Wednesday, January 23, 2008

Humira Kicking Ass for Abbott

Abbott Laboratories Inc on Wednesday posted a quarterly profit in line with expectations, driven by higher sales of its drugs and medical devices and favorable foreign exchange factors that bolstered overseas revenue.

Abbott posted a fourth-quarter profit of $1.20 billion, or 77 cents per share. That compared with a loss of $476 million, or 31 cents per share, in the year-ago period when the company took charges related to its purchase of Kos Pharmaceuticals.
Excluding special items, Abbott earned 93 cents per share, in line with the company's forecast of 91 to 93 cents per share.

Company revenue jumped 16 percent to $7.22 billion in the quarter, above the $6.96 billion average forecast of analysts polled by Reuters Estimates. Growth would have been 4.5 percentage points less if not for the weak dollar, which boosted the value of sales outside the United States.

The suburban Chicago-based health-care company said global revenue from prescription medicines rose 18.7 percent, fueled by double-digit gains for its Humira arthritis drug, Kaletra HIV treatment and TriCor medicine to lower blood fats called triglycerides.
Abbott, which is based in suburban Chicago, forecast that sales of Humira will rise to $4 billion in 2008 as the injectable drug makes further inroads against Johnson & Johnson's popular Enbrel. All three medicines work by blocking an inflammation-causing protein called tumor necrosis factor.

Global sales of Abbott's medical products, including diagnostics and diabetes-care brands, rose 11.5 percent.

Wednesday, January 16, 2008

Due for a Humira Shot

I feel like I am ALWAYS one step away from a Crohn's flare up. Dr. Shafran has just put me on weekly Humira shots. I am a day overdue because the Insurance company always screws it up, but my refrigerated shipment of Humira should arrive today. Hope all is well with you guys.

Saturday, January 12, 2008

David Garrard - CBS Interview - 3:30 - Crohn's Focus?

CBS is doing a special on Jacksonville Jaguars quarterback David Garrard (and wife Mary) at 3:30. It will be about his "remarkable journey", and I assume it will focus on or at least highlight the football player's battle with Crohn's Disease.

Stay tuned for details and possibly a link to the inverview. As you know, I am a big football fan, and am dissapointed that I can't really cheer for my favorite athlete with Crohn's disease today...on account of them playing my team....the New England Patriots. Search my blog for several articles detailing David Garrard's Battle with Chron's.


More info on his Crohn's (from interview)
One test came in 2004, when he had surgery for Crohn's disease, a painful inflammation of the intestines. He takes medication every eight weeks, a 3?-hour procedure; his next appointment is Tuesday, three days after playing the Pittsburgh Steelers in the first round of the playoffs tonight.

"It's a horrible disease, something that a lot of people are affected by," he says. "But I think the Lord blessed me with it, so I could talk about it."
To Mary Garrard, her husband's Christian faith is a key to both his personality and his playing style. "About 95 percent of his temperament comes from his faith," she says. "We're both Christians: There's a higher power, God is in charge of everything, there's no reason to worry about anything."

From IBD site:
David Garrard has been fighting Crohn's disease since 2003. He was sidelined from playing football for the NFL and lost 35 pounds. This season he is back in full force, and the Jaguars have won 6 of his last 7 starts. He credits the turnaround in his health to Remicade. With starting quarterback Byron Leftwich possibly sidelined for the rest of the season, Garrard is now likely to start for the Jaguars for the rest of the year.
Most of us with IBD just struggle to get through a day, or a week, at a time. Sometimes a simple everyday activity like a shopping trip or a night out seems like an impossible task, rather than a pleasure. People with IBD such as David Garrard, Pearl Jam Guitarist Mike McCready, and San Diego Chargers legend Rolf Benirschke are good reminders for us--a productive and fulfulling life is possible with IBD!

Original Story of his Crohn's (From
Jaguars backup quarterback David Garrard will have surgery next week to alleviate symptoms of Crohn's disease and hopes to be back in time for training camp. Garrard will have diseased tissue removed from where his colon meets his small intestine.
Jacksonville Jaguars' second string quaterback David Garrard will have surgery for Crohn's disease.

Crohn's causes blockage in the intestines, resulting in chronic diarrhea, abdominal pain, fever and weight loss. There is no known cause or cure, and it afflicts more than 500,000 people in the United States.

Garrard, 26, said he will have surgery next Thursday at Baptist Medical Center, and be sidelined until mid-July. He hopes to get himself ready for training camp in late July or early August.

Although the surgery will not cure the disease, Garrard said patients sometimes go 15 to 20 years without symptoms after the surgery.

"I'll be done with football by that time," Garrard said. "There shouldn't be any problems. I could have lived with it if I was a normal person."

Garrard decided to have the surgery after he was hospitalized last weekend when he was in constant pain because his intestines had swollen and were pressing on his bladder.
Garrard stared feeling sick in January and was diagnosed in March.

He completed nine of 12 passes last year for 86 yards and a touchdown. Although the Jaguars signed undrafted rookie Bryson Spinner to give them a fourth quarterback, coach Jack Del Rio said he will await Garrard's return.

"Get healed and come back," Del Rio said. "We're not rushing anybody."

Monday, January 7, 2008

Phenomenal Article on Crohn's and The Work Place and FMLA

Crohn’s Disease: Intermittent Distress and FMLA
by Presley Reed, M.D.

Crohn's disease is a chronic inflammatory bowel disease that intermittently debilitates a small percentage of the US workforce.

The disease usually occurs in younger employees which sometimes makes it difficult for employers and coworkersto understand the individual.s need for intermittent leave.
Because Crohn's disease is a permanent condition with symptoms that flare upintermittently, the employer must remain receptive and responsive to requests for intermittent FMLA leave for the duration of the individual.s employment.

Not only do the symptoms present intermittently, but their intensity also varies greatlybetween episodes for any patient. Consequently, physicians may be hardpressed to establish specific estimates for reasonable periods of leave. Only rough estimates pertain which makes FMLA administration more difficult. Some individuals will need extended leave, particularly when the individual's condition requires surgical treatment or when complications arise, such as severe arthritis.

The Medical Disability: Workplace Guidelines for Disability Duration, FourthEdition (MDA) serves as an educational tool that may help FMLA administrators understand the significance and unpredictability of crohn's disease. The MDAcouples general descriptions of medical conditions with specific workplace related information, with the result that those managing disability cases and/or administering FMLA leave can make educated decisions. According to the MDA, crohn's disease shares the following symptoms and characteristics. Crohn’s disease produces areas of patchy inflammation primarily in the smallintestine, but can also produce inflammation in any part of the digestive tract, including the mouth, esophagus, stomach, and colon.

Where inflammation exists, it extends into all the tissue layers. This results in abdominal pain, diarrhea, gastrointestinal bleeding, and poor absorption (malabsorption) of nutrients fromfood. The disease affects men and women equally and typically develops before theage of 30 years. Although the disease is chronic, usually lasting a lifetime, itproduces inflammation intermittently and can be in remission for long periods of time. The cause of Crohn’s disease is unknown, but an immune system abnormality may play a role.

Because the disease seems to run in families, there may be agenetic element to its development. Crohn’s disease is found in 0.1% of the US. population and is most common in white and Jewish individuals. Stress is believed to aggravate the disease.Symptoms vary according to the severity of the disease, the location of the inflammation, and whether intestinal complications have developed.

Typically an individual experiences intermittent periods of fever, diarrhea, pain in the lower right abdomen, fatigue, and weight loss. Sometimes, symptoms develop outside of the digestive tract. Joint pain, swelling,and tenderness are common extra intestinal symptoms.
Crohn’s disease increases the risk of colon cancer, a development that significantly influences theseverity of the disease.

Long-term use of corticosteroids may causeosteoporosis, cataracts, diabetes, hypertension, and aseptic necrosis of the hip. Crohn’s disease cannot be cured, but its symptoms can be controlled throughnutrition and diet modifications, medication, and sometimes surgery. A brief discussion of each of these responses will help us better understand thes eriousness of the diagnoses and the personal discomfort of the individual.

Not only the discomfort associated with pain but of not knowing whether to expect remission or recurrence. Nutrition is important in this disease, so a diet adequate in calories, vitamins, and protein is recommended.

Diet modifications vary according to the symptoms ofthe disease. During periods of diarrhea, a low-fat, high-fiber diet should befollowed. In contrast, early in the relapse of the disease or if symptoms of obstruction are present, a low-fiber diet is needed. During an acute stage of the disease, no food should be taken by mouth in order to rest the colon. Sometimes, especially with advanced disease, nutritional supplementation is needed.

Nutrients may be placed directly into the stomach or intestine through a tube (enteral therapy) or into the bloodstream intravenously (total parenteral nutrition, or TPN). Anti-inflammatory drugs of the 5-amino salicylic acid group are given to reduce inflammation. Corticosteroids reduce inflammation during an acute attack, but aregiven for only a few months at a time because they may cause significant long term adverse effects.

Immuno suppressive drugs are given to help relieves ymptoms in individuals with severe progressive disease who have no tresponded to other treatments. Iron may be needed to treat anemia, and vitamin B12 injections may be neededdue to malabsorption, particularly if there is advanced disease of the smallintestine. When abscesses are present, antibiotics are given to fight the infection. Bile salt binding agents or other antidiarrheal medications may be helpful during episodes of diarrhea. These, however, should be used with caution. Many individuals gain significant relief from surgery in which a portion of theintestine is removed (resection). In severe disease, the entire colon may beremoved (colectomy). Depending on how much of the intestine is removed, atemporary or permanent passageway may need to be created through which waste materials can be emptied.

Surgery may also be needed to remove a fistula (fistulectomy) or open an obstructed portion of intestine (stricturoplasty). As with any chronic disease, living with Crohn’s disease is challenging. Psychotherapy or participation in a support group may help an individual cope with the particular difficulties associated with Crohn’s disease and the general difficulties of living with chronic disease. Serious as it is, crohn's disease need not stop individual productivity. With medical and surgical management, individuals with Crohn’s disease can be fullyfunctioning throughout a long life. The disease will have periods of exacerbationand periods of remission, but typically does not lead to death. Some workplace adjustments may be necessary.

Flexible and private lavatoryaccess may be needed, particularly during periods of exacerbation. For example,the individual suffering from crohn's disease will not be able to continue at workif only two 15-minute breaks can be provided throughout the workday. Federal FMLA regulations mandate that the individual be allowed as much time as necessary, within the 12-week limit, to seek relief on an intermittent basis and for unpaid job protection. Severe attacks may require a lighter work assignment or time off for recovery orhospitalization.

If surgery is performed, individuals may need to be restricted from heavy lifting for a short period.The length and frequency of disability will depend on several factors: the degreeof inflammation, the amount of bleeding, the individual’s nutritional state, and theextent to which an individual’s disease can be controlled through diet andmedication. If abscesses, obstruction, or fistulas are present, surgery may beneeded.

Although surgery results in immediate disability, the potential for greatersymptomatic relief may decrease future disability absence. The cause of crohn's disease is unknown, but there are documentable effects onthe individual who suffers with this chronic condition. Discounting the severity ofthe symptoms or disregarding requests for FMLA leave may only serve toproduce a negative impact on workplace productivity. This may be especially relevant because stress apparently aggravates the condition. Crohn's disease is without question a "serious health condition" that meets the FMLA criteria for job protection. The difficult aspect of administering leave related to crohn's disease is the chronic, yet unpredictable, nature of its debilitating-symptoms. When the employee’s specific medical condition is known to the administrator (e.g., when FMLA is administered in concurrence with short-term disability or employee illness banks), the employer may then be able to make thebest of a difficult situation. Administering FMLA leave to the mutual benefit of the individual and the company.

PS. I pulled this from a PDF (located here) so there were some spaceing issues

Crohn's Disease Blog