Clinical Research Studies in Wichita Kansas

  One of the greatest freedoms we enjoy in America is the right to choose. This is evident from the millions of food products lining the shelves of our supermarkets, countless restaurants ranging from fast food to fine dining, as well as take out food, catering, and even vending machines. We even have a cable channel devoted to the preparation and consumption of food. We want for nothing when it comes to our choices in food items. And it shows.

The Centers for Disease Control released the sobering announcement last week that the number of states where at least 30 percent of the population is obese has climbed to twelve. Just four years ago only one state fell into that category. It is also little comfort that the one state with an obesity rate under 20 percent, Colorado, would have been considered the heaviest in 1995.

So what happened? At what point after 1995 did America begin the slippery-slope into adjustable waistband pants and sensible shoes? The blame ranges from our habits, lack of exercise, additives in food, poor diet, supersized portions at restaurants, so-called "healthy" foods with deceptive labels or marketing, and social and economic status. Lack of personal responsibility is often the biggest culprit, but food companies and government also play a role. The following is a list of my personal thoughts of what contributes to this problem as well as my pet peeves regarding reckless marketing schemes.

We don't know that we don't know:

 Unless you happen to be a dietician or someone who is fit and has really brushed up on the most current data regarding healthy eating, chances are you're not alone in your confusion over what really constitutes a healthy diet. Most of us get our information from the news or an article in a magazine. We follow the advice only to find out that the latest study does not support the initial claims that were reported as gospel in the first place. With so many contradictory statements and information, how do you know what works and what doesn't? With the information changing all the time, it's no wonder so many people give up.

We haven't identified the habits that keep us unhealthy:

 Do you skip breakfast, or worse, do you start your day with a donut and soda? Is your idea of exercise texting with the opposite hand? Maybe you're eating out several days a week. Whatever the reason is, our minds have come to accept certain rituals and habits as normal but our waistlines think otherwise. In order to truly live a healthy lifestyle, you must identify what has made you unhealthy. Sometimes it's not always obvious. Sugary drinks are a culprit that can even sabotage people who genuinely try to eat and live healthy. I will go into this more when I talk about vitamin water

 Eating healthy is an acquired taste:

 All the health rags preach that adults need at least five to nine servings of fruit and vegetables a day. In addition, we're supposed to supplement this with servings of nuts, fish, and other lean proteins. What they almost always fail to mention is that if a person's diet has mostly been fast food and sodium or sugar-laden snacks, they will still want those things and the flirtation with healthy food will end. A good way to reduce the shock is to introduce these foods gradually by  replacing an unhealthy food with a healthy one. For example, swap chips for baby carrots or a crunchy vegetable that you like, candy for grapes, or a fruit for a donut. It won't happen overnight, but the body will acquire a taste for these things and, along with reducing portion sizes and exercise, one lays the cornerstone for a healthier lifestyle.

 So many choices. So much temptation:

 Remember that little neighborhood grocery store where you could just run in and get all your meat, dairy, produce, and dry goods and bypass all those snack foods? Neither do I. What was considered a supermarket 20 years ago would be a general store by today's standards. Many of the aisles in the stores now would not be necessary were it not for so-called convenience foods that have replaced the made-from-scratch nutrition found in home cooking. Add to this the snack aisles jam-packed with those sneaky "mini" treats that actually make us consume more than had we just bought the regular size. Why have three full size Oreos when you can rationalize that it's better to eat a whole bag of minis? Which leads us to...

 Deceptive marketing. Buying what they're selling:

 One of the biggest tricks that food manufacturers have pulled on consumers is convincing us that certain things were healthy when in fact they were not. Nowhere is there a more glaring example of this than the product called Vitaminwater. First of all, vitamins are not naturally found in water. Neither is flavoring. Yet, the marketing gurus behind Vitaminwater convinced the public that the product was all natural without ever having to come out and say it. The truth of the matter is that Vitaminwater contains a pinch of synthetic vitamins with no known benefits and as much sugar as some soft drinks. This should come as no surprise since Vitaminwater is produced by soft drink giant Coca-Cola. Similarly, trans fats have come under attack and food companies have found ingenious ways to get around having to identify them in their product. Trans fats are associated with heart disease and obesity. They differ from other fats because the body recognizes trans fat as saturated which raises bad cholesterol (LDL) and lowers the good (HDL).  Many foods may list partially-hydrogenated fats on the label which are the same as trans fats. To help avoid the trans fat trap, look for foods that contain Poly and Monounsaturated fats.

 There has been a lot of talk in the news lately, especially from politicians, about a time not so long ago when things were better, less complicated, idyllic.                             

 To look at the past through rose-colored glasses is certainly understandable, given the uncertainty of the times we're living in and our division over the war, politics, and whether or not Kim Kardashian should get a butt reduction. Some notions from only twenty years ago may seem quaint by today's standards, but just how rosy is the past, really?

 By health and medical standards, not very. Medical science is a progression where looking backward is only a tool for comparing data and measuring what works and what does not. Many soldiers who survived the Civil War lived the rest of their lives with breaks and fractures that never healed correctly or with infections that made them susceptible to other illnesses or left them crippled.

 This was largely due in part to the fact that there were no antibiotics during the Civil War and small infections often led to serious illness. There was also no anesthetic. Often the cure for a broken limb was amputation via a dirty hand saw. The overwhelming numbers of wounded soldiers left no time for sanitation and limited water supplies didn't allow for handwashing between procedures.

 In the 20th century, there were many advancements in medicine: the discovery of penicillin, development of vitamin supplements, development and use of X-rays, development and medical use of insulin to treat diabetics, advances in cancer treatment, and placebo controlled, randomized, blinded clinical trials, but to name a few.

 Clinical trials conducted at PRN of Kansas and other medical research facilities worldwide are heavily regulated to help ensure the safety and privacy of the individuals who choose to participate in them. It has been through trial and error over the last couple of centuries since the earliest controlled medical studies began that we have reached this point, an era where participating in clinical trials has never been safer.

 The latest statistics support that people in the 21st century are living, and will live longer than those in previous generations due to the breakthroughs of medical science. While it may be tempting to long for a simpler time where we were less connected and words like multitasking hadn't yet been coined to replace the expression "working your fingers to the bone", it is helpful to remember that the simple life was not always so simple. And although there is still so much more to do, especially for Cancer, Obesity,  and A.I.D.S research, we are still much further along than we were.

 This is a great (and rather healthy) recipe I found online!

Refried Bean Soup

1 lb ground beef

1 can (28 oz) whole stewed tomatoes

1 can (14 oz) refried beans (use 2 cans to substitute for beef for a vegetarian recipe)

1 can (2cups) beef broth (or vegetable stock for a vegetarian variation)

1 can green chiles (optional)

2 tbsp olive oil

1 onion

3 stocks celery

2 peppers (red and yellow)

2 tsp minced garlic (or more if you prefer)

1 pinch cayenne pepper

1 tsp cumin

1 tsp chilli powder

 Heat oil in large pot. Rough cut the onion, peppers, and celery and toss in oil with garlic and cook until tender. Brown the ground beef in separate skillet, drain excess grease and add to vegetables. Add the beef stock, cumin, cayenne, chilli powder, tomatoes, refried beans and green chiles and bring to a boil and then simmer for 30 minutes . Using a measuring cup, put the soup in small increments into a food processor or blender and puree. Top with tortilla chips and sour cream or plain greek yogurt for a lower fat option. Serves 6. Enjoy!

  We all get them. A well-meaning but completely uninformed relative or friend forwards an email that carries a dire warning. Whatever this email claims will happen to those who do not heed the warning will be much worse if we do not forward this email to at least everyone in our contact list. This email is vague on sources if it supplies any at all; but the message urgently screaming at us in bold, red, capital letters removes all doubt about its authenticity.

 Welcome to the misinformation age. I once received an email warning of the dangers of margarine. The email claimed that "Margarine is but ONE MOLECULE away from being PLASTIC.." The letter went on to state that if one were to leave a tub of margarine in a garage in the summertime it will not grow mold on it. I once found a tub of margarine that had made its way to the back of the refrigerator and can personally attest that it is possible to grow mold on margarine.

 snopes.com is a great resource for checking the origins of emails with questionable accuracy. My own built-in fact checker tells me that the more alarmist in message and appearance the email is(i.e. flashy visuals, ALL CAPS, "Delete this message if you don't love this country" etc.) the more likely it is to be completely baseless and false.

 Misinformation about medical research is spread much in the same way. Spam emails crowing about class action lawsuits against pharmaceutical companies are common. On a much grander scale, Hollywood has not been kind in its portrayal of the medical research industry, often portraying research clinics as secretive, government-operated entities run by sadists who use their patients as unwilling guinea pigs.

 While there have been much publicized low-points in medical research, it is worth mentioning that those have been far outweighed by the achievements made through research. Accomplishments such as organ transplants, the deciphering of the structure of DNA, polio vaccines, the discovery of insulin, the use of anesthesia in surgery, and more effective treatments for cancer and HIV/AIDS, but to name a few, were not possible without research.

   It is my hope in writing this blog that I will be able to dispell most of the myths and misperceptions about clinical trials that have been propagated through internet hoaxes and negative media portrayals. Making decisions about our health and our bodies is much easier when we are armed with facts. Now, isn't that something we can all agree is a good thing?

 The Christmas decorations have been taken down, the party hats and whistles swept away. The family is headed home and resolutions have been made. Collectively, we tell ourselves that this year will be different. This is the year that we are going to lose weight, exercise more, quit smoking, drink less, pray more, fix whatever is broken in our homes and in ourselves. Then the sense of deja vu sets in. Isn't this the same thing we said last year?

 Resolutions, as they say, are meant to be broken and the only difference between a true resolution and an empty promise are actions. For a great example of a promise not backed by actions look no further than the gym. January 1st always brings with it a swell of gym memberships. One who goes to the gym regularly can always spot the newbies. They walk around looking perpetually confused and choose machines at random, not knowing what they do or how they work. They engage in stretches and exercises not seen in any video or found in any magazine.

 The lack of planning and educating oneself about how to effectively begin an exercise routine inevitably leads to frustration and then failure. Like turtles trying to reach the ocean, only a persistent few make it past the sand. The rest shrug their shoulders and say "'maybe next year'". One can hardly blame those who do give up. We as a society are constantly being told to shape up, get up and move, and eat healthy while we shop at megamarts that offer countless convenience foods and snack aisles. We are bombarded with advertisements for pills that will make us slim and machines that claim we will look like Brad and Angelina even if we look like Danny Devito and Rosie O'Donnell.

 The reality is that most of these machines, even when used properly did not deliver the results promised. The diet pills only worked as long as one was willing to take it with a bland breakfast and a "nutritious" shake at lunch and dinner. The disappointment is akin to ordering a mouth-watering steak and only getting parsley. The difference is that parsley will not leave a bad taste in your mouth.

 Breaking resolutions is not only relegated to to crash diets and lofty fitness goals. Every year parents tell themselves that they'll spend more time with their children  only to have this goal undermined by a demanding work schedule. Couples who resolved to fix their marriages found that a new year did not necessarily mean a new start for them. So what does it mean then when we make promises to ourselves and don't keep them? Does it mean that we have failed ourselves when this happens, or is a better question whether or not these goals were realistic to begin with?

 Resolutions are not a bad thing. They can be followed through. Where they become problematic is when they are made not by our inner-selves, but arbitrarily mandated by a date on a calendar. New Year's resolutions in particular have a built-in failure mechanism because of when they are concieved; most of them are made in the week following Christmas, a time that is generally too busy to think through and carry out decisions that may effect us throughout the year. To put this another way, a resolution is a gift you give to yourself to positively affect your life and the lives of others. Trying to do this in the midst of a season based around the idea of only giving to others makes this nearly impossible.

 For a small percentage of the population, the strength-in-numbers approach to setting a goal on the first of the year works. For the rest of us, maybe another strategy is in order.  For someone just beginning at the gym, it can be intimidating trying to figure out where to start. This is where matching the goal with the action becomes important. Was the goal to lose weight? Focus on cardio equipment, walking or running tracks, or swimming and worry about the rest after you have familiarized yourself better. Enlist a friend who has a similar goal or consult with a trainer to help you with your fitness goals.

 Are you not spending enough time with your family because you work too much? Maybe something as simple as learning how to say no could fix that. If saying no is not an option, or the requirements of your job force you to choose between work and family, you may have to consider a complete reevaluation of your priorities. Again, a decision such as this requires careful thought and focus that is hard to achieve during the holidays.

 The key in these scenarios is that small steps are made in order to make the resolution attainable. Rather than looking at the big picture, it makes more sense to ask if you've looked at the obvious, and go from there. By doing it this way the actions required to achieve each step is not so great that it feels impossible. PRN of Kansas has had a great year because of our volunteers who resolved to be part of the future through medical research. We hope all of you have a great 2012 and that you fulfill all your resolutions both great and small!

 When a person changes something about their outward appearance, whether it's updating their wardrobe, changing their hairstyle, or even opting for cosmetic surgery, it is oftentimes the result of a change that's happening within. The same can also be said for a business. For some, the changes are all on the surface while it's still business-as-usual behind the scenes. For us, the changes are reflective of what we want to present to our patients and the community, and also of where we want to go in the future.

 October 20th marked the unveiling of our newly-renovated space at PRN. We had many visitors at our open house, some of whom have caught glimpses of the transformation of our space from neighboring offices. These changes include the addition of two exam rooms, an original hand-painted mural by local Wichita artist Scott Korth, and a completely redecorated lobby by John Nevitt.

 Open house was not only a chance for us to reconnect with friends and associates; it was a chance to meet new people as well. Drs. Lara Pollock and Shelly Callahan were on hand to talk to the invitees about wellness through oriental medicine, acupuncture, and therapeutic massage. Both Pollock and Callahan sublease offices within our suite and, although they are not employed by, or affiliated with PRN, their presence at our location illustrates the diversity of medicine as well as an opportunity for those who wish to explore alternative therapies.

 What we ultimately hope our guests took away from the open house is a feeling of warmth from our staff and a sense of always being welcome. Whether it’s to inquire about medical research or just visit and have a cup of coffee, we welcome the opportunity to get to know YOU! Thank you to all who gave us that chance last week.

If you have been within 6 feet of me this past week you would have heard me talking about my "loud experiences".  It seems that my ears are getting more sensitive than in the past???  I will give you a brief summary of the situation:

We were in a local ice cream place on a Saturday night.  This place could not have been bigger than 25' by 25'.  They had a nice guitarist playing and had her hooked up to a mic and speakers.  The music was consequently resonating throughout the place.  It was nice music but it totally trumped any family conversation or even logistical conversation that may be happening. 

So often I hear cars with the music so loud that I hear the words clearly several cars away.  While I think as an American you should listen to any music you want I also don't want to be forced to listen to your choice.  While I am sitting in the car at a stop light I am a captive audience with little choice to do anything other than listen to it when it is that loud.                                        

Aside from the 1st Amendment issue there is a hearing health issue that I wonder how many of us are blowing right past.  If you ask anyone who has hearing issues (and you will probably have to ask them loudly, in a certain tone and without additional background noise) they will tell you that living with hearing deficits is a frustrating existance.  Thank goodness for hearing technology today as the hearing aids are at least not such an eye sore and so cumbersome to handle.  They also have better technology to block out or filter out background noise.  Still they have to insert the device(s) into their ears every morning if they want to enjoy conversation, listening to music, the TV or the birds singing outside.

So what is my point?  The point is that much of our hearing loss can be prevented.  Unless you have had chronic infections, brain damage or a congenital condition, hearing loss is often caused by exposure to chronic lound noises.  100% of noise-induced hearing loss is preventable.  The following was copied from www.medicinenet.com.  It gives you some points of reference:

Regular exposure of 110 decibels (and higher) for more than one minute risks permanent hearing loss.

No more than 15 minutes of unprotected exposure of 100 decibels is recommended.

Prolonged exposure to any noise above 90 decibels can cause gradual hearing loss!

•Rock concerts and firecrackers are 140 decibels!

•Loud bass in cars (when other cars can feel the vibration and hear the noise) and snowmobiles are 120 decibels!

•A chainsaw is 110 decibels

•Wood shop is 100 decibels

•Lawn mowers and motorcycles are 90 decibels

•City traffic noise is 80 decibels

•Normal conversation is 60 decibels

•Refrigerator humming is 40 decibels

So people, do your ears a favor and dial down the volume!  Unplug! 

 Listen to crickets more often!  Silence can inspire.  You might actually hear your inner self and it might actually have been trying to tell you stuff for a while now! 

If you choose to not dial down take heart that this is an issue that has top research priority in the regulatory bodies...which means we hope to find better answers for hearing loss for you. 

Take care and I hope you all hear some beautiful things this weekend! kt

This week PRN welcomed a suite mate:  Lara Pollock.  She is a graduate from the Kansas College of Chinese Medicine.  Her practice is growing and so she needed a bigger, more accessible place.  I know Lara from my church and have been her client as well.  I know of her high standards and deep compassion and commitment to caring for people.  She is smart as a tack too!!  I hope her time here brings many opportunities for her.

We welcomed her with a luncheon with my staff that elicited many questions.  My staff here does research on traditional medicince.  How will this work?  I guess I take the stand that if I need care I want it ALL:  traditional and all other alternatives to chose from. We all know that some medications work and about side effects.  We also know that there are some conditions that respond beautifully with mainstream, traditional treatments.  But wouldn't it be great if some of the other therapies could be considered to increase efficacy, decrease the side effects or the intensity of the side effects?  What if you could get good benefits without the cost of some medications? 

When I counsel patients here in the clinic I am very careful about recommending things to them.  They are in a study, after all, and if they do something that radically changes things, data is skewed.  Bad data = drugs on the market that shouldn't be or drugs NOT on the market that should be.  So I weigh out what is best for the person and the situation.  Utimately I give the decision over to the patient.  That patient is the only one that has to live with that body without escape after he/she leaves my office.  So they get to make decision:  the study, suggested treatment 1(which may or may not be a prescription drug) or follow up with their primary care provider....I like that title:  primary care provider.  Allows for more than an MD to be considered as one that is your main source of care.

Speaking of titles!  So Lara has a degree from the college so she practices Eastern-based medicine, specifically in her case, accupunture and herbology.  In the state of Kansas there is not currently a licensure for this practice.  In New Mexico there is and she has taken the exam and passed.  So if you spot her in New Mexico you can say, "hey, Dr. Pollock" (vs. Dr. Lara as to not be confused with less reputible 'doctors' :)).  Somewhat annoying to those in the profession but it is the environment they live.  The nursing profession has similar issue with titles, etc.  Now we have a doctorate of clinical nursing so you could have a 'Dr. nurse'....or something.  So far I haven't heard any guidance on the proper way to address these folks.

Knowing the titles and credentials is important to me.  I feel that for someone who has a title there are a set expectations that I can have of that person.  I know not everyone meets them but at least I know the starting point of the relationship.  Nor do I diminish the importance of one that has less alphabet soup behind their name but if you are flaunting the soup you better have the muster behind it.  I HATE calling a doctor's office for my own personal needs and getting put through to Dr. SoAndSo's nurse only to find out I am speaking to a medical assistant (MA).  NOT the same; good, but NOT a nurse.  Are you a doctor?  Great!  Of what nature?  An MD, DO, DC, DDS, DVM, PhD, DNP, ScD, Pharmd, JD, OD, DBD, EdD, O.T.D, DPT?????  This list does really go on. 

The up side of this is that there are standardized titles.  At least you can call someone out if they are using inappropriate credentials.  You can't just say you are a QOE and expect people to respect and understand that you are indeed the Queen of Everything.  We can pretend, but that is our own little world.  We had a situation in the office that struck that chord this week too.  For our name tags we wanted to put SCA on someone's badge to make it look more important than 'just' a study coordinator assistant.  My friends, when you see 'assistant' on anyone's title KNOW that this person is one of most important people on the team.  Without our assistants here at the office we would certainly be inefficient and crazy!

I hope everyone has a great 3-day weekend and spends a minute pondering on the Labor we do everyday.  Each person is highly important in our workforce despite the specific titles.  We are all in this big sand box together and we all bring our gifts, talents, celebrations and baggage that make it so fun!

Several years ago I was 'fortunate' enough to experience life with chronic pain.  For 8 months I had unexplained muscle pain in my legs that would be so bad I could hardly manage stairs.  It interfered with my sleep.  I was irritable and cranky much of the day.  I remember lying in bed and wondering if I could look to a future of this type of pain for the rest of my life.  I was 30 years old at the time I had a hard time wrapping my brain around that concept.  I wasn't suicidal but looking forward was totally incomprehensible.

We have a chronic pain study now at our office and will have 4 more by the end of October this year.  This is not our first experience working with patients that deal with pain EVERY minute of their lives.  But we never lose our compassion for them nor our complete admiration that they still continue to function and do what they are able to do. Some of them have mastered the poker face and put on a smile despite the fact that walking to the door is agony to them. 

Chronic pain beats one down, physically, mentally and emotionally.  It takes your 'mojo'!  After time a person chooses to 'ignore' as much as possible or they would be consumed by the pain.  This is why it is hard to assess chronic pain patients to get an objective measurement of their pain (you know, the scale of 1-10...1 being very little and 10 being the worst pain you ever have felt).  Really?  If chronic pain patients rated it as they had felt it in the beginning they would all be walking around in remorse at a 10.  They can't remember what it is like to NOT be in pain. 

What do people with chronic pain need?  From what I can remember I wanted less stimulation: noise, light and touch. I wanted to be reassured that this pain would not be written off for me to deal with all my own.  Most of all I needed to be validated.  I was in pain.  It hurts.  Don't feel sorry for me but don't patronize me or worse tell me it is in my head....that is another blog!

I would like to hear some thoughts from those that deal with chronic, debiliating pain.  Let us hear your words so we can appreciate what you do every day.

 Thank you for visiting our new website. Hopefully, you have found the information on this site useful, the links helpful, and the layout of the site easy to navigate. For those of you already acquainted with PRN, you will notice that the website isn't the only thing that has changed. Last November, PRN celebrated its tenth year in business, a year that also marked the start of Kim Talbot's role as sole owner of PRN.

 In the months since, PRN has joined the ranks of other independently-owned companies that have survived the economic downturn. It has been through a mix of perseverance, decision-making, and luck that this has been possible. This process has not been without its transitions, however, as new faces have replaced familiar ones and long-running studies closed and new ones began. Other changes include a complete remodel of our lobby and the addition of an extra exam room and multi-purpose space. 

 Let us know what you think. The purpose of this blog is to open a dialogue about the subjects posted on it and to answer questions about clinical research. I encourage all who visit this site to subscribe by clicking on the link http://www.prnofkansas.com/contactus.htm in order to make the best use of the features it offers and to get the latest updates on our studies.