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Our Monthly Newsletter And Notes
From Nancy
I hope that you find this newsletter informative and helpful. I try to browse the
net to find interesting information about GERD. This month has been a very busy
month. Great News! We've found someone who is willing to print out the
brochures for us---free of charge!!! So, we'll hopefully have those done by this
time next month! If you would like one mailed to you, please email me your name and
address. If you would like several to hand out and give your ped to hand out, just
let me know that too.
There is not much going on in the world of GERD this month! I wasn't able to find
much at all.
Lets's work really hard in the coming months to SPREAD THE WORD---the GERD WORD!!
We've added about 10 new members to the Reflux Support Email Loop in the last month and
look forward to adding even more!
Take care, and write me if you have any questions!
Nancy
Here is a link to Last month's newsletter: August
Newsletter
This Month's Newsletter Includes:
1: Experience with 220 consecutive laparoscopic Nissen fundoplications in infants
and children: Abstract
2: An ABSOLUTELY FANTASTIC description and explanation of reflux by Dr. Greene(not
ER's doctor--LOL---Dr. Greene of House Calls--a great web site)
3: FDA Issues Heartburn Drug Warning for Propulsid.(See PROPULSID Warning
Letter)
4: Baby of The Month!
5: We are working on trying to get funding, sponsorship and
banner advertising on the GERD WORD!
6: "How Everyday Medicines Can Drive You Crazy! (Really) By: Joe
and Teresa Graedon, PhD
1: Experience with 220 consecutive laparoscopic Nissen fundoplications
in infants and children
Abstract
Backgroond/Purpose: Fundoplication for gastroesophageal reflux disease is a common
procedure performed in infants and children. This report describes a 4-year experience
with 220 consecutive laparoscopic Nissen fundoplications.
Methods: Ages ranged from 5 days to 18 years and weight from 1.4 to 100 kg. The procedures
were performed using a five-trocar technique and with 5- or 3.4-mm instruments depending
on the size of the patient.
Results: Two hundred eighteen fundoplications were completed successfully. Average
operative time dropped dramatically from 109 to 55 minutes for the first 30 cases compared
with the last 30, Intraoperative and postoperative complication rates were 2.6% and 7.3%,
respectively, Average time to discharge postfundoplication was 1.6 days, The wrap failure
rate is 3.4%.
Conclusions: This study shows that although the learning curve for laparoscopic
fundoplication may be steep, the procedure is safe and effective in the pediatric
population. The clinical results are comparable to the traditional open fundoplication but
with a significant decrease in morbidity and hospitalization.
JOURNAL OF PEDIATRIC SURGERY33274-277
Author: Rothenberg,S.S. Date: 1998/02//
2: Dr. Greene's wonderful response to the question: "My
daughter has gastroesophageal reflux. Will she outgrow it? How long will it last?"
Click Here: House Calls
3: FDA Issues Heartburn Drug Warning for Propulsid.(See PROPULSID
Warning Letter
WASHINGTON (AP) - The government urged doctors Monday to prescribe heartburn
patients every reasonable alternative before trying the drug Propulsid, issuing new
warnings that it may cause serious heart problems.
The Food and Drug Administration strengthened warnings on Propulsid's label after reports
of hearth rhythm abnormalities, including 38 deaths, since the pill hit the market in
1993.
The FDA noted that it cannot prove the drug caused any deaths, but said Propulsid -
approved specifically for nighttime heartburn - already was known to cause heart
arrhythmias when taken together with certain other medicines. Monday's action strengthens
those warnings, adding newly discovered drug interactions and a list of other illnesses
that increase the risk.
Manufacturer Janssen Pharmaceutica wrote thousands of doctors and pharmacists Monday to
alert them to the strengthened warnings.
The warnings say:
Never prescribe Propulsid, known chemically as cisapride, to patients taking a list of
other drugs, including such antibiotics as erythromycin, antifungals such as ketoconazole,
certain antidepressants or any AIDS drugs known as protease inhibitors.
Never prescribe Propulsid to patients with congestive heart failure, chronic obstructive
pulmonary disease, advanced cancer or electrolyte disorders, including dehydration and
vomiting. Also do not give it to patients needing acute-care diuretic or insulin
treatment.
There are some people who still could benefit from Propulsid, said FDA drug chief Dr.
Murray Lumpkin. But ``this really ought to be the drug for after you've tried everything
else,'' he stressed.
AP-NY-06-29-98 1811EDT
:
4: We Need Reflux Child of the Month Candidates!!
We have an entire page here on the GERD Word devoted to our Reflux CHild of the
Month. We need more children! If you would like to submit your child's story
and photo, please click here and send them to Nancy. Please send photos in .jpg
format.
5: We are working on trying to get funding, sponsorship and banner
advertising on the GERD WORD!
We need your help! If you know of ways to get sponsorship or grant
money please email Nancy! We are in need of financial assistance to keep this web
site up and running. We also would like to move it to it's own
domain---www.GERDWORD.org to make it easier to find. We are also considering selling
advertising on the GERD Word to companies that sell products for children suffering from
reflux.
6:"How everyday medicines can drive you crazy (really)"
by Joe and Teresa Graedon, Ph.D.
The Star-Ledger newspaper, August 25, 1998
When Sylvia was put on a heartburn medicine called Reglan, she never expected to
experience a psychotic breakdown. After all, how could something for your stomach affect
your brain? Yet Sylvia was in and out of a mental hospital during the times she was
on Reglan because she experienced hallucinations, depression, confusion and anxiety.
She wondered whether any of her medicines might be contributing to her problems, but her
psychiatrist didn't think that was likely. Little did he know that Reglan (metoclopramide)
can cause psychiatric symptoms such as severe depression and hallucinations, seizures,
insomnia, involuntary muscle contractions and restlessness. Linda was put on the
antibiotic Floxin (ofloxacin) for a urinary tract infection. She took her medicine for
granted, expecting a rapid cure with few side effects. In the past, antibiotics had caused
some stomach upset and mild diarrhea. Floxin was different. Insomnia, anxiety, visual
disruption, paranoid thoughts and hallucinations
panicked Linda. she was diagnosed with toxic psychosis. Like Sylvia and Linda, most
people are unprepared for psychiatric reactions to everyday medicines. We heard from one
bereaved daughter whose father committed suicide after taking the cholesterol-lowering
drug Zocor (simvastatin) for a few years: "Prior to that he had never been depressed.
I have since met a patient who can directly attribute the start of depression with
beginning on Zocor and its end with stopping the drug." Another reader
described her downward spiral after starting hormone replacement therapy. The migraines
that resulted led to a prescription for a beta blocker called propranolol. Within months
she found herself severely depressed and barely able to function. When the hormones were
discontinued, her migraines stopped. Without headaches or medication the depression
lifted.
Many physicians do not warn patients about psychiatric side effects. When someone reports
anxiety, depression or insomnia, doctors may assume the problem lies with the patient's
coping skills or life circumstances. This faulty thinking is sometimes extended to
patients having trouble getting off anxiety medicines such as Ativan or Xanax or
antidepressants like Effexor, Paxil or Zoloft. Some physicians believe withdrawal
difficulties are caused by a return of the patient's initial complaint. One woman
was distressed that her doctor did not take her symptoms of dizziness, bizarre dreams,
headaches, sensory disturbances and anxiety seriously. Although he had heard of Paxil
withdrawal, he thought only "troubled" or seriously depressed patients had such
problems, and she didn't fit that category. Readers of this column who would like to
know more about such reactions may want to order our guides to Psychological Side Effects
and Antidepressant Pros and Cons. For a copy, please send $2 with a long (No.10) stamped,
self-addressed envelope to Gradeons' People's Pharmacy,
No. MD-209, P.O. Box 52027, Durham, N.C. 27717-2027. Physicians and patients must
recognize that symptoms ranging from depression or disorientation to anxiety and
hallucinations might be due to medication. Certain antibiotics, cholesterol-lowering
drugs, pain relievers and steroids such as prednisone are just a few of the commonly
prescribed drugs that can trigger psychiatric side effects.
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