Tag Archives: m.d.

University of Washington #5 Cancer Hospital and More Genotyping Patients by Vanderbilt

A little more about cancer research and treatment….

Good news for us closer to home is that our own University of Washington Medical Center is # 5 on the leading list of cancer hospitals in the nation, according to US News and World Reports.



“Vanderbilt-Ingram Cancer Center (VICC) has launched its new Personalized Cancer Medicine Initiative, becoming the first cancer center in the Southeast and one of the first in the nation to offer cancer patients routine “genotyping” of their tumors at the DNA level….”

Meaning patients will receive personalized treatments based on their own body changes pushing the cancer growth.

…”Vanderbilt is further leading the nation in personalizing medicine by leveraging its sophisticated Electronic Medical Record (EMR) to use the genotype information in point-of-care decision-making.
“The EMR for each patient is automatically updated to contain the latest genome-based treatment information, so that all healthcare providers at Vanderbilt caring for the patient are fully informed and guided by the latest decision support on these advanced therapies,” said Dan Masys, M.D., chair of the Department of Biomedical Informatics.

“We know that genetic differences in humans at the molecular level not only contribute to the disease process, but can also significantly impact an individual’s ability to respond optimally to drug therapy,” said Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine. “…Project, with highly personalized therapy for our patients.”

Vanderbilt’s Personalized Cancer Medicine Program is led by William Pao, M.D., Ph.D., Ingram Associate Professor of Cancer Research and an expert in lung cancer….”“…
“The Personalized Cancer Medicine Initiative is our commitment to providing the most cutting-edge treatment for our patients,” said Jennifer Pietenpol, Ph.D., director of Vanderbilt-Ingram and B.F. Byrd Professor of Oncology.
Jeffrey Sosman, M.D., professor of Medicine, noted that having the genotype information is also important to help patients avoid the side effects of traditional chemotherapy.

“We are starting to understand how each patient’s tumor may have specific mutations that cause the cancer, but some of those mutations may also make the cancer vulnerable to specific therapy,” said Sosman, who directs the center’s Melanoma Program. “Tumor genotyping allows us to personalize our approach. If a tumor is likely to respond to a targeted therapy then we can avoid the side effects of traditional chemotherapy.”




Following are portions of a letter written by a woman to her parents during a time when her husband was dying of pancreatic cancer far off in another state – with her permission.

She once told me the timed painkillers he had available didn’t stop the pain for long and he would scream out to her with the pain and beg her to give him another shot early.

A concern of the hospital seemed to be that he would become addicted to the drugs.
I wondered then, as now – what different would it make if he became addicted to pain medications?
He was dying.

The good news about Vanderbilt’s Personalized Cancer Medicine Initiative is one more step in the battle against cancer.

‘Dated Monday, Nov 2 -87.
Dear Mom & Dad,

Received the money you sent me…thank you.
It helped a lot because his drugs he has to have are very costly.
Just his filled morphine shots I give him are $163.00 every two weeks, not counting his other medicine.
This is mixed with cocaine.

Brought him home Sat.
Got here about 1:30pm and so thankful to be home again.

The nerve blocks he went through have deadened many of his nerve endings leading to his cancer.
He knows he is dying.
His mind is still very alert.
Thank God.
He told the Dr while I was out of the room that he was afraid of dying.
God what suffering.

He is in God’s hands.
He is humble & has prayed so hard for God to take him.
His spirit will one day go back to the Lord who gave it & then his struggle & his pain will be over.
Cancer is a slow & painful death.

I wonder sometimes why humans have to suffer so much. There is no answer of course.

I’ll never forget the beautiful people at the hospital who gave me their support & hands & hearts that reached out to us, & before I left the hospital, I went around & thanked them all for giving me so much when God knows I needed it.

Two wonderful & beautiful Drs -Dr Stewart & Dr Wright, they cared too, what we are facing.

They are frustrated because they can’t stop this cancer.
There is no form of x-rays that will show the kind of cancer Kenneth has in the early stages, only after it’s too late.

They became Dr’s to help heal their patients & in Kenneth’s case, it’s too late but they both did everything medically possible to ease him.

They are both so kind.
They wished they could tell me that it wasn’t too late.

Both of them would meet me in the hallway & be on the way to surgery but they always took the time to stop & take my hand & talk to me.

Thank God, for the wonderful & beautiful people left in this world.
There will always be a dawn because of the beauty of their souls & it rubbed off on me.

I’ll never forget any of them. Everyone at the hospital knew me & put their arm around me & asked how I was; no matter where I was in the hospital, so many people came over to me.
God Bless them all.

I know God has a special place for them & I have in my heart.

Don’t worry about me, I’m all right.

God Bless my two parents that I so dearly love. I keep you close to my heart & the miles apart make no difference.
With lots of love, Karen”

More later… Sharon O’Hara

Constrictive Bronchiolitis, Jon Carr, Vanderbilt U Honor Memorial Day

Memorial Day 2010
To those who served, to those serving and to those unlucky who continue to serve a lifetime sentence of unrecognized disability through our own military and governments, Look The Other Way.
After writing of this neglected horror twice, I interviewed a submarine sailor who was stationed in Baghdad 10 months. Jonathon Carr offered a different perspective of what we are doing over there as well as look at a deadly disease our military is not acknowledging nor training our troops how to survive .

Vanderbilt University – “Since 2004, physicians serving the Fort Campbell Army base have been referring dozens of soldiers with exercise-induced shortness of breath to Vanderbilt, to see Robert Miller, M.D., associate professor of Allergy, Pulmonary and Critical Care Medicine”. – holds the key to hope. Will our military and government wake up soon enough to turn the key and protect our troops?

A short reminder…
Our Returning Soldiers and Constrictive Bronchiolitis

Too many of our returning soldiers have it – the Agent Orange of 2010 – lung disease leading to the good, the bad and the ugly.
The only thing “good” about the following is that it is bringing public attention to an invisible disease and the 4th leading cause of death in the nation, killing 120,000 people a year. COPD is expected to be the 3rd leading cause of death by 2020.



March 2010

Sharon We are sending our military to fight in a different culture and live among people in jeopardy, but many are coming home with unexpected results similar to Agent Orange.

Vanderbilt contacted CNN but not surprisingly, they are not interested in the story. I am not surprised about CNN, but Navy Times apparently is not interested in the story either

Jon: I don’t know. It seems like something right up their alley that they would like to publicize because they are always talking about health care and Tricare. There is a section in the back that has veteran’s affairs where all the veterans can write in.

Sharon: I was told Navy Times showed some interest, but have they actually written about it? We must do something about it.

Jon, I know you were on submarines but I want to ask about your 10 months of duty in Baghdad and if you ran into some of the things talked about in the article that may have led to air pollution.

Jon: On the base where we were, all the trash that we get, we bag it up, separate the recyclables, and anything that’s not recyclable, they take to a big burn pit,. There is one right on the base.

It is a big ’hole where they throw all the trash and they burn it just about every night. There are all kinds of stuff going into the air, including fecal matter and whatever else is in the sand over there. When the dust kicks up, so you are just breathing all that stuff in.

Sharon: You are not wearing masks or anything.
Why isn’t the military jumping on this to protect our people there now and in future? Nothing can be done about the past…but now . . . you have been there, Jon. You could have picked up something that has not shown up yet.

Jon: Right after I got back, I was reading in Navy Times about exposing the burn pits that are over there. I remember reading about a female sailor who had gone over there and she was talking about how it is like black lung, almost like the coal miners get. They were burning all kinds of trash – anything that would burn was put in there. In addition, it was just going out in the air and people were breathing it in.

Sharon: What was the area you were in?

Jon: It was Baghdad, Iraq.

Sharon: How long were you there, Jon?

Jon: I was there for ten months.

Sharon: And you actually breathed this stuff.

Jon: Oh, yeah. The smoke . . . because every night at the same time, they would start the burn pits and they would burn all the stuff for that day. During the winter months, it was not as bad because it would rain, causing the fine sand particles and whatnot to turn into mud. But during the summer, when it’s all dry and there was no rain and the wind’s blowing, we would get huge dust storms, so that’s kicking all that stuff up, too.

Sharon: How often would you say, out of a month, out of 30 days, that you had conditions that you were breathing that, noticeably breathing that?

Jon: Right before I came back for a period of about a month and a half, I would say the longest that we went in a sand storm was probably about 4-5 days, then it would clear up for about two weeks. Then it would come back for a couple days then clear up again, it was just all depending upon the wind kicking all that stuff up.

Jon: It was bad. When I was over there, I had to go to medical because I had gotten a piece of sand in my eyelid like where your eyelashes come up. It had lodged in there and gotten infected.

Sharon: Oh, my gosh. Yes, I guess it would be infected. In addition, not one person over there, none of the military people, wore masks, filters, or anything.

Jon: No, not during sand storms. Some of the guys that would do burn pits, mainly the 3rd company nationals, the local people there that they did security screening, they would hire on the base to do odd jobs, Most of those guys operated the burn pits but we would always have soldiers there escorting them, making sure they were doing the right things. Those guys, the 3rd company nationals and the soldiers that were operating to put stuff on the burn pits would have just basic masks that cover your nose and mouth, the white ones that have the straps going behind the ears.

Sharon: One of the nurses at the University of Washington told me that they fill up after 20 minutes. So did they change out?

Jon: No, they would use them until they got to a point where they were obviously not white any more.

Sharon: (laughing) and that was the criteria.

Jon: And then they would change it out.

Sharon: Based on the Vanderbilt article, most of the people sent there for examination had the lung condition.

Jon: It doesn’t surprise me. It’s a dirty country over there with all the stuff that’s in the sand and then when the sand storms come thru and kick it up, then everybody’s just breathing all this stuff.

Sharon: It never occurred to me that sand was dirty. I thought the sand was always clean.

Jon: No, not over there. Because they have all those stray animals and there is some people over there that don’t have indoor plumbing.

Sharon: Oh, then it is all into the sand to be part of the environment.

Jon: Yes.. There is a bunch of stray dogs and cats and goats.

Sharon: What do you think that could be done for our military men and women over there that would protect them against the threat of getting this? Because this disease is permanent.

Jon: It is such a big area over there. At the least they could . . . because the burn pits were on the outskirts of the base where we were but they were still on the base. In addition, I know there is some risk about taking all that stuff out in the middle of nowhere because they have to worry about roadside bombs and all that stuff and all the trucks going out. They could take it further away from the base or maybe develop better respirators or something that aren’t . . . because the respirators that would prevent inhaling this stuff, over there in that environment is impossible to wear for 24 hours a day or however long that you are outside. The job that you’re doing with all the other gear on it’s just impossible …

Sharon: You had trouble breathing through it then.

Jon: Yes. Because you have the helmet on, you got your body armor on, and then you are carrying around magazines, weapons, and all that stuff while you are outside the base, so it is just one more thing. When we were going through training, they trained us on chemical and biological attacks and we got the suits and all that stuff, so we learned how to put those on and you have a certain amount of time from when they sound that alarm to get that stuff on. It comes with a full-face respirator and it has a big canister filter, charcoal filter. To wear that thing for greater than 45 minutes, you’re sweating. It’s crazy. If they make those little masks like we were talking about before, if they make them readily available and at least wear them during the sand storms, that would cut down not 100 percent but it would decrease the risk a little bit.

Sharon: A little is better than nothing is.. If our military people were forewarned . . .

Jon: Oh, yeah, that too. Give better training before you get over there.

Sharon: Absolutely Some of the greatest strides forward in our history have been the need to have something, so it is invented. If we’re going to be there lets train in air quality survival. I it is bad enough. You go over there and you expect to get bombed and shot at… you’re getting things you expect .Respiratory disease is not something you expect. We have to spread the word…. It has to become known.

Was your group mainly sailors over there?

Jon: No. I was on one of the biggest bases in Baghdad where the higher-ranking officials were in charge of everybody over there, a big base headed by General Petraus.

Sharon: Did he ever at any time wear a mask while he was there that you ever saw?

Jon: I did see him, but I didn’t see him that often and never wearing lung protection. He was flying around checking on other things and coming back to Washington to do Senate briefs and all that stuff.

Sharon: Well, he probably wasn’t aware then. Generals or officers leading their troops protect those troops as best they can. That is their job.

Jon: He did a good job, too. He is a good guy.

Sharon: Wow. Good. Well, thank you for saying that. My gosh.

Jon: The way the process works now for the Navy guys, because that is totally out of our element, was going over there. We’re used to going out to sea and doing all that stuff. Drop us in the middle of the desert with only bottled water around and we’re out of our element a little bit. However, we did go to training, and the training that I went to get us ready to go over there was only two weeks. Now since I’ve gone over there, they have extended that. Now you’re in training getting ready to go over there for about a month and a half. Therefore, they have incorporated more things. I don’t know if they . . . because I didn’t find out about how bad the dust storm and all that stuff were until I got over there. Now I’m sure that they’ve worked that in there because of all the feedback that all of the people coming back have provided.

Sharon: Right. However, did any of them talk about this?

Jon: No. As I said, I didn’t know anything about this until probably two months after I got back. I was reading Navy Times and I saw an article in there about the postal clerk where she was talking about the burn pits and all that stuff.

Sharon: OK. I wonder if they have incorporated using masks or protecting the service people against the stuff they’re breathing.

Jon: They might have. I don’t know.

Sharon: Who would know? Whom could I contact to find out?

Jon: The Wounded Warrior program is a good program for injured service members.

Sharon: The Wounded Warrior program? I never heard of that. How do you get in touch with them?

Jon: I know if you goggled the Wounded Warrior program, they come up. They have a website, they have contact numbers, and all that stuff on there. They have done documentaries that have been on TV; I saw one . . . they usually come on like HBO like HBO documentaries. I saw one probably about a month and a half ago. The one that I saw was pretty much the same one that shows repeatedly. It was talking about the guys who were there during the first wave and they were being hit by ID’s, getting burns. The Wounded Warrior program was just kicking into effect and now they’re steadily getting bigger and incorporating more things so this would probably a good thing to talk to those guys…

Sharon: Absolutely. I’ll give them a call.

Jon: While I was over there, during those sand storms, we always kind of jokingly talked about how we’re probably going to come down with something ten years down the road and they are not going to know what in the world caused it. Moreover, this is exactly. . . I didn’t have a clue about any of this stuff until after I got back. Now, looking back in irony. We were just joking about it.

Sharon: Here it is, it is real.

Jon: It is kind of unnerving a little bit. Because now it’s like a waiting game. What’s going to happen in ten years down the road from me being over there? Nobody knows.

Sharon: Nobody does know, no. Nevertheless, you do have healthy genes, right?

Jon: Yes.

Sharon: OK, well, that is a step in the right direction. You’ve led a relatively clean life; you’ve never smoked.

John: Well, I have but . . .

Sharon: Not . . . I was a hard-core smoker for 40 years. You certainly didn’t do that and you certainly don’t smoke now.

John: No.

Sharon: Well, you see that’s a step in the right direction, so you are not doing anything that would exasperate this sort of condition but you could still get it. However, I don’t remember how long it was after they came home when they had a problem. You’ve been home about a year, more than a year.

Jon: I got back in July of 2008, almost two years.

Sharon: Well, you may be one of the lucky ones because not everybody is hit with this stuff.

Jon: I know up here in this area for the Navy guys returning, there’s a hefty screening process when you get back.

Sharon: What sort of things do they do?

Jon: You fill out about a 50-question questionnaire and if you have had any issues . . . it is mainly geared toward PTSD-type symptoms. Nevertheless, there are some questions about have you have had any respiratory issues; it is just a questionnaire and then if you check Yes, I guess they go further into detail. Then they do chest x-rays and all kinds of that stuff.

Sharon: They follow through with it. I didn’t know that. I didn’t think about it. How did you feel about it, coming home?

Jon: Oh, about this? It’s like I said, it’s kind of unnerving It’s kind of a waiting game, because right now all seems fine, but ten years down the road, something else could trigger something that’s been lurking.

Sharon: That’s exactly right. I know that’s what COPD was–just the beginning for me. Now it’s about 12 diagnosed things. Each one is nastier than the one before. Then it could be that nothing is going to happen, Jon.

Jon: Exactly.

Sharon: And so you might be one of the lucky ones. I suspect that you will. You led a healthy life as a kid, healthy and active. Well, I think that makes a big difference. Everything that I’m reading nowadays talks about exercise being mandatory for everybody with any disease. That you’re going to do better than if you do not exercise.

Jon: That is one good thing about being in the military; you have that structured PT program.

Sharon: Those are a few of the things that Agent Orange exposed us to.

Jon: That’s some nasty stuff.

Sharon: That’s right.

Jon: And they didn’t know about this until it was about eight to nine years after those guys were coming back.

Jon: All the guys that I was over there with and have kept in contact with are doing well. I guess we might have been in one of the not-so-affected areas. Most of the guys I keep in contact with were in the same area of Baghdad.

Sharon: How big an area would you say this pit was?

Jon: It was probably about 50 feet by 75 feet. It was decent sized.

Sharon: Was it deep?

Jon: Yes, it was probably between 10 and 15 feet deep. They just dump all that stuff in there and pour whatever kind of incendiary stuff in there.

Did you ever notice anything about the citizens of the area, if they had trouble breathing?

Jon: There were some, we were out doing patrols and it was generally the older civilians there. However, yes, there were a couple of them and they don’t have, unlike here, they don’t have any kind of health care pretty much. They did it and they have to live with it.

Sharon: So you didn’t see any oxygen tanks.

Jon: No.

Sharon: I am glad Ashley is married to you.

Jon: Me too!

Sharon: So can you think of anything? I have never done this before and this is very important information

Jon: No, basically, just get the word out there right now and that’s what you are doing. So that’s the first step.

Sharon: Is there anything in particular that you can think of, though, that people can maybe write to their representatives about getting some sort of protection for our service people?

Perhaps if people call, email their representatives and Congress people and insist that our service people be protected and be made aware so at least they could take care of themselves.

Jon: Yes. On the air conditioners, they do have filters but it’s minimal. I saw the guys that would come around and do the cleaning for the building; they would take the filters out and kind of spray ‘em off with a hose, but I don’t think they ever changed them.

Sharon: And none of them used hepa filters that you know about?

Jon: No, I don’t think so, no. They were the cheap, spongy things.

Sharon: Well maybe that would be a good idea then to protect our people, at least when they’re inside a building.

Jon: Well even during a sandstorm, over there in the buildings, you still get dust particles and all because that stuff is super fine, and I’ve noticed if I was in where my berthing area was during the middle of a sandstorm, it would be dusty inside the quarters.

Sharon: Well then, you were 24/7 then; you were not getting away from it.

Jon: No. You’d have to wait for the dust storm to blow out and then you would clean everything and wait for the next one and then clean it again and wait for the next one.

Sharon: How often did you have a dust storm?

Jon: During the summer, it was probably once every two to three weeks, maybe once a month, sometimes twice a month.

Sharon: You were there for ten months.

Jon: I got there in September and pretty much from September to early November; we’d have a couple of dust storms. It wasn’t as much, and then probably about May or April to June. April to June, it was real bad because that’s when it was coming up on the summer so everything was really dry and the wind would start kicking up even more.
As I said, there was a time the dust storm lasted five days, five to six days, almost a whole week.

Jon: It’s something else over there. You would take a shower and then 30 minutes later you’d be covered in sand. You would have to take another shower.

Sharon: Do you think the local people seemed receptive to you being over there or not?

Jon: For the most part yes, they did. I’d say probably 75 percent of the civilian population over there wanted us to be there because they knew that things were going to change for the better for them. The other 25 percent were in with the Taliban and those groups and they didn’t want change whatsoever.

Sharon: Right, I understand that, but the majority of the people were glad you were there.

Jon: Yes.

Sharon: Fantastic. I don’t think the people over here know that. I didn’t know it anyway.

Jon: Yes and when I got back, if people found out that I was over there, then that question would always come up:

Sharon: Well, do you think those people were glad you were over there?

Jon: Yes. Because while we were over there, all you’d see on the news is all the bad stuff because that’s what will make the news, of course. However, for all the bad stuff you would see on the TV, there were probably ten good things that we were doing over there. We were helping to rebuild schools, rebuilding a light rail system over there that was destroyed when we were first over there because of all the bombings; we were repairing that. All the oil refineries over there, we were getting those back into operation so they could go back to work.

Then right outside of Baghdad, there was a water park for the civilians over there that they had built and it was destroyed so we were helping them to get that back in operation so during the summer months, the kids could have somewhere to go to cool off because it gets hot over there, hot.

Sharon: That’s what I heard. How hot does it get?

Jon: The day that I left, I took a picture and it was 125 degrees. It was nasty.

Sharon: Is it humid, too?

Jon: No, not humid. But I mean if it’s that hot, it’s hot. We’d go from an air conditioned space,, open the door and it felt like when you open your oven after it is preheated to put the food in there, it was like that but constant. If you are outside. it was like sitting in the oven with somebody blowing a hot air dryer on your face. That is how hot it was.

Sharon: How many people did we lose from that?

Jon: There was quite a few.
You know, that was part of the training. They would tell us, hey, the environment you’re going to is a lot different from what you’re used to.
Therefore, you have to drink a lot of water. In addition, they had water readily available everywhere. You could walk ten feet and it was kind of like Starbucks around here.

Sharon: That is so cool, though; that the majority of the people were glad you were there.

Jon: Yes. We would be out doing patrols and we’d see all the little kids running up. Pretty much every time that we would go out, we would have soccer balls, chocolate, footballs, anything, because all the little kids would come running up and the guy that was sitting in the turf would always throw them a soccer ball or throw them some candy and whatnot.

Sharon: That doesn’t make the news, does it?

Jon: No, it doesn’t. Because before I went over there, you’d see all the time on the news, this American soldier was killed by a roadside bomb and wonder, what am I getting myself into? Then I get over there and it’s like, wait a minute, this is not how it’s portrayed on the news.

Sharon: If you could ask a question of one of the Vanderbilt doctors, Robert Miller, M.D., associate professor of Allergy, Pulmonary and Critical Care Medicine or Critical Care Fellow, Matthew King, M.D, what would the question be?
Jon: I guess the number one question would be how do I as a serviceman, if I’m over there, how do I pick up the initial signs that yes, you are going start developing these symptoms, and you can cut it off before it happens, if there’s a way to do that?

Sharon: You ask a good question. I hope they will comment.

Jon: There has to be. Because if you’re over there, they do have medical clinics you can go to, but I don’t think that the military physicians that are over there are keyed into this. Pretty much everybody back here stateside is good about this, but there has to be a way over there that you can go, hey, I’m having this symptom . . . . is this what . . .?

Sharon: .any people have a tendency to discard their own condition . . . say, well, it’s the weather or I’m tired and it’s discarded.

Jon: They could incorporate that into the training prior to going over there.

Sharon: That’s a good idea

Jon: I know from that article that we were talking about in Navy Times there were some changes made because of that article. They had restricted some of the things. They tried not to burn as much stuff; they tried to recycle as much stuff as possible and burn less.

Sharon: OK, well that makes more sense. Well then, because of this life has to be better for the citizens of that country as well
We will get the word out.
Moreover, you are at Bangor in case anybody wants to know.

Sharon: I sent the information to Greta on FOX. I have not heard a word.
I feel good learning most of the people living there appreciate what you are doing over there. I am glad to know that.

Before we close, can you think of anything at all that we could add to this?

Jon: Well, I looked at it as going to make a difference, and I did the best I could while I was over there, so that’s all you can ever do.

Sharon: You have a neat, neat attitude, Jon.
I can’t think of anything more except I am very happy that you are married to my granddaughter.

John: Me too!

. More later… Sharon O’Hara

Restless Leg Syndrome, Breast Cancer Prevention, Radiation Treatment Hope for Tomorrow

Restless Leg Syndrome (RLS), Breast Cancer Prevention and Radiation Treatment effectiveness or, What do three students from the University of Alabama have in common?

Why are they so important?

For those with RLS or Breast Cancer and those who have experienced Radiation Treatment, it is an easy answer.

The more research leading to discoveries, treatment and cures, the fewer future patients.

Atbin Doroodchi, 20 is a member of the Science and Technology Honors Program and an undergraduate researcher in the lab of Yuqing Li, Ph.D., investigating a gene’s relationship to my particular interest, restless leg syndrome.

Shweta Naran Patel is 21 majoring in molecular biology. She is a member of the University Honors Program and undergraduate researcher for Trygve Tollefsbol, Ph.D studying the natural compound role in breast caner prevention.

Tamara Michelle Burleson, 20 is majoring in Chemistry and a Supplemental Instruction Leader. She is investigating the role between certain proteins and radiation treatment effectiveness in the lab of Christopher Willey, M.D..

The Barry M. Goldwater Scholarship and Excellence in Education Foundation have named Doroodchi, Patel and Burleson 2010 Goldwater Scholars.

The faculties of colleges and universities select the Goldwater Scholars based on academic merit and the one and two-year scholarships cover school expense up to $7,500 a year.

Heartfelt congratulations to all!


More later… Sharon O’Hara

Our Returning Soldiers and Constrictive Bronchiolitis.

Too many of our returning soldiers have it – the Agent Orange of 2010 – lung disease leading to the good, the bad and the ugly.

The only thing “good” about the following is that it is bringing public attention to an invisible disease and the 4th leading cause of death in the nation, killing 120,000 people a year. COPD is expected to be the 3rd leading cause of death by 2020.

The “bad” is our soldiers were hit by the invisible permanent lung damage of constrictive bronchiolitis.

“…In 2008, Miller and pulmonary/critical care fellow, Matthew King, M.D., pulled together the first round of what they believe is solid evidence that soldiers are returning with serious and permanent lung injuries related to their service….”

“…The soldiers also shared similar stories of exposure in Iraq to massive amounts of smoke from sulfur fires in 2003, or breathing air fouled by sand and smoke from burn pits all over the country. Miller made a… “unconventional” move and recommended surgical biopsies.

“So far, all but a few of these soldiers we have biopsied have had constrictive bronchiolitis,” Miller said…”

The ‘ugly’ is that our soldiers and nation are faced with 2010’s version of ‘Agent Orange.

“… typical example of what may be an emerging profile: a soldier who was fit, a lifelong non-smoker, and who returned from deployment in Iraq with permanent lung damage.

Since 2004, physicians serving the Fort Campbell Army base have been referring dozens of soldiers with exercise-induced shortness of breath to Vanderbilt, to see Robert Miller, M.D., associate professor of Allergy, Pulmonary and Critical Care Medicine. “

“The soldiers also shared similar stories of exposure in Iraq to massive amounts of smoke from sulfur fires in 2003, or breathing air fouled by sand and smoke from burn pits all over the country.

Miller began to wonder if conventional testing might not be enough. He made what he calls an “unconventional” move and recommended surgical biopsies.

“So far, all but a few of these soldiers we have biopsied have had constrictive bronchiolitis,” Miller said.

Constrictive bronchiolitis, also called Bronchiolitis Obliterans, is a narrowing of the tiniest and deepest airways of the lungs.

It is rare, and can only be diagnosed through biopsy. Cases that have been documented in the medical literature show striking similarities to what is seen in the soldier’s biopsies.

“These are inhalation injuries, suffered in the line of duty,” said Miller.

In 2008, Miller and pulmonary/critical care fellow, Matthew King, M.D., pulled together the first round of what they believe is solid evidence that soldiers are returning with serious and permanent lung injuries related to their service.

Most of the first patients biopsied were 101st Airborne soldiers who fought the Mishraq Sulfur Mine fires in 2003. Later, many soldiers reported exposure to burn pits, especially a massive, 10-acre burn pit in Balad, Iraq….”

Deployment in Mosul renders a former marathon runner and mom of 7-year-old daughters “unable to pass her military physical fitness testing.”

“The former marathon runner and mother of 7-year-old twin daughters returned from deployment in Mosul in 2007 unable to pass her military physical fitness testing. Even her colleagues at the Army hospital couldn’t help her pinpoint what was wrong.

When Waters heard about Miller’s work she came to Vanderbilt in 2008. Her biopsy confirmed constrictive bronchiolitis.

“As a medical officer, I am considered fit for duty because I can still work in the O.R., even if it is only one day per week,” Waters said. “But my future is uncertain. Once I leave the service it could be very difficult to get medical coverage because of my preexisting medical condition.”

Miller says he is concerned soldiers continue to be tested for shortness of breath across the country using only conventional methods.

He says surgical biopsy and definitive diagnosis are required just to create the possibility of proper compensation, but even then, there is no guarantee.
“Even with positive biopsy, disability ratings have been highly variable,” Miller said.”


Thanks to the bright, thinking and unconventional medical folks approach at Vanderbilt and elsewhere, Chronic Obstructive Pulmonary Disease (COPD) is beginning to see the light of day.

More later… Sharon O’Hara

New NIA Senior Walk Study

The National Institute on Aging wondered ‘What Can Prevent Walking Disability in Older People’ and awarded $29.5 million to the University of Florida’s Institute on Aging to find out.

To be a part of such a study is the greatest opportunity for us…person, patient or senior to be a part of something important for future generations, meet the most amazing people and have fun at the same time…such as the University of Washington’s Shortness of Breath Study https://www.managesob.org/RS/StudyII/

Unfortunately, our own close-by University of Washington in Seattle isn’t one of the eight sites for the study but for those seniors close enough to one of the sites of the new “Lifestyle” – get your feet wet and get involved. I’ve been lucky enough to have been part of two COPD studies and can’t recommend them highly enough.

This six year “Interventions and Independence of Elders “(LIFE) study involves about 200 people, from 70 to 89 years at each of the eight sites around the nation.

I hope those of us who get involved will keep us posted when you can… the results of the study will help millions of future seniors maintain a quality of life and save future taxpayer dollars in health care.

“There is a lot of evidence indicating that exercise can help in preventing diseases, such as diabetes, among older people. But we do not know whether and how a specific regimen might prevent walking disability in older people who are at risk of losing mobility,” said NIA Director Richard J. Hodes, M.D.

“This research is critically important at a time when the population is aging and new interventions should be sought to keep people healthy and functioning in the community longer.””

“At eight sites around the country, LIFE will involve 1,600 people aged 70 to 89, who at the start of the study meet its criteria for risk of walking disability, defined as the inability to walk a quarter of a mile or four blocks.

About 200 participants will be enrolled at each of the study sites, which include the University of Florida; the University of Pittsburgh; Northwestern University School of Medicine in Chicago; Stanford University in Palo Alto, Calif.; Pennington Biomedical Research Center in Baton Rouge, La.; Yale University in New Haven, Conn.; Tufts University in Boston and Wake Forest University School of Medicine in Winston-Salem, N.C. Wake Forest will also coordinate the data management and analysis.”

“Limitations in walking ability compromise independence and contribute to the need for assistive care,” said Evan C. Hadley, M.D., director of NIA’s Division of Geriatrics and Clinical Gerontology, whose program is overseeing the trial. “Older people with impaired walking are less likely to remain in the community, have higher rates of certain diseases and death, and experience a poorer quality of life. A successful intervention might help prevent these bad outcomes.”

“We know that many older people have chronic health problems that affect their ability to walk,” said Jack Guralnik, M.D., Ph.D., chief of the NIA’s Laboratory of Epidemiology, Demography and Biometry and co-principal investigator of the study. “Arthritis, muscle weakness and poor balance can all affect how well and how far a person can walk. And, some older people have all of these problems. We will test the LIFE intervention in this population to see how it works in a real-world setting.”

Study participants will be randomly assigned to one of two groups. One group will follow a structured intervention consisting of walking at moderate intensity, stretching, balance and lower extremity strength training; the control group will participate in a health education program. The participants will be followed for about three years.

Researchers will evaluate whether, compared to health education, the physical activity intervention reduces the risk of major walking disability, serious fall injuries and disability in activities of daily living, and whether it improves cognitive function. They will also assess the cost-effectiveness of the intervention.

“This will be the largest randomized controlled trial to prevent major mobility disability ever conducted in older persons who are at high risk of losing their physical independence,” said Marco Pahor, M.D., director of the University of Florida’s Institute on Aging and study principal investigator. “Typically, this population is excluded from large trials, and from this perspective the LIFE study is unique.”

The NIA leads the federal effort supporting and conducting research on aging and the medical, social and behavioral issues of older people.

For more information on research and aging, go to www.nia.nih.gov.

The NIH — the nation’s medical research agency — includes 27 institutes and centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

For more information about NIH and its programs, visit www.nih.gov.”

More later…Sharon O’Hara