2012年1月4日星期三

Gout recurrence can be prevented

What happened to you is actually not that unusual. I do believe that, with some diet changes and maybe a visit to your regular doctor, we may have a chance to make another gout attack much less likely.

Gout is a type of arthritis caused by uric acid crystals forming inside the joint or a space between two bones. The most common location for gout is at the base of a big toe, but it can affect other joints as well.

Uric acid is a product of a breakdown of purines -- substances found in foods like beans, asparagus, mushrooms and certain meats and seafood. The most common symptoms of gout are a red, swollen, painful toe or other joint and, for some, fatigue and fever. The intensity is the worst in the first 12 to 24 hours, but the symptoms may continue for weeks. It is important to know that this is a self-limiting illness, which means that it will eventually go away even when not treated by any medication.

Gout affects about 1 to 2 percent of the population in the United States. It is generally more common in men, but it can attack women, especially after menopause. It is a very old disease -- it was known by Egyptians in ancient times. It has been called the "disease of the kings" due to its presumed association with eating certain foods and alcohol.

Now you may ask why exactly the uric acid crystallizes inside the joints. It is due to one of two reasons. There may be too much of the uric acid made by the body, which happens in about 10 percent of cases. But, more often, the kidneys are unable to get rid of the uric acid properly and, as a result, there is just too much uric acid in the blood. The level of uric acid can be measured by a blood test and, to some extent, can guide treatment and diet modifications. Interestingly enough, gout attacks are influenced by outside temperatures, which is why they happen more often in early morning. Uric acid may also crystallize in other parts of the body, causing funny-looking, small, painless lumps around joints and tendons, which doctors call "tophi." Gout is also associated in some people with kidney stones -- again caused by the uric acid.

This disease does run in families, but just because your dad or mom has had it does not mean you will get it as well.

It is also associated with elevated blood pressure, obesity and elevated cholesterol. As we have mentioned before, excessive alcohol use (more than two drinks daily) is one of the risk factors. Some medications can make gout attacks more likely. Simple aspirin and commonly used water pills -- known in "doctor talk" as thiazide diuretics -- have been associated with gout.

On the other hand, coffee and vitamin C, as well as dairy foods and physical exercise, may be protective for gout sufferers. as they lower uric acid levels in the blood.

2011年12月29日星期四

Anger as cancer fund has cash left over

MILLIONS of pounds set aside to fund vital drugs for Oxfordshire patients have not been spent.

The 200m Cancer Drugs Fund was introduced by the Government last year to give people who have been denied key drugs on the NHS a last chance to get treatment.

However, just over a year after it was announced, the Oxford Mail can reveal less than a fifth of the money for vital life-extending drugs for dying patients in our area has been spent.

Just 1.6m of 9.3m has been spent by the NHS South Central Strategic Health Authority, which covers Oxfordshire, although the majority of applications have been funded.

Prime Minister David Cameron announced the fund while visiting cancer campaigner Clive Stone, from Eynsham.

At the time Mr Stone, who set up the campaign group Justice for Kidney Patients to pressurise officials to approve funding for more anti-kidney cancer medicines, said it was the ‘right thing to do’.

But Mr Stone said: “This is an appalling state of affairs and it is high time that we insisted on full accountability from our many highly-paid NHS administrators.”

The fund was introduced as a way of combating the so-called ‘postcode lottery’ which sees some Primary Care Trusts turn down applications for life-extending drugs because of regional funding restrictions.

Applications are made by a consultant specialist, who recommends a drug on behalf of the patient.

But a recent survey by Macmillan Cancer Support showed some doctors are unaware the fund exists. Patients reported that they found out about the money after doing their own research on the internet.

Last night an NHS South Central spokesman said: “It is important to remember that alongside the fund, cancer drugs for thousands of local patients are funded through the usual commissioning channels.

“Since April 2011 until the end of November 2011, the South Central fund has received 493 applications of which 416 have been approved, 26 have been declined and the remaining have been withdrawn or are pending a decision.

“Applications are considered by a clinical panel.”

If the money is not used this financial year, the SHA said it ‘expects’ it will be carried forward, but there is no guarantee.

Mr Stone added: “What possible reason could there be for declining applications when the funds are readily available?

2011年12月28日星期三

‘Losing my donor has saved my life’

LINDA Joel hit rock bottom earlier this year when her husband Gary left her and took with him the kidney needed to keep her alive.

But the Abingdon mother of five now says losing her donor has saved her life.

The diabetic, 58, realised without the chance of an organ donation she had to lose weight and survive.

And after a gastric bypass operation to shrink her stomach in April, she is now looking forward to a brighter new year after shedding more than a third of her body weight.

She said: “I hit rock bottom and I did get really ill. But there was no turning back for me, it was either lose the weight and get healthy or die within a year.”

Mrs Joel, of Tower Close, has only one working kidney and suffers from heart problems.

The Oxford Mail reported in December 2009 how Mr Joel had pledged to donate the vital organ to his wife, and we reported again in March that the couple had split.

The couple had been together for nine years and were married in Abingdon in 2006.

Mrs Joel had the bypass operation at the Churchill Hospital in Oxford in April and has lost more than eight stone – going from 22 to about 13 stone.

She had to have daily injections for a month afterwards and could not eat solid food for 10 weeks.

She said: “It was really scary. The 10 weeks after I had the operation I just felt like digging a hole and disappearing.”

She is now following a strict diet and is banned from eating unhealthy food. Every day she will typically eat two spoonfuls of cereal for breakfast, a quarter of a tin of soup for lunch, and then a small plateful of food for dinner.

Mr Joel was in the same blood group as his wife, which meant the chance his kidney would be compatible was 70 per cent.

After the split he wrote her a note which read: “Linda, you and I have not been okay for a long time. I have felt the walls closing on me.

“I wish you and your family all the luck in the world but I’m not coming back.”

Last night, she said although she was heartbroken at the time, she was now glad to have broken up with Mr Joel, adding: “I haven’t seen or heard from him from that day.”

Mrs Joel used to be too embarrassed about her weight to exercise but now regularly goes walking and swimming.

The grandmother of 15 still needs a kidney and is on the NHS organ donor register.

But she said losing the weight had given her a lot more time before the situation became critical.

She added: “They told me if I had not lost the weight I would have been dead within six months.”

Mrs Joel, who is still single, said: “I am going to be living the rest of my life healthy and fit and I am going to be a fighter.

“Now I am looking for Mr Right.”

Her daughter Hayley Smith, 35, said the family had not expected her mum to live until Christmas.

She said: “Getting rid of him was the best thing that could have happened to her. You look at her now and she looks like a completely different person.

“We are all so proud of her.”

2011年12月27日星期二

New York Methodist Upgrades Its Kidney Stone Treatment

New York Methodist Hospital is now using a new, improved version of a common technology to dissolve kidney stones.

Extracorporeal shock-wave lithotripsy is a minimally invasive surgical procedure used to treat patients with kidney stones. Physicians in NYM’s Division of Urology, headed by Ivan Grunberger, M.D., make up the first team in the United States to use a new lithotripsy device that offers improved results. Kidney stones are solid masses of tiny crystals that can form in the kidneys and cause bleeding, kidney damage or ongoing urinary tract infections.

It is estimated that more than one million patients are treated with ESWL annually in the United States. “The new generation of lithotripter is capable of generating shock waves with the same intensity from one firing to the next, something that older models could not do,” said Grunberger. “This makes the pulverization of the kidney stones more accurate, and also means that a higher number of patients will be stone-free after the first treatment.”

The new lithotripter can also monitor patient movements in real time with revolutionary infrared tracking. If the patient moves slightly during the procedure, the machine locates the kidney stone and completes treatment. The extended penetration depth of the shock waves also allows for treatment of patients who are obese.

“With the added conveniences of a handheld ultrasound probe to locate the stones, and the ability to generate consistent shock waves, we can treat lithotripsy patients with more precision and accuracy than ever before,” said Grunberger. “The new ESWL technology gives our urologists the ability to better target and monitor stones, ensuring better patient outcomes.”

New York Methodist Hospital, a voluntary, acute-care teaching facility located in Park Slope, houses 651 inpatient beds (including bassinets) and provides services to almost 38,000 inpatients each year. An additional 300,000 outpatient visits and services are logged annually.

2011年12月26日星期一

Richmond woman gives kidney to ailing former boss

This year, Susan Preston gave Bruce Dodds a Christmas gift that is changing his life.

Preston donated a kidney to Dodds.

"Her gift means a normal life again," Dodds said.

The living donor kidney transplant surgery took place Dec. 7 at IU Health University Hospital in Indianapolis. Dodds and Preston, both Richmond residents, are well on the mend.

For the first time in three years, food tastes good again to Dodds. His fluid intake is no longer restricted and he is free from dialysis.

"It's pretty amazing for someone not related to our family to make that gift," said Dodds' daughter, Lara Dodds.

Preston's husband, Roger Preston, and her daughters, Jessica McMorrow and Elise Chadwick, were not surprised by Preston's generosity.

"Susan is a make-a-difference kind of person," Roger Preston said.

"I would say my mom was unswerving in her decision (to donate) from Day One," McMorrow said.

Preston feels the Christmas season is the perfect time to celebrate Dodds' renewed life.

"The greatest gift given to us was Jesus," she said. "It almost seemed minuscule (in comparison) to give a kidney. It just seemed so right."

Preston and Dodds became acquainted eight years ago when he became her boss at Earlham College, where she is an administrative assistant. They each have three children and became grandparents at about the same time.

They worked together for five years before Dodds was blindsided by kidney failure from polycystic kidney disease, a genetic disorder causing cysts. It is the most common life-threatening genetic disease, one that often lies dormant for years.

Dodds had been treated for cancer not long before the kidney failure and believes that was his trigger.

His life changed immediately.

The kidneys control about 80 to 85 percent of the body's operating systems, Dodds said. He couldn't work and had to have dialysis three days a week.

"It (dialysis) takes over your life," Dodds said.

Most people, he said, understand that dialysis cleanses the blood because the kidneys can no longer handle that function. What they don't realize, he said, is that dialysis also removes the excess fluid from the body because without working kidneys, urination is not possible.

Each dialysis treatment, Dodds said, is as hard on the body as running a marathon and that body is operating at just 30 percent of its normal energy level.

Roger Preston, who works at Reid Hospital, said there is a misconception that a person can handle dialysis indefinitely.

"It's a Band-Aid on a gaping wound," he said.

"We had no idea it was such a physical hardship," Susan Preston said.

The past three years have been an emotional roller coaster for Dodds and his family. Initially, Dodds' wife, Marilyn, was deemed a match as his kidney donor. But when doctors discovered she had kidney stones, she became ineligible. Dodds said his wife literally cried for two weeks.

Other family members sought to be a match, but they were discovered to have the genetic predisposition to polycystic kidney disease. Dodds was listed as a transplant candidate on state and national databases. He had one near match.

"It's been three years of trying circumstances," Lara Dodds said. "(My father) has gotten through it with great courage and great strength."

2011年12月25日星期日

X Factor USA Final: Braggadocio And Budget Cuts

Oh God. Just when I thought I was out, they pull me back in. Two weeks after saying goodbye to Little Mix and their Cannonball (although I think she prefers answering to ‘Jesy’) here I am again, staring down the barrel of another four-hour finale. Only Simon’s in this one, in body if not in mind.

As usual with the X-Factor, there’s always one breakout star that everyone’s talking about. Unfortunately, this series it’s Steve Jones, and no-one’s being especially complementary. In fact, looking back at my notes from this show, it’s really a tragi-comic single-hander. Like something Alan Bennett would write if he liked talent shows. The first show opens with Steve, floundering around in his bow-tie, PUTTING the emphasis on all THE wrong WORDS. Making this particularly uncomfortable is the fact that we all know he’s been dropped quicker than Christina Aguilera’s salad fork.

We’re provided a momentary relief from his awfulness, as he introduces the judges. Over the course of this series, they’ve each been working on their own distinctive hand gesture to give to the audience when their name is called. Now we’re at the final, it’s become like a carefully coordinated routine – LA Reid does kissy finger and a royal wave, Nicole does prayer hands and a dramatic bow, Paula offers her blow-kissy double hands, followed by ‘rock-on’ fingers, and Simon goes from military salute to exaggerated wink. Watched in rapid succession, it’s like American Sign Language for ‘Why aren’t you watching the Real Housewives of Atlanta instead?’

In an attempt to salvage what’s left of his once-promising career, Steve has obviously been on a presentation skills training course. Three days in a Trusthouse Forte outside of Guildford, practicing open palms and finger-thumb gesturing. When he’s not gripping his microphone tightly with both hands, he uses this training to ask for Paula’s famed insight. She comments how proud she is that the acts are so separate and distinct. I would love to see conjoined twins in next year’s final, just to watch her flounder.

It’s fair to say that the music performances in tonight’s show are going to be nowhere near as interesting as big Steve’s attempts to hold onto his job. So let’s make cursory mention of Josh’s gruff duet with Alanis Morrissette. Flat, tuneless and ineffective, it perks up a little when Alanis takes to the stage. She’s trying her best to look interested, but I’m sure she’s thinking “I used to chew on Ryan Reynolds, and now I’m singing in a fake wood with Fozzie Bear.”

Despite all the bluster and braggadocio before the show started, the debut season of X-Factor USA has been less than epic. It’s almost as though the disappointing ratings have forced a few budgetary cutbacks. Need an example? Well, those god-awful bits where we cut to a sports centre full of screaming supporters in the contestants’ home towns don’t even have a host. I mean, how much would it have cost to dump Kelly Osborne in Ohio for a couple of hours? Instead, they’ve just stuck a microphone in the hands of Josh’s grandmother. I’m sure she’s a game old bird, but the world of broadcasting didn’t exactly miss out on a bright shining talent.

Chris is on next, once again using his drug abuse as a bargaining chip. If we don’t vote for him to win, he’ll be firing up the crystal meth before the last glitter cannon has blown. He’s mangling an Avril Lavigne song, so it’s only a matter of time before she joins him onstage to show him how to fuck it up like a pro. Neither of them is in tune, and they’re rattling through more keys than a Victorian jailer. I’m also getting the vibe that this week’s theme is ‘Canadian guest stars’. Wouldn’t it be great if Melanie got lumbered with Rita MacNeil, the woman with a hair-lip who sings about Nova Scotian miners?

Before we get to that, the judges try their best to avoid mentioning how bad Chris’ vocals were, and Steve’s on hand to point out “You just did a duet with Avril Lavigne.” Big help, fella. Meanwhile, Paula’s trying to make a point about relevance, but then goes on to say “That song Complicated is the antithesis of the foundation that you’re built upon.” Simon’s as confused as I am, so he offers up his own nugget of wisdom – “That could be a record.” And this from the man who gave Mr Blobby a recording career. Forget about Josh’s Grandma, now it’s time to hear from Chris’ next-door neighbour in Santa Cruz, California. Somewhere in Florida, Melanie Amaro’s dry-cleaner is getting very excited.

2011年12月22日星期四

Longtime divers Troy and Justin Dumais still like making a splash

A diving competition in the United States is bound to have several necessities: a springboard, a platform, some deep water and a Dumais -- in fact maybe two of them, or three. Otherwise, it seems, the meet is just a bunch of guys splashing around in the pool. Might as well be a triple Lindy and a cannonball.

On Monday, Olympians Troy Dumais, 31, and his older brother, Justin, 33, finished fourth and fifth on the three-meter springboard event at the USA Diving Winter National Championships in Nashville, qualifying for the Olympic trials at ages when most divers are done. (Younger brother Dwight Dumais, 25, is a Stanford senior majoring in human biology. Though not as accomplished in the sport as his brothers, he is still a five-time national qualifier and bronze medalist at nationals on the one-meter board in 2005.) In Nashville, Troy teamed with Kristian Ipsen, a Stanford freshman, to win the three-meter synchro title. Ipsen recalls asking Troy for his autograph when he was eight years old.

Ipsen and Dumais clinched the meet by scoring nine or higher on five of six dives. They received perfect marks of 10 for a back dive pike, a forward 3 somersault and a forward 2 somersault with a twist. Their partnership is all the more remarkable because Ipsen has been training at his university in Palo Alto Calif., and can only train a few days each month with Dumais, who trains at the University of Texas and works as a Life Advisor for other Longhorns sports teams. His resume for the role comes from a sport that requires ups, downs, twist and turns is vast.

Troy Dumais almost made the Olympic team as a 16-year-old in 1996. In '98, he won a silver medal at the world championships on the one-meter springboard, an event not contested at the Olympics. Two years later, Dumais had an unusually high degree of difficulty at the U.S. Olympic Trials in Federal Way, Wash., and that was for just getting to the pool.

At 2 o'clock one morning, 17 hours before the finals of the men's three-meter event, he was admitted to St. Francis Hospital, trying to pass the large kidney stone that was breaking up in his body. "I felt like my whole side was exploding," he said. To complicate matters, Dumais, one point off the lead after the semifinals, had told doctors not to administer the usual narcotic given to patients in his condition because it was on the IOC's banned list. Instead they hooked him up to an IV bag, injected him with non-steroidal Toradol and sent him on his way at 5 a.m. after he passed a large stone into his bladder. Twelve painful hours later he was back again, taking in a liter of IV fluid and trying to force himself to excrete the stone completely so he could dive without incident or pain. Instead he passed either a second stone, or a fragment of the original, into his bladder and arrived at the Weyerhaeuser Aquatic Center 45 minutes before competition began. In the stands his parents Kathleen and Marc and 28 other supporters wearing light blue shirts saying Dumais Diving had no clue about Troy's illness. "I didn't want my mom to freak," Dumais said, "so only my brother Justin knew."

Justin Dumais, who was then 21 and would finish 13th in the springboard final, was one of four Dumais siblings who followed Troy into diving after his parents chose it as an outlet for Troy's hyperactivity. "Teachers would ask a question," Kathleen recalled, "and Troy would blurt out the answer without being called." One teacher suspected he had Attention-Deficit Disorder and suggested his parents keep him on Ritalin. Instead they kept him on diving boards.

Should he qualify for the squad at the Olympic Trials in Federal Way in June, Troy would be the first U.S. diver to compete in four Olympics. Still, he admits that there is a void without an Olympic medal to show for his toils. He placed fourth in synchro three-meter with David Pichler at the Sydney Games in 2000, missing out on bronze by less than two points. Even after a sixth-place finish in Beijing two summers ago, he sounded like a man who wasn't done with his dives. "What should I do, sit behind a desk and ask myself if I left it out there?" he said. "If I leave the sport, the sport I love, the sport I've been doing my whole life, I have to be ready to walk away saying I did everything I could, and I know I haven't done that yet."

So at 28, Troy started hitting the weights on the advice of his longtime coach Matt Scoggin. Even though his technique was on par with many of the top Chinese divers, Scoggin felt that a stronger Dumais with a touch more lean muscle could jump a tad higher and have that much more time and space to square himself for cleaner entries that leave a more dramatic impression for the judges. He added between 10 and 15 pounds of muscle thanks to a four-day-a-week program in the gym. He won silver medals in the three-meter springboard and synchronized three meter, diving with Ipsen, at the world championships in Rome in 2009, keeping the elusive Olympic medal within reach.

Justin, 33, is the eldest. He competed with Troy at the 2004 Olympics in Athens, finishing sixth in the synchro springboard event with Troy and won a bronze in synchro with Troy at the worlds in 2005. It was about that time, when doctors diagnosed him with Graves Disease, a thyroid ailment he beat in part by switching medications and keeping diet soda out of his fridge. He has since taken time away from diving for another high-flying vocation, flying F-16 jets for the South Carolina Air National Guard, before his tour of duty in Iraq. Justin had briefly quit the sport to move to Florida with his wife, Amy.

Though they have been each other's rocks throughout the sport, the Dumais boys actually had to be separated in college. Though he is the older diver, Justin had always fought to keep up with Troy. The boys began their collegiate careers at different universities -- Justin at USC and Troy at Texas -- but Justin soon transferred to join the Longhorns. Kenny Armstrong, their coach at Texas, decreed that Troy would compete in springboard events, while Justin jumped from the platform. That kept the two of them from competing against one another instead of for themselves.