Oncologist Offers 7 Tips for Increasing Awareness

Not too long ago – just after World War II – few people in the United States brushed their teeth with any regularity. Now, the mere thought of going an entire day or night without brushing one’s teeth is simply out of the question for most. Hopefully, someday in the near future, a similar attitude will prevail regarding mental well-being, says Dr. Matt Mumber, an oncologist and author of “Sustainable Wellness: An Integrative Approach to Transform Your Mind, Body, and Spirit,” (www.sustainablewellnessonline.com), coauthored by Yoga therapist Heather Reed.  “Human happiness and well-being are rudderless without awareness, which I define as the quality of paying attention to what’s going on in the present moment from an inquisitive, nonjudgmental and focused perspective,” he says. An easy way to think of optimal wellbeing might be to envision a three-legged stool, says Reed. “The three legs include physical activity, nutrition and that underappreciated component missing from too many Americans’ lives – stress management, or a healthy mental state,” she says. After checking off a healthy diet and exercise from the list, how does one go about ensuring a healthy mind? Mumber and Reed say the key is mindfulness, which they define as paying attention on purpose, non-judgmentally and as though your life depended on it. Framed another way, mindfulness means focusing on something without trying to change it, like the sky holding passing clouds without clinging to them.

They describe the states necessary for attaining mindfulness:

• Beginner’s mind is the ability to see things with new eyes. The Bible warns against putting new wine in old wine skins – doing so risks tainting the new stock. A beginner’s mind opens people to the world of possibilities that exist in the present moment. That does not mean throwing away good ideas from the past; rather, it means to entertain new ideas with a truly open sensibility.

• Trust: Believe in your authority to know your own body, thoughts and feelings. We need to have the confidence necessary to trust that our thoughts and feelings at any given moment have value.

• Non-judging is the ability to see things for what they are, to hold an open and neutral place for whatever comes up within and around you, without thinking of anything as categorically better or worse than anything else.

• Patience is a willingness to continue with the process of paying attention on purpose even when it appears that no progress is being made. Learning and growing through mindful practice happens with time, and we can’t force the outcome.

• Acceptance refers to allowing whatever comes up in the moment to be held in our field of awareness. This is not the same as giving up or being passive; acceptance is merely acknowledgement.

• Letting go is refusing to attach to specific thoughts, feelings or behaviors. This can feel like losing something, but every time we let go, we open ourselves to something new and, potentially, deeper.

• Non-striving: In our goal-oriented society, this may seem counterintuitive. However, non-striving refers only to practicing mindfulness without expectation of some future goal or dream, which helps us better live in the now.

“By having our three-legged stool firmly planted in awareness, we can drop into what we typically call a sense of spiritual wellbeing,’ says Mumber.

HOUSTON

Dr. Anthony Maresso, assistant professor of molecular virology and microbiology at Baylor College of Medicine in Houston, answers questions on ricin:

Q:  What is ricin?

 Ricin is a protein toxin.  It is not an infectious agent, so it is not believed to be able to spread from person to person.  If it enters your body, it can enter into your cells and when it does so, it can prevent proteins that your body wants to make from being made, which is very toxic.

Q:  How are you exposed to ricin?

There are a number of ways you can be exposed to ricin.  One way is through inhalation, meaning that you breathe it in.  Eating or ingesting the toxin would be gastrointestinal exposure and then there’s the direct injection into your body.  The concern with what has happened in Washington, D.C. would be inhalation exposure to ricin protein toxin being sent via the mail.

Q:  Where is ricin found?

Ricin comes from the castor bean plant. It’s possible to obtain the beans and isolate the toxin and use that for harmful purposes.  However, this is a very crude way to isolate the toxin and I suspect that what’s happened in Washington, D.C. is very crude.

Q:  Is this similar to the anthrax scare?

This is very different from the anthrax scare in 2001 where the spores of the bacterium B. anthracis, which causes anthrax and are infectious, were made to be distributed and more easily aerosolized.  It’s much harder to get ricin intoxication through a letter than it is to get an anthrax infection through inhalation of spores, which is a bacterial infection.  That’s not to diminish the concerns for safety and the impact of this event, just that it is more difficult to be intoxicated with crude ricin than it is a specially formulated spore of anthrax.

Q:  Is it always toxic?

It’s thought that enough ricin of the size say of a few salt grains is enough to kill an adult human being. Relative to botulinum toxin, it is less toxic but it is much more toxic than many other proteins or protein toxins.

Q:  What are the symptoms if you are exposed to ricin?

Inhalation symptoms manifest three to six hours after breathing it in (and you have to breathe in a significant amount), include:

-Shortness of breath

-Pain or tightness in the chest

-Cough

-Nausea or vomiting (especially if ingested)

-Fever If untreated, a person can succumb or die from ricin intoxication in about three to five days.

Q:  What is the treatment?

The treatment for ricin exposure is supportive, meaning that the symptoms you are experiencing are treated.  This can include intravenous fluids or pumping of the stomach (if ingested).  There is no known vaccine or antidote that is readily available to the public.

Q:  Can it spread from person to person?

If you are exposed to ricin and it’s in your clothing or hair, it’s very low probability (not likely) that it can be transferred from one person to another.  If you are experiencing symptoms of exposure to ricin, you cannot transmit to another person.

Q: How do you detect ricin?

There are measures in place that the government uses to screen for this, but those are not available to the general public.  However, it’s important to avoid all suspicious powder-like material, regardless of its color or texture.

Q:  What should you do if you think you are exposed to ricin?

If you know you’re exposed via aerosol, immediately leave the area and get fresh air as soon as possible.  If you believe it’s on your clothing the general recommendation is to remove the clothing, preferably by cutting the clothing off rather than pulling it over your head. Take a shower and thoroughly rub your body with soap for 10 to 15 minutes and wash your hair as well.  Immediately contact emergency personnel.  Don’t manipulate, handle or touch any suspicious packages or letters that you do not recognize.

Q:  If it’s detected in an area, or there is a suspicion of ricin, who needs to evacuate?

Do not manipulate, handle, or touch any suspicious packages, letters, or material suspected of containing ricin or powder-like material. Contact emergency personnel immediately. If exposure is in a single room, other parts of the building may be contaminated, and the entire room or building should be evacuated.

Q:  Any additional information you would like to add?

The Center for Disease Control and Prevention (www.cdc.gov) is a good resource to learn more about ricin. Relative to some other toxins, the amount of ricin needed for death is much higher and exposures of this sort are usually with a crude preparation, which in and of itself is not usually very potent.  However, all the normal procedures for handling or staying away from suspicious packages and letters should be applied.

At rare, extremely high blood glucose levels (1024 mg/dL and above), the FreeStyle lnsuLinx Blood Glucose Meter may provide an inaccurate reading

April

Abbott announced it is initiating a voluntary recall of FreeStyle lnsulinx® Blood Glucose Meters in the United States. The company has determined that at extremely high blood glucose levels of 1024 mg/dL and above, the FreeStyle lnsulinx Meter will display and store in memory an incorrect test result that is 1024 mg/dL below the measured result. For example, at a blood glucose value of 1066 mg/dL, the meter will display and store a value of 42 mg/dL (1066 mg/dL - 1024 mg/dL = 42 mg/dL). No other Abbott blood glucose meters are impacted by this issue. Blood glucose levels at 1024 mg/dL and above are very rare. However, if high blood glucose levels of 1024 mg/dL and above do occur, they are a serious health risk and require immediate medical attention. As the FreeStyle lnsulinx Meter can display an inaccurate low result at a blood glucose level above 1024 mg/dL, there may be a delay in the identification and treatment of severe hyperglycemia, or incorrect treatment may be given.

This could lead to serious injury or death. Customers who are using the FreeStyle lnsulinx Meter should immediately take one of the following actions to address this issue with their meter:  

• Customers can access a software update to resolve the issue at www.freestyleinsulinx.com/swupdate. The software update will allow customers to maintain settings and historical data on their meter.  

• Customers can contact Abbott Diabetes Care Customer Service at 1-866-723- 2697 to expedite return and replacement of their FreeStyle lnsulinx meter at no charge. Replacements are available, and Abbott will send meters to customers immediately upon request.   Until customers are able to update the meter software or until a requested replacement meter arrives, the current FreeStyle lnsulinx meter may be used; however, if patients experience symptoms that are not consistent with their readings, they should contact their healthcare professional and follow his or her treatment advice. "Our first priority is to safeguard the health and safety of patients," said Heather Mason, Senior Vice President, Diabetes Care, Abbott. "We are committed to ensuring that our customers are able to continue to test their blood glucose with confidence, and we initiated this voluntary recall to ensure our products continue to meet the highest standards of quality and safety. We regret any inconvenience this action may cause." The company is notifying all registered users, healthcare professionals, pharmacies and distributors where the FreeStyle lnsulinx Meter is sold. Abbott estimates that there are approximately 50,000 active FreeStyle lnsulinx Meter users in the United States. Upon identifying the issue, Abbott promptly developed and implemented an update to the meter.