Never Too Old to Donate?

Updated 3/2017-- all links removed as many no longer active.

I happened to see this press release from American Society of Nephrology via Eurekalert regarding an article in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN) advocating the safety of kidney donation in individuals over 70 years old.  The press release does note that kidneys from these elderly donors do not last as long as those from younger living donors.

Currently, as noted on the University of Maryland Medical Center website:

Donors need to be between the ages of 18 and early 70s and can include parents, children, siblings, other relatives, and friends. An ideal donor should have a genuine interest in donating and a compatible blood type with the recipient.

Donors should be in good general health. Donors do not need to be genetically related. Typically, someone who has cancer, diabetes, kidney disease, heart disease, liver disease, sickle cell disease, HIV or hepatitis will not qualify to be a donor. However, these diseases are not all absolute contraindications to donation. Every donor will be considered on an individual basis.

Many individuals over 70 years of age are ineligible simply due to chronic illnesses.   This recent article (full reference below) is a result of a study done by John Hopkins University School of Medicine. 

Jonathan Berger, MD, Dorry Segev, MD, PhD , and their colleagues studied 219 healthy adults over the age of 70 years who donated kidneys and compared them with healthy elderly individuals who were not organ donors.  The surgeries were done at 80 of the 279 transplant centers in the United States.

The researchers found that among recipients of older live donor allografts, graft loss was significantly higher than matched 50-to 59-year-old live donor allografts (subhazard ratio [SHR] 1.62, 95% confidence interval [CI] 1.16 to 2.28, P = 0.005) but similar to matched nonextended criteria 50-to 59-year-old deceased donor allografts (SHR 1.19, 95% CI 0.87 to 1.63, P = 0.3).

Mortality among living kidney donors aged ≥70 was no higher than healthy matched controls drawn from the NHANES-III cohort.

I don’t have full access to the article (only the abstract).  I wonder how old the oldest donor was (ie 72? or 82?).  I wonder if the risk is different for the 70-75 age group vs the 75-80 age group.

Living Donors Online: FAQ (kidney donation)

REFERENCE

Living Kidney Donors Ages 70 and Older: Recipient and Donor; Jonathan C. Berger, Abimereki D. Muzaale, Nathan James, Mohammed Hoque, Jacqueline M. Garonzik Wang, Robert A. Montgomery, Allan B. Massie, Erin C. Hall, and Dorry L. Segev;  Outcomes CJASN October 27, 2011 CJN.04160511; published ahead of print October 27, 2011, doi:10.2215/CJN.04160511 (full article is not open access)

Cheerful Robots Baby Quilt

I found this robot fabric at Hobby Lobby.  It became the center piece of this baby quilt.  I used bright colors in a basket weave pattern to frame the robots (red, orange, yellow, green, blue, and purple – though the photos don’t show them well).

The quilt is machine pieced and quilted.  It measures 37 in square.  I sent it to our blog friend Dr. Smak.

Here you can see one of the robots who is actually surrounded by orange, green, yellow, and purple strips.
And this smiling robot.
The back is a pretty yellow and white fabric.

Prophylactic Mastectomy in BRCA Carriers: Can the Nipple Be Preserved? (an article review)

Updated 3/2017 -- photos and all links removed as many no longer active.

The entire article is available via open access (full reference below).  Women with the BRCA gene (both 1 and 2) often elect to have prophylactic mastectomy to reduce their risks of developing breast carcinoma.  This is even more so for the contralateral breast when a primary is found.  Skin-sparing mastectomies (SSM) and nipple-sparing mastectomies (NSM) greatly improve the cosmetic results for women undergoing reconstruction.  Traditionally, the NAC has been removed due to concerns of possible tumor recurrence or development of a new primary in the remaining breast tissue of the NAC. 

The article notes "numerous retrospective studies have shown a wide range(0-58%) of nipple involvement by tumor in mastectomy specimens." 

This retrospective study involves a small cohort of 33 patients (25 BRCA1, 8 BRCA2) who underwent mastectomy between March 1987 and June 2009 treated at Mayo Clinic.  The entire nipple-areolar complex (NAC) was excised and evaluated histologically.  There was a total of 62 NACs available for evaluation. [TDLS = terminal duct lobular units]

Sixty-two NACs from 33 women (25 BRCA1, 8 BRCA2) were studied. TDLUs were present in 15 (24%) NAC specimens. No evidence of atypical hyperplasia, carcinoma in situ, or invasive carcinoma was found in any of the 33 prophylactic mastectomy specimens. Among the 29 breasts with cancer and available tissue, 2 (7%) had malignant findings and 1 (3%) had atypia in the NAC. One woman who underwent bilateral mastectomy for bilateral invasive carcinoma had one nipple with tumor within lymphatics, and her contralateral nipple had atypical lobular hyperplasia. A second woman had ductal carcinoma in situ involving a single major lactiferous duct..

They conclude the probability of premalignant or malignant lesions in the NAC of BRCA carriers is low overall.  It must be remembered that it is higher (10%) in the subgroup of women undergoing therapeutic mastectomy.  It may be safe for select women with BRCA mutations to have a nipple sparing procedure, but she and her physicians (oncologist and surgeon) should have a frank discussion about her individual case.

REFERENCE

Prophylactic and Therapeutic Mastectomy in BRCA Mutation Carriers: Can the Nipple Be Preserved?; Carol Reynolds, Jennifer A. Davidson, Noralane M. Lindor, Katrina N. Glazebrook, James W. Jakub, Amy C. Degnim, Nicole P. Sandhu, Molly F. Walsh, Lynn C. Hartmann and Judy C. Boughey; Annals of Surgical Oncology Volume 18, Number 11, 3102-3109, DOI: 10.1245/s10434-011-1908-8

Shout Outs

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active. 

Laika,  Laika's MedLibLog, is the host for this week’s Grand Rounds. You can read this week’s edition here.

Welcome to the Grand Rounds, the weekly summary of the best health blog posts on the Internet. I am pleased to host the Grand Rounds for the second time. The first time, 2 years ago, was theme-less, but during the round we took a trip around the library. Because, for those who don’t know me, after years of biomedical research I became a medical librarian. This also explains my choice for the current theme:. ………….

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Margaret Polaneczky, MD, TBTAB, explains Emergency Contraception is NOT an Abortifacent

When patients ask me how emergency contraception prevents pregnancy, I tell them that it’s primary mechanism is to delay ovulation (release of an unfertilized egg from the ovary).  There is no evidence that the EC aborts or prevents implantation of an already fertilized egg.

The efficacy of EC depends on where you are in your menstrual cycle when you have unprotected sex. …..

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H/T to @MtnMD for the link to the NY Times visual guide to the euro debt crisis:  It’s All Connected: An Overview of the Euro Crisis (interactive visual guide).

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H/T to @MedicalNews for the link to CNN article by Elizabeth Landau: When your cancer nurse has cancer, too

When new patients worry they don't know how they'll get through breast cancer, Cindy Davis puts her hand on theirs and says, "I know, but I want to tell you, I truly know, because I went through this two years ago."

"Their eyes light up and they go, 'Whoa. Really?'" says Davis, 54. "Suddenly, I'm a human being. I'm not just the nurse." ……….

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Check out this NY Times piece by Jane Rosett, an artist and a brain injury patient at Spaulding Rehabilitation Hospital:  Starting Again After a Brain Injury

“WANT a piece of gum, Jane?” asked my friend Andrée.
“What?” I asked her.
“Gum!”
I didn’t know what she was talking about.
“It’s Trident.”
It was delicious.
That evening, I told my friend David about my day’s big discovery. “It’s called gum and you chew it and it’s fun and there’s this one kind that will let me blow bubbles!”
“Yes, it’s called bubble gum, Jane,” he told me, patiently. …………..

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H/T to @ctsinclair for the LifeHacker piece:  Carve and Preserve the Ultimate Pumpkin

Halloween is just around the corner; it's the perfect time to brush up on your pumpkin carving skills and learn how to make sure your masterpiece looks as good for the trick-or-treaters as it did the day you carved it……...

Here’s mine from last year post on Safe Pumpkin Carving

Learning, Part Two

Updated 3/2017 -- photos and all links removed as many no longer active. 

I have now completed three weeks at my new job with the Disability Determination Services office.  I sort of knew there were two types of disability payments under SSI:  Title II and Title XVI.  Now I understand the differences much clearer.

I would urge everyone who can afford it to purchase disability insurance.  As the person training me put it, “If you are disabled, you are still ‘costing’ your family in addition to not contributing to the family income.”

The big difference between the two (II and XVI) is that anyone who has worked and paid taxes has in effect purchased disability insurance (Title II – DIB).  Title II is not based on your I & R (income and resources) as you are insured.  Title XVI individuals are the truly poor who must meet an I& R test. 

Both Title II and Title XVI must the SSI definition of a disability to be eligible:  The individual must not be able to perform substantial gainful activity (SGA) due to a medically determinable impair (MDI) which can be substantiated by a medical consultant backed up by significant signs, symptoms, and laboratory data.  The MDI had to be one which is expected to result in death or which has lasted or will last 12 months.

The person training me is blind (due to RP).  Note he does not meet the able definition as he is working.  He is an amazing person who was a pediatrician prior to taking a job with DDS as his sight began to go.  He uses a program called JAWS to read to him at work, but types faster than I do.  He has the listings memorized.

Lace-Autograph Star Quilt

Here is another quilt top whose photos I found as I cleaned my office.  The quilt top is machine pieced using an autograph star block.  Instead of signatures, I put a piece of antique lace in each signature bar of the stars.  The top was made for a friend who loves lace and quilts.  I think it was made late 90s or early 2000s.  Each block is 12 in square, so the quilt is probably 72 in X 86 in.

Hopefully in these next two photos you can see the laces and fabrics better. 


I’m not sure if my friend ever finished quilting the top.  I do know she is an active quilter.

Shout Outs

Updated 3/2017 -- photos and all links removed as many no longer active.

Dr. Sumer, Sumer's Radiology Site, is the host for this week’s Grand Rounds. You can read this week’s edition here.

For people who are new to this concept "Grand Rounds is a weekly summary of the best health blog posts on the Internet. Each week a different blogger takes turns hosting Grand Rounds, and summarizing the best submissions for the week. The schedule for Grand Rounds is available at the Better Health Blog and at Blogborygmi.com. Both Dr. Val Jones and Dr. Nick Genes coordinate the schedule for Grand Rounds.” For people who are new to this concept "Grand Rounds is a weekly summary of the best health blog posts on the Internet. Each week a different blogger takes turns hosting Grand Rounds, and summarizing the best submissions for the week. The schedule for Grand Rounds is available at the Better Health Blog and at Blogborygmi.com. Both Dr. Val Jones and Dr. Nick Genes coordinate the schedule for Grand Rounds.” .............

My suggestion- we should all share each edition of grand rounds on our facebook pages as well as our blogs for more viewership. My thanks to all those who submitted to this edition and Grand Rounds Surely Rock. ………….

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H/T to @SeattleMamaDoc for tweeting about this NY Times Health article: Well Blog: Doctor and Patient: From Needle Stick to Hepatitis Cure

As doctors-in-training in the early 1990s, my friends and I became obsessed with the question of what we would do if we were pricked with an infected needle at work. We all had witnessed the inexorable, often painful march toward death of patients with hepatitis C and AIDS. We imagined the despair we would feel in that situation: the dashed hopes, the lost years of schooling and training. Many of us saw ourselves walking out of the hospital and not looking back. We couldn’t imagine throwing ourselves back into the fray.

We had not met Dr. Douglas Dieterich. …..

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I agree with @jordangrumet who tweeted: Bummer! on.wsj.com/ra3DTa The Vocal Cord Injury Affecting Adele

The Grammy-winning singer Adele has canceled a series of U.S. tour dates due to a vocal-cord hemorrhage.

As she wrote on her blog this week, she was first diagnosed with a hemorrhage in May, then rested and recovered. But recently, she was diagnosed with another hemorrhage. “My voice yet again went … it just switched off,” she wrote.

That sort of “instantaneous hoarseness” is typical of hemorrhages of the vocal cords, which are also called vocal folds, says Kenneth Altman, an associate professor of otolaryngology at the Mount Sinai School of Medicine. …..

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H/T to @doc_rob for the link to this “Great video about depression.” If you have depression, please, get help.

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This Reuters new articles reminds us that “Many cancer survivors struggle with trauma stress: study”

A cancer diagnosis can leave lasting psychological scars akin to those inflicted by war, with the impact in some cases lasting for years, U.S. researchers found in a study.
More than a decade after being told they had the disease, nearly four out of 10 cancer survivors said they were still plagued by symptoms of post-traumatic stress disorder, or PTSD ……………SOURCE: bit.ly/n1pJMg

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H/T to @GregSmithMD for the link to this “Beautiful post about things that heal.” -- Stop And Smell The Roses

Even though the title is cliche and many of us hear it from time to time, I am going to guess that the majority of us don't actually do it. I know I don't or at least I haven't in the past. ……….

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From @Berci. --- Picture of the Month: Left brain-right brain (photo credit)

This is one of the best pictures I’ve ever seen. I’m almost totally a left brain… What about you?

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Some of my nephew-in-law @eleonfreeman’s paintings will be included in the upcoming art exhibit at the Boswell-Mourot in Miami. Exhibit opening is November 5, 2011.

Including this lovely one: Treasure Reef" by Eric Leon Freeman (2011) Oil on Linen, 48" x 72"

My Review of Lifetime’s Movie: Five

Updated 3/2017-- all links removed (except to my own posts) removed as many no longer active.

I caught this movie last week flipping though channels looking for something to watch while I knitted. 

"Five" stars Patricia Clarkson, Rosario Dawson, Lyndsy Fonseca, Ginnifer Goodwin, Josh Holloway, Tony Shalhoub, Jeffrey Tambor, and Jeanne Tripplehorn.  It is an anthology of five short films exploring the impact of breast cancer on people's lives.

The first one, the story of Charlotte (Ginnifer Goodwin), is set in 1969.  Charlotte lays dying in her bedroom while the family mills around the house and the TV showing the mans first step on the moon.   Her story for me was taken over by the affect of her cancer on her young daughter Pearl who only wants to see her mom.   Finally she manages to sneak into the room.

The second one is Mia’s story.  Mia (Patricia Clarkson) is the tale of someone who beats the odds.  She was expected to die and even held her own mock funeral.  Her segment begins with her second wedding and flashes back through the chemo, the hair-loss, her first husband walking out on her, her “mock” funeral, etc.

The third one is Cheyanne’s story.  Cheyanne (Lyndsy Fonseca) is a 24 year old exotic dancer.  This one also focuses on how the diagnosis affects the husband Tommy (Taylor Kinney).  Very emotional.

The fourth is Lili’s story.  Lily (Rosario Dawson) is a successful career woman who recruits her sister to help tell their hard-nosed mother that she has breast cancer. They struggle through past family issues to stand by and support Lili.  This segment also introduces male breast cancer through a male patient the three women meet in the hospital waiting room.

The fifth story is Pearl’s.  Pearl grew up to be an oncologist.  She ties all the stories together as she is the oncologist of the middle three.  Pearl (Jeanne Tripplehorn) finds herself in her parents’ position of needing to tell her own daughter of her diagnosis. 

The stories are very emotional.  Within the short stories, the writers and directors did a decent job of keeping too much sentimentality out of them, but remember these are Lifetime movies so expect some.

You can watch the full length movie online here.
Five Movie Cast & Characters


Related posts:
Risk Factors for Breast Cancer (October 2, 2007)
New Breast Cancer Screening Guidelines (November 17, 2009)
Screening Mammogram Recommendations (January 7, 2010)
The New Mammogram Guidelines - What You Need to Know (December 27, 2009; TBTAM)
Dr. Marya Zilberberg’s, Healthcare, etc, post:  Why medical testing is never a simple decision (December 15, 2010)

Say Cheese Baby Quilt

This baby quilt was inspired by the bandana which makes up the center.  It is machine pieced and quilted.  It measures 40 in square.  I have given it to my niece.  She and her husband are expecting their first baby (a girl) in February.

Here is a closer view of the center featuring Mickey Mouse and Pluto.  I added bright, basic colors to frame the center.
Then added eight-pointed stars with Pooh, Tigger, Piglet, and a dog riding a motorcycle for the border area.

Here is the back.

Shout Outs

Updated 3/2017-- photos and all links removed (except to my own posts) removed as many no longer active.

Jason Shafrin, PhD, Healthcare Economist, is the host for this week’s Grand Rounds. You can read this week’s edition here.

This is a great time to be the Healthcare Economist. Not only am I hosting Grand Rounds for the first time, but Wisconsin sports are enjoying a renaissance. The Milwaukee Brewers are in the NLCS, the Green Bay Packers are Super Bowl Champs and undefeated, and the Wisconsin Badgers also have not lost.

How does this relate to this week’s edition of Grand Rounds? I have no idea. But I know if you’ve made it this far, you might as well take a few more minutes to review the best medical posts on the blog-o-sphere during the past week. Enjoy! ………….

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The 2011 Charles Prize for Poetry Contest deadline for entries has passed. Now while we await the announcement of the winners I hope you will enjoy reading the many wonderful entries.

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TBTAM (@tbtam) has another nice blog post on mammograms: Mammograms – Reality Check

A well-written and balanced article on mammography from USA Today may help move the conversation about this screening test away from hype and a bit closer to reality. The title – “Mammogram is ‘terribly imperfect’, though recommended.” ...

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H/T to @DrMarkham and @doctorblogs for this BMJ article by Prof Joseph Ana on this horrifying practice: Breast flattening, ironing, straightening, and pounding: a new form of violence against girls and women

Until a few weeks ago, I had never heard about the cultural barbarism of breast flattening, a native attempt to delay the development of a girl’s breasts so that they are not “attractive” to men and boys before they are ready for marriage.

Just before a girl reaches puberty her mother will (sorry but please get yourself ready to soldier on with reading this sordid topic) pass a hot instrument, usually a hot wire into the victim’s breasts or pound the victim’s breast with a pestle without any form of anaesthesia or analgesic. …..

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Runawaydoc (@runawaydoc) is a “newbie blog / pediatrician in training” who recent blog post introduces us to “the man with the golden heart.”

……As a doctor, I regret to accept that our medical system is also hijacked into this dark world. Every doctor, every lab, every pharmacist wants to extract an extra rupee. The feel of the notes satisfy more than the contentment of the patient. …….

However, in one of those social networking portals I came across a man called “Morpheus”. I was jarred with his conviction to clean the dirty waters of medicine where doctors happily waddle in. He told me that healing profession has to be cleaned, somebody has to make a move, and somebody has to start it. At the end of the day the patient should not suffer. …..

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Did you catch Radio Rounds interview of ZDoggMD? If not, you can listen to it here: Slightly Funnier Than Placebo

This week features the hottest hip hop hospitalist in the nation, ZDoggMD. When not making videos, ZDogg is a hospital physician working at a Bay Area academic hospital. Along with some of his fellow physicians he moonlights in medical satire writing and producing his own videos and songs, claiming to be slightly funnier than placebo. This episode is about the man behind the name as we delve deeper into the mind of ZDoggMD.

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My friend Methodical Madness uses her recent Mothers in Medicine post to encourage donation of blood products: Blood Bank Halloween.

The Blood Bank always has some pretty interesting Halloween decorations. Last year they had gel blood dripping from the top of the main door. This year I was excited to see a bloody hand at the Blood Bank blood product distribution window. The window is kind of like a fast food restaurant window - only it opens bottom to top instead of sliding sideways. I imagine it was designed in the 1960's. This morning when I went to take a photo of it for this blog that was marinating in my head, I was upset to find it missing. I wandered into the blood bank.

"Where is that bloody hand decoration that was in the window?" …………

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H/T to @scanman for this tweet: Superb collection/selection >> RT @mankuthirai: The 50 Best Short Stories of All Time

The short story is sometimes an under-appreciated art form. Within the space of a few pages, an author must weave a story that’s compelling, create characters readers care about and drive the story to its ultimate conclusion — a feat that can be difficult to accomplish even with a great degree of savvy……….

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Thanks to @glevin1 who noticed this website on Google+ and know I’d appreciate it: LUKE Quilts. Luke’s website has three main sections – about, projects, and blog. His quilts are amazing! Check them out.

Motivation

Updated 3/2017-- photos and all links removed (except to my own posts) removed as many no longer active. 

I have meet several amazing people at my new job.  Here is one of them:  Richard Vaughn.  The poster isn’t accurate any longer, the 12 should read 20.

Richard is the IT guy at my work place.  He broke his back at age 17.  This hasn’t kept him from having a full life. 

……Shortly after graduation as a 17 year old, a severe accident - a fall of roughly 85 feet from a scaffolding - left me paralyzed and in a wheelchair. This was in the early 1970s. It was suggested that I enter one of several “special schools” for the handicapped. There, I was told, I might learn a vocation and become a “contributing member of society.”

I did go to a “special school” – college! Within 5 years, I was a Systems Programmer in the largest data center in the State of Arkansas. Though probably hired because of my handicapped status, I worked my way from Computer Operator to Programmer, then Systems Programmer and, finally, established a firm career as a Network Administrator. I am now in my 35th year as a computer professional……

He stumbled upon the idea for the motivational poster a few years ago at the gym (lifting weights) when another gym user stated “What’s my excuse?”  He now uses the sale of the poster to raise money for the Leukemia/Lymphoma Society.   Help spread the word on his poster and inspiration.

If he can be so active, then indeed “what’s your excuse?”  Remember too much sitting is bad for you, so get up and move.

"Save All" Signature Quilt

Updated 3/2017-- all links removed (except to my own posts) removed as many no longer active. 

Clearing out my office I found photos (not great ones) of this quilt I made in 1995 to help raise money for breast cancer research.  The quilt used fabric (between the dark green strips) which say “yes, mam” as in “say yes to a mammogram”.  The main body of the quilt uses a pattern called “save all” and the pillow area has the pink ribbons associated with breast cancer.

I solicited signatures from past presidents of the ASPRS and PSEF and members on the boards/committees.  I received 31 signatures.  I photocopied each signature onto fabric using freezer paper backed fabric which I ran through a laser printer.

The quilt is machine pieced by me, but I recall having it hand quilted by Scottie Brooks.  I’m not sure of it’s size (that’s a full size bed in the photo) so my guess would be 90+ in X 110+ in.
The quilt was donated to ASPRS’s Executive Office museum.  The signatures are from Frederick J. McCoy, MD, Peter Randall, MD, H. William Porterfield, MD, Mark Gorney, MD, George Reading, MD, James G. Hoehn, MD, Elvin G. Zook, MD, William Riley, MD, H. Bruce Williams, MD, Simon Fredricks, MD, Hale Tolleth, MD, Ronal B. Berggren, MD, Stephen H. Miller, MD, R. Barrett Noone, MD, William D. Morain, MD, Malcolm A. Lesavoy, MD, Bruce Achauer, MD, Gregory Borah, MD, B. R. Burkhardt, MD, David T. W. Chiu, MD, Loren Eskenazi, MD, Robert Goldwyn, MD, Frederick Heckler, MD, Ronald E. Iverson, MD, J. Michael Kelly, MD, Susan MacKinnon, MD, Paul Manson, MD, Karen Montero, MD, Rod Rohrich, MD, S. Larry Schlesinger, MD, and Brooke Seckel, MD.

Learning

This is a test (to see how posting from email works for me)  ...

 

This week and for several more I am training to do my new job:  disability determination for SSI.

 

Currently, I am learning definitions and jargon (read:  abreviation, acronyms). 

 

First definition which must be memorized and understood:

For the purpose of social security disability, the definition of disability is the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable impairment (MDI) -- physical or mental -- diagnosed by a medically acceptable source which is supported by sufficient signs, symptoms, and laboratory findings which can be expected to result in death or which has lasted or can be expected to last for a continous period of not less than 12 months.

 

I hope to find a way to continue to write about plastic surgery, but expect that medicine and disability will find it's way into this blog as I learn this new work.

 

Shout Outs

 Updated 3/2017-- photos and all links removed (except to my own posts) removed as many no longer active.

Colorado Health Insurance Insider is the host for this week’s Grand Rounds. You can read this week’s  edition here.

Welcome to the Fall Colors Grand Rounds!  We have several excellent articles from around the healthcare blogosphere for you this week.  Enjoy!

HealthBlawg’s David Harlow recently attended Health 2.0 in San Francisco and provides us with an excellent summary post about the conference. ………….

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The 2011 Charles Prize for Poetry Contest deadline for entries has passed.  Now while we await the announcement of the winners I hope you will enjoy reading the many wonderful entries.

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H/T to @DrMarkham for her new blog “eating despite cancer.”   The latest post is “i'm on chemo and food doesn't taste right...what can I do?”

The taste of foods often changes for people undergoing chemotherapy. This doesn’t happen to everyone receiving chemotherapy as part of cancer treatment, but it certainly happens to a lot. I’ve seen it happen as early as the first dose of chemotherapy, and it’s become my practice to warn people about this side effect. …….

We aren’t sure why this side effect happens, but there is medical literature to suggest that changes in both the sense of smell and the sense of taste occur with various chemotherapy drugs. The sense of smell is heavily tied into our sense of taste, so an alteration in either can really mess things up……..

The most important rule is to just keep trying. You’ll find something that will work. …..

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H/T to @The_Radiologist  for this tweet:  Great R4 piece on antibiotic resistance by @Dr_Stuart was repeated last night. Sobering times ahead. bbc.co.uk/iplayer/episod… #medicine

The link will allow you to listen to the 30 minute program which is well worth the time.

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I love the idea of self-healing materials!  H/T to @krupali for the link to this BBC news article by Leila Battison:  Bio-inspired plastic self-heals

The development of self-healing materials has surged forward as scientists have taken inspiration from biological systems.

Researchers at the University of Illinois in the US have found a way to pump healing fluids around a material like the circulation of animal's blood.

Materials that could repair themselves as they crack would have uses in civil engineering and construction.  …….

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Another great T-shirt!  This one with great advice:

  Available here.

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From WebMD:  Slideshow: Surprising Ways Smoking Affects Your Looks and Life (photo credit).  This is the first slide of the series.  Can you pick out the smoker? Make your pick and go check out the rest.

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Threads Magazine website has a very nice video (wish I could embed it here, but can’t):  Teach Yourself to Sew 2: Two Great Seam Finishes.  One uses the product Seams Great, the other is the Hong Kong finish.  Burda Style has a nice tutorial on the Hong Kong Binding Seam Finish

Parents and Their Child’s Genital Ambiguity

Updated 3/2017-- all links removed (except to my own posts) removed as many no longer active. 

There is more information in the Science Daily news article than the journal article abstract (full access is not free):  Parents Feel Shock, Anxiety and the Need to Protect Children With Genital Ambiguity

Parents of babies born without clearly defined male or female genitals experience a roller-coaster of emotions, including shock, anxiety and the need to protect their child, according to a study in the October issue of the Journal of Advanced Nursing.  …….

I never had to walk a family through this as a practicing physician.  As a medical student, we had a patient which led to much discussion. 

Early surgical decisions raised strong emotions in some parents. Sian was anxious about whether she had done "the right thing," but Anne described a documentary that suggested that parents shouldn't be allowed to make decisions about genital surgery as "ridiculous."

I tend to agree with Anne.  Parents should be in on all the decisions being made.

Reconstructive genital surgery made it easier for some parents to protect and bond with their child. Medical evidence about whether the child was predominantly male or female, and how they looked, guided the parents' decisions when it came to surgery. But one mother who learnt that her child had both male and female internal organs described the news as a "double whammy."

It’s a tough diagnosis for families to have to deal with and ongoing support and care is important.  


REFERENCE

Searching for harmony: parents’ narratives about their child’s genital ambiguity and reconstructive genital surgeries in childhood; Caroline Sanders, Bernie Carter, Lynne Goodacre;  Journal of Advanced Nursing, 2011; 67 (10): 2220 DOI: 10.1111/j.1365-2648.2011.05617.x (abstract free, full article is not)