MESSY LIFE

Organ donation

Sadly Natasha Richardson died from a brain injury while skiing in Canada. Much has been written about helmets, brain injury and sudden death.The most positive information just released is that,family sources said that Richardson's organs were donated and that this act provided comfort for her family knowing that through this generous act ,others in need would be helped.

Many lives can be saved through donor donation. Although the decision can be difficult for families of the donor,  the gratitude from recipients and the relief it provides is immensely appreciated.

Nearly 100,000 are on the U.S. organ donor list. To dispel myths and fears about organ donation visit www.mayoclinic.com/health/organ-donation/FL00077

And for information on how you can become an organ donor www.organdonor.gov/

For related stories: www.examiner.com/x-785-Relationship-Examiner~y2009m3d18-Relationships-in-the-news-Natasha-Richardson-dies-from-head-injury

www.examiner.com/x-785-Relationship-Examiner~y2009m3d18-Relationships-in-the-newsreports-that--Natasha-Richardson-will-not-recover

www.examiner.com/x-785-Relationship-Examiner~y2009m3d17-Relationships-in-the-news-Natasha-Richardson-is-flown-to-NY-for-treatment

www.examiner.com/x-785-Relationship-Examiner~y2009m3d16-Relationships-in-the-news-Natasha-Richardson-injured-in-ski-accident

Kids & Cold Medicine

Over the counter cold medications are no longer being recommended for children under the age of four. This article in SF Chronicle outlines the new agreement between drug companies and the Food and Drug Administration.  Pediatricians have been concerned with the use of these over the counter medications in children ages two to six because there is no validity to symptom reduction and young children are at risk to adverse reactions.

This article seems to suggest that the greater concern by pediatricians is a parent's  misuse of the medications, fears of overdose, or the risk of a child taking the medication accidentally. Especially at risk are children age two to three.

Cold medication as with any medication, or potentially poisonous substance, should be safely out of reach of children. Parents need to check with their pediatrician for treatment recommendations and when to seek additional care, regardless of the latest cold symptom pitch.

Bi -Polar Children

This issue and debate is going to continue for a long time because it is complex and often difficult to discern. I have written about this before and will again as new information becomes available.

I think this article in the NY Times is an interesting look and this on-going concern of over diagnosing and medicating.  It still addresses that there are parents with children whose behavior  is so outside the realm of both experience and understanding,  that they are  faced with some very difficult decisions. Some feel grateful and others feel at the mercy of the mental health professionals for  help with finding the best course for treatment.

Vaccine Fears - Measles on the rise

No matter how many times there are studies released that state that vaccines are not the cause of Autism and that mercury is no longer being used as a preservative (just in case there is a causal link), parents are understandably concerned that vaccinating their child is going to have serious adverse effects to their child's health.

The recent ruling in favor of the Poling family on this vaccine issue further scared parents and made them fear their health provider's reassurances. The CDC and other health care professionals have long warned that the risk of not vaccinating is more harmful in the long run.

There is now a report issued by the CDC that there is an increase from 42 reported cases of measles last year to 131 this year and the year is not yet over. This CBS news report gives more information.
 There are no easy answers, but getting as much information as you can to help further discussions with your child's physician and fully understanding the risks of not vaccinating can help you protect your child from illness.

  

Menopause Tummy and Other Afflictions

I spent yesterday celebrating my girlfriend's birthday.  Our conversation these days focuses on body changes; ours and every other woman in her 50's we know. We intend to talk about other things, but the conversation invariably arrives at and stays stuck on everyones health issues. We hate to sound cranky and we swore we never would sound like those other "old people" complaining about their body parts, but there we go. The rant begins: our tummy is bigger, things are lower,we can't see or hear that well anymore, we don't want to have the colonoscopy  because so and so just got diagnosed and we are just not ready for being next, and....

It is not as if we feel we are exempt from the aging process or should be, but rather we continually find ourselves surprised by what our body is doing or refusing to do. It does not feel as if this has been gradual. It feels as though one day we tried to get up in the morning and someone substituted our body for an older less healthy model.  We clearly took our bodies for granted and now they are getting even.

Unfortunately by our age, we have now had parts of ourselves monitored, removed, or replaced. Illness and injury have become a concern and trips to the doctor seem more anxiety provoking now that we and those we love, have been treated for things.

Before I call someone, I have to stop and think what ailment I am inquiring about because I have made some mistakes in the past. No one wants to be asked about their knee when it was their torn Achilles; especially when they fear their knee is next.

Most of us understand that we are more than our afflictions, but reaching out to others and becoming  more informed can help remind us of that. 

For women going through menopause: a great site is menopausetheblog.com    Today's post has an article on Belly fat with a great accompanying tummy photo.  Another menopause site I like and have used regularly, is Dr. Susan Love. She writes about menopause and breast cancer.

 

Midlife & Memory

One day we look into the mirror and we see our mother looking back. I've always looked like my mother, so this has not been such a shock over the years. But now I find myself saying and doing the same thing I remembering her doing when she was my age and that has been...well... unsettling.

When my mom was in her 50's she use to look at me in the middle of a conversation about a TV show or a movie ( safe topics for mothers and teens back then) and she'd say, "you know the guy who was in the movie with what's her name. The one who was in the TV show about the two women who work at the factory..."

The description of the associations took longer than the point she was trying to make. She could remember the plot detail, but not the character's or actor's name. Sometimes she would run through my siblings names before landing on mine, or she would forget the name of a common thing, or even where she put that common whatchamacallit thingy doodad.

I find that most of my conversations begin  the same lately, with forgotten names of people, places, or things. Remembering facts ( like 2 + 2 =4 ) is called semantic memory and mine is slipping.

Episodic memory is our personal history. The memories that are unique to us.Who we met with yesterday, what we talked about, and what we ate for lunch. The combination of semantic (factual) with episodic (personal) is referred to as declarative memory. 

Procedural memory is what we do regularly and automatically. How to feed ourselves, tie our shoes, and so forth. So far so good on that one, although occasionally my food misses my mouth and lands on my shirt. This is of course happens only when I have on nice clothes. So, it could be more related to anxiety than memory.

As we age we begin to loose some of our semantic and episodic memories. It is not that important to our survival to remember all the details of an encounter we had at lunch yesterday, but it is important to remember what lunch is and how to eat it.

I had no idea when I was a kid why my mother could not remember what I told her. I found playing twenty questions and this new verbal charades ("you know, it's yellow and looks like a lemon...") was annoying and required talking to her more than was allowed in my teen handbook.

Now here I am, these oh so many decades, later struggling to remember where I put that file I had in my hand two seconds ago and the name of the actor who appeared in the movie about fighting ( Fight Club) and he's married to the woman with all the kids ( Angelina Jolie) and they just had twins and he was in that other movie with the guy who was in ER( George Clooney) and...

Losing our memory is a natural process and doesn't mean we have, or are going to get Alzheimer's. However, it is disconcerting to notice that things that rolled easily off our tongue, now get stuck somewhere between our brain and our throat.

There is a wonderful book by New York Times writer, Martha Weinman Lear called, "Where did I Leave My Glasses?" Brain functioning and memory are fascinating reading, but it can be very complicated without prior knowledge of the topic. Lear manages to explain how our memory works from a variety of perspectives without becoming overly technical. It is a fun read and very normalizing and comforting if you feel that you might be loosing too many of your basic brain cells.

In case you were wondering who I was referring to, two paragraphs above; the actor in Fight Club was, Brad Pitt.

The latest on sarcasm

Not that I'm  particularly interested in this topic or anything, but I've noticed that the Memory and Aging Center at UCSF  seems to be cited everywhere I turn. Of course I am in the demographic that worries about these sort of things. The center studies Alzheimer's and other forms of dementia.  

This was one of their studies recently reported in the NY Times. The study revealed what part of the brain detects the social and behavioral cues necessary to recognize sarcasm. More and more brain researchers are finding that certain cognitive tasks are not as clearly isolated to either the left and right hemispheres, as previously thought. In this case, it was not the left part of the brain that loss functioning  ( the area that recognizes language and social cues)  it was the right part of the brain ( the area responsible for assigning visual context) that did not respond.

Adults with dementia or other brain disorders have lost their ability to read social cues, or understand the subtlety of sarcasm and irony. And young children have similar difficulties because their brains have not fully developed those centers yet.  Both populations take things literally and concretely. The more we understand  overall brain development, the better we can create treatment modalities for different populations that are experiencing cognitive impairments.

The latest study on childhood obesity

I am not a statistician, nor am a I researcher. I believe in health research.However, I get concerned by methodology, sample sizes, and data collection and analysis. I wonder how useful some research is in determining appropriate treatment strategies. Researchers  want to find answers and they also need to fund programs. Research results help  get funding for future research and hopefully fund subsequent  treatment programs spearheaded by  other researchers or other health care practitioners . However, any given result can also prevent further programs or research, if  funding sources want  to declare "an issue resolved."

Much has been written over the years about the increase of childhood obesity in this country.   The NY Times just ran this article titled,  " After Steady Climb, Childhood Obesity Rates Stall."   They cited a  study that was recently published in The Journal of the American Medical Association (JAMA) that found that, "The prevalence of high BMI for age among children and adolescents showed no significant changes between 2003-2004 and 2005-2006 and no significant trends between 1999 and 2006."

BMI stands for Body Mass Index and is determined by taking a child's weight and dividing it by their height. This might be good news that our nation's children are not becoming more obese,  except that they also state that "Because no statistically significant differences in the prevalence of high BMI for age were found between estimates for 2003-2004 and 2005-2006, data for the 4 years were combined to provide more stable estimates for the most recent time period." 

I wonder if this really complicates the findings or clarifies it. For those of us not skilled in statistical analysis,  it makes it difficult to question if the study has flaws. As recently as October and December of 2007, JAMA also published articles titled: "Childhood Obesity as a Chronic Disease," " The Childhood Obesity Epidemic," and "Researchers Address Childhood Obesity Through Community Based Programs."

The reason this could be problematic is that childhood obesity has long term health consequences that we don't yet fully understand.  It is also not clear if any of the attempts to better treat and prevent this health condition has indeed been successful, or if  this latest study is just reflecting the limits of the research methodology.
 

Breast Cancer Detection

The thought of a breast cancer diagnosis can be very frightening and can cause some women to avoid early detection screening.   I found this article to be helpful about the switch over from film to digital mammography tests.

Digital imaging  is the latest in mammography technology and radiologists believe it may help them to better determine the evidence of tumors in women with denser breast  tissue. However, with new technology  comes a new learning curve for radiologists. 

In order to feel confident reading and diagnosing from  digital film, radiologists need to log more patient hours using this medium. For the patient, this means that a radiologist may ask for additional or repeat tests.

Although this is anxiety provoking for the patient, I am glad that this has become public information.Technology changes and  I would rather have my radiologist say, "This is a new screening device that I am getting more familiar with and rather than misdiagnose, I would like to have a comparison test done."  I am more concerned when doctors become too comfortable and complacent.

Humility and experience is a good combination.

To Swim or Not to Swim......

As summer approaches, parents begin to sign up their children for swim lessons. This summer ritual is nothing new, but there is a new controversy. The American Academy of Pediatrics in 2006, came out against infant swim schools.   According to a recent SF Chronicle newspaper article, (see full article here) the report stated that,  "Children are not developmentally ready for formal swimming lessons until after their fourth birthday."

The reason that this may be back in the news, is that there has been a  growing number of infant swim schools claiming that early exposure creates "drown-proof" children. The academy fears that parents are unaware that an infant or toddler is not cognitively able to problem solve in order to either prevent, or remove themselves from potential harmful situations.

As stated by Academy chairperson Dr. Marilyn Bull, "Teaching swimming that early gives parents the potential to assume their children have become drown-proof," Bull said. "Do they really want to reduce their child's fear of water at that age? If there's one thing we've learned over time, parents tend to overestimate their own child's cognitive skills and underestimate their physical abilities."

What is reasonable for parents to take away from the Academy's position, or the swim school's marketing?   I would hope that the American Academy of Pediatrics is underestimating the intelligence of parents. No one is "drown-proof" and swim classes or no, I can't imagine that  parents would allow their  infant or toddler around a pool unsupervised.

Suddenly falling into a body of water would be traumatic and dangerous at any age. Who as a kid hasn't been reprimanded for running around the pool? Parents know that even if you can swim, slipping and falling in is dangerous.

I would argue with Dr. Bull's statement about swim classes reducing the fear of water. Children unfortunately fall into pools whether or not they are fearful of water. If we went by this logic we shouldn't put them in bathtubs either. Children drown because developmentally they  don't perceive or predict danger.  And once in a crisis situation, they often don't have enough problem solving skills to get out of it.

The academy suggests starting lessons by age four. However,  a four year old isn't any more capable than a three, five, or six year old, in terms of understanding or perceiving the inherent dangers. What is more likely is that really young children, if they aren't  swimming daily,  "forget" what they learned from summer to summer.  They can even "forget" that they loved the water.

If parents enjoy swimming with their infants and toddlers that's great.  It doesn't have to be structured or in lesson form to be beneficial at that age. Spending time together is what really matters. Ultimately,
whenever a parent decides to provide swimming lessons, it doesn't replace adult supervision.