Children from across Philadelphia will receive free eye screenings during the upcoming “Give Kids Sight Day.”
Screenings will occur April 14 from 8:30 a.m. to 1 p.m. at Thomas Jefferson Hospital Alumni Hall, 1020 Locust St.
The event arose out of a need to ensure that low-income children have access to eye care services.
“Fourteen thousand children every year in this city fail their mandatory school vision test and never see an eye doctor and that’s a tragedy,” said Dr. Alex Levin, chief of the Wills Eye pediatric ophthalmology and ocular genetics service.
“In an effort to address that tragedy a group called the Vision Coalition has come together to plan this opportunity where any child in Philadelphia who needs eye care can walk in the doors of Jefferson and get the care that they need at no cost.”
The Vision Coalition consists of Wills Eye Hospital, Jefferson Hospital, Philadelphia Eagles Youth Partnership, Public Citizens for Children and Youth and other organizations.
During the event, children are offered vision screening to detect whether there are any problems. Children who fail the vision screen will be checked to see if they need glasses. Glasses will be provided free of charge, if needed. Those who have greater eye care needs will receive a full pediatric ophthalmology exam at Wills Eye.
“So essentially what we’re offering is not only free vision screenings, but the top level of pediatric ophthalmologic care to anyone regardless of their ability to pay,” said Levin.
“Wills has a tremendous commitment to ensure that the children in this city can see, and Wills is dedicated in many ways to finding ways to reach out to these children.”
In addition to Sight Day, Wills assists children through its Wills on Wheels van that brings eye care to children in schoolyards, and its affiliation with the Eagles Eyemobile, which works to make comprehensive vision care accessible to under-and uninsured children in the region.
During Sight Day, Public Citizens for Children and Youth will focus on educating parents about public health insurance availability.
The free eye care event comes at a time when approximately 26,000 Philadelphia children are uninsured, yet as many as 75 percent of these kids could be eligible for pubic health insurance, according to Colleen McCauley, health policy director for the organization.
“Some parents are unaware that public health insurance exists and that their children are eligible,” said McCauley, noting that the reasons vary.
“Faced with a job loss eliminating employer-paid health coverage, many families are using the public safety net for the first time and do not know that public health insurance even exists.”
Also at issue are immigrant families who face additional barriers such as language, cultural differences and confusion over immigration status.
“A parent’s status does not affect the ability for their children to get public health insurance coverage,” McCauley pointed out.
During last year’s Sight Day, 600 of the 1,400 children who received the free eye screenings had eye care benefits that were covered by Medical Assistance and the Children’s Health Insurance Program, but their parents did not know it.
Public Citizens conducted a survey of 100 parents during the last Sight Day revealing that a majority of patients enrolled in MA and CHIP did not know what their benefits covered. Sixty-three of MA and 70 percent of CHIP parents understood the plans covered their child’s eye exams. Just 52 percent of MA parents and 60 percent of CHIP parents knew their child's eyeglasses were paid for by insurance.
Nearly half the parents surveyed, 44 percent, reported their child needed replacement glasses in the past. However, half of these parents got their child's replacement glasses at Sight Day — unnecessarily McCauley said. She says MA covers replacement glasses and CHIP pays for replacement lenses, but not frames.
Public Citizens also followed up with several opticians and optometrists and discovered that very few were able to accurately describe MA and CHIP eye care benefits.
“Some families are being misinformed by the very people who are being contracted to render services to them,” said McCauley.
“Therefore the emphasis at this year’s “Sight Day” is on educating parents. We have to do a better job of informing parents about what their children’s eye care benefits cover and make it easier to access these benefits as well.”
The upcoming Sight Day is open to children 18 and younger. Screenings are available on a walk-in basis. No appointments are necessary.
As the director of the minimally invasive thoracic surgery program at Thomas Jefferson University Hospital, Dr. Nathaniel Evans III specializes in treating lung cancer patients.
The standard treatment for early-stage lung cancer has been to surgically remove the affected lobe of the lung, a procedure that is referred to as a lobectomy. Evans specializes in treating lung cancer patients with a procedure known as VATS, video-assisted thoracic surgery, a minimally invasive procedure to remove tumors from the lung.
The procedure calls for specially designed surgical instruments to be inserted into the chest cavity through small incisions. One of these instruments has a tiny camera that sends pictures to a monitor to provide surgeons with a clear view of the internal organs.
“It’s an exciting time for us in lung cancer because we are finding more and more people with earlier stage cancers and those are the people we can actually cure with surgery,” said Evans, who joined Thomas Jefferson in 2010.
Patients who undergo a traditional lobectomy are left with a surgical incision in their side, are hospitalized for a least a week and experience more postoperative pain.
At Jefferson, about 85 percent of the lobectomies are done using minimally invasive surgery as compared to a national average of 20 percent. Jefferson has done approximately 300 of the procedures thus far.
Patients who undergo the minimally invasive surgery average a two-to-three day hospital stay and shorter recuperation time. Evans said that people with early-stage lung cancer are typically the best candidates for the surgery.
“I think that a lot of the patients who come to see us are scared that they have cancer and they are also scared because they know a family member or a friend who had a lung cancer surgery and didn’t do well and it took months for them to do better. I think that, unfortunately, leads to people not seeking care when they probably should,” Evans said.
According to the Centers for Disease Control, about 200,000 people in the United States are diagnosed with lung cancer every year.
African Americans are more likely to develop lung cancer than any other population in the U.S. The American Lung Association 2010 report titled “Too Many Cases, Too Many Deaths: Lung Cancer in African Americans” found that African Americans are more likely to be diagnosed later, when the cancer is more advanced. The report indicates that African Americans are more likely to wait longer after diagnosis to receive treatment, more likely to refuse treatment, and more likely to die in the hospital after surgery. The report lists various factors that contribute to these health disparities including socioeconomic status, environmental exposure to toxins, access to healthcare, discrimination and social stress.
“Surgery is the best treatment for early-stage lung cancer, and that’s the place where we can really make the best difference in terms of survival - and for whatever reason Black patients are less likely to have surgery,” Evans pointed out.
Evans questions whether or not Black patients with lung cancer are offered surgery as often in the healthcare system.
Evans takes the time to explain to his patients why surgery is considered the best standard of care.
“I think that people often times feel like doctors tell them what they should do just because they feel that’s what needs to be done, and doctors don’t feel the need to explain to patients why they made those recommendations,” says Evans, who is the married father of three children.
“I feel like if we do a better job explaining to people why we made those recommendations, they are much more likely to agree with us or at least feel like they could make the decision themselves.”
After growing up in Moorestown, N.J., Evans obtained his undergraduate degree from Princeton University and his medical degree at Stanford University School of Medicine. He received his postgraduate training in thoracic surgery from Massachusetts General Hospital, University of Pittsburgh Medical Center and Memorial Sloan-Kettering Cancer Center.
ATLANTA — The whooping cough vaccine given to babies and toddlers loses much of its effectiveness after just three years — a lot faster than doctors believed — and that could help explain a recent series of outbreaks in the U.S. among children who were fully vaccinated, a study suggests.
The study is small and preliminary, and its authors said the results need to be confirmed through more research. Nevertheless, the findings are likely to stir debate over whether children should get a booster shot earlier than now recommended.
"I was disturbed to find maybe we had a little more confidence in the vaccine than it might deserve," said the lead researcher, Dr. David Witt, chief of infectious disease at the Kaiser Permanente Medical Center in San Rafael, Calif. Witt presented his findings Monday at a medical conference in Chicago.
The study was done in California, where whooping cough vaccinations are a hot-button issue. The state had a huge spike in whooping cough cases last year, during which more than 9,100 people fell ill and 10 babies died. California schools have turned away thousands of middle and high school students this fall who haven't gotten their booster shot.
Government health officials recommend that children get vaccinated against whooping cough in five doses, with the first shot at age 2 months and the final one between 4 and 6 years. Then youngsters are supposed to get a booster shot around 11 or 12. That means a gap of five to eight years.
Witt's study looked at roughly 15,000 children in Marin County, Calif., including 132 who got whooping cough last year. He found that youngsters who had gone three years or more since the last of their five original shots were as much as 20 times more likely to become infected than children who had been more recently vaccinated. The largest number of cases was in children 8 to 12 years old.
Whooping cough, or pertussis, is a highly contagious bacterial disease that in rare cases can be fatal. It leads to severe coughing that causes children to make a distinctive whooping sound as they gasp for breath.
Marin County has a reputation for anti-vaccine sentiment, and Witt said that when he started the study he expected to see the illness concentrated in unvaccinated people. But more than 80 percent of the children who developed whooping cough in Witt's study were fully vaccinated.
California health officials told doctors last year that they could give the booster to kids as young as 7 in an effort to stifle the outbreak. Federal health officials said that they are still studying the issue and that it is too soon to make that a standard practice.
At the Centers for Disease Control and Prevention, which makes recommendations on childhood shots, officials acknowledged that the vaccine's protection declines, but they said the agency's own studies show the drop-off is not as pronounced as Witt's research found.
The CDC has estimated that the risk of the disease can increase fourfold several years after vaccination, not 10 to 20 times. One reason may be differences in how a case of whooping cough is defined: Witt counted positive test results, while the CDC also requires more than a week of symptoms.
CDC officials stressed that the vaccination is still much better than nothing — it reduces how sick a child becomes. Also, the nation no longer sees thousands of whooping cough deaths each year, as it did before there was a vaccine.
The shots "are still our best protection against pertussis, and they still protect well against fatal disease," said Dr. Tom Clark, who leads the CDC's epidemiology team focused on vaccine-preventable diseases.
Versions of the vaccine are made by two companies — Sanofi Pasteur and GlaxoSmithKline. The companies have acknowledged that the immunity conferred by the vaccine wanes over time, but they declined to comment on Witt's study.
The type of vaccine given in the U.S. has been in use since the late 1990s. It is typically administered in a combination shot that also protects against tetanus and diphtheria. Nearly every state requires children to get the full series of shots before enrolling in school.
Periodic outbreaks still occur in places with high vaccination rates.
The short-term effectiveness of the vaccine has been shown to be 90 percent or higher in the first couple of years. The long-term effectiveness is not well understood, but researchers thought it was more than three years.
A preliminary study conducted by the CDC last year found the five-dose vaccination for children was about 70 percent effective five years after the last shot. Witt's research suggests the effectiveness may drop much lower than that, perhaps below 50 percent after just three years.
Witt also found that shots work great in the short term. Rates of whooping cough dropped dramatically after kids were age 11 and 12, when many get the booster shot.
The long-term effectiveness of that booster also is not known and has received relatively little study. Health officials are also discussing whether additional boosters may one day be recommended for teenagers or adults.
"It's a little too soon to say much" about the longer-term effectiveness of that booster, said Lara Misegades, a CDC epidemiologist. -- (AP)
Will aerobic exercise help me burn fat? How will I know when I’ve done enough?
Stephanie, Los Angeles
Aerobic workouts will help you burn body fat if you do 30 minutes or more of continuous movement. It takes your body 25 minutes to switch to the fat-burning stage during a workout. Try to get in at least 30 minutes of aerobic exercise three to four times a week. Try to keep your aerobic workout less than 60 minutes. This way you won’t overdo it and you’ll decrease your risk of injury due to repetitive stress. You may have to start below 10 minutes and increase your workout time gradually. Some examples of aerobic exercise are 30 minutes or more of brisk walking, jogging, bicycling, swimming, walking in a pool, aerobic dance and jumping rope. Workouts that include a lot of stop-and-go movements will burn calories but are not considered aerobic.
Cardio Calorie Counter
How can I tell how many calories I’m burning when I ride a stationary bike, run on the treadmill or use the stair climber? Some of the counters make some big claims.
Actor Grizz Chapman, whose severe hypertension led to kidney failure, has taken a leading role in raising awareness about kidney disease.
Chapman, who is part of Tracy Morgan’s entourage on the NBC show “30 Rock,” is serving as a spokesperson for the National Kidney Foundation.
Chapman received a transplant from an altruistic donor, 19-year-old Ryan Perkins of Phoenix, Ariz., last June and had previously managed to shoot “30 Rock” while undergoing dialysis treatment three times a week, and now has a powerful message for the public.
“Take care of your health, even when you feel good. Especially keep your blood pressure under control and pay attention to your urine. If it’s foamy, that’s not a good sign and you need to check out your kidneys,” Chapman said in a release.
The alarm was sounded for the father of an 18-year-old daughter and 10-year-old son, when he began spilling protein in the urine a little over two years ago. It wasn’t long before he spiraled from there to congestive heart failure and kidney failure.
“I should have been more conscious of my health, but since kidney disease can be silent, I felt fine — so I kept up with my regular life, traveling all over the country and eating the wrong things,” Chapman said.
Chapman says most people have no clue what the kidneys do in the body and whether they’re at risk. With that in mind, he’s spreading awareness by being involved with the NKF. Over the course of the year, Chapman has made personal appearances at seven Kidney Walks sponsored by the organization.
Now he’s gearing up to join thousands of Delaware Valley residents for the upcoming 2011 Kidney Walk in Philadelphia.
Hosted by the NKF Delaware Valley, the walk will be held Oct. 9 at 9:30 a.m. at the Philadelphia Zoo. More than 5,000 participants are expected to turn out for the event that is regarded as the second largest Kidney Walk in the country.
“Kidney disease affects so many people. Those who have a history of kidney disease in their family, high blood pressure and diabetes are at risk and that’s a really big population of people. It’s really important that people who are at risk can be aware,” Clare Herlihy, NKFDV development manager.
“Nationally, one in nine people are at risk for kidney disease, here in the Delaware Valley, it’s one in six.”
The NKFDV has set a goal of raising $500,000. Proceeds from the event will be used to fund the foundation’s patient programs and kidney disease screening outreach events. Through its signature Kidney Early Evaluation Program (KEEP) program, the organization hosts screening at churches and community organizations.
For information about the walk call (215) 923-8611 ext. 22 or visit www.nkfdv.org.
Another new medical facility for children is coming to West Philadelphia.
The Children’s Hospital of Philadelphia recently broke ground for the Nicholas and Athena Karabots Primary Care Center at 48th and Market streets.
Established with a $7.5 million gift from Nicholas and Athena Karabots and the Karabots Foundation of Fort Washington, the $30 million, 52,000-square-foot facility will offer top-quality pediatric care and community programs for children and families in the surrounding community.
“We are grateful that Nicholas and Athena Karabots are so passionate about ensuring all children, regardless of socioeconomic background, receive high quality care,” said Mortimer J. Buckley, chair of the board of trustees at CHOP.
“Their generous gift makes it possible for the Children’s Hospital of Philadelphia to better serve the families in West Philadelphia. We are honored to continue the Karabots’ tradition of helping children in need and will fulfill the promise of excellent care.”
As the chairman of the Spartan Organization, Nicholas Karabots has achieved prominence in the printing and publishing industry. The Karabots family is known for supporting projects focused on youth and inner-city causes.
“My wife and I are delighted to be able to support the creation of this facility that will help so many in need. The West Philadelphia community will benefit enormously with the opening of this state-of-the-art center,” said Karabots.
“I feel strongly that all children, especially those living under difficult circumstances, deserve the opportunity to live a healthy and productive life. To do this, they need to have access to good health-care services.”
Located on a four-story site, the two-story building will contain 56 child-friendly examination rooms; rooms dedicated to radiology, hearing and vision testing, and a phlebotomy laboratory.
The facility will also house community programs offered by Children’s Hospital including Early Head Start, Reach Out and Read, domestic violence education and asthma education.
The center plans to accommodate more than 45,000 outpatient visits annually.
“We are proud to create additional economic and community benefits to Philadelphia at the same time we provide a higher level of care for children,” said Dr. Steven M. Altschuler, chief executive officer of CHOP.
“This generous donation from Nicholas and Athena benefits our community on so many levels.”
Construction of the building is projected to finish in late 2012, with an opening planned for early 2013.
The principal architect for the center is Brawer & Hauptman Architects and the contractor is INTECH Construction. Stanley, Beaman and Sears are the interior design consultants and Medequip International is the medical equipment consultant. The Procz Group is serving as the building systems engineer, while the civil/structural engineer is Klein and Hoffman.
The existing CHOP Pediatric and Adolescent Care Centers at 39th and Chestnut streets and 3550 Market St. will relocate to the Karabots Center. The centers in South Philadelphia and Cobbs Creek will remain in their current locations.
There’s a new guide designed to empower Black women with the tools needed to take charge of their health.
Philadelphia-based writer Hilary Beard and president and CEO of the Black Women’s Health Imperative Eleanor Hinton Hoytt have co-authored “Health First! The Black Woman’s Wellness Guide.” (SmileyBooks, $27.95)
“Black women are disproportionally impacted by almost all the major diseases and chronic conditions; and unfortunately, many of us believe that being ill or developing a chronic illness or just living beneath our potential because of different health challenges — we accept that as our fate,” says Beard, who is an award-winning health journalist.
“In reality, people have genetic predispositions to things, but it’s really our lifestyle choices that trigger it.”
To that end, “Health First!” serves as a reference tool to help Black women address their most critical health challenges from adolescence through senior citizenship.
The book is organized into three parts: The first part takes the reader through the life stages of Black women, while the second section focuses on the top 10 health risks for Black women including heart disease, cancer, obesity, depression and violence. The third section addresses the steps women can make to take care of their mind, body and spirit.
“We look at health as a process, and how the life choices and decisions that we make in one phase in life carry over into subsequent phases — and either prepare us to be productive members of society — or can undermine our health,” says Beard.
The book connects the dots through discussions with health experts and uncensored stories of real women who survived and thrived.
“‘Health First’ teaches Black women how to see themselves through new eyes and encourages them to make new choices. It explains why we must place our self-care above all other responsibilities in our lives,” says Hoytt, who is regarded to be an advocate for eliminating health disparities among women and communities of color.
“Decisions made today have consequences tomorrow; that’s why we encourage women to think of their lives and health as a lifelong process, not just a series of disconnected events.”
While Black women have long been regarded as the nurturers who care for their family and loved ones, this often happens at the expense of their own health.
“What we’re proposing is that Black women flip the script, and we start taking care of our own health first,” said Beard.
“When you take care of your own health first, you surprisingly find yourself in better shape to take care of other people. We think that if Black women learn to take care of themselves first, they’ll find they won’t need to suffer from all of these debilitating conditions and are able to take care of all the people who we love — but it doesn’t have to be at own expense.”
“In many families — the mother, the auntie or the grandmother — is the last line of defense for the family between where they are now and the social service system. So it the Black woman goes down, the family goes down and the community goes down,” Beard pointed out.
“If Black women can learn to take care of themselves — mind, body and spirit — then we think that the Black woman can also be the lynch pin for building the community back up.”
The authors are in the midst of a multi-city book tour.
Recently, a study, widely publicized in the news, reported that women who took vitamins stood a greater chance of dying than women who didn’t.
Older women who took a daily vitamin supplement — even just a multivitamin — had an increased risk of dying of cardiovascular disease and cancer, according to a study published Monday in the journal Archives of Internal Medicine.
Researchers from the Iowa Women’s Health Study found not only did the vitamins and mineral supplements offer no protection for older women from cardiovascular disease, cancer or diabetes, but also some are “associated with increased mortality rate.” They include: multi-vitamins, vitamin B6, folic acid and the minerals magnesium, zinc, copper and, according to researchers, most strongly, iron.
Many in the supplement industry criticized the study. Among other things they pointed out that the study did not distinguish if the women in the study took the vitamins to fight diseases or to maintain health.
As with most studies like this, there are other factors found in the participants that would cause one to include that there is no benefit from taking supplements:
Supplement users were significantly (statistically) more likely than non-users to:
• Be non-smokers
• Be more educated (graduates)
• Have lower risk of diabetes mellitus
• Have a lower body mass index (BMI)
• Have a lower hip-to-waist ratio
• Be more physically active
• Ingest fewer calories
• Consume more protein
• Consume less total fat
• Consume more polyunsaturated fatty acids
• Consume more fruit
• Consume more vegetables
• Consume more whole grain products
Are you considering taking vitamin or mineral supplements? Do you think you need them? Or that they “can’t hurt” so you may as well take them? Here are some questions to ask before you decide to take them:
1. Do I really need them?
First and foremost, nutritional needs should be met by eating a variety of foods. In some cases, vitamin/mineral supplements or fortified foods may be useful for providing nutrients that may otherwise be eaten in less than recommended amounts. If you are already eating the recommended amount of a nutrient, you may not get any further health benefit from taking a supplement. In some cases, supplements and fortified foods may actually cause you to exceed safe levels of intake of nutrients. Fortified foods are those to which one or more essential nutrients have been added to increase their nutritional value.
The Dietary Guidelines for Americans makes these recommendations for certain groups of people:
• People over age 50 should consume vitamin B12 in its crystalline form, that is, from fortified foods (like some fortified breakfast cereals) or as a supplement. (Note: Older adults often have a reduced ability to absorb vitamin B12 from foods. However, crystalline vitamin B12, the type of vitamin B12 used in supplements and in fortified foods, is much more easily absorbed.)
• Women of childbearing age who may become pregnant and adolescent females should eat foods that are a source of heme-iron (such as meats) and/or they should eat iron-rich plant foods (like cooked dry beans or spinach) or iron-fortified foods (like fortified cereals) along with a source of vitamin C.
• Women of childbearing age who may become pregnant and those who are pregnant should consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet.
• Older adults, people with dark skin, and people who get insufficient exposure to sunlight should consume extra vitamin D from vitamin D-fortified foods and/or supplements.
It is important to note that vitamin/mineral supplements are not a replacement for a healthful diet. Remember that in addition to vitamins and minerals, foods also contain hundreds of naturally occurring substances that can help protect your health.
Here are some questions that the Food and Drug Administration recommends asking yourself and discussing with your doctor when considering whether you should take a vitamin/mineral supplement:
• Do you eat fewer than 2 meals per day?
• Is your diet restricted? That is, do you not eat meat, or milk or milk products, or eat fewer than 5 servings of fruits and vegetables per day?
• Do you eat alone most of the time?
• Without wanting to, have you lost or gained more than 10 pounds in the last 6 months?
• Do you take 3 or more prescription or over-the-counter medicines a day?
• Do you have 3 or more drinks of alcohol a day?
2. Should I talk to my doctor about taking vitamin/mineral supplements?
Yes, you and your doctor should work together to determine if a vitamin/mineral supplement is right for you.
If you are already taking dietary supplements, you should inform your doctor. Research shows that many people do not let their doctors know that they are taking a dietary supplement or are considering taking one. You may think side effects happen only with prescription medicines, but some dietary supplements can cause side effects if taken with other medications or if certain health conditions exist. Even if you don’t take medication or have a chronic health problem, the wrong dietary supplement or the wrong amount, can cause problems. So check with your doctor before taking a dietary supplement.
3. Where can I find scientifically sound information about vitamin/mineral supplements?
Your doctor is a good place to start. In addition, pharmacists and registered dietitians are helpful.
The NIH Office of Dietary Supplements has a series of Vitamin and Mineral Fact Sheets that provide scientifically-based overviews of a number of vitamins and minerals. They can provide a good basis for a discussion with your doctor about whether or not you should take a vitamin/mineral supplement.
The Food and Drug Administration (FDA) has a variety of articles and consumer advisories to help consumers inform themselves about dietary supplements, including warnings and safety information, labeling, evaluation information, and FDA’s role in regulating dietary supplements.
4. What should I do if I suspect I may be having a side-effect from a dietary supplement?
First, stop taking the supplement. Next tell your doctor or health care professional.
Many experts consider taking extra vitamins and minerals unnecessary — at least for most in the Western world, where eating a healthful diet is relatively easy.
But for at least a few people, supplements offer clear benefits.
• Vegetarian women of childbearing age, for instance, may need supplemental iron.
• Women who are pregnant, or plan to become pregnant, should take folic acid to prevent neural tube defects. Some people need to take vitamin D as well.
• And calcium supplementation — the only type found beneficial in the Archives of Internal Medicine study — can slow the progress of osteoporosis.
In summary, check with your doctor or a registered dietitian about which, if any, vitamin or mineral supplements might be right for you. And remember that while there are circumstances when it may be appropriate to take vitamin/mineral supplements, they are not a replacement for a healthful diet.
Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended or implied to be a substitute for professional medical advice. Readers should always consult their healthcare providers to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.
Glenn Ellis is a health advocacy communications specialist. He is the author of “Which Doctor?,” and is a lecturing health columnist and radio commentator, and an active media contributor nationally and internationally on health related topics. His second book, “Information is the Best Medicine,” is due out in fall, 2011. For more good health information, visit www.glennellis.com.
When Tiersa Cross was only 24 weeks pregnant, she underwent a surgery that positively impacted her baby’s life.
Cross was referred to the Children’s Hospital of Philadelphia’s Center for Fetal Diagnosis and Treatment, when a prenatal screening test determined that her baby girl had spina bifida — a common birth defect that affects about 1,500 babies a year in the United States.
Spina bifida is a defect in which the backbone and spinal canal do not close before birth. The birth defect could cause partial or complete paralysis of the newborn’s legs, loss of bladder or bowel control, weakness of the hips and legs or feet and build up of fluid in the brain.
On October 19, Cross and her baby Madisyn Cruickshank underwent surgery at CHOP.
“They said that if I didn’t get the surgery, her chances of being able to walk would be slim to none. Closing that hole in her back was really important at that time, for her to be able to walk and also to keep fluid from retaining in her brain,” says the resident of Norristown.
“I just wanted to let her have the best life possible. I was just really looking out for her.”
While she was aware of the risk that her baby could possibly be born prematurely, Cross was more concerned about the potential outcome of the surgery.
Madisyn was born January 18 in CHOP’s Garbose Family Special Delivery Unit. Since her birth, she’s returned to the hospital every week for follow-up visits with her doctors.
“She’s doing really well. Her legs are moving. She has full bladder and bowel control,” Cross says of the baby.
Cross also noted that Madisyn doesn’t need a shunt — a surgically implanted tube that drains fluid from the brain.
“We’re optimistic that the operation [she had] before birth will help that baby, but obviously we need to do the long-term follow up. I think that it will end up being a good result,” Dr. Scott Adzick, CHOP’s surgeon-in-chief and director of the Center for Fetal Diagnosis and Treatment says of Madisyn’s surgery.
The surgical highlight comes on the one-year anniversary of a CHOP-led groundbreaking national study published in the New England Journal of Medicine, which found that performing delicate surgery in the womb could substantially improve outcomes for children with spina bifida. The Management of Myelomeningocele Study (MOMS) trial showed that surgery reduced the need to divert fluid from the brain, improved mobility and the chances that the child will be able to walk independently. CHOP worked with Vanderbilt University and the University of California San Francisco to conduct the National Institutes of Health-funded trial.
Adzick says the concept of fetal surgery arose approximately 30 years ago out of frustration by doctors who realized that they couldn’t treat the damage done to babies’ organs before birth.
After undergoing the surgical procedure, the baby’s mother is monitored very closely.
“With fetal surgery as we do it now, there is a substantial risk of pre-term birth,” said Adzick, noting that a study showed that babies who undergo the procedure were born approximately three weeks early.
Adzick said mothers who undergo this operation need to understand that the procedure leaves a scar on the uterus that can rupture during subsequent pregnancies. With that in mind, mothers who undergo this surgery must deliver their babies by Cesarean section.
According to Adzick, this year the Center for Fetal Diagnosis and Treatment will evaluate approximately 1,200 mothers from around the world who are carrying babies with birth defects.
I’m currently on a liquid supplement to help me lose weight. I drink one serving for breakfast, one for lunch and have dinner around 6 p.m. The problem is I get headaches and feel tired all day long. Also, once I start eating I want everything in sight. What can I do to make this diet work for me?
Cheryl, West Philadelphia
Cheryl, first of all I recommend that you lose weight slowly (1–2 pounds a week) by using a combination of exercise and good nutrition. Dieting does not get rid of body fat and does not tone muscle, exercise does. People tell me all the time about their diet aids and how they expect them to work. Unfortunately, so many are convinced that diet gimmicks will get them the results they want. Many people do lose weight on these programs, but 95 percent will eventually gain back all the weight lost and more. If you insist on using such a diet aid, use it as your last meal of the day. Make sure you have 2 to 3 servings of fruit early in the morning. By mid-morning have a light breakfast like a whole-grain cereal with soy drink or a couple of slices of toast with oatmeal or grits. For lunch have some turkey breast and a tossed salad with very little dressing (less than a tablespoon). Late afternoon have a serving of pasta or a baked potato or rice pilaf with salt-free whole-wheat crackers. These small meals will fuel your body throughout the day and keep you from getting headaches or wanting to binge later. If you insist on having your diet drink, have it in the evening when your pace is slowing down. The best way to achieve lasting weight loss is to develop good eating habits and an exercise program you can stick with for life. When you decide to give up your diet drink, make dinner a light meal of 2 to 3 vegetables to complement a serving of beans, lean meat or fish or a low-fat starch like pasta or roasted herbed potatoes.
How do I know if I’m suffering from depression, and what should I do about it?
Sally, Trenton, N.J.
Depression from stress is one of society’s fastest-growing ailments. There’re many ways of dealing with prolonged depression, which can include a fitness routine. Working out helps release endorphins in the brain, which gives you a natural feeling of well-being, like a natural high. The good feelings you get from working out will carry over for hours. A combination of proper nutrition and exercise can help you fight depression.
If you find yourself suffering from one or more of the following most common symptoms of depression, you may need to seek professional help.
1. Feeling hopeless about the future
2. Having a difficult time making decisions
3. Not enjoying things you used to
4. Having difficulty doing things you did in the past
5. Feeling worthless or not needed
Fish and Sodium
Do saltwater fish contain more sodium than freshwater fish?
Tina, Dallas, Texas
The answer is no. Just as your body doesn’t absorb salt from swimming in the ocean, fish don’t absorb it from their surroundings. A three-ounce serving of freshwater bass contains almost as much sodium as three ounces of Pacific cod.
Fish are an excellent source of protein, polyunsaturated fatty acids and minerals. Fish contain the highest sources of iodine and potassium. Most fish are also low in saturated fat.
Each of the categories differs slightly in nutritional value. Freshwater fish provide magnesium, phosphorus, iron and copper. Saltwater fish and shellfish are rich in iodine, fluorine and cobalt. The fat content of fish varies not only with the size and type of fish, but with the time of year. Fatty fish, which include halibut, mackerel and salmon, are higher in fat but contain more vitamins A and D. Shellfish are low in fat, but are higher in cholesterol than most other fish.
Running Every Day
I run every day at 6 a.m., but I feel tired all the time. I thought that doing cardio exercise would help me feel more energetic. What can I do to feel better?
Alfred, Woodbury, N.J.
Alfred, running every day could be too much exercise. You need at least one full day of rest to recover from any exercise routine. You should read your body; if you feel tired, cut back until you feel better mentally and physically. It could sometimes take a week to get back to normal.
I also want you to do some muscle-building exercises. This will help you with the stress running puts on your body. If you can go to a gym, go. Pick 2 to 3 exercises for each body part. Do at least 3 sets of 10 to 12 reps. If you can do more than 12 reps, increase the weight you’re using.
I want to lose more
I’m 35 years old, 5’ tall, and I weigh 131 pounds. Eight months ago I hired a personal trainer and started working out five days a week. I also hired a nutritionist to help me learn to eat better. I only lost 5 pounds. I do see changes in my body, but my weight has not moved. What should I do?
Ed, you may be at your ideal weight. Your main focus should be to stay healthy, not weight loss. As your body becomes more toned your new muscle weighs more but takes up less space. Your bone structure will also increase weight and density. These two facts could account for your lack of body weight change. What do your mirror and your old clothes say about that 5-pound weight loss? That 5-pound loss could mean a lot of inches off your problem areas. A 5-pound loss of body fat is a lot of fat. A better way to chart your body tone is to take pictures. You should take photos once a month to keep track of your progress.
Keep up the good work and let me know how you’re doing.
High Blood Pressure Tips
My doctor just told me I have high blood pressure. Don’t like taking medication. What should I do?
Shirley, Denver, Colo.
Please follow your doctor’s recommendations.
Usually, people with high blood pressure don’t experience discomfort or outward signs of trouble.
High blood pressure isn’t like a toothache, a bruise or constipation. In most cases, nothing hurts, looks discolored or fails to work. Many people who have high blood pressure don’t know it. That’s why hypertension is called the silent killer. Uncontrolled high blood pressure increases the odds that you’ll have a heart attack, stroke or kidney failure.
Here are some tips to help control high blood pressure:
Take your medication as prescribed.
Lose excess weight.
Limit alcohol intake to less than 2 drinks a day.
Limit your salt intake.
Exercise 3–5 times a week.
Learn to deal with stress.
Take blood pressure medicine as prescribed.
Talk to your doctor if you use oral contraceptives.
Avoid drug with phenyl propanolamine, which can be found in decongestants and over-the-counter diet pills.
Before starting your fitness program, consult your physician.
For help with drug, alcohol and mental health problems call Sobriety Through Outpatient drug, alcohol and mental health treatment center at (215) 227-7867. Watch or listen to our recovery media stations every day at www.stop-recoveryradio.com.
Listen to “Tips to be Fit” with Vince daily at www.stop-recoveryradio.com.