Category: Disease

Early treatment saves more lives

The benefits of early treatment are clear for both people living with HIV (PLWH) and the whole society. Last Wednesday, based on the findings of the largest clinical trial, federal health officials announced that the benefits of the early treatment are obvious. Besides, they also said that people with HIV should take antiretroviral drugs as soon as they are diagnosed.

This trial is a strong evidence to show that those who got treatment immediately were 53 percent less likely to be infected and develop AIDS or die during the trial. Therefore, the early treatment saves more lives. At present, according to the Centers for Disease Control and Prevention (C.D.C.), 450,000 of the estimated 1.2 million with HIV are on treatment. Although the influence of early treatment is sound and profound, only 37 percent of infected Americans had the access to get the prescriptions of the drugs. This small percentage is partly due to the limited access to HIV testing, health insurance. Therefore, people infected by AIDS could not afford the drugs or did not see doctors.

In addition, though the substantial evidence of the benefits of early treatment is defining, the shortage of funding is the main cause of a small amount of people living with HIV have the access to the early treatment — antiretroviral medicines. For instance, the Global Fund to Fight AIDS, Tuberculosis and Malaria constantly struggle to raise money.

It’s true that antiretroviral treatment (early treatment) is the best way to curb AIDS. The shortage of money is the mainly daunting challenge facing organizations targeting at HIV.

Photo credit from: http://www.bchdmi.org/cchs/hiv

Humanity VS. Ebola

“You can’t hold your children the way you would in this situation.” “You can’t bury your relatives.”

2 months ago, Ebola was escalating and spread in a wide geographical area. This virus popped up in Nigeria, as a result, this disease aroused international concern. Although lots of NGOs and governments came to assist and to start helping people to address this disease, several opposites happened. Commercial advertisements frightened both people in Nigeria and people around the world. The health system collapsed, the school closed, the market did not function as it would be, the misinformation and misperceptions start even faster throughout the community. Most importantly, people who were exposed to the virus did not allowed to travel. Consequently, Nigeria did not receive the needed help instead it was being isolated.

It is true that we’ve never met this kind of scale in this situation before. Strategies used to address other diseases may not be effective to handle Ebola. However, what we can do is providing emotional and financial support to stand with those people who were exposed to the virus instead of isolating them.

Let’s fight, we will win this war.

photo credit from: http://www.doctorswithoutborders.org/our-work/medical-issues/ebola

“So Long, Farewell”

[dropcap]A[/dropcap]s they say in the Sound of Music, “So long, farewell/Auf Wiedersehen, adieu/Adieu, adieu/To you  and  you and you.”  I have had the amazing privilege to contribute to this blog for the past two semesters.  This blog is a part of the Interdisciplinary Health Communication (IHC) Certificate I chose to pursue in addition to my Masters of Science in Public Health (MSPH).  Pursuing this certificate has provided me with the ability the take some very interesting courses; helping to further my goal to help advocate for others.  Communication is a vital tool needed for all careers.  I have learned so much and have enjoyed every moment.  Since completing this certificate means I will not be posting my blogs on Upstreamdownstream.org, I will continue “Type 1 Tuesdays” on typeonetuesdays.blogspot.com.

IHC Certificate Photo

As I reflect on the experiences I have had while earning my bachelor’s degree at Wake Forest University and my Masters of Science in Public Health at UNC Gillings School of Global Public Health, I realize how truly fortunate I have been to be able to pursue my dreams.  Next stop on my journey, law school!  I know that as humans, we have our strengths and our weaknesses, however, chronic diseases, like T1D, or other adverse circumstances should not limit our accomplishments.  So, “Climb every mountain/Ford every stream/Follow every rainbow/Till you find your dream.”  Pursue your dreams!

 

Photo: L to R: Joan Cates, Amanda Mezer and Seth Noar.

Pass the Cheese for Less Heart Disease?

Ever wondered about that “French Paradox” and how the French have lower rates of heart disease even with a diet high in saturated fats? Much of the research has focused on the health benefits of wine and active lifestyles, but a new approach examines how cheese metabolism could be the missing link to explain the phenomenon.

In a recent study published in The Journal of Agricultural and Food Chemistry, researchers found that subjects who ate cheese or milk (compared to a control diet) had higher levels of a compound called butyrate in their fecal samples. This fatty acid is produced by the bacteria in the large intestine and was linked to lower levels of total blood cholesterol levels, as well as low-density lipoprotein (LDL) cholesterol. Higher levels of LDL-cholesterol are generally associated with a greater risk for cardiovascular disease.

However, it must be noted that the study only included 15 young, healthy men. The authors speculate that because gender and age both have effects on the metabolic by-products, this could mask any effect a specific diet has in a future intervention study of similar design. Additionally, the association between the butyrate and lower cholesterol was only a weak correlation. This means the findings should be taken as a mere piece of the whole puzzle and not a reason to eat a diet built entirely on dairy and saturated fats (as tempting as that may seem).

 

Image source: ulterior epicure on Flickr.com

Wellness Wednesdays: How to Fit Exercise into a Busy Schedule

Growing up, I was a competitive endurance swimmer. During meets,  I swam events like the 1500 meter (~1 mile) freestyle. For me, training meant between two and four hours of practice in the pool every day, swimming lap after lap (after lap after lap). The conventional exercise wisdom doesn’t leave many alternatives – if you want to increase your endurance, you’ve just got to put in the hours. Or do you?

High intensity interval training (HIIT) has been increasing in popularity over the past few years, with programs like Insanity and Crossfit gathering a huge following among athletes, both recreational and competitive alike. As a graduate student, what attracted me to these programs was their efficiency – in 20 minutes or less, I could see the same long-term health benefits as if I spent an hour or more sweating it out? Sign me up!

So, does HIIT work? According to the latest research, the answer is a definitive ‘Yes’. A 2012 study compared two exercise regimens, a high-intensity interval workout and an endurance workout, both using a stationary bike. The HIIT approach involved 30 seconds of cycling at maximum effort, followed by 4.5 minutes of ‘active’ rest (low-effort pedaling). Participants completed this workout three times per week for six weeks. The endurance (classic) approach involved 40-60 minutes of cycling, at 65% effort (pushing hard, but not gasping for breath). Participants in this group worked out five times per week for six weeks. Two common measures of physical fitness, peak oxygen consumption and time-to-exhaustion, were used to determine differences before and after the six weeks of training.

Amazingly, both groups saw virtually the same improvement in physical fitness, based on the two measures collected. However, the HIIT group saw these improvements with only one hour per week of training, while the endurance group logged 4-6 hours each week.

HIIT seems like it may allow busy people the opportunity to reap the same health benefits of exercise in less time – but is it for everyone? Some evidence suggests that these programs may be less appropriate for people with pre-existing medical conditions, like congestive heart failure, because of the ‘stress’ they put on the body. For these people, lower intensity endurance exercise has shown to be more beneficial for improving overall health and functioning.

However, if your busy schedule is the primary thing keeping you from exercising, HIIT offers a potential solution – after I started critically evaluating these programs, I realized that I just couldn’t use the ‘I don’t have time to exercise’ excuse any more. Now I always make sure to fit in at least three HIIT workouts a week. If you’re looking for a way to fit exercise into your schedule, I encourage you to explore some of the HIIT programs out there to see if they might be right for you.

 

Photo credit: http://www.dailymail.co.uk/health/article-2033197/How-vigorous-workout-burning-calories-day.html

Guaranteed to Arrive Before You Leave the ER Waiting Room

Various mailing services guarantee your package to be delivered by a certain time – often the next day, but sometimes even the same day, but who knew a mother living three states away could be to you before you get out of the waiting room in the ER?  As I mentioned in an earlier blog, I have been diagnosed with gastroparesis.  Last week, I spoke with my primary care, who said I needed to go to the urgent care associated with her practice, because I had been sick and not able to re-hydrate myself.  The doctor at urgent care said I needed to go the Emergency Room (ER) at Duke Hospital.  When I arrived at the ER, at 5:00 P.M., I called my mom at her office in Tampa, Florida and to tell her what was happening.  She said that she was leaving immediately and would get to North Carolina as fast as she could.  She had always said if I ever had a problem she would be to me within hours, but thankfully, I have never needed her to come in an emergency situation.  After checking into the ER, a nurse did an initial evaluation in triage and took me back to draw blood and put in an IV.  I was then left sitting in the waiting room in a wheelchair with two bags of IV fluids.  Around 11:00, my mom arrived at the ER shocked to find me still in the waiting room.  After another hour, my mom talked to one of the nurses who indicated that the 6 hours I had been waiting was actually a fairly short wait time for this hospital, as many patients have to wait 10 to 12 hours in the waiting room.  The nurse who finally took us back to a room in the ER, seemed very abrupt, but when my mom said that she was able to get from Florida to Duke ER before I was taken to a room, her stern face actually broke into a small smile.  Even she recognized the absurdity of this situation.  It is understandable that emergency rooms, especially those at major trauma centers, like Duke Hospital, where the most critically ill emergency cases are handled, could sometimes have long wait times.  However, if it takes over 6 hours to be seen when sent by two different physicians, and the normal wait time is 10 to 12 hours, what is wrong with our healthcare system?  How can we have people wait such long wait times for urgent care?  I am thankful for the services provided by Duke Hospital.  This blog is not intended to speak negatively about this hospital, but rather to make a point about wait times at hospitals in general.  Wait times in general, but particularly in the ER are another aspect of our healthcare system that seems to be broken and urgently needs to be repaired.  What have your experiences with emergency care been?  Have you had positive experiences when needing emergency care?

Type One Tuesdays: “May the Odds Be Ever in Your Favor”

I’m sure many of you have read the book, watched the movie or are at least familiar with the plot of the book or movie series The Hunger Games, written by Suzanne Collins. To recap, it is about a group of districts that each must pick a boy and girl representative to compete in the annual hunger games during the reaping, where all of the selected participants must compete against each other until only one participant remains living.   How does this relate to health and my weekly blog?

Type 1 Diabetes (T1D) is a battle no one asked for, but being diagnosed with T1D and living life with T1D is very similar to the reaping process in The Hunger Games, where Effie Trinket picked our names.  During the reaping process, the older a person is or if their family needs food assistance from the government, that person’s name is put into the lottery process additional times, thereby increasing his or her odds of being selected.  With T1D, if we don’t take care of ourselves, we are putting our names in more times to be picked for a complication.  However, just like the reaping process, a person with T1D can be picked even if his or her name is in only once, that being diagnosed with T1D.  One can do everything to take care his or her T1D correctly and still have complications.  So, we can all think of it as Effie Trinket is determining when we are diagnosed and saying to us every time we go to a doctor’s appointment, “May the odds be ever in your favor.”

So, the moral of the story, or blog in this case, is that we are all in the hunger games in District T1D hoping that the odds are in our favor to not be selected to go to the Complication Games.  This is not say that we should not do everything we can to battle this disease and strive to be the one that is standing at the end of the game.  But, it also says that, to some extent, this is beyond our control and we should not be too hard on ourselves or blame ourselves when outcomes are not as we would hope.

Wellness Wednesday: The Importance of ‘Real’ Food

Full disclosure: I Love cheese (with a capital ‘L’). As a child, a visit to Vermont introduced me to Cabot cheddar cheese for the first time – the rest, as they say, is history. Today, I buy at least a pound of Cabot Extra Sharp cheddar cheese every week.

Aside from the fact that Cabot is wholly-owned and operated by a cooperative of dairy farmers in the Northeast, I buy their cheese because it’s Real. The nutrition facts label reveals just four simple ingredients – pasteurized milk, cheese cultures, salt, and enzymes. With so many foods we purchase today becoming more and more processed, as a Registered Dietician-in-training, I appreciate the wholesomeness of products made by companies like Cabot who so obviously care about the quality of the food they produce.

Unfortunately, it appears that my beliefs on this topic of ‘real food’ diverge from those of the Academy of Nutrition and Dietetics, a trade group representing 75,000 nutrition professionals around the United States. The Academy recently granted permission for Kraft to use the new ‘Kids Eat Right’ label on their Kraft American Singles ‘pasteurized prepared cheese product’ (sounds delicious, right?). This decision only makes it even harder for already confused parents to make choices about what foods they should be feeding their kids.

The majority of children in America between the ages of 4 and 18 do not get adequate calcium and vitamin D, essential nutrients that are commonly found in dairy products. Per serving, Cabot cheddar cheese and Kraft Singles contain the same amount of calcium – however, Kraft has to add calcium phosphate to its product in order to match the calcium found naturally in Cabot’s cheese. The Kraft product also has nearly twice as much sodium, by weight, and less protein (even with a boost from both ‘milk protein concentrate’ and ‘whey protein concentrate’).

The lesson here? Parents, if you want to help your kids grow and mature into healthy adults, feed them Real Food. The more packaged, processed, and manipulated a food is, the less Real it gets. They may tout ‘all natural’ or ‘no artificial ingredients’ on the front, but next time you go grocery shopping, turn the package over and have a look at the ingredient list for Kraft Singles or a Lunchables product. What you’ll find will encourage you to put it back on the shelf, instead of in your cart.

 

Photo credit: http://www.nyctaughtme.com/2012_05_01_archive.html

Type 1 Tuesdays: Oh No! Not Him/Her Too!

We all have fond memories of our Moms – whether it be their hugs, voices, cooking or just their amazing support. What is your fondest memory of your Mom? On a similar note, what comes to mind when someone says that name Emma Watson? Many may know this young talented star as Hermoine Granger, the female heroine in JK Rowling’s blockbuster movie series, Harry Potter, or the new Belle in the live Beauty and the Beast Production.  However, did you know that her mother has Type 1 diabetes?  Watson is now speaking out about how her mother is her hero, specifically because she has T1D.  Will we see more of Ms. Watson in other T1D advocacy movements in years to come?

Another British actor with even more personal ties to T1D is Jeremy Irvine, who stars in the film Warhorse. He has been a T1D since he was six years old and is actively involved in the bionic pancreas project.  In a quote on the JDRF website he said, “Thanks to the huge developments being made in the treatment of type 1 diabetes, no child should have to feel diabetes needs to stop them following their aspirations.”  These celebrity spokespersons spread awareness and understanding about T1D, helping all of us who live with this disease.  They are out heroes along with our mothers, both playing a major role in helping us successfully live with this disease.  Who is your favorite star with T1D?  Mary Tyler Moore? Halle Barry? Crystal Bowersox? Brett Michaels? Nick Jonas? Any others?

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Photo Credit: Steven Mezer (In Photo: Amanda Mezer and Karen Mezer (Mom)).

Type One Tuesdays: Conferences, Bonding and Life Long Friends…Priceless!

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As Spring Break approaches and, hopefully, with the snow days behind us, we eagerly look forward to and begin to make plans for summer.  Do you have a favorite place to visit during the summer or a conference to attend?  Over the summer, there are many interesting and fun diabetes camps and conferences.  Two major national conferences that occur over the summer are Students With Diabetes (SWD)’s National Conference and Children With Diabetes (CWD) Friends for Life Conference.

Conferences provided invaluable information, networking opportunities and lifelong friends for people with Type 1 diabetes (T1D).  There are informative sessions that provide information on the latest technology, inspirational and encouraging presentations by successful T1Ds and social activities that provide time to meet and bond with fellow T1Ds.  The relationships made at the conferences provide a great resource for support on the other 364 days of the year when you are not with people who understand your disease.  I met one of my closest friends at the SWD conference several years ago.  Attendees at the conferences relate to each other in a way that is rarely experience in any other setting.  The commonalities between attendees and conference events create an atmosphere for bonding over just a few days.  Even if you don’t keep in touch regularly, some of these people will cross paths with you at other conferences or through other aspects of your life.  Recently, I reconnected with a person, who I had met at a Friends for Life Conference many years ago, when we both participated in a national group project.  It was so great to have a familiar person in the group!  Additionally, when you go back the next year, it is like a family or high school reunion, with the opportunity to also meet new attendees or create stronger bonds with people from previous years.  The experience is priceless.  Are you going to any conferences or camps this summer?  What is your favorite memory?  Don’t let your summer go by without a conference or two to make life-long friends!  Hurry and sign up before registration closes!

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