Category: Health

By Sarah Shafer, as told to Stephanie Watson

I began having Crohn’s disease symptoms of as far back as age 13 or 14. At the time, I tried to hide my condition. The teenage years are already awkward. The last thing I wanted was for my friends and family to know how often I ran to the bathroom and how urgently I had to go.

I did eventually tell my family and I saw a doctor about my symptoms. The doctor thought it was stress-related. He assumed that I had ulcers.

When I was 25, I developed abdominal pain so severe that I almost passed out at work. It turned out to be an abscess. My doctor told me that it wasn’t normal for a 25 year old to have an abscess. That discovery led to further testing, which led to me being diagnosed with moderate to severe Crohn’s disease.

Keeping My Crohn’s Under Control

I’ve been on a couple of different biologic drugs to manage my Crohn’s disease. It took a few tries to get my treatment right. One involved a 4-hour infusion, which interfered with my job. I had to take a day off of work once every 5 or 6 weeks. The one I’m on now turned out to be easier because it’s an injection I give myself.

My doctor, Raymond Cross, MD, at the University of Maryland, has helped me figure out which combination of medications works best for me. He kept up with the research and gave me references to read. I feel like our partnership has made a big difference because it has kept me engaged in my own care.

By monitoring my symptoms and staying up to date on the latest research, I’ve learned how to control my Crohn’s flare-ups. Today I know how to stick with my treatment plan and manage my triggers.

Fine-Tuning My Diet

About 8 years ago, I started to read research on the link between food sensitivities and Crohn’s disease. For 3 months, I cut out dairy and gluten to see if that helped my symptoms. Then I slowly reintroduced these foods, a little at a time.

I came to realize that dairy is OK for me in limited quantities, but gluten is a consistent trigger. I cut gluten out of my diet, and I’ve avoided it for about 10 years.

Stress Management

My disease is under pretty good control, but whenever I get stressed, the frequent urge to go to the restroom comes right back. So I try to keep my stress in check.

I find that running is one of the best stress relievers, but it can also be a problem for me. It isn’t always easy to get to a bathroom when you’re on a jogging trail.

I’ve run seven marathons, but I have had to get creative. I either find trails that have restrooms along the way, or I run on a treadmill so I can stop and go the bathroom whenever I need to go.

Medication Management

Sticking to my medication regimen is also key to managing my symptoms. I take a pill every morning.

I also give myself an injection of the biologic once every 10 days. At first, I played around with the frequency of the injections. I started with one injection every 14 days. When that wasn’t enough, I went down to once every 12 days, and now I space the doses 10 days apart.

I can tell when I need my injection. As the day gets closer, I become more sensitive to dairy foods and the frequency of my bathroom visits increase. So I don’t mess around with the timing.

I have to be careful with my medication when I travel. Because the medicine has to be kept chilled, I keep my schedule in mind when planning a trip. I either have to bring a cooler pack with me or make sure that I have somewhere to keep the medicine cool until I reach my destination.

A Good Support System

Managing Crohn’s flare-ups is easier when you’ve got a strong support system. Having someone you can talk to about how you feel is really important. All those years when I was too embarrassed to discuss my symptoms with anybody was tough on me emotionally, as well as physically.

My husband has been extremely supportive. Not everyone you meet will be willing to change their diet and lifestyle to accommodate your needs, but he has.

It makes a big difference when the people in your life are supportive and they don’t make you feel like you’re impeding on their lives by having to make accommodations, like avoiding certain foods or stopping multiple times to use the bathroom during a road trip. When the people around you are supportive, it can make a big difference in how you feel and how well you manage your Crohn’s disease.

By McKenna Plant, as told to Barbara Brody

I started having Crohn’s disease symptoms when I was 15 and was formally diagnosed about a year later. In a way, I was lucky: Many people wait years before getting the right diagnosis, but I got a jump-start because my father has ulcerative colitis, another form of inflammatory bowel disease (IBD). He rarely talked about it when I was younger — I don’t think I even heard the words “ulcerative colitis” or “inflammatory bowel disease” until I started having symptoms myself, but once I did, he opened up and became my advocate.

In the years since — I’m 29 now — I’ve had a rough ride. One of the hardest things about living with IBD is the unpredictability. One day you could be feeling great and the next you’re curled up in a ball. I’ve found that connecting with others with IBD is immensely helpful. I was initially reluctant to join support groups because I thought that they were only for old people or those who wanted to sit around commiserating about their problems. But after I gave them a try I realized that it’s a relief to be able to open up in a safe space. I’ve also spent a lot of time on Instagram engaging with people who are really vocal about their experience with IBD or just chronic illness in general.

Over the years as I built my IBD tribe — which now also includes my fiancé, who has ulcerative colitis — I’ve become empowered to advocate for people with IBD. I started volunteering with the Crohn’s & Colitis Foundation when I was a teenager. When I graduated from college, I joined the staff that manages Camp Oasis, the foundation’s residential summer camp for kids with IBD. I also frequently speak at fundraising events. I truly hope that by sharing my journey I’m encouraging others to share theirs.

Talking about IBD isn’t easy. It’s not a glamorous illness, and discussing your intestines and bathroom habits can be embarrassing. But I believe it’s the best way to get the support you need while educating others. There are so many misconceptions about IBD, and it’s helpful for those who have it as well as those who don’t to learn the facts. Some misconceptions I try to dispel:

“If you don’t look sick, you can’t be that sick.”

This is a big one for anyone with an invisible illness. I look like a young, healthy, active person, but that doesn’t mean my body isn’t attacking me on the inside.

“You’d feel better if you just ate healthier.”

I wish it were that simple! Crohn’s is a chronic autoimmune ailment, and when I’m in a flare I won’t go near a vegetable. My body can’t even digest a piece of lettuce at that point.

“It’s not a big deal; I have IBS.”

IBD sounds a heck of a lot like IBS (irritable bowel syndrome), but they’re totally different. I fully understand that some people with IBS feel lousy, but it’s not the same thing as having an autoimmune condition. It’s not unusual for people with Crohn’s to develop serious complications including abscesses, bowel obstruction, and fistulas, which is when the body forms a tunnel that connects the intestines to nearby organs or tissue.

I have a fairly severe case of Crohn’s, and I’ve already had to have two surgeries: one that entailed removing about 10 inches of my small intestine and another to create a permanent ostomy, which allows stool to exit my body though an opening (stoma) on my stomach and into an external ostomy bag.

“Just take your medicine and you’ll be fine.”

Even the strongest IBD medications on the market (I get two via infusion every 4 weeks) don’t work for everyone. And sometimes a drug that initially works for you stops working. That’s really scary as a patient because you’re worried you’re going to run out of options. It’s also why fundraising is so important; we need new treatments so that everyone with IBD can get the help they need.

“Getting an ostomy will ruin your life.”

I got my ostomy about 4 years ago, and I wish I had done it sooner! Before I had my ostomy I was constantly worried about where the closest bathroom was. I always kept an emergency kit in my car with an extra pair of underwear, pants, and toilet paper. Do you know how embarrassing it is for a 20-something person to have an accident? You feel like you never want to go out in public again and just want to isolate yourself. Now I can go for a run or take a road trip without being paralyzed with fear.

“It’s better to keep Crohn’s to yourself.”

I know how hard it can be to talk about having IBD, but staying silent is stressful. If you’re able to open up to friends, family, and co-workers, you’ll feel so much better because you won’t have to worry about hiding it. Sharing your story and letting others know what you’re going through also has the potential to make life better for everyone with IBD. I once got into a fight with a flight attendant because I was in the middle of a flare and desperate to use the bathroom as the plane was about to take off. If he had understood more about IBD, he would have known that waiting until the plane reached cruising altitude was not an option.

Talking about IBD is also key to influencing legislators who have the power to enact laws that help you get the best care. Right now many insurance companies require that you try a series of cheaper treatments that don’t help before they’ll pay for more expensive options like biologic drugs. This process, known as “step therapy” or “fail first,” puts us at risk by delaying the right treatment, which can be dangerous.

Many states have recently passed step therapy reform acts, and I’m hoping that California — where I live — will soon join them. I’m also optimistic that federal legislation called the Safe Step Act will be passed in the not-too-distant future.

I hope that by talking to lawmakers, which I’ve done during various advocacy events, they’ll gain a better understanding of why these changes are so important. It’s a pretty amazing feeling to realize that simply sharing your story has the power to impact change on a local and federal level and will have lasting benefits for the IBD community.

By Christine Morris, as told to Susan Bernstein

I was 16 when I was diagnosed with Crohn’s disease. It was 2004. I was just a very sick

kid. Even as a baby, my mom told me that I had to be on soy formula because I was lactose intolerant. When I was older, doctors told my parents I had cyclic vomiting syndrome. This was a permanent thing where my diaphragm was hyperactive. If I throw up more than once, I can’t stop. I would just go on and on until there was nothing in my stomach anymore. I had to get fluids at the emergency room. I learned as an adult that I can get ahead of this as it starts. I take a drug called Zofran. It makes me drowsy, but the good thing is that it dissolves under the tongue, so you don’t vomit it back up.

Alien in My Stomach

It all started with those warning signs. Doctors said, “Well, maybe she is just more susceptible to catching stomach bugs.” At 13 or 14, I suddenly took a turn for the worse. I developed an intestinal blockage. Crohn’s had been doing damage to my small intestine for years. I missed almost a whole year of classes during my sophomore year of high school. I had vomiting episodes and severe abdominal pain.

We joked sometimes that I had an alien in my stomach, because it would rise and fall so heavily. I wore sweaters and sweatshirts to muffle the noise it would make. Through this whole process, I saw multiple doctors and had multiple tests, including colonoscopies and endoscopies that didn’t find anything. It was terrible.

Doctors would say to me, “Well, maybe it is psychological.” At that age as a girl, they were always thinking that my symptoms might be caused by an eating disorder. This condition can stunt your growth, too. I lost so much weight. I was unable to absorb any food or nutrients. I wasn’t developing at the normal rate a teenage girl should. I looked 12 at age 15.

At 15, we finally decided to try to see a pediatric gastroenterologist in Atlanta. I grew up in Rome, GA. Unfortunately, I didn’t have access to high-quality care there. With a more severe disease, we wanted to be seen by a specialist at a research hub. We drove an hour into Atlanta to see a specialist at Children’s Healthcare of Atlanta at Scottish Rite. He was one of the greatest doctors I ever had and he knew Crohn’s so well. He looked at my hands and said, “Have you ever noticed that your fingernails are shaped like the back of a spoon?” He called this clubbing.

Surgery, and an Answer at Last

Eventually, the only way to definitely learn what was going on was to do exploratory surgery. In August 2004, they found exactly where my Crohn’s damage was located. It was just above the ileum, so too far in to be seen on a colonoscopy and too far down to be picked up by an endoscopy. Apparently, this had been developing for so long that inflammation had destroyed a whole section of my small intestine.

I was relieved to get a diagnosis. The big thing you want when you go through all of this is to have an answer for your symptoms and a plan. When I woke up after the surgery, they said, “You definitely have Crohn’s disease. It’s a permanent, chronic illness.” They did a resection of my intestine while I was in surgery, and they thought that hopefully, my disease would stay in remission with medications. It did for 6 years. Then, it came back with a vengeance in 2010. I had flaring, active disease again in my large intestine.

Play the Cards You’re Dealt

Crohn’s can appear anywhere in your digestive tract from your mouth to your large intestine. Colitis is only in your colon. The unfortunate thing about Crohn’s is that no amount of resecting can cover it. It was at that point when I realized the unfortunate cards I had been dealt. I realized that it would always be difficult for me to keep my Crohn’s under control.

Between 2004 and 2014, I was on seven different medications. At first, I only had to take an anti-inflammatory and an immunomodulator [drugs that treat the immune system to control Crohn’s flares]. That worked for 6 years. When I flared again, they put me on high doses of prednisone, a steroid: short bursts, but often. Then, I switched to biologics when nothing else would work. They worked longer, and initially, they were more effective. I have taken literally everything.

Reach Out for Help

What did I wish I knew when I was younger? I definitely wish I had known there were resources available to help us understand Crohn’s and what I was going through. Obviously, the Crohn’s & Colitis Foundation of America (CCFA) does all it can to get information out there for patients. My family and I had no idea what this disease was or where to go for help. We never knew anyone else who had Crohn’s. We found out later that a cousin on my dad’s side had Crohn’s, too, but nobody else in my family had it.

Another thing I wish I knew was that, maybe for far too long, we thought the right doctor to see for my symptoms was my pediatrician. I really needed to see a gastroenterologist, because they specifically treat the GI system. Some of these doctors specialize in inflammatory bowel disease (IBD). I wish I had known that you could see someone who was also involved in Crohn’s or IBD research. They could have told us about clinical trials of new treatments that are not available to the general public yet but could be available for you if you have Crohn’s. These are medicines that can save lives.

I wish I had known that there were other resources to help people with Crohn’s. It was a very big issue for me that I was missing so much school. My school didn’t understand why I was missing classes. My dad had to go to get doctor’s records and letters to prove that I was out of school for legitimate medical reasons.

25 Bathroom Trips a Day

By 2010, I kept trying different biologics. I was learning to do home injections. I kept telling myself, “Well, it’s better than the alternative! Better than experiencing all of my symptoms.” Eventually, those drugs weren’t working either. I was going to the hospital more and more for vomiting, pain, and incontinence. These were signs that something was amiss. I had loose, bloody stool. I was running to the bathroom 25 times a day. I could not even finish a meal without running to the bathroom.

In 2014, I made the decision to do a diverting ileostomy [surgery to steer waste to a pouch instead of the inflamed gut]. They thought that giving my colon some bowel rest would help. I did that for a year, and I didn’t get better. My disease was severe. So, in 2015, I had permanent ileostomy surgery. They removed my large intestine and what’s called “the stump,” which is basically the anus. I don’t have a large bowel anymore. All stool comes through my small intestine to an ileostomy bag.

Thankfully, I worked for 9 years at CCFA. They were very understanding about patients working for them and had good insurance. I had to take short-term disability and max out my FMLA [Family Medical and Leave Act] leave. They were able to work with me, and I was able to keep my job. Recently, I was laid off due to the pandemic, and I now work at Habitat for Humanity.

Don’t Overlook Your Mental Health

On the first day of my current job, I had so much scar tissue built up that I had a severe vomiting episode. On my first day! I had to have surgery to remove scar tissue. Thankfully, with this job, I was open and honest with my boss about my Crohn’s disease. She was able to give me leave time in advance so I could get better. I love my job.

If I could give advice to someone who is first diagnosed with Crohn’s, it would be this: Have a support system, whether that’s your parents, a friend, or someone else. You will need people who can drive you to the hospital or for tests.

Crohn’s can be mentally taxing as much as physically taxing. Don’t underestimate your mental health needs. Get help or medication if you need it. I learned this the hard way. When I had surgery, they prescribed pain medication, which you need at first. But these drugs can cause depression, too. You don’t feel the physical pain for a while, but when you come off those drugs, you can feel so low. Trying to avoid that situation whenever possible helped me. I also take an antidepressant. Talk about all of your options with your doctor. Over-the-counter probiotic supplements also helped me, and I wish I had known this earlier.

One thing I’ve learned is that you must look at the whole body when you’re treated for an autoimmune condition like Crohn’s. My condition is more systemic. I have become very interested in the connection between the brain and the gut. They’re clearly connected.

Stress can affect your gut health. My Crohn’s flares happened to me during stressful times in my life, such as when I was graduating from high school and college and planning my wedding. Don’t overlook your mental health.

By Cara Murez 

HealthDay Reporter

THURSDAY, Oct. 20, 2022 (HealthDay News) – Just a few years ago, “Friends” actor Matthew Perry almost died from opioid overuse that nearly destroyed his colon and almost killed him.

Now, he’s sober and wants to tell his story.

Perry has written a memoir, “Friends, Lovers and the Big Terrible Thing,” which will be published Nov. 1.

“I wanted to share when I was safe from going into the dark side of everything again,” Perry told the magazine PEOPLE. “I had to wait until I was pretty safely sober — and away from the active disease of alcoholism and addiction — to write it all down. And the main thing was, I was pretty certain that it would help people.”

Perry shares that he has gone to rehab 15 times, but he doesn’t say how long he’s been sober.

“It’s important, but if you lose your sobriety, it doesn’t mean you lose all that time and education,” he says. “Your sober date changes, but that’s all that changes. You know everything you knew before, as long as you were able to fight your way back without dying, you learn a lot.”

Perry talks about how his alcohol addiction was just beginning when he was 24 and cast on the TV show “Friends.” Perry, now 53, played Chandler Bing on the show.
 

“I could handle it, kind of. But by the time I was 34, I was really entrenched in a lot of trouble,” he admits. “But there were years that I was sober during that time. Season 9 was the year that I was sober the whole way through. And guess which season I got nominated for best actor? I was like, ‘That should tell me something.'”

Among his lows during the “Friends” years were when he was taking 55 Vicodin a day and weighed only 128 pounds.

“I didn’t know how to stop,” Perry says. “If the police came over to my house and said, ‘If you drink tonight, we’re going to take you to jail,’ I’d start packing. I couldn’t stop because the disease and the addiction is progressive. So it gets worse and worse as you grow older.”

His cast mates were aware of his conditions and patiently propped him up.

“It’s like penguins. Penguins, in nature, when one is sick, or when one is very injured, the other penguins surround it and prop it up. They walk around it until that penguin can walk on its own. That’s kind of what the cast did for me.”
 

A few years ago, at age 49, Perry nearly died because of his addiction. His colon burst from opioid overuse, causing him to spend two weeks in a coma, five months hospitalized and to use a colostomy bag for nine months.

“The doctors told my family that I had a 2% chance to live,” Perry told PEOPLE. “I was put on a thing called an ECMO machine, which does all the breathing for your heart and your lungs. And that’s called a Hail Mary. No one survives that.”

Perry said he’s now healthy and that scars on his stomach remind him of his journey to sobriety.

“I’m pretty healthy now,” Perry said, before joking, “I’ve got to not go to the gym much more, because I don’t want to only be able to play superheroes. But no, I’m a pretty healthy guy right now.”

Perry said his therapist suggested that when he thinks about taking Oxycontin, he think about the possibility of having a colostomy bag for the rest of his life.

“And a little window opened and I crawled through it and I no longer want Oxycontin anymore,” Perry said.

Perry, the only survivor among five people put on an ECMO machine at his hospital the night his lengthy stay began, is determined to help others who struggle with addiction.

“I say in the book that if I did die, it would shock people, but it wouldn’t surprise anybody. And that’s a very scary thing to be living with. So my hope is that people will relate to it, and know that this disease attacks everybody. It doesn’t matter if you’re successful or not successful, the disease doesn’t care,” Perry said.

He has learned “everything starts with sobriety. Because if you don’t have sobriety, you’re going to lose everything that you put in front of it, so my sobriety is right up there,” he says. “I’m an extremely grateful guy. I’m grateful to be alive, that’s for sure. And that gives me the possibility to do anything.”

More information

The U.S. Substance Abuse and Mental Health Services Administration can help people struggling with addiction.

SOURCE: PEOPLE magazine

Oct. 20, 2022 – Clarissa Ghazi gets lye relaxers, which contain the chemical sodium hydroxide, applied to her hair two to three times a year.

A recent study that made headlines over a potential link between hair straighteners and uterine cancer is not going to make her stop. 

“This study is not enough to cause me to say I’ll stay away from this because [the researchers] don’t prove that using relaxers causes cancer,” Ghazi says.

Indeed, primary care doctors are unlikely to address the increased risk of uterine cancer in women who frequently use hair straighteners that the study reported. 

Among frequent users of hair straighteners — meaning those who used them more than four times a year — the researchers found that women were 2.55 times more likely to be diagnosed with uterine cancer than those who never used these products.

In the recently published paper on this research, the authors say that they found an 80% higher adjusted risk of uterine cancer among women who had ever “straightened,” “relaxed,” or used “hair pressing products” in the 12 months before enrolling in their study.

This finding is “real, but small,” says internist Douglas S. Paauw, MD, professor of medicine at the University of Washington in Seattle. 

Paauwis among several primary care doctors interviewed for this story who expressed little concern about the implications of this research for their patients. 

“Since we have hundreds of things we are supposed to discuss at our 20-minute clinic visits, this would not make the cut,” Paauw says. 

While it’s good to be able to answer questions a patient might ask about this new research, the study does not prove anything, he says.

Internist Alan Nelson, MD, an internist-endocrinologist and former special advisor to the CEO of the American College of Physicians, says while the study is well done, the number of actual cases of uterine cancer found were small.

One of the reasons he would not recommend discussing the study with patients is that the brands of hair products used to straighten hair in the study were not identified. 

Alexandra White, PhD, lead author of the study, said participants were simply asked, “In the past 12 months, how frequently have you or someone else straightened or relaxed your hair, or used hair pressing products?” 

The terms “straightened,” “relaxed,” and “hair pressing products” were not defined, and “some women may have interpreted the term ‘pressing products’ to mean non-chemical products” such as flat irons, says White, who is also head of the National Institute of Environmental Health Sciences’ Environment and Cancer Epidemiology group, in an email.

Dermatologist Crystal Aguh, MD, associate professor of dermatology at Johns Hopkins School of Medicine, tweeted the following advice in light of the new findings: “The overall risk of uterine cancer is quite low so it’s important to remember that. For now, if you want to change your routine, there’s no downside to decreasing your frequency of hair straightening to every 12 weeks or more, as that may lessen your risk.”

She also noted that “styles like relaxer, silk pressing and keratin treatments should only be done by a professional, as this will decrease the likelihood of hair damage and scalp irritation.”

“I also encourage women to look for hair products free of parabens and phthalates (which are generically listed as “fragrance”) on products to minimize exposure to hormone disrupting chemicals.”

Not Ready to Go Curly

Ghazi says she decided to stop using keratin straighteners years ago after she learned they are made with several added ingredients. That includes the chemical formaldehyde, a known carcinogen, according to the American Cancer Society.

“People have been relaxing their hair for a very long time, and I feel more comfortable using [a relaxer] to straighten my hair than any of the others out there,” Ghazi says.

Janaki Ram, who has had her hair chemically straightened several times, says the findings have not made her worried that straightening will cause her to get uterine cancer specifically, but that they are a reminder that the chemicals in these products could harm her in some other way.

She says the new study findings, her knowledge of the damage straightening causes to hair, and the lengthy amount of time receiving a keratin treatment takes will lead her to reduce the frequency with which she gets her straightened.

“Going forward, I will have this done once a year instead of twice a year,” she says.  

White, the author of the study, says in an interview that the takeaway for consumers is that women who reported frequent use of hair straighteners/relaxers and pressing products were over twice as likely to go on to develop uterine cancer compared to women who reported no use of these products in the previous year. 

“However, uterine cancer is relatively rare, so these increases in risks are small,” she says. “Less frequent use of these products was not as strongly associated with risk, suggesting that decreasing use may be an option to reduce harmful exposure. Black women were the most frequent users of these products and therefore these findings are more relevant for Black women.”

“We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%,” White says in a statement.

 “One of the original aims of the study was to better understand the environmental and genetic causes of breast cancer, but we are also interested in studying ovarian cancer, uterine cancer, and many other cancers and chronic diseases,” White says in an interview. 

HealthDay Reporter

MONDAY, Sept. 26, 2022 (HealthDay News) — Biking while stoned leads to thousands of serious crashes each year, a new study suggests.

Between 2019 and 2020 alone, more than 11,000 people were treated in U.S. emergency rooms for injuries that happened as they rode a bicycle while high on methamphetamine, marijuana or opioids, researchers found.

“The people affected by these injuries likely have substance use disorder, may be more likely to be homeless and may not have access to other types of transportation,” explained lead researcher Bart Hammig, a professor of public health at the University of Arkansas in Fayetteville. “This is an often overlooked and ignored population when addressing serious injuries related to bicycle crashes.”

One way to curb these crashes is to get these drugged individuals off their bikes, he said.

“Better and easier access to transportation for persons who may use bicycles as their main mode of transportation is needed in order to aid in the prevention of injuries among this population,” he said. “In addition to treatment of injuries, drug referral systems need to be readily accessible in emergency departments.”

Hammig and his University of Arkansas colleague Robert Davis, an assistant professor of public health, found that bicyclists who crashed while high often had more serious injuries than those who weren’t using drugs.

Most of those injured were men (86%), according to the study. Of those, 22% had broken bones; 19% injured internal organs; and almost 33% had to be hospitalized. In all, 1% suffered a concussion.

Some likely resulted in deaths, but because the data came from emergency room records, researchers couldn’t report on fatalities.

The most common drugs found were methamphetamine (36%); marijuana (32%); and opioids (19%). Nearly a quarter of injured bikers had also been drinking alcohol, the study found.

For the study, researchers used data from the National Electronic Injury Surveillance System. Of more than 480,000 injuries reported between 2019 and 2020, about 3% involved drugs.

Dr. Eugene Vortsman, an emergency room physician at Long Island Jewish Medical Center in New Hyde Park, N.Y., said that riding a bike stoned can greatly increase the risk for crashes and serious injury.

He suspects that the number of crashes identified in the study is only the tip of the iceberg.

“Due to the limitations in data, this study is underestimating the true severity of the incidence, as well as the severity of injury associated with any intoxicant,” Vortsman said. “Even with the data available, it is clear that the risk of injury is elevated.”

More study is needed to learn about bikes for primary transportation and to find ways to lower the risk, Vortsman said.

Some examples include evaluating social factors affecting health to better earmark resources. Improving access to public transportation, better roadside safety measures, and education about the dangers of operating any mode of transportation while under the influence are key, he said.

“Proper education allows patients to better understand their risk of injury and can provide a safer road for them as well as other bicyclists,” Vortsman said.

The study was recently published online in the Journal of Studies on Alcohol and Drugs.

More information

For more about drug abuse, visit the U.S. Substance Abuse and Mental Health Services Administration.

SOURCES: Bart Hammig, PhD, MPH, professor, health, human performance and recreation, University of Arkansas, Fayetteville; Eugene Vortsman, DO, emergency room physician, Long Island Jewish Medical Center, New Hyde Park, N.Y.; Journal of Studies on Alcohol and Drugs, Aug. 1, 2022

By Cara Murez 

HealthDay Reporter

THURSDAY, Oct. 20, 2022 (HealthDay News) – Americans will now have another choice if they want a COVID booster shot.

On Wednesday, the U.S. Food and Drug Administration approved Novavax Inc.’s protein-based vaccine as a first booster dose. Until now, it had only been approved as a two-dose primary series.

“The U.S. now has access to the Novavax COVID-19 Vaccine, adjuvanted, the first protein-based option, as a booster,” Novavax President and CEO Stanley Erck said in a news release. “According to CDC data, almost 50 percent of adults who received their primary series have yet to receive their first booster dose. Offering another vaccine choice may help increase COVID-19 booster vaccination rates for these adults.”

The Novavax booster could be used by adults who can’t find or are not able to use an mRNA boosters from Pfizer or Moderna. It’s also available to people who prefer this vaccine for a booster over the mRNA options. The Novavax booster can be given at least six months after the primary series.

The Novavax vaccine uses a more traditional approach to fighting the virus, teaching the immune system to recognize modified fragments of the coronavirus spike protein.

Scientists created the vaccine from a genetic sequence of the original strain of the virus. Vaccines that fight hepatitis B and pertussis are also made in this way.

Public health officials are encouraging people to get their boosters. About 68% of U.S. residents have had an initial COVID vaccine series, but only 33.5% have received boosters, CDC data shows. Novavax’s vaccine is one of four options available in the United States now.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19 vaccines.

SOURCE: CNN

By Steven Reinberg 

HealthDay Reporter

THURSDAY, Oct. 20, 2022 (HealthDay News) — Using marijuana increases the risk of developing the heart rhythm disorder atrial fibrillation (a-fib), a new study suggests.

It’s been known that drugs such as methamphetamine, cocaine and opiates can directly affect the heart and cause abnormal rhythms like a-fib, but weed can increase the risk by 35%, researchers found.

“There is a common perception that cannabis may be healthy because it’s ‘natural,'” said lead researcher Dr. Gregory Marcus, a professor of medicine at the University of California, San Francisco. “But as laws become more lenient in allowing use of these substances, it’s important to recognize adverse consequences that may substantially impact the lives of users.”

This study doesn’t prove drug use causes a-fib, only that users seem to be at greater risk.

“These data are sufficiently compelling to suggest that cannabis users suffering from atrial fibrillation should at least experiment with cessation to see if it indeed has a meaningful effect on their particular arrhythmia,” Marcus said. “Once one has had an episode of atrial fibrillation, I find that patients are often especially eager to identify anything they can do to avoid subsequent episodes.”

A-fib reduces quality of life and increases the risk of stroke, heart failure, kidney disease, heart attack and dementia, he said.

“We used to think that a diagnosis of atrial fibrillation was just bad luck, but we now recognize this common and sometimes devastating disease can actually be prevented, largely with lifestyle interventions such as reducing alcohol consumption or enhancing physical fitness,” Marcus said. “Although various treatments are available, avoiding the disease in the first place is always better.”

Methamphetamine, cocaine, opioids and cannabis use were each associated with a heightened risk for a-fib in the study, even after adjusting for multiple established risk factors for the disease.

Methamphetamine increased a-fib risk by 86%, researchers found. For cocaine, the risk rose 61%, and for opiates, 74%.

For the study, Marcus and his colleagues collected data on more than 23 million people treated in California emergency rooms from 2005 through 2015.

Of 1 million patients who had no preexisting a-fib but developed it later, nearly 133,000 had used marijuana. Nearly 99,000 had used methamphetamines; nearly 49,000 had used cocaine, and 10,000 had used opiates.

How marijuana increases a-fib risk is unknown, Marcus said.

“There are several candidates, and they may act in concert,” he said.

Inhalation of combustible products is known to trigger an inflammatory response, and acute inflammation heightens a-fib risk, Marcus said. In addition, blood from the lungs flows directly to where a-fib begins — the pulmonary veins and left atrium of the heart. As such, lung irritants such as pot smoke could aggravate areas of the heart that are particularly vulnerable to arrhythmia.

All of the drugs studied can have dramatic effects on the link between the nervous system and the heart, Marcus noted. “Rapid fluctuations occur with the use of these substances and can also trigger atrial fibrillation,” he said.

A-fib is an abnormal pumping rhythm caused by electrical disturbances in the heart’s upper chambers, the atria. In severe cases, clots can form in the atria and then break off into the bloodstream, causing strokes. Strokes related to a-fib claim more than 150,000 Americans a year.

In addition, cocaine and meth can lead to sudden cardiac death from disruptions in the electrical signaling and pumping in the ventricles, the heart’s lower chambers. Researchers said there is no way, however, that pot causes these life-threatening arrhythmias.

Dr. Laurence Epstein, system director of electrophysiology at Sandra Atlas Bass Heart Hospital in Manhasset, N.Y., said many factors can trigger a-fib. Therefore, it’s not easy to predict which will trigger an episode.

“I don’t think it’s like, oh my God, nobody should ever smoke weed because they’re going to develop a-fib,” said Epstein, who wasn’t part of the study. “Everybody’s different. I have patients I treat for atrial fibrillation, and we talk about triggers, and everybody’s different.”

For some patients, coffee or chocolate may trigger an episode, and for some, the trigger may be marijuana, Epstein said. Patients who are sensitive to it should avoid it, he advised.

“My recommendation to patients is know thyself,” Epstein said. “Moderation is the key. If you find every time you get high, you start having palpitations, maybe that’s not for you. If you’re not having issues with it, then I’m not sure that puts you at increased risk.”

With the other drugs discussed in the study, the risk is known, Epstein said.

“It’s not only the risk of a-fib, but the risk of other bad things, which can give you an acute heart attack or cardiac arrest,” he concluded.

The findings were published Oct. 18 in the European Heart Journal.

More information

Learn more about atrial fibrillation from the American Heart Association.

SOURCES: Gregory Marcus, MD, professor, medicine, University of California, San Francisco; Laurence Epstein, MD, system director, electrophysiology, Sandra Atlas Bass Heart Hospital, Manhasset, N.Y.; European Heart Journal, Oct. 18, 2022

By Christina Gentile, PsyD, as told to Barbara Brody

First things first: Stress does not cause Crohn’s disease. But physical ailments often overlap with mental ones. And Crohn’s is hardly the exception. Research suggests that people with inflammatory bowel disease (such as Crohn’s and ulcerative colitis) are two to three times more likely than members of the general population to struggle with anxiety or depression.

Even if you don’t meet the official criteria for an anxiety disorder or major depression, living with Crohn’s disease might make you feel stressed, frustrated, upset, or scared. Navigating a new diagnosis, having debilitating symptoms, and adjusting to changes in treatment can be very challenging. 

Whether your mental health problems tend to be mild or more serious, don’t be surprised if they get worse when your Crohn’s is flaring. During a flare, you might feel anxious about having urgent, bloody diarrhea or flatulence. You may worry about whether you’ll be able to find a bathroom in time. You could feel embarrassed about your symptoms. You may develop body image issues, which might prompt you to withdraw from social situations.

Fear of food and its effect on GI symptoms is another common issue for people with Crohn’s. It’s natural to be concerned about how eating might worsen your condition. But if you get so scared that you drastically restrict your diet, you may be at risk for an eating disorder called avoidant/restrictive food-intake disorder (ARFID). That can lead to malnutrition and unhealthy weight loss. And it can take a toll on your relationships.

Whatever kind of mental health issues you’re facing, don’t ignore them. Help is available, and it can make you feel better physically and emotionally.

The Gut-Brain Connection

One reason Crohn’s disease is so closely connected to anxiety and depression is that your brain and your gut are linked through your vagus nerve. Signals run in both directions along this pathway.

Although Crohn’s is an autoimmune disease that causes inflammation in your GI tract, what’s going on in your mind can certainly affect your digestive health. Research has shown that people with inflammatory bowel disease who also have anxiety or depression are more likely to get frequent flares and tend to have a lower quality of life.

As a clinical health psychologist who specializes in digestive diseases, I try to understand how Crohn’s disease affects my patients’ daily lives. I’ll come up with a treatment plan that uses skills-based training to help them better manage flare-ups and improve their quality of life. When I meet with a patient, I teach them how to reduce stress and manage it better. I also help them deal with negative thinking patterns that may keep them from coping well with their Crohn’s disease.

Learning how to manage stress and anxiety related to their symptoms can reduce their risk of flares. It can also help them cope with symptoms when they do occur.

Treatment Options

Several different mental health treatment options may be helpful for people with Crohn’s who are having anxiety, depression, or trouble coping with their diagnosis.

The best-known treatment is cognitive behavioral therapy (CBT). It aims to identify and challenge negative thought patterns and behaviors that can increase stress, lead to worsening mood or anxiety over GI symptoms, or interfere with managing Crohn’s disease. 

Another approach is acceptance and commitment therapy (ACT). This has a slightly different focus. It emphasizes accepting what you can’t change (your Crohn’s disease and the discomfort that might come with it). It involves becoming more mindful of your thoughts, emotions, and gut sensations. It also teaches you skills to improve your quality of life, even in the face of your symptoms.

Many people with Crohn’s also benefit from gut-directed hypnosis. This involves deep relaxation techniques combined with soothing images and verbal suggestions, aimed at calming your digestive system and managing pain.

Getting the Right Help

If you’re struggling emotionally because of Crohn’s disease, your first step should be to talk to your gastroenterologist, who may refer you to a mental health provider. Ideally, you’ll work with someone who has special training in gastropsychology, a discipline within clinical health psychology that focuses on digestive diseases. You can also try searching for an expert near you at the Rome Foundation’s gastropsych registry.

If you can’t find this type of specialist in your area, look for a mental health professional who has experience with chronic health conditions, stress, and anxiety disorders. You doctor may be able to recommend someone. Or check with your local hospital or health center.

Assuming that your mental health issues are mostly related to having Crohn’s (and not part of a broader anxiety or depressive disorder), you’ll probably benefit fairly quickly from a skills-based treatment approach.

When you find a provider, be as direct as possible about what you hope to get out of the experience. Maybe you want to focus on how your anxieties over Crohn’s are keeping you from getting restful sleep. Or maybe you need to learn to cope with discomfort and pain without getting stressed about it. Setting a clear and specific goal will help you make the most of therapy so you can feel better faster.

By Frances Downey, as told to Sarah Ludwig Rausch

I was diagnosed with psoriatic arthritis 9 years ago. Looking back, I realize that I had the symptoms for quite a while before that, and it took about 18 months to get diagnosed. So I’ve had this disease for about 12 years.

There are plenty of challenges when you live with psoriatic arthritis. Since I’m single, some of mine may be different from someone who has a partner.

For instance, because my flare-ups look like I have the flu, if I’m having one and I’m in bed, there’s no one to clean the house, do the laundry, go grocery shopping, or pick up my medications. I have to rely on others to do that or I just do without.

It’s also really hard dating, especially knowing when to tell the person that you have this disease. When I have brought it up, they don’t get it. They think of their grandmother who has arthritis and don’t realize that this is different and can affect your whole body.

I’ve heard from many people that they’ve lost friends due to psoriatic arthritis. I certainly have. People just don’t understand this disease and that it’s unpredictable. Sometimes you’re unable to keep social plans because you don’t feel well, and that can be hard for friends and partners.

Despite the challenges, I’ve learned ways to handle my disease and make life easier on myself.

Track Triggers for Flare-Ups

I believe the major trigger for flare-ups is stress. For me, when my medications aren’t working, that can cause a flare-up, too. My doctor says lack of sleep is another cause. Certain foods may be a trigger too.

What causes a flare-up for one person doesn’t mean it’s going to lead to one for someone else, though. And sometimes you have a flare-up, and the doctors can’t figure out what caused it. It just happens.

The key to recognizing triggers is keeping a log. There’s a great app called ArthritisPower that helps you track your sleep, fatigue, pain, and other symptoms. This can help you figure out triggers. It shows you the data it collects in different charts and graphs. You can email that information directly to your doctor so they can use it to have data-driven conversations during your appointment.

The data is donated to the research registry so that researchers can use it for their studies. You can also participate in surveys and other studies that are going on inside the app.

Keep Stress at Bay

I’m a more relaxed person than when I was diagnosed because I found out very quickly at the beginning of my own experience that stress caused flare-ups. So I’ve been training myself over 9 years to recognize when there is a stressor or there might be one that could occur.

I ask myself how I’m going to deal with it. I remind myself that I can’t get stressed because I know what it’s going to do to me. That gentle reminder helps me a lot.

I also take time to avoid causing myself stress. For example, if I’m meeting friends for lunch, I don’t leave at the last minute. That way, I don’t get nervous about traffic or being late. I can give myself a 15-minute buffer, relax, take a leisurely walk to the restaurant, have an enjoyable lunch with my friends, and come home versus having a stressful time.

Things that you have control over, control them, because there are a lot of things in your life you don’t realize that you do actually have control over.

Get the Most Out of Treatment

Follow your medical professional’s instructions, regardless of how you feel. You may feel great, but you should not stop taking your medication unless your medical professional has said you are in remission and it’s OK to stop.

You can also be in remission while you’re still on medication, so that’s why it’s important to get your doctor’s blessing before quitting. If you stop on your own, you may have a flare-up.

Keep a log of any improvements or setbacks so that you can talk to your doctor about it and get the best treatment plan. Then you can give them details about what’s working and what’s not.

For instance, right now, I’ve been having pain in my foot and I didn’t think it was a big deal. But my doctor is extremely concerned, so I’m getting an MRI on my foot. This is a good example of something you should track. How long has it been hurting? Has it gotten worse? When did it get worse? Does anything make it feel worse? Better? Things like that. That helps your doctor treat you more effectively.

I always write a list of questions before I go into my medical professional’s office. That way I don’t forget anything. I write down the answers and follow-up questions while I’m there. I find that to be really useful.

It’s important to have a medical professional who suits you. That may mean shopping around if you find yours isn’t a good fit. If you don’t feel like you’re being treated well and listened to, go to another doctor if your health insurance allows.

Have a Backup Plan for Bad Days

I have a backup plan for everything because your symptoms can interrupt your daily life at any time. You can feel well in the morning, and by afternoon or evening, you could be feeling lousy.

I have a trip planned to Costa Rica, and since my medicine hasn’t really been working well, my doctor and I have a backup plan. I have one for work, too. I happen to have a great boss who is very supportive and encouraged me to get a medical accommodation.

Find support from other people with psoriatic arthritis or rheumatoid arthritis, which is very similar. I’m a member of both CreakyJoints.org and Bensfriends.org, and I highly recommend them both. I’ve met lots of people through these sites. When I’ve gone through flare-ups and I’ve been low and depressed, it helps to have people who understand.

I also get support from my friends who don’t have psoriatic arthritis. In the end, despite having lost friends over this disease, I feel like it’s worked out well for me. Now I have the greatest friends, both with and without psoriatic arthritis. I’m surrounded by understanding and supportive people.