Death, anyone?

Dr. Victor Sierpina

Dr. Victor Sierpina

The emerging fears about Ebola are only in part about getting an infection. To put the snake on the table, the real issue is our fear of death.

The subject of death and dying is almost always difficult. As a physician, I have had the opportunity to be present and bear witness as patients died from trauma, disease and old age. Attending these souls in their final days is one of the most profound experiences in medicine. Being with death challenges the families of the dying and each of us. It pushes each of us to examine and experience the emotions, beliefs, spiritual issues, as well as earthy and pragmatic matters tied to this ultimate material transition.

If you are not in health care, you likely do not have a lot of experience with death. Perhaps you have some experience of death those in your family, workplace or friends. This is predictably painful, bringing not only grief but also more questions than answers. Continue reading

Semiprecious pathogens

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Some diseases are older than others. AIDS, for instance, is a recent phenomenon, while malaria has plagued humans for millennia.

Recently, scientists examining ticks fossilized in amber found they were infected with bacteria similar to those that cause Lyme disease, a spirochete bacteria named Borrelia burgdorferi.

Lyme disease is a bacterial infection caused by the bite of an infected tick. The discovery of an ancient Borrelia-like bacterium, now named Palaeoborrelia dominicana, shows that tick-borne diseases have been around for millions of years.

Lyme disease was identified in the early 1970s when mysterious cases of rheumatoid arthritis struck children in Lyme, Conn. and two other nearby towns.

The first symptom is a rash called erythema migrans, which begins with a small red spot where the tick bite occurred. Over the next few days or weeks, the rash gets larger, forming a circular or oval red rash much like a bull’s-eye. This rash can stay small or can cover the entire back. Continue reading

Start reading to your child by 6 weeks old

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Learning disabilities are best defined as the failure of the child to learn subject matter despite adequate intelligence, instruction and motivation.

Although learning disabilities can occur in mathematics, written expression, language problems and information processing, most children with a learning disability have a problem with learning to read.

Reading disabilities can be more devastating than other learning problems because there is less available to help the learner, such as a calculator or spell check.

There are three types of reading disabilities:

Deficits in sound-symbol association, also known as the dyslexic type of reading disability, means the child has tremendous difficulty sounding out words. These children have difficulty in recognizing that the written symbols have a certain sound. They have trouble recognizing the symbols or sounds within words. They have trouble with creating rhyming words. Some children have trouble remembering to read from top to bottom and from left to right. They may start at the end of a word reading “saw” instead of “was.” This type of reading disability is sometimes inherited. Continue reading

Falling is big risk for older women

Dr. Tristi Muir

Dr. Tristi Muir

Our Bodies, Our Selves

While most women today no longer fight off wild animals for survival, we constantly try to combat other dangers. Cancer screenings are now on most women’s preventive health agendas. We know that regular mammograms, pap smears and colonoscopies help keep us safe.But what about the risks posed by taking a fall?

As we age, we fall more frequently and recover more slowly.Falls are responsible for 70 percent of accidental deaths in people 75 and older.Only seven percent of woman diagnosed with stage 2 breast cancer die of their disease within five years. Yet fully one-quarter of all elderly people who fracture a hip will be dead within six months.Among those who survive a hip fracture, half end up in a nursing home after hospitalization. Of women sent to nursing homes, half remain there for more than a year.With frightening statistics like those, we need to take the dangers of falling very seriously.

Everyone loses muscle, bone mass and strength as they age.Some women envision enjoying their golden years in a rocker on the front porch, passively watching the years roll by, rather than taking life by the horns and signing up for Zumba class.Pain, arthritis, neurological conditions or incontinence may hold them back. Yet maintaining and even gaining muscle strength is a very important way to guard against falls.Weightlifting or water aerobics can increase muscle strength and function without the dangers associated with high-impact sports. Building muscle is the first step to improved balance.As children, we darted side-to-side avoiding a tag in the middle of a game, all the while building our core strength and muscle memory to keep us upright. We need to regain that kind of agility. Pilates, yoga and water aerobics classes help women improve their flexibility and balance. They allow a woman to keep her body, rather than her rocker, moving. Continue reading

You ain’t from here

Dr. Victor Sierpina

Dr. Victor Sierpina

Today, I finally met and had a nice conversation with ole John Dundee, whose father’s family has been in Galveston since long before the Storm. Not Ike, the 1900 one. Oh, that big one. It is fascinating what draws people to a place and how some just settle in for generations while others move on to happier hunting grounds.

Galveston seems to be a magnet for both the lifers and the gypsies and we are all richer for it. My talk with John and his mom, who is a relative newbie to the Island, only having lived here since 1942, reminded me of Cecil, a 93-year-old patient I took care of in Colorado.Sometime in the 1930s, during the Great Depression, Cecil and his family were traversing the U.S. looking for a better life. Their Model T pickup broke down in the high country San Luis Valley of Colorado. Their only possessions were a bag of potatoes and a bag of beans, so they decided to light there and became contributing members of the community, teachers, farmers, small business owners, and so on. Continue reading

Ebola — you won’t get it from shaking hands

Dr. Victor Sierpina

Dr. Victor Sierpina

A strange thing happened to me last Monday when I went to the clinic.

With the report of a man in Texas with Ebola who had been discharged from a Dallas hospital, then readmitted very sick a couple days later, I realized that any patient I came in contact with that day, or any day, might have this deadly virus.

Now we don’t usually think of work in health care as inherently a hazardous profession — say like being a soldier, firefighter or policeman. Yet it has actually always been so. From doctors and nurses who cared for patients with leprosy and bubonic plague in medieval times to those caring for the Ebola epidemic in Africa today, our colleagues in white coats put their lives on the line caring for those who have no other recourse for help.

Emergency workers, ambulance crews, and paramedics are often called into dangerous settings after shootings, bombings, and other catastrophes where the sites are not always secure or safe. They transport people with unknown diseases and unknown risk.

Of course, we have developed methods of reducing risk. Part of annual training at UTMB for all clinical staff includes reviewing universal precautions, which include several levels of infectious disease control. These range from basic hand washing and use of rubber globes to advanced personal protective equipment, including specialized gowns, masks, and in some cases like the Galveston National Laboratory, even hazmat type suits and respirators. Continue reading

Single change in one letter makes you a natural blond

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Out of the 3 billion letters contained in the human genetic code, all it takes to be born a blond is a single change in a certain place from an A to a G.

With the sheer complexity of the human genome, this new discovery shows how remarkably simple it is to be a natural blond. Especially when you consider the lengths people go to become one artificially.

This discovery actually came from research on the evolution of Sticklebacks, small fish that emerged from the oceans and colonized streams, rivers and lakes at the end of the last Ice Age.

Scientists at Stanford University have been studying how Sticklebacks have adapted to different habitats around the world, and particularly how different populations acquired their skin colors.

They discovered that changes in a single gene determined the pigmentation of fish throughout the world. The gene responsible, the Kit ligand gene, is also in the human genome. Different versions of it have evolved around the world and are associated with differences in skin color. Continue reading

The real skinny on holistic bariatric surgery

Dr. Victor Sierpina

Dr. Victor Sierpina

I recently read a really well-done book by a highly successful bariatric surgeon in Dallas and former UTMB medical student.

Dr. Nick Nicholson’s book, “Weight Loss Surgery: The Real Skinny,” is an essential read for those of you who might be contemplating surgery for your weight problem, as well as for your family and friends. Such surgery has become the second most common general surgery procedure after gallbladder removal. So if you haven’t met someone who has had this surgery, you surely will.

Bariatric means relating to weight loss, thus bariatric surgery involves one of several types of procedures to help people lose weight. This is not a minor event. If your six-pack has turned into a 12-pack, you are 10-30 pounds overweight, don’t fit into your favorite dress or jeans, bariatric surgery is likely not for you. It is not a cosmetic treatment like getting a face-lift or getting a boob job.

Your BMI needs to be over 40, or over 35 if you have certain obesity related medical conditions to even qualify for this kind of surgery. Additionally, most insurances, if they cover this treatment, require psychological evaluation, documentation of failed attempts at diet, exercise, and the usual approaches to losing weight. Continue reading

Low-power laser treatment works on molecular level for cavities

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

For all those who cringe at the thought of going to the dentist or hearing the word cavity, there is hope.

Apparently, when low-power laser light is focused onto damaged teeth, it stimulates the regrowth of dentin to correct the damage.

The laser light stimulates the stem cells that already are in teeth to differentiate and repair damage from within, so that someday dentists can repair or even regrow teeth without fillings.

Teeth consist of four different tissues; three of these — enamel, dentin and cement — are harder than bone, while one — dental pulp — is soft. Enamel, the hardest material in the body, is the outer surface of the crown of a tooth.

Once enamel has completely formed it cannot be repaired, but it can remineralize. It allows teeth to withstand large amounts of stress, pressure and temperature differences.

Dentin lies beneath enamel and forms the main portion of a tooth through numerous microscopic channels called dentin tubules. Continue reading

Recommendations on bicycle safety for kids

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The following are recommendations from the American Academy of Pediatrics on bicycle safety:

Do not push your child to ride a 2-wheeled bike without training wheels until he or she is ready.

Consider the child’s coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes. Consider a balance bike with no pedals for young children to learn riding skills.

Take your child with you when you shop for the bike so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new one. Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.

Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many injuries happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Set the example: Whenever you ride, put on your helmet.

When purchasing a helmet, look for a label or sticker that says the helmet meets the CPSC safety standard.

A helmet protects your child from serious injury and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.

A helmet should be worn so that it is level on the head and covers the forehead, not tipped forward or backward. The strap should be securely fastened with about two fingers able to fit between the chin and strap.

The helmet should be snug on the head but not overly tight. Skin should move with the helmet when moved side to side. If needed, the helmet sizing pads can help improve the fit.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.