HealthyConcerns.com

So, is this another sign of age or what?!

Elisa Camahort — 2009-07-12T10:11:27-07:00

Twice in my life, once more than 20 years ago and once surely more than 10 years ago, I was given a steroid treatment to curb my allergies. In each case it consisted on one shot, and then a few days of taking pills.

And in each case that treatment lasted about 4 months. We're talking 4 months basically allergy-free. You could expose me to cats, to dust, to mold, to grass, and I was symptom-free.

So, this year after weeks of being sick and miserable, I strong-armed my reluctant doctor into, once again, trying the steroid route. She reminded me of side effects associated with steroids. I reminded her that one treatment once a year wasn't likely going to result in those side effect. I walked out triumphantly shot up with prednisone and a few weeks later I was crowing about how well it worked.

Only, at about the two month mark exactly, it stopped working so well.

I first noticed it a couple of weeks ago when, after a long walk outside...amongst the plant life, oh noes!...and then dinner and some TV-watching at a friend's house. A friend with two cats. Yup, by evening's end I was miserable. And it lasted a day or two.

Then, this week, I decided to have a little cocktail on a flight home from a quick trip. Figured I was entitled after the four hour delay I had just experienced. Used about half the little airline bottle of vodka for my Bloody Mary and sure enough, next trip to the restroom? My face was all red and splotchy.

So, I got 2 months, not 4 months of complete relief this time around.

Think the doctor low-dosed me?

Think it's cause I'm 10-20 year older than I was back when I tried this before?

Think my allergies are just that much worse?

Back when I picked up the prescription for the pill portion of the steroid treatment, the pharmacist noted that the doctor had included a second pill sequence in the prescription...so I had 6 extra pills. The pharmacist kind of shrugged his shoulders and said, "Maybe she wanted you to have a second round of pills handy" and handed me the bag.

So, two more questions?

Think I should take those pills now?

Think I should email my doctor and ask?

Yeah, I'm guessing it's smart to ask...especially in this day and age of email with your doctors.

Sigh. Whatever the reason, it's a disappointing development, that's for sure!

What a waste, and what are you thinking Yahoo?

Elisa Camahort — 2009-06-30T07:01:04-07:00

Today a reader here at this poor neglected blog pointed out to me that a few of the links in my MedBlogs blog roll were defunct. One had changed URLs...easily fixed. Several were personal bloggers from various doctors or patients who had stopped blogging (and apparently stopped paying hosting fees to keep their archives live for the finding)...a shame, but understandable.

But one dead pool blog really surprised me. It was the Beat the Blues blog on Yahoo!'s health site, written by one of their Health Experts, Dr. David Neubauer.

OK, so times change, the economy is tough, I get that they may have cut back on their experts. But as far as I can tell the archives of this blog is gone. His most recent post was earlier this month, but searching by his name or by the last few topics he wrote about brings up nothin'!

Dr. Neubauer may not have blogged often (and who am I to judge on that?) but when he blogged it was simple, straightforward, easily digestible information for a lay audience on an important topic. Important because depression is realtively widespread, but still a pretty silent ailment.

So, apparently, the Internet isn't always forever. Isn't Yahoo! a search company? Shouldn't they get that people will still be searching for help with their depression long after the end of this one individual's contract? And that his info should be evergreen and ever-available? Perhaps there were contract issues at stake here. If not, I'd say Yahoo! blew it by wiping out a valuable archive of information.

I'd still like to have a good link to a medblog about depression in my blog roll. Any suggestions?

Food Inc is all the buzz this week (cross-post)

Elisa Camahort — 2009-06-20T12:54:03-07:00

Here's one example where one post I write is appropriate for cross-posting at almost every blog I write.

Over at Elisa's Green Scene, I did a brief recap of some of the reviews and some of my thoughts about the new documentary, Food, Inc.

Food, Inc is somewhat based on MIchael Pollan's work and a great deal of its focus is on the health ramifications of our current agro-industrial complex approach to food production on humans, particularly lower-income families.

So I thought it belonged here, and I'm wondering if any of you are planning to see it or have seen it?

Of course, I also have a vegan blog. And a personal blog where I write both movie reviews and occasionally items about animal rights. So this belongs there too.

Might start to feel a little bit like cheating though!

For this blog, I'd like to direct you to a particular part of the site about this documentary: The Hungry for Change Cafeteria.

Healthy school lunches seem like a total no-brainer, but in fact one of the small things you can do is start to activate around your local schools, particularly by telling your local schools to stop selling sodas, junk food, and sports drinks.

Hell, I'd say you should do that even if you don't have kids in school!

But if you do have kids in school: What are their food options like? Food, Inc. wants us all to know...and to work to make those options healthier...for children in every kind of school at every kind of income level.

Who could argue with that?

The continuing saga of Vitamin D deficiency

Elisa Camahort — 2009-06-06T14:41:50-07:00

When you blog, your friends send you links. Links to stories similar to what you've been writing about. Sometimes stories they simply think you should be writing about.

Today my friend Maria NIles contributes to my ongoing series of posts about Vitamin D, or Vitamin D deficiency to be more specific.

The post: Why Black People Need More Vitamin D from TheRoot.com.

This I already knew, but the article goes into some detail about why.

Bottom line: The melanin in the skin of people of color does something great: It protects them from harmful UV rays. but it also does something not-so-great: It blocks Vitamin D production.

And since the medical community has evolved from thinking Vitamin D only impacts bone health, but also may lower the risk of diabetes, hypertension and other very common illnesses and conditions, they are thinking that epidemic Vitamin D deficiency is really not a great thing!

The article's bottom line is that it is very very difficult to get enough Vitamin D naturally from either our diet or from foods. They recommend supplements all the way.

Kind of a bummer, but there it is...

Surviving the system, courtesy of the ACS

Elisa Camahort — 2009-05-31T11:32:14-07:00

The American Cancer Society has a lobbying arm called the Cancer Action Network [Read about it here.] The ACS CAN recently launched a big initiative for cancer patients called "Surviving the System". They launched it with a Lobby Day which took place on the 20th.

The idea was to get regular people sharing their stories...and reachng out to their elected officials to ask for health care reform, for cancer patients and in general.

While cancer isn't the number one killer in America, it does claim over half a million lives a year. And getting cancer can be devastating to families for more reasons than just the fear and anxiety over our lvoed ones' health. According to a study released to coincide with ACS CAN's Lobby Day:

Nearly one in three people diagnosed with cancer under the age of 65 has been uninsured since their cancer diagnosis. Scientific research shows that being uninsured can adversely impact your chance of survival.
One in five families affected by cancer have used up all or most of their savings because of health care costs and more than 40 percent have had difficulty affording their health care costs in the last two years.
More than two-thirds of Americans under age 65 who tried to find insurance outside their employer couldn’t afford a plan.

Our family just went through a cancer scare or two ourselves, but luckily we are all covered, well-covered. Imagining the stress of having no or insufficient coverage, on top of the stress cancer brings on its own...well, I wouldn't want to experience that.

And once again, it begs a fundamental question: Insufficient or non-existent coverage can impact someone's chance of survival. Is it OK that people live or die in this country based not on whether what they have is treatable or curable or not, but rather on their income level or class or employment status? All of which seems highly volatile in this economy. And what if we're talking about children, who surely aren't responsible for their parent's socio-economic status?

California is experiencing record unemployment, and I'm guessing a lot of people are losing their coverage. Or being forced to choose between paying exorbitant COBRA payments vs. paying for other necessities, like food, shelter etc.

Those people may be very employable, may have new jobs with coverage waiting around the corner. Is it OK that they have to hope that nothing catastrophic happens to them...whether one-time, like a car accident, or chronic, like a cancer diagnosis...while they're toughing out this economy like we all are?

I continue to think it's not. You can read more about the ACS's perspective and their efforts for health care reform on their site and their blog.

In case you've been wondering: Being a bad patient works sometimes

Elisa Camahort — 2009-05-31T00:00:00-07:00

I wrote about once I finally went to the doctor for my lingering plagues, I was the typical bad patient, wanting my doctor to drug me up.

So, how's that working out? Thanks for asking.

As I suspected, getting the steroid shot and prednisone treatment has made a huge difference. My allergies have gone from out of control and wearing me down, to barely a blip on my radar. How does that make a difference in day to day life?

How about this: The other night I went out for drinks with a friend who is leaving the country. About 7 years ago i developed an allergy to alcohol out of nowhere. Any kind of alcohol. I basically stopped drinking altogether. I visited an allergist who thought that being allergic to alcohol in such a sweeping way was unlikely. He instead subscribed to the bucket theory. My allergies are like a bucket, and when the bucket is full, lots of things can act as a trigger to push them to overflow...like alcohol. He suggested getting on Claritin, and that eventually that would bring my allergies under control. Well, i did take Claritin...and later switched to Zyrtec. And while my allergies are more under control taking a daily pill than taking nothing, I have not taken back up drinking. Occasionally I have a 1/2 glass of wine, maybe almost a full beer...but I always feel it when I do. Until a couple of evenings ago when I had one whole margarita. And felt nothing. No itchiness. No flushing/heat. No swollen eyes.

Or this: Friday evening I went to a book launch party for BlogBuddy Tara Hunt...which was held out in a beautiful backyard surrounded by lots of plant life. There have been countless times that I have left parties early, usually with two catalysts: Pets or outdoor plant life. But yesterday I hung out for about two hours and better yet: I didn't feel it. My eyes were a tiny bit red and icky this morning, but generally, I didn't sneeze, I didn't cough etc. etc.

Now my allergist back those few years ago isn't the only guy who subscribes to the "bucket" theory. I got an email the other day from a blog reader who said much the same thing. He represents the folks from a company called Phadia, who sponsor a site called Do I Have Allergies?.com

Their explanation of the bucket theory:

Allergy patients are often sensitive to a number of allergens, and allergy symptoms emerge only when cumulative exposure to these allergens pushes them over the symptom threshold. As long as the cumulative exposure is below threshold, allergy symptoms are not present. But once the threshold is breached all hell breaks loose.

For example, a patient may be sensitive to three allergens, such as pet dander, dust mites, and pollen. For 11 months of the year, the cumulative load of the pet dander and house dust mites is just below the threshold. No symptoms. But that one month when pollen is in the air, the patient is over the threshold and symptoms are unmanageable. As a result, a patient suffering from terrible allergic symptoms during pollen season may be able to avoid these symptoms by targeting and reducing their exposure to other allergens, in short, rendering their sensitivity to pollens less than harmful.*

Sounds reasonable to me. And that's where I was a few weeks ago. I fully credit the steroid treatment for letting my enjoy life a little more.

I gotta do this every year!

*Thanks to Joseph Crivelli from Gregory | FCA Public Relations for sending me this description

Do patients have a right to visitors? Wow.

Elisa Camahort — 2009-05-22T12:29:56-07:00

OK, when I saw the headline of this NY Times blog post, Do patients have a right to visitors?, I really thought it was going to be about something else. I thought perhaps there were cases of family members who were awful to hospital staff and banned, despite a patient wanting to see them.

I didn't think it was actually about that well-worn cliche: Gay life partners being banned from their partners' bedsides. I mean, admit it, haven't you heard that a million times and wondered if it really still happened?

Call me naive, I thought that argument was more about the possibility, not the reality. I mean, in this day and age? In America? Oh, silly silly blogger!

Well, two such cases are becoming court cases, one in Florida and one in Washington state. The NY Times blog post points to a more detailed column about the cases. If you have a heart, you will feel terribly upset upon reading these accounts.

I don't care about your politics, what kind of people would basically force someone to die alone? Would prevent children from being able to say goodbye to a dying parent?

The phrase is "First, do no harm." There's nothing but harm in these stories. Harm to those poor dying souls. And irreparable harm to their partners and children.

Do you see some rationale I'm missing here?

Your heroes unveiled

Elisa Camahort — 2009-05-14T16:46:25-07:00

Last month I blogged about a project from the folks at Our Bodies, Ourselves to name our Women's Health Heroes.

And on May 11th they announced the Heroes.

From the release:

The 2009 inaugural inductees represent seven countries and a wide range of health fields and disciplines. Among them: Elisabeth Bing, founder of Lamaze International; Efua Dorkenoo, an activist against female genital mutilation; Jenni Prokopy, founder and editor of ChronicBabe.com; Susan Corrado, a community parish nurse in Wisconsin; and Bene E. Madunagu, a professor of botany in Nigeria.

Two nominees were selected for special honors: Lisa Copen, founder of Rest Ministries, received the Audience Choice Award, and the Fair Haven (Conn.) Community Health Center Midwifery Group was selected by OBOS.

This event marks OBOS's first annual effort to spotlight the diversity of care, education and activism in communities around the world. Within five years, at least 100 people who have made significant, long-lasting contributions to women's health will be honored for their work as Our Bodies Ourselves Women's Health Heroes.

The full list is here.

Kind of exciting that one of the honorees, Jenni Prokopy from ChronicBabe is speaking at BlogHer!

Congrats to all the winners.

My S.O. will be so happy

Elisa Camahort — 2009-05-12T13:48:10-07:00

My S.O. gets infuriated with people who go to the office when they're sick...including me. I am definitely of the ilk that I will go in unless I'm on death's door. He will stay home with a hangnail.

Turns out, at least according to the NY Times, that he may have the better approach.

As a resident, my greatest pride was in never having missed a day for illness. I’d drag myself in and sniffle and cough through the day. Once, I’m embarrassed to admit, I trudged up York Avenue to the hospital making use of my own personal motion sickness bag every few blocks while horrified pedestrians looked on.

Now, though, I see the foolishness of this bravura. And I confront it almost daily in my primary care practice. No one can miss a day — a minute, even — of work, carpooling, volunteering, vacation, anything. “I don’t have time to be sick!” my patients wail. Everyone must soldier on, leaving sick days to those with less important things to do.

Yes, I agree there is a certain sense of arrogance inherent in the idea that people cannot live without me coming into the office. I already work from home one day per week, why not more when I'm sick?

But I also think it's a kind of denial. Like "...if I can make it to the office and work a full day, then I must not really feel so bad..." and it's mostly ourselves we're trying to convince. Combine that with the underlying belief that how sick you are can actually be influenced by how you feel mentally, then it would seem like good medicine to convince yourself you're not so bad off, and go to work.

It all seems pretty flimsy when I write it out in black and white, but time for true confessions...how many of you think exactly that way?

So, apparently I've been doing it wrong: Vitamin D and sunlight

Elisa Camahort — 2009-05-09T12:27:34-07:00

Ever since I found out I have a Vitamin D deficiency (like half the population), I've been trying to get a little more sunlight into my life, unblocked by sunscreen

This consisted mostly of me exposing my face and lower arms to the sun when I got a little chance to. (Not for extended periods of time mind you, I was shooting for 10 minutes.)

Well, apparently, my approach is all wrong.

Thanks to this link from Jack Norris, RD, I got this very different advice about sun exposure from a Vitamin D expert, Dr. Michael Holick:

“I typically recommend people go out for a period of time—depending on the time of the year, the time of day, the latitude, and the degree of skin pigmentation—if you know you’re going to get a mild sunburn after 30 minutes, I typically recommend about 10, no more than 15, minutes of arms and legs exposure, or if you’re in a bathing suit, abdomen and back exposure as well, 2 to 3 times a week. Always wear sun protection on your face because that’s the most sun-damaged area and it’s only about 9% of your body surface, so it doesn’t provide you with that much vitamin D. Go out, enjoy yourself, get some sensible sun exposure, then put sunscreen on if you plan to stay out for a longer period of time. People with a higher degree skin pigmentation, such as African Americans, are walking around with an SPF of 8 to 15. That’s why they need to be exposed for much longer periods of time and why people of color are at especially high risk of having vitamin D deficiency.”

So yeah, "always wear sun protection on your face". D'oh.

I've been doing it wrong :(