Multiples, the journey begins….

Avolonne Kimble, MDAs a, wife, parent of twin girls AND twin boys and a pediatrician, my perspective of pregnancy, life as a working mother and plans for the future may be a little skewed. I see everything in two’s. Being pregnant and having a baby is a joy and it can also be scary. Being told that you’re having more than one can be even scarier, especially if you have just a little bit of knowledge.

Multiples occur in 3% of all pregnancies with twins being the most common. When carrying two babies the risk of maternal complications rise and prematurity is more prevalent. Higher order multiples occur in much smaller numbers and with even more possibility of complicated pregnancies, risk of prematurity and less chance of survival. In my case, as a pediatrician working full time, co-owner in private practice, considering pregnancy is a very serious one and then to be told that you were having multiples brings in a very different element.

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Colonoscopy Facts

What is colonoscopy? Do I have to get one? How often? Why do I need one? What is the goal of that test?

These are questions that one asks as they visit their physician for their annual exam. A colonoscopy is a test that where the physician looks with a magnifying camera at the inner lining of a person’s large intestine. Sample biopsies may be done at the time of the test. The colonoscopy test is typically performed for colon and rectal cancer screening, but the physician may order it for other reasons as well, which include: blood in the stool, abnormal test results from another colon test, family history of colon cancer, anemia unexplained otherwise. The stated are some indications for colonoscopy, but it is not an inclusive list.

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August is National Immunization Awareness Month

Selwyn Rogers, Chief Medical OfficerIt was a typical Tuesday in my former job as chair of surgery at Temple University in Philadelphia, but that morning I felt sluggish. Although I wasn’t feeling well, I knew I had three surgical operations to perform that morning followed by an afternoon full of meetings.

I trudged out of my apartment and started the 15-minute drive to work.

A few miles into my commute, a feeling of illness suddenly enveloped me. I had to pull over and call my chief resident to cancel the morning’s surgeries.

I turned the car around and headed back home to bed. The next three days were a blur of sore throat and fever; it was the first time I’d had the flu, and I swore that I would never endure that experience again.
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How to decrease added sugar in your child’s diet

Dr. Lauren Raimer-GoodmanSugar is sneaky.  There are plenty of foods out there that we think of as healthy that have added sugar.  Unfortunately we don’t know exactly how much added sugar there is, as companies are not required to make a distinction between natural and processed or added sugars on nutrition labels. They also don’t have to tell you what percent of the recommended daily value of added sugar their product contains.  (fortunately the FDA has proprosed changing this – if the proposed changes can make it through the legislative process).

There is a lot in the news these days about the negative health effects of added sugar.  Notably, increased sugar intake adds to the risk of heart disease, obesity, type 2 diabetes, cancer and many other health issues we would rather our children not have to experience. Continue reading

Have to … choose to … get to …

Dr. Victor Sierpina

Dr. Victor Sierpina

Do you ever feel overwhelmed with life? So many things simply need doing and you have not enough time to do them.

You might feel like a victim of one more demands on your time and energy.

Try this simple gratitude exercise from the Naikan book mentioned last week. Medical students in UTMB’s Physician Healer track were assigned to create a list of routine daily activities and apply the following to them:

1. I have to …

2. I choose to …

3. I get to …

Such a process helped remove a sense of helplessness, victimhood, or the burdensomeness of daily activities. Once we realize we choose or even get to do the things we do, our whole attitude shifts.

Here are some examples of this process from a student journal: Continue reading

Medieval antibiotic

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Almost every week there is another report about the catastrophe of drug-resistant bacteria, and very few new antibiotics have been developed to treat people who have been infected. But a possible solution to this modern-day problem has been discovered in a 1,000-year-old source: an eye salve, as recorded in a ninth-century text, has effectively killed methicillin-resistant Staphylococcus aureus, or MRSA.

One of the oldest known medical texts, “Bald’s Leechbook” contains instructions for various medicines and treatments. One is a remedy for sty, an infection of the eyelash follicles that is usually caused by the bacterium Staphylococcus aureus. Christina Lee, an expert in the Anglo-Saxon language at the University of Nottingham, translated the instructions for making the eye salve and collaborated with the university’s Centre for Biomolecular Sciences to test its effects on MRSA. The recipe is simple: equal parts of minced garlic and onion or leek are crushed in a mortar for two minutes, then mixed into 25 milliliters of wine from a historic English vineyard. To that, cow bile salts dissolved in distilled water were added, and then the mixture was aged in a brass vessel for nine days at refrigerator temperature. Finally, it was filtered through a cloth to clear it and put into a horn. The instructions said to apply the salve to the eye with a feather. Continue reading

Naikan: Gratitude, grace and the art of self-reflection

Dr. Victor Sierpina

Dr. Victor Sierpina

Gratitude opens untold blessings in our lives. The cultivation of gratitude requires constant discipline in an era often surrounded by a mentality of lack, of ever needing more material goods to believe we can be happy, or when we blame others for not meeting our expectations to make our lives better.

A technique that UTMB students and faculty practice as part of the Physician Healer Track comes from Naikan, a book, by Gregg Krech. You might recall my description that the aim of the healer track is to preserve empathy in physicians in training.

A week after my empathy piece, Time magazine ran a feature article on physician burnout, depression, and suicide. It described a program called The Healer’s Art that is being offered at Stanford University to residents to deter these negative spirals into dysfunction. This long-standing program, developed by holistic physician Dr. Rachel Naomi Remen offers reflection, insight, healing, and opportunities for including gratitude in medical education. It offers many similar skills and practices as does the healer track. Continue reading

Snake bite defense: The Opossum

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

If you live in a rural area, you’ve probably had to deal with snakes. Almost 500,000 people are bitten by snakes and more than 20,000 die from them worldwide each year, although the World Health Organization notes these figures may be closer to 1.8 million incidents and 94,000 deaths. Opossums, on the other hand, never have to worry about that since they are resistant to snake venom. Opossums have a protein in their blood that binds to the toxins in snake venom and neutralizes them. Now scientists are looking into whether this protein could be used to treat human victims of snake bites.

Venomous snakes generally have different combinations of toxins: cytotoxins that kill cells, neurotoxins that affect the nervous system, cardiotoxins that act on the heart, hemotoxins that influence the blood and mycotoxins that are toxic to muscle. Venomous snake bites can cause paralysis that prevents breathing and can cause fatal hemorrhages, irreversible kidney damage and destruction of tissue in and around the bite site, which can lead to amputation. Continue reading

Child Cancer Awareness Month — Part one

Dr. Sally Robinson

Dr. Sally Robinson

Keeping Kids Healthy

September is Childhood Cancer Awareness Month. Did you know that one in every 285 children in the U.S. will be diagnosed with cancer? The next three articles will discuss cancer and its treatment.

The word “cancer” certainly strikes a scary and emotional note in our hearts, and when attached to the word “childhood” it can be especially frightening. However, as with many things we fear, we can be empowered by understanding. This week we explain just exactly what “cancer” really is.

Every part of the body (the brain, liver, heart, bones, fingernails, muscles, and so on) is made up of hundreds of millions of microscopic cells that are specialized for that particular organ. These cells follow a very complex and highly organized instruction set from their DNA to multiply, grow, and eventually die and become replaced throughout our entire lifetimes. Occasionally, however, the instruction set becomes damaged as it is copied into newly formed cells. Usually our bodies can recognize cells with damaged DNA and repairs or destroys them. But sometimes when the instruction to “stop multiplying” is damaged, cells can multiply and grow out of control faster than our bodies can repair the damage. This is how cancer begins. Continue reading

Planting trees whose fruit we will never eat

Dr. Victor Sierpina

Dr. Victor Sierpina

The week before last, I made a house call to Robert, a patient on hospice. He was listless, semi-comatose, with pinpoint pupils from the morphine, and yellow as a gourd from cancer-related liver failure. His devoted wife, along with friends, family, and the hospice care team were keeping him as comfortable as possible as he transitioned from life after a decadelong courageous battle with colon cancer.

Even after spending some time with him talking, examining, reading, praying, I wasn’t quite sure he could hear or understand me. At that point, I started to feel like I had done what I could for him. Now I was there for his family.

This was a special man who had fought his hardest, had created a cancer survivor support group, and who was dying at a prematurely young age. He kept going to his work as a scientist at a local university up until about 2 weeks before his death. Yes, he could only last a few hours at the lab, but his study of sargassum seaweed was his passion and gave his life meaning and purpose until the end. He also played a huge role in the education of the students he mentored. Like his love of planting fruit-bearing trees, he planted seeds of scholarly inquiry, motivated them, and challenged them to achieve more. Continue reading