DiversityNursing Blog

By Eun Kyung Kim

Even before she had a groom in mind, Katie Breland Hughes knew she wanted to walk down the aisle at her wedding on her own two feet.

It became one of her initial goals after a horrific car accident left her paralyzed from the waist down. But first, she needed to survive her injuries.

“Honestly, I had so many skin graft surgeries and so many burns, my first goal was just to sit up in the bed," said Hughes, now 27. "I was literally at rock bottom."

In October 2011, the Louisiana personal trainer and physical therapy assistant missed a stop sign while driving home from an appointment with a client. A truck hit her vehicle broadside, and Hughes went flying through her windshield. She landed in a ditch and, seconds later, her burning car landed on top of her, searing her back.

Conscious throughout the ordeal, Hughes knew she was either paralyzed or that her legs were amputated because she couldn’t feel either one.

“Immediately, I started asking myself all the physical therapy questions. Is my spinal cord severed? What kind of injury is this? How far up? How low down?” she recalled for TODAY.com. 

At the hospital, doctors told Hughes that she would never walk again. But during a nine-hour surgery to insert rods and plates along her spine to stabilize it, they learned that Hughes' spinal cord wasn’t severed as they originally thought. 

“That was all I needed to hear to keep pushing forward,” she said. “That was kind of my prayer.”

After her 100-day hospital stay, Hughes went home and immediately started training. An athlete all her life —she was supposed to run a marathon the week after her crash — exercise had always given Hughes an emotional outlet. After the accident, her love of exercise proved critical to her recovery, and to attaining the new goal she had created for herself.

“I told my sister from the beginning, I will not get married — whoever it be to, or whenever it happens — I will not do it until I can walk down the aisle. I just won’t be in a wheelchair,” she said. “So that was always a goal. I didn’t know the next year it would actually happen.”

Hughes heard about a Michigan trainer who had worked with other paraplegics. She reached out to him and flew to Michigan to begin training.

“The first time I talked to her on the telephone, she was like, ‘Look, I don’t want to be in this chair forever. I understand what happened to me, but I want to work hard and see where I can get,’” said Mike Barwis, a strength and conditioning coach who frequently works with Olympic and professional athletes. 

It was during a session with Barwis that Hughes moved her legs for the first time since the accident. 

Meanwhile, Hughes had reconnected with a former acquaintance, Odie Hughes. She initially worried about meeting him again now that she was in a wheelchair.

“I didn’t know how he would accept that, or how he would feel about that,” she recalled. “But it was like he never even saw the chair, he just saw me. He believed everything with me. If I told him, ‘I think I can do this. I want to try this,’ then he would be my biggest cheerleader.”

Within three months, they were engaged. Hughes started the clock: She had nine months to get on her feet. Barwis said he had no doubts they could make it happen.

“Katie is a vibrant person. She has an amazing personality and she’s very driven,” he said. “Her mentality has been one of absolute determination.”

But while working to build up the strength in her legs, Hughes also had to plan a wedding. She also opened a gym she started in her community of Bogalusa, about 70 miles north of New Orleans. 

There was also the issue of finding a wedding gown. 

“I actually bought three dresses. I didn’t like any of them,” she said. After getting ready to settle on one of them, she received a call from the cable network TLC, asking if she wanted to be featured on the show, “Say Yes to the Dress.” Hughes flew to the Atlanta bridal store featured on show (the episode airs Jan. 2) and finally found a gown she was happy with.

“Everything about it was perfect,” she said.

Except she never practiced walking in it until the day of her wedding. "I didn’t want anybody to see the real one," she explained. So instead, she practiced using one of the other gowns. She started in a full-body brace, then with a walker before moving on to two canes. Finally, she used two leg braces that went up from her feet to just above the knees, all while holding on to a person on each side of her.

On her wedding day, Sept. 20, Hughes walked down the aisle, on her own two feet, holding the hands of the two men giving her away: Her dad, who stood to her right, and Barwis, on her left. 

As excited as she was, Hughes said she never anticipated the nerves she experienced as she stared down the aisle at her guests.

“I felt like this was everybody’s fairytale ending. This was the story they had been following for so long and this was the ending they were waiting to see,” she said. “So I felt like there was a lot of pressure but there was no greater reward than getting to the end of that aisle, for sure.”

Waiting for her there with a huge smile was her fiance.

"When her foot caught that slip my heart stopped. But she just held it together like a champ," said Odie Hughes. "I had complete faith in her."

He said he never for a second doubted the woman he considers "the most stubborn person I know" 

"When she said she was gonna do it, it was a done deal," he said. "Never one doubt in my mind she'd not only make it down the aisle but she'd do it in dramatic fashion. That's my Katie." 

Months later, Katie is back at work, keeping busy with her physical therapy patients and running her gym, Katie's Shed, where she teaches various cardio and full-body workout classes.

She enjoys newlywed life and said it helps to have a partner who is familiar with life-altering injuries: Her husband once broke his neck during a car accident that left him with metal rods in his legs.

“Me and him both just really understand how quick this life is and how short it can be made,” she said. “We really value each other and the time we have together and with our family. We know first hand how quickly it can be taken from you, so we try to make the best of that.”

Hughes still uses her braces, alternating between them and her wheelchair, depending on the circumstances.

She speaks at local and regional events about her accident and hopes her story will inspire others to reach beyond traditional expectations.

“A lot of people would say, ‘Okay, I did it and now I’m going to be content with my progress right now.’ But I think contentment is our worst enemy a lot of times, just being content with where you are,” she said. “You should always try to excel forward and move forward and continue to reach goals and set new ones.”

Source: www.today.com

By David McNamee

Between 1990 and 2013, global life expectancy increased by nearly 5.8 years in men and 6.6 years in women, according to a new analysis of the Global Burden of Disease Study 2013 published in The Lancet.

"The progress we are seeing against a variety of illnesses and injuries is good, even remarkable, but we can and must do even better," says lead author Dr. Christopher Murray, professor of Global Health at the University of Washington. 

"The huge increase in collective action and funding given to the major infectious diseases such as diarrhea, measles, tuberculosis, HIV/AIDS and malaria has had a real impact," he says. 

"However, this study shows that some major chronic diseases have been largely neglected but are rising in importance, particularly drug disorders, liver cirrhosis, diabetes and chronic kidney disease."

The analysis suggests that life expectancies in high-income regions have been increased due to falling death rates from most cancers - which are down by 15% - and cardiovascular diseases - which are down by 22%.

In low-income countries, rapidly declining death rates for diarrhea, lower respiratory tract infections and neonatal disorders have boosted life expectancy.

Despite the increases in global life expectancy by nearly 5.8 years in men and 6.6 years in women, some causes of death have seen increased rates of death since 1990.

These increased causes of death include:

• Liver cancer caused by hepatitis C (up by 125%)
• Atrial fibrillation and flutter (serious disorders of heart rhythm; up by 100%)
• Drug use disorders (up by 63%)
• Chronic kidney disease (up by 37%)
• Sickle cell disorders (up by 29%)
• Diabetes (up by 9%)
• Pancreatic cancer (up by 7%).

HIV/AIDS has 'erased years of life expectancy' in sub-Saharan Africa

The report also points to one notable global region where life expectancy is not increasing. Deaths from HIV/AIDS have erased more than 5 years of life expectancy in sub-Saharan Africa, say the authors. HIV/AIDS remains the greatest cause of premature death in 20 of the 48 sub-Saharan countries.

Since 1990, years of life worldwide lost due to HIV/AIDS is reported as having increased by 334%.

In Syria, war is the leading cause of premature death - the conflict caused an estimated 29,947 deaths in 2013, and up to 54,903 and 21,422 deaths in each of the preceding 2 years.

Countries that the authors consider to have made "exceptional gains in life expectancy" over the past 23 years include Nepal, Rwanda, Ethiopia, Niger, Maldives, Timor-Leste and Iran - where, for both sexes, life expectancy has increased by more than 12 years.

Life expectancy at birth in India increased from 57.3 years for men and 58.2 years for women in 1990 to 64.2 years and 68.5 years, respectively, in 2013. The authors say that India has made "remarkable progress" in reducing deaths, with the death rates for children dropping 1.3% per year for adults and 3.7% per year for children.

The report also welcomes dramatic drops in child deaths worldwide over the study period. In 1990, 7.6 million children aged 1-59 months died, but this death rate was down to 3.7 million by 2013.

Igor Rudan and Kit Yee Chan, from the Centre for Population Health Sciences and Global Health Academy at the University of Edinburgh Medical School in the UK, write in a linked comment:

"Estimates of the causes of the global burden of disease, disability, and death are important because they guide investment decisions that, in turn, save lives across the world.

Although WHO's team of experts have been doing fine technical work for many years, its monopoly in this field had removed incentives to invest more time and resources in continuous improvement [...] the competition between WHO and the GBD [Global Burden of Disease Study] has benefited the entire global health community, leading to converging estimates of the global causes of death that everyone can trust."

 

Source: www.medicalnewstoday.com

By Terri Peters

When 2-year-old Ryan Aprea had cochlear implant surgery in November, his mom, Jennifer, says she wasn’t sure what to expect when the device was activated a month later.

Aprea shared the moment last week in a video that has now gone viral. In the clip, the Huntington Beach, California, mom says, “Hi, Buddy,” to her son, and is rewarded with a reaction she calls “amazing” — a fit of giggles from her little boy.

Born as a micro preemie at only 25 weeks gestation, Aprea says Ryan began his life with a seven-month stay in the neonatal intensive care unit, where she and her husband learned that he was deaf shortly before his discharge.

But a cochlear implant offered hope.

“We went into the appointment not knowing if he would respond at all. Throughout this process, they had informed us that while sound would enter his brain, every child has a different response. We weren’t sure if his brain would process the sound, but we wanted to give him a chance to hear us and communicate because he is also visually impaired,” said Aprea.

Aprea, who has posted frequently about the cochlear implant process on the Facebook page of her cloth diaper supply company, tells TODAY Parents that since the activation, Ryan has been doing great — exploring toys that make sounds for the first time and taking in his surroundings with his newfound ability to hear.

“He’s been interacting with us and giving us more intentional eye contact just in the few days since he’s had it turned on. My heart melts every single time he looks at me,” said Aprea.

As for future plans for Ryan’s treatment, Aprea says she and her family are taking things one day at a time. The mother of two says she’s looking forward to taking her son for a drive to look at holiday lights while listening to Christmas music — a tradition her family shares every year, but one that will have new meaning this season.

Aprea says she is shocked that her video has gone viral, adding that she looks forward to seeing more people learn about cochlear implants as videos and articles about stories like Ryan’s become more prevalent.

She’s heard a lot of strong opinions about cochlear implants from online commenters — including some negative ones — and offers some advice to parents dealing with big decisions about their child’s health care.

“You know your child better than anyone — I learned that one in the NICU. You need to do what’s best for him or her and give them every opportunity available to succeed in life. I would say, do a lot of research, talk to people who have been through it with their own kids, and then go with your heart,” she said.

Source: www.today.com

By Tony Marco and Catherine E. Shoichet

 It started with a sore throat on Thanksgiving and an antibiotic from a friend who wanted to help.

Now 19-year-old Yaasmeen Castanada is fighting for her life inside a California hospital's burn unit, suffering from an allergic reaction that's so severe she has large open wounds all over her body.

"It is heartbreaking, every day is a different look. Every day, she's like, shedding away. ... Overnight, it's a whole different person that you're looking at," Martha Hughes, Castanada's aunt, told CNN affiliate KABC.

Doctors diagnosed Castanada with Stevens-Johnson Syndrome, a rare disease that can be triggered by antibiotics or other medications.

"When she took the medication, she started having a hard time breathing, and she told her mom that her lips were burning, her throat, her eyes, they got so red that she couldn't talk. So she rushed her to the ER, and that's when they diagnosed her with the disease. And from there it has just spiraled to a nightmare," Hughes said.

Now Castanada, the mother of a 4-month-old, is in critical condition at the University of California, Irvine, burn center.

Her prognosis is good, even though the disease has a high mortality rate, according to Dr. Victor Joe, the center's director.

But the situation, Castanada's family says, has been devastating.

"Just unreal, just watching your daughter burn in front of you, literally, burn in front of you," her mother, Laura Corona, told KABC. "Every day, a new blister, a new burn, a new scar. And she's just, 'Mommy, I want to go home.' And I can't take her home. I can't put water on her lips."

Mom: 'Don't share medication'

On a website created to raise funds for Castanada's care, her mother said the harrowing ordeal began soon after her daughter took the medicine.

"A friend offered her an antibiotic pill that she had from a previous illness," Corona wrote. "She was thinking that it would help her. This would be the biggest mistake of her life."

Now, Corona says she's hoping to spread the word so others don't make the same mistake.

"Don't share medication. Don't give someone else your medication. Don't offer medication," she said.

She also advises parents to find out what their children are allergic to -- before it's too late.

Doctor: Reaction causing skin to separate

At first, doctors diagnosed Castanada with Stevens-Johnson Syndrome, which refers to a condition where between 10% and 30% of the skin on the body is affected, Joe said. Now she's experiencing Toxic Epidermal Necrolysis, the diagnosis when more than 30% of the body is affected. Joe estimates that 65% of Castaneda's skin and mucus membranes have been affected.

The allergic reaction is causing layers of Castaneda's skin to separate, Joe said, creating lesions that grow into large open wounds.

"Patients can experience problems with taste, swallowing, eyesight and sexual functions can be affected. In Yaasmeen's case, we are particularly concerned because her eyes have been affected. This can cause scarring of the corneas, which could lead to permanent blindness," he said. "We are trying to prevent that from happening."

Photos on the fundraising website show Castanada lying in a hospital bed, with openings for her eyes cut from the bandages that cover her.

As part of her treatment for the disease, doctors have wrapped her body in a special dressing, Joe said.

"We have chosen to place a dressing that adheres to the open wound, which allows her skin to heal without having to remove the bandages to wash the wounds," he said.

Mortality for those suffering from Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis can be as high as 25% in adults, but tends to be lower with early treatment, according to the Merck Manual.

Though it's uncommon, Joe said his hospital has treated around six cases in the past year, because the burn center has experience treating open wounds.

"This is very sobering. The fact that you can get a life-threatening situation from taking a medication. It can happen, and most people don't think twice about taking pills for things," Joe said. "In fact, most of the time you do have some sort of side reaction to medication, just not this severe."

After recovering from Stevens-Johnson Syndrome, patients usually only have minor issues with their skin, such as dryness, Joe said.

"Hopefully new skin will come in," Corona told KABC. "I'm just there watching. All I can tell her is, "Hang on, hang on. It's almost over.'"

Source: www.cnn.com

Jessica Zegre-Hemsey, a cardiac monitoring expert at the University of North Carolina at Chapel Hill, and her colleagues at the University of California San Francisco, revealed more than 2.5 million alarms were triggered on bedside monitors in a single month - the first figure ever reported from a real-world hospital setting.

Alarm fatigue occurs when nurses and other clinicians are exposed to a high number of physiological alarms generated by modern monitoring systems. In turn, alarms are ignored and critical alarms are missed because many alarms are false or non-actionable.

The work, the first of its kind to investigate the frequency and accuracy of alarms, addresses a growing patient safety issue that has gained national attention in recent years when a patient died despite multiple alarms that indicated low heart rate. The issue also addresses hidden downsides to modern monitoring technologies.

"Current technologies have been instrumental in saving lives but they can be improved," said Zègre-Hemsey, who is an assistant professor at the UNC-Chapel Hill School of Nursing. "For example, current monitoring systems do not take into account differences among patients. If alarm settings were tailored more specifically to individuals that could go a long way in reducing the number of alarms health care providers respond to."

Zègre-Hemsey and her colleagues collected alarm data on 461 adults in five intensive care units at the UCSF Medical Center for a period of 31 days. Zègre-Hemsey was one of four scientists who analyzed the alarms and helped to determine if they were true or false.

Investigators analyzed a subset of 12,671 arrhythmia alarms, which are designed to alert providers to abnormal cardiac conditions, and found 88.8 percent were false positives. Most of the false alarms were caused by deficiencies in the computer's algorithms, inappropriate user settings, technical malfunctions, and non-actionable events, such as brief spikes in heart rate, that don't require treatment.

A potential solution the researchers suggested would be to design monitors that could be configured to individual patients. No two bodies are exactly the same, and if the monitors could be adjusted to a patient's unique vital signs, the machines would not mistake a normal condition for an abnormal one. A "gold standard" database of annotated alarms could also help developers create computer algorithms that are less sensitive to artifacts.

According to Zègre-Hemsey, reducing alarm fatigue will ultimately require strong collaborations between clinicians, engineers, and hospital administrators as well as additional research.

"Alarm fatigue is a large and complex problem," she said. "Yet the implications are far-reaching since sentinel events like patient death have been reported. This is a current patient safety crisis."

The study was led by primary investigator Barbara J. Drew at UCSF. Co-authors on the paper include UCSF researchers Patricia Harris, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, and Xiao Hu from the UCSF department of physiological nursing and Tina Mammone from the UCSF department of nursing.

Source: www.medicalnewstoday.com

By GILLIAN MOHNEY

A Colorado family welcomed a larger-than-expected bundle of joy when their newborn daughter was born weighing almost 14 pounds.

Mia Yasmin Hernandez tipped the scales at 13 pounds, 13 ounces after her delivery Monday at San Luis Valley Hospital in Alamosa, Colorado. The newborn’s father, Francisco Garcia, said doctors had estimated the baby would weigh 8 pounds at birth.

Mia didn't seem especially large when she was born, Gracia said.

“She was swollen and everything” after delivery, he said. “I thought she was going to [weigh] 10 or 11 pounds.”

But after weighing Mia, the nurse told Garcia the infant’s weight.

“I was like, ‘Whoa, she’s the biggest baby I’ve ever seen,’” Garcia told ABC News.

Even hospital personnel agreed. Garcia said the nurse told hi she’d never seen “a baby that big.”

Dr. Robert Barbieri, chief of obstetrics and gynecology at Brigham and Women’s Hospital in Boston, said in a previous interview about one out of 1,000 babies could weigh 11 pounds, and one out of every 100,000 could weigh 14 pounds. A 14-pound baby, he said, is extremely rare, because usually a doctor will induce labor if a baby appears oversize.

While Mia’s delivery via Caesarean section went smoothly, the infant developed breathing problems and was eventually moved to Children’s Hospital of Colorado in Aurora, Colorado, according to Garcia.

Garcia said Mia is on oxygen and doing well, although they’re not sure when she will get home.

Garcia said the couple has another four daughters at home, which might come in handy for new baby clothes.

“We bought her a lot of stuff like a newborn cap and pampers,” Garcia said. “They don't fit her. She’s too big.”

Source: http://abcnews.go.com

Researchers have developed a new device that may result in more comfortable mammography for women. According to a study being presented next week at the annual meeting of the Radiological Society of North America (RSNA), standardizing the pressure applied in mammography would reduce pain associated with breast compression without sacrificing image quality.

Compression of the breast is necessary in mammography to optimize image quality and minimize absorbed radiation dose. However, mechanical compression of the breast in mammography often causes discomfort and pain and deters some women from mammography screening.

An additional problem associated with compression is the variation that occurs when the technologist adjusts compression force to breast size, composition, skin tautness and pain tolerance. Over-compression, or unnecessarily high pressures during compression, is common in certain European countries, especially for women with small breasts. Over-compression occurs less frequently in the United States, where under-compression, or extremely low applied pressure, is more common.

"This means that the breast may be almost not compressed at all, which increases the risks of image quality degradation and extra radiation dose," said Woutjan Branderhorst, Ph.D., researcher in the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam.

Overall, adjustments in force can lead to substantial variation in the amount of pressure applied to the breast, ranging from less than 3 kilopascals (kPa) to greater than 30 kPa.

Dr. Branderhorst and colleagues theorized that a compression protocol based on pressure rather than force would reduce the pain and variability associated with the current force-based compression protocol. Force is the total impact of one object on another, whereas pressure is the ratio of force to the area over which it is applied.

The researchers developed a device that displays the average pressure during compression and studied its effects in a double-blinded, randomized control trial on 433 asymptomatic women scheduled for screening mammography.

Three of the four compressions for each participant were standardized to a target force of 14 dekanewtons (daN). One randomly assigned compression was standardized to a target pressure of 10 kPa.

Participants scored pain on a numerical rating scale, and three experienced breast screening radiologists indicated which images required a retake. The 10 kPa pressure did not compromise radiation dose or image quality, and, on average, the women reported it to be less painful than the 14 daN force.

The study's implications are potentially significant, Dr. Branderhorst said. There are an estimated 39 million mammography exams performed every year in the U.S. alone, which translates into more than 156 million compressions. Pressure standardization could help avoid a large amount of unnecessary pain and optimize radiation dose without adversely affecting image quality or the proportion of required retakes.

"Standardizing the applied pressure would reduce both over- and under-compression and lead to a more reproducible imaging procedure with less pain," Dr. Branderhorst said.

The device that displays average pressure is easily added to existing mammography systems, according to Dr. Branderhorst.

"Essentially, what is needed is the measurement of the contact area with the breast, which then is combined with the measured applied force to determine the average pressure in the breast," he said. "A relatively small upgrade of the compression paddle is sufficient."

Further research will be needed to determine if the 10 kPa pressure is the optimal target.

The researchers are also working on new methods to help mammography technologists improve compression through better positioning of the breast.

Source: www.sciencedaily.com

U.S. health officials are poised to endorse circumcision as a means of preventing HIV and other sexually transmitted diseases.

The U.S. Centers for Disease Control and Prevention on Tuesday released its first-ever draft guidelines on circumcision that recommend that doctors counsel parents and uncircumcised males on the health benefits of the procedure.

The guidelines do not outright call for circumcision of all male newborns, since that is a personal decision that may involve religious or cultural preferences, Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, told the Associated Press.

Discussion board is open for inputs on this subject.

But "the scientific evidence is clear that the benefits outweigh the risks," Mermin said.

Circumcision involves the surgical removal of the foreskin covering the tip of the penis. Germs can collect and multiply under the foreskin, creating issues of hygiene.

Clinical trials, many done in sub-Saharan Africa, have demonstrated that circumcision reduces HIV infection risk by 50 percent to 60 percent, the CDC guidelines note. The procedure also reduces by 30 percent the risk of contracting herpes and human papilloma virus (HPV), two pathogens believed to cause cancer of the penis.

The guidelines do point out that circumcision has only been proven to prevent HIV and sexually transmitted diseases in men during vaginal sex. The procedure has not been proven to reduce the risk of infection through oral or anal sex, or to reduce the risk of HIV transmission to female partners.

The scientific evidence is mixed regarding homosexual sex, the guidelines say, with some studies having shown that circumcision provides partial protection while other studies have not.

Circumcision does reduce the risk of urinary tract infections in infants, according to the CDC guidelines.

The most common risks associated with the procedure include bleeding and infection.

Male circumcision rates in the United States declined between 1979 and 2010, dropping from almost 65 percent to slightly more than 58 percent, according to a CDC report issued last year.

The new draft guidelines mirror an updated policy on circumcision released by the American Academy of Pediatrics in 2012.

"The American public should take confidence that these are pretty much converging guidelines. There is no doubt that it [circumcision] does confer health benefits and there is no doubt it can be performed safely, with a less than 1 percent risk of complications," Dr. Susan Blank, chair of the task force that authored the AAP policy statement, said Tuesday. "This is one thing a parent can do to protect the future health of their children."

In its policy statement, the AAP declared that the health benefits are great enough that infant male circumcision should be covered by insurance, which would increase access to the procedure for families who choose it, said Blank, who is also assistant commissioner of STD Control and Prevention at the New York City Department of Health and Mental Hygiene.

"The push from the academy's point of view is to really have providers lay out for parents what are the risks, what are the benefits, and give the parents the information they need to make a decision," Blank said. "And the academy feels strongly that since there are proven health benefits, the procedure should be covered by insurance."

The guidelines are expected to spur a response from anti-circumcision groups.

"There are certainly groups that are troubled by circumcision of an individual who is not in a position to provide their own consent," Blank said.

The public can comment on the draft guidelines through Jan. 16, according to the CDC.

Source: www.nlm.nih.gov

By Honor Whiteman

Cancer is one of the leading causes of morbidity and mortality worldwide. In 2012, there were around 14 million new cases of cancer and around 8.2 million deaths from the disease. But despite such alarming numbers, a new study by researchers from the UK finds that most people ignore cancer warning signs, attributing them instead to symptoms of less serious illnesses.

Lead study author Dr. Katriina Whitaker, senior research fellow at University College London in the UK, analyzed the responses of 1,724 people aged 50 and over to a health questionnaire that was sent to them in April 2012.

The questionnaire asked participants whether they had experienced any of 17 symptoms, 10 of which are defined as cancer "alarm" symptoms by Cancer Research UK. These symptoms include unexplained cough, changes in mole appearance, unexplained bleeding, persistent change in bowel habits, unexplained weight loss, difficulty swallowing and unexplained lumps. 

Participants were not told which symptoms are cancer warning signs.

The respondents were also asked what they thought was the cause of any symptoms they experienced, whether they deemed the symptoms to be serious and whether they visited their doctor as a result of their symptoms.

Only 2% of respondents considered warning symptoms to be cancer-related

Results of study - published in the journal PLOS ONE - revealed that 53% of participants reported that they had experienced at least one cancer warning sign over the past 3 months.

The most common cancer warning symptoms reported were persistent cough and persistent change in bowel habits, while unexplained weight loss and problems swallowing were the least common.

However, the researchers were surprised to find that of the respondents who reported cancer warning symptoms, only 2% considered cancer to be a potential cause.

What is more, Dr. Whitaker says that of participants who reported the most obvious signs of cancer - such as unexplained lumps or changes in mole appearance - most did not consider them to be cancer-related.

"Even when people thought warning symptoms might be serious, cancer didn't tend to spring to mind," adds Dr. Whitaker. "This might be because people were frightened and reluctant to mention cancer, thought cancer wouldn't happen to them or believed other causes were more likely."

On a positive note, respondents did deem the cancer warning signs to be more serious than symptoms not linked to cancer - such as shortness of breath, fatigue and sore throat- and 59% of those who experienced cancer warning signs visited their doctor.

But the researchers say their findings show that the majority of people are dismissing potential warning signs of cancer, which could be putting their health at serious risk. Dr. Whitaker says:

"Most people with potential warning symptoms don't have cancer, but some will and others may have other diseases that would benefit from early attention. That's why it's important that these symptoms are checked out, especially if they don't go away. But people could delay seeing a doctor if they don't acknowledge cancer as a possible cause."

"Most cancers are picked up through people going to their general practitioner (GP) about symptoms, and this study indicates that opportunities for early diagnosis are being missed," adds Sara Hiom, director of early diagnosis at Cancer Research UK. "Its results could help us find new ways of encouraging people with worrying symptoms to consider cancer as a possible cause and to get them checked out straight away with a GP."

Source: www.medicalnewstoday.com

By Barry Hoffman

Paul Alexander's most impressive accomplishment is something most people never think about.

He taught himself how to breathe.

Alexander, 67, is a victim of the worst that polio had to offer children in the late 1940s and early 1950s. At the age of 6, he was completely paralyzed by the disease, his lungs stopped working, and he was literally thrown into an iron lung.

Alexander has been in that iron lung for 61 years because he remains almost totally paralyzed, able to move only his head, neck and mouth. He is one of an estimated seven people in the United States who are still living in an iron lung, and yet he has had a long and successful career as a lawyer. 

"Over the years, I've been able to escape this machine for a few hours at a time by teaching myself voluntary breathing," Alexander said recently as he lay in the iron lung at his home in Dallas, Texas. "I have to consciously push air into my lungs, something that's done involuntarily by just about everyone else. It's hard work, but it allows me to escape this infernal device, if only for a little while."

Alexander "escapes" the machine most often when he is litigating a case -- his specialty is family law -- or gives a speech.

While he sometimes condemns the contraption that keeps him alive, Alexander is most grateful for his iron lung, whose machinery is essentially unchanged from the first ones that were put in use in the late 1930s. His machine, in fact, is the same one he entered 61 years ago.

"It is my cage, but it's also my cocoon," he said, as the iron lung issued a noticeable whishing sound, an almost uncanny replication of normal breathing.

But we're getting ahead of the story.

This year marks the 60th anniversary of the nation's first mass polio vaccine inoculations, a time when hundreds of thousands of grade school students -- many of them throughout the South -- lined up in school gymnasiums, stuck out their arm and gritted their teeth as a nurse gave them Dr. Jonas Salk's experimental vaccine.

The shot was literally a game-changer. Most of these children had seen at least one or two classmates come to school on crutches, paralyzed by the ravages of polio. More than a few knew other students and friends who had died from the disease. 

So 1954 signified their liberation during the summer -- they could return to public swimming pools and play in the rain and eat in restaurants and not be afraid that they would wake up the next day with a fever and terrible leg pains, which could rapidly lead to paralysis.

That's what happened to 6-year-old Paul Alexander in 1952, two years too early for the Salk vaccine.

"I remember it was really hot and raining, something that is sort of rare for Dallas in August," he recalled, "and my brother and I had been outside playing, running around and getting wet when the rain started.

"Our mother called for us to come in for dinner, and I remember her taking one look at me -- hot and wet and feverish -- and she cried out, 'Oh my God!' She ripped my clothes off and threw me onto her and my dad's bed and called the doctor.

"She knew right away that I had polio. I don't know how she knew, but she knew. I remember feeling hot and feverish, and for the next few days, I stayed in the bed and didn't move. I remember I had this coloring book, and I felt this compulsion to color as much as I could, sort of like maybe I wouldn't be able to do it in the future."

Why didn't Alexander's parents take him to the hospital? "Our family doctor said that all the kids with polio were at Parkland (Dallas' big municipal hospital), and he didn't want me there with the other kids because maybe I had a better chance to recover at home," Alexander said.

But all of that became moot about six days later when he could no longer move and found it difficult to breathe: "I remember having terrible pains in my legs, and breathing became really laborious. So they finally took me to Parkland."

And that's when the most horrifying event occurred before Alexander's long battle with polio could even begin: "I had become immobile; I don't think I could even talk, so the hospital staff put me on a gurney in a long hallway with all the other hopeless polio kids. Most of them were dead."

That would have been Alexander's fate, too, if not for Dr. Milton Davis, a well-known pediatric cardiologist who was examining all of the children in the hallway. "He took one look at me, gathered me up in his arms, and I think he performed a tracheotomy on me almost immediately so I could breathe," Alexander said. "And the next thing I remember, I was inside an iron lung."

And then he blacked out.

Alexander woke up weeks later still in the iron lung: "The pain was still there, although it seemed much less to me, and the iron lung pumped hot steam through a thick plastic water pump into my chest. This kept the mucuous loose enough so I could breathe." 

He couldn't see through the steam at first, and he couldn't talk. But Alexander said he found some sort of determination within himself as strong as the iron in the device that was keeping him alive. "I decided I was going to fight this," he said. "I was going to have a life."

Eighteen months later, his parents brought him home. They stayed with him in shifts, fed him, helped him with school work (he was still enrolled in elementary school) and encouraged him to keep up his curiosity and enthusiasm for learning.

"My mother lobbied the school district for home-school learning, something very rare in the 1950s," he said. His dad fashioned a writing implement for him, similar to a T-square, which Alexander would put in his mouth and move around with his neck muscles in order to write.

Through their efforts and his own fierce determination, Alexander graduated high school as the class salutatorian. "I would have been valedictorian but the biology teacher gave me a B because I couldn't take lab," he joked.

Scholarships to Southern Methodist University in Dallas and the University of Texas in Austin allowed Alexander, with the help of a paid health aide, to get an undergraduate degree and then a law degree. He returned to the Dallas area and became associated with an Arlington law firm for a while, but eventually established a private practice that still handles everything from family law to financial cases.

"With help from a medical aide or one of my friends, I can get out of the lung and attend functions in a wheelchair or argue a case for a few hours," he said. "But I always have to remember to tell myself to inhale, exhale, inhale."

Alexander came to the attention this year of the leaders of the Dallas area's Rotary clubs through one of his doctors, Alexander Peralta, Jr., who is a Rotarian from Duncanville, Texas. 

Rotary International has been working with the Bill and Melinda Gates Foundation to eliminate polio worldwide, just as smallpox has been eradicated.

"One of our clubs, which is well-versed in modern technology (the Dallas e-Club) went to Paul's house and made a four-minute video with him," said Bill Dendy, District Governor of District 5810, which has 65 local Rotary clubs in the north Texas area.

"What none of us realized at first is what a compelling story this is, not only Paul's triumphs under difficult circumstances, but also what a terrifying experience it can be, just sitting in the presence of that machine that keeps him alive. The iron lung personalizes the horror all those thousands of kids went through a little more than half a century ago," Dendy said. The video they made has been submitted to the local PBS station in Dallas. 

Since making contact with Alexander, various district Rotary clubs have volunteered to make improvements to his house -- an old ramp leading to the front door was replaced -- and to be available to take him to his appointments. Throughout his life, Alexander has had a combination of help from health aides provided through the government and friends who pitch in.

Alexander said his iron lung is no longer supported by any company on an ongoing basis. The last company to service his machine, Philips Respironics, no longer does so. "So now, we have to strip spare parts from other discarded iron lungs to keep us going," he said. So far, it hasn't been a problem, he added: "There are only seven iron lung users left, so I don't think this is going to be a big problem of supply and demand."

How did he accomplish so much -- and keep his sense of humor -- while being virtually immobile for more than 60 years?

"It all starts with love," Alexander said. "My parents raised me in love. They taught me never to give up. They taught me the importance of relationships. They were always there for me.

"So, naturally, I had to reciprocate. And you know what? They were right. Anything is possible."

Source: www.medicinenet.com