Abigail Trafford (The Post)

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What is the latest news in health today? This week's Health Talk is a general free-for-all discussion on current issues that concern you the most. Have a complaint about managed health care or new drug regulations such as hormone replacement therapy? Have you heard about the latest concerns on the West Nile virus? What alternative medicine can promote a healthy lifestyle?

Join Post Health columnist Abigail Trafford to discuss health issues and better living on Tuesday, Aug. 13 at 2 p.m. EDT.

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Abigail Trafford: Hello everybody. Lots in the news. The terrible spate of kidnappings. The spread of West Nile Virus. More questions of HRT. And some good news: The president signed legislation to help east the shortage of nurses. The FDA just approved a drug for advanced colon cancer. And more. Send in your questions and comments.

Somewhere, USA -- RE: HRT: Interesting article on HRT this morning. To me it underscores the importance of people taking responsibility for their own decisions. It wasn't clear to me if the writer ever understood that her decision to take HRT was entirely discretionary, and that the Rx police were not going to come after her if she stopped.

washingtonpost.com: A High Price for HRT (Post, Aug. 13)

Abigail Trafford: You're right. You are responsible for making your won health decisions. Problem is that there is no one right answer in many instances. For some people, taking HRT is the right answer to a problem of hot flashes.

Arlington, Va.: How dangerous is it for people training for marathons in this heat? My brother had to run 18 miles on Sunday a.m.

Abigail Trafford: It can be dangerous. You gotta drink lots and lots of fluids. It's easy to get dehydrated--and overheated. That can lead to heat exhaustion and collapse. So, pay attention to your body. Don't take chances. Hopefully there are coaches at marathon trainings to safeguard the runners.

Belmont, Mass.: Question about West Nile: I hate to even know, but what are the symptoms? How does one get diagnosed, what are the warning signs? should kids be kept away from swamps etc now that West Nile has been discovered to be spreading?

Abigail Trafford: West Nile is spreading--it's becoming a fact of life. But don't panic. Getting bitten by a mosquito is not the same as getting infected. Fewer than 1 percent of people biten by an infected mosquito become seriously ill. Accroding to the Centers for Disease Control, the incubation period is usually 5 to 15 days. symptoms include fever, headache and body aches, often with skin rash and swollen lymph glands. In severe cases hospitalization is required.

Fairfax, Va.: Did you read the Chicago Tribune's series last month about sanitary practices in hospitals? Hospital-obtained infections are the 4th leading cause of death in the U.S.!

I haven't spent time in the hospital since I was born, but if I ever do, I'm going to make sure a relative or a healthcare professional never lets me leave their sight.

Abigail Trafford: Good policy, Fairfax. Hospitals are risky places. One of the best ways to prevent hospital infections is for health professionals to WASH THEIR HANDS. Yet studies suggest this is not always done. . . . the other thing is the nursing shortage in hospitals. A new study blamed the lack of nurses on nearly a quarter of "misadventures" in the hospital--complications that led to serious injury or death.

Vienna, Va.: Can you tell us how twins can be conjoined? What happens for them to be born like that and how come doctors can't detect it early on?

Abigail Trafford: Conjoined twins are in the news. Surgeons recently separated twins joined at the head. But some twins decide not to be separated. I'll post a story on that!

washingtonpost.com: At Age 40, Conjoined Twins Are Following Their Dreams (Post, Aug. 12)

Abigail Trafford: This is a fascinating story. . . .

Cambridge, Mass.: I have questions/thoughts about children's health and policies surrounding nutrition etc. Who regulates, locally or nationally, our drinking water, and the use of chemicals in it? Have not the standards changed recently, and in what way are we parents kept informed of this potential health hazard?

Abigail Trafford: The Environmental Protection Agency oversees water quality--and state and muniple governments are responsible for supplying "healthy" water to citizens. You can also get the water that comes out of the faucet tested. A lot of people use filters or bottled water for drinking water.

Massachusetts: What to date is the salient information or evidence of the negative effects of hormone infusion in so many of our meat and dairy products? I am aware that some studies or research has been done linking hormones to numerous health problems. What are the major players in congress or elsewhere trying to do to monidy this apparent problem? (Trying to find things "organic" is terribly costly to the average consumer like myself, if seems.)

Abigail Trafford: Huge controversial area! Many researchers are concerned about the use of estrogen-based pesticides as a potential factor in the increased rates of breast cancer, for example. The problem is that the evidence is murky and the money stakes are huge. That makes environmental hormones a very difficult political issue.

Mt. Rainier, Md.: I volunteer at a local hospital. My impression of the nursing shortage is that the president can't do one ding-dong thing about it. Until the corporations that hire nurses change their evil ways, there will be little to no incentive for people to enter that field. Nurses tend to rate very high on altruism (that's why they're there, duh), but they're not altruistic enough to accept the abuse handed out. They are given rotten hours, compelled to work overtime, get less pay than most professionals with their education requirements, and are the scapegoats and targets for doctors with attitude. Most hospitals are now hiring agency nurses which means changing your work site just about the time you've gotten to know where everything is and what the SOPs are. You still won't know who the other employees are. It's easy for thieves to target ERs now - all they have to do is put on a lab coat or OR suit and they're invisible. As a chaplain I find this incredibly depressing.

Abigail Trafford: You are so right, Mt. Rainier. We have a crisis in nursing. The job stinks. It shouldn't be this way. And we consumer-patients depend on the nursing staff when we go to the hospital. But nurses are overworked and not adquately supported in what they do. The President's bill will help increase recruitment of nurses. But it doesn't address the basic problems with the job. And younger nurses are leaving hospital care faster than older nurses. Big problem . . .

Washington, D.C.: I drink, on average over 80 ounces of water a day, and am very active. I try to run at least 30 minutes a day. Is this too much water? Can too much water be harmful for you? Thanks,

Abigail Trafford: This is a question for your physician. And it depends on your body and the conditions in which you exercise.

Washington, D.C.: Hi!
Saw on "The View" today a new GPS you can strap on to your kid like a watch. Can only take it off with a key. Will be available in September. Don't remember the brand name, but if you log on to "The View" Web site after 4:00 p.m., they will run a transcript of today's show.

Abigail Trafford: What is this? A way to track a child in the event of a kidnapping? You know abduction by a stranger is very very rare. I don't think such a measure would be right for most children.

Chevy Chase, Md.: Thanks for your column on protecting the children -- I'm a grandmother, too. The administration's (and/or Congress') refusal to ratify the Rights of the Child treaty seems consistent with the similar refusal to endorse the UN Rights of Women treaty, and to prevent population control funds to go to China. Am I right that this aligns our country with some pretty unsavory companions?

washingtonpost.com: Second Opinion: Police Alone Can't Keep Kids Safe, (Post, Aug. 13)

Abigail Trafford: Yes. The only other country not to ratify the Rights of the Child is Somalia. . . . Our international reputation in this field is dismal. And I think we should be the leaders in protecting children worldwide. Goes with super power status.

Cottage City, Md.: Compared to nursing homes, hospitals are the Ritz in staffing and facilities. Not necessarily cheaper, though. The rules governing staffing on nursing homes are obscenely lax and mostly ignored. The person who will take care of your ailing mother will probably speak poor English and might have a high-school education, will probably be a woman from a foreign country hired because she would accept low wages to get here, will probably have little/no idea what to do beyond a bedbath, will certainly get no training. The paramedics and firefighters who are generally called to emergencies in the nursing homes have no way to report substandard care or response, yet they see people who are dying of neglect and ignorance.

Abigail Trafford: You're right. The situation is so scary that some families are hiring a private nurse to stay with an ailing relative in a nursing home or hospital. What is that all about? And only people with resources can do this. Shocking situation.

Washington, D.C.: Great column today. Doesn’t it amaze you how some people seem to be oblivious of certain things, especially if it doesn’t touch them personally -– like the problem doesn’t exist? In addition to the things you mentioned, I think Bush should convene a summit about violence toward women and working adults who cannot afford health care. My policy was cancelled (I’m a temp right now), and the new one, at over $300/mo for myself, will not take effect until Sept. 1. Maybe if our politicians had to pay healthcare costs from their own pockets, we’d see something done for those not covered by group plans.

Abigail Trafford: If members of Congress were in your situation, we would have legislation for universal health insurance today. I'm not talking about "socialized medicine." I'm talking about coverage for everyone so that each of us can have access to care when we need it.

Rockville, Md.: I have a question about conjoined twins. I know it is rare for babies to be joined, however, when we see it on the news, it is always infants from countries whose health care isn't the greatest. Is there any correlation between the type of health care a mother receives and this condition?

washingtonpost.com: Conjoined Twins Split in 22-Hour Operation, (Reuters, Aug. 7)

Abigail Trafford: I think it's just really really rare. When it happens, it makes news. Here's a story about the recent conjoined twins.

Washington, D.C.: What do you think about the recent articles that indicate the need for eight glasses of water a day is overrated? (I could never make it to eight, so secretly, I am thrilled).

Abigail Trafford: I love it when a study overturns conventional dogma! I also wait for the next study on an issue because I know that matters in medicine are rarely settled. For now, I'm content not to feel guilty about not drinking gallons of water. . . . . .

Washington, D.C.: Hello Abigail,

I'm overweight (50 pounds). My thighs rub together and my breast are large. My skin tends to redden in these areas (under my breast because of my bra rubbing). Is there some type of ointment or cream I could use for my skin to lessen the redness and bumps that occur? Yes, I'm dieting and exercising to lose weight.

Thank you.

Abigail Trafford: This is a quetion for a dermatolotist or your primary care doctor. There are effective creams. It's also important to keep these areas dry, which is hard on hot humid summer days.

Washington, D.C.: Have you thought of collaborating on some health-diet articles with Sally Squires?

Abigail Trafford: Sally is a colleague and we have worked together. Diet is a huge area. She is an expert on nutrition and personal advice. Her column is great. I confess--I'm not an expert on diet. I tend to look at the public health aspects of diet and obesity.

Silver Spring, Md.: Re: Nursing bill

Does this mean it will FORCE the hospitals run by MBA's to view nurses as human beings, rather than economic units to be moved around like chess pieces?

FORCE the MD.s to pay attention when a nurse points out possible serious side effects when two different classes of drugs are prescribed simultaneously?

FORCE anyone to pay these people what they are WORTH?

Until then, make the hospital administrators do the work.

Abigail Trafford: Alas, the answer is no. That will take an upheaval on the inside. Nurses -- and doctors -- are calling for a reform of the hospital culture to just what you outline.

washingtonpost.com: A Sad Case for Cloning, (Post, June 4)

washingtonpost.com: done and done

Arlington, Va.: Did you see the piece Connie Chung did last night about an American couple that is steps away from attempting to clone the wife. Apparently, all other attempts have failed for this couple -- in vitro, fertilization drugs, etc. And, the shocker was that it is an American doctor who is going to perform the cloning attempt. They're just going to fly to an "undisclosed" country to do the procedures. What are your thoughts?

Abigail Trafford: One of the hardest columns to write was on the subject of human cloning. I wondered if there could ever be an instance when reproducting cloning was justified. I thought about couples who had lost an only child and couldn't have any more. I thought of certain infertile couples who wanted to have a baby with a close genetic connection to the mother. After all, cloning technology is just a technology to get cells to reproduce. I ended up with this opinion. I wouldn't do it myself--but I would support others who wanted to try. . . . . You've opened up a Pandora's Box!

Washington, D.C.: Two things -- the GPS watch is in fact for kidnapping, but I suppose a parent in the middle of a nasty divorce might want their kid to wear one in case of an ex-spouse kidnapping. (Awful to think about, but it happens).

About the conjoined twins (we used to call them "Siamese"), it happens when a fertilized egg doesn't divide completely. If it divided completely, you'd get identical twins. I suspect the reason we don't see conjoined twins in the U.S. anymore is that they are aborted following a sonogram.

Abigail Trafford: Thank you for the info. And you're right to point out that the biggest danger of child-napping is in bitter contested divorce cases. A terrible terrible trauma for the child and the family.

Mt. Rainier, Md.: The situation with hospitals and nursing homes is a good example of privatization at its worst. Hospitals used to be community-owned and community-run, and there was a certain civic pride taken in a well-run institution. Sure, people with egos could make working there bad news, but that hasn't changed. Hospitals now belong to major corporations like Inova. They would mind having a well-run hospital, but they much prefer a hospital with an excellent bottom line that keeps the salaries of the executives in 6 and 7 figures. So our civic institutions are being bought up and made into cash cows. And no surprise, expenses like staff are the first to be cut. By using agency staff, they don't have to hire/fire/discipline or even have Human Resources people to do those things. Makes hospitals much cheaper, and also lousy places to work.

Abigail Trafford: The agency nurse is a huge issue. Hiring a temp on an as needed basis is good for the bottom line. But unless the agnecy nurse is familiar with the hospital, it's procedures and cultures, the nurse is not going to be as effective as a staff nurse, who knows the place and can get things done. Nurses talk about the "failure to rescue." This is when complications occur, it's the nurse who usually prompts the rescue. First because the nurse is the one who monitors the patient and detects the first signs of trouble. Second because the nurse is the one to organize a speedy response to a crisis. If the nurse is looking after too many patients, a crisis may not be picked up. And if the nursing staff doesn't have a good relationship with the physicians and administrators, the nurse can't organize an effective response. Thus: failure to rescue.

Cambridge, Mass.: In another question regarding nutrition, and children's health, I am wondering what the liability of unnatural ingredients in so much of our children's foods (proffered at schools and everywhere else) is, from a national health prespective? Who monitors/regulates the listing of ingredients in foods, and in your opinion, is the listing of them (high fructose curn syrup in everything!) sufficient to duly protect our collective health?

Abigail Trafford: The Food and Drug Administration regulates food. The labels are a great resource for consumers. The problem for children is more availability. Schools have soda pop machines in the cafeteria. The unhealthiest food is the most popular--and available to kids. There has to be a more concerted effort in the schools to offer healthy food that not tasteless.

Abigail Trafford: Our time is up. Thank you all very much. In September I will be going on special assignment to write a book. I'll write a monthly column in the Health section. But Health Talk will take a vacation and return when I get back in the New Year. Meanwhile, you can always reach me by e-mail to the Post. All the best!

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