Lupus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems, including your joints, skin, kidneys, blood cells, heart and lungs. The disease is diagnosed more often in young women like Lady Gaga but men, including R&B star Seal, are also afflicted. Lady Gaga says her aunt died of lupus in 1976, which ties in with research that suggests a genetic link as the disease appears to run in certain families.

Sometimes called “the great imitator” because its symptoms often mirror those of other diseases, sufferers experience fatigue, headaches, painful or swollen joints, fever, rash and hair loss, among other things.

“Because a lot of the symptoms are nonspecific in the early stages, lupus can still be somewhat difficult to diagnose” says DeLisa Fairweather, assistant professor at Johns Hopkins University. “The benefit with diagnosing lupus compared to other autoimmune diseases is that it is so well-known and doctors might be on the look out for it.”

I am curious about what tests Lady Gaga was given because there is no single diagnostic test for lupus. The ANA (anti-nuclear antibody) test is most commonly used to screen for the disorder. However, a positive ANA test doesn’t necessarily mean you have lupus. Instead, it helps narrow the range of possible diagnoses that could include lupus.

Fairweather studies autoimmune diseases closely and says that treatment research is geared toward calming down the hyper-immune response without getting rid of too much immunity that would put a patient at increased risk for infection. Due to her borderline test results, Lady Gaga isn’t undergoing lupus treatment.

“As of right now, I do not have it, but I have to take good care of myself,” the pint-sized dynamo known for her colorful and sometimes outrageous antics told King. The good news is that, with proper treatment, most people with lupus can lead active lives. That means that Lady Gaga won’t have to hang up her sequined-covered platforms even if she does develop the disease.

CONNECT THE DOTS

The Lupus Foundation is a great resource to learn more about lupus, its symptoms and treatments. The Lupus Research Institute and the Alliance for Lupus Research are both dedicated to the prevention, treatment and cure for lupus.

The debate on the benefits of prostate screening rages on.  The American Cancer Society (ACS) no longer recommends routine annual PSA screenings for early detection and treatment. Durado Brooks, MD, MPH, ACS director for Prostate and Colorectal Cancers says, “We aren’t certain that annual prostate screenings will actually save lives.”

Many men’s health advocacy groups, such as Zero the Project to End Prostate Cancer, argue that early detection is the best chance at saving more lives. According to a Swedish study that followed 20,000 men between the ages of 50 and 65, over 14 years, published in the July 2010 Lancet, the PSA test cut deaths due to prostate cancer by 44 percent.  However, another study published in the July 2010 Archives of Internal Medicine suggests that screening leads to overtreatment and shows little evidence of improving lifespan.

ACS now recommends that men age 50 and over should talk to their doctors about the risks and limitations of the PSA screening. It also advises men in high-risk groups, including men with brothers, fathers or sons who have had a prostate cancer diagnosis at a young age consult with their provider, starting at age 45.

So what’s a man supposed to do with these mixed messages?   Ultimately, it is a personal decision.  Larry Johnson says that living with cancer growing inside him was just not an option. “Hearing that I had cancer, after my biopsy came in was not easy,” Johnson says. “ And the surgery and treatments were hard. But I am still here, living cancer-free” He says when men ask him, “I tell them to take control and get the test.”

Connect the Dots

For more information on making a decision to be screened, visit The Centers for Disease Control Informed Decision Making.  The Prostate Cancer Foundation and UsTOO International are men’s health advocacy groups that also offer guidelines. The   James Buchanan Brady Urological Institute and John Hopkins Medicine has analysis of recent studies in a report.

Guest blogger, Andrea King Collier is a freelance health and health policy writer and the author of Still With Me… A Daughter’s Journey of Love and Loss (Simon and Schuster, 2003) the Black Woman’s Guide to Black Men’s Health (Warner, 2007).

They are here for health care.
Formally called Phelophepa (a combination of seSotho and seTswana words meaning “good clean health”) the Miracle Train started as an eye and vision care project with major funding from the Transnet Foundation, the philanthropic arm of the state-owned rail carrier. The original train had just three basic cars; today, 18 air-conditioned cars carry medical students and volunteer doctors and nurses to remote rural areas to treat more than 45,000 patients a year. Services include vision, dental, and psychiatric services, cancer screening, preventative care for Type 2 diabetes, and HIV/AIDS counseling. Since its launch in 1994, the train has served more than 500,000 patients and traveled more than 100,000 miles.

“For many patients, we provide the only modern healthcare available,” says Dr. Cingo, Phelophepa’s manager, while showing a group of journalists around the train. “Some people walk here for a day or more.” Indeed, the only other choice is often a visit to the local witch doctor. So the train also supports a clinic where participants nominated by their communities receive basic medical training so that they can bring modern information back to their villages. And the staff work with local leaders and healers to publicize the train’s services and maximize its impact.

Inside the train, work proceeds in an orderly fashion. In the psychiatry car, two private compartments are set aside for privacy. In the optometry car, patients peer into a phoropter to see an eye chart, and smile widely as they see clearly, sometimes for the first time in years

“The train has to move from place to place, so we focus on immediate treatable problems,” Cingo explains. “We can’t treat conditions such as cancer in a single session. But we can do screening. and refer the patient to the nearest hospital for continuing care.”

A black South African, Dr Lillian Cingo studied as a nurse and midwife during South Africa’s Apartheid years, then studied neurosurgery, tropical medicine, and HIV/Aids counseling in London. She returned to South Africa, and has been with Phelophepa since 1995. For her, Phelophepa’s miracles have worked both ways: Her work has been both empowering and uplifting, helping to heal some of the scars of Apartheid.

As a result of Phelophepa’s success, Transnet is funding a second train, Phelophepa II, in partnership with the South African government and pharmaceutical companies such as Roche and Colgate Palmolive. Transnet estimates spending more than 80 million S.A. Rand on the project, which is expected to launch in 2011.

Connect the Dots:

Phelophepa has been a joint project of the Transnet Foundation, which funds 75 percent, government agencies, and companies such as Roche (which supports the cancer screening programs) and Colgate Palmolive (which supports dental care). The project is headed by Dr. Lillian Cingo.  To find out how you can help, visit Train of Hope.org.

However, some medical experts fear that the treatment might cause Michael Douglas to lose his voice or suffer from chronic hoarseness. “Odd Couple” actor Jack Klugman continued his acting career after a 1974 battle with throat cancer, then suffered a second bout in 1989 that left him unable to speak for several years. After rehabilitation, Klugman eventually regained a small, raspy voice, according to the Oral Cancer Foundation.

How likely is Douglas to suffer debilitating side effects—and what might lie ahead for him?

Each year, more than 25,000 Americans develop cancer of the throat and larynx (voice box). It’s ten times more common in men than women, and typically strikes older men like Douglas, 65, who is married to actress Catherine Zeta-Jones.

Years of smoking and drinking are the most common culprits, reports Mona Karim, MD, vice chair of radiation oncology at Morristown Memorial Hospital in New Jersey, who is not involved in the actor’s care. “That combination chronically irritates the throat’s lining, which can lead to cancerous changes.” Douglas underwent rehab for excessive drinking in 1992, according to Vanity Fair, and reportedly kicked a half-pack-a-day cigarette habit in 2006.

However, the Hollywood icon hasn’t announced the cause of the cancer, which can also strike nonsmokers and nondrinkers. Other risk factors include gastroesophageal reflux disease (GERD), which causes stomach acid to rise into the throat, exposure to asbestos, and HPV, a sexually transmitted disease that can infect the mouth and throat.

Regardless of the cause, the star of Romancing the Stone and War of the Roses has every reason to be optimistic, adds Dr. Karim. “Based on his treatment with chemotherapy and radiation, Michael Douglas most likely has intermediate stage cancer that hasn’t spread outside the neck. There is a very sophisticated way to shape the radiation beam so there’s a lower dose to healthy tissue. If his tumor is in the voice box, there could be an issue of hoarseness, but if the tumor is somewhere else, this might not be a problem.”

The good news for Douglas and his fans: “The prognosis for people with throat cancer has improved dramatically,” reports Dr. Karim. “He could potentially be cured.”

Connect the Dots

To learn more about throat cancer, visit MedlinePlus. Warning signs include coughing up blood, trouble swallowing, hoarseness, chronic sore throat, and swelling in the neck. The best ways to prevent the disease are avoiding smoking and excessive alcohol use.

The statistics are alarming: Childhood obesity has more than tripled in the past 30 years, the Centers for Disease Control reports. Currently, 12.5 million American kids ages 2 to 19 are obese—17 percent of the population. And another 16.5 percent are at risk for becoming overweight.  But the good news is that three surprisingly simple family habits can help kids maintain a healthy weight. Practicing even one can trim risk for obesity by 25 percent, a recent study found, while adopting all three shrinks risk by 40 percent.

*Dine Together. “Children who eat dinner with their parents at least five times a week tend to weigh less and have healthier eating habits,” says Goutham Rao, MD, clinical director of the weight management center at Children’s Hospital of Pittsburgh and author of Child Obesity: A Parent’s Guide to a Fit, Trim, and Happy Child (Prometheus Books, 2006).  “When families eat together, meals are typically healthier than when the child just grabs food on the run without adult supervision.”

*Turn Off the Tube.  “Having meals in front of the TV encourage mindless overeating,” explains Dr. Rao. “When the TV is off, there’s discussion about what the family is eating, which teaches kids about good nutrition.” Also consider unplugging the tube for a week, advises Dr. Rao. “Research suggests that when you turn it back on a week later, your child will be less interested in the shows.” Instead of vegging out in front of the tube, take an after dinner walk to boost family fitness. The American Academy of Pediatrics advises no more than two hours a day of quality programs for older children, while kids under two shouldn’t watch TV at all.

*Make Sure Kids Get Enough Sleep. Skimping on Z’s is linked to obesity in both kids and adults worldwide, research shows. “A tired child is less physically active, so burns fewer calories,” says Dr. Rao. “Also, levels of cortisol are higher in children who don’t get enough sleep. There’s some evidence cortisol stimulates appetite, which could contribute to obesity.” In the healthy habit study, four-year-olds who snoozed at least 10.5 hours a night had lower rates of obesity. Dr. Rao recommends 10 hours a night for older kids, and at least eight for teens.

Connect the Dots

For more information on preventing childhood obesity, visit the Let’s Move website. The Mayo Clinic has tips for parents and the US Department of Agriculture provides ideas on cooking with kids. The National Sleep Foundation report, “How Much Sleep Do We Really Need?” includes guidelines for slumber needs at various ages.

Effective September 2010

* You can keep your adult children under the age of 26 on your health insurance plan, as long as they are not eligible to be insured under their employer’s plan.

* All new plans must cover preventative screenings, such as mammograms or colonoscopies, without a co-pay or insurance deductible.

* Insurance companies can no longer cancel coverage or refuse to pay for services because of an error or technical mistake on your application.

* You will now have clear and defined ways to appeal denied claims with your insurance company.

* Job-related insurers will no longer be allowed to deny coverage for a child under 18 who has a pre-existing condition.

* Health insurance providers will no longer be able to put lifetime dollar amount limits on your health care coverage.

Effective January 2011

* Seniors who have reached their cap on Medicare drug expenses will get a 50 percent discount on their Part D approved, brand name prescription drugs. They will also get more savings on brand name and generic prescriptions over the next ten years.

* Seniors on Medicare will be eligible for free annual wellness visits and personalized prevention plans.

Effective January 2014

* Most Americans must have health insurance. If your employer doesn’t offer insurance, or you are unemployed, you will be able to buy affordable coverage through the Exchange, an insurance market place that will offer you a choice of health plans.

* Prenatal and newborn care will be covered in all  Exchange plans

* Dental and vision care for children under 18 will be covered in all Exchange plans

* Families of four who make less than $88,000 will be eligible for tax credits to pay for their insurance coverage

* Insurance companies will no longer be able to discriminate against consumers or charge higher premiums for pre-existing conditions or gender.

The Act has also designated $15 billion for prevention and public health programs. Mrs. Obama, who launched Let’s Move to fight childhood obesity says “a focus on prevention will help us to combat diabetes, heart disease, and high blood pressure — chronic illnesses that right now lead to 70 percent of deaths in the United States and 75 percent of  national health care costs.

Connecting The Dots

For more information on what the Act may mean for you, and how to access these new benefits, visit Families USA’s Health Reform Central. AARP has also has a rundown on the Act as it impacts people over 50, called 10 Things You Need to Know About Health Care Reform. And the Commonwealth Fund has an analysis of what the Act will mean for 30 million women in America.

On November 17, 2009, Desiree arrived at her usual bus stop to find a crowd of 30 to 40 people standing around a man who had passed out and was turning purple. She immediately sprang into action.

“Someone call 911,” she yelled, while laying him flat on the ground to begin CPR. “That bus stop is not the cleanest place in the world and I didn’t want to put my mouth on his,” she recalls.

Fortunately, she didn’t have to give mouth-to-mouth to a stranger to help save his life. Hands-Only™ CPR, a two-step process of calling 911 and pushing hard and fast in the center of the chest until help arrives, is easier to administer and was developed specifically for such situations. Chest compressions alone are just as effective at saving lives as traditional CPR, according to clinical trial results released on July 29 in the New England Journal of Medicine.

The American Heart Association says that when effective CPR is provided immediately, a victim’s chance of survival increases dramatically. However, less than a third of victims receive CPR from bystanders because people worry that they might do something wrong or make the situation worse.

While Desiree worked furiously to save the man’s life, onlookers yelled at her not to touch him, saying that she would get in trouble. “That didn’t make any sense to me so I kept doing exactly what I was doing–thinking about the steps, counting my compressions to make I was doing it the right way.”

When help arrived several minutes later, the man was transported to a nearby hospital where he passed away 10 days later. Later, his family thanked Desiree for intervening to prolong his life and giving them time to say goodbye.

Despite the sad ending, Desiree knows she did the right thing and would do it all over again. “CPR is a good thing to know because this can happen to anybody, even someone in your own home,” says Desiree. “Learning how to do it only takes a little while.”

Connect The Dots

Learn more about the ‘Hands Can Do Incredible Things’ campaign from the Ad Council and the American Heart Association (AHA), This YouTube video from the Mayo Clinic demonstrates the Hands-Only CPR technique. The AHA recommends that if an adult suddenly collapses, trained or untrained bystanders should call 911 immediately and provide Hands-Only™ CPR.

Research also shows that people with periodontal disease are nearly twice as likely to have heart disease than those with healthy gums. What’s more, oral infections also raise risk for stroke, says Amy Doneen, ARNP, medical director of the Heart Attack & Stroke Prevention Center in Spokane, Washington. “We’ve started checking patients for periodontal disease because it can sometimes lead to a heart attack or stroke, while treating infected gums reduces risk.”

What’s the link between oral health and the heart? “The bacteria that cause gums to become swollen and inflamed can also spark systematic inflammation that silently damages blood vessels,” explains Doneen. “Heart attack and stroke are opportunistic problems that are driven by inflammation of plaque in the arteries, which can rupture, causing a blood clot to form.” That clot can trigger a heart attack (if the clot travels to vessels that supply the heart) or stroke (if it goes to the brain).

Warning signs of periodontal disease include red, swollen, tender or receding gums, bleeding when brushing or flossing, persistent bad breath, mouth sores, and pockets of pus between gums and teeth. One in three adults over 30 have periodontal disease—and millions of them don’t know it.  Ask your dentist to check your gums, which typically involves taking painless measurements with a periodontal probe to check for pockets of disease.

The good news is that once diagnosed, gum disease can be treated, adds Doneen. “Repairing the problem has huge benefits for your blood vessels.” One study found that after six months of intensive treatment, patients with periodontal disease not only had healthier gums, but also improved endothelial function, indicating that the inner lining of their blood vessels also benefited.

Good oral health—including brushing and flossing two to three times a day, and seeing your dentist at least once a year—can give you a lot to smile about.

Connect the Dots

Wondering if you might have gum disease? The American Academy of Periodontology has a risk assessment test and oral health tips.  University of Maryland has a detailed report on prevention and daily dental care.

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Paltrow, 37, recently announced in her Internet newsletter GOOP that she was diagnosed with osteopenia, the precursor to osteoporosis, after suffering a severe shinbone (tibia) fracture.  She also received other scary news from her doctors. Her vitamin D levels “turned out to be the lowest they had ever seen,” says the Academy Award-winning star of Shakespeare in Love and Iron Man, who was put on prescription strength vitamin D and told to spend more time in the sun.

What’s the link between the sunshine vitamin and bone health?  “We see patients with severe vitamin D deficiency who don’t absorb calcium,” a mineral that’s one of the building blocks of bones, says Chad Deal, MD, head of the Cleveland Clinic’s Center for Osteoporosis and Metabolic Bone Disease.  Vitamin D deficiency is now epidemic, affecting more than half of Americans. Since relatively few foods contain this crucial nutrient, ask your doctor if you need a supplement. Dr. Deal advises patients to aim for 800 to 1,000 i.u. per day. Some people need higher doses.

If you’re deficient, your body can’t make enough calcitriol, a hormone called “active vitamin D.” As a result, your body doesn’t absorb enough calcium, forcing it to draw on calcium stored in the skeleton, weakening existing bone and blocking formation of strong new bones.

It may surprise you that your skeleton isn’t a rigid, unchanging frame. Your body continually tears down sections of old bone and replaces them with new bone, a process called remodeling. Until age 25, bone is built faster than it’s broken down.  After menopause, the opposite is true. Think of it like a retirement account: The more bone you “bank” when you’re young, the more reserves you’ll have to draw on when you’re older.

Since estrogen helps regulate bone health, hormones can be one reason why young women, such as Paltrow, may lose bone, adds Dr. Deal. “Being thin can be a factor, since estrogen is stored in body fat, so very little fat means less estrogen is stored. “ Other factors that can lower bone mass in young women include irregular or infrequent periods (less than six a year), smoking (which reduces estrogen), a poor diet and eating disorders.

Genes also play a major role, adds Dr. Deal. “The peak bone mass you accrue by age 25 is 70 percent determined by about 100 different genes.” A diet rich in vitamin D and calcium, regular weight-bearing exercise like jogging, walking or jumping rope, and avoiding smoking are the keys to preventing osteoporosis and osteopenia.

Connect the Dots

To bone up on prevention, visit the National Osteoporosis Foundation, which has exercise tips and a factsheet. Discuss your risk factors and how to protect your bone health with your doctor. National Institute of Arthritis and Musculoskeletal and Skin Diseases offers osteoporosis resources and information on calcium and vitamin D. For more resources and news on osteoporosis, visit MedlinePlus.

The GE Show is new form of digital storytelling. It combines entertainment and interactivity—including the game and a poll to see how much you know about hospitals—with a behind-the-scenes look at the medical team of Glens Falls Hospital in upstate New York. (Some of their jobs and comments will surprise you).

The show highlights new technologies to make hospitals smarter, more efficient, and in better tune with patients’ needs. GE researchers are developing a real-time early warning system to inform staff about potential “hot spots” where patient beds may be limited, so critical needs can be addressed quickly, shortening wait time.

GE’s Guardian Angel uses special sensors to monitor a patient’s room and alert caregivers if certain safety procedures aren’t being followed. And to keep everyone’s medical bills down, a hospital can save over $750,000 a year—and trees—by switching from paper to electronic medical records. A nurse can save 1,283 hours per year by sending prescriptions to the pharmacy electronically. That means better care for your and your loved ones.

Not only will the “Patient Shuffle” game help appreciate the challenges staff face, but it’s fun. So far, the top score for hospital discharges is 22 in three minutes—with all of the patients satisfied. Can you beat the record?

Connect the Dots

How healthy are our hospitals? For a graphic look at 30 key measures of quality, go to GE’s interactive visualization. Centers for Disease Control conducted a national survey of emergency rooms, while the Commonwealth Fund has an international comparison of US healthcare with that of five developed nations.  You’ll find more resources at The GE Show. And stay tuned for new episodes in the fall and winter about electric vehicles, air traffic control and the rail system.