TUESDAY, JULY 12, 2022 . THE WASHINGTON POST EZ EE E3 8 BIG NUMBER FROM CONSUMER REPORTS factors Routinely getting a good night’s sleep has been added Staying flexible as you grow older to the American Heart Association’s list of key components of cardiovascular health, lengthening the DBY KEVIN LORIA bottom of the towel. Pull down on list to eight factors the association believes can lead o you often feel stiff the towel with your left hand until to a longer, higher-quality life without heart disease. and tight? Notice fre- you feel tension in your right Heart disease is the leading cause of death in the quent aches and pains? shoulder and upper arm. United States and has been for the past century, There’s probably a according to the Centers for Disease Control and good reason. “As we Neck: While seated with your Prevention. Since 2010, the AHA had focused on start to get older, we lose fluid and spine straight, shoulders back seven points: maintaining a healthy weight, not smoking, being flexibility in our joints and in our and feet flat on the floor, turn your physically active, eating a healthy diet, and keeping blood pressure, muscles,” says Lynn Millar, a fel- head to one side, trying to stretch cholesterol and blood sugar at acceptable levels. Now, however, as low of the American College of your chin toward your shoulder. indicated in its report published in the journal Circulation, the AHA Sports Medicine (ACSM). These Hold when you feel the stretch. believes that healthy sleep also should be taken into account. The effects of aging — along with Stop aches in 5 minutes group’s suggested goal is seven to nine hours of sleep daily for conditions such as arthritis, years adults, and more for children (eight to 10 hours for 13- to 18-year- of hunching over a computer or Giving your muscles a thor- olds, nine to 12 hours for 6- to 12-year-olds and 10 to 16 hours for the repetitive movements of gar- ough stretch can take as little as children 5 and younger). Sleep has long been considered vital to dening — can make you less flexi- five to 10 minutes (although more good health, both physically and psychologically. Sleep gives the ble and reduce your range of mo- time is better). body a needed break to heal and repair itself, setting people up to tion. function normally when they awaken. But a lack of sleep (or poor- You’ll want to focus on one area quality sleep) puts a person at higher risk for such conditions as In addition to causing back at a time — your shoulder, for diabetes, obesity, high blood pressure and more. Besides adding pain and other daily aches, this example — and stretch until you sleep, the AHA tweaked some of the other factors on its list, which it inflexibility can make it harder to ISTOCK feel some tension but no pain. The dubbed “Life’s Essential 8.” For instance, the topic of smoking was do everyday tasks, such as picking general advice is to then hold the expanded to account for exposure to secondhand smoke and vaping, up a fork that has dropped to the program, once muscles are al- thing holistic with a little stretch for 10 to 30 seconds. But and cholesterol monitoring was changed to tracking non-HDL floor or turning your neck to look ready warmed up. strength, a little balance, flexibili- older adults may benefit from cholesterol rather than total cholesterol. The AHA offers an online over your shoulder while you’re ty and maybe some mental staying in position for up to 60 tool for people interested in checking their cardiovascular health driving. That lack of flexibility Not feeling fit? Stretching may health,” she says. seconds, according to the ACSM. and risks they may face, based on the organization’s new checklist. also reduces your ability to en- be especially helpful at prevent- 3 moves to try To get the most out of your ses- — Linda Searing gage in cardiovascular and ing injuries in people who are sion, repeat each stretch several strength exercises, says Michael sedentary, Garber says. Although we all have different times. HEALTH NEWS Rogers, research director for the areas of tightness, most people Center for Physical Activity and To find a stretching program, can benefit from a flexibility And note: If you have limited 58 percent of women with uterus transplants Aging at Wichita State University. you can check your local commu- boost in the hamstrings, shoul- mobility or other physical issues, successfully gave birth, according to a study nity center or gym. But depending ders and neck, Rogers says. These you can do many stretches from a Regular stretching feels good, on your level of fitness, offerings stretches, done three times on seated or standing position, and BY SHAWANA ALLEYNE- After the recipient gives birth, is easy to do and can go a long way at these places may or may not be each side for 10 to 60 seconds, can use a stable chair to help yourself MORRIS the transplanted uterus is re- in helping to keep you flexible, right for you. You can also check loosen them up: get up and down as needed. moved to avoid the need for which is why the ACSM recom- out the stretching routines for More than half of U.S. women lifelong use of immunosuppres- mends doing it two or three times older adults on the National Insti- Hamstrings: Sit on the edge of Consumer Reports is an who received a uterus through a sive drugs. a week, and more if possible. tute on Aging’s YouTube channel. a chair and extend your right leg independent, nonprofit organization transplant went on to have suc- Here’s how. Another option: Ask your doctor straight out, heel on the floor. that works side by side with cessful pregnancies, a study The U.S. surgeries — per- about seeing a physical therapist Keeping your back straight, lean consumers to create a fairer, safer, shows. formed at Baylor University Med- Getting started who can teach you a personalized forward and reach toward your and healthier world. CR does not ical Center, the Cleveland Clinic If you’re already involved in routine. A fitness trainer may do right foot with your right hand. endorse products or services, and Between 2016 and 2021, and the Hospital of the Univer- the same. Once you feel a stretch in your does not accept advertising. CR has 33 women received uterus trans- sity of Pennsylvania — are among physical activity several times a hamstrings, stop and hold. no financial relationship with plants, and so far 19 of them, or some 100 uterus transplants so week, Carol Garber, a past presi- And if you would like to com- advertisers in this publication. Read 58 percent, have delivered a total far performed worldwide. dent and fellow of the ACSM, bine stretching with other exer- Shoulders: While standing, more at ConsumerReports.org. of 21 babies, researchers reported recommends adding in stretch- cises, consider yoga or tai chi, hold a small towel in your right last week in JAMA Surgery. Cost may be a barrier for some ing after your walk or exercise Millar says. “These are really ben- hand, and throw it over your right women. eficial if somebody is having prob- shoulder. Reach your left hand “Uterus transplant should be lems doing it on their own, likes behind your back to grab the considered a clinical reality in “Uterus transplant is de facto a group activities, or wants some- the U.S.,” the researchers wrote. fertility treatment,” and some insurance companies might re- ANIMALS All of the women had “absolute fuse to cover it, co-author Giulia- uterine-factor infertility,” mean- no Testa of Baylor said in an Orcas displace white sharks off South Africa’s coast ing they were either born without email. a uterus or needed to have it BY JAMES BIKALES coast of San Francisco. But they sharks moved into the territory according to the study. Scien- removed. “Insurance coverage for uterus had never been documented do- for the first time, a sign of the tists are examining whether transplantation is part of a larger In 2017, five great white shark ing so off South Africa, according rapid effects it could have lower changing conditions offshore More than 1 million U.S. wom- discussion involving coverage for carcasses washed ashore in four to the recently published study. on the food chain, researchers linked in part to climate change en could benefit from uterus infertility care in general,” Johan- months in South Africa. Four of said. are driving orcas out of their transplantation, study leader nesson said. them were missing livers, and The researchers likened the normal hunting grounds, Town- Liza Johannesson of Baylor Uni- one had its heart removed. great whites’ behavior to wild In Gansbaai, great white er said. versity Medical Center in Dallas In two-thirds of the U.S. trans- Now, scientists have zeroed in dogs in the Serengeti in Tanzania, sharks keep the local Cape fur said in an email. plants, the uterus came from a on the suspects: a pair of male which abandon territory for the seal population in check. With- Although great whites are be- living donor, roughly 1 in 4 of orcas named Port and Starboard long term when lions move in. out a predator to fear, they will coming more prevalent in cer- In 74 percent of recipients, the whom experienced a complica- with a taste for energy-rich shark be able to prey on endangered tain areas, such as off the Cali- uterus was still functioning one tion from the surgery. liver. The study also examined how African penguins or gorge on the fornia coast, their overall popu- year post-transplant. In this The attacks have continued, the ecosystem responded to the small fish the penguins rely on. lation remains fragile and the group, 83 percent had live-born “Reducing the risk to living and the pair are probably not the missing great whites. They emergence of a new predator is children, researchers reported. donors should be a goal . . . if the only orcas terrorizing great warned that it could lead to a The researchers considered al- concerning, the researchers deceased donor pool is not ad- whites in the area. A study trophic cascade, when the de- ternative explanations for the said. The babies were all delivered equate,” Rachel Forbes and Seth recently published in the peer- cline or disappearance of one great whites’ absence, such as sea by Caesarean section, at an aver- Karp, physicians at Vanderbilt reviewed African Journal of Ma- level of the food web destabilizes surface temperatures and fish- Towner said the study serves age of 14 months after the trans- University, wrote in an accompa- rine Science found that orcas are the entire ecosystem. ing, but neither could explain the as a warning sign of more eco- plant. More than half were born nying editorial. “sudden localized decline” at logical damage to come. after 36 weeks’ gestation. “Ecology is a balance,” Towner Gansbaai. In Mossel Bay, another — Reuters wrote. “Remove sharks at the top area frequented by great whites It is “almost as if the science and everything is disrupted, roughly 200 miles to the east, the cannot keep up with how rapid displacing great whites as the smaller predators dominate and orca pair was not seen and shark the ecology is changing,” she top predator in Gansbaai, a pop- the system can potentially col- sightings remained stable. said. “The evidence is there, it ular shark viewing destination lapse or certainly some species needs to be taken into account HEALTH SCAN about 75 miles east of Cape Town. within it.” The orcas may have been by policy makers to [avoid] the drawn to the area by a decline in situation escalating completely With great whites increasingly In the absence of the great prey elsewhere in their territory, beyond help.” CONTAGIOUS DISEASES absent, smaller predators can whites, smaller bronze whaler multiply unchecked, threatening CDC offers tips on how to keep germs away prey species and destabilizing from your kids at ‘spraygrounds’ this summer the entire ecosystem. Similar responses when a new top predator arrives in a land BY ERIN BLAKEMORE Splash Pads ecosystem have been For parents with young chil- Centers for Disease Control and well-studied, but documenting GIt’sentevterhbeeenFeaascierttso dren, a trip to the splash pad can Prevention the same phenomenon in the About Senior Living be a welcome relief from swelter- ocean is rare, said Alison Towner, ing summer temperatures. That has presented serious a marine biologist at the Dyer at Ashby Ponds, Greenspring, “Spraygrounds” are more pop- consequences for some Island Conservation Trust who and Riderwood ular than ever. In its 2022 report spraygrounds. In 2005, thou- led the study. on park amenities nationwide, sands of people contracted a “We now have direct evidence These past years, we’ve learned the Trust for Public Land’s Center gastrointestinal illness after visit- that one of the oceans largest how important it is to be part of for City Park Excellence docu- ing an Upstate New York water apex predators completely dis- a community like Ashby Ponds, mented over 1,800 splash pads in attraction. And in more recent places the another, and it is the Greenspring, and Riderwood. major cities, up from 1,300 in years, children have been sick- first time in the world that white 2017. ened and some have even died shark carcasses have been avail- Order your FREE brochure. They’re billed as a great way to after playing in splash pads. able for scientific examination It’s packed with over 40 pages cool off and a safer alternative to directly after being hunted by of great information, about swimming pools. But the fun In 2020, a 6-year-old contract- Killer whales,” she wrote in an apartment homes, amenities, interactive fountains can spray ed and died of primary amebic email to The Washington Post. financial value, and more. something else: germs. meningoencephalitis after play- Researchers launched the Some splash pads use recircu- ing in a decorative fountain in study in 2017 after performing Order your FREE brochure today! lated water that’s disinfected be- Texas. Last year, a 3-year-old died necropsies on the likely victims fore it’s pumped upward again. of the same condition after a of Port and Starboard, identified Call 1-800-306-7271 or visit us But their mechanisms can make splash pad visit in Texas. Naegle- by their distinctive dorsal fins. appropriate disinfection diffi- ria fowleri, the amoeba implicat- The waters off Gansbaai are at DMVSeniorLiving.com. cult, especially in an environ- ed in both deaths, thrives in normally teeming with sharks — ment frequented by children in warm water and is known as in the months leading up to the diapers. “brain-eating” because it de- 2017 attacks, scientists were log- Sitting or standing on the jets stroys brain tissue. It is fatal in ging close to seven sightings per — a favorite pastime of children over 97 percent of cases. day. But following the orca at- of all ages — can wash feces, dirt tacks, sightings immediately and microorganisms into the wa- Although rare, the deaths and plummeted to 1.17 per day on ter and spray them into the air or illnesses have prompted some average for the next six months. people’s mouths. states and municipalities to The average remained under two tighten up regulation of splash sightings per day for 2018 and MICHAEL CATERINA/ASSOCIATED PRESS pads. 2019. Before 2017, there had been Damian Stewart, 8, plays in the Parents can play a role, too. only two periods since data col- splash pad at a park in South On its website, the Centers for lection began that great whites Bend, Ind., last month. Over Disease Control and Prevention had not been observed for a week 1,800 splash pads operate in recommends that parents keep or more, a week in 2007 and a major cities, a group says. kids out of the water if they’re three-week stint in 2016. In 2019, sick with diarrhea, encourage scientists were averaging almost frequent bathroom breaks and 10 weeks between sightings. check diapers regularly. Parents The rapid departure and pro- should discourage kids from longed absences — which length- swallowing water, make sure they ened as sightings of orcas went don’t urinate or defecate in or up — led the researchers to near the fountains, and prevent conclude that fear of the larger children from sitting or standing predators was probably driving on the jets. the great whites away from those It might be tough to wrangle waters. kids mesmerized by the interac- Orcas can grow to 50 percent 434040 tive fun of splashing water. But larger than great whites, and a it’s worth it to prevent disease for previous study showed that they everyone — and keep the fun displaced great whites off the going all summer long.
E4 EZ EE THE WASHINGTON POST . TUESDAY, JULY 12, 2022 Unexplored most severe form occurs prena- scribed. “Our understanding of bone problems tally, while the mildest affects the disease has really evolved explained at last only teeth. over the past decade,” she said. MYSTERY FROM E1 He was prescribed prednisone, EMILY BLOCKER The disease is particularly And there may have been a a mainstay drug used to treat prevalent among Mennonites in clinical reason doctors did not At 24, while a graduate student Crohn’s. Blocker said he took a Aaron Blocker, his wife, Emily, and their son, Jude, 4. Manitoba, a province in Canada, follow up on Blocker’s abnormal- in biomedical research, Blocker relatively low dose of the corti- where about 1 in 2,500 babies are ly low ALP levels. Until fairly harnessed his skills and trained costeroid, which reduces inflam- “I knew in my gut that something was born with severe HPP, which is recently, low levels were not nec- them on himself. He spent several mation, for about eight weeks. not right. . . . I thought, ‘I’m going to try inherited in an autosomal reces- essarily regarded as clinically sig- weeks digging into his medical sive manner: Two copies of the nificant in contrast to high levels records and scrolling through A year later in January 2011 to figure it out if nobody else will.’ ” mutated gene, usually one from and may not have been flagged. scientific websites before hitting when the disease flared, Blocker each parent, are required to That has changed, she said, and pay dirt: a possible diagnosis that was hospitalized again and un- Aaron Blocker cause disease. In such cases the “is just a quantum leap forward.” was subsequently confirmed by derwent an abdominal CT scan. parents may be carriers who do genetic testing. The scan revealed an alarming to move. His wife, Emily, sum- was always extremely low. ALP is not show signs of illness. Less Blocker’s history of Crohn’s and unexpected incidental find- moned a friend who carefully an enzyme found primarily in the severe autosomal dominant disease may have played a role, “It was a relief to have an ing: avascular necrosis of both scooped Blocker off the bed, car- liver, bones and digestive system. forms of HPP result from the too. Although there is no known answer,” said Blocker, who works hips. A bone density scan also ried him to the car and drove him High levels of ALP can signal inheritance of a defective gene association between HPP and for an insurance broker. “But I’ve found that Blocker had severe to a nearby emergency room. cancer, a problem with the liver from one parent who also may Crohn’s, “it makes the diagnosis always wondered, how did this go osteoporosis. or mononucleosis. Low levels have the disease. more complicated,” Dahir ob- missed for so long?” Doctors diagnosed a partially may indicate a zinc deficiency, served. “It’s really tough to have Avascular necrosis occurs dislocated hip. Blocker was sent malnutrition or a rare genetic Blocker took the articles he two things that affect you muscu- The answer, one of his doctors when the blood supply to a bone home on crutches and told to see disease called hypophosphatasia found to his family physician, loskeletally. It’s hard to figure out later theorized, may reflect evolv- is cut off, causing the tissue to an orthopedist, who told him his (HPP), which affects roughly 1 in who had never heard of HPP. He what is causing what.” ing scientific knowledge about collapse and die and threatening new hips had failed after less 100,000 people and causes bone referred Blocker to a geneticist at his rare diagnosis, as well as the integrity of the structure. than four years. and dental problems. the University of Mississippi, After jousting with his health Blocker’s own complicated medi- Causes include long-term steroid whom he saw in July 2017. insurance company, Blocker was cal history. use particularly at high doses, “I knew in my gut that some- “I realized I fit every symp- approved to take Strensiq, the Tooth trouble excessive alcohol consumption, thing was not right,” he recalled. tom,” Blocker said. “I had a mo- After reviewing Blocker’s med- only drug approved to treat HPP. fractures and a variety of medical “It made no sense to me that ment that felt like clarity. I ical history, including his bowed Blocker said the medication, Blocker’s bones weren’t his conditions. People with inflam- these had failed when they’re thought, ‘This could be it.’ ” legs at birth, numerous fractures, which he injects six times per only problem. matory bowel disease may have a supposed to last for 15-plus years. osteoporosis and history of hip week, costs his insurance compa- reduced ability to absorb calcium I thought, ‘I’m going to try to Hypophosphatasia is an inher- replacements, the specialist or- ny about $1.6 million per year. “I had a lot of issues with my and vitamin D, which can affect figure it out if nobody else will.’ ” ited disorder caused by muta- dered genetic testing for HPP. The drug is designed to replace teeth growing up,” he said. His bone density and lead to osteopo- tions of the ALPL gene that dis- alkaline phosphatase and to im- molars, typically the largest and rosis, a condition in which bones Blocker gathered his medical rupt mineralization, the essential The results confirmed Block- prove bone health. strongest teeth, would crack inex- become weak and brittle. records from doctors’ offices and process by which calcium and er’s hypothesis: He had the dis- plicably. By the time he graduat- hospitals around Jackson and phosphorous are deposited in ease, inherited in an autosomal “He was very impaired with no ed from high school, seven teeth “The orthopedist told me my began digging. developing teeth and bones, mak- dominant pattern. Blocker, who other treatment available,” said had been extracted. Blocker also hip bones were dying and said it ing them strong and rigid. There was raised by his maternal grand- Dahir, who sees Blocker two or had numerous cavities, which his could be related to the predni- Going back years, he noticed are several forms of the disease, parents, said he doesn’t know three times a year. “He’s doing dentist attributed to “weak sone use,” Blocker recalled. But that his level of alkaline phos- which vary in age of onset. The which parent passed the gene on okay, but he continues to have teeth.” In high school he had two that seemed questionable: He phatase (ALP), a component of a to him. additional surgeries.” wisdom teeth removed and heal- had taken the drug for about routine blood chemistry panel, ing was unusually slow; the oral eight weeks and not at a high “I was relieved,” he said of the While Blocker’s Crohn’s dis- surgeon noted a weakness in his dose. news that something other than ease has been in remission for jawbone but did not recommend clumsiness or bad luck was to five years, his problems related to further investigation. A year later, after other treat- blame. “It was nice to be right and HPP have not abated. ments had failed and Blocker’s not feel like a crazy person and In his midteens, Blocker devel- hip joints began to collapse, both have an answer.” So far this year he has under- oped recurring problems with his hips were replaced in operations gone four operations on his el- right shoulder. The first time, he three months apart. Connecting with an expert bows and teeth and has been told dislocated it while throwing a It quickly became clear to he needs knee replacements. Af- ball. Another dislocation oc- “I spent 2012 mostly inside,” ter a surgical incision on his curred while he was sleeping, said Blocker, then a 20-year-old Blocker and his doctors that he elbow failed to heal last month, although no one could explain undergraduate who took a year- would need specialized care out Blocker was diagnosed with a how or why this had happened. long medical leave from Missis- of state. The closest expert, 400 MRSA infection, his second in a sippi College and moved back miles north of Jackson, was endo- year. He is receiving potent intra- During his senior year of high home. “It was very difficult.” crinologist Kathryn Dahir at Van- venous antibiotics to treat the school, Blocker was forced to derbilt University School of Med- resistant bacterial infection. contend with a more urgent prob- Premature failure icine in Nashville. A specialist in lem. After a two-week hospital- Between 2012 and 2016, Block- metabolic bone disorders, Dahir Blocker is trying to ensure that ization that capped months of treats patients and families af- his nearly 4-year-old son benefits abdominal pain during which his er said, he again broke his nose fected by HPP from “cradle to from his hard-won knowledge weight plummeted to 100 and wrist, along with several grave.” and experience. “He’s being mon- pounds, Blocker, who is 5-foot-10, toes. One night in February 2016 itored and as of now he’s perfectly was diagnosed with Crohn’s dis- Blocker was sitting on his bed Blocker saw Dahir in early healthy,” Blocker said. ease. The chronic inflammatory when he turned to grab some- 2018 and spent two days at Van- bowel disease causes severe diar- thing off a bedside table. He derbilt undergoing testing and He remains incredulous that rhea and weight loss. instantly felt a shooting pain in evaluation at the Center for Bone doctors did not suggest probing his hip so intense he was unable Biology. He is among a handful of the causes of his numerous frac- the approximately 100 HPP pa- tures, dental problems and low tients Dahir has treated who have ALP levels and that it was he — self-diagnosed their disease. not one of them — who came up with the diagnosis. “Aaron is a really smart guy — really medically curious,” she “You wonder where the discon- said. nect is,” Blocker said. Submit your solved medical mystery One reason his case may have to [email protected]. eluded diagnosis, Dahir said, is No unsolved cases, please. Read that the less severe form from previous mysteries at wapo.st/ which he suffers — juvenile onset medicalmysteries. — has only recently been de- People with epilepsy navigate a murky and unregulated CBD market BY ERIC BERGER have used cannabis to treat epi- tised, according to the report. cult.” compounds, creating what scien- tect consumers and allow CBD In 2013, Tonya Taylor says, she lepsy for centuries, according to The study also pointed out that About five years ago, Trina tists describe as a beneficial “en- manufacturers to sell their prod- was suicidal because her epilep- a report co-written by Sirven in the problems “mirror concerns” tourage effect.” ucts in stores as dietary supple- tic seizures kept coming even the journal Epilepsy & Behavior. raised for generic anti-seizure Ferringo of Turnersville, N.J., ments. though she was taking a long list medications, which the FDA asked a pediatric neurologist A 2017 review of CBD studies of medications. More than 180 years ago, Irish does regulate. about giving CBD to her teenage in the journal Frontiers in Neu- But Jensen Jose, regulatory Then a fellow patient at a physician William Brooke son, Luke, because his prescrip- rology, written by scientists in counsel for the Center for Sci- Denver neurologist’s office men- O’Shaughnessy administered “I’m not anti-CBD,” said Barry tion drugs were causing severe the cannabis industry, found ence in the Public Interest, said tioned something that gave Tay- drops from a hemp tincture to an Gidal, a professor of pharmacy side effects yet not preventing 71 percent of patients with treat- such legislation would actually lor hope: a CBD oil called Char- infant experiencing severe con- and neurology at the University his epileptic seizures. The doctor ment-resistant epilepsy reported make consumers less safe. The lotte’s Web. The person told her vulsions. “The child is now in the of Wisconsin at Madison who was “adamantly opposed to it” a reduction in seizures after FDA does not have the authority the oil helped people with uncon- enjoyment of robust health, and co-wrote the study and worked because of the lack of FDA over- taking the CBD-rich products, to review dietary supplements trolled epilepsy. The doctor, how- has regained her natural plump as a consultant for the Epidiolex sight and concerns it might con- but among patients taking puri- for safety and effectiveness be- ever, would discuss it only “off and happy appearance,” manufacturer. “There needs to tain THC, the chemical in mari- fied CBD, the share was only fore they are marketed and does the record” because cannabidiol O’Shaughnessy wrote at the be oversight so that patients juana that produces a high, Fer- 46 percent. not routinely analyze their ingre- was illegal under federal law, and time. know what they are getting.” ringo recalled. dients. he worried about his hospital Patients taking CBD-rich losing funding, Taylor said. Much of the recent interest in Some states, such as Michigan, Instead, in 2018, the doctor products rather than purified “If a CBD company right now The federal government has CBD stemmed from the 2013 have cannabis regulatory agen- prescribed Epidiolex. Luke went CBD also reported taking lower is doing something questionable since legalized CBD, and it has CNN documentary “Weed,” cies. As such, Gregory Barkley, a from having several seizures daily doses and experiencing or potentially unsafe, the FDA become a multibillion-dollar in- which featured Charlotte Figi, neurologist at Henry Ford Hospi- each week to a couple per month. fewer side effects. can easily remove the product dustry. The Food and Drug Ad- then 5, who had hundreds of tal in Detroit, thinks that when a Ferringo is pleased with the out- simply for being illegally market- ministration also has approved seizures each week. With the use person shops at one of the state’s come but now often fights with “Every cannabinoid when in- ed as a drug,” Jose said. If the one cannabis-derived prescrip- of CBD oil, her seizures suddenly dispensaries, “you have a pretty her insurance company because dividually tested has a degree of legislation passes, he said, the tion drug, Epidiolex, for three stopped, CNN reported. After good idea of what you’re getting.” Epidiolex, which has a list price anticonvulsant properties so FDA could not do that. rare seizure disorders. that, hundreds of families with Barkley regularly reviews his pa- of $32,500 per year, isn’t ap- that if you give a blend of various But not much has changed for children like Charlotte migrated tients’ CBD products and dis- proved for her son’s form of cannabinoids, they will have Instead, Jose said, Congress people with other forms of epi- to Colorado, which had legalized cusses how many milligrams epilepsy. some additive effect,” Barkley should provide the FDA with lepsy like Taylor who want advice marijuana in 2012. Then in 2018, they take to help control their said. more authority to regulate CBD from their doctors about CBD. the federal government removed epilepsy. Charlotte’s Web typically costs and dietary supplements and Joseph Sirven, a Florida neurolo- hemp from the controlled sub- between $100 and $400 each Bipartisan legislation in Con- more funding to hire inspectors. gist who specializes in epilepsy, stances list, which allowed com- But Barkley said CBD has month, depending on how much gress would designate CBD as a said all of his patients now ask panies to ship CBD across state inherent variability because it someone takes. Unlike Epidiolex, dietary supplement or food. The The FDA does not comment on about it. Despite the buzz around lines and meant families no lon- comes from a plant. insurance never covers it. Senate version would allow the pending legislation, spokesper- it, he and other physicians said ger needed to relocate. federal government to “take ad- son Courtney Rhodes said. they are reluctant to advise pa- “It’s no different than saying, Beyond the cost difference, it’s ditional enforcement actions” tients on over-the-counter CBD The FDA still prohibits compa- ‘I’m going to treat you with a unclear whether a highly puri- against such products. Patients such as Taylor aren’t because they do not know what is nies from marketing CBD prod- Honeycrisp apple for an ailment.’ fied CBD product such as Epidi- waiting for the federal govern- in the bottles. ucts as dietary supplements and Every apple is a little bit differ- olex is more effective than prod- Jonathan Miller, general coun- ment. After the doctor’s visit, she The FDA does little to regulate making claims about their ben- ent,” Barkley said. “The lack of ucts such as Charlotte’s Web that sel to the U.S. Hemp Roundtable, borrowed money from family CBD, so trade groups admit that efits for conditions such as epi- standardization makes it diffi- contain CBD and other plant a coalition of hemp companies, members and bought a bottle of the marketplace includes poten- lepsy. said the legislation would pro- Charlotte’s Web. tially harmful products and that quality varies widely. They say The agency is gathering “re- ANGELA WEISS/AGENCE FRANCE-PRESSE/GETTY IMAGES “The effects were night and pending bipartisan federal legis- search, data and other safety and day,” she said. “I was able to get lation would protect those who public health input to inform our CBD oils at Empire Standard, a hemp extract processing and distribution plant in Binghamton, N.Y. out of bed.” use CBD. But some consumer approach and to address con- advocacy groups say the bills sumer access in a way that pro- She befriended a grower and would have the opposite effect. tects public health and main- spends about $50 per month on Caught in the middle are Tay- tains incentives for cannabis CBD powder, gummies and oil. lor and other patients desperate drug development through es- She now takes only one prescrip- to stop losing consciousness and tablished regulatory pathways,” tion medication for seizures having convulsions, among other Janet Woodcock, then the FDA’s rather than four. She has about symptoms of epilepsy. They must acting commissioner, said in one seizure per month, which navigate the sometimes-murky 2021, according to a dietary sup- means she cannot drive. Her CBD market without the benefit plements trade group. medical providers still do not of regulations, guidance from seem open to discussing CBD, doctors or coverage from health “The FDA has really done little she said, but that doesn’t bother insurers. In short, they are “at to protect consumers from an her much. the mercy and the trust of the unregulated marketplace that grower,” said Sirven, who prac- they have created,” said Megan “After being on it for this many tices at the Mayo Clinic in Jack- Olsen, general counsel for the years and seeing the evidence — sonville, Fla. Council for Responsible Nutri- the 180-degree turnaround that Although the CBD industry is tion, another dietary supple- my life made — it’s a choice I’m new territory for the FDA, people ments trade group. going to make whether they are with it or they are against it,” she A recent study in Epilepsy & said. “It’s working for me.” Behavior on 11 oils found that This article was produced by Kaiser three contained less CBD than Health News, a program of the claimed, and four contained Kaiser Family Foundation, an more. Charlotte’s Web contained endowed nonprofit organization that 28 percent more CBD than adver- provides information on health issues to the nation.
TUESDAY, JULY 12, 2022 . THE WASHINGTON POST EZ EE K E5 Women’s Physician’s videos show periods, funny side of medicine asthma problems HEATHER DUNHAM ISTOCK TIKTOK FROM E1 reaction. And those are the ones where there’s a lot of truth about a ASTHMA FROM E1 Lynn Johnson, a board member for the Asthma and Allergy monologist and researcher at the year of residency at the University subject that’s a little bit more Foundation of America, noticed that her asthma symptoms Cleveland Clinic. One study of Iowa. Then, on May 12, 2020, he sensitive . . . people have a more Larger puzzle intensified just before her period. found that hormonal contracep- went into cardiac arrest (not heart of a reaction to it because they Aggravation of symptoms tion improves symptoms; an- attack) and was saved by his wife, feel heard. [Not matching] is a her asthma symptoms and men- University Medical Center, who other did not. Kristin, who performed CPR. Fla- really difficult thing to deal with, around menstruation is just one strual cycle on a spreadsheet. She studies the role of sex hormones nary still doesn’t know what and I’m able to put it through a part of a larger puzzle of the role noticed, as Jess Johnson had, that in asthma. “That doesn’t make a Part of the reason for the hazi- caused his heart to stop beating. lens of humor. sex differences play in asthma. In they intensified just before her lot of sense.” ness about oral birth control’s Q: I watched some reaction general, the different levels of sex period — a phenomenon experts efficacy for asthma symptoms From his home in Portland, videos from doctors. The trauma hormones in males vs. females call “perimenstrual asthma.” The best explanation experts might have to do with when the Ore., Flanary, who served as the surgeon laughed really hard at seem to cause an increase in the have is that the fluctuations in studies were conducted. Most of Yale Medical School commence- the part where the “surgeon” tells number and severity of asthma Changes in asthma symptoms levels of sex hormones underlie the research on oral birth control ment speaker this year, talked the “medical student” he’s mad at cases in adult women. And the align with the ebb and flow of perimenstrual asthma, says Sally is decades old, when the amounts about finding humor in the every- the student for not being psychic. rise and fall of hormones during estrogen and progesterone dur- Wenzel, a pulmonologist and di- of hormones in the pills were day, what he hears from other “It’s wrong, but it’s also true,” said the menstrual cycle seems to ing the menstrual cycle, which rector of the University of Pitts- different from all the options doctors and his side hack as a the surgeon. How do you know exacerbate asthma symptoms, usually lasts 28 days, researchers burgh Asthma & Environmental available today. Cameo star. This interview has the little idiosyncrasies so well? too. say. Typically, when the symp- Lung Health Institute. been lightly edited for style and A: Every specialty in medicine toms of people like Jess Johnson “It’s a study begging to be done clarity. has a kind of personality, an Differences related to asthma and Lynn Johnson start to wors- As for why the change in hor- again, but using different hor- Q: How did this whole social essence, and they’ve been the between males and females start en, they are about a week away mones matters more than abso- monal combinations,” Wenzel media gig get started? same since the beginning of early and shift dramatically as from starting their period. At that lute amounts, researchers are says. A: It’s been a little bit surprising, modern medicine. I don’t know if people age. While more adult point, their levels of progesterone less sure. The fall in progesterone I’ve just done it as a creative the specialty makes the women live with asthma than do and estrogen have begun to before menstruation seems to Plus, there is a lot of variation outlet. I started doing the video personality or the personality is men, the trend is flipped for plummet. Asthma exacerbations play an important role in trigger- between people in terms of levels format at the right time — drawn to the specialty, it’s a children: Before puberty, boys persist as the levels of hormones ing perimenstrual asthma. But of sex hormones, types of asthma especially with the pandemic, chicken or egg kind of thing. I are 1.5 times more likely to have fall to their lowest point during “exactly how it triggers it again, I and exposure to risk factors. And more people have been on online. draw a lot on my experience from asthma than are girls, and twice menstruation, when women get think, is pretty unclear,” Wenzel there are additional factors that It’s been a little bit surprising how med school, and even though I’m as likely to be hospitalized for their periods. says. influence the immune system — popular the characters are — it’s 10 years removed from med their symptoms. Experts attri- and indirectly, asthma — such as taken on a life of its own. school, things don’t really change bute this in part to structural These changes in symptoms Help for symptoms the genes contained on X vs. Y Q: Why do you think it’s become — there’s always going to be the differences in the lungs, since during the menstrual cycle are Because hormone fluctuations chromosomes. That makes it hard such a hit, particularly for people dynamic between surgery and boys have airways that are dis- confusing given what researchers to speak in generalizations such outside the medical world? anesthesia. Sometimes I’ll still proportionately narrow com- know about the role of sex hor- seem to trigger perimenstrual as “birth control is bad” or “birth A: They may not get some of the have to do some research, so I’ll pared with the large volume of mones in males and females. asthma, researchers suspected control is good,” Chiarella says. terminology, some of the jokes, get on Reddit message boards their lungs. Female sex hormones can in- that therapies providing con- “It’s very context dependent.” but they get the personalities, and and read what people love about crease inflammation in and stant amounts of hormones — that resonates with people. That’s being a neurologist or a When puberty hits, though, around the lungs, “but the times such as some types of oral birth Personalized medicine, or tai- a big compliment to me, that cardiologist, so I’ll get a lot from children’s systems are flooded in which the symptoms appear control — might temper symp- loring the therapy to the unique people who are not in medicine that. with sex-specific hormones. Fe- are when [levels of hormones] toms. But “it’s kind of a mixed context of the patient, makes the still watch, because that tells me Q: Do you ever get any flack from males get higher levels of estro- are lower,” says Dawn Newcomb, bag” when it comes to the scien- most sense, he says. my acting skills are decent. doctors? gen and progesterone, and males associate professor at Vanderbilt tific evidence in support of that Q: A lot of the doctors you portray A: I never get backlash from get higher levels of testosterone. prediction, says Joe Zein, a pul- That is the approach that final- have very specific personality surgeons. I’ve gotten the most The change in hormonal milieu ly helped Lynn Johnson. When traits. What is an backlash from family medicine/ drives what researchers call the Johnson was hospitalized for re- ophthalmologist’s personality? primary care doctors. They don’t “puberty switch,” when women spiratory failure five years after A: We’re kind of boring. We don’t like the portrayal of the some of overtake men in the number of her diagnosis, she told her pul- like to work for long periods of them as overworked, underpaid new asthma cases, with about monologist about her spread- time. We love taking breaks. We sympathetic figure, always doing two adult women diagnosed for sheet. They looked at the docu- really enjoy sitting down. That’s some sort of fellowship. They every one man. ment, and Johnson’s doctor effectively a personality — “loves think that by portraying the agreed that there was an associa- to sit down.” character that way, I’m The ways that each of the sex tion between her menstrual cycle Q: You wrote in your bio about dissuading people from entering hormones affects the lungs are and asthma symptoms. doing stand-up, but never that field, which I don’t buy for a complex, and their effect varies explained how you ended up second. But it’s a minority — most depending on which cells are Together they made a plan. becoming an ophthalmologist? people are just fine with it. involved. On balance, though, the During a normal week, Johnson A: When I started med school at Q: What did you learn about testosterone that kicks in after would use her nebulizer — a way Dartmouth, everyone was being a doctor from being a puberty in males helps protect to self-administer asthma medi- assigned a random adviser, and patient? against asthma by decreasing in- cation — each morning, adding my adviser was an A: It reinforced for me how flammation. Estrogen and pro- an extra dose a couple of times a ophthalmologist. It wasn’t until I important it is for doctors to show gesterone, on the other hand, week as needed. Before her peri- was able to do a rotation in who they are from a personality increase inflammation and can od, however, she would ramp up ophthalmology at the beginning standpoint. For a long time, therefore worsen asthma, says her medications. Based on her of my fourth year that I made the there’s been this idea that it’s not Sergio Chiarella, an allergist-im- doctor’s advice, she would dose decision, so I decided really late. professional to show that side of munologist at the Mayo Clinic. herself with one kind of asthma It was the juxtaposition between yourself as a doctor; that you’re medication every four hours my previous rotation, which was supposed to be this emotionless For example, progesterone can round-the-clock, and another ev- vascular surgery, where you’re machine and you can’t show that impair the hairlike structures ery eight. standing for like six-hour cases, things affect you mentally, or that line the airways. Those holding the retractor and you make you angry or sad or laugh. structures — called cilia, Latin for “It’s helped me plan and man- have really sick patients. And Social media is a great way to eyelash — undulate back and age my asthma a whole lot bet- then there’s ophthalmology, show that side, because you can forth to propel inhaled debris out ter,” Johnson says. where I get to sit down to operate. reach a big audience and it shows of the lungs. Researchers have I get to go home at a reasonable the public that we have things shown that progesterone de- But doctors and researchers time and develop meaningful that suck about our job or that we creases the cilia’s movement and still have many questions about relationships with my family. I hate health care, and it allows the makes it harder to expel outside the links between asthma and sex like knowing there’s an end to my general public to relate to us, and particles that wander into the hormones. And when, historical- day when you get to go home. that’s something that’s been body. Those outside particles can ly, two times more women have Q: You made a video in March missing for a long, long time. then nestle into the lungs and died of asthma than men, an- about “Match” day, where Q: I see that you are frequently worsen the inflammatory re- swering those questions is impor- medical students “match” into hired on Cameo ($249) to send sponse in women with asthma. tant. Without more research to residency, basically cementing messages — usually fill in those gaps, doctors and their medical specialty. But your congratulations on medical But while female hormones patients must continue operating video focused on the students school acceptance but also for increase the risk for asthma over- without “clear-cut recommenda- who don’t match, and how they’ll wedding anniversaries. How is all, the picture gets more compli- tions,” Zein said. be okay. That garnered so many that working out? cated when looking at the day-to- comments from students and A: I’ve done more than 1,000 day experiences of women with doctors. Cameos! asthma, whose symptoms can A: That’s a good example of one Q: Does your family think you’re change over the course of their that surprised me. One thing I’ve as funny as everyone else does? menstrual cycles. learned is that the videos that get A: No! They’re all funnier than ‘Perimenstrual asthma’ the biggest reaction are the ones me. where there is an emotional Lynn Johnson, a board mem- ber for the Asthma and Allergy Foundation of America who lives in Alabama, was diagnosed with asthma at age 45. After her diag- nosis, Johnson began charting Why can’t we remember things that happened to us when we were infants? MEMORY FROM E1 course, infants cannot exactly tell a baby naturally presses down. ing infants on one of these tasks 6 months, if infants are trained as they said in the 1970s when the you what they remember. So the Next, they turn the lever on, and for a couple of days, Rovee-Col- for one minute, they can remem- task was created. about babies and memory. key to Rovee-Collier’s research every time the infant presses on lier later tested whether they ber an event a day later. The older Infants can form memories was devising a task that was it, the train moves around its remembered it. When the little the infants were, the longer they Then researchers place the sensitive to babies’ rapidly track. Infants again learn the ones returned to the lab, re- remembered. She also found that infant in front of a mirror. In- While people cannot remem- changing bodies and abilities to game quickly and press on the searchers showed them the mo- training infants for longer peri- fants younger than 18 months ber much before age 2 or 3, assess their memories over a long lever significantly more when it bile or train and measured ods of time and giving them just smile at the cute baby in the research suggests that infants period. makes the train move. whether they still kicked or reminders — for example, show- reflection, not showing any sign can form memories — just not pressed the lever. ing them the mobile moving very they recognize themselves or the the kinds of memories you tell In the version for 2- to 6- What does this have to do with briefly on its own — helps them red mark on their face. Between about yourself. Within the first month-old infants, researchers memory? The cleverest part of Using this method, Rovee-Col- remember events longer. 18 and 24 months, toddlers touch few days of life, infants can recall place an infant in a crib with a this research is that after train- lier and colleagues found that at their own nose, even looking their own mother’s face and dis- mobile hanging overhead. They Autobiographical memories embarrassed, suggesting that tinguish it from the face of a measure how much the baby ISTOCK If infants can form memories they connect the red dot in the stranger. A few months later, kicks to get an idea of their mirror with their own face — infants can demonstrate that natural propensity to move their in their first few months, why they have some sense of self. they remember lots of familiar legs. Next, they tie a string from don’t people remember things faces by smiling most at the ones the baby’s leg to the end of the from that earliest stage of life? It Another possible explanation they see most often. mobile, so that whenever the still isn’t clear whether people for infantile amnesia is that be- baby kicks, the mobile moves. As experience infantile amnesia be- cause infants don’t have lan- There are plenty of different you might imagine, infants cause we can’t form autobio- guage until later in the second kinds of memories besides those quickly learn that they’re in con- graphical memories, or whether year of life, they cannot form that are autobiographical. There trol — they like seeing the mobile we just have no way to retrieve narratives about their own lives are semantic memories, or mem- move and so they kick more than them. No one knows for sure that they can later recall. ories of facts, such as the names before the string was attached to what’s going on, but scientists of different varieties of apples, or their leg, showing they’ve have a few guesses. Finally, the hippocampus, the capital of your home state. learned that kicking makes the which is the region of the brain There are also procedural memo- mobile move. One is that autobiographical that largely is responsible for ries, or memories of how to memories require you to have memory, isn’t fully developed in perform an action — think open- The version for 6- to 18-month- some sense of self. You need to be the infancy period. ing your front door or driving a olds is similar. But instead of able to think about your behavior car. lying in a crib — which this age with respect to how it relates to Scientists will continue to in- group refuses to do for very long others. Researchers have tested vestigate how each of these Research from psychologist — the infant sits on their parent’s this ability in the past using a factors might contribute to why Carolyn Rovee-Collier’s lab in the lap with their hands on a lever mirror-recognition task called you can’t remember much, if 1980s and 1990s famously that will eventually make a train the rouge test. It involves mark- anything, about your life before showed that infants can form move around a track. At first, the ing a baby’s nose with a spot of age 2. some of these other kinds of lever doesn’t work, and the ex- red lipstick or blush — or “rouge” This article was originally published memories from an early age. Of perimenters measure how much on theconversation.com.
E6 EZ EE THE WASHINGTON POST . TUESDAY, JULY 12, 2022 NWS SEATTLE Earlier this month, the National Weather Service office in Seattle took this image of noctilucent clouds, which appear during the summertime in each hemisphere. This summer sees more rare, night-shining clouds BY KASHA PATEL absence of extraordinary events, typically appear around dusk or tilucent clouds earlier this month missions can lead to the forma- might take some time to see the Early this month, sky watchers they can appear over the north- dawn. Unlike other clouds, they was higher than noted in at least tion of noctilucent clouds. effect on the behavior of the in the upper United States, Cana- ern continental U.S.” form so high in the atmosphere 15 years of observations by the clouds. da and Europe spotted a flurry of that they can continue to reflect AIM mission. Yet the reason is a At least 16 rockets were shimmering, ghostlike wisps in The clouds most commonly sunlight after the sun dips below bit of mystery. launched in June, “any of which “This season might be too soon the night sky. occur near the poles but occa- the horizon, illuminating the could have been responsible for to get some impacts,” said De- The blue-silver streaks shine sionally appear at lower latitudes clouds from below. Noctilucent clouds rely on two some clouds forming,” said Mi- land, a scientist with Science, brightly only after the sun has as well. Rare and vibrant sight- main ingredients in the meso- chael Stevens at the Naval Re- Systems and Applications at disappeared beyond the horizon, ings had been reported from Or- “They’re really sphere: plenty of water vapor and search Laboratory. He said two NASA. The “question becomes entrancing viewers with their egon, Washington, Canada, Brit- remarkable to see.” cold temperatures to aid ice crys- launches from the United States how long does it take to transport beautiful yet somewhat eerie ap- ain and Denmark recently. The tal formation. Randall and col- on June 18 and 19 are probably the water vapor upward in the pearance. best chance to see the clouds is to Atmospheric scientist league Lynn Harvey said data the best candidates for contribut- atmosphere to the region where These are not your everyday find a clear view close to the Matthew Deland from the Microwave Limb Sound- ing to the recent uptick in cloud the clouds form.” clouds. horizon and look north. er on NASA’s Aura satellite sightings, as it can take up to 10 Researchers say these noctilu- “This season has been quite showed temperatures near the days for the water vapor plume Deland said the vibrant cloud cent, or night-shining, clouds are “There’s really nothing else extraordinary” recently, said mesopause increased a few weeks from the rocket to reach the activity at lower latitudes such as the rarest, driest and highest quite like them,” the National Randall, who is also the principal ago and were about average for latitudes where the clouds form. Seattle is uncommon and he is clouds on Earth. The uptick of Weather Service office in Seattle investigator for the Cloud Imag- this time of year. But water vapor This explanation is preliminary, not sure if it will persist for the recent activity has been unlike wrote on social media. ing and Particle Size instrument concentrations are at a record however, and would require a rest of the season. He said it any seen in at least the past 15 on NASA’s Aeronomy of Ice in the high for this time of the year in 15 quantitative analysis to confirm. depends on circulation patterns years, according to satellite data. Noctilucent clouds, also Mesosphere (AIM) mission that years of observations. and whether there are embedded “Folks in the northern U.S. and known as polar mesospheric was designed to study the night- Atmospheric scientist Mat- waves that allow cold tempera- Canada should absolutely be on clouds, appear during the sum- shining clouds. “The season be- “The increase in temperature thew Deland said the eruption tures or extra water vapor to get the lookout for noctilucent mertime in each hemisphere at gan as a rather average season, would be unfavorable for clouds, from the underwater volcano drawn down to lower latitudes. clouds,” Cora Randall, a professor about 50 miles high in the layer of but [recently] the cloud frequen- but the increase in water vapor Hunga Tonga on Jan. 15 also On rare occasions in recent years, at the University of Colorado the atmosphere called the meso- cies have increased dramatically.” would be favorable,” Randall pumped large quantities of water the clouds have appeared in lati- Boulder, said in an email. “We are sphere. They form when water said. vapor into the stratosphere. The tudes as low as London, central near the peak of the noctilucent vapor congregates around specks She said the frequency of noc- volcano even spewed material 36 California and Oklahoma. cloud season, and even in the of meteor dust floating in the Randall said one explanation miles high and reached the meso- mesosphere and freezes, forming for the increase in water vapor sphere, setting a world record of “They’re really remarkable to ice crystals. could be tied to rocket launches. the highest volcano plume on see,” Deland said. “The clouds Previously, researchers found wa- satellite record. But he said it really just shine against the dark These thin, wavy, icy clouds ter vapor released from these sky.” glow bright blue and white and INSPIRED LIFE In rare surgery, two women share one organ and become ‘split-liver sisters’ BY SYDNEY PAGE were “in disbelief ” at her deci- Maria Contreras and Monica sion, and they were “praying I Davis share many things — would change my mind.” including a vital organ. To their relief, a few years later, The two Ohio women, who she did. refer to themselves as “split-liver “I owe it all to my faith, my sisters,” received a liver trans- family and my friends,” Davis plant on July 1, 2020. But it wasn’t said, adding that she had an an ordinary transplant surgery: epiphany one day and realized They had a split-liver transplan- she still had a life worth living. tation, in which a donor’s liver In May 2019, Davis’s name was was divided into two distinct added to the national list of pro- portions, which were then im- spective organ recipients, man- planted into each patient. aged by the United Network for “This is an extremely rare pro- Organ Sharing, a nonprofit or- cedure,” said Koji Hashimoto, a ganization that runs the country’s surgeon at Cleveland Clinic, who transplant system. performed Contreras’s operation Meanwhile, Contreras — using 40 percent of a deceased whom Davis did not know at the donor’s liver. time — had been patiently wait- The remaining 60 percent ing for a new liver for several went to Davis, whose surgery was years. She almost died in the performed simultaneously by a process. different surgeon. In 2019, she needed to get a The women shared the same stent in her heart to address a diagnosis. separate health condition, and Contreras — a Cleveland-based she had a near-fatal reaction to mother of four and a grandmoth- the blood-thinning medication er of two — was diagnosed with she was prescribed because her cirrhosis of the liver in 2014 after liver couldn’t properly process it. she started experiencing severe “My body wasn’t able to heal,” itching on her hands and feet, Contreras said. “It was back and CLEVELAND CLINIC prompting doctors to perform a liver biopsy. forth to the hospital.” Maria Contreras, 53, and Monica Davis, 59, with their respective surgeons, Koji Hashimoto, left, and Cristiano Quintini. “It was at the point that I After six years of waiting — and couldn’t sleep,” said Contreras, doing everything she could to mines the size of the liver need- What is much rarer, he contin- The day after her transplant, “I Davis — both of whom had 53, who was informed that she stay healthy — Contreras received ed,” Hashimoto said. “It’s also ued, is dividing one liver between was asking my nurse, ‘Do you smooth recoveries and are able to would probably be on the trans- a call on July 1, 2020, from her very important to take into con- two adults. Of the more than know about my liver sister?’” lead relatively normal lives — plant list for 10 years or more. “I transplant coordinator that it sideration how sick the patient is. 9,000 liver transplants per- Contreras recalled. “I was so ex- shared a tearful hug at Cleveland felt depressed.” was finally her turn to receive a If you have a really sick patient, formed in the United States in cited to see her.” Clinic. Their instant bond, they Around the same time, Davis, lifesaving liver. She had to com- you need a bigger liver.” 2021, only a small number were said, was overwhelming. 59, started experiencing agoniz- mit to the surgery immediately, adult-only split-liver transplanta- “Not all donors are ing stomach pain, and in January because the transplant would The health of the donated liver, tions, Hashimoto said. good for split-liver in “It was great to meet my sister,” 2014, she, too, was told she had take place later that same day. which grows to be a standard size terms of quality. We Davis said. The closeness she feels cirrhosis of the liver. And there was a caveat: She about six to eight weeks after the The reason, he added, is that with Contreras “is so powerful to “The diagnosis was really life- was told she would be sharing the transplant, is also crucial to con- “it’s very labor-intensive” and re- have to use very me, it’s hard to describe.” threatening,” Davis said, adding organ with another patient, sider. quires three medical teams work- complex techniques that at first, “I really wasn’t inter- through a rare and potentially ing at the same time. One team to divide the liver Contreras agreed. ested in having the transplant.” risky medical procedure. “Not all donors are good for works on the donor, while the “When we met, I cried, I Despite knowing it was the Contreras didn’t think twice. split-liver in terms of quality,” other two perform the transplant into two pieces.” hugged her, I was jumping with only available treatment for end- “I was just happy because I was Hashimoto said, adding that the surgeries. her,” she said. “I could feel the stage liver disease, Davis decided going to have a new liver,” she quality of the organ is naturally Surgeon Koji Hashimoto connection.” she did not want to add her name said. “It didn’t matter if it was half diminished when it is divided, so Hashimoto said that blood “I was so happy, and I said, to the list of more than 100,000 or whole. I was just thinking a young, healthy donor is neces- clotting and other complications Because of privacy policies, it ‘Thank you God,’ because He Americans who need a lifesaving about a new life.” sary for the procedure. “We have are more likely with split-liver was difficult to coordinate a gath- didn’t only give me a new life, but transplant. An average of 17 peo- Her surgeon, Hashimoto, to use very complex techniques to transplantation, although the ering, and the pandemic also He gave me a new sister, too,” ple die every day while awaiting briefed her on what a split-liver divide the liver into two pieces.” long-term survival rate is the postponed their plans to meet Contreras continued. their turn to receive an organ. transplantation entailed and out- same. safely. Hashimoto was also present “My children were all grown, lined why she was a good candi- The split-liver transplantation for the meeting, as well as Davis’s and I didn’t think my husband date. was pioneered in Germany in the Still, for Contreras and Davis, Both women are immunocom- doctor, Cristiano Quintini. would need me around. He is so A patient’s degree of sickness late 1980s and was initially per- “the risk would have been higher promised and had to be especially Seeing the split-liver sisters self-sufficient,” said Davis, who and their size are the main factors formed on one pediatric and one waiting. This was a better option,” careful in the months after their together — in good health — “that lives in Elyria, Ohio, and has that must be considered before a adult patient. he said. procedures. was rewarding,” Hashimoto said. three children and four grand- split-liver transplantation, The women speak regularly on children. “In hindsight, I know I Hashimoto said. In this case, both Child-adult split liver trans- “I’m just glad that option is Finally, in April, Contreras and the phone, and they have sched- shouldn’t have been thinking like patients were considered suitable plants are “relatively common,” available, because two people re- uled a second meetup. that.” in size and illness progression to said Hashimoto, and they are ceived a blessing that day,” echoed Their shared liver, they believe, Her family members, she said, be viable recipients of a partial performed by splitting the organ Davis, who was also given just has made them feel inextricably liver. into two portions, one of which is hours’ notice before her liver linked. “The size of the patient deter- 20 percent and the other 80 per- transplant. “We are going to be friends cent. forever,” Contreras said. “She is a Both surgeries were successful, part of me.” “A smaller piece goes to the and almost immediately after child and a larger piece goes to their operations, the two women the adult,” he said. were eager to meet.
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