Organ Donation: Living & Saving Lives

By Kimberly Baldwin | MAEd Student, UAB Community Health & Human Services

There are over 100,000 people waiting to receive a life-saving organ transplant.  Another person is added to the national waiting list every 10 minutes. A single organ donor can save 8 lives, and impact over 75 through bone and tissue donation.  Those waiting for a kidney transplant make up the vast majority of the national transplant waiting list, and experience the longest wait times due to the shortage of available organs for transplant.

Unlike those waiting for other organ transplants, kidney and liver transplant candidates can receive a life-saving organ one of two ways: from a deceased donor or from a living donor.  Through living donation, a healthy person can donate a portion of their liver or one of their kidneys to someone in need, and continue to live a normal, healthy life.

About 600,000 people in the United States live with kidney failure, and require dialysis treatments to remove waste from the body.  Hypertension and Diabetes disproportionately affect those living in the South, and contribute to a host of chronic disease processes including chronic kidney disease (and ultimately, kidney failure).  Alabama has some of the longest kidney transplant wait times in the nation, where 18% of those listed will have to wait more than 5 years for a kidney transplant (OPTN 2022).  Receiving a kidney directly from a healthy living donor can drastically reduce this wait time, as a living donor can be evaluated and cleared for donation in as little as 4 weeks (National Kidney Registry 2019).  According to the United Network for Organ Sharing (UNOS 2022), kidneys from living donors function better and last longer.  A kidney from a living donor will function for an average of 15-20 years, compared with a kidney from a deceased donor which will function an average of 10-15 years.  Increased awareness about living kidney donation can positively impact the number of those willing to donate, thereby improving the lives of those in need of a kidney transplant.

A living kidney donor must be:

  • Over the age of 18
  • Mentally and physically healthy

Living donors go through a thorough evaluation to determine if they are healthy enough to donate their kidney.   Once approved, the surgery is scheduled, and both donor and recipient are admitted to the hospital.  The average hospital stay for living donors is only 2-3 days, and most donors return to regular physical activity within 4-6 weeks. 

Donors are often willing to help, but are concerned about their own health, job security, and finances during recovery.  In order to alleviate these concerns and to increase the pool of living donors, many private organizations, states, municipalities, and the federal government offer their employees paid leave benefits for living organ donation and bone marrow donation (American Transplant Foundation 2020).  The cost for the transplant surgery is covered by the recipient’s insurance company; however, donation-related expenses extend beyond the surgery itself.  The National Living Donor Assistance Center (NLDAC 2021) can help donors cover travel expenses, lodging, lost wages, and dependent care expenses.  Increased awareness about living kidney donation can help to bridge the gap between those waiting and those willing to give.

Frequently Asked Questions about living donation:

Will donating a kidney shorten my lifespan?

Donors tend to live a longer life because they are even more health-conscious post-donation, and hence have a better quality of life.

Should I follow a special diet following donation?

A kidney donor should eat a healthy, well-balanced diet, but there are no dietary restrictions following donation.

Will I still be able to exercise and participate in sports?

A kidney donor should be able to return to regular activities and exercise about 4-6 weeks after surgery.

After I donate a kidney, will I have to take medications for the rest of my life?

A kidney donor will be given prescriptions for pain medication and stool softeners at discharge from the hospital, which are only for use during the immediate post-operative period (1-2 weeks).  After that time, a donor does not have to take medication.   A kidney donor does not have to take anti-rejection medications (National Kidney Register, 2019).

References

National Living Donor Assistance Center. 2021. How NLDAC Helps. Retrieved from:  https://www.livingdonorassistance.org/How-to-Apply/How-NLDAC-Helps

United Network for Organ Sharing (UNOS). 2022. Living Donation. Retrieved from:  https://unos.org/transplant/living-donation/

U.S. Department of Health & Human Services. 2022. Organ Procurement and Transplant Network (OPTN). Retrieved from:  https://optn.transplant.hrsa.gov/data/view-data-reports/state-data/

American Transplant Foundation. 2020. Living Donor Laws: State by State and Federal. Retrieved from: https://www.americantransplantfoundation.org/wp-content/uploads/2020/03/Living_Donor_Laws_Federal_And_State_By_State.pdf

National Kidney Register. 2019. Get The Facts About Kidney Donation. Retrieved from:  https://www.kidneyregistry.org/for-donors/i-want-to-learn-more-about-living-kidney-donation/kidney-donation-facts/ National Kidney Register. 2019. Am I Qualified to Donate a Kidney? Retrieved from:  https://www.kidneyregistry.org/for-donors/am-i-qualified-to-donate-a-kidney/


Reducing Stroke Risk in the South

By Tyler Cook | MAEd Student, UAB Community Health & Human Services

Photo by Anna Shvets on Pexels.com

Stroke is a leading cause of death and disability in the United States. Stroke is also preventable and treatable. Being intentional about your daily activities can minimize or increase your risk of having a stroke. Knowing your family’s health history and engaging in health promoting activities are some of the few approaches to minimize your chances of having a stroke. According to the Center for Disease Control and Prevention (CDC), “The brain controls our movements, stores, our memories, and is the source of our thoughts, emotions, and language. The brain also controls many functions of the body, like breathing and digestion (CDC, 2022). It is important to keep our brain and body healthy in order to reduce our risk for stroke.

A stroke, sometimes called a brain attack, occurs when something blocks blood supply to a part of the brain or happens when a brain’s blood vessel bursts (CDC, 2022). The leading cause of strokes are high blood pressure, followed by high cholesterol, heart disease, diabetes, obesity, and sickle cell disease. These conditions are commonly found in
individuals within the southern regions of the United States and is the main reason why stroke risk high in the South. According to the CDC (2022), “People with a family history of stroke are also likely to share common environments and other potential factors that increase their risk. The chances for stroke can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet.” However, if those lifestyle
choices are poor choices, it can increase the chances of having a stroke. Those lifestyle choices including eating high in fat foods, lack of physical activity, alcoholism, and constant use of tobacco products.

Not only do unhealthy lifestyle choices contribute to stroke risk, but risk is also greater with older age, male sex, and certain racial/ethnic minority groups (i.e., African Americans, Latino Americans). Another major contributor to stroke risk is stress. Constant and increased stress can raise blood pressure and thusly increase risk for stroke. For these reasons, consider the following healthier lifestyle practices below and let’s lower our risk of stroke in the South.

Health Tips from the CDC:

  • Eat foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol.
  • Limit salt (sodium) intake
  • Keep a healthy weight in consultation with your doctor
  • Be physically active, getting at least 2 hours and 30 minutes of moderate-intensity aerobic physical activity, such as a brisk walk, each week.
  • Don’t smoke
  • Limit alcohol intake to no more than two drinks per day for men, 1 per day for women.
  • Manage your medical conditions such as hypertension, diabetes, or heart disease in consultation with your doctor.
  • Work with your health care team, including health coach, pastor/spiritual advisor, counselor, etc.
  • Let’s support our family, friends and neighbors in the adoption of the health tips above

College Students: Why does Sleep Matter?

By Alliemarie Humphries | PhD Student, UAB Community Health & Human Services

Did you know college students are more susceptible to poor sleep hygiene and sleep quality? Over the last decade, studies have found that college students reported having poor sleep and poor sleep behaviors (Kloss et al., 2015; ACHA, 2020; Gipson et al, 2019). Getting a good night’s rest can improve your cognitive performance and capabilities, your mood, and overall health. The cited health risks include potentially developing a sleeping disorder, low sleep hygiene and practices can lead to a myriad of both long and short term adverse health outcomes.  Health ailments include: high blood pressure, depression, and obesity have been linked to poor sleep quality and quantity.  In extreme cases, individuals can be fatally injured while driving if they are experience poor sleep. An annual report by the Traffic National Highway Traffic Safety Administration found that more than 697 accidents are as a result of falling asleep behind the wheel that resulted in fatal injuries (2020). This is an issue that places the individual driving and members of the community at risk.

It is recommended that adults receive 7 to 9 hours of sleep per night (CDC, 2017). To compare, young adults are recommended to receive 8 to 10 hours and infants are recommended to receive up to 16 hours of sleep nightly (CDC,2017).  A growing need to review the lifestyles and behaviors in the college context is necessary, especially regarding how students perceive their own wellness as a means of sacrificing healthy behaviors to achieve academic goals. The past 20 year of scientific literature explains that college students experience higher rates of poor sleep quality and sleep deprivation (Hicks et al., 2001). So which is more important, quality or quantity of sleep. Neither, they are both important. As college students, there are already numerous factors that must be balanced to ensure success towards graduation. How could one possibly add another item to the already many demands of college life? Remember, college is a period in your life, but sleep is a part of your whole life and is thusly important to your quality of life.

Sleep hygiene is a combination of an individual’s sleep quality and sleep habits. The regular maintenance of routine and consistency are found at the rudimentary comprehension of sleep (NHLBI, 2009). To improve this area of your health, specifically your relationship and perceptions towards your sleep, it’s helpful to consider what your current sleep hygiene routine and behaviors look like. To do this using a sleep journal can help to navigate what your behaviors are throughout the day and their influence on your sleep schedule and ultimately the quality of sleep. Additionally, some tips are below in support of sleep wellness.

For a healthier sleep, avoid:
– Avoid exercising within a 3-hour window of when you plan to go to bed
– Avoid eating heavy meals before bed
– Avoid alcohol, nicotine, and over the counter stimulants
– Do not use screens or other digital items with blue light before bed
– Avoid stimulating activities before bed
– Avoid drinking caffeine 8 to 10 hours prior to going to sleep

For healthier sleep, try:
– Daily physical activity (more than 3 hours before your bedtime)
– Implement a sleep schedule; going to bed and waking up at the same time each day
– Embrace a cat nap; keep your naps between 15 and 20 minutes
– Keep your sleeping environment clean and calming space
– Only use your bed for sleep and sex; avoid doing homework from your bed
– If you like to read before bed, read in a different space than your bed

If you have trouble sleeping, try:
– If you are unable to fall asleep after 20 minutes, get out of bed and engage in a light activity until you feel sleep once again
– Breathing techniques, such as meditation or light yoga stretches
– Journaling

References
American College Health Association (ACHA). (2020, May). The Healthy Campus Framework. Healthy Campus. Retrieved January 18, 2022, from https://www.acha.org/healthycampus 

Centers for Disease Control and Prevention. (2017, March 2). How Much Sleep Do I Need? Retrieved March 25, 2022, from https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html

George, D., Dixon, S., Stansal, E., Gelb, S. L., & Pheri, T. (2008). Time Diary and questionnaire assessment of factors associated with academic and personal success among University undergraduates. Journal of American College Health56(6), 706–715. https://doi.org/10.3200/jach.56.6.706-715

Gipson, C. S., Chilton, J. M., Dickerson, S. S., Alfred, D., & Haas, B. K. (2018). Effects of a sleep hygiene text message intervention on sleep in college students. Journal of American College Health67(1), 32–41. https://doi.org/10.1080/07448481.2018.1462816 

Kloss, J. D., Nash, C. O., Walsh, C. M., Culnan, E., Horsey, S., & Sexton-Radek, K. (2015). A “sleep 101” program for college students improves sleep hygiene knowledge and reduces maladaptive beliefs about sleep. Behavioral Medicine42(1), 48–56. https://doi.org/10.1080/08964289.2014.969186 

Hanson, J. A., & Huecker, M. R. (2021). Sleep Deprivation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK547676/

National Heart Lung and Blood Institute (NHLBI). (2009, August). At-A-Glance: Healthy Sleep. National Heart Lung and Blood Institute. Retrieved January 18, 2022, from https://www.nhlbi.nih.gov/ 

National Center for Statistics and Analysis. (2020, December). Overview of motor vehicle crashes in 2019. (Traffic Safety Facts Research Note. Report No. DOT HS 813 060). National Highway Traffic Safety Administration


We Believe You: The Harsh Realities of Sexual Violence

By Lacey George | MAEd Student, UAB Community Health & Human Services

Photo by Duanu00e9 Viljoen on Pexels.com

Conversations surrounding the controversial topic of sexual violence, and its effects on survivors, their loved ones, and our society, have been increasing over time. In light of the
#METOO movement, sexual abuse, assault, and violence survivors are finally given a voice to tell their story, sometimes years later. Because of this, we are finally confronting the
realities of what those brave women, men, and children have endured.

Sexual Violence is too Common

  • Each year, sexual assaults occur in approximately 463,634 Americans, which is roughly 1 every 68 seconds.
  • More than 1 in 3 women and 1 in 4 men have experienced sexual violence, including physical contact in their lifetimes.

Sexual Violence Starts Early:

  • 1 in 3 females will experience rape between the ages of 11-17 years of age, and 1 in 8 experience it before the age of 10.

The effects of sexual violence are long-lasting and far-reaching. Sexual violence negatively affects the survivor’s quality of life, psychological wellbeing, and social opportunities, such as dating and social isolation. Sexual violence intersects with many chronic health problems, such as sexually transmitted infections, unwanted pregnancies, depression, and sexual health problems. Moreover, sexual violence is linked to adverse health behaviors. For example, victims are more likely to smoke, abuse alcohol, use drugs, and engage in risky sexual activities.

Stopping sexual violence before it has the chance to occur has become the primary focus of sexual violence prevention efforts. This type of prevention effort focuses on changing out-of-date beliefs and victim-blaming attitudes and framing sexual violence as a significant public health problem. To effectively prevent sexual violence, we must make the connection between all forms of oppression (including racism, homophobia, sexism, adultism, and many others) and how oppression has created a culture in which inequality thrives, and violence is seen as the norm.

Actions to Prevent Sexual Violence:

  • Promoting social norms that protect against sexual violence encourages men and boys to be allies for others.
  • Teaching skills that can prevent sexual violence, such as teaching safe-dating and intimate relationships skills, promoting healthy sexuality, and teaching healthy coping mechanisms to adolescents.
  • Creating protecting environments, such as improving safety and monitoring in schools, community centers, and workplaces.

Alabama & Local Resources for Support:

References:

Centers for Disease Control and Prevention. (n.d.). Prevention strategies. Retrieved on February 2, 2022, from https://www.cdc.gov/violenceprevention/sexualviolence/prevention.html

Centers for Disease Control and Prevention. (n.d.) Sexual Violence. Retrieved on February 2, 2022, from https://www.cdc.gov/violenceprevention/index.html

Cherniavsky, E. (2019). Keyword 1: #MeToo. Differences, 30(1), 15–23. https://doi.org/10.1215/10407391-7481176

Jaffe, S. (2018). The collective power of #MeToo. Dissent, 65(2), 80-87. https://doi.org/10.1353/dss.2018.0031

Rape, Abuse, & Incest National Network. (2020). About sexual assault. Retrieved on January 29, 2021, from https://rainn.org/about-sexual-assault

Smith SG, Zhang X, Basile KC, Merrick MT, Wang J, Kresnow M, & Chen J. (2018). The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 Data Brief— Updated Release. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Retrieved on January 28, 2022, from https://www.cdc.gov/violenceprevention/pdf/2015data-brief508.pdf


Epilepsy

by Shayna Bryan, Jaelyn Copeland, Shon Mack, and Senequa Malone | Interns and UAB Community Health and Human Services students

(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])


Epilepsy is a commonly misunderstood illness. Tonight’s conversation explores seizure types, how to recognize seizures, and tips for managing seizure healthWhat is epilepsy?

Epilepsy is a disorder of the brain, also called a neurological disorder, where brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. These recurring seizures are the single symptom of epilepsy.

People are generally diagnosed with epilepsy when they have had at least two or more seizures within a 24-hour window that are not caused by a known and reversible medical condition.

In the US, there are about 3.4 million people with epilepsy; 470,000 of these are children.

What causes seizures and epilepsy?

Seizures can be caused by many things, some of which and known and will resolve on their own. Some of these conditions are:

  • High fever (febrile seizure)
    • Contact doctor if fever is over 102ºF for children, 103ºF adults
  • Head trauma
  • Very low blood sugar (diabetic seizures)
  • Alcohol withdrawal
    • Alcohol withdrawal syndrome can be very dangerous and even deadly, should be overseen by a trained medical professional

These are non-reversible conditions that can cause seizures, such as any conditions that affect a person’s brain. Some of these causes include:

  • Stroke
  • Brain tumor
  • Traumatic brain injury or head injury
  • Central nervous system infection

However, for 60% of people with epilepsy the ultimate cause is unknown.

Triggers or factors that affect the frequency of seizures:

  • Missed medications
  • Lack of sleep
  • Stress
  • Alcohol
  • Drug abuse
  • Menstruation
  • Photosensitivity (Flashing lights)
    • Affects only 3% of people with epilepsy, despite popularity of depiction in media
  • Nutritional deficiencies
  • Over-the-counter medications

How common is epilepsy? Who is affected?

Epilepsy is the fourth most common neurological disorder and affects people of all ages.

About 1 out of 10 people may have a seizure during his or her lifetime and 1 in 26 will develop epilepsy, so they are fairly common. Seizures can last a few second to several minutes. All age, ethnicities, and genders can develop epilepsy, but it is more common in children and older adults and slightly more common in males.

New cases of epilepsy are most common in children till age 10, then decease and then increase again after age 55.

What do you do if you have a seizure? Is there treatment?

What to do: Go to your regular family physician if you have not already been to the hospital or seen by medical professionals. More information about proper first response to a seizure can be found further down.

For the majority of people, epilepsy can be treated or managed with medications or sometimes surgery to control seizures. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.

What do seizures look like? What are the types?

Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. A mild seizure may be difficult to recognize as it can last a few seconds during which you lack awareness. 

There are two types of seizure, depending on how much of the brain is affected: Focal and Generalized. In both, the person may or may not lose consciousness

  • Focal – Affects part of the brain (can be any part), also called partial seizures.
    • Alterations to sense of taste, smell, sight, hearing, or touch
    • Dizziness
    • Tingling and twitching of limbs
    • Staring blankly
    • Unresponsiveness
    • Performing repetitive movements
  • Generalized – Affects both sides of the brain (the whole brain)
    • Repetitive movements like lip smacking or blinking
    • Muscle stiffness
    • Loss of muscle control (you may fall down suddenly)
    • Repeated, jerky muscle movements of the face, neck, and arms.
    • Spontaneous quick twitching of the arms and legs.
    • Tonic-clonic seizures, (which used to be called “grand mal seizures”) are a type of generalized seizure that is what most people probably imagine a seizure to look like. The symptoms are:
      • Stiffening of the body
      • Shaking
      • Loss of bladder or bowel control
      • Biting of the tongue
      • Loss of consciousness

How does epilepsy affect daily life?

Having seizures and epilepsy can impact one’s safety, relationships, work, driving, and more.

Public perception and treatment of people with epilepsy are often bigger problems than actual seizures. Some people have service dogs that can alert them to an oncoming seizure so they can find a safe place to lie down. People with epilepsy are sometimes burdened with unnecessary medical costs by bystanders who call 911 even when emergency medical help is not needed.

What should you do if you see someone seizing?

Most seizures end in a few minutes, and do not usually require emergency medical attention. If you see some seizing, here’s what you should do:

  1. First, keep yourself and other people calm. If you do not know the person, check or call out to see if there is someone around who can attest to the seizing person’s medical history.
  2. Start a timer. You’ll want to keep track of how long the seizure lasts.
  3. Check to see if the person is wearing a medical ID bracelet or other emergency information.
  4. Clear the area of potential hazards so the seizing person doesn’t hurt themselves
  5. Try to gently ease the person on to their side to help them breathe easier
  6. Only call 911 if one or more of these are true:
    • They have never had a seizure before
    • They have a health condition like diabetes, heart disease, or are pregnant.
    • They have difficulty breathing or waking after the seizure
    • The seizure lasts longer than 5 minutes
    • Another seizure follows soon after the first one
    • The person is hurt during the seizure
    • The seizure happens in water
  7. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
  8. Comfort the person and speak calmly.
  9. Offer to call a taxi or another person to make sure the person gets home safely.

ABSOLUTELY DO NOT

  • Hold the person down
  • Try to put anything in their mouth
  • Try to give mouth-to-mouth CPR

Check out these resources to learn more about epilepsy:

Epilepsy Foundation Alabama

(205) 453-8205 / Toll-Free: (800) 626-1582 /  alabama@efa.org
3100 Lorna Road Suite 311
Birmingham, Alabama 35216-5452

Walk to END Epilepsy – Birmingham (November 6, 2021)

Seizure First Aid and Safety Course offered by Epilepsy Foundation (with live webinars hosted in English and Spanish)

Children’s of Alabama – Pediatric Epilepsy Program

UAB Epilepsy Center – Home to Alabama’s only Level IV Epilepsy Center, the highest designation available from the National Association of Epilepsy Centers


Sources:

Centers for Disease Control and Prevention. (2020, September 30). Epilepsy fast facts. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/fast-facts.htm.

Centers for Disease Control and Prevention. (2020, September 30). Seizure first aid. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/first-aid.htm.

Centers for Disease Control and Prevention. (2020, September 30). Types of seizures. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm.

Mayo Foundation for Medical Education and Research. (2021, October 7). Epilepsy. Mayo Clinic. Retrieved November 8, 2021, from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093.

Pietrangelo, A. (2018, September 17). Epilepsy: Causes, symptoms, treatment, and more. Healthline. Retrieved November 8, 2021, from https://www.healthline.com/health/epilepsy.

Schachter, S. C., Shafer, P. O., & Sirven, J. I. (2013, July). Who gets epilepsy? Epilepsy Foundation. Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/who-gets-epilepsy.

What is epilepsy? disease or disorder? Epilepsy Foundation. (2014, January 21). Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy.


Breast Cancer Awareness

by Senequa Malone, Jaelyn Copeland, and Shon Mack, with contributions from Shayna Bryan | Interns and UAB Community Health and Human Services students

Graphic by Jaelyn Copeland

(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])


October is Breast Cancer Awareness month. Breast cancer is one of the most prevalent cancers out there. According to the CDC, it is the second most common cancer in women (after some skin cancers) and the second leading cause of cancer death in women (after lung cancer). About 1 in 8 women will be diagnosed with some kind of breast cancer in her lifetime. No one is exempt from a breast cancer diagnoses. It affects men and women, old and young.

Today we’re going to learn about what breast cancer is, what the risk factors are, how you can reduce your risk, and how it affects Women of Color in our community.

What is Breast Cancer?

Breast cancer is a type of cancer that starts in the breast. Cancer starts when cells begin to grow out of control. There are many different types of breast cancer, these depend on where in the breast the cancer cells are located. The breast is made up of 3 parts:

  • Lobules (glands that produce milk)
  • Ducts (connect glands to nipple)
  • Connective tissue (fat that surround the breast and makes up a large part of the volume)

Most breast cancers begin in the lobules or ducts. When the cancer spreads to other parts of the body, it is said to have metastasized.

How common is Breast Cancer? What about dying from Breast Cancer?

Every person has breast tissue, so everyone one is capable of developing breast cancer. It is most common in women, but men can develop it too. The lifetime risk is of getting breast cancer for a woman is 13% and the risk of dying from breast cancer is 2.6%. The 5-year survival rate post diagnosis is 90%. The number of new cases of breast cancer is going slightly up (0.5% per year), but death is going down (1% per year). This is likely due to early detection and better screening. Men are 100 times less likely to develop breast cancer, but that number is not zero. While rare, men are diagnosed and die from breast cancer every year

What are the risk factors for Breast Cancer?

  • Being born a woman
  • Being older
  • Obesity
  • Family history
    • 15% of women with breast cancer have a family member with it
  • Early menstruation (starting before age 12)
  • Late menopause (starting after age 55)
  • Having dense breast tissue

What are dense breasts?

Breast density is a term that describes the relative amount of different types of breast tissue (glandular, connective, and fat tissue) as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.

Only a mammogram can show if a woman has dense breasts. Dense breast tissue cannot be felt in a clinical breast exam or in a breast self-exam. Nearly half of all women age 40 and older who get mammograms are found to have dense breasts.

Whether your breasts are dense is often due to genetics, but other factors can influence it. Factors associated with lower breast density include increasing age, having children. Factors associated with higher breast density include having a high body-mass index and using postmenopausal hormone replacement therapy.

Is there any way to reduce our risk of Breast Cancer?

Factors we can change include:

  • Maintain a healthy weight
  • Be regularly physically active
    • 150-300 minutes of moderate intensity per week (or about 20-30 minutes a day)
  • Eat a healthy diet
    • Vegetables, whole grains, unsaturated fat
  • Perform monthly breast self-exams
    • 40% of diagnosed breast cancers were detected by women who feel a lump
    • Start at age 20 to become familiar with your “normal”
    • Monitor regularly for changes
  • Consume alcohol moderately, or not at all
    • Women who have 2-3 drinks a day have 20% higher risk than non-drinkers
  • If you have children, breastfeed if you are able

What about Breast Cancer risk among African American women?

African American women have a 31% breast cancer mortality rate – the highest of any U.S. racial or ethnic group. While the reasons behind this disparity are numerous and complicated, the issue is real and there are at least some solutions everyone agrees on: more screening, more self-exams, and more access to treatment for African American women.

New Cases of Breast Cancer per 100,000 People

AreaAll GroupsAfrican American
Women
National121.4124.3
Alabama128.8126.1
Jefferson County130.5128.7
Data pulled from statecancerprofiles.cancer.gov/

Deaths due to Breast Cancer per 100,000 People

AreaAll GroupsAfrican American
Women
National19.927.1
Alabama21.427.5
Jefferson County25.628.4
Data pulled from statecancerprofiles.cancer.gov/

How do I perform a Breast Self-Exam?

Set a schedule and do it regularly. A good time to start is 3-5 days after your period it ends, then continue to perform a BSE every month.

  1. Remove your clothing and take a good look at yourself in the mirror. If you’re never done something like this before, it can feel a little silly and embarrassing at first, but it’s very important to become familiar with your own body and what is normal for you, so you can detect changes.
    • Breasts come in all shapes and sizes (many women have one breast larger than the other), so once you know what is normal for you, when you perform these exams you’re going to be looking for anything that stands out as different or unusual
  2. Look for any distortion of the shape, dimpling, puckering, or odd bulging.
    • How’s the color? Are there any areas of redness, a rash, or parts that look swollen? Is the nipple in its normal positions or has that changed, is it inverted? Is there any discharged? It could look “watery, milky, or yellow fluid or blood”.
  3. Raise your arms, and look for the same things. Does this position aggravate any soreness or pain in your breasts?
  4. Next lie down flat on your back and place one arm behind your head.  With the other hand, use the pad of your fingers to press firmly around your breast tissue. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
    • Use a pattern to make sure you cover your entire breast. Two common patterns are to start in the center and make your way outwards in circles, another is to go top to bottom across the breast like you’re mowing the lawn.
  5. If you do feel a lump, don’t worry, stay calm, and make an appointment with your regular physician.
    • Most lumps are benign (non-cancerous). There are many benign breast conditions that can cause lumps that resolve on their own.

What about Mammograms?

            A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.

  • Women ages 40-44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so, particularly if they have family history of breast cancer
  • Women ages 45-54 should get mammograms every year
  • Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.

Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.


Sources and References:

African American women and breast cancer. Breast Cancer Prevention Partners (BCPP). (2021, July 22). Retrieved October 28, 2021, from https://www.bcpp.org/resource/african-american-women-and-breast-cancer/.

Breast cancer information and support. Breastcancer.org. (2021, October 27). Retrieved October 28, 2021, from https://www.breastcancer.org/.

Breast cancer statistics. Susan G. Komen®. (2021, October 6). Retrieved October 28, 2021, from https://www.komen.org/breast-cancer/facts-statistics/breast-cancer-statistics/.

Breast cancer: Breast cancer information & overview. American Cancer Society. (n.d.). Retrieved October 28, 2021, from https://www.cancer.org/cancer/breast-cancer/.

Centers for Disease Control and Prevention. (2021, September 20). Breast cancer. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://www.cdc.gov/cancer/breast/.

Centers for Disease Control and Prevention. (n.d.). USCS data visualizations – CDC. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://gis.cdc.gov/Cancer/USCS/.

Dense breasts: Answers to commonly asked questions. National Cancer Institute. (n.d.). Retrieved October 28, 2021, from https://www.cancer.gov/types/breast/breast-changes/dense-breasts.

Mayo Foundation for Medical Education and Research. (2021, October 14). Swollen lymph nodes. Mayo Clinic. Retrieved October 28, 2021, from https://www.mayoclinic.org/diseases-conditions/swollen-lymph-nodes/symptoms-causes/syc-20353902.

Moore, J. X., Han, Y., Appleton, C., Colditz, G., & Toriola, A. T. (2020). Determinants of mammographic breast density by race among a large screening population. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkaa010

Price, D. (2021, October 7). Black women and the breast cancer disparity explained. The Birmingham Times. Retrieved October 28, 2021, from https://www.birminghamtimes.com/2021/10/black-women-and-the-breast-cancer-disparity-explained/.

State Cancer Profiles. (n.d.). Retrieved October 28, 2021, from https://statecancerprofiles.cancer.gov/.


Intimate Partner Violence: Love Shouldn’t Hurt

By Shon Mack and Senequa Malone | Interns and UAB Community Health and Human Services Students

Image credit Unknown, Graphics by Shayna Bryan

(This article is based on a discussion from WWL’s Monday Night Wellness Watch You can watch a recording of that livestream in the video player below, or on our YouTube page by clicking this link.)


Intimate partner violence (IPV), also known as domestic violence, is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain control over another intimate partner.

IPV can take many forms. Some are more overt, such as physical violence, others are subtle like verbal, mental, emotional abuse, or other forms. Always, the goal is to control the victim through manipulation.

What are the warning signs?

            Aggressive behavior, controlling, manipulation, isolation, talking down or belittling, frequent bouts of jealousy are all common signs of an abusive relationship. The cycle of abuse ebbs and flows. Love bombing occurs when the abuser overwhelms their victim with loving words, actions, and behavior as a manipulation technique. This often acts as an apology for the abuse, maybe following an incident where the victim threatens to leave. Once the victim is convinced, or guilted, into staying the abuse resumes and may escalate.

Who are the victims?

            Anyone can be a victim of intimate partner violence. Women are more common in IPV cases, but men suffer as well and are often forgotten or disregarded. Statistics show that 1 out of 3 women 1 out of 4 men become victims. In Alabama, 37.5% of women and 29.5% of men experience intimate partner physical violence, sexual violence, and/or stalking in their lifetimes. Every case is different, and victims may have one or several of these indicators in common.

What are some of causes?

            Main cause is poor upbringing. Children growing up in households that normalize abuse. Research points to many causes of domestic violence, but all these causes and risk factors have one underlying commonality: the abuser feels the need to exert complete control over his or her partner. Some studies indicate that a cause of domestic violence stems from an intersection of both environmental and individual factors.

Who are the perpetrators?

  • Toxic – People who are full of toxicity
  • Hurt – People who are dealing with hurt
    • “Hurt people, hurt people”, people who have been hurt themselves can lash out to hurt others as a destructive way of dealing with their own pain
  • Broken – People who suffer from insecurities, low self-esteem
  • Learned – People who come from generations of abuse and repeat the abusive behaviors their learned from their family

Why do people stay?

Most people stay in abusive relationships due to a combination of love and fear. They love the person; believe they can change the person. Change comes from within. Loving an abusive person will not make them stop being abusive, they need to acknowledge their behavior and want to change before they are able. It is of utmost importance to understand it is no one’s responsibility to change the abuser. You do not owe them.

However, the number one reason people stay in abusive relationships is fear. People who are in these relationships have often been manipulated into believing it is normal, they deserve it, and/or that they cannot function on their own. They fear life on their own. They feel that no one will want them. For some, the abusive situation might be better than where they came from prior.

Unfortunately, ending an abusive relationship is not as simple as the victim choosing to leave; it is often a matter of the victim being able to safely escape their abuser. Finance can play a major role as well and situations are more complex when children or assets are involved.

How can you escape an abusive relationship?

There are many dedicated experts and volunteers out there to help victims of abuse escape their situation. Contacting the Crisis Center, National Domestic Violence Hotline, and/or other local and national services is a good first step. Here is a list of common steps to take when leaving a domestic violence situation:

  • Create a safety plan
  • Have options where you can go (have a few in mind)
  • Have a bank account or credit card put in your name
  • Get a new cell phone
  • Change the locks, get a security system and outside lights
  • Think of ways to get your children to safety without being obvious
  • You can also think of excuses on how to get out of the house as mentioned earlier

If you do not feel safe researching or accessing online resources in your home, the public library is a great resource and a safe place where your activity cannot be tracked.

Love:  Love is patient, love is kind. It does not envy, it does not boast, it is not proud.It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres.

1 Corinthians 13:4-7

Local resources:

National Resources:


Citations:

Lamothe, C. (2019, December 17). Love bombing: 10 signs to know. Healthline. Retrieved October 15, 2021, from https://www.healthline.com/health/love-bombing. 

National Coalition Against Domestic Violence (2020). Domestic violence in Alabama. Retrieved from http://www.ncadv.org/files/Alabama.pdf

Statistics. NCADV: National Coalition Against Domestic Violence. (n.d.). Retrieved October 15, 2021, from https://ncadv.org/statistics. 

Warning signs of abuse. The Hotline. (2021, June 15). Retrieved October 15, 2021, from https://www.thehotline.org/identify-abuse/domestic-abuse-warning-signs/. 

Why Do Victims Stay? NCADV: National Coalition Against Domestic Violence. (n.d.). Retrieved October 15, 2021, from https://ncadv.org/why-do-victims-stay. 


Salmon and Vitamin D

By Jaelyn Copeland, Intern & UAB Community Health & Human Services Student

Photo by Christina Voinova on Pexels.com

Did you know Salmon is packed with Vitamin D?

Vitamin D insufficiency in both infants and adults is now recognized as a global issue. Both children and adults avoid sun exposure or use sun protection because of concerns about skin cancer, putting them at high risk for vitamin D insufficiency. As a result, diet or supplementation are their only sources of vitamin D.

Vitamin D is fortified in milk, some orange juices, and some breads, yogurts, and cheeses in the United States. Vitamin D2 is present in varying levels in irradiated mushrooms. Vitamin D is naturally contained in the flesh of oily fish. Salmon is recommended based on the dietary tables. It has been suggested that dietary sources of vitamin D, rather than sun exposure, should be the primary supply of the vitamin.

Milk is the most common fortified dietary source of vitamin D, though it typically does not contain at least 80% of what is stated on the label. Fish, particularly oily fish like salmon and mackerel, has long been regarded as a good source of vitamin D. The influence of various cooking procedures on the vitamin D content of fish is poorly understood. A study determined the vitamin D content of various fish species, as well as the influence of baking and frying on vitamin D content. Give baked salmon a try!


Source:

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – vitamin d. NIH Office of Dietary Supplements. Retrieved September 30, 2021, from https://ods.od.nih.gov/factsheets/VitaminD-health%20Professional/.


Swollen Balls: Say It Ain’t So?

By Flora Johnson, M.Ed. | UAB Community Health & Human Services Alumni

Image from Alex Green | Graphics by Shayna Bryan

Question of the Day

A 23-year-old male is referred for treatment due to swollen testicles. He explains that the reaction occurred after receiving a COVID-19 vaccination. What is the best response?

  1. Laugh at the gentleman and dismiss his claim.
  2. Report on the condition to the local county health department immediately.
  3. Thank them for their honesty and let everyone know why not get vaccinated.
  4. Assure it is scientifically impossible and offer evidence-based reasons for testicle swelling.

Continue reading for the answer.


Vax Facts

A reasonable amount of blame has been placed upon the COVID-19 pandemic. Shoveling our woes on the virus is not uncommon. Sure, the virus has caused major and minor disruptions. However, the coronavirus vax jab facts remain the same – it is safe for medical use with little to no known major medical disruptions.

COMRINATY is the Pfizer-BioNTech vaccine approved by the Food and Drug Administration (FDA) for injection use in individuals age 16 and older. The known side effects are mild and include injection site pain, redness, and/or swelling. Chills, fever, headache, muscle pain, nausea, and tiredness are also side effects experienced throughout the body.

These side effects occur within two days. This is normal and will go away within a few days. It is 95% effective at preventing infection or death.

My cousin in Trinidad won’t get the vaccine cuz his friend got it & became impotent. His testicles became swollen. His friend was weeks away from getting married, now the girl called off the wedding. So just pray on it & make sure you’re comfortable with ur decision, not bullied.

-Nicki Minaj (@NICKIMINAJ)

The Thing Is

Recording artist, Grammy winner, and actress, Nicki Minaj stirred controversy for her vaccine hesitancy perception. The star explained that their Trinidadian cousin’s best friend’s testicles swelled after receiving a vax jab. He allegedly experienced impotence.

Whoa! Let’s fact-check this. The Messenger’s message has a resounding magnitude – one that matters.

Nicki was uninvited to the Met Gala for non-vaccination. She had unanswered COVID-19 questions and refused to take the shot. Her primary concern was valid. However, the controversy caused chaos in Trinidad and abroad. An opportunity to express her vaccine hesitancy concerns with Dr. Fauci, the Director of the National Institutes of Health (NIH) and leading COVID-19 physician advisor to the United States, during a live-streamed phone call resulted.

As we stand now, there is no reported such side effect or adverse event of testicular swelling in Trinidad, or I dare say… none that we know of anywhere else in the world.

Trinidad and Tobago Minister of Health, Terrence Deyalsingh

Question of the Day Answer

D. Assure it is scientifically impossible and offer evidence-based reasons for testicle swelling. There are no identified reproductive side effects. Possible reasoning for scrotal swelling is the following:

  • Trauma that causes inflammation
  • Testicular cancer
  • STIs (chlamydia, gonorrhea, and syphilis)

Take Away This

While the coronavirus vaccines were developed rapidly, they are safe. They reduce viral transmissions and can keep you from getting seriously ill if infected. All side effects are mild and are experienced at the injection site or throughout the body. The vaccine does not disturb the reproductive system.

If I want to ask questions about the vaccine, what’s wrong?”

– Nicki Minaj (@NICKIMINAJ)

There is absolutely nothing wrong with asking questions. However, be certain the information you find is credible. Click here to learn the vax jab facts and where to find other plausible wellness resources.


Use this image to share the message on social media!

Sources and Further Reading:

Centers for Disease Control and Prevention. (n.d.). Benefits of getting a COVID-19 vaccine. Centers for Disease Control and Prevention. Retrieved October 6, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html.

Centers for Disease Control and Prevention. (n.d.). Pfizer-biontech COVID-19 vaccine overview and Safety. Centers for Disease Control and Prevention. Retrieved October 6, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html.

Cohen, L. (2021, September 16). White House offers Nicki Minaj a call after she expressed COVID-19 vaccine hesitancy, official says. CBS News. Retrieved October 6, 2021, from https://www.cbsnews.com/news/nicki-minaj-white-house-call-covid-vaccine-hesitancy/.

Kahn, A., & Fisher, J. K. (2019, July 2). What you need to know about scrotal swelling. Healthline. Retrieved October 6, 2021, from https://www.healthline.com/health/scrotal-swelling#causes.

U.S. Department of Health and Human Services. (n.d.). Anthony S. Fauci, M.D., Niaid director. National Institute of Allergy and Infectious Diseases. Retrieved October 6, 2021, from https://www.niaid.nih.gov/about/director.


Rethinking that Ugly Four-Letter Word: DIET (Part 2)

By Shayna Bryan, Intern & UAB Community Health & Human Services Student

Images from Magda Elhers and Caleb Oquendo | Graphics by Shayna Bryan

Eat a balanced variety, enough of the good stuff, not too much of the other stuff. If the principles of a healthy diet are so simple, why do so many dieters fail? Maybe our perspective is to blame.

As discussed previously, your diet is everything you eat over your entire life, so changing your diet is more akin to changing your lifestyle. The best diet is one you can stick to; one that embraces the rhythms and changes of life. The most restrictive diets demand total compliance and encourage a cult-like devotion. These severe restrictions, such as those that eliminate whole categories of food, make it harder to comply and easier to give up. It sets us up for failure. While someone can give up tobacco or alcohol, we still have to eat every day of our lives.

Small changes, slowly incorporated over a long period of time, are the best way to ease yourself into a healthy diet. Here’s how you can do it:

  • Set realistic goals that you can achieve
    • Set yourself up for success, not failure!
    • Take an honest look at what your current habits are and look for ways to make changes
    • Example: I currently drink about 20 oz of water a day, my new goal is to drink 40 oz a day.
  • Reduce, instead of remove
    • It’s not necessary to eliminate certain things from your diet, especially if you like them. Look for the balance.
    • Example: I currently eat fast food 5 times a week, my new goal is to reduce that to 3 times a week. Eventually I will work towards eating fast food only once a week.
  • Reevaluate
    • If you didn’t meet your goals, set new more achievable goals! Failure is an opportunity to learn and improve, not proof that you can’t do something.
    • Example: I previously drank a case of soda (24) every week, so I set a goal to reduce that to 1 soda per day (7 per week). I didn’t meet that goal, so my new goal is to drink half a case (12) of soda per week.
  • Try new things!
    • New foods, new techniques, new cuisines!
    • Living life to the fullest isn’t meant to be about endlessly cutting back, so neither should your diet. You might surprise yourself with what you find and how your tastes change!
    • Example: I didn’t like brussel sprouts until I tried roasting them, now they’re my favorite go-to green veggie.

Love Yourself and Keep Going

Our stumbles in life do not undermine our previous efforts. Days of self-love and indulgence are part of a healthy lifestyle, both in mind and body. It’s easier to eat dessert in moderation if you don’t view it as a breach of contract. These cycles of adherence are a natural part of living. If we consider the long term, that your diet will be defined by what you consume over a lifetime, maybe we’ll have an easier time sticking to healthy eating and won’t see a failure as the end.

Did you miss Part 1? Find it here!

You can also read our posts about the Mediterranean Diet and DASH Diet.


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Sources and Further Reading:

Calorie Restriction and Fasting Diets: What Do We Know? (n.d.). Retrieved from https://www.nia.nih.gov/health/calorie-restriction-and-fasting-diets-what-do-we-know

Freedhoff, Y. (2014, November 17). No, 95 Percent of People Don’t Fail Their Diets. Retrieved from https://health.usnews.com/health-news/blogs/eat-run/2014/11/17/no-95-percent-of-people-dont-fail-their-diets

Godman, H. (2018, January 24). How fast should you change your diet to lose weight? Harvard Health. Retrieved September 20, 2021, from https://www.health.harvard.edu/diet-and-weight-loss/how-fast-should-you-change-your-diet-to-lose-weight

Mayo Clinic Staff. (2019, January 9). 8 steps to a heart-healthy diet. Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-healthy-diet/art-20047702