Browsing Tag

Accident and Injury

Has A Seattle Doctor Found the Cause of SIDS?

By April 29, 2015 3 Comments
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Sudden Infant Death Syndrome (SIDS) looms over many new parents like a poltergeist, an unpredictable thief of life and joy. It is the third most common cause of infant mortality in the US (0.6 deaths per 1,000 live births), yet it is still little understood. SIDS is such a visceral fear for parents that an entire industry has popped up claiming to provide parents with early notice should their baby stop breathing in the night, for the low-low price of $199.99 per device. Unfortunately for many concerned parents these devices are unlikely to have any positive effect on SIDS deaths.

That’s why we weren’t surprised when a number of readers forwarded us this article from the Seattle Times that claims, One Seattle Children’s Doctor Thinks He’s Close to Stopping SIDS. Each reader said the article gave them a sense of safety and relief to know that since their infants had passed their hospital hearing tests, they were considered safe from SIDS. When we read the article Julia and I came away with a different understanding, which is why we haven’t shared the article.

So, is the article bunk or what? Has this doctor really found the cause of SIDS?

The answer to this lies somewhere in the middle, it is neither bunk, nor is it science … yet. The physician named in the article, Dr. Daniel D. Rubens, is indeed a practicing, board certified anesthesiologist with Seattle Children’s Hospital, with a special interest in SIDS. He’s formed the SIDS Research Guild at Seattle Children’s and is currently seeking funding to further his research into the causes of SIDS.

Scientific Parent SIDS InfographicWhile Julia and I read the article and saw a plea for research funding, not a definitive answer on SIDS, as many readers did. This is because Julia and I have either been in that position or have been on the receiving end of these pitches. But the way the article is worded, it could easily be interpreted as an announcement of new findings.

Dr. Rubens hypothesis that the inner ear dysfunction plays a role in SIDS is supported by initial research, much of which has been conducted by Dr. Rubens himself. This doesn’t invalidate his existing research, but we hold off saying that something is a scientific fact until others can replicate findings independently.

To get an independent take on the article, we reached out to Dr. Rachel Moon, Associate Chief, Division of General Pediatrics and Community Health, and a SIDS researcher at Children’s National Medical Center in Washington, DC. Dr. Moon feels that Dr. Rubens findings are compelling, but should be considered preliminary at this point, and parents shouldn’t change their behaviors based on the article or panic if their infant fails a newborn hearing test.

For right now, Dr. Moon says parents should follow these guidelines to reduce their baby’s chance of SIDS:

  • Put your infant to sleep on their back back
  • Infants should sleep in a crib with a firm surface, with nothing else in the crib except for the baby
  • Sleep in a crib next to the parents’ bed for the first months of life
  • Do not sleep on the same surface with another person
  • Never sleep on a couch, sofa, or armchair
  • Avoid smoke exposure, both during pregnancy and after birth
  • Breastfeed for as long and as much as possible
  • Avoid exposure to alcohol and illicit drugs during pregnancy and after birth
  • Offer a pacifier at sleep time
  • Immunize your baby

 

Resources:

Hoyert, D. and Xu, J. National Vital Statistics Report: Deaths: Preliminary Data for 2011. Centers for Disease Control and Prevention. 61:6. October 10, 2012

Alexandra Sifferlin. Don’t count on Smart Baby Monitors to Prevent SIDS. Time Magazine. November 19, 2014.

King, D. Marketing Wearable Home Baby Monitors: Real Peace of Mind? The British Medical Journal. doi: 10.1136/bmj.g6639

Nicole Brodeur. One Seattle Children’s doctor is close to stopping SIDS. The Seattle Times. April 3, 2015.

Seattle Children’s Hospital. Find a doctor: Daniel D. Rubens. Retrieved April 28, 2015.

Seattle Children’s Hospital. SIDS Research Guild. Retrieved April 28, 2015.

National Institutes of Health. Pub Med Search: SIDS + “inner ear.” National Center for Biotechnology Information. U.S. National Library of Medicine. Retrieved April 28, 2015.

Children’s National Health System. Find a doctor: Rachel Moon, MD. Retrieved April 28, 2015.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. Reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death. September 2012. Retrieved April 28, 2015.

Centers for Disease Control and Prevention. SIDS and SUID > Parents and Caregivers. Last Updated December 1, 2014. Retrieved April 28, 2015.

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Categories: Accidents, Injuries, + Abuse, Ages + Stages, Newborns + Infants

Ian Montgomery Graham: He Would Have Given More If He Could Have

By April 21, 2015 9 Comments
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I got the call at 3:10 a.m. from the Durham County Police. I knew as soon as the phone rang at that hour that it was bad news. They were at Duke Hospital. They told me that my 32 year-old son, Ian Montgomery Graham, had been in a motorcycle accident and they had been trying to find his family for hours.

They put the attending physician at the ICU on the phone. She was kind and professional. She said that his neck was broken and that he had not regained consciousness. I asked her how bad that was and she replied that it was very bad. I said that it sounded like I should come as soon as I could, and she said yes.

I don’t remember exactly how I knew he was essentially gone already. I knew he was on a respirator. She told me his brain stem was terribly damaged. I didn’t call anyone until 7:00 a.m. I have no idea what I did between the phone call you never want and 7:00.

I left the next morning with Ian’s best friend and her husband. I called a few people, including my friend who is a physician at Duke. He was waiting for us when we arrived at the hospital. When we arrived at the hospital we discovered that at the time of the accident an ICU nurse, on her way home from work, was the first on the scene and performed an emergency tracheotomy. The quickly arriving paramedics “bagged him” (hand pumped air) so his body would get oxygen. At the hospital, he was on a respirator.

He was on the respirator for two reasons: one, so that my daughter Lydia, his friends, and I could get there to say good-bye; and two, to keep his body alive – because he was an organ donor.

Mary's son, Ian Montgomery Graham

Ian Montgomery Graham

Ian was a free spirit. He was smart, funny and loving. Two weeks before his accident, I dislocated my hip for the fifth time, had surgery, and he came to help me out. He made me laugh, cooked, ran errands, and was good company. I can still see him standing at the kitchen counter in his favorite Aloha shirt, drumming on the counter. He always had a song in his head and drummed along to whatever it was. He was an excellent drummer, photographer and writer. He was terribly disorganized, but I was glad to see during his last visit that he was getting a grip on that by making lists. I keep one in my bag. The list starts with “make list.”

Ian’s accident was on a Wednesday evening, and by Thursday morning, the ICU waiting room was filling with his friends. Close friends from North Carolina were waiting for me. They had known him since he was a toddler. Ian was never alone from Thursday morning until Sunday afternoon. It was like a vigil. A stranger with a family member in ICU made a wonderful colorful drawing entitled “Ian’s Army.” Ian’s army was perfect as he treated everyone he met with respect.

The four days in the hospital were numbing. I remember telling a friend that I felt like I was outside my body watching a play I did not want to be in. And except for the fact he was warm and his heart was beating, he was gone. One day I just laid across him and sobbed. I told him I loved him from the moment I knew I was pregnant. I told him how much I loved him and always would. I told him that I loved his “Mom” tattoo. I told him that life for him would go on in a different way. He would be saving the lives of others. I told him that his friends were in and out and talking to him also. He was loved by so many.

Because Ian had also sustained other injuries when he was thrown from the motorcycle, not all of his organs were viable for transplant. His liver and one kidney went to men in their 60’s, both grandfathers whose lives depended on a transplant. His corneas went to other recipients. One of his close friends and I laugh about the cornea transplants for the following reason: He viewed life through his own lens. We wonder if the cornea recipients are saying “Wow, I never saw it like THAT before?”

Mary with Ian and Lydia as children.

Mary with Ian and Lydia as children.

The medical staff at Duke Hospital were wonderful to us. I can’t say enough about their caring and professionalism. This, and we are obnoxious Carolina basketball fans! One of the nurses asked if I wanted a picture of Ian’s “Mom” tattoo. I hadn’t even thought of that. He surprised me, really surprised me, one Thanksgiving when he arrived and said “Look what I got!” I was stuck between love and horror at that moment! He explained it to me: The wings were that I would be forever a free spirit, the halo was because I was an angel to him, and the boxing gloves were from our Tae Kwon Do days together. At the bottom of the tattoo were the words “Mother,” “Mentor,” and “Grace.” (Grace was a college nickname because I am clumsy.)

On Sunday, Lydia and I went with Ian to the surgical floor. We each sat on one side of the bed, holding his hands. The doctors removed the respirator, and his heart gave out quickly. He had not moved at all for four days, but, after they removed the respirator, he squeezed my hand. I still wonder if he was aware during those four days of what was going on. I don’t think so, but as he was dying, he knew I was there with him. He had to, but, again, this is just speculation. I hope he knew he was not alone and that his sister and I were part of the journey, certainly a journey we didn’t want.

My daughter and I are also organ donors, although I’m sure I’m too old for my organs to be used. The three of us never considered “not” being organ donors. Why would you? The medical expertise is there so why not allow someone else to live? Let a man enjoy his grandchildren and let them enjoy him. It’s a gift of life. As his life journey ended, others were able to begin the journey to recovery.

I have never once regretted that he chose to be an organ donor. I know that he would have wanted to have given more if he could have.

Editor’s note: You can read more about the bold and vibrant life Ian lived here.  To find out more about organ donation, or to register to be an organ donor please visit DonateLife.org.

 

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Categories: Accidents, Injuries, + Abuse

Accidental Medication Overdoses: the Pediatric Case for U.S. Metric Conversion

By April 1, 2015 3 Comments
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When I encounter something that interests me, I tend to intensely focus on that subject and try to master the basics as soon as possible. Though I don’t consider myself “domestic” per se (since when does cooking and organizing within my home make me of the non-exotic/wild/free spirit variety? I have to eat and survive, don’t I?), I will admit I have recently taken on to teach myself some old-timey skills. I mean, after all, you never know when one of those godawful sci-fi plotlines come to fruition and we’re all forced to live primitively, right? I’m looking at you, Leslie, and your ardent love of The Walking DeadThat being said, I’ve taught myself how to bake bread. And not just any bread. Gorgeous, beautiful, delicious, and dare I say it, edible bread. Like a mad scientist, I’ve learned how to work with yeast and flour and make things happen. Like a grown up who does real things! Which brings me by way of a long introduction, to the topic of this post.

Did you know that most experienced bakers try to use recipes measured in the metric standard? I’m referring to yeast, flour, sugar, salt and water being measured in grams and milliliters, not the preferred US Customary Units, a version of the imperial system. I was completely irritated by it at first, being so accustomed to relying on my measuring spoons and cups, until I saw how a slight deviation in precision could lead to a bread science disaster.

bread1

My delicious bread, Loafy the Fourth

Somewhere along the way, the recipe I’d been faithfully using to produce what my future hubby and stepsons call Loafy the First and Loafy the Second, I slightly mis-measured. Not enough for it to be noticeable at first, of course; I checked and rechecked measurements and nothing seemed out of the ordinary. But as that mixer churned, I found that I was left standing with a bowl of sticky pellets, a frown, and the youngest of the wolfpack consoling me on the untimely passing of Loafy the Third.

I sometimes take my mistakes as issues of a bigger problem; was I not careful enough? Should I have rechecked once more? But, no matter. It’s easy to throw away $1 worth of dough and start again. But what if it had been something more important, like medication for one of the kids, our future babies, or even my cat?

I’m no stranger to medical malpractice on account of pediatrician-prescribed medication overdose. In fact, I’ve seen what it looks like up close, the suffering and long-term damage that can happen to a child as a result. It can be devastating both for the child and the parents that provided the medication.  And it’s not as uncommon as you would think – according to a recent policy paper by the American Journal of Pediatrics, each year more than 70,000 children end up in the emergency room due to accidental medication overdoses. Many of these are due to the difficulty in measuring appropriate dosages, which can be even more complicated for infants and children due to the frequency and small amounts – and the tendency to prescribe in teaspoons or tablespoons (which are neither consistent or standardized from home to home unless one uses cooking utensils).

Fortunately, The AJP has pushed in recent years for pharmaceutical conversion to metric measurements, and the American Medical Association and Food and Drug Administration support the transition as well. For tips on how to prevent a medication error with your own child, The Institute for Safe Medication Practices has advice for parents that CBC News summarizes well, which you can check out here.

In the meantime,  my wolfpack is a rowdy one and naturally rallied for a Loafy the Fourth. Which, thanks to my digital scale measuring in grams, came out perfectly. But really, I’m more grateful that this time, it was just an inexpensive mistake.

 

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Categories: Accidents, Injuries, + Abuse, Policy, Politics, + Pop Health

The Consequences of Whooping Cough: How I Developed Cerebral Palsy

By March 16, 2015 No Comments
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I have cerebral palsy, and it’s something I’ve been hesitant to talk about my entire life. Cerebral palsy (CP) “is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb. But they can happen at any time during the first 2 years of life.” As humbling as it is to accept, I have brain damage.

Except for the arrival of their favorite son, my parents have told me there was nothing remarkable about my birth in the mid-70s. Everything went according to plan, but when I was nearly three months old, too young for the vaccine, I contracted pertussis, more commonly known as whooping cough. This is likely how I came to develop CP.

Over the years my parents have told me how terrifying it was to hear me coughing and gasping for air. If they weren’t in the room with me and I got quiet they would have to check to see if I was sleeping or if I’d stopped breathing. Once I started walking my parents noticed my left foot was always on its toes and turned inwards. On the advice of a family friend, my parents took me to get evaluated, where I was eventually diagnosed with CP.

It wasn’t until my mid-20s that I truly understood what that experience must have been like for my parents. They had just witnessed their baby struggle through whooping cough and then learned their baby had cerebral palsy. I had just started walking, too young to talk, there was no telling the extent of my injury at that stage. Can you imagine their concern?

The years that followed involved frequent trips to the Children’s Hospital of Eastern Ontario (CHEO) for physiotherapy and testing, more than 10 years with a brace on my left leg, a decade of at-home exercises and casts on both legs for a period of time (which made for an awesome Hallowe’en costume that year – most candy EVER).

Having CP doesn’t mean you cannot succeed in life. My university Sociology professor informed the class that he had CP. He was the first person with CP I had come across that, like me, was only affected physically and not mentally. He suffered from slurred speech and tremors in his arms and hands, but obviously was able to flourish in academia.

I have had more than 35 years to come to terms with the long-term impacts of CP. IWorldCPDayCP-Infographic walk with a slight limp, my balance is a bit of an issue and my left calf is noticeably smaller than my right. I’m at a disadvantage in most sports (which is a shame since of the 3 children in family I was the only one that expressed any interest in sports). Despite my brothers’ claims, I haven’t suffered any mental impairment. I graduated with honors from high school and received a degree in Computer Science at the University of Waterloo.

I mentioned earlier that I’m hesitant to discuss my cerebral palsy, not because I am embarrassed by it, but due to the extent of my injury. I have the most minor case I have personally encountered. Every time I publicly mention that I have CP, I think of all the others with the same affliction. The trials in my life due to CP pale in comparison to theirs. I do not take for granted that I have been extremely lucky.

CP has a wide spectrum of injuries that can result in mental impairment, physical impairment, or both. Growing up, the son of the family that lived next door also had CP, his was the result of an avoidable birth injury. While Stephen was able-bodied, he was a man in his 30s with the intellect of a 6 year old and needed special care throughout his life. I cannot stress enough how lucky I am.

Just like my neighbor’s CP, mine was also avoidable. I was too young for the pertussis vaccine when I contracted the virus, however I caught it from someone. That person was likely either unvaccinated or were under-vaccinated. Recently there has been a movement against vaccinations in general and it frightens me that parents may not have their children vaccinated against pertussis and other illnesses. Measles, mumps, pertussis and others are seen as minor afflictions to some, but I see myself as an example of what can happen as a result of contracting one of these illnesses.

I’m sharing my story and the story of others in the hopes that it will sway at least one doubtful parent to vaccinate. While I’ve been extremely lucky, I was likely seconds away from being severely impaired. A parent should take advantage of any protection they can offer their child, and that includes vaccination.


 

References:
National Institutes of Health. Cerebral Palsy. Updated August 22, 2014. Retrieved March 15, 2015.

Centers for Disease Control and Prevention. Pertussis (Whooping Cough). Last updated December 1, 2014. Retrieved March 15, 2015.

Mayo Clinic. Whooping Cough. Last updated January 15, 2015. Retrieved March 15, 2015.

Children’s Hospital of Eastern Ontario (CHEO). Resources – Cerebral Palsy. Last updated May 2014. Retrieved March 15, 2015.

Mayo Clinic YouTube. Infant Girl with Whooping Cough. Published October 7, 2013. Retrieved March 15, 2015.

World Cerebral Palsy Day. What is Cerebral Palsy Infographic. September 2013. Retrieved March 15, 2015.

Booth, Michael. Nearly Half of All U.S. Children Undervaccinated, A New Study Shows. The Denver Post. January 21, 2013. Retrieved March 15, 2015.

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Categories: Accidents, Injuries, + Abuse, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines

Does HPV Vaccine Gardasil Really Have A Dark Side?

By February 9, 2015 No Comments
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In their story on the purported devastating side-effects of the HPV vaccine, Gardasil, the Toronto Star’s David Bruser and Jesse McLean buried the lead. In both the print and video amplifier, the message “in the cases discussed in this story, it is the opinion of a doctor or patient that a particular drug has caused a side effect. There is no proof the vaccine caused a death, illness or hospitalization,” [emphasis mine] was buried either at or towards the end.

I’m usually a fan of the Star’s reporting, a good friend is a former reporter and editor with the paper, so I was shocked to see the specious connections made by the Star’s team about a life-saving vaccine. The Star’s story arrives in the midst of a national dialogue on the safety, efficacy and necessity of vaccines, which makes it all the more crucial to fact check the story’s claims.

If Gardasil carries with it a risk higher than reward I would be the first to say it needs to be pulled, but the data does not bear this out. But multiple studies (Chao, et al., 2012; Arnheim-Dahlström, et al., 2013; and CDC MMWR Weekly July 26, 2013 / 62(29);591-595) involving literally millions of subjects have shown no increased incidence of autoimmune disorders post vaccination with either variation of the HPV vaccine.

A crucial error in the story is Bruser and McLean’s misinterpretation (misrepresentation? misunderstanding?) of the Vaccine Adverse Event Reporting System (VAERS). In the simplest of terms VAERS is quantitative input, not qualitative output. Anyone can, and is encouraged to, report an injury to VAERS that they believe to be caused by a vaccine. Reporting a suspected injury to VAERS is not the same as a confirmed causal relationship.

The stories told by the girls and their mothers in the Star piece are heartbreaking, and I do not doubt these girls suffered debilitating illnesses. But what’s crucial to the story is whether or not those illnesses were caused by the Gardasil vaccine.

In one story, there may be a clear connection, however, the connection speaks not to the safety of the vaccine but rather to importance of vaccine safety communication. The article and video highlights the story of Kaitlyn, a teenage girl given the shot even though she told the nurses(s) she was allergic to a key component in the vaccine. If the nurse(s) did ignore Kaitlyn’s warnings and gave her the shot anyways, this does not imply an issue with the safety of the vaccine. It does imply that our health care professionals need to better educated about the components and contraindications for each vaccine.


Resources:
Chao, C., Klein, N. P., Velicer, C. M., Sy, L. S., Slezak, J. M., Takhar, H., Ackerson, B., Cheetham, T. C., Hansen, J., Deosaransingh, K., Emery, M., Liaw, K.-L. and Jacobsen, S. J. (2012), Surveillance of autoimmune conditions following routine use of quadrivalent human papillomavirus vaccine. Journal of Internal Medicine, 271: 193–203. doi: 10.1111/j.1365-2796.2011.02467.x

Arnheim-Dahlström, L., Pasternak, B.Svanström, H., Sparén, P., Hviid, AAutoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study

CDC Morbidity and Mortality Weekly Report (MMWR). Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007–2012, and Postlicensure Vaccine Safety Monitoring, 2006–2013 — United States July 26, 2013 / 62(29);591-595

CDC Vaccine Adverse Event Reporting System (VAERS). Last updated July 24, 2013. Retrieved February 8, 2015.

U.S. Department of Health and Human Services Centers for Disease Control and Prevention Food and Drug Administration. Do Your Part for Vaccine Safety: Report to VAERS. Retrieved February 8, 2015.

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Categories: Ages + Stages, Infectious Disease + Vaccines, School-Aged Children, Science 101 + Mythbusting, Tweens + Teens