Sepsis contributes to 1 in every 2 to 3 deaths - Video: Faces of Sepsis

Regular readers of this blog likely know that one of my clients is a patient advocacy organization called Sepsis Alliance. Sepsis is a little known, but frighteningly common illness that affects as many as 750,000 hospitalized patients annually, and kills more than a quarter of a million Americans each year. Thousands more are left with long-term problems, such as amputations, chronic pain, chronic fatigue, and post-traumatic stress disorder (PTSD).

How common is sepsis? The Centers of Disease Control (CDC) lists the top five causes of death in the U.S. as follows:

1. Heart disease - 597, 689
2. Cancer - 574,743
3. Chronic lower respiratory disease - 138,080
4. Stroke - 129,476
5. Accidents - 120,859

But if the CDC was monitoring sepsis deaths, the list would look like this:

1. Heart disease - 597, 689
2. Cancer - 574,743
3. Sepsis - 288,204
4. Chronic lower respiratory disease - 138,080
5. Stroke - 129,476

More people have heard about sepsis since Sepsis Alliance was founded in 2007, and more research is being done to try to find better ways to identify sepsis more quickly and to treat it more effectively. But, if we look at the results of a study presented yesterday at the annual meeting of the American Thoracic Society, we still have a long way to go. The study looked at almost 7 million patients to see how many patients were dying from sepsis, and the results were startling:

"We were surprised to find that as many as 1 in 2 patients dying in US hospitals had sepsis," the authors said in a release. 

So what is sepsis? Simply put, sepsis is the body's toxic (bad) reaction to an infection. It can affect anyone at any time. The infection can be as serious as one from a perforated (burst) bowel or pneumonia, or as seeming innocent as an infected hangnail or abscessed tooth. As your body tries to fight the infection, something goes wrong and your body starts to attack itself, causing a cascade of events that lead to organs shutting down and can result in death.

Who gets sepsis? Anyone can get sepsis. Sepsis Alliance just released this video, called The Faces of Sepsis, where you can meet three people who were touched by illness. You can read their stories in full in the Faces of Sepsis section of the SA website.



To learn more about sepsis, the symptoms, and the importance of early treatment, visit www.SepsisAlliance.org. It could save a life.

Red wine good, bad, yes, no? Who should we believe?

It wasn't all that long ago that there was great joy among lovers of red wine and chocolate. The announcement that these two treats (or necessities, depending on the person) could be good for you was very welcome news.

The basis of this news was the belief that resveratrol, a substance found in products like red wine and chocolate, could be cardioprotective. Studies such as this 2009 one published in the Journal of Cardiovascular Pharmacology, concluded:

Both wines and grapes can attenuate cardiac diseases such as atherosclerosis and ischemic heart disease. Recently, wine was also found to increase life span by inducing longevity genes. It appears that resveratrol and proanthocyanidins, especially resveratrol, present in grapes and wines play a crucial role in cardioprotective abilities of grapes and wines.

Another example is this article, which is a review of studies done on the effects of resveratrol, published in 2011 in the journal Molecular Nutrition & Food Research, in which the authors wrote:

The emerging data from human clinical trials confirms what the past decade of in vitro and laboratory animal models have suggested; resveratrol has considerable potential to improve health and prevent chronic disease in humans. We believe the evidence is sufficiently strong to conclude that a single dose of resveratrol is able to induce beneficial physiologic responses, and that either weeks or months of resveratrol supplementation produces physiologic changes that are predictive of improved health, especially in clinical populations with compromised health. However, it is not yet certain if long-term resveratrol supplementation will maintain these physiologic benefits to ultimately impact the incidence of chronic disease or extend lifespan, and the small number of human clinical trials remains dwarfed by the thousands of basic science experiments.

Not all researchers got on the resveratrol bandwagon though. In 2005, the journal Circulation published an article that wasn't so positive about the whole idea. While admitting that the research was pointing to benefits, the authors were cautious about recommending red wine:

Despite considerable data from epidemiological studies and strong suggestions from experimental research, the evidence is still insufficient to encourage patients who do not drink to start consuming red wine as part of a strategy to protect against atherosclerosis.

And now, new research is saying, nope -that resveratrol stuff isn't true. Yet another study, this time published recently in JAMA Internal Medicine said that, resveratrol in combination with a Western diet did not increase lifespan or decrease the incidence of illnesses, such as heart disease and cancer.

This was a small study, if anyone is looking for hope that it may not be really true. There were only 783 subjects who were followed over a course of nine years.

So before we start closing our wine cellars and tossing our dark chocolate, maybe we should do what is recommended for most things - consume them in moderation unless we're told by our physician to abstain.

Fibromyalgia Awareness Day - New Site Announcement

May 12 is Fibromyalgia Awareness Day. I'm marking this day by introducing my new project, 101 Answers About Fibromyalgia.

This project is dedicated to not only those who have fibromyalgia, but those who love people who have fibromyalgia. The goal is to collect at least 101 questions about the condition and gather the answers from different experts around the world.

Regular visitors to this blog know that I've written about fibromyalgia before, both here and for other outlets. There are many people living with fibromyalgia who have no idea that they have it or they believe they do, but they've not been diagnosed. So it is important to write about it and to talk about it.

According to the most recent research, a study published in 2013 found that fibromyalgia affects between 0.5 to 5 percent of the population. The Centers for Disease Control (CDC) in the United States estimates that fibromyalgia affects 2% of the US population - or about 5 million adults, and that it affects women seven times more often than men.

More interesting statistics:

• While it's not a genetic disease, 28% of children who have a parent with fibromyalgia will eventually develop it themselves.
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• Adults with fibromyalgia are 3 to 4 times more likely to develop depression.
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• Thirty to 40% of people with fibromyalgia must stop working or switch jobs.
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• Fibromyalgia costs the U.S. economy an estimated $20 million per year.

Please visit my new site and leave your questions to be answered.

Electronic cigarettes - not as harmless as some may think

I'm not a proponent of electronic cigarettes, or e-cigarettes. While I concede that they may be the lesser of two evils, smoking a combustible cigarette or an e-cigarette, I still believe they are dangerous and should not be promoted.

I wrote a piece about e-cigarettes for Forbes.com last year (What Are Electronic Cigarettes and How Safe Are They?), for which I interviewed a physician and someone in the e-cigarette industry. The physician felt much like I do; he'd rather no one use them, but if they were truly being used by someone who would ordinarily be smoking regular cigarettes, then this would be better. The pro-electronic cigarette person denied that there were any risks at all and vehemently denied my questions as to whether the manufacturers were trying to get teens and children to use them. I might have believed him if the e-cigarettes didn't come in flavors clearly designed to appeal to children.

Those who advocate for electronic cigarettes make the following claims:

• They are not addicting as are traditional cigarettes
• You aren't "smoking," you're "vaping," because you aren't inhaling smoke, which is an irritant to the lungs
• You aren't inhaling many of the traditional cigarette ingredients/pollutants
• E-cigarettes can be a smoking cessation tool, helping people quit smoking traditional cigarettes.

Those opposed to the new cigarettes say:

• E-cigarettes are not effective as a smoking cessation tool because they don't rid the person of the hand-to-mouth and time-of-smoking habits, they just transfer them from traditional cigarette to e-cigarette form
• While you aren't inhaling smoke, you are inhaling vapor, which is not meant to go into your lungs. You are still inhaling substances that are not meant to be inhaled.
• Children and teens are drawn to them because of the marketing and flavors

Interestingly, the Centers for Disease Control (CDC) issued a press release on April 3, 2014, to notify the public of a significant increase in calls to poison control centers across all states in relation to e-cigarette use.

"The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, according to a CDC study published in today’s Morbidity and Mortality Weekly Report. The number of calls per month involving conventional cigarettes did not show a similar increase during the same time period."

Research has been ongoing since the introduction of e-cigarettes as doctors and regulators try to sort out the truth from the claims. The most recent study was just published last month. According to the study, undertaken by RTI International:

Electronic cigarette “vapors” are made of small particles containing chemicals that may cause or worsen acute respiratory diseases, including asthma and bronchitis, among youth, 

Although the FDA does regulate the sale of cigarettes and tobacco (both smoking and smokeless), it doesn't control the sales of e-cigarettes unless they are specifically marketed for therapeutic purposes. The FDA has proposed that it should cover "additional products that meet the legal definition of a tobacco product, such as e-cigarettes."

The FDA is encouraging people to submit their thoughts on e-cigarettes: Extending Authorities to Additional Tobacco Products.

As with regular cigarettes, I believe that as long as they are a legal product, if someone chooses to smoke that is their decision. I feel the same way about electronic cigarettes. If people choose to use them, that is their decision. However, I do feel it important to sort out what is true. Are they really harmless? Are they really effective smoking cessation products? It's not the use I am debating, it's the claims.

What do you think? Is there a place for e-cigarettes? What about the argument from the industry that they are not marketing it towards children and teens? What do you think?

The words we use to describe mental illness - how they matter

We hear the words often - words that imply that a person is a disease and the disease is a person. For example, we may say that someone is a diabetic or a hypertensive. But that's not right. The diabetes and the hypertension (high blood pressure) don't define the person. The person lives with or has diabetes or hypertension. Do you see the difference?

This use of words is particularly important when it comes to mental health. Someone may say that a sibling or coworker is a schizophrenic or that someone committed suicide. The first is wrong for the same reason that saying someone is diabetic is wrong. But what is wrong with "committed suicide?" A lot really, because people commit crimes - and suicide isn't a crime. 

Someone I love killed himself. I don't say he committed suicide. I say he killed himself or he took his life. He didn't commit a crime and by implying it with the words, his death is stigmatized even more.

How we use words evolves over time and writers and journalists play a role in how this happens. If writers repeat hurtful or incorrect terminology or phrases, the readers begin to think that this is normal and what they should be using too. Because of this, I was glad to see that the Canadian Journalism Forum on Violence and Trauma partnered last year with CBC News (the Canadian Broadcasting Corporation), to put together a comprehensive guide on writing about mental health. Mindset - Reporting on Mental Health was compiled to help Canadian journalists navigate the waters of reporting on mental illness. The English version was launched last week, April 24, and is now available for download.

While it was written for Canadian journalists, there is no reason why English-speaking writers and journalists from around the world can't use the guide. It addresses issues about how not all mental illness can be put into one category, how the majority of people with mental illnesses don't commit crimes, interviewing techniques, and mental illness and the law - among other things.

It's an interesting read for students who will be working in social fields, such as psychology, teaching, policing, social work, law, and so many other professions. It's also interesting for the general public, because it gives some context to the issue of mental illness and how we talk about it. 

Think about it - how do you talk about mental illness? I know that I learned quite a bit from just browsing the document. 

Yes, vaccines do save lives

I encourage vaccinations. My three children received all recommended vaccinations. As an adult, I have received all recommended vaccinations and I try to keep them up-to-date. I did so and I continue to do so because they save lives. I refuse to watch or listen to celebrity moms who have become "experts" on any health issues, particularly the anti-vax celebrity moms.

When my children were young in the late 80s and early 90s, before anti-vax publicity really took hold, I remember saying to my husband that there was going to be trouble. While he and I remember what it was like to know children who did get the childhood diseases - or we got them ourselves - the fully vaccinated generation was heading into parenthood and they would probably not have seen the devastation that these diseases can cause.

It's unlikely that they'll meet a person who is hearing impaired or completely deaf because his or her mother was exposed to rubella (German measles) when she was pregnant with that child. It's unlikely that they know of children who were severely affected by the so-called "harmless" childhood illnesses. It's unlikely they know of someone who has lost a sibling or child to a preventable illness. And as such, many have no clue as to the damage these illnesses can actually do. I had mumps when I was a child. It was awful. I got through it without any lasting effects, but the boy I passed the mumps on to was not that lucky. He developed serious and painful complications that could have been avoided. My children all had the chicken pox when my five-year-old brought them home from kindergarten and then passed them to my three-year-old and one-year-old. The vaccine wasn't available yet. They were miserable and one was particularly ill. Why would anyone wish that on their child?

Autism is not something you want for your child. But with all the mounting evidence that the vaccines do not cause it, you would think that this myth would die down instead of keep growing. Are vaccines fool proof? No, they're not - and they don't claim to be. Some people who are vaccinated still may become ill, but often it is not as severe as it may have been otherwise. Do people have side effects? Yes, there are a few people who do experience side effects. But the number of lives saved by vaccines far, far, far outnumbers those who are affected by side effects.

I read of a pediatrician who does not recommend vaccines because she said it interferes with nature. Really? But then so does removing a ruptured appendix or a tumor. In vitro fertilization, pulling teeth, taking antibiotics - those are all "interfering with nature" if you're going to follow this physician's way of thinking.

I attended a health journalist conference in March, where the key note speaker, a physician, told us of a toddler in his ICU who was admitted just the week before. This toddler had not been vaccinated for childhood diseases. The parents rushed their child to the emergency room because she caught one of the "harmless childhood disease viruses." The child was saved, but was so brain damaged that she will likely never wake up.

Vaccinations are not a government plot to control everyone. They are not a pharmaceutical plot to make money (if so, they'd make you take more than one or two doses in your lifetime). They are lifesaving tools that aren't perfect. But they are what we have right now.

May is Huntington's disease awareness month - Have you heard of Huntington's disease?

Have you ever heard of Huntington's disease (HD)? Perhaps you may know it by its earlier name, Huntington's chorea. It's a brain disease that can strike at any age, but most commonly shows signs during the middle-age years. It affects both men and women equally, but it is a genetic disorder passed from parent to child, so for someone to have the disease, one parent must have a dominant HD gene. There are about 300,000 people in the U.S. who have HD. I couldn't find statistics for Canada, but they are very likely proportionally the same as in the U.S.

The disease is a progressive one, with no cure. For some people, the symptoms start slowly, for others more quickly. Unless you know you have your parents have the gene, HD isn't usually the first illness that a doctor would think of if you start complaining of memory loss and confusion, difficulty coping in new situations, some muscle twitching, fidgeting, or clumsiness.

Eventually the symptoms become stronger and begin to interfere with daily activities. The jerking motions and involuntary movements make it difficult to perform even simple tasks, and falls may be common. As the symptoms continue to worsen, it becomes impossible for someone with HD to care for him or herself.

The Huntington's Disease Society of America website has a booklet - a Family Guide - that discusses the symptoms of HD, living with HD, testing for HD, and the search for a cure. The site also offers information on how to get help and ongoing research. For Canadians, the Huntington Society of Canada offers several tip sheets and also provides a good bit of information on HD and on how to find help. These sites are good places to go to learn more about HD.

I personally don't know too much about Huntington's disease, but an online friend who I met several years ago has it. I've been following her journey over the past few years and it made me realize how little most people know about it. So I hope this post has helped raise a bit of awareness about this little known and little understood disease.