Migraine Doctors in Short Supply Across U.S.

Only 416 specialists available nationwide, study found

By Robert Preidt

HealthDay Reporter

FRIDAY, June 28 (HealthDay News) -- There are too few migraine headache specialists in the United States, a new study finds.

Migraines affect about 36 million Americans over age 12 (more than 11 percent of the population). That's more than the number affected by asthma and diabetes combined. However, only 416 specialists nationwide are certified by the United Council for Neurologic Subspecialties to diagnose and treat migraine, according to researchers.

States with the highest number of migraine specialists include New York (56), California and Ohio (29 each), Texas (25), Florida (24) and Pennsylvania (23). Six states have no migraine specialists, according to the study presented this week at the International Headache Congress meeting in Boston.

States with the worst specialist-to-patient ratios include Oregon, Mississippi, Arkansas and Kansas. The District of Columbia has the best ratio, followed by New Hampshire, New York and Nebraska.

"This is a troubling picture," study leader Dr. Noah Rosen, of the Pain and Headache Center of the North Shore-Long Island Jewish Health System, said in a congress news release. "Migraine is a highly disabling disorder -- the seventh most disabling in the world and the fourth most disabling among women. It's clear that many more specialists need to be trained and certified to meet the need."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Migraine costs the United States more than $29 billion a year in direct medical expenses such as doctor visits and medications, and indirect expenses such as missed work and lost productivity, the release noted.

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Short Strolls After Meals May Lower Diabetes Risk

Walking 15 minutes three times a day was better for blood sugar levels than one 45-minute walk, small study found

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- Older adults at risk for getting diabetes who took a 15-minute walk after every meal improved their blood sugar levels, a new study shows.

Three short walks after eating worked better to control blood sugar levels than one 45-minute walk in the morning or evening, said lead researcher Loretta DiPietro, chairwoman of the George Washington University School of Public Health and Health Services in Washington, D.C.

"More importantly, the post-meal walking was significantly better than the other two exercise prescriptions at lowering the post-dinner glucose level," DiPietro added.

The after-dinner period is an especially vulnerable time for older people at risk of diabetes, DiPietro said. Insulin production decreases, and they may go to bed with extremely high blood glucose levels, increasing their chances of diabetes.

About 79 million Americans are at risk for type 2 diabetes, in which the body doesn't make enough insulin or doesn't use it effectively. Being overweight and sedentary increases the risk. DiPietro's new research, although tested in only 10 people, suggests that brief walks can lower that risk if they are taken at the right times.

The study did not, however, prove that it was the walks causing the improved blood sugar levels.

"This is among the first studies to really address the timing of the exercise with regard to its benefit for blood sugar control," she said. In the study, the walks began a half hour after finishing each meal.

The research is published June 12 in the journal Diabetes Care.

For the study, DiPietro and her colleagues asked the 10 older adults, who were 70 years old on average, to complete three different exercise routines spaced four weeks apart. At the study's start, the men and women had fasting blood sugar levels of between 105 and 125 milligrams per deciliter. A fasting blood glucose level of 70 to 100 is considered normal, according to the U.S. National Institutes of Health.

The men and women stayed at the research facility and were supervised closely. Their blood sugar levels were monitored the entire 48 hours.

On the first day, the men and women did not exercise. On the second day, they did, and those blood sugar levels were compared to those on the first day.

The men and women were classified as obese, on average, with a body-mass index (BMI) of 30. The men and women walked on a treadmill at a speed of about three miles an hour (a 20-minute mile, which DiPietro described as the lower end of moderate).

The walks after meals reduced the 24-hour glucose levels the most when comparing the sedentary day with the exercise day.

A 45-minute morning walk was next best.

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Should Short Boys Take Growth Hormone?

If they're healthy, probably not, experts say

By Amy Norton

HealthDay Reporter

WEDNESDAY, March 27 (HealthDay News) -- Parents often worry when their child, especially a son, is much shorter than average. But as long as there is no medical cause, parents can rest easy, experts say.

Writing in the March 28 New England Journal of Medicine, two pediatric endocrinologists describe a scenario pediatricians see all the time: Parents bring in their 11-year-old son because he's substantially shorter than his classmates, and his growth seems to have slowed in recent years.

Their concern is reasonable, said Dr. David Allen, co-author of the article and a professor of pediatrics at the University of Wisconsin School of Medicine and Public Health in Madison.

In the vignette, Allen and Dr. Leona Cuttler describe a boy whose height was in the third percentile at age 9 years. (That means he was shorter than 97 percent of boys his age.) But his growth rate slowed further, so that he is now in the first percentile for height.

"When a child falls off the growth curve like that, it's appropriate for parents to be concerned and have him evaluated," Allen said.

The potential medical causes include growth hormone deficiency, certain genetic disorders or an underactive thyroid gland. Fortunately, though, most short kids are healthy.

The "conundrum," Allen said, is that parents are often still worried, especially when that child is a boy. And, in the United States, human growth hormone is approved to treat so-called idiopathic short stature -- that is, short stature with no known medical cause -- when a child is below the first percentile for height.

So parents may want costly treatment even if their child has a clean bill of health.

Dr. Patricia Vuguin, a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y., said some doctors will recommend doing nothing. And, "some will say, let's try growth hormone," she said.

But both Vuguin and Allen said it's important for parents to have realistic expectations of growth hormone. For short, healthy children, studies predict that growth hormone will deliver an extra 1 to 3 inches as an adult. And that's the average; other factors come into play.

If both parents are short, that limits what growth hormone therapy can do. "We can't modify your genetic potential," Vuguin said.

The fictional family in Allen's report fit that scenario. The mother was 5 feet tall, while the dad stood at 5 feet 6 inches. Their son's predicted height, with no intervention, was 5 feet 5 inches -- the lower end of "normal."

"You have to think, how important is an inch or two of extra height in the big picture?" Vuguin said. "Is the difference between 5 feet 5 inches and 5 feet 6 inches that important?"

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Calcium and Potassium falling short....

Hello All, 

I am trying to find things to balance all my little sections under the analysis section but I seem to be falling for in the Calcium and Potassium Sections. I know Calcium I can get through more dairy products which I plan on getting some fat free yogurts for that but I have no clue how to get my potassium up any higher without going over my daily calorie limits :/ I do already eat 2 medium bananas a day for potassium but it just doesn't seem to be enough. So any suggestions on these 2 areas would be great.... Thank You :D 

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Flu Vaccine Fell Short for Seniors This Season: CDC

By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 21 (HealthDay News) -- The flu vaccine has fallen markedly short of expectations for older Americans this winter, offering this vulnerable population protection against the most virulent strain of flu virus just 9 percent of the time, U.S. health officials reported Thursday.

Even among the general population, the vaccine's effectiveness was just 56 percent, which is considered slightly below average, according to the latest data from the U.S. Centers for Disease Control and Prevention.

Complicating matters, the 2012-13 season has turned out to be one of the more severe flu seasons in recent years because of the presence of the H3N2 virus -- a strain associated with severe bouts of influenza.

"This was really a worse-than-average flu season," said CDC spokesman Tom Skinner. "It hit the elderly particularly hard. We saw a lot of hospitalizations and, unfortunately, a lot of deaths of the elderly."

"For reasons we don't fully understand, the efficacy rate in those 65 and older against H3N2 was lower than what we would like," he said.

This makes it even more important for the elderly, even if they've been vaccinated, to seek treatment early with antiviral drugs like Tamiflu when they come down with the flu, Skinner said.

Dr. Marc Siegel, associate professor of medicine at NYU Langone Medical Center in New York City, agreed that it's "not an ideal vaccine, but it offers a public health advantage -- it's worth taking."

"The reason this vaccine is not that effective for the elderly is because it's hard for the elderly to mount an immune response," he added.

The vaccine is most effective against influenza B viruses, reaching a level of 67 percent protection both overall and among seniors, the CDC report showed.

"The message is we need better vaccines," Skinner said.

Skinner noted that vaccination is still the best protection against the flu, because even if you get sick the vaccine may make the illness milder.

"If people use these numbers not to get vaccinated, I think that will be a tragedy," Skinner said. "Some protection is certainly better than no protection at all."

The findings were published Feb. 22 in the CDC publication Morbidity and Mortality Weekly Report.

This flu season has caused high hospitalization rates, with seniors accounting for 50 percent of all those admitted for the flu.

"This is the highest hospitalization rate [for seniors] since 2003, and may be the highest ever," Siegel said.

Also, nearly 10 percent of deaths up to Feb. 9 have been attributed to the flu or pneumonia associated with the flu. Again, the elderly were hit the hardest, Skinner said.

Sixty-four children have died from flu this season. That number is precise, because the federal government keeps track of pediatric flu deaths. No such count is kept on adults. Typically, approximately 25,000 Americans die from the flu every year, according to the CDC.

Skinner said this year's flu season started early, but seems to be winding down. "But we'll see if that trend continues," he added.

More information

For more on the flu, visit the U.S. Centers for Disease Control and Prevention.

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Flu Vaccine Fell Short for Seniors This Season: CDC

Title: Flu Vaccine Fell Short for Seniors This Season: CDC
Category: Health News
Created: 2/21/2013 2:36:00 PM
Last Editorial Review: 2/22/2013 12:00:00 AM

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Kids' Tamiflu Still in Short Supply

Feb. 21, 2013 -- With flu season dragging on, supplies of the children’s version of the flu drug Tamiflu continue to dwindle nationwide, according to the drug's maker.

The liquid medicine, called Tamiflu OS (for oral suspension), is approved for children 2 weeks old and older.

It attacks the flu virus, helping to lessen the flu's ability to spread in the body. It must be taken within 48 hours of the first symptoms. In clinical trials, it did not cure the flu, but shortened its length by 1.5 days in kids.

Supplies are spotty. "While we have shipped all quantities of Tamiflu OS to distributors, some retail pharmacies may still have it," says Tara Iannuccillo, spokeswoman for Genentech, the drug's maker.

"However, quantities are limited nationwide," she says.

No additional supplies of Tamiflu OS will be available for this season, Iannuccillo says.

"Given the amount of time it takes to manufacture Tamiflu OS, we don't plan to make more for the 2012/13 flu season, as it wouldn't be ready in time," she says.

However, the adult version is still available. Parents can ask their pharmacist to make a liquid suspension for children using the adult Tamiflu capsules, Iannuccillo says.

Concerns about a Tamiflu shortage began earlier in the season. In mid-January, the FDA warned of upcoming occasional shortages of the children's medicine.

Supplies of Tamiflu for children ran low due the severity of this year's flu season, Iannuccillo says. Compared to past seasons, flu season began earlier this year, according to the CDC.

To ensure continued supplies of the adult version, the FDA is allowing Genentech to distribute 2 million units of the 75-milligram capsules that have an older version of the package insert, says Sarah Clark-Lynn, an FDA spokeswoman.

"These additional reserve supplies of Tamiflu 75-milligram capsules are not outdated," she says. "Only some information included in the labeling is older."

The older labeling does not have dosing information for children aged 2 weeks to less than 1 year, for instance.

The FDA just granted the approval of Tamiflu OS for younger children in December.

Both children's and adults' Tamiflu is $101.50 a package, Iannuccillo says. On average, the co-pay for insured people is $35, she says.

"The vast majority of insurance plans cover Tamiflu, including Medicare and Medicaid," she says. The company also offers a $10 co-pay coupon on its web site, she says.

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Life is So Short

  Photo from Pinterest

My heart is heavy tonight after hearing a dear friend and co-worker lost her father today.

Yes, it is the circle of life.  Yes, it is bound to happen.  Yes, people get old and die and leave us here to mourn and feel the loss.

It doesn’t make it any easier!

There is a woman at work who loves E-V-E-R-Y-O-N-E!  Every child, adult, and person she meets, she has an instant smile for.  She is an encourager, a helper, a friend, a passionate person, a mother, sister, and daughter.   Most of all, she is loved back from all who she comes in contact with!  She is truly living life to the fullest!

In hearing the loss of her father today, I am reminded that life is so short!  I had to ask myself the following questions:

What am I doing to make a difference in the life of others?

What am I doing to impact others for the good?

What have I done to impact the future through each child I came in contact with today?

What am I doing to better my health so I can live as long as possible for those around me?

Now, I ask you.  What are you doing to make a difference and leave behind a legacy when you go?  Life is so short…live it to the fullest!

To our dear Momma Moran…you are in our hearts and prayers this week as you mourn the loss of your father.  I hope you know how much your EV family loves you!  I hope you know what a difference YOU make each and every day to children and adults alike!  During this loss, feel His arms around you and know He is right there beside you.

One List LifeWhen Life Hands you a Cupcake…GIVE IT AWAY!!!!!

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