Presentation: Celebrating Minnesota’s African American Photographers and Artists

Saturday February 17, 2018

This presentation will take place at the Minneapolis Hennepin County Library, 300 Nicollet Mall.

Presenters include: Olivia Crutchfield, Bruce Palaggi, Gilbert Baldwin and Dr. Charles Crutchfield III.

The time of this event is 11 am – 1 pm.

The George Scott Trio will provide entertainment, and refreshment will be served. The Pollination Project Foundation will sponsor entertainment and refreshments.

Spotlight on Minnesota’s Black Community Project  

Newly approved drug a trail-blazing approach to cancer treatment

The FDA just approved a new revolutionary drug for the treatment of cancer. The medication, Vitrakvi (larotrectinib), is unique in that it treats the geneticbasis of what is driving cancer and not the type of cancer once it hasdeveloped.

The mutation that causes cells to become cancerous is found in many different types of cancers. So, this new treatment is not just for one cancer but may treat many different types of cancer. This is avant-garde thinking.

Vitrakvi (larotrectinib) is manufactured by Bayer and is available in pill and liquid forms. It can treat cancers in children and adults, but it isn’t cheap. For adults, the medicine is just under $400,000 per year. In children, the cost is about $135,000 per year.

How does Vitrakvi (larotrectinib) work?

This drug works by blocking a specific mutated enzyme (tyrosine kinase) in cancer cells. When present, this defective enzyme causes cancerous growth in many different types of cancer.

Why is it revolutionary?

Vitrakvi (larotrectinib)is one of the first drugs of its kind that focuses on treating the genetic basis of cancer, not just the type of cancer. That is, it goes after the switch that turns a normal cell into a cancerous cell.

By analogy, there are many types of car manufacturers. Instead of trying to treat a single entity, like a Chevy or a Ford or Honda, this medicine focuses on treating the force that makes the cars go — the engine!

As a result, this radical approach has the potential of treating many kinds of cancers (all cars have engines) rather than a specific type of cancer (Chevy, Ford or Honda). This groundbreaking approach has a much broader potential in the war against cancer. By developing the ability to stop the engine of any car, there is the potential of stopping many different types of cars from running, which supports the analogy of fighting many kinds of cancer.

Since it is FDA-approved, will insurance cover it?

Yes and no. The drug has a broad appeal and the benefit of treating both children and adults.  Unfortunately, the price tag is astronomical.

Medicare and Medicaid are not covering the medication yet, but it is hopeful that they will.  If they do, third-party payers usually follow suit, but once again, due to cost, any and all insurances may have restrictions, limitations, and only partial coverage. Insurance coverage, of course, will improve as the price comes down.

If someone has cancer, how do they discover if this medicine will work for them?

The appeal of this medication is that it works in many different cancers both in children and adults. This fact, by itself, is remarkable and substantial.

Unfortunately, the type of genetic mutation that drives these cancers represents only a small percentage of overall cancers, probably less than five percent. So, it certainly won’t work in all cancers. But when it does work — and it has already helped many patients in the tests and trials — some patients have experienced remarkable results.

We currently don’t know which cancers will respond. Fortunately, tests will be available to see if a person’s cancer is responsive to this new treatment. A person’s cancer will be mapped for mutations. Once the mutations are discovered, any available medications that attack that mutation can be employed.

Hopefully, over time, we will build a bigger and bigger army of medicines that attack a wide variety of genetic mutations that cause a wide range of cancers located anywhere in the body. Unfortunately, these tests are new, expensive and challenging. They will very likely get better and less costly on a rapid and regular basis. Regardless, people should get tested, because we now have a revolutionary and effective treatment for select cancer patients.

The future of cancer treatment

Vitrakvi (larotrectinib) is the first medication designed specifically to attack cancers based on the gene mutations that make them malignant and not where they occur in the body or the type of tissue the cancer comes from. We will no longer treat the tissue where cancer comes from; we will address the DNA mutation that causes a cancer in the first place.

Calling a cancer by the mutation that causes it and not the tissue or organ it comes from, such as breast or prostate cancer, is a trail-blazing approach in the treatment of cancer. It now shifts our thinking and focus when it comes to treating and curing cancer. This new view is the future of cancer treatment.

We no longer need to consider or call cancer the name based on its tissue type. We will now look at cancers based on the gene mutations that drive them. These very mutations can then be detected, and drugs can be designed and selected to attack the mutations.

Attacking the genetic cause of malignancy has been the Holy Grail for cancer treatment, and we are now about to sip from the cup. The future has never been brighter for the war on cancer.

Related content:

New advances in the war on cancer: living cell therapy

What is cancer?

Good news: we are winning the war on cancer

Carbon monoxide is a silent winter killer

Carbon monoxide is a very sneaky killer. The poisonous gas has no odor, no color, no smell, and no taste.

Carbon monoxide is a gas given off by everyday fuel-burning items that we regularly use. Usually, using appliances is not a problem, but if there is improper ventilation in an area where an engine or other devices are burning carbon monoxide-producing fuels, carbon monoxide can build up to dangerous levels. Humans in the area can breathe it in and become poisoned.

Breathing in smoke from a house fire can also cause carbon monoxide poisoning. Because carbon monoxide is odorless, colorless and tasteless, a person can be exposed to it and not even know it.

This situation is especially dangerous for people who are sleeping or intoxicated. Carbon monoxide poisoning can more easily affect unborn babies, children, elderly adults, and persons with heart conditions.

The way carbon monoxide poisons a person is that the carbon monoxide molecule binds to hemoglobin in our blood, preventing the usual binding of oxygen to hemoglobin. Our blood typically carries oxygen to all the cells in our body. Without oxygen, our tissues and organs can become damaged and even die. A fresh and constant supply of oxygen is essential for life.

Every year, 16,000 people are rushed to the emergency room with carbon monoxide poisoning. Over 500 people die from it every year in the U.S. Most deaths from carbon monoxide occur in the winter, especially December and January.

The experts suspect that the numbers of deaths from carbon monoxide poisoning are much higher due to under-reporting. Less than 15 states require the reporting of carbon monoxide deaths, there are no good autopsy tests for carbon monoxide poisoning, and coroners rarely suspect it as a cause of death.

When certain fuels are burned, they will produce carbon monoxide. Common fuels that can produce carbon monoxide when burned include:

  • Gasoline
  • Wood
  • Propane
  • Charcoal

Common producers of carbon monoxide include:

  • Gas furnaces
  • Charcoal grills
  • Automobiles
  • Propane stoves
  • Portable generators

The symptoms of carbon monoxide poisoning are common and non-specific. They include:

  • Headaches
  • Nausea and vomiting
  • Weakness
  • Lightheadedness
  • Fatigue
  • Dizziness
  • Blurry vision
  • Shortness of breath
  • Confusion
  • Loss of consciousness

Depending on how much carbon monoxide one is exposed to, the results of carbon monoxide poisoning can cause:

  • Severe illness
  • Irreversible brain damage
  • Heart damage that can be life-threatening
  • Death of an unborn baby in pregnant mothers
  • Death

To prevent carbon monoxide poisoning, the Centers for Disease Control and Prevention suggests:

  • Annually, have a certified technician check your furnace/heating systems, water heaters, and other gas-burning appliances. Your utility company can help you with this.
  • Install carbon monoxide detectors on all levels of your home and outside of sleeping areas. Change the batteries with daylight saving time changes, twice per year. If the alarm goes off, leave the area immediately and call 9-1-1.
  • Seek immediate medical attention if you suspect your ill-feeling, dizziness or nausea is the result of being near a fuel-burning engine or appliance.
  • Never use a generator, a camp stove, charcoal grill, or any other fuel-burning device inside a home.
  • Never use fuel-burning devices near a window even if they are running outside.
  • Never run an automobile inside a garage, even if the garage door is open.
  • Never use solvents inside. Many can produce fumes that can break down into carbon monoxide, especially solvents used to thin and clean varnish and paint. Use only in a well-ventilated area.
  • Never burn anything in a fireplace if it is not properly open or vented to the outside.
  • Never use a gas oven to heat your home.

The treatment of anyone with carbon monoxide poisoning includes getting into fresh air and getting medical help immediately. At the hospital, treatment may require breathing pure oxygen or even placement into a special pressurized oxygen treatment chamber.

Carbon monoxide poisoning is a life-threatening medical emergency. It is a silent, poisonous killer that is common in the winter or anytime one is around burning fuels. If you think you or someone you’re with may have carbon monoxide poisoning, get into fresh air and seek emergency medical care immediately by calling 9-1-1.

Katlyn H., CMA, Answers 5 Questions – Crutchfield Dermatology Skin & MediSpa

Crutchfield Dermatology spa esthatician
Katlyn H.

Favorite TV show?

The Good Life

Favorite skin care product?

Neostrata Smooth Surface Daily peel pads followed by Dr. Crutchfield’s Natural Face Cream!

If there’s one thing you wish people did for their skin, what would it be?

Stop worrying too much about what you’re cleansing with and just keep it simple. Cleanse WELL to give your skin a good base before putting anything on your skin and never skip a moisturizer!

When and why did you decide to enter the Dermatology World?

5 years ago I started my Career as a Medical Assistant and it was pure luck that I ended up here, but I cannot imagine not working with skin now!

What’s your favorite Treatment and why?

HydraFacial because it is simply great for anyone. The afterglow and fresh feeling is addicting!

What are my beauty must haves in your purse? 

Jane iredale Lip drink lip balm in color “flirt” and Aquaphor ointment for additional lip moisture!

Experts agree: More activity, exercise mean better health

Last week, the federal government came out with new recommendations for exercise and health. It is the first update issued by the government on exercise in 10 years.

A unique new position of the proposal by the U.S. Department of Health and Human Services (HHS) is that exercise, even in small amounts, can make a big difference. “Sit less and move more. Whatever you do, it all matters,” said Brett P. Giroir, assistant secretary for the HHS, in a recent interview.

The new guidelines are much more flexible. Previously, they said exercise should take place in blocks of at least 10 minutes. Not anymore. Even brief periods of activity, including housework, can count toward the overall daily total.

The report, published in the Journal of the American Medical Association, also states ongoing concern that the minimum goals of exercise are not being met by 80 percent of Americans, and almost 40 percent of Americans are obese.

The new exercise guidelines (for adults) cite 150 to 300 minutes of moderate-to-intense activity per week or 75 to 150 minutes of vigorous-to-intense activity per week. Additionally, two days per week should include muscle and bone strengthening activities. For older adults, balance-improving work should occur weekly, too. These are goals consistent with the 2008 recommendations.

Moderate-to-intense activities include:

  • Brisk walking
  • Raking leaves
  • Vacuuming
  • Playing volleyball
  • Casual swimming
  • Casual biking
  • Dancing
  • Softball

Vigorous activities include:

  • Jogging
  • Running
  • Intense fitness class
  • Intense biking
  • Intense swimming
  • Basketball
  • Intense dancing
  • Carrying heavy groceries
  • Active soccer

Recommendations for kids and teens (ages 6-17) call for at least 60 minutes of intense or vigorous activity daily, combined with three days per week of muscle-strengthening exercises. New to the guidelines are exercise recommendations for preschoolers, ages three to five. The report calls for three hours of daily activity for this group too. Activity means active play.

One parent reports a successful way to pull children away from screen time is to structure active play with other children and in groups settings. Have their friends over and let them play without devices/screens.

Experts state that overweight preschoolers often continue to be overweight children, and the continued obesity becomes harder and harder to correct over a lifetime. The health status and activity level of small children, unchecked, can chart a course for decades.

The report also has exercise guidelines for pregnancy, for the post-partum period, and with disabilities as detailed in the reference provided below.

Doctors say that since the 2008 report, we have come to confirm and understand more than ever how vitally important movement and exercise are for our overall health benefits. Increased movement and exercise show improvements in:

  • Sleep
  • Cancer prevention (especially bladder, colon, esophagus, stomach, breast, endometrium, kidney and lung)
  • Anxiety
  • Depression and post-partum depression
  • Emotional health
  • Bone health
  • Cognitive function and academic success
  • Balance and fall prevention in older adults
  • Diabetes
  • Weight control and healthy weight maintenance

Researchers report that every year in the United States alone, we spend over one billion dollars in healthcare costs related to the problems of inactive lifestyles. Experts say that even exercising one day a week can have profound health effects.

“Being physically active,” the guidelines reports, “is one of the most important things people of all ages can do to improve their overall health.”

Remember, a journey of 100 miles begins with a single step. Talk to your doctor or a physical fitness expert to get started on an exercise program today. Think about including the whole family. Starting at just a few minutes a day and building on that foundation can have fantastic quality-of-life and health benefits for you and your family.

 

Reference: The Physical Activity Guidelines for Americans, bit.ly/2P2HlRz

All About Colds

How to lessen their frequency and ease their symptoms

It’s that season again — cold season! Let’s talk about what a cold is, how to prevent them, and how to treat them.

A cold is a viral infection of your sinuses/nasal passages and
throat. Sometimes it can spread into your deep throat and cause
bronchitis.

There are over 99 different viruses that can cause a cold. Because
colds often affect the nasal passages, most of the viruses that cause
colds are “rhinoviruses”; the term “rhino” means “nose.”

There is no cure for colds, so one must let a cold “run its course.” Most colds last about four to seven days.

The difference between a cold and the flu is that colds are not as
severe, don’t produce high fevers, and don’t cause significant tiredness
or fatigue. There are measures one can take to prevent the number of
colds one gets and to treat the symptoms if a cold develops.

Common cold symptoms

  • Stuffy nose
  • Runny nose
  • Sore throat
  • Coughing
  • Sneezing
  • May have mild fever
  • May have mild fatigue-tiredness
  • Nasal pressure
  • Watery eyes

Prevention

The best way to treat a cold is to prevent it in the first place. Some things that help to prevent colds include:

  • Hand washing. This is the most important thing you can do to prevent
    colds. Wash hands for at least 30 seconds. Some people sing “Happy
    Birthday” silently, twice, as a timing device as they wash their hands.
  • Get a flu shot or mist every year.
  • Don’t touch the faucet handles or doorknobs in public restrooms. Use
    a towel to turn the water off and your elbow to open the door.
  • If a sink is not available, use hand sanitizing gels.
  • Don’t cough into your hand; cough into your elbow.
  • Don’t touch your food with your hands; use eating utensils.
  • Get plenty of rest.
  • Eat healthy, including a daily multivitamin.
  • Clean commonly encountered surfaces regularly with disinfectant
    sprays. This includes bathroom surfaces, cell phones, doorknobs,
    refrigerator handles, steering wheels, and other commonly touched door
    handles.

Treatment

There is no cure for the common cold, so reducing aggravating
symptoms is the goal. Because colds are caused by a virus, classic
antibacterial antibiotics are useless. The following are steps to reduce
symptoms:

  • Take a pain reliever such as Tylenol, Ibuprofen or aspirin. Talk to
    your doctor before giving any child with cold symptoms a fever aspirin;
    unwanted side effects can occur.
  • Use nasal decongestant sprays. These work well to ease breathing but
    should only be used for two or three days. If used too long, the user
    can develop dependence.
  • Use cough medicines. This includes throat lozenges and liquid
    syrups. These will make you feel better, but they won’t resolve a cold
    any sooner.
  • Drink lots of fluids. Sports-like drinks, fruit juices, and warm tea
    and broths work well.  Chicken soup has been proven to make cold
    sufferers feel much better. Avoid alcoholic beverages or anything that
    can cause dehydration.
  • Take Vitamin C. 1000 milligrams a day for three to five days has been reported to be helpful.
  • Calm the throat. For sore throats, gargling with warm salt water or throat lozenges works well.
  • Get plenty of rest. Don’t over-extend yourself; allow your body’s immune system to strengthen and fight back.

We all get colds. It is a part of living. Hopefully, this information
will lessen their frequency and symptoms. Remember, if you are
concerned about any illness, contact your doctor immediately.

Tinnitus: common, constant, incurable — but very manageable

Dr. Crutchfield, my sister told me recently that she was suffering with severe ringing in her ears. Her doctor told her it was something called ‘tinnitus.” What is tinnitus?

Great question. I’ve asked one of my colleagues, Inell Rosario, MD, an
expert on the subject, to enlighten us with a discussion on tinnitus
this week.

Dr. Rosario: Tinnitus is a fairly common medical malady that afflicts
many people in mild forms, although they may not always be aware of it.
As many as 50 to 60 million people are affected by a phantom ringing,
whistling or buzzing noise that is usually only perceived by them. A
much smaller percentage (usually one to two percent) describes the
condition as debilitating and, although there is no cure, must seek
treatment to see a significant impact on their condition and to live a
normal life.

Most of the time, the cause of tinnitus is unclear. In the absence of
damage to the auditory system (such as head or neck trauma), things
like jaw-joint dysfunction (TMJ), chronic neck-muscle strain, and
excessive noise exposure have been suggested as causes. Certain
medications can also cause tinnitus, which, in this case, can either
disappear again after usage of the medication ends or can cause
irreparable damage that results in permanent tinnitus.

Other causes may be wax buildup, cardiovascular disease, or a tumor
that creates a strain on the arteries in the neck and head. These tumors
are usually benign.

Tinnitus can be managed through strategies that make it less
bothersome. No single approach works for everyone, and there is no
FDA-approved drug treatment, supplement, or herb proven to be any more
effective than a placebo.

Behavioral strategies and sound-generating devices often offer the
best treatment results; this is partially why distracting the
individual’s attention from these sounds can prevent a chronic
manifestation. Some of the most effective methods are:

Cognitive behavioral therapy (CBT) 
Uses techniques to relax and restructure the way patients think about
and respond to tinnitus. Sessions are usually short-term and occur
weekly for two to six months. CBT usually results in sounds that are
less loud and significantly less bothersome, with the overall quality of
life improved.

Tinnitus retraining therapy 
Effective based on the assumption that the tinnitus results from
abnormal neuronal activity. This therapy habituates the auditory system
to the tinnitus signals, making them less noticeable or bothersome.
Counseling and sound therapy are the main components, with a device that
generates low-level noise that matches the pitch and volume of the
tinnitus. Depending on the severity of the tinnitus, treatment may last
one to two years.

Masking 
Use of devices generating low-level white noise that can reduce the
perception of tinnitus and what’s known as residual inhibition. Tinnitus
will be less noticeable for a period of time after the masker is turned
off. A radio, television, fan, or another sound-producing machine can
also act as a masker.

Biofeedback 
A relaxation technique that helps control stress by changing bodily
responses to tinnitus. A patient’s physiological processes are mapped
into a computer, and the individual learns how to alter these processes
and reduce the body’s stress response by changing their thoughts and
feelings.

Treatment options are vast, but vary in effectiveness depending upon
the type of tinnitus. Research shows more than 50 percent of tinnitus
sufferers also have an inner-ear hearing impairment. While hearing aids
act as an effective relief method for those with tinnitus by amplifying
external sounds to make internal sounds less prevalent, they are not the
only method.
Careful diagnosis by a professional with years of experience creating solutions for tinnitus sufferers is essential.

Everything you need to know about acute flaccid myelitis

This rare but very serious condition can cause paralysis in children

Dr. Crutchfield, I saw on the news that many Minnesota children are developing polio-like symptoms. What is this about?

The condition is called acute flaccid myelitis (AFM). It is a rare,
but very serious condition that affects a person’s nervous system via
the spinal cord. The results are a weakening of one or more of the arms
or legs or other muscles of the body. The weakening of the legs can
cause extreme difficulty walking and even paralysis. As a result, the
condition is very similar, clinically, to polio.

Some patients make a rapid recovery and others may have a lengthy,
perhaps even permanent paralysis. The prognosis can vary depending on
the patient. If a person does have AFM, it is essential to use all
treatment and rehabilitation options available.

We currently are uncertain of what causes AFM. There may be one
singular cause, or the condition may be a result of many causes that can
produce the same effects. Scientists postulate that it could be a
yet-to-be-identified virus or even environmental toxin. I would also
submit for consideration infectious proteins called “prions” that can
cause disease. Additionally, doctors are not sure of any factors that
would increase one’s risk of developing AFM.

What we do know

  • The condition is very rare, affecting less than one in a million persons in the United States.
  • There have been six documented cases of AFM in Minnesota, with over 20 suspected cases.
  • From August 2014 through September 2018, there have been about 390
    reported cases of AFM in the United States. (Reporting is voluntary, so
    this number is probably lower than the actual number of cases that have
    actually occurred.)
  • Most cases are of children. The average age is four, and 90 percent of cases occur in those younger than 18.
  • In no cases have doctors discovered a causative agent, including the polio virus.

Symptoms

  • Sudden weakness in the arms or legs
  • Facial droop
  • Facial weakness
  • Slurred speech
  • Drooping eyelids
  • Difficulty moving the eyes
  • Difficulty swallowing
  • Difficulty breathing. This is the most severe complication of AFM
    because a weakening of the muscle that controls breathing is a medical
    emergency that, without immediate support, can lead to death.

What the Centers for Disease Control (CDC) is doing

The CDC is actively investigating all reported cases of AFM and
working closely with doctors and other healthcare providers and health
departments to increase awareness of AFM.

CDC activities include:

  • Encouraging healthcare providers to be watchful and report suspected cases of AFM
  • Actively looking for risk factors for developing AFM
  • Testing specimens, including stool, blood, and cerebrospinal fluid, from alleged AFM cases
  • Working with researchers across the country and world to determine the cause of AFM
  • Disseminating all new information on AFM to doctors, healthcare providers, and health departments as it becomes available

What you can do

Because the condition mimics the result of a viral infection, it is essential to:

  • Practice good hand-washing techniques
  • Use appropriate mosquito repellants and protection
  • Ensure all vaccinations are up to date

If your child develops weakness of any limb, especially if they have
cold-like symptoms or other viral symptoms, take them to the doctor
immediately. The prognosis now depends on getting prompt medical care as
soon as possible.

Eventually, we will understand the cause of AFM. Until then, these
action steps are our best hope for prevention and a good recovery.