Staying Safe From The Sun

With Memorial Day behind us, and summer unofficially here, spending more time outdoors and in the sun is likely for most of us. And right now, because indoor socializing has become risky, the safest way to see family and friends will be outside. And let’s face it, fresh air, blue skies and social gatherings, even from a distance, will be the mental boost we could all use. More time in the sun isn’t. A surge in sun exposure isn’t. While we all need some sunshine, it’s one of the best sources of vitamin D, early morning or late afternoons are the safest times to absorb it. The glow of sun-kissed skin may seem like a sign of good health, but sunspots and wrinkles are not the only unwelcome side effects of the sun. The most common cancer in the United States (fortunately also one of the most preventable) is skin cancer, and all it takes is 15 minutes of exposure for unprotected skin to be damaged by the sun’s ultraviolet rays. There are three different types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and the most dangerous and deadly, melanoma. One in five Americans will develop skin cancer by the age of 70 and more than 2 people die every hour of skin cancer in the U.S. Basal cell and squamous cell are the most common forms and make up 95% of all skin cancers; both directly due to a lifetime of sun exposure, but are highly curable when caught early and treated properly. Melanoma is a different story. Malignant melanoma is a highly aggressive cancer and will typically spread to other parts of the body, becoming difficult to control if left untreated. When discovered in its earliest stages, melanoma has a 99% five-year survival rate; if it has metastasized to other organs, the prognosis becomes grim. Skin type, having many or unusual moles, and family history are all factors in developing melanoma, but UV exposure causes the most cases. A history of blistering sunburns and ultraviolet light exposure from the sun or from tanning beds are directly attributable to melanoma. Staying indoors during the suns strongest hours is the most effective way to protect your skin. The use of high SPF sunscreens, shade, and covering your skin is essential for the hours you do spend outside. Protecting your skin and regularly checking your skin are paramount to your overall health. The most common sign of skin cancer is a change on the skin, typically a new mole or spot, or a change to an existing mole. Self-examinations should include the ABCDE rule that tells you signs to watch out for: Asymmetry, Border, Color, Diameter, and Evolution. All changes should be followed up with your doctor, and seeing a dermatologist every year should be a part of your routine exams. While it’s a great time for the great outdoors, do it wisely: avoid the sun. For more information visit: aad.org  

Protecting the Herd

It’s called “herd immunity,” or “community immunity,” and has been making headlines and into everyday conversation among everyday people. As a society we had become so reliant upon it that unless you were among the vulnerable you didn’t think much about it. For most people it meant no more worrying about measles or polio. For those with underlying conditions it was a shield from a potential life-or-death situation. Germs from viruses can make their way quickly through a community. Some are fairly benign as in the case of the common cold. But others can pose a threat to otherwise healthy people, and are a serious cause for concern for those with underlying conditions. Illnesses such as cancer, diabetes, hypertension, autoimmune diseases, or COPD make it harder for a body’s immune system to fight off infection. Treatment for those illnesses can leave a person immune-compromised, leaving them doubly vulnerable. A term created by veterinarians, “herd immunity” is defined as “the indirect protection for a contagious infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection.” Meaning that even if a person can’t be vaccinated, they are protected because those around them are immune, therefore not passing along disease. Eventually, once herd immunity is established, diseases can become rare or eradicated, as in the case of smallpox. Prior to the middle of the 20th century, thousands of people died from measles, mumps, polio, whooping cough and rubella. Natural herd immunity, achieved through infection, was challenging to induce without a lot of serious illness and death. Once vaccines were developed we saw those diseases nearly eliminated. Widespread adoption of vaccines protected individuals and the community at large. In recent years people choosing not to vaccinate, “anti-vaxers,” have garnered attention as measles and whooping cough and other diseases have crept their way back into our population, leaving the vulnerable exposed to old threats. But COVID-19 has brought the discussion of vaccines and herd immunity to the forefront, ringing the bell and giving us a harsh reminder of why they are so vital. This novel virus has halted work, altered lifestyles and damaged economies worldwide. Here in the U.S. it’s responsible for the loss of tens of thousands of lives in a matter of weeks, and confounded the scientists we assumed could protect us from disease. Some believe that relying the development of natural herd immunity is the way forward, but scientists warn that millions more people will be lost if that’s the path. Developing herd immunity is challenging. Scientists at the NIH believe that this particular virus will need 70% or higher population immunity to develop herd immunity and that it won’t be reached until 2021 at the earliest. We can all live in hope that herd immunity will magically develop, but without widespread adoption to vaccines we may not achieve it without suffering devastating loss of life. A vaccine is critical to achieving it and to saving lives.  

The Struggle is Real. So is the Stigma.

“Suck it up.” “Get a grip.” “Snap out of it.” Anyone who suffers from a mental illness has likely heard these words at some point in their struggle. But what’s offered as well-meaning advice often contributes to the self-doubt and feelings of shame that can come as a result of living with these conditions. If it were as easy as putting on a happy face, mental illness wouldn’t be the leading cause of disability in the United States. And though the discussion has become more open and the understanding of these conditions has grown, the reality is that literacy is still low and stigma and social exclusion remain. Tell someone you have cancer and they’ll bring you lasagna. Tell them you’re struggling with mental illness…don’t wait for dinner. May is Mental Health Awareness Month and a great time to get educated. Historically mental illness was a source of shame. Families didn’t want to acknowledge it, much less address it. A loved one struggling was often hidden from the world and labeled by outsiders. Ignorance and misinformation continue to fuel the stigma attached to many of these disorders, leaving people who suffer reluctant to get help, often resulting in delay in treatment. The National Alliance on Mental Illness defines mental illness as “a condition that affects a person’s thinking, feeling, behavior or mood.” Day-to-day living is often profoundly impacted by these conditions, as well as relationships. One in five adults in the U.S. experience mental illness each year. One in twenty-five adults experience serious mental illness each year, and one in six children between the ages of 6-17 will also experience a disorder each year. Some of the more common mental health disorders are: anxiety, depression, bipolar disorder, obsessive compulsive disorder, and eating disorders. Mental illness is no one’s fault and isn’t the result of one event. Genetics, environment, and lifestyle all contribute to whether someone develops a mental health condition. Stress, traumatic events, and brain chemistry can all play roles. Common signs include: excessive worry or fear, feeling low, problems concentrating, extreme mood changes, difficulty with relationships, substance abuse, suicidal thoughts, and intense fear of weight gain. Some people have mild illness while others might suffer from an eating disorder that can lead lasting damage to bones, organs, or even death. Other conditions can lead to homelessness or suicide. Living with a mental illness is hard and presents a range of challenges, such as side effects from medications. Add to that the feelings of frustration and inferiority that often go along with it. Many countries offer programs to help young people gain basic knowledge and skills for protecting their mental health and understanding mental health issues. Research shows early detection and intervention improves prognosis for severe mental illness. Promoting mental health awareness is important to building positive responses and seeking help. Opening your mind and your heart may help someone you know or love get the help they need.  

Celebrating Nurses

Approaching each day with dedication, commitment, and compassion are some of the hardest working and trusted among us. Never before have we collectively been reminded of their selflessness and devotion. If there’s ever been a time to recognize and celebrate nurses, this is the year.  As it happens, 2020 is the 200th birthday of Florence Nightingale and was already declared the global “Year of the Nurse and Midwife.” This May, a month that typically includes a week for recognizing nurses, the celebration goes on all month. They’re with us from birth to death; the first person to care for you when you enter a hospital and the last to see you before you leave. Nurses not only administer most of your medical treatment during a stay, they nurture you, encourage you, provide a warm smile, a hand to hold, and often a shoulder to cry on. If doctors treat the patient, nurses treat the person. Since the COVID-19 pandemic began, we’ve seen their images across television screens and newspapers. The faces, or really just the eyes, of tired, tested, but devoted people who are fighting a nontraditional war against a new and mysterious enemy. Some have come out of retirement to help and others have traveled to hot spots to bring relief to their peers. In a profession that could be described as more of a calling than a career, these front-line workers are sacrificing themselves to help and heal us all. But not all nurses work in hospitals. They serve in a variety of healthcare settings, playing significant roles in private practices, schools, nursing homes, as well as at-home care. They run immunology clinics, blood drives, public health seminars, and general health screenings. Nurses not only take care of the sick or injured, they are also responsible for promoting the overall good health of individuals, families and communities. Many are academics, involved in healthcare research, management, policy deliberations, and patient advocacy. Their hours are often erratic and typically long. Nursing dates back to the earliest times, but Florence Nightingale professionalized it with her pioneering work beginning in 1851. Florence was a well-educated girl from a wealthy British family who made what was considered a radical decision in choosing to care for the sick and the poor in hospitals or their homes. Other young women in her class traditionally only cared for family or intimate friends, but Nightingale believed that a woman with her scientific knowledge and education could help dramatically improve the health of patients. At the same time she blazed a path to personal freedom and an independent career option for all women. Making up the largest health care occupation in the United States, there are more than 2.9 million nurses here and millions more worldwide. Today the demand for nurses remains high, and with advancements in healthcare technologies and healthcare systems, and the potential for further health crises, we can expect the need for nurses to increase. Chances are pretty good a nurse has touched your life in some way. Take this month to thank one.  

May is Vasculitis Awareness Month!

Vasculitis? What is it and why should you care? Indeed vasculitis is a rare disorder, one you may have never heard of and one that you likely will never personally develop. But the disorder includes nearly twenty different rare autoimmune diseases and at some point, you or someone you know or love may be faced with it. Awareness may help you recognize its symptoms, address them and perhaps save a life. Vasculitis is a general term for inflammation of the blood vessels. Inflammation that causes narrowing, weakening and scarring, and can restrict blood flow and possibly cause damage to vital organs and tissue. The diseases in the vasculitis family are counted among many other autoimmune illnesses where an overactive immune system mistakenly attacks it’s own healthy cells. Some of them, without treatment, are life threatening. Up until the seventies, several forms of vasculitis were almost always fatal. That was until a young doctor began working on it with his mentor; examining it in their work at the National Institutes of Health, Dr. Anthony Fauci, (yes, that Dr. Fauci), and Sheldon Wolff were asked to also consult on cancer treatment for patients at the National Cancer Institute. The powerful forms of chemotherapy that were being used had the side effect of suppressing the immune system. Fauci realized that perhaps, vasculitis patients would also benefit from the same drugs at a lower dose. By utilizing the same chemotherapy, they were able to put patients in remission with these life saving measures. The more severe forms of vasculitis usually require lifelong medical care, but today, patients can live long and relatively normal lives. Some forms are mild and may improve on their own. The diseases are categorized by the size and location of the vessels that they affect. Many share similar symptoms and treatments, but each is distinct and needs to be treated specifically. Among these diseases are:  Goodpasture’s Syndrome, Behcet’s Disease, Kawasaki Disease, Polyarteritis Nodosa, Granulomatosis with Polyangiitis, Rheumatoid Vasculitis, and Takayasu’s Arteritis. The different symptoms of the different forms of vasculitis can be mistaken for other illnesses, some appearing very benign, but could signal serious illness: chronic congestion and/or sinus and ear issues, headaches, rashes, eye pain and redness. Other symptoms such as fever, muscle or joint pain, excessive fatigue or weakness, lack of appetite or weight loss, abdominal pain, shortness of breath, a lingering cough or coughing up blood, abdominal pain, neuropathy, and bloody or dark colored urine can be alarming. Some experience mild symptoms of the same illness that may strike another person aggressively. Vasculitis can affect anyone at any age, and usually affects women and men equally. While some forms may be more common among certain age or ethnic groups, none are exclusive to any one group. Diagnosing these diseases can be challenging, and so finding the right doctor is paramount to finding the right treatment. After a full exam, and depending on symptoms, doctors may order a variety of lab work or imaging, biopsies or lung function tests in order to accurately diagnose and confirm their diagnosis before beginning treatment. Once diagnosed, a team approach with several specialists is typically recommended depending on the organs involved. Vasculitis is rare, but there’s a good likelihood you’ll know someone living with it. Awareness leads to knowledge and that’s always a good thing. For more information visit: VascultisFoundation.org    

Hope Trust serves clients throughout the United States.