Review Category : Health

Anatomy of a Shark Bite: How Doctors Tackle Gruesome Wounds

Courtesy of Health First(NEW YORK) — Amy Tatsch was boogie boarding off the coast of Florida less than three months ago when she felt something bump her right leg. Hard.

Just as it registered that there was a shark in the waist-deep water with her, she felt razor-sharp teeth rip away half of her calf.

“I really didn’t think I was going to make it back out with the amount of blood I saw,” the 38-year-old mother of six told ABC News. “I thought I would end up passing out, or I thought the shark was going to come back and attack me and my brother.”

Tatsch, whose 2-year-old twins were with her family on the beach, never saw the shark that bit her, but the rare encounter left her lower right leg almost unrecognizable. The bite had gone down to the bone. A shark expert later determined from the wound that it was a 6-foot bull shark that had attacked her.

Somehow, she caught a wave into shore and shouted for help. She remembers being rushed to the hospital, but the next 13 days were a blur, she said.

Dr. Daniel Segina, a traumatologist at Health First’s Holmes Regional Medical Center in Melbourne, Florida, said he’s treated about a dozen shark bites over the last 15 years he’s been practicing, but Tatsch’s was the worst.

Most of his patients had shark bites to their legs, though a few were bitten on their hands, he said.

“The lower leg is probably the most common one we see,” Segina told ABC News. “If you can imagine surfers sitting on surf boards, paddling in the water as they’re waiting for a wave to come. That’s usually when they get bitten.”

Dr. Nicholas Namias, who famously treated shark attack victim Krishna Thompson in 2001, said trauma surgeons generally follow standard trauma guidelines when they get shark bite patients. Namias, medical director of Ryder Trauma Center at the University of Miami Health System, has treated two shark attack victims in his career.

“You make sure there’s no ongoing bleeding and you repair what you can,” Namias said.

Then, an anesthesiologist puts the patient to sleep so he can clean the wound, Segina said. Since a shark bite has been exposed to the bacteria-filled “marine environment,” doctors worry about contamination and infection, he said.

But Segina doesn’t use chemicals or antibiotics to do the cleaning, he said.

“Just sterile water,” he said. “For the most part, it’s been shown to be the most effective.”

Tatsch said she felt no pain after the initial bite, but when she woke up from her the surgery, her leg hurt. She would later learn that she’d lost a chunk of her muscle, that her Achilles tendon had been torn on both ends, and that she needed a plasma transfusion.

Despite Segina’s prompt surgery, Tatsch’s wound became infected.

It would take five surgeries, more than 150 stitches and countless hours of physical therapy to get Tatsch walking again.

She said she started walking for the first time without crutches only two weeks ago, but she has a limp and can’t go for too long without pain and swelling. Teeth marks and a deep indentation are visible on her calf, but she says she’s not interested in plastic surgery.

As she spoke to ABC News, she was walking along the beach and collecting shells.

“I have not been back on the boogie board,” she said. “But I have gone back in the water.”

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The Flipside of a Funny Bone Can Be a Troubled Psyche

iStock/Thinkstock(NEW YORK) — Robin Williams’ apparent suicide has put a spotlight on the dark side of comedy. Williams, like many comedians, lived with long-term depression and addiction.

Experts say these mental illnesses are no laughing matter.

“Comedy can often be a defensive posture against depression,” said Deborah Serani, a clinical psychologist who treats performers with depression and other mental health problems.

Serani, author of the book, Living With Depression, said that for many comedians, humor is a “counter phobic” response to the darkness and sadness they feel. Their intelligence, she said, helps them put a funny spin on their despair.

“They often wear what we call ‘the mask of depression,’ which helps them put on a more acceptable face to the world,” she said. “But behind that mask there is a terrible struggle going on. There is a stigma about depression and oftentimes the laughter distracts from feelings of weakness.”

Williams spoke openly about his lifelong battle with addiction, alcoholism and depression. In 2006, he checked himself into rehab after a relapse, and then checked himself in again for undisclosed reasons last month.

He is certainly not the only comedian who has ever lived with depression and addiction. Comedian Marc Maron has spoken publicly about having severe depression. So has stand-up comedian Jim Norton.

John Belushi, Chris Farley and Greg Giraldo all died of drug overdoses. And in 2007, Richard Jeni committed suicide by shooting himself in the face.

The reason so many comedians are at risk for mental illness is because being funny is not the same thing as being happy, said Dr. Rami Kaminski, a professor of psychiatry at Columbia University School of Medicine. He said he believes many comedians mine humor as a way to escape depression and anxiety.

“It’s like someone who is afraid of heights but chooses to take up skydiving,” he said. “If they are funny all the time, maybe they will be able to feel a little bit better.”

Dr. Michael Clarke, the vice chairman for clinical affairs and the Department of Psychology at the Johns Hopkins School of Medicine, said research shows that, in general, creativity and mental illness often go hand in hand.

“People with a more creative side do seem to have a greater rate of mood disorders like depression and bipolar disorder,” he said. “We don’t know exactly why this is but it could have a biological basis in the emotional centers of the brain.”

However, Clarke said, not every comedian is mentally ill. He added that mental illness usually hampers creativity — so that when someone is in a depressed state, they are often less productive.

“Illness can inform someone’s work but when we are talking about mood disorders we are talking about disease states of the brain. Their thinking is impaired and they aren’t always capable of making good decisions,” he said.

Kaminski said Williams may have been in this impaired frame of mind when he decided to commit suicide.

“Many comedians tend to be depressed because they are trying to get out of their dark world by being funny,” he said. “But only those that are clinically depressed are at risk for committing suicide.”

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WHO Says Use of Experimental Ebola Interventions Is Ethical

Hemera/Thinkstock(GENEVA) — The World Health Organization has given the green light for the use of experimental Ebola treatments to combat the deadly virus or prevent it from spreading.

“It is ethical to offer unregistered interventions as potential treatments or prevention,” WHO Assistant Director General Dr. Marie-Paule Kieny said.

As West Africa is being hit with what the WHO calls the “largest, most severe and most complex outbreak of Ebola” in history, scientists have developed drugs and vaccines that could counter the virus, but sit only behind one obstacle — that these interventions have yet to be tested on humans.

“This is an opportunity to right a wrong of history that it is only relatively recently, in the last decade, that researchers have begun investigating interventions for Ebola,” said WHO Assistant Director-General Dr. Marie-Paule Kieny.

But the WHO says that provided certain conditions are met, the unproven interventions should be available options for patients. The conditions, or ethical criteria, include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community. The WHO panel of consultants tasked with assessing the ethical implications of using unproven interventions adds that there is a “moral obligation” to collect and share any data that is generated from the use of these drugs.

While the two American health care workers who contracted the disease in Liberia have been given medications not yet tested on humans, the WHO panel has not specified which treatments it would condone or where the drugs should be sent.

“We do not get involved into the discussion about who should get what drug at the moment,” Kieny said.

The UN Health agency says over 1,000 West Africans have died as the outbreak continues to grow. Nearly 2,000 more cases have been recorded.

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LGBT Community Feels Less Connection to Religion than Others

David McNew/Getty Images(WASHINGTON) — A new Gallup poll says that only about one in four Americans who identify themselves as either lesbian, gay, bisexual or transgender feel that religion is an important part of their daily lives.

Being “highly religious” also means attending services weekly or almost every week.

While 24 percent of the LGBT community put themselves in this category, just over four in 10 who are not LGBT say they are “highly religious.”

The reason for this disparity, according to Gallup, may have to do with LGBT members not feeling welcome by the religious groups they want to be affiliated with. Also, there is also a greater concentration of LGBT people in cities where religion tends to be a less of priority than in the suburbs or rural America.

The Gallup survey also reveals that two-thirds of LGBT adults identify with a particular religion, compared to 83 percent of non-LGBT respondents.

Meanwhile 35 percent of LGBT adults say they are Protestant, far lower than more than 50 percent of the non-LGBT population.

The survey involved more than 100,000 interviews with 3,242 adults saying they were lesbian, gay, bisexual or transgender.

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Once a Cheater, Probably Always a Cheater

iStock/Thinkstock(DENVER) — Cheating in a relationship happens. That’s just a fact of life. But if you’re the one who’s been betrayed and are more than willing to forgive and forget, you may want to rethink your decision.

Kayla Knopp, a graduate student at the University of Denver, says that people who cheat are likely to do it over and over again.

In fact, after interviewing nearly 500 unmarried people between 18 and 34, Knopp found that people who stray in one relationship are three-and-a-half times more likely to have an affair when they move on to another relationship.

The researcher says this repeat behavior also pertains to aggressive acts such as “yelling, shouting, pushing and shoving,” a bad sign if ever there was one.

According to Knopp, “We like to think that we can learn from our experiences and our mistakes, especially when it comes to love.” But as her small survey suggests, people should try to think less with their hearts and more with their brains.

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Which Five Animals Can Be More Deadly Than Sharks?

iStock/Thinkstock(NEW YORK) — Despite their terrifying reputation as cold-blooded killing machines, once sharks get a taste of human flesh, they rarely come back for a second bite, according to the Discovery Channel, which is in the midst of its annual Shark Week.

In fact, sharks kill only about four people a year worldwide and only one in the U.S., according to the nonprofit organization Oceana.

Sharks aren’t even close to being the most deadly animal on Earth. Here are five creatures that are — perhaps surprisingly — more likely to lead to your demise than a shark.

1. Hippos

They reach up to 15 feet in length and weigh up to three and a half tons. They can sprint up to 20 miles an hour and their 20-inch teeth never stop growing. And, according to the Bill Gates Foundation, hippopotamus kill up to 500 people a year.

Of course, there aren’t any reports of death by hippo on urban streets. Most hippo deaths take place in the wilds of Africa, with one study verifying an average of 30 people a year are killed by hippos in the country of Mozambique alone. In Africa, crocs and elephants are the only land animals more deadly.

2. Cows

Cows may look docile, but they kill more than five times the number of people than sharks do. Using statistics from the U.S. Centers for Disease Control and Prevention, one research study reported an average of 22 deaths a year by bovines, typically due to stomping or goring.

The study noted that horses are also pretty lethal, causing up to 20 deaths per year. Agricultural workers are among the groups at greatest risk of “death by mammal,” a category that also lists cats, pigs and raccoons as the cause of death.

3. Dogs

Man’s best friend is high up on the list of killer critters.

CDC statistics show nearly 4.5 million Americans are bitten by dogs each year. Half of dog bite victims are children. Though only about 40 canine bites a year are fatal, according to the group, the CDC reports that nearly 27,000 people require reconstructive surgery yearly as the result of a dog bite.

For the record, identifies pit bulls as the most dangerous dog breed, claiming they account for over 60 percent of reported attacks. Rottweilers, American bull dogs and huskies round out the list of top canine chompers.

4. Snails

They aren’t large and their top speed is only about three feet per hour, but the United States Agency for International Development lists snails as one of the top killers on the planet.

More accurately, certain freshwater snails carry parasitic worms that in turn carry a deadly disease known as schistosomiasis. When humans come into contact with water where these snails live they can become infected and die of organ failure. In sub-Saharan Africa, schistosomiasis is the second-leading cause of death after malaria, with more than 200,000 deaths per year reported.

5. Ants

Death by teeny tiny ant is becoming more common and is almost certainly more common than death by shark — though reliable statistics of ant deaths are hard to come by. We do know that insect stings send more than 500,000 Americans to emergency rooms every year, according to the American College of Allergy, Asthma and Immunology, and more than 40 people die annually from insect sting anaphylaxis.

A recent study listed 280 species of ants throughout the world capable of causing fatalities in humans. The red fire ant, species that has invaded the southeastern part of the U.S. from Asia, stings an estimated 14 million people annually, according to entomological studies done at Texas A&M University.

Up to six percent of the population has a severe reaction to their stings, and a number of deaths have recently been reported. Last year, a woman in Georgia died shortly after being attacked by a swarm of red fire ants.

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Three Missionaries Return to US from Liberia

iStock/Thinkstock(CHARLOTTE, N.C.) — Three missionaries serving in Liberia during the recent Ebola outbreak returned to the United States Sunday evening.

Among the three people on board the private charter en route to Charlotte, North Carolina, were David Writebol, Nancy Writebol’s husband. Nancy, who was infected with Ebola in Liberia, is currently in isolation in an Atlanta hospital.

Bruce Johnson, president of SIM, said David Writebol looked physically healthy and had no symptoms.

Johnson said the missionaries were brought back because, “They needed a break physically, emotionally. They have watched people die from this dreadful disease.”

The three people are being quarantined until doctors are ensured that they have not contracted Ebola.

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Florida Holds Record for Most Shark Attacks in US

iStock/Thinkstock(NEW YORK) — Despite the fear instilled by the 1975 cult classic Jaws, small New England resort towns aren’t too much of a shark attack hotspot — not as much as Florida, at least.

Of the 29 shark attacks recorded so far this year by the Smithsonian-affiliated International Shark Attack File, 17 attacks were reported in Florida throughout eight separate counties.

The high number isn’t too surprising. Florida has held the record for the most shark attacks in the United States for decades, making up 49% of unprovoked attacks last year.

Other East Coast states — Delaware, Georgia, North Carolina and South Carolina — have had some shark attack action of their own, with six attacks so far on the East Coast outside Florida.

Down south, Texas and Louisiana were the sites of one attack each.

As for the West Coast, there have been two attacks reported in California. Hawaii accounted for the final two attacks.

None of the attacks so far this year have been fatal.

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Five Tips to Combat Flight Anxiety

iStock/Thinkstock(NEW YORK) — Do you have a fear of flying? You’re not alone.

Nearly 7 percent of people have what’s called aerophobia, according to Statistic Brain. And recent news events, including a yet-to-be found Malaysia Airlines flight and another Malaysia Airline plane shot down over Ukraine, killing 298 people, haven’t done much to ease those worries.

But if the fear’s so bad you’re thinking about skipping your next vacation, don’t act too fast. Industry experts agree that, by and large, commercial air travel is very safe. CEO Jeff Klee, who flies for a living, shared with ABC News his top five tips to combat flight anxiety:

1. Trust the industry.

The truth is that a lot of flying anxiety is caused by projecting and misplacing fears. Your worries are probably not based on whether or not you’re actually safe in your seat in an airplane (in the highly capable hands of the flight crew), but rather the incidental inconveniences and discomforts that disrupt your personal “control” instrument panel. An economy seat in 2014 is not going to be relaxing and comfortable in the manner that you are probably accustomed to at home. Even our most seasoned travelers over here at CheapAir headquarters don’t deny that the seats in coach are often cramped. Some of us even have mild claustrophobia, which, let’s face it, can be exacerbated by sitting knee to knee with a couple of strangers on a full flight. It may take a little pre-flight concentration/meditation, but if you can manage to isolate your feelings of discomfort and loss of control, you’ll be able to better manage those feelings and separate them from feeling unsafe.

2. Go with your feelings.

Wait a minute, you might be saying. You say I’m starting to feel anxious just as we back away from the gate and I’m supposed to feed that rising sense of panic? Well, yes and no. Basically, science shows that fighting feelings of anxiety can actually inflate those feelings. When you start to feel out of control or panicked, the typical response is to dig in emotionally and fight to try and override the feelings. Most of the time, this tactic just doesn’t work. You actually work yourself into a much more anxious state by battling yourself. If you’re on a flight and you start to feel anxious, take a moment to recognize these feelings and acknowledge them. It could be as simple as saying to yourself, “I am starting to feel very anxious. I am starting to worry about the plane’s safety. My heart is beginning to pound.” The next step is to accept these feelings and say something affirmative to yourself like, “This is going to be tricky but I can handle these feelings. I can get through this.” Finally, take some deep breaths in through your nose and out through your mouth to combat the shallow breathing that can lead to panic attack and hyperventilation.

3. Drink responsibly.

If you’re feeling anxious, you’re probably planning to have a cocktail (or a few) before the plane takes off and a few more en route. While that does sound like a rollicking good time, we recommend that you do not get plastered on an international flight. Flying while inebriated? Totally fun! Finding your bags and orienting yourself in a city while inebriated? Not so much. Have you ever tried to describe your lost luggage to baggage claim staff while under the residual influence of six glasses of in-flight Cabernet? Not a pretty picture. Also, a drunk tourist might as well be wearing a sign around his neck reading, “Rob Me.” If you’ve just landed in a foreign country and you’re tipsy, you’re catnip to thieves on the airport circuit. On the other hand, dehydration is also your enemy — so do plan on drinking loads of water both before and during the flight. And finally, more bad news. Avoid caffeine and coffee if you’re prone to panic attacks. Wean yourself off it for a few days before you fly if it’s too painful to do cold turkey. A stimulated mind can spin out in all kinds of jittery, panicky directions. Just. Don’t.

4. Hold fast to the facts.

Remind yourself that the most dangerous part of your travel day is the drive to the airport. Your chance of being in an air disaster is approximately one in three million. You would need to fly once a day for more than 8,200 years to accumulate three million flights. While you should avoid disaster news, it might not be a bad idea to read up on some basic facts and figures about what a normal flight will feel and sound like. There are reasonable explanations for many seemingly distressing noises on a plane. You can even watch a great video called “Flying Without Fear” on YouTube from Virgin Atlantic that illustrates typical sounds and movements on takeoff and landing. Easy peasy.

5. Distract yourself.

If you know you are going to be anxious, surround yourself with familiar pleasures from home. Load up the iPad with some old school Seinfeld or Friends. Listen to a few of your favorite, relaxing albums. Start a great book before you leave and pick up mid-read during the flight. Basically, don’t depend on the airline to provide you with a distraction that will work for you. Their in-flight programming might not be the medicine you require. The key is to keep these distractions to what you are already accustomed. Think of it as comfort food for your mind.

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Brooke Burke on Bouncing Back from Cancer

ABC/Todd Wawrychuk(NEW YORK) — Brooke Burke-Charvet has come back from cancer stronger than ever.

“It’s crazy that not long ago I had cancer and now I’m cancer-free, and that might not be the case if I hadn’t gone for a checkup,” the former Dancing with the Stars co-host, 42, told Shape for the magazine’s September issue. “Now I feel like I’m beginning the best part of my life.”

About a year ago, Burke discovered she had thyroid cancer. Despite seeing a doctor for more than a decade for Hashimoto’s disease, the most common cause of hypothyroidism, and taking synthetic thyroid medicine every day for years, Burke said the cancer was discovered during a routine physical.

“The condition wasn’t even diagnosed by a thyroid doctor but during a regular checkup,” Burke told the magazine. “They found a questionable lump. Then I got an ultra-sound and biopsies, and sure enough, it was cancer. But the prognosis was great.”

“It’s so important, when you get any alarming news, to do research, get a second opinion, and not panic,” she added.

Since her thyroidectomy, Burke said she’s been cancer free.

“They took it out, it’s gone, and it’s all good,” she said.

Burke said she avoided the sun after her surgery and now has barely a scar. But she’s still making adjustments to her thyroid medication.

“That was a little tricky, but that’s one of the challenges with thyroid issues: figuring out the amount of Synthroid you need, getting your hormone levels right, and then making adjustments,” she told Shape. “Having too much energy or not enough energy, and rolling through those changes — I’ll continue to deal with that for a while.”

Burke also said she returned to her regular exercise routine a few weeks after surgery.

“I started working out the day I was allowed to. That’s just me. I feel better after my workout for a million reasons,” Burke said.

Today, she’s in better shape than ever, she said.

In addition to promoting her new athletic-wear line, Caelum, Burke, who was replaced by Erin Andrews on Dancing with the Stars at the beginning of the year, has been doing more acting. She just finished a couple episodes of Melissa & Joey, playing the mother of Joey’s daughter.

“I’m committed to doing something more creative now,” Burke said.

Her advice to other women following her life-changing year: “Care for yourself, especially as you get into your 40s. Always get your annual physicals and mammograms.”

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