“Mother Earth living” and turmeric: I tried it and wished FDA regulated the labeling, including interactions with blood thinners

May 2, 2016

People living with low vision trip a lot, stumble, and invariably too often fall, leaving them to seek solutions for the effects, which for me included trying turmeric for joint inflammation. For many, falling leads to broken bones [remember my shattered wrist last year], sprains–which I am constantly dealing with because of the activities I enjoy, and may trigger other conditions. Options of what to do about this situation include sit rather than risk these events. No. Use the white cane I was trained to use during my sessions with the counselor from PA Office for Blindness and Visual Services [https://www.portal.state.pa.us/portal/server.pt/community/blindness_and_visual_services/10367/bbvs_office_directory/718649]. Not so much [more about this another time]. I do use marvelous hiking sticks when hiking, but as discovered last month, they don’t really alert me to tree roots in my path until I trip over them. Ahem…

So, last month, I was on a hike through our woods with my husband and another dreaded fall happened. I am getting so much better at knowing how to do these things. Hence, my reference a couple of days ago to what I have been up to in spending my time learning to adapt. I tried to avoid falling but when it became clear it was inevitable, I fell backwards, landing on my butt, and not repeating any injury to my wrists. In the process, however, I did wrench my knee in a very awkward position because my foot was caught under a massive tree root hidden under the fall leaves that remained. And the knee promptly began to swell.

Because I have had a couple of prior hits to my knee[s] due to my failure to see something in my path [like a coffee table I sent flying], I have learned that I have a condition called calcium pyrophosphate deposition disease or CPPD [http://www.mayoclinic.org/diseases-conditions/pseudogout/basics/definition/con-20028152]. When I hit the coffee table with my knee, it triggered the condition, a reminder that so much of our health is an equation and when we communicate about it, we have to keep all the parts of the equation in mind. Had I not hit the coffee table, I might never have known of this underlying condition [which would have been fine with me]. Since I did, I learned about it. I learned that 19-21 inches for a swelled knee [when the normal other knee is 15 inches] does not feel so good. I learned that a soft brace allowed me to go to work, though I put the leg up on a chair as often as possible. And I learned that after weeks of that, and still too much swelling and pain, a needle was used to aspirate the fluid…which hurt…but then the knee was closer to normal in size, though I was instructed to keep it wrapped in an ace bandage or the swelling would reappear. That lasted for awhile. And from it, I learned all about compression wear and ace bandages… So, fast forward, with this fall and swelling of the knee, I iced it and I wrapped it. And that kept the swelling to more like 17 inches as I watched it.

Some weeks passed and I was catching up on some reading, including my subscription to “Mother Earth living”the Nov/Dec 2015 issue with the headline: ‘all about amazing turmeric.’ The article is quite lengthy; I recommend reading it. In the pages of positive summaries related to its effects, I went back recently to find if anything indicated anything negative. “Most of the laboratory-based evidence for curcumin does appear favorable, but we do have to be aware that there are limited reports of potential for adverse effects” [p. 70]. Curcumin is the commercial product designed to deliver turmeric in a time-released, more easily absorbed fashion. Under a section labeled “Safety” in the article, it is noted “Doses up to 8 grams a day of curcumin cause only mild side effects, primarily stomach upset, nausea and diarrhea” [p. 71].

To be honest, I did not remember those cautionary phrases embedded in thousands of words. I just remembered the general gist when I began to have knee swelling that required bandaging…persistently. So I had looked up the research published regarding Curcumin. I liked what I saw. I bought the product. I took it. Day 2…I was sickkkkk. But I did not link it to Curcumin. I knew a friend had told me she takes turmeric when her arthritis acts up…keeps a bottle on the counter. I had literally felt relief in my knee 12 hours after taking a dose. I had told my sister. She then told me her husband uses the same product… It took until day 3 and being to the point of not keeping food down that I went back to the bottle and read it. Nothing about the stomach upset etc. Just a warning to pregnant or nursing women not to use it.

So I went to trusty WebMD [http://www.webmd.com/vitamins-supplements/ingredientmono-662-turmeric.aspx?activeingredientid=662]. I found the warning about stomach upset, which led me back to the Mother Earth article and the above. But, in addition to that content, WebMD noted under that side effects tab: ” Bleeding problems: Taking turmeric might slow blood clotting. This might increase the risk of bruising and bleeding in people with bleeding disorders. ”

That led me to read about interactions, where I found: “Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with TURMERIC. Turmeric might slow blood clotting. Taking turmeric along with medications that also slow clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.”

UHHHHH, that is a pretty big oversight missing from the product label and discussion of Curcumin, wouldn’t you agree?

Bono and me…my orange lenses are not a fashion statement

May 1, 2016

A new identity. One with which I share something in common with Bono, tho it would take years before I would realize that. After more medical tests than I could keep track of, and literally pictures of my eyes that looked like perhaps all that testing was making them bleed, the ophthalmologists finally did the medical equivalent–figuratively speaking–of throwing up their hands and diagnosed the cause of my sudden loss of sight and my dead optic nerve as “idiopathic.” Then the head of the team that had been leading the poking and prodding said, “I am scheduling an appointment for you with our low vision specialist.” “What?” “Well, yes, there is kind of a whole industry–she can explain it to you.” And he was off with a trail of others in his wake. And I was left to wonder what more tests were coming my way. And to think, ‘like my experience over these past weeks hasn’t been part of…a whole industry…to use his phrase?’

My first appointment with the low vision specialist took hours. There truly are many devices and many many many questions and some, yes, eye exams that go along with figuring out what ‘aids’ might be offered to assist those of us with low vision. On that particular first day, the real life-changing event came when I was handed a large ‘key chain’ like collection of lenses of many colors. The specialist asked me to look through the one that I jokingly said, “Oh, you want me to look through rose-colored glasses?” Get it? At any rate, when I did and looked again at the laminated card she handed me, there was nothing. “Anything?” she asked. “Not really.” Silence. “Well, how about if you take the pile and go ahead and look through them.” So I did. And…what to my wondering eyes did appear but a sharper image when I held up the brightly colored hunter orange lens… Yeah. Auburn hair and bright orange…there is a color combination you want to recommend. Sigh.

All I can say when people ask me to describe it is to compare it to putting on the glasses you wear–if you do–to deal with bright sun glaring off the snow to go sledding or skiing. Those of you who use such glasses know what I mean. And that is really the closest thing I can think of to share what happens when I put on glasses that have been tinted that delightful orange color corrected to my prescription. No, It does nothing for the dead optic nerve. But somehow, for that central vision in the right eye, it makes the contrast sharper…

And so, when I read that Bono finally revealed–after 20 years [see, I am not taking that long to share…] that he wears orange specs due to his glaucoma [http://www.theguardian.com/music/2014/oct/17/bono-glaucoma-20-years-u2-dark-glasses], I felt some real kinship. And when he says, ” “You’re not going to get this out of your head now and you will be saying, ‘Ah, poor old blind Bono’”–I felt particularly connected to him and his experiences…

How do different metaphors to define genes relate to understanding?

November 14, 2013

Many of the important messages about health include information about the role of genes for health. Genes matter. Behavior matters. Environments matter. The problem is how to communicate that genes do not absolutely determine health. This will be an important part of health communication for many decades to come.

Professor Celeste Condit wrote about how genes have been defined in her book, “The meanings of the gene” [http://www.amazon.com/The-Meanings-Gene-Heredity-Rhetoric/dp/0299163644].

Efforts to define genes often depend on the use of metaphor, explaining what a gene is in terms of something else that an audience is assumed to already understand. Many of these metaphors use “instruction” as a key component. Professor Rachel Smith and I decided to evaluate two of these instruction metaphors, one that defined genes as “a blueprint of our possibilities” and the other that defined genes in terms of “instructions” more generally. The abstract of the article to be published in February in the journal, Health Communication, appears at: http://www.tandfonline.com/doi/abs/10.1080/10410236.2012.729181#.UtLxv1OFeSo. The online article is at: DOI: 10.1080/10410236.2012.729181

Participants received a message about the role of genes for health for which the introduction varied the definition of a gene, and all other content was the same. Participants who read a message with the blueprint metaphor were more likely to believe that genes absolutely determine health and that genetic therapies are the effective means to address the role of genes for health. The instruction metaphor related to participants having stronger beliefs that genes make one more susceptible to disease but do not absolutely determine the onset of disease, and beliefs that we have some personal control over the role that genes have for our health.

These results support the importance of the metaphors used to define health and scientific terms. Just one exposure to a message that defines genes in different ways can have powerful effects on our attitudes about genes and health.

What we all should know about the Food Safety Modernization Act

September 6, 2013

The news often tells us something about the quality of our food. It may be a story about salmonella and chicken. Or it may be about a recall based on something being in a food that should not be there–perhaps due to defective equipment in a processing plant or two foods getting mixed together or peanuts being present when they should not have been. These stories help us select healthy food and should make us realize how much is done to keep our food safe. One of the more recent policies relating to our food safety is explained at http://www.fda.gov/Food/GuidanceRegulation/FSMA/ucm247559.htm and makes clear that illness from food remains a big problem. With one in six of us becoming ill from foodborne illness, more than 120,000 hospitalizations, and about 3,000 deaths each year–we should all be aware of what we can do to stay safe and what the modernization act does to make it more likely.

What is a patent and what did the US Supreme Court decide about human genes and patents?

June 13, 2014

The US Supreme Court ruled that human genes cannot be patented. A patent is the authority to make, use, or sell something. Myriad Genetics Inc. sought patents regarding genes for which some versions have been linked to breast and ovarian cancer–the BRCA gene mutations. The Court decided that identifying and isolating these genes is not worthy of a patent. On the other hand, Myriad also has created a synthetic form of DNA known as cDNA and that was determined to be worthy of a patent.

For patients, testing for BRCA gene mutations may become more accessible. Until now, Myriad has had the only genetic test for BRCA gene mutations. Perhaps others will now develop testing and contribute to cost reductions, since Myriad does not hold exclusive rights to make, use, or sell products associated with these genes.

HPV and throat cancer message from Michael Douglas

June 5, 2013

Michael Douglas has been in the headlines because he talked about the connection between throat cancer and the human papillomavirus–HPV. There is a rather complete discussion of the issue here: http://www.cbsnews.com/8301-204_162-57587350/oral-sex-and-throat-cancer-michael-douglas-hpv-report-spotlights-epidemic/.

As with Angelina Jolie and BRCA mutations and breast cancer, Michael Douglas’ celebrity gives him a platform to increase public awareness about cancer causes. I appreciate his willingness to discuss it and to get a conversation going about an increase in throat cancers, particularly for men, related to the HPV.

Talking about Angelina Jolie’s dislcosure about BRCA mutation and surgery

June 4, 2013

With Angelina Jolie’s disclosure about testing positive for the BRCA mutation that strongly predicts the likelihood of developing breast cancer, a lot of media stories have covered her genetic testing diagnosis and subsequent decision to have a mastectomy. A number of important ideas have been included in Angelina’s talk about her diagnosis and decision. She has emphasized that the genetic test is expensive–about $3,000. Perhaps there has been less emphasis on why and when health insurance is more or less likely to pay for the genetic testing, or some part of it at least. Payment is more likely in situations where a family member has tested positive for the mutation or has developed breast cancer at a young age.

The story has focused more on her decision perhaps than on the relative rarity of having the genetic mutation linked to breast and ovarian cancer. The decision to have the mastectomy relates to the 85% or more likelihood that she or anyone with the mutation would develop breast cancer. So this mutation of a gene that we all have is indeed very strongly indicative of a future breast cancer diagnosis. The decision to have breast tissue removed is Angelina’s way of reducing that risk to more like 5%.

Another fact that the stories have not emphasized is the reality that only about 5% of the women diagnosed with breast cancer have a BRCA mutation. For the other 95%, environmental and behavioral factors contribute to the diagnosis. So it is critical that we focus attention on that reality.

Applause applause for Disney and ban on junk food ads for cartoons

June 11, 2012

Disney has decided to ban ads for junk food when it comes to kids’ cartoons. That’s some good news when it comes to media exposure and kids’ learning product names. The bad news is that it won’t take effect until 2015. Wow. Why? Contracts?

Read more in the AP story here: http://www.registerguard.com/web/business/28184338-41/disney-ads-junk-ban-sugar.html.csp

Health communication and Dr. Oz’s message about paraben

May 1, 2012

I am in the midst of final exam week and grading. In the background, Dr. Oz started talking about ‘paraben’ and how it acts as an estrogen. I am always on the alert for these kind of messages. Hormones, research, cancer, blood clotting… these all came to mind. I got up from the computer and went to listen carefully. And then I went to my bathroom. My shampoo have five kinds of paraben in it. My two different types of body lotions had multiple forms of paraben as well. I got rid of them. Trash. Not a moment’s hesitation.

Why? Well, one of the facts Dr. Oz shared is that in one research study, 19 of 20 women diagnosed with breast cancer had significant levels of paraben in their breast tissue. I will hunt down the research and share it soon. For now, here is a summary of content from Dr. Oz with the link to the story at the end:

”

Flushed Away

We all know about industrial pollution and climate change, but there’s a new threat to the environment much closer to home – pharmaceutical and personal care product pollution (PPCP). Experts are increasingly worried that marine life across America is showing us the harm it’s doing to our planet and ourselves.

What’s Happening to the Environment?

In river basins around the country, the United States Geological Survey has found fish with both female and male sex organs. Intersex frogs are also popping up all over. And experts have found evidence of chemicals called endocrine disruptors, such as atrazine (an herbicide) and Bisphenol-A (BPA) in the country’s water supplies.

What are Endocrine Disruptors?

These chemicals alter the actions of hormones in our body, which can hurt us in 2 ways. First, they can block our hormones from acting as they normally would, and, secondly, they can act like hormones triggering effects that may include early onset puberty in adolescents.

What’s Happening to Us?

Breast cancer rates are increasing, girls are entering puberty earlier, sperm counts and testosterone levels are falling drastically, and certain genital abnormalities are on the rise.

What Should We Watch Out For?

Though the evidence is not definitive, experts fear that products we are introducing into our environment could be to blame, and they are urging us to decrease the use of certain chemicals. Here’s what to look for:

Bisphenol-A (BPA)You may have heard about BPA, the chemical used to make hard plastics, line cans, and create carbonless receipts. It’s proven to raise the risk of breast cancer in rats and the FDA has raised an alarm about the potential harm BPA can cause; Connecticut even banned its use in children’s products.

Ninety-three percent of us have BPA in our bodies. We live with it, and we excrete it when we go to the bathroom, sending the chemical into the environment.

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Phthalates

These difficult-to-pronounce ingredients help fragrance linger on the body after you have applied a lotion or body cream to your skin. They’re also found in toys, floor coverings, detergent, soaps, nail polish, and shampoos. Unfortunately, they mimic the hormone estrogen and have been linked to reproductive problems in rodents, such as lower testosterone and fetal malformation. Often they are not listed on beauty products, so the best rule of thumb is to avoid any products with fragrance.

Parabens

Found in moisturizing shampoos and body lotions, parabens are the most widely used preservatives in the beauty product industry, and they also act similar to estrogen in our bodies. One study found parabens in the breast cancer tissue of 19 out of 20 women studied; experts worry there could be a connection.

Use these chemicals as a litmus test for a healthy product. If you see them listed on the label (often as methylparaben, butylparaben, or propylparaben), it shows that the manufacturer is not concerned about limiting exposure to potentially harmful chemicals.

Leftover Prescription Medicine

The medication we take ends up in our water supply in 1 of 2 ways. We secrete it in our urine (which we can’t control), but many of us also flush unused medication down the toilet, contributing to the rising amount of pharmaceutical pollution found in our water supply. In 2008, the Associated Press found that dozens of pharmaceuticals end up in our water supplies, and eventually, in our tap water. That’s because water treatment plants are designed to neutralize biological hazards, such as bacteria, but not pollutants such as antibiotics. Scientists are now discovering bacteria in the wild that are not only resistant to antibiotics, they can actually live off them.

What Can You Do?

Drink water from stainless steel bottles
Avoid plastics with the numbers 3, 6, and 7 on the bottom
Never heat plastic in the microwave (even if it says it is microwave safe)
Choose frozen and fresh produce over canned
Use BPA-free baby bottles
Avoid any products that contain fragrances; opt for those that get their scent from essential oils
Stay away from parabens
Choose products that are paraben- and phthalate-free
Dispose of leftover medication by throwing it in the trash with coffee grinds or cat litter (to keep harmful medications from being picked from the trash), return the unused portion to your pharmacy, or go online to find your local hazardous waste disposal facility.”

http://www.doctoroz.com/videos/flushed-away?page=2

What we can learn from bald eagles about our health…

March 3, 2012

Last night was the annual dinner of the Juniata Clean Water Partnership group [www.jcwp.org]. The evening’s speaker is a biologist working in the field. He spoke about the comeback of the bald eagles to be removed from the endangered species list. It was fascinating. It sent me on a hunt for children’s books about this topic. I found some but if any of you can recommend such books, please share here. But I digress.

When a species becomes endangered, efforts to save them depend on identifying the cause. Often, it relates to a loss of habitat. For the bald eagle, it turned out to relate to the use of DDT–an effective pesticide that, as is usually the case when we find something to solve one problem, has costs as well as benefits. Here is a summary of science and policy relating to DDT: http://pmep.cce.cornell.edu/profiles/extoxnet/carbaryl-dicrotophos/ddt-ext.html

DDT use was banned from use in the U.S. the same year that I graduated from high school, 1972. Note the caveat relating to use. If we faced a public health emergency, such as an outbreak of malaria, it might be used. Tipping the scales toward benefit over cost.

Those costs? For use as humans–nerve damage and other significant health harms summarized in the link above. For the bald eagle–The shells of the bald eagle’s unborn became so thin that just the act of the parent bird sitting on them caused the shell to crack. Hence, the new generation of eagles was eliminated.

Once the cause was identified, the efforts to bring the bald eagle back and restore their population involved humans climbing large trees to remove young eagles from a nest [nests that average six feet wide and 8-10 feet deep]. If there was only one young eagle in a nest, the bird was left in place. If there were 2 or more, one was carefully removed and taken to another location where bald eagles used to exist. With care and effort to assure that they had habitat to survive, the transplanted birds thrived. In 2007, the bald eagle was removed from the endangered species list. A success.

Let’s hope we aren’t creating conditions in some parts of our planet that will lead to us being the endangered species…