W.D.M.

Lubbock, Texas

We’re always up for a challenge! After checking with physicians and researchers, we turned to other key members of the health care team—nurses. Here’s expert advice from Suzanne Prevost, R.N., Ph.D., associate dean at the University of Kentucky, College of Nursing and president-elect of Sigma Theta Tau International, a global network 
of nurse leaders:

“Persistent itchiness (pruritus) has many causes and is the most common skin problem among seniors. It is wise to consider medications, especially if people note increased itching when a drug regimen is changed. Itching may be a side effect of vitamins and minerals, including folic acid, calcium, iron, vitamin D, and vitamin B12. Prescription drugs such as prednisone (Deltasone, Liquid Pred), methotrexate (Rheumatrex, Trexall) for rheumatoid arthritis, and furosemide (Lasix) for edema can also cause skin changes.”

Ironically, getting wet can dry you out, too. “Daily bathing with hot water dries the skin,” says Prevost. “Instead, take two or three baths per week with lukewarm water to exfoliate dead cells that increase itchiness. Just after exiting the tub or shower, apply a heavy moisturizing cream (which is more effective than a lotion) while skin is still damp. Over-the-counter preparations referred to as ‘body butter’ are good choices. Keep nails trimmed very short. Scratching provides momentary relief, but ultimately increases inflammation and the itching sensation. If your home tends to be dry, adding a humidifier may help.

“Finally, don’t give up on health care providers. The problem you are experiencing causes tremendous discomfort and deserves to be treated seriously. If you have not already done so (and regardless of your age), consider seeking help from a geriatric dermatologist or nurse practitioner who is familiar with this problem.”

Ditch Itchy Skin The Saturday Evening Post

Protection is the key to saving your skin. Fortunately, consumers have a wide array of choices of sunscreens, sunglasses, sunless tanning products, and clothing that offers coverage from the No. 1 cause of all skin cancers and the primary cause of aging—the sun.

To learn more about current measures to preserve the skin and reduce the appearance of sun-damaged, the Post interviewed dermatologist Zoe. D. Draelos, M.D., F.A.A.D., vice president of the American Academy of Dermatology. A consulting professor of dermatology at Duke University School of Medicine, Dr. Draelos is also editor-in-chief of the Journal of Cosmetic Dermatology and has written eight dermatology textbooks, 32 book chapters, and more than 300 scientific articles. She has served as president of the North Carolina Dermatology Association and as a member of the board of directors of the American Society for Dermatology Surgery.

PP: Why do so many products use botanicals in their ingredients?

ZD: Botanicals are usually used as antioxidants, which are designed to prevent the damage that occurred from UV radiation striking the skin. But botanicals can be used for many purposes in anti-aging products—for their anti-aging properties, to color or scent the product, and many other purposes.

PP: What do you see as the major anti-aging breakthroughs in skin treatment today?

ZD: One of the big breakthroughs is understanding aquaporins, which are responsible for regulating the transport of water and other small solutes across plasma membranes, ultimately acting as pores within the walls of skin cells to keep skin moisturized and hydrated.

Old-fashioned ingredients, such as glycerin, actually affect the amount of water the skin holds. Many moisturizers now contain very high glycerin levels. Anti-aging moisturizers attempt to reduce the appearance of fine lines and wrinkles by enhancing the skin’s water-holding capacity. Glycerin is a well-known emollient and lubricant that is great for dry skin. Glycerin—a basic ingredient for Corn Husker’s Lotion—has been rediscovered for its water-holding ability. When you increase the water-holding capacity in the skin, you can get rid of the fine lines of dehydration.

Many sophisticated fillers (see below) that doctors use to rid wrinkles contain a substance known as hyaluronic acid (HLA), which soaks up water. Holding water in the skin is a very powerful cosmetic tool to improve skin appearance. This water balance is like the spigot on the hose. When you turn the spigot down, not as much water comes out, so the skin is better hydrated. If you open it up and let a lot of water out, the skin becomes dehydrated. It may be that the aquaporin channels are defective and the reason why the skin dries out is because too much water is leaving the body. Understanding how aquaporins work would allow you to develop therapeutic moisturizers to increase the water-holding capacity of the skin and alleviate dry, itchy skin that is especially found in elderly people.

Rejuvenating Aging Skin

Innovations in anti-aging skin care are on the fast track to meet the growing demand of baby boomers (and their parents). Therapies are available that improve the skin’s surface texture, reduce irregular pigmentation, and help reverse the effects of sun damage.

Fillers: These reduce the appearance of facial lines and wrinkles by “plumping” furrows and hollows in the face, giving the skin a more youthful-looking appearance. Fillers (Juvaderm, Restylane, Gore-Tex) are very effective at contouring specific areas on the face, such as around the lips, including long, vertical “marionette” lines that start at the corners of the mouth and extend down the chin. Botulinum toxin type A (Botox, Dysport) injections also diminish lines and wrinkles associated with facial expression, including vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow’s feet.

Saving Face: Exclusive Web Update The Saturday Evening Post

Mark McEwen, former TV weatherman for The Early Show on CBS, found out during a flight to Orlando in 2005. He had been dozing, then woke up, feeling odd. “It was like being underwater and trying to swim to the surface,” says McEwen, now 55. “You’re just trying to survive, to make sense of something that is senseless.” He had no clue it was a stroke. Nor apparently did the attendant who helped him off the plane—or the skycap who left McEwen sitting curbside in a wheelchair. McEwen could barely talk, but he did manage to ring his wife’s cell phone and convey a basic message. “Help me. Not good.”

If someone near you, like McEwen, were having a stroke, would you recognize it? Would you know what to do? Stroke is the third leading cause of death in this country—and every 40 seconds on average, someone in the United States suffers one. About 30 percent of strokes 
are mild, resulting in no disability. But the 20 percent that are severe, yet survivable, can be crippling.

“A major stroke can change everything—the ability to speak, to move, to work,” says Dr. Walter Kernan, professor of medicine at Yale University School of Medicine. “It may seem to rob a person of his life without actually taking it.” Fortunately, new therapies are in the works that may help improve outcomes.

Striking Out Against Stroke

The most significant advance is the clot-busting drug, known as tissue plasminogen activator, or tPA, which can help the 85 percent of patients whose strokes are caused by clots in the brain. “Sadly,” says Dr. Ralph Sacco, a neurologist and president-elect of the American Heart Association (of which the American Stroke Association is a division), “only about 5 percent of patients actually get it because they don’t reach the hospital in time or they don’t go to a [hospital certified as a] primary stroke center, which can give it rapidly.” Administered intravenously, it takes time to dissolve a clot, particularly a large one and as neurologists say, “time is brain.” Last year, the AHA revised its guidelines, saying that tPA could be given up to four hours and 30 minutes after the onset of stroke—a significant increase over the previous three-hour window. But sooner remains better.

“The best outcomes are still in patients with small clots who receive tPA in less than 90 minutes,” says Dr. Rishi Gupta of Vanderbilt University Medical Center.

Other technologies are already available at comprehensive stroke centers (a notch above primary stroke centers, which are mainly geared to giving tPA). At the Cleveland Clinic, doctors are using stents to prop open blocked blood vessels during a stroke, as well as two FDA-approved devices to help remove clots. One, the Merci Retriever, works like a miniature corkscrew to pull the clot out. The other, the Penumbra, breaks up a clot with microjets of water, then suctions out the pieces. Both devices require highly skilled specialists, and not every patient is a candidate. “You have to image the brain first to see if functional tissue remains that could benefit from restored blood flow,” says Dr. Irene Katzan, medical director of the stroke program at the Cleveland Clinic.

Refining Recovery

Acute treatment is only the first step in stroke recovery. Fortunately, therapists are getting better results with post-stroke rehabilitation than ever. “We used to say to patients, ‘you have three to six months to improve, and after that you can’t expect a whole lot,’ ” says Dr. Richard Zorowitz, chair of physical medicine and rehabilitation at Johns Hopkins Bayview Medical Center. Now, knowledge about the brain’s ability to rewire itself—a concept called neuroplasticity—has encouraged therapists (and patients) to try longer and harder.

“Thanks to the neuroplasticity of the brain—the ability of the brain cells to rearrange their connections, our brain has more capacity than we ever imagined to rewire itself for greater levels of recovery,” says researcher and stroke survivor Dr. Jill Bolte Taylor (read “Life After Stroke”).

Dr. Steven C. Cramer at the University of California, Irvine, is working with robotic therapy to help restore function as well as investigating two hormones that may encourage stem cells to develop into new neurons, key cells that transmit nerve signals to and from the brain. So far, early results look promising. Meanwhile, Dr. David Simpson at Mount Sinai School of Medicine in New York is using botulinum toxin (Botox) to help reduce the spasms that lead to twisted limbs and abnormal gaits, a frequent result of stroke.

For the most part, rehab consists of hard work—and lots of it. Three hours a day is the rule of thumb. But technologies like Nintendo’s Wii video game console keeps exercises interesting—engaging stroke patients in games such as bowling or tennis to improve balance and shifting of weight.

As for McEwen, he’s back on his feet after 14 months of rehab. Today the former weatherman, who described his experiences in his 2008 book Change in the Weather, is a motivational speaker and spokesperson for the American Stroke Association. The organization’s latest campaign (PowerToEndStroke.org) is directed at people with risk factors for stroke—high blood pressure, diabetes, excess weight, and a history of heart disease. “There are lots of things you can do to lower your risk for stroke,” says McEwen. “Knowledge
 is power.” And it could just save your life.

The Post Investigates: Stroke Advances The Saturday Evening Post

Considered a hallmark of the bone-robbing disease osteoporosis, mild to severe fractures of the lower back called vertebral compression fractures (VCF) affect nearly a quarter of all older American women. Researchers hope that an advanced medical device may help relieve pain and restore mobility better than conventional methods.

In the July issue of the American Journal of Roentgenology, Dr. Lucia Flors and colleagues report on an innovative method called vesselplasty that was tested on 29 patients previously treated with medicines and physical therapy for painful VCF at the Hospital Universitario Doctor Peset in Valencia, Spain.
During the minimally invasive procedure, doctors utilized a new device called the Vessel-X bone Filling Container System to create a cavity—and a container—into which bone cement is injected to stabilize broken bones, improve posture, and prevent further fractures. With standard versions of the therapy, referred to as vertebroplasty and kyphoplasty, the cement leaked out from the targeted area in up to 70 percent of cases.

“Theoretically, this technique solves the problem of leakage of cement from the vertebral body because most of the cement is contained by the expandable artificial vessel,” Dr. Flors’ group wrote.

Preliminary outcome data on 29 patients with 37 fractures show reduced pain scores in all treated patients, improved mobility in 93 percent, and reduced analgesic use in 62 percent. Asymptomatic leakage of cement occurred in 2.7 percent of the cases and the technique appeared to be as effective in treating new fractures as in older ones.

Most patients had fractures related to osteoporosis (73 percent). Other VCF were caused by trauma (13.5 percent), myeloma (8 percent), and cancer that had spread from other organs (5.4 percent).

Further investigation will determine long-term effectiveness and safety. The Container System device is yet to be approved in the United States.

Despite recent research questioning the effectiveness of vertebroplasty and kyphoplasty, pain specialists point to several large studies that demonstrate their short- and long-term clinical benefit for treating painful VCF.

Novel Therapy for Back Pain The Saturday Evening Post

This month, Mental Health America is celebrating its 100th anniversary —a remarkable legacy of one man who turned his personal struggle into a national movement.

Around the turn of the 20th century, recent Yale graduate and newly minted Wall Street financier Clifford W. Beers suffered his first episode of bipolar disorder (manic depressive illness) and spent the following three years learning firsthand of the inadequate and often cruel treatment of people with mental illnesses.

Upon his release, Beers set out to expose the abuse and reform care. In 1908, his autobiography roused the nation to the plight of people with mental illnesses. And on February 19, 1909, Beers, along with the philosopher William James and psychiatrist Adolf Meyer, created the National Committee for Mental Hygiene, an organization we know today as Mental Health America. The modern mental health movement had begun.

Today, we remain focused on many of the issues highlighted by Beers in a speech delivered in June 1932 to the French National League for Mental Hygiene: a struggle to eradicate stigma, to focus on prevention as well as treatment, and to bring mental illness under the umbrella of care designated for physical illnesses. Consider his words:

“One who founds a movement of vital importance to humanity inevitably builds better than he knows. In my earliest plans and first editions of my autobiography, A Mind That Found Itself, the salient features of the mental hygiene movement were outlined as follows: scientific treatment and humane care for the mentally ill; research into the causes and cure of disorders of the mind; and the application of methods and measures for their prevention. The movement, however, is now so broad in scope and purpose that it can be of possible benefit to everyone.

“One [result] is the remarkable and steady change in the attitude of the public toward disorders of the mind, toward those who suffer from them and, also, toward the institutions in which such patients are treated. Indeed, so-called insanity is now widely regarded as a disease and not as a disgrace.

“A second outstanding result of organized work in mental hygiene is the bringing of the medical profession, especially the psychiatrists, into close and continuous cooperation with the lay public, particularly the leaders in education, law, religion, and in social work.

“With this merging of forces, the mental hygiene movement will not only reach its known objectives, but will continue to develop and will endure so long as the mind of man serves as the sanctuary of the divine spark that makes possible such work and such movements as have brought this distinguished audience together in this great amphitheater tonight.”

Inspired by the work of Beers and many others over the past 100 years, Mental Health America continues to transform our nation’s approach to mental health. The Mental Health Parity Act ended discrimination in insurance coverage for people with mental illness, removing some of the financial barriers that have kept people from treatment. We must, and will, continue our efforts to remove the stigma of mental illnesses, effectively treat and prevent mental health conditions, and promote positive mental health as a reality for all.

For more information from Mental Health America about advocacy, education, and support for Americans with mental health conditions, visit mentalhealthamerica.net .

A Century of Mental Health The Saturday Evening Post

Inflammation of a thick band of tissue (called the plantar fascia) often causes persistent heel pain. In a preliminary study of 44 patients not helped by conventional therapies for plantar fasciitis, doctors report that all but two were pain-free within two or three weeks of a procedure called dry-needling followed by a steroid shot. During the procedure, doctors insert a needle into the area where the fascia connects to the heel bone. This creates a small amount of bleeding and activates blood platelets to help the tissue heal. The needle is then pulled back into soft tissue surrounding the fascia and used to inject a steroid. The promising data was presented by an Italian research team at the 2008 annual meeting of the Radiological Society of North America held in Chicago.

Dry-needling Helps Constant Heel Pain The Saturday Evening Post

My husband, Tom, placed three letters on the table. The first was a payoff notification from the bank. After 30 years of monthly payments, the house was finally ours. The second contained the finalization of Tom’s retirement package. No more Monday-through-Friday nine-to-five days. Every day would feel like Satur­day. However, the third note brought the biggest smile to our faces. It listed the itinerary for our recently booked European vacation. After years of being tied down to family, work, and home responsibilities, we would finally have the life and foreign adventure we’d dreamed about.

Tom’s excitement equaled mine. “I promised Thomas that Grandma and Grandpa would buy him something in every city we visit,” Tom said.

Sixteen-month-old Thomas was our only grandchild. He didn’t communicate, nor did he respond to the world around him like other children his age. His pe­diatrician labeled Thomas a late bloomer. Because we are members of a genera­tion who’d been raised to believe a doctor was never wrong, Tom and I accepted this. Our daughter, a single mother, did not. Her gut feeling said something wasn’t right with Thomas. Despite the pediatrician’s lack of concern, she insisted Thomas be referred to a doctor who specialized in developmental disorders.

During the past two weeks, Thomas had undergone a series of physical and psychological tests to answer the ques­tions our daughter had raised. The neurologist, who headed the testing team, asked us to meet him at his office the same day we took our suitcases from their attic storage. The diagnosis, a mere six letters, changed our lives forever.

“There are several degrees of autism. Some children remain trapped within the confines of their own worlds; others are able to progress into functioning adulthood. Only time will tell how severely Thomas is affected,” the neurologist explained.

I’m a writer, a lover of books. At his birth, my gift to Thomas was an entire set of classics in anticipation of the two of us exploring Sherlock Holmes’ eerie moors and sharing the intrigue of King Arthur’s court. Now the possibility existed that Thomas would never read nor develop the comprehension neces­sary to enjoy such tales.

Whenever a person says that his or her “heart broke,” it’s usually thought to be just an expression of speech. However, at this diagnosis, my heart did break—with an emotional pain so severe I almost fainted. Everything else the neurologist said that day about early intervention and specialized education didn’t register in my numb mind. My grandson, the light of my life, had been condemned to what I considered a living death.

My daughter and my husband, who are both “glass-half-full” optimists—in­stead of a “glass-half-empty” pessimist like me—accepted and adapted to the addition of autism into our lives. Tom canceled the trip he knew neither of us now had the heart to take, while our daughter investigated how best to get Thomas the help he needed.

I simply fell apart. I didn’t leave the house for a week. I cried; I worried; I questioned my faith each time I read a research summary that stated there is no cure for autism. I did things to­tally out of character. I took Thomas to a faith healer and probably would have participated in a curse-removal ceremony if I’d known somebody who practiced voodoo. I made bargains with God and the devil. My love for my grandson was so great that I would have gladly given up the remaining years of my life and burned in the fires of hell if my eternal suffering would cure this little boy.

I rarely slept more than an hour at a time. I lay awake in the dark and tor­tured myself with questions that never had an answer. How did this happen to us? Why? No members of our fam­ily tree have it, so it can’t be genetic. Was there something in the air? In the water? Did something go wrong dur­ing a pregnancy that had no notable problems? Was it, maybe, undercooked meat? How about the pesticides sprayed on fruit? Food additives?

One Sunday morning I had an altercation with a judgmental church member who announced in front of the entire congregation, “God punished your daughter with an autistic child because she had him without the ben­efit of marriage.” If not for the pastor’s intercession, we probably would have come to blows. I did not regret Thomas’ birth before the diagnosis, and I do not regret it now! It took several weeks, but I finally came to terms with the unex­pected life thrust upon us. Within the remnants of my broken heart, I deter­mined to stop grieving for the grandson I once dreamed Thomas would be and put all my energy into developing the person he was.

Our daughter did not ask us to change our chosen senior life path to provide home care for Thomas. We volunteered to stand by her side while she struggled to support the two of them and do what was in Thomas’ best interest. Our world-travel plans were put indefinitely on hold. Tom got a part-time job that allowed him the flex­ibility to spend many hours a day with Thomas. Our lives revolved around the schedules of the six early intervention therapists working daily with Thomas at our house.

Each morning after his 6 a.m. arrival, I cupped Thomas’ chin in my hand, looked deep into his eyes, and told him, “I know you’re in there, Thomas. Don’t you worry. I’m going to find a way to come in and get you. We will explore the world, maybe not the way I planned, but in another, better way.”

Thomas hugged me whenever I told him this, and I felt an understanding in the little arms wrapped around my neck. I stopped reading emotionally devastating case histories and listen­ing to the dire predictions of doctors. Instead, I developed a new hope in the intervention path we’d chosen to pur­sue with Thomas, along with the total family involvement that continued and supplemented the therapy.

The months spread into years. Life fell into a new routine where tears no longer had a place. We took weekend trips to the New Jersey shore where Thomas splashed in the ocean, went to restaurants, Thomas & Friends events, and the circus. We never avoided any family event because of Thomas’ autism.

Challenges? Many! Thomas went through a period where high-pitched sounds, such as those emitted by a house alarm, sent him into a panic. He’d bolt into traffic if he weren’t held onto tightly. This terror disappeared, only to be replaced by fear of a certain color of ice-cream truck. The sight of this truck would send him into a melt­down of sobbing and hiding in his bed. This reaction also left him as mysteri­ously as it came upon him. Thankfully, neither problem has resurfaced.

By age 4, Thomas proved to be high-functioning. He was toilet-trained, able to converse, and possessed a memory that was sometimes sharper than mine! However, despite his aging out of the early intervention services he’d received at home (and therapists’ recommenda­tions that he be put in a mainstream program with an aide), he was denied entrance into a universal pre-K.

Ignorance, unfortunately, exists in school systems. For her first excuse, the school administrator said, “We don’t have any autistic children in our school.” She also said, “We don’t allow aides into our pre-K classrooms.” However, if a child was in a wheelchair, or needed medical care, an aide would be permit­ted. Finally, I was callously informed, “There are schools for kids like this.” The administrator, who hadn’t taken the time to meet Thomas, handed me a list of schools she’d written out on a yellow sheet of paper; each school was for severely retarded kids. Thomas is not retarded —he simply learns in a different way than other children.

I was offended, and I vowed to fight back. Thomas has his quirks, but in a group of other boys his age, it would take a trained eye to realize he is autistic. He is not violent, he is very social, and he loves all the things other boys do—playground swings, slides, worms, fire engines, building snowmen. The only reason he has an aide is to help keep him on track when the class transitions from one task to another. He would much rather work on an art project than practice printing his letters!

Believe me, hell hath no fury like angry grandparents. Together, Tom and I declared war on the ignorant segment of society that doesn’t have a clue when it comes to autism. Vocal opposition, writing letters, public protesting with signs—we’ve become so visible at local rallies that we are affectionately known as Grandma and Grandpa Autism. We’re disgusted with the parents who don’t invite Thomas to their child’s party because they’re afraid he might act up. Put 10 4-year-olds in a room for any amount of time, and some will mis­behave —it’s the age, not the condition.

We’re angry about our major medi­cal plans. Our daughter must work a certain number of hours to maintain medical coverage. No plans cover the cost of all the specialists Thomas must see, and some specialists, knowing how desperate parents of autistic children are, do business on a cash basis only. The retirement savings Tom and I had put aside has been depleted to pay for services Thomas must have and his mom can’t afford.

We’re tired of always having to re­tain legal representation for Thomas to receive the services, school placement, and benefits he’s entitled to under law. And yes, he is now attending the pre-K we applied to and doing better than many of his classmates, but help was necessary to gain acceptance.

We’re disappointed in the behav­ior of former friends, some of whom have been part of our lives for decades. Rather than support us emotionally and accept that Thomas is who he is, they decided to ignore his existence. When confronted, a common defense was, “We don’t know what to say.” Not an acceptable excuse. A simple “How is Thomas?” would have done just fine.

Most of all, I’m concerned for my declining health. Conditions brought about by stress affect my life, yet I must hang on until the day when Thomas realizes —and he will —that he was born into a cruel world where people will always shun him because he has autism. I must be here so that I can instill in him that autism doesn’t matter to those who love him. Yes, he has a mother who is his greatest advo­cate, a grandfather who adores him, and two aunts ready to assist him in his life journey. Still, I believe there is no love more intense than a grandmother’s love. So I take my prescription medica­tions, diet, exercise, and pray a lot!

Thanks to intensive one-on-one early intervention therapy, a strong family support system, and his now-mainstream class, Thomas continues to make excellent strides in his devel­opment. He is a good boy and will become a good man, despite the tough future he faces. We believe the day will come when an adult Thomas, with some supervision, will have a job and be able to live independently.

This past summer, Thomas received his passport. He would like to visit the Caribbean because he wants to swim with the dolphins. If I can squeeze myself into the bathing suit purchased for the canceled retirement trip, I just might take that swim with him.

Occasionally, someone asks us if we regret not taking that European vaca­tion. Tom and I always laugh because we have been on a never-ending journey called autism. It’s our everyday foreign land. We don’t speak the language; we learn as we go; we get confused, lost, and exhausted. Still, we are not unhappy as we move forward with our senior lives. The addition of autism to our family made us stumble, but we did not fall. Together, with high hopes for the future, we go onward.

Advice for grandparents who have an autistic child

1. Let out your grief! Cry. Rant. Break some glasses. Throw rocks at the ocean. It won’t cure your grandchild’s autism, but you will feel better.
2. Accept that you are second in command. Although you may feel strongly about what should be done for your grandchild, the final decision ultimately belongs to the parents.
3. Do not compare your grandchild to other autistic children. Although each child shares some behaviors, they are all different.
4. Learn your grandchild’s legal rights! Find a lawyer who specializes in representing children with disabilities. Some offer a free consult, a senior-citizen discount, or base payment according to economic need. It is also a good idea to find the best way to legally protect your grandchild’s financial future after your death.
5. A pediatrician will be one of the most important persons in your grandchild’s life, so it’s imperative you help your son or daughter find someone with autism experience. A knowledgeable doctor will be able to care for your grandchild’s special physical needs, and he or she can also guide you to other beneficial services.
6. Network. Speak with others who have an autistic grandchild. It helps you mentally to know that you are not alone with your fear and your hope. With autism reaching epidemic proportions, it’s not hard to locate families who share your situation. Other families are also great sources of information when you need to locate activities such as an autism-friendly Cub Scout pack or a Little League geared to special-needs children.
7. Do not assume you must refinance your home to help pay for your grandchid’s care! Our neurologist referred us to an Early childhood Direction Center that, in the state of New York, is administered by the Office of Vocational and Educational Services for Individuals with Disabilities. They helped us secure services that Thomas required – free of charge. However, financial allowances for services for Individuals with Disabilities. They helped us secure services that Thomas required – free of charge. However, financial allowances for services, such as home-based early intervention, vary from state to state.
8. Take time for yourself. I like to sit in the silence of our local Barnes & Noble, browsing through books that have nothing to do with autism. Tom enjoys stretching out on the sofa and watching vintage television shows.
9. Spend quality time with each other. Tom and I take evening walks along a favorite oceanfront path. We also take advantage of early-bird specials and eat out once a week.
10. Finally, just love your grandchild for the special person he or she is.

Autism: An Unexpected Life The Saturday Evening Post

Solving the Diabetes Puzzle

An international scientific consortium reports that at least six previously undetected genetic variants are involved in type 2 diabetes, boosting to 16 the total number of genetic risk factors associated with increased risk of the disease. The surprising discovery provides clues about what goes awry when diabetes develops, and may someday lead to new ways to treat or even prevent it. In the future, genetic testing may help doctors and their diabetic patients develop individualized treatment and lifestyle plans. Former director of the National Human Genome Research Institute Francis S. Collins, M.D., Ph.D., is a coauthor of the study conducted by the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) group.

Work by an Australian Ph.D. student revealing a new action of insulin may explain how it prompts body cells to absorb glucose, a question that has perplexed scientists since the 1920s discovery of the drug. Freddy Yip’s groundbreaking finding suggests that diabetes may develop when signals between insulin and the myo1c protein become blocked. Learning more about this mechanism may yield innovative therapies.

Not Diabetic? Two Reasons to Get Tested

People with high blood pressure should be screened for diabetes, even though they show no signs of it, according to recently updated federal guidelines. The U.S. Preventive Services Task Force confirmed that screening is “moderately certain” to be of substantial benefit for adults with a sustained blood pressure greater than 135/80. In a major change, the group dropped a general recommendation that adults with high blood levels of fats (hyperlipidemia) get screened for diabetes, citing a lack of evidence as to whether this is beneficial. Testing might still be warranted for those with additional cardiovascular risk factors, such as a family history of diabetes, they added. Another group who should watch their blood sugar levels are those undergoing heart surgery. In a Michigan study, nearly half of all heart surgery patients experienced blood sugar levels high enough to require temporary insulin treatment after their operation, despite never having diabetes.

Avoiding the “Ouch”

Here’s a new spin on the old adage that necessity is the mother of invention. When one Texas mother tired of the multiple insulin injections needed to treat her diabetes, she invented a simple and convenient alternative to the standard shots. The disposable i-port injection port, about the size of a quarter, minimizes the need to puncture the skin with each dose of medicine. When applying the adhesive device, an insertion needle guides a tiny, flexible tube under the skin. The insertion needle is then removed and the soft tube remains below the skin, allowing access into the underlying tissue. Up to 75 insulin doses from a syringe or insulin pen may be delivered through the i-port without puncturing the skin. Patton Medical Devices, the manufacturer of the device, is planning clinical trials to further support the medical need for the prescription-only device and to explore additional uses. For more information, visit i-port.com.

Drug Developments

An experimental insulin nasal spray may someday offer diabetics a fast and convenient option for mealtime glucose control. Phase II clinical testing shows that the ultra-rapid-acting intranasal insulin maintained safe glucose levels better than oral antidiabetes medicines and basal insulin. In addition, the nasal spray performed as well as NovoLog, a rapid-acting injectable insulin. For the study, blood glucose was measured 60 and 90 minutes after a meal. Data were reported at the 2008 Scientific Sessions meeting of the American Diabetes Association.

Discoveries in Diabetes The Saturday Evening Post

We sent your letter to Dr. Walter Coyle, gastroenterology program director at Scripps Clinic Torrey Pines in LaJolla, California. Dr. Coyle responds:

“Unfortunately, you are not alone. More than 60,000 admissions per year to U.S. hospitals are associated with chronic pancreatitis.

“The pancreas is an organ in your abdomen that is critical to digestion and control of blood sugar. In chronic pancreatitis, the pancreas is damaged and becomes progressively scarred. It often becomes calcified and may contain stones and cysts. In this country, about three quarters of cases are due to alcohol use. Other major causes include hereditary (genetic) diseases, metabolic problems such as high calcium or triglyceride levels, abnormalities or blockages of the pancreatic duct, and autoimmune diseases. Sometimes, the cause is unknown.

“The first key to treatment is eliminating the cause, if possible. This could mean abstaining from alcohol, treating high calcium or triglyceride levels, fixing blockages, or treating the autoimmune disease. Some newer studies suggest that taking antioxidants like vitamin E may help prevent attacks, but there is not yet solid proof. Once the pain and nausea start, however, these measures often do not alleviate symptoms.

“Taking pancreatic enzymes by mouth aids digestion and sometimes helps relieve pain and bloating. Moderate to severe pain usually requires the use of narcotics. Newer nonnarcotic medications can blunt the pain response and reduce the need for high-dose narcotics. On occasion, gastroenterologists can treat pain with new endoscopic treatments to unblock the drainage ducts, remove stones, or drain cysts. Pain specialists may block the main nerve involved, which is called the celiac plexus. In rare cases, we resort to surgery to remove part of the diseased organ or drain the duct.

“Doctors experienced in pancreatic diseases are best equipped to treat moderate-to-severe chronic pancreatitis. I encourage you to seek out a medical center that specializes in diseases of the pancreas.”

Medical Mailbox supplements the advice of your healthcare provider, whom you should consult for personal medical problems.

Chronic Pancreatitis The Saturday Evening Post

While vitamins can’t cure age-related macular degeneration (AMD), research suggests that eating plenty of fish, green leafy vegetables, and fruits may delay its progression and preserve vision. See below for a list of potentially sight-saving nutrients in foods and supplements.

Most people with macular degeneration have the “dry” form of the disease. It is characterized by the gradual breakdown of cells in the macula, the part of the eye responsible for detailed vision. In “wet” AMD, abnormal blood vessels damage the macula—disrupting vision in the process. Laser and drug therapies to eliminate the extra vessels may allow patients to see more clearly.

Periodic dilated eye exams help ophthalmologists and their patients monitor symptoms and make treatment decisions. Getting regular exercise, maintaining normal blood pressure and weight, and not smoking are also important. In the future, scientists hope that advances with stem cells and genes will prevent or cure the disease.

Data from the Age-Related Eye Disease Study show that taking the following supplements reduced the risk of vision loss in some people with intermediate or advanced AMD:

• 500 mg vitamin C
• 400 IU vitamin E
• 15 mg beta carotene
• 80 mg zinc (as zinc oxide)
• 2 mg copper (as cupric oxide)

More recent studies show that adding lutein and zeaxanthin to the diet may also reduce the risk of developing advanced AMD. These carotenoids are found in the macula. Food sources include Brussels sprouts, spinach, broccoli, kale, and greens.

Medical Mailbox supplements the advice of your healthcare provider, whom you should consult for personal medical problems.

Aging Eyes The Saturday Evening Post