Notes from the Newsroom NewsOK.com Blogging Community

As part of The Oklahoman and NewsOK.com’s new monthly special project, ‘Know It…’, we are proud to present our first topic this month.

Search ‘cancer’ on NewsOK.com to explore Know It: Cancer.

The special Web site is an online resource on everything you’d need to know about cancer – living with it, getting treatment, supporting someone with it, choosing a physician, finding cancer-related events and so much more.

One of the key parts of the site is the hundreds of links that our researchers put together to give you a starting point for any cancer-related topic you are looking for. The Web site also offers interactive forums to discuss various aspects of cancer with other people.

The video player offers vignettes of people who have cancer stories to tell to compliment our comprehensive range of cancer stories told on a very personal level.

Related articles from The Oklahoman and from all over the Web are automatically fed to the page, so whether you look at the stories today or in six months from now, the content will be up-to-date and give you the most current information you need.

Everyone is touched by cancer in some form or another. Know It: Cancer is the place where you can gather all the information you need to help your situation when cancer gets close to you.

- Lindsay Hodges, Web editor

You can be forgiven for thinking yesterday was anything more than a nice day to watch college hoops.

It was, but it also was National Doctor’s Day.

The American Medical Association uses the day to honor the more than 900,000 physicians in the United States.

“On this day of tribute, Americans can express appreciation for physicians’ continued commitment to providing exceptional medical care,” according to an AMA release.

The nation’s doctors, throughout almost 1 billion patient visits annually, are called to be healers, confidants and advocates, the AMA says.

The organization also says two-thirds of U.S. doctors provide some form of charity care and in 2006 were ranked the nation’s most trusted occupation.

Furthermore, the AMA says:

• Ninety percent of patients say they are very satisfied with their doctor.
• Americans’ life expectancy has increased by seven years since 1960.
• There has been a 77 percent decrease in the infant mortality rate since 1950.
• There has been a 63 percent decrease in the overall death rate for heart disease since 1950.
• There has been a 72 percent decrease in the overall death rate for stroke since 1950.
• There has been a 14 percent decrease in the overall death rates for cancer since 1990.

Do you consider the medical profession admirable and respectable? Do you respect your physician? Are you satisfied with him/her? Drop me a line at The Medicine Bag blog at http://blog.newsok.com/health.

Now back to basketball!

Jeff Raymond, Medical Writer

Researchers have seen that weight-loss surgery appears to cure type 2 diabetes, which they have attributed to the huge drop in pounds. After all, being overweight is a risk factor for diabetes, and losing weight can effectively take care of the problem.

An article that appeared in a supplement to last month’s issue of Diabetes Care argues that the bowel is the site of mechanisms that lead to diabetes.

The study’s author, Dr. Francesco Rubino of New York-Presbyterian Hospital/Weill Cornell Medical Center, presents evidence on the mechanisms of diabetes control after surgery.

“Clinical studies have shown that procedures that simply restrict the stomach’s size (i.e., gastric banding) improve diabetes only by inducing massive weight loss. By studying diabetes in animals, Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese,” according to a press release.

Rubino’s previously has shown that the main way gastrointestinal bypass controls diabetes is by skirting the upper small intestine — the duodenum and jejunum.

“It has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the regulation of sugar metabolism,” according to the release.

Rubino’s findings suggest bypassing the upper intestine may work by reversing abnormalities of blood glucose regulation.

He guesses the upper intestine of diabetic patients may be the site where an “abnormal signal” is produced that causes or predisposes one to diabetes.

Gastrointestinal surgery offers the possibility of complete disease remission. This is a major shift in the way we consider treatment goals for diabetes. It is unprecedented in the history of the disease,” he said.

What do you think of using surgery to treat diabetes? Have you had an experience with it? Leave me a comment at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

Is retirement going to be a luxury for thirty- and forty- something workers? I increasingly think it will be, and a new estimate from investment giant Fidelity does nothing to dispel that.

A 65-year-old-couple retiring this year will need approximately $225K to cover medical costs in retirement, Fidelity estimates. Let’s not lose sight of the fact that this is in addition to the coverage available under Medicare, which may itself not be available when I and others retire.

The hypothetical retirees will still have to have enough money to live, either independently or in long-term care.

Perhaps what’s even more sobering than the estimate is its growth since 2002 — 41 percent.

The roughly 6 percent annual growth in the Fidelity projection about matches the growth of my 401K fund during a slow year. I know that doesn’t take into account contribution matching and interest compounding, but I think it raises a worthwhile point nonetheless.

And health care costs show no signs of flattening or decreasing.

Does paying for retirement terrify you as much as it terrifies me? Leave me a comment at http://blog.newsok.com/health.

Fidelity recommends:

- Creating an individual retirement plan

- Starting early and maximizing opportunities to save

- Assessing health status and becoming a smarter consumer of health care

- Determining details of any employer-sponsored coverage

- Understanding the financial impact of health care costs on Social Security income

Jeff Raymond, Medical Writer

We Oklahomans know dust — perhaps better than anyone. Like it or not, the hardscrabble Joad family is as much a part of our cultural heritage as Curly, Laurey and Jud.

The Dust Bowl completely destroyed the state, and some would argue it took us a half-century to recover.

I mention this because University of Colorado researchers have found the West has become 500 percent dustier in the past 200 years because of human activity.

My first thought was how they measured such a thing. Turns out the researchers used sediment records from dust blown into lakes in Colorado’s San Juan Mountains. Co-author Jason Neff, an assistant professor of geological sciences at CU-Boulder, attributed the “sharp rise” in dust deposits to the railroad, ranching and livestock of western expansion.

“From about 1860 to 1900, the dust deposition rates shot up so high that we initially thought there was a mistake in our data,” Neff said in a press release. “But the evidence clearly shows the western U.S. had it’s own Dust Bowl beginning in the 1800s when the railroads went in and cattle and sheep were introduced into the rangelands.”

A paper on the research was published in the Feb. 24 issue of Nature Geoscience. In it, the scientists described a “dust fall” that exceeded that of the previous 5,000 years. Because of the size of the dust particles, the authors concluded the dust particles came from the Southwest.

Neff said the West’s increasing dustiness isn’t drought-related. Instead, he said, it is because of “intensive land use, primarily grazing.” Researchers used radiocarbon dating and lead isotope analysis of soil cores to determine this.

“There were an estimated 40 million head of livestock on the western rangeland during the turn of the century, causing a massive and systematic degradation of the ecosystems,” he said in the release.

The five-fold increase in nitrogen, phosphorus, potassium, calcium, magnesium and other byproducts of ranching, mining and agriculture can affect ecosystems.

Then, of course, there’s dust’s effect on allergies.

“There seems to be a perception that dusty conditions in the West are just the nature of the region,” Neff said. “We have shown here that the increase in dust since the 1800s is a direct result of human activity and not part of the natural system.”

For more health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

The need for donor livers outstrips their supply. Each year, about one-third of those with end-stage liver disease who need an organ will receive one. Some die while on the waiting list.

The February issue of Mayo Clinic Proceedings examines how the current system for allocating organs in the United States affects recipients’ outcomes.

The United Network for Organ Sharing (UNOS) oversees organ allocation. With the goal of giving organs to the most critically ill transplant candidates, UNOS adopted the MELD — Model for End-Stage Liver Disease — scoring system in 2002. The score is calculated from the results of three lab tests.

“Unlike past evaluation systems, the MELD score de-emphasizes the length of time a patient has been waiting for a donor organ. … Research has shown that although the donor liver shortage persists, implementing this allocation system has decreased the number of patients who die while waiting for donor organs,” according to a Mayo Clinic press release.

The study looked at the evaluation practices and acceptance criteria for liver transplant used by the Mayo Clinic Jacksonville Transplant Center after implementation of MELD scoring. Researchers examined medical records from 555 patients referred for liver transplants at the Jacksonville center from Jan. 1 through Dec. 31, 2005. Of these patients, 53 percent were denied for a transplant. Half of those denied were considered too early to have the procedure, while the rest were excluded because of medical conditions and psychosocial issues — poor support systems or continuing substance abuse problems, for example.

Many were subsequently accepted.

“Patients seeking referral often undergo repeated assessments by selection committees, as their eligibility can change over time or following treatment and/or changes in conditions that led to their initial exclusion,” according to the release.

Data suggest a “broad range” of patients could benefit from early referral to a transplant center, according to the release.

Basically, management of their disease and other medical and psychosocial conditions could make them transplant candidates sooner.

To read the report, click here.

People seldom realize transplant waiting lists are anything but static: They constantly change, depending on organ availability and patients’ medical states. They’re definitely moving targets. People move up, they move down; they drop off, they’re added back.

“Our study suggests that early referral for LT (liver transplant) evaluation is beneficial for reasons unrelated to the time patients spend on the LT waiting list. If patients too early for LT were evaluated but not listed, LT centers could initiate management of ESLD (end-stage liver disease) and address psychosocial issues in a sub-group of patients who could also ultimately benefit from LT,” the authors wrote.

Although not exactly the same thing, last month I wrote about this man, Dr. Ludvik Artinyan, left, who registered on organ waiting lists in California and Oklahoma. He was able to receive a liver transplant quicker by traveling to Integris Baptist Medical Center to have the procedure performed rather than having it done in Los Angeles. Because patients’ MELD scores typically are higher in California for various reasons, double-listing likely allowed the Armenia-born physician to shave months off his wait time and perhaps saved his life.

UNOS allows potential transplant recipients to be listed in multiple regions — they must meet each site’s criteria and be ready to respond to the phone call or page when an organ becomes available.

Is the current organ allocation system fair? E-mail me at jraymond@oklahoman.com or post your thoughts at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

Statistically speaking, men will die six years sooner than women. We have higher death rates for the 15 leading causes of death.

Here are some stats from the National Center for Health Statistics:

• In 1950 the age-adjusted death rate per 100,000 men was 1,647.2.
• For women it was 1,236.
• In 2000 the rate for men was 1,053.8.
• For women it was 731.4.
• In 2004 the rate for men was 955.7.
• For women it was 679.2.
• In 1950 the death rate among men from heart disease was 697.
• For women it was 484.7.
• In 2000 the rate for men was 320.
• For women it was 210.9.
• In 2004 the rate for men was 267.9.
• For women it was 177.3.

The numbers, whether taken together or broken down by cause of death, show that while age-adjusted death rates of men and women have made huge strides, men still trail.

Check out the rest of the document here.

I bring this up to spotlight Integris Health’s annual Men’s Health University Men’s Fit Club. The program appropriately began the day after the Super Bowl. It is a weight-loss class offered just for men, of all ages. It focuses on eating habits and increasing fitness.

Men-U is a series of events throughout the year to educate men and their loved ones on how to take care of their health. Health checks such as prostate cancer screenings are featured, and then there’s the Man Card, from Integris and WWLS The Sports Animal. Cardholders earn points that can be redeemed for prizes.

The class runs through April 17 and will be every Monday from 5:30 to 7:30 p.m. at Integris Pacer Fitness Center. The cost is $240 — less for those with a Man Card. Call (405) 951-2277 or (888) 951-2277 for more information.

One reason men die earlier may be because they avoid going to the doctor. A 2007 survey of more than 1,000 men for the American Academy of Family Physicians showed almost one-third wait as long as possible before seeking medical attention.

For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

On a recent weekend I saw something spectacular. No superlatives — it really deserves to be called spectacular.

The introduction in the dimly lit anteroom at the Science Museum of Oklahoma pretty much sums up the “Our Body: The Universe Within” exhibit: A detailed look inside the human body is something that historically has been limited to doctors and researchers yet has fascinated man for millennia.

Despite its $23.95 cost per adult, the 13,000-square-foot exhibit is something everyone should see. Go now, go this weekend, go whenever — just go before it closes May 11. If you have ever wanted your child to become a physician, as just about every parent has, roll the dice and take him or her to the museum; there’s a good chance your child will leave with an abiding fascination about anatomy.

The exhibit is thought-provoking, gasp-inducing, and a real coup for the Science Museum, formerly the Omniplex. It features 18 complete bodies and 135 other body-system, anatomical and health-related items.

One of the most striking things is how respectfully the bodies on display have been treated. Even when posed, with muscles splayed, or seated, with veins and nerves hanging like plumb lines from thick rings of flesh, the bodies retain their dignity. The only time I was uncomfortable was with a man on a spinning platform who is holding his own skin in front of him. I’m not sure if I was uncomfortable because he was holding his skin or because his skin looked like a hide from any other animal.

I know how similar man is to lesser species. Anatomically, genetically and physiologically, the similarities far outweigh the differences. Still, it’s disconcerting to see how much man, stripped of speech and conscience, resembles other mammals.

The bodies don’t smell because they have been treated with a special solution that “plasticizes” tissue and renders it odorless.

Two things particularly stood out to me:

1. The first was how dense veins, arteries and capillaries are in some parts of the body. One memorable part of the exhibit has legs, or at least the vasculature of the legs. Take the lungs, liver and kidneys — all are stocked for blood transport, per their functions. It’s one thing to see a spongy lung and quite another to see the vessels that deliver the blood that allows us to breathe. It’s this sort of big-picture perspective that was always lacking in school. It’s one thing to study the nephons in the kidneys, for example; it’s another to see how they look together, by the millions, life-size.
2. Parts of the exhibit show slices down the sagittal and transverse planes (take a look at the picture above to see what I mean). I was able to understand, for the first time, how the internal organs relate and where they are located in body cavities. I saw the ventricles, or chambers, of the brain, and the pillow the lungs provide the heart.

I got the impression the exhibit attracts doctors as well: After hearing one describe what he looks for when examining someone’s ears, I realized docs must be thrilled to share what they do with loved ones in a way words simply can’t convey. The man described looking at a patient’s ear drum, and how he would see internal structures and note them on the patient’s chart. Hearing about this and looking into an actual ear and skull must have made the woman with him understand his work so much better.

Have you been to the exhibit? What did you think? E-mail me at jraymond@oklahoman.com.

Jeff Raymond, Medical Writer

A paper in this month’s edition of the Journal of Pediatric Nursing describes ADHD from the perspective of college students who have it and have learned to cope.

The subject is interesting for several reasons, not the least of which because it features 16 adults recalling how ADHD affected their lives as children. Plenty of research exists on child and adolescent ADHD, but there is little out there on how the condition affects and has affected adults.

The study, from the University of North Carolina at Greensboro and Wake Forest University, is poignant in interviewees’ descriptions of how it feels to have ADHD — being called “stupid” or “slow,” not having parents understand why things don’t get finished.

The study noted common feelings among the group of loneliness and isolation.

“Can’t anyone see I’m struggling,” one study participant lamented.

Common threads through participants’ lives were:

• Trouble getting along with parents

“In their view, children with ADHD have more trouble than others,” the authors wrote.  

One’s adolescence is rough no matter what, “but it tends to be a little rougher on people with special needs,” a participant noted.

Another participant described the “mass chaos fights” with parents and siblings — often due, participants said, to failing to perform chores within an expected time frame.

“Because of their distractibility and hyperactivity, participants said that they had difficulty completing tasks, causing problems with their parents,” the authors wrote.

Some parents provided support, but it was tough for them as well.

“My parents did provide support … with homework; making sure I was on top of things. But it kind of got to the point where it was nagging, but that’s how they got the actual answer from me,” a participant recalled. “They had to play 20 questions. I wasn’t trying to withhold information; it just took 20 questions to get the full description.”

• Missing a lot of material at school

Trouble paying attention and hyperactivity affected participants’ ability to learn.

“In class, I had a kind of lag time, ’cause in-between me figuring out what had been going on, the entire class moved on, so I missed out on information. So that was one of the biggest things — missing out — taking a longer time to get the entire idea,” a participant explained.

Participants learned to cope: They allowed help from their parents, asked for more time on tests or took them in different formats, recorded lectures and re-copied notes after class.

• Feeling different

Children with ADHD felt different in school, and situations such as sitting still and grasping concepts quickly made these differences clear.

“Other kids at school would call them retarded, slow, or stupid, and then ostracize them,” the authors wrote.  

As such, they often had trouble making friends, and wondered why people didn’t like them. Social difficulties sometimes persisted into adulthood.

“Not only do I have a tendency to interrupt …  but the main problem I have is, you need to think before you say something that can offend other people, or when you ask too many questions … they’ll say it makes them feel uncomfortable,” one participant said.  

• Feeling misunderstood

“Friendships for children and adolescents with ADHD were fraught with misunderstandings,” the authors wrote.

One participant described how her friends kidded her about her problem.

“I have friends who say, ‘Oh, it’s my ADD and I don’t want to do my work. It’s my ADD kicking in.’ … and they’ll say it in front of me when they know I have it … and I’ll have it the rest of my life. I’ve gotten very mad at them,” the participant explained.

One participant suggested those with ADHD find friends who understand and will call out their names or tap them on the shoulder when they’re “zoned out.”

In 2003, according to the Centers for Disease Control and Prevention, nearly 8 percent of school-aged children were reported to have ADHD.

I don’t mean to suggest that the themes in the study are unique to those with ADHD, but I do think the research provides a window into how adults with ADHD think and the difficulties they face.

Parents of children with ADHD ought to take a look at it to see what their kids may say about their upbringing a decade from now.

What are your opinions on ADHD? Is it overdiagnosed? E-mail me at jraymond@oklahoman.com.

Check out a blog in The New York Times on the study here. To read the study, click here.

For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

U.S. hospitals charged $873 billion in 2005 — a nearly 90 percent increase from the $462 billion charged in 1997 — according to the Agency for Healthcare Research and Quality. The inflation-adjusted 2005 bill represents the amount charged for 39 million hospital stays.

With an average annual growth rate in hospital charges of 4.5 percent, researchers predict the bill will reach $1 trillion by 2008.

AHRQ also found:

-Medicare paid $411 billion of the national bill, followed by private insurance ($272 billion) and Medicaid ($124 billion).

-The uninsured accounted for $38 billion.

This is taken from the AHRQ report:

For more health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer