Friday Five: withdrawal, Amanda Bynes, gluten-free labels, vaccine rates, urgentrx

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Pulling out is surprisingly popular

A study that will be published in the September issue of Obstetrics & Gynecology shows that 31% of women aged 15-24 used withdrawal as the primary form of contraceptive at least once. The study also found that 21% of those women became pregnant, compared to 13% of women who used other methods. I was pretty outraged to learn that so many young women rely on their partners to pull out, so I consulted the Kinsey Institute site Kinsey Confidential to compare different forms of contraceptives:

Method Typical Effectiveness Theoretical Effectiveness
Withdrawal 81% 94%
Male condoms 85% 98%
Oral contraceptives 92% 99.9%
Intrauterine Device (IUD) 99% 99%
Implant 99.01% 99.01%

Whelp, turns out the much-touted condoms don’t fare much better in preventing pregnancy than withdrawal, but IUDs and implants are far better. Advocating for more extensive use of IUDs and implants would help more women learn about their effectiveness and safety, and could play a major role in reducing the number of unplanned pregnancies. (FYI: condoms protect against some STIs, so keep using them, okay?)

Now we know what’s ailing Amanda Bynes

After publicly unraveling, actress Amanda Bynes has been placed on psychiatric hold and reportedly diagnosed with schizophrenia. Schizophrenia is a debilitating yet treatable disease that can lead to delusions, hallucinations (including hearing voices and smelling odors that don’t exist), and cognitive issues, among other symptoms. I sincerely hope that her family and doctors help her find the right treatment so she can find relief from her suffering. This story is playing out all over the gossip mills, and we can learn from this: erratic behavior requires intervention. In an open letter, her former co-star Nick Cannon also taught us an important lesson about how provide compassion:

So I say to my sister Amanda Bynes you’re not alone. I’m here for you. I understand. I care and I appreciate you, because that’s what family does and that’s what family is for. I also extend this to anyone else in my life, past or present that may find themselves in hard times. I’m here! Call me! Because I truly believe, the hand you’re helping up today may be the one you’re reaching for tomorrow.

Side note: take a look at this fantastic Atlantic article with Dr. Christine Montross titled “How well do we really understand mental illness?” for more insight into the hows and whys of treating severe mental illness.

Gluten-free labels, now with accuracy!

People with celiac disease, those with gluten sensitivity/intolerance, and dieters can all rejoice because this week, the FDA standardized the label “gluten-free.” The limit is 20 ppm, the lowest amount of gluten detectable in a food product. Foods such as fresh fruit and eggs can carry the label “gluten free” because they naturally contain no gluten. Regulations like this help consumers make informed choices. Considering more than two million Americans cannot digest gluten, having consistent, effective labels is the right thing to do for their health.

State-by-state vaccine rates tell us about exemptions

Each year, the CDC analyzes vaccine rates among the 50 states, Washington DC, five cities, and eight other US jurisdictions that receive federal funding for immunizations. This year, Mississippi topped the list, with 99.9% of kindergarteners receiving full doses of MMR, DTaP, and varicella (chicken pox). Overall, median exemption rate for the country was 1.8%; Oregon had the highest, with 6.5% of kindergarteners not meeting the vaccine standards. Interestingly, Mississippi does not allow religious or philosophical exemptions for immunizations. Removing religious and philosophical exemptions altogether wouldn’t be appropriate, but perhaps the success Mississippi has with getting children vaccinated will spark a conversation about strengthening the requirements for getting an exemption.

UrgentRx: alleviating upset stomachs, potentially saving lives

Forbes just published its list of what it deems the 25 most innovative consumer and retail brands of the year. An over-the-counter medication company, UrgentRx, made the cut. The company produces powders of common treatments for headaches, allergies, and digestive issues, along with plain aspirin intended for use during a heart attack. UrgentRx powders can be taken without water, meaning that you can give yourself a hit of heartburn medicines whenever you need it. The implication for potentially life-saving doses of aspirin are immense: a study in the American Journal of Cardiology, as reported by Harvard Medical School, showed that chewed aspirin worked faster against heart attacks than swallowing it whole or taking a liquid version. For a person with heart disease, carrying around a powdered dose eliminates the need to chew and provides the benefits of aspirin as quickly as possible.

Why we can't let Jenny McCarthy join The View

Jenny McCarthy’s dangerous vaccines-cause-autism message has been well catalogued and critiqued by writers across the Internet (you can start here, here, and here). But I hadn’t ventured far into her world until hearing the news that she was “in serious talks” to join the popular daytime talk show The View. Vaguely knowing that she advocates for some batty autism cures, I stuck my toe into the world that literally made her its president, Generation Rescue. My conclusion? If ABC makes the mistake of hiring her, and she brings her anti-doctor, anti-science rhetoric to The View, all of us concerned with spreading evidence-based information better be ready every day to combat her misinformation. McCarthy's book chronicling how she "cured" her son of autism.

A note about sources: finding balanced sources on vaccine safety is a tough task, and I found myself questioning both the Generation Rescue folks and the people criticizing them. Many of the sources I found are very biased and a link to them does not mean I endorse their message. As you find yourself going down the rabbit hole, remember to read everything skeptically. However, the best resource I found for anyone interested in the actual science regarding this issue is the Children’s Hospital of Philadelphia’s Vaccine Education Center.

I learned about the “Biomedical” approach to “curing” autism through a video McCarthy made a few years ago. Generation Rescue no longer has on its site, but YouTube squirreled it away for our viewing pleasure—Part 1 Part 2.  She goes into detail about how and why “Biomedical” is the only thing that makes sense for healing children with autism. I suggest you carve out fifteen minutes to watch it so you know what’s coming if she makes it onto The View.  Warning: the video may cause bouts of rage.

The two most important parts of the video are direct quotations from McCarthy that summarize the danger she poses to public health:

  1. After listing brand name supplements and referring viewers to Kirkman Laboratories to purchase them, McCarthy encourages parents to give supplements to children in order to “detox” them from yeast and toxins, and says, “If you’re unsure about dosage, ask your pediatrician.” Then she rolls her eyes. “Or, most of the time, they don’t know anything. So I would say, um, ask someone at Kirkman Laboratories.”

So here we have McCarthy herself telling us not to trust pediatricians. Rather, we should call up a company that sells allergen free supplements and ask them how much to give to children. She encourages us to trust salespeople over trained professionals, simply because she believes in what they’re selling. In her view, doctors are useless and possibly malicious.

2. Attesting to the power of positive thoughts, she invokes the book “The Secret” and says, “Whatever you think becomes your reality.”

This is some serious magical thinking. McCarthy believes that her wishes will come true. She imagined her own son being healed of autism, and lo and behold, he was! When all a person has to do is believe something is true, she has no need for scientific facts. Give that person a microphone, and she may be able to convince others that whatever they believe is the truth, too.

By lending her face and considerable charisma to the cause, McCarthy has already done serious damage to immunization levels across the country by raising the profile of misguided vaccine fears. Many states are below the necessary vaccination level to maintain herd immunity for pertussis, measles, and diphtheria. Herd immunity means that there is a certain percentage of the population that needs to be vaccinated against a disease in order to keep the unvaccinated safe. Vaccination keeps infectious diseases from spreading by containing the possibility of an outbreak. For example, in order to protect those who cannot be vaccinated—infants, pregnant women, etc. from measles, 92-94% of the population needs to be vaccinated against it. When immunization levels drop below 92%, the population is at risk for an outbreak and the same people who could not get the vaccine are now at risk for the disease.

The View is a daily show. If she’s hired, I’m sure McCarthy will talk about anything from insomnia to hair color to shoe insoles, if her Twitter feed is any indication. But it will only be a matter of time until the issue for which she is best known becomes part of the conversation. When it does, we must be ready to talk openly about the results of research and the reliability of doctors to give sound, proven advice. Though talking about it over and over may seem redundant or boring, the truth is that vaccine levels are declining and we must speak on behalf of public health.

In the meantime, tell ABC what you think about McCarthy joining The View. Phil Plait at Slate has an excellent example of the polite note he wrote and inspired me to write to them and make my note public. Here is what I wrote to them. Feel free to use some version of my letter if you’d like:

I strongly urge you not to hire Jenny McCarthy as a new co-host. She is the president of the group Operation Rescue, which advocates for practices that harm the public's health, especially avoiding vaccines. If she is hired by The View, she will have a daily opportunity to influence the health decisions of viewers. Please do not add to the ease with which bad and potentially dangerous health information is spread.

For more information, please see http://bit.ly/12pTOyW  

Sincerely,

Teagan Keating

Please take the time to write to ABC before they hire her. Because if she does make it onto the show, we’ll have to do a lot more than that.

The Friday Five: Angelina, E. coli, Tetanus, Cloning, Sodium

This is the first week of my new feature: The Friday Five! Each Friday, I’ll use fewer than five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Here we go! Angelina Jolie’s preventative double mastectomy

The lovely actor-turned-humanitarian published an op-ed explaining her decision to undergo a preventive double mastectomy (and probably an oophorectomy in the future). Angelina even allowed—encouraged? Demanded?—her doctor to publish her pre- and post-op treatment plan. The Internet unsurprisingly buzzes with commentary: some support her, some worry her privilege sets an unattainable standard of care, and some are concerned she lopped off two of her most attractive assets. I’m impressed with her openness. While most of us do our best to keep medical information offline, Angelina willingly shared hers, hoping her candor would help other women.

Swimming pools teem with E. Coli

A study conducted last summer in Atlanta area pools showed swimmers were cooling off in more than just water.  E. coli was found in 59% of the pools, and as the CDC says, E. coli is a “fecal indicator.” Uh oh, seems like we need a refresher course in pool hygiene. The CDC gives a good finger wagging, reminding us all to take a soapy shower before swimming and to avoid the pool altogether if we’ve been suffering from diarrhea. Pool staff also should remain vigilant about chemical levels and health departments must enforce regulations.

Newborn tetanus mortality declines dramatically thanks to UNICEF

When women give birth in less than ideal conditions, and non-sterile instruments are used during delivery and to cut the umbilical cord, both the mother and child are at risk of contracting Maternal and Neonatal Tetanus if the mother has not been vaccinated. In the early 1990s, tetanus was identified as one of the most common causes of death for infants. In response, UNICEF partnered with national governments, The Gates Foundation, and many others in order to vaccinate 118 million women. The problem has been eliminated in 31 countries, but the programs in 28 countries are still vulnerable to financial cuts and shifts in political support.

Human embryonic stem cells successfully cloned

Researchers at the Oregon Health and Science University implanted donated eggs with a baby’s skin cells and for the first time, the resulting embryos lived long enough that researchers were able to extract usable stem cells. This development inspires hope that we are on the path toward creating genetically matched replacement organs for those in need and treating patients with rare diseases of the mitochondria. However, the usual suspects (mostly Catholic leaders) have moral objections and call for the elimination of all stem cell research, even though researchers are not creating viable embryos. The promise of healthy lives for children and adults will outweigh these concerns. To paraphrase Jurassic Park: science will find a way.

Questions surface about healthy sodium levels

Federal healthy eating guidelines and the American Heart Association have long encouraged us to keep sodium consumption under 2,300 mg/day and under 1,500 mg/day for anyone who is over 51, African American, or has diabetes, heart, or kidney disease. A new report questions this claim. The link between sodium, blood pressure, and heart disease may be more tenuous than most of us thought. A low sodium diet may have unintended health consequences and may not, in fact, reduce risk of heart attack or stroke. This challenge to nutritional orthodoxy shows that investing in nutrition research is vital to population health and reducing illness and death linked to diet.

I leave you with the song that plays in my head every Friday at 6:00 pm. Have a great weekend!

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