2011 Year In Review

Here's the best that I can remember from 2011 with links to many of the highlights...Please be sure to read my blurb at the end. Thanks guys!!!

January-In January I had the opportunity to speak at the Stony Brook CF Center in Long Island, New York. I met some absolutely wonderful people and was able to touch some snow which is always a treat. We were also knee deep in getting Mandi's body ready for IVF. That in and of itself caused some very memorable moments.

February- I celebrated my 31st birthday and then quickly realized that I only had 6 years left to live. I'm of course being very tongue in cheek there, which I know would surprise most of you (NOT). The two things that were seared in my brain from this month was finding out that we were pregnant and the sperm extraction that led us to that moment.

March- We had our first annual Outrun CF Virtual Race in March and it was a smashing success. We received pictures from all over the world, and there is no doubt that CF awareness was spread and more people were active on that day. We also had our very first ultrasound and were able to lay eyes on our little Peanut.

April- We continued with weekly ultrasounds (a perk of IVF) and of course celebrated Easter with family. Another highlight was having a very successful clinic visit in which I blew a number I hadn't seen since 2003. I was about 6 or so weeks post hospital and really felt like I was getting in the exercise groove.

May- In May we celebrated one year of wedded bliss! to celebrate, we took an impromptu road trip out to Canyon Lake for a day of relaxation in the sun. We enjoyed a little bit of exploring as well as a feast of fruit while sitting in the back of the truck overlooking the lake! 

June- We found out that we would be having a girl this month!! We also took our annual trip to Rocky Point, Mexico to enjoy some family time, my cousin's wedding and playtime on the beach. It was also my first time snorkeling in a very long time and I thoroughly enjoyed it!!

July- Mandi and I headed out to South Carolina to enjoy the 4th of July weekend with some friends. They live on a lake, so we had many days full of swimming, fishing and boating. The fireworks show was beautiful and the only issues we had was packing for the trip and packing to come home :)

August- August was a big home improvement month around our house. Mandi went out of town for the weekend and I really wanted to surprise her with some changes when she got home. We were also knee deep in birthing classes but were able to break away for a trip to California for a good friend's wedding.

September- I spent a good part of September in the Hole which was a good chance for me to get tuned-up before the arrival of Peanut. Speaking of her arrival, she took Labor Day a little too seriously and gave us a little bit of a scare. The weekend after I got out of the Hole we were able to take some maternity shots which turned out to be amazing!!

October- This had to be the best month of the year! On the 16th we were able to celebrate Mandi's 25th birthday, and then about 44mins after Mandi's birthday ended, we were given the best birthday present of our lifetime. Mckenna Day Sharpe was born at 12:44 am and weighed in at 6lbs 2oz and was 17 inches long. She truly was a little Peanut!!

November- We got adjusted to life with a baby this month and did everything we could to spend every single second of every single day together. We also were pleasantly surprised to see how all of the maternity photos turned out, and if I may say so myself, I married a model. Mckenna seemed to grow-up a little bit each day and it was exciting to watch her grow into a little person. We were also able to host our first Thanksgiving meal at our own home with the help of my Dad and step-mom. It was so great to be able to spend time with them and watch them love up on Mckenna as well.

December- December was much like November in that most of the month was spent in amazement as we watched our little girl grow before our eyes. We also were able to make the perfect Christmas gift for family members with the arrival of Mckenna's first photos. We were also able to take a great family trip up to Williams, Arizona to ride on the "magical" Polar Express. We're hoping to make it a family tradition of sorts and I will admit it was a pretty  good time. As a bonus, I got to touch some snow for the holidays!!

And finally, I want to give my sincere gratitude to all who have followed our journey over this past year and shared in all of the joy, chaos and life-changing events. We are truly humbled by all of your kind words and support. We appreciate each and every comment as you guys give us the energy and strength to write in this blog almost every single day. If there are any particular subjects you would like me to write about in 2012, please let me know. This blog is just as much about you guys as it is about us.

Again, thank you, thank you thank you from the bottom of my heart. Have a safe and happy New Year and I'll see you guys in 2012.

Love from my family to yours,

Ronnie

Teenagers and Cystic Fibrosis

Question: My 15 yr old granddaughter. She has rebelled at times on treatments.Drs say it is age she will get better as she gets older. Were you always as good about it? Any feed back on this will help.

The doctors are correct in saying that it will get better with age. Teenagers in general are rebellious with or without CF. CF only exacerbates the problem as there is nothing more important in a teen's life than status and friends. Having CF and doing treatments can unfortunately at times interfere with these two things. I'm guessing that she has said more than once "I just want to be like my friends," or "I hate CF". Both of these are very common and very valid responses to having CF as a teenager. What she's going through is tough and is not at all fun.

What we must realize however that, "being like our friends", includes having the ability to do what they do. Whether we like it or not, this is made possible by our health. Not being at a good place with our health inhibits our ability to just be "one of the guys" (or in this case girls), but it's hard to see that as a teen.

We often think about treatments as a means to an end when we're sick. I encourage people to think about treatments as a means to an end when we're healthy. What I mean is this - we must be willing to do everything necessary when we're healthy to put ourselves in the best position not to be sick. Treatments need not be a response to sickness, but used in conjunction with wellness.

I use the analogy of a scale. On one side we have someone "sick" with CF and on one side we have someone "healthy" with CF. Now, if you had a rock that represented doing treatments, which side of the scale would you put the rock? Who do we as a community instinctively think about as "doing more treatments" than the other person? I would put forth that most of us would put the rock on the side of the scale with the sick CFer. This certainly isn't true for everyone, but from my experience, that would be my hunch. Now, each one of us must answer why we put the rock where we did and that will generally tell us about our view of CF, control and treatments.

As for me, I put the rock on the side of the healthy CFer. When I was a teen? Not so much. I thought only "sick people" did a bunch of treatments. Granted, I was doing two a day, but it was rarely willingly and not something that I looked forward to. In many ways, I fell into the trap of being "too healthy" with CF. See, in high school; my FEV1% was around 110. I felt and acted just like everyone else. The only time I thought about CF was during said treatment times and when I required a hospital stay due to an exacerbation (about twice a year). Apart from those times, CF never entered my mind. I felt some relief from my treatments, but I didn't feel THAT much.

What really made my lungs feel like a hundred bucks was football practice, or any other physical activity like basketball, baseball, running etc. That's another thing to point out - until I started playing sports year round, my FEV1% was nowhere near that 110% that I mentioned earlier. So in essence, I was doing a ton of treatments, 2-3 hours per day to be exact, just not the traditional treatments (nebs, vest) that we think about. I was doing additional treatments in the form of sports and exercise. To this day, nothing makes me cough more or produce more mucus than running, be it on the treadmill, street or football field.

My family supported me in many ways regarding treatments and CF care. I think a lot of the credit has to go to my mom for being quite possibly the biggest reason that I took such good care of myself growing up. She had quite a “unique” strategy – My house, my rules (I’m of course kidding when I say that it was unique). One thing I’ll say however is she delivered this strategy with complete love. I never doubted for a second that I, and in turn my health, was the single most important thing to my mom when I was growing up. I was an only child for quite some time, so my mom was able to focus all of her energy and time on making sure she did everything necessary to put me in the best position to succeed. This included running me around to practice, supporting me when I wanted to try a new sport and most of all, holding her line when it came to treatments. 

Here’s the deal though, she balanced that with great freedom. I had a very normal childhood. I could do just about anything I wanted to do in terms of sleepovers, extra curricular activities, etc AS LONG AS my treatments were done. And when I stepped out of line, she didn’t waffle or give me another chance; I faced consequences for not following the rules. She only had to keep me out of football practice one time to show me she was serious after I chose to rebel against treatments that particular morning.

All teens have something important to them. All parents find their children, including teens believe it or not, important. In my opinion, effective parents mesh what’s important to them with what’s important to their teen. There is one key thing to remember though – one is the parent and one is the teen. In a perfect scenario the parent and the teen can come to a mutual agreement about treatments and expectations. But, and this is a big but, perfect scenarios aren’t the majority. At some point, the parent must decide what’s more important to them, a perfect scenario or their teen doing his or her treatments.

There is hardly a fool-proof strategy when it comes to convincing teens that treatments are important or implementing a system that results in few missed treatments, there is however a great reward for parents, and teens, that manage to do so.

Thankful Thursday: Shorts & Thoughtfulness

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. Please take this time to share with us what you're thankful for as well. If you have a blog expressing your thankfulness, please share the link! Without further ado, here's what we're thankful for:

Mandi's List:

I'm thankful for Christmas. There is nothing like celebrating the birth of Jesus Christ! I'm so thankful God sent His only son, so that I may be forgiven of my sins. I'm also thankful that there is a holiday to celebrate Jesus' birthday that is always so joyous and exciting.

I'm thankful for the first Christmas with my baby girl. She obviously doesn't get it yet, as her day was just filled with more eating, pooping, sleeping and playing, but she was the best gift this year. I can't wait for future Christmases with her. Next year she'll be able to open her own gifts, which will be exciting. That being said, I don't want her to ever grow up - I'm cherishing the baby phase!!

I'm thankful for a husband who listens. I hate buying workout shorts because I think they're over-priced, and he knows that. But I have been talking about needing new shorts for some time now. Being the great listener he is, he bought me several pairs of workout shorts AND some shirts. YIPPEE!! What a good listener and thoughtful hubby!

Ronnie's List:

I'm thankful that I was able to have my first family Christmas morning. Now when I say family, I'm talking about just me, Mandi and Mckenna. I was looking forward to doing our own thing Christmas morning and starting our own little traditions as a family. We also were able to have the best of all worlds as we hung out with my side of the family Christmas Eve and Mandi's side on Christmas Day after starting at our house. It was really a special time had by all at all stops during this year's Christmas Tour :)

I'm thankful for thoughtful family members. I myself have never claimed to be a great, or should I say, thoughtful, gift giver. I tend to be very practical with my gifts and often times just listen for a family member to actually say that they need something or that an item often used is about to break. Not only do most of my family members give very practical gifts, but they're also very thoughtful since a majority of the things that I got are not something that I already own, but something that will make my life easier. If you're reading this and you gave me a Christmas gift, THANK YOU. If you didn't get me a gift, WHY NOT?? Kidding.

I'm thankful for fresh squeezed Orange Juice. I'm only thinking about it right now because I'm sipping on some as I write this. We have a couple of orange trees in our yard and December is a great month to harvest the delicious little orange balls. I generally drink nothing but water, but I'll make an exception for anything that comes from one of our fruit trees!!

So, what are you thankful for today?

Rondi's Recipes: Apple Nachos

Looking for a tasty treat this Holiday Season? Want to spice up your New Year's party with something unique and messy? Look no further!! I present, Apple Nachos :)

Slice apples to your desired size:

Melt marshmallows in microwave or use marshmallow paste:

Other ingredients include Caramel sauce and chocolate chips (we did both semi-sweet and white chocolate): 

Spread on melted marshmallows:

Drizzle on some caramel sauce:

We also added some of these mini-marshmallows:

Enjoy!!

Let me know what you guys think if you decide to try it out! I'd also love to hear some of your unique dessert ideas :)

Mckenna Loves Her New "Playmat"...Thanks Momma!!

Christmas Eve & Day in Photos

Christmas Eve

Christmas Day

To My Democrat Friends:

Please accept with no obligation, expressed, implied or implicit, my best wishes for an environmentally conscious, socially responsible, low-stress, non-addictive, gender-neutral celebration of the winter solstice holiday, practiced within the most enjoyable traditions of the religious persuasion of your choice, or secular practices of your choice, with respect for the religious/secular persuasion and/or traditions of others, or their choice not to practice religious or secular traditions at all. I also wish you a fiscally successful, personally fulfilling and medically uncomplicated recognition of the onset of the generally accepted calendar year 2012, but not without due respect for the calendars of choice of other cultures whose contributions to society have helped make America great. Not to imply that America is necessarily greater than any other country nor the only America in the Western Hemisphere . Also, this wish is made without regard to the race, creed, color, age, physical ability, religious faith or sexual preference of the wishee.

To My Republican Friends:

Merry Christmas and a Happy New Year


But seriously, I hope that everyone has a great time with their family over the next few days and enjoys this Christmas season. God bless.

If this doesn't get you in the Christmas spirit...

....nothing will :)

Moganko For Cystic Fibrosis Awareness

In the mood to not only be entertained today, but also educated? Good, you've come to the right place!! Allow me to introduce you to Moganko. Moganko is a buddy of Josh from Joshland and his job is to spread awareness of Cystic Fibrosis, as well as show kids (and adults) that living with CF can be full of fun and laughs. Please watch the following video and then head over to www.mogankoforcf.org to check out a TON of other cool videos that will entertain AND teach your kiddos some great lessons about life and CF.



Now following the following link to support this incredible project and give my fellow fibro Josh some love...and you can say hi to Moganko too :)

Moganko For Cystic Fibrosis Awareness: Welcome Everyone!

Thankful Thursday: Zoos & Home Depot

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. Please take this time to share with us what you're thankful for as well. If you have a blog expressing your thankfulness, please share the link! Without further ado, here's what we're thankful for:

Mandi's List:

I'm thankful for holidays. My parents just got back into town for Christmas so we get to spend time with them, the house is decorated for Christmas, I eat at least 5 mini candy canes a day, Starbucks has a special Carmel Brulee latte, and everyone is especially nice and filled with holiday cheer. I LOVE everything about the Christmas season :-)

I'm thankful for my sweet baby girl. I love her so much. Her every smile, coo, squeal, you name it, make me smile. She is such a doll - so sweet, happy, silly, and smiley. It's amazing to watch her grow. Each day I love her more and sometimes find myself just staring at her (generally while feeding her) and wondering how we got so blessed and why God chose us to be the parents to this little peanut. This may be weird, but sometimes I just want to squeeze her...but I refrain.

I'm thankful for girlfriends...and girlfriends with babies Mckenna's age. Yesterday we went to the zoo with my friend Angie, who has a little girl, Harlow, that is 4 months old. We bought a year membership, so we are going to start having our weekly get togethers there, so we can get a little fresh air and exercise while we chat. Angie and I get together weekly with the girls to hang out and swap baby stories (every notice once you have a baby you find it hard to find other things to talk about?!) I can't wait for Mckenna and Harlow to get a little older so they can start actually playing together instead of just looking at each other.

Ronnie's List:

I'm thankful for the Phoenix zoo. I've been living in Phoenix for almost 7 years now yet I had never been to the zoo until yesterday. I'm no zoo connoisseur, but I'd have to give the zoo high marks for it's walkability. A few of the animals were pretty cool to see, like the mountain lion, giraffe and baboon, but I mostly enjoyed the nice relaxing walk around the grounds.

I'm thankful to have a Home Depot so close to the house. It's so nice to be able to hop in the truck and be to HD in a matter of minutes. I'm not the most handy guy in the world, but having that place so close definitely serves as a security blanket during projects. If I don't know exactly what to do, which is generally the case, I can usually find someone at HD who does!

I'm thankful for bath time with Mckenna. One thing that I look forward to everyday is bath time with my little girl. Mckenna totally relaxes during the bath and is usually in the mood to interact and smile at her daddy. It's definitely a time with her that I greatly cherish. 

So, what are you thankful for today?

Ever Have One of Those Days?

You ever have one of those days? I can see all of you throwing up your hands right now saying “Uhh, YEAH!!!". And for those of you who don't know what I'm talking about - I'm talking about those days where you're running around like a chicken with its head cut off and just when you think the day is winding down something pops up. The days when you're at the post office and decide to use the self-service machine to “save time” and the woman in the front of the line decides to use said machine to get all of her postage and stamp each one of her Christmas cards individually. Yeah, that kind of day. The kind of a day where all you want to do when you get home is kick off your shoes, put up your feet and just hang out. The kind of the day that the thought of doing something active at the end of it makes you want to cringe. Do you guys know what kind of a day I'm talking about now?

Yesterday was that kind of day.

All day I knew that at some point I was going to have to get my butt to the gym. It was tough to get done everything else that I needed to get done, including treatments, but gym time felt like it was looming over my head. I made a commitment to myself and to my family that I would make my health my number one priority. A big contributor to my increased lung function and energy has been consistently getting to the gym. It's not that I love being there, I actually love leaving the gym, but I know it's what I have to do if I want to be the best version of myself. Still, there are days like yesterday. The kind of a day that even a priority in your life seems just too hard to accomplish.

When I finally got home from running around the city, the first thing I did was love up on my family. It was probably a little bit of a stall tactic on my end thinking that the further off I put the gym maybe it would go away. I asked Mandi what our plans were for last night (take note guys) and she responded with, “you're going to the gym”. I love that woman. I felt guilty about being gone a good part of the day and even when I was home not really “being” there, but Mandi made me feel at peace with it by saying those five words. It's so nice to have a supportive wife that is willing to recognize how important it is that my health needs to be our family's priority. Admittedly, it makes my life about 1000 times easier. And it's not something that I think we can expect out of our spouses either, it should be, but sadly it often times isn't. I think communication was key and is key for us in terms of setting priorities for our family. Mandi made it very clear that she wouldn't be a nag when it came to my health, but she also made it very clear that she would kill me if I didn't take care of myself (Duly noted). That made setting my priority pretty easy. Oh yeah, I did in fact make it to the gym and I had a very good workout.

I guess my main point of this blog though is to encourage you guys to not only put your health as your number one priority, but to be willing to do anything to be the healthiest version of yourself. This doesn't have to just be for CFers either. To you parents, start right now with instilling in your child that there's nothing more important than their health. Without good health, we don't have much. And we must make taking care of ourselves the most important thing in our life.

Don't want to start with health? That's fine. Here's my challenge for you. Do something today that you've been putting off. It could be cleaning the bathroom, running errand, doing an extra treatment or finishing a school paper, whatever it is, promise yourself that you'll get it done today. Because here's the thing -  both you and I know that once you do it, you won't regret it.

Landscaping Troubles and Cystic Fibrosis

Mandi and I had been talking about buying plants for quite some time. We finally brought ourselves to get to a nursery and walked around for about an hour with the worker picking out plants to go in our yard. Like most people, we were really trying to find luscious, green, drought tolerant, freeze tolerant, hardy, beautiful and pleasant on the eye plants to fill up our yard. That's not too much to ask for right? I'm quite green when it comes to all of this yard stuff as I grew up with nothing but typical Arizona landscape. My idea of a yard included a lot of dirt, some pea gravel and a few desert style plants. I had never lived anywhere that had grass I had to maintain nor am I so sure that I knew what a drip system was.

After hemming and hawing over a handful of plants we finally decided on: duranta, fortnight lily, gardenia and agapantha. We were assured that this winter wouldn't be as harsh as last and that all of these plants would be fine if planted right now. I've been putting off planting for quite some time mostly because I had yet to yank out all of the dead stuff from last winter, whoops. While my dad was in town for Thanksgiving he finally gave me the motivation, and help, that I needed to get the job done. Let me just say this right now– I'm so thankful that I don't dig up plants for living.

When it finally came time to plant I woke up nice and early in the morning so I could get a jumpstart on the day ahead. I decided to start in our courtyard as this was the place that was going to require the most digging. There were a couple of spots that I was basically just replanting and those were no big deal, but the places that I needed to dig fresh holes was harder than expected. It is seriously amazing how hard the ground can be in some spots. It's pretty disheartening after digging for 20 min. and getting the hole to a place that you think is deep enough only to put the plant in said hole and see four inches of the root sticking out. Fortunately, I had nothing much going on that day, so I kept digging!

I finally got done in the courtyard (we planted three gardenias and two agapanthas) and it was on to the planters in back. I started with the planter on our North wall. We decided to plant three duranta and try our hand at training them up a trellis. The other task that I was intent on completing was building the beds back up. Over the years they've lost some of their soil to various conditions and it was definitely time to address that situation. I was able to plant the plants fairly easily as there were roses bushes and shrubs there previously, so it was a just a matter of ripping out a few existing roots. After I got them planted I cleaned up the drip lines, threw on some topsoil and followed that by mulch. I must say, it looks pretty good.

Then it was on to the bed/planter on the Northeast side of our yard. There were a few more rose bushes planted there previously which we ripped out when my dad was here. All that was left was the Queen Palms. We decided to throw in some fortnight lilies and an agapantha. After having a fairly smooth and trouble-free time, I was really looking forward to knocking out this project. But as we all know things rarely continue to go smooth in this life, I was up for quite a big challenge. Little did I know how “crazy” and difficult it would get.

To be continued...

Mckenna Monday: Making the Butter

Have you noticed the trend yet? Mandi Monday's come so late that they practically get posted on Tuesday! I used to write my Mandi Monday's on Sunday and have them automatically post Sunday night/Monday morning (shhh don't tell). But days just come and go and then all of a sudden it's Monday morning and I realize I've been a slacker for another week. So since I'm terrible, I'll send in my replacement...Mckenna. Sooo without further ado: Mckenna Monday:

Things are going pretty well for me. I'm getting bigger by the second. Mom says I'm a tank, but they still call me Peanut, so I'm not sure how that all fits together...maybe I'm a small tank? I had my 2-month check-up last Monday. I came in at 10 pounds 2 ounces and 22 inches long. If you're keeping track, that's exactly 4lbs and 5 inches since I was born. I'm growing like a weed! At that appointment I also got some shots. OUCHY!! I let out a huge wail once I realized what happened and that it didn't feel the greatest. Mom looked sad for me and like she was going to be sick, dad smiled with delight and kept saying "oh my goodness your face is so cute when you cry like that."

I'm pretty sure my name is Mckenna because they say it all the time (although they don't know I know because I don't respond to my own name yet). However, they call me lots of other names too. They call me Peanut a lot, which I've heard all along...I didn't hear Mckenna until much later in my life. But they also call me Goosey, short for Silly Goosey, which they call me some.

If there's one thing I'm good at it's making the butter. "Huh?" you probably thought to yourself. Yeah that's what I wondered too at first. My parents just kept asking "are you making the butter baby?" I finally realized that they're talking about going poo poo. Because everytime I dirty my diaper they say, "oh my goodness, did you make the butter? You're so good at making the butter, baby!" I didn't get it at first until I heard my mom explaining it to someone. Apparently mom thinks my poo poo smells like movie theater popcorn butter (you'll never look at it the same again I'm sure)...and it's yellow in color (I guess theirs is something different?) And because I drink milk and it churns in my tummy and then there's butter. So there you have it, mom and dad think I'm a butter factory.

Hm what else? Oh yeah, I've started sleeping like a champ. Bedtime is fun. I know what's coming because we do the same thing every night. I eat, we play a bit, I take a bath, eat again and then it's straight to bed. I go to bed around 9:30-10:30 and I wake up at 7ish. I either eat once around 4 or I just sleep all the way through. On the nights I sleep all the way through I could swear my mom looks like a different person and man is she thrilled to see me. She comes in and sings about what a good sleeper I am. I mean she's happy to see me every morning, but those mornings you'd think I had been out of town for the last week and she missed me like crazy. So maybe I'll start sleeping through the night every night? I'll try my best.

So, that's it. Life is good!

Inhaled Anti-Pseudomonal Drugs Promising in Cystic Fibrosis Patients

NEW YORK (Reuters Health) Dec 12 - Fosfomycin/tobramycin for inhalation (FTI) is a promising treatment for cystic fibrosis patients with chronic Pseudomonas aeruginosa airway infection and reduced lung function, researchers say.

Their phase II safety/efficacy study tested 28 days of FTI against placebo, immediately following 28 days of inhalation therapy with aztreonam.

Such continuous therapy is not typical. As the authors point out, "a 28-days 'on' and 28-days 'off' dosing schedule is used for inhaled antibiotics that are currently approved in the U.S. for airway P. aeruginosa in cystic fibrosis patients.

But the rationale for the "off" period is being questioned because of changing microbiological profiles and the increasing use of two or more inhaled antibiotics in rotation, they wrote online November 17 in the American Journal of Respiratory and Critical Care Medicine.

Both FTI and the aztreonam inhalation solution are being developed by Gilead Sciences, which sponsored the current trial.

Altogether researchers enrolled 119 patients (average age, 32 years) with a mean forced expiratory volume in one second (FEV1) of 49% predicted at screening.

After the 28-day open-label course of inhaled aztreonam three times daily, patients were randomly allocated to twice-daily FTI (60/40 mg or 80/20 mg) or placebo, for another 28 days.

With aztreonam, the mean improvement in FEV1 predicted was 7.0%. This improvement was maintained with FTI, whereas lung function in placebo-treated patients declined toward pre-aztreonam levels. The treatment effect favoring FTI 160/40 mg was 6.2% (p=0.002) and 7.5% favoring FTI 80/20 mg (p<0.001).

In addition, the researchers found reductions in mean P. aeruginosa sputum density in the FTI 80/20 group versus placebo (p=0.01).

FTI "was also effective against methicillin-resistant Staph aureus, for which there are relative fewer drugs," first author Dr. Bruce Trapnell, of University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Ohio, told Reuters Health.

He and his colleagues found that in 13 of 63 patients co-infected with S. aureus and P. aeruginosa, S. aureus could not be cultured from the end of the FTI treatment period (day 28) through the end of follow-up on day 56.

"However, the study was not set up or powered to evaluate this outcome," Dr. Trapnell cautioned. "The data should be considered supportive, but further studies are needed."

Fosfomycin is a phosphonic acid antibiotic active against gram-positive, gram-negative, and anaerobic bacteria. Tobramycin is an aminoglycoside with gram-negative activity.

"Adverse events, primarily cough," were noted, the authors say. Respiratory events, including dyspnea and wheeze, were less common with FTI 80/20 than FTI 160/40. All respiratory events were mild or moderate in severity, and there were no clinically significant changes in laboratory values.

Along with sponsorship by Gilead Sciences, Inc., the study was supported by grants from the FDA and the NIH General Clinical Research Center.

SOURCE: http://bit.ly/vjcVCR

Original article: http://www.medscape.com/viewarticle/755291?src=nl_topic

The Power of Placebo

In a recent issue of the New Yorker, long-time staff writer Michael Specter explored the nature of the placebo effect in medicine, primarily by describing the work of Ted Kaptchuk, who directs Harvard University’s Program in Placebo Studies and the Therapeutic Encounter (PiPS). The program’s mission is “to examine the placebo response and the implications of medical ritual, the patient-provider relationship, cultural context, and the power of imagination and hope in the healing process. Through endeavors in the clinical, basic, and social sciences, bioethics, the history of science and philosophy, PiPS seeks to elucidate, quantify, optimize and reaffirm the humanistic and more intangible dimensions of health care.”

Kaptchuk, who studied Chinese medicine in Macau and practiced acupuncture for many years, is arguing for a shift in contemporary medicine away from high-tech and pure science to a greater emphasis on healing. Having recently received funding from the National Institutes of Health, he and his colleagues are undertaking neuroimaging and molecular studies to understand the biological underpinnings of the placebo response.

In one study, he and his group acknowledged that a problem in directly exploring the placebo effect in a clinical setting was the use of deception — not letting patients and providers know of they are receiving an active drug or not. So they designed a randomized study in which patients with irritable bowel syndrome were given pills they were told were “an inert substance, like sugar pills” or no treatment. After 21 days, patients given the placebo had significantly different changes on global improvement scores (5 versus 3.9, P=0.002) and symptom severity (P=0.03).

In another study, patients with asthma were randomized to treatment with an albuterol inhaler, a placebo inhaler, sham acupuncture, or no treatment. The albuterol group experienced 20% improvement in forced expiratory volume in one second (FEV₁) measured on spirometry, and the other three groups all improved by 7%. However, when patients were asked if they felt better, 50% on albuterol reported improvements, as did 45% of those using the placebo inhaler, and 46% of those who had sham acupuncture, compared with only 21% of those who had no treatment (P<0.001). The researchers concluded that, while objective measures such as FEV1 are important in asthma care, “other outcomes such as emergency room visits and quality-of-life metrics may be more clinically relevant to patients and physicians.”

Specter concludes his article with a personal anecdote. He had been experiencing chest pain and was worried, being an overstressed middle-aged man, so went to his doctor, who conducted a careful examination. The physician told him he was fine, but needed to relax — and the pain simply disappeared. This was an example of “exactly the type of ritual that, according to Kaptchuk, will have to play a critical role in the future of American health care.

So what do you think should be the role of placebo — if any — in tomorrow’s medicine?

Original article: The Power of Placebo http://bit.ly/t39hKo from @medpagetoday

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