Physician Blog -- Kate Scannell, MD

Medical Writer

Recent Newspaper and Online Columns by Kate Scannell, MD

A view of autism -- Making sense of the numbers

April 15, 2014

Tags: autism, incidence of autism, prevalence of autism, Young-Shin Kim, ASD, autism spectrum disrders

By Dr. Kate Scannell, columnist
First published in Print: 04/04/2014

We live in a world of Big Data, spending much time searching for meaning in its vast shadows and often emerging from those shadows drawing wildly different conclusions. But the hard facts of Big Data become so soft and malleable in varied human hands, and solid data points often transform into flexible storylines.

Two weeks ago, another vast shadow of Big Data drifted over U.S. media outlets when the Centers for Disease Control and Prevention reported its upwardly revised prevalence of autism spectrum disorders, or ASD. Its 2010 surveillance of 8-year-old children identified 1 in 68 -- 1 in 42 boys, and 1 in 189 girls -- as having ASD.

Emerging from that report, media headlines often concluded that autism rates were "surging." Others heralded the data as proof of an incremental jump in the number of children living with autism.

But what was true? (more…)

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Zohydro: The pained debate over approval of a new painkiller

March 23, 2014

Tags: Zohydro, hydrocodone, palliative care, pain treatment, opiate abuse, debate, Amy Haddad, Robert V. Brody

By Dr. Kate Scannell, contributing columnist © 2014 Bay Area News Group
First Published in Print: 03/23/2014

For a powerful new pill that's supposed to ease pain, Zohydro is causing major headaches for an increasingly vocal group of critics.

Zohydro is a potent extended-release formulation of hydrocodone, an opiate painkiller that's been in use for decades and the primary analgesic ingredient in drugs like Vicodin. However, unlike other formulations of hydrocodone, Zohydro is uniquely free of added medications like aspirin (as in Azdone and Lortab ASA), ibuprofen (Vicoprofen), or acetaminophen (Vicodin and Norco). That means that Zohydro can be prescribed as stand-alone hydrocodone -- free from worry about aspirin allergy and side effects, ibuprofen kidney and GI toxicities or acetaminophen overdose and liver damage.

This improved patient safety profile is what makes Zohydro an appealing alternative to traditional hydrocodone-combination drugs. Additionally, because Zohydro is engineered in an extended-release form, it need be given only twice a day -- a convenience for patients requiring chronic opiate therapy.

And yet these same selling points are cited by critics in advancing arguments against Zohydro's release. That's because with Zohydro, if you're not forced to take a dose of acetaminophen or aspirin every time you swallow a hydrocodone tablet, the amount of hydrocodone you can take is no longer limited by side effects from acetaminophen or aspirin. Critics insist that will encourage excess intake of hydrocodone, worsen the epidemic of opiate-drug abuse, and lead to higher death rates from overdose. They've petitioned the FDA to withdraw its approval of Zohydro, and bills have been filed in the House and Senate to remove Zohydro from the market. (more…)

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Our national shortage of IV saline has become critical

March 11, 2014

Tags: IV saline shortage, national drug shortage, FDA Critical Drug Shortage, drug rationing, American Society of Health-Systems Pharmacists

By Dr. Kate Scannell, Syndicated columnist
First published in print: 03/09/2014


Bags of IV saline may appear ubiquitous as props on TV medical dramas, but they're currently in short supply on the nation's hospital pharmacy shelves. In fact, more than 75 percent of U.S. hospitals and other health care settings were experiencing critical shortages of intravenous saline solutions, according to a February survey of pharmacy directors by the American Society of Health-Systems Pharmacists.

It's unsettling and hard to fathom that such an essential staple of medical and emergency health care could become so scarce. (more…)

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What to say -- and not to say -- when someone has cancer

February 23, 2014

Tags: what to say to someone with cancer, Bob Riter, communication guidelines cancer, Scannell, when your life is touched by cancer

By Dr. Kate Scannell, Syndicated columnist
First published in print: 02/23/2014

I was startled by a man's voice calling out my name in the doctors' parking lot. Turning toward it in the predawn light, I saw a physician-colleague fast approaching me, a wide-eyed look on his face. "Oh, my God!" he stammered. And before I could manage a response he blurted out, "I thought you'd be dead by now!"

It was my first day back to work after a long medical leave for cancer treatment. Having spent a year at home recovering in relative solitude, I was anxious about returning to my frenzied clinic job. (more…)

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The 2014 Winter Flu Olympics

February 10, 2014

Tags: 2014 olympics, flu season, annual awards, worst sneeze, Winter Flu Olympics, Flu Jeopardy, most atrocious cough, irony in the time of influenza

By Dr. Kate Scannell, syndicated columnist
First published in print: 02/07/2014

It's time to announce the annual awards for Bay Area performances in this year's Winter Flu Olympics!

Even though the California flu season is not yet over, the competition to date has proved fierce, particularly for Most Atrocious Coughing Technique, and Worst All-Around Performance during a flu season. And it's hard to imagine anyone able to top my current choice for Lousiest Long Distance Sneezing, even if the existing flu season were to continue through May -- as it just may

That award goes to the sickly man who last November repeatedly blew his nose while standing behind me in a slow-moving hospital cafeteria line. When his nasal gusts began registering on my neck, I turned toward him with a public health message in mind. But then it all happened so fast, before I could say a word or shield myself and my cold shepherd's pie. In an instant, the man's body stiffened, his head flung back and forth, and he let loose a Goliathan sneeze that dampened more than my spirits. Every person and so-called "daily special" within spitting distance was similarly showered. In consideration of the enormous number of people he may have infected, he was additionally awarded a dishonorable mention in the Worst All-Around. (more…)

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The top 10 health and medical stories of 2013

January 4, 2014

Tags: top stories 2013, Obamacare, ACA, statin guidelines, DSM-5, Sunshine Act, hospital billing

By Dr. Kate Scannell, First published in print: 01/01/2014
With this column, Dr. Kate is returning from a 4-month sabbatical.

As we enter 2014, let's take a moment to reflect on last year's signature health news.

The Affordable Care Act slogged toward 2014

Bruised, bewildered and dodging political bullets, the Affordable Care Act (ACA), also known as "Obamacare," slogged through 2013. It stumbled badly at its October deadline to establish online marketplaces for purchasing health insurance. System errors plagued the HealthCare.gov website, frustrating consumers and obstructing enrollment. Millions of previously insured Americans felt betrayed when, contrary to the president's promise, their policies were canceled as ACA's implementation advanced. At the same time, hundreds of thousands of previously uninsured Americans cheered the ACA rollout as it newly granted them access to health care coverage in coming years.

Giving support to 'None-A-Day' vitamins

For the overwhelming majority of Americans, vitamins are useless -- so concluded three studies published in December's Annals of Internal Medicine. (more…)

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Nation is overdosed on antibiotics

August 18, 2013

Tags: antibiotic misuse, antibiotic overuse, antibiotics in meat, livestock, antibiotics in food, antibiotic resistance

By Dr. Kate Scannell, Syndicated columnist
First published in print: 08/17/2013

"Take two cheeseburgers and call me in the morning."

That's appallingly bad medical advice to give patients who may be suffering bacterial infections and requiring antibiotics. Still, you have to wonder about that prospect, if only imaginatively, when you consider the enormous amount of antibiotics pumped into our country's meat supply.

Indeed, according to the FDA, a whopping 29.9 million pounds of antibiotics were administered to our livestock in 2011 -- fourfold more than the 7.3 million pounds used to treat humans. Just imagine the greater appeal (for non-vegetarians) of spooning up chili-con-carne to treat pneumonia, compared to forking over $100 for some nasty-tasting antibiotic. Or feasting on lamb stew to cure cellulitis, rather than stewing over side effects from prescription antimicrobials.

But, clearly, that's not how things work. Livestock aren't inert containers that simply store all the antibiotics we dump into them. Instead, like humans, animals ingest, metabolize, and eliminate antibiotics from their bodies.

And, also like humans, animals naturally harbor millions of bacteria within their bodies, and those bacteria are affected by antibiotics consumed by the animals. Consequently, sensitive bacteria are killed off, while insensitive others proliferate. Some bacteria with Darwinian survival skills genetically mutate, gaining resistance against the antibiotics to which they've been exposed. (more…)

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Douglas' HPV disclosure should prompt education

August 11, 2013

Tags: Michael Douglas, HPV, human papillomavirus, cancer, throat cancer

By Dr. Kate Scannell, Syndicated columnist
First published in print: 08/03/2013

Eyebrows were raised when actor Michael Douglas announced in June that his throat cancer had been caused by an infection with the human papillomavirus (HPV) acquired from having oral sex. Some people cringed or wondered whether Douglas was merely mouthing off about his purportedsexual exploits. Others shouted "TMI!" not wanting to envision ... well, you know. And a sizable group of cynics questioned whether a viral infection could truly cause a cancer.

But throughout the ensuing media coverage, Douglas's claims have been subject to considerable public scrutiny. Scientists have solidly reaffirmed the role of HPV in causing cancers of the throat. (more…)

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Dr. Kate Scannell: The "July effect" in hospitals -- seasonal fact and fiction

July 22, 2013

Tags: July effect in hospitals, July effect, patient safety, hospital error, physician inexperience, The Common Sense Medical Society

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 07/20/2013

The first thing I remembered was waking up in a strange room with severe pain in my lower back. It felt like someone was jabbing an ice pick into my spine, repeatedly.

Indeed, as it turned out, a man was actually standing behind me and pokingme with a long metal needle. "Don't move!" he warned.

It took me a few moments to realize that I was in a hospital emergency room. The clues gradually emerged: Everyone was wearing scrubs or white coats, the room was loud and harshly lit, blood (perhaps mine?) spotted the floor, and, tellingly, I was freezing -- marginally covered with a hospital gown that didn't quite merit a 5-thread-count rating. (more…)

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Too sick and tired to be in the hospital

July 7, 2013

Tags: hospital noise, sleep disruption, disrupted sleep, hospital, Florenece Nightingale, Ivan Illich, vital signs

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 07/07/2013

In May, for one week, I sat daily at the hospital bedside of a dear friend who was trying to recover from a formidable bedsore and two surgeries related to her hip fracture. She was thoroughly exhausted and depleted from the frequent surgical check-ups, thrice-daily wound dressings, every-two-hour turning of her body, vital sign monitoring throughout the day and night, and persistent attempts by perky rehab specialists to get her back on her feet.

"All I want is some rest," she would plead. "Can't you tell them I need sleep to get better?"

Sleeping in a hospital? Resting a worn body that needed deep healing? How could I convey such radical concepts to the hospital staff? (more…)

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Selected Works

Fiction
Torrential rains pour into Thalburg Canyon, California. Flooding ensues, and a universal human drama unfolds as the interconnected stories of the canyon residents are acted out on center stage.
Nonfiction, Memoir
The author begins her medical career as a young physician caring for people who are dying with AIDS during the 1980s.
Book Editing
A Soldier's Story—World War II and the Battle at Sessenheim, France offers a gripping personal account of one soldier's combat experiences on the bloody battlefields of France and Germany during the months preceding the Allies' 1945 victory in Europe.
Book Reviews -- Examples
Journalist Rebecca Skloot’s new book is a gripping read that embodies all abstractions about research ethics in a compelling tale about Henrietta Lacks – a woman whose microscopic cancerous cells shook the world’s medical establishment in 1951.
Newspaper Columns
Since 2000 -- Syndicated medical opinion columns about the sociopolitical and ethical dimensions of American health care.
Medical Essays
Documentary, executive producer
DVD -- Journey by Heart -- an engaging and intimate view of Alzheimer's Services of the East Bay.