Showing posts with label case study. Show all posts
Showing posts with label case study. Show all posts

Zumba is an extremely popular exercise today but for instructor Karen Bedford, it not just about the dance moves; it’s about mental health. For Karen, 49, exercise was the reason that she survived and beat decade-long battle with depression.


 


In 1998, Karen developed depression out of a series of mental health-damaging personal events. She broke up with her long-term partner, was made redundant from her job at a publishing house and was fighting to keep her family home in Potters Bar, Hertfordshire. She was anti-depressants for a year, but still this was no permanent fix. ‘The antidepressants probably helped but I don’t think they were the right solution for me,’ she explains. ‘I questioned if it was worth taking them, especially because they made me feel unwell.’


 


While a new relationship and another job in publishing helped to stabilise her depression, mother-of-two Karen went on antidepressants again after her partner, Randy, died from pancreatic cancer in 2003. ‘I was terrified I’d be stuck on them for ever and I wanted to sort out the underlying problems,’ she notes. Then her life changed when her friend suggested an exercise class, and Karen picked the lively dance music-fueled Zumba. ‘I loved it – I felt better instantly after each lesson and it gave me a real high,’ she says. ‘Since Zumba became part of my life my mental state’s been more stable and I haven’t needed the pills. I get the odd down day, but because I’ve regained my confidence I face my problems much better now.’


 


In fact, Karen needs no convincing about how exercise benefits mental well-being. ‘I’d recommend it to anyone with depression and doctors should do too,’ she enthuses. ‘It’s definitely offered me a solution.’ However, not all wellness experts are so sure. For example, a study recently reported in the British Medical Journal found that depressed patients who exercised more as well as receiving antidepressants actually did no better than those who had just the standard treatment. According to lead researcher Professor John Campbell, from the University of Exeter Medical School, ‘The message isn’t that exercise won’t help depression but we couldn’t show it had an added effect beyond standard treatment. For sufferers, their world is black, so it’s not always an appropriate treatment to start with.’

When Andrea Meisgeier gave birth to her son Maxwell, she was 33. Maxwell was conceived so easily that Andrea and her husband didn’t worry about family wellness in terms of the timing of a second pregnancy. However, six years on, Andrea has taken fertility drugs, tried acupuncture and undergone more than $25,000 in fertility treatments that included intrauterine insemination and in vitro fertilization – none of which were successful.


Andrea says, ‘I have made my first round of peace with it. There is still definite times when you feel there is a lot of mum guilt. My husband and I don’t talk about it a lot. In a sense you feel like you failed your first child. Maybe a piece of it is you feel like you failed yourself.’ According to Diana Wu, a reproductive endocrinologist at the OHSU Centre for Women’s Health, secondary infertility – the inability to get pregnant after having a child – is on the rise.


Wu notes about four million families in America experienced secondary infertility in 2010. Approximately 35% experience problems because of the woman and another 35 percent are due to the man. About 20% are due to both, and 10% never find an explanation. Wu comments that couples ‘don’t realise there could be something wrong and they are busy with work and taking care of their child or baby. They may continue to wait longer,’ before seeking medical help.


Wu cites that 7% of women experience infertility by age 29; 11% by 34, 33% by age 39, 50% by age 41 and 87% by age 44. ‘It’s always shocking to see these numbers, which are a lot lower than what we expect,’ she says, adding ‘In our prime, couples in their early 20s have somewhere between 20 to 25% chance to conceive at best, even in their first month of trying.’ Wu urges couples trying to conceive to see a reproductive specialist after a year of regular unprotected intercourse without conceiving.


As for Meisgeier, she is deeply grateful for her son, but she always imagined having two children who would share their childhood and support each other into adulthood. ‘You feel guilty if you don’t appreciate what you’ve got. Complaining about not having a second child really feels indulgent and guilty,’ she explained. ‘I wish along the way my gynaecologist had reminded me at every single appointment that just because you put your fertility on hold all these years doesn’t mean it’s going to be there when you are 34 or 35.’

Nahid Zafari, 24, is the first in Lethbridge to undergo an intricate orthopaedic surgery that aims to repair the bow legs that have affected her wellbeing for half of her life. Due to a childhood crippled by malnutrition and a lack of access to adequate medical care, the Iranian immigrant feels she has only ever been treated as a “disabled girl”, which has taken its toll on her emotional wellness, as well as her bone health.


She explained, ‘I just gave up on my knees a few months ago. I was so sad when I was going to university. All the girls, all the boys were looking at my knee and (pretending) it’s normal, but I could see their eyes. And then I met Dr. Kollias and she gave me a new hope.’ Nahid has had knee pain since she was 12 years old, but her doctor in her native Tehran told her it was just growing pains and she would be fine. Overtime, the pain worsened and her knees began to point outward due to soft bones brought on by malnutrition and a severe lack of Vitamin D.


However, Dr Carrie Kollias, an orthopaedic surgeon at Chinook Regional Hospital, is one in a small group of Alberta doctors who has been trained to use and aluminum and stainless steel device that could have Nahid fully recovered by September. The Taylor Spatial Frame system contains six external struts that can be adjusted to lengthen and align limb bones as they grow and heal – every day for at least three months.


Dr Kollias performed the surgery on Zafari’s right leg in February. ‘She’s sort of the most meaningful patient for me because she was the first,’ Kollias commented. ‘It’s a very powerful correction, so when they have a crooked leg and you make it straight or when they have a short leg and you make it the same length as the other side, that’s difficult stuff to do. Mentally, you think “Wow, that sounds really tough.” It’s still tough but it’s not impossible. So when it works out, it’s meaningful and you remember those patients.’


The magnitude of the surgery’s meaning is not lost on Nahid, who commented, ‘It will change my life. Before, I couldn’t walk normally, before I couldn’t go out with my friends, I couldn’t wear what I want. But now it totally changed my clothing; it changed my life. I can go out with my friends, I can wear what I want, even I can eat what I want.’ She added, ‘It was hard, but I did it. I said no matter what happens, I’m going to do this.’



Life-Changing: New Procedure Completely Fixes Bow Legs





Four years ago, three year-old Janelly Martinez-Amador had the gross motor skills of a newborn and a ventilator kept her alive; now, she can sit in a wheel chair, turn her head, and wave. This may seem nothing to other seven year-olds, but to Janelly and her family, it’s miles away from what her wellness once was.


Janelly has a rare genetic disorder called hypophosphatasia (HPP), a metabolic disease that affects the wellbeing of her bones and teeth. She was born with thin, fragile bones, and by age three, she had no visible bones on X-rays. In HPP, your bones can’t absorb important minerals such as calcium and phosphorus, so they become soft and at risk to pain, breaks and deterioration. Now, a girl who wasn’t expected to survive her first birthday will turn seven this year, thanks to an experimental drug therapy and her care team at the Monroe Carell Jr. Children’s Hospital at Vanderbilt.


Salvadore Martinez, Janelly’s father, explained, ‘Imagine your child laying all the time in bed, not being able to lift herself, not being able to move herself, making sure she is not falling or tripping on things. The treatment has worked very well but it has been a compilation of doctors, nurses, assistants … everyone that has been a part of her care that has helped her make a meaningful recovery.’ Janet Amador, her mother, added, ‘If you saw her in 2009 and see her now, it’s not the same Janelly. She used a ventilator, an oxygen mask – many machines to help her breathe.’




Janelly had the worst case of HPP in a group of 11 children, under the age of three, who participated in a clinical trial to receive an enzyme-replacement drug therapy, asfotase alfa. According to lead investigator Michael Whyte, MD, medical-science director of the Centre for Metabolic Bone Disease and Molecular Research at Shriner Hospitals for Children in St. Louis, ‘For many years, it seemed there was nothing that was very helpful for this disorder. We were fearful that her bone disease was so terribly severe that it might not work. But by looking at the X-rays and hearing about her visits, we were thrilled to hear about her progress.’







Clinical Trial Gives Hope to Girl with Rare Bone Disorder