Why is it Important to Know My Family Health History?

Family Health History: Why It’s Important and What You Should Know
Why is it important to know my family history?

by Kimberly Holland

Family members share more than similar appearance. You may recognize that you have your father’s curly hair or your mother’s button nose. Thank goodness my kids got my wife’s food looks. What is not so easy to see is that your great-grandmother passed along an increased risk for both breast and ovarian cancer.

That’s why discovering and knowing your family health history is vitally important. Your medical history includes all the traits your family shares you can’t see. These traits may increase your risk for many hereditary conditions and diseases, including:

• cancer
• diabetes
• asthma
• heart disease and blood clots
• Alzheimer’s disease and dementia
• arthritis
• depression
• high blood pressure and high cholesterol

Whose history do I need?

The general rule for family health history is that more is better. First, you’ll want to focus on immediate family members who are related to you through blood. Start with your parents, siblings, and children. If they’re still alive, grandparents are another great place to start. They may know partial histories of many members of your family.

You can also gather information from your aunts and uncles, and other blood relatives. Once you move beyond this core circle of family, genetic makeups change so greatly that you may not be able to learn much about your own risk. Still, keep information handy for any family members you learn about during your search for medical history. It may be helpful down the road.

How can I gather this information?

Talking about health may not come naturally to you or your family. You can start the conversation by letting your family members know why you want to gather health information. Also, let them know that you’re willing to share information with them, so that you can all have more complete health histories. It may be easier to start out by having one-on-one conversations.

Get the right information

When you’re ready to gather family health history information, keep these things in mind:

Major medical issues: Ask about every major medical issue anyone in close relation to you has been diagnosed with. In this fact-finding stage, nothing is too small, though issues are only significant if the cause was genetic. Lyme disease, injuries, and other things caused by external factors can’t be inherited.
Causes of death: Find out the cause of death for any family members who’ve passed away. That might provide a clue to your family medical history, too.
Age of onset: Ask when each family member was diagnosed with each condition. This may help your doctor recognize the early onset of certain diseases.
Ethnic background: Different ethnicities have varying levels of risk for certain conditions. As best you can, identify your ethnic background to help spot potential health risks.
Environment: Families share common genes, but they also share common environments, habits, and behaviors. A complete family history also includes understanding what factors in your environment could impact your health.

5 questions to ask

Here are some questions you can ask to start the conversation:

  1. How old was my relative when they died, and what was the cause of death?
  2. Are there health problems that run in the family?
  3. Is there a history of pregnancy loss or birth defects in my family?
  4. What allergies do people in my family have?
  5. What is my ethnicity? (Some conditions are common among certain ethnicities.)

What should I do with this information?

Knowing your own health history is important, and sharing it with your doctor may be more important. That’s because your doctor can help you interpret what it means for your current lifestyle, suggest prevention tips, and decide on screening or testing options for conditions you may be more at risk for developing.

The genes you’re born with can’t be changed or altered. If you know your family history, you’re one step ahead of the game. You can take the initiative to adopt healthier lifestyle habits. For example, you could decide to stop smoking or drinking alcohol, or to start exercising regularly and maintaining a healthy weight. These lifestyle changes may reduce your chances for developing hereditary conditions.

Is incomplete information still useful?

Even a family health history that’s incomplete is still useful to your doctor. Share any information you have with them.

For example, if you know that your sibling was diagnosed with colon cancer at age 35, your doctor may suspect a possible genetic issue. They may then decide it’s important that you have regular colon cancer screenings before the recommended age of 50. Your doctor may also suggest you undergo genetic counseling or testing to identify any genetic risks.

What if I was adopted

Environment plays an important part in your health history, and you can get the details for this from your adoptive family. Learning more about your birth family’s health history may require a large investment of time and energy.

Ask your adoptive parents if they have any information about your birth parents. It’s possible family health history information was shared during the adoption process. If not, ask the agency that arranged the adoption if they retained any personal health history information for your birth parents. Understand your state’s statutes before you begin requesting adoption history information.

If all of these avenues come up short, you may need to make a choice about seeking out your birth parents. You may not wish to pursue that route, or you may be unable to connect with them. In that case, alert your doctor to your personal history. The two of you can then work to identify ways to screen for and detect your risk of certain conditions.

What if I’m estranged from my family?

If you’re estranged from only part of your family, you can try a few things to collect your family health history:

Talk to the family members you’re connected with. You may not need to reconnect with your whole family to collect your family health history.
Reach out via your doctor. Some medical offices may be able to send out questionnaires to family members asking for information in an official capacity. This may prompt people to respond.

Do some research. You may be able to discover the cause of death of your relatives from death certificates. Search online to find state-specific death records or check ancestry sites for this information. Obituaries, often available online or archived by public libraries, might also provide health information.

What about genetic testing and genetic predisposition?

Certain ethnic backgrounds and races may be predisposed to conditions for which a genetic test is useful. For example, women of Ashkenazi Jewish ancestry have an increased risk for breast cancer. A specific gene mutation is more common in these women than in other women. Genetic screening may help your doctor detect this gene mutation and prepare you for treatment options early.

Although genetic tests can help identify potential risks you may have inherited for a specific disease, they don’t guarantee you’ll develop that disease. Results may show you have a predisposition to several conditions. While you may never actually develop any of these, you might feel the added anxiety isn’t worth the knowledge. Seriously consider the benefits and concerns you may have with knowing your genetic risk factors before you do any testing.

How do I record the details?

Make sure you write down or electronically document the health information your relatives provide. You can use HealthLynked for this. Just complete one profile per family member whose medical records you are responsible for and have other family members complete and share their own with you.

Outlook

Knowing your health history helps you to be more proactive about your health. Share this information with your doctor so they can screen early for conditions you’re predisposed to and suggest lifestyle choices that can help reduce your risk.



Also talk to your doctor if you need more help figuring out how to uncover your health history or what questions you should ask. If you don’t have one you depend on today, you might find a great physician using the first of its kind social ecosystem designed specifically for everything described in the article.

Ready to get Lynked? Go to HealthLynked.com now to start compiling your medical history and sharing with those you choose, for Free, today!

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UV Exposure: Why Do We Ignore the Health Risks?

 

Published Thursday 17 July 2014

By Honor Whiteman

The sun is shining, so what are your plans? For many of us, the answer will be to hit the beach and soak up the rays. But while you are busy packing beachwear and towels, are you considering the dangers of sun exposure?

Exposure to ultraviolet (UV) radiation – from the sun, tanning beds, lamps or booths – is the main cause of skin cancer, accounting for around 86% of non-melanoma and 90% of melanoma skin cancers. In addition, excessive UV exposure can increase the risk of eye diseases, such as cataract and eye cancers.

The health risks associated with exposure to UV radiation have certainly been well documented, so much so that the World Health Organization (WHO) have now officially classed UV radiation as a human carcinogen.

This year alone, Medical News Today reported on an array of studies warning of UV exposure risks. One study, published in the journal Pediatrics, revealed that tanning bed use among youths can increase the risk of early skin cancer, while other research found that multiple sunburns as an adolescent can increase melanoma risk by 80%.

Furthermore, in response to reported health risks, the Food and Drug Administration (FDA) recently changed their regulation of tanning beds, lamps and booths. Such products must now carry a visible, black-box warning stating that they should not be used by anyone under the age of 18.

How does UV radiation cause damage?

UV radiation consists of three different wavebands: UVA, UVB and UVC. The UVC waveband is the highest-energy UV but has the shortest wavelength, meaning it does not reach the earth’s surface and does not cause skin damage to humans.

However, UVA has a long wavelength and accounts for 95% of solar UV radiation that reaches the earth’s surface, while UVB – with a middle-range wavelength – accounts for the remainder. Tanning beds and tanning lamps primarily emit UVA radiation, sometimes at doses up to 12 times higher than that of the sun.

Both UVA and UVB radiation can damage the skin by penetrating its layers and destroying cellular DNA. UVA radiation tends to penetrate deeper layers of skin, known as the dermis, aging the skin cells and causing wrinkles. UVB radiation is the main cause of skin reddening or sunburn, as it damages the outer layers of the skin, known as the epidermis.

Excessive UV exposure can cause genetic mutations that can lead to the development of skin cancer. The browning of the skin, or a tan, is the skin’s way of trying to stop further DNA damage from occurring.

Of course, it is not only the skin that can be subject to damage from UV radiation. Bright sunlight can penetrate the eye’s surfaces tissues, as well as the cornea and the lens.

Ignoring the risks of UV exposure

But regardless of the numerous studies and health warnings associated with UV exposure, it seems many of us refuse to take note.

A 2012 survey from the Centers for Disease Control and Prevention (CDC) found that 50.1% of all adults and 65.6% of white adults ages 18-29 reported suffering sunburn in the past 12 months, indicating that sun protection measures are not followed correctly, if at all.

A more recent study from the University of California-San Francisco stated that the popularity of indoor tanning is “alarming” – particularly among young people.

The study revealed that 35% of adults had been exposed to indoor tanning, with 14% reporting tanning bed use in the past year. Even more of a concern was that 43% of university students and 18% of adolescents reported using tanning beds in the past year.

Overall rates of tanning bed use, the researchers estimate, may lead to an additional 450,000 non-melanoma and 10,000 melanoma skin cancer cases every year.

It seems unbelievable that so many of us are willing to put our health at risk to soak up some sunshine. So why do we do it?

The desire for a ‘healthy tan’

A recent study published in the journal Cell suggested that UV radiation causes the body to release endorphins – “feel-good” hormones – which makes sun exposure addictive.

But Tim Turnham, executive director of the Melanoma Research Foundation, told Medical News Today that many people simply favor a tanned body over health:

“Despite elevated awareness of the dangers of UV radiation, people still choose to ignore the dangers in the pursuit of what they consider to be a ‘healthy tan.’ This is particularly an issue among young people who tend to ignore health risks in favor of enhancing their social status and popularity. We know that tanning appeals to people who are interested in being included, and this is a primary driver for teens – being part of the ‘in’ crowd.”

Anita Blankenship, health communication specialist at the CDC, told us that the desire for a tan is particularly common among young women.

“In the US, nearly 1 in 3 young white women ages 16-25 years engages in indoor tanning each year,” she said. “These young women may experience pressure to conform to beauty standards, and young people may not be as concerned about health risks.”

Turnham agreed, telling us that the indoor tanning industry specifically targets this population. “Aggressive marketing, deep discount and package deals are used routinely by tanning salons, who market their services preferentially to young women,” he said.

Blankenship added that the public are also presented with “conflicting messages” when it comes to the safety of excess UV exposure. She pointed out that a recent US report found that only 7% of tanning salons reported any harmful effects from tanning beds, booths or lamps, while 78% reported health benefits.

“It is important to monitor deceptive health and safety claims about UV exposure, as they may make it difficult for consumers to adequately assess risk,” she told us. “It is important for people to understand that tanned skin is damaged skin, and that damage can lead to wrinkles and early aging of the skin, as well as skin cancer including melanoma – the kind of skin cancer that leads to the most deaths.”

Progress has been made, but more needs to be done

This month is UV Safety Month – an annual campaign that aims to increase public awareness of the health implications caused by UV exposure.

With the help of such campaigns and an increase in studies detailing UV risks, many health care professionals believe there has been a change for the better in attitudes toward UV exposure.

Many health care professionals believe much progress has been made in increasing awareness of UV exposure risks in recent years, but more needs to be done.

“Certainly the scientific community, a number of federal agencies, and possibly the general public are more aware of the risk of UV exposure,” a spokesperson from the National Cancer Institute (NCI) told Medical News Today.

“Action and more coordinated efforts increased markedly about 4 years ago, when a number of epidemiological studies documented the harms of indoor tanning, the FDA held their scientific advisory committee meeting to discuss need for changing indoor tanning device regulations, and they also acted on their previous proposals to change sunscreen regulations.”

The spokesperson continued:

“We think these summaries acted as a catalyst for efforts to make the public and policy makers aware of the risks of indoor tanning, and also they gave a boost to efforts to increase awareness of outdoor sun exposure risks and encourage sun safe protective behaviors.”

In addition, some studies have indicated that many youngsters may even be moving away from the use of tanning beds. A recent Youth Risk Behavior Survey found that among high school students, indoor tanning activity decreased from 15.6% in 2009 to 12.8% in 2013.

Turnham told us that since sunless tanning – such as the use of spray tans – is on the increase, it may be that youngsters are using this as an alternative to tanning salons. But the NCI spokesperson said such an association needs to be investigated before any conclusions can be reached:

“We do not know if changes in indoor tanning are related to increases in use of spray-on and sunless tanning products and services,” they told us. “Some studies indicate that sunless products and services are used by people who continue to engage in indoor tanning, but it is an area we continue to research. We are hopeful that we will be able to measure this in an upcoming national survey supplement that is being developed by NCI and CDC.”

But despite widespread efforts to increase UV safety awareness, Turnham believes there is still a lot more that can be done to protect public health:

“Regulators could and should do much more to fight the ravages of UV exposure. We need federal legislation banning the use of tanning beds by minors. We need more funding for awareness and prevention efforts.”

He added that doctors can also play a role in increasing UV exposure awareness by warning patients of associated risks – something the US Preventive Services Task Force (USPSTF) recommend. They state that health care providers should counsel fair-skinned youths between the ages of 10 and 24 about the risks of indoor tanning and how to protect themselves against UV radiation from the sun.

However, Turnham noted that doctors do not have much time with each patient and proposes that signage in waiting areas warning of the risks of UV exposure may also be effective.

Protecting against UV radiation

Whether there will be further regulation for indoor tanning or an increase in awareness efforts is unclear. But one thing is certain: we can help ourselves to avoid the negative health implications associated with UV exposure.

The American Cancer Society notes young children need extra protection from the sun, as they spend more time outside and can burn easily.

The CDC recommend the following for protecting against UV radiation:

  • Stay in the shade if possible, particularly when the sun is at its strongest – usually around midday
  • Wear clothing that covers your arms and legs
  • Wear a wide-brimmed hat that provides shade for your head, face, ears and neck
  • Wear wrap-around sunglasses that protect against both UVA and UVB radiation
  • Use sunscreen with a minimum sun protection factor (SPF) of 15 that protects against UVA and UVB radiation, and reapply every 2 hours
  • Avoid indoor tanning.

In addition, the American Cancer Society notes young children need extra protection from the sun as they spend more time outside and can burn easily. They add that babies younger than 6 months should be kept out of direct sunlight and be covered with protective clothing. Sunscreen should never be used on an infants skin.

As  we embark on the glorious, sunny days of the summer season and enter into the Fourth of July Celebration, let’s do all we can to protect ourselves and our little ones from UV rays’ potential threats to our skin. Remember, UV rays are the major causes of several deadly skin cancers and sunscreen is one of the most easy and accessible ways to protect against them. So, get out those sunscreen tubes and cover your head with a hat and your eyes with some shades because sun protection is trending today and everyday!

And, if you do find an odd spot on your body’s biggest organ, you can use HealthLynked to find a great physician near you and get the help you need.  Simply go to HealthLynked.com and sign up for free, then Connect and collaborate through HealthLynked to heal your skin!

 

Genes linked with sunburn, skin cancer risk

 

May 8, 2018

Certain genes can determine which people are more at risk of getting sunburn and possibly develop skin cancer as a result..

In a trawl of the genetics of nearly 180,000 people of European ancestry in Britain, Australia, the Netherlands and United States, researchers found 20 sunburn genes.

Eight of the genes had been associated with skin cancer in previous research, according to findings published in the journal Nature Communications.

And in at least one region of the genome, “we have found evidence to suggest that the gene involved in melanoma risk… acts through increasing susceptibility to sunburns,” co-author Mario Falchi of King’s College London told AFP.

Sun exposure is critical for the body’s production of vitamin D, which keeps bones, teeth, and muscles healthy, and which scientists say may help stave off chronic diseases, even cancer.

But too much can be painful in the short-term, and dangerous for your health.

The new study, which claims to be the largest to date into the genetics of sunburn, helps explain why people with the same skin tone can have such different reactions to exposure to sunlight—some burn red while others tan brown.

It may also begin to explain factors in skin cancer risk.
“It is necessary to explore these genes in more detail, to understand the mechanism by which they contribute to propensity to burn,” said Falchi.

In future, the research may help identify people at risk, through genetic testing.

“People tend to ‘forget’ that sunburns are quite dangerous,” said Falchi.

“Given the rise in incidence in skin cancer, we hope that knowing there is a genetic link between sunburn and skin cancer may help in encouraging people to lead a healthy lifestyle.”

More information: Genome-wide association study in 176,678 Europeans reveals genetic loci for tanning response to sun exposure, Nature Communications (2018).
nature.com/articles/doi:10.1038/s41467-018-04086-y
Journal reference: Nature Communications

Millennials aren’t getting the message about sun safety and the dangers of tanning

Many millennials lack knowledge about the importance of sunscreen and continue to tan outdoors in part because of low self-esteem and high rates of narcissism that fuel addictive tanning behavior, a new study from Oregon State University-Cascades has found.

Lead author Amy Watson and her colleagues found that those with higher levels of self-esteem were less likely to tan, while those with lower self-esteem and higher levels of narcissism were more likely to present addictive tanning behavior. The motivation for the addictive tanning behavior was the perception of improved appearance.

“This study gives us a clearer understanding of actual consumer behavior,” said Watson, an assistant professor of marketing at OSU-Cascades. “The number of people still deliberately exposing their skin to the sun for tanning purposes is alarming. We need to find new ways to entice people to protect their skin, including challenging the ideal of tan skin as a standard of beauty.”

The findings were published recently in the Journal of Consumer Affairs. Co-authors are Gail Zank and Anna M. Turri of Texas State University.

Skin cancer is the most common type of cancer worldwide, with more than 3.5 million cases diagnosed annually. Melanoma cases among women rose sharply between 1970 and 2009, with an 800 percent increase among women 18 to 39.

In an effort to improve consumer education about the role of sunscreen in the prevention of skin cancer, the Centers for Disease Control and the Food and Drug Administration developed a new “Drug Facts” panel of information now required on all sunscreen bottles. The panel includes directions for sunscreen use and advice on other sun protection measures, among other information.

The researchers’ goal with the study was to gauge whether the information on this new label is effective at curbing tanning behavior and if new information is helping to increase consumer knowledge about how and when to use sunscreen and how much to use.

The study of 250 college students, most between 18 and 23 years old, measured their sun safety knowledge and included: questions about their beliefs regarding sunscreen effectiveness and ultraviolet light exposure danger; questions about tanning motivation and behavior; an assessment of tanning addiction; and personality questions relating to self-esteem, narcissism, appearance and addictive behavior.

The study participants, 47 percent male and 53 percent female, scored an average of 54 percent on an 11-question sun safety knowledge test, which included true/false statements such as: “On a daily basis I should use at least one ounce of sunscreen on exposed skin” (true); and “When applied correctly, SPF 100 is twice as effective as SPF 50” (false).

About 70 percent of the study participants reported purposefully exposing their skin to the sun to achieve a tan. About a third of the participants reported that having a tan is important to them, while about 37 percent said they feel better with a tan, and 41 percent indicated that having a tan makes them more confident in their appearance

The participants’ levels of tanning addiction were measured through questions such as “I get annoyed when people tell me not to tan,” and “I continue to tan knowing that it is bad for me,” and “I feel unattractive or anxious to tan if I do not maintain my tan.”

The researchers found that those with lower self-esteem and higher narcissism rates were also more likely to exhibit addictive tanning behavior. They found no evidence that increased knowledge about sun safety leads to lower levels of addictive tanning.

“What we found is that this knowledge doesn’t matter to the consumers,” Watson said. “That tactic to require sunscreen manufacturers to include this information is not effective.”

Sun safety and sunscreen messaging from the CDC is all statistics-based, emphasizing the likelihood of a skin cancer occurrence or diagnosis, Watson said. But that type of message isn’t resonating with millennials. The next step for Watson and her colleagues is to begin testing other types of messages to identify ways millennials would respond more positively to sun safety measures.

“People are starting to get the message about the dangers of using tanning beds, but a large number of people are still tanning outdoors, deliberately exposing their skin to the sun, because they think it’s attractive,” she said.

“We need to move away from the narrative where tan skin is associated with health and youth. That’s the opposite of reality. Because reality is tan skin is damaged skin.”

More information: Amy Watson et al, I Know, but I Would Rather Be Beautiful: The Impact of Self-Esteem, Narcissism, and Knowledge on Addictive Tanning Behavior in Millennials, Journal of Consumer Affairs (2018). DOI: 10.1111/joca.12179
Provided by: Oregon State University

Here comes the sun, and kid sun safety

(HealthDay)—Summer sun brings childhood fun, but experts warn it also brings skin cancer dangers, even for kids.

“Don’t assume children cannot get skin cancer because of their age,” said Dr. Alberto Pappo, director of the solid tumor division at St. Jude Children’s Research Hospital in Memphis, Tenn. “Unlike other cancers, the conventional melanoma that we see mostly in adolescents behaves the same as it does in adults.”

His advice: “Children are not immune from extreme sun damage, and parents should start sun protection early and make it a habit for life.”

So, this and every summer, parents should take steps to shield kids from the sun’s harmful UV rays.

Those steps include:

* Avoid exposure. Infants and children younger than 6 months old should avoid sun exposure entirely, Pappo advised. If these babies are outside or on the beach this summer, they should be covered up with hats and appropriate clothing. It’s also a good idea to avoid being outside when UV rays are at their peak, between 10 a.m. and 2 p.m.

* Use sunscreen. It’s important to apply a broad-spectrum sunscreen to children’s exposed skin. Choose one with at least SPF15 that protects against both UVA and UVB rays. Pappo cautioned that sunscreen needs to be reapplied every couple of hours and after swimming—even if the label says it is “water-resistant.”

However, sunscreen should not be used on infants younger than 6 months old because their exposure to the chemicals in these products would be too high, he noted.

* Keep kids away from tanning beds. Melanoma rates are rising among teenagers, partly due to their use of indoor tanning beds. Use of tanning beds by people younger than 30 boosts their risk for this deadly form of cancer by 75 percent, according to the International Agency for Research on Cancer.

* Get children screened. Early detection of melanoma is key to increasing patients’ odds of survival. Children with suspicious moles or skin lesions should be seen by a doctor as soon as possible, Pappo advised. Removing melanoma in its early stages also increases the chances of avoiding more invasive surgical procedures later on, he added.

More information: There are more sun-safety tips at the Skin Cancer Foundation.

The Beat Goes On | Heart Transplants Still a Marvel of Modern Medicine

On this day in 2001, a petite 44-year-old woman received a successful heart transplant at Ronald Reagan UCLA Medical Center, thanks to an experimental Total Artificial Heart designed for smaller patients.

The UCLA patient was the first person in California to receive the smaller Total Artificial Heart, and the first patient in the world with the device to be bridged to a successful heart transplant — that is, to go from needing a transplant to receiving one.

The 50cc SynCardia temporary Total Artificial Heart is a smaller investigational version of the larger 70cc SynCardia heart, which was approved for use in people awaiting a transplant by the Federal Food and Drug Administration in 2004 and has been used by more than 1,440 patients worldwide.

The 50cc device is designed to be used by smaller patients — including most women, some men and many adolescents — with end-stage biventricular heart failure, where both sides of the heart are failing to pump enough blood to sustain the body. The device provides mechanical support until a donor heart can be found

Nemah Kahala, a wife and mother of five, was transferred to UCLA from Kaiser Permanente Los Angeles Medical Center in March.  She was suffering from restrictive heart muscle disease and in critical condition.  Her heart failure was so advanced that repair surgery and other mechanical assist devices could not help.

Kahala was placed on a life support system called extra corporal membrane oxygenation, but this only works for about 10 days before a person’s organs begin to deteriorate.

With the clock ticking, doctors needed to buy time by replacing Kahala’s failing heart with an artificial heart while she waited for a heart transplant.  Her chest cavity was too small for her to receive the larger 70cc artificial heart.  However, under a one-time emergency use permitted under FDA guidelines, her doctors were able to implant the experimental 50cc device.

“Mrs. Kahala’s condition was deteriorating so rapidly that she would have not survived while waiting for a transplant,” said her surgeon, Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of the UCLA Heart and Lung Transplant Program. “We were grateful to have this experimental technology available to save her life and help bridge her to a donor heart.”

The artificial heart provides an immediate and safe flow of blood to help vital organs recover faster and make patients better transplant candidates.

After the two-hour surgery to implant the artificial heart, Kahala remained hospitalized in the intensive care unit and eventually began daily physical therapy to help make her stronger for transplant surgery.

Two weeks after the total artificial heart surgery, she was strong enough to be placed on the heart transplant list.  After a week of waiting, a donor heart was found.

“In addition to the high-tech medicine that kept her alive, Mrs. Kahala and her family exemplified how a solid support system that includes loved ones and a compassionate medical team practicing what we at UCLA have termed ‘Relational Medicine’ plays an important role in surviving a medical crisis,” said Dr. Mario Deng, professor of medicine and medical director of the Advanced Heart Failure, Mechanical Support and Heart Transplant program at UCLA.

Kahala was discharged from UCLA on April 18.

Since 2012, the UCLA Heart Transplant Program has implanted eight 70cc SynCardia Total Artificial Hearts. UCLA also participated in the clinical study of a 13.5-pound Freedom portable driver — a backpack-sized device that powers the artificial heart, allowing the patient to leave the hospital — that received FDA approval on June 26, 2014.

The FDA cautions that in the United States, the 50cc SynCardia temporary Total Artificial Heart is an investigational device, limited by United States law to investigational use.  The 50cc TAH is in an FDA-approved clinical study.

First Fully Contained Artificial Heart

On the same day, a patient was implanted with the world’s first self-contained mechanical heart after a 7-hour operation, a hospital in Louisville, Kentucky. The procedure was the first major advance in the development of an artificial replacement heart in nearly two decades.

The device, created by Danvers, Massachusetts-based Abiomed Inc., replaces the lower chambers of a patient’s failing heart with a plastic-and-metal motorized hydraulic pump which weighs 2 pounds (1 kg) and is about the size of a grapefruit.

It was the first artificial heart to be free of wires connecting it to the outside.

“This is the first time this has ever been done,” said Kathy Keadle, a spokeswoman at Jewish Hospital where the procedure was performed by University of Louisville surgeons Laman Gray and

Neither Abiomed nor hospital officials would disclose the name, sex or gender of the patients, all of whom are seriously ill.  The long-awaited surgery had been expected by June 30 but was delayed because the company had not completed patient screening.

Abiomed got U.S. Food and Drug Administration approval in February’s 2001 to test the device on as many as 15 patients, all of whom are too ill to be candidates for a heart transplant.  Unlike existing devices, which serve as a temporary solution to extend a patient’s life until a patient can secure a donor heart, the AbioCor heart is designed to be a fully functioning replacement heart.

The trial involved severely ill patients with less than 30 days to live, said John Thero, vice president and chief financial officer of Abiomed.

“This is not a bridge to transplant. There is a scarcity of donor hearts available,” Thero said in a telephone interview. “We are starting with patients who are at the ends of their lives. They are not candidates for transplant and are near death. Our goal is to provide them with a reasonable quality of life and an extension of life.”

Thero said the current candidates had a life expectancy of two months. “While the device is designed to eventually go much longer, if we were able to double someone’s life expectancy, we would be very pleased,” he said.

The 40,000 patients awaiting heart transplants far outnumber the number of hearts available, and a successful mechanical heart could fill a huge need.

Earlier versions of the artificial heart were bulky and provided limited benefit to patients.  In 1982, Dr. Barney Clark, 61, of Salt Lake City, Utah, received the first permanent artificial heart, known as Jarvik-7. He was bound to his bed by protruding cables, tubes and a noisy box-like air compressor during the 112 days that he survived with the artificial heart.

With the Jarvik-7 and other “bridge devices,” the outside connectors leave patients exposed to infection.  The AbioCor contains a small electric motor attached to an implanted battery and is designed to last for years. Patients could wear a battery pack or plug into an electrical outlet to recharge the heart’s battery.

A Brief History of Heart Transplant

Long before human-to-human transplantation was ever imagined by the public, scientists were conducting pioneering medical and surgical research that would eventually lead to today’s transplantation successes. From the late 1700s until the early 1900s, the field of immunology was slowly evolving through the works of numerous independent scientists. Among the notable breakthroughs were Ehrlich’s discovery of antibodies and antigens, Lansteiner’s blood typing, and Metchnikoff’s theory of host resistance.

Because of advances in suturing techniques at the end of the 19th century, surgeons began to transplant organs in their lab research. At the start of the 20th century, enough experimentation had taken place to know that xenographic (cross species) transplants invariably failed, allogenic transplants (between individuals of same species) usually failed, while autografts (within the same individual, generally skin grafts) were almost always successful. It was also understood that repeat transplants between same donor and recipient experienced accelerated rejection, and that graft success was more likely when the donor and recipient shared a “blood relationship.”

Alexis Carrel was a French surgeon and Nobel laureate whose experiments involved sustaining life in animal organs outside the body. He received the 1912 Nobel Prize in Medicine or Physiology for his technique for suturing blood vessels. In the 1930s, he collaborated with the aviator Charles Lindbergh to invent a mechanical heart that circulated vital fluids through excised organs. Various organs and animal tissues were kept alive for many years in this fashion.

Throughout the 1940s and 50s, small but steady research advances were made. In 1958, Dickinson Richards, MD, chairman of the Columbia University Medical Division, and Andre Cournaud were awarded the same Nobel Prize for their work leading to fuller understanding of the physiology of the human heart using cardiac catheterization.

In that same year, Keith Reemtsma, MD, a member of the faculty of Tulane University who later became chairman of the Department of Surgery at Columbia University Medical Center, showed for the first time that immunosuppressive agents would prolong heart transplant survival in the laboratory setting.

At this time, Norman Shumway, MD, Richard Lower, MD, and their associates at Stanford University Medical Center were embarking on the development of heart-lung machines, solving perfusion issues, and pioneering surgical procedures to correct heart valve defects. Key to their success was experimentation with “topical hypothermia,” the localized hyper-cooling of the heart which allowed the interruption of blood flow and gave the surgeons the proper blood-free environment and adequate time to perform the repairs. Next came “autotransplantation,” where the heart would be excised and resutured in place.

By the mid-1960s, the Shumway group was convinced that immunologic rejection was the only remaining obstacle to successful clinical heart transplantation. In 1967, Michael DeBakey, MD, implanted an artificial left ventricle device of his design in a patient at Baylor College of Medicine in Houston.

In 1967, a human heart from one person was transplanted into the body of another by a South African surgeon named Dr. Christiaan Barnard in Cape Town. In early December, Dr. Barnard’s surgical team removed the heart of a 25-year-old woman who had died following an auto accident and placed it in the chest of Louis Washkansky, a 55-year-old man dying of heart damage. The patient survived for 18 days. Dr. Barnard had learned much of his technique from studying with the Stanford group. This first clinical heart transplantation experience stimulated world-wide notoriety, and many surgeons quickly co-opted the procedure. However, because many patients were dying soon after, the number of heart transplants dropped from 100 in 1968, to just 18 in 1970. It was recognized that the major problem was the body’s natural tendency to reject the new tissues.

Over the next 20 years, important advances in tissue typing and immunosuppressant drugs allowed more transplant operations to take place and increased patients’ survival rates. The most notable development in this area was Jean Borel’s discovery of cyclosporine, an immunosuppressant drug derived from soil fungus, in the mid 1970s.

The cardiac transplant program at Columbia University Medical Center began in 1971 as part of an investigational surgery program initiated by Dr. Keith Reemtsma. At that time, Columbia University Medical Center was one of only a handful of medical centers in the nation actively engaged in cardiac transplant research. Columbia University Medical Center’s first cardiac transplant was performed by Dr. Reemtsma in 1977, when survival rates had begun to improve significantly. That patient survived for 14 months. Two additional transplants were performed that year. Initially Columbia University Medical Center accepted patients deemed too risky for transplantation by Stanford and the Medical College of Virginia, the only other medical centers in the country performing heart transplants.

Thanks to the persistence of pioneers in immunosuppression research, transplant patients have dramatically expanded life expectancies. The first immunosuppressant drugs used in organ transplantation were the corticosteroids. In 1983, Columbia University Medical Center became one of a small group of medical centers to initiate clinical trials of cyclosporine; approved for commercial use in November of that year, it is still the most commonly prescribed immunosuppressant used in organ transplantation. General information on the variety of medications that may be prescribed for you is found in the chapter on Medications in the section Care and Concerns after Your Operation.

In 1984, the world’s first successful pediatric heart transplant was performed at Columbia on a four-year-old boy. He received a second transplant in 1989 and lived until he succumbed to other health issues in 2006.

Also, in 1984, in Loma Linda, California, Leonard Bailey, MD, implanted a baboon heart into a 12-day-old girl who came to be known as “Baby Fae.” The infant survived for twenty days as the most famous recipient of xenographic transplantation. Throughout the decade of the 1980s and into the 90s, physicians continue to refine techniques for balancing dosages of immunosuppressant medications to protect the new heart yet allow the patient sufficient immunologic function to stave off infection. In 1994 a new drug, tacrolimus or FK-506, originally discovered in a fungus sample, was approved for immunosuppression in transplant patients. Newer formulations of cyclosporine now enable efficacy (effectiveness) at lower, less toxic dosages.

While research on transplantation issues continues, other techniques for the management and cure of heart disease are also under development. Some future directions include:

Coronary assist devices and mechanical hearts are being developed or perfected to perform the functions of live tissues. Artificial hearts have been under development since the 1950s. In 1966, Dr. DeBakey first successfully implanted a booster pump as a temporary assist device. Columbia’s cardiac surgeons have been instrumental in the development of a LVAD (left ventricular assist device) to function as a bridge-to-transplantation for those waiting for a new heart to become available. Columbia University Medical Center’s lead role in the REMATCH clinical trial helped to lead to approval for the the LVAD as a permanent, or destination, therapy as well.

In 1969, Dr. Denton Cooley implanted the first completely artificial heart in a human, again on a temporary basis. The first permanent artificial heart, designed by Dr. Robert Jarvik, was implanted in 1982. Numbers of patients have received Jarvik or other artificial hearts since, but surviving recipients have tended to suffer strokes and related problems.

There is a tremendous gap in the number of patients waiting for new hearts and the number of organs that actually become available. In addition to avoiding the immunosuppression and rejection complications of transplantation, success in clinical application of such mechanical devices can help resolve the issue of organ availability and thus, stakes are high to continue research in this arena.

Advances in immunosuppression have most recently involved the development and expanded use of polyclonal and monoclonal antibodies to counteract steroid-resistant rejection. Research continues into the management, reversal and avoidance of accelerated atherosclerosis in the transplanted heart, believed to be caused or aggravated by the required suppression of the body’s normal immunology. From the development of more powerful and specific immunosuppressants to new treatments for accelerated graft atherosclerosis, advances in the science of immunology appear to hold the key to expanding the success of heart transplantation in our treatment of end-stage cardiac disease.

If your ticker needs an update, or you are just feeling a little BLAH, go to HealthLynked.com to find the right physician for you.  We are the world’s first every healthcare ecosystem designed to connect physicians to patients in unique ways for the efficient exchange of information.

Transplant the old ways of finding and sharing with your doctor.  Restore great relational medicine.  Go to Healthlynked.com today and sign up for free!

Sources

UCLAnewsroom.edu

Wired.com

Columbiasurgery.org

Title:  The Beat Goes On | Heart Transplants a Marvel of Modern Medicine

 

#heart,#transplant,#immunosuppression

 

11 Ways Laughter IS the Best Medicine, and It IS Contagious !

Do you remember that last time you had a good, hearty, deep from your very soul laugh? For my family, it was last night while we enjoyed fireworks with friends over the lake in anticipation of the 4th of July celebration. Josh Billings said, “Laughter is the fireworks of the soul”; and great wisdom can be found in Proverb (17:22): “A cheerful heart is good medicine, but a broken spirit saps a person’s strength.”

There are tremendous health benefits found in laughing – it strengthens your immune system, triggers the release of endorphins that lift your mood, helps protect your heart, diminishes pain and protects you by reducing effects of stress.

One of the best feelings in the world is that deep belly laugh – to have one and even to hear it in others. While the ability to laugh is a powerful health resource, mentally, emotionally and physically. it can also bring people together and establish amazing connections. Everything from a slight giggle to a side-splitting guffaw can change the atmosphere of a room from chilly unfamiliarity to warm and family-like. Studies have shown a strong, positive bond is created when we laugh with one another.

So, when was the last time you found yourself laughing out loud? Hopefully, you are one of the fortunate ones that has enjoyed the delights of laughing recently – and the powerful preventive benefits its joy offers. There is so much to love about laughter and many ways it promotes wellness and wellbeing in everyday life, at home, work and at play.

What is laughter?

While the brain mechanisms behind laughing (and smiling) remain a mystery, it is often a spontaneous response to humor or other visual, auditory, or emotional stimuli. And, too, it can occur on command—as either voluntary or contrived.

When we laugh, air is forced through the vocal cords as a result of chest wall contractions, in particular from the diaphragm. It is often followed by a deep inspiration of air. Thus, laughter recruits a number of muscles—respiratory, laryngeal, and facial. And when “exuberant,” it can also involve the arms and legs.

When do humans begin laughing?

Our first laugh typically occurs between 3 to 4 months of age—even before we learn to speak! It is believed that a baby’s laugh serves as a way to communicate, bond, and, too, explore sound and vocalization.
There is already so much to love for laughter that it seems greedy to look for more, but that’s exactly what researchers Dr. Lee Berk and Dr. Stanley Tan at the Loma Linda University in California have done. These two doctors have researched the benefits of laughter and found amazing results.

1. Lowers blood pressure
People who lower their blood pressure, even those who start at normal levels, will reduce their risk of stroke and heart attack. So, grab the Sunday paper, flip to the funny pages, and enjoy your laughter medicine, or pull up the latest memes in social media. Of even better, watch your favorite funny movie, or check out these YouTube posts from LucidChart.

2. Reduces stress hormone levels
By reducing the level of stress hormones, you’re simultaneously cutting the anxiety and stress that impacts your body. Additionally, the reduction of stress hormones may result in higher immune system performance. Just think: Laughing along as a co-worker tells a funny joke can relieve some of the day’s stress and help you reap the health benefits of laughter.

Psychologically, having a good sense of humor—and applying it by laughing—may permit us to have a better perspective on things by seeing situations in a “more realistic and less threatening light.” Physically, laughter can put a damper on the production of stress hormones—cortisol and epinephrine—as well as trigger the release of endorphins. Endorphins are our body’s natural painkillers and can boost our mood. And, too, it has been shown that a good LOL or ROTFL — texting slang for “laugh out loud” or “rolling on the floor laughing” — can relax our muscles for up to 45 minutes after.

3. Works your abs
One of the benefits of laughter is that it can help you tone your abs. When you are laughing, the muscles in your stomach expand and contract, similar to when you intentionally exercise your abs. Meanwhile, the muscles you are not using to laugh are getting an opportunity to relax. Add laughter to your ab routine and make getting a toned tummy more enjoyable.

4. Improves cardiac health
Laughter is a great cardio workout, especially for those who are incapable of doing other physical activity due to injury or illness. It gets your heart pumping and burns a similar number of calories per hour as walking at a slow to moderate pace. So, laugh your heart into health.

The American Heart Association states that laughter can help our hearts. Research shows that by decreasing stress hormones, we can see a decrease in blood pressure as well as artery inflammation and bad cholesterol levels. Elevated blood pressure forces our heart to work harder in order to generate the force needed to pump against the increased resistance. And inflammation and high cholesterol contribute to the development of fatty plaques that decrease blood flow to the heart, or, even, complete blockage that can cause a heart attack.

5. Boosts T-cells
T-cells are specialized immune system cells just waiting in your body for activation. When you laugh, you activate T-cells that immediately begin to help you fight off sickness. Next time you feel a cold coming on, add chuckling to your illness prevention plan.

6. Triggers the release of endorphins
Endorphins are the body’s natural painkillers. By laughing, you can release endorphins, which can help ease chronic pain and make you feel good all over.

7. Produces a general sense of well-being
Laughter can increase your overall sense of well-being. Doctors have found that people who have a positive outlook on life tend to fight diseases better than people who tend to be more negative. Smile, laugh, and live longer!

8. Improves bonding
There has been much written that laughter is not primarily about humor, but, instead, social relationships. When we laugh, we create a positive emotional climate and a sense of connection between two people. In fact, with romantic partners, shared laughter—when you laugh together—is an indicator of relationship well-being, in that it enhances closeness and perceptions of partner supportiveness.

9. Can shed pounds
In a study published in the International Journal of Obesity, researchers found that 15 minutes of genuine laughter burns up to 40 calories, depending on the individual’s body weight and laughter intensity. While this cannot replace aerobic physical activity, 15 minutes of daily LOL, over the course of a year, could result in up to 4 fewer pounds.

10. Enhances our ability to fight off germs
Laughter increases the production of antibodies—proteins that surveillance for foreign invaders—as well as a number of other immune system cells. And, in doing so, we are strengthening our body’s defenses against germs. Additionally, it is a well-known fact that stress weakens our immune system. And because laughing alleviates our body’s stress response, it can help dampen its ill-effects.

11. A natural pain-killer
The iconic Charlie Chaplin stated: “Laughter is the tonic, the relief, the surcease for pain.” Although Mr. Chaplin probably meant this figuratively, laughter can literally relieve pain by stimulating our bodies to produce endorphins — natural painkillers. Laughter may also break the pain-spasm cycle common to some muscle disorders. The best part: You do not need a prescription and there are no known side-effects.

Is it contagious?

Yes. The saying “laugh and the whole world laughs with you” is not just figurative, it is literal. When we hear laughter, it triggers an area in our brain that is involved in moving the muscles in our face, almost like a reflex. This is one of the reasons television sitcoms have laugh tracks—a separate soundtrack that contains the sound of audience laughter. We are more likely to find the joke or situation funny and chuckle, giggle, or guffaw.

How to use laughter to heal and uplift.

Laughter is a physical expression of pleasant emotions among human beings. It is preceded by what one sees, hears or feels. When shared, it serves to connect people and increases intimacy and is a good anti-stress medicine.

LOL or lol, has become a very popular element of internet communications and texting in expressing great amusement in a chat. As well, according to research, the smiling and “tears of joy” laughing emoji faces are tops in digital communications. Their usage is so widespread and so common, that we now actually have data that demonstrates that the use and placement of emojis carries an emotional weight which impacts our perception of the messages that frame these icons (understanding the mental states of others is crucial to communication). And yes, in today’s busy world we may be utilizing =D and LOL’s at every turn, but let’s lean in to the hilarious and enjoy the good, hearty health benefits of laughter.

And remember, know when not to laugh. Laughter at the expense of others or in hurtful situations is inappropriate.

Now, make a commitment to laugh more.

In his book, The Travelers Gift, Andy Andrews challenges the traveler to start each day with laughter within moments of waking. It changes your whole being, even if you only laugh for seven seconds. I have tried it. I have faked it, and even as I start with the fake laugh, I can’t stop after seven seconds.

Practice laughing by beginning with a smile and then enact a laugh. Although it may feel contrived at first, with practice, it will likely become spontaneous. At Laughter University (yes, there is one) they encourage at least 30 seconds. There is so much going on around us that is laughable!

We can also move towards laughter by being with those who laugh and return the favor by making them laugh. And, too, surround ourselves with children and pets. On average, children laugh 300 times a day! And we know that laughter is contagious. Studies have shown people are immensely happier just seeing a picture of a dog!

Even make an effort to find the humor in an unpleasant situation, especially with situations that are beyond our control.

For all this, you will be made glad. Laughter wipes away stress, decreases blood pressure, burns calories, alleviates pain, connects us to others, reinvigorates us with hope, helps ward off germs … (the list goes on) – and feels soooo good. LOL for better health, connection and joy!

Want to find a physician who tickles your funny bone or at least knows where it is?  Find them in the fastest growing HealthCare ecosystem around.

HealthLynked is the first of its kind network designed to connect patients with their physicians for a higher purpose – Improving HealthCare!

Ready to get Lynked?  Got to HealthLynked.com to sign up for free!

Sources:
Gaiam.com
laughteronlineuniveristy,com
Dr. Nina Radcliff, Laugh, giggle, be joyful — for lol; ‘The fireworks of the soul’. Washington Post

Link between 2 key Alzheimer’s proteins explained | Targeting tau production may lead to treatment


by Tamara Bhandari•March 21, 2018

Alzheimer’s disease is characterized by clumps of two proteins – amyloid beta and tau – in the brain, but the link between the two has never been entirely clear. Now, researchers at Washington University School of Medicine in St. Louis have shown that people with more amyloid in the brain produce more tau, which could lead to new treatments for the disease based on targeting the production of tau.

It’s a paradox of Alzheimer’s disease: Plaques of the sticky protein amyloid beta are the most characteristic sign in the brain of the deadly neurodegenerative disease. However, many older people have such plaques in their brains but do not have dementia.

The memory loss and confusion of Alzheimer’s instead is associated with tangles of a different brain protein – known as tau – that show up years after the plaques first form. The link between amyloid and tau has never been entirely clear. But now, researchers at Washington University School of Medicine in St. Louis have shown that people with more amyloid in their brains also produce more tau.

The findings, available March 21 in the journal Neuron, could lead to new treatments for Alzheimer’s, based on targeting the production of tau.

“We think this discovery is going to lead to more specific therapies targeting the disease process,” said senior author Randall Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor of Neurology.

Years ago, researchers noted that people with Alzheimer’s disease have high levels of tau in the cerebrospinal fluid, which surrounds their brain and spinal cord. Tau – in the tangled form or not – is normally kept inside cells, so the presence of the protein in extracellular fluid was surprising. As Alzheimer’s disease causes widespread death of brain cells, researchers presumed the excess tau on the outside of cells was a byproduct of dying neurons releasing their proteins as they broke apart and perished. But it was also possible that neurons make and release more tau during the disease.

In order to find the source of the surplus tau, Bateman and colleagues decided to measure how tau was produced and cleared from human brain cells.

Along with co-senior author Celeste Karch, PhD, an assistant professor of psychiatry, and co-first authors Chihiro Sato, PhD, an instructor in neurology, and Nicolas Barthélemy, PhD, a postdoctoral researcher, the researchers applied a technique known as Stable Isotope Labeling Kinetics (SILK). The technique tracks how fast proteins are synthesized, released and cleared, and can measure production and clearance in models of neurons in the lab and also directly in people in the human central nervous system.

Using SILK, the researchers found that tau proteins consistently appeared after a three-day delay in human neurons in a laboratory dish. The timing suggests that tau release is an active process, unrelated to dying neurons.

Further, by studying 24 people, some of whom exhibited amyloid plaques and mild Alzheimer’s symptoms, they found a direct correlation between the amount of amyloid in a person’s brain and the amount of tau produced in the brain.

“Whether a person has symptoms of Alzheimer’s disease or not, if there are amyloid plaques, there is increased production of this soluble tau,” Bateman said.

The findings are a step toward understanding how the two key proteins in Alzheimer’s disease – amyloid and tau – interact with each other.

“We knew that people who had plaques typically had elevated levels of soluble tau,” Bateman said. “What we didn’t know was why. This explains the why: The presence of amyloid increases the production of tau.”

Tau is strongly linked to brain damage, so overproduction of the protein could be a critical step in the development of Alzheimer’s, and reducing tau’s production may help treat the disease, the researchers said.

“These findings point to an important new therapeutic avenue,” Karch said. “Blocking tau production could be considered as a target for treatment for the disease.”

Sato C, Barthélemy NR, Mawuenyega KG, Patterson BW, Gordon BA, Jockel-Balsarotti J, Sullivan M, Crisp MJ, Kasten T, Kirmess KM, Kanaan NM, Yarasheski KE, Baker-Nigh A, Benzinger TLS, Miller TM, Karch CM and Bateman RJ. Tau Kinetics in Neurons and the Human Central Nervous System. Neuron. March 21, 2018.

This work was supported by the National Institutes of Health (NIH), grant number R01NS095773, R01NS078398, K01 AG046374, K01 AG053474, P30DK056341, P01AG003991, UL1TR000448, P30NS098577, P50AG005681, and P01AG026276; Brightfocus Foundation, grant number A2014384S; the National Institute of Neurological Disorders and Stroke, grant numbers P01NS080675 and P30NS098577; Tau SILK Consortium (AbbVie, Biogen, and Eli Lily); Metlife Foundation; ALS Association; DIAN-TU; Hope Center for Neurological Disorders; The Foundation for Barnes-Jewish Hospital; Kanae Foundation for the Promotion of Science; McDonnell Science Grant for Neuroscience; the Tau Consortium; the Knight Alzheimer’s Disease Research Center; Coins for Alzheimer’s Research Trust; Alzheimer’s Association; and resources provided by Washington University Biomedical Mass Spectrometry Research Facility (NIH P41GM103422), Diabetes Research Center (NIH P30DK020579), and the Nutrition Obesity Research Center (NIH P30DK056341).

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

MEDIA CONTACT
Judy Martin Finch, Director of Media Relations

314-286-0105
martinju@wustl.edu
WRITER
Tamara Bhandari, Senior Medical Sciences Writer

Tamara Bhandari covers pathology, immunology, medical microbiology, cell biology, neurology, and radiology. She holds a bachelor’s degree in molecular biophysics and biochemistry and in sociology from Yale University, a master’s in public health/infectious diseases from the University of California, Berkeley, and a PhD in infectious disease immunology from the University of California, San Diego.

314-286-0122
tbhandari@wustl.edu


In honor of ALzheimers and Brain Awareness Month, this has been reproduced with permission.

“Doing It My Way, Testing for HIV” | HIV Testing Day 2018

National HIV Testing Day (NHTD) is an annual observance encouraging people of all ages to get tested for HIV and to know their status.  Too many people are unaware they have HIV. At the end of 2014, an estimated 1.1 million persons aged 13 and older were living with HIV infection in the United States, including an estimated 166,000 (15%, or 1 in 7) persons whose infections had not been diagnosed.

Getting tested is the first step to finding out if you have HIV. If you have HIV, getting medical care, taking medicines regularly and changes in behavior help you live a longer, healthier life and will lower the chances of passing HIV on to others.

Testing is the only way for the Americans living with undiagnosed HIV to know their HIV status and get into care. CDC estimates that more than 90% of all new infections could be prevented by proper testing and linking HIV positive persons to care. HIV testing saves lives! It is one of the most powerful tools in the fight against HIV

How do I know if I am at risk to get HIV? 

Knowing your risk can help you make important decisions to prevent exposure to HIV.  Overall, an American has a 1 in 99 chance of being diagnosed with HIV at some point in his or her lifetime. However, the lifetime risk is much greater among some populations. If current diagnosis rates continue the lifetime risk of getting HIV is:

  • 1 in 6 for gay and bisexual men overall
  • 1 in 2 for African American gay and bisexual men
  • 1 in 4 for Hispanic gay and bisexual men
  • 1 in 11 for white gay and bisexual men
  • 1 in 20 for African American men overall
  • 1 in 48 for African American women overall
  • 1 in 23 for women who inject drugs
  • 1 in 36 for men who inject drugs

Your health behaviors also affect your risk. You can get or transmit HIV only through specific activities. HIV is commonly transmitted through anal or vaginal sex without a condom or sharing injection and other drug injection equipment with a person infected with HIV. Substance use can increase the risk of exposure to HIV because alcohol and other drugs can affect your decision to use condoms during sex. To learn more about your HIV risk and ways to reduce these risks, visit: https://wwwn.cdc.gov/hivrisk/

How do HIV, Viral Hepatitis, and STDs relate to each other? 

Persons who have an STD are at least two to five times more likely than uninfected persons to acquire HIV infection if they are exposed to the virus through sexual contact. In addition, if a person who is HIV positive also has an STD, that person is more likely to transmit HIV through sexual contact than other HIV-infected persons.

Hepatitis B virus (HBV) and HIV are bloodborne viruses transmitted primarily through sexual contact and injection drug use. Because of these shared modes of transmission, a high proportion of adults at risk for HIV infection are also at risk for HBV infection. HIV-positive persons who become infected with HBV are at increased risk for developing chronic HBV infection and should be tested. In addition, persons who are co-infected with HIV and HBV can have serious medical complications, including an increased risk for liver-related morbidity and mortality.

Hepatitis C Virus (HCV) is one of the most common causes of chronic liver disease in the United States. For persons who are HIV infected, co-infection with HCV can result in a more rapid occurrence of liver damage and may also impact the course and management of HIV infection.

How do I protect myself and others from HIV, Viral Hepatitis, and STDs? 

HIV Prevention

Your life matters and staying healthy is important. It’s important for you, the people who care about you, and your community that you know your HIV status.  Knowing give you powerful information to help take steps to keep you and others healthy. You should get tested for HIV, and encourage others to get tested too.

For people who are sexually active, there are more tools available today to prevent HIV than ever before. The list below provides a number of ways you can lower your chances of getting HIV. The more of these actions you take, the safer you can be.

  • Get tested and treated for other STDs and encourage your partners to do the same.All adults and adolescents from ages 13-64 should be tested at least once for HIV, and high-risk groups get tested more often.  STDs can have long-term health consequences.  They can also increase your chance of getting HIV or transmitting it to others. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly. Find an HIV/STD testing site.
  • Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex for HIV transmission. Anal sex is the highest-risk sexual activity for HIV transmission. Sexual activities that do not involve the potential exchange of bodily fluids carry no risk for getting HIV (e.g., touching).
  • Use condoms consistently and correctly.
  • Reduce the number of people you have sex with.  The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
  • Talk to your doctor about pre-exposure prophylaxis (PrEP). CDC recommends that PrEP be considered for people who are HIIV-negative and at substantial risk for being exposed to HIV.For sexual transmission, this includes HIIV-negative persons who are in an ongoing relationship with an HIV-positive partner. It also includes anyone who 1) is not in a mutually monogamous relationship with a partner who recently tested HIV-negative, and 2) is a gay or bisexual man who has had sex without a condom or been diagnosed with an STD in the past 6 months; or heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners). For people who inject drugs, this includes those who have injected drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.
  • Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting medicine immediately (known as post-exposure prophylaxis, or PEP) and taking it daily for 4 weeks reduces your chance of getting HIV.
  • If your partner is HIV-positive, encourage your partner to get and stay on treatment.  ART reduces the amount of HIV virus (viral load) in blood and body fluids. ART can keep people with HIV healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently and correctly.

Hepatitis Prevention

The best way to prevent both Hepatitis A and B is by getting vaccinated.   There is no vaccine available to prevent Hepatitis C.  The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, such as sharing needles or other equipment to inject drugs.

STD Prevention

The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do several things to lower your chances of getting an STD, including:

  • Get tested for STDs and encourage your partner(s) to do the same. It is important to have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs.  Your healthcare provider can offer you the best care if you discuss your sexual history openly.  Find an STD testing site.
  • Get vaccinated. Vaccines are safe, effective, and recommended ways to prevent hepatitis A, hepatitis B, and HPV.
  • Be in a sexually active relationship with only one person, who has agreed to be sexually active only with you.
  • Reduce your number of sex partners.  By doing so, you decrease your risk for STDs. It is still important that you and your partner get tested, and that you share your test results with one another.
  • Use a condom every time you have vaginal, anal, or oral sex. Correct and consistent use of the male latex condomis highly effective in reducing STD transmission.

What puts me at risk for HIV, Viral Hepatitis, and STDs? 

Risks for HIV

The most common ways HIV is transmitted in the United States is through anal or vaginal sex or sharing drug injection equipment with a person infected with HIV. Although the risk factors for HIV are the same for everyone, some racial/ethnic, gender, and age groups are far more affected than others.

What puts me at risk for Hepatitis A?

Hepatitis A is usually spread when a person ingests fecal matter — even in microscopic amounts — from contact with objects, food, or drinks contaminated by the feces or stool of an infected person. Due to routine vaccination of children, Hepatitis A has decreased dramatically in the United States. Although anyone can get Hepatitis A, certain groups of people are at higher risk, including men who have sex with men, people who use illegal drugs, people who travel to certain international countries, and people who have sexual contact with someone who has Hepatitis A.

What puts me at risk for Hepatitis B?

Hepatitis B is usually spread when blood, semen, or another body fluid from a person infected with the Hepatitis B virus enters the body of someone who is not infected. This can happen through sexual contact with an infected person or sharing needles, syringes, or other drug-injection equipment. Hepatitis B can also be passed from an infected mother to her baby at birth.

Among adults in the United States, Hepatitis B is most commonly spread through sexual contact and accounts for nearly two-thirds of acute Hepatitis B cases. Hepatitis B is 50–100 times more infectious than HIV.

What puts me at risk for Hepatitis C?

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Hepatitis C was also commonly spread through blood transfusions and organ transplants prior to the early 1990’s. At that time, widespread screening of the blood supply began in the United States, which has helped ensure a safe blood supply.

STDs

Risks for  Genital Herpes

Genital herpes is a common STD, and most people with genital herpes infection do not know they have it.   You can get genital herpes from an infected partner, even if your partner has no herpes symptoms.  There is no cure for herpes, but medication is available to reduce symptoms and make it less likely that you will spread herpes to a sex partner.

Risks for Genital Human Papillomavirus (HPV)

HPV is so common that most sexually active people get it at some point in their lives. Anyone who is sexually active can get HPV, even if you have had sex with only one person. In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer. HPV is passed on through genital contact (such as vaginal and anal sex). You can pass HPV to others without knowing it.

Risks for Chlamydia

Most people who have chlamydia don’t know it since the disease often has no symptoms.  Chlamydia is the most commonly reported STD in the United States.  Sexually active females 25 years old and younger need testing every year. Although it is easy to cure, chlamydia can make it difficult for a woman to get pregnant if left untreated.

Risks for Gonorrhea

Anyone who is sexually active can get gonorrhea, an STD that can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years. But it can be easily cured.  You can get gonorrhea by having anal, vaginal, or oral sex with someone who has gonorrhea. A pregnant woman with gonorrhea can give the infection to her baby during childbirth.

Risks for Syphilis

Any sexually active person can get syphilis. It is more common among men who have sex with men. Syphilis is passed through direct contact with a syphilis sore. Sores occur mainly on the external genitals, anus, or in the rectum. Sores also can occur on the lips and in the mouth. A pregnant women with syphilis can give the infection to her unborn baby.

Risks for Bacterial Vaginosis

BV is common among women of childbearing age. Any woman can get BV, but women are at a higher risk for BV if they have a new sex partner, multiple sex partners, use an intrauterine device (IUD), and/or douche.

Managing Your Appointments

HIV is a treatable condition. If you are diagnosed early, get on antiretroviral therapy (ART), and adhere to your medication, you can stay healthy, live a normal life span, and reduce the chances of transmitting HIV to others. Part of staying healthy is seeing your HIV care provider regularly so that he or she can track your progress and make sure your HIV treatment is working for you.

Your HIV care provider might be a doctor, nurse practitioner, or physician assistant. Some people living with HIV go to an HIV clinic; others see an HIV specialist at a community health center, Veterans Affairs clinic, or other health clinic; and some people see their provider in a private practice. Current guidelines recommend that most people living with HIV see their provider for lab tests every 3 to 4 months. Some people may see their provider more frequently, especially during the first two years of treatment or if their HIV viral load is not suppressed (i.e. very low or undetectable). Current guidelines say that people who take their medication every day and have had a suppressed viral load at every test for more than 2 years only need to have their lab tests done two times a year.

In addition to seeing your HIV care provider, you may need to see other health care practitioners, including dentists, nurses, case managers, social workers, psychiatrists/psychologists, pharmacists and medical specialists. This may mean juggling multiple appointments, but it is all part of staying healthy. You can help make this easier by preparing a plan for yourself.

Before Your Visit

For many people living with HIV, appointments with their HIV care provider become a routine part of their life. These tips may help you better prepare for your visits to your HIV care provider and get more out of them:

  • Start with a list or a notebook. Write down any questions you have before you go. (The Department of Veterans Affairs offers a useful list of sample questions you can bring with you.)
  • Make a list of your health and life goals so that you can talk about them with your HIV provider and how she/he can help you reach them.
  • Make a list of any symptoms or problems you are experiencing that you want to talk to your provider about.
  • Bring a list of all the HIV and non-HIV medications that you are taking (or the medications themselves), including over-the-counter medications, vitamins, or supplements. Include a list of any HIV medications you may have taken in the past and any problems you had when taking them.
  • Bring along a copy of your medical records if you are seeing a new provider who does not already have them. You have the right to access your medical records and having copies of your records can help you keep track of your lab results, prescriptions, and other health information. It can also help your new provider have a better understanding of your health history. The best way to do this is by using a global, portable personal health record like the one you will maintain here at HealthLynked.
  • Be prepared to talk about any changes in your living situation, relationships, insurance, or employment that may affect your ability to keep up with your HIV appointments and treatment or to take care of yourself. Your provider may be able to connect you with resources or services that may assist you.
  • Be on time. Most healthcare providers have full appointment schedules—if you are late, you throw the schedule off for everyone who comes after you. If you are late, there is a chance your provider will not be able to see you the same day.

During Your Visit

  • If your provider wants to run some lab tests during your visit, make sure you understand what the lab tests are for and what your provider will do with the results. If you don’t understand, ask your provider to explain it in everyday terms. Typically, you will be asked to give a sample (blood, urine) during your visit and your provider’s office will call you with your results in a few days. Keep track of your results and call your provider back if you have any questions.
  • Be honest. Your provider isn’t there to judge you, but to make decisions with you based on your particular circumstances. Talk about any HIV medication doses you have missed. Tell your provider about your sexual or alcohol/drug use history. These behaviors can put you at risk of developing drug resistance and getting other sexually transmitted infections (STIs) as well as hepatitis. Your provider will work with you to develop strategies to keep you as healthy as possible.
  • Describe any side effects you may be having from your HIV medications. Your provider will want to know how the HIV medications are affecting your body in order to work with you to solve any problems and find the right combination of medications for you.
  • Ask your provider about your next visit and what you should bring to that appointment.
  • Ask for a list of your upcoming appointments when you check out. Work with your case manager, if you have one, to develop a system to help you remember your appointments, such as a calendar, app, or text/e-mail reminders.

Asking Questions and Solving Problems

It’s important for you to be an active participant in your own health care and it’s your right to ask questions. You may need to direct your questions to different people, depending on what you need/want to know:

HIV care providers (doctors, nurse practitioners, physician assistants) can answer specific questions about a wide range of issues that affect your health. They can also help you find resources and solutions to problems you may have that affect your health, including:

  • Your prognosis (how your HIV disease is affecting your body)
  • How to manage any symptoms you may be experiencing
  • Medication issues, including medication changes, new medications, and how the HIV medications may interact with other medications you take.
  • Sexual health issues, including questions about any sexual symptoms you may be having, and how you can prevent or treat STIs, and how you can prevent transmitting HIV to your partner(s).
  • Family planning considerations, including your goals; birth control options for you and/or your partner, if relevant; your options for having children should you wish to do so; and, if you are an HIV-positive woman who is pregnant or considering getting pregnant, how you can reduce the risk of transmitting HIV to your baby
  • Substance use issues, including how alcohol/drug use can affect your HIV treatment and overall health, and whether you should be referred for substance abuse treatment
  • Mental health issues, including questions about any mental health symptoms you may be having, and whether you should be referred for mental health treatment
  • Referrals for other medical issues you may be experiencing
  • The meaning of lab test results
  • The need for surgical procedures, if relevant
  • Medication adherence strategies (tips for keeping up with your medication and ensuring you take it as scheduled and exactly as prescribed)
  • Any clinical trials or research studies that may be relevant for you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

Nurses and case managers often have more time to answer questions about what you discuss with your provider and to help identify solutions to problems that are affecting your health, particularly around:

  • Understanding your HIV treatment plan, including how many pills of each medicine you should take; when to take each medicine; how to take each medicine (for example, with or without food); and how to store each medicine
  • Understanding possible side effects from your HIV medication and what you should do if you experience them
  • Challenges you may have in taking your medications and/or keeping your medical appointments, and strategies for overcoming these challenges
  • Resources to help you better understand lab reports, tests, and procedures
  • Mental health and/or substance abuse treatment, housing assistance, food assistance, and other resources that exist in your community
  • Insurance and pharmacy benefits, and other aspects of paying for care
  • Understanding other medical conditions you may have
  • How to quit smoking and resources that are available to assist you
  • Information about resources and services that can help you with issues or challenges you may be having that affect your health.

If you are HIV positive, attending your medical appointments is one of the most important things you can do to ensure your HIV is optimally managed. Make sure you are ready for your appointments with HealthLynked.  Using our novel healthcare ecosystem, you can collate your medical information in one place and Connect there with the physicians who care for you.

Ready to get Lynked?  Go to HealthLynked.com today to sign up for Free!

 

Adapted from:

HIV.org

CDC.foc

Aidsinfo.NIH.gov

 

 

 

 

 

Forgiveness Fills Life with Research Proven Health Benefits

Maybe you are considering forgiveness for yourself or others, but you’re not sure it’s worth the emotional effort. You might prefer to ignore the painful memories, stuff it down and keep going about your daily affairs. You will just deal with it later, right?

To forgive, whether yourself or others, and to be forgiven, brings relief beyond just the emotional or even spiritual, if you at a person of faith.  Today is Forgiveness Day – one of many observed throughout the year.  The original was established as International Forgiveness Day in response to a call to set aside old differences made by Desmond Tutu.  There is also Global Forgiveness Day next Saturday, and National Forgiveness Day in October.  All have one purpose – to encourage us to set things right; and there are great health benefits to doing so!

Whether it’s a bout with your boss, a feud with a family member or friend, or a spat with your spouse, unresolved conflict can go deeper than you may realize—it may be affecting your physical health. Not forgiving has its costs. When we harbor grudges and grievances, we retain everything that goes with them: anxiety, irritability, anger, and depression.  We may suffer insomnia, experience weight gain or loss, endure depletion of trust in ourselves and others, get caught up in numbing addictions and get stuck in a nerve fraying fight-or-flight mode.

The list is long and disabling.  The good news: Studies have found the act of forgiveness can pay huge dividends for your health, And research points to an increase in the forgiveness-health connection as you age.

What are the health benefits of forgiveness?

In a study at Virginia Commonwealth University, researchers sought to prove what many might already feel is common sense. They wrote, “Chronic unforgiveness causes stress. Every time people think of their transgressor, their body responds. Decreasing your unforgiveness cuts down your health risk. Now, if you can forgive, that can actually strengthen your immune system.” [1]

Dr. Bernie Siegel, author, surgeon and retired medical professor at Yale University, said, “I have collected 57 extremely well-documented so-called cancer miracles. At a certain particular moment in time, they decided that the anger and the depression were probably not the best way to go, since they had such little time left.

And so, they went from that to being loving, caring, no longer angry, no longer depressed, and able to talk to the people they loved. These 57 people had the same pattern. They gave up—totally—their anger, and they gave up—totally—their depression, by specifically a decision to do so. And at that point, the tumors started to shrink.” [2]

Medical researchers have become increasingly interested in studying the effects of forgiveness as a healing process. Evidence is mounting:  holding onto painful memories and bitterness results in long-term health problems. Forgiveness, on the other hand, offers numerous benefits, including:

  1. Lower blood pressure

When we no longer feel anxiety or anger because of past grievances, our heart rate evens out and our blood pressure drops. This normalizes many processes in the body and brings us our heart and circulatory system into stability.

  1. Stress reduction

Forgiveness eases stress because we no longer recycle thoughts (both consciously and subconsciously) that cause psychic stress to arise. By offering our burdens for healing, we learn how to leave irritation and stress behind.

  1.  Less hostility

By its very nature, forgiveness asks us to let go of hostility toward ourselves and others.  Spontaneous hostile behavior, like road rage and picking a fight for no reason, diminishes as our commitment to forgiveness goes up.

  1. Better anger-management skills

With fewer and fewer burdens from the past weighing us down, we have more self-control when we do get angry. We’ll be better able to take some breaths, count to ten, take a time-out or get some exercise—rather than strike out or lash out in anger.

  1. Lower heart rate

Forgiveness relaxes our hearts –  pain will ease out of our system. Our hearts calm down, and our heart rate decreases as a result.

  1. Lower risk of alcohol or substance abuse

This is a big one – possibly the biggest and best reason to jump into a forgiveness practice without delay. Substance abuse is a mask for underlying pain. Forgiveness helps release that pain and find the gifts in our situation instead.

  1. Fewer depression symptoms

Similar to lowering substance abuse, this is a crucial issue with retained anguish. Depression is debilitating and can lead to suicide. On the other hand, forgiveness gives us healing and can leave room to replace depression with a sense of purpose and compassion.

  1. Fewer anxiety symptoms

Almost everyone needs to forgive him or herself as well as others. Anxiety often arises when we fear we’ve done something wrong. Our guilty conscience causes tension at a deep level. Forgiveness helps us to love ourselves deeply, relieving inner pain.

  1. Reduction in chronic pain

Physical pain often has psychological underpinnings. When we allow a profound shift to happen with forgiveness, we heal ourselves on both psychological and physical levels. Thus, chronic pain can be reversed, and we can be restored to best health.

  1. More friendships

When we’re no longer holding grudges, we can get a lot closer to friends and family. Old relationships have a chance to change and grow, and new relationships can enter—all because we made room for them with forgiveness.

  1. Healthier relationships

When we make forgiveness a regular part of our emotional practice, we start to notice all of our relationships begin to blossom. There’s far less drama to deal with, and that’s a huge bonus.

  1. Improved psychological well-being

A good life, full of quality relationships, service to others and fun, is something that most of us hope for without ever knowing how to create it.  By releasing our grievances, we become more harmonious on all levels. Nightmares recede, and exciting new life visions become commonplace. We feel calmer, happier and ready to give compassion and love to the world.

  1. Enhanced immune function

Forgiveness lowers cortisol – a steroid hormone produced in response to stress that causes weight gain – and boosts immune function. You’ll feel more relaxed and centered, and you won’t get sick as easily once you’ve let go for good through forgiveness.

Looking at the list, it’s easy to see that if you had lower stress, hostility, blood pressure and chronic pain, you’d be far healthier for it. Also, if you had better relationships, improved psychological well-being and greater emotional connection, you could be living a life of joy and purpose.

Can You Learn to Be More Forgiving?

Now, look at this list below to see if you would enjoy improvements in any of these areas of your life:

  • Your Physical Health
  • Relationships with Loved Ones (Lovers, Spouse, Exes, and Friends)
  • Family Issues with Parents, Siblings and Children
  • Trauma from Childhood
  • Impacts of Racism, Sexism and Other “Isms”
  • Money Worries
  • Sexual Issues
  • Blocked Creativity

Forgiveness is not just about saying the words. It is an active process in which you make a conscious decision to let go of negative feelings whether deserved or not. As you release anger, resentment and hostility, you make room for empathy, compassion and sometimes even affection for the person who wronged you.

Studies have found some people are just naturally more forgiving. Consequently, they tend to be more satisfied with their lives and to have less depression, anxiety, stress, anger and hostility. People who hang on to grudges, however, are more likely to experience severe depression and even post-traumatic stress disorder, as well as other health issues described earlier. But that doesn’t mean they can’t train themselves to act in healthier ways. 62 percent of American adults say they need more forgiveness in their personal lives, according to a survey by the nonprofit Fetzer Institute.

Making Forgiveness Part of Your Life

Forgiveness is a choice.  You are choosing to offer compassion and empathy to the person who wronged you.  The following steps can help you develop a more forgiving attitude—and benefit from better emotional and physical health.

Reflect and remember.

That includes the events themselves, and also how you reacted, how you felt, and how the anger and hurt have affected you since.

Empathize with the other person.

For instance, if your spouse grew up in an alcoholic family, then anger when you have too much to drink might be understandable.

Forgive deeply.

Simply forgiving someone because you think you have no other alternative or because you think your faith requires it may be enough to bring some healing, but one study found people whose forgiveness came in part from understanding no one is perfect were able to resume a normal relationship with the other person.  This was true even if that person never apologized. Those who only forgave in an effort to salvage the relationship typically wound up with a worse relationship.

Let go of expectations.

An apology may not change your relationship with the other person or elicit an apology from them. If you don’t expect either, you won’t be disappointed.

Decide to forgive.

Once you make that choice, seal it with an action. If you don’t feel you can talk to the person who wronged you, write about your forgiveness in a journal or even talk about it with someone else in your life whom you trust and can be supportive.

Forgive yourself.

The act of forgiving includes forgiving yourself. Failings of the past are not a reflection of your worth.

If you are suffering any of the debilitating effects of unforgiveness, it is a great day to relieve yourself and others of the tremendous burden of holding on to hurt.  And if you need a professional to speak with about any of the physical effects you are feeling, find them in HealthLynked.

In our novel HealthCare ecosystem, we are connecting physicians and patients in unique ways.  Lower the stress and confusion of seeing a provider and sharing relevant health information through HealthLynked.

Ready to get Lynked?  Go to HealthLynked.com to register for free!


Definitions

Immune response: How your immune system recognizes and defends itself against bacteria, viruses, toxins and other harmful substances. A response can include anything from coughing and sneezing to an increase in white blood cells, which attack foreign substances.

Post-traumatic stress disorder (PTSD): A disorder in which your “fight or flight,” or stress, response stays switched on, even when you have nothing to flee or battle. The disorder usually develops after an emotional or physical trauma, such as a mugging, physical abuse or a natural disaster. Symptoms include nightmares, insomnia, angry outbursts, emotional numbness, and physical and emotional tension.

 

Sources:

[1] Worthington, Everett & Witvliet, Charlotte & Pietrini, Pietro & J Miller, Andrea. (2007). Forgiveness, Health, and Well-Being: A Review of Evidence for Emotional Versus Decisional Forgiveness, Dispositional Forgivingness, and Reduced Unforgiveness. Journal of behavioral medicine. 30. 291-302. 10.1007/s10865-007-9105-8.

[2]Meisner-Morton, Carole J.  Entering Your Own Heart: A Guide to Developing Self Love, Inner Peace and Happiness.  Balboa Press. 2015.

[3] HopkinsMedicine.org

[4] WisdomTimes.com

 

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Title:  forgiveness fills your life with research proven health benefits.

 

Insight into Vitiligo: The Truth and Treatment of Leucoderma | Medical News

Today, June 25th, marks World Vitiligo Day, aimed at raising awareness about the disease.  Vitiligo affects roughly 100 million people worldwide and almost 2 million in the US. It’s not contagious or fatal, but scientists are unsure of what causes it.

What is Vitiligo

Vitiligo is a patchy loss of skin coloring (pigmentation). The average age of onset of vitiligo is in the mid-twenties, but it can appear at any age.  95 percent of people with vitiligo have been diagnosed before reaching age forty. It tends to progress over time, with larger areas of the skin losing pigment. Some people with vitiligo also have patches of pigment loss affecting the hair on their scalp or body.

Myths VS Facts

Myth 1: Vitiligo is an outcome of the wrong combination of foods, for instance, milk consumption shortly after eating fish can bring on the disorder.

Fact: Vitiligo has no apparent link with the diet. It is irrational to deprive patients of healthy foods they enjoy in the hope of declining the possibility of the disease.

Myth 2: Vitiligo is a kind of leprosy and is communicable.

Fact: Though often referred to those who do not understand the disease as “white leprosy”, vitiligo is in no way linked to leprosy. It is not infectious or contagious and, hence, cannot pass on from one person to another.

Myth 3: Vitiligo is connected to serious skin diseases, such as skin cancer and albinism.

Fact: There are clear dissimilarities among each of these syndromes, and not of them are linked to Vitiligo.

Myth 4:  There are no effective treatments for vitiligo.

Fact: Medications like steroids, Ultraviolet A, immunomodulator drugs and the newer narrowband Ultraviolet B are accessible, along with several surgical options.

Types of Vitiligo

Generalized vitiligo, also called non-segmental vitiligo, is the most common form.  It involves loss of pigment (depigmentation) in patches of skin all over the body. Depigmentation typically occurs on the face, neck, and scalp, and around body openings such as the mouth and genitals. Sometimes pigment is lost in mucous membranes, such as the lips. Loss of pigmentation is also frequently seen in areas that tend to experience rubbing, impact, or other trauma, such as the hands, arms, and places where bones are close to the skin surface (bony prominences).

Segmental vitiligo is associated with smaller patches of depigmented skin that appear on one side of the body in a limited area; this occurs in about 10 percent of affected individuals.

What causes Vitiligo?

Vitiligo is generally considered to be an autoimmune disorder. Autoimmune disorders occur when the immune system attacks the body’s own tissues and organs. In people with vitiligo the immune system appears to attack the pigment cells (melanocytes) in the skin. About 15 to 25 percent of people with vitiligo are also affected by at least one other autoimmune disorder, particularly autoimmune thyroid disease, rheumatoid arthritis, type 1 diabetes, psoriasis, pernicious anemia, Addison disease, or systemic lupus erythematosus.

In the absence of other autoimmune conditions, vitiligo does not affect general health or physical functioning. However, concerns about appearance and ethnic identity are significant issues for many affected individuals.

Some researchers think that the melanocytes destroy themselves. Others think that a single event such as sunburn or emotional distress can trigger vitiligo. But these events have not been proven to cause vitiligo.

Role of Genetic Changes

Variations in over 30 genes, occurring in different combinations, have been associated with an increased risk of developing vitiligo. Two of these genes are NLRP1 and PTPN22.

The NLRP1 gene provides instructions for making a protein that is involved in the immune system, helping to regulate the process of inflammation. Inflammation occurs when the immune system sends signaling molecules and white blood cells to a site of injury or disease to fight microbial invaders and facilitate tissue repair. The body then stops (inhibits) the inflammatory response to prevent damage to its own cells and tissues.

The PTPN22 gene provides instructions for making a protein involved in signaling that helps control the activity of immune system cells called T cells. T cells identify foreign substances and defend the body against infection.

The variations in the NLRP1 and PTPN22 genes that are associated with an increased risk of developing vitiligo likely affect the activity of the NLRP1 and PTPN22 proteins, making it more difficult for the body to control inflammation and prevent the immune system from attacking its own tissues.

Studies indicate that variations in a number of other genes also affect the risk of vitiligo. Many of these genes are also involved in immune system function or melanocyte biology, and variations in each likely make only a small contribution to vitiligo risk. Some of the gene changes associated with an increased risk of vitiligo have also been associated with an increased risk of other autoimmune conditions.

It is unclear what specific circumstances trigger the immune system to attack melanocytes in the skin. Research suggests that the immune system of affected individuals may react abnormally to melanocytes that are stressed by factors such as chemicals or ultraviolet radiation. In addition, the melanocytes of people with vitiligo may be more susceptible to stress than those of the general population and therefore may be more likely to be attacked by the immune system. The condition probably results from a combination of genetic and environmental factors, most of which have not been identified.

What are the symptoms of Vitiligo?

White patches on the skin are the main sign of vitiligo. These patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:

  • The armpits and groin (where the leg meets the body)
  • Around the mouth
  • Eyes
  • Nostrils
  • Navel
  • Genitals
  • Rectal areas.

People with vitiligo often have hair that turns gray early. Those with dark skin may notice a loss of color inside their mouths.

Will the white patches spread?

There is no way to tell if vitiligo will spread. For some people, the white patches do not spread. But often the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other people, spreading occurs quickly. Some people have reported more white patches after physical or emotional stress.

How is vitiligo diagnosed?

A doctor will use family and medical history, physical exam, and tests to diagnose vitiligo. The doctor may ask questions such as:

  • Do you have family members with vitiligo?
  • Do you or family members have any autoimmune diseases?
  • Did you have a rash, sunburn, or other skin problem before the white patches appeared?
  • Did you have some type of stress or physical illness?
  • Did your hair turn gray before age 35?
  • Are you sensitive to the sun?

A physical exam will be completed to rule out other medical problems.

Tests might include:

  • Taking a small sample (biopsy) of the affected skin to be examined
  • Blood tests
  • An eye exam.

How is vitiligo treated?

Treatment may help make the skin look more even. The choice of treatment depends on:

  • The number of white patches
  • How widespread the patches are
  • The treatment the person prefers to use.

Some treatments are not right for everyone. Many treatments can have unwanted side effects. Treatments can take a long time, and sometimes they don’t work.

Current treatment options for vitiligo include medical, surgical, and other treatments. Most are aimed at restoring color to the white patches of skin.

Medical treatments include:
  • Medicines (such as creams) that you put on the skin
  • Medicines that you take by mouth
  • A treatment that uses medicine plus ultraviolet A (UVA) light (PUVA)
  • Removing the color from other areas so they match the white patches.
Surgical treatments include:
  • Skin grafts from a person’s own tissues. The doctor takes skin from one area of a patient’s body and attaches it to another area. This is sometimes used for people with small patches of vitiligo.
  • Tattooing small areas of skin.
Other treatments include:
  • Sunscreens
  • Cosmetics, such as makeup or dye, to cover the white patches
  • Counseling and support.

Complications

Vitiligo does not develop into other diseases, but people with the condition are more likely to experience:

  • painful sunburn
  • hearing loss
  • changes to vision and tear production

Overcoming social challenges

If the skin patches are visible, the social stigma of vitiligo can be difficult to cope with. Embarrassment can lead to problems with self-esteem, and in some cases, anxiety and depression can result.  75% of those with vitiligo report having social anxiety in some from as a result of the changes to their skin.

People with darker skin are more likely to experience difficulties, because the contrast is greater. In some countries, vitiligo is known as “white leprosy.”

Increasing awareness about vitiligo, for example, by talking to friends about it, can help people with the condition to overcome these difficulties. Connecting with others who have vitiligo may also help.

Anyone with this condition who experiences symptoms of anxiety and depression should ask their dermatologist to recommend someone who can help.

To build the right team of professionals who know what you are going through and will truly help you in every way possible, you might use HealthLynked.com to find specialists with the skills and the will to help and heal in every way they can.

Ready to get Lynked?  Go to HealthLynked.com right now to register for Free and start taking control of your medical care.

 

Sources:

NIH.org

Medical News Today.com

 

 

 

 

Five [PLUS] Senses Working Overtime. Are You Tuned In…?

Today is Celebration of the Senses Day – a time to consider your amazing sensory abilities and how they interrelate. We all learn as children humans have five basic senses: touch, sight, hearing, smell and taste. Science has done a fantastic job describing the organs associated with each, how they send information to the brain to help us understand and perceive the world around us, and has gone even further to uncover how they uniquely cross-talk for heightened awareness.

Touch

Touch is thought to be the first sense humans develop, according to the Stanford Encyclopedia of Philosophy. Touch consists of several distinct sensations communicated to the brain through specialized neurons in the skin. Pressure, temperature, light touch, vibration, pain and other sensations are all part of the touch sense and are all attributed to different receptors in the skin.

Touch isn’t just a sense used to interact with the world; it also seems to be very important to a human’s well-being. For example, touch has been found to convey compassion from one human to another.

Touch can also influence how humans make decisions. Texture can be associated with abstract concepts, and touching something with a texture can influence the decisions a person makes, according to six studies by psychologists at Harvard University and Yale University, published in the June 24, 2010, issue of the journal Science.

“Those tactile sensations are not just changing general orientation or putting people in a good mood,” said Joshua Ackerman, an assistant professor at the Massachusetts Institute of Technology. “They have a specific tie to certain abstract meanings.”

Sight

Sight, or perceiving things through the eyes, is a complex process. First, light reflects off an object to the eye. The transparent outer layer of the eye – the cornea – bends the light that passes through the hole of the pupil. The iris (the colored part of the eye) works like the shutter of a camera, retracting to shut out light or opening wider to let in more light.

The cornea focuses most of the light. Then, it passes through the lens, which continues to focus the light.  The lens of the eye then bends the light and focuses it on the retina, which is full of nerve cells. These cells are shaped like rods and cones and are named for their shapes. Cones translate light into colors, central vision and details. The rods translate light into peripheral vision and motion. Rods also give humans vision when there is limited light available, like at night. The information translated from the light is sent as electrical impulses to the brain through the optic nerve.

People without sight may compensate with enhanced hearing, taste, touch and smell, according to numerous studies. Their memory and language skills may be better than those with sight, as well.

“Even in the case of being profoundly blind, the brain rewires itself in a manner to use the information at its disposal so that it can interact with the environment in a more effective manner.”  That’s according to Dr. Lotfi Merabet, senior author of a 2017 study and the director of the Laboratory for Visual Neuroplasticity at Schepens Eye Research Institute of Massachusetts Eye and Ear.

Hearing

This sense works via the complex labyrinth that is the human ear. Sound is funneled through the external ear and piped into the external auditory canal. Then, sound waves reach the tympanic membrane, or eardrum. This is a thin sheet of connective tissue that vibrates when sound waves strike it.

The vibrations travel to the middle ear. There, auditory ossicles — three tiny bones called the malleus (hammer), incus (anvil) and stapes (stirrup) — vibrate. The stapes bone, in turn, pushes a structure called the oval window in and out, sending vibrations to the organ of Corti.  This spiral organ is the receptor organ for hearing. Tiny hair cells in the organ of Corti translate the vibrations into electrical impulses. The impulses then travel to the brain via sensory nerves.

People retain their sense of balance because the Eustachian tube, or pharyngotympanic tube, in the middle ear equalizes the air pressure there with the air pressure in the atmosphere. The vestibular complex, in the inner ear, is also important for balance, because it contains receptors that regulate a sense of equilibrium. The inner ear is connected to the vestibulocochlear nerve, which carries sound and equilibrium information to the brain.

Smell

Humans may be able to smell over 1 trillion scents, according to researchers. They do this with the olfactory cleft, which is found on the roof of the nasal cavity, next to the “smelling” part of the brain – the olfactory bulb and fossa. Nerve endings in the olfactory cleft transmit scents to the brain, according to the American Rhinologic Society.

Dogs are known as great smellers, but research suggests humans are just as good as man’s best friend. Research published in the May 11, 2017, issue of the journal Science suggests humans can discriminate among 1 trillion different odors; it was once believed humans could discern only about 10,000 different smells.

“The fact is the sense of smell is just as good in humans as in other mammals, like rodents and dogs,” John McGann, a neuroscientist at Rutgers University-New Brunswick in New Jersey and the author of the new review, said in a statement. The Rutgers study backs up a previous study at the Rockefeller University in New York, whose findings were published in the March 2014 issue of the journal Science.

Humans have 400 smelling receptors. While this isn’t as many as animals that are super smellers have, the much more complicated human brain makes the difference.  In fact, poor smelling ability in people may be a symptom of a medical condition or aging. For example, the distorted or decreased ability to smell is a symptom of schizophrenia and depression. Old age can also lessen the ability to smell properly. More than 75 percent of people over the age of 80 years may have major olfactory impairment, according to a 2006 paper published by the National Institutes of Health (NIH).

Taste

The gustatory sense is usually broken down into the perception of four different tastes: salty, sweet, sour and bitter. There is also a fifth taste, defined as umami or savory. There may be many other flavors not yet discovered. Also, spicy is not a taste. It is actually a pain signal, according to the National Library of Medicine (NLM).

The sense of taste aided in human evolution, according to the NLM, because taste helped people test the food they ate. A bitter or sour taste indicated that a plant might be poisonous or rotten. Something salty or sweet, however, often meant the food was rich in nutrients.

Taste is sensed in the taste buds. Adults have 2,000 to 4,000 taste buds. Most of them are on the tongue, but they also line the back of the throat, the epiglottis, the nasal cavity and the esophagus. Sensory cells on the buds form capsules shaped like flower buds or oranges. The tips of these capsules have pores that work like funnels with tiny taste hairs. Proteins on the hairs bind chemicals to the cells for tasting.

It is a myth that the tongue has specific zones for each flavor. The five tastes can be sensed on all parts of the tongue, although the sides are more sensitive than the middle. About half of the sensory cells in taste buds react to several of the five basic tastes. The cells differ in their level of sensitivity. Each has a specific palette of tastes with a fixed ranking, so some cells may be more sensitive to sweet, followed by bitter, sour and salty, while others have their own rankings. The full experience of a flavor is produced only after all of the information from various parts of the tongue is combined.

The other half of the sensory cells are specialized to react to only one taste. It’s their job to transmit information about the intensity — how salty or sweet something tastes.

Other factors help build the perception of taste in the brain. For example, the smell of the food greatly affects how the brain perceives the taste. Smells are sent to the mouth in a process called olfactory referral. This is why someone with a stuffy nose may have trouble tasting food properly. Texture, translated by the sense of touch, also contributes to taste, and recent studies even show color and shape can affect the way we perceive a properly attribute taste to a food.

The sense of space

In addition to the traditional big five, other senses help us translate a myriad of inputs into how we perceive and relate to the physical world.  One deals with how your brain understands where your body is in space. This sense is called proprioception.

Proprioception includes the sense of movement and position of our limbs and muscles. For example, proprioception enables a person to touch their finger to the tip of their nose, even with their eyes closed. It enables a person to climb steps without looking at each one. People with poor proprioception may be clumsy and uncoordinated.

Researchers at the NIH found that people who have particularly poor proprioception through mechanosensation — the ability to sense force, such as feeling when someone presses down on your skin — may have a mutated gene that is passed down from generation to generation. That comes from a September 2016 study in the New England Journal of Medicine. “The patient’s version of [the gene] PIEZO2 may not work, so their neurons cannot detect touch or limb movements,” said Alexander Chesler, a principal investigator at the National Center for Complementary and Integrative Health and the lead author of the study.

Additional senses & variations

There are more-subtle senses that most people never really perceive. For example, there are neuron sensors that sense movement to control balance and the tilt of the head. Specific kinesthetic receptors exist for detecting stretching in muscles and tendons, helping people to keep track of their limbs. Other receptors detect levels of oxygen in certain arteries of the bloodstream.

While our five  basic sense seem to operate independently, as distinct modes of perceiving the world, in reality, they collaborate closely to enable the mind to better understand our surroundings. We can become keenly aware of this collaboration under special conditions.

In some cases, a sense may covertly influence another we think is dominant. When visual information clashes with that from sound, sensory crosstalk can cause what we see to alter what we hear. When one sense drops out, another can pick up the slack.  For instance, people who are blind can train their hearing to play double duty. Those who are both blind and deaf can train touch to step in—even to help them interpret speech.

Our senses must also regularly meet and greet in the brain to provide accurate impressions of the world. Our ability to perceive the emotions of others relies on combinations of cues from sounds, sights and even smells.  Perceptual systems, particularly smell, connect with memory and emotion centers to enable sensory cues to trigger feelings and recollections, and are incorporated within them.

The crosstalking of the senses provides some of the most magnificent material for interesting science, illusions, inventions and just plain art.  Here are a few of the best examples of the complex interactions – and extraordinary feats – of our cross-wired senses.

Calling to See

Bats and dolphins, among other animals, emit sounds into their surroundings —not to communicate with other bats and whales — but to “see” what is around them.  They read echoes of the sound waves, which bounce off objects, to identify and locate objects.

This sensory system is called echolocation. Although most of us can only imagine the pictures that form from sound, some sightless people have managed to master a form of echolocation. By uttering sounds and clicks, these individuals can use their ears to navigate. Some, such as Daniel Kish, have even taught others to use this form of human sonar. Kish once described human echolocation as “something like seeing the world in dim flashes of light.”

Fingers Do the Hearing 

People who are both deaf and blind are incredibly good at using other senses, such as touch, to navigate and understand the world. Some use the Tadoma Speechreading Method to perceive speech by touching the lips of another person as they talk. First taught in the 1920s, lip-reading by touch was a popular form of communication among the deafblind. Helen Keller was one of its early adopters.

If taught early in development, the Tadoma Method can help a deaf-blind child learn to speak as well as to understand others. Those who lose their sight and hearing later in life can use it to read lips.

But because the method is extremely difficult and time consuming to learn, by the 1950s it began to lose ground to American Sign Language as the dominant teaching method. Today, only about 50 people in the world still use of the Tadoma Method.

Still, In ASL, the deaf-blind place their hands over another signer’s hands and follow the motions with their fingers—which is easier because the movements are far less subtle.

Beep Baseball

Blind baseball seems almost impossible to even imagine, but since 1975, when a few blind Minnesotans invented “beep baseball”, those who lack sight have taken part in America’s favorite pastime. Thanks to a one-pound beeping oversized softball and some tweaks to the game, players can hit a home run without ever seeing the ball. They use the sound the ball emits to orient themselves, make contact using a bat and to field.  Special bases make it possible to round the diamond. They might be particularly well-suited to this form of the game, as previous research suggests that blind individuals can more easily localize sounds than sighted people can.

Then there is synesthesia

For a few individuals with a condition called synesthesia, the senses collide dramatically and uniquely to form a kaleidoscope world in which chicken tastes like stars, a symphony smells of fresh baked bread or words are bathed in red, green or purple.

People with synesthesia have a particularly curious cross wiring of the senses in which activating one sense spontaneously triggers another. They see colors when they hear noises, associate particular personalities with days of the week, or hear sounds when they see moving dots.

Synesthesia is thought to be genetic, and recent research even suggests it may confer an evolutionary advantage.  Most synesthetes don’t notice anything strange about the way they perceive their environments until it is brought to their attention.

Given that, at any moment in time, we are bombarded by such a diverse combination of sensory experiences, our appreciation of the individual senses can become somewhat muddled. Our taste experience is affected by the smell, texture and temperature of our food. Similarly, our hearing is said to decrease after overeating, and our sight is affected by noises around us. Sight can also be hampered after eating fatty foods.

Here’s another interesting snippet – if a sad, depressed person tells you their world is dull and grey, and flowers have lost their smell, they’re not just speaking metaphorically. Research shows sensory perception can actually be diminished in depressed individuals.  So focussing on a renewed appreciation of your senses can actually help one get out of an emotional rut.

Five senses? More than ten!

The categorization of our five primary senses (sight, smell, hearing, taste and touch) is attributed to Aristotle. While this basic list is still valid, humans have a number of additional ‘sensory abilities’ not covered above. These secondary senses include:

  • Sense of balance and acceleration– the ability to sense body movement, direction and acceleration, and to maintain balance and equilibrium.
  • Temperature sense– the ability to sense heat and the absence of heat (cold).
  • Sense of Pain– the sense of pain was previously believed to be an overloading of pressure receptors, but it has since been identified as a distinct phenomenon that intertwines with the other senses, including touch.
  • Sense of Time– the ability to perceive the passage of time, both short passages as well as longer time cycles.

We are gifted with a complex system of basic and intertwined senses designed to help us take it all in….If any of these seem a little “off” for you, consider seeing a physician who can help you with a tune up….At HealthLynked, we work every day to get you connected with physicians who will really have a great “sense” for what is going on….

Take a brief moment to get a “taste” for how being at the center of your care using the first ever HealthCare social ecosystem will, well, make you “feel”.  Go to HealthLynked.com to get started for free!

Sources:

livescience.com

idahoptv.org