Monique Whitfield started feeling pain in her lower back and stomach sometime Tuesday morning.
Could this be the onset of labor, she wondered, or was it kidney stones acting up again?
"I didn't know," Whitfield admitted.
Regardless, she needed to get it checked out. So she got in her car and headed toward Baptist Memorial Hospital-Golden Triangle.
But she decided to take a quick detour first.
Whitfield owns a beauty salon in Columbus, and the power bill was due.
She took the Main Street exit onto Highway 82 eastbound, and at around 12:15 p.m., she lost control of her car.
"It didn't go as planned," Whitfield said.
As Whitfield was driving along the exit ramp, her car ran off the right side of the road. The dark blue Dodge Ram Charger knocked down a light post and highway signage, traveled down a slope and ended entrenched in the trees alongside the highway.
"It was already slippery because it had been raining," Whitfield said. "When I got to the curb, I hit the brakes, and I lost control of the car."
She was nine months pregnant.
'Two angels'
Derek Whitfield, Monique's husband, was the first one to receive a phone call from his wife after the crash.
"I was scared," he said. "I didn't know. Anything could have happened (to the pregnancy)."
Monique Whitfield was unable to open her door due to trees and bushes surrounding the wrecked vehicle.
"It was awful," Monique Whitfield said.
However, two passersby saw the accident and called for help.
"Thank God for the two people who did see the accident," Diane Moore, Monique's mother, said. "I thank God for the two angels he sent."
Emergency response units rushed to the scene, removed shrubs and branches to get a stretcher near the driver's side door and carried Monique from the vehicle to a nearby ambulance. She was transported to BMH-GT.
2011年9月29日星期四
2011年9月28日星期三
Prognosis good for Liberty Elementary student
She was bubbling and laughing and bouncing off the walls one day and the next day she was at the doctor’s office hearing a horrifying diagnosis.
That’s about how fast the events of the last few weeks have happened for Kolbye Kaye Hamilton, 6, of Sallisaw.
“She woke up that morning and said her side hurt. She had very obvious blood in her urine,” Kolbye Kaye’s mother, Debra Hamilton, said of the morning of Sept. 8, the day all this began.
“I took her to see Dr. (Jennifer) Scofous here in Sallisaw. Dr. Scofous sent us to Sparks in Fort Smith for a CT scan. They thought she might be passing a kidney stone and blood clots.
“They sent us home with antibiotics. Several days later she was still hurting and there was still a lot of blood in her urine. We knew something wasn’t right. We got Dr. Scofous to refer us to Children’s Hospital in Tulsa. Our first appointment was on the 15th. They did a scan with dye in it,” Hamilton said.
Within 24 hours the pediatric urologist called them to tell them they needed to get back as soon as possible.
“They called us on Friday and said they had found a large mass on her right kidney,” she said. “That’s when we learned about the nephrectomy, the removal of a kidney.”
Less than a week later, her happy, bubbly daughter went into surgery for more than three hours to remove a kidney that had been diagnosed as a stage II Wilms tumor.
Hamilton said the doctors explained that Wilms tumors typically occur in children under the age of eight years old.
“They explained the tumor is a result of a kidney cell that failed to mature before she was born. After a child is born the cell tries to catch up and instead forms a cancer,” Hamilton said.
Doctors operated on Sept. 21 to remove the cancerous kidney. Pathology reports indicated that the cancer had spread to four of the 11 lymph nodes removed with the kidney.
“They put in a port for chemo,” Hamilton said. “Kolbye Kaye has named it Sally. She’s got a good attitude about it. She knows it’s going to save her life.”
Hamilton said the doctors expected her to remain in intensive care for three to five days, but she did so well she was out of ICU in 24 hours and home on Sept. 25.
“She feels good right now. She’ll be homebound, but if she feels like going to school she will be able to,” Hamilton said.
Kolbye Kaye is in Gloria Neer’s first grade class at Liberty Elementary School in Sallisaw.
The next step for this energetic first grader will be 18-24 weeks of chemotherapy and possibly radiation. Blood work every week will be a necessity.
“She’s got a good attitude now, but she doesn’t know about all the side effects, like losing her hair,” Hamilton said.
She said the prognosis is very good as 90 percent of children with a stage II Wilms tumor survive.
“The next year is going to be hard,” Hamilton said. “Up to six months of chemo and then six months for her immune system to get back to normal.”
Family and friends have set up a number of benefits to help the family with the costs of traveling to the hospital and related expenses.
That’s about how fast the events of the last few weeks have happened for Kolbye Kaye Hamilton, 6, of Sallisaw.
“She woke up that morning and said her side hurt. She had very obvious blood in her urine,” Kolbye Kaye’s mother, Debra Hamilton, said of the morning of Sept. 8, the day all this began.
“I took her to see Dr. (Jennifer) Scofous here in Sallisaw. Dr. Scofous sent us to Sparks in Fort Smith for a CT scan. They thought she might be passing a kidney stone and blood clots.
“They sent us home with antibiotics. Several days later she was still hurting and there was still a lot of blood in her urine. We knew something wasn’t right. We got Dr. Scofous to refer us to Children’s Hospital in Tulsa. Our first appointment was on the 15th. They did a scan with dye in it,” Hamilton said.
Within 24 hours the pediatric urologist called them to tell them they needed to get back as soon as possible.
“They called us on Friday and said they had found a large mass on her right kidney,” she said. “That’s when we learned about the nephrectomy, the removal of a kidney.”
Less than a week later, her happy, bubbly daughter went into surgery for more than three hours to remove a kidney that had been diagnosed as a stage II Wilms tumor.
Hamilton said the doctors explained that Wilms tumors typically occur in children under the age of eight years old.
“They explained the tumor is a result of a kidney cell that failed to mature before she was born. After a child is born the cell tries to catch up and instead forms a cancer,” Hamilton said.
Doctors operated on Sept. 21 to remove the cancerous kidney. Pathology reports indicated that the cancer had spread to four of the 11 lymph nodes removed with the kidney.
“They put in a port for chemo,” Hamilton said. “Kolbye Kaye has named it Sally. She’s got a good attitude about it. She knows it’s going to save her life.”
Hamilton said the doctors expected her to remain in intensive care for three to five days, but she did so well she was out of ICU in 24 hours and home on Sept. 25.
“She feels good right now. She’ll be homebound, but if she feels like going to school she will be able to,” Hamilton said.
Kolbye Kaye is in Gloria Neer’s first grade class at Liberty Elementary School in Sallisaw.
The next step for this energetic first grader will be 18-24 weeks of chemotherapy and possibly radiation. Blood work every week will be a necessity.
“She’s got a good attitude now, but she doesn’t know about all the side effects, like losing her hair,” Hamilton said.
She said the prognosis is very good as 90 percent of children with a stage II Wilms tumor survive.
“The next year is going to be hard,” Hamilton said. “Up to six months of chemo and then six months for her immune system to get back to normal.”
Family and friends have set up a number of benefits to help the family with the costs of traveling to the hospital and related expenses.
2011年9月27日星期二
Prepared Patient: Responding to Acute Pain
Jan Adams, 66, a retired general practitioner who lives a Minneapolis suburb, has had multiple experiences of acute pain—most of which were managed well but one that was not. While Adams’ post-surgical back pain received excellent care, her most traumatic experience with acute pain came during an emergency gastrointestinal procedure.
Lys Fulda, a 36-year-old sales and marketing professional from Chicago, also had a terrifying experience with acute pain during a root canal in her 20s, which left her with a fear of dentists that took 10 years “and a very patient dentist” to conquer.
Fifty-four-year-old Mike Gaynes, a media consultant, suffered extreme acute pain during an attack of kidney stones. On his way to a hike with his wife, he was suddenly overcome by it. “I’ve never been shot or stabbed, but talking to people who have, that’s the closest thing to it,” he says.
Getting the Right Help for Acute Pain
Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.. Receiving prompt and helpful treatment can make all the difference in the world. But lack of care or inadequate care means that the acute pain may develop into chronic agony.
Fortunately, acute pain is not always long lasting or overwhelming, such as when you have short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See sidebar].
Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer. Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call.
“If it hurts like hell, come to the E.R.,” says Dr. Sergey Motov, assistant program director for emergency medicine at Maimonides Medical Center in Brooklyn. “The problem is that it’s so subjective, there’s no really good objective way to tell when [help is required]. If it’s the worst pain you’ve ever experienced, [come].”
Once you seek medical attention, you should be treated promptly and with compassion. “If you don’t treat acute pain properly, it can become chronic,” Motov says. “If someone comes in with acute pain and it’s sub-optimally treated, they go home and come back in three days and it’s sub-optimally treated again and later on they’re in chronic pain, that started with us because we did not address the acute pain properly in the first place.”
So how should extreme acute pain be treated? Jan Adams, a retired general practitioner herself, describes receiving excellent care after she had back surgery following an injury. She was immediately given strong opioid medication because of the intensity of the pain.
“What they did right was allow me to manage how much pain medication I needed for the first few days,” she says. “I needed more at first and what they did right was to allow me to manage the pain, understanding that there’s a big difference between abuse of pain medication and acute pain use of narcotics.”
Mike Gaynes, a media consultant, received similarly caring treatment with opioids when he reached the ER suffering with kidney stones. Although he does not normally have high blood pressure, the pain had made it skyrocket. “This was cork-popping,” he says, “They gave me I.V. morphine and it helped somewhat, then they gave me more and it helped a little more. It took the edge off but did not shut [the pain] down entirely.”
Lys Fulda, a 36-year-old sales and marketing professional from Chicago, also had a terrifying experience with acute pain during a root canal in her 20s, which left her with a fear of dentists that took 10 years “and a very patient dentist” to conquer.
Fifty-four-year-old Mike Gaynes, a media consultant, suffered extreme acute pain during an attack of kidney stones. On his way to a hike with his wife, he was suddenly overcome by it. “I’ve never been shot or stabbed, but talking to people who have, that’s the closest thing to it,” he says.
Getting the Right Help for Acute Pain
Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.. Receiving prompt and helpful treatment can make all the difference in the world. But lack of care or inadequate care means that the acute pain may develop into chronic agony.
Fortunately, acute pain is not always long lasting or overwhelming, such as when you have short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See sidebar].
Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer. Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call.
“If it hurts like hell, come to the E.R.,” says Dr. Sergey Motov, assistant program director for emergency medicine at Maimonides Medical Center in Brooklyn. “The problem is that it’s so subjective, there’s no really good objective way to tell when [help is required]. If it’s the worst pain you’ve ever experienced, [come].”
Once you seek medical attention, you should be treated promptly and with compassion. “If you don’t treat acute pain properly, it can become chronic,” Motov says. “If someone comes in with acute pain and it’s sub-optimally treated, they go home and come back in three days and it’s sub-optimally treated again and later on they’re in chronic pain, that started with us because we did not address the acute pain properly in the first place.”
So how should extreme acute pain be treated? Jan Adams, a retired general practitioner herself, describes receiving excellent care after she had back surgery following an injury. She was immediately given strong opioid medication because of the intensity of the pain.
“What they did right was allow me to manage how much pain medication I needed for the first few days,” she says. “I needed more at first and what they did right was to allow me to manage the pain, understanding that there’s a big difference between abuse of pain medication and acute pain use of narcotics.”
Mike Gaynes, a media consultant, received similarly caring treatment with opioids when he reached the ER suffering with kidney stones. Although he does not normally have high blood pressure, the pain had made it skyrocket. “This was cork-popping,” he says, “They gave me I.V. morphine and it helped somewhat, then they gave me more and it helped a little more. It took the edge off but did not shut [the pain] down entirely.”
2011年9月26日星期一
Hospitals analyzing the radiation risk
Dr. Paul Gabriel saw a young man in the Grant Medical Center emergency department last week who had kidney pain and blood in his urine.
The default step for the ER director would be to order a CT scan. But the patient had undergone six scans — including one the month before — that all confirmed kidney stones.
To send him for another was probably a waste of time and resources, but more important, it was going to increase the man’s lifetime exposure to radiation.
So they agreed to skip the test.
“He was extremely appreciative,” Gabriel said. “He said, ‘I don’t want to have cancer in 20 years,’ and I said, ‘I don’t want you to.’ ”
Americans are increasingly asking whether medical professionals are doing all they can to limit patients’ exposure to CT scans and X-rays.
Doctors and hospital leaders say they’re investing time and money making sure that decisions are medically wise and err on the side of protecting patients.
“There’s everywhere in America a growing awareness,” said Dr. Richard White, chairman of radiology at the Ohio State University Medical Center. “The awareness is justified, but some of the fear isn’t.”
Patients with cancer, gastrointestinal disorders or repeated kidney stones, for example, have repeated scans and should be most concerned, White and others said.
And if the scans begin early in life, there’s more reason to be cautious, as radiation exposure over many years poses more risk.
Two years ago, news that Cedars-Sinai Medical Center in Los Angeles gave hundreds of patients about eight times the normal amount of radiation during diagnostic scans drew the attention of patients, doctors and regulators, and it has served as a catalyst for improvements nationwide.
Last month, the Joint Commission, which accredits hospitals and often prompts quality-improvement efforts, sent a notice urging health-care providers to find new ways to avoid repeated doses of harmful radiation.
In the past 20 years, Americans’ radiation exposure has nearly doubled because of increased use of imaging.
“CT scanning has become the single-most-important source for radiation exposure in humans,” said Dr. Pablo Ros, chairman of radiology at University Hospitals in Cleveland.
“It’s very successful, very powerful and provides a lot of information, but particularly our nonradiology colleagues may not realize the significance of the radiation exposure,” he said.
At times, those tests aren’t necessary, or the patient might be better served by other diagnostic tools, such as ultrasound or MRI.
If a patient does need a CT scan, the dose can be limited. Other times, no scan is really needed, but doctors feel obligated to order one to guard against legal problems.
“We order way too many CT scans. There’s tremendous pressure,” Gabriel said.
To reduce exposure, hospitals are buying better equipment and educating referring physicians about how best to determine whether CT scans or X-rays are really needed, White said.
At Ohio State and other centers, technicians have been trained to better tailor the scans to patients.
“A little tiny lady won’t get the same strength of the power of the beam as a larger person,” White said.
This practice “takes some more time and effort, but once it’s put into the daily grind, the techs respond well and the patients like it,” Ros said.
Michelle Hamilton, director of radiology at Mount Carmel West, said conversations with patients about the risks and benefits of scans are routine.
And the hospital continues to evaluate changes it can make to reduce exposures, including recently lessening the dosing for cardiac CT scans.
One important advance within the OhioHealth system has been a viewing program that allows radiologists to look at all the scans a patient has had within the system, said Dr. Harlan Meyer, radiology medical director at Grant.
They can see all exams since 2003, and if a patient has had 25 since then, it qualifies as a “ radiation alert,” prompting more evaluation. In some cases, those patients go on to undergo a different diagnostic approach, such as MRI, Meyer said.
The default step for the ER director would be to order a CT scan. But the patient had undergone six scans — including one the month before — that all confirmed kidney stones.
To send him for another was probably a waste of time and resources, but more important, it was going to increase the man’s lifetime exposure to radiation.
So they agreed to skip the test.
“He was extremely appreciative,” Gabriel said. “He said, ‘I don’t want to have cancer in 20 years,’ and I said, ‘I don’t want you to.’ ”
Americans are increasingly asking whether medical professionals are doing all they can to limit patients’ exposure to CT scans and X-rays.
Doctors and hospital leaders say they’re investing time and money making sure that decisions are medically wise and err on the side of protecting patients.
“There’s everywhere in America a growing awareness,” said Dr. Richard White, chairman of radiology at the Ohio State University Medical Center. “The awareness is justified, but some of the fear isn’t.”
Patients with cancer, gastrointestinal disorders or repeated kidney stones, for example, have repeated scans and should be most concerned, White and others said.
And if the scans begin early in life, there’s more reason to be cautious, as radiation exposure over many years poses more risk.
Two years ago, news that Cedars-Sinai Medical Center in Los Angeles gave hundreds of patients about eight times the normal amount of radiation during diagnostic scans drew the attention of patients, doctors and regulators, and it has served as a catalyst for improvements nationwide.
Last month, the Joint Commission, which accredits hospitals and often prompts quality-improvement efforts, sent a notice urging health-care providers to find new ways to avoid repeated doses of harmful radiation.
In the past 20 years, Americans’ radiation exposure has nearly doubled because of increased use of imaging.
“CT scanning has become the single-most-important source for radiation exposure in humans,” said Dr. Pablo Ros, chairman of radiology at University Hospitals in Cleveland.
“It’s very successful, very powerful and provides a lot of information, but particularly our nonradiology colleagues may not realize the significance of the radiation exposure,” he said.
At times, those tests aren’t necessary, or the patient might be better served by other diagnostic tools, such as ultrasound or MRI.
If a patient does need a CT scan, the dose can be limited. Other times, no scan is really needed, but doctors feel obligated to order one to guard against legal problems.
“We order way too many CT scans. There’s tremendous pressure,” Gabriel said.
To reduce exposure, hospitals are buying better equipment and educating referring physicians about how best to determine whether CT scans or X-rays are really needed, White said.
At Ohio State and other centers, technicians have been trained to better tailor the scans to patients.
“A little tiny lady won’t get the same strength of the power of the beam as a larger person,” White said.
This practice “takes some more time and effort, but once it’s put into the daily grind, the techs respond well and the patients like it,” Ros said.
Michelle Hamilton, director of radiology at Mount Carmel West, said conversations with patients about the risks and benefits of scans are routine.
And the hospital continues to evaluate changes it can make to reduce exposures, including recently lessening the dosing for cardiac CT scans.
One important advance within the OhioHealth system has been a viewing program that allows radiologists to look at all the scans a patient has had within the system, said Dr. Harlan Meyer, radiology medical director at Grant.
They can see all exams since 2003, and if a patient has had 25 since then, it qualifies as a “ radiation alert,” prompting more evaluation. In some cases, those patients go on to undergo a different diagnostic approach, such as MRI, Meyer said.
2011年9月25日星期日
Fight kidney disease with weight, not water: prof
Drinking lots of water will not protect your kidneys from disease, but avoiding being overweight might.
That is the message from British kidney researcher and specialist Prof Peter Mathieson, who said in Dunedin yesterday there was a need for increased awareness of kidney disease.
That would include an end to people being squeamish about urine.
People were insufficiently receptive to the messages about keeping their kidneys healthy, but it was the job of health professionals to make information about kidney disease more accessible.
Kidney disease was "not a very sexy subject", but it was a significant health burden.
The best way to prevent kidney disease was to control diabetes and obesity.
Not gaining weight was the most important thing people could do to keep their kidneys healthy, Prof Mathieson said.
Having your blood pressure checked and controlled if necessary, moderating salt and alcohol intake, and "good levels" of physical exercise also played a part.
There was no evidence drinking lots of water protected kidneys, and the vogue for everyone to drink bottled water had no health evidence to support it, he said.
The body's thirst mechanism was extremely powerful and "if you need more water you will feel thirsty. If you don't feel thirsty, you don't need it".
Tap water was perfectly adequate, he said.
However, in some very hot parts of the world, such as Saudi Arabia, there was a need to keep up fluid intake to prevent the urine becoming too concentrated, because this could lead to kidney stones.
Prof Mathieson would ban high energy drinks if he could.
While they did not have a direct damaging effect on kidneys, their high calories led to associated health risks.
There were "very powerful" statistics suggesting the current generation of children would have a lower life expectancy than their parents.
Parents, who generally wanted their children to have a "better deal", should start disease prevention early.
This included encouraging physical activity and avoiding junk foods and high calorie drinks.
In the United Kingdom, there had been an emphasis on increasing physical exercise in the young, but this was not addressing the major problem of calorie intake, he said.
Prof Mathieson, who was the foundation professor of renal medicine at Bristol University where he is now the dean of medicine and dentistry, has been studying protein in urine, a sign of kidney disease; and ways to prevent kidney disease.
Often kidney disease was diagnosed late because it did not produce early symptoms.
A key to early detection was screening the urine for protein using sensitive tests, and the United Kingdom Government was being encouraged to introduce that.
In the long term, it was hoped research would lead to the ability to predict, by genetics or other means, who was at risk; and aim preventive strategies at those people.
People needed to realise paying for treating complications from obesity and diabetes rather than concentrating on prevention was "already overwhelming most of the developed world economies" where some form of health rationing was inevitable.
There were not enough kidney transplants available and the cost of dialysis meant clinicians would be forced to choose which patients would get a good quality of life on dialysis because they were dealing with a "finite resource".
That is the message from British kidney researcher and specialist Prof Peter Mathieson, who said in Dunedin yesterday there was a need for increased awareness of kidney disease.
That would include an end to people being squeamish about urine.
People were insufficiently receptive to the messages about keeping their kidneys healthy, but it was the job of health professionals to make information about kidney disease more accessible.
Kidney disease was "not a very sexy subject", but it was a significant health burden.
The best way to prevent kidney disease was to control diabetes and obesity.
Not gaining weight was the most important thing people could do to keep their kidneys healthy, Prof Mathieson said.
Having your blood pressure checked and controlled if necessary, moderating salt and alcohol intake, and "good levels" of physical exercise also played a part.
There was no evidence drinking lots of water protected kidneys, and the vogue for everyone to drink bottled water had no health evidence to support it, he said.
The body's thirst mechanism was extremely powerful and "if you need more water you will feel thirsty. If you don't feel thirsty, you don't need it".
Tap water was perfectly adequate, he said.
However, in some very hot parts of the world, such as Saudi Arabia, there was a need to keep up fluid intake to prevent the urine becoming too concentrated, because this could lead to kidney stones.
Prof Mathieson would ban high energy drinks if he could.
While they did not have a direct damaging effect on kidneys, their high calories led to associated health risks.
There were "very powerful" statistics suggesting the current generation of children would have a lower life expectancy than their parents.
Parents, who generally wanted their children to have a "better deal", should start disease prevention early.
This included encouraging physical activity and avoiding junk foods and high calorie drinks.
In the United Kingdom, there had been an emphasis on increasing physical exercise in the young, but this was not addressing the major problem of calorie intake, he said.
Prof Mathieson, who was the foundation professor of renal medicine at Bristol University where he is now the dean of medicine and dentistry, has been studying protein in urine, a sign of kidney disease; and ways to prevent kidney disease.
Often kidney disease was diagnosed late because it did not produce early symptoms.
A key to early detection was screening the urine for protein using sensitive tests, and the United Kingdom Government was being encouraged to introduce that.
In the long term, it was hoped research would lead to the ability to predict, by genetics or other means, who was at risk; and aim preventive strategies at those people.
People needed to realise paying for treating complications from obesity and diabetes rather than concentrating on prevention was "already overwhelming most of the developed world economies" where some form of health rationing was inevitable.
There were not enough kidney transplants available and the cost of dialysis meant clinicians would be forced to choose which patients would get a good quality of life on dialysis because they were dealing with a "finite resource".
2011年9月22日星期四
WHMP radio personality Chris Collins recovering after near-death ordeal
"Look, I'm not dead," said Chris Collins from his home Tuesday, as he sought to dispel rumors that suggested that very thing. "I'm also not brain-dead, blind, or any of the other things people have heard."
Of course, Collins, 43, who had been WHMP's news and program director since 2001 before his major organs shut down, was at death's door all summer and not expected to pull through. All of it brought on, he said, by a decade of burning candles at both ends and playing "fast and loose with Type 2 diabetes for years. I was riding for a fall."
He also strongly relates to the tail-end of "The Sopranos'" run, where Mob boss Tony, in a coma after being shot by his uncle, goes into this altered state as a harried heating salesman from Arizona, Kevin Finnerty. Collins can tell you about comas.
And talk about a shell of one's former self. In the last six months, betweenkidney failure, a three-week coma and open heart surgery, Collins has involuntarily shed 116 pounds, which puts him roughly at his 1986 fighting weight of 212, when he was the goalie for Greenfield High's hockey team. Not that he's in any shape to start lacing 'em up and taking his place between the pipes. But he's alive. Which may be some sort of a modern miracle in itself. "My nurses couldn't believe I was alive," he said.
Collins' ordeal began in late March, with intense pain in his back. Since he had been rushed to the hospital 2½ years before with what turned out to bekidney stones, he thought he was in for more of the same. But this time it proved to be a blocked right ureter, which led to a kidney infection. "My kidneys basically stopped functioning," he said. "It came out of the blue - I never saw this happening."
Co-workers at WHMP who saw him taken by ambulance to Cooley Dickinson that morning suspected it was a heart attack.
Renal stents were inserted to allow Collins' kidneys to function. He was sent home to recuperate, but the drug regimen he was prescribed had adverse affects. "I had (the stents) in for three months," he said, "but the bloating - I bloated like a mile-high balloon. Couldn't sleep, could barely walk upstairs; it was obvious that something was wrong. My echocardiogram was high but normal, but my symptoms were not consistent with that," he said.
An ambulance's wail could be heard once again in Collins' ears. "The last thing I remember is being wheeled into the Franklin ER.," said Collins. The paddles of a defibrillator shocked his heart back to life and again when he was rushed to Baystate Medical Center in Springfield. Collins credits cardiologist Mara Slowsky with saving his life. "She saw that my heart was beating at 15 percent capacity. Major blockage. They drained 2 liters of fluid out of my chest."
He went into a coma - from late July to mid-August he was on extreme life support. "I coded three times and three times they brought me back," said Collins. "It was hour-to-hour, minute-to-minute."
Of course, Collins, 43, who had been WHMP's news and program director since 2001 before his major organs shut down, was at death's door all summer and not expected to pull through. All of it brought on, he said, by a decade of burning candles at both ends and playing "fast and loose with Type 2 diabetes for years. I was riding for a fall."
He also strongly relates to the tail-end of "The Sopranos'" run, where Mob boss Tony, in a coma after being shot by his uncle, goes into this altered state as a harried heating salesman from Arizona, Kevin Finnerty. Collins can tell you about comas.
And talk about a shell of one's former self. In the last six months, between
Collins' ordeal began in late March, with intense pain in his back. Since he had been rushed to the hospital 2½ years before with what turned out to be
Co-workers at WHMP who saw him taken by ambulance to Cooley Dickinson that morning suspected it was a heart attack.
Renal stents were inserted to allow Collins' kidneys to function. He was sent home to recuperate, but the drug regimen he was prescribed had adverse affects. "I had (the stents) in for three months," he said, "but the bloating - I bloated like a mile-high balloon. Couldn't sleep, could barely walk upstairs; it was obvious that something was wrong. My echocardiogram was high but normal, but my symptoms were not consistent with that," he said.
An ambulance's wail could be heard once again in Collins' ears. "The last thing I remember is being wheeled into the Franklin ER.," said Collins. The paddles of a defibrillator shocked his heart back to life and again when he was rushed to Baystate Medical Center in Springfield. Collins credits cardiologist Mara Slowsky with saving his life. "She saw that my heart was beating at 15 percent capacity. Major blockage. They drained 2 liters of fluid out of my chest."
He went into a coma - from late July to mid-August he was on extreme life support. "I coded three times and three times they brought me back," said Collins. "It was hour-to-hour, minute-to-minute."
2011年9月21日星期三
Maxims, aphorisms: true and false
We base much of our lives on scraps of wisdom known as maxims or aphorisms. Some of them have value; many are nonsense, and should be disregarded.
Today, let’s examine some of these pithy sayings.
“This, too, will pass.” That’s known as thekidney stone philosophy. It has some truth to it, in that most events – both good and bad – ultimately fade away. But not always. Ask anyone who has lost a child, or who has contracted AIDS.
“If at first you don’t succeed, try, try again. Then quit. There’s no use being a damn fool about it.” W.C. Fields gave that advice, and I’ve followed it all my life.
Another of his utterances that I heeded for many years: “You can judge a man by what he believes. And I believe I’ll have another drink.”
“When one door closes, another will open.” That saying has sustained millions of people who have met misfortune. It occurs to me, however, that during an economic slump there seems to be fewer doors opening than there are in boom times.
“You’re only as sick as your secrets.” That little piece of rubbish is peddled by amateur therapists who want to peer into every cranny of a troubled person’s mind. Truth is, our secrets are what form much of our character. Without them, we risk turning into human ciphers.
“No pain, no gain.” I’m told such advice is valid for body-builders, who must tear down muscle tissue to allow it to rebuild into even a larger mass. And that hurts. But I don’t think pain or great stress is an automatic prerequisite for all other forms of improvement. Think of being taught how to dance, by an attractive partner. Any pain there?
“Use it or lose it.” What a load. Dear Abby often used that in her advice columns, trying to encourage people to resume romantic relationships after a bust-up. She implied that your erotic apparatus will fall off or dry up unless it’s kept on the firing line. Abby was wrong. Anyone who’s had to undergo celibacy for a time can testify that when the good times resume, the equipment is ready and waiting. And there’s seldom any rust on it.
“Life is either a daring adventure, or nothing.” – Helen Keller.
“If you ain’t busy living, you’re busy dying.”– Bob Dylan.
These examples of all-or-nothing philosophy ignore the fact that most people go along quite well at 30 to 50 mph. We don’t have to be busting a monumental gut or striving for the Olympics in order to enjoy life and find it meaningful. For every person who’d choose daring adventure, ten would opt for solid, predictable comfort.
“The measure of a man is what he does with power.” Quite true. Or how he treats waitresses.
“That which does not kill you makes you stronger.” The German nut job Nietzsche foisted that blob of horse puckey on the waiting world, and it has been gobbled up by millions. Except for people who were maimed while serving in Vietnam and Mideast wars, or survived Hiroshima and Nagasaki, or went through a few years of chemotherapy. Folks like that may not be dead, but they’re seldom stronger.
“Cynicism isn’t smarter, it’s only safer.” Marvelous. Right on target.
“Don’t look back. Someone may be gaining on you.” Pitcher Satchel Paige said that. Few ball players ever gained on him, however.
“There is time for everything.” So said Thomas Alva Edison, who was never a mother with six small children squalling for her attention.
“You got to have a dream. If you don’t have a dream, how you gonna have a dream come true?” Bloody Mary sang that lovely line from a great song in a superb musical, “South Pacific.” Words to live by, through thick and thin.
“Cheaters never prosper.” Hedge fund managers and mortgage brokers throughout the land double over with laughter each time someone breaks out that idealistic adage. The sad truth is that cheaters often have a leg up on all other contestants.
“Never say more than is necessary.” British playwright Richard Brinsley Sheridan (1751-1816) is the source of that quotation, which has been ignored by politicians, columnists and almost everyone else you can name, ever since.
“Life is like a game of cards. The hand that is dealt you represents determinism; the way you play it is free will.” A great deal of wisdom in that statement, but it can drive you crazy if you review some of the stupid moves you’ve freely made, especially after four martinis and Charlene’s fingers caressing your cheek.
Today, let’s examine some of these pithy sayings.
“This, too, will pass.” That’s known as the
“If at first you don’t succeed, try, try again. Then quit. There’s no use being a damn fool about it.” W.C. Fields gave that advice, and I’ve followed it all my life.
Another of his utterances that I heeded for many years: “You can judge a man by what he believes. And I believe I’ll have another drink.”
“When one door closes, another will open.” That saying has sustained millions of people who have met misfortune. It occurs to me, however, that during an economic slump there seems to be fewer doors opening than there are in boom times.
“You’re only as sick as your secrets.” That little piece of rubbish is peddled by amateur therapists who want to peer into every cranny of a troubled person’s mind. Truth is, our secrets are what form much of our character. Without them, we risk turning into human ciphers.
“No pain, no gain.” I’m told such advice is valid for body-builders, who must tear down muscle tissue to allow it to rebuild into even a larger mass. And that hurts. But I don’t think pain or great stress is an automatic prerequisite for all other forms of improvement. Think of being taught how to dance, by an attractive partner. Any pain there?
“Use it or lose it.” What a load. Dear Abby often used that in her advice columns, trying to encourage people to resume romantic relationships after a bust-up. She implied that your erotic apparatus will fall off or dry up unless it’s kept on the firing line. Abby was wrong. Anyone who’s had to undergo celibacy for a time can testify that when the good times resume, the equipment is ready and waiting. And there’s seldom any rust on it.
“Life is either a daring adventure, or nothing.” – Helen Keller.
“If you ain’t busy living, you’re busy dying.”– Bob Dylan.
These examples of all-or-nothing philosophy ignore the fact that most people go along quite well at 30 to 50 mph. We don’t have to be busting a monumental gut or striving for the Olympics in order to enjoy life and find it meaningful. For every person who’d choose daring adventure, ten would opt for solid, predictable comfort.
“The measure of a man is what he does with power.” Quite true. Or how he treats waitresses.
“That which does not kill you makes you stronger.” The German nut job Nietzsche foisted that blob of horse puckey on the waiting world, and it has been gobbled up by millions. Except for people who were maimed while serving in Vietnam and Mideast wars, or survived Hiroshima and Nagasaki, or went through a few years of chemotherapy. Folks like that may not be dead, but they’re seldom stronger.
“Cynicism isn’t smarter, it’s only safer.” Marvelous. Right on target.
“Don’t look back. Someone may be gaining on you.” Pitcher Satchel Paige said that. Few ball players ever gained on him, however.
“There is time for everything.” So said Thomas Alva Edison, who was never a mother with six small children squalling for her attention.
“You got to have a dream. If you don’t have a dream, how you gonna have a dream come true?” Bloody Mary sang that lovely line from a great song in a superb musical, “South Pacific.” Words to live by, through thick and thin.
“Cheaters never prosper.” Hedge fund managers and mortgage brokers throughout the land double over with laughter each time someone breaks out that idealistic adage. The sad truth is that cheaters often have a leg up on all other contestants.
“Never say more than is necessary.” British playwright Richard Brinsley Sheridan (1751-1816) is the source of that quotation, which has been ignored by politicians, columnists and almost everyone else you can name, ever since.
“Life is like a game of cards. The hand that is dealt you represents determinism; the way you play it is free will.” A great deal of wisdom in that statement, but it can drive you crazy if you review some of the stupid moves you’ve freely made, especially after four martinis and Charlene’s fingers caressing your cheek.
2011年9月20日星期二
Teen gets wish to spend a summer by the lake
Karrie Nichols got her wish this summer to spend every day looking out over Hartwell Lake and casting her rod into its waters.
The 17-year-old West Union resident has the most severe form of spina bifida, a disorder of the spinal cord that has paralyzed her from the waist down since birth.
Since mid-June, she has been living at a new campsite built just for her at the Coneross Campground in Oconee County. Her parents are with her, monitoring her medications and making sure she is comfortable — complications of the disease have caused several infections and kidney stones.
But like any teenager, U.S. Army Corps of Engineers chief ranger Zach Harkness said, Karrie wants a measure of independence.
“We built a concrete pad so she can get around by herself,” Harkness said. “Then there’s a sidewalk to go down to the shoreline. Then we built a fishing bulkhead with rails. She can take herself down there as she pleases.”
And she does.
Karrie is shy, choosing to speak only to those she’s known for a while — especially when she’s not feeling well. She offers an occasional smile and wry look to strangers. Jean Brown, a clinical nurse specialist at the Shriners Hospital of Greenville, said Karrie typically picks one person at the hospital to open up to.
“She’s a funny girl,” Brown said.
Karrie’s father, Ricky Nichols, vouched for his daughter’s catches this summer — mostly bream and a catfish or two.
“The first time she fished, there was something on the line, and she didn’t know it,” he said.
Family members helped net the fish.
Brown recommended Karrie for this special gift from the U.S. Corps of Engineers after the teen spent more than three months in the hospital last spring. She had been on life support after an infection made her ill and her temperature spiked to 105 degrees. Shortly thereafter, she had surgery for kidney stones.
“We didn’t know if we’d lose her,” said Karrie’s mother, Kathy Nichols.
“She didn’t want to eat or drink,” her father said.
The Atlanta-based Children’s Wish Foundation coordinated the details of Karrie’s gift, but the corps took on all the expenses, including giving the campsite free to the Nicholses all summer.
Karrie takes seizure medicines every six hours, and the frequency of her infections has rendered most antibiotics ineffective. She is on oxygen at night. She faces surgery for 11 more kidney stones again this fall, and her father said he knows it could be dangerous.
Spina bifida occurs during a baby’s early development in the womb. The material that will become the baby’s spine does not fully fuse, and the resulting hole exposes the enclosed nerves, said Amanda Darnley, spokeswoman for the Spina Bifida Association. No one knows the exact cause, though it has been linked to a deficiency of folic acid in the mother’s diet.
“We call them $1 million babies,” Darnley said. “The cost to a family or society is about $1 million by the time they reach the age of 10. The cost is overwhelming. Depending on actual conditions, they may face additional surgeries as they get older.”
When Karrie was born, several nerve endings protruded through her back, her father said, and she had a 50 percent chance of survival. Surgery within days of her birth closed the fist-sized wound, but the damage was already done. She’d lost the ability to control her legs.
“They took the feeding tubes off, and she ate. They took the breathing tube off, and she was still breathing,” her father said. “Her doctor couldn’t believe it.”
Her body’s response to the exposed nerves was to create an excess of spinal fluid, which built up in her brain. Doctors inserted a shunt into her head that still drains fluid from her head down to her belly.
The 17-year-old West Union resident has the most severe form of spina bifida, a disorder of the spinal cord that has paralyzed her from the waist down since birth.
Since mid-June, she has been living at a new campsite built just for her at the Coneross Campground in Oconee County. Her parents are with her, monitoring her medications and making sure she is comfortable — complications of the disease have caused several infections and kidney stones.
But like any teenager, U.S. Army Corps of Engineers chief ranger Zach Harkness said, Karrie wants a measure of independence.
“We built a concrete pad so she can get around by herself,” Harkness said. “Then there’s a sidewalk to go down to the shoreline. Then we built a fishing bulkhead with rails. She can take herself down there as she pleases.”
And she does.
Karrie is shy, choosing to speak only to those she’s known for a while — especially when she’s not feeling well. She offers an occasional smile and wry look to strangers. Jean Brown, a clinical nurse specialist at the Shriners Hospital of Greenville, said Karrie typically picks one person at the hospital to open up to.
“She’s a funny girl,” Brown said.
Karrie’s father, Ricky Nichols, vouched for his daughter’s catches this summer — mostly bream and a catfish or two.
“The first time she fished, there was something on the line, and she didn’t know it,” he said.
Family members helped net the fish.
Brown recommended Karrie for this special gift from the U.S. Corps of Engineers after the teen spent more than three months in the hospital last spring. She had been on life support after an infection made her ill and her temperature spiked to 105 degrees. Shortly thereafter, she had surgery for kidney stones.
“We didn’t know if we’d lose her,” said Karrie’s mother, Kathy Nichols.
“She didn’t want to eat or drink,” her father said.
The Atlanta-based Children’s Wish Foundation coordinated the details of Karrie’s gift, but the corps took on all the expenses, including giving the campsite free to the Nicholses all summer.
Karrie takes seizure medicines every six hours, and the frequency of her infections has rendered most antibiotics ineffective. She is on oxygen at night. She faces surgery for 11 more kidney stones again this fall, and her father said he knows it could be dangerous.
Spina bifida occurs during a baby’s early development in the womb. The material that will become the baby’s spine does not fully fuse, and the resulting hole exposes the enclosed nerves, said Amanda Darnley, spokeswoman for the Spina Bifida Association. No one knows the exact cause, though it has been linked to a deficiency of folic acid in the mother’s diet.
“We call them $1 million babies,” Darnley said. “The cost to a family or society is about $1 million by the time they reach the age of 10. The cost is overwhelming. Depending on actual conditions, they may face additional surgeries as they get older.”
When Karrie was born, several nerve endings protruded through her back, her father said, and she had a 50 percent chance of survival. Surgery within days of her birth closed the fist-sized wound, but the damage was already done. She’d lost the ability to control her legs.
“They took the feeding tubes off, and she ate. They took the breathing tube off, and she was still breathing,” her father said. “Her doctor couldn’t believe it.”
Her body’s response to the exposed nerves was to create an excess of spinal fluid, which built up in her brain. Doctors inserted a shunt into her head that still drains fluid from her head down to her belly.
2011年9月19日星期一
We all need help to navigate rough waters
How do you do it?" is a question put to many a working parent. My husband and I have been working parents for the past 24 years and still wonder how we can handle life's expected and unexpected challenges.
It reminds me of riding the rapids. We had quite a ride this last month.
Summer is a time of playing catch up to doctor and dentist check ups for the kids. When you have multiple kids, you can have one or two appointments each week.
Here was my list for the month: wisdom teeth out, eye doctor for contacts, physical exam, dentist check up, and orthodontist. My husband and I had to dig in our paddles to get through the doctor visit "rapids" with our busy work schedules.
In the middle of this month, my husband had a bout with kidney stones while driving home from work. He pulled over and called 911. An ambulance and two fire trucks responded. He was taken to the emergency room.
From then on I compare the experience to being caught in a white water hydraulic. Once you are pulled in, you really struggle.
An older daughter got to the hospital first. A friend helped us pick up the car he abandoned on the highway. My travel scheduled had to be cancelled. The kids at home had to fend for themselves.
When it got to be around midnight and I was beat, who did I call? My night owl college age daughter, who came and stayed with her dad. I thought to myself, how fitting, she normally starts her evenings out at midnight anyway.
In the end, he had to go through two separate procedures to get the kidney stones out. Poor guy!
As working parents know, time does not stand still at the office while the river of life takes its twists and turns. I had my laptop, Blackberry and brief case and carried on business in the waiting rooms and halls of doctors, dentists and even throughout the time warp of the emergency room.
It reminds me of riding the rapids. We had quite a ride this last month.
Summer is a time of playing catch up to doctor and dentist check ups for the kids. When you have multiple kids, you can have one or two appointments each week.
Here was my list for the month: wisdom teeth out, eye doctor for contacts, physical exam, dentist check up, and orthodontist. My husband and I had to dig in our paddles to get through the doctor visit "rapids" with our busy work schedules.
In the middle of this month, my husband had a bout with kidney stones while driving home from work. He pulled over and called 911. An ambulance and two fire trucks responded. He was taken to the emergency room.
From then on I compare the experience to being caught in a white water hydraulic. Once you are pulled in, you really struggle.
An older daughter got to the hospital first. A friend helped us pick up the car he abandoned on the highway. My travel scheduled had to be cancelled. The kids at home had to fend for themselves.
When it got to be around midnight and I was beat, who did I call? My night owl college age daughter, who came and stayed with her dad. I thought to myself, how fitting, she normally starts her evenings out at midnight anyway.
In the end, he had to go through two separate procedures to get the kidney stones out. Poor guy!
As working parents know, time does not stand still at the office while the river of life takes its twists and turns. I had my laptop, Blackberry and brief case and carried on business in the waiting rooms and halls of doctors, dentists and even throughout the time warp of the emergency room.
Nurse Accused of Stealing Pain Meds Gets Probation
The nurse who reportedly told her patient to "man up and take some pain" after allegedly stealing a portion of his intended fentanyl dose has copped a plea that will keep her out of jail.
Sarah Casareto, RN, received 3 years' probation as part of the plea agreement. The alleged theft occurred while she was tending to patient Larry King, 56, who was on his way to the OR forkidney stone
"Clearly I remember (the "man up" comment)," Mr. King told local reporters. "I can't really use the language I'd use to describe what it's like when you lay on that table and can hear and feel everything they're doing to you."
OR personnel reportedly had to hold down the screaming and moaning Mr. King during the procedure. Ms. Casareto, who was said to appear drugged, told him to "Go to your beach. Go to your happy place."
Ms. Casareto's attorney says he was prepared to call witnesses who would have denied that Mr. King was in excessive pain during the procedure. But he refused to comment further, citing Ms. Casareto's pending review before the state nursing board, where she will attempt to regain her license.
Tony Nemo, Mr. King's attorney, says he "vigorously" opposed the plea deal and is pursuing civil lawsuits against Ms. Casareto and the hospital that formerly employed her.
"Due to confidentiality we cannot discuss current or former employees," said Abbot Northwestern in a statement issued at the time of Ms. Casareto's arrest in February. "She no longer works (at the hospital). Patient safety is our primary concern."
Sarah Casareto, RN, received 3 years' probation as part of the plea agreement. The alleged theft occurred while she was tending to patient Larry King, 56, who was on his way to the OR for
"Clearly I remember (the "man up" comment)," Mr. King told local reporters. "I can't really use the language I'd use to describe what it's like when you lay on that table and can hear and feel everything they're doing to you."
OR personnel reportedly had to hold down the screaming and moaning Mr. King during the procedure. Ms. Casareto, who was said to appear drugged, told him to "Go to your beach. Go to your happy place."
Ms. Casareto's attorney says he was prepared to call witnesses who would have denied that Mr. King was in excessive pain during the procedure. But he refused to comment further, citing Ms. Casareto's pending review before the state nursing board, where she will attempt to regain her license.
Tony Nemo, Mr. King's attorney, says he "vigorously" opposed the plea deal and is pursuing civil lawsuits against Ms. Casareto and the hospital that formerly employed her.
"Due to confidentiality we cannot discuss current or former employees," said Abbot Northwestern in a statement issued at the time of Ms. Casareto's arrest in February. "She no longer works (at the hospital). Patient safety is our primary concern."
2011年9月18日星期日
Kidney Stoned, But Recovering
What started with a wicked pain in my side the last week in June morphed into a summer’s worth of pain, infection, complication, hospitalization, ICU, procedures, sick days, frustration, rage, humility and a new knowledge of myself I didn’t imagine when my king hell kidney stone first announced its presence.
I’ve been one of those guys who just doesn’t get really sick. I’ll have the occasional flu or upper respiratory infection, sprain or cavity. The sort of minor ache or ailment that requires the minimal amount of medical care—take two aspirin and call me in the morning.
But after the first treatment didn’t work and the second came with complications, and I found myself catheterized, on a steel table in the emergency room with a 103.5 fever and the doctor on duty saying “you’re staying in the hospital,” I realized that with middle age had arrived middle aged discontents, illness and medical procedures a big part of them.
My family was traumatized, my workplace amazingly understanding, some friends engaged and concerned while others unaware of my travails (I didn’t post the gnarly details to Facebook—you’re welcome). I'm blessed to have a good health insurance plan.
But inside my head things reached a point where I wondered what the next complication might be, whether a fever that turned into a night in the hospital and spread into a six-day stay would morph into something more menacing.
Then it did. Back in the hospital for an outpatient procedure days later I unexpectedly aspirated under general anesthesia, only to awaken 16 hours later, hands tied down to the bed rails and tubes down my throat to my lungs and stomach. It was the sort of living horror movie I only imagined in those disengaged moments when the lawyer explains the medical power of attorney and living will documents before you sign.
All in all, my doctor said I was lucky to come out of it with two days in the ICU and a bad sore throat and congested lungs; I could’ve had a tracheotomy and been on a ventilator. Laying there with multiple tubes in and out of my body it was hard to feel lucky.
But the anesthesiologist had been quick on the draw, my doctor was able to extract the malevolent renal calculus, and though greatly weakened, I was on my way back to my workaday week, the simple joys of my family, and the entitled curmudgeonliness Patch lets me display here from time to time.
So it came to be this week I had a final procedure and was cleared by my doctor with the happy news that he didn’t want to see me for six months. I’m regaining strength, and I’m happy for the little things. My child’s hug, a wife who can freak out a little less, a walk outside in the evening air, four in the morning passing without someone waking me up to draw blood—these are a few of my favorite things, to paraphrase Hammerstein.
That which does not kill us makes us stronger. Nietzsche wrote that, and I’m trying to make it fit my current situation, although I’m still weak enough that I can’t quite yet play practice goalie for my daughter’s pre-practice soccer workouts. My fears about growing old and invasive medical procedures have been realized.
It won’t make the next round, should it come, any easier. But I certainly will have a higher threshold for pain, embarrassment, frustration and rage. And I think I’ll try to not sweat the minor aggravations as much.
As I lay in the hospital in the evening gloaming one night, machines going ping and beep around me and nurse-angels drifting by my bed to hang another bag of antibiotics or shoot another syringe of sweet narcotic into my lines to kill the pain, I wondered if things would ever return to normal for me and if I would appreciate them more if they did.
They are, and I’m trying.
I’ve been one of those guys who just doesn’t get really sick. I’ll have the occasional flu or upper respiratory infection, sprain or cavity. The sort of minor ache or ailment that requires the minimal amount of medical care—take two aspirin and call me in the morning.
But after the first treatment didn’t work and the second came with complications, and I found myself catheterized, on a steel table in the emergency room with a 103.5 fever and the doctor on duty saying “you’re staying in the hospital,” I realized that with middle age had arrived middle aged discontents, illness and medical procedures a big part of them.
My family was traumatized, my workplace amazingly understanding, some friends engaged and concerned while others unaware of my travails (I didn’t post the gnarly details to Facebook—you’re welcome). I'm blessed to have a good health insurance plan.
But inside my head things reached a point where I wondered what the next complication might be, whether a fever that turned into a night in the hospital and spread into a six-day stay would morph into something more menacing.
Then it did. Back in the hospital for an outpatient procedure days later I unexpectedly aspirated under general anesthesia, only to awaken 16 hours later, hands tied down to the bed rails and tubes down my throat to my lungs and stomach. It was the sort of living horror movie I only imagined in those disengaged moments when the lawyer explains the medical power of attorney and living will documents before you sign.
All in all, my doctor said I was lucky to come out of it with two days in the ICU and a bad sore throat and congested lungs; I could’ve had a tracheotomy and been on a ventilator. Laying there with multiple tubes in and out of my body it was hard to feel lucky.
But the anesthesiologist had been quick on the draw, my doctor was able to extract the malevolent renal calculus, and though greatly weakened, I was on my way back to my workaday week, the simple joys of my family, and the entitled curmudgeonliness Patch lets me display here from time to time.
So it came to be this week I had a final procedure and was cleared by my doctor with the happy news that he didn’t want to see me for six months. I’m regaining strength, and I’m happy for the little things. My child’s hug, a wife who can freak out a little less, a walk outside in the evening air, four in the morning passing without someone waking me up to draw blood—these are a few of my favorite things, to paraphrase Hammerstein.
That which does not kill us makes us stronger. Nietzsche wrote that, and I’m trying to make it fit my current situation, although I’m still weak enough that I can’t quite yet play practice goalie for my daughter’s pre-practice soccer workouts. My fears about growing old and invasive medical procedures have been realized.
It won’t make the next round, should it come, any easier. But I certainly will have a higher threshold for pain, embarrassment, frustration and rage. And I think I’ll try to not sweat the minor aggravations as much.
As I lay in the hospital in the evening gloaming one night, machines going ping and beep around me and nurse-angels drifting by my bed to hang another bag of antibiotics or shoot another syringe of sweet narcotic into my lines to kill the pain, I wondered if things would ever return to normal for me and if I would appreciate them more if they did.
They are, and I’m trying.
2011年9月15日星期四
Family holds fundraiser to help find cure for son's rare disease
Mason Reiter of Livonia is an active 6-year-old boy who loves swimming, elephants and Star Wars.
But since infancy, he has suffered from an extremely rare genetic disease of the kidney and liver that causes the formation of painful kidney stones. Currently, the only available treatment for the disease, called primary hyperoxaluria, is a combined kidney and liver transplant, which can lead to severe complications.
“If you saw Mason, you wouldn't know he has a genetic disease,” said Alison R. De Noia, project manager of the Oxalosis & Hyperoxaluria Foundation. “Mason loves to run, jump and play with his friends. He always has a smile on his face when you meet him that will warm your heart.”
But when a stone passes, it causes him so much pain that he has fainted in the past. And doctors say Mason's kidney can crystallize and fail at any time, with no warning.
“No child should have to suffer this way,” De Noia said.
Mason's family members are hoping for a cure.
To that end, they will host the inaugural “Take the Challenge Walk for a Cure” in honor of Mason at 1 p.m. Sunday, Sept. 25, at Wayne County Parks' Nankin Mills in Westland.
“We need to A) raise dollars and B) raise awareness,” said Mason's mom, Nancy Reiter.
All proceeds will benefit the OHF, the only foundation in the world dedicated to finding a cure for hyperoxaluria. The OHF also funds the Hyperoxaluria Center at the Mayo Clinic, which treats Mason. “They are the specialists in this disease. We want to keep that center open,” Reiter said.
Reiter said awareness needs to be raised because the disease is so rare, health professionals at local hospitals don't know about it and don't know how to treat the complications that arise from it.
For example, Mason has been treated locally for pneumonia four times because of breathing problems. “He was on medication and the levels weren't correct,” his mother said.
Mason passed his first known kidney stone at age 15 months. But there was at least one time before that that his mother suspects he passed a stone. “He screamed to the point where he fainted,” she said. “He was in a walker. I had no idea; I thought maybe his finger was pinched.”
After Mason was diagnosed at age 2'ªø1‚-2, doctors put him on a low-oxalate diet, which means avoiding foods like chocolate, and ordered him to drink two liters of fluid a day. He goes for ultrasounds every four months and blood draws about every eight weeks.
“The scary part of this disease is dialysis doesn't work. The kidney actually crystallizes,” Reiter said, explaining that patients with Mason's disease produce large levels of oxalate because of a missing liver enzyme.
“We hope with increased fluids, we can keep the kidney working,” she said, adding Mason already has reduced kidney function. She said doctors have told them they may not have any advance warning of kidney failure. “He could get the flu at school and if it dehydrates, he could go into failure.”
According to De Noia, all patients with primary hyperoxaluria have kidney stones, 50 percent have kidney failure by age 15 and 80 percent have kidney failure by age 30.
But since infancy, he has suffered from an extremely rare genetic disease of the kidney and liver that causes the formation of painful kidney stones. Currently, the only available treatment for the disease, called primary hyperoxaluria, is a combined kidney and liver transplant, which can lead to severe complications.
“If you saw Mason, you wouldn't know he has a genetic disease,” said Alison R. De Noia, project manager of the Oxalosis & Hyperoxaluria Foundation. “Mason loves to run, jump and play with his friends. He always has a smile on his face when you meet him that will warm your heart.”
But when a stone passes, it causes him so much pain that he has fainted in the past. And doctors say Mason's kidney can crystallize and fail at any time, with no warning.
“No child should have to suffer this way,” De Noia said.
Mason's family members are hoping for a cure.
To that end, they will host the inaugural “Take the Challenge Walk for a Cure” in honor of Mason at 1 p.m. Sunday, Sept. 25, at Wayne County Parks' Nankin Mills in Westland.
“We need to A) raise dollars and B) raise awareness,” said Mason's mom, Nancy Reiter.
All proceeds will benefit the OHF, the only foundation in the world dedicated to finding a cure for hyperoxaluria. The OHF also funds the Hyperoxaluria Center at the Mayo Clinic, which treats Mason. “They are the specialists in this disease. We want to keep that center open,” Reiter said.
Reiter said awareness needs to be raised because the disease is so rare, health professionals at local hospitals don't know about it and don't know how to treat the complications that arise from it.
For example, Mason has been treated locally for pneumonia four times because of breathing problems. “He was on medication and the levels weren't correct,” his mother said.
Mason passed his first known kidney stone at age 15 months. But there was at least one time before that that his mother suspects he passed a stone. “He screamed to the point where he fainted,” she said. “He was in a walker. I had no idea; I thought maybe his finger was pinched.”
After Mason was diagnosed at age 2'ªø1‚-2, doctors put him on a low-oxalate diet, which means avoiding foods like chocolate, and ordered him to drink two liters of fluid a day. He goes for ultrasounds every four months and blood draws about every eight weeks.
“The scary part of this disease is dialysis doesn't work. The kidney actually crystallizes,” Reiter said, explaining that patients with Mason's disease produce large levels of oxalate because of a missing liver enzyme.
“We hope with increased fluids, we can keep the kidney working,” she said, adding Mason already has reduced kidney function. She said doctors have told them they may not have any advance warning of kidney failure. “He could get the flu at school and if it dehydrates, he could go into failure.”
According to De Noia, all patients with primary hyperoxaluria have kidney stones, 50 percent have kidney failure by age 15 and 80 percent have kidney failure by age 30.
2011年9月14日星期三
Natural Supplements to Address Kidney and Gallbladder Stones
Kidney stones are one of the most common disorders of the urinary tract, reported to affect about 12 percent of men and 5 percent of women over their lifetime.
Certain factors appear to increase the risk of kidney stones, such as a high-animal-fat diet with resulting increased urinary acidity; low fiber intake; low fluid intake; gout (high uric acid levels); high blood pressure, family history; being overweight; and inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. There is no conclusive evidence that calcium supplements or foods containing oxalates increase the risk of kidney stones. High doses of vitamin C may aggravate kidney stone development in susceptible individuals.
In the case of gallbladder stones, a low-fat, low-cholesterol diet is advisable to prevent gallstone formation, but some susceptible individuals may develop gallstones even when consuming a healthy diet.
Patients who develop kidney or gallbladder stones may wish to take a combination supplement containing ingredients shown to help dissolve stones and prevent their recurrence. The best evidence in this regard suggests supplementation with the herb Chanca piedra, vitamin B6 and magnesium.
Chanca piedra is a popular South American herb that has been used to dissolve and eliminate kidney stones and gallbladder stones. The English translation for Chanca piedra is "stone crusher." Recent scientific evidence has provided solid evidence of this therapeutic effect. A 2006 Brazilian study showed that the therapeutic effect of Chanca piedra may be due to its ability to modify the shape and texture of stones (calculi) to a smoother and more fragile form, which would allow for easier elimination and/or dissolution of the stones.1
Another study demonstrated that Chanca piedra has an inhibitory effect on crystal growth and aggregation in human urine, which may inhibit stone formation, acting as an important part of a prevention strategy in those with a past history of kidney stones.2
A 2006 study involving 150 patients with kidney stones tested the efficacy of Chanca piedra supplementation in patients administered shock-wave therapy. Shock-wave therapy (delivered from outside the body) breaks down stones to facilitate their elimination. Upon completion of this therapy, approximately half of the patients were given 2 grams of Chanca piedra every day for 30 days. The remainder of the group did not take the herb and acted as controls. Stone clearance was assessed after 30, 60, 90 and 180 days by abdominal X-ray and ultrasound scan. The herb-supplemented patients were shown to have a stone-free rate 10-23 percent higher than the control group.3
As an aside, Chanca piedra has also been shown to increase the urinary excretion of uric acid; thus, it may also be helpful in the management of gout and hyperuricemia.4
Vitamin B6 and magnesium: Supplementation with vitamin B6 and magnesium has also shown positive effects in preventing the recurrence of kidney stones. In a landmark study, 149 patients with longstanding recurrent kidney stones (calcium oxalate and mixed calcium oxalate/calcium phosphate) received 100 mg of magnesium three times a day and 10 mg of pyridoxine (vitamin B6) once a day for 4.5-6 years. The mean rate of stone formation fell by 92.3 percent, from 1.3 stones per patient per year prior to the study to 0.10 stones per patient per year during the study. No significant side effects occurred.5 Other studies have shown that using various forms of magnesium alone can prevent the recurrence of kidney stones in previous sufferers.6-7
Based on the research summarized above, in patients with existing kidney or gallbladder stones and no medical treatment currently planned, I suggest patients make appropriate dietary changes, drink more water (for kidney stones) and take a supplement twice per day containing therapeutic dosages of Chanca piedra, vitamin B6 and magnesium.
Certain factors appear to increase the risk of kidney stones, such as a high-animal-fat diet with resulting increased urinary acidity; low fiber intake; low fluid intake; gout (high uric acid levels); high blood pressure, family history; being overweight; and inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. There is no conclusive evidence that calcium supplements or foods containing oxalates increase the risk of kidney stones. High doses of vitamin C may aggravate kidney stone development in susceptible individuals.
In the case of gallbladder stones, a low-fat, low-cholesterol diet is advisable to prevent gallstone formation, but some susceptible individuals may develop gallstones even when consuming a healthy diet.
Patients who develop kidney or gallbladder stones may wish to take a combination supplement containing ingredients shown to help dissolve stones and prevent their recurrence. The best evidence in this regard suggests supplementation with the herb Chanca piedra, vitamin B6 and magnesium.
Chanca piedra is a popular South American herb that has been used to dissolve and eliminate kidney stones and gallbladder stones. The English translation for Chanca piedra is "stone crusher." Recent scientific evidence has provided solid evidence of this therapeutic effect. A 2006 Brazilian study showed that the therapeutic effect of Chanca piedra may be due to its ability to modify the shape and texture of stones (calculi) to a smoother and more fragile form, which would allow for easier elimination and/or dissolution of the stones.1
Another study demonstrated that Chanca piedra has an inhibitory effect on crystal growth and aggregation in human urine, which may inhibit stone formation, acting as an important part of a prevention strategy in those with a past history of kidney stones.2
A 2006 study involving 150 patients with kidney stones tested the efficacy of Chanca piedra supplementation in patients administered shock-wave therapy. Shock-wave therapy (delivered from outside the body) breaks down stones to facilitate their elimination. Upon completion of this therapy, approximately half of the patients were given 2 grams of Chanca piedra every day for 30 days. The remainder of the group did not take the herb and acted as controls. Stone clearance was assessed after 30, 60, 90 and 180 days by abdominal X-ray and ultrasound scan. The herb-supplemented patients were shown to have a stone-free rate 10-23 percent higher than the control group.3
As an aside, Chanca piedra has also been shown to increase the urinary excretion of uric acid; thus, it may also be helpful in the management of gout and hyperuricemia.4
Vitamin B6 and magnesium: Supplementation with vitamin B6 and magnesium has also shown positive effects in preventing the recurrence of kidney stones. In a landmark study, 149 patients with longstanding recurrent kidney stones (calcium oxalate and mixed calcium oxalate/calcium phosphate) received 100 mg of magnesium three times a day and 10 mg of pyridoxine (vitamin B6) once a day for 4.5-6 years. The mean rate of stone formation fell by 92.3 percent, from 1.3 stones per patient per year prior to the study to 0.10 stones per patient per year during the study. No significant side effects occurred.5 Other studies have shown that using various forms of magnesium alone can prevent the recurrence of kidney stones in previous sufferers.6-7
Based on the research summarized above, in patients with existing kidney or gallbladder stones and no medical treatment currently planned, I suggest patients make appropriate dietary changes, drink more water (for kidney stones) and take a supplement twice per day containing therapeutic dosages of Chanca piedra, vitamin B6 and magnesium.
2011年9月13日星期二
Why I provide free medical services to less privileged –Enugu medical doctor
All the years Dr Samuel Ngwu, who hails from Ogui Nike in Enugu North Local Government Area of Enugu State sojourned in Dallas Texas, United States of America, he always had home in mind. He had practiced as a medical consultant in South Western Medical Centre, Dallas, USA. He is also a fellow of American College of Physicians; President and founder of a non-governmental organization, African Mission of Hope. He speaks on the activities of African Mission of Hope in this interview with Daily Sun.
It is a non-governmental organisation with the primary goal of alleviating African health care burden with the poor and the sick.
We have over the years brought doctors yearly with all kinds of specialty, doing free medical services to Nigerians in this Eastern part of the country. We go from villages to villages attending to health care needs of Nigerians and Africans.
We provide specialties, consultations, medications and drugs. We provide durable medical equipment like wheel chairs, crutches, beddings, to relive sores in people that have bed sores and diabetic equipment where they can check their sugars.
Primary health care awareness is also one of our focuses because we have found out over the years that there is many of what western people call avoidable deaths, which means that what shouldn’t kill somebody is killing somebody in Africa, especially in Nigeria. And once people are aware, they can do the right thing to prolong their longevity.
We target the masses. We are open to all Nigerians. We have people that bring all kinds of records. X-rays, reports for help with consultations. We also have ability to send people overseas for services that are not available here in Nigeria. We have taken a 20-year-old lady to America for brain tumour surgery. We have taken a three-year- old Nigerian to America with a hole in the heart for open heart surgery.
We have taken people with renal stones, which is kidney stones, that is too big for anything to be done in this country, overseas for urological interventions.
I own a medical clinic in the United States of America, which is quite a busy clinic and we support the NGO through the clinic. And that has been the main source of our funding for most of the work that we have done here in Nigeria and Africa.
Well, I grew up here in Africa. My parents were poor and I was a member of the Red Cross Society when I was in secondary school and we go around schools in Akpugo and Agbani, distributing high protein biscuits for malnourished children. Over the years when I became a medical doctor, when I come back on holidays with my family, I am overwhelmed with sick people lining up, coming with all kinds of medical ailments. From there, I started bringing things home to do one thing or the other. I remember one day, they brought a man with bad abdominal pain. He was in so much distress and then he couldn’t urinate and I had nothing with me, so I just felt his bladder was too full and based on my clinical experience, I knew it was prostatic hypertrophy.
I had 18 gauge needles and I just brought it out and pinched it in the pelvis and you can see the urine shooting out. He got relieved and that was how the pains left. Since then, even now, I have the equipment to take care of it now. So, that is how I started doing this job. I hated human suffering. And then too many avoidable deaths and from there it kept progressing. Like today, I have seen three patients. Unless they don’t know that I am in town. Sick people are coming in every day. And as a result, I started setting up medical hospital at presidential road, Enugu so that I don’t lose people to follow up. Then, I can have a place for continuity of care.
I actually started Enugu USA medical mission, but it got too political for my vision. So, I decided to leave them alone and formed the African Mission of Hope. And we have people on our computer data base that we provide with their drugs yearly. We have kids with seizure. Like the other day, about two years ago, I was coming back and a young kid was experiencing seizure and I stopped and held her until the seizure stopped.
We accompanied her to her home so that we know who her parents are. Since then, I have been buying her drugs. Her mother told me that at school when it starts, people surround her; she is knocking her head on the ground, getting bruises until finally it comes down. So, I have been able to stop that seizure from medicines for about three years now. So, these are the kind of work we are doing. We have people from Nsukka, Nkanu, Awgu and Nike on my data base that I send their one year medicine. Their medical supply will expire in January, but before then, I have enough time to re-supply their medicine. These are people with stroke, with heart disease, hypertension and congestive heart failure who need to continue their medicine daily for them to maintain their lifespan.
Well, the social service, as I do this, even hypertension is rampant here, though people don’t understand it. We have cases of kidney problem stage three because of uncontrolled blood pressure. So, medical awareness is an important part of the mission of African Mission of Hope. We have pamphlets we are distributing to people. If you have blood pressure, you have to take care of it because if you develop advanced kidney disease, you cannot treat it because the treatment is expensive which is dialysis. And dialysis is another thing that we are hoping to supplement in our hospital because you have to get dialyzed three times in a week to be able to maintain your lifespan.
But here, I understand that dialysis cost N45, 000 a session and most people don’t have it. So, what they do is that they get one session and they wait until they develop what is called uremic symptoms, which means that the kidney disease is making them too sick. And then, they have to go and get one dialysis which may take about six weeks or three months. But, that is not how it is supposed to be, it is supposed to be three times a week to maintain a normal life span. And as I deal with all these with my personal resource, I decided to dabble into public service because I hate human suffering and I believe that we can do more.
It is a non-governmental organisation with the primary goal of alleviating African health care burden with the poor and the sick.
We have over the years brought doctors yearly with all kinds of specialty, doing free medical services to Nigerians in this Eastern part of the country. We go from villages to villages attending to health care needs of Nigerians and Africans.
We provide specialties, consultations, medications and drugs. We provide durable medical equipment like wheel chairs, crutches, beddings, to relive sores in people that have bed sores and diabetic equipment where they can check their sugars.
Primary health care awareness is also one of our focuses because we have found out over the years that there is many of what western people call avoidable deaths, which means that what shouldn’t kill somebody is killing somebody in Africa, especially in Nigeria. And once people are aware, they can do the right thing to prolong their longevity.
We target the masses. We are open to all Nigerians. We have people that bring all kinds of records. X-rays, reports for help with consultations. We also have ability to send people overseas for services that are not available here in Nigeria. We have taken a 20-year-old lady to America for brain tumour surgery. We have taken a three-year- old Nigerian to America with a hole in the heart for open heart surgery.
We have taken people with renal stones, which is kidney stones, that is too big for anything to be done in this country, overseas for urological interventions.
I own a medical clinic in the United States of America, which is quite a busy clinic and we support the NGO through the clinic. And that has been the main source of our funding for most of the work that we have done here in Nigeria and Africa.
Well, I grew up here in Africa. My parents were poor and I was a member of the Red Cross Society when I was in secondary school and we go around schools in Akpugo and Agbani, distributing high protein biscuits for malnourished children. Over the years when I became a medical doctor, when I come back on holidays with my family, I am overwhelmed with sick people lining up, coming with all kinds of medical ailments. From there, I started bringing things home to do one thing or the other. I remember one day, they brought a man with bad abdominal pain. He was in so much distress and then he couldn’t urinate and I had nothing with me, so I just felt his bladder was too full and based on my clinical experience, I knew it was prostatic hypertrophy.
I had 18 gauge needles and I just brought it out and pinched it in the pelvis and you can see the urine shooting out. He got relieved and that was how the pains left. Since then, even now, I have the equipment to take care of it now. So, that is how I started doing this job. I hated human suffering. And then too many avoidable deaths and from there it kept progressing. Like today, I have seen three patients. Unless they don’t know that I am in town. Sick people are coming in every day. And as a result, I started setting up medical hospital at presidential road, Enugu so that I don’t lose people to follow up. Then, I can have a place for continuity of care.
I actually started Enugu USA medical mission, but it got too political for my vision. So, I decided to leave them alone and formed the African Mission of Hope. And we have people on our computer data base that we provide with their drugs yearly. We have kids with seizure. Like the other day, about two years ago, I was coming back and a young kid was experiencing seizure and I stopped and held her until the seizure stopped.
We accompanied her to her home so that we know who her parents are. Since then, I have been buying her drugs. Her mother told me that at school when it starts, people surround her; she is knocking her head on the ground, getting bruises until finally it comes down. So, I have been able to stop that seizure from medicines for about three years now. So, these are the kind of work we are doing. We have people from Nsukka, Nkanu, Awgu and Nike on my data base that I send their one year medicine. Their medical supply will expire in January, but before then, I have enough time to re-supply their medicine. These are people with stroke, with heart disease, hypertension and congestive heart failure who need to continue their medicine daily for them to maintain their lifespan.
Well, the social service, as I do this, even hypertension is rampant here, though people don’t understand it. We have cases of kidney problem stage three because of uncontrolled blood pressure. So, medical awareness is an important part of the mission of African Mission of Hope. We have pamphlets we are distributing to people. If you have blood pressure, you have to take care of it because if you develop advanced kidney disease, you cannot treat it because the treatment is expensive which is dialysis. And dialysis is another thing that we are hoping to supplement in our hospital because you have to get dialyzed three times in a week to be able to maintain your lifespan.
But here, I understand that dialysis cost N45, 000 a session and most people don’t have it. So, what they do is that they get one session and they wait until they develop what is called uremic symptoms, which means that the kidney disease is making them too sick. And then, they have to go and get one dialysis which may take about six weeks or three months. But, that is not how it is supposed to be, it is supposed to be three times a week to maintain a normal life span. And as I deal with all these with my personal resource, I decided to dabble into public service because I hate human suffering and I believe that we can do more.
2011年9月12日星期一
Particle accelerators used to compile nutritional database in Sudan
Forty-one percent of the children in Sudan are malnourished and underweight, according to the Food and Agriculture Organization of the United Nations. Mohamed Eisa, a physicist at the Sudan University of Science & Technology, would like to change this statistic, and he believes that particle accelerators can help.
By using the powerful beams of a proton accelerator, Eisa is analyzing the elemental composition of hard human tissues, such as kidney stones, hair and teeth from all regions in Sudan. His plan is to investigate and determine the levels of calcium, phosphate, iron and other elements in the samples and use the information to create a database that records nutritional deficiencies in the country.
“Sudan is a country of civil war for a long time, and this results in many problems, such as poverty and lack of main services like clean water and medical care,” Eisa says. “This is reflected on the lives of citizens in those affected areas, and I would like to have more focus on these problems to help the development and stability of those affected areas.”
Eisa started using accelerators to analyze samples about ten years ago when he was a graduate student at the iThemba Laboratory for Accelerator-Based Science and Cape Town University in South Africa. He uses a specialized technique called a nuclear microprobe.
In the accelerator, each sample gets exposed to a low-energy proton beam. The protons cause the sample to emit X-rays with wavelengths specific to a particular element. Eisa collects the information to analyze the composition of each sample and note deficiencies, such as iron.
“There is a deficiency in iron in most of the Sudanese regions due to diet, as stated by the Food and Agriculture Organization,” he says. “Fifty percent of all the children are anemic particularly at the war regions and rural areas.”
By pinpointing the specific regions of the country where children are lacking iron, for example, Eisa hopes the database will give officials the information necessary to provide nutrients to the areas that need them most.
“The results show a marked difference between the regions due to differences in food availability, climate as well as regional food habits in Sudan,” he says.
Eisa hopes to complete the study in 2012.
The following organizations have supported his work: iThemba LABS and the iThemba Collaboration in South Africa, Sudan University of Science and Technology, and the Third World Academy of Science – United Nations Educational, Scientific Cultural Organization.
By using the powerful beams of a proton accelerator, Eisa is analyzing the elemental composition of hard human tissues, such as kidney stones, hair and teeth from all regions in Sudan. His plan is to investigate and determine the levels of calcium, phosphate, iron and other elements in the samples and use the information to create a database that records nutritional deficiencies in the country.
“Sudan is a country of civil war for a long time, and this results in many problems, such as poverty and lack of main services like clean water and medical care,” Eisa says. “This is reflected on the lives of citizens in those affected areas, and I would like to have more focus on these problems to help the development and stability of those affected areas.”
Eisa started using accelerators to analyze samples about ten years ago when he was a graduate student at the iThemba Laboratory for Accelerator-Based Science and Cape Town University in South Africa. He uses a specialized technique called a nuclear microprobe.
In the accelerator, each sample gets exposed to a low-energy proton beam. The protons cause the sample to emit X-rays with wavelengths specific to a particular element. Eisa collects the information to analyze the composition of each sample and note deficiencies, such as iron.
“There is a deficiency in iron in most of the Sudanese regions due to diet, as stated by the Food and Agriculture Organization,” he says. “Fifty percent of all the children are anemic particularly at the war regions and rural areas.”
By pinpointing the specific regions of the country where children are lacking iron, for example, Eisa hopes the database will give officials the information necessary to provide nutrients to the areas that need them most.
“The results show a marked difference between the regions due to differences in food availability, climate as well as regional food habits in Sudan,” he says.
Eisa hopes to complete the study in 2012.
The following organizations have supported his work: iThemba LABS and the iThemba Collaboration in South Africa, Sudan University of Science and Technology, and the Third World Academy of Science – United Nations Educational, Scientific Cultural Organization.
2011年9月8日星期四
Lakeview offers fall health classes
Lakeview Hospital will offer several fall health classes on topics that range from from finding your way through cancer, dealing with kidney stones to understanding and deal with back pain.
Stillwater Medical Group urologist Dr. Tom Stormont and dietician Mary Miller discuss kidney stone prevention and how some stones can be treated locally with minimally invasive methods at Kidney Stone School from 6:30 to 7:30 p.m. Sept. 19 at Lakeview Hospital.
Because kidney stones can be a recurring and lifelong problem, a comprehensive approach is best to treat stone "attacks" and prevent recurrence.
Back pain hurts - physically, mentally, emotionally and sometimes even financially. From simple sprains and strains to more serious problems such as a herniated disc, St. Croix Orthopaedics' Dr. Bruce Bartie will discuss different types of back pain and the latest treatment option at the "Oh, My Aching Back" free class from 6:30 to 7:30 p.m. Sept. 20 at Lakeview Hospital.
"Finding Your Way through Cancer" is a four-week series for persons and their families dealing with a cancer diagnosis. Julie Edstrom leads the group, which meets from 7 to 8:15 p.m. on four consecutive Thursday nights Starting Sept. 22 at Lakeview Hospital.
The information is helpful to anyone experiencing the illness or a family member or loved one caring for someone facing cancer. Each week addresses an issue that most people confront at one time or another during their journey through cancer, including the new normal and making decisions.
Stillwater Medical Group urologist Dr. Tom Stormont and dietician Mary Miller discuss kidney stone prevention and how some stones can be treated locally with minimally invasive methods at Kidney Stone School from 6:30 to 7:30 p.m. Sept. 19 at Lakeview Hospital.
Because kidney stones can be a recurring and lifelong problem, a comprehensive approach is best to treat stone "attacks" and prevent recurrence.
Back pain hurts - physically, mentally, emotionally and sometimes even financially. From simple sprains and strains to more serious problems such as a herniated disc, St. Croix Orthopaedics' Dr. Bruce Bartie will discuss different types of back pain and the latest treatment option at the "Oh, My Aching Back" free class from 6:30 to 7:30 p.m. Sept. 20 at Lakeview Hospital.
"Finding Your Way through Cancer" is a four-week series for persons and their families dealing with a cancer diagnosis. Julie Edstrom leads the group, which meets from 7 to 8:15 p.m. on four consecutive Thursday nights Starting Sept. 22 at Lakeview Hospital.
The information is helpful to anyone experiencing the illness or a family member or loved one caring for someone facing cancer. Each week addresses an issue that most people confront at one time or another during their journey through cancer, including the new normal and making decisions.
2011年9月7日星期三
A Regional Leader for Urologic Services
Offering a wide variety of services for patients of all ages, the urology program at Memorial Hospital provides access to tertiary services previously unavailable in the community.
“We offer the full spectrum of urology services in York County, which is a huge advantage for referring physicians and their patients who no longer have to travel out of the community to receive the care they need,” says M. Azeem Bhatti, M.D., FRCSC, urologist at York Urology Specialists.
Memorial Hospital delivers all levels of urologic care, ranging from the basic to the most complex surgeries that may require extensive reconstructive work. Innovative treatment options provided through Memorial Hospital include minimally invasive robotic-assisted surgery; percutaneous kidney stone removal; laser surgery using GreenLight XPS laser technology for treatment of enlarged prostate; and holmium laser therapy ureteroscopy for renal calculi.
“Because of these technological advances, we are able to offer our patients an outpatient option that allows them to return to their regular activities within days,” says Dr. Bhatti. “Diagnostic cystoscopies and pediatric diagnostic ultrasound are also available at the office.”
The availability of pediatric diagnostic ultrasound is enhancing convenience for area families. More children with urologic concerns, such as voiding dysfunction, are able to receive care at Memorial Hospital instead of having to travel outside of the area.
At Memorial Hospital, robotic surgery is used to treat a wide variety of urological conditions, including prostate, bladder, kidney and adrenal cancers. Procedures offered using the da Vinci® SiTM HD Surgical System include bladder removal with bowel reconstruction, radical prostatectomy, and radical or partial nephrectomy.
“Urology is one field that has really embraced robotic and laparoscopic surgery,” says Dr. Bhatti. “There have been many changes in the approaches used to treat different types of urologic cancers, and Memorial Hospital is committed to making this technology available to patients in the York area.”
Robotic surgery presents several benefits for both patients and physicians, as patients who undergo robotic surgery generally have shorter recovery times and reduced postoperative pain. The enhanced visualization and instrumentation of the da Vinci® SiTM HD Surgical System also allows for better patient outcomes.
“Recently, I treated a patient with an enlarged prostate utilizing the da Vinci,” says Dr. Bhatti. “This was his second prostate surgery, so it was more difficult due to the presence of scar tissue. After undergoing robotic surgery, he was back to regular activities within a week, and he also had a functional recovery without voiding disruption. In the past, he would have had to go out of the area to receive this advanced care; however, we were able to treat him at Memorial Hospital.”
In addition to robotic surgery, cryoablation is available for prostate cancer treatment, and Dr. Bhatti works closely with radiation oncologists to offer radiation therapy, if necessary.
“We offer the full spectrum of urology services in York County, which is a huge advantage for referring physicians and their patients who no longer have to travel out of the community to receive the care they need,” says M. Azeem Bhatti, M.D., FRCSC, urologist at York Urology Specialists.
Memorial Hospital delivers all levels of urologic care, ranging from the basic to the most complex surgeries that may require extensive reconstructive work. Innovative treatment options provided through Memorial Hospital include minimally invasive robotic-assisted surgery; percutaneous kidney stone removal; laser surgery using GreenLight XPS laser technology for treatment of enlarged prostate; and holmium laser therapy ureteroscopy for renal calculi.
“Because of these technological advances, we are able to offer our patients an outpatient option that allows them to return to their regular activities within days,” says Dr. Bhatti. “Diagnostic cystoscopies and pediatric diagnostic ultrasound are also available at the office.”
The availability of pediatric diagnostic ultrasound is enhancing convenience for area families. More children with urologic concerns, such as voiding dysfunction, are able to receive care at Memorial Hospital instead of having to travel outside of the area.
At Memorial Hospital, robotic surgery is used to treat a wide variety of urological conditions, including prostate, bladder, kidney and adrenal cancers. Procedures offered using the da Vinci® SiTM HD Surgical System include bladder removal with bowel reconstruction, radical prostatectomy, and radical or partial nephrectomy.
“Urology is one field that has really embraced robotic and laparoscopic surgery,” says Dr. Bhatti. “There have been many changes in the approaches used to treat different types of urologic cancers, and Memorial Hospital is committed to making this technology available to patients in the York area.”
Robotic surgery presents several benefits for both patients and physicians, as patients who undergo robotic surgery generally have shorter recovery times and reduced postoperative pain. The enhanced visualization and instrumentation of the da Vinci® SiTM HD Surgical System also allows for better patient outcomes.
“Recently, I treated a patient with an enlarged prostate utilizing the da Vinci,” says Dr. Bhatti. “This was his second prostate surgery, so it was more difficult due to the presence of scar tissue. After undergoing robotic surgery, he was back to regular activities within a week, and he also had a functional recovery without voiding disruption. In the past, he would have had to go out of the area to receive this advanced care; however, we were able to treat him at Memorial Hospital.”
In addition to robotic surgery, cryoablation is available for prostate cancer treatment, and Dr. Bhatti works closely with radiation oncologists to offer radiation therapy, if necessary.
2011年9月6日星期二
Kidney stones on rise among women
Smoking, drinking and a poor diet are behind the rise in the number of women needing treatment for kidney stones, an expert has said.
Noor Buchholz, a urology consultant at Barts and the London NHS Trust, said the number of women treated for kidney stones at Barts had doubled in the last few years.
He said: "Five years ago, we treated 400 women a year for kidney stones - in the last year that figure increased dramatically to 800. We've had to expand our services to cope with the number of people requiring treatment and it doesn't show any sign of slowing down."
Mr Buchholz was speaking on the eve of the European Section of Urolithiasis (EULIS)Stone Conference, being held at Barts.
Kidney stones may not always be due to a single cause, although too much meat and salt could be to blame. A sedentary lifestyle and excessive smoking and drinking are also risk factors.
Mr Buchholz said: "There is no doubt in my mind that the increase in poor lifestyle choices including smoking and drinking among women is the key reason we are treating so many more of them. One in eight people in this country will develop kidney stones at some point.
"Traditionally they were seen as a man's disease, but that is no longer the case with women fast catching up with men."
Mr Buchholz said new technology means patients now experience a quicker recovery time when being treated for kidney stones.
Barts and London use a treatment called lithotripsy, which uses shock waves to break up the stones.
Shock wave lithotripsy is the most common way of treating kidney stones that cannot be passed in the urine. Other procedures include treating the kidneystone with laser via a small incision, and passing a tube through the ureter.
Noor Buchholz, a urology consultant at Barts and the London NHS Trust, said the number of women treated for kidney stones at Barts had doubled in the last few years.
He said: "Five years ago, we treated 400 women a year for kidney stones - in the last year that figure increased dramatically to 800. We've had to expand our services to cope with the number of people requiring treatment and it doesn't show any sign of slowing down."
Mr Buchholz was speaking on the eve of the European Section of Urolithiasis (EULIS)
Kidney stones may not always be due to a single cause, although too much meat and salt could be to blame. A sedentary lifestyle and excessive smoking and drinking are also risk factors.
Mr Buchholz said: "There is no doubt in my mind that the increase in poor lifestyle choices including smoking and drinking among women is the key reason we are treating so many more of them. One in eight people in this country will develop kidney stones at some point.
"Traditionally they were seen as a man's disease, but that is no longer the case with women fast catching up with men."
Mr Buchholz said new technology means patients now experience a quicker recovery time when being treated for kidney stones.
Barts and London use a treatment called lithotripsy, which uses shock waves to break up the stones.
Shock wave lithotripsy is the most common way of treating kidney stones that cannot be passed in the urine. Other procedures include treating the kidney
2011年9月5日星期一
Meet your calcium requirement
Remember how your mother ran after you when you were small so that you finish the entire glass of milk and she must have insisted that it is rich in calcium.
Calcium is an important nutrient for bone formation, muscle contraction, neuromuscular transmission and blood clotting. Moreover, it is essential for women
especially when her body is going through changes. During pregnancy, women need
calcium for the development of foetus. While during lactation period, it preserves mother’s bone and supplies proper amount of calcium to the baby.
Furthermore, calcium is more essential for women
during the age of 15 to 25 as it is the time to attain peak bone mass that help protect to avoid osteoporosis later in life.
A must in diet
The best way to obtain the required amount of calcium in everyday life is to consume a diet rich in calcium. Every dairy product provides calcium. Non-dairy food products like salmon, tofu, spinach, turnip, okra, broccoli, almonds, peas and beans are also good source of calcium.
But there are times when a woman needs more calcium than what she gets from food. Elaborating on this Professor Dr Heera Tuladhar, gynaecologist, Kist Medical College Hospital, Lalitpur, said, “During pregnancy and the time of onset of menopause and after menopause women must add calcium supplements to balance the quantity of calcium in body.”
Requirement for mothers
When a woman is pregnant there is
additional need of calcium in body thus she requires extra calcium. During that
period the
growing baby consumes calcium from mother’s bones. Dr Tuladhar elaborated, “Calcium supplied through food is inadequate for a pregnant woman. The baby growing within her also needs calcium to build strong bones and teeth, to develop a healthy heart, nerves and muscles plus to build blood-clotting abilities.”
Calcium supplement maintains the normal amount of calcium — one to two gram per day — in the blood and protects bones from the loss. She added, “A pregnant woman needs 500 gram extra than the regular calcium requirement. The baby will draw calcium from mother’s bones where 99 per cent of calcium is stored and if she doesn’t take the
required amount she is at risk of bone damage later.”
Rich in calcium mother’s milk fulfils baby’s calcium
requirement, but leaves the mother without calcium. “To avoid such situation calcium supplement is vital, as extra calcium intake for the
mother during lactation
period is 500 to 1000 gram per day,” added the doctor.
Few misconceptions Calcium and iron supplements are very important for a pregnant woman from her first trimester till the end of the lactation period. A misconception prevails that if a mother takes calcium supplement when pregnant, baby’s size becomes bigger creating trouble while
delivery. Dr Tuladhar cleared the doubt saying, “Calcium does not make the baby grow extra large. When there is unnecessary amount of calcium in mother’s body, kidney helps extract it out through excretion.”
Another misconception is that calcium intake develops stone in kidney, “but that is not true as long as a person takes doctor’s recommended calcium supplement.”
Menopause and bones Before puberty, both boys and girls gain bone mass consisting calcium in the same ratio. But after puberty men have higher bone mass than women. Furthermore, when the ovaries stop functioning after menopause a woman’s bone structure weakens leading to problem like osteoporosis, which is decreased density of bone or bone mass. According to Dr Tuladhar, this makes the bone vulnerable leading to breaking even after slight trauma like falling or even from coughing or sneezing.
Dr Tuladhar said, “After the age of 35 till menopause most of the women slowly lose bone mass collected in early age. But the rate increases rapidly in post menopause phase because of ovary’s dysfunction.” Talking further on this she said that estrogen produced by ovary helps absorb calcium and when this stops bones become fragile and weak increasing the chances of osteoporosis and fractures. She added, “To prevent fracture and damage in the bone, calcium supplement is essential for woman after certain age.”
Calcium is an important nutrient for bone formation, muscle contraction, neuromuscular transmission and blood clotting. Moreover, it is essential for women
especially when her body is going through changes. During pregnancy, women need
calcium for the development of foetus. While during lactation period, it preserves mother’s bone and supplies proper amount of calcium to the baby.
Furthermore, calcium is more essential for women
during the age of 15 to 25 as it is the time to attain peak bone mass that help protect to avoid osteoporosis later in life.
A must in diet
The best way to obtain the required amount of calcium in everyday life is to consume a diet rich in calcium. Every dairy product provides calcium. Non-dairy food products like salmon, tofu, spinach, turnip, okra, broccoli, almonds, peas and beans are also good source of calcium.
But there are times when a woman needs more calcium than what she gets from food. Elaborating on this Professor Dr Heera Tuladhar, gynaecologist, Kist Medical College Hospital, Lalitpur, said, “During pregnancy and the time of onset of menopause and after menopause women must add calcium supplements to balance the quantity of calcium in body.”
Requirement for mothers
When a woman is pregnant there is
additional need of calcium in body thus she requires extra calcium. During that
period the
growing baby consumes calcium from mother’s bones. Dr Tuladhar elaborated, “Calcium supplied through food is inadequate for a pregnant woman. The baby growing within her also needs calcium to build strong bones and teeth, to develop a healthy heart, nerves and muscles plus to build blood-clotting abilities.”
Calcium supplement maintains the normal amount of calcium — one to two gram per day — in the blood and protects bones from the loss. She added, “A pregnant woman needs 500 gram extra than the regular calcium requirement. The baby will draw calcium from mother’s bones where 99 per cent of calcium is stored and if she doesn’t take the
required amount she is at risk of bone damage later.”
Rich in calcium mother’s milk fulfils baby’s calcium
requirement, but leaves the mother without calcium. “To avoid such situation calcium supplement is vital, as extra calcium intake for the
mother during lactation
period is 500 to 1000 gram per day,” added the doctor.
Few misconceptions Calcium and iron supplements are very important for a pregnant woman from her first trimester till the end of the lactation period. A misconception prevails that if a mother takes calcium supplement when pregnant, baby’s size becomes bigger creating trouble while
delivery. Dr Tuladhar cleared the doubt saying, “Calcium does not make the baby grow extra large. When there is unnecessary amount of calcium in mother’s body, kidney helps extract it out through excretion.”
Another misconception is that calcium intake develops stone in kidney, “but that is not true as long as a person takes doctor’s recommended calcium supplement.”
Menopause and bones Before puberty, both boys and girls gain bone mass consisting calcium in the same ratio. But after puberty men have higher bone mass than women. Furthermore, when the ovaries stop functioning after menopause a woman’s bone structure weakens leading to problem like osteoporosis, which is decreased density of bone or bone mass. According to Dr Tuladhar, this makes the bone vulnerable leading to breaking even after slight trauma like falling or even from coughing or sneezing.
Dr Tuladhar said, “After the age of 35 till menopause most of the women slowly lose bone mass collected in early age. But the rate increases rapidly in post menopause phase because of ovary’s dysfunction.” Talking further on this she said that estrogen produced by ovary helps absorb calcium and when this stops bones become fragile and weak increasing the chances of osteoporosis and fractures. She added, “To prevent fracture and damage in the bone, calcium supplement is essential for woman after certain age.”
2011年9月4日星期日
How to detox your body with fruits
Juicing is one of the most powerful ways to assist and speed up the process by the use of cleansing ingredients and combining it with concentrated nutrition to help the body perform this function better.
Studies have shown that a person has at least 5 to 10 pounds of accumulated toxins in his body. Not to mention the accumulated toxins that are attacking on a daily basis as a result of a polluted environment.
Fortunately, juicing recipes for detox can help us in a big way as far as cleansing and looking and feeling best is concerned. Juicing for detox can repair on the cellular level; thus one can really drop an unhealthy pound of toxins from his body.
In juicing recipes for detox, one must make sure to make use of organic ingredients only. Avoid as much sugar as possible – the goal is to detoxify and sugar and detoxification don’t mix well.
The greener your vegetables the better – wheatgrass is a must in this juicing for detox recipe. Green vegetables are rich in chlorophyll which is a powerful blood cleanser. Chlorophyll is also a great alkaline nutrient. Here are some of the vegetables and fruits that one can use in juicing recipes for detox:
Cucumber
It is water dense therefore it is great for eliminating toxins and it helps dissolve kidney stones and it cleanses and purifies the skin too.
Celery
It is a natural diuretic so make sure when it is juiced, everything is put into the juicer – stick and leaves included.
Lettuce
Lettuce are natural body cleansers and they are dense in nutrients.
Carrot
It stimulates digestion, cleanses the liver and has a high amount of beta carotene.
Cabbage
This vegetable is often used and recommended for weight loss, improves poor skin and helps alleviate constipation.
Beetroot
It is one of the most powerful cleansing foods. It helps cleanse the kidneys and it even has properties to cleanse the blood.
Asparagus
Asparagus cleanses body tissues and reduces blood acidity.
Spinach
It is also rich in chlorophyll and helps rebuild the digestive track; stimulates the liver and gall bladder too.
Watercress
A powerful cleanser of the intestines and neutralizes toxins as well. It also helps stimulate fat burning activity. Watercress is good for the skin as well.
Apples
Apples help control blood pressure, bloodsugar levels and helps eliminate body toxins.
Here is one recipe one could definitely enjoy while detoxifying his body:
One cucumber, one large cup of spinach, one large cup of parsely, one celery stick and half medium lemon (but not including the peels this time) – put everything in a juicer and one would be delighted not only of with the taste but as well as of the hea
Studies have shown that a person has at least 5 to 10 pounds of accumulated toxins in his body. Not to mention the accumulated toxins that are attacking on a daily basis as a result of a polluted environment.
Fortunately, juicing recipes for detox can help us in a big way as far as cleansing and looking and feeling best is concerned. Juicing for detox can repair on the cellular level; thus one can really drop an unhealthy pound of toxins from his body.
In juicing recipes for detox, one must make sure to make use of organic ingredients only. Avoid as much sugar as possible – the goal is to detoxify and sugar and detoxification don’t mix well.
The greener your vegetables the better – wheatgrass is a must in this juicing for detox recipe. Green vegetables are rich in chlorophyll which is a powerful blood cleanser. Chlorophyll is also a great alkaline nutrient. Here are some of the vegetables and fruits that one can use in juicing recipes for detox:
Cucumber
It is water dense therefore it is great for eliminating toxins and it helps dissolve kidney stones and it cleanses and purifies the skin too.
Celery
It is a natural diuretic so make sure when it is juiced, everything is put into the juicer – stick and leaves included.
Lettuce
Lettuce are natural body cleansers and they are dense in nutrients.
Carrot
It stimulates digestion, cleanses the liver and has a high amount of beta carotene.
Cabbage
This vegetable is often used and recommended for weight loss, improves poor skin and helps alleviate constipation.
Beetroot
It is one of the most powerful cleansing foods. It helps cleanse the kidneys and it even has properties to cleanse the blood.
Asparagus
Asparagus cleanses body tissues and reduces blood acidity.
Spinach
It is also rich in chlorophyll and helps rebuild the digestive track; stimulates the liver and gall bladder too.
Watercress
A powerful cleanser of the intestines and neutralizes toxins as well. It also helps stimulate fat burning activity. Watercress is good for the skin as well.
Apples
Apples help control blood pressure, bloodsugar levels and helps eliminate body toxins.
Here is one recipe one could definitely enjoy while detoxifying his body:
One cucumber, one large cup of spinach, one large cup of parsely, one celery stick and half medium lemon (but not including the peels this time) – put everything in a juicer and one would be delighted not only of with the taste but as well as of the hea
2011年9月1日星期四
Obesity not behind kidney stones in kids: study
The finding seems "counterintuitive," say researchers who have noticed an increasing number of both adult and kid patients with kidney stones as obesity levels have been on the rise.
"I think everyone would agree that there's an increasing incidence of stone disease," said Dr. Brian Matlaga, a urologist at the Johns Hopkins University School of Medicine in Baltimore who was not involved in the new study.
Whether overweight and obesity trends are behind that or not, "I think it's something in the modern American diet, a high-sodium diet that may be associated with this increased risk," he told Reuters Health.
Too much calcium in the urine is known to cause kidney stones, as is dehydration -- both conditions influenced by sodium. Studies of adults have found that those who are obese, or who have high blood pressure or diabetes, are at an increased risk of getting stones.
Nationwide numbers are generally lacking, but the rise in kidney stones among kids can be glimpsed in records from individual hospitals, medical practices and databases. One recent study using a pediatrics database as a sample identified 125 kids admitted to hospitals for kidney stone treatment in 1999, compared to 1,389 kids admitted in 2008. Adjusted for other factors, the change represented a 10 percent annual increase in cases.
But it's been unclear if weight is also driving kidney stone rates in kids. To get at that question, researchers led by Dr. Steve Kim from Children's Hospital Los Angeles consulted electronic health records from kids treated at Philadelphia-area doctors' offices.
Between 2002 and 2009, they found 110 cases of kidney stones in kids and adolescents 21 and younger. For each of those cases, the researchers picked out four kids of the same age and treated at the same practice who didn't have a kidney stone.
According to their health records, two percent of kids with kidney stones were overweight, and about four percent were obese. That compared to four percent of the non-kidney-stone group that was overweight, and close to five percent that was obese.
Girls and boys were equally likely to get kidney stones, whereas white kids were more likely than black kids to have a stone, according to the findings published in The Journal of Urology.
Experts suggest that the diet of adults who are overweight and the metabolic changes in the body caused by extra weight affect the contents and chemistry of the urine -- possibly leading to a higher risk of kidney stones.
Because "children are not little adults," weight might affect them differently, Matlaga said. But diet could still be behind the increase in childhood stones, he added.
Kim agreed. "We know that sodium is associated with calcium metabolism in the urine," he said. "Certainly a higher-salt diet would likely contribute to more kidney stones." But, he cautioned, "we don't have any good proof of that yet."
Kids are also getting fewer dairy products in their diet, he said, and that could be related to urine chemistry and kidney stone risk. Or, dehydration may be to blame. "In general, a lot of kids drink less water than they should, or less fluid in general than they should. They don't stay as well-hydrated," he told Reuters Health.
Clearly, Kim said, more studies are needed to nail down what is behind the "dramatic shift" in kidney stone cases that pediatricians have noticed in the past few years.
Once doctors have the answer to that question, they'll be more prepared to counsel kids at risk and their families about kidney stones and other conditions that might go hand in hand with stones, Matlaga added.
"I think everyone would agree that there's an increasing incidence of stone disease," said Dr. Brian Matlaga, a urologist at the Johns Hopkins University School of Medicine in Baltimore who was not involved in the new study.
Whether overweight and obesity trends are behind that or not, "I think it's something in the modern American diet, a high-sodium diet that may be associated with this increased risk," he told Reuters Health.
Too much calcium in the urine is known to cause kidney stones, as is dehydration -- both conditions influenced by sodium. Studies of adults have found that those who are obese, or who have high blood pressure or diabetes, are at an increased risk of getting stones.
Nationwide numbers are generally lacking, but the rise in kidney stones among kids can be glimpsed in records from individual hospitals, medical practices and databases. One recent study using a pediatrics database as a sample identified 125 kids admitted to hospitals for kidney stone treatment in 1999, compared to 1,389 kids admitted in 2008. Adjusted for other factors, the change represented a 10 percent annual increase in cases.
But it's been unclear if weight is also driving kidney stone rates in kids. To get at that question, researchers led by Dr. Steve Kim from Children's Hospital Los Angeles consulted electronic health records from kids treated at Philadelphia-area doctors' offices.
Between 2002 and 2009, they found 110 cases of kidney stones in kids and adolescents 21 and younger. For each of those cases, the researchers picked out four kids of the same age and treated at the same practice who didn't have a kidney stone.
According to their health records, two percent of kids with kidney stones were overweight, and about four percent were obese. That compared to four percent of the non-kidney-stone group that was overweight, and close to five percent that was obese.
Girls and boys were equally likely to get kidney stones, whereas white kids were more likely than black kids to have a stone, according to the findings published in The Journal of Urology.
Experts suggest that the diet of adults who are overweight and the metabolic changes in the body caused by extra weight affect the contents and chemistry of the urine -- possibly leading to a higher risk of kidney stones.
Because "children are not little adults," weight might affect them differently, Matlaga said. But diet could still be behind the increase in childhood stones, he added.
Kim agreed. "We know that sodium is associated with calcium metabolism in the urine," he said. "Certainly a higher-salt diet would likely contribute to more kidney stones." But, he cautioned, "we don't have any good proof of that yet."
Kids are also getting fewer dairy products in their diet, he said, and that could be related to urine chemistry and kidney stone risk. Or, dehydration may be to blame. "In general, a lot of kids drink less water than they should, or less fluid in general than they should. They don't stay as well-hydrated," he told Reuters Health.
Clearly, Kim said, more studies are needed to nail down what is behind the "dramatic shift" in kidney stone cases that pediatricians have noticed in the past few years.
Once doctors have the answer to that question, they'll be more prepared to counsel kids at risk and their families about kidney stones and other conditions that might go hand in hand with stones, Matlaga added.
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