GenevaLunch covers little celebrity news because we don’t think this is why most of our readers (70,000+ mainly news pages viewed a month) follow us. They’re looking for local or regional news or world news that has an impact on them. And boosting our site traffic with yet more stories about Michael Jackson isn’t part of our business plan.

But two CNN stories today, about two recent actors’ deaths, do give pause and should touch us.

US actress Brittany Murphy’s autopsy results have come out and they show that she suffered from acute pneumonia without being aware of it and died from a combination of drugs that were all legal and were being used mainly to treat common cold and flu symptoms. There’s a warning for all of us in this: get to the doctor early enough and don’t just pile on over-the-counter medications assuming they are safe.

The other death is of 41-year-old actor Andrew Koenig, whose body was just found in Stanley Park in Vancouver, Canada. His father, also an actor, announced the news. He pleaded with other families not to ignore signs of depression in their family members – and addressed those contemplating suicide, saying “If you’re one of those people who can’t handle it anymore, you know, if you can learn anything from this, there are people out there who really care,” he said. “You may not think so and ultimately it may not be enough, but there are people who really care.”

No cash for gold bars? Go for gold bunnies: instant satisfaction (Swiss chocolate, Thoune storefront)

The headline reads “website offers emotional rescue from economy” and I was expecting Playboy bunnies or Easter bunnies or something else light and bouncy. It’s a nice gesture by the US government to help those who are sinking under the pressure of faltering economies. It points to danger signals, symptoms for depression, substance abuse and the other health concerns that crop up when life hands you a tough one. Here’s the site: http://www.samhsa.gov/economy/ with thanks to Reuters for pointing it out.

There must be some economic cheer-up sites out there, or if not, someone should get cracking and make one. A little more humour could do the trick. Closest I come is The Onion (“Getting randomly picked to make half-court shots now the best way to make a living”) and Private Eye (“Lookalike” – check them out!).

For people who don’t have small children and who aren’t Swiss the current brouhaha in Switzerland over measles vaccinations can be puzzling. This week’s news, that cantonal public health authorities have said mandatory vaccinations should be considered if the country continues to have outbreaks, has already sparked reporting that takes sides, but not over measles: over another agenda. It’s the ages-old French-speaking versus German-speaking tug-of-war. It will only add to the confusion for many parents and young people.

The Tribune de Geneve this morning carries a headline that the arguments in favour of mandatory vaccinations are convincing. If you read the story to the end, past the bit about how the German-speaking cantons have radically changed their opinion on vaccinations, the doctors who are quoted appear to be saying they are not in fact in favour of mandating vaccinations. I’ve interviewed Drs Masserey and Siegrist, the quoted specialists in Vaud and Geneva, including a phone conversation with Dr Siegrist Monday afternoon, part of a news story on the cantons’ decision. I interviewed her at length a year ago. I feel safe saying that while she is a strong proponent of vaccinations she was firm yesterday that she sees mandatory vaccinations as a measure of last resort and she’s proud of the fact Geneva has achieved 95% coverage without mandating vaccinations. She believes the rest of Switzerland can do the same.

The Tribune article points out that the laggards in vaccinating are some German-speaking cantons, certainly true. Basel State has had the highest number of measles cases, double the number in Vaud. The key point in the article seems to be that these cantons have now changed their minds (read that: finally changed their minds!). But the focus should now be on educating people to ensure that enough of them vaccinate, rather than on whether or not shots are made obligatory for school-age children. A few points that might help:

• Switzerland’s coverage is low, 86% instead of the 95% the World Health Organization recommends, because some cantons have only 70% coverage while others, such as Geneva, have very high, 95%
• 95% vaccination coverage should “eradicate” measles, but what does this mean? There will always be measles cases, but when the number falls to fewer than one in a million, the highly contagious disease is considered to have been eradicatd in a country. Australia was declared measles-free this month, although there are still some cases. In Switzerland, with a population of 7.4 million, this would mean under eight cases a year, countrywide.
• Some people do not vaccinate their children because of religious beliefs, others because they fear medical side-effects, of which the most commonly mentioned is autism. Feelings run high on the autism issue and while the medical world weighs in heavily on the side of no link between MMR shots and autism, doubts remain and there is enough concern, about a possible link that we don’t yet understand, for some people to remain cautious about vaccinating. As the mother of an autistic child, who was vaccinated and suffered no side effects (nor did it cause her autism, already present), I have followed these arguments and read the literature for 16 years. There are no black and white answers, and no shortage of people who insist, on either side, that there are. The US court that hears vaccination damage cases threw out three test cases linking the MMR and autism last week, but if you read closely, the legal decision was based on no link between thimersol in the vaccinations and autism. There will be more cases, based on other possible links, which for right now doesn’t mean anything except that some people believe there is a link and that they have evidence of it. Among the concerns raised: too many vaccinations at once, or at too young an age, or too close together.
• Mandatory vaccination works in the United States to the extent that measles has been eradicated there, but the programme has spawned a whole new social phenomenon of people trying to get around the rules. School systems and parents battle over it. Australia has eradicated measles without making vaccinations mandatory. A significant factor appears to be moving the second shot forward from age four to 18 months. A higher number of parents come in for the second shot at that point. The first shot is given at 12 months. The doctors who studied the impact of the change suggest that a more effective solution would nevertheless be to increase coverage for the first shot, from 93% to 96%.
• The age group most touched by the measles outbreaks in Switzerland in the past year has been adolescents, 15-18. A very high percentage, 93%, of those who fall ill, have not been vaccinated. Of the other 7% many have had only one shot.
• Measles vaccinations work quickly and anyone who has had exposure and who has not been vaccinated should see a doctor immediately. The problem, of course, is that the person who is ill may have been contagious for two weeks before showing symptoms.

For me, vaccinations are like any other part of life where there is a risk. We can’t avoid risks, so we need to approach them intelligently, and that means weighing them, trying to inform ourselves without being emotional and without listening to inflammatory rhetoric. Personally, I believe the risk of a child becoming very ill from measles, or even dying, is greater than the risk of a healthy child becoming autistic after the MMR shot, and I would vaccinate my children unless I had a specific reason not to. Hoping that everyone else will do it and you can be part of the 5% who is safe without doing it is both selfish and foolhardy, for the risk to your own child might be diminished but is still there.

For my daughter, whose health is sometimes fragile, I insist that she be given shots of any kind only if she appears to be infection-free, which I think is common sense for the rest of us, too. I would never give her several shots at once. I have an adult son whose health is fine and I just suggest caution with shots: don’t go if you have a cold.

For a small child, if and only if there are medical problems in the family, I would research these carefully, find an open-minded pediatrician who will discuss these with you, which might mean shopping around, and then ask to have shots spread out over time, if there are concerns. I would ask that the MMR (measles, mumps, rubella) be given as three separate shots. The peace of mind is probably worth it, but then be prepared for the trouble of going to the doctor more often.

My family and I were the subject of an NPR (National Public Radio in the US) report last summer on the Swiss health care system. A team of reporters from Washington interviewed us at length and spent a few days with us. They visited Swiss health care specialists to better understand how our severely disabled 16-year-old and others are treated by the system. This was the last in a five-part series that NPR carried on European health care systems. This one asked if Switzerland could serve as a model for the US.

Our daughter has been diagnosed at different times in her life with severe epilepsy, atypical autism and atypical Rett Syndrome. The last two mean she doesn’t quite fit into any neat medical slot. In that respect, she is typical, ironically, of most of the children I am aware of who have severe neurological disorders.

Google Jett Travolta and you’ll find more than 3,000 reports today on the death of the 16-year-old son of actors John Travolta and Kelly Preston. And these don’t even include the articles in other languages, such as  French stories in our local media in Switzerland, which say he died from a heart attack. Or a seizure. Or a head injury when he fell. Or complications of autism, or Kawasaki’s disease.

Much of the media ink is devoted not just to the cause of the young man’s death but to underlying health problems he may have had and whether or not the family was in denial over their son’s autism or severe epilepsy, if he had either of these.

Two things strike me about these reports. Since virtually no information has been made available by the family, and an autopsy is pending, most of these reports are unfounded, but that hasn’t stopped web sites and newspapers from publishing them as if they are fact. Secondly, there appears to be little understanding  in the media of how common it is not to know exactly what problems a child like Jett may have, and this despite much testing and treatment in many, many cases.

A label for health problems and a clearcut cause of death is demanded, and if they aren’t there then the parents must be irresponsible, is the implication.

Most of us would love to know the cause of our children’s problems, the precise nature of them and the best treatment. We spend our lives, money and what little spare energy we have seeking the answers, realizing as the children get older that we are unlikely to find them.

In the US it is often difficult to obtain medical, educational and rehabilitation services for a child with major health care problems unless there is a clear diagnosis. Unfortunately, despite great strides in medicine in recent decades, children with neurological disorders remain an enigma much of the time, even when, for convenience’s sake, diagnostic tags are put on them. People who ask me what our daughter has are visibly distressed when I say no one really knows: we all prefer answers, a black and white world.

Often the medical tag fits this week, but not next. Our daughter had up to 300 seizures a day for several years. We stopped the medication for seizures – and we had tried many, with varying success – when it interfered dangerously with her growth. Miraculously, since no one could predict it, she has been off medication and seizure-free for four years. We know this could change in a flash and when I hear a story like that of Jett Travolta, my blood runs cold with fear, and for the umpteenth time I wonder if we’re doing the right things.

I feel very lucky that the Swiss system doesn’t insist on a label, which would not bring us any closer to the right treatment; if I were in the US I would need the label for insurance coverage. The insistance on labels, in order to have access to care, unfortunately breeds the notion that all you need to do is check with doctors and your child’s health problems will be explained. Sadly for too many Americans with disabled children, having a label can sometimes backfire.

The story of another child, now an adult, was sent to GenevaLunch this morning by her mother, who had found the NPR story on our family (see her comment on the GL contacts page). The girl grew up in Switzerland with a major health problem (not neurological), she attended college in the US, where the Swiss-American family had moved, and then she fell sick while spending a year studying in China. She had to be repatriated to the US, where the family learned her health insurance would not cover her because of the pre-existing condition. If this sounds familiar it might be because you remember dozens of similar stories in Sicko, Michael Moore’s documentary on the the American healthcare system.

The young woman is now continuing graduate studies in Geneva where the Swiss disability insurance system will pay for her medical treatment.

Related: Swiss train travels with Tara is a series of travel articles about exploring this country with my daughter, which I began to publish on GenevaLunch in December. A third article will be posted this week.

As a non-dog owner it startles me to think anyone might consider giving their dog chewing gum, but apparently people do. If you’re a dog’s master and you’re tempted, don’t do it. Here is why, according to Wrigley, which has a cautionary note to dog owners on its home page. Back to chewing old shoes, dear pup.

Note: autism and measles vaccinations are words that are much in the news at the moment, and tomorrow GenevaLunch will carry a feature on the MMR vaccinations, autism and the state of the measles epidemic in Switzerland.

Photos: Tara, named for what we think of as the hill of peace in Ireland and after her aunt in Nebraska. A bonus: we also like the richness of centuries of Eastern Tara deities, Buddhist and Hindu.

TODAY is World Autism Awareness Day, the first one ever in a series scheduled by the United Nations "to perpetuity." For once, I feel like this one’s for me and my family – anti-smoking and diabetes and even women’s day: most of the other declared special days don’t touch us the way autism does. We are a family of four, and the youngest, Tara, soon to be 16, is autistic. Like a majority of, but not all, children with autism she has neurological and other health problems, and the autism is probably secondary, a result of these.

The first time I heard the world "autistic" was when I was 24, eating a large bowl of popcorn and drinking wine, sitting around with friends in an apartment in Minneapolis in the US. We were waiting for a BBC programme, picked up by US public television, to come on, but first we watched the end of a programme that showed a screaming autistic child rolling on the floor. "I would die if I had a kid like that," I said.

Decades later, after having a kid like that I can say I’m here to recount the tale, cheerful about life and I still like popcorn and wine. There is a lot to be said for getting older and wiser.

I could recount our whole saga of having a child with major health problems which involve a loss of communication and social skills. Autism is a disorder, not a disease, with many causes. It would take a book, not a web post to describe our journey with it, and it would be different from that of every other family with an autistic child.

I could go for your sympathy or at least your attention by sharing numbing numbers from Tara’s childhood, so here are a few (we all love sympathy): she had up to 300 epileptic seizures a day for several years, she didn’t walk until she was nearly four. She learned to eat with a spoon when age 8 and a fork at age 10. She gained only one kilo in five years and grew only two centimetres from ages 9-14. Fortunately, just as we considered the difficult business of growth hormones, she began to grow and put on weight.

She makes a lot of noise but she doesn’t talk. She has found her own ways, and is still finding new ones, to explain what she wants.

I don’t think I could share the number of pills she’s taken to control seizures and vitamins to help her grow or various other things she’s had to take over the years.  I’ve lost track.

What I would like to do, for a change, is tell you a little about the delightful if often trying girl who is part of our family. For once, I would like to see her bask in a bit of limelight (her older brother would grumble that she already gets too much attention – there is some truth to this). I rarely write about her because I think she deserves her privacy, like any of us. But today, let’s get her up on the podium for a minute.

Read more…

Kevin Warwick doesn’t look anything like Arnold Schwarzenegger, but he has spent three months of his life as a cyborg, bringing to mind the weird fictional world Schwarzenegger has put on cinema screens. Warwick is, however, a very serious scientist who tested implants to his central nervous system, in his arm, as part of a project to help develop artificial arms that could be moved by its "owner" using brain cells.

Warwick talked at the Lift08 conference in Geneva about his cyborg experience, but he had newer, less headline-grabbing news, that work is progressing on developing electronic implants that can be used to predict, in advance, Parkinson’s tremors and epileptic seizures. The idea is to initially help prevent these, but Warwick’s work at the University of Reading in the UK is also leading to a better understanding of how brain cells can be trained (not his words), to use a simplistic explanation, in order to get them to shift paths. The goal is to eventually reroute them to stave off the tremors and seizures.

TSR today carries a major story on how the University of Newcastle has managed to create an embryo from the cells of one father and two mothers. TSR is right to say this is a major medical breakthrough story, but the accent is on the wrong place. The story matters because it offers the first good chance to see how mitochondrial diseases are transmitted. The fact that the solution is the result of yet another new success using embryonic research makes interesting reading. I fear it will distract people into uninformed discussions about the moral implications of having one father, two mothers, which is misleading since that’s not what will happen as a result of this research.

If "mitochondrial" leaves you asking what those are, it’s not surprising. Mitochondrial diseases were once considered rare but as medical research in the past five years has increased our knowledge of genetic disorders the number of diseases that might be part of the mitochondrial family has increased.

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Madly coping with too many deadlines and technology that lets you down when you least need it, this from Reuters jumps off the screen: "Middle-age is truly depressing." How did they know! It turns out that some two million people were asked. Researchers in the US questioned people in 80 countries and concluded that we almost all have u-shaped curves in our happiness and contentment levels, starting with pretty upbeat at age 20, then heading downhill until we become depressed in our forties, and finally, if we make it to age 70 we find we are as happy and as mentally fit as at 20.

An intriguing bit of information: only eight nations, all of them developing countries, offer exceptions, but Reuters doesn’t mention which ones nor in what way they are exceptions, which could range from a lifetime of happiness to an average age of death of 40.

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[Update, 11 January, typos corrected after the author put in her bifocal contact lenses]

I love it, love it, love it: The Economist says there is just an outside chance we might abolish aging (they say ageing, I say tomato). They get right down to the basics and talk about mitochondrial function but as I skim the article, since skimming in this age of word-excess is one of our tools to a longer life, I read this: eat under 1,500 calories a day and you’ll live longer. Ok,there are a few details, such as adding in the French fat and red wine factors, but the gist is: starve and you’ll live longer, a conundrum they do wisely question.

Their fine reporting aside I see two problems, personally: I’m good at three days a week of under-1,500c and then I double the intake for the other four, so the, um, average is not good in terms of potentially good mitochondrial function. And secondly, I read this because I have a daughter whose fuzzy diagnosis, Rett Syndrome, might involve mito disfunction. We try to focus on her ability to live, and aging is hardly even in the picture.

On the other hand, parents of children with neurological problems, and we are a rapidly growing group, worry about their own aging for a practical reason. Who will take care of my daughter when I am old?

Therefore, I do worry about aging. But I also worry, ever so selfishly, about my own mental approach to aging, and the Economist article ignores this (it’s a bit off-topic, in fairness). If I see sagging skin, thinner hair and dry scaly patches, will I think I am older: therefore I am? And what is that impact of that mental state? Scientists also need to also work on the inner system that defines our self-perception.

Conversely, if the mito experts find a way to convince me I’m yippeeee!! young, will I be?