Tag Archives: MD

The University of Washington Rocks!

The University of Washington is a God send to us. I wrote the following in answer to a letter to the editor and decided to add it here as well.

“The University of Washington ‘elitist’? If ‘elitist’ means dedicated fine professors teaching a subject they they live their work. They teach what they are passionate about to kids eager to learn.

It was the University of Washington’s Medical Center Specialties and Dr. Raghu specifically with then, Super Fellow, Christopher Goss, who gave me an open lung biopsy and found the granulomas and fibrosis in my lungs to prove Sarcoidosis added to emphysema (COPD)

When I had a sudden loss of ability to breathe, the local pulmonologist just handed me a steroid inhaler to add to the others he had prescribed and I was on my way out the door.

Mom’s worry. My mother worried that her daughter all of a sudden lost even more ability to breath and nothing was being done. She strongly pushed for me to get evaluated through the U or the Mayo Clinic. We needed to know.

I went to the U. The following letter is a direct quote from a Thank you card I have written out but forgot to leave there last week after my appointment.

Dr. Raghu –
Dr. Goss –

“Thanks for all you do for us now and in future to make the next generation of lung patients fewer, I hope, living quality lives.
When I first came here I never expected to live out the year much less be here years later and looking at tomorrow.”

The doctors at the U are open minded, they look and think about the entire body, not just lungs. Had I not gone there, I would not be sitting here now.
Their doctors are open minded and actually THINK. They treat their patients like partners in their own care and work together.

The old type doc and his “I Tarzan, You Jane’ mentality is over. Patients have a right to be involved and understand what is going on and what they can do to help themselves.

The University of Washington offers stellar, quality, educated medical people and professors. Who wouldn’t want the best training available?

That said, my own primary care doctor, Dr. Eady, is right here in town. If she ever moved I’d have to move too…same with my pulmonologist at the U. They, and others, are examples of medical care and caring not easily found these days.

I haven’t even touched on the superb Nursing Program at the U…in fact they lead THE COUNTRY…ask US News and World Reports…they are #1.

Is this what you call ‘elitist?

University of Washington – you rock!

Read more: http://www.kitsapsun.com/news/2010/jun/09/my-turn-is-university-of-washington-only-for-the/?comments_id=233309#ixzz0qyxBonTy

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Psoriasis Educational Seminar in Seattle

Sharon O'Hara

Psoriasis is painful and can be disfiguring…even to a pair of slippers.
I had to cut off the tops of my slippers and parts of the sides and front to alleviate pressure on my feet and toes but this post is about hope and education and to announce the Psoriasis Society’s upcoming Educational Event in Seattle. Don’t miss it.

Saturday, March 13, 2010
Seattle, Washington
Hotel Nexus
Room: Cascade Ballroom
2140 N. Northgate Way
Seattle, WA 98133

[Psoriasis is more than skin deep. A genetic disease of the immune system, psoriasis can be associated with other health conditions. Results from recent studies are changing the way we understand psoriasis and bringing new insights to treatment.

Psoriasis: More Than Skin Deep is an educational presentation that will address these issues and provide tools to access the treatment you need.]

Parking: Free hotel parking

Speaker
Bernard Goffe, MD

Schedule and registration information

9-9:30 a.m.—Complimentary breakfast and registration
9:30-11 a.m.—Psoriasis: More Than Skin Deep program
11-11:30 a.m.—Additional information and networking
11:30 a.m.-1 p.m.—Open invitation to attend an informal group presentation about our second annual Walk to Cure Psoriasis in Seattle. Learn why we are raising funds to support research efforts to find a cure and how you can get involved.

Complimentary lunch provided.
For more information, please contact walk@psoriasis.org.
________________________________________
If you would like more information about an event, please email events@psoriasis.org or call 800.723.9166, ext 402.

If anyone needs a ride or wants to carpool, let me know.
This free event is a wonderful opportunity to learn about the latest research and newest treatments.

More later… Sharon O’Hara

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Mummies and Fast Food and Clogged Arteries

Sharon O'Hara

The following study shoots down many of today’s theories with the discovery that clogged arteries existed 3,500 years ago.
Clogged arteries show up everywhere, even thousands of years ago.

What does the National Bank of Egypt in Cairo, Siemens Healthcare in Florsheim, Germany, and St. Luke’s Hospital Foundation in Kansas City, MO have in common? They supported the study showing the recent discovery of 3,500-year-old mummies with clogged arteries and not a Big Mac or Fries in sight.

So far as I know, no fast food restaurant existed 3,500 years ago, so who do we blame and tax now for making present day America a nation of obese, tubby folks?
Big Macs, French fries and fast food restaurants are not to blame, folks…they were not even a twinkle in someone’s eye 3,500 years ago.

Randall Thompson, MD … “”I tell my patients that I think these ancient Egyptians had a genetic hand-me-down as my patients do,” Thompson said, “that we have to look beyond traditional risk factors to explain atherosclerosis.”

Randall Thompson, MD from Mid America Heart Institute, Kansas City, MO made the surprising report at the American Heart Association meeting in Orlando and in the November 2009 issue of the Journal of the American Medical Association.
“
Of the 16 mummies housed in the Egyptian National Museum of Antiquities in Cairo that had vascular tissue available for CT examination, nine had probable or definite evidence of calcification in the arteries.

“The calcification in these arteries looks just like it does in modern humans,” Thompson said.

Co-author L. Samuel Wann, MD, of Wisconsin Heart Hospital in Milwaukee, said it was surprising the mummies had calcification at all.
“We would have thought that atherosclerosis and heart disease is a disease of modern man, a disease of McDonald’s, if you will.”

The oldest mummy to have the finding — Lady Rai, nursemaid to Queen Ahmose Nefertari — lived between 1570 and 1530 BC.

Although ancient Egyptians did not smoke tobacco or eat processed foods, and likely didn’t lead sedentary lives, the researchers said, they were not a society of hunter-gatherers.
“Agriculture was well established in ancient Egypt and meat consumption appears to have been common among those of high social status,” they said.
Additionally, Thompson said, the ancient Egyptians salted their food for preservation, and so they may have had a high salt diet.

Commenting on the study, Sidney Smith, MD, of the University of North Carolina at Chapel Hill, said, “Food other than that which comes in packages can also do us in.”
“The study emphasizes the importance of understanding dietary and environmental factors that may cause coronary disease,” said Smith, an AHA spokesperson.

On the other hand, the development of atherosclerosis could be at least partially hard-wired in humans.
“I tell my patients that I think these ancient Egyptians had a genetic hand-me-down as my patients do,” Thompson said, “that we have to look beyond traditional risk factors to explain atherosclerosis.”
He said this helps his patients get past some of the guilt and denial about their condition.

The idea for the study came from a visit to the museum by two of the study authors. They noticed that the descriptive plate next to one of the mummies — Pharaoh Merneptah — said he had had atherosclerosis.
The researchers didn’t believe that there would be any way of knowing that, Thompson said.

So a team of Egyptologists, preservationists, and imaging experts used six-slice computed X-ray tomography to examine 22 mummies, selected because they were in good condition.

They dated from 1981 BC to 334 AD. Of the 16 for which social status could be determined, all were from a high social class. They were either members of the pharaoh’s court or priests and priestesses.
Evidence of vascular tissue was found in only 16; four had an intact heart.

Definite atherosclerosis — defined as calcification in the wall of a clearly identifiable artery — was present in five of the mummies. Probable atherosclerosis — defined as calcification along the expected course of an artery — was found in another four.

Atherosclerosis was significantly more common in the mummies estimated to be at least 45 when they died (87% versus 25%, P=0.029), but it was equally likely in men and women.

“While the presence of calcification does not demonstrate that atherosclerosis was a common cause of clinically manifest disease or death,” the researchers said, “it does provide evidence that humans in ancient times had the genetic predisposition and environment to promote the development of promote the development of atherosclerosis.”
http://www.medpagetoday.com/MeetingCoverage/AHA/17061?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_AHAtherosclerosis.””

More later… Sharon O’Hara

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Dr. Tom Speaks … Like it or Not

Sharon O'Hara

If COPD has a living guru in this nation, it is Thomas L. Petty, MD.

The following message is important and can save lives through early detection. Dr. Tom’s comment, “COPD is associated with numerous co-morbidities, and indeed, the entire body may become involved” is spot on….believe it… YES!

Since COPD diagnosis, then landing in the hospital in 1997, I have gone from being healthy and fit into my fifties to COPD and another EIGHT medical conditions. Each has its own set of ‘rules’. If I take pain pills for the Cellulites, I know that my respiratory system will be adversely affected….not a good thing with two lung diseases. The latest medication, Diovan, adds to the mix.

The point is that a COPD diagnosis is only the beginning of a medical adventure that need not happen with early detection…the simple Spirometry test.

Please, read Dr. Tom’s comments.
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COPD Progress and Challenges 2009

By Thomas L. Petty, MD
…
In the four decades I’ve devoted to lung health, chronic obstructive pulmonary disease has been slow to excite the practicing physician. Yet COPD should create great enthusiasm because we have made so many advances in identification and treatment. Many new therapies are available that are effective and favorably influence the disease.

COPD is associated with numerous co-morbidities, and indeed, the entire body may become involved.1It is now regarded as a systemic disease.2Traditionally; COPD has included emphysema (loss of alveolar walls and loss of elastic recoil), chronic bronchitis, inflammation in the small and large airways, and various degrees of lung inflammation throughout the lung parenchyma.

More recently, bronchiectasis has been added to this spectrum, although there are significant differences in manifestations and pathogenesis with repeated bacterial infections playing a more prominent role in bronchiectasis than with emphysema and chronic bronchitis.

Spirometry’s significance

COPD is characterized by irreversible airflow obstruction as judged by simple spirometry. Only the FEV1is needed to judge the severity of airflow obstruction, although a number of other measurements of airflow volume and gas transfer (diffusion test) are commonly undertaken to assess the disease states in more detail.

Spirometry is used to monitor the course of disease. All physicians who treat COPD should have immediate access to spirometers, including primary care practitioners because of their growing involvement in COPD managment.

The benefits and barriers to spirometry have been summarized.3For some reason, there appears to be an unfortunate bias against spirometry, particularly in the diagnosis and assessment of early disease. This is where treatment has the opportunity to do the most good. It is astonishing that only 37 percent of hospitalized patients had a spirometric diagnosis of COPD at the time of a hospitalization for an exacerbation.4

Established therapies

Early diagnosis can change outcome of disease through smoking cessation and the selective use of a growing body of pharmacologic agents.5The pathogenesis of COPD relates to interaction of a complex array of genetic abnormalities under current study, interacting with environmental factors, most notably smoking, other dusts, and volatile compounds involved in various industries on a worldwide basis. Treatment focuses on eliminating these environmental factors.

Medications that are most useful in COPD are comparable to those used in asthma with reversible airflow obstruction. Thus, inhaled beta-agonists, corticosteroids, and in selected cases, anticholinergics are widely used in achieving better scientific scaffolding. Oral corticosteroids seem particularly effective in slowing the progress of disease.6

Active patients

Oxygen is established as an effective method of increasing not only the length, but quality of life for patients with COPD. At least 140,000 people with COPD and related disorders benefit from oxygen therapy in the U.S. alone. Ambulatory oxygen systems allow full activity, and they should be equipped with a pulse oximeter in order to monitor therapy’s effectiveness.

Portable oxygen concentrators are now approved for air travel. Most weigh about 10 pounds and deliver oxygen only by the demand mode; however, one exception weighs 17 pounds and gives up to 1 to 3 Liters of continuous flow.

Pulmonary rehabilitation is established as improving the exercise tolerance of many with COPD. Controlled clinical trials show pulmonary rehabilitation improves depression, anxiety, and somatic preoccupation, which are particularly common in the early stages of disease.7Most pulmonologists can provide the necessary breathing training, assistance in graded exercise, and other components that are key to patient and family education.

The future involves increased awareness of COPD among patients, physicians, and other health care providers.

COPD is the only disease increasing in morbidity and mortality among the top five killers, and by 2010, it is expected to become the third most common cause of death in the U.S. It resulted in direct and indirect losses of $30.4 billion to the U.S. economy in 2001. Approximately 16 million adult Americans have COPD, and it is very likely that a similar number have asymptomatic or even symptomatic lung disease that is neither diagnosed nor treated.
…
Thomas L. Petty, MD, MACP, Master FCCP, is chairman emeritus of the National Lung Health Education Program, Denver.
http://respiratory-care-sleep-medicine.advanceweb.com/Article/COPD-Progress-and-Challenges-2009.aspx

My next blog post will put money where my mouth is in a challenge to join me to prove that patients educated about their disease/s WILL make whatever lifestyle changes needed for the best health possible.

More later… Sharon O’Hara

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Dr. Tom Speaks … Like it or Not

Sharon O'Hara

If COPD has a living guru in this nation, it is Thomas L. Petty, MD.

The point is that a COPD diagnosis is only the beginning of a medical adventure that need not happen with early detection…the simple Spirometry test.

Please, read Dr. Tom’s comments.
*****************************************
COPD Progress and Challenges 2009

Spirometry’s significance

Established therapies

Active patients

The future involves increased awareness of COPD among patients, physicians, and other health care providers.

More later… Sharon O’Hara

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Lung Cancer COPD Confusion

Sharon O'Hara

Lung cancer is almost entirely caused by smoking…just as in COPD and COPD kills more people per year than lung cancer and breast cancer combined.

A vast difference though is that COPD is a long slow smother without treatment other than inhaled steroids, several other inhalers, lung reduction and lung transplant while physical exercise beyond the shortness of breath and inhalers, is the single most important thing a COPDer can do to help them live a quality life

Lung cancer is usually faster from diagnosis to death since most lung cancer is not diagnosed until a late stage.

Why?
Because there is no proven screening process that can find it earlier while early detection is possible for COPDers with the simple Spirometry test …the only problem is finding a doctor willing to give the quick, inexpensive test….and the only opportunity to give the patient, if a smoker, a chance to change behavior knowing what lies ahead.

Keep in mind too, only about 20 % smokers develop COPD while about 80% COPDers were smokers. (Speaking of patient changing behaviors if the consequences and benefits are known…my next post here will challenge me to do what I preach and throw out a challenge)

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According to Jennifer Croswell, MD, of the National Institutes of Health…” Low-dose computed tomography — now under study in two large randomized trials — has delivered significantly more false positives than chest X-rays…”
The false positives can lead to “… more invasive diagnostic procedures among patients screened with the low-dose CT, Dr. Croswell said at the annual meeting of the American Society of Clinical Oncology and “”False-positive results may create increased psychological stress in patients and an increased burden on the healthcare system…”
…
“According to the American Cancer Society, the five-year survival rate for localized lung cancer is 49.5%, but that falls to 20.6% for disease that has spread outside the lung and 2.8% if there are distant metastases.

The authors of the current study “break a little bit of new ground” in that they are looking at a study with a comparison group, according to Peter B. Bach, M.D., of Memorial Sloan-Kettering Cancer Center in New York.

But it has been known for some time that CT screening uncovers a “very, very high” frequency of lung abnormalities — up to 50% in one study and usually in the same range found by Dr. Croswell and colleagues.
Such findings can be nerve-wracking for patients, he said, and can require invasive procedures to pin down the cause of the “abnormal thing in the lung.”

But “only very rarely is that thing a lung cancer,” he said. “

Complicating the issue, Dr. Bach said, is that for physicians, the results of a CT scan that showed a minor abnormality are rarely a Yes or No issue. Instead, he said, they may increase suspicion and lead a doctor to follow a patient more or less closely.
…
The work of Dr. Croswell and colleagues, he said, adds to the available information, but “nothing really changes here. There is no organization in the world that recommends screening for lung cancer with CT” or any other technique.
“The status of the science is that (screening is) unproven, no one has ever shown it’s beneficial, numerous studies have shown it causes harm, and no one should be doing screening until we have randomized trials that are completed and show a benefit that outweighs all the harms,” he said.

On the other hand, “there is no question that CT screening will detect many lung cancers,” said Martin Edelman, M.D., of the University of Maryland Greenebaum Cancer Center in Baltimore.

The question is whether the approach will reduce the risk of death and illness, while minimizing harm to patients, said Dr. Edelman, who is on the independent committee verifying the endpoints of the National Lung Screening Trial.
So far, there is still a “complete absence of evidence that this approach decreases mortality or morbidity due to lung cancer,” he said.

Advocates for screening “have long claimed that there is little or no risk of harm, Dr. Edelman said, but Dr. Croswell and colleagues “demonstrate that there is a small, but real potential for harm from screening.”
What’s more, he said, “the potential for false positivity is highest in those at greatest risk for lung cancer.” “

medpagetoday.com/MeetingCoverage/ASCO/14432?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_ASCO

More later… Sharon O’Hara

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COPD Funding Available Through NHLBI!

Sharon O'Hara

Great news for unwary lungs on the way to rack and ruin!
The National Heart, Lung, and Blood Institute are ready, willing and able to bring COPD awareness and early detection testing to… US.
After years of collaboration with doctors and medical organization, researchers, patient organizations, the COPD Learn More Breathe Better® campaign will extend a hearty Welcome to all organizations engaged in COPD education and awareness through the campaign.

The NHLBI offers limited funding to those organizations working for COPD on the state and local level. All interested organizations are asked to apply:
http://www.nhlbi.nih.gov/health/public/lung/copd/get-involved/partner-program.htm
The deadline for proposals is July 23, 2009.

For us, locally, the American Lung Association of Washington could apply using the Colorado COPD Coalition Strategic Plan—used as a prototype for other State Plans-information and copy thanks to Edna Fiore.

The American Association for Respiratory Care’s (http://www.aarc.org) Respiratory Therapists are invaluable to the COPDer. We need more and sooner. Here in Kitsap County, Eric Anderson at Harrison Medical Center is a member of AARC – maybe he and Harrison Medical Center will tackle the project. Eric, how about it?

AARC is noted for Dr. Tom…a COPDer National Treasure and best friend for his insight and wisdom. Dr. Tom of Colorado is not only a noted physician and expert on lungs, I am sorry to say he is one of us.

Thanks to all the organizations dedicated to educate and march for early detection.
Thanks to all the people who dedicate their lives to fight disease, the researchers, the support folks and the patient caregivers.
Sharon Blomlie O’Hara

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