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By Bob Aronson

partners in antibiotic resistance

Antibiotics and drugs called antimicrobial agents have been used for the last 70 years to treat patients with infectious diseases who might genotherwise have died.  Unfortunately these “Miracle” drugs were used for such a long time and so indiscriminately that the organisms they were designed to kill have mutated and become more resistant to them. In some cases the drugs don’t work at all anymore.

Each year in the United States, at least 2 million people become infected with antibiotic resistant bacteria and at least 23,000 of them die as a result. While 23,000 is a significant number it does not even come close to being in the catastrophic category so there’s not much media attention given to the problem  – until now and this headline.

Is Antibiotic resistance: the greatest public health threat of our time?

Tsuperbugshis is not the stuff of science fiction.  It is real and it is supported by both the World Health Organization (WHO) and by the U.S. Centers For Disease Control in Atlanta, Georgia (CDC)

The WHO says we are in a “post-antibiotic era”, in which even the most minor bacterial infections could mean death, a statement made true because of antibiotic misuse, overprescribing and poor diagnoses.

A world without antimicrobials would be a world without modern medicine, so why is there not more urgency in addressing the global rise of drug resistance? The New Statesman brought leading health experts together to discuss the problem. http://www.newstatesman.com/sci-tech/2014/07/antibiotic-resistance-greatest-public-health-threat-our-time

Antibiotic-resistant infections can happen anywhere. The CDC says that most of them happen in the general community; however, most deaths related to antibiotic resistance happen in healthcare settings such as hospitals and nursing homes.  http://www.cdc.gov/drugresistance/threat-report-2013/index.html

 The Threat to You

Diseases that either are or are becoming antibiotic resistant http://www.cdc.gov/drugresistance/DiseasesConnectedAR.html

A growing number of disease-causing organisms or pathogens, are resistant to one or more antimicrobial drugs—including the bacteria that cause tuberculosis, the viruses that cause influenza, the parasites that cause malaria, and the fungi that cause yeast infections.  All are becoming resistant to the antimicrobial agents used for treatment.  Curious about other diseases that may not respond to your antibiotics?   Here’s a partial list from the CDC.  The full list can be seen by clicking on the above link.

Acinetobacter acinetobacteris a type of gram-negative bacteria that is a cause of pneumonia or bloodstream infections among critically ill patients. Many of these bacteria have become very resistant to antibiotics.

Anthrax

Anthrax is a serious disease caused by Bacillus anthracis, a bacterium that forms spores. Anthrax most commonly occurs in wild and domestic mammalian species, but it can also occur in humans when they are exposed to infected animals or to tissue from infected animals or when anthrax spores are used as a bioterrorist weapon. Some strains of B. anthracis may be naturally resistant to certain antibiotics and not others. In addition, there may be biologically mutant strains that are engineered to be resistant to various antibiotics.

EnterobacteriaceaeCarbapenem resistant Enterobacteriaceae

Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities. CRE have become resistant to all or nearly all the antibiotics we have today. Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection.

 

Gonorrhea

Neisseria gonorrhoeae causes gonorrhea, a sexually transmitted disease that can result in group b strepdischarge and inflammation at the urethra, cervix, pharynx, or rectum.

Group B streptococcus

Group B Streptococcus (GBS) is a type of bacteria that can cause severe illnesses in people of all ages, ranging from bloodstream infections (sepsis) and pneumonia to meningitis and skin infections.

Methicillin-resistant Staphylococcus aureus (MRSA)

Methicillin-resistant Staphylococcus aureus (MRSA) causes a range of illnesses, from skin and wound infections to pneumonia and bloodstream infections that can cause sepsis and death. Staph bacteria, including MRSA, are one of the most common causes of healthcare-associated infections.

Salmonella, non-typhoidal serotypes

Non-typhoidal Salmonella (serotypes other than Typhi, Paratyphi A, Paratyphi B, and Paratyphi C) usually causes diarrhea (sometimes bloody), fever, and abdominal cramps. Some infections spread to the blood and can have life-threatening complications.

Shigella

hand washingShigella usually causes diarrhea (sometimes bloody), fever, and abdominal pain. Sometimes it causes serious complications such as reactive arthritis. High-risk groups include young children, people with inadequate hand washing and hygiene habits, and men who have sex with men.

Streptococcus pneumoniae

Streptococcus pneumoniae (S. pneumoniae, or pneumococcus) is the leading cause of bacterial pneumonia and meningitis in the United States. It also is a major cause of bloodstream infections and ear and sinus infections.

Tuberculosis

Tuberculosis (TB) is among the most common infectious diseases and a frequent cause of death TBworldwide. TB is caused by the bacteriaMycobacterium tuberculosis (M. tuberculosis) and is spread most commonly through the air. M. tuberculosis can affect any part of the body, but disease is found most often in the lungs. In most cases, TB is treatable and curable with the available first-line TB drugs; however, in some cases, M. tuberculosis can be resistant to one or more of the drugs used to treat it. Drug-resistant TB is more challenging to treat — it can be complex and requires more time and more expensive drugs that often have more side effects. Extensively Drug-Resistant TB (XDR TB) is resistant to most TB drugs; therefore, patients are left with treatment options that are much less effective. The major factors driving TB drug resistance are incomplete or wrong treatment, short drug supply, and lack of new drugs. In the United States most drug-resistant TB is found among persons born outside of the country.

Typhoid Fever

Salmonella serotype Typhi causes typhoid fever, a potentially life-threatening disease. People with typhoid fever usually have a high fever, abdominal pain, and headache. Typhoid fever can lead to bowel perforation, shock, and death.

Vancomycin-Intermediate/Resistant Staphylococcus aureus(VISA/VRSA)

Staphylococcus aureus is a common type of bacteria that is found on the skin. During medical procedures when patients require catheters or ventilators or undergo surgical procedures, Staphylococcus aureus can enter the body and cause infections. When Staphylococcus aureus becomes resistant to vancomycin, there are few treatment options available because vancomycin-resistant S. aureus bacteria identified to date were also resistant to methicillin and other classes of antibiotics.

Malaria

malariaMalaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills, and flu-like symptoms. The development of resistance to drugs poses one of the greatest threats to malaria control and has been linked to recent increases in malaria morbidity and mortality. Antimicrobial resistance has been confirmed in only two of the four human malaria parasite species, Plasmodium falciparum and P. vivax.

 WHO: Antibiotic Resistance Now a ‘Major Threat to Public Health’

Antibiotics are powerful tools for fighting illness and disease, but their overuse has helped create bacteria that are outliving the drugs used to treat them.

Antibiotic resistance is a quickly growing, extremely dangerous problem. World health leaders have described antibiotic-resistant bacteria as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world. Many more people die from other conditions that were complicated by an antibiotic-resistant infection.

In addition, almost 250,000 people who are hospitalized or require hospitalization get Clostridium difficile each year, an infection usually related to antibiotic use. C. difficile causes deadly diarrhea and kills at least 14,000 people each year. Many C. difficile infections and drug-resistant infections can be prevented.

How Bacteria Become Resistant

When bacteria are exposed to antibiotics, they start learning how to outsmart the drugs. This process occurs in bacteria found in humans, animals, and the environment. Resistant bacteria can multiply and spread easily and quickly, causing severe infections. They can also share genetic information with other bacteria, making the other bacteria resistant as well. Each time bacteria learn to outsmart an antibiotic, treatment options are more limited, and these infections pose a greater risk to human health.

Infections Can Happen to Anyone, Anywhere

Anyone can become infected with antibiotic-resistant bacteria anywhere and anytime. Most infections occur in the community, like skin infections with MRSA and sexually transmitted diseases. However, most deaths related to antibiotic resistance occur from drug-resistant infections picked up in healthcare settings, such as hospitals and nursing homes.

 What you can do to protect yourself against drug-resistant infections

 Bob’s Newheart is providing two answers to this question.  The first from the CDC and the second from a panel of physician experts who were interviewed for the PBS TV show, Frontline.

 CDC Advice

 There are many ways you can help prevent the creation and spread of resistance. First, when you are sick, do not demand antibiotics from your doctor or take antibiotics that were not prescribed to you directly for your specific illness. When taking antibiotics, do not skip doses, and make sure to follow the directions about dose and duration from your doctor.

Second, like all diseases, common safety and hygiene methods can prevent disease and spread. Make sure to:

  • Get updated and regular vaccinations against drug-resistant bacteria
  • Wash your hands before eating and after using the restroom to avoid putting drug-resistant bacteria into your body
  • Wash your hands after handling uncooked food to prevent ingesting drug-resistant bacteria that can live on food
  • Cook meat and poultry thoroughly to kill bacteria, including potential drug-resistant bacteria

What healthcare providers can do to protect patients from drug-resistant infections (CDC)

patientsThere are many ways to help provide the best care to your patients while protecting them against antibiotic-resistant infections.

  • Follow all necessary infection control recommendations, including hand hygiene, standard precautions, and contact precautions.
  • Diagnose and treat resistant infections quickly and efficiently. Treatment options change often because resistance is complex. Make sure to follow the latest recommendations to ensure you are prescribing appropriately.
  • Only prescribe antibiotics when likely to benefit the patient, and be sure to prescribe the right dose and duration.
  • Be sure to clearly label dose, duration, and indication for treatment, and include appropriate laboratory diagnostic tests when placing antibiotic orders. This will help other clinicians caring for the patient to change or stop therapy when appropriate.
  • Take an antibiotic time out, reassessing therapy after 48-72 hours. Once additional information is available, including microbiology, radiographic, and clinical information, a decision can be made on whether to continue the same therapy.
  • When transferring patients, ensure the other facilities are notified of any infection or known colonization.
  • Keep tabs on resistance patterns in your facility and in the area around your facility.
  • Finally, encourage prevention methods with your patients. Make sure they understand how to protect themselves with vaccines, treatment, and infection control practices such as hand washing and safe food handling.

From PBS “Frontline”

 Eight Ways to Protect Yourself from Superbugs

http://www.pbs.org/wgbh/pages/frontline/health-science-technology/hunting-the-nightmare-bacteria/eight-ways-to-protect-yourself-from-superbugs/

protet yourself from superbugsOctober 22, 2013, 9:32 pm ET by Sarah Childress

Everyone is at risk of becoming infected by drug-resistant bacteria, especially as some have begun to appear outside of hospitals in the general community. So how worried should you be?

The PBS investigative show, “FRONTLINE” asked three infectious disease doctors these questions: what the risks are, how to protect yourself, and what questions to ask when a loved one is in the hospital.

Dr. Sean Elliott is the medical director of infection prevention at the University of Arizona Health Network Dr. Brad Spellberg is an infectious diseases specialist at Harbor-UCLA Medical Center Dr. Wendy Stead is an infectious diseases specialist at Beth Israel Deaconess Medical Center in Boston

Frontline condensed their advice into eight handy tips to help keep bugs at bay.

Of course, none of this substitutes for actual medical advice. For serious concerns, always consult your doctor.

 1. Don’t Panic

Everyone may be at risk, but the chances of catching a drug-resistant bug outside of the hospital are small for most. “For the average healthy person walking down the street?  Those organisms are not much of a threat,” Stead says.

“The first principle is to try to live a healthy lifestyle to reduce the need to be in the hospital” where you are more likely to encounter these bugs, Spellberg says. Keep your home and work space clean. Be aware of the food you eat: Wash fruits and vegetables carefully and cook other food properly to reduce your chance of coming into contact with harmful bacteria.

2. Know What to Look For

How do you know if you have a superbug?

“You don’t.  And your doctor won’t either, at least at first,” Spellberg said. “The infections caused by antibiotic-resistant bacteria do not cause different symptoms than infections caused by antibiotic-susceptible infections.”

While it’s impossible to give broad advice about so many different kinds of bacteria — and if you’re concerned, you should call your doctor first — there are some signs that an illness might be more serious. “In general, fevers, if they’re accompanied by shaking chills, if they’re getting worse instead of better, that would suggest there’s a bacterial process,” Elliott said.

With community-acquired MRSA, many people first notice a skin infection or boil that becomes larger and more painful, Stead says.

But if you do suspect such an infection, don’t rush to the emergency room, where you might be exposed to other bugs or infect others. Call your primary-care doctor first for advice.

3. Wash Your Hands with Soap and Water. Really wash them. Doctors say they cannot recommend this enough.

 “Wash your hands regularly and religiously in the normal times that you would think you should wash them,” Stead says. “Give it a good amount of time” — about 15 seconds — “scrubbing hands thoroughly, not just in and out of the water.”

Turn off the faucet using a paper towel.

Alcohol-based hand-sanitizers are handy too, but remember that one bug, C.Diff, is resistant to that as well. But it does respond to soap and water. So Wash. Your. Hands.

4. Be Careful with the Antibacterial Soap

 antibacterial soapThe FDA hasn’t determined whether these soaps are more effective than regular soap, and some doctors don’t recommend using them. “You do not need to take ‘antibacterial’ soaps for routine use,” Spellberg says. “There may be specific medical circumstances that warrant special antibacterial cleansers, but these should be prescribed by your physician.”

“A lot of the antibacterial soaps are more drying to the skin than would be a simple soap,” Elliott says. “So the more that we break down our skin barriers the higher the risk of getting superimposed bacterial. The real key is the soap and water and the physical action  — and keeping hands moisturized. “

5. Ask Your Doctors to Wash Their Hands

“It is every patient’s right to have every health-care provider entering the room to have clean hands,” Elliott says. “We’re supposed to do it, we mandate 100 percent hand- hygiene wash your handscompliance, but the reality is that doesn’t happen,” he says.

Some hospitals even make health-care providers wear buttons encouraging patients to ask them if they’ve washed their hands. Even if they’re buttonless, you should feel free to ask your providers about it.

“Really — we are not offended by that,” Stead says.

6. Get A Flu Shot

“When people get influenza, they actually become at higher risk as they recover for complicating bacterial infections,” Stead says, because people with weakened immune systems are more vulnerable to other bugs.

“Community-acquired MRSA is a big risk in patients who have recently had influenza,” she notes. “They get influenza and they start to get better, and then the staph comes in. … That’s life threatening.  They wouldn’t have been at risk for that if they hadn’t had influenza in the first place.”

7. Ask Whether You Need that Antibiotic

 Doctors sometimes feel pressured by patients or their families to prescribe an antibiotic, even if it’s not necessary. Don’t assume you need one — antibiotics don’t work on viral infections like colds or the flu. If your doctor does recommend one, ask whether you really need it.

“Using antibiotics does kill off non-resistant bacteria in your body and makes you likely to acquire antibiotic-resistant bacteria in their place,” Spellberg says. “If your doctor says that they think your infection is probably caused by bacteria and that you do need an antibiotic, ask, ‘Do I need a broadly active antibiotic, or can I take a narrower antibiotic?’ The broader the antibiotic, the more damage to your normal bacteria can be caused. We want physicians to try to prescribe antibiotics that are as narrow as possible for a given infection.”

8. Advocate for Loved Ones in the Hospital

 patient advocateOne of the ways drug-resistant bacteria spreads in hospital is through tubes inserted in the body, such as catheters. If someone you care about is on such a device, don’t be afraid to ask doctors whether they still need it, and when the tubes can come out.

“Hospitals are much more aggressive about removing things if they’re not needed anymore,” Stead says. “But having patients be aware and try to get things out too is good.”

“Every day that decision needs to be made: Do these things need to stay in or do they need to come out?” Elliott says. The key, he says, is “empowering patients or their advocates to stand up for their health-care needs.”

Conclusion

While physicians and health care workers have a responsibility to provide the best health care, patients also have some responsibility for their own well-being and it boils down to being informed and not being afraid to ask tough questions.

Most of us don’t like challenging physicians, we just assume that will all those many years of education and the raft of framed diplomas on the wall that they must know what they are doing, but the practice of medicine is as much art as it is science.  That means even highly educated medical experts can come to the wrong conclusions, so it is extremely important for patients to expand their knowledge of the conditions to which they are exposed or have contracted, ask tough, knowledgeable questions and then, demand clear unequivocal answers. Doing so could mean the difference between life and death.

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bob minus Jay full shot Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


 Introduction by Bob Aronson

arrow through the head

Dr. Priscilla Diffie-Couch, regularly sends out health, fitness and medical tips and ideas to family members and some friends.  She is highly regarded as a resource, and an amazing researcher with a knack for cutting through the medical terminology and making it understandable.  In our family it is not uncommon to hear, “Priscilla says…..”  and that makes it gospel.

Today I received this email from her:

“INAPPROPRIATE TEST ORDERS INUNDATE HEALTH SYSTEM”

From Priscilla Diffie-Couch

 That was the headline in one of my health sources today.  They cited three health tests that are misused frequently:

  • Test for healthy vitamin D levels.  The correct test is called 25-dehydroxyvitamin D test.  The incorrect test ordered more often than not is called 1,25-hidroxyvitamin D test.  Note the 1 and the comma in front of the wrong test (designed to detect renal failure) plus the “I” instead of an “E” in the word dehydroxyvitamin.  Of course, you who read my health notes have known the correct test to request for several years now.
  • Test for anemia by determining levels of B12.  The older you are, the more questions you need to ask about the lab standards that apply to your B12 test results.
  • Ionized calcium tests are overused and do not tell you if you have a shortage of calcium.

Upon reading Priscilla’s email I wondered what other tests might be unnecessary so I did some quick internet research and found plenty.  Here’s my quick intro followed by a report from AARP.

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Physicians are among the most trusted people on earth.  When a Doctor orders a CT scan or an X Ray or even a blood test few of us think to question her.  We know she has completed several years of medical school and for many of us it is unthinkable to question that kind of expertise.

But – question we must because physicians regularly order unnecessary tests and those tests can negatively affect the patient in two ways; 1) it could well be money out of your pocket either in higher medical bills (An MRI, or magnetic resonance imaging scan, can cost $1,000 or more), increased co-pays or more costly insurance and; 2) the tests could be dangerous. Ordinary X-rays are rarely a concern, but super-sharp X-rays called CT scans involve relatively large radiation doses and can raise the risk of cancer.  And So, you might ask, “Why would they order tests they know are unnecessary?  Is it because they are afraid of lawsuits?”  Good question, and lawsuits are part of the answer.  Professional pride is another.  Like us, doctors don’t like being wrong either.

As suggested, the most commonly cited reason is “defensive medicine”: the fear of being sued by lawsuitpatients for not ordering a test. An American Academy of Orthopedic Surgeons study that involved 72 orthopedic surgeons who saw over 2,000 patients reported ordering 20% of their expensive imaging tests “for defensive reasons.”  Included was 57% of bone scans, 53% for ultrasounds, 38% for MRIs, 33% for CT scans and 11% for x-rays.

Those unnecessary and overused tests account cost the American patient upwards of $60 billion a year. That’s a whole lot of hard earned money, but fear of lawsuits alone is not the prime motivator.  The leader is something most people have never heard of. It’s called the M & M conference (Morbidity and Mortality).  That’s where you stand up in front of your peers and “fess up” to your mistakes.  Needless to say, that can be quite embarrassing.  The M & M conference, though, is a double edged sword because while it is unlikely the physician will ever make that mistake again, it is very likely they will order more unnecessary tests because they are good insurance against another M & M visit.Medical tests 2

With that background here is a summary of 7 tests that may be unnecessary.  Tests you should ask about when you are scheduled for any of them.  AARP did a fine job of assembling this information along with the dangers the tests present and the exceptions that can be made for having them.

 

7 Medical Tests and Treatments You May Not Really Need

Think twice before getting these procedures 

by: Elizabeth Agnvall, AARP

The American Board of Internal Medicine Foundation (ABIM) asked nine medical societies —American board of internal medicine from family doctors to allergists and cardiologists — to each identify five commonly used medical tests and treatments that are often unnecessary. A list of 45 overused procedures was presented Wednesday, April 4, 2012, at a news conference at the National Press Club in Washington, D.C.

“We’re changing the culture in medicine,” says Christine K. Cassel, M.D., president of the ABIM, about this new Choosing Wisely campaign, which represents some 375,000 doctors. Consumer Reports also has joined the doctors’ campaign.

Related

“Too much testing is being done that isn’t needed, that doesn’t work,” says John Santa, M.D., who directs health ratings for Consumer Reports.

Here are seven of the most popular, most overused tests and treatments for people over age 50 that the AARP Bulletin has selected from the Choosing Wisely campaign. For the complete list go to www.choosingwisely.org.

  1. ekgEKG and other heart screening tests for low-risk people without symptoms.

American Academy of Family Physicians

These can be lifesaving for those experiencing chest pain or other symptoms of heart disease. But a 2010 Consumer Reports survey found that 44 percent of people with no signs or symptoms of heart diseasehad an EKG, an exercise stress test or an ultrasound. For several years, cardiology guidelines have discouraged heart screening tests for people who have no symptoms and are not at high risk, and yet their use “is more common than it needs to be,” says James Fasules, M.D., an official with the American College of Cardiology. For those at low risk for heart disease, an EKG or cardiac stress test is far more likely to show a false positive result than find a real problem.

DangersFalse positive tests often lead to more tests and even invasive heart procedures.

Exceptions: If you have diabetes or other conditions that raise your risk, talk to your doctor. Use this calculator to find out your 10-year risk of having a heart attack.

2. Bone scans for osteoporosis for women under 65 and men under 70 with nobone scan 2 risk factors.

American Academy of Family Physicians

Bone density decreases and the risk of fractures increases with age, but medical experts say that most women don’t need a bone density test until age 65. Still, many doctors recommend the scan starting at age 50.

Dangers: Bone density (DXA) scans can lead to unneeded medications that can have serious side effects.

Exceptions: Talk to your doctor about a scan before age 65 (70 if you’re a man) if you were or are a smoker; you’ve used steroid medications regularly; have low body weight; or have already had a fracture. ThisFRAX tool can help you calculate your risk.

antibiotics3. Antibiotics for mild-to-moderate sinus infections.

American Academy of Family Physicians, American Academy of Allergy, Asthma & Immunology

Despite physician awareness campaigns about the overuse of antibiotics for sinus infections, the drugs are prescribed in more than 80 percent of cases, according to the American Academy of Family Physicians. More than 90 percent of sinus infections are caused by viruses — and the drugs only work against bacterial infections. 

Dangers: The widespread overuse of antibiotics is behind the spread of increasingly virulent strains of drug-resistant bacteria.

Exceptions: If symptoms last more than seven days or worsen after initially improving. Some people develop a secondary bacterial infection and then antibiotics may be needed.

4. NSAID painkillers for people with high blood pressure, heart failure and anynsaids chronic kidney disease.

American Society of Nephrology

Many people use Advil, Motrin (ibuprofen) or prescriptions such as Celebrex and Voltaren for everything from arthritis to headaches. But these common painkillers can be dangerous, especially for people with high blood pressure or kidney disease. (These medications can raise blood pressure, cause fluid retention and interfere with kidney function.) Tylenol (acetaminophen), tramadol, or short-term use of narcotic painkillers may be safer than NSAIDs, according to the nephrologists.

Dangers: These drugs are linked to stomach bleeding and increased risk of heart and kidney problems.

X ray5.  X-ray, CT scan or MRI for low back pain.

American College of Physicians, American Academy of Family Physicians

About 80 percent of Americans will suffer from back pain. Low back pain is the fifth most common cause for all doctor’s visits. “The vast majority of people with nonspecific low back pain simply get better … within four to six weeks, with or without a physician’s intervention,” says Patrick Alguire, M.D., an official with the American College of Physicians. If older people get an image, experts say the results will almost always show an innocent abnormality that has nothing to do with the back pain.

Dangers: Some tests expose people to unnecessary radiation and can lead to expensive back surgery.

Exceptions: When the doctor suspects serious underlying conditions or if the pain isn’t better in six weeks.

6. Diagnostic tests for suspected allergies.allergy tests

American Academy of Allergy, Asthma & Immunology

Some 35 million Americans suffer from seasonal allergies. And millions of Americans increasingly blame a food allergy or sensitivity — fromgluten to milk — for their health woes. Some doctors or health providers now perform a blood test, called an immunoglobulin (IgG), for food allergies. But Linda Cox, M.D., president elect of the allergy group, says the test simply doesn’t work. For seasonal allergies, many doctors run abattery of blood and skin tests dubbed IgE, when just a few specific tests would do. By asking patients when and where they have symptoms, doctors can pinpoint what tests they should run.

7. CT scans and other imaging procedures for uncomplicated headaches.ct scan

American College of Radiology

Severe headaches can be excruciating and frightening, but unless they are accompanied by other key symptoms it rarely makes sense to get a CT scan or MRI of the brain. Yet “it happens all the time,” says David Seidenwurm, M.D., a neuroradiologist in Sacramento, Calif. Patients get frightened, doctors worry about lawsuits and people “want all the information right away,” he says. “It’s easier to do the scan than to have the conversation.”

Dangers: Radiation exposure raises cancer risks in the population and false-positives lead to more testing and patient anxiety.

Exceptions: Worrisome symptoms — trouble speaking, blurred vision, weakness on one side — or other signs that the headache is caused from something more dangerous, such as a brain tumor.

Remember readers, despite all the diplomas on the wall, the high tech office and the “Dr.” title, the physician works for you, just like your plumber, electrician or carpenter.  If you don’t understand, if you are confused or if you disagree, speak up. It is your health we are dealing with here so be polite and courteous but be firm.  Physicians have been known to make mistakes.  Make sure they don’t happen to you.  Probe a little more and demand understandable answers .  By being a little more assertive you just might get better care.

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 bob magic kingdomBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


 Introduction by Bob Aronson

blackboard cartoon

Since Bob’s Newheart began publishing on WordPress over seven years ago, we have tried to offer encouragement, sound medical information, choices for healthy living,  news of what’s to come and  as much inspiration as possible for those who suffer from debilitating diseases.   As a heart transplant recipient I know what its like to feel desperate and without hope.  I also know there is always hope,  always.

Dr. Priscilla Diffie-Couch and her sister Dawn Anita Plumlee have been contributors to our inspiration series in the past.  Today Dr. Diffie-Couch returns with the amazing story of how she suvived what could have been — what should have been–
a deadly cancer. 

MY PERSONAL MEDICAL MIRACLE

Priscilla Diffie-Couch ED.D.

Friday morning I awake relieved.  My doctor has pronounced my ulcer completely healed.  I return from my errands humming happily and stop to check my message machine.  Why has my doctor’s office tried three times to reach me?  I already know the good news.  Now I have my doctor on the phone and listen to his strange tight voice. phone answering machine

“We need to repeat your biopsy.  I’m afraid it looks suspicious.”

“Suspicious?”  Characters in murder mysteries look suspicious.  People lurking in dark alleys look suspicious.  My biopsy looks suspicious?

“How suspicious?” I ask cautiously.

“Highly suspicious?”

“You mean, as in malignant?”

“Well…yes.”

“So are we talking cancer in my stomach?”

“Yes.  I’m afraid so.”

“The prognosis if that’s true?”

“Not very good, I’m afraid.”

He’s afraid?  I’m trembling with fear.  We settle the details for another more extensive biopsy.  I call my husband Mickey.  Probably a mix-up, we agree–someone else’s tissue.  My friend Donna, who happens to be a pathologist calls.  Her voice too is strained.  Having reviewed my biopsy, she and her pathologist husband Dee appear after work with two bottles of their best wine.  We toast to a “mistake in the lab.”  And feel for the real owner of the suspicious biopsy tissue because the samples they both examined were literally cluttered with countless cancer cells.

stomach cancer factsSaturday begins with a long close silent hug.  If the biopsy tissue truly is mine and I have cancer, we need to be informed.  We head for the medical books in the huge used book store.  We go from there to the library.  We read in silence–page after page of gloom and doom. It is a deadly disease.  Statistics point to a 10% survival rate for victims of stomach cancer. Pictures of my grieving family flash through my mind as the tears well up in my eyes.

Another sustained quiet hug when we get home.  I break away suddenly and declare that the statistics are on our side. If ten percent of the people beat this cancer, that will include me, so my chances then become one hundred percent.  That is how we will present the news to family.  That is optimistic but believable, given my general good health and fighting spirit.

Sunday Mickey calls family members.  My son Jeff and his wife Diana arrive shortly to share our outlook of a hundred percent chance of survival.  My sister tells me to get a copy of Bernie Siegel’s Love, Medicine and Miracles, which I vow to do immediately.  Later that evening Mickey and easily win our mixed doubles tennis match.  I begin reading the book my sister suggested.  The seeds for positive thinking are being planted as I do.

On Monday I undergo what is called a D & C for a feminine bleeding problem also related to cancer and set a tentative schedule for full removal of my stomach on Thursday, should these suspicious cancer cells truly be mine.  They are.  Donna and Dee deliver that dreaded news.  They know the grim outlook for stomach cancer.  Shattering silence.  I say something funny.  I must have.  We all burst out laughing.  I can feel a change in the climate.  I can see they are now on board as believers in my chances of survival.

On Tuesday I spell out my situation to my friend Sharon, who recently sold her share in Sound Warehouse for $46 million dollars.  Upon arrival at my doorstep, she declares with authority that she is “here to insure that I have the best medical care that money can buy.”  The doorbell rings again.  Cissy. Nancy.  Charlene.  Margie.  All bearing gifts–elegant gowns.  I may end up without a stomach but I will be the most beautifully dressed patient in the cancer ward.  We laugh at my concern about bleeding all over the operating table since the D & C didn’t arrest my flow.  We women are commonly such vain creatures.  But good friends like these are rare indeed.

The healing process begins the moment the diagnosis is confirmed with a third biopsy.  As I look at Mickey, his shoulders shaking with stifled sobs—a weak moment of looking ahead at life without me—he apologies.  Suddenly my role in this ordeal becomes clear.

When faced with your own mortality, your primary concern becomes protecting those who love you from all possible pain.  It is not a matter of bravery.  It is just a matter of loving that deeply.  Mickey and I share an uncommon love.  We have overcome enormous obstacles and built a history oIllness and the mind 1f disproving fatalistic predictions.  I have developed an extraordinary closeness with his family.  My own family fills my life with indescribably intense feelings.  They have known the never-ending anguish of losing Mom to a drunk driver.  They don’t deserve to deal with another untimely death.  I cannot let any of them suffer.  So the smile on my face is not an act.  It is an act of love prompted by a genuinely selfish need to be there with them to share whatever memorable moments await us all.

Donna and Dee have already made certain that I will have the best cancer surgeon in the area.  The chairman of Fina Oil, where Mickey works as a VP, vows to see that I receive VIP treat at the best cancer treatment center available.  I have too many people determined that I will be among the survivors.  I cannot let them down.

I arrange for pictures of all my family to surround me when I come out of surgery.  Sitting up on my knees on the gurney, wondering why I can’t trot down the hall to the OR, I smile at my family’s faces and remind them not to have too much fun for the next five hours.  The last thing I remember is Mickey’s hand holding mine as I am wheeled away.  I am still smiling.

Sometime during those next five hours, I lose my sense of humor.  I am groggy but aware and can hear my plaintive plea:  “Pain.  Pain.  Pain.”  I can faintly make out the images above me—my ICUhusband, son, daughter-in-law.  They watch as I am transported to ICU.  The next morning I am sure my scream shatters the glass window when two huge orderlies toss me onto the waiting gurney.  “Don’t—you—touch—me—again—without—a—member—of—my–family—present.”  They step back and are surprised when I pull myself from the gurney to the bed in my room.  My daughter, worlds away from me in lifestyle and philosophy—will stay with me the next ten days.  I watch with wonder as she handpicks the most attentive and caring staff of nurses anyone could hope for and begins to line out the plan for my care.

My gastroenterologist drops by and asks if I mind being a “teaching subject” since mine is such an unusual case.  I eagerly agree, glad to be a part of advancing medical science.  He is joined by my pathologist friend Donna, who announces that my stomach was totally clear of cancer save a tiny millimeter located at the top.  Leaving even a small part of my stomach will be too risky I am told.  “Yours must be the earliest case of stomach cancer ever diagnosed,” she declares.  How could my stomach, so full of cancer five days ago, be almost totally free of it now?  No one tries to explain that but I would later discover other equally rare and miraculous instances of spontaneous remission.SPONTANEOUS REMISSION  My body was eradicating the cancer by itself.

My cancer surgeon tells me he will construct a pouch from a piece of my large intestine that will serve as my stomach.  (I am eating a small portion of sugar-free Jello as he describes this phenomenal feat.  I smile as I recall a passage from humorist Dave Berry’s delightful book Stay Fit and Healthy Until You Are Dead in which he claims that our skin is the most important of our vital organs, because without it, all the disgusting hideous inner parts of us would fall out onto the sidewalk for all manner of people to trip over.

“Ok, Mother,” my daughter beams brightly at 7:00am (she who has never knowingly arisen before noon any day in her life since she ran away from home).  “Up we go now.  We have our goals for the day.”  First, soap bubbles so thick I have little peep holes for eyes, the triple scrub, a quick shave under the arms, a little talcum powder here and there, and lots of lotion everywhere.  Maneuvering seamlessly around all the wires and tubes, she is making sure every inch of me will be supremely soft and supple.

In and out of my morphine mind, I make a list of questions for her to ask my cancer surgeon, should I be asleep when he drops in.  I can hear him now whistling cheerfully down the hallway.  I emulate his demeanor as I am trying for the perfect-patient-of-the-ward award.  That shouldn’t be difficult since I am surrounded by the most efficient medical staff in America.

I feel for those people who hear the word cancer and drop into a deep and unalterable depression.  With the constant arrival of guests, flowers, gifts and cards, I am not likely to let my spirits sag. I am already writing thank you notes in my mind.  And they seem so inadequate when I think of the how everyone continues to buoy my spirits in so many countless ways.

Flitting around my hospital room, I accidentally pull out the feeding tube that was implanted in my side to insure my nourishment should my new “stomach” fail in some way.  I will be fine, I tell myself.  (I later learn that this little set-back will have a serious impact on my recovery.)

Following the highly regimented eating plan the first few weeks at home is not working.  Revulsion and nausea are my constant companions.  One day, as I step out of the bath tub, I glance up at the bank of mirrors I have so carefully avoided.  I gasp.  Looking back at me is the image of a captive in a concentration camp.  My skin clings to my bones.  My eyes are buried deep in their sockets.  I have gone too long without sufficient nourishment.

I call a friend who listens to my plight and reports that she knows someone who stopped his weight loss with Ensure, a repulsive high-calorie sickeningly sweet shake.  I have no choice.  Slowly, I begin to restore my lost pounds.ENSURE

This morning I am awakened by my loving husband who has been sleeping elsewhere, partly because of his cold and partly because I have to sleep upright to keep bile from coming into my throat.  “It’s time to get out and see what’s happening in the rest of the world.  We are going to Jeff’s  weightlifting meet.”  I smile.  Life is full.  Life is good.  I’m still in it.

A quarter of a century later, I am still in it.  I beat the odds and way beyond.  In 2005 two doctors from Australia were awarded the Nobel Prize in medicine for their discovery that the bacteria H-Pylori causes almost 90% of gastric ulcers and these can lead to stomach cancer.  The actual date of their discovery was three years before my ulcer appeared in 1988.  But one study shows that it can take as many as seventeen years before American doctors adapt new medical discoveries into their practice.  That means that we must all do diligent research on the nature of and treatment for our own medical conditions.  As late as 1999, still at risk for a new cancer in my intestine, I could not find a gastroenterologist who would test me for H-Pylori.  It was my family doctor, an osteopath, who did so and prescribed the two-week treatment of triple antibiotics that could have saved my stomach in 1989.

I still face challenges associated with having no stomach.  Battling the bile that comes up from my liver makes getting good sleep an elusive dream.  Ballooning up when my colon locks up brings on birthing-like pain.  Staying hydrated to avoid arrhythmia remains a struggle.  But trips to the ER are increasingly rare and sublingual B-12 has replaced those dreaded self-administered shots. I can, I can I can now say with conviction that I am an active healthy survivor who has much to be thankful for.  I credit my friends for their devotion and for referring me to the gastroenterologist who was thorough enough to biopsy my healed ulcer.  I credit him and the talented surgeon who constructed a replacement “stomach” that has worked so flawlessly all these years.  When diagnosed with stomach cancer, most people are dead within five years.  So, many call my case a medical miracle.

I remain dubious about a beneficent god who would opt to save me while letting more deserving people die.  I am more open to the possibility that having a positive spirit causes the body to pump out protective agents yet to be identified.  I don’t pretend to be able to explain medical miracles but I am deeply thankful–for the sake of those who care–that one happened to me.

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priscilla pictureAn award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

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 Bob Aronson  has worked as a broadcast journalist, Minnesota Governor’s Communications Director and for 25 years led his own company as an international communication consultant GIF shot bob by TVspecializing in health care.

In  2007 he had a heart transplant at the Mayo Clinic in Jacksonville, Florida.  He is the Bob of Bob’s Newheart and the author of most of the nearly 250 posts on this site.  He is also the founder of Facebook’s nearly 4,000 member Organ Transplant Initiative (OTI) support group.

You may comment in the space provided or email your thoughts to him at bob@baronson.org.  And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Bob Aronson

statue of libertyOver the years this blog has offered a lot of information on how to take care of your organs.  We believe strongly that the way to solve the shortage of transplantable organs is to 1) encourage donation and 2) do everything possible to reduce the demand.  That means we must continually be on guard  to prevent threats to our health and we depend on public health officials and the news media to provide us with that information.  Ebola is the latest threat and it’s a dandy. It can destroy all of your organs — all of them.

After watching the Ebola story develop in the past few weeks I came to the conclusion that we are getting mixed messages from a number of sources and the mass media doesn’t do a very good job of filtering them, they just hop,  skip and jump from one new development to another with little effort given to finding and tying loose ends.

To date most of the regular TV news stories on the Dallas, Texas Ebola incident lack detail and as a result serve no purpose but to inflame, confuse and cause panic.  Print stories have been better but it has been hard to find many really comprehensive reports.   That’s probably because Ebola is a moving target.  Just as I was about to publish this blog, there were two new developments.

The first new development is that one of the health care workers at the Dallas hospital where the first Ebola patient died, has tested positive for the Ebola Virus.  This is a breaking news story so it won’t be covered in detail here.  The second development today is from President Obama’s National Security advisor Susan Rice who is expressing some dismay at the sorry state of the world response to the Ebola Threat. She is not so subtly sounding the alarm and calling for “All hands on Deck.”

With the exception of some investigative or in-depth network reports, TV news channels have been saying pretty much the same thing.  As the story goes, a man who had recently traveled from Liberia in West Africa to Dallas, Texas checked into an emergency room at Presbyterian hospital there with a temperature of 103 degrees.  He was treated for a stomach virus and sent home.  That’s pretty much what most people know about the Dallas situation and the Ebola virus.  The story, though, is grossly incomplete.  That is not to say the hospital in question should be exonerated of any responsibility, they should not, but nothing is ever as simple as it sounds.

It is important first, to understand what we are dealing with.  Ebola hemorrhagic fever (EHF), caused by the Ebola virus, is a severe viral hemorrhagic disease characterized by initial fever and malaise followed by gastrointestinal symptoms, bleeding, shock, and multi-organ system failure. Over 25 different viruses cause viral hemorrhagic fever. Ebola virus is a member of the virus family Filoviridae, along with Marburg virus.

EHF is difficult to distinguish from a host of other febrile illnesses, at least early in the course of disease. Other viral hemorrhagic fevers need to be excluded, especially Marburg hemorrhagic fever, as well as malaria and typhoid fever.

Patients should be isolated and viral hemorrhagic fever precautions (face shields, surgical masks, double gloves, surgical gowns, and aprons) should be used to prevent transmission. As there is presently no antiviral drug available for EHF, treatment is supportive, following the guidelines for treatment of severe septicemia. Persons who had unprotected contact with someone with EHF should be monitored.  Case fatality rates vary consistently with the specific infecting virus, ranging from zero to over 80%.

I spent 25 years of my life as a communication consultant and specialized in working with health care organizations like infection controlclinics, hospitals, research centers, pharmaceutical companies, research labs and more.  I know how important infection/contagion control is in these facilities and how much time, effort and money is spent on programs to ensure patient safety.  That’s why what happened in Dallas with the Ebola patient stands out.  Numerous studies make it very clear that in the great majority of cases in which patient safety is at risk communication is the culprit.

While Ebola may sometimes be difficult to diagnose, every hospital and clinic in this country has check lists on contagious diseases and infections.  They do regular drills, have training sessions and should be well prepared for any eventuality.  What happened in Dallas shouldn’t have happened, but it did.  Now what?

Dr. Anthony FauciDr. Anthony Fauci from the National Institutes of Health (NIH) an acknowledged expert on infectious diseases says that while he understands our fears we also need to understand that what is happening in West Africa is because of the weaknesses in their health system.  “West Africa,” he says, “Is not the United States, we won’t have an outbreak. Scientists know how to stop the virus from spreading.”

While I hope he is right, I wish Dr. Fauci had not said that.  Knowing how to do something and actually accomplishing it may be worlds apart.  This isn’t just about the medical profession knowing what to do, it is about all of us knowing what to do and when — and then communicating properly and following the plan.  Nothing, Dr. Fauci, is as easy as it seems. and your overly simplistic assurances could be harmful, lulling us into a false sense of security. I’ll explain more shortly.

An ABC News report tells a story that differs from Dr. Fauci’s view.   The Network account quoted Dr. Ryan Stanton, an emergency room physician in Lexington, Kentucky, and spokesman for the American College of Emergency Physicians as saying, “We’re all a little bit on edge because we’ve never seen it before.  Stuff we’ve seen before, like heart attack and stroke, we recognize as soon as we walk in the door. For Ebola, it’s not going to come as naturally.  It’s not even a needle in a haystack,” he went on. “It’s a needle in a hayfield we’re trying to find.”  That statement kind of casts some doubt on Dr. Fauci’s position.  Add the Susan Rice comments to the mix and Dr. Fauci is sounding far too positive.  If after reading this far you think, “There’s more to the Ebola outbreak than meets the eye,” you’d be right.  There is.

The question on everyone’s mind is, “How could the ER people in Dallas have missed this case?  Well, they did not miss it, it kind of missed them.  Dallas presbyterian We have it on good authority that the Dallas ER nurse properly accounted for the feverish patient’s recent travel in Africa, but that information did not get communicated to the rest of the team. Instead, the patient was treated with antibiotics for a presumed run-of-the-mill stomach virus. So it appears that while the checklist was completed poor team communication prevented its proper execution.

It is entirely possible that the Nurse’ proper reaction was ignored for any number of reasons. 1) It came from a nurse, not a doctor (yes, there is institutional, professional arrogance) 2. The team was busy, tired and careless and chose to ignore the Nurse’ efforts and 3) the Nurse did not communicate with the right people and the communication was unclear, unreadable or could not be heard. I suspect that there might be a dozen more reasons or excuses as well.

I am not qualified to argue medical facts with Dr. Fauci — I don’t even want to and the reason is simple, he is right.  What he said is absolutely correct.  The medical profession does know how to stop Ebola.  What they don’t do very well,  is communicate what they know to those of us who don’t.

After 25  years of working as a communications coach and consultant to the medical profession I can tell you that communication is not one of their strong suits.  I have great respect for physicians and loved working with them but their ability to speak in understandable and memorable terms is not a well developed skill.  Think about your interactions with your doctors and how many times you leave his or her office saying, “I don’t think my questions got answered,” or, “What did he mean when he said,….”

But, let’s go back to the Dallas case.  I do not doubt that the Dallas medical team knew how to deal with Ebola.  The question that is at the core of the issue, though is, “How effective was the communication they used to put the systems in place to accomplish that end?  It is not their medical expertise I doubt, it is their ability to communicate what they know and suspect in an effective and understandable manner.   And — if the patient safety record in American health care institutions is any indication of that prowess then we are in a heap of trouble. This is where the Fauci assurances fall flat.  A 2013 story in Forbes Magazine said: http://www.forbes.com/sites/leahbinder/2013/09/23/stunning-news-on-preventable-deaths-in-hospitals/

Forbes logo“In 1999, Americans learned that 98,000 people were dying every year from preventable errors in hospitals. That came from a widely touted analysis by the Institute of Medicine (IOM) called To Err Is Human. This was the “Silent Spring” of the health care world, grabbing headlines for revealing a serious and deadly problem that required policy and action.

As it turns out, those were the good old days.

According to a new study just out from the prestigious Journal of Patient Safety, four times as many people die from preventable medical errors than we thought.  That could be as many as 440,000 deaths a year.

With these latest revelations, medical errors now claim the spot as the third leading cause of death in the United States, dwarfing auto accidents, diabetes and everything else besides Cancer and heart disease.

These people are not dying from the illnesses that caused them to seek hospital care in the first place. They are dying from mishaps that hospitals could have prevented. What do these errors look like? The sponge left inside the surgical patient, prompting weeks of mysterious, agonizing abdominal pain before the infection overcomes bodily functions. The medication injected into a baby’s IV at a dose calculated for a 200 pound man. The excruciating infection from contaminated equipment used at the bedside. Sadly, over a thousand people a day are dying from these kinds of mistakes.

If you aren’t alarmed enough that our country is burying a population the size of Oakland every year, try this: you are paying for it. Hospitals shift the extra cost of errors onto the patient, the taxpayer and/or the business that buys health benefits for the infected patient. My nonprofit, which provides a calculator of the hidden surcharge Americans pay for hospital errors, finds most companies are paying millions or even billions of extra dollars for the cost of harming their employees.

No Cure,  No Vaccine Because There’s No Money In It

A recurring question in the case of Ebola or diseases like it is, “Why don’t we have a vaccine or a cure?”  Part of the answer to that orphan diseasesquestion is that diseases like Ebola and Marburg fall into the “Orphan disease” category. These are very rare diseases.  The rarity of the diseases provides little incentive for private industry to invest in research and development because the cost per prescription or treatment per patient would be so high few could afford them.  There is some government assistance for research but nowhere near enough.

The Orphan Drug Act of 1983 http://tinyurl.com/3vkffup provides incentives for drug companies to develop treatments for rare diseases. Since the Act was signed into federal law, the U.S. Food and Drug Administration (FDA) has approved more than 200 treatments for rare diseases.

While that number sounds good it is small when put in perspective because there are about 7,000 orphan diseases and some are quite familiar like:

  • Cystic fibrosis, which affects the respiratory and digestive systems.
  • Huntington disease which affects the brain and nervous system.
  • Single genes are also responsible for some rare, inherited types of Examples of these are the BRCA1 and BRCA2 genes, in which certain mutations increase the risk for hereditary breast and ovarian cancers, and the FAP gene, in which mutations increase the risk for hereditary colon cancer.

You can find more information here http://rarediseases.info.nih.gov/about-ordr/pages/31/frequently-asked-questions

As noted the Orphan Drug Act is why there is any activity around Orphan diseases, but it is nowhere near enough because there are so many of them.

Thanks to marketing campaigns aimed at people exposed to asbestos we are all likely familiar with the disease called mesothelioma — perhaps the best-known orphan disease in the nation.

About 3,000 patients are diagnosed with mesothelioma each year, placing it well within the U.S. definition of a rare or orphan disease as one that affects no more than 200,000 patients at a given time.  To further complicate matters there are several different forms of the disease so what might work to control one, likely wouldn’t for another. Patients with mesothelioma live for 1 to 2 years past their diagnosis.
mesothelioma“One of the difficult aspects of mesothelioma is that it often not diagnosed until it is in the later stages, and it is a very aggressive cancer,” says Joe Belluck, a New York mesothelioma lawyer.

The disease is difficult to detect since symptoms come after asbestos fibers have invaded organ linings and often mimic that of a bad cold or virus. It also surfaces decades after exposure to asbestos, so it has historically affected an older population with age-related health

It is a very deadly form of cancer and one that falls into the “Orphan” category. Mesothelioma is listed as an orphan disease on registries like rarediseases.org maintained by the National Organization for Rare Diseases (NORD).

Because it affects fewer than 200,000 people at a given time (due to its high mortality rate), treatments specifically for mesothelioma are eligible for orphan drug funding from the Food and Drug Administration (FDA). Under the Orphan Drug Act, companies involved in developing and testing drugs, biologics, and other treatments specifically to treat rare diseases can get tax credits and other incentives to continue development them including:

  • 7 years of exclusive marketing for the drug
  • Tax credits to cover half the cost of clinical investigations
  • Waiving user fees

As you can see, there is far more to the Ebola story than meets the eye.  It is a complex issue because Ebola is an Orphan disease that attacks in a multitude of ways and is not always easy to identify.  So what can you do?  Be informed. Don’t wait for information, seek it out, you might save your life and the lives of people you love.  Below are some essential facts, but click on the links, too.

Here are some fast facts on Ebola from CNN:  http://tinyurl.com/npqfzt2

CNN Eb0la Fact Sheet

Ebola hemorrhagic fever is a disease caused by one of five different Ebola viruses. Four of the strains can cause severe illness inCNN humans and animals. The fifth, Reston virus, has caused illness in some animals, but not in humans.

The first human outbreaks occurred in 1976, one in northern Zaire (now Democratic Republic of the Congo) in Central Africa: and the other, in southern Sudan (now South Sudan). The virus is named after the Ebola River, where the virus was first recognized in 1976,according to the Centers for Disease Control and Prevention.

Ebola is extremely infectious but not extremely contagious. It is infectious, because an infinitesimally small amount can cause illness. Laboratory experiments on nonhuman primates suggest that even a single virus may be enough to trigger a fatal infection.

Instead, Ebola could be considered moderately contagious, because the virus is not transmitted through the air, well at least not much.  A sneeze could spread it if the droplets  from an infected person come in contact with someone who is not, but that’s a very short distance.  In the most contagious diseases, such as measles or influenza, virus particles are airborne for longer distances and much more time.

Humans can be infected by other humans if they come in contact with body fluids from an infected person or contaminated objects from infected persons. Humans can also be exposed to the virus, for example, by butchering infected animals.

While the exact reservoir of Ebola viruses is still unknown, researchers believe the most likely natural hosts are fruit bats.

Symptoms of Ebola typically include: weakness, fever, aches, diarrhea, vomiting and stomach pain. Additional experiences include rash, red eyes, chest pain, throat soreness, difficulty breathing or swallowing and bleeding (including internal).

Typically, symptoms appear 8-10 days after exposure to the virus, but the incubation period can span two to 21 days.

Unprotected health care workers are susceptible to infection because of their close contact with patients during treatment.

Ebola is not transmissible if someone is asymptomatic or once someone has recovered from it. However, the virus has been found in semen for up to three months.

Deadly human Ebola outbreaks have been confirmed in the following countries: Democratic Republic of the Congo (DRC), Gabon, South Sudan, Ivory Coast, Uganda, Republic of the Congo (ROC), Guinea and Liberia.

According to the World Health Organization, “there is no specific treatment or vaccine,” and the fatality rate can be up to 90%. Patients are given supportive care, which includes providing fluids and electrolytes and food.

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I  hope this report helped to clarify the Ebola issue. If you have comments make them in the space provided or contact me directly at bob@baronson.org.bob cropped smaller

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


optimism cartoonIntroduction by Bob Aronson

Post  by Dawn Anita Plumlee

This post is one of several in the “Inspirational” category.  It is about hope, it is also a love story  and it’s about the pot of gold at the end of a rainbow.  Best of all, it is true, every word of it.  I can vouch for its veracity because I know the author very well.

Bob’s Newheart blogs was launched over seven years ago to help support and motivate critically ill people, their families, caregivers and friends. Many if not most of our posts speak directly to medical and health issues. A good many focus on organ donation/transplantation issues because my 2007 heart transplant is what motivated me to start writing this blog. Today’s entry, while not about medical issues or transplants in particular is true to our original intent because it deals with motivation and inspiration. 

Dawn Anita (Diffie) Plumlee is my wife Robin’s (Diffie) cousin. She is a remarkable woman with a “Can do,” upbeat attitude. Dawn Anita and her husband Jerry are special people. They have overcome incredible odds to get where they are today. Many who might experience setbacks or reversals in life are bitter and resentful. Not so with these two. I know them well and we talk often. They endured incredible life hardships but viewed them as learning experiences and never looked back other than to use their knowledge to help others.

Bob’s Newheart gets a lot of requests for “inspirational posts,” for blogs that give hope to those who feel they have none. I often get notes from people who feel hope is lost, that they cannot recover from whatever hardships have befallen them. I know  about Dawn Anita’s journey, having heard some of it from her and the rest from reading her Amazon book, “One More Last Chance,” and cannot think of a story more likely to inspire and to give hope.  It is in that spirit that we present it today.  

I should point out that she did not write this posting to sell books. That’s not Dawn Anita. Rather, she wrote it because I asked her to submit part of her story so I could include it in the “Inspirational” category of my blogs. While Dawn Anita would not use this forum to promote her book, I can. It’s a darn good read. If you like what you read here you can get more under the same title at Amazon.com.

One more note. Dawn Anita’s sister is Priscilla Diffie-Couch, another of our guest bloggers here on Bob’s Newheart.

By: Dawn Anita Plumlee

If we live long enough, all of us will face hardship in our lives, i.e. finances, death of a loved one, illness. It is up to us to decide how we handle life’s challenges. As I see it, there are two choices. Give up or have the grit and determination it takes to tackle life’s dilemmas. There is always a way if you choose to seek one more last chance. I came to this realization while writing my memoirs which bear the same title. Reaching back into my past was definitely a challenge and not one I was sure I could achieve. Recalling events in my life led me to a better understanding of myself and the way I handled adversity and the many second chances I had.

Dawn Anita and Jerry, the beginning.

Dawn Anita and Jerry, the beginning.

I was a naïve 16-year old country girl from Oklahoma when I decided to run away to marry my sweetheart Jerry Plumlee.

I met my first challenge on the 5-day bus trip from Oklahoma to Seattle when I divulged my story about running away to a young military man who punches masher b and wboarded the bus late one night. He saw what he thought was an opportunity to take advantage of a young, innocent country girl, only to be met with a right hook to the jaw which landed him in the aisle of the bus.

That incident, along with the very charming man with a smooth easy way of talking who convinced me that he had my best interests at heart when he asked me to come to his apartment in LA during an eight-hour layover, didn’t deter my faith in people. I could have chosen to give up and terminate my journey, but I still held on to the hope that life would be rosy once I reached my destination.

scorpionLearning to survive in a mouse infested, run-down shack with stinging scorpions so thick that several were trapped in our bathtub and in the glasses and bowls each morning with wasps swarming the house all day and copper heads under the front porch was indeed a challenge. We survived on 50 cent watermelons for several days because the $80.00 my husband earned didn’t stretch to the end of the month. The real revelation is that when I remember this time in our lives, I remember it as a great experience, and I realize that these events helped us become better equipped to face other dilemmas in life. The ironic thing is, you can survive one dilemma only to find yourself entrapped in another one just as bad or worse.

Traveling from Oklahoma to Idaho in an old pickup that rocked and rolled down the road pulling pickup and horse traileran enclosed U-haul  trailer with 3 horses inside and trying to calm a two-week old baby was definitely an adventure I will never forget. Having to overcome the fear of an empty gas tank in the middle of nowhere in Wyoming, knowing you have no milk for your baby was indeed a challenge, unaware at the time that this was merely one mishap in a long line of difficulties on the same trip. A flat tire with no spare, having to unload a horse to take the tire to be repaired, not knowing how far it may be and later to have the u-joint on the pickup break in the middle of a treacherous road on a dark and dreary night definitely can test ones character

Relieved that our resourceful brother-in-law came to our rescue and repaired the u-joint, we could not know that just a short time later, we would literally “run into” another dilemma; our brother-in-law hit a cow and smashed in the radiator on the truck. Still, we were not defeated. Our brother-in-law pulled our pickup, horse trailer, horses and all with his car over 100 miles to our destination. This was an unbelievable feat in itself. Arriving at our destination In Idaho, we did not find the paradise we were hoping for. Turmoil filled the household with too many families living under one roof.

parkMoving out in the middle of the night, we found ourselves stranded in a park in Coeur d-Alene with no money, food or shelter. Leaving me alone in the park with our baby, Jerry assured me that he could enroll in college, get a student loan and find a place for us to live. As I watched Jerry leave, an empty feeling washed over me. My baby is hungry; I have no milk for him and no money to buy any. Then suddenly a thought struck me; Ipop bottles can trade the empty pop bottles lying around in the park for some milk for my baby. I walked into a little store nearby with my baby and the empty bottles in hand, and with a touching display of generosity, the clerk gave me some milk for the bottles.

Thankful but still distraught, it seemed an eternity before Jerry returned and he had indeed accomplished his mission. He enrolled in college, obtained a $200.00 loan and found a place to live where we could keep our horses. Once again, perseverance and determination paid off. Life was good in Idaho with a few bumps along the way. I had a beautiful baby girl, Jerry was in college and I went to work for a flower shop, but Oklahoma was calling us.

It was a struggle when we moved back to Oklahoma, but we eventually found our way. Jerry went to work on the ranch where my dad was the foreman. I went to work for an attorney, and although I dawn anita, the early daysloved my job, I had an ever-burning desire to become a country singer. I joined a local band and sang almost every weekend. Many opportunities presented themselves in the music business. I let several chances slip away which would have no doubt led to fame, the most significant of which was a contract with RCA Records. I wanted it so badly, but I couldn’t bear to leave my children and go on tour. I felt sure I could achieve my goal in music when the kids graduated. Little did I know that when we finally took the leap of faith and moved to Nashville, that Music City welcomes a 40-year-old female with a closed mind and a cold heart. I did have several regional hits, won several awards for my singing and songwriting, including “Female Vocalist of the Year” and “Entertainer of the Year” at the Oklahoma Opry, but it seemed that my vision of becoming a country music star would be an elusive dream.

The years passed quickly; our lives were full with our jobs, family and music. Little did we know that life as we knew it was about to come to an end. The company who owned the ranch where Jerry had worked for ten years and Dad had worked for over twenty changed management and fired Dad and Jerry. We had to move out in thirty days. Shattered, we didn’t know how we would survive; where would we live, where would Jerry work. It was so sudden. This upset in our lives was devastating, but it could not begin to compare with the tragedy that would soon tear our lives apart. My mother was killed in a car wreck. Such a waste, a horrible, tragic loss. Mom was only 55. She was our strength; how could we go on without her? We were not prepared to handle a trauma of this magnitude.

Mom and Dad had a rare and beautiful relationship like no other.

Dawn Anita's Mom and Dad

Dawn Anita’s Mom and Dad

He needed comfort, someone to lean on, and I was that person. Somehow I pulled myself together because I knew Dad needed me now more than ever. It was difficult for him to cope, and the everyday struggles of life without Mom were insurmountable. At times his actions were not those of the dad I had always known. A neighbor called one morning to report that Dad had spent the night in the pasture in a cow trough. I completely understood when he told me that sometimes he just couldn’t face that empty house. Dad eventually learned how to cope and make the pieces in life fit once again. Evidence that with just a little help and a strong will, you can recover and overcome the toughest of times.

oil gusherOur life definitely took a sudden turn when Jerry went into the oil business and we decided to move to Dallas. Our world quickly crumbled around us when the oil business went south. We were sitting in a house that didn’t belong to us, obligated for furniture we didn’t need with a responsibility to pay a year’s lease on an office and office furniture. The most devastating part was not our loss, but Dad’s. He had invested a sizeable sum of money in the business and we had no way to recover his money.

We returned to our little ranch house in Oklahoma with sad hearts and empty pocketbooks only to discover that all of our worldly possessions had been stolen. Times like these can definitely test ones spirit. Desperate times call for desperate measures, so we decided Dawn Anita and Jerryto saddle our horses and embark on a journey from Oklahoma to Nashville with only a few dollars, a lot of guts, my old guitar and some cassette tapes with my music. Our goal was to make it to Nashville in time for me to sing at FanFair. We were definitely a sight to behold with all of the gear loaded onto our horses… saddles, saddle-bags, bed rolls, nose bags, horse feed, camping supplies, canteens and slickers. We could not begin to fathom what an adventure we were about to undertake. Our journey took 24 days and it rained 22 days. We had many close calls…a lightning storm, Jerry’s horse jumping out in traffic, close calls on slick bridges, but the memories of the wonderful friends we made along the way helped us forget the saddle sores, the danger and the aching bones.

Total strangers opened their hearts, their homes and their pocketbooks to help us on our journey. The healing rain during that long ride from the state we have always known as home to the city of country music had washed our spirits clean. I knew that there might never be one more last chance for fame and fortune in the tenuous trouble-strewn world of music, but I was certain there would be one more last chance for us to feel whole again.

It has now been 56 years since I first boarded that bus in Tulsa, Oklahoma, as a naïve 16-year old country girl and 22 years since our horseback ride from Oklahoma to Nashville. It seems so long ago, and yet time has passed so quickly. There have been many twists and turns in the road on our journey up the hill, but we have persevered. We have 2 gorgeous children, 7 grandchildren and 4 great-grandchildren. Life is beautiful, but the road hasn’t always been smooth. I lost my dad and many other close friends and relatives.

We’ve had to overcome sickness and have had many personal struggles, but through it all, we have Dawn anita singingbelieved and held onto the hope that all will turn out well. As we stroll hand in hand down the other side of the hill, we feel confident that whatever happens, we will remain strong and resilient to the end.”

Another note from Bob Aronson

Dawn Anita’ s story is inspirational because of her spirit.  She just refuses to lose faith and to give in to adversity.  While she may  not have become a huge country music star that’s Nashville’s loss.  Go to her website http://www.freecountryrecords.com/ watch and listen to her perform and you’ll agree.  She is the consummate performer, when she takes the stage and begins to sing, audiences are captivated.  I am proud to call her “Cousin” and friend.  Thank you Dawn Anita and Jerry, you are wonderful examples of the American Spirit.

bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.


By Dr. Priscilla Diffie-Couch

A while back, family member Priscilla Diffie-Couch who holds a doctorate in communication, penned a blog for Bob’s Newheart titled, “How do You Apologize and Why Should You?”  (http://bobsnewheart.wordpress.com/2014/08/18/how-do-you-apologize-and-why-should-you/) It became very popular but in its popularity generated a multitude of questions.  Dr. Diffie-Couch, who is never comfortable with loose ends provided some very thoughtful and effective answers.  Please feel free to share them and the original blog with anyone you choose.

In forwarding her response draft she said, “I am pleased that so many of you read my blog on effective apologies.  Several of your comments and questions have prompted some points of clarity.”

QUESTION

I have repeated my apology so many different times that my friends now treat it as though it is not sincere.sincerity

If you find yourself repeating the same apology for the same offense to the same people, you must question whether you have ever included all of the five dimensions of an effective apology:

 

  1. RECOGNITION
  2. RESPONSIBILITY
  3. REMORSE
  4. RESTITUTION
  5. REPETITION

At the very minimum, you are evidently repeating the offensive behavior that caused the original distress.  People grow tired of hearing repeated promises when a change in your behavior is what they really expect from you.

QUESTION

I try to explain my offensive behavior very carefully before I actually say the words “I’m sorry” when I apologize.  Is that the best approach?sorry puppy

 

No.  You run two risks with this approach.  (1) You will add to the anger and hurt of those you have offended, the longer you put off saying the two words they want to hear:  “I’m sorry.”  (2) You will waste your lengthy explanation because the listener or reader will be so focused on hearing or seeing those two magic words that they will miss much of the rest of your message.

QUESTION

What is the best way to end an apology so that it doesn’t drag on endlessly?Get two the point

Start by saying you are sorry.  Determine what the hurt party expects.  Make sure you come to a mutual understanding of the exact nature of the offense.  Work to include the five dimensions.  Is it something you said or didn’t say?  Did or didn’t do?  Then end by saying exactly what you intend to do to avoid repeating the offense.

QUESTION

How soon do I have to apologize?     timimg            

Apologize without delay.  Undue delay adds to the offended person’s distress and allows for compounding the problem and even encourages imagined transgressions that never occurred.  Allow yourself enough time to pull your thoughts together and assess the nature of your offensive words or behavior.  It never hurts to take great pains in how you plan to phrase an apology.

 QUESTION

Is it better to apologize in person or in writing?  Can I do so on the phone?

Faceo to faceYou would think apologies should be done in person.  But that is not always the best or most practical approach.
You can express a simple “I’m sorry” immediately through any medium.  But you need to let the party know you plan to follow up with specifics.  Even when it is practical to apologize in person, a carefully-thought-out written apology can smooth the way for a more comfortable and satisfying personal interaction.  Put yourself in the reader’s place.  Reread your apology many times with a careful eye as to the “tone” of the words you have chosen.

As a person who wears top-of-the-line hearing aids, I can tell you that apologizing on the phone is fraught with potential perils.

QUESTION

Isn’t it better to keep my apology very general so that I can avoid getting into the same issues that caused the hurt feelings?say what you mean

Absolutely not.  In fact, the offended party will be looking for a direct reference to the exact hurtful deed or word and will wonder if you really understand why you are giving an apology if you fail to recognize the specific nature of your offense.  It is pointless to promise to make obscure and general behavior changes when it is a particular offense that caused the hurt.  Until you address the matters of contention fully, the offended person is unlikely to view your apology as satisfying or sincere.

QUESTION

Regardless of how explicitly I apologize for my offense, the wounded party keeps bringing up some other offense I’ve committed in the same altercation?  Isn’t enough enough?gunny sack

Unfortunately, it is all too common for people to “gunny sack” a lot of old grievances and then to dump them all at once in a given confrontation.  Ask yourself if you recognize your guilt in each separate issue the offended party raises.  If you do, you are obligated to make amends for each issue as a separate matter.  In healthy relationships, people avoid “gunny sacking.”  Every disagreement should be dealt with independently without delay.

QUESTION

Shouldn’t I just keep my apology very simple if that is my style?

That depends on your goal.  If you seek only satisfy your own personal standards with your apology, mistakesyou can choose what to include and hope for the best.  However, if your goal is to repair and restore a damaged relationship, then you should heed the approach that works most successfully in a larger world.

QUESTION

Wouldn’t it be better in some cases just to skip the apology, let things go, and growthmove on with your life?
That is what many people do who are left wondering why they have so much trouble maintaining close, trusting relationships.  Those same people excuse offending behavior by saying, “That’s just the way I am.”  If you are one, ask yourself, “When did the death of my growth occur”?  At age three?  Thirty-three?  Sixty-three?

CONCLUSION

Unresolved issues left to smolder can burst into flames in sudden and devastating ways. firey image

Valued relationships must be nurtured.  That demands taking responsibility for any role you may play in eroding a relationship.  responsibilityAs human beings, we will find ourselves guilty more than once of causing temporary distress in other people’s lives.  Learning how to repair the damage that distress can cause necessarily involves utilizing effective apologies.  That is a part of actively becoming a better person.  That kind of growth is possible and desirable as long as we live.

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Apriscilla picturen award winning high school speech and English teacher, Priscilla Diffie-Couch went on to get her ED.D. from Oklahoma State University, where she taught speech followed by two years with the faculty of communication at the University of Tulsa.  In her consulting business later in Dallas, she designed and conducted seminars in organizational and group communication.

An avid tennis player, she has spent the last twenty years researching and reporting on health for family and friends.  She has two children, four grandchildren and lives with her husband Mickey in The Woodlands, Texas.

Bob informal 3Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 


By Bob Aronson

Almost everyone is familiar with the commercials and ads that offer relief for men suffering from “Low T.”   Most interpret that to mean “diminished sex drive” and there is no end to the number of claims of treatments and/or cures.  Bottom line?  They are selling sex.  The manufacturers   of “Low T” products, physicians, clinics and therapists are pandering to the male fear of erectile dysfunction and there’s absolutely no guarantee that any of the products will work.  Worse yet, they could kill you.

The ads produced by those who are promoting Testosterone therapy amount to fear mongering at itskeep it up ad...
worst.  Nothing will destroy a man’s ego faster than an inability to perform in bed and many will go to any extreme to make sure that doesn’t happen.  If you could drill deeply into the male ego you likely would find that the ability to get and hold an erection is extremely important and when that ability is lost even once, many men will feel as though they have lost their manhood and that their life is over. The ads posted here are real.

low T sexual image ad

 

low t ad

 

 

The “Low T” condition should not be taken lightly, if in fact that is an accurate diagnosis.  Unfortunately the number of physicians and others who offer that diagnosis is far greater than the number who are qualified to do so or who even perform a thorough examination

In 2013, 2.3 million men received a prescription for testosterone, up from 1.3 million in 2010, according to the U.S. Food and Drug Administration (FDA).  About 70 percent of men prescribed testosterone drugs were between the ages of 40 and 64.

According to an FDA analysis, 21 percent of patients prescribed testosterone drugs did not appear to have had their testosterone concentrations tested before or during treatment, something the agency described as “concerning.”

Ofda logo 2n Tuesday, September 17, 2014 an FDA advisory panel said that Testosterone replacement therapies should be “Reserved for men with specific medical conditions that impair function of the testicles.”  While the FDA is not obligated to follow advisory panel advice, it typically does.  The panel also recommended that companies be required to conduct additional studies to assess the cardiovascular risk of their products for patients with age-related low testosterone.

Symptoms of low testosterone include loss of libido, decreased muscle mass, fatigue and depression.

The panel voted 20-1 in favor of restricting the drugs’ authorization to people with medically related low testosterone, such as a tumor or genetic disorder.

If the FDA acts on the recommendation companies could not market or promote their products for age-related low testosterone, but physicians would still have the right to prescribe products “off label” in any way they choose.  An important lesson for consumers is that just because a physician prescribes it, doesn’t mean it’s right for you.

What is Testosterone?

The Mayo Clinic says this: Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men’s:

  • Bone density
  • Fat distribution
  • Muscle strength and mass
  • Red blood cell production
  • Sex drive
  • Sperm production

Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.

What are the Risks of Testosterone Therapy?

Also according to the Mayo Clinic http://www.mayoclinic.org/healthy-living/sexual-health/in-depth/testosterone-therapy/art-20045728?pg=2

Testosterone therapy has various risks. For example, testosterone therapy may:

  • Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts
  • Increase your risk of a heart attack
  • Cause acne or other skin reactions
  • Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer
  • Enlarge breasts
  • Limit sperm production or cause testicle shrinkage
  • Increase the risk of a blood clot forming in a deep vein (deep vein thrombosis), which could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism)

The American Recall Center  http://www.recallcenter.com is a consumer oriented groupAmerican recall center logo with the following vision.  “At the American Recall Center, we aim to give pertinent information on FDA warnings for prescription drugs and medical devices. Through our extensive library of recalls and medical information, and our experienced editorial team, it is our mission to empower those who have been adversely affected.”  In other words, they monitor the health care environment and provide accurate and timely information about drugs, procedures, devices and practices that affect individual Americans.

Recently I was contacted by The American Recall Center http://www.recallcenter.com and alerted to their concerns about Testosterone Therapy and the various actions being taken with regard to the practice.  I looked carefully at what they had to say and also conducted my own brief investigation that resulted in verification of their claims.  What follows is a direct copy from their website.  It is alarming and should be taken very seriously by anyone either undergoing such therapy or considering it.

lawsuit imageTESTOSTERONE LAWSUIT

http://www.recallcenter.com/featured-topics/testosterone-replacement-therapy/testosterone-recall/

The treatment of low testosterone (also known as hypogonadism or Low-T) in men has increased significantly since the year 2000. However, with the growth of such testosterone replacement therapy, there has also been an increase in the number of studies that have shown a link to various medical problems, such as the increased risk of heart attacks, strokes and other potentially deadly outcomes. As a result, the FDA has issued several statements on the use of testosterone therapy, and a number of lawsuits have been filed claiming that treatments to combat low testosterone have resulted in harm to the patient or even fatalities.

FDA Investigation and Testosterone Replacement Therapy

Although the FDA has not issued any recalls of testosterone due to the possibly dangerous nature of various treatments, early in 2014 the agency published an alert stating that it was going to begin investigating the potentially adverse outcomes of testosterone supplements. Specifically, the FDA denied any conclusions related to increased probability of heart attacks, strokes or death in men undergoing testosterone replacement therapy. However, the agency said that would analyze data from multiple studies and monitor side effects of testosterone treatments as reported through its MedWatch program. The FDA also advised patients and physicians to understand both the risks and the benefits of drugs and supplements before beginning any treatment.1

In June 2014, the FDA announced that it manufacturers of testosterone would be required to add a warning label to their products indicating the possible formation of blood clots in patients’ veins. The agency stressed that this requirement was unrelated to the separate investigation into the other health problems that may be associated with testosterone use.2

Testosterone Lawsuits and Multidistrict Litigation

As a result of the potentially dangerous consequences of taking various low-testosterone treatments — which are available as topical gels, transdermal patches, buccal systems, subcutaneous pellets and injections — a significant number of lawsuits have been filed against manufacturers of testosterone products.

Because of the large number of cases related to testosterone products, and the even larger number of potential future case that could expand into the thousands, the United States Judicial Panel on Multidistrict Litigation has created MDL No. 2545 to handle actions related to testosterone products. In the original order, the panel noted its hesitancy to encompass an entire industry with a broad range of products under a single MDL. However, the panel members acknowledged that even among different products and across competing companies, many of the claims associated with the testosterone cases have common discovery, and thus are suitable for MDL status.

At the time of the original order on June 6, 2014, forty-five cases across four districts were pending. Since then, additional cases have been added.4

Testosterone Manufacturers Facing Lawsuits

The following table lists companies that have faced lawsuits related to their testosterone treatments, along with the names of some commonly known testosterone products they have developed. Other companies also may have faced litigation for their testosterone products.

COMPANY TESTOSTERONE PRODUCT(S)
AbbVie Inc./Abbott Laboratories Inc. AndroGel
Eli Lilly and Co./Lilly USA LLC Axiron
Endo Pharmaceuticals Aveed, Delatestryl, Fortesta
Actavis, Inc. ANDA, LibiGel, Testosterone Enanthate Injection USP, Testosterone Cypionate Injection USP, AndroDerm
Auxilium Pharmaceuticals, Inc. Testim, Testosterone Gel CIII, Testopel, Striant
Pfizer, Inc./Pharmacia & Upjohn Co. Depo-Testosteroneh, Depo-Testadiol

Alternatives?

According to Healthline (http://www.healthline.com/health/low-testosterone/natural-boosters#1),  there are some alternatives to Testosterone Therapy and while there’s no guarantee they will work, there is no guarantee the therapy will work either and these alternatives, unlike the therapy, won’t hurt you.

Additionally, following these suggestions can help your general health as well as low testosterone production.  Try them, you have nothing to lose and a better life to gain.

  1. Get a Good Night’s Sleep

It doesn’t get more natural than a good night’s sleep. A University of Chicago study showed that lack of sleep can greatly reduce a healthy young man’s testosterone levels. That effect is clear after only one week of shortened sleep. Testosterone levels were particularly low between 2:00 and 10:00 p.m. on sleep-restricted days. Study participants also reported a decreased sense of well-being as their blood testosterone levels dropped.

How much sleep your body needs depends on many factors, but theNational Sleep Foundation suggests that adult males generally need between seven and nine hours per night.

  1. Lose That Excess Weight

It is not uncommon for overweight, middle-aged men with prediabetes to also have low testosterone levels. A 2012 study revealed that weight loss among men with prediabetes improved their testosterone levels by almost 50 percent.

These findings don’t mean you have to go on a crash diet. The healthiest way to achieve and maintain a healthy weight is through a sensible diet and regular exercise.

  1. Get Enough Zinc

Men with hypogonadism generally have zinc deficiencies. Studiessuggest that zinc plays an important part in regulating serum testosterone levels in healthy men.

According to the Office of Dietary Supplements, adult males should get 11 mg of zinc and females should get 8 mg of zinc each day. Oysters have a lot of zinc. It is also found in red meat and poultry. Other food sources include beans, nuts, crab, lobster, whole grains, and many fortified foods.

  1. Go Easy on the Sugar

Zinc isn’t enough to ensure you’re getting the all the nutrition you need. The human body is a complex system that requires a wide variety of vitamins and minerals for smooth operation.

Research published by The Endocrine Society shows that glucose (sugar) decreases testosterone levels in the blood by as much as 25 percent. This was true of study participants whether they had prediabetes, diabetes, or a normal tolerance for glucose.

  1. Get Some Good Old-Fashioned Exercise

Studies show an increase in total testosterone levels after exercising, especially after resistance training. Low testosterone levels can affect your sex drive and your mood, but the good news is that exercise improves mood and stimulates brain chemicals that help you feel happier and more confident. Exercise also boosts energy and endurance and helps you sleep better. All that can help with your sex drive and sexual performance, too. Fitness experts recommend 30 minutes of exercise every day.

Avoid Alcohol.  And…a final tip and this one is mine.  If you are concerned about your ability to perform sexually you should know that consuming alcohol will not help.  Alcohol often will present two contradictory effects.  The first effect is that it will diminish your inhibitions and therefore boost your desire for sex.  Unfortunately, the increased desire is usually met with a decreased ability to get an erection.  You get all dressed up with nowhere to go.

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bob minus Jay full shotBob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,000 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.