Researchers in Germany find that mental health practitioners tend to diagnose ADHD using their intuition and unclear rules of thumb, not recognized diagnostic criteria.

PROBLEM: The rates of ADHD diagnosis in the developed world have become almost inflationary, increasing annually by an average of three percent from 1997 to 2006 and 5.5 percent from 2003 to 2007 in the U.S. but how accurate are these diagnoses?

METHODOLOGY: Researchers led by University of Basel’s Katrin Bruchmueller surveyed 1,000 child and adolescent psychotherapists and psychiatrists across Germany, 473 of whom participated in the study. they received one of four case vignettes, and were asked to give a diagnosis and a recommendation for therapy. in three out of the four cases, the described symptoms and circumstances did not fulfill ADHD diagnostic criteria. The gender of the child was included as a variable as well, resulting in eight cases.

RESULTS: Many mental health practitioners seem to proceed heuristically and base their decisions on unclear rules of thumb. The respondents more readily diagnosed ADHD when the case involved a male patient and presented prototypical symptoms, such as impulsiveness, motoric restlessness, and lack of concentration. they were, for instance, twice more likely to conclude ADHD with the boy version of the vignettes than with the girl vignettes. interestingly, even the therapist’s gender played a role in the diagnostic as male doctors diagnosed ADHD more frequently than their female counterparts.

CONCLUSION: ADHD is over-diagnosed because doctors rely too much on their intuition and not on defined, established diagnostic criteria.

SOURCE: The full study, “Is ADHD Diagnosed in Accord With Diagnostic Criteria? Overdiagnosis and Influence of Client Gender on Diagnosis,” is published in the Journal of Consulting and Clinical Psychology.

You would never know Joaquin Diaz has cancer. The shaggy-haired 5-year-old races after his older brother, teasing 7-year-old Rafael about his newly shaved head.

But it’s because of Joaquin’s diagnosis — Acute Lymphoblastic Leukemia — that Rafael and 31 other kids and moms either shaved or donated their hair at a Shave for the Brave event organized by Sonrise Christian Private School Satellite Program.

PSP administrator Mary Carnighan said the event got its start when she learned that Rafael was going to be shaving his head to raise money for the St. Baldrick’s Foundation. one of the mothers mentioned taking up a collection to support his cause, when Carnighan thought that it would be nice to get the rest of the children involved.

“What better way to teach them compassion, camaraderie, and investing time and energy in something meaningful that is not about self-gratification,” Carnighan said.

Instead of raising money for St. Baldrick’s, which funds research to help cure cancer in children, though, the 28-year administrator decided to donate the money to the Diaz family.

“It seemed like our kids would be more excited and better able to relate to donating to them than to collecting money for research,” Carnighan said. “There are just so many expenses related to caring for a sick child.”

In 2009, the Diaz family was the picture of happiness. Jessica and Francisco were teachers in Azusa Unified and their two sons were 3 and 5 years old.

Jessica was a dual immersion teacher at Valleydale Elementary and Francisco had taught fourth- and fifth-graders at Magnolia, Paramount and Murray elementaries for 10 years when the recession hit. Dual immersion programs were cut and in spring of 2009, Francisco was one of the many casualties in the education field.

And then in the summer, Joaquin started getting fevers and a severe leg pain that wouldn’t go away.

“That’s how leukemia and a lot of the blood cancers start, because the cancer cells get so compacted in the bone marrow and that’s painful,” Jessica said. “So he was having frequent fevers, they kept giving him antibiotics and it was like, `why aren’t the antibiotics working?”‘

A month after Joaquin’s third birthday and a month after the symptoms started, a new doctor ordered a blood test.

“An hour later I got the phone call, and they can’t tell you over the phone what they suspect it is,” Jessica recalled, “but they told me, `You need to get into the oncology/hematology floor at Loma Linda. There’s a bed there for you yesterday, as fast as you can get there, just pack some stuff and go.’

“And that’s when you know.”

That was July 13, 2009. The next six months were a nightmare, Jessica said. The family, already hit by Francisco’s layoff, struggled with insurance to cover the medical bills. They lost their home to foreclosure so they moved to Rialto, closer to the hospital. with that one call, their dreams — four kids, house, careers — were all put on hold.

Acute Lymphoblastic Leukemia is one of the most common of the childhood cancers, said Dr. Saro Armenian, assistant professor of pediatrics and population sciences department at City of Hope. ALL is an umbrella term for a cancer of the white blood cell and is treated primarily through chemotherapy, either by vein, mouth or spinal cord.

“In the early ’60s, if someone had this it was virtually incurable in pediatric children,” Joaquin’s doctor said. “Through the development of chemo agents and by combining various agents of chemo together we’ve been able to raise cure rates to above 85 percent for children.”

Current research is directed toward giving children therapy in a smarter way, Armenian said. where treatment now is a sort of “carpetbombing,” the doctor explained that the focus has now turned to targeting only leukemia cells and decreasing the intensity of treatment without reducing the success rate.

“The research is twofold: one, we’re trying to find smarter drugs targeted toward leukemia itself,” Armenian said. “And two, if there aren’t smarter drugs, can we give the current drugs in a better way, to minimize side effects without compromising cure rates?”

Joaquin is in the home stretch of his treatment, Jessica said. The family transferred from Loma Linda Children’s Hospital to City of Hope because of the Duarte hospital’s survivorship program.

“When you have a newborn, the first one you have, they tell you, `OK it’s time for you to go home’ and that’s when you have a feeling of, wait, I have to take the baby home?” dad Francisco said. “What am I going to do if he’s sick or how am I going to know if he’s hungry, so it’s the same thing, when September comes we’re going to be like, what do we do now?”

In September, the doctors will remove a port planted under Joaquin’s skin where the chemotherapy is injected and Joaquin will be free to be a normal 6-year-old.

“He’s been on chemo for about three years so it’s like a safety net,” Jessica said. “Because I know while he’s on chemo the chances of him relapsing are zero. Relapses happen when the chemo stops.”

Relapses in leukemia are aggressive, Jessica said. Doctors go straight to bone-marrow transplants and from there, survival rates are a coin toss.

Joaquin knows he’s sick, mom said. “I think he suspects something scary is going on because sometimes as parents you just can’t hide the fear.

“But he was so little when he was diagnosed that I think that’s just his reality.”

And they’re waiting to see if the side effects of the chemo — liver damage, hypoglycemia, arthritis — will cause lasting damage.

But it’s Rafael who Jessica worries about, she said. Rafael will turn 8 years old this summer and he understands that not everybody’s brother is this way.

“Being in the pediatric cancer community, you make friends and you lose friends, and it’s really hard to explain to a child that they died from the same thing that brother has.”

It was a chance encounter shortly after the first round of treatment that led the family to Sonrise. Before the diagnosis, Jessica had been taking the boys to a preschool reading group and the naturally outgoing mom had made friends in the group. during Joaquin’s treatment, though, he couldn’t be around too many children so they dropped out of the group.

One morning when Joaquin was feeling better, the family decided to go to Chuck E. Cheese in Covina really early, for “a post-chemo celebration,” Jessica said.

“All of a sudden this herd of kids came running in and I thought, oh my gosh, we have to leave now, because at that point his treatment was so intense that he couldn’t be around kids,” she said. “I thought, who comes to Chuck E. Cheese at 10 o’clock in the morning?”

On the way out, Jessica recognized one of the mothers from the preschool reading group and they started talking. after learning that the boys were being homeschooled during Joaquin’s treatment, the other mother suggested that Jessica look into Sonrise.

“When I signed up with Sonrise there was just no question about whether I was going to join because they were all so accepting,” Jessica said. “We were strangers and they were cooking casseroles from day one.

“Ever since then, I don’t know what I’d do without them because those casseroles rock!”

At the Shave for the Brave event, families crowded around the stylists, taking pictures of the boys’ newly shorn heads and the girls with their stylish bobs. Though the atmosphere was full of excitement and purpose, there were some tears and grimaces as some of the kids did have trouble parting with their hair.

Desiree Lang said her son Jake had been growing his hair out for months to get it to the perfect length. The towheaded 11-year-old had only decided that week to shave his head and, through some Facebook posts, had raised more than $200 for the Diaz family.

Four members of the Paraiso family participated in the event, with sons Elijah, 12, and Ethan, 10, shaving their heads and mom Anna and daughter Danielle, 8, donating 12 and 8 inches of hair, respectively. The family raised about $500 and was still collecting more donations.

Jessica Diaz is no stranger to shaving events. she has shaved her head twice for St. Baldrick’s as part of the 46 Mommas, even traveling to Washington, D.C., to shave her head. The group gets its name from the 46 children diagnosed with cancer every school day and the 46 mothers affected by the news.

“It’s so special when it’s children (shaving),” Jessica said. “It’s a great way to teach compassion and empathy and they’re just so willing to do it.”

The past three years have been a learning process for the family. Older brother Rafael keeps Joaquin active and cheerful through the medical procedures, lifting the spirits of the entire family.

“Rafael’s a clown, when Joaquin isn’t feeling good he goes out of his way to make him feel better,” Jessica said. “When Joaquin was first in the hospital, Rafael couldn’t understand why he wouldn’t get out of bed so he would overexert himself trying to make him laugh.”

At home, the boys are average kids. They love soccer and cheer for Club Atlas in the Mexican league, play “a lot of Wii,” read and torment the dog.

And the boys are excited about the new addition to the family. Jessica is currently pregnant with the family’s third child, another boy, due in August.

“I told the boys that they could help me decide what the name was, so we’re trying to decide between Woody, Snoopy, Slash and Nacho,” Jessica said. “I’m letting them believe that we’re actually considering those names, and then we’re going to torment the baby when he gets older, `your name was almost Woody!’ “

Francisco is currently getting his certification to teach science in high school. Offered as part of the teachers’ severance, a National Emergency Grant pays for his credential to teach biology, earth science and physical science.

“I like learning, I’ve already gotten my master’s from CGU (Claremont Graduate University), so this is just a supplement to get teachers back in the classroom,” Francisco said.

The family hopes the next five months go smoothly and are nervous about the next two years, until Joaquin can officially be declared cancer-free.

“I think being pregnant helps, because my husband and I feel more hopeful, like this doesn’t have to mean that our future has to end, that we’re defined by cancer,” Jessica said. “The Sonrise group, just knowing that they’re praying every day — they have a calendar and families sign up and pray for us — just knowing that, it takes such a burden off.”

The Shave for the Brave event raised more than $2,700 for the Diaz family and Carnighan was waiting for more donations to come in. to contact Sonrise or make a donation to the Diaz family, call Carnighan at 626-938-1199, email marycarnighan@gmail.com or make checks payable to the Diaz family and send them to Mary Carnighan, c/o Sonrise Christian School, 1220 E. Ruddock, Covina, CA 91724. to see Joaquin’s blog, go to kickincancersbooty.blogspot.com.

“Our life has changed so much in the last three years that the next two years will be very different with no medications,” Francisco said. “I can’t even imagine, it’s like there was a storm and now it’s clear, and it hasn’t been clear in a long time.”

626-962-8811, ext. 2472

Chepstow woman’s Race for Life is tribute to husband

11:50am Friday 23rd March 2012 in News

TWO years after her husband died of stomach cancer, his wife Jo Rees, with her family and friends are backing the Race for Life in memory of him.

less than a month before being diagnosed with stomach cancer Barry Rees was playing five-a-side football regularly – but within four months of diagnosis, he was dead.

Jo, 38, still struggles to comprehend the speed with which the disease took her husband from her and their two children Luke, six, and four-year- old Amelia.

she admits to days when she feels like “climbing into a dark cupboard and not coming out”. but she is also confronting the hurt and despair head-on, by corralling friends into taking part in Cancer Research UK’s Race for Life, to raise money for research.

Mrs Rees, of Chepstow, said her engineer husband, was physically fit with a healthy lifestyle, and they did not even consider cancer as a possibility.

“He had some symptoms with indigestion the previous autumn, but it had been a stressful year for us both and we suspected a stomach ulcer,” she said.

“It wasn’t until Christmas that he started to get really ill. He became very weak, to the extent that he couldn’t even hold a screwdriver to assemble the children’s Christmas toys.”

mr Rees was admitted to the Royal Gwent Hospital on Boxing Day 2010, and the diagnosis came two weeks later. Stomach cancer can be particularly difficult to detect, and thus to treat, as symptoms often only manifest themselves once the disease is well-established.

“The cancerous cells were in the stomach lining, so there was no obvious tumour or growth. Barry understood the consequences, because he had researched stomach cancer as a possibility when he first became unwell,” said Mrs Rees.

“I was totally unprepared though, and just couldn’t take it in.

“The implications for me and our children, who were two and four years old at the time, were im-mense.”

After two full cycles of chemotherapy, mr Rees began then stopped a third, as the cancer was not responding, and the couple felt it was robbing him of his quality of life.

Mrs Rees recalls a “nightmarish”

time, wanting to be there for her husband and the children.

“I’d often stay up all night with Barry, then drive home to be there for the children in the morning. I don’t know how I got through it,” she said.

“My friends and family were great though, often just popping round with food because I didn’t have much time or energy for cooking.

“The hospital also helped, providing a bed so I could get some rest while with Barry.”

Mrs Rees also had the heartbreaking task of breaking the news to her children, and was helped to prepare for it by a support worker from St David’s Foundation Hospice Care.

“I wanted to be open and honest with them and explain the situation in terms they would understand,”

she said.

mr Rees died on April 7, 2010, aged just 37.

More News stories

SAN DIEGO — the director of a wildly popular video about brutal African warlord Joseph Kony has been diagnosed with brief psychosis and is expected to stay in the hospital for weeks, his wife said Wednesday.

Jason Russell, 33, was hospitalized last week in San Diego after witnesses saw him pacing naked on a sidewalk, screaming incoherently and banging his fists on the pavement. he was in his underwear when police arrived.

His outburst came after the video’s sudden success on the Internet brought heightened scrutiny to Invisible Children, the group he co-founded in 2005 to fight African war atrocities.

Russell’s family said that the filmmaker’s behavior was not due to drugs or alcohol. he was given a preliminary diagnosis of brief reactive psychosis, in which a person displays sudden psychotic behavior.

“Doctors say this is a common experience given the great mental, emotional and physical shock his body has gone through in these last two weeks,” Danica Russell said in a statement.

Researchers say those with personality disorders are at greater risk for having an episode. Brief reactive psychosis is triggered by trauma or major stress such as an accident or death of a loved one. other stressors can include sleep deprivation or dehydration.

Symptoms include hallucinations, delusions and strange speech and behavior. People typically recover within a few weeks without medication. others have to take antipsychotic drugs to alleviate symptoms or undergo talk therapy to cope.

The condition causes “temporary debilitation, but in general people have good recoveries,” said Dr. Stephen Marder, professor of psychiatry at UCLA.

In some cases, doctors say brief reactive psychosis can signal the beginning of a more serious mental illness such as schizophrenia.

Danica Russell said it may be months before her husband returns to San Diego-based Invisible Children.

“Jason will get better. he has a long way to go, but we are confident that he will make a full recovery,” she said.

Russell narrates the 30-minute video “Kony 2012,” which has been viewed more than 84 million times on YouTube since it was released this month. in the video, Russell talks to his young son, Gavin, about Kony and the Lord’s Resistance Army.

The Invisible Children group has been criticized for not spending enough directly on the people it intends to help and for oversimplifying the 26-year-old conflict.

Invisible Children has acknowledged the video overlooked many nuances but said it was a “first entry point” that puts the conflict “in an easily understandable format.” It said money that directly benefits the cause accounted for more than 80 percent of its spending from 2007 to 2011.

—

Copyright © Mindful Mum 2009 – 2012. all rights reserved. Web design by dreilly.co.uk. Web development by RSGWD.

This site is published by the Mum Dad Baby Group (Mum Dad Baby Ltd), which is responsible for its contents as outlined in the terms & conditions. It is intended for visitors from the United Kingdom of Great Britain and Northern Ireland.

The information presented on this website is not intended as specific medical advice and is not a substitute for professional medical treatment or diagnosis. If you have any concerns about your own health or the health of your child, you should always consult a doctor or other healthcare professional.

Please review the terms & conditions before using this site. Your use of the site indicates your agreement to be bound by these terms & conditions.

Can you die of a broken heart? it can certainly feel that way, and anyone who experiences intense grief after losing a loved one may wonder whether they will survive.

Dr Alexander Lyon, who is a consultant cardiologist at the Royal Brompton, the specialist heart and lung hospital, is working with researchers at Imperial College to understand why some people die in the few days after a sudden, devastating loss.

A rush of overwhelming fear or extreme pain are the types of shock he says might also lead to catastrophic heart failure. but it’s not just “bad” emotions that can trigger a condition known as “broken heart syndrome”, Lyon says – it could equally be the shock of intense, unexpected happiness, such as winning the lottery.

The trigger for the syndrome – also called stress cardiomyopathy or Takotsubo cardiomyopathy – is the body’s sudden, massive release of adrenaline, which can “stun” the bottom half of the main pumping chamber of the heart, in effect paralysing it and requiring the top portion of the chamber to work much harder to compensate.

This, says Lyon, can be confusing to someone attempting a diagnosis, as doctors are taught that adrenaline is the “fight or flight” hormone that makes hearts pump faster and stronger. Broken heart syndrome is a condition in which adrenaline causes weakness instead. In his research Lyon is trying to find out why this type of acute stress causes the heart to get weaker, why just one part of the heart is affected by the adrenaline surge, and what factors make some people particularly susceptible – or resilient – to the hormone rush. to expand his research sample, he’s inviting anyone who thinks they may have experienced Takotsubo cardiomyopathy to contact him (uk).

Interestingly, survival rates for anyone discharged from hospital having suffered the condition are pretty much 100%. Although, he says, the condition is little known and many of the typical symptoms indicate a standard heart attack caused by a blockage to a coronary artery. This means the patient may be misdiagnosed initially.

Reliable numbers of cases are hard to come by as there is currently no official tag for logging stress cardiomyopathy as a diagnosis on relevant databases. Lyon, however, has lobbied to get the syndrome added as a datapoint, so proper statistics will soon become available. He is also setting up a European network of doctors interested in the condition, who will pool their results to increase understanding of this newly emerging condition.

Current figures suggest that in the UK about 2% of the 300,000 “heart attacks” each year will in fact be broken heart syndrome. Over 10 years, that could be up to 60,000 cases. And Lyon suggests that rather more people may be dying suddenly of the condition before arriving at hospital, without an accurate diagnosis ever being made either pre- or post-mortem. Dying of a “broken heart”, therefore, may be more common than imagined.

“Humans have always been exposed to these kinds of stresses,” says Lyon. “The only reason we know about the syndrome now is because people presenting with heart attack symptoms can have coronary angiograms very soon after their chest pain begins.

“To a cardiologist, a heart attack means a blocked coronary artery, but in this condition we find the coronary arteries are open and the blood supply is fine. We then look at the pumping chamber and it’s paralysed, plus it’s taken on a unique and abnormal shape; it looks like a Japanese fisherman’s octopus pot, called Takotsubo, hence its name.”

About 90% of diagnosed broken heart syndrome cases are in post-menopausal women – which begs the question, why aren’t men getting it? Lyon suggests that men may in fact be suffering from the condition – but collapse and die before reaching hospital and medical attention.

“Our current hypothesis is that men drop down dead if they have a big stress, whereas women recover,” he says.

“There is one guaranteed, huge, stress in everyone’s life; their birth. but for many women there is another stress, childbirth, which may happen multiple times. it would be odd if these repeated stresses gave rise to a life-threatening heart condition, so we think women have a protective factor, which, after menopause, may drop off.”

Lyon believes that when men are hit with a stress overload and very high adrenaline levels, there may be instances in which they die very suddenly. the real cause of death may not be obvious to the pathologist, he says. “The pathologist opens the heart, sees some signs of coronary artery disease, because in western society pretty well all adult men will have evidence of it, and so records coronary heart disease as the cause of death,” he says.

Sudden deaths in otherwise healthy young men in custody, young men who are high on drugs and have been forcibly restrained, and deaths under restraint in psychiatric hospitals, are all situations in which Lyon says stress cardiomyopathy should be considered.

“Restraint is a very provocative stressor, not least if you have a loss of insight because you’re high on drugs or have a psychiatric illness,” he says. “And with deaths in custody, we know that hearts are very often normal when examined, so this syndrome becomes relevant. it may be happening far more often than is reported.”

It may be a less than romantic question on Valentine’s Day, but can you, quite literally, die of heartbreak after being dumped, or from the emotional pain of a loved one’s sudden demise?

The answer, it seems, is that during the few days after experiencing extreme stress of this nature, it is possible – a thought that might prompt GPs to consider how to support people in such situations. A recent study shows that the risk of dying suddenly from a cardiac arrest is 16 times higher the day after losing a spouse.

A cheery thought for Valentine’s Day lovers looking forward to a long and happy life together…

Contact Dr Lyon at uk Hear him at the free Valentine’s Day Mending Broken Hearts seminar, 6-8pm 14 February at the Pathology Museum, London E1

Seventy-year-old Don Wright doesn’t believe in giving up without a fight. Since being diagnosed with multiple myeloma (MM), also known as myeloma, eight years ago, he has become a beacon of light for patients battling the crippling cancer of the plasma cells in bone marrow. While no exact cause has been found to lead to this disease, it does primarily affect elderly folks. the median age of diagnosis is roughly 70 years.

A picture of health, the retired American lawyer has used his passion for running marathons to keep physically fit, controlling the cancer with a clinical trial drug called pomalidomide to give himself a new lease of life. He has been on this drug since March 2008, with positive results. Prior drugs gave him little to no relief.

Wright spoke to Life following his speech at the 53rd American Society of Hematology (ASH) conference in San Diego late last year, where medical experts congregated to promulgate and analyse new treatments for myeloma suffers. He spoke candidly to the audience about how encouraged he was to see fresh developments taking place in the treatments for MM patients. a trial drug has worked wonders for him, he said with enthusiasm, offering him a life he would not have imagined a few years ago.

“I want patients around the world to be emotionally and physically strong to fight this disease,” said Wright. “Trial drugs might not be easily accessible to the masses and might not always work, but that should not put people off from looking after themselves both physically and emotionally.

”Pomalidomide, the trial drug, is working for me. It will not cure the myeloma but it keeps it stable. I want people in my shoes to be encouraged to live and celebrate life. I have a disease but despite that I have a wonderful life. Despite the odds, it is pivotal to have hope. At the conference, doctors talked about a cornucopia of treatments, which are at trial stage, so there is a lot of hope for new cures on the horizon. Life is there to be lived to the fullest despite the impact the disease has had on us both mentally and physically.”

Afterwards, he took time out to run a mini-marathon with a small group. He has competed in 55 marathons in 37 states, while his goal is to compete in 50 states. Wright was diagnosed with myeloma two weeks after running his first marathon in 2003. His doctor_ who gave him a five-year survival estimate _ was always supportive of his running which he believed would strengthen his bones. He decided to continue for the sheer enjoyment of pushing his physical limits to the next level. Admitting that with advancing age and the sickness, he is simply content with reaching the finish line.

Adhering to a healthy lifestyle is a must to boost your chances of fighting the disease, he said. Smoking, obesity and fast food should be kept at bay. Nutritious food is a must, organic is most advised. Exercise of all forms can lift people from depression and stress, he enthused with a twinkle in his eyes. Wright credits good emotional health to a supportive family, a wife and daughter that also participate in marathons with him.

The well-toned athlete calls them his pillar of emotional support. Wright concluded on a poignant note: ”I do realise that I don’t know just when the cancer might deteriorate. But for the meantime, my family and I are relishing the extra time that we have been given to be together. To make the most of it, we have been travelling and doing these running events together to celebrate life.”

Meanwhile, Dr Weerasak Nawarawong, president of the Thai Myeloma Working Group, who also attended the ASH meetings, said that while the experimental drug pomalidomide is not available in Thailand, it is important for Thai patients not to lose hope because many new treatments are being tested to find suitable cures. Judging from all the positive developments that are taking place in the field of blood cancer studies, there is reason to be optimistic about the future.

Despite being diagnosed with multiple myeloma, a treatable yet incurable cancer, Don Wright (foreground, right) has fought tooth and nail to keep it under control through a positive attitude and healthy lifestyle.

He said a number of updates were shared at the American Society of Hematology conference about the treatment of multiple myeloma. one which includes the next generation immunomodulatory drugs pomalidomide, proteasome inhibitors and carfilzomib. Patients taking these drugs, in addition to other experimental medication, tested in no increased toxicity.

In Thailand he said most MM patients are in the age bracket of 60-70 years old. Annually, there are approximately 150 new cases in comparison to 15,000 in the US. Dr Weerasak noted that while myeloma is treatable it yet remains incurable. important treatment advances, however, have developed in higher rates of remission and lengthier survival than were seen in the past. As experts attain a better understanding of the development and progression of this disease, targeted treatment strategies are generating further benefits.

He said that a routine blood screening can catch a number of myeloma cases while it is still in an asymptomatic state. the symptom at the onset of the disease for most Thai patients is bone pain. In those who have pathologic fractures especially fractures of the thoracic and lumbar vertebral bodies, it usually results in severe spasms and back pain. the anaemia, which may be quite severe, is the most common cause of weakness in patients with MM.

Dr Weerasak admitted that while Thailand has kept statistics of the number of myeloma patients through the years, it had not made an epidemiologic study of the disease as such. Due to lack of awareness physicians under-diagnose their patients, he noted. Epidemiologic studies in countries such as China and Korea have given him reason to believe that the number of patients with multiple myeloma in Thailand is increasing steadily.

To raise awareness the Thai Myeloma Working Group organises several functions to educate both physicians and patients on the disease. they also have a website (thaimyeloma.org/th) for patients to obtain information about multiple myeloma. He also hopes that in the near future, they will be able to set up supportive groups for myeloma patients to receive counselling.

Thai myeloma patients can expect medication that is approved worldwide.

”All the anti-myeloma drugs that have been approved for treating multiple myeloma are available in Thailand,” noted the veteran medical expert. ”The success of the treatment is as good as you would find in Western countries if only we can get access to novel drugs, which don’t come cheap. There are numerous determining factors that influence the positive outcome of the treatment. Few examples include age, the advancement of the symptoms and the duration of time that has elapsed before the patient gets the anti-myeloma therapy.

”Novel drugs also have no guarantee and can be expensive. so Thai myeloma patients’ biggest setback can be the ability to purchase these drugs. the government does not also have a big enough budget to cover the expense.”

Dr Weerasak said doctors are looking for appropriate drugs that can be used to maintain the status of remission which is quite successful in some of the sufferers.

He explained that clinical trials are research studies of new treatment methods. Even if you are newly diagnosed with multiple myeloma, he said you might be offered a clinical trial drug. the early phases I and II of the clinical trials focus mainly on a safe dosage level, side effects and type of cancer to ascertain

that the new drugs are working. the phase III trials then determine if the patient is making better progress from the currently available treatment they have undergone. Patients might have to take some risks, such as suffering from adverse effects, so it is up to them to continue or discontinue with the treatment.

Asked to share common causes and symptoms of myeloma, Dr Weerasak explained that as there is no exact cause of MM, there are several risk factors that could lead to the disease. Repeated exposure to chemicals such as pesticides, benzene and spraypaints have been proposed as potential causes.

”Most people with MM have no known risk factors other than age,” he said. ”Scientists have identified a few risk factors for instance, obesity, exposure to radiation or chemicals. Not everyone with risk factors gets multiple myeloma. Myeloma is slightly more common in men than women, and most people are diagnosed in their sixties.

”Symptoms could include frequent low back pain. the pain could nonetheless occur in other areas like ribs, arms, legs and pelvis.

”For patients that develop anaemia, they will have paleness, dizziness, weakness, fatigue and shortness of breath. Infections such as pneumonia, sinusitis are frequent. Weakness or numbness in your legs might be the result of spinal cord compression. Unexplained weight loss is common. High calcium levels cause excessive thirst, nausea, constipation, loss of appetite and confusion. Swelling, especially in the legs, along with weakness are symptoms of kidney failure.”

Best prevention methods are to keep healthy through having a good diet, exercise to enhance your physique, observe good personal hygiene to prevent infection and avoiding smoking and alcohol. Exposure to toxic chemicals and radiation is believed to increase the risk of multiple myeloma and other cancers, so keep this in mind and avoid being around these substances for long periods of time. Regular medical examinations for early detection and timely treatment is always advisable.

Photojournalist Ed Kashi captures the lives of patients suffering myelodysplastic syndromes, a group of closely related but diverse blood cancers, which also affect the aged.

Latest stories in this category:

That intensity — Rabil refers to himself as “cutthroat determined” — has informed his approach to lacrosse and is guiding his new effort to help young people with learning differences thrive through athletics, and to raise public awareness about the need for early diagnosis and intervention.

“I want kids with learning differences to know that they can do great things,” said Rabil, who lives in Baltimore. “It may sound like a cliche, but I don’t look at my condition as a disability, but as something that made me work hard to get where I wanted to go.”

Learning disabilities are caused by differences in brain structure. Estimates vary on the percentage of Americans with a disability; government agencies cite 10 to 15 percent. The most common disability is dyslexia, an inherited disorder in which the brain does not properly recognize and process symbols, making it difficult to read and write. Those with auditory processing disorder can hear, but their brains do not properly process some sounds.

These disorders have nothing to do with a child’s vision or intelligence. there is no cure, but there are successful treatments. Katherine Schantz, principal of the private Lab School in Northwest Washington, one of the nation’s premier schools for children with learning disabilities, said that modern brain research can show how a brain has changed after specific interventions, helping target them to individuals.

Rabil, whose new foundation is starting a lacrosse program at the Lab School, knows he is one of the lucky ones. his sister, who attended Lab, has dyslexia, and his brother has auditory processing disorder. he received his diagnosis when he was young enough to avail himself of tutors, note-takers and other accommodations as he went through school, graduating from private DeMatha Catholic High School in Hyattsville. An invaluable tool that helped him at Hopkins, he said, was the Kurzwell 3000, a program that scans a document, displays it and reads it aloud while highlighting the image of the print as it is being read.

Because the key to helping people learn to live and thrive with dyslexia is early detection and intervention — along with strong family support — Rabil plans to advocate with lawmakers in Maryland for universal dyslexia screening among school children. he is starting a lacrosse program at Lab and plans to raise funds for an annual scholarship there.

Philip Schultz wasn’t as lucky as Rabil. Schultz, of New York, did not learn he had dyslexia until he was in his 50s and his son, then in second grade, received a diagnosis.

As he heard the doctor describe his son’s symptoms, it sounded like his own life story. he remembers being put with other kids who had trouble learning at “the dummy table.” Held back twice and kicked out once for fighting with bullies, Schultz says he was “a big disappointment” to his parents.

But he persevered, becoming a writer who won the 2008 Pulitzer Prize in poetry. He’s authored eight books, the latest a memoir called “My Dyslexia.” his work ethic echoes Rabil’s: he writes slowly, and rewrites over and over and over.

Rabil and Schultz visited the Lab School last week as two of five honorees at the annual gala. Schultz, founder and director of the Writers Studio, a private school for fiction and poetry writing based in New York City, was most struck by the environment at the Lab School, where every student can understand what the rest are going through.

“I wonder what that would have been like, to have that kind of support, and what a difference it would have made,” he said.

Copyright © Mindful Mum 2009 – 2011. All rights reserved. Web design by dreilly.co.uk. Web development by RSGWD.

This site is published by the Mum Dad Baby Group (Mum Dad Baby Ltd), which is responsible for its contents as outlined in the terms & conditions. It is intended for visitors from The United Kingdom of Great Britain and Northern Ireland.

The information presented on this website is not intended as specific medical advice and is not a substitute for professional medical treatment or diagnosis. if you have any concerns about your own health or the health of your child, you should always consult a doctor or other healthcare professional.

Please review the terms & conditions before using this site. your use of the site indicates your agreement to be bound by these terms & conditions.

Copyright © Mindful Mum 2009 – 2011. all rights reserved. Web design by dreilly.co.uk. Web development by RSGWD.

This site is published by the Mum Dad Baby Group (Mum Dad Baby Ltd), which is responsible for its contents as outlined in the terms & conditions. It is intended for visitors from the United Kingdom of great Britain and Northern Ireland.

The information presented on this website is not intended as specific medical advice and is not a substitute for professional medical treatment or diagnosis. if you have any concerns about your own health or the health of your child, you should always consult a doctor or other healthcare professional.

Please review the terms & conditions before using this site. Your use of the site indicates your agreement to be bound by these terms & conditions.