Eric Dishman’s Story of Health and Transformation

Health care insiders know Eric Dishman as an Intel Fellow and general manager of the corporation’s Health and Life Sciences Group. When he spoke this year at the Mayo Center for Innovation’s Transform Symposium, he chose not to present his usual address about technology in health and health care. Instead, he shared a riveting story of his own experience with cancer he titled “A Short Tragicomedy in Five Acts with a Happy Ending.” He explains that cancer taught him how unprepared American health care providers are for patients who are proactive and expect to be in charge of their health.

Avoiding medical tests: is ignorance bliss?

A sign for free HIV testing. Mario Tama/Getty Images

A sign for free HIV testing. Mario Tama/Getty Images

People avoid going to the doctor or getting medical tests for different reasons — some don’t have money or insurance, some are anxious and others are apathetic. The Atlantic looked into the phenomenon, called information aversion.

It’s also called the “ostrich effect,” which comes from the idea that ostriches bury their heads in sand when faced with danger.

While ignorance can be bliss, The Atlantic says it is also dangerous because putting off a medical test could lead to a late diagnosis or unknowingly spreading a disease.

In a recent study, many college students opted out of a free herpes test, listing unnecessary stress or anxiety as the reason.

The Atlantic talked to Katrina Walker, a Michigan native who has a 50 percent chance of having Huntington’s disease. Her mom has the degenerative disease, so Walker could have the gene. There are tests available, but she doesn’t want to know.

She told The Atlantic the thought she might have the gene makes her anxious and sad — she would rather live her life without a 10 to 20 year life sentence hanging over her head.

“Some people avoid tests because they don’t want to deal with the stress right now and just want to enjoy life,” says Dr. Ghadeer Okayli, a psychiatrist who specializes in anxiety.

You can read the full article here.

Poop pills help fight against antibiotic-resistant diseases

Researchers are turning to fecal transplants to fight certain antibiotic-resistant illnesses like Clostridium difficile, commonly known as C. diff. The latest form of the transplants comes in a frozen poop pill.

The L.A. Times says the idea is that a healthy person’s poop contains the right mixture of gut bacteria, and transplanting that into a person suffering from C. diff can help get their GI tract working properly again. C. diff is a bacteria that causes diarrhea and nausea. According to the CDC, people who are taking antibiotics are more susceptible to contracting the infection, which is spread through fecal matter, mostly in health care settings.

The L.A. Times reports that doctors are becoming more open minded about unconventional treatments as antibiotic-resistant bacteria become more prevalent.

Before the pill, NPR reports fecal transplants required a fresh poop donation from a relative, which was then delivered via colonoscopy.

The pills have been administered with success to people involved in a handful of studies. The most recent was a group of 20 involved in a study by a team from Massachusetts General Hospital, Boston Children’s Hospital, Harvard Medical School and Tel Aviv University in Israel published in The Journal of the American Medical Association.

It took four days for the pills to work, and they were successful in 90 percent of the patients in the study — some of whom were suffering from diarrhea up to 30 times a day.

Researchers say the results of the study are preliminary, but could help make fecal transplants more accessible. This Discovery Channel “DNews” video sums up the new treatment approach.

Profiles in Health: Dr. Maria Veronica Svetaz

By Jennifer Vogel

Being an immigrant is like having a chronic illness, says Dr. Maria Veronica Svetaz, a native of Argentina who runs a health program on Lake Street in Minneapolis tailored to the needs of Latinos. “Somehow it never goes away and will always be there, for good and for bad.” Svetaz is referring to the “extra layer of complexity” that can infuse virtually every aspect of an immigrant’s life, from the ability to communicate to the opportunity to earn enough money to the fortitude needed in navigating a byzantine immigration bureaucracy. “It makes you more vulnerable in some ways but also stronger and savvier in others.”

Dr. Maria Veronica Svetaz

“All of us can belong to lots of places…And we all have the ability to help the other to feel that they belong – with something so simple as a question or a word.” Caroline Yang / For Healthy States

Svetaz’s bilingual, bicultural health program, called Aqui Para Ti, which translates as “Here For You,” is part of Hennepin County Medical Center’s East Lake Clinic. It provides a range of services to young Latinos and their families including mental health and substance abuse counseling, assistance with birth control and prenatal care, and even help strengthening communication between parents and children who may not speak the same language, literally or figuratively.

“Mental health issues are higher in Latinos, particularly in Latino girls,” says Svetaz, 47, an energetic presence in a small, homey office, surrounded by cards and memorabilia. “It’s mainly depression. And suicide attempts, they are number one. One out of seven Latina teens will try to kill themselves. It’s the pressure of the two cultures. They get entangled.”

On the wall above her desk hangs a colorful collage of a woman with the inscription “No soy la mujer maravilla” or “I am not wonder woman.” The painting, from an art fair in Buenos Aires, is a reminder of how demanding Svetaz’s work can be and that, no matter how much she wishes the contrary, she can’t do it all. Working to close the health equity gap for her Latino clients and realizing that all many need is “a little love and tender care, puts you at moments at odds with trying to do too much,” she says. “And when you have so much passion, I learned that you need to ‘curb your enthusiasm’ as burn out is for real.” Continue reading

U.S. Ebola Guidelines Criticized as Lax

Obama on Ebola

Cabinet members and others listen as US President Barack Obama (R) makes a statement for the press after a meeting in the Cabinet Room of the White House October 15, 2014 in Washington, DC. Obama canceled campaign and fundraising travel for Democrats to attend the meeting on Ebola after a second case of the disease was contracted inside the United States. Brendan Smialowski/AFP/Getty Images

In response to the news that a second nurse at Texas Health Presbyterian Hospital has been diagnosed with Ebola, the Centers for Disease Control and Prevention acknowledged this week that its guidelines for protecting care workers needed to be stricter. Medical experts have called the original CDC caregiver guidelines for protection from Ebola “irresponsible.” The new federal guidelines come closer to those recommended by Doctors Without Borders, an organization with many years of experience with Ebola.

On Wednesday it was revealed that the second nurse who has been diagnosed with the virus was given the ok by the CDC to fly on a commercial airliner just hours before she was diagnosed, while she was reporting a mild fever.

Public health officials and the White House continue to assure the country that while Ebola is serious, it is not a significant threat to most Americans.

Congress will hold hearings today on the Ebola response. The head of the CDC, Dr. Thomas Friedan, is expected to apologize for not responding more vigorously to the Texas cases.

See NPR’s coverage of Ebola for more information.

ALS and the end of life

“Death Focuses You” – Bruce Kramer

This week MPR News aired Cathy Wurzer’s most recent conversation with Bruce Kramer. Wurzer has been recording conversations with 58-year-old Kramer since he was diagnosed with ALS, or Lou Gehrig’s Disease, in 2010. Kramer is a former academic dean at the University of St. Thomas and lives in the Twin Cities. He is married with two grown sons and one young granddaughter.

In this conversation we learn that Bruce is in the final stages of the disease. Kramer says they are working through their fear of death in order to accept the reality that he will die sooner than anyone wants. They are sad. And yet they are grateful for the chance to focus so keenly on how much they love one another.

What I have learned in this past four years is that death focuses you. It brings what’s important right to the front, and it cuts through the things that just really don’t need to take priority anymore.

Kramer says he is embracing this perspective to handle his own death. He also sees his purpose as helping others develop the same perspective.

I’m looking for the alignment of love and gratitude and acceptance and trying to help people, as they come in to see me, to have a little space for that in their lives. If they could find that same space for acceptance and gratitude, maybe it doesn’t take facing something like ALS to bring that along. And maybe that’s opportunity for tremendous growth as a human.

ALS is a disease that affects a person’s musculature but not one’s cognitive ability. Some have described the condition as “a living death” and those afflicted often struggle to maintain a will to live. People living with terminal illness have written about the power of dismissing fear and accepting death. They say it can dramatically improve quality of life — even if it’s just for one’s last few months.

Exercise may help prevent stress-induced depression

A man jogs in St James's Park on November 4, 2013 in London, England. Dan Kitwood/Getty Images

A man jogs in St James’s Park on November 4, 2013 in London, England. Dan Kitwood/Getty Images

You’ve already heard of the link between exercising and feeling good — often called a “runner’s high,” that is related to increased endorphin levels.

Now, in studies with mice, researchers in Sweden have found that exercise may actually help protect against stress-induced depression.

The Washington Post explains it like this: a stress-induced amino acid called kynurenine is associated with mental illness. The neuroscientists at Karolinska Institute in Stockholm who worked on the study found that exercise helps rid the body of that amino acid.

In other words, well-trained muscles purge the body of this harmful substance.

The authors suggest these findings could eventually lead to new principles for the treatment of depression.

You can read more coverage on the study from Forbes here.

“A Celebration of Women & Recovery” in Tweets

Last night at the Fitzgerald Theater in St. Paul, Healthy States and Hazelden Betty Ford Foundation presented “A Celebration of Women & Recovery.” Close to 700 people gathered to hear writer and musician Dessa speak with two authors, Jennifer Matesa and Gayathri Ramprasad, about their experiences of recovery from mental illness and addiction, and to celebrate the power and purpose of healthy recovery. Check out these Tweet samples to get a feel for the event.

NEJM Case Study: Multi-Generational “Social Determinants”

The New England Journal of Medicine this week published an unusual case history of three generations of a British family who were treated by the same general practitioner and whose health histories, including heart disease, depression, chemical dependency, abuse, and poverty, show a picture of familial health and social problems that survive across the generations. The case study is captured in this remarkable infographic timeline.

From the article by Caroline Sayer and Dr. Thomas Lee:

The case study revealed what will come as no surprise to primary care physicians: that “social determinants of health” actually do determine health. The life stories of these three people are punctuated by health care events: fractures, hospitalizations (for heart failure, chronic obstructive pulmonary disease, liver disease, kidney disease, seizures, and gastrointestinal bleeding), suicide attempts, and psychiatric admissions. Patterns of behavior associated with deprivation and mental illness have led to the development of a textbook range of chronic conditions.

An audio interview with Dr. Lee explores the issues for the primary care physician.