing and death. Fortunately, these risks are rare.

Several studies have been conducted across the globe to determine the safety and effectiveness of convalescent plasma therapy for the treatment of sick COVID-19 patients. Doctors in China began experimenting with the therapy in January 2020.

In one of their studies, published in the Proceedings of the National Academy of Sciences in April, the Chinese doctors reported that 10 out of 10 patients who received convalescent plasma improved, whereas three out of 10 patients with the same characteristics who didn’t get the therapy died. Other Chinese studies, as well as small studies from Italy and elsewhere look promising as well.

In the US, a comprehensive nationwide study, the results of which were posted on a public server called MedRxiv May 14, found convalescent plasma therapy safe for use on COVID-19 patients. A team of more than 5,000 doctors from more than 2,000 hospitals and laboratories tested the experimental therapy. Of the 5,000 seriously ill patients treated as part of the study, fewer than 1 percent experienced serious adverse events.

The study’s principal investigator, Dr. Michael Joyner, a physiologist at Mayo Clinic, said researchers will start receiving data on the treatment’s effectiveness in the next few weeks, and he expects to have a “much clearer picture” within the next several months.   

“We’re very encouraged that the treatment is safe,” Dr. Joyner says. “That was really the first hurdle for us. And showing that it’s safe gives us confidence to move on and begin to try to understand the efficacy.”

A study from Houston Methodist Hospital published in the American Journal of Pathology May 26, confirmed that convalescent plasma therapy is safe for COVID-19 patients. In that study, 19 out of 25 patients improved with the treatment and 11 were discharged from the hospital. Houston Methodist was also the first academic medical center in the nation to transfuse plasma from recovered COVID-19 patients into two critically ill patients.

With no adverse side effects caused by the convalescent plasma transfusions, the Houston Methodist study concluded that the treatment is a safe option for patients with severe COVID-19 disease.

While these initial studies are promising, randomized controlled clinical trials (RCTs) are necessary to truly gauge the overall safety and effectiveness of convalescent plasma therapy for the treatment of sick COVID-19 patients.

RCTs are clinical research studies in which participants are allocated at random to receive either the new treatment being studied or a control treatment. The control may be the current standard or care, a placebo or no treatment. RCTs are the most effective way to study new treatments without bias.

These clinical trials, which will provide more definitive answers on convalescent plasma therapy for sick COVID-19 patients, are currently being conducted in the US.

A Hernia History Lesson

June 5th, 2020

Even as the country reopens amid the COVID-19 pandemic, many of us are still staying close to home as much as possible and spending time at our computers. The computer is a good tool for learning about many topics. Join us today for a short history lesson on hernias as we celebrate June as Hernia Awareness Month.

According to The Cleveland Clinic: “A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it.” There are several common types of hernias that develop in different areas of the body. The most common is the inguinal hernia.

With an inguinal hernia, fat tissue or a piece of small intestine bulges through a weakness or tear in the peritoneum, the thin, muscular wall that holds the abdominal organs in place, and into the inguinal canal, a tubular passage through the lower layers of the abdomen. This type is more common in men than in women.

The femoral hernia is another common type. It occurs when fat or small intestine protrudes into the groin at the top of the inner thigh. This type is more common in older women. An umbilical hernia occurs near the belly button and most often affects babies and young children. An incisional hernia is found near the site of an incision from a previous surgery.

All of these types of hernias present with a noticeable bulge or lump on the outside of the body. But there’s one type of hernia you can’t see, the hiatal hernia. This type occurs when the upper portion of the stomach pushes out of the abdominal cavity and into the chest cavity through an opening in the diaphragm, the sheet of muscle that separates the chest from the abdomen.

Graphic courtesy of MedicineNet. (

Picture of different types of hernias.

The presence of a bulge or lump in the affected area is the most common symptom of a hernia. Typically, a hernia is painless, but it may result in discomfort when standing, straining or lifting heavy objects. Symptoms of a hiatal hernia may include heartburn, trouble swallowing and chest pain.

A hernia can be congenital or present at birth, such as a developmental weakness in the muscles of the abdomen or groin. Hernias can also develop later in life. There are certain activities and medical conditions that put you at greater risk for developing a hernia.

Hernia risk factors include straining on the toilet, intensive exercising, lifting objects too heavy for you or not lifting properly, being overweight or obese, having fluid in your abdomen, having an enlarged prostate, smoking and having a persistent cough. Being pregnant and having had surgery also increase your hernia risk.

Most hernias don’t cause problems and don’t require active treatment. Once your doctor has discovered a hernia, often on a routine physical exam, they will likely choose to “watch and wait.” This involves observing the hernia over time to see if it becomes larger, causes pain or threatens complications. If this occurs, your doctor may recommend hernia repair surgery.

Hernia repair surgery is quite common. More than one million procedures are performed each year in the United States, and approximately 800,000 of those are performed to repair inguinal hernias. Inguinal hernia repair is among the most frequently performed surgeries in the nation.

Surgery to repair a hernia may be open or laparoscopic. With open surgery, an incision is made near the hernia, the bulging tissue is pushed back into place and the weakened tissue is stitched back together, often using a mesh material for support.

During laparoscopic surgery, the same steps are taken, but the entire surgery is performed through several small incisions using tiny surgical instruments and a lighted camera. Sometimes, doctors perform laparoscopic hernia repair surgery using robotic techniques, where the surgeon operates by maneuvering a precise robotic arm that holds the surgical instruments and camera.

Hernias caused by congenital weaknesses generally cannot be prevented, but you can lower your risk for developing a hernia later in life by concentrating on a few key steps. Stop smoking, maintain a healthy body weight, try not to strain when going to the bathroom, eat a high-fiber diet to avoid constipation and perform exercises that strengthen abdominal muscles. Also, avoid lifting weights that are too heavy for you and when you do lift, use proper lifting techniques.

There you have it: a short history lesson on hernias. While there’s no test, you are encouraged to share what you know with others and share this site with your online friends. Stay healthy and be aware of hernias!

Stressed by the Headlines? There’s Hope

June 4th, 2020

Infections. Deaths. Racism. Brutality. Rioting. Looting. Shooting. Killing. It seems today’s headlines herald terrible news that the world we live in is in utter chaos. If you’re like me, you’re probably feeling somewhat frazzled by it all. And if you’re a news junkie, you may even be feeling downright depressed! There’s actually a name for that feeling.

Psychologist Steven Stosny originally coined the term election stress disorder to describe the feeling of anxiety caused by the onslaught of news surrounding the 2016 presidential election. Stosny later renamed the condition headline stress disorder when the anxiety persisted past the election. The term is pretty fitting for what’s happening today as well, don’t you think?

Headline stress disorder reflects the fact that to grab attention, news headlines often use words that create fear or anger in readers. Stosny recommends reading past the headline. Typically, once you read on and get all the facts, the situation being reported is not as awful as the headline portends.

But today’s news is stressful beyond the headlines. And we must learn to deal with stress in our lives because it can have a profound effect on our physical and mental health.

Stress is a natural response to life experiences. In potentially threatening situations, your central nervous system reacts to stress by initiating the “fight or flight” response. Your CNS triggers your adrenal glands to release the stress hormones adrenaline and cortisol, which increase heart and breathing rates and send blood to your organs and muscles to prepare them for action.

Ideally, when the threat is over, your body returns to a normal, relaxed state called homeostasis. But with chronic stress, your body remains hyped up on stress hormones. This can lead to symptoms such as irritability, anxiety, depression, headaches and insomnia.

Chronic stress can also elevate blood pressure, cause chest pain and sexual problems and worsen symptoms of existing diseases, including heart disease, cancer and lung disease. It’s also been linked to low back pain, inflammatory bowel disease, changes in women’s menstrual cycles and structural changes in the brain leading to memory, thinking and learning difficulties.

Some people living with chronic stress develop unhealthy behaviors as a way of coping. They may misuse food, alcohol, tobacco or drugs, or gamble compulsively, engage in sex, shop or use the internet excessively. Unfortunately, these behaviors tend to cause more stress rather than relieve it. It becomes a vicious cycle.

Today, we’re bombarded with a nearly constant flow of news about COVID-19 and the riots surrounding the George Floyd protests. And the bad news is keeping some in a state of chronic stress beyond headline stress disorder. The American Psychological Association notes that a few lessons learned from past disasters are applicable to what’s happening now.

We’ve learned that social media may escalate anxiety more than traditional media, but too much media of any kind can undermine mental health. Also, it was found that trustworthy information sinks in. The bottom line: you can stay informed of events, but be sure to find authoritative sources and be mindful of how much time you’re absorbed in the news.

To help you tune out the bad news for a while, set a limit on how much time you spend looking at the news on TV or on your social media on your phone or computer. This can give you a chance to relax from headline stress disorder and allow your body’s stress response to return to homeostasis.

You can also benefit by engaging in stress management. Regular exercise is a good way to manage stress in your life, as is spending time with your friends and family. Practicing relaxation techniques such as meditation, deep breathing and yoga can also help with stress. If you find that you can’t handle stress on your own and it’s affecting your health, seek professional help.

It’s important that you take care of yourself, especially if you feel stressed about the latest headlines. Self-care enhances your nervous system’s response to stress, and that improves your physical health and overall wellbeing. And when you feel good, you can better handle the negative impact of headline stress disorder and whatever crises are in the news.

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