Saturday, November 7, 2015

Gimlet Media | Podcast #42 Blind Spot

SRUTHI: Okay. So this is a story about a woman whose body started breaking down in increasingly weird ways. It's as if her body turns into a David Lynch movie, and there's nothing she can do to understand it, and nothing she can do to convince people it's real. For the purposes of the story, we will call this woman "Hope." And it all starts last year. Hope is 29, living in the suburbs of Pittsburgh. And one beautiful winter morning…

HOPE: I was walking at a soccer field that's near my house when I first noticed, "Well that feels weird, my eye feels such a weird nagging eye pressure. Almost like my eye was bulging a little bit, from the inside out.

SRUTHI: It's so bad that she feels as if people can see it, like it's bulging so much, this one eye.

PJ: Can she, like if she stands in front of the bathroom mirror and stares at her face, can she feel like she can see her eye bulging?

SRUTHI: No. So it goes on for a couple of weeks, doesn't go away. And then she says you know what, I'm just gonna have this looked at.

HOPE: I actually just went to the eye doctor that's in Walmart, and she looked at my eye, and she didn't find anything at all wrong with the eye. The eye was perfectly healthy and normal.

SRUTHI: This bulging feeling, it goes on for a whole month. And then one day, she wakes up and it's gone.

HOPE: This would, be I should say this, this would be something in my life that I would probably never give a second thought to, this mild eye problem that I had for a month, if… what happened next hadn't happened.

SRUTHI: It's evening. Hope is working. She's a wedding photographer, and she's setting up room in her house where she can meet clients.

HOPE: And all of the sudden I stood up, and I couldn't see out of my right eye. I thought, "Oh my gosh, am I having a stroke?" I had field of vision in like three-quarters of the eye, but the one quarter was completely covered by this weird zigzag freaky thing. It's almost like a kaleidoscope when you were a kid, and you used to hold up a kaleidoscope to your eye and it would… it would like shine and shimmer, like a piece of mirrored paper in there. So I actually remember waking up my sister, and she said "what are you talking about?" and I said "I can't see out of my eye, I'm freaking out."

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Friday, November 6, 2015

Claims for Cryotherapy Treatment Get New Scrutiny After a Death - The New York Times

You step into an upright cylindrical capsule, padded on the inside and open on top. The floor grinds upward, and your head pops out. There's a whoosh. And suddenly you are encased in gas, below the neck, in a tank that is minus 300 degrees Fahrenheit — colder than the coldest naturally occurring temperature recorded on Earth.

These are cryotherapy chambers. When a woman named Chelsea Ake-Salvacion, 24, died in one in Nevada in October, it focused attention on the fast-growing but little-known practice of full-body cryotherapy, which enthusiasts bill as a path to pain reduction, injury recovery and mood enhancement. Among the many cryotherapy centers opening around the country, some go further, saying that the chambers prevent osteoporosis, treat asthma, increase libido and kick-start rapid weight loss. Celebrity athletes like LeBron James and Shaquille O'Neal have been among their earliest proponents in the United States.

In interviews, cryotherapy operators — some prefer the term "cryotherapists" — call the practice safe, noting that people have applied cold to injuries for thousands of years and that serious athletes routinely take ice baths. But the Food and Drug Administration does not recognize any medical benefits from cryotherapy chambers, nor does it regulate the devices. The death of Ms. Ake-Salvacion has many questioning the safety of the procedure and the claims of those who praise it.

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What It’s Like to Live With an Invisible Illness - The Daily Beast

"Just because I look normal...that doesn't mean I don't have a major disability." So reads a Facebook post from 24-year-old Ste Walker that has been shared tens of thousands of times and shone a light on the reality of living with an "invisible illness."

Ste, from Halifax, England, has Crohn's disease and "a number of other quiet ailments," which have resulted in him needing a range of medical aids from a stomach-draining ryles tube to a stoma bag.

Crohn's is a chronic inflammation of the intestines, which can result in severe pain, malnutrition, ulceration of the digestive tract, parts of the bowel needing resection or removal, and even cancer. Secondary issues include skin and eye inflammation, mouth and throat ulcers, and arthritis, among others. It is most commonly diagnosed among 15-30-year-olds, and there is no known cure.

Ste was prompted to write on social media after he bumped into an acquaintance at the hospital, who questioned why Ste was still there as he looked "fine." "It just made me blow my top. To release the anger, I wrote the post," he tells me.

"People are too quick to judge these days," his Facebook post began. "To look at me I look like any normal guy my age, but that's because I want you to view me like that...look a bit closer though, or ask me questions, and you will soon realize that I have a major illness."

Ste goes on to explain the grueling treatments he is undergoing that do not get seen: the Hickman line from his heart to his chest, feeding him both nutrition and medication as his stomach is unable to, the removal of large sections of his bowels, the scar that runs down his chest, marking where he has been operated on three times within two years for life saving surgeries.

Perhaps the most concealed ailment of all is the toll these illnesses have taken on sufferers' mental states. In the last 18 months, Ste has spent a handful of days here and there amounting to four weeks at home—the rest has been spent in hospital. He hasn't eaten a meal in two years. "There is a mental battle raging inside me all the time," he shared. "Being away from my family and friends, seeing what my illness does to them has a massive effect on my state of mind."

There are an estimated 1.6 million Americans with Crohn's and, like chronic pain, which affects 11 percent of the population, it is a largely hidden disease, with representations of disabilities in the news or popular culture usually reserved for more noticeable afflictions. But as Ste highlights, "invisible illnesses need to be seen. So much more needs to be done, and so much more awareness needs to be raised."

Though there have been other instances of what Crohn's sufferers deal with going viral—last year, a number of women began posting photos of themselves in bikinis, proudly displaying their stoma bags—it remains an illness that is widely misunderstood. "The next time someone says to me: 'well you look perfectly fine, why are you using that disabled toilet, or parking in that disabled spot, you're not disabled…' just stop and think maybe I just want to be fine or to feel normal, you don't know what I go through on a daily basis," he says.

"You don't know what goes on inside…so stop and think before you speak, think about the struggle I've gone through just to get out of bed and get dressed and try to look 'normal.'''

Ste's status has been liked some 63,000 times and more than 20,000 have shared it at the time of publishing, demonstrating, perhaps, that people are finally ready to acknowledge a debilitating illness that has long been overlooked.

How one of the most obese countries on earth took on the soda giants - The Guardian

Mexicans love their soda. Construction workers go to their jobs in the early morning clutching giant two-litre or even three-litre bottles. Babies in strollers suck on bottles filled with orange soda. In the highlands of Chiapas, Coca-Cola is considered to have magical powers and is used in religious rites.

In fact, Mexicans drink more soda than nearly anyone else in the world; their top three daily sources of calories in 2012 were all high-calorie drinks. Mexico also has by far the world's highest death rate from chronic diseases caused by consumption of sugary drinks – nearly triple that of the runner-up, South Africa. In other words, excessive consumption of soda kills twice as many Mexicans as trade in the other kind of coke that Mexico is famous for.

But Mexico also loves the soda industry. Vicente Fox, who in 2000 became the country's first democratically elected president, had earlier been president of Coca-Cola Mexico and then head of the company's Latin American operations. The symbolism was noteworthy: soda companies – particularly Coke, which controls 73% of the Mexican market (compared with only 42% in the US) – have amassed extraordinary influence over health policy in Mexico.

The consequences of this became apparent in 2006, when the release of Mexico's National Survey of Health and Nutrition revealed that diabetes – the country's leading cause of death – had doubled since 2000. Between 1999 and 2006, the average waist size among women of childbearing age increased by nearly 11cm. And during the same period, obesity among children aged five to 11 rose by 40%. No other country in the world had experienced a rise in obesity of that magnitude – Mexico was on its way to becoming the fattest major country.

The 2006 obesity statistics sounded an alarm in Mexico. The country's then health secretary, José Ángel Córdova Villalobos, approached Juan Rivera, the founding director of the Centre for Research in Nutrition and Health at Mexico's National Institute of Public Health – perhaps the country's most prominent nutrition scientist – and asked him for recommendations to combat the obesity epidemic.

Rivera laid out a programme, involving various parts of the government, to educate the public, encourage behaviour change, and regulate advertising, among other things. "That's very complicated," Córdova said. "You're an academic. I'm a politician – I'm very pragmatic. Choose one thing."

Reduce soda consumption, Rivera replied. The health survey showed that soda intake had more than doubled among adolescents between 1999 and 2006, and nearly tripled among women. So Rivera worked with a group of Mexican and US nutritionists to produce a diagram shaped like a jug with layers of various drinks to illustrate the ideal balance for daily beverage intake. The idea was to put a poster with the jug in every health centre. "It never happened," said Rivera. "Opposition from the industry was tremendous."

As Mexico began to grapple with obesity, and soda's role in it, the industry began to counterattack with the argument it uses everywhere that soda is under siege. "Obesity comes from taking in more calories than you spend," said Jaime Zabludovsky, chair of the board of ConMexico, the processed food and beverage producers' group. "If Michael Phelps eats 5,000 calories a day and swims 10km, there is no problem. If you eat 2,000 calories per day but don't move, you have a problem. The source can be soda, tortillas, chocolate, sandwiches, fritanga, bagels – there is not any product that in itself causes obesity."

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Wednesday, November 4, 2015

Big and deadly: Major foodborne outbreaks spike sharply - The Washington Post

Major foodborne outbreaks in the United States have more than tripled in the last 20 years, and the germs most frequently implicated are familiar to most Americans: Salmonella, E. coli, and Listeria.

In the most recent five-year period -- from 2010 to 2014 -- these multistate outbreaks were bigger and deadlier than in years past, causing more than half of all deaths related to contaminated food outbreaks, public health officials said Tuesday. A wide variety of foods were involved, ranging from vegetables and fresh fruits to beef and chicken. Some had never before been linked to outbreaks, such as the caramel apples, tainted with Listeria, that led to an outbreak in which seven people died and 34 were hospitalized in late 2014.

Just last weekend, a rash of E. coli cases in Washington state and Oregon prompted Chipotle to temporarily shutter 43 of its restaurants there. No deaths have been reported. On Tuesday, health officials in Oregon and Washington said the number of cases has jumped to at least 37, with 25 in Washington and 12 in Oregon.

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Tuesday, November 3, 2015

Nearly 60 percent of Americans — the highest ever — are taking prescription drugs - The Washington Post

Nearly three in five American adults take a prescription drug, which is up markedly since 2000 because of much higher use of almost every type of medication, from antidepressants to treatments for high cholesterol and diabetes.

In a study published Tuesday in the Journal of the American Medical Association, researchers found the prevalence of prescription drug use among people 20 and older had risen to 59 percent in 2012 from 51 percent just a dozen years earlier. During the same period, the percentage of people taking five or more prescription drugs nearly doubled, to 15 percent from 8 percent.

One likely factor driving the increase in prescription drug use: Obesity.

Researchers noted that eight of the 10 most commonly used drugs in the United States are used to treat hypertension, heart failure, diabetes or other elements of the "cardiometabolic syndrome." In addition, another frequently prescribed drug treats gastroesophageal reflux, a condition that's widespread among people who are overweight or obese.

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Monday, November 2, 2015

A group of middle-aged whites in the U.S. is dying at a startling rate - The Washington Post

A large segment of white middle-aged Americans has suffered a startling rise in its death rate since 1999, according to a review of statistics published Monday that shows a sharp reversal in decades of progress toward longer lives.

The mortality rate for white men and women ages 45-54 with less than a college education increased markedly between 1999 and 2013, most likely because of problems with legal and illegal drugs, alcohol and suicide, the researchers concluded. Before then, death rates for that group dropped steadily, and at a faster pace.

An increase in the mortality rate for any large demographic group in an advanced nation has been virtually unheard of in recent decades, with the exception of Russian men after the collapse of the Soviet Union.

The rising death rate was accompanied by an increase in the rate of illness, the authors wrote in the Proceedings of the National Academy of Sciences.

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Sunday, November 1, 2015

Book Review: ‘Ending Medical Reversal’ Laments Flip-Flopping - The New York Times

"Ending Medical Reversal" is a subtly subversive book in need of a considerably snappier title. "OOPS!" perhaps, or "Are You Kidding Me?"

This last was the reaction of a diabetic patient described by the authors who, after years spent dutifully following the most spartan of diets in order to keep his blood sugar in check, just learned he needn't have bothered. The goal his doctor (and doctors everywhere) were routinely setting for their patients had just been proven by a new study to be far too stringent.

All that broiled fish, all those unbuttered green beans, all that willpower, all for nothing. Oops.

This kind of medical whiplash is increasingly common and every bit as scary and damaging as the physical kind. What was good for you yesterday is useless or even bad for you today (and may be good for you again tomorrow; who knows). Medical gospel is rewritten daily on the evening news.

The incremental progress of ordinary science is one thing, as individual treatments are progressively replaced by better variants. We all happily accept that kind of revision. But medical reversal, the authors' sober term for sudden flip-flops in standards of care, unnerves and demoralizes everyone, doctors no less than their patients.

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