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October 11, 2017

By MATTIBETH NELSON

Ehlers Danlos Syndrome is a connective tissue disorder that can affect any part of your body. The comorbidies that come with it are growing each year. There are some that are too non specific to pin down so we are depending on research to connect all the dots. In medical school doctors are taught when you hear hoof prints to think horse not zebra making someone with EDS a medical zebra.

Madison, Emma, and Mackenzie Nelson and their mother Mattibeth Nelson.Madison, Emma, and Mackenzie Nelson and their mother Mattibeth Nelson.


As someone who loves her hometown I know our doctors are up to the challenge of learning more about EDS. I have been to the past two learning conferences on Ehlers Danlos Syndrome and have discovered a few things:

*  1. The number of doctors familiar with E.D.S is so scarce that on average people go 5 or more years before they get a diagnosis.

*  2. These patients often have to travel for hours and feel like giving up before having their symptoms are validated.

*  3. The hopes of the new criteria is to serve as a starting point for the EDS (zebra) community.

*  4. This criteria will change as more research is done but we need your help.

 

On March 15th 2017 there was new criteria published for the diagnosis of EDS specifically, hEDS. Although they are searching for the gene mutation at this time, it has not been found so they are relying on a clinical diagnosis. We want to stick local so I implore you to please take the time to read about hEDS and help us stay local.

A program sponsored by EDS awareness.com is now offering free C.M.E.'s for medical professionals. You can sit at home on your computer and get all your C.M.E.'s for free. If that is not enough to interest you then how about this? The number of diagnoses in Louisa is going up and familiar doctors are so full that they are turning away patients.

Our local dazzle (group of zebras) consists of 15 members that have been officially diagnosed to include:

Donna Brady and her daughter, three of my children: Madison, Emma, and Mackenzie Nelson. This list also includes myself now. All residing in Louisa/Prichard area.

There are several in our group that suspect it as well but need more local medical professionals to understand it. Come grow with us. This program is aimed at just the basic explanation of E.D.S. and symptoms that go along with it.

For more information you can go to www.Ehlers-Danlos-CME.org

 

October 8, 2017

On Tuesday, Oct. 10, nations, organizations and advocates will recognize WORLD MENTAL HEALTH DAY. The Kentucky Department of Veterans Affairs (KDVA) works every day to ensure veterans receive the mental health evaluation and treatment they need.

“There are mental health programs for veterans throughout the Commonwealth,” said KDVA Commissioner Norman Arflack, “and we want to make sure that every veteran who may need those programs can find and use them.

“Good mental health is as crucial as good physical health,” Arflack said. “The stigma of seeking mental health treatment is long gone. The only thing wrong is not seeking the treatment you need.”

KDVA’s benefits counselors, who serve veterans in every county of Kentucky, are federally certified and can refer veterans to exactly the services they need. KDVA’s services are always free of charge to veterans.

Find the Veterans Benefits Field Representative who serves a particular county here.

World Mental Health Day is observed on Oct. 10 every year, with the overall objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health. The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.

Find resources and information for veterans at these links:

Connect with KDVA for services and benefit information

Mental Health from the federal VA

Locate your local VA

Other free resources:

Give An Hour

Military OneSource

Mission 22

 

From Kentucky Department of Veterans Affairs

Date: 10-02-2017

A driver crashes into a bus, killing her 1-year-old daughter. She was in a haze from a sedative mixed with medicine meant to curb heroin cravings. A 4-year-old dies after taking his uncle’s pills. A patient in addiction treatment stops taking his medicine, then overdoses and dies.

All of these deaths — blamed on the misuse of the same drug — could have been prevented. Now, two Kentucky researchers are testing a breakthrough treatment that injects addiction medicine straight into the patient’s body, reducing the chance of abuse.

It’s being hailed as a potential “game changer.”

The weekly or monthly injections — called CAM2038 — release buprenorphine over time. Doctors prescribe the narcotic (prounounced bew-preh-nor-feen) to wean patients off heroin or powerful opioid pain pills.

It’s not a new drug. It’s a new, safer way to get the drug into the patient’s body.

For years, doctors have prescribed buprenorphine during medication-assisted treatment to reduce urges for heroin and other opioids that dangerously slow breathing and heart rate. The medicine is the main ingredient in Suboxone, a popular addiction treatment drug.

Buprenorphine also lessens painful withdrawals, which are commonly cited by addicts as an excuse to keep using heroin or other deadly poisons.

Some doctors, patients and their relatives won’t even consider using buprenorphine or other drugs to wean addicts off stronger opioids because of what can go wrong. Dr. Michelle Lofwall, a Lexington psychiatrist who led a national study of CAM2038, said injecting the drug could alleviate most of those concerns.

“This could be a game-changer if it stops the stigma,” she said.

Treatment

First, the proposed injections must win approval by the U.S. Food and Drug Administration. Sharon Walsh, director of the Center on Drug and Alcohol Research at the University of Kentucky, and Lofwall, a faculty member, plan to tout the injections based on their own research when they appear before an FDA panel in November.

If approved, Lofwall said, the treatment could be available as soon as early 2018.

Currently, doctors in Kentucky and Indiana prescribe buprenorphine once a week, twice a week or monthly. Patients are given multiple doses and are supposed to take either a tablet each day or a film that dissolves under the tongue or is placed on the cheek.

The injections are designed to address several current risks of buprenorphine, including:

*   Forgetting to take a daily dose.
This could leave patients more vulnerable to cravings. One relapse can be deadly at a time when heroin and other drugs are being laced with fentanyl. A tiny amount – about the size of Abraham Lincoln’s cheek on a penny – can be lethal.


*   Deciding to stop the pills or films. Some patients who want to go on a bender skip their pills or films for a few days so the euphoric effects of heroin or other strong opioids aren’t blunted.

One of Lofwall’s patients who did this overdosed and died.
“It’s heartbreaking,” she said. “It’s a very unforgiving disorder.
“I can’t help but think if that person had a monthly injection, they would still be alive.”


*   Selling, trading or giving away films or pills. Or leaving the medicine out somewhere it can be stolen.

A North Carolina woman ended up with someone else’s buprenorphine and took a tablet along with a sedative, then got behind the wheel. She lost control in a curve, overcorrected and veered into oncoming traffic, ramming a YMCA bus. The impact killed her 1-year-old daughter.


*  Children could accidentally take the drug if they find the pills or film.

After a 4-year-old Michigan boy found his uncle’s prescribed buprenorphine and swallowed a tablet, the uncle pleaded guilty for his role in the child’s accidental death. He admitted that he failed to get the boy immediate medical care because he didn’t want to get himself or his family in trouble.

Last year, the Kentucky Poison Control Center handled 56 calls about children younger than 6 ingesting buprenorphine, said director Dr. Ashley Webb. Ten more calls involved kids ages 6-18.

Calls to the center’s hotline are voluntary, so the actual number of poisonings is likely much higher, Webb said.

In most of the cases, she said adults left prescription bottles on bedroom nightstands or coffee tables, within reach of children.
Injections would provide a safeguard, said Dr. Ashley Peak, an addiction psychiatrist with the Morton Center.

“It limits the risk of children getting a hold of it,” she said.

‘Not a magic bullet’

Even with injections, some risks remain.

Doctors are concerned about patients combining the medication with alcohol or other drugs. That can be deadly, Peak said, even when mixed with anti-anxiety medicines such as alprazolam, the main ingredient in Xanax.

In one case, a 17-year-old who had an enlarged heart died last year in Jefferson County after taking a buprenorphine film or pill and alprazolam, according to local coroner’s office data.

In another case that resulted in a fatal wreck, an impaired Evansville, Indiana, man crashed his Jeep into a Toyota last year, causing the car to flip on Interstate 64 in Warrick County. The impact ejected a 60-year-old man who died at the wreckage site. The Jeep’s driver had mixed buprenorphine, oxycodone and benzodiazepines.

Still, that’s a fraction of the deaths from heroin and fentanyl – deadly addictions buprenorphine and other medication-assisted treatment are trying to curb. Last year, an average of about one person a day died from an overdose in Jefferson County. Most were from opioids, mainly heroin and fentanyl.

Some treatment centers only promote abstinence-based recovery.
But with relapses common, many people need medication to wean themselves off the powerful poisons, according to a report by the U.S. Substance Abuse and Mental Health Services Administration.

It also recommends counseling and support from family and friends.
Buprenorphine and methadone, also used to treat addiction, trick the brain into thinking it’s still getting the problem opioid, according to the health administration’s Center for Substance Abuse Treatment. The patient feels normal, not high.

If buprenorphine injections are approved, “It’s not a magic bullet,” said Scott Hesseltine, vice president of addiction services at Centerstone, formerly Seven Counties Services. “It just expands options.”

Dr. Mark Jorrisch, medical director of Louisville’s MORE Center, said he has seen many patients regain some normalcy through medication-assisted treatment, maintaining jobs and improving their social and family lives.

“The frequent comparison is diabetes,” Jorrisch said. “There’s a genetic component. You may do all the right things and still need medicine to keep it under control.”

Kentucky researchers’ key role

Before buprenorphine injections gain approval, they need to be tested. And that’s how Kentucky is playing a key role.
University of Kentucky researchers led two multi-state clinical trials that concluded last year.

Both studies were funded by Braeburn Pharmaceuticals, in Princeton, New Jersey, which developed the drug treatment through a partnership with Camurus, based in Lund, Sweden . A similar product by another company also is seeking FDA approval.

Walsh, who has evaluated new opioids used to treat pain as a contractor for the FDA, led a study on CAM2038 conducted at three sites: the University of Kentucky in Lexington, Columbia University in New York City and Vince Associates in Kansas City.

Lofwall led a second study that spanned 36 locations across the country.

Both found that the injections of buprenorphine worked as well as the pills or films in lessening the pain of withdrawals and reducing cravings for heroin and other drugs. Their findings were published in the September issue of theAmerican Medical Association’s monthly journal JAMA Psychiatry.

“If approved, they definitely will provide more options for patients and physicians,” Walsh said.

Jorrisch said he would use the injections with some patients, but not until he first tries tablets or films in case the patient has an allergic reaction or suffers side effects such as headaches, nausea, constipation or sweating. With daily doses, he said, you can stop the medication right away.

Lofwall said, based on her research, she would give it to her own patients.

“It’s a breakthrough,” she said. “It’s something that will give treatment providers one more tool to fight this epidemic.”

By Beth Warren
The Courier-Journal


As summer ends and fall approaches, we begin to hear a lot about the seasonal flu and the importance of getting vaccinated. Influenza, also known as “the flu,” is a contagious respiratory disease caused by the influenza virus, which affects the nose, throat and lungs. Every year in the United States more than 200,000 people are hospitalized because of the flu, according to the Centers for Disease Control and Prevention. Several important steps can be taken to help prevent contracting and spreading the virus.

Individuals who are at high risk for developing flu-related complications should exercise particular caution during flu season. Children under age five, adults 65 and older, pregnant women, people with chronic medical conditions and people who live in nursing homes or long-term care facilities are especially susceptible to complications related to flu.

The best way to prevent getting the flu and spreading it to others is to get a vaccine. It’s best to get vaccinated as early as possible in the season as it takes about two weeks for antibodies to develop after vaccination. For the 2016-2017 seasons, the CDC recommends using an injectable influenza vaccine. Two types of injectable vaccines will be available this flu season:

Trivalent flu vaccine: A three-component vaccination injected into the muscle of the arm. There are several trivalent shots that are appropriate for people 18 and older. High-dose trivalent shots are recommended for people over 65.
Quadrivalent flu vaccine: A four-component vaccination approved for use in different age groups. The intradermal quadrivalent flu shot uses a smaller needle and is injected into the skin instead of the muscle.

Besides vaccination, there are several other things you can do to minimize the risk of catching the virus and spreading it to others. Most viruses spread through direct contact, so it is extremely important to wash your hands regularly in warm, soapy water and avoid contact with face, mouth and eyes. When sneezing, always use a clean tissue and discard used ones, and if a tissue is not available, sneeze away from others.


Using natural methods to help prevent to the flu can also be effective. Staying hydrated and drinking plenty of fluids can help flush out the body. Getting fresh air can also help keep the body hydrated, especially during the cold months when central heat tends to dry out the skin. Exercising regularly and eating a diet high in vegetables and fruits can help increase blood flow and stimulate the body’s natural virus-killing cells.

The seasonal flu virus changes every season, so it is important to stay current with your vaccinations each year. Practicing good cleanliness habits and healthy routines can also help keep you and your loved ones healthy throughout flu season and all year long.


 flu shots part 2flu shots part 2