Baby Strokes

One of our favorite guilty pleasures is the tv show House because the program is about the unusual rather usual diseases. If House is your doctor he'll get to your problem and will save your life when all other doctor's will leave you for dead because it's not medical protocol. Dr. Gregory House looks for zebras when all the other doctors only look for horses, to paraphrase the old joke - when you hear hoof beats think horses not zebras! When we're sick we want a doctor who will find the answer regardless of standard medical protocol.

Number one (1) cause of death to children under the age of fifteen (15) in the nation from 2006 data is accidents. The number is four (4) times greater and any other causes. The number two (2) cause of death is assault (homicide) followed by heart diseases in the number three (3) position. According to the Center for Disease Control and Prevention (CDC).

Dr. Rebecca N. Ichord, director of the pediatric stroke program at Children’s Hospital of Philadelphia, who continues to be deeply involved in Jared’s care, said that while conditions like migraines and poisoning could cause similar symptoms, “front-line providers need to have stroke on their radar screen as a possible cause of sudden neurologic illness in children. Dr. Heather J. Fullerton, a leading pediatric stroke researcher at the University of California, San Francisco, was even more emphatic. “When a child comes into an emergency room with strokelike symptoms,” Dr. Fullerton said, “it should be considered a stroke unless proven otherwise.” (New York Times)

Every hospital isn't highly rated in healing strokes of any kind. We suggest a HOUSE type of hospital with a unit designed specifically to care of a patient suffering from a stroke.  In the District of Columbia if you're a resident or visitor you'll want to be take or have someone take you to one of the three hospitals that offers the best care available for you or your loved one. They are in no order of importance: Georgetown University Hospital, The George Washington University Hospital and/or Washington Hospital Center.

These all received the Joint Commission the Gold Seal of Approval. Their are a choice of seventeen (17) hospitals and medical centers for Maryland. Their are a choice of nineteen (19) hospitals and medical centers for North Carolina.  Their are a choice of eighteen (18) hospitals and medical centers for Virginia.

We know the warning signs. Unfortunately they seem so normal that unless you've experienced some major discomfort the signs are too easy to ignore. Hospitals often ignore the signs as well unless you're unlucky enough or rather lucky enough to suffer a stroke while on a monitor - to many times the indicators are missed.

Stroke Warning Signs
If you notice one or more of these signs, don't wait. Stroke is a medical emergency. Call 9-1-1 or your emergency medical services. Get to a hospital right away!
* Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
* Sudden confusion, trouble speaking or understanding
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness, loss of balance or coordination
* Sudden, severe headache with no known cause (American Heart Association AHA)

One other thing the time you choose to go to the hospital could save your life.

"In two separate studies, one in the United States and the other in Australia, investigators found possible significant delays when doctors’ offices were called first. Calling an emergency number or an ambulance is the quickest way to reach a hospital within the three-hour window of opportunity for acute stroke treatment that can potentially avert serious post-stroke disability."(AHA)

While you're on your way to the hospital, and because you're reading this now instead of after the fact, keep some wild blueberry juice in your refrigerator. Not grape juice but the expensive variety of wild blueberry juice frozen if you've got it. Wild blueberries are available only from Maine or Canada. In animal trials since 2002 with rats wild blueberries appear to have health benefits being verified by research that now include human subjects. Yes, the studies have been small but consistent. As we always say - It couldn't hurt!

More Pepa Less Salt

The year was 1986 and our god brother was "knocked out" by two female rappers who wanted to "talk about sex, baby!" They were the multi-hued Salt & Pepa whose recent revival on VH1 and subsequent re-split has resulted in a separate show for the very bawdy Pepa.


What's this got to do with the recent news about the research on salt in our diets? We thought it timely. We've always known that too much salt has been harmful to us resulting in or contributing to hypertension, heart attacks and possibility leading to death. The life savings, to just our community would result in 2006, of 50,000* individuals.

We aren't our god brother and aren't a big Pepa fan. We like Salt. Pepa was too crude for our taste. If we keep the two a duo instead of a single act we'd, and in our opinion so would the women, be better off.

“Reducing dietary salt is one of those rare interventions that has a huge health benefit and actually saves large amounts of money. At a time when so much public debate has focused on the costs of health care for the sick, here is a simple remedy, already proven to be feasible in other countries,” said Lee Goldman, MD, MPH, senior author, executive vice president for health and biomedical sciences and dean of the faculties of health sciences and medicine at Columbia University. The American Heart Association (AHA) reports that salt consumption among Americans has risen by 50 percent and blood pressure has risen by nearly the same amount since the 1970s - despite evidence linking salt intake to high blood pressure and heart disease." (University of California San Francisco UCSF)

If we do an equal share of seasoning say instead of three shakes of the salt shaker do one and half and one and half of pepper. Or if that's not possible because for us adding salt is more of an automatic response regardless of how the food is prepared. We don't even taste the food before grabbing the salt. What we learn from eating out with friend, or at least what the men learn, is that your hostess is insulted by an automatic salt reach. Try some spices if pepper is your "salt." For some of us its spicy hot and for others its spicy sweet.

Now if only VH1 learns the same lesson cause we really don't want to talk about Pep! We will use her to emphasize a point that will help us all live longer use a celebrity to help us be a better we.

Reducing the salt and not eliminating salt from our diet is a couching activity we can take. It's not a pill but since it took the Food and Drug Administration (FDA) two (2) months to decide that Meridia can kills us. So waiting for a pill we can take might not be the scientific solution. Salt reductions might just be the science we need. It doesn't take making drastic changes that can't be maintained. It can only help. We can start this new year, new decade with a reasonable dedication we can sustain and so can you!

It's Better To Look Good...

...than to feel good if you know what I mean. (Billy Crystal as Fernando Lamas (Video)

For many people including pseudo celebrities "Speidi" you never really look good until you've had something "fixed" with plastic surgery. The latest trend in research seems to be following that credo. Today's news comes this story from ABC News, LA Times and Wall Street Journal:

Fish Oils May Slow Genetic Aging in Heart Patients - "In the study, Dr. Ramin Farzaneh-Far of the University of California San Francisco and colleagues followed more than 600 men with heart disease and found those taking the most omega-3 appeared "biologically younger" -- that is, the ends of their chromosomes, called telomeres, looked longer and healthier."

The question becomes: What could it hurt? Though if we were heart patients aging wouldn't be so much on our minds as not dying. To be honest you can't age if you're dead. So "younger" appearing wouldn't be our first concern.

The American Heart Association (AHA) understands this and offers us a way of not just looking healthier but staying alive which is a great way of slowing death. AHA doesn't just offer a single solution but seven (7) simple life's steps to live better. Unfortunately it's seven or the familiar blah, blah, blahs as before or to quote Seinfeld: "YADA YADA YADA long story short" we've heard it all before and it doesn't work for the couch obsessed.

The information isn't really news worthy or new. It bears repeating because regardless of the familiar blah, blah, blahs until there's a change in the causes of death not just in country but locally as well. If the AHA wasn't trying to keep us alive we'd be fairly perturbed. From their no news news to their "National Wear Red Day" as a tool of celebration featuring real women to make this a day to remember?!?! It's all so confusing. We mean aren't all women, except maybe for "Speidi," real? We guess they mean not actresses, who are after all real women aren't they? If you're an actress do you lose your gender?

It's purpose seems lost on the organization which only later suggests that purpose is to help raise awareness of cardiovascular disease in women. Our suggestion to raise awareness of something that doesn't sound so medical and isn't so confusing. Maybe we can help raise awareness of not prematurely dying.

Study Shows Regular Exercise Benefits Prostate Cancer Survivors - "even a moderate amount of exercise – taking regular walks, for example – reduced overall mortality rates in men with prostate cancer. The more vigorous the exercise, the greater the benefits, the study found." (23% - 51% - editor's note) "Find an activity you enjoy and get moving. Just be sure to talk to your doctor before starting any exercise program to make sure it's safe for you, especially if you haven't exercised in a long time." (American Cancer Society)

TYPES OF CANCERS By Jurisdiction 1ST 2ND 3RD District of Columbia Maryland Virginia United States North Carolina

Cancer is the number one (1) and number two (2) cause of death in our jurisdiction and the nation falls into several categories. The figures are estimated for 2009 by the ACS. We've charted the top three cancers in our area by ribbons. In the District of Columbia first (1) sky blue for prostate, second (2) pearl (white) is lung and bronchus and third (3) is the familiar pink for breast cancer. Maryland, Virginia and the Nation places places lung first, breast second and prostate third. North Carolina does lung and bronchus first, prostate second and breast third.

In the beginning 51,529 men in health professions participate(d) in the study. This group is composed of 29,683 dentists, 4,185 pharmacists, 3,745 optometrists, 2,220 osteopath physicians, 1,600 podiatrists, and 10,098 veterinarians. Among the study participants are 531 African-Americans and 877 Asian-Americans. (Harvard School of Public Health)

We hesitated to use ribbons as symbols of types of cancer because of the conflict and crossover in colors and causes from the expanded use of the ribbons symbols. Yet no other symbols could consistently be used and understood in our minds.

"For the first time, the American Heart Association has defined poor, intermediate and ideal cardiovascular health -- using seven easy-to-understand measures." (AHA)

We're obviously in the poor category because we're too lazy to find the tools to measure what qualifies as poor but optimistic enough to consider ourselves "intermediate." What's most interesting is that our staff, comprised largely of women, are in the process of losing and while the men are gaining weight.

This is the kind of study we think should be prompted. We call this "couch" research because to do it we don't have to get off the couch to implement and benefit from it.

"Researchers at the University of Minnesota's Stroke Research Center looked at 4,435 people, aged 30 to 75 years, who were participating in ongoing national government health research from the National Health and Nutrition Examination Study. They found that over a 20-year period, those who had never owned a cat had a 40 percent greater risk of death due to heart attack and a 30 percent higher risk of death due to any sort of cardiovascular disease than previous or current cat owners. Researchers found no such protective effects for dog owners." (ABC News)

Our problem with the ABC report is in an effort to be fair and balanced they included opinions that referenced an older not as well researched study that contradicted this longer and larger study.

Pet ownership, social support, and one-year survival after acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial (CAST) - "One year survival data were obtained from 369 patients (87%), of whom 112 (30.4%) owned pets and 20 (5.4%) died..."

Yes compare a one (1) year study with three hundred and sixty-nine individuals to a twenty (20) year study with forty-four hundred individuals. We verify and so now can you.

We can couch study with cats but other study says that we can't nap or rather if we do we'd better be careful.

"Among 2,153 participants in a prospective study with an average follow-up of 2.3 years, the risk of stroke was 2.6 times greater for those classified as doing “some dozing” compared to those with “no dozing.” Those in the “significant dozing” group had a 4.5 times higher risk." (AHA)

So cat in the lap but no cat nap with the cat in the lap! Also we've got to be careful when the cat is not in the lap but somewhere in the house.

Dogs and cats provide comfort and companionship, but it’s important to realize that pets and pet items can cause falls that result in injuries, including fractures. Every day it is estimated that an average of 240 people are treated in emergency departments—about 86,600 each year—for injuries from falls involving dogs and cats. This study examined five years of emergency department data and found that 88 percent of fall injuries involved dogs than cats. Among injuries related to dogs, about 31 percent of persons fell or tripped over dogs and 21 percent fell after being pushed or pulled by dogs. For injuries related to cats, 66 percent fell or tripped over cats. Raising public awareness that pets can cause falls and pets and pet-related items can be fall hazards can help reduce possible injuries. (Center for Disease Control and Prevention - CDC)

So as long as we're careful - What could it hurt? Maybe your cat? Did you know your pets can also get strokes? Neither did veterinarians until recently when research showed differently.

"Strokes in cats can be caused by an underlying medical condition, or through an accidental injury or poisoning. Ischemic strokes occur when the blood supply to the brain has been reduced, and hemorrhagic strokes occur when a vessel within the brain breaks." (PETWAVE)

It may be good for us to have our cats in our laps but it could kill your cat! For the solution to that problem we'll leave that up to the PETA scientists. Since cardiovascular disease isn't something that deserves more attention from us in our jurisdiction than the three (3) cancers that actually kills more of our residents we probably won't be wearing red on "National Wear Red Day!" We hope the AHA understands.

A Well-Stocked First Aid Kit

The above headline happens to be a copyrighted term used by the Red Cross and all most every medical organization on the face of the planet in reference to self care. However first aid is no substitute for emergency or ER care. We thought the answer to the question of what is a "well-stocked" first aid kit that every home should have would be found at the Red Cross because it was a non-profit organization. Until we discovered that the organization sells first aid kits. While a great source of information we're hesitant to purchase items from the source of information. That's just us we're a little suspicious and uncomfortable with the Red Cross based on prior parental history.

Our relatives were in the military and told stories of having to buy items from the Red Cross that were given freely by the Salvation Army. The charity's recent scandals concerning corporate salaries and excesses in 2007 in the wake of budget cuts and cutbacks.

While the Red Cross is only a three (3) star rated agency the Salvation Army is exempt from filing and ratings because it's a religious organization which puts SA at an advantage over the Red Cross. We can make comments about the RC without having to submit our familiar favorite to the same test. This we admit is inherently unfair. We concede the point however, until the hairs on the backs of our neck settle down we will seek alternative forms of contributions. For instance in the case of Haiti we'd recommend the higher rated charity: AmeriCares, spammy yes but consistently correct as well.

Some of the highest rated charities to Haiti include: MedShare International for Health Care and Supplies; Haitian Health Foundation which works to improve the health and well being of the poor, sick, and the infirm of the greater Jérémie area of Haiti; ActionAid International USA in 49 countries across Africa, Asia and Latin America, by providing relief from disasters; and Hope for Haiti Children's Center; Data Source Charity Navigator.

While the metropolitan area is relatively earthquake, tornado and hurricane free storms floods and high winds can and do affect our area. Our favorite source for first aid information and what's needed in a "well-stocked" first aid kit can be located from the San Francisco, Department of Emergency Management.

In the District of Columbia their Emergency Management Department list eighteen (18) major hazards. Which included the number three (3) cause of death in the city but with no suggestions for hazard. While the current alert is moderate there is no suggestion for explosions (manhole covers), critical resource shortages, human viruses and epidemics, prison problems, terrorism or urban crime.

D.C. Fire Spokesman Pete Piringer says streets were closed due to concerns of an explosion. "Manholes have a potential for explosion. There can be a build up of pressure and gas, so certainly we wanted to err on the side of precaution."

Maryland sends you to the Federal Emergency Management Agency (FEMA) Plan or the U.S. Department of Homeland Security (DHS).

Virginia even has a suggestion for what you'd need in an Emergency Preparedness Kit. God forbid that we'd ever need to use their suggestions - but the next time you hear, read or see something tragic don't just feel bad prepare your car, family and or home. Make many copies and include the information in multiple locations but keep it secure.

What Does Not Destroy

"Out of life's school of war: What does not destroy me, makes me stronger." - Friedrich Nietzsche [1895] MAXIMS AND ARROWS, 8 of 44, Twilight of the Idols, Translated from the original German

CAUSES OF DEATH By Jurisdiction 1ST 2ND 3RD 4TH 5TH District of Columbia North Carolina Maryland Virginia United States of America North Carolina Virginia

We take the quote to mean to learn from your losses, disasters or setbacks. What makes us stronger is to learn from the problems in fighting the H1N1 and the problems in the distribution of limited supplies to a wide majority.

Haiti, the island and its people, has sufferred and unreasonable amount of natural and manmade disasters yet in their struggle to survive comes great stories of love, faith and courage. Their survival can only, we hope, make them stronger. Almost universal in voice is the belief and hope for such strength for Haiti's recovery.

May we find such strength in the things that destroy us. The top destroyers us are: cancer, heart disease, high blood pressure and accidents. It's just the order that varies and not that much from line to line. Surprising The District of Columbia and North Carolina share the same first two (2) causes: cancer and heart disease while Maryland, Virginia and the nation as a whole share the same first three (3) causes: heart disease, cancer and high blood pressure (cerebrovascular diseases). North Carolina share the last three (3) cause with MD, VA and the US: high blood pressure (cerebrovascular diseases). The District of Columbia shares it's third (3) cause with North Carolina and Virginia's fourth (4) cause: accidents. The fourth (4) for the District: high blood pressure (cerebrovascular diseases) and Maryland which reflects the national pattern: chronic lower respiratory diseases.

Data Source:
Table 29. Number of deaths, death rates, and age-adjusted death rates for major causes of death for the United States, and each state, Puerto Rico, Virgin Islands, Guam, American Samoa, and Northern Marianas, 2006 (CDC)

American Lung Association Report Card: Most States Flunk

Cancer is the word for today whether its breasts good news for women or lung bad news for all of us. It's not enough to just not smoke - it seems we've also got to actively education the next generation on the evils of tobacco. That is According to the American Lung Association (ALA). The ALA, Center for Disease Control and Prevention (CDC) and World Health Organization (WHO) announced in December that the problem is so bad, though improving, they used the "E" word. There is a tobacco epidemic. While the CDC and WHO are defending their actions on the H1N1 against unfounded charges of corporation corruption both agencies are moving forward.

Do you know how much money Big Tobacco spent each day in 2006 marketing their products? $34 million. The companies spend billions each year on advertising & marketing their deadly products to try & hook kids to become their “replacement generation.” That’s why it’s so important that the Food and Drug Administration move quickly to implement new marketing restrictions on the tobacco companies. (American Lung Association)

Unfortunately the Food and Drug Administration (FDA) has to count and review exactly what the public wants them to do. Deadline for public comment was extended until December 2009 and the agency hasn't released any comments to the public since the agency's request for comment.

The report finds the federal government made major strides but still has significant room for progress. Most state governments, however, failed to enact critical measures to protect people from deadly tobacco products. Ten states made alarming cuts to their tobacco control programs.

Tobacco's toll continues to be devastating. Smoking-caused illness remains the number-one preventable cause of death in the U.S., killing more than 393,000 Americans each year and costing the economy more than $193 billion. Another 50,000 Americans die from exposure to secondhand smoke. The U.S. Surgeon General has declared there is no safe level of exposure to secondhand smoke.

No state received straight “A’s” on its report card. Six received all “F’s.” They are Alabama, Kentucky, Missouri, South Carolina, Virginia and West Virginia. (PDF)

Only two states, Alaska and North Dakota, received “A” grades for funding tobacco prevention and control programs at 80 percent or more of the level recommended by the Centers for Disease Control and Prevention (CDC).

Research shows that the more states spend on comprehensive tobacco control programs, the greater the reductions in smoking—and the longer states invest in such programs, the greater and faster the impact. States that invest more fully in comprehensive tobacco control programs have seen cigarette sales drop more than twice as much as in the United States as a whole, and smoking prevalence among adults and youth has declined faster as spending for tobacco control programs has increased. (CDC Best Practices for Comprehensive Tobacco Control) (PDF)

No state received an “A” for offering comprehensive tobacco cessation treatments to its Medicaid recipients and to state employees.

Tobacco Control 2009 DC MD NC VA US Tobacco Prevention & Control Spending Smokefree Air Cigarette Tax Cessation Coverage Framework Convention on Tobacco Control FDA Regulation of Tobacco Products F A B D F A C F F F F C F F F F D F D A OVERALL GRADE AVERAGE C D D F C

Despite a perception that smoking is a dying public health danger, the tobacco epidemic persists. It causes tragedy, staggering costs and devastation. In 2008, the latest year for which data is available, smoking in the U.S. failed to decline for the first time in years, staying right around 20 percent. Forty-six million adults smoke. The nation’s progress in ending the epidemic has halted, according to the CDC.

Each year approximately 440,000 people die of a smoking-related disease in the United States. (CDC) The World Health Organization (WHO) says internationally about 600,000 premature deaths per year, countless crippling and disfiguring illnesses and economic losses in the tens of billions of dollars per year.

The rates for our jurisdictions with figures from 2006 and estimates from 2007 CDC death rates. In the District of Columbia and North Carolina the numbers 1 and 2 causes of death are in order: Cancer and Heart Disease. The third cause of death in the DC is Accidents. For Maryland, Virginia and the US as a whole the results are reversed and numbers are 1 and 2 causes of death are in order: Heart Disease and Cancer. The third cause of death for MD, NC, VA and most of the US is Cerebrovascular disease (High blood pressure).

What has to be noted is the District of Columbia has no ability to raise taxes on tobacco without Congressional permission from "tobacco growing" state legislators. However MD, NC and VA have no such restrictions. 

Flu Like Symptoms

When your only editor is ill and you've got a small office it doesn't matter what everyone else does nothing gets published. Nothing gets up and nothing gets out. So boo on the small office and small businesses. There should be medium businesses or nothing at all. Small businesses are too personality driven. So welcome our new senior editor who was interviewed and hired before our illnesses but didn't have any access necessary to start work.

Our "flu like symptoms" didn't include a fever and only included coughing and migraine like headaches that felt like our heads would explode. To remind you here's what the Center for Disease Control and Prevention (CDC) said were the symptoms for H1N1. (Warning Signs) Though we do have to admit that their exact words were: "You may have the flu if you have some or all of these symptoms." While their symptoms numbered nine (9) ours personally only numbered four (4). The CDC list concluded with this asterix: "It’s important to note that not everyone with flu will have a fever."

Yeah, well we missed that and should be excused because we had flu like symptoms!

We made fun of Dr. Sanjay Gupta when he complained of his H1N1 symptoms. Ours we're the same. We weren't nauseated and our entire body didn't hurt nor the freezing cold. We sweat but without the fever. We couldn't hold ourselves up and other than taking ourselves to the nearby bathroom it was difficult to stand. There was some dizziness. That was just when the trouble began.

This editor got married and joined his spouse in holy matrimony and medical insurance coverage without his prior medical records and only his current medications. Without a medical history this editor made the mistake that can result in disastrous medical mistakes not included in the website Wrong Diagnosis.

Complications due to adverse interaction resulted in a one (1) day hospitalization. Other complications included a rejection of his doctor's specific prescription by the insurance company (which included a letter received one week later explaining their reasons), in-house staffing problems within the doctor's office (which was duplicated from prior physicians offices and may indeed be a common problem) and timing (getting sick as the doctor goes on vacation). This just wasn't our month!

On our first real day of health (there's still some coughing on all our parts but other than that) some of us attended church services as a group to discover that the 19th Street Baptist Church(located on 16th St in a building that was a former synagogue. Considered the "First Colored Church of Washington" some how it all makes sense in a very strange and bizarre way) had a guest speaker - former Governor now HHS Secretary, Kathleen Sebelius. This turned out to be the start of: National Influenza Vaccination Week.

“This is a challenging flu season for millions of Americans and their families, and it’s not over yet,” said HHS Secretary Kathleen Sebelius. “The H1N1 vaccine is safe, effective and the best way to prevent the flu. We urge all Americans to protect themselves and their families by getting the H1N1 flu vaccine.”

From April 2009 until mid-November 2009, H1N1 flu infected approximately 47 million Americans and contributed to more than 200,000 hospitalizations and nearly 10,000 deaths. Flu season is unpredictable and typically lasts until May.

“The window of opportunity to get the H1N1 vaccine is still open,” said Thomas R. Frieden, M.D., M.P.H., director of CDC. “We do not know how many more cases of flu there will be in the coming weeks and months, but we do know that the H1N1 vaccine is the best way to protect yourself.”

Launched in 2006 as an annual initiative, National Influenza Vaccination Week brings awareness of flu’s risks and complications—and encourages vaccination—by designating each day of the week for an at-risk group or individuals who are in close contact with them. So far, over 130 events are planned around the country, and more are being added.

"Sebelius got a mixed reaction when she kicked off vaccination week Sunday at a prominent Washington church" MSNBC. We didn't think so but unlike MSNBC we thought her response was warm. However according to the individual volunteers less than 200 shots were given out on the rainy Sunday after Haiti afternoon. Though the church is largely African-American the few stragglers at evenings end were not. We were in that number. So we must concede that indeed the reaction was mixed if not warm.

We were at the right place and the right time doing the right thing. Just as Secretary Sebelius dropped this bombshell about the H1N1 that the rate of infection was "five (5) times higher than in the regular flu season." This would indicate that failure to inoculate the vast majority of resident can create a financial and medical disaster that affects us. Better crowded shot lines than crowded emergency rooms and doctor's office. All can serve to make treatment, that even in the less trying times can result in less than quality care - insurance or no insurance.