The end of illness?

By Brian Bethune - Monday, January 23, 2012 at 10:00 AM - 0 Comments

A. Bello/Getty Images

Take statins if you’re over 50, and baby Aspirin, too. Drop the vitamin supplements like they were a lit cigarette. Junk the juicer. If the vegetables at the supermarket aren’t today-fresh, opt for fresh frozen. Wear sensible shoes. Eat lunch and go to bed at the same time every day. Get your flu shot. Move around a lot, even when you aren’t exercising. Digitize your medical records, family history and genetic profile, and store this information on a USB stick. Carry it with you always. Share it, anonymously, with the world.

Think of yourself as a system: cancer is not something the body gets and health is not something it has—both are states, dynamic processes really, that the body undergoes. And your system is not the same as anyone else’s: the daily glass of red wine that does wonders for your friend may be killing you. Take note of the specific, unchanging details of your system. Is your ring finger longer than your index finger? That ups the risk of prostate cancer for a man, and of osteoarthritis for a woman. (No one knows quite why, but the marker is well-established.) Keep an eye on your more changeable fine points. Check your nails: yellowish hue bad (go for a diabetes check); white crescent at the base good (iron levels are sufficient). Check your ankles: indentation marks from your socks or loss of hair could mean circulatory problems and increased risk of blood clot.

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Saskatchewan goes rogue on CCSVI clinical trials

By Anne Kingston - Friday, January 13, 2012 at 12:58 PM - 0 Comments

Yesterday Saskatchewan Premier Brad Wall left the Canadian Institute of Health Research (CIHR) and the MS Society of Canada in the dust when he announced his government has allocated $2.2 million for 86 multiple sclerosis patients in Saskatchewan to participate in Phase II clinical trials into chronic cerebrospinal venous insufficiency, or CCSVI, currently underway in Albany, NY. (Phase II trials consist of randomized treatment in a clinical setting, as opposed to Phase I trials, which research the safety and efficacy of a drug or procedure.) Applications, which will be accepted until Feb. 24 from patients who fit trial criteria, will be chosen randomly. Results from the lottery, one destined to be oversubscribed, could be announced as early as March. “It’s a good day in the province of Saskatchewan,” the premier said at a press conference, adding that very few residents of his province, which has one of the country’s highest incidence of MS per capita, have not been touched by the disease. He also noted the FDA has approved the Albany trial, the largest double-blinded study yet into the venous angioplasty treatment for MS pioneered by Italian vascular specialist Paolo Zamboni.

Anyone following the tortuous politics in the battle for CCSVI clinical trials in Canada over the past two years couldn’t help but read the comment as a not-so oblique reference to the fact the CIHR, which did an about-face on a previous decision not to fund clinical trials last year, has yet to announce its research team into Phase I trials (Phase II trials aren’t on the radar). Or that the MS Society, which allocated $700,000 into ongoing studies reviewing only the efficacy of CCSVI scanning, not treatment, has not exactly been a trailblazer on the issue, one that has dominated MS-patient activism in the past two years.

In sending Canadian MS patients to the U.S., after failing to get a home-grown trial off the ground, the premier is also debunking any myth that Canada is “a leader” in CCSVI research. Though the Albany trial is expected to take two years, Wall is already strategizing. While saying he didn’t want to get ahead of himself, the premier did allow that “if we find any symptom relief for MS, treatments that work for the many who suffer—the 3,500 plus in this province—I think it will be incumbent on the province of Saskatchewan to provide those proven and efficacious treatment to those patients.” Those are compassionate words. They’re also fighting words, suggesting that Saskatchewan, the home of once-universal Canadian health care, could also be ground zero for furthering CCSVI science—and possibly providing new treatment for a mysterious, incurable condition that afflicts so many Canadians.

Asking for an outbreak of preventable diseases

By Kate Lunau and Martin Patriquin - Monday, January 9, 2012 at 11:30 AM - 0 Comments

Photograph By Andrew Tolson

On April 8, Pierre Lavallée took a call from Quebec’s public health office. Lavallée was into his fifth and last year as principal at Marie-Rivier high school in Drummondville, a town of about 67,000 an hour’s drive east of Montreal. He learned that a school employee had gone to the emergency room with a fever and rash the day before. Doctors quickly isolated the woman and rushed her to intensive care, where she was diagnosed with measles, a highly contagious and potentially deadly virus. According to the World Health Organization, measles was eradicated from the Americas in 2002.

Later, just after four o’clock, Lavallée received a fax from Dr. Danièle Samson, the director of infectious diseases for the region. “The staff and students at Marie-Rivier were in contact with a person very likely suffering from measles,” it began. The letter was to be forwarded to 1,475 students and staff, but most had already left for the weekend, so it was only circulated the following Monday. “I actually had measles when I was six or seven years old,” says Lavallée. “It was 40 years since I’d even heard of it popping up.”

Thus began what the Quebec government calls by far the worst measles outbreak in the Americas in 20 years. Over the next eight months, 763 cases were reported in the province, the vast majority in Mauricie and Centre-du-Quebec, a region that includes Drummondville. Roughly 11 per cent of those who were infected were hospitalized. Even a few who were inoculated as children caught the virus. “I didn’t think I could get it,” says Pascal Tarakdjian, 38, a science teacher at Marie-Rivier and the second confirmed case at the school. “I went to the hospital and told the staff that I might have measles symptoms, but they didn’t react because they didn’t know.”

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The enduring stereotype of the male nurse

By Kate Lunau - Thursday, December 22, 2011 at 11:30 AM - 0 Comments

Todd Korol

One recent November day, Tyler Hume, a 20-year-old nursing student, was at work in the maternity ward of Calgary’s Foothills Medical Centre. Tending to a patient who’d just given birth, he listened to her heart and checked other vital signs, then moved on to her new baby. Being a male nurse in a maternity unit can be tricky, he says—but as one of just a handful of men in the University of Calgary’s entire faculty of nursing, Hume is used to feeling like the odd man out sometimes. “It’s unconscious things, like when [an instructor] is talking about a nursing action, and always refers to the nurse as ‘she,’ ” he says. To create a resource for men in the program, he co-founded the Nursing Guys’ Group, a club for male nursing students.

This fall, 13 per cent of the high school students admitted to the University of Calgary’s nursing program were male, an all-time high. Across the country, the number of male nurses has doubled in the past decade, according to the Canadian Nurses Association (CNA), and now sits at roughly six per cent. But, compared to other professions that suffer from a gender imbalance, nursing is still incredibly skewed. Consider the fact that about 19 per cent of Canadian police officers are female, or that upwards of 30 per cent of elementary school teachers are male. The CNA predicts we’ll be short about 60,000 nurses by 2015, but there are no national strategies to attract more men into the profession. Calgary’s Nursing Guys’ Club is one of the few supports that’s been set up specifically for male nurses, who still face what Hume calls a “societal stigma.”

Male nurses have long been viewed as “less masculine,” notes a study in the American Journal of Men’s Health in November that attempts to put this stereotype to bed. Researchers took a survey of male and female nursing students across the U.S., scoring them based on certain personality traits. It concluded that the nursing profession attracts “males who hold a high degree of masculinity.” The fact that researchers bother to study questions like this might seem surprising, but gender-driven clichés about the nursing profession go back generations: for women, it’s “Hot Lips” Houlihan, or the “sexy nurse” Halloween costume. If female nurses are over-sexualized, male nurses are just the opposite, like Ben Stiller’s goofy character in Meet the Parents. On the TV show Scrubs, one of the main characters (a female doctor) finds herself attracted to a “murse,” despite her initial aversion to his profession.

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A brain injury library online

By Cathy Gulli - Thursday, December 8, 2011 at 5:33 PM - 0 Comments

http://www.sportconcussionlibrary.com/

After all the attention paid to Sidney Crosby and his concussion this year, countless questions remain about the injury, and countless more athletes will succumb to it yet. For these reasons, Dr. Paul Echlin, a sports physician and concussion researcher in London, Ont., has just launched a website devoted to sharing information about the injury.

The Sport Concussion Library, launched today, features a collection of scientific studies, documentaries, as well as federal and provincial legislation pertaining to brain injuries. General information is tailored to parents, coaches, players, teachers and first responders, while education modules allow users to gauge and improve their knowledge of concussions. Even the SCAT2, the diagnostic test used by medical professionals to diagnose concussions, is explained, and first responders and health workers can register to use it online.

Perhaps most interesting of all on the website are the various lengthy and candid testimonials from individuals who have experienced concussion firsthand, including hockey and football players, cyclists, and a wrestler, plus parents of injured athletes.

“I know how easy it is to tell yourself you don’t have a concussion when you really do; I told myself that a few times,” says one former hockey player in his testimonial. “Doing serious damage to your brain is not worth playing that extra game or those few extra shifts. Concussions can lead to so many other serious problems that I personally experienced and would not wish upon anybody. A concussion is a very serious injury and should be treated that way.”

This is one more step towards making that happen.

Hurry up and wait for a CCSVI strategy

By Anne Kingston - Wednesday, November 30, 2011 at 4:51 PM - 0 Comments

Update 2: The second reading of Bill C-280 is now scheduled for Thursday, December 8 at 6:30.

Update: The second reading and debate for Bill C-280 was pushed off the House of Commons schedule on Nov. 30 due to other business. It hasn’t been rescheduled. Stay tuned.

CPAC is not always recommended viewing but tonight’s programming is must-see-TV. At 5:30 pm EST (and later in endless loop) Liberal MP Kirsty Duncan’s private member’s Bill C-280 calling for a national CCSVI strategy is set for second reading and debate. (If the House of Commons vote scheduled to begin at 6:15 pm goes past 7:01 pm, private member’s business will be cancelled and rescheduled for another time at the discretion of the Speaker.)

Duncan, a Ph.D. and adjunct professor at the University of Toronto, was the Liberals’ public health critic when she initiated the 2010 sub-committee on neurological diseases, which called upon Italian vascular specialist Paolo’s Zamboni to answer questions about his hypothesis that venous malfunctions in the neck and chest are linked to multiple sclerosis—and that venous angioplasty can relieve MS symptoms dramatically. The member for Etobicoke North is calling for CCSVI clinical treatment trials as well as a national tracking program for the estimated thousands of Canadians who’ve traveled offshore for treatment—and have been denied after-care upon return. Continue…

Routine mammograms: evil, necessary, or both?

By Anne Kingston - Friday, November 25, 2011 at 7:12 PM - 0 Comments

Last week, the Canadian Task Force on Preventive Health Care issued new breast cancer-screening guidelines that have raised questions and stoked debate. The task force recommended women under 50 who are not at high risk of breast cancer forego routine mammograms. It also recommended that the interval time between mammograms for women aged 50 to 69 be extended from every one to two years to every two to three years—unless their doctors suggest otherwise. And, contrary to what women have been told for decades, it concluded women should no longer conduct regular breast self-examinations.

To sort through the confusion, Anne Kingston spoke with Eileen Rakovitch, a radiation oncologist and chair of the breast cancer program at Toronto’s Sunnybrook hospital.

Q: It seems this debate never ends. Let’s start with mammograms. Radiologists in the U.S. and Canada have disagreed on this in the past: in the U.S., the recommendation is that women over age 40 should have regular mammograms; in Canada, the thinking has been that women at average risk should begin screening at age 50. Continue…

How AIDS really got started

By Brian Bethune - Wednesday, November 23, 2011 at 11:00 AM - 0 Comments

Daniel Rosenthal/laif/Redux

In 1976, a handful of Belgian nuns were operating a badly needed hospital in Yambuku, a remote village in Zaire. Some 300 patients a day came, many seeking antiviral drugs, which nurses provided via the poorly funded hospital’s five reusable syringes. The result of the inevitable cross-infection was the first outbreak of the blood-borne virus Ebola, which killed 280 of its 318 victims—far more deaths than if there had never been a hospital in the first place.

The Yambuku incident is one of the most harrowing proofs ever recorded of the old adage that no good deed goes unpunished. But the story of the Ebola outbreak differs little in its essentials from that of an exponentially more lethal disease, AIDS. Now marking its 30th official birthday—counting from the 1981 U.S. Centers for Disease Control paper about an unlikely pneumonia cluster in Los Angeles—AIDS has so far killed 30 million people. And in Dr. Jacques Pepin’s convincing account of its history, The Origins of AIDS, it emerges as the greatest man-made health disaster of our times.

The disease itself is much older than 30. Molecular studies show that chimpanzees, hosts to the virus that causes AIDS in humans, have carried it for centuries. Pepin, an infectious disease physician and professor at Quebec’s Université de Sherbrooke, uses mathematical modelling to show that dozens of people—chimp hunters or their wives preparing the meat—must have thereby contracted AIDS. One spouse would then infect the other sexually, but those couples became what Pepin calls in an interview “epidemiological dead ends: the disease would develop in them for a decade, and then they would die, with no effect on the larger population.”

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Headache-free wine?

By Ken MacQueen - Thursday, November 17, 2011 at 11:30 AM - 0 Comments

Photo by Simon Hayter

Enlightened self-interest is a powerful motivator. For 15 years now, Hennie van Vuuren has been building an army—one yeast cell at a time—to make the world a better, safer place for fellow wine lovers, a world without headaches and other nasty things. Van Vuuren, a South African-born microbiologist, holds the Eagles Chair in Food Biotechnology at the University of British Columbia, and he is the founding director of its Wine Research Centre, a little slice of heaven for oenophiles, and home to some 30 graduate student researchers and faculty.

The heart of the centre, at least for the less scientifically inclined, is the Wine Library, a temperature-controlled vault cradling a growing collection of some 6,000 bottles, many from B.C.’s burgeoning Okanagan vineyards. But there’s also a sampling of some of the best vintages from around the globe—donated by patrons in exchange for a tax receipt. You can’t make great wine unless you have tasted greatness, he says, and few students can afford that luxury. “We use these wines to train our graduate students.”

But while van Vuuren is passionate about the finished product, the focus of his academic research in South Africa, at Ontario’s Brock University, and now 12 years at UBC, is the lowly yeast cell, one of wine’s essential building blocks. Through years of research and genetic manipulation, his team has created a yeast that stops the production of headache-inducing allergens in wine, others that drastically reduce the presence of a carcinogen, and he’s closing in on another to reduce alcohol levels while enhancing flavour and body.

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Predicting problems

By Cathy Gulli - Thursday, November 17, 2011 at 11:20 AM - 0 Comments

Ask a heart or kidney transplant patient about the worst part of recovery and they’ll often say it’s the biopsies to ensure they aren’t rejecting the new organ. “It’s about fear, discomfort, inconvenience, minor risks,” says Dr. Bruce McManus, a professor of pathology and laboratory medicine at the University of British Columbia. So he is working to make this necessary evil much less awful.

With his team at the Prevention of Organ Failure Centre of Excellence (Proof Centre) in Vancouver, McManus is developing a blood test to detect acute and chronic rejection, or predict its occurrence. Since starting their research in 2003, the scientists have identified a collection of blood molecules, known as biomarkers, that indicate when an individual is a “rejector” and when they are not, says McManus, director of the Proof Centre. He hopes the blood tests will be widely used in hospitals by the late summer of 2013.

Besides being painless, the tests will be processed faster—the same day, instead of overnight. And the results will be based on quantitative information rather than the subjective reading of a pathologist using international guidelines.

Going forward, McManus has two goals in mind: first, “reduce the number of biopsies” that patients endure. And then, “to eliminate the biopsy” altogether.

Painless gum disease testing

By Cathy Gulli - Thursday, November 17, 2011 at 11:00 AM - 0 Comments

Photograph by Andrew Tolson

“Rinse and spit” is a routine part of a trip to the dentist. But a University of Toronto researcher is turning the exercise into a tool to diagnose gum disease early and painlessly.

Typically, dentists detect the disease by running a metal probe underneath the gums, which can be uncomfortable and only catches it once damage has occurred. This rinse test, invented by Dr. Michael Glogauer, an immunologist, oral biologist and periodontist, identifies gum disease by measuring the amount of white blood cells—which indicate infection—present in the mouth.

After swishing water for 20 seconds, the patient spits into a cup; a dental professional adds in two drops of a chemical, and within a minute the water turns blue if disease is detected. “The degree of blueness tells you the severity,” says Glogauer, who is working to bring the test to market in Canada and the United States.

Diagnosing gum disease early is important for overall well-being. It has been associated with increased risk of diabetes, stroke, cardiovascular disease and low-birth-weight babies. “It’s not just about losing your teeth,” says Glogauer. “It’s about causing damage to the rest of your body.”

Detection in two seconds

By Ken MacQueen - Thursday, November 17, 2011 at 10:40 AM - 0 Comments

Verisante

One in seven Canadians will develop skin cancer during their lifetime. The good news is the disease has a high survival rate—if detected early.

Enter the Aura, a world-beating device that detects if a lesion is cancerous in less than two seconds. The technology, developed by the B.C. Cancer Agency and the University of British Columbia, was recently approved by Health Canada. The Aura should be available to health professionals by summer, says Thomas Braun, founder of Vancouver-based Verisante Technology, which licensed the device. It uses a hand-held wand to optically analyze the skin, allowing early detection of deadly melanoma, and more common skin cancers. Variants of the technology are under development for detecting lung, colon, cervical and gastrointestinal cancers. Both in terms of treatment costs and unnecessary biopsies, says Braun, “it’s got great potential to save lives, and save money.”

Where the clinic hits the road

By Kate Lunau - Wednesday, November 16, 2011 at 11:50 AM - 0 Comments

Photography by Nayan Sthankiya

At home and in her job, Jodi Spence has to deal with other people’s health problems—major and minor—on a nearly daily basis. She’s the mother of four kids, all under eight, one of whom has a heart rhythm disorder. She’s also director of a daycare centre located inside a Saskatoon high school that watches over the babies of adolescent moms while they’re in class. So, whether it’s a baby’s rash, a teen who needs birth control, or her daughter requiring a medication refill for her heart condition, “I probably [go for medical attention] once a week,” says Spence, 32. Instead of visiting an overcrowded emergency room or her family doctor, who’s often booked solid for the day, Spence goes to the Health Bus—Saskatoon’s walk-in clinic on wheels.

A retrofitted 1976 RV that launched in 2008, the Saskatoon Health Bus parks at different spots around Saskatoon’s inner-city neighbourhoods—outside a Giant Tiger store, the Safeway or a Shell station, for example—seven days a week, year round, seeing an average of 12 to 14 clients a day. A nurse practitioner and paramedic are on the bus, offering medical attention to anyone who stops by, whether they have a health card with them or not. Known as the “Magic Bus,” it’s been so successful that, on Nov. 24, the rickety old RV will be replaced with a new model.

The Health Bus was created as a way to reach out to Saskatoon’s Aboriginal population, newcomers, children, the elderly and others who might not have regular access to a doctor, says Sheila Achilles, director of primary health and chronic disease management at Saskatoon Regional Health, which oversees the program. “There are family physicians in the area, but people aren’t going to see them,” Achilles says. And unlike patients who visit a series of walk-in clinics and emergency rooms, those who come back to the Health Bus get some continuity of care. “People who visit feel very safe,” Achilles says, and because it’s mobile, it can reach different people in different parts of the city.

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Heart in a box

By Alex Ballingall - Wednesday, November 16, 2011 at 11:20 AM - 0 Comments

Photograph by Andrew Tolson

How long can a human heart sit in a cooler of ice—thirsty for vein-borne blood, detached from oxygen and lungs—before it becomes useless to the transplant patient who desperately needs it? Not much longer than six hours, and that’s already pushing it, says Dr. Thierry Mesana, chief of cardiac surgery at the Ottawa Heart Institute. “We don’t have so much trouble with anything under four hours,” says Mesana, who has been transplanting hearts for 25 years. “Beyond six hours is certainly too long.”

Those time restrictions lead to some unfortunate limitations for Canadian hospitals holding patients waiting for heart transplants (as of the end of last year, there were 135 of them in Canada). Even when a perfect match becomes available for transplant, it’s sometimes lost due to degradation over time. Mesana says it’s rare to be able to bring hearts to Ottawa from Vancouver, for example, even when a match—by blood type, age, weight—arises. “We basically can’t do it, most of the time,” he explains. If a match doesn’t turn up within a six-hour radius, the heart is lost.

But the makers of a new technology currently undergoing clinical trial in the United States and Europe say the traditional means of transporting hearts could soon be history. In place of the ice-filled cooler, they promise something seemingly out of science fiction: a box-like machine that carries a beating human heart.

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The end of blood samples?

By Kate Lunau - Wednesday, November 16, 2011 at 11:10 AM - 0 Comments

Photograph by Andrew Tolson

When Virginia Commonwealth University’s first-year students arrived on campus this fall, they received a seemingly bizarre invitation—to “Spit for Science.” A team of researchers at VCU, which is based in Richmond, is looking into whether genes might predispose some individuals to struggle with drug and alcohol use, or emotional problems. To accomplish this, they asked students to take part in a confidential survey: first they had to fill out an online questionnaire about their moods, their behaviour and relationships, and then provide a saliva sample, which is rich in DNA. These samples were collected with a unique device created by DNA Genotek, an Ottawa-based company that corners the market on high-tech spittoons.

As much as 70 per cent of the cells in saliva are white blood cells, which contain DNA, says company president Ian Curry. With this product, “you spit into a tube, and the device releases the DNA from inside the cells,” he says. It’s much less invasive than a blood sample, which makes it popular with scientists: instead of summoning study participants into a clinic to provide blood, health researchers can actually send out these devices by regular mail, have them provide a saliva sample, and then mail it back to the lab for testing. Unsurprisingly, Curry notes that participants in a lab study are much more likely to provide a saliva sample than blood.

“Spit for Science” is just one example of the many ways this sampler is being used. DNA Genotek (which was acquired by Pennsylvania-based OraSure Technologies in August) has thousands of clients around the world, according to Curry, and scientists are using the device to study everything from obesity to tropical disease. “Just two millilitres of saliva,” he says, “gives a researcher enough DNA to study for a decade.”

Your Chia pet is good for you

By Joanne Latimer - Wednesday, November 16, 2011 at 11:10 AM - 0 Comments

Photograph by Jessica Darmanin

“Who knew, 30 years ago, that chia had all these wonderful health properties?” exclaims Joseph Pedott, the entrepreneur who marketed the Chia Pet, the famous terracotta figurine of infomercial fame that’s sold more than 10 million units. “It was the furthest thing from my mind back then. I’d heard something about chia as food for the Aztecs, but I never imagined it was actually true.”

It’s true, and then some. Chia (Salvia hispanica L.) is a seed cultivated since pre-Columbian times in Mexico and Guatemala. “There are four main things to know about chia,” says Edmonton-born Wayne Coates, known as the “father of chia” and professor emeritus at the University of Arizona, where he started studying the seed in 1991. “It’s the highest plant source of omega-3 fatty acids. It’s an antioxidant on par with wild blueberries. It has over 20 per cent protein, which is higher than wheat, and it’s a great source of soluble and insoluble fibre.”

Compared to flaxseed, chia has three times the calcium and half the sodium, says Coates. “I don’t like to run down flax, especially since Canada is the largest maker of flaxseed, but chia is just easier to use and it has no flavour or known allergens. The calories sound high, at 525 per 100 g, but they’re good calories, from chia’s 30 per cent oil, which has the omega-3s we need.” The gluten-free chia seeds absorb up to 10 times their weight in water, which helps make people feel full faster and longer. “When people ask me the difference between the black and white seeds,” notes Coates, author of Chia: Rediscovering a Forgotten Crop of the Aztecs, “I explain that the darker seeds contain more antioxidants, just like darker fruits and vegetables. But the white seeds are less noticeable when they get stuck in your teeth.”

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Using avatars to assess mental health

By Emma Teitel - Wednesday, November 16, 2011 at 11:05 AM - 0 Comments

University of Manitoba

Pediatric nursing and video game development don’t usually appear in the same sentence. But University of Manitoba professor Roberta Woodgate has brought them together in the same laboratory. A seasoned nurse and professor, Woodgate teamed up with Winnipeg tech company Complex Games five years ago to create a “virtual computer environment” (she is hesitant to call it a game) that gauges the psychological moods of child cancer patients. EMÜD—pronounced “e-mood”—is an online adventure that allows young people with cancer to create their own avatars and explore up to seven virtual fantasy worlds—complete with bridges, mazes and imaginary pets—while at the same time answering specially engineered questions about their psychological state. Woodgate says her motive is to assess the mental health of patients in an interactive and diversionary way, rather than subject them to a series of questions in a doctor’s office. Or as she puts it, “Assigning a number [from one to 10] to how you feel doesn’t give the whole picture.” Her ultimate goal is for kids “to communicate how they’re feeling in a fun way.” EMÜD will undergo a pilot test in the new year. If all goes well, Woodgate hopes it will become a tool used by people suffering from “any life-changing event.”

Is Canada ready for human trials on stem cell therapy?

By Kate Lunau - Wednesday, November 16, 2011 at 11:00 AM - 0 Comments

Photograph by Colin O'Connor

Before his accident, Mike Kowalski loved fast motorcycles. At 26, he rode his bike from his home in Markham, Ont., three hours north to Haliburton—it has “nice roads and less cops,” he says—when he took a turn too fast. Hitting a gravel patch, Kowalski lost control. His first and only motorcycle crash left him paralyzed from the chest down. Devastated, he tried to be optimistic: rapid advances in stem cells seemed to suggest powerful new treatments on the horizon. “I was mentally prepared for five years,” Kowalski says. “Not to be back where I was, but that I’d be using a cane instead of a wheelchair.”

Kowalski kept up with the latest research, attending conferences and chatting with scientists about their work in stem cells. As time went by, and treatments failed to materialize in North America, he got increasingly frustrated. Two years after his accident, he went to Taiwan, where an experimental “nerve cocktail” was injected into his spine. Five years later, he went to Beijing and received an embryonic stem cell transplant. Neither treatment, which cost about $20,000 each, made much of a difference, he says. He kept waiting. “Five years came and went, and then 10.” It’s now been 11 years, and Kowalski still uses a wheelchair. “It seems incomprehensible that we can fix rats in a lab and fly rovers to Mars,” he says, “but we can’t regenerate some nerves in my spine.”

Stem cells, which can grow into any cell type in the body, have been touted as a potential cure for everything from type 1 diabetes to stroke. They aren’t without controversy—embryonic stem cells come from discarded human embryos—but they hold huge promise, too. This is certainly true when it comes to spinal cord injury, a devastating condition that affects about 86,000 Canadians. Unlike muscles, organs, skin and blood, the central nervous system can’t repair itself; despite huge advances in treatment and rehabilitation for this type of injury, the damage is often permanent. In theory, stem cells could be injected into a damaged spinal cord to promote repair. Now one influential Toronto neurosurgeon says it’s time to take stem cells out of the lab and into the clinic.

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Knocking people off their feet

By Chris Sorensen - Wednesday, November 9, 2011 at 11:30 AM - 0 Comments

Sunjoo Advani

Visitors to the basement of the Toronto Rehabilitation Institute’s new 13-floor building on “Hospital Row” could be forgiven for thinking they had unwittingly stumbled upon a super-villain’s subterranean lair. Several floors below the ground, technicians monitor computer consoles perched above a deep chamber that houses three giant fibreglass pods—each with an interior about the size of a spare bedroom. A claw-like system dangles from the ceiling, waiting to hoist one of the pods off the ground and carry it along a track into a neighbouring chamber, where it is placed atop a set of giant hydraulic legs bolted to the cement floor.

There are, however, no plans to take over the world with this high-tech equipment, part of the institute’s new Challenging Environment Assessment Lab, or CEAL, a computer-controlled motion simulator system similar to those used to train pilots and astronauts. Except these simulators, part of a $36-million initiative to make Toronto Rehab a leader in geriatric and neurological rehabilitation research, will be used to replicate more mundane environments like icy sidewalks and household staircases—both of which are responsible for a staggering number of injuries among elderly and disabled Canadians every year. “We take on the big problems,” says Geoff Fernie, the vice-president of research at Toronto Rehab, as he levels his gaze over the glasses perched on the end of his nose. “Stairs kill and maim three times as many people as car accidents.”

In Canada, one out of three people over the age of 65 has a slip or a fall every year, and they are responsible for nearly 20 per cent of injury-related deaths and two-thirds of all hospitalizations among the same age group, according to the Public Health Agency of Canada. And falls break more than just brittle bones. They also shatter confidence and can often mark the beginning of a rapid decline in health and quality of life among the elderly, a growing national health issue for an aging Canadian population.

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Q&A: Edzard Ernst on alternative medicine

By Julia Belluz - Wednesday, November 2, 2011 at 3:41 PM - 0 Comments

Dancing Lemur/Flickr

Steve Jobs’ tragic death may have added a new urgency to Edzard Ernst’s work. In October 2003, when Jobs was diagnosed with pancreatic cancer, he turned not to conventional medicine but acupuncture, macrobiotic diets, and visits to a spiritualist, delaying surgery some doctors suspect could have saved his life. About ten years before that diagnosis, Ernst—an award-winning, U.K.-based physician—began establishing an evidence base for alternative therapies. Since then, Ernst has become the world’s first professor of complementary medicine at Peninsula Medical School in Exeter, England, founded two academic journals on the topic (Perfusion and Focus on Alternative and Complementary Therapies), and published more than 1,000 papers and over 40 books (including the recent Trick or Treatment? Alternative Medicine on Trial).

So far, only five per cent of the alternative therapies Ernst turned his critical gaze to have shown curative powers beyond those of a placebo. The demise of Apple’s founder, then, seems a fitting occasion to reflect on the powerful allure that alternative medicine holds—even for the geniuses among us. “My first thought was, ‘How tragic,’ and the second, ‘When will we learn the lesson?’” said Ernst. “People—even if they are smart—are all too easily misled to do the most stupid things, particularly with the promotion of alternative medicine being as viciously effective as it is.” Indeed, Jobs wasn’t the first VIP to use alternative medicine: Bob Marley, Peter Sellers and Steve McQueen were all enthusiastic proponents. And in this country, recent estimates put our out-of-pocket spending on alternative-care providers at $5.6 billion.

So what does Ernst think we need to know about this type of care? I caught up with him at Evidence2011 to discuss the evidence base for alternative therapies.

Q: You’ve said you are fed-up for being known as a quack buster. Why?

A: Quack busters, just like enthusiasts of alternative medicine, do their work to confirm their prior beliefs. They are not even trying to be objective. Scientists test hypotheses initially with an open mind and bend over to be objective.

Q: So what areas of alternative medicine are helpful or effective, according to your research?

A: The best evidence by far emerges from herbal medicine. Some herbs, like St. John’s Wort, are both effective and safe if used properly.

Q: If you had to pick, are there particular claims that alternative medicine practitioners make that irk you most?

A: That their pet therapy somehow defies scientific scrutiny. A close second would be: “My notions have not been proven wrong, so they might be correct.”

Q: What are some of the direct risks associated with alternative medicine that people need to consider?

A: Chiropractic neck manipulations can injure an artery that supplies the brain. This can cause strokes or deaths.

Q: Can you give me an idea of the absolute or relative risks related to complementary medicine?

A: Risks of alternative medicine are under-researched and under-reported. We know of some 700 serious complications after chiropractic. We also know that under-reporting is such that this figure could be larger by one or two orders of magnitude.

Q: Do you think regulating this industry would help? If so, what kind of regulation would you like to see?

A: Yes, regulation is essential. But it must be regulation according to accepted standards. If not, regulation will just be a way of giving credence to people or products that do not deserve it.

Q: Have you looked at whether alternative medicine can lead patients to postpone seeing conventional health professionals? If so, what are the dangers here?

A: Even homeopathic remedies, or other treatments which are pure placebos, can kill someone if they are used as an alternative to effective therapies. The most recent, tragic example is Steve Jobs.

Q: Are there any good, trustworthy references for patients who want to learn more about the risks or benefits of alternative therapies?

A: Because there is so much misinformation and so much unreliable information, we have decided to write Trick or Treatment. I recommend it as an honest attempt to summarize the evidence.

Q: A lot of people use acupuncture, yet high-level studies show that sham acupuncture is just as good as ‘real’ acupuncture. What does this tell us?

A: It shows how important the placebo effect can be, particularly if expectations are high. But we do not need bogus treatments to benefit from a placebo response. Any effective therapy also comes with a free placebo effect in addition to its specific therapeutic effects, as long as it is administered with compassion and empathy.

Q: Taken as a whole, your research shows that only five per cent of the therapies you have studied have rendered a benefit above and beyond a placebo or hint that further research might be warranted. How do evangelical alternative-medicine users or practitioners react to this finding?

A: The 5 per cent figure is based on the evidence we evaluated for our book Desktop Guide. For that, we pre-selected the most promising areas. Thus, the five per cent figure is a gross over-estimation. Across the board, the true percentage is probably one dimension less. Believers react with disbelief in such data. You cannot easily disprove a religion.

Q: What do you say to people who argue that conventional medicine kills more people than alternative medicine and that the latter is even more dangerous, so we should focus on this threat to public health?

A: I say it’s true but misses the point. Treatments must be judged by their risk-benefit balance. If a therapy causes some harm but, at the same time, saves thousands of lives, it still might be worth considering. Very few alternative medicines generate a lot of benefit. This means even small risks can affect the risk-benefit balance significantly.

Q: Any final messages for consumers who are considering alternative medicine?

A: If it sounds too good to be true, it probably is.

The sleepover dilemma

By Anne Kingston - Tuesday, October 25, 2011 at 11:50 AM - 3 Comments

Katrin Thomas/Getty Images

Seven years ago Veronica Redgrave made a decision that many parents wouldn’t even consider. The Montreal-based publicist permitted her 17-year-old daughter to have her steady boyfriend sleep over occasionally. “Our communication was always very open,” says Redgrave, who was raised in a strict British family where sex was not discussed. “She had her own space in the basement. And I respected it.” Her daughter is now 24, a graduate of the London School of Economics and living in Amsterdam. She’s still involved with the same boyfriend.

At the time Redgrave knew her permissiveness was unconventional by North American standards. But now, with the November publication of Amy Schalet’s Not Under My Roof: Parents, Teens and the Culture of Sex, it turns out she was “being Dutch.” As Schalet, an assistant professor of sociology at the University of Massachusetts-Amherst, reports, nine out of 10 Dutch parents sanction such arrangements, versus the “not under my roof” directive maintained by nine out of 10 American parents.

Schalet interviewed 130 parents and teenagers in both countries to explore the cultural gulf. Dutch parents “normalize” teenage sexuality, Schalet concludes, as a way of maintaining a connection with and continuing to exert an influence over their teenagers. It’s an extension of a Dutch matter-of-fact attitude toward sex ushered in since the ’70s: sex education begins at age four and contraception is readily available. Yet it’s far from an “anything goes” attitude, Schalet writes: Dutch parents have to feel comfortable that their child, generally 16 or 17, is old enough to be sexually active, is using reliable contraception, and is in a stable relationship with someone who will fit into the family unit. Dutch parents also expect teenagers to abstain from sex until they’re ready.

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Give mom a cigarette break

By Rebecca Eckler - Thursday, October 13, 2011 at 8:40 AM - 296 Comments

Photograph by Jenna Marie Wakani

The first rule of the Secret Smokers Mother’s Club is that you don’t talk about the Secret Smokers Mother’s Club. At least you don’t talk about it to anyone who is a non-smoker and especially to mothers who are non-smokers.

Like Alcoholics Anonymous, none of the mothers who secretly smoke are willing to share their names. It makes sense, since many of them have kept their secret for years. “I never smoke in front of my kids. Never. No one in my life knows I smoke, except for one person and that is my husband. But no one else,” says one member.

According to reports, one in two smokers hides their habit from friends, family and colleagues. And, boy, do these women go to great lengths to keep this secret from their children. “If Noah is watching television and my husband is with him, I’ll take out the garbage, then run around the house and hide in the bushes, because I don’t even want my neighbours to see that I’m a mother who smokes. I feel disgusting about it,” she admits.

But that hasn’t stopped her from smoking, even after two children, and she has no plans to quit. “Because you know people judge smokers anyways, but mothers who smoke? To non-smokers, they’d consider that worth stoning me.”

Club members end up doing a lot of unnecessary chores to get their fix. “I’ll run out to the all-night grocery store,” says one mother. “I’ll tell my husband we’re out of milk, but usually we are anyway. And this store is not close. I don’t go to the store near my house, because I worry I’ll run into people I know. I go to another grocery store that takes me about 30 minutes to get there, so I get a couple of cigarettes in before I go back home.”

But do they notice the smell? These mothers resort to more subterfuge to mask the lingering aroma of smoke. “As soon as I come back from smoking, I wash my hands, my chest, I brush my teeth, and I have clean shirts all over the house, so I can immediately change into one of them,” says one mother.

Another member’s purse could be mistaken for an Avon lady’s kit because she has so many supplies. “I keep a small tube of toothpaste and toothbrush. I have a big bottle of body lotion that smells like vanilla. I have face cream that I rub all over my face. And I have a body spray from Victoria’s Secret that I spray in my hair and all over my clothes.”

This mother also got a great tip from a makeup-artist friend who sometimes smokes. She now carries around Downy April Fresh or Bounce sheets meant for the dryer. “I rub it on my hair and it works amazingly well. Also, they are really small to carry around, which makes it easier.”

If it takes so much energy to keep smoking a secret, why not just quit? These women know the health risks and they have children they’d like to see grow up. “It’s the one last thing of my old life,” explains one. “It’s mine and it’s all mine.” Another adds, “Because I sometimes like to be bad, and as a mother you can’t be bad.”

Then there is the dark side of the addiction. “I really love smoking so much,” says one. “I sometimes find that I’m waiting for my kids to take a nap so I can go smoke. And as awful as this sounds, I’m excited my son will be going to daycare in the afternoons this fall.” Another admits that when she’s having a nicotine fit, she loses her temper with her children more often.

But even though they puff away in secret, they look down on mothers who smoke openly around their children. “When I see a mother smoking, all I can think is, ‘You disgusting wretch,’ ” says one. “When I see a mother smoking and pushing a baby in a stroller, I’m horrified. But who am I to judge? At night, I’m in the bushes putting out my cigarettes in a beer bottle.”

On the run from radio frequencies

By Alex Ballingall - Thursday, October 13, 2011 at 8:20 AM - 273 Comments

Simon Hayter/Maclean's

As the mother of two young girls, Samantha Boutet does what she believes is necessary to protect her family. That’s why, with the spread of radio frequencies from increasingly common wireless technology, Boutet is a refugee in her own land. The naturopathic doctor and her two daughters are relocating more than 600 km east of their home in Maple Ridge, B.C., to a small cabin in a remote valley in B.C.’s Kootenay mountains.

The decision was spurred by a series of health problems affecting her older daughter, Amelia, which started in Grade 4. For more than a year, Amelia suffered from deep headaches, nagging nausea, inexplicable muscle soreness, tingling extremities, and insomnia, Boutet says. Eventually, after visiting a number of specialists, the family doctor diagnosed Amelia with electromagnetic hypersensitivity (EHS), a medical condition that involves a range of non-specific symptoms attributed to electromagnetic frequencies (EMFs), much like those described by sufferers of multiple-chemical sensitivity, another environmental illness believed to be caused by low-level exposure to chemicals. “I felt really bad because her body was telling her there was something wrong, and I was telling her there couldn’t be, and I couldn’t understand why she was behaving the way she was,” says Boutet.

EMFs are invisible radioactive frequencies emitted from radio towers, WiFi routers, cellphones, wireless laptops, TV remotes—even the new smart meters that measure water and electricity use and beam information to the utilities. These non-ionizing radioactive waves travel through the air at much lower frequencies than ionizing radiation (which includes X-rays and gamma rays) and are widely considered harmless. And due to the proliferation of technology that releases them, others like Amelia, now 11, feel as if their health is being compromised. They can either live with their pain, or flee to backcountry refuges. “It’s not that I’m just worried,” Boutet says. “My older daughter will be deathly sick, so we have to leave.”

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Marriage does a man’s body good

By macleans.ca - Wednesday, October 5, 2011 at 2:37 PM - 1 Comment

Canadian women are less healthy than Canadian males, according to the results of a survey conducted by Scienta Health for Maclean’s. Last year, nearly 30,000 Canadians took the survey, which asked respondents about the frequency and intensity of approximately 150 symptoms associated with discomfort, disease and emotional stress. (Take this year’s survey here.) While some of the results shouldn’t come as a surprise, others are more likely to raise eyebrows.