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Roald Dahl’s Heartbreaking Lesson About Childhood Vaccinations

Olivia Dahl was seven years old in November 1962 when she displayed the hallmarks of a measles infection. After days in bed, her fever waned—but the next morning, her condition soon deteriorated.By Charlotte Brown Stork, MD

November 23rd marks the anniversary of the death of Roald Dahl, the beloved British storyteller. During his illustrious and prolific career Dahl penned several screenplays, nine collections of poetry, works of non-fiction, and nineteen adored children’s books. He dedicated two of his most famous novels to his oldest daughter, Olivia. He wrote the first, James and the Giant Peach, when she was still alive.

He dedicated the second book, The BFG, to her memory after she died from measles.

Olivia Dahl was seven years old in November 1962 when she came home from school with a letter from the headmistress notifying parents of a measles outbreak. At that time, this was not particularly alarming or unexpected. The measles virus, also known as rubeola, is extraordinarily contagious. Before the discovery of a vaccine in 1963, infection was a nearly universal childhood experience.

Three days later Olivia displayed the hallmark fever, runny nose, cough, and blotchy red rash that characterize a measles infection. After days in bed, her fever waned and recovery seemed imminent. The next morning however, Olivia started to complain of a headache and sleepiness. Her condition soon deteriorated rapidly—and later that night she died. Olivia had developed encephalitis (inflammation of the brain), a rare and sometimes fatal complication of measles.

When Measles Turns Scary

Although most patients will recover from measles on their own without any serious or permanent damage, the virus can be extremely severe and dangerous. Close to 30 percent of measles patients will experience complications, including ear infections, croup, diarrhea and pneumonia. Although rare, complications can lead to blindness, permanent brain damage, and death. In developed countries, one or two out of every thousand children who get measles will die; in the developing world the mortality rate is as high as 10 percent. According to the World Health Organization, measles remains one of the leading causes of death among children worldwide.

Following the introduction of the first measles vaccine in 1963, measles rates began a steady decline. By 1995 measles deaths had fallen by 99 percent in the United States and 95 percent worldwide. In 2000, U.S. measles rates hit an all-time low; the CDC declared that endemic measles had been eliminated.

But in recent years, the infection rate has started to rise. In 2011, there were 220 cases in America. So far in 2014, there have been 592 confirmed cases.

Why in a day and age where we have access to a vaccine that is safe and effective do we have an increasing number of measles cases in this country? In short, because a significant percentage of children in this country remain unprotected. Once introduced into a community, measles can rapidly spread to susceptible populations, including infants too young for the vaccine (the first dose is not given until 12 to15 months), people who can’t receive the vaccine because of underlying health issues, and those who have not been vaccinated due to parental objections.

After his daughter Olivia’s death, Roald Dahl campaigned ceaselessly for childhood vaccinations. In 1986, 24 years after Olivia’s passing, Dahl penned a pro-vaccination letter to parents entitled, “Measles: A Dangerous Illness.” He implores:

“There is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunized against measles… Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.” 

As a pediatrician, I have seen the devastating effect that vaccine-preventable illnesses have on children, their families, and entire communities. I consider vaccinating a child to be the single greatest contribution I make to the health of children. This November, in memory of Roald and Olivia Dahl, talk to your physician about childhood vaccinations. As he concluded his letter, “I know how happy she would be if only she could know that her death had helped to save a good deal of illness and death among other children.”

3 Mini Health Tests You Can Do Right Now (That Might Help Save Your Life)

Scientists say your performance on everyday activities can predict as much about your health as a blood test or a brain scan. If you're worried about your results, ask your doctor if further tests or a treatment plan are needed.

Time yourself as you stand on one leg with your eyes open. Hold this position for up to 60 seconds. If you wobble after just 20, you may be at risk for future brain problems. In a Japanese study, 30 percent of older adults who couldn’t balance for this long had microbleeds in the brain. These tiny drops of blood in the brain leaked from vessels are only detectable through MRI and are an early indication of risk for stroke or dementia. While these bleeds are a warning sign of bigger brain problems to come, they have an immediate impact on balance as well as a person's memory and decision making.

Can You ... Move From Sitting In a Chair to Standing?

And back again? Do this 10 times, and watch the clock to see how long it takes. In the original study, which was performed in the U.K., adults who were able to do 10 reps in 21 seconds or less had higher rates of overall survival than those who took longer to complete the exercise. Doing well on the test requires lower-body muscle strength and power, balance and coordination, and cardiorespiratory fitness. Researchers believe that low levels of performance in the test in mid-life could indicate the presence of underlying disease even before symptoms arise.

Can You ... Touch Your Toes?

Sit on the floor with your back and head pressed up against a wall. Reach forward and try to touch your toes. If they're still far, far away from your fingers, you may be at risk for cardiovascular problems. Using this test, researchers at the University of North Texas found that a flexible body was may be a predictor of flexible arteries. The reverse was also true: People who were inflexible (and unable to touch their toes) had stiffer, less elastic arteries than those who were more lithe. When arteries have some give to them, blood can flow easily. When arteries are stiff, due to inactivity or unhealthy habits like smoking, the heart must work harder to pump blood, potentially putting the body at risk for heart attack or stroke.

Low Carb or Low Fat? Treadmill or Elliptical? Surprising Answers to 3 Contentious Health Debates Experts weigh in with the final word on the best choices for your health.

1. What’s healthier in your coffee—sugar or artificial sweeteners?

Winner: Sugar.

Go ahead and opt for the real stuff. Not because artificial sweeteners aren’t safe (they are, confirms the FDA), but the premise that we should eat “real foods” in moderation is persuasive. Whereas your body knows how to deal with sugar  (i.e., you burn it for energy and,  if you eat too much of it, store the  rest as fat), emerging animal research suggests that, on the other hand, a habit of artificial sweeteners may interfere with metabolism and blood sugar regulation, possibly even contributing to weight gain and glucose intolerance. (One possible exception: People with diabetes, who must closely monitor their blood sugar levels, should talk to their doctor about the healthiest choices for them.)

But more important than how  you sweeten your java is your overall  intake of sugar or artificial sweeteners, says Elisa Zied, RDN, a former spokeswoman for the Academy of Nutrition and Dietetics and the  author of Younger Next Week.

The World Health Organization says adults should limit sugar intake to about six teaspoons total each day (one can of soda can have about  ten teaspoons). While FDA recommended limits for sweeteners vary, Zied advises using no more than  a couple of packets a day.

2. Which provides a superior workout—treadmill or elliptical?

Winner: Treadmill.

You can raise your heart rate and burn calories on any piece of cardio equipment, but every time your foot comes down on that treadmill belt, you get the bonus of building bone strength too, says Jessica Matthews, senior adviser for health and fitness education for the American Council on Exercise. Unlike the elliptical, only weight-bearing exercises—such as walking, jogging, jumping rope, and weight training—help to  preserve bone density.

Most exercisers also simply like  the treadmill more than the elliptical, found a recent study published in the journal Perceptual and Motor Skills, which is a helpful factor if they’re  trying to stick to an exercise program. That said, folks with arthritis or who are overweight may find the lower-impact elliptical to be more comfortable for their joints, says Matthews.

3. Which diet is more effective for weight loss—low fat or low carb?

Winner: Low carb.

Researchers have been bickering over this diet dilemma for decades, but last year, a randomized study funded by the National Institutes  of Health firmly tipped the scales in favor of low-carbohydrate diets.

At the end of 12 months, low-carb eaters lost more weight than did low-fat dieters (about eight pounds more). But a low-carb diet doesn’t mean no carb, points out Melina Jampolis, MD, president of the  National Board of Physician  Nutrition Specialists.

Low carbers in the NIH study, for example, took in about 30 percent of their calories from carbohydrates—about 110 grams of carbs a day for  a 1,500-calorie diet. That equates roughly to a cup of oatmeal with  half a cup of blueberries and a  teaspoon of brown sugar, a small  apple, a cup of low-fat Greek yogurt with half a cup of high-fiber cereal, and one piece of whole wheat bread, as well as a lot of veggies and  protein. Plenty of wiggle room for pasta lovers.

5 Ways to Protect Your Arteries From a Fatty Meal

High-fat meals can constrict arteries for hours, reducing blood flow. If you can't give up grill time, this advice from holistic heart doctor Joel K. Kahn, MD, will help make a splurge meal less toxic to your arteries.By Joel K. Kahn, MD

Marinate your meat

Cooking meat at high temperatures creates compounds called advanced glycation end products (AGEs), which increase inflammation and the risk of diabetes. To minimize AGE exposure, marinate meat in lemon juice or vinegar, grill it moist at lower temperatures, and pick off charred corners.

Sip red wine

Chilean researchers found that adding about eight ounces of red wine a day to a high-fat diet reduced the meals’ negative effects on participants’ arteries. Another study showed similar benefits from grape juice.

Pad patties with healthy grains

In a Yale University study, when people ate bowls of oats or wheat cereal with a high-fat meal, their arteries didn’t constrict as much. These grains may reduce fat absorption into the body. Add oats to hamburger patties, or serve meat on whole wheat buns.

Add sliced avocado

After people ate hamburgers, UCLA researchers documented a harmful reaction in their arteries within two hours. When the people topped the burgers with a slice of avocado, the harm nearly disappeared. Nutrient-packed produce (even an avocado, with high fat content) seems to neutralize the inflammatory effects of meat.

Take a quick walk

Thirty minutes or more of brisk walking after a meal can reduce the rise of fat concentration in your blood by 10 to 25 percent.

3 Quirks You Never Knew About Your Body Temperature

Body temperature gets lower with ageiStock/AleksandarNakicYour average body temperature doesn’t stay the same your whole life, either. Temperature seems to dip slightly from decade to decade, and this change becomes particularly important in the elderly. According to the New York Times, drops of even a couple of degrees can lead to fevers going undetected. In a study published in the Journal of the American Geriatric Society, about half of patients who had infections had temperatures under 101 degrees, even though they had large swings in body temperature (of 2.4 degrees or more). Quirks You Never Knew About Your Body Temperature

Women have a higher percentage of body fat and conserve more heat around the core, which helps keep vital organs warm, but not extremities. And when your hands and feet feel cold, so does the rest of your body, Kathryn Sandberg, director of the Center for the Study of Sex Differences in Health, Aging and Disease at Georgetown University, told Reader’s Digest. Research also indicates that women have a lower threshold for cold than men. When women and men are exposed to the same freezing temperature, blood vessels in women’s fingers constrict more than men’s do, which is why they turn white more quickly.

Your temperature is not 98.6 degrees

That gold standard number came from measurements on thousands of patients calculated by German physician Carl Reinhold August Wunderlich in the 19th century—but more recent research has proved that number wrong, according to Real Clear Science. Using far more accurate thermometers, University of Maryland researchers found that the average body temperature is closer to 98.2 °F. But for what it’s worth, your temperature at any given time is unlikely to be 98.2 degrees exactly. As the site explains, “Your body's temperature fluctuates throughout the day, from roughly 97.6 °F at six in the morning to 98.5 °F at six in the evening. In fact, a temperature as high as 99.5 °F is still considered healthy.”

Picture a highway with 100 passengers. If they are driving 10 to a minivan, there are only 10 large vehicles on the road and it is not too congested. If all 100 are riding in individual small cars, there’s a lot more traffic. That is how large and small LDL.

Lots of LDL particles clog up the artery highway. Those LDL riders in cars can also be hard and dense, like a golf ball, or large and soft, like a sponge. The small, dense LDL particles do a lot more damage to arteries. This is why two people with an LDL level of 100 mg/dl can have different heart disease risks, because it’s possible that they have widely different particle numbers and sizes. If someone has fewer than 1,000 LDL particles in a blood sample and they are large in size, their risk for hardening of arteries is low. A second person might have a particle number of 2,000 be loaded with small “golf balls” that are knocking into and entering arteries to cause plaques. An advanced cholesterol panel blood test can tell you more about your LDL particle number and size.

High-sensitivity C-reactive protein

This is a marker for inflammation which slowly erodes blood vessels and other organs. In the past decade, a blood test for high-sensitivity C-reactive protein has changed the assessment of patients dramatically. If your hs-CRP is normal (usually less than 0.1 mg/dl), your arteries do not appear inflamed by your diet, lifestyle, or other risk factors. On the other hand, if your hs-CRP is elevated, something is wrong with your lifestyle or health, and we should identify and correct them. I order this exam on every patient at least once a year.

Coronary Artery Calcium Scoring

Tiny amounts of calcium are floating through your blood at this very moment. Just as it hardens your bones, it can also make your blood vessels stiffen. This makes it harder for your heart to pump blood, drives up blood pressure, and makes it more likely that small particles in the blood (like small, dense LDL) stick to the lining of the arteries, setting the stage for dangerous plaque to form.

How it works:

A CT scan detects calcium in your heart blood vessels. The ideal score is zero. If your score is between 1 and 10, be very motivated to change your lifestyle. If it’s between 100 and 400+, follow up with a stress test, and make a commitment to change your habits to prevent and reverse this coating of bone in your heart pipes.

Who needs it:

The American College of Cardiology strongly recommends this test for anyone with some risk of early heart disease. Because it delivers some radiation, however, hold off until you are 50 or older, unless you have a major heart disease risk factor such as strong family history of early heart disease, smoking, or diabetes. Most insurance companies don’t cover this screening exam, but many hospitals now charge only $100 or less.

Caveat:

In addition to radiation exposure, the other limitation is that some artery plaques don’t calcify. That means even if you have a calcium score of zero, you could still have some plaque. There are few plaques like this, however, and these softer plaques generally do not progress to heart disease.

Carotid Intimal Medial Thickness (CIMT)

This test uses an ultrasound machine to see inside the major carotid artery in the neck, which connects the heart to the brain. When it’s diseased, it’s very likely that other arteries in your body are also diseased.

How it works:

The ultrasound shows the thickness of the inner two linings of the wall of the artery (called the intima and media). If these walls are getting too thick, it’s a sign of early atherosclerosis. The advantage of CIMT is that it uses ultrasound so there is no radiation risk. If the CIMT is in a normal range (approximately 0.7 mm or less based on age or a thin artery wall), the risk of blockages anywhere else in the body is very low. If the CIMT is 0.8 mm and up, it is time to make over your lifestyle.

Who needs it:

This test has received a high recommendation from the American College of Cardiology and there are more than 500 scientific studies that speak to its effectiveness. I recommend it to patients starting at age 50, but even earlier for people who smoke, have high cholesterol, or a family history of vascular disease. CIMT is only covered by some insurance plans. Clinics charge between $150 and $250 on average.

Caveat:

While many places own the equipment to do a CIMT, they don’t all have the special software package needed to measure the thickness of the carotid artery and compare it to a normal thickness. Ask if your health care provider will be doing the test with special software dedicated to measuring CIMT.

EndoPAT

iStock/webphotographeerArteries are lined with a single layer of super cells called the endothelium, which keep the vessel resistant to injury and clotting and allow them to dilate to provide more blood flow when needed. Healthy arteries spring back quickly after being squeezed, for example, by a blood pressure cuff. Once the cuff is removed, blood flow doubles, triples, or even quadruples for a few seconds to a few minutes. Diseased arteries don’t do this. When blood vessels don’t spring back, it is a sign of something called endothelial dysfunction, which is one of the earliest signs of artery disease we can detect.

How it works:

A blood pressure cuff is placed on an arm and inflated for five minutes, while a special clip is placed on one finger of each hand. When the cuff suddenly releases, the blood flow should increase greatly in the hand of the cuffed arm, but not on the hand that was not. When Mayo Clinic researchers did this test on more than 250 people and tracked their health for six years, those with poor blood flow had a higher risk of heart attack or death.

Who needs it:

I recommend EndoPAT for people who just want to know where they stand, but also for those who already know they have heart disease. A patient with a stent who has a normal EndoScore is much healthier than a similar patient with a poor one. The test costs under $200, and it’s covered by most insurance plans.

Caveat:

It’s possible to have full-blown heart artery disease (and even to have undergone bypass surgery or stenting) and still have normal endothelial function. This is a good place to be for a heart patient, but it doesn’t mean you should ignore lifestyle changes.

Homocysteine

About 40 years ago, an astute doctor observed early artery damage in young children who had an elevated level of an amino acid called homocysteine. More research has shown that in adults, increased levels of homocysteine have also been associated with increased risk of vascular damage. A safe homocysteine level, determined by a blood test, is under 10 micromoles per liter and even better is under 8. I get very concerned when it is in the high teens or over 20 micromoles per liter. Patients with high levels can be treated with B complex vitamins, which is a pretty simple solution.

Lipoprotein-A

Lipoprotein-a or Lpa is an inherited form of the LDL cholesterol bound to a special protein. Much research has connected high levels of Lpa to early cardiovascular disease. This is a widely available blood test. I draw it on patients if they have an abnormal calcium score or a thick carotid artery, as well as anyone with any sign of heart disease at a young age. High levels can be treated with niacin, hormone replacement, and vitamins. Most labs indicate a normal Lpa is under 30 mg/dl, but I have seen readings as high as 200 mg/dl. If you test high, consider it an opportunity to incorporate lifestyle changes that will both lower the LDL cholesterol particle number and Lpa level too.

Fasting blood sugar, insulin, and A1c

Health care providers may not worry until your blood sugar is in the diabetic range of more than 125 mg/dl, but studies suggest that a fasting blood sugar of less than 85 mg/dl is optimal. Each jump above 85 increases the risk of blood vessel injury. Blood sugar, however, only presents half of the equation because it is regulated by insulin. If the level of insulin is elevated, the pancreas is working overtime to maintain blood sugar, and the arteries are at risk. I also order a hemoglobin A1c to look at average blood sugar levels over a two- to three-month period. This is a sneaky way of checking for pathologic glycation—or sugar coating—of the hemoglobin molecule. Elevated blood sugar levels not only coat the hemoglobin molecule, but they also coat cholesterol particles, modifying them to become more dangerous.

Vitamin D

A low vitamin D level has been associated with high blood pressure, arterial damage, congestive heart failure, poor brain health, and other important problems. Normally vitamin D is obtained by sunlight and foods such as mushrooms and fortified foods, but even in sunny areas, most people test low. People with dark skin are especially at risk for vitamin D deficiency in the skin. Ask your health care provider to check your level; you want your blood level of vitamin D to be over 30 ng/ml, and optimally, 50 to 80 ng/ml.

Ferritin

Ferritin is a protein in the blood that binds with iron. If ferritin levels are high or low, that means the same is true of iron. Iron overload can oxidize cells in the arteries, leading to heart disease, and can make blood more prone to clotting. Iron overload in the arteries can be checked by a simple blood test for ferritin. Levels above 380 micrograms per liter indicate excess iron. If you test high in ferritin, take care to avoid iron in vitamins and high-iron foods like red meat. Donating blood once a quarter, if possible, can also lower your own iron levels while helping others at the same time.

Uric acid levels and GGT

These two simple and older blood examinations are coming back in use as they provide unique insight to the health of the cardiovascular system. Uric acid is produced from energy products like ATP (the energy used by cells) and an elevated level is linked to cardiovascular damage. GGT is a liver enzyme that may indicate an overall poor functioning of cell membranes in the liver and insight to the overall health of your metabolism. Normal uric acid levels are 4 to 8 mg/dl; levels over 10 are concerning. Normal levels of GGT will fall below 50 IU/L and levels over 100 IU/L are concerning for generalized cell membrane dysfunction.

8 Conventional Life Rules Successful People Break All the Time

The myth of multitasking for efficiency has been busted. However, it still has a powerful hold over us, especially with smart phones and other technologies that allow our brains to distract us. According to Gary Keller, author of The One Thing, multitasking leads to more mistakes due to the mental tendency to favor new information over old; a distorted sense of time, taking far longer than necessary to accomplish the important things; lost time as you bounce back and forth between tasks (Keller estimates a 28 percent loss of your workday!), and more. Keller’s research found multitaskers are less happy than those who learn to focus on one thing at a time.

I am a very nice guy, but if you saw me facing a new class at the start of Kokoro camp (a class modeled after U.S. Navy SEAL Hell Week), you probably wouldn’t say so. In those moments, a casual passerby could mistake me for a monster even though there isn’t a negative thought in my head. Focused determination is often mistaken for stern, cold, or even mean. That’s fine: It’s okay to be both nice and intensely focused. In those moments, everyone who matters—those who actually know you—knows you have your game face on and are not intending to be short or mean, even if you might appear that way. “Nice” in our society typically means you go overboard to get along; you give in to peer pressure or allow “B” players to stay on the team to avoid making them feel bad. These are all recipes for mediocrity.

This is actually true in a very few cases, yet it is a dominant belief in our society. More responsibility is given by moving someone up the ladder, even though doing so may not be in the best interests of the individual or organization. Bigger business is seen as better by “the markets” even though the bigger an organization is, the more divorced it gets from its original mission and its customers, investors, and stakeholders. The more you stack your to-do list with tasks, commitments, projects, and leadership roles, the less meaningful work you will actually get done.

Do you think that drunk at the local watering hole is going to restrain from taking cheap shots when he charges you? Can you count on a coworker in competition with you to highlight favorable details about your project or results when she makes a presentation to your bosses? If you must “fight,” you must be offensive and unconventional in your approach. This means being aggressive and leveraging surprise to defeat your competition. However, you can be intensely competitive while at the same time super cooperative. In the SEALS, we would train together daily—a very cooperative, team-building endeavor. But each training session turned into a barn-burning competition to stimulate intensity and our winning spirit. The best businesses have this same balance between competition and cooperation. It requires deep confidence in your skills and the personal power you bring to the table so you can help others without feeling as if you were risking your own win in the process.

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Neutrino - a life saver

The humble neutrino particle won its fourth Nobel Prize in physics this year (also in 2002, 1995 and 1988). Despite being millions of times smaller than other subatomic particles, it is of major importance in physics and could be the key to unravelling some of the universe’s best-kept secrets. So where is neutrino research heading next – and what could it discover?

Matter is made of fundamental particles. Most people will have heard of electrons, neutrons and protons – and perhaps even quarks, which make up the latter two. But to me, the neutrino is the most amazing fundamental particle. They are everywhere. About 65 billion neutrinos, produced by nuclear fusion in the Sun, pass through every square centimetre of area on Earth, every second (you could try and calculate that yourself), without doing anything.

Because neutrinos hardly interact with other matter, this year’s Nobel prize winners for physics, Takaaki Kajita and Arthur B McDonald, had to build vast detectors, filled with thousands of tonnes of water, in order to study them. What they found out was that the neutrino is even more interesting than we thought.

While travelling through space, a neutrino apparently continuously flips between different “types” of neutrino, changing the way they interact with matter. This is called neutrino oscillations. You might imagine this as a little fellow that, while running at nearly the speed of light, continuously changes the colour of its jacket by which you are trying to identify it. Neutrinos can only do this if they have mass. So until the results from these experiments were published, they were assumed to be massless. Clearly this was ground-breaking news.

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I believe that at the end of the century the use of words and general educated opinion will have altered so much that one will be able to speak of machines thinking without expecting to be contradicted.

Alan Turing https://openquotes.github.io/authors/alan-turing-quotes/#d9efdd11 (via thewelovemachinesposts)

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