Category: Disease

Headache Me This

What causes headaches? I find myself Googling this at least once every few months when a particularly nasty or persistent headache of my own decides to show up. And I think it’s because I never really get a satisfying explanation from my searches, likely due to the fact that there are hundreds of headache types and only 10% have a known cause. Let’s focus on primary headaches, ones not caused by an underlying condition.

There are a lot of culprits for primary headaches. Nerves/blood vessels/tissue around the skull, muscles of the head/neck, and chemical changes within the brain can spur on that pain. So what triggers these physical pain signalers? It is probably no surprise that stress or alcohol are included. Skipping meals, poor posture (thanks, laptops), disrupted sleep patterns, and changing weather as well.

Some of these triggers are outside of our control like the weather, but there are measures we can take for prevention. Even though yes, easier said than done, try to avoid known stressors where possible. Eat low-processed meals at regular intervals and prioritize consistent sleep habits. Deficiencies in magnesium may play a role so eat some avocado and nuts. And when all else fails, put the screens away, take a warm shower, apply a soothing compress to the neck, and go the heck to sleep. Admittedly just writing about all the things that I should be doing right now has not made my headache go away, so off to self-care I go.

Source: https://www.mayoclinic.org/symptoms/headache/basics/causes/sym-20050800

Discrimination and Health Part I: LGBTQ+ Americans

Past research has suggested that discrimination can impact health outcomes – perhaps through vehicles such as stress of daily interactions and negative experiences with the healthcare system. One group whose experiences with discrimination can be linked to negative health outcomes is LGBTQ+ Americans. A study found that over half of LGBTQ people have experience slurs and offensive comments, and over half have been sexually harassed or experienced violence, or had an LGBTQ friend or family member experience such trauma.

We can make the connection between discrimination and trauma through various factors. One is through microaggressions –  seemingly harmless daily interactions with others who express, in this case, homophobic or transphobic views. These have been found to negatively impact health. Another is through discrimination within the healthcare system that lead LGBTQ Americans to seek healthcare less frequently. 18% of this population has avoided necessary medical care. Various forms of discrimination they face at the hands of medical professionals, police, and community members are much worse for those of color and those who are transgender.

Unfortunately, we can already see the health outcomes of discrimination to this population – they have higher rates of psychiatric disorders, substance dependence (including higher tobacco use), and suicide; lesbian women are less likely to get preventative services for cancer, and gay men are at higher risk for certain STIs.

How can we work to eliminate these gaps, even when interpersonal discrimination may take longer to tackle as our culture continues to evolve? HealthyPeople2020 provides several recommendations. First, healthcare providers should discuss sexual orientation and gender identity (SOGI) respectfully with patients, and collect data on it. Medical students should be trained in LGBTQ culturally-responsive care. In addition, we must be spokespeople against legal discrimination of this population in social services such as employment, housing, and health insurance.

Sources:

https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

https://www.centerforhealthjournalism.org/2017/11/08/how-racism-and-microaggressions-lead-worse-health

https://www.psychologytoday.com/us/blog/microaggressions-in-everyday-life/201011/microaggressions-more-just-race

http://www.apa.org/topics/health-disparities/fact-sheet-stress.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747726/pdf/nihms134591.pdf

The Duck-Billed Platypus

Antibiotic resistance is an alarming public health threat and who better to help in our fight against Superbugs than the super platypus? Not the platypus we deserve, but the platypus we need.

Part of the monotreme family, the platypus both lays eggs and produces milk to feed their young. Where does this milk come from though? Platypuses (it’s disappointingly not actually “platypi”) don’t have teats. The milk is instead secreted from their belly.

With the milk exposed to the environment before the platypus babies (highly recommend that adorable Google search) drink it, bacteria could pose a problem to the babies. Enter researchers at Australia’s national research agency, the Commonwealth Scientific and Industrial Research Organization (CSIRO), and Deakin University; they sought to examine the unique protein in platypus milk that protected it from becoming contaminated with bacteria. What they found and imaged was aptly named the “Shirley Temple,” a three-dimensional fold in the protein that looks like a ringlet. This newly discovered protein and its structure is only present in monotremes and may prove promising once traditional antibiotics reach their limit. Thanks platypus! Nature is so cool.

Source: http://scripts.iucr.org/cgi-bin/paper?S2053230X17017708

The Highs and Lows

In the hospital, the nurse told me that by the time I turned 10 they’d have a cure. This voice echoed in my head for years, as I imagined those very doctors and nurses working overtime in their labs, after their long days helping kids like me. Each birthday after the 10th one, I became more and more bitter thinking about that nurse, realizing she had delivered a false promise.

Type 1 diabetes (T1D) is misunderstood, even within the public health field. It’s rare – only 3% of all diabetes cases in the U.S. – and cannot be cured. T1D people live 12 years shorter on average.

T1D is an autoimmune disorder that occurs when the pancreas stops producing insulin. Unlike for Type 2, scientists still aren’t sure why. They have found that some T1D patients share a particular HLA (human leukocyte antigen) complex, but in order for this to trigger an immune response, it has to be triggered by something else, like a viral infection. Because it takes years for the T-cells to completely destroy the beta cells of the pancreas, it can be hard to track.

But this theory checks out for me: I had a nasty virus as an infant, and was diagnosed with T1D 5 years later.

Managing T1D is incredibly difficult. Every variable of everyday life affects blood sugars, and interact with each other such that it’s nearly impossible to know what causes a high or low. Today, by blood sugar was 152 when I woke up, I ate 18 carbs for breakfast, gave 2.1 units of insulin, and remained steady through the morning. Tomorrow, I might wake up at 152, eat 18 carbs, give 2.1 units, and end up with a dangerous low in the middle of an important meeting.

Despite this, I am lucky. I have health insurance, allowing me to have technology that makes it more likely I’ll beat the odds. For the uninsured, the estimated cost of T1D is over $13,000 a year – and that’s just for the bare minimum. What are we doing for the people who need the 6th most expensive liquid on earth to survive, but can’t afford it?

Sources:

https://www.scienceabc.com/eyeopeners/what-which-are-the-most-expensive-liquids-in-the-world.html

http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html

https://www.npr.org/sections/health-shots/2015/01/06/375395383/tight-control-of-type-1-diabetes-saves-lives-but-its-tough

https://www.endocrineweb.com/conditions/type-1-diabetes/type-1-diabetes-causes

https://login.medscape.com/login/sso/getlogin?urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3ZpZXdhcnRpY2xlLzg2MTU0Mg==&ac=401

 

Photo retrieved from: Insulin Nation

STOP Act: Implementation and Effects on the Opioid Epidemic in North Carolina

The rise of the opioid epidemic nationwide has led to an increase of attention from both media and policy makers. Here in North Carolina, a recently passed policy is the Strengthen Opioid Misuse Prevention, or STOP Act, which aims to reduce the amount of Opioids prescribed a one approach to tackle the epidemic. The STOP Act was signed into law by Governor Roy Cooper on June 29, 2017, and since then its four stage implementation has been put into effect, which will continue until 2020.

The first step of implementation occurred almost immediately after the law’s passage, on July 1st 2017, requiring Physician Assistants (PAs) and Nurse Practitioners (NPs) to personally consult with a supervising physician. This applied to Pas and NPs at facilities that primarily engage in treating pain, and the prescription will, or is expected to, last longer than 30 days. Additionally, PAs and NPs have to consult with a supervising physician every 90 days for patients for are continuously prescribed opioids.  Providers are also required to provide information on the disposal of controlled substances, both written and orally, when a patient concludes a course of treatment. The second aspect, implemented on September 1st, 2017, requires that pharmacies report targeted prescriptions to the North Carolina Controlled Substance Reporting System within a day of the prescription is dispensed.

The most recent aspect of the STOP Act was implemented on January 1st, 2018, and limits the amount of opioids prescribed for acute pain. Practitioners are not able to prescribe more than five days’ worth of any Schedule II or III Opioid or Narcotic, with an exception to things like pain after surgery, where the prescription cannot for longer than seven days. The final part of the law will be implemented on January 1st, 2020, and will require practitioners to electronically prescribed targeted controlled substances, with a few exceptions.

While it is still unclear what impact the law will have on overdose deaths in the state, it appears that the State government is attempting to address this issue. While more resources could be devoted to mental health services, naloxone access and syringe exchanges, and more programs geared toward injecting drug users rather than only those who use prescription drugs, it’s commendable that a joint effort was reached to combat this ongoing epidemic.

 

Sources:

New! Summary of NC’s new opioids law, the STOP Act: North Carolina Medical Board – https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/notice/new-summary-of-ncs-new-opioids-law-the-stop-act

FAQs: The STOP Act of 2017: North Carolina Medical Board – https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/article/faqs-the-stop-act-of-2017

STOP Act Provision Takes Effect Jan. 1, Will Limit Opioid Prescriptions: NC Governor Roy Cooper – https://governor.nc.gov/news/stop-act-provision-takes-effect-jan-1-will-limit-opioid-prescriptions

STOP Act Bill Summary: North Carolina Medical Board – https://www.ncmedboard.org/images/uploads/article_images/The_STOP_Act_summary-OnLetterhead.pdf

 

Raw Water: from the wellspring of life or death?

While most people struggle to drink enough water, there is now the added challenge of knowing what water is safe to drink.  This is due to a growing raw water trend that is drenching the nation.  Unprocessed, “raw”, water refers to water that has not been filtered, sterilized or treated.  Drinking raw water is equivalent to drinking rainwater or water from creeks, rivers, and streams, but today you may also find it in your local grocery store.

Raw water, which fits right in with the larger natural food movement, is applauded by many as more healthy than traditional tap and bottled water. Many say that its health profile beats treated water because of its natural properties.

Let’s review a couple.

More Vitamins and Mineral

Lovers of raw water claim that it is an excellent source of vitamins and minerals because processing has not filtered out these beneficial components. While unfiltered water may contain more vitamins and minerals, more is not always better. People in our country generally consume all the vitamins and minerals that they need and it is possible to consume too much of a good thing. Excess iron for example can cause nausea, vomiting and death in extreme cases. Our government is required to remove harmful compounds from drinking water and to add beneficial elements that keep us healthy. This includes elements like fluoride, which keeps our teeth cavity free.

Essential Probiotics

Raw water is said to contain probiotics, gut bacteria that support intestinal health. These microorganisms are often found in fermented drinks and yogurt. While raw water could contain probiotics, in many places it also contains harmful bacteria like Campylobacter jejuni, Escherichia coli, and Shigella dysenteriae. These bacteria can cause conditions like cholera and dysentery which result in extreme vomiting, diarrhea, and death. Proper hygiene and water sanitation are effective ways of preventing these conditions. In other words, drink treated water.

Final Thoughts

The damaging properties of raw water far outweigh the possibility of benefits. Unfiltered water retains many harmful elements. The U.S. Geological Survey found that in some parts of the United States unfiltered water contains mercury and dioxin. These compounds are toxic to humans and often accumulate in our bodies over time resulting in conditions like cancer and infertility [1]. When given the option of filtered or unfiltered, opt for filtered water and let’s hope this trend is on the way out.

Additional References:

[1] http://www.who.int/mediacentre/factsheets/fs225/en/

Deep in Flu Season

This season’s flu virus is particularly virulent (infectious and dangerous) as it involves the H3N2 strain. The flu vaccine in the U.S. is being reported as only 10% effective based on data from Australia, where the flu season is in the summer. It is more difficult to grow H3N2 in eggs for vaccines, and it also mutates at a faster rate than other strains as it moves through the population.

Flu hospitalizations have hit a new high compared to recent years. Alabama has declared a public health emergency, and school districts in Chicago and Florida have had to close. In North Carolina there have been nearly 100 flu-related deaths since October, more than double from last season’s flu over the same time period.

There is additionally a shortage of saline IV bags used to treat those hospitalized with the flu because almost half are made in Puerto Rico, where Hurricane Maria hit.

Remember to practice the staples of protective hygiene such as coughing into the crook of the arm and hand washing. Stay well!

 

Reference: https://www.vox.com/2018/1/12/16882622/flu-season-epidemic-prevention-vaccine

UNC alumnus writes about journalism’s role in stopping stigma against obesity

Chioma Ihekweazu is a recent doctoral graduate from our very own School of Media and Journalism here at UNC. Not only was I thrilled to see a kind peer’s work showcased in my newsfeed, I was also drawn in by her accurate criticism of how we talk about weight–obesity in particular.

She makes the very important point that while it’s not likely to hear patients who are suffering from cancer referred to as “cancerous” or “diseased”, it is quite common, even among respected news sources, to see the descriptor “obese people”. Chioma advises us to avoid playing into shaming language and “put the person before the condition”.

Please read her article here, though a few key takeaways are outlined below:

  • Avoid headless imagery (this is a form of shaming)–if needed, use non-stigmatizing stock photos
  • Recognize that weight loss is influenced by many factors–such as location, time, and access to food/physical activity
  • Do not use value-laden language; use “classes”, based on BMI, defined by CDC and NIH to talk about obesity
  • Have an appropriate headline
  • Report on facts

Chioma also provides some great examples and resources in her article, to not only help writers and reporters change their words, but also to recognize the flaws in our perspective.

 

 

Responding to the Ebola Outbreak

The unexpected and rapid advance of the Ebola Virus outbreak of 2014 caught the entire world off guard. Not only did the virus take hold of one of the most vulnerable areas of the world, but it also exposed a major weakness in the global infectious disease control process.

At the time the outbreak took place, current technologies still took up to five days to properly test for the Ebola Virus. Luckily, in the few years since the crisis, there has been a lot of thought put into how we could address a similar global issue more effectively.

Enter FieldLab, a solar-powered lab-in-a-box created by two graduate students at Rhodes University in South Africa. This new technology will simplify the process of conducting laboratory tests out in the field. Designed to be carried like a briefcase, FieldLab was created specifically for the issues that Africa faced trying to test individuals for the Ebola Virus; affordability, mobility, and robustness.

With successful execution and new technologies, hopefully, we will be able to manage disease outbreaks better than how we did with the Ebola Virus. What are some ways you think we could improve response time to global issues of this stature?

Top 5 “Wins” for Health in 2017

2017 has been one for the books! Our country inaugurated a new president, two major hurricanes swept through the South, the first solar eclipse in a 100 years, the riots in Charlottesville, and most importantly the royal engagement of Prince Harry and Meghan Markle. In the health-related realm there were many notably scientific and policy advances that occurred this year. Here is my top 5 list of these occurrences.

  1. US Federal Court requires tobacco companies to put out corrective statements about harmful health effects of smoking as a consequence for misleading the public about this through advertisements
  2. First diagnosis of CTE in an alive patient (traumatic brain injury typically seen in football players)
  3. First baby born from a uterus transplant
  4. Development of a digital ingestion tracking system. This is a new technology with the ability to monitor drug adherence after the pill has been taken
  5. Decrease in daily consumption of sugary beverages consumed by Americans since 2014

There were many more significant health-related achievements over this year. What is your top 5 list?

 

References:

https://www.nytimes.com/2017/11/14/health/soda-pop-sugary-drinks.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=stream&module=stream_unit&version=search&contentPlacement=2&pgtype=sectionfront

 

http://abcnews.go.com/US/nfl-player-confirmed-1st-diagnosis-cte-living-patient/story?id=51181721

 

https://www.cbsnews.com/news/first-baby-born-from-a-uterus-transplant-in-the-u-s-delivered-in-texas/

 

http://www.cnn.com/2017/11/14/health/fda-digital-pill-abilify/index.html

 

https://www.tobaccofreekids.org/media/2017/corrective-statements