Thursday, January 31, 2008
A First in History
So very likley that the Democratic nominee in our country will be either a black man or a woman. I did not think I would see either if these in my lifetime. I feel hopeful about the people of our country.
FDA Warns Epilepsy Drugs May Raise Suicide Risk
Interesting study sumary below. I also understand depression is more common in individuls with epilepsy than the general population. It is true for me.Oh I guess I never put that in the "about me" section of the blog.
I still can't tell from the various articles if the control group also had epilepsy-I would assume so to make this a remotely valid study. Yes, my medication is listed... I have felt really low before-but I don't think ever suicidal.
FDA Warns Epilepsy Drugs May Raise Suicide Risk
01.31.08, 12:00 AM ET
THURSDAY, Jan. 31 (HealthDay News) -- Commonly used antiepileptic drugs may boost the risk of suicide among patients who use them, the U.S. Food and Drug Administration warned Thursday.
A review of 199 studies comparing 11 of these drugs to placebos found that patients taking the drugs had about twice the risk of suicidal behavior compared with patients taking a placebo. In fact, of the almost 44,000 patients in the studies, four people taking antiepileptic drugs committed suicide while none of the patients receiving a placebo did.
"We have been looking at these drugs since 2005," said FDA spokeswoman Sandy Walsh. "We have just come to the conclusion that it's time to alert heath-care providers."
Currently, some of drug labels do list suicide or suicidal behavior as a side effect, but others don't, Walsh noted.
The drugs included in the warning are: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR), Felbamate (marketed as Felbatol), Gabapentin (marketed as Neurontin), Lamotrigine (marketed as Lamictal), Levetiracetam (marketed as Keppra), Oxcarbazepine (marketed as Trileptal), Pregabalin (marketed as Lyrica), Tiagabine (marketed as Gabitril), Topiramate (marketed as Topamax), Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) and Zonisamide (marketed as Zonegran). Some of these drugs are also available as generics.
According to the FDA, antiepileptic drugs are used to treat epilepsy, bipolar disorder, migraine headaches and other conditions.
Over the next several months, the agency intends to work with drug companies to change the labels of the drugs to reflect this risk, Walsh said. "We will be working with the companies to make sure the latest data is reflected in their prescribing information and labeling," she said. In addition, the agency will hold an advisory committee meeting on the issue.
The 11 drugs listed above were included in the studies the FDA analyzed. However, the agency expects that the increased risk of suicidality is present in all antiepileptic drugs and so the labeling changes will be applied to all drugs in the class.
As of now, the FDA is advising patients not to make any changes in their medication without talking to their doctor, Walsh said. "Caregivers should pay close attention to changes in mood, behavior and actions," she said. "They should be aware of the development of these symptoms."
One expert supported the FDA's move to require drug makers to have a warning about the possibility of suicidal behavior on the product label.
"This is not new, it's something that has been known for a long time," said Epilepsy Foundation Vice President John Schneider.
Schneider noted that some people with epilepsy may be clinically depressed, so it's hard to tell whether it's the medication or the condition that is causing the suicidal behavior.
"Patients need to know their medications," Schneider said. "The goal should be no seizures and no side effects."
Another expert finds the association between antiepileptic medicines and suicide surprising.
"We do know that the incidence of comorbid affective [emotional] disorders and risk of suicide is higher in patients with epilepsy compared with the general population, and therefore it is not surprising to see higher incidence of suicide in the FDA report," said Dr. Gholam Motamedi, director of the Epilepsy Service at Georgetown University Hospital, in Washington, D.C.
However, the data showing a raised risk of suicide with medication use is surprising, Motamedi said.
"It's also surprising to attribute suicide to the antiepileptic drugs, per se, because a good number of these drugs are used in psychiatry for their positive effects on mood and depression," Motamedi said. "Nevertheless, this emphasizes the importance of screening for signs and symptoms of depression and suicidal tendencies in the epilepsy clinics."
I still can't tell from the various articles if the control group also had epilepsy-I would assume so to make this a remotely valid study. Yes, my medication is listed... I have felt really low before-but I don't think ever suicidal.
FDA Warns Epilepsy Drugs May Raise Suicide Risk
01.31.08, 12:00 AM ET
THURSDAY, Jan. 31 (HealthDay News) -- Commonly used antiepileptic drugs may boost the risk of suicide among patients who use them, the U.S. Food and Drug Administration warned Thursday.
A review of 199 studies comparing 11 of these drugs to placebos found that patients taking the drugs had about twice the risk of suicidal behavior compared with patients taking a placebo. In fact, of the almost 44,000 patients in the studies, four people taking antiepileptic drugs committed suicide while none of the patients receiving a placebo did.
"We have been looking at these drugs since 2005," said FDA spokeswoman Sandy Walsh. "We have just come to the conclusion that it's time to alert heath-care providers."
Currently, some of drug labels do list suicide or suicidal behavior as a side effect, but others don't, Walsh noted.
The drugs included in the warning are: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR), Felbamate (marketed as Felbatol), Gabapentin (marketed as Neurontin), Lamotrigine (marketed as Lamictal), Levetiracetam (marketed as Keppra), Oxcarbazepine (marketed as Trileptal), Pregabalin (marketed as Lyrica), Tiagabine (marketed as Gabitril), Topiramate (marketed as Topamax), Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) and Zonisamide (marketed as Zonegran). Some of these drugs are also available as generics.
According to the FDA, antiepileptic drugs are used to treat epilepsy, bipolar disorder, migraine headaches and other conditions.
Over the next several months, the agency intends to work with drug companies to change the labels of the drugs to reflect this risk, Walsh said. "We will be working with the companies to make sure the latest data is reflected in their prescribing information and labeling," she said. In addition, the agency will hold an advisory committee meeting on the issue.
The 11 drugs listed above were included in the studies the FDA analyzed. However, the agency expects that the increased risk of suicidality is present in all antiepileptic drugs and so the labeling changes will be applied to all drugs in the class.
As of now, the FDA is advising patients not to make any changes in their medication without talking to their doctor, Walsh said. "Caregivers should pay close attention to changes in mood, behavior and actions," she said. "They should be aware of the development of these symptoms."
One expert supported the FDA's move to require drug makers to have a warning about the possibility of suicidal behavior on the product label.
"This is not new, it's something that has been known for a long time," said Epilepsy Foundation Vice President John Schneider.
Schneider noted that some people with epilepsy may be clinically depressed, so it's hard to tell whether it's the medication or the condition that is causing the suicidal behavior.
"Patients need to know their medications," Schneider said. "The goal should be no seizures and no side effects."
Another expert finds the association between antiepileptic medicines and suicide surprising.
"We do know that the incidence of comorbid affective [emotional] disorders and risk of suicide is higher in patients with epilepsy compared with the general population, and therefore it is not surprising to see higher incidence of suicide in the FDA report," said Dr. Gholam Motamedi, director of the Epilepsy Service at Georgetown University Hospital, in Washington, D.C.
However, the data showing a raised risk of suicide with medication use is surprising, Motamedi said.
"It's also surprising to attribute suicide to the antiepileptic drugs, per se, because a good number of these drugs are used in psychiatry for their positive effects on mood and depression," Motamedi said. "Nevertheless, this emphasizes the importance of screening for signs and symptoms of depression and suicidal tendencies in the epilepsy clinics."
Meeting with Brunhilda
Pops and I have a mtg in 20 min with Brunhilda (Aj's teacher)and inclu specialist and another SPED person to finally sign IEP. (Remember last time I blew up?).
I called the mtg b/c I want to know how he is doing now that he is on meds, and what else we should look at for him.
It is a bit like PTSD, I dread this teachers comments.
SPED person is so good because he already told inclu spec and myself that the mtg will start with him asking her-"So, tell us about what is going well for Aj." As she herself can't seem to frame this. So I feel supported that way,
but still tender given: prior experiences, birthday thing posted below was yesterday.
I called the mtg b/c I want to know how he is doing now that he is on meds, and what else we should look at for him.
It is a bit like PTSD, I dread this teachers comments.
SPED person is so good because he already told inclu spec and myself that the mtg will start with him asking her-"So, tell us about what is going well for Aj." As she herself can't seem to frame this. So I feel supported that way,
but still tender given: prior experiences, birthday thing posted below was yesterday.
Kids Birthday Parties
I hate 'em.
I have yet to have a birthday pary for either of my kids in the last 2 years. Aj turned 9 in Nov and Ki turned 7 in Jan. I do need to give credit that we went out to the dinner of their choice and had gifts and cake on their b-days.But with both I have talked with them about havin ga party and they, of course, want one.
With AJ I am afraid "typical" kids won't want to come. Or that he'll have a major blowout, like is occurring a few times daily recently, and end up stigmatizing himself furhter. Pops and I had discussed having an indoor soccer party (there is an indoor soccer place in town). So the idea is good-a situation where he looks most typical. I am just not sure who all to invite, how to get invites out etc. All the boys in his class plus a few others that play soccer at recess??????
For Ki I am not sure what to do interms of what type of party (she is not really specifying) or where to have it, as it is winter. Again, should it be just a few kids or more?? Girls, boys ???? Boys, of course top her list. But I am fearful of hurting anyone's feelings as that is the bane of the existence of a special needs parent.
Then there is the other side of the coin. Aj not getting invited to birthday things. Yesterday after school a few of the same kids were playing on the playground and one of them said-"OKAY LET'S GO FOR.." And she was quickly interrupted by her mother sitting next to me who said "Don't say that, we aren't (or can't) take everyone for ice cream." She then explained that it was her dtrs bday and she told her she could take a few friends out for ice cream after school. Which, of course did not include Aj.
""Oh it's okay I don' think the other kids heard," I said, trying to make light. Of course the Mom then apologized saying that they had known this family and that since the girl was 4. I could tell she was uncomfortable and didn't want to hurt my feelings, she is a nice gal. But I teared up after she left anyway. What would have been a little thing for that family would have been a huge thing for Aj (and me!). Offering to have us join them would have been ideal.
Of course Alex had no idea about all of this. Which is good.
Anyone want to be my birhtday party planning consultant and counselor for RSVP's?
I have yet to have a birthday pary for either of my kids in the last 2 years. Aj turned 9 in Nov and Ki turned 7 in Jan. I do need to give credit that we went out to the dinner of their choice and had gifts and cake on their b-days.But with both I have talked with them about havin ga party and they, of course, want one.
With AJ I am afraid "typical" kids won't want to come. Or that he'll have a major blowout, like is occurring a few times daily recently, and end up stigmatizing himself furhter. Pops and I had discussed having an indoor soccer party (there is an indoor soccer place in town). So the idea is good-a situation where he looks most typical. I am just not sure who all to invite, how to get invites out etc. All the boys in his class plus a few others that play soccer at recess??????
For Ki I am not sure what to do interms of what type of party (she is not really specifying) or where to have it, as it is winter. Again, should it be just a few kids or more?? Girls, boys ???? Boys, of course top her list. But I am fearful of hurting anyone's feelings as that is the bane of the existence of a special needs parent.
Then there is the other side of the coin. Aj not getting invited to birthday things. Yesterday after school a few of the same kids were playing on the playground and one of them said-"OKAY LET'S GO FOR.." And she was quickly interrupted by her mother sitting next to me who said "Don't say that, we aren't (or can't) take everyone for ice cream." She then explained that it was her dtrs bday and she told her she could take a few friends out for ice cream after school. Which, of course did not include Aj.
""Oh it's okay I don' think the other kids heard," I said, trying to make light. Of course the Mom then apologized saying that they had known this family and that since the girl was 4. I could tell she was uncomfortable and didn't want to hurt my feelings, she is a nice gal. But I teared up after she left anyway. What would have been a little thing for that family would have been a huge thing for Aj (and me!). Offering to have us join them would have been ideal.
Of course Alex had no idea about all of this. Which is good.
Anyone want to be my birhtday party planning consultant and counselor for RSVP's?
Granny
I am having to remind Granny not to wear the same pants & shirt for 3 days in a row and to get her hair done (washed because it looks dirty).
It just occurred to me a few days ago that if this is the case it is most likely that she is not remembering to shower regularly. So Mon I reminded her and told her to take a shower. She gives me this slightly pissy look and voice, like you are so condescending. And I would sound the same way if I were her.
It just occurred to me a few days ago that if this is the case it is most likely that she is not remembering to shower regularly. So Mon I reminded her and told her to take a shower. She gives me this slightly pissy look and voice, like you are so condescending. And I would sound the same way if I were her.
Monday, January 28, 2008
SEPTAR Presentation
Today Double trouble and I presented about SEPTAR to principals and dept heads for our school district. Signora Blog was there in spirit too, as I was wearing the fancy black Italian loafers that no longer fit her and were donated to me.It seemed to go wel despite my being a bit nervous. Double Trouble alwyas does a great job. Good advertising, so to speak. We are lucky to have a Spec Ed Director that is so supportive of us.
Ki as an adult
Evidently my newly-7-year-old-daughter will be about 5'9" as an adult. She is currently 90th%ile for height and 75th%ile for weight.
Sunday, January 13, 2008
Spinach and Artichoke Calzone Recipe
Made a great quick dinner the other night and meant to give my dear friend Sandrini the recipe-and didn’t. So here ya go!!!! Compliments of Rachel Rayy. I got all ingredients at Traderr J’s (*) and modified to match
Spinach Artichoke Calzones
serves 4 to 6
2C part skim ricotta (*1 15 oz container was fine)
1/4 t ground nutmeg
Ground salt and pepper to taste
½ C/or couple handfuls parmigiano reggiano cheese (*use bag of shredded parmigianno)
*10 oz frozen chopped spinach, defrosted and squeezed dry
¾ bag of frozen artichoke hearts
2 cloves minced garlic
2 bags of prepared whole wheat pizza dough (from the refrigerator section)
2 C shredded mozzarella
1 jar of Tj’s pizza sauce
Preheat over to 450F
Combine ricotta, nutmeg, salt/pepper, parmigiano, spinach, artichokes, and garlic.
Take one container of dough and divide in half. Roll into oval/rectangle. Place
½ C mozzarella and ¼ of mixture on ½ of the rolled out dough and fold over. Roll over edges to seal. Repeat with remaining dough to create 4 calzones.
Place on pizza stone/cookie sheet and cook until dough is brown and cooked thru. (20 min plus)
Serve with warmed pizza sauce.
Spinach Artichoke Calzones
serves 4 to 6
2C part skim ricotta (*1 15 oz container was fine)
1/4 t ground nutmeg
Ground salt and pepper to taste
½ C/or couple handfuls parmigiano reggiano cheese (*use bag of shredded parmigianno)
*10 oz frozen chopped spinach, defrosted and squeezed dry
¾ bag of frozen artichoke hearts
2 cloves minced garlic
2 bags of prepared whole wheat pizza dough (from the refrigerator section)
2 C shredded mozzarella
1 jar of Tj’s pizza sauce
Preheat over to 450F
Combine ricotta, nutmeg, salt/pepper, parmigiano, spinach, artichokes, and garlic.
Take one container of dough and divide in half. Roll into oval/rectangle. Place
½ C mozzarella and ¼ of mixture on ½ of the rolled out dough and fold over. Roll over edges to seal. Repeat with remaining dough to create 4 calzones.
Place on pizza stone/cookie sheet and cook until dough is brown and cooked thru. (20 min plus)
Serve with warmed pizza sauce.
Friday, January 11, 2008
Wanna get away...
I did. So I came over to jennyalice's empty house and using my key, let myself in. It is SO quiet here it is unnerving. I miss noise. Need some music. Even the dog snoring isn't enough. Her house is decorated like mine. Pile here, pile there. So I move a pile and pop down at the dining room table to dawdle on the computer. So far I have had: a cup of coffee, a toasted croissant and 3 pieces of Sees's candy. The candy cupboard is well stacked as is fridge. I highly rec staying here. Price is right too.
Tuesday, January 08, 2008
When chewing is pricey
Earlier today I took Aj and Ki to TJ's grocery shopping. Suddenly, Aj was holding a $5.00 bill. When I asked him where he got it, he told me it had been in his pocket. Later, I let Aj go out front to watch for trains. I could see him and from a distance I noticed him put something in his mouth and begin to chew. Well, I hadn't given him any food. He wandered over then and I asked, "Aj what are you eating?!"
"Part of that $5.00."
"You are eating the $5.00?!"
"Not the whole thing, I put the rest in the trash."
"Part of that $5.00."
"You are eating the $5.00?!"
"Not the whole thing, I put the rest in the trash."
Friday, January 04, 2008
Water, water everywhere
There is big storm here in No. Cal. Lots of rain. It occurred to me when I rolled out of bed this am that the sump pump was not going on. The front yard was flooding as it does when the sump pump is not working and there is lots of rain. So at 9:30 am I found myself outside in the rain shoveling sand and gravel wearing my pink rainboots, flannel Eeyore pajama pants and fleece coat. I called Pops home from work as there was flooding under and around the house, and it was increasing. In the meantime I caled jennyalice and asked for refuge. Ki and I went to her house and I took a hot shower there (as our plumbing usually goes out with flooding). She gave me a clean towel, toasted me a coissant and warmed coffee for me. That's a good friend. Then I had to go back home and face the water. Pops was busy digging trenches. We called the county again as it seems the line from the street is again dumping into the backyard. Luckilly, it wasn't sewage this time. I drove and bought a sump pump and got some sand bags. At home we worked more outside to change out the non-working sump pump. I changed out of my 2nd set of wet boots and clothes. We drove to get a sump pump that was the right size and more sand bags. Our calls to the county continued as the city and county were engaging in a pissing match over which of them were responsible for the flooding. Aj let us know that toilet in the back of the house had overflowed. At home by 4:15 the rain had stopped and Pops and I successfully replaced the sump pump and began draining under the house. My body will be sore tomorow as my ususal daily excerise of rolling from one side of the couch to the other isn't a match for shoveling gravel and hauling sand bags. Nothing is damaged, but we couldn't continue to have water rising under the house. As we were wrapping up I was called inside by Aj because Ki was vommitting. Aj had vommitting and dry heaves all night 2 nights ago. I changed out of my third set of wet clothes and boots just a few moments ago. Good news is the plumbing is working now and the rain and has stopped. Ki just vommitted again. We'll be ordering out for dinner. Wanna come over?
Thursday, January 03, 2008
Feeding, Feeding, Feeding and Swallowng
I'm excited! I have spent the evening looking into courses on feeding and swallowing for pediatrics. I have found 3 that all sound very different and I can get to them. I think I can get to them. One is in San diego in 2 weeks -that would mean flying dowen and ataying w/ Dad and his wife. That would be good b/c I could visit with them. I could also then write off the flight and wouldn't have to pay for hotel. May still have to rent a car-mmm.
Another course is 2 or 3 weeks after that in So SF-very close.
A month after that is another course in Davis-Perhaps I could stay w/ Ali's Mom who lives there. Or maybe even my friend's friend...sounds like I'd be imposing possibly.
Anyway, the good news is that in 2 months I could have completed 39 continuing education hours specifically in pediatric swallowing and feeding. And I will be out $1,200.00 in course fees alone. But I think it is worth it. I love learning and it will be a good booost for my practice and for me professionally.
I should also look into becoming board certified in swallowing and swallowing disorders. This is a newer thing (a few years old) from my national professional organization. This certification from our national organization is not required, but is just a fancy thing to put after your name. When I was working regularly at Stanford I could've cleared all the req's in a heart beat. But I think it has been too long now.
I also looked into certification for NDT for pediatrics (neuro-developmental treatment). The focus of this certification is the evaluation and treatment of babies through adults with CP and related neuromotor difficulties. It is an 8 week full-time certification. Yes, you read that correctly. It didn't have the cost listed. But when I did the 3 week certification for adults with hemiplegia 10 years ago-that was ...I think $3,000.00 then. mmmm. I didn't have kids then and Stanford paid for part of it.
Lot's to think about. But very exciting!
Another course is 2 or 3 weeks after that in So SF-very close.
A month after that is another course in Davis-Perhaps I could stay w/ Ali's Mom who lives there. Or maybe even my friend's friend...sounds like I'd be imposing possibly.
Anyway, the good news is that in 2 months I could have completed 39 continuing education hours specifically in pediatric swallowing and feeding. And I will be out $1,200.00 in course fees alone. But I think it is worth it. I love learning and it will be a good booost for my practice and for me professionally.
I should also look into becoming board certified in swallowing and swallowing disorders. This is a newer thing (a few years old) from my national professional organization. This certification from our national organization is not required, but is just a fancy thing to put after your name. When I was working regularly at Stanford I could've cleared all the req's in a heart beat. But I think it has been too long now.
I also looked into certification for NDT for pediatrics (neuro-developmental treatment). The focus of this certification is the evaluation and treatment of babies through adults with CP and related neuromotor difficulties. It is an 8 week full-time certification. Yes, you read that correctly. It didn't have the cost listed. But when I did the 3 week certification for adults with hemiplegia 10 years ago-that was ...I think $3,000.00 then. mmmm. I didn't have kids then and Stanford paid for part of it.
Lot's to think about. But very exciting!
Tuesday, January 01, 2008
Happy and Grace-I can smell that
I have 2 spray on fragrances that I enjoy. One is "Happy" by Cliniquee. The other, which is new to me, is called "Grace" by Philosophy.
I like what is printed on the box and will share it on this first day of 2008.
Amazing Grace
philosophy:
how you climb up the mountain is just as important as how you get down the mountain. and, so it is with life, which for many of us becomes one big gigantic lesson. in the end, it all comes down to one word. grace. it's how you accept winning and losing, good luck and bad luck, the darkness and the light.
If spraying on Happy and Grace can help me to achieve those states, I am all for it. Want a squirt?
I like what is printed on the box and will share it on this first day of 2008.
Amazing Grace
philosophy:
how you climb up the mountain is just as important as how you get down the mountain. and, so it is with life, which for many of us becomes one big gigantic lesson. in the end, it all comes down to one word. grace. it's how you accept winning and losing, good luck and bad luck, the darkness and the light.
If spraying on Happy and Grace can help me to achieve those states, I am all for it. Want a squirt?
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