Trust me when I say this is information every parent should know; it’s why I agreed to partner with Med-IQ to spread the word. But first, let’s talk about what exactly inflammatory bowel disease is because I am a stickler for defining terms. It must be all of that time I spent in medical school.
It’s important to understandthat inflammatory bowel disease (IBD) is NOT the same as irritable bowel syndrome (IBS). The “I” stands for very different things, butI often hear people using “inflammatory” and “irritable” interchangeably.
IBD (remember, “I” = inflammatory) is actually a collection of diseases, the two most common of which are Crohn’s disease (CD) and ulcerative colitis (UC).
CD is inflammation that can affect any part of the gut, from the mouth all the way down to the anus. It can progress from mainly superficial inflammation in the lining of the intestine to a deeper inflammation that burrows into nearby organs or through to the skin. There can also be scarring that narrows the intestines and causes blockages that can lead to hospitalizations and surgeries.
UC is inflammation that is confined to the large intestine (colon). Complications can include toxic megacolon (an emergency condition where the colon dilates), and in the long-term, colon cancer.
IBS (remember, “I” = irritable) does not involve inflammation, and having IBS does not make you more likely to develop other colon conditions like UC, CD, or colon cancer. Although IBS can produce cramping, abdominal pain, and diarrhea like IBD, it does not have the IBD symptoms of bloody stool, lack of appetite, weight loss, and fatigue.
So now that we know exactly what we are talking about, let’s discuss why it should be on your radar as the parent of a teen.
Nearly 25% of people with IBD are diagnosed during childhood or the teen years.
In 2015, 1.6 million people were treated for IBD, and 80,000 of those were under the age of 18.
Taking these numbers into consideration, it is important to also understand that adolescents have a way of adjusting to a “new normal” when they don’t realize what they are experiencing is unusual. For instance, they may have diarrhea so routinely (and associate it starting with something they ate so completely) that it’s just a way of life for them that they never think to mention. If you hear frequent complaints like “my stomach hurts,” it’s time to dig a little deeper.
Ask about the following symptoms, and remember these can fluctuate over time:
Diarrhea
Rectal bleeding
Urgent need to move bowels
Abdominal cramping and pain
Sensation of incomplete evacuation (feeling like you have to “go” even after you “go”)
Constipation
There are also non-specific symptoms associated with IBD including fever, loss of appetite, weight loss of 5% of body weight, fatigue, night sweats, and loss of a normal menstrual cycle. You can also experience joint pain, eye inflammation (uveitis), painful lumps on the shins, and mouth ulcers.
If your child appears to have even one of these symptoms, it’s time to make an appointment with your doctor because fast and aggressive treatment with immunomodulators or biologic agents can induce remission, heal the bowel wall, and reduce the number of future hospitalizations and surgeries. Starting with these agents improves the overall quality of life more than past therapeutic strategies in which treatment would start with less-intensive therapies and only “step up” if symptoms didn’t improve. Common prescription medications to treat IBD can be found here.
To prepare for your appointment:
Be aware of any pre-appointment restrictions (like fasting)
Write down symptoms
List all medications
Schedule a family member or friend to bring along
Write down questions to ask the doctor
There is a fantastic app for tracking symptoms called GI Buddy.
More general information about IBD and preparing for appointments can be found on the Mayo Clinic website.
Useful information is presented during this Q&A Session with IBD expert, Dr. Hanauer. I especially found the probiotic discussion informative.
If your child is diagnosed with IBD, support groups are available:
Remember, knowledge is power and early, intensive treatment can not only improve your child’s quality of life right now, it can reduce complications later down the road.
-Ellen
I was compensated by Med-IQ through an educational grant from Takeda Pharmaceuticals U.S.A., Inc. to write about the signs and symptoms of inflammatory bowel disease. All my opinions are my own.
Furthermore, this post does not constitute medical advice or diagnosis. Contact a medical professional with any symptoms, questions, or concerns.
Links are being provided as a convenience and for informational purposes only; they are not intended and should not be construed as legal or medical advice nor are they endorsements of any healthcare provider or practice. Med-IQ bears no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.
Okay relax. There will be no pictures because TMI is not my thing, and I try rather diligently not to mortify my teens.
What is my thing is sharing brilliant solutions . . . that drop into my lap. You know how when you’re shopping around online and there are suggested products that pop up in the sidebar? Well, sometimes it’s terrifying how spot-on the internet elves who choose the recommendations actually are.
About a month ago, an electric razor popped up for me.
And now it’s living in my bathroom because review after review said it gave a close shave without a rash. Maaaaayyybbeee everything you read on the internet isn’t exactly true, but for $19.99 it was a no-brainer after what I have spent to banish those little bumps.
I have tried waxing and it made my skin very, very angry. And then I tried waxing again when I was fed the hype that it was actually dirty wax that caused the bumps. First of all, ewwwwww. Secondly, I’m pretty sure it was the molten hot wax ripping the hairs out by the roots that played a major part. I not only got a rash immediately after the torture, I got ingrown hairs when they started to grow back through my traumatized skin.
Oh, and then I tried laser hair removal: fairly painful, REALLY expensive, and a total waste of time for me. Sure the hair was sparser, but there was still hair so what was the point? I just had a little less hair to remove with some other method. I even went through two rounds spaced months apart to catch the hair that was in a dormant growing phase during the first round. Apparently, I have hairs that plaque me every other day now with their growth spurts, but were napping during the entire eight months of laser time. Sure.
That left me with plain ol’ shaving . . . and bumps all of the time. I tried depilatories like Nair, but who has that kind of time? And that smell? Yuck.
So basically, tons of money and time later, I was relegated to wear bathing suits with skirts. Now, don’t get me wrong, skirted suits are super cute, but sometimes you want to be able to choose something else.
But I have freedom of choice once again thanks to the Panasonic ES2207P Ladies Electric Shaver! Within one week of using it with post-shaving dabs of my secret solution of antibiotic and cortisone creams, my bikini line was smooth and clear. (More about that in a bit.)
You can use this razor wet or dry and the charge lasts forever. The pop-up trimmer is what gets in there close, but it honestly doesn’t get quite as close as a regular razor so I have to use it every day. I have no problem with that because the bumps are banished! Also, I no longer have any ingrown hairs because the hair is not short enough to get trapped when it starts to grow. I use the tiny dabs of antibiotic and cortisone cream after each use once I dry off to make sure everything stay smooth and clear.
So there you have it. This isn’t a sponsored post (it does contain affiliate links: you can buy it here), I just wanted to share the solution I have been searching out for decades. Hallelujah! No go forth and enjoy bathing suit season any way you see fit. The freedom is yours now.
You know when you get treated wrongly and you think of the perfect thing to say or do to give the bullies their comeuppance?
Me neither. At least not 99.87% of the time.
But no matter because you know what happened in that 0.13% sliver of chance? Not a thing except the opportunity to serve up the biggest heaping dose of karma EVER. If you’ve never had the chance to bury your own hatchet, by all means, live vicariously through me. Underdogs of the world unite!
My tale of triumph took place during my internship on Labor and Delivery. To be more specific, it was 2:00 am and I was on call at the private hospital where we did rotations. Working in this hospital was a little different than when we were at the university one. Here, very few patients were “ours.” These women had private doctors whom they had lovingly and thoroughly researched, interviewed, and selected. Exhaustively and with extreme commitment. All of this research was frequently laminated and saved in binders as prologues to their twenty-five page birth plans.
Unfortunately for them–and really me–these ladies often had not read the fine print:
Your doctor has a sweet deal at a teaching hospital. This means he has residents as his scut monkeys to do the majority of his labor (pun intended and reveled in). The resident’s job is to stay up for ungodly stretches of time caring for you while absorbing your ire. Your physician will glide in just minutes before your baby crowns. He is NOT coming in to triage or to supervise your labor because let’s be honest, he’s just not that into you.
Yeah, no one was ever pleased about not seeing THEIR doctor “right now!” so I thought my new preterm labor patient in triage was just having the typical indignant reaction when she saw me pop through the curtain. The indignation always amused me because in triage, I reigned as judge and jury, deciding who got to stay and who shouldn’t let the door hit her on the way out. Staying was a good thing when you wanted your spawn out yesterday, not so good when you were preterm.
As I strode into the room, the patient jerked up in bed and practically levitated. She was twenty-seven weeks pregnant, so preterm labor was a scary situation. My eyes flew to the fetal monitor, but no contractions were registering. In the blink of an eye, I introduced myself, asked the patient if she was in pain, and moved to adjust the monitor on her belly.
“Are you having contractions?” I asked as I moved the monitor around, reassured to see the strong and responsive fetal heart rate.
“No,” she squeaked.
I was scanning her chart to see if she was a preterm labor risk, but her strangled response tore my eyes away from the chart.
“You seem to be in a lot of distress. What’s going on?” I asked.
“I had a little spotting and some pressure so Dr. Busyonhisyacht wanted me to come in and be monitored.”
“Do you feel any contractions now?”
“No,” she stammered.
“Well that is excellent, but I’m going to need to do an exam with the speculum to see if you are dilated or have any rupturing of your membranes.”
“Where is my doctor!?!!” The squeak was now so shrill it could have cracked a wine glass. Or my nerves.
I replied, “It’s standard procedure here for a resident to exam you and report to your doctor what is going on. Using this information he will make decisions about your care.” Implied but not stated: On a side note, I would not piss me off because I will have my hand up your vagina in about five minutes. Just sayin’.
“But won’t he come in for ME?”
Poor delusional thing. “No, Sweetie, I’m sorry. And besides, we need to know now if your cervix is changing for the safety of the baby. We can’t wait for him to drive in.”
“You don’t remember me do you?”
Mental Rolodex whirred furiously. I am abysmal at remembering people on a good day. I had been working for twenty hours, so I had no hope .
“We were in the same suite in college,” she whispered. She at least had the decency to look ashamed.
Insert screeching brakes and a twelve car pile up in my head. This was the girl who had tag-teamed with my other suite-mates to inflict misery upon me for five months of my junior year. Sleep deprivation was not the culprit here. My brain was functioning under the protection of denial and repression.
At my college, getting into the fabulous upperclassmen suites was an exercise in backroom politics. It was all about who you knew. People already living in the suites got to pull other people in. At housing lottery time, the schemes, bribery and treachery flew around like glitter during a pole dance.
After countless hours of wheeling and dealing, I thought I got pulled into the Nirvana of all suites. It was two stories with five bedrooms, a kitchen, and a living room. I pulled my good friend into my room with me. We even had our own bathroom.
Well, to put it simply, things went to hell when the girl who pulled me in unexpectedly moved off campus and we ended up in this suite with four rooms of the cliquiest Mean Girls whom we enraged with our very existence. We had blocked the final members of their Axis of Evil from moving in and they were bent on making us pay.
They were pros at tormenting us. Some of their attacks were blitzkreig-esque like when they threw our pots and pans away or when they dumped our possessions out into the stairwell. Sometimes the torture had more of a prisoner of war flavor when they would place speakers up against our door or they would jack up the thermostat. We counted ourselves lucky when they were just calling us names.
My friend and I lived like hermits behind our locked bedroom door until we could be liberated at the end of the semester. We tried to have as little contact as possible with the other girls.
But here SHE was . . . about to have a lot of contact with me. Can you imagine? Regret served up on a speculum. Sounds like the worst country western song ever.
I treated her professionally, and thank goodness she was not in preterm labor. But in those wee hours of the morning, as I snapped on my gloves, I like to think that I not only served up great patient care, but I delivered the most epic dose of karma a Mean Girl has ever had to swallow.
In April 2014 I wrote about vaccines because there was a measles outbreak in New York City. An outbreak that should never have happened because there is a safe MMR (Measles/Mumps/Rubella) vaccine. With the dawning of outbreaks in Disneyland, and now possibly Arizona, it’s time to revisit the proof again.
And I am talking PROOF. Not what you read in a Facebook feed. Not what you overheard in your child’s playgroup. Not some anti-vaccination propaganda vomit dressed up as a scientific paper. Have you ever followed the supposed references listed at the end of those articles? I have. They lead to more bias drivel—if not outright lies—not scientific research.
I am very picky about nuances like that because I went through the rigors of earning a Microbiology B.S. and an M.D. from the University of Maryland. I’m not practicing medicine at this time, but I know vaccines are safe because I understand research. I have performed research myself and have extensive training in how to evaluate it.
I am not swayed by the hype that drives ratings sweeps and cranks up website pageviews. I have been on the inside of the medical profession and here’s a news flash: most doctors really do want to help humanity. Heck, most of us are too exhausted to concoct Evil Plans to Ruin the World. Why do you think the media always latches onto that one doctor who supports the anti-vaccine movement? Because generally, they can only find one or two out of about one million United States physicians. It’s easier to find a psychopath since they make up 1% of the population.
Also, while Big Pharma is a favorite punching bag, the fact is they manufacture the drugs and devices that save our lives. Also? While they do make profits off of vaccine production (as they should), they would make more money from treating the diseases the vaccines prevent. There is no Soylent Green conspiracy. It’s just medicine and business. It’s American altruism and capitalism. They are not mutually exclusive.
But speaking of America, we have rights and freedoms! You can make your own choices about vaccines! True . . . but not completely. I understand that as an individual, it may seem like no big deal for YOU to skip immunizations for your kids or to alter the administration schedule. Unfortunately, in this case, we are all in this together. You are part of a community or in immunological terms, a “herd.”
It all comes down to herd immunity: the collective level of inoculation that protects even the unvaccinated. When many people are immunized, it doesn’t leave a place for the diseases to “breed and live.” When the community at large is protected, it means people who are not eligible to be vaccinated—such as infants, pregnant women, and immunocompromised people—get some measure of protection from the disease because the collective community immunity doesn’t give it room to spread. This also means that even if a vaccine is not 100% effective (and none of them are because biology doesn’t work that way), people are unlikely to get sick because the disease is just not around.
So if YOU decide not to vaccinate your kids in an area with high immunization rates, your children will probably be fine. They’re getting the benefits from your community’s responsible actions.
And guess what? You’ve not only put your children at risk, but you’ve also put those at risk who can’t be vaccinated, like people fighting cancer with chemotherapy.
Oh, and one more thing, YOU may be at risk too. Up to five percent of children vaccinated fail to develop immunity and sometimes immunity can wane, but this is usually overcome by giving a second dose of MMR before entering school. However, the second dose policy was not implemented until 1989. Did you get that second dose? You’d better find out because the herd is not what it used to be. We’re moving to a wild-west-every-man-for-himself mentality.
The decision not to vaccinate seems to sprout like a fungus from false beliefs such as:
Vaccines cause autism.
Childhood illnesses are no big deal unless they cause death.
Lawsuits equal scientific proof.
1. False Premise: Vaccines cause autism.
A few things first. I understand that scientific papers are hard to slug through. And not all research is created equal. Studies that are observational, do just that, observe what has already happened. These rely heavily on patient reporting.
This is a weaker study than the gold standard, randomized controlled trials, in which the subjects are randomly distributed into groups which are either subjected to the experimental procedure or which do not receive it and serve as controls. In this kind of study, there is less bias and it is easier to weed out coincidences.
Also, published research is not a proclamation of fact. It is a sharing of what has been discovered to advance science. It doesn’t mean it is flawless. “Discoveries” do not come from a single paper. Multiple scientists must replicate and advance a finding before a real “Eureka!” moment is reached.
It’s easy to forget this when the press latches onto a concept like “MMR causes autism,” and pukes it from the rooftops to stir panic and fear because that keeps you coming back for more.
All of the MMR vaccine misinformation can be traced back to one paper. The link between this vaccine and autism was proposed by a British physician, Andrew Wakefield, in the February 1998 issue of The Lancet. This finding has never been replicated by any other researchers. More importantly, it was discovered to be manufactured from fraudulent data and has been RETRACTED.
There were only twelve children in the observational study–this means that even if the findings were true, they really only provided a starting point for other research, not for conclusions. However, that hardly matters since the entire causal effect was based on what the parents reported as the length of time from the administration of the vaccine to onset of autism spectrum symptoms AND THAT DATA WAS FALSIFIED. The timelines of the children’s symptoms were misrepresented.
Also damning was Wakefield’s conflict of interest. How could an article with such a small sample size and the title, Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children, cause such a fervor? Wakefield had an agenda to advance because he was a paid consultant to attorneys representing parents with anti-vaccine lawsuits. The General Medical Council in the U.K. revoked Wakefield’s medical license because of his fraudulent report and unethical behavior.
What is atrocious is that it took until 2010 for that paper to be retracted and for Wakefield to lose his license. For over a decade the fires of misinformation have been fanned and stirred into a bonfire so raging that five years after it should be extinguished, it is still smoldering. Why is this paper still used in arguments in 2015?!
But the controversy has expanded. The original autism scapegoat was the MMR vaccine, but the blame game has subtly shifted to focus on the ethylmercury vaccine perservative, thimerosal. This shift was spurred more by activist and political groups than science. Regardless, thimerosal has been removed from vaccines, mostly since 2001.
My heart breaks for the parents who are just looking for answers for their children on the autism spectrum, but I seethe over all of the money that has been diverted from worthwhile autism research to prove over and over again that vaccines are not linked to it. With the combined studies to date, millions of children have been studied and no link has been found.
2. False Premise: Childhood illnesses are no big deal.
In the United States, some parents mistakenly think that refusing vaccinations is a benign choice because they do not remember, or maybe they have never even seen the diseases. But these childhood diseases aren’t just spotty rashes or coughs. They can cause lasting disabilities, and at times death. At the very least, they cause weeks of suffering for the patients, and prolonged time off from work for caregivers. Because these are viral diseases, there is generally no specific treatment once they are contracted.
Here’s a heart stopper. For measles encephalitis (swelling of the brain) which occurs in 1 in 1,000 patients infected with measles, the treatment is still just supportive: rest, fluids, and nutrition. Ribavirin may help, or it may not. There’s not a whole lot of current research going on because measles was declared eliminated in the United States in 2000. So really the treatment is no better than it was when author Roald Dahl’s daughter, Olivia, died from it in 1962. The only difference is he did not have the choice to vaccinate his daughter because it was not available until 1963.
Oh and if your child contracts measles before they are 2-years-old, you get to be on the lookout for subacute sclerosing panencephalitis (SSPE), a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles. So that herd immunity is pretty important for infants before they can be vaccinated because the worry never ends.
Thank goodness those complications are rare, but don’t forget measles can cause diarrhea (dangerous for young children because of dehydration), pneumonia, ear infections, deafness, and blindness. An acute infection with measles while pregnant can lead to premature birth.
I can’t believe in the middle of my scientific citations, I’m linking to Buzzfeed, but if you want to see what measles really looks like, they have an excellent article.
While court decisions can be be based on scientific proof, scientific proof cannot come out of court decisions. Just because a jury awards money in a vaccination lawsuit does not prove that vaccines are bad. Many decisions are based on the skills of the lawyers and the height of the emotions.
When discussing adverse outcomes of immunizations, the Vaccine Adverse Event Reporting System (VAERS) is often bandied about. This is a tremendously useful surveillance tool co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) that allows doctors and the public to report any adverse events they think may have been associated with vaccine administration. It receives around 30,000 reports annually.
What it is:
A gathering of unfiltered information. Anyone can submit. (About 7% are from vaccine recipients or their guardians, 36% are from health care providers, and 37% are from the vaccine manufacturers.)
A place to monitor adverse vaccine events.
A tool to trigger further investigation if correlations are shown.
What it is NOT:
It is NOT the final outcome from research triggered by trends.
It does NOT show causal relationships.
No conspiracy theories necessary. (Did you notice the biggest contributor of information was Big Pharma itself?) And it works as can be seen in the case of the RotaShield vaccine.
VAERS detected reports for cases of intussusception (a condition where part of the intestine slides or telescopes into an adjacent part of the intestine) over what would be expected to occur by chance alone after the RotaShield rotavirus vaccine came out in 1999. Epidemiological studies were triggered and confirmed an increased risk, which contributed to the product’s removal from the US market.
For RotaShield, a risk was apparent less than a year after release, it was investigated, and the vaccine was removed. The MMR vaccine was released in 1971 to replace single doses of each viral vaccine that had been around for a decade longer. You can feel confident about its safety. I do.
My oldest child was born in 1998 and was due for her first MMR vaccination in 1999, right when the Wakefield autism hysteria was gaining momentum. My husband and I had her vaccinated. I had read Wakefield’s paper for myself and realized the flaws. Also, a well performed study by Brent Miller was already published. He studied 498 children and could not find a link between the MMR vaccine and autism.
Since that time, millions of children have been studied and no links have been found with autism. In fact, the vaccine has been shown to be exceptionally safe on all accounts. Those who claim otherwise are lying or deceived by unreliable statistics. You can read a very good article about this in layman’s terms here.
Please weigh the scientific evidence versus popularized fraud when making decisions for your kids. Your decision not only affects them, but the health of the whole community. Don’t let herd immunity die.
Our question this week is how to flip the switch that will change your couch potato cake-gorging ways. We talk about Fitbits, food plans, and Ellen brings some hard core doctor advice.
What can help you flip your switch? Just hit play on the soundbar at the bottom of the post.
Now you were promised the recipe for stuffed pepper soup, but we’re going to give you even more. Here are THREE recipes you can make at the same time. If you’re browning one pound of ground meat, you might as well brown two and have dinner and lunches done for the whole week.
You can follow the links to the fully printable recipes, but here are Ellen’s tips for assembling the soup, Mexican casserole, and Greek beef at the same time.
When making these recipes all at once, Ellen typically uses one pound of extra lean ground beef and one pound of extra lean ground turkey.
She browns the turkey with the onions and peppers for the soup in her soup pot (because it cooks with very little fat draining off). She cooks the beef with the onion and the pepper for the Mexican casserole in a skillet. She drains both separately and removes her quarter cup of ground beef for the Beef with Greek Yogurt Sauce. but then returns half of the turkey to the skillet and half to the soup pot. She does the same for the beef, trying to get more of the peppers back in the soup pot.
She then proceeds with all three recipes. It’s a lot of cooking, but then you have dinners and lunches for days. So worth it.
Now these recipes weren’t the only resources mentioned. Another tool we talked about was this little guide that is so very useful for planning what you are going to eat when you go out:
Now while you can easily get this awesomeness on Amazon for under $9.00, Ellen mentioned another book that is unfortunately out of print: The Skinny: How to Fit Into Your Little Black Dress Forever by Melissa Clark and Robin Aronson. So since you can’t easily buy this for yourself, we’ll share the two philosophies in it that first helped Ellen “flip her switch.”
1. Eat what you want and banish the guilt. If you really want a food, there is a portion and a way to work it into your day.
2. You can indeed eat a few bites of something decadent, like cake, enjoy each bite, and know that there will be bites of cake in your future. You don’t have to consume it all right now.
Keeping these two philosophies in mind are a great way to supplement a diet plan so that you can kick boredom, bingeing, and guilt to the curb . . . along with your fat pants.
By the way, we were raving about the positive reinforcement our Fitbits give us. We both have Zips. You can look at the details and buy one here:
Three years ago, we asked the question that started it all, “What’s a blog?” We have been sharing stories from our test lab of parenting ever since. Ever wanted to hear some of those conversations for yourself?
Well, look who’s talking now! Check out our “What’s New” on the blog—our new podcast.
Welcome to the Sisterhood of the Sensible Moms Soundbites!
Click this to hear our very first podcast!
Stick Around! There are more where these came from!
I know I have a loathe/hate relationship with WebMD, but this is not my prejudice talking. Heed my warning and do not go there. You just might land on this little charmer of a video and if you harbor even a little spark of anxiety over Ebola, it might be ignited into a raging bonfire of panic:
It starts out, to quote: “Everyone knows that Ebola kills, but what exactly does it do?”
Whew! Glad he started out with a little reassurance.
Followed by: “This worm-like virus has a devious way of working.”
Way to soothe by personifying a hunk of RNA with the intentions of a villain.
But at least he follows up with this: “In the current outbreak, 60% of the people have died.”
Where? Where are you talking about?! My local Shoparama?!
It’s not until the last few seconds of the video that we get: “The risk of catching Ebola is extremely low in the U.S.”
Well, hope you were able to grab some smelling salts and hang in through the “particle explosions of virus” storming through your body and “bleeding from your eyes” to get to that part.
Don’t get me wrong. Everything in that video is accurate and Ebola is serious. Serious for the people in West Africa where in the current outbreak there have been more than 4,900 deaths. But keep in mind, those deaths are out of about 10,100 cases, making the rate of death below 50% even with what we would consider sub-par medical care.
In contrast, in the United States, there have been 4 confirmed cases out of a population of almost 319,000,000. There has been one death and he contracted it in Liberia. There are contentions that his diagnosis was delayed, but I wouldn’t lose sleep about future misdiagnoses. Anyone with a fever is prompting cries of “Is it Ebola?!”
Let’s focus on the “to date.” Here’s a fun fact, Ebola was first recorded in 1976. This isn’t some new-fangled disease. The people of Africa have suffered through outbreak after outbreak for about four decades. It’s just that the American public didn’t really take notice until it flew onto our doorsteps.
It was the same way with HIV. The first HIV/AIDS epidemic took root in Africa in the 1970s with the spread of the disease exploding in the 1980s. But Americans only really became concerned when it landed in Los Angeles; and it didn’t take long for that concern to rocket to hysteria. The rampant fear spawned discrimination and hate crimes: children were banned from schools. adults lost their jobs, and houses were burned down.
During my medical training, I started my rotation on the HIV infectious disease ward when fears were still bubbling and the FDA approval of life-prolonging multi-drug therapies was still on the horizon. Heck, at the time, AIDS was the leading cause of death for all Americans ages 25 to 44.
But I was not afraid. Because science.
I knew HIV was spread through bodily fluids and I wore my gloves and face shields. With scientific evidence as my guide, I calmly and compassionately took care of those HIV patients.
You need to know, though, that I am not cavalier. There are some things that get me jittery, like diseases with a respiratory route for transmission. We canceled our trip to Mexico in 2009 when the H1N1 pandemic was gripping the world. I did not want to end my vacation in quarantine because an infected person happened to be sharing the recirculated air with me on my tin can of an airplane. If I had to choose between snakes or swine flu on a plane? I would pick the reptiles all day long.
With this evidence and background, I present without further ado, my reasons for NOT panicking over Ebola.
Top 3 Reasons NOT to Panic over Ebola
1. It is NOT transmitted though the air.
To become infected, a healthy person’s broken skin or mucous membranes must come in direct contact with the blood, or other bodily fluids (stool, urine, saliva, semen) of a symptomatic, infected person. Infection can also occur if broken skin or mucous membranes of a healthy person come into contact with environments, such as soiled clothing, bed linen, or used needles, that have become contaminated with an Ebola patient’s infectious fluids .
2. Ebola is highly infectious, but moderately contagious.
Infectious and contagious are not interchangeable. Ebola is highly infectious because only a small amount of the virus is needed to cause disease, BUT it is only moderately contagious because it requires direct contact to catch it. To reiterate: Ebola is not spread through the air, water, food, or mosquitoes.
3. Ebola is not transmissible if someone is asymptomatic.
There are no silent carriers sneaking around amongst us. A person has to be sick to spread it. Even if someone is starting to be ill with a fever and fatigue, they are still not that contagious. Spread of infection becomes very risky once a patient’s bodily fluids are exploding forth because of violent vomiting and diarrhea. By the time a patient is this sick, he or she is incapacitated and not moving about in public.
There you have it. Ebola has gripped our attention because the disease, once contracted, progresses so quickly and is so visibly horrifying; but there is no reason to worry that it is going to storm through our country via casual contact. Be concerned, but do NOT panic. In fact, you may want to save your worry for the health care providers who are treating Ebola patients. Worry that they are following recommendations for personal protective equipment and environmental infection control. Say a little prayer of thanks that there are people willing to take care of us.
And maybe be a little grateful that with this new and glaring Star Spangled spotlight, efforts are finally intensifying to find vaccines and treatments for all of the world.
Why did the NFL have to see the video of former Baltimore Raven, Ray Rice, actually hitting his then-fiancée to take serious action? Well, actually, the NFL needed to have the public see the video of Rice hitting his fiancée to take action, but that is another ugly side of this tale. For now, I’m perplexed that the video of Rice roughly dragging her unconscious body out of the elevator like a sack of laundry and his confession to hitting her, were only enough to warrant a two game suspension.
Have we become such a visual nation with Instagram, Vines, and YouTube that if we can’t see it, then we can’t imagine it? I’ve been guilty of texting a friend attending a star-studded event, “Take a picture or it never happened.” Please, Dear Lord, don’t let that be the case with domestic violence.
It is coincidental that Baltimore, Maryland is the stage for this drama because that’s where violence became more than just the nightly news for me. Working at the University of Maryland Hospital took the brutality that I had previously “tsk, tsked” over in the safety of my living room, and dumped it squarely in my lap.
There, as a fresh-faced med student, I had to retract the eyelid of a screaming, writhing woman so the ophthalmologist could see if her retina was detached by the brutal pistol whipping delivered by her boyfriend. I discovered there were some chinks in the armor of my steel stomach after all.
During my rotations through the ER, I had to collect rape kits on victims who decided the “I love you-s” were empty and it was time to press charges. I cried over what I had to do to these women to collect evidence.
As an OB/GYN resident, I had to hide a patient on another hallway and work around an armed police officer because her husband had sent her into labor with a kick. He was still at large and dangerous to us all.
I mercifully did not see the violence that rained down on these women, but I saw the aftermath, so I could imagine the horror. But more importantly, I cared enough to imagine the horror.
The NFL, of all organizations, should not abide by “seeing is believing.” Their referees frequently can’t make the right calls, even with instant replay.
There shouldn’t have to be photos or footage to provoke outrage over the cracked ribs, fractured cheekbones, and broken spirits. We should be able to use compassion to decode those injuries into the violence that produced them.
Please, Dear Lord, don’t let “Take a picture or it never happened” be our standard for domestic violence.
The recent outbreaks of measles in the United States hurt my scientific heart. And I say “heart” not because the way I regard vaccines is based on a feeling or what a Playboy Bunny said or a real estate mogul tweeted, but because there are children who are seriously ill who could have been protected.
My scientific brain that was put through the rigors of earning a Microbiology B.S. and an M.D. from the University of Maryland is not happy either. I’m not practicing medicine at this time, but I know vaccines are safe because I have read and evaluated the scientific research. I am not swayed by the hype that drives ratings sweeps and cranks up website pageviews. If the MMR (measles/mumps/rubella) vaccine was a cartoon, many would draw it with a pitchfork and horns.
I understand that as an individual, it may seem like no big deal for YOU to skip immunizations for your kids or to alter the administration schedule. “It’s MY right. I’m just being safe.” Unfortunately, you are part of a community or in immunological terms, a “herd.”
It all comes down to herd immunity. When many people are immunized, it doesn’t leave a place for the diseases to “breed and live.” When the community at large is vaccinated and protected, this means that people who are not eligible to be vaccinated such as infants, pregnant women, and immunocompromised people also get some measure of protection from the disease because the collective “community immunity” doesn’t give it room to spread. This also means that even if a vaccine is not 100% effective, people are unlikely to get sick because the disease is just not around.
So if YOU decide not to vaccinate your kids in a community with high immunization rates, your children will probably be fine. They’re getting the benefits from your community’s responsible actions.
The problem comes when you “herd” yourself with other anti-vaccinators. You create a lovely pool for the disease to infect and spread as can be seen in New York City. We live in a global society and measles is still out there because of fear mongering and because OTHER COUNTRIES CAN’T AFFORD THE VACCINE.
And guess what? You’ve not only put your children at risk, but you’ve put those who can’t be vaccinated, as mentioned before, at risk also.
Oh, and one more thing, YOU may be at risk too. Up to five percent of children vaccinated fail to develop immunity and sometimes immunity can wane, but this is usually overcome by giving a second dose of MMR before entering school. However, the second dose policy was not implemented until 1989. Did you get that second dose?
The decision not to vaccinate seems to sprout like a fungus from the false beliefs that 1) vaccines cause autism and 2) that childhood illnesses are no big deal.
1. False Premise: Vaccines cause autism.
A few things first. I understand that scientific papers are hard to slug through. And not all research is created equal. Studies that are observational, do just that, observe what has already happened. These rely heavily on patient reporting.
This is a weaker study than the gold standard, randomized controlled trials, in which the subjects are randomly distributed into groups which are either subjected to the experimental procedure or which do not receive it and serve as controls. In this kind of study, there is less bias and it is easier to weed out coincidences.
Also, published research is not a proclamation of fact. It is a sharing of what has been discovered to advance science. It doesn’t mean it is flawless. “Discoveries” do not come from one paper. Multiple scientists must replicate and advance a finding before a real “Eureka!” moment is reached.
It’s easy to forget this when the press latches onto a concept like “MMR causes autism,” and pukes it from the rooftops to stir panic and fear because that keeps you coming back for more.
All of the MMR vaccine misinformation can be traced back to one paper. The link between this vaccine and autism was proposed by a British physician, Andrew Wakefield, in the February 1998 issue of The Lancet. This finding has never been replicated by any other researchers. More importantly, it was discovered to be manufactured from fraudulent data and has been RETRACTED.
There were only twelve children in the observational study–this means that even if the findings were true, they really only provided a starting point for other research, not for conclusions. However, that hardly matters since the entire causal effect was based on what the parents reported as the length of time from the administration of the vaccine to onset of autism spectrum symptoms AND THAT DATA WAS FALSIFIED. The timelines of the children’s symptoms were misrepresented.
Even more damning was Wakefield’s conflict of interest. How could an article with such a small sample size and the title, Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children, cause such a fervor? Wakefield had an agenda to advance because he was a paid consultant to attorneys representing parents with anti-vaccine lawsuits. The General Medical Council in the U.K. revoked Wakefield’s medical license because of his fraudulent report and unethical behavior.
What is atrocious is that it took until 2010 for that paper to be retracted and for Wakefield to lose his license. For over a decade the fires of misinformation have been fanned and stirred into a bonfire so raging that four years after it should be extinguished it is still smoldering.
And the target of controversy has also shifted. The original autism scapegoat was the MMR vaccine, but the blame game has subtly shifted to focus on the ethylmercury vaccine perservative, thimerosal. This shift was spurred more by activist and political groups than science. Regardless, thimerosal has been removed from vaccines, mostly since 2001.
My heart breaks for the parents who are just looking for answers for their children on the autism spectrum, but I seethe with anger over all of the money that has been diverted from worthwhile autism research to prove over and over again that vaccines are not linked to it. With the combined studies to date, millions of children have been studied and no link has been found.
2. False Premise: Childhood illnesses are no big deal.
In the United States, today’s parents mistakenly think that not vaccinating is the safer choice because they do not remember, or maybe, they have never even seen the diseases. But these “childhood diseases” aren’t just spotty rashes or coughs. They can cause lasting disabilities and, at times, death. At the very least, they cause weeks of suffering and prolonged time off from work for caregivers. Because these are viral diseases, there is generally no specific treatment once they are contracted.
Here is a crash course on a few, but not all, preventable diseases.
Mumps: The infections are usually mild but cause painful swelling of the salivary glands. Sometimes there is swelling of the pancreas and testicles (rarely, this can lead to infertility).
Rubella: It’s generally a mild disease in children; but the infection of pregnant women is dangerous because it can cause congenital rubella syndrome (a variety of birth defects) in developing babies.
Pertussis: Also known as whooping cough, it is most severe for young babies. About half of babies younger than 1 year of age who get it end up in the hospital, and a few even die from the disease. It can be pretty serious in adults too. The coughing can be so forceful, it can crack ribs. Pertussis is seeing a resurgence so check with your doctor to see if you need the Tdap vaccine as a booster. You may be due.
Chicken Pox: While the disease is usually mild, it can lead to pneumonia and swelling of the brain. Also, the chicken pox virus “embeds” in your nerve endings. You may get painful shingles infections later in life when the dormant virus re-emerges.
This is not a childhood disease, but it deserves an honorable mention.
Human Papilloma Virus: This virus causes cervical cancer. The vaccine reduces the risk of CANCER. That is amazing.
My oldest child was born in 1998 and was due for her first MMR vaccination in 1999, right when the hysteria was gaining momentum. My husband and I had her vaccinated. I had read Wakefield’s paper for myself and realized the flaws. Also a well performed study by Brent Miller was already published. He studied 498 children and could not find a link between the MMR vaccine and autism.
Since that time, millions of kids have been studied and no links have been found. Please consider the weight of the evidence produced versus the fraud that was popularized when making decisions for your kids. You’re not just affecting yourself, but the health of the whole community.
