What is a PFT Test?

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Anybody who is new to any kind of breathing disorder may likely be asked to perform what is called a “PFT” test or Pulmonary Function Test. This provides your physician, or your specialist/pulmonologist with a baseline of how your lungs perform in a series of test situations.

Pulmonary Function Testing is not scary, but it can be a little tiring if you aren’t expecting it because the technician will be asking you to take lots of breaths, hold them, breathe in and out, blow out as hard as you can for some breaths, and do a lot of waiting in between. The test generally takes about an hour to complete. Taking all of these breaths in and out can not only make you dizzy, it can make you hyperventilate a little, but if you go in with the knowledge that this can happen, you will be less surprised if it does! You can make yourself rather anxious during these tests trying to do well — so the best thing to do is to go in as calm and relaxed as possible. Each test is repeated many times, so there is no chance of “messing up”. Be prepared for it to be tiring — get a good night’s sleep the night before, try to schedule your appointment for the morning, if possible. If you learn that you get lightheaded afterwards, learn to schedule your PFTs on a day when you have a light schedule.

Depending on what kinds of lung testing your doctor has scheduled for you (LAM patients will require different tests from asthma patients, and COPD patients may require other tests as well), when you get to the testing center, the technician will first check you in and go over with you what tests you have to do that day. He or she will likely give you a nose clip to plug off your nasal breathing, and a sterile mouthpiece collar similar to a piece of scuba equipment to fit inside your mouth that you will breathe into the machine with that will be testing your air volumes.

One standard and very common test is the FEV1, or Forced Expiratory Volume in 1 second. This is the amount of air that can be forced out of the lungs in 1 second. The range for healthy adults should be 80% to 120% of the average value. Other common parameters measured are Vital Capacity (VC) and Forced Vital Capacity (FVC).

In LAM, the FEV1/FVC ratio is important, as it is with other restrictive lung diseases, see your doctor for your own values and interpretations.

June 1 — Worldwide LAM Awareness Day

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Thanks for dropping by. Leaders from The LAM Foundation in the United States and the leader of LAM organizations in 17 other countries came together last month to declare June 1st as an annual international day of awareness. Because LAM is such a rare disease, it does not usually get the media attention that other, more commonly diagnosed diseases often get.

In its mild state, LAM can be easy to live with. In later stages, the disease is ravaging and deadly, and the women who have it suffer greatly, both from the disease itself and because the lack of awareness forces them to become patient advocates for rare diseases by default, something which takes a lot of effort. Let’s help them by spreading the word about this rare disease so more medical professionals know what it is.

This post is dedicated to all of the women in the last year who died from complications of LAM.

Tomorrow is Worldwide LAM Awareness Day — ASTHMA VS LAM

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Leaders of the Worldwide LAM Alliance have come together and declared June 1 as an annual day of awareness for lymphangioleiomyomatosis (LAM), which is a rare lung disease that affects exclusively women, destroying the smooth muscle tissue of the lung.

Many people find this website looking for information on asthma. Women who have LAM are often misdiagnosed with asthma, as the symptoms can be similar (shortness of breath, wheezing, chest tightness). Asthma can occur concurrently with LAM, but they are actually very different diseases. Asthma is an inflammatory disorder of the airways, causing a reversible airflow obstruction. Attacks can be caused by numerous things, and are mediated by all kinds of strategies, including inhaled medications.

LAM is not a disease of the airways, and it is not reversible. Rather, it is an irreversible disease of the smooth muscle of the lung, in which cysts grow and replace the tissue of the lung. Eventually the entire lung can become replaced with cysts, leading to respiratory failure.

This does not mean that if you have asthma you should suspect that you have LAM! LAM IS EXTREMELY RARE!

However, there are 1600 women diagnosed with LAM currently, and it is estimated that 250,000 – 300,000 women worldwide have LAM. We are trying to raise awareness of this disease so that more women can be diagnosed in the early stages and live a long life!! I am grateful to be hopefully be one of those!

The Countdown Continues By Adding Up

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In honor of Worldwide LAM Awareness day, the LAM Foundation has made it possible for LAM patients to help the fundraising effort by creating a webpage on the fundraising site firstgiving.com. If you don’t know about this website, it’s a fabulous business model that allows groups and individuals to raise money through the internet for a cause without needing to set up the infrastructure to do fundraising in traditional ways.

The LAM Foundation’s Fundraising Description: The LAM Foundation is dedicated to funding scientific research in an effort to find a cause and cure for Lymphangioleiomyomatosis, or LAM, while offering knowledge, emotional support and hope to women with this fatal lung disease.

The LAM Foundation has a mandate to raise $1 per letter of LYMPHANGIOLEIOMYOMATOSIS, $24 closer to a CURE!

If everyone who lands on this blog could click over to my first giving page and donate just $24 to the cause, imagine how much money could be raised to help LAM find a cure. Come on, folks, I want to see those numbers add up!

LAM around the World…

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Introducing Patricia Vallejo. She’s 34 and lives in Guadelejara, Mexico. She was diagnosed in 2009. She was being treated for asthma at the time — very typical, LAM can present like asthma. She had a CT scan that showed aggressive LAM with a couple hundred cysts. She has been on Rapamycin for a year, is on oxygen 24/7 and is on the transplant list. She is supported by her husband and beautiful twin 2 and 1/2 year old boys. Let’s cheer for her bravery, folks.

Countdown to Worldwide LAM Awareness Day — Another LAM Star

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Introducing Peggy Swisshelm Haupt. Peggy is an amazing inspiration. She is a mother of 4 and a grandma of 1. She was diagnosed with LAM in 2008, after a series of lung collapses. She’s another lucky and blessed woman who is “mild and stable” as I am, so she devotes energy to helping the LAM community through awareness and fundraising. She has run two fundraising Laps for LAM in her home town of Chowchilla, California and believes a great deal can be done through nutrition, eating correctly and exercise. She is inspired by the younger women with LAM who are her daughter’s age and wants to get the word out about this disease

Introducing: Catherine Chenoweth

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Hello Readers…I am beginning a new series in which I will be introducing and profiling the rare and wonderful Women with LAM that I have met and whose bravery I admire. Along the way, I hope to educate all of us about the many faces of LAM — not just the personal faces, but about all the stories that come with this illness and the trials that have been FACED, and what it means to be a woman with a woman-only disease. It’s almost impossible to educate and bring enough volume to make the world understand how important this little disease is with my still, quiet voice alone — so my hope is that by channeling these other great women that together we can stir up a storm….

So to move on with our very first volunteer…Catherine….

Catherine was diagnosed with LAM in 1996 and has gradually earned herself the title of “Pneumo Queen”. What does that mean, you ask… A pneumothorax is a major hallmark of LAM, and is another word for lung collapse. Our Catherine was diagnosed because of a pneumo (many women are diagnosed with LAM because of a first pneumo) and has had over 40 of these already! With LAM, the lungs can collapse and have to be inflated over and over again. Fortunately, some of these have been small. Catherine says she hopes to hang on to her crown, for the sake of her fellow LAM sisters. Thank you, Catherine… Catherine lived and worked in New York City until 2001 and then relocated to Maine. She is currently on a transplant waiting list (in Boston), like many other LAM women. She valiantly practices tai chi, qi gong and other meditation practices and though she can’t fly any more (most women at this point cannot go to altitude due to LAM and fear of lung collapse from the air pressure) she still travels cross country via train. Go Catherine! What an incredible spirit.

Worldwide LAM Awareness Day – June 1, 2011

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NEWS RELEASE: Lymphangioleiomyomatosis (LAM) is a rare, progressive, and frequently fatal lung disease that affects almost exclusively women, usually during their childbearing years. Symptoms may include shortness of breath, cough, collapsed lung, chest pains and/or fatigue.

Leaders from the LAM Foundation in the United States and and the leader of LAM organizations in 17 other countries came together last month to declare June 1st as an annual international day of awareness. Because LAM is such a rare disease, it does not usually get the media attention that other, more commonly diagnosed diseases often get.

The LAM Foundation has knowledge of approximately 1600 cases of LAM worldwide but it is estimated that there may be as many as 250,000 – 300,000 women with LAM who are currenly undiagnosed or misdiagnosed.

Thanks, NPR!

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I am not sure why it has taken so long for the LAM community to find a place online, but Facebook has finally given our little bleating disease a voice — along with so many other causes. I learned about a great support group for LAM patients on NPR recently.. Hello sisters! Am happy to not be blogging alone in the darkness any longer!

American Beauty

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LAM has been a spectre, a strange ghost that lives in my mind as the cells live in my lungs quietly and lay claim there. They have sat there for at least a year and a half that I have known about, likely longer. Today was the first time that the disease called my name.

I was walking with a friend and climbing a hill when suddenly the breath went out of me. Fast. Strange, like a vacuum tube had been placed in my mouth and the suction turned on, or the tip of a bellows from the fireplace with hands pulling it apart to suck the air out of my lungs.

I had to stop and sit on a stone wall until I could breathe normally again. I have asthma, but this felt a lot different than asthma, which feels more like trying to pull air through swollen tubes, like overcooked pasta – this was breathlessness like I’d never experienced — a WHOOSH.

Later, I confessed to my husband the strange sensation of floating up above myself and watching myself expire. He said we know that’s going to happen, and you’re not going to die tomorrow. And I said, I know….probably not for a long time. But it was very bizarre, to be aware. How rare…..to be so aware of your own clock ticking down……and the way that it opens my eyes makes my soul so sensitive to everything……….. I do not know whether to cry or to laugh out loud at both the pain that is in this world, as well as the incredible beauty that makes every day a gift.

Give me Poetry

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Receiving the diagnosis of an illness that has the word “fatal” in it will often stir up a period of existential angst.

Why are we here? What is the meaning of life?

Then you start searching for meaning. You can find meaning in nothing. That is very depressing. That could send you in a direction of not appreciating anything and being abusive of people or things. On the other hand, you could start to find meaning in absolutely everything, and then you start to cross the line of what a wise person I know said is the line between “poetry and psychosis”.

So, I suppose some meaning is good, a lot of meaning is better — meaning in everything just sort of blows up your brain.

I’ll just take some poetry, thanks.

Explanation to my daughter about life

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I just had to explain to my daughter what asthma was.

It was at her request.

She’s seen me do my inhaler before. Asthma is so common, I see no reason to hide my inhaler. She just said to me, “Mommy, what is that thing you breathe into sometimes?”

“You mean my inhaler.”

“Yeah, XXX has one at school. And so does YYY. And so does ZZZ’s little brother.”

“Well, I have asthma.” She nods. “A lot of people have asthma. It’s very common.”

So I proceed to explain what asthma is, and how you can get it as a child or as a grown-up. She notices she doesn’t have it now, but says almost excitedly but nonchalantly that she might have it when she grows up, in that voice she uses when I know she is saying something because she wants to be like me but not show it. I tell her, “No! You don’t want to have it. You can’t breathe and it is scary and not fun.” I want to scare her so she doesn’t want to have asthma. Silly kids.

Sigh. I’m not ready for this. She’s starting to notice so much. I don’t just have asthma. How long before I have to explain I don’t know how long I’m going to live? Who knows how long they are going to live? Am I going to explain it? How do I make this decision? What are the rights of my children to know and at what point are they old enough that they have the right to know?

LAM (definition)

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Lymphangioleiomyomatosis (LAM) is the result of disorderly smooth muscle proliferation throughout the bronchioles, alveolar septa, perivascular spaces, and lymphatics, resulting in the obstruction of small airways (leading to pulmonary cyst formation and pneumothorax) and lymphatics (leading to chylous pleural effusion). LAM occurs in a sporadic form, which only affects females, who are usually of childbearing age. LAM also occurs in patients who have tuberous sclerosis.

Source: Wikipedia

Exorcising

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Winning the war over one of your inner demons grants a great power. It was only your devil because you gave it that name, devil, and you can take away that boogeyman moniker by taking back your power.

Then, that elixir spreads throughout your entire body to every cell and every molecule, because you’ve taken back a part of yourself to become whole.

On the way to health, it’s important to exorcise.

Whew (Both Kids Were Happy For a Moment)

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Making spinning color wheel tops out of cardboard and multihued crayons on a snowy Tuesday afternoon I see the opposition of belief and disbelief. Both children color their wheels diligently – the older given the responsibility of the entire visible spectrum to color on hers: violet, blue, green, magenta, red, orange, yellow. She colors with the proper skill of a third grader. The younger is simply given red and blue, and we coach him on his coloring skills (“Try to not let the cardboard show through!!), trying to be encouraging so as not to make him feel always youngest, always the one climbing the rungs, but it is so hard to prevent.

The wheels do not work at first, they flip and flop over, nothing spins. The older perseveres, trying to spin hers. The younger is dejected, giving up. He looks to me for a solution. I quickly come up with the brainstorm of removing half the radius of the circle, but alas, I cut it unevenly, and the top wobbles precariously, eliciting a howl of angst from the younger every time it is placed on the kitchen floor. Oops. I attempt to even out the circle. It wobbles less. But not enough to spin.

Meanwhile, the older is starting to whiz hers happily in the corner and make gleeful sounds. I am frantically trying to shred bits of the circumference of the cardboard circle to make the darn thing even so it will spin. Finally, the three of us decide to toss it, and try again with a third circle which had been previously colored in hued thirds — purple, yellow, and blue – as lovely as the older, by me.

Decision made, the younger hangs his head and trudges over to the trash can to crumple up the small, cut-up disk that is now unusable and put it in the trash. Mr. Pessimism.

Ms. Optimism (who is only Ms. Optimism because her precarious creation is working – she would be Ms. Pessimism too if her spinner were floppy) looks at me and states quite knowingly, “And DON’T cut his this time!”

I smile inwardly at her know-it-all attitude.

I tell her, “BUT remember – we had to cut it to know that that trimming the size doesn’t help this particular top spin, unless maybe you get it exactly even. Even failed experiments are important ones. Right? So we learned something important.”

I can see the wheels turning. She shrugs her shoulders and says “Ok, I guess that’s right.”

Both of the wheels spin.

Both of them scream with glee.

How Rare is Rare?

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According to About.com: “A rare disease occurs in less than 200,000 individuals in the United States”.

According to The LAM Foundation: “The exact number of people living with LAM is not known. Though just 1,500 cases of LAM have been identified, scientists estimate that as many as 250,000 women may be going undiagnosed.”

That is WORLDWIDE.

I’ll take my LAM rare, thanks….

New York Times’ Jane Brody on Chronic/Fatal Illness

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“A chronic or potentially fatal illness or injury in a loved one can also substantially and permanently affect the life of everyone else in the family. Far too often, the impact of these events is even more disruptive to the affected individual or the person’s family than the actual medical problem warrants. Most people are ill equipped to cope with the effects of chronic illness on their emotional and social well-being.

Some may hide their torment, only to have it take its toll in ugly, self-destructive or family-disruptive ways.

Others may rage against their fate, wasting precious energy and pushing away those who could help them live more constructively.

Still others may try to struggle bravely through on their own, unaware of potential sources of assistance that could smooth their way and expand their opportunities.”

Read the full article

Wake Up Call, February 28 2009

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Rare Disease Day 2009

If LAM wasn’t enough of a wake up call, this week I got hit by a car while out walking! I am miraculously fine, and encourage all of you to treasure your lives and celebrate World Rare Disease Day 2009 with me.

You can visit www.rarediseaseday.org
Visit the LAM Treatment Alliance by clicking on the red button in the corner of this blog
Watch the LAM Treatment Alliance World Rare Disease Day 2009 video

Want To Learn More About LAM?

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You can.  Thursday March 3rd.

At 5 pm.  Live.  In Boston.  At Harvard Med School, 77 Avenue Louis Pasteur, Rm 350.

Or, if you’re not in Boston, tune in to the live webcast.

email:      ltaadmin@lamtreatmentalliance.com for the password

and go to www.lamtreatmentalliance.org at 5 pm

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Recently Diagnosed?

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Read Randy Pausch’s “The Last Lecture”

Randy was a professor at Carnegie Mellon who was diagnosed with terminal cancer and wrote this amazing book.
Here, watch some video of “Really Achieving Your Childhood Dreams”:

Actually, anyone could read it, even without the diagnosis, it’s a great book.

LAM is NOT a Lung Disease

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LAM is a disease of the LYMPHATIC system (hence the name Lymph-Angioleio-Myomatosis). If LAM were simply a lung-only disease, medical nomenclature would have a latin or greek word or root referring to lung or air (for example, something containing the root “pulmo” — the greek word for lung — such as COPD, which stands for “Chronic Obstructive Pulmonary Disease”, of which “Emphysema” is a subcategory, “a chronic, irreversible disease of the lungs characterized by abnormal enlargement of air spaces in the lungs accompanied by destruction of the tissue lining the walls of the air spaces” — “emphy” comes from the greek “to blow up”). While the LUNGS are usually the primary organ from which death occurs in LAM (really, “Pulmonary LAM”), LAM is a multi-system disease. Many other organs are affected, including the kidneys, lymphatic system, and at times, the brain. Some women find out they have LAM not through lung symptoms at all. Science is learning more and more about how LAM affects the body as a system every day.

Please note: This view of lymphangioleiomyomatosis is a growing and radical shift in perception of the disease. If you look up the word lymphangioleiomyomatosis, most definitions and websites still describe it as a lung disease, including wikipedia, the NIH, and others.

The LAM Treatment Alliance is leading the way in broadening our understanding of this rare disease. We are gradually learning more and more about how it affects the whole body, not just the lung.

For more information, visit here, or click on the LAM Treatment Alliance icon in the upper left corner of this blog. The LTA has graciously also linked to this blog. The LAM Treatment Alliance has been instrumental in establishing the LAM Center of Excellence at the Brigham and Women’s Hospital in Boston, MA, a main teaching hospital of Harvard Medical School.

News Reports From Toronto!

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Click for the MSN link that reports this text:

Patients, doctors meet to solve mystery of women’s lung disease

An international group of doctors, scientists and patients met in Toronto on Friday to try to solve the mystery of an incurable and hard-to-diagnose lung disease that attacks mainly young women.

The 30 delegates are looking at lymphangioleiomyomatosis, or LAM.

It’s a progressive disease that sometimes kills a person in just a couple of years, and it’s almost always a woman in her childbearing years.

“We don’t know how long people live,” said Dr. Elizabeth Petri Henske, a LAM specialist at Harvard Medical School who is attending the summit.

“Partly because it’s so hard to diagnose that we guess that only the most severely affected women get diagnosed. Probably many women have it and don’t know it.”

Doctors don’t know what causes LAM, and the only cure at this point is a complete lung transplant. A few experimental drugs are now being tried.

Symptoms include:

- Shortness of breath.

- Chest pain.

- Collapsed lung.

- Abdominal discomfort.

- Frequent coughing.

The disease, discovered in the 1930s, forms abnormal cells that attack the lungs, kidneys and lymph system by creating cysts and destroying healthy tissue. A patient’s lungs can be so deprived of oxygen that the patient suffers respiratory failure.

Estrogen suspected

About 30,000 to 50,000 people have been diagnosed with pulmonary LAM disease worldwide, while about 250,000 have LAM as part of another disease known as tuberous sclerosis complex (TSC), a hereditary disorder.

About 100 people in Canada are known to have LAM, but it may be underdiagnosed because its often confused with asthma or emphysema. It can take years for a patient to find out she has it.

Henske said the fact that it’s almost always young women who get it leads to speculation that hormones are involved.

“There’s a big effort in my lab to find out if estrogen is contributing and that’s what everyone suspects. I think in all of human disease ? it has a stronger gender predisposition than breast cancer. It’s very striking.”

The one-day summit has pulled in researchers from different disciplines ? people who study LAM, TSC and pulmonary destruction ? to see if they can come up with some models to study because so little is known about the ailment’s origins.

The biggest breakthrough came eight years ago when it was discovered that both LAM and TSC showed similarities in a mutation in one of two tumor suppressor genes.

A cure can’t come fast enough for Catherine Lawrence of Toronto and Amy Farber of Cambridge, Mass.

They both have the disease and have formed organizations to raise awareness, raise money for research and organize these kinds of summits.

Lawrence, a former marathon runner, says she is short of breath at this point, and Farber’s case has progressed to the point where her lungs are now full of holes.

Says Farber: “I know that time is ticking and so the urgency and the desire to raise the red flag and say, ‘Now is the time to act,’ is what drives me to mobilize the scientists, 24 hours a day, working across the world with patients.”

NEXT Thursday! Pathways Regulating Neural Crest Development in Melanoma

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Join The LAM Treatment Alliance and The LAM/TSC Seminar Series in person or remotely via live webcast on Thursday, April 30, 2009, from 5-7pm EST for this presentation followed by discussion moderated by Lisa Henske, MD, light dinner and informal networking.

This and all upcoming sessions will be streamed live on the Internet with password protection. To participate remotely, please email ltaadmin@lamtreatmentalliance.org with “4/30/09 Seminar” in the subject line. Requests for the password must be submitted by 11am EST on 4/30/09.

Illness: The Art of Living

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illness3
Illness
By Havi Carel
An Art of Living Series title

Published: 18th September 2008

“The experience of illness and its sweeping effect on every aspect of life shocked me into thinking about these issues. This is a book founded on my experience of living with a degenerative and potentially fatal illness. An illness that has no treatment…”

“I learned to cope, to surrender vanities. I adjusted. I learned to live a Janus-headed life: young but old, healthy-looking but ill, happy but also incredibly sad.”

Havi Carel is a philosopher, lecturer and writer. She is also one of only 120 women in the UK to suffer from the potentially life-threatening illness, Lymphangioleiomyomatosis (LAM), a rare lung disease. On diagnosis, in 2006, Havi was told that life-expectancy was approximately ten years. Since then, her life has changed beyond recognition and yet, at the same time, has remained the same. Despite being young and healthy looking, she has had to reinvent her life, rethink her aspirations and plans and, more than anything, learn to love the life she has.

While Illness, a unique and often moving book, is founded on Havi’s experience of living with a degenerative illness, it was her training as a philosopher that pushed her to reflect more generally on health and illness. For the ancient Greeks, philosophy was a set of practical skills intended to enhance and improve life by helping people to think clearly about it. Philosophy was an aid in challenging times. Could the same set of skills, with its focus on personal understanding and reflection be applied to illness in the 21st century? This book presents a positive reply to this question. Havi found that the theories and language used to describe illness today are, all too often, inappropriate and misleading. They are too detached, clinical and “third-person”, lacking focus on the actual experience of the ill person, her fears, her hopes, the way she interacts with others and, ultimately, experiences life. This neglected dimension is the focus of this book, which offers a fresh perspective on illness, as well as practical suggestions on how to live well with illness.

“Illness can be a journey. Like some journeys, you do not always know where it will take you. This particular journey moved from personal experiences of illness to a philosophical exploration of their meaning… It ends, or rather stops, here, in the middle. In the present. Where I am now. I do not know what the future will bring; no one does. But being here, now, is enough.”

Bringing together two perspectives, a own personal account of life with illness and the philosophical account – Illness takes us on a thought-provoking journey through life as it is affected by illness. From the betrayal of the body to the geographical changes encountered by an ill person (what may seem near and easy to a well person may be distant and difficult for the ill), from how the ill are seen by others (healthcare professionals, family, friends and strangers) to changes in the social world of the ill (the ability to participate socially, for many, become restricted), this clearly-written book begins to unravel the tension between the universality of illness and its intensely private, and often lonely and isolating nature.

By focusing and reflecting on the experiences of personal growth, adaptation and rediscovery, Illness offers a genuinely new and, most importantly, a practical and positive way of looking at a matter that will, without doubt, affect us all.

Havi Carel is Senior Lecturer in Philosophy at the University of the West of England, Bristol

Havi Carel is happy to be interviewed and to write articles. If you would like to arrange to speak to her, or would like to see a proof copy of Illness, please contact:

Kate Shepherd, The Oxford Publicity Partnership Ltd, 5 Victoria House, 138 Watling Street East, Towcester, Northants, NN12 6BT Tel: 01327 357770 and /or Home Office Tel: 01993 815835
Email: kate.shepherd@oppuk.co.uk

Illness – By Havi Carel – paperback – £9.99 – ISBN: 978-1-84465-152-8

About LAM: Lymphangioleiomyomatosis (sporadic pulmonary LAM) is a rare fatal lung disease that affects women from all racial backgrounds in their childbearing years. There currently is no effective treatment for the disease. An estimated 50,000 women world-wide suffer from LAM. While a lung transplant is an option of last resort if a matched donor can be found, there is a critical shortage of lungs available. For more information on LAM contact www.lamaction.org.

The Art of Living is published by Acumen Publishing
We live in a world where people are searching for new insights and sources of meaning. Religion often seems questionable; work and the consumer treadmill unbalanced; and self-help worthy but simplistic. Philosophy is the great untapped resource of our generation. From Plato to Russell philosophers have engaged wide audiences on matters of life and death. The Art of Living series aims to reinvigorate philosophy and open up the subject’s riches to a wider public once again. Taking its lead from the concerns of the ancient Greek philosophers, the series asks the question “how should we live?” Authors draw on their own personal reflections to write philosophy that seeks to enrich, stimulate and challenge the reader’s thoughts about their own life. For further information go to: www.acumenpublishing.co.uk

Other titles in The Art of Living series:
• Clothes – John Harvey
• Deception – Ziyad Marar
• Fame – Mark Rowlands
• Hunger – Raymond Tallis
• Pets – Erica Fudge
• Sport – Colin McGinn
• Wellbeing – Mark Vernon
• Work – Lars Svendsen

Making History — Launch of The Journal of Participatory Medicine

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Reporting from the field — yesterday I attended the official Launch of the Journal of Partipatory Medicine in Boston. Very exciting times for patient advocacy. The Journal will be soliciting submissions and will be publishing both print and multimedia.

Please visit http://e-patients.net to view more information about the Society and the Journal.

Attendees seemed extremely excited as this new chapter in medicine begins to unfold. Comments welcome.

A Lung Assoc — NOV is COPD Awareness MONTH

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How serious is COPD?
More than 12 million people in the U.S. have COPD.
Another 12 million people may have impaired lung function, not diagnosed as COPD.
COPD is the fourth leading cause of death in the U.S. and more women than men die from the disease.
Smoking is the major cause of COPD.
The good news is that COPD can be diagnosed early and there are effective treatments to help manage the disease. Please be sure to speak with your healthcare provider if you’re at risk, and remember, we’re here to help.

The American Lung Association offers information about COPD, lung cancer and other lung diseases at www.LungUSA.org. You’ll also find support and help with treatment decisions if you’ve been diagnosed.

Statement by the Scientific Advisory Board of the Patient Advocate Foundation/National Patient Advocate Foundation on Changes to the USPSTF Mammography Guidelines

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“WASHINGTON, Nov. 20 /PRNewswire-USNewswire/ — Patient Advocate Foundation (PAF) is a national, non-profit organization that provides case management services to patients diagnosed with chronic, life-threatening and debilitating diseases. Last year, PAF served 48,369 patients and responded to an additional 9.5 million contacts for information. PAF’s companion organization, the National Patient Advocate Foundation (NPAF), is a national, non-profit organization dedicated to the mission of creating avenues of improved patient access to health care through public policy reform at the state and federal levels. The advocacy activities and policy positions of NPAF are informed and influenced by the experience of patients who are served by PAF. The PAF/NPAF Scientific Advisory Board has reviewed the recommendations released by the U.S. Preventive Services Task Force (USPSTF) on screening for breast cancer.”

For the rest of the article, please see http://www.prnewswire.com/news-releases/statement-by-the-scientific-advisory-board-of-the-patient-advocate-foundationnational-patient-advocate-foundation-on-changes-to-the-uspstf-mammography-guidelines-70614687.html

The buzz about new mammogram recommendations for breast cancer

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“The new recommendations for breast cancer screening call for no mammograms until the age of 50.

According to the Press Democrat, the new guidelines are being reacted to with a mixture of skepticism, anger, and concern. Outrage is the emotion mentioned by Dr. Harry Phillips, a radiologist, whose practice may suffer if the guidelines are implemented.
The panel also recommended that women over 50 be screened only every two years, that no routine screenings be given to women over 74 and that breast self-examinations should no longer be encouraged or taught because it leads fearful women to seek out tests that prove unnecessary.”

For the rest of the article, see http://www.examiner.com/x-17695-Tampa-Health-Care-Examiner~y2009m11d20-The-buzz-about-new-mammogram-recommendations-for-breast-cancer

UPDATE: Canada Makes News on the Chronic Illness Frontier

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Despite scandal, eHealth Ont. pushes on

Updated: Sun Dec. 06 2009 11:57:03 AM

The Canadian Press

TORONTO — Electronic medical records would be a huge help during pandemics because they allow doctors to quickly identify patients in high-risk categories, either by age or by underlying medical conditions, says interim eHealth Ontario president and CEO Rob Devitt.

Doctors in Peterborough are “pioneers” in using computerized records for their patients and had a much easier time identifying people who were in priority groups for the H1N1 vaccine than doctors who are still using paper records for every patient, Devitt said in a recent interview.

“Pre-(electronic medical records), if I wanted to call all my patients who were under six and those six to 18 with a chronic medical condition, I would have had to have someone come in and pull all these paper charts and go through each one, and of course miss stuff,” he said.

“Probably you wouldn’t even do it because it would be such a huge task, but (with electronic records) a couple of key strokes and it’s done.”

Ontario already has 3,300 physicians using electronic medical records for about four million patients. It plans to get that number up to 10,000 doctors covering 80 per cent of the province’s nearly 13 million people by 2012.

“We often hear Ontario is behind,” said Devitt. “That (four million) is more people covered by an electronic medical record than any other province.”

Devitt’s vision of an electronic records system that streamlines health care delivery in the province follows a challenging first year for eHealth.

Created after its predecessor agency, Smart Systems for Health, was quietly shut down after achieving very little in its first six years, the agency was mired in a scandal involving hundreds of millions of dollars in untendered contracts given to consultants.

The controversy cost a health minister his job — along with the CEO and the chairman of the eHealth board — and saw the auditor general issue a damning report on the agency’s spending and procurement practices.

It got so bad that employees at eHealth — the unsung “heroes” of electronic health records in Devitt’s eyes who had nothing to do with untendered contracts or expense account abuses — were afraid to tell people where they worked.

“I’ve had a number of staff tell me stories about what it was like going to the grocery store or the hockey rink and they’d be chatting with someone and say they worked at eHealth and suddenly the tone would turn,” he said.

“We’ve started a lot of work in trying to restore our internal mood and morale.”

Health Minister Deb Matthews, who was appointed after David Caplan was forced to step down, said the province won’t slow progress on electronic health records despite a $24.7-billion deficit.

For the rest of the article, click HERE

NDRI Partnership Supporting LAM research

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“Featured on the program in Chicago, was Amy Farber, Ph.D., Chief Executive Officer and Founder of the LAM Treatment Alliance. Dr. Austin and his team have been working closely with the Alliance to try to movecurrent scientific knowledge of the disease closer toward drug development. Currently they are working to validate the “hits” from the screening of all approved drugs to identify in a fast track and unbiased way
those that can selectively kill surrogate LAM cells.

Amy Farber, herself, is someone who knows too well the importance of accelerating patient centered research. Farber has LAM (lymphangioleiomyomatosis), a multi-system disease that primarily affects women and is often eventually fatal. “We cannot overstate the importance of keeping an eye on the critical challenges related to timely data sharing, collaboration, broad researcher access to global patient data, patient partnership in advancing research and transparency in dealings related to biospecimen repositories ,” she says. “Having a partner such as NDRI committed to high quality and rapid procurement, banking and distribution of biospecimens is absolutely mission critical.””

For the rest of the article, visit the Genetics Division of the NDRI’s Blog at http://hbdiatndri.blogspot.com/2009/12/ndri-hosts-seminars-nationally-to-help.html

Big Pharma Adopting Orphan Drug Strategy

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Big Pharma Adopting Orphan Drug Strategy

Patricia F. Dimond, Ph.D. Dec 14, 2009

Potential for profitability in small markets is beginning to lure companies away from the failing blockbluster model.

Lymphoma is one of the many cancers considered a rare disease along with various hereditary enzyme deficiencies.

By anyone’s standards the Orphan Drug Act (ODA) of 1983 has proven remarkably successful in effecting the development of unique therapies for rare human diseases. It provides several economic incentives including tax credits on clinical trial expenses, grant funding by FDA, seven years of marketing exclusivity for a designated orphan drug, and a waiver of PDUFA fees. The act makes it possible for biotechnology and pharma companies to reap a return on investments made on therapies for rare diseases, considered to be those that affect fewer than 200,000 people in the U.S. or, in the EU, five or fewer per 10,000 people.
Such diseases include hereditary enzyme deficiencies such as Gaucher and Fabry disease as well as multiple types of cancer. Oncology is the most frequently investigated therapeutic area, with nearly half of all such treatments in development designated as orphan drugs. In the 10 years prior to 1983 when the ODA was passed, fewer than 10 pharmaceutical drugs or biologics for orphan diseases saw the light of day. As of April 2009, of the 1,994 orphan designations, 339 resulted in approval with market exclusivity.

For the rest of the article please visit http://www.genengnews.com/specialreports/sritem.aspx?oid=71053206

The Decade Patients Control Healthcare

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The landscape of healthcare is changing rapidly — not only politically, but on the internet, where patients are rapidly gaining control in the social sphere.

Patient participation — online communities of patients and doctors — wishing to share data and communicate about what is going on in their lives and research, becomes more reality every day.

This will be the decade it becomes reality, and the LAM Treatment Alliance is one of the organizations leading the way — with collaborations with Novartis, major Boston teaching hospitals, and a novel online patient/researcher social and information database…..a model system that leads the way in medicine with pride…

For more information, start your journey here…

LAMSight: A Data-Driven Disease Community

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I’d like to introduce you to LAMSight, a collaboration between the LAM Treatment Alliance and MIT, specifically Frank Moss, Ian Eslick and Amy Farber. This web-based community is breaking new ground for patients and researchers. While our disease, LAM, is rare, this model for community and research serves as an experimental ground for possible other, much larger diseases that affect greater portions of the population.

By serving as a research models for our own rare disease, we hope to lead the way in breaking ground for other rare diseases, as well as more common diseases.

Visit LAMsight!

MIT Media Lab Director Aims to Transform Healthcare

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“An avalanche of new technology promises to transform healthcare. You’ve heard a lot about it: Electronic medical records. New ways to mine genomic data to match patients with the right medicines. Everything from iPhone apps and robots to help you exercise or take your meds. Not to mention relatively “old” advances like digital imaging and telemedicine video hookups that connect those in remote places with doctors.”

(The Media Lab is my Alma Mater… Always have great memories of that place…)

For the rest of the article, visit HERE

LAM is NOT a Lung Disease, III

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Quite recently, this blog has risen from obscurity in the world of google searches on my rare illness to rather prominent. Thanks, readers!

I want to comment on the fact that if one searches for “LAM Disease”, it’s the third hit that comes up — at the moment. No wonder I am getting so much traffic on the first installment in the series of this post’s title!

There are some groundbreaking ideas in there about LAM and how the perception of the disease is changing (led by the LAM Treatment Alliance – including the redefinition of LAM as more than a just a lung disease).

Thanks for reading, and for commenting, to those who have. And to those who havent, who are reading for the first time, please read the first post — LAM is NOT a Lung Disease.

On Becoming a Lab Rat or Not

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Recently, I was recruited for a study on LAM, and asked to try out a new drug that might help slow down the course of LAM progression in women who are progressing rapidly.

The drug was not intended for me at this time. I do not need it yet. I may need it at some point, but not now. I was told “the purpose of doing this would be “to help science, and to give something to other women”. The side effects of this drug are potentially pretty nasty, and could include headaches, mouth sores, extreme fatigue, and because of a lowered immune system — ironically — pneumonia. But because I’m not too sick yet, I could probably withstand such an infection at this time.

So I had to make a pretty difficult decision. Would doing this be helpful to others and potentially to myself one day? I like to help, why else would I spend time writing here?

The C word

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Well, readers, LAM has finally been reclassified as a cancer.

I wish it had not taken so long, fear of the C word is worse than the positive outcomes from gaining the label, and the doors it opens for research funding are many! What a big hand that gives to a little orphan disease!

It is an unusual kind of cancer, and you can read a little bit about why in one of the articles that quotes Dr. Frank McCormack, who is running a study with money he got for Cancer Research.

Now, you will just have to figure out what color ribbon to wear, since there is no color for LAM.

Or, you could choose not to wear the ribbon, but be careful of what might happen……

No Change

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I had my three-and-a-half-year check up this week. Miraculously, there is no change. The LAM disease has not progressed at all. The CT scan looks exactly the same as it did in 2007. The PFT (breathing test) scores are actually a bit better, though not significantly so.

I don’t know what I am doing to keep this from progressing, I don’t think I’m doing anything, it is just part of my biology that I’m not affected by the cysts (at least not yet). What do you think is going on?

I was asked to take part in a genetic trial to figure out what it is about women like me that seem to be protected against progression in LAM, so maybe a genetic therapy can be devised for women who do progress……

A Device to Help us Train Our Breathing? Maybe Someday. Affectiva Releases the Q Sensor

Affectiva, Inc., spun out of the MIT Media Laboratory, finally releases the Q Sensor. It is a wristwatch-style biofeedback device that measures skin conductivity, temperature and movement.

The Q Sensor has many, many uses — it’s been used in labs all over the world in its test phase and they released it today. It’s been used to help understand autistic children and emotional distress, it’s helped understand sleep research in a new way, it’s helped understand post-traumatic stress. The era of of wearable sensors for management of emotional well being has begun.

The company is selling it as a market research device for any company interested in customer reactions and feedback. Technology Review wrote a great article explaining this.

For the health community, the applications are vast, and have not even begun to be explored. I personally used it for learning how to relax and lower my skin conductance. I took long slow steady breaths, similar to a yoga class or meditation class, and was able to train myself to lower my skin conductance by biofeedback with the device.

The cost is high right now, but the more they sell, the more the price will go down

Visit Affectiva for more images and videos and to purchase a sensor.