Child cancer patient deals with drug shortage

Editor's note: Owen McMasters, 12, was diagnosed with Acuta Lymphoblastic Leukemia in November 2011. His family has been dealing with the shortage of methotrexate, a drug that treats cancer by slowing the growth of cancer cells. Between 2006 and 2010, drug shortages increased by more than 200%. Read more about these shortages, and what the FDA is doing to help, on The Chart.

Learning that the enlarged lymph nodes I showed my mom meant Acute Lymphoblastic Leukemia (ALL), a type of cancer, and not mono, was devastating.
It meant that I would not be returning to school until at least next August. It meant I would spend unknown amounts of time in the hospital. It meant I would not be able to be around groups of people. (I have to limit which friends and family members I am around, since a simple cold for you could mean severe illness for me.)
It meant my hair I loved fell out, leaving me with baby bird fuzz on my head.
I underwent two operations in the first 36 hours and then went under anesthesia for either a spinal tap with chemotherapy, a bone marrow biopsy, or both, nearly every week. Because my platelets and white blood cell count are often critically low, I am unable to ride my bike, play any sports, wrestle with my brothers or do many of the things I like to do.
My new friends are other kids with bald or fuzzy heads who are going through the same thing as me.

Because I have every intention of beating cancer, and seem to be doing a great job of it so far (despite being told in November that my cancer was high-risk), I have done everything my doctors have asked of me.
I take many different kinds of chemotherapy drugs, at least once per week and sometimes many days per week. I have to get my blood drawn frequently. I have to get up early, go to the doctor’s office or the hospital, and spend many hours getting treatment. I have been in the hospital sometimes for up to 10 days in a row.
I had a severe infection from my immune system being wiped out.
I have to get radiation treatments in my brain. Sometimes the treatments don’t bother me too much; sometimes they make me tired, weak, nauseated and unable to eat for days. They make me cramp all over and swell.
While none of this is any fun, I do what I have to do and deal with it in my own way. I joke with the doctors. I entertain my parents. Sometimes I use bad words and get away with it because I have cancer. But I do everything I am told to do because I am going to live and be cured of cancer. The doctors say I have a very good chance to be cured if I take all of the treatments, which last for three and a half years.
Two weeks ago my main doctor told me I was doing better than he ever expected. He was honestly shocked with my latest bone marrow biopsy. But in the next minute he told my mom I would likely not be able to undergo my next phase of chemo.
The next phase is high dose methotrexate. I would receive this drug all the time - through an IV in my spine. It is the most frequent drug and the high dose is evidently going to be hard. I was ready for it because it is also what will keep my cancer from returning. It is what will make me live.
My doctor told me drug companies had stopped making methotrexate in the form I needed and that the shortage was so bad no one would be able to get it in the next few weeks unless something drastic changed. He said the shortage had been going on to some degree for two years, but that it was critical now.
I knew it was critical - it was going to affect me and all the other kids in the clinic that day and all the kids in the U.S. who also have ALL.
I asked if we could get it from other countries and was told it isn’t that easy. He also said that the shortage of chemotherapy drugs for kids with cancer was a constant problem and was not just with methotrexate. Six months ago there was a shortage of AraC, another drug I take frequently.
That very day the clinic nurses asked me if I had decided what I wanted for my wish from the Make A Wish Foundation. The people from Make a Wish had visited me the last time I was in the hospital, but I was so sick I only talked to them briefly.
I talked to my parents and told them I would feel bad asking for something to be bought for me but might consider something all the kids could enjoy at clinic or on the children’s oncology unit at Kosair Children’s Hospital.
After I got home from clinic, we researched the methotrexate shortage and found that my doctor wasn’t exaggerating. I decided my wish would be to fix the shortage of chemotherapy drugs so that other kids could get the treatments that they need to be cured of cancer.
I wanted to make the shortage of methotrexate known by everyone who could do something about it. I wanted the drug companies to share my goal of curing my cancer and cancer in lots of other kids by making these drugs, even though they are cheap and might not make as much money as some others.
The FDA has said that methotrexate will be available for now. But this problem is not solved for good. A permanent solution to this problem must be found. I don’t care how the problem is solved, it just needs to be solved.
I like to think that I helped to make a difference by sharing my story. Thanks to Dr. Gupta and others who have expressed an interest in helping my wish to come true.
I plan to live.
See Owen and his family and learn more about the shortage of critical cancer drugs on "Sanjay Gupta, M.D." on Saturday and Sunday at 7:30 a.m. ET.

Post by: Owen McMasters -- Special to CNN Filed under: Cancer • Children's Health

http://thechart.blogs.cnn.com/2012/02/24/child-cancer-patient-deals-with-drug-shortage/

12:26 PM ET Share Comments (20 comments) Permalink Tweet CDC director: We can reduce prescription drug overdoses

Thirty years ago, I attended medical school in New York. In the key lecture on pain management, the professor told us confidently that patients who received prescription narcotics for pain would not become addicted.
While pain management remains an essential patient right, a generation of health care professionals, patients, and families have learned the hard way how deeply misguided that assertion was. Narcotics - both illegal and legal - are dangerous drugs that can destroy lives and communities.
Millions of Americans struggle with substance abuse. Across the United States, overdoses involving opioid painkillers - a class of drugs with narcotic effects that includes hydrocodone, methadone, oxycodone - have skyrocketed in the past decade.
Today, the United States consumes most of the world’s supply of opioid painkillers. By 2010, enough opioid painkillers were prescribed to medicate every American adult around-the-clock for a month. And every year, nearly 15,000 people die from overdoses involving these drugs... more than from heroin and cocaine combined.

Studies by scientists at the Centers for Disease Control and Prevention and elsewhere show that most of these deaths are not the result of people taking small doses of opioids for a short time. Typically, problems arise when people take large amounts of painkillers or use them over a long period of time.
About 1 in 20 people in the United States age 12 or older reported using opioid painkillers for non-medical purposes in 2010. Some of these people engage in doctor shopping - getting prescriptions for commonly abused drugs from several practitioners in a short time and having the prescriptions filled at several pharmacies. In this way, people can obtain dangerous amounts of a prescription drug rapidly.
And in addition to the heavy toll this can take on lives and communities, non-medical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.
We can do more as a society to help prevent overdoses involving prescription painkillers while making sure patients who need them have access to safe, effective treatment.
Health care providers should prescribe opioid painkillers only under specific conditions, as in the treatment of chronic cancer pain when other treatments have not worked, and in limited quantities.
Providers can also screen patients for risk and history of substance abuse before prescribing opioid painkillers. Drug addiction is a disease of the brain that can be treated.
But health care providers aren’t the whole answer. Insurers and health care institutions must set up systems to identify and take action when providers or patients are using prescription drugs in dangerous ways. Some states have passed laws to rein in rogue pain clinics (“pill mills") run solely for profit, that attract drug shoppers from other states.
Individuals can help protect themselves and others by doing the following:
– Talk with your provider about alternatives to opioid painkillers.
– Use opioid painkillers only as directed by a health care provider.
– Make sure you are the only one to use your painkillers. Not selling or sharing them with others helps prevent misuse and abuse.

– Store opioid painkillers in a secure place and dispose of them properly.
To learn more about prescription painkiller overdoses, join Dr. Frieden on Twitter @DrFriedenCDC today at 2 p.m. ET

http://thechart.blogs.cnn.com/2012/02/24/cdc-director-we-are-not-powerless-against-prescription-drug-overdoses/?hpt=he_c2

Top Chef' Talbot: Cooking and diabetes can mix

Editor's note: In the Human Factor, we profile survivors who have overcome the odds. Confronting a life obstacle – injury, illness or other hardship – they tapped their inner strength and found resilience they didn't know they possessed. This week meet Sam Talbot, executive chef at the Surf Lodge in Montauk, New York, who became known across the nation when he joined season 2 of Bravo's reality show "Top Chef." He is living with type 1 diabetes.

I remember being about 8 years old in Cleveland, Ohio, and going to the farmer's market with my grandmother, and getting eggs and making scrambled eggs and all those types of things that an 8-year-old doesn't necessarily just pick up.
And I fell in love with it. As time went on, I'd try to make my parents breakfast in bed. It would be Saturday morning and they had to ban me from the kitchen because I was in there at 7 a.m. banging things around.

	Post by: Sam Talbot - Special to CNN Filed under: Celebrity Health • Diabetes • Human Factor

http://thechart.blogs.cnn.com/2012/02/24/top-chef-talbot-cooking-and-diabetes-can-mix/?hpt=he_c2
My whole thing is about being as eco-sustainable as possible and cooking sustainable seafood, and food that makes sense for the mind, body and soul. 

I am a person living with type 1 diabetes, but I'm not necessarily cooking for diabetics all the time. Diabetes has never hindered me or stopped me from doing something I wanted to do.
The cookbook "The Sweet Life" that I just came out with is like a chronicle, almost like a memoir with a cookbook. It really goes into the story about when I was 12 and goes until present day.  It goes into, not just the healthy aspects of eating and the things you should be eating, but how to manage stress when you're living with diabetes; how to be able travel the world; how to be able to have syringes in your pocket or an insulin pump.  [If you] go to Budapest, they don't speak English – how do you explain you're diabetic to someone in Budapest? I go into those things because I've really had mishaps happen along the way of traveling [and talk about] overcoming those obstacles.
I think one of the key components that really makes up a good chef is really taking to heart what you're doing and knowing that basically the customers' lives are in your hands when you're cooking. You want to make food that makes sense, that nourishes, that fuels, that can be heart healthy and doesn't leave you just feeling like you ate a loaf of bread. 
If you take all those things into consideration and you're creative and that's your creative outlet and you really spend the time to know about the food you're serving, you can educate those who want to be educated about what they're eating.
I've made it my passion to take the food that I grew up on, to take the food I know, that I love and the food that I create on a daily basis and really just fine tune those modern, healthy tweaks and swap outs you can make. Instead of using heavy cream, try almond milk. Instead of using white flour, try coconut flour, almond flour, whole wheat flour or whatever it is and that's what I've dedicated my cooking to.

How to fake a good night's sleep

 
Early-morning sunlight is best for helping you start the day feeling rejuvenated
 
(Health.com) -- No matter how dedicated you are to getting your shut-eye, sometimes a less-than-stellar night's sleep is inevitable. The good news: "One bad night's sleep isn't going to hurt you long term," says Joyce Walsleben, Ph.D., coauthor of "A Woman's Guide to Sleep."
But it can make you feel not so great the next day. Luckily, there are ways to feel normal (or very close!) after a rocky night's rest.
1. Open your shades
A big dose of sunshine is the first thing you'll want to try. "Natural light resets your body clock, helping you function better all day," Walsleben says. "Even the low light on a cloudy or rainy day wakes you up better than any indoor bulb."
Early-morning sunlight is best for helping you start the day feeling rejuvenated. To perk up fast, open your shades as soon as you get up.

Dr. Oz's rules for better sleep

Help for women to get sleep

Health.com: 7 tips for the best sleep ever
2. Grab the right eats
"When we're tired, our instinct is to reach for sugary foods for a quick rush," says Samantha Heller, R.D., clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Connecticut. "But those foods make your blood sugar spike and crash, setting off a roller coaster of energy highs and lows."
For lasting energy, start your day with healthy protein and whole-grain carbs, Heller says. Try a whole-wheat English muffin with peanut butter and a sliced banana.
Health.com: America's healthiest fast-food breakfasts
3. Try this if you can't take a nap
The ideal remedy for the mental fatigue that occurs after sleep loss is an afternoon nap, says Matthew Edlund, M.D., author of "The Power of Rest." But since that's not possible for most people with jobs, the next best thing is a form of active rest called "paradoxical relaxation."
Edlund explains: Focus on one muscle group in your body for at least 15 seconds, concentrating only on how it feels and nothing else. Repeat up and down the body. Surprise -- you feel recharged.
4. Drink your coffee nice and slow
No need to gulp down that morning brew: Pour it into a thermos and sip slowly enough to make it last most of the workday. People who consumed the caffeine equivalent of just 2 ounces of coffee per hour still got a kick, according to a study in the journal Sleep. Just cut off the java by 3 p.m., or you may have trouble falling asleep that night.
Health.com: Big perks: coffee's health benefits
5. Take a walk to wake up
The time of day when the sleep deprived drag the most is between 1 p.m. and 3 p.m., says Michael Breus, Ph.D., author of "The Sleep Doctor's Diet Plan." If you find yourself yawning through afternoon meetings, try stepping out for a 10-minute walk.
"Movement boosts core temperature and stimulates the heart, brain, and muscles, preventing a slump," Breus says. Even pacing around your office will help kick your body back into gear.
Health.com: How to instantly boost your energy
6. Go to bed on time
As tempting as it is to crash at 8 p.m. the evening following a rough night's sleep, you'll feel most refreshed if you hit the sack close to your usual bedtime.
"Our bodies have a natural rhythm of sleep and wake -- you'll get the most restorative sleep if you stick to that pattern," says Janet Kennedy, Ph.D., a New York City--based clinical psychologist who specializes in sleep disorders. "Changing your schedule to make up for lost sleep can actually lead to other problems, like early waking and even insomnia."
Instead of hitting the sack (or sacking out on the couch) after dinner, go to bed no earlier than an hour before your normal bedtime and wake up no later than an hour past your normal wake time to catch up on lost sleep without overdoing it.
Health.com: Alarm clocks for heavy sleepers
7. Hang around the water cooler
Sleep deprivation can mildly dehydrate you, even if you're not suffering from a happy-hour hangover. And dehydration actually compounds fatigue, Breus says -- so sipping water will help lessen sleepiness. Drink enough so you're not thirsty and you have clear-ish urine, Breus recommends.
Another trick: Throw in a few ice cubes. "Unlike warm drinks, which tend to relax you, cold beverages can increase alertness because they are more refreshing," Kennedy says.

http://edition.cnn.com/2012/02/23/health/fake-good-nights-sleep/index.html?hpt=he_t5

Are women turned off by stressed-out men?

 
A study found that men with higher testosterone levels tended to have stronger immune systems and faces that were more attractive to women.
 
(Health.com) -- Scientists have been trying to confirm what Hollywood has known for decades: Women are often attracted to men with chiseled cheekbones and lantern jaws.
These and other masculine facial features are associated with high testosterone levels, and women seem to know this fact intuitively. Studies suggest that women are especially drawn to rugged-looking guys when they're in the mood to mate (i.e., when they're ovulating), while at other times, when they're more interested in companionship, they tend to prefer a softer, more delicate look—think Ryan Gosling versus Burt Lancaster.
It's not entirely clear why testosterone-fuelled features are attractive, but some experts have proposed that they're a sign of a healthy immune system. Testosterone dampens immune function, so a man with high testosterone who's still standing, the theory goes, is likely to have a stronger-than-average constitution. And he'll pass those hardy genes on to his offspring, making him an attractive mate choice.
Health.com: How love changes your body chemistry
A new study, published this week in the journal Nature Communications, provides the strongest evidence yet to support this theory. It also adds a new wrinkle: stress.
In the study, men with higher testosterone levels tended to have stronger immune systems and faces that were more attractive to women. This relationship, however, was especially pronounced in men with low levels of cortisol, a stress hormone involved in the so-called fight-or-flight response.
This finding, researchers say, suggests that a man's stress levels may play a key role in whether his testosterone is free to work its magic on women. Cortisol may even have a direct impact on a man's facial features, although it's much too soon to say if that's the case or not, says Benedict Jones, Ph.D., a psychologist at the University of Aberdeen, in Scotland, who researches the influence of hormones on attractiveness.
"The important thing here is that...we're seeing evidence that the relationship between men's facial attractiveness and their hormone levels is probably much more complex than we once thought it was," says Jones, who was not involved in the new study. "The interplay between cortisol and testosterone seems to be more important than the effects of any one hormone."
Health.com: Surprising libido boosters
Why is testosterone so sexy and cortisol, apparently, such a turnoff? The answer may lie in something called the "handicap hypothesis."
Biologists who study mate choice across species have suggested that attention-getting male features—such as the peacock's tail, or the deer's antlers—are attractive to females because they're largely useless and impractical. They're often a disadvantage in areas of life besides attracting a mate, but they signal to females that a male is healthy enough to divert some energy away from surviving and put it towards looking good.
"The very fact that you're able to stay alive with this handicap means that the female choosing you is getting a high-quality mate," says Anthony Little, Ph.D., a research fellow at the University of Stirling, in the United Kingdom, who did not participate in the new research but has studied how human faces communicate information.
Health.com: Celebrity health secrets: fit, famous men over 40
Rugged features aren't exactly seen as a handicap in humans, but a similar dynamic nevertheless may be at work, Little says. "Humans don't have colorful feathers, but we pay lots of attention to things like facial appearance and body appearance."
The handicap hypothesis has been around since 1975, but the new study is the first to provide concrete evidence for a link between high testosterone levels, good immune system function, and attractiveness in humans.
In the study, researchers asked a large group of female college students in Latvia to look at photographs of 74 male students and rate their facial attractiveness. Meanwhile, the researchers tested the men's testosterone and cortisol levels and gauged their immune-system function by measuring their antibody response to the hepatitis B vaccine.
The men with the strongest immune systems—those with the most antibodies—generally got the highest marks on looks. "Women seem to be able to detect the men who've got the strongest immune response, and they seem to find them the most attractive," says study coauthor Fhionna R. Moore, Ph.D., a psychology lecturer of Abertay University in Dundee, Scotland.
Health.com: 4 secrets to never getting sick
A stronger immune system was also linked to higher testosterone levels, but all of these links were weaker in men who also had high cortisol levels. It's as though cortisol, which tends to suppress the immune system, interferes in the conversation between testosterone, immune response, and attractiveness.
Cortisol isn't a perfect marker for stress, Little notes. It's not clear from one test, for instance, whether high cortisol levels are due to a momentary spike in stress or to chronic stress that keeps cortisol persistently elevated.
Still, he says, the fact that cortisol appears to come between testosterone and facial attractiveness suggests there's something about stress that women find unattractive.
Once again, Hollywood seems to have beaten science to the punch: It's no secret that there's something attractive about a man who seems relaxed and cool under pressure.

http://edition.cnn.com/2012/02/22/health/living-well/testosterone-women/index.html?hpt=he_t4