Why Aging Might Become a Thing of the Past

Scientists have found a way to reverse aging in mice and rejuvenate their cells.
Mice Muscle Cells (old right) Credit: www.livescience.com

Muscle cells of mice (old right)
( Credit: www.livescience.com)

With the aftermath of the holiday season still sliding off of my shoulders, I vaguely recall the conversations of my older relatives around the dinner table.  Each story began with the familiar phrase, “I remember when I was your age,” followed by a list of cautions targeted at my generation. Of course, nostalgia is an important part of any family dinner. But what if my relatives could actually return to my age after all? What if aging was optional?

Sound too good to be true? Recent studies show that the process of aging is reversible. An article published late last year on social news website Live Science states that scientists at the Salk Institute in La Jolla, California, have discovered a way to “turn back the clock on human and animal cells, making them look and behave like younger versions of themselves.”

Where can you get this magical product, you ask? Don’t run to the phone just yet. The method is not yet ready for trials on humans. Instead, scientists use lab mice.

A mouse used in study of aging

Credit: www.pbs.org

“Obviously, mice are not humans and we know it will be much more complex to rejuvenate a person,” Izpisua Belmonte, a professor in Salk Institute’s Gene Expression Laboratory said. “But this study shows that aging is a very dynamic and plastic process, and therefore will be more amenable to therapeutic interventions than what we previously thought.”

Genes Are the Key

The science lies in our genes. By “turning on” four key genes, known as the Yamanaka factors, scientists can convert cells back to a state seen in human embryos. Cells that undergo this procedure are called induced pluripotent stem cells (iPS), which are capable of becoming any type of cell and dividing indefinitely.

Previous experiments with these factors almost always resulted in the development of cancer due to unregulated cell growth. But in the most recent study, scientists were able to stimulate Yamanaka factors for shorter periods of time, thus reducing the risk of cancer.

Scientists started with mice that have progeria, a disease which causes them to age faster than normal. They then genetically engineered the mice to turn on the Yamanaka factors. The treatments began when the mice were about eight weeks old, and continued in short sessions throughout their lifetimes.

three generations of women show aging

Credit: www.rand.org

Eventually, researchers reported that the treated mice looked and acted younger than their untreated counterparts. They showed less curvature of their spines with age and their organ function improved. They also lived about 30 percent longer than the untreated mice. A research associate at the Salk Institute reported, “Mice treated with these reprogramming factors had tissues that were better looking…more healthy, and they didn’t accumulate the aging hallmarks.”

Although this treatment is not yet available for humans, scientists say that human cells stimulated with Yamanaka factors show reversal of signs of aging. This means that one day we might have the option to decide whether to “age gracefully” or not.

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Sand Sculptures Capture A Grieving Widow’s Life

Artist collective Sand In Your Eye depicts wartime loss
A Sand In Your Eye artist adds details to the sand sculpture's face, a grieving woman

Credit: blog.sandinyoureye.co.uk

Those aren’t tears. You just have sand in your eyes. This is the concept behind Sand In Your Eye, a group of artists who craft memorable and heartbreaking portraits out of unconventional materials. They build enormous sand portraits, carve pumpkins and mold ice sculptures to depict the enormity of grief and the complexity of life.

One of the group’s most memorable pieces is “Loss Is Eternal.” In it, a woman made out of sand covers her mouth with a tissue. Her expression is forlorn and yearning. In her hand, she holds an ominous letter.

The sand sculpture captures the moment when a woman discovers her husband has died on the battlefield in WWII. The letter she receives says, “We regret to inform you your husband has been killed in action.”

The artists used more than 10 tons of sand create the sculpture, all of it packed by hand. They also struggled with the grieving woman’s facial expression, finding it more complicated than anyone initially imagined it would be.

A sand sculpture of a grieving woman holding a tissue and looking like she is going to cry

Credit: sandinyoureye.co.uk

As one artist, Jamie, said, “It is very challenging to make someone look like she is about to cry.” They knew they were finished when they felt that they were about to cry as they looked at her.

In the end, the piece took four days to complete.

It might seem easier to use a medium other than sand to make such a complex work of art. But the sculptors said the sand is an important part of the work. As the sand makes micro movements in the wind, the artists’ work comes alive. Suddenly, the sculpture’s facial muscles twitch. If you look closely, you can see grains of sand trickle from her eyes like real tears.

This sculpture is just one piece in a series, showing that grief is an eternal emotion. In the first rendering, the sculpture shows a grieving widow in her late 20s, just hearing the news of her husband’s death for the first time. In this version, the pain is still as fresh as her youthful face.

Over the course of the next two months, the artists slowly change the grieving widow’s face and hands to show her age. In the next version she is 55 years old, with some new wrinkles. And she is still grieving the loss of her husband decades ago.

An artist finishes sculpting the sand on the woman's face, which looks much older now, with more wrinkles

Credit: sandinyoureye.co.uk

The last sculpture in the series depicts the grieving woman in her late 80s. Although her wrinkles are now deep, she still remembers the loss as she approaches the end of her own life.

The artists unveiled this final edit on Remembrance Day, 2014. In describing the sculpture, they said it was important to them that the grieving woman looked as though she could be from any time or any country. They wanted to show the pain of losing someone in war, no matter which side of the battlefield the person was on when they died.

With “Loss is Eternal,” the Sand in Your Eye collective shows us that grief is not something we “get over.” It’s something that we learn to live with as time goes on. We cope, and we eventually move on with our lives. But the loss is still with us buried deep our minds. It changes us forever.

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How Can Natural Rituals Ease Grief?

An Interview with Christina Zampitella, Part Two

Welcome to the second part of my interview with Christina Zampitella, Psy.D., FT. (Read part one here.) Christina is a full-time professor and also has a private practice. She is interested in the healing power of natural rituals.

Debra: Christina, how did you become interested in the idea of rituals to help heal?

Christina Zampitella

Credit: drzampitella.com

Christina: The more I studied psychology, the more I came to believe that therapy had to involve not only the mind but the body and spirit as well. Rituals embrace all three of these elements.

Debra: How do you define a ritual?

Christina: A ritual is a ceremony made up of a series of actions or behaviors performed in a certain order and with a clear intention. The emphasis here is on intention. That’s the difference between a ritual and a habit. A habit is engaging in a behavior without thinking about why, like automatically kissing a cross when entering a church. While you’re doing it, you may be thinking about your kids’ overdue library books or what you’re going to make for dinner. Rituals are acts or behaviors performed mindfully, with the intention of obtaining a specific outcome.

Debra: How do you go about helping people create a natural ritual?

Christina: Actually, that was a large part of my dissertation. Since I had lost a sibling when I was an adult, my subjects were also adults who had had a brother or sister die. The research with that population, by the way, is incredibly scarce. I also wanted to do something that utilized the intrinsic healing properties of nature.

I met with each of my subjects to plan a ritual that would help ease his or her grief. For instance, we talked about the symbols each person wanted to use and why that symbol held personal meaning. Some of the symbols we used included rocks, feathers, water, candles, photographs or flowers, to name just a few.

Debra: What are the other elements of rituals?

Christina: Of course as I mentioned earlier, one of the most important elements is defining intent. What does the person or people performing the ritual hope to accomplish? This could be anything from, “I want to ensure my brother’s soul is at peace” to “I want to form a beautiful memory of my sister that I can always carry with me.”

Words are another part of many natural rituals. This could be the same word or phrase chanted over and over, or it could be the reading of a poem or the telling of a story about the sibling who has died. Songs may be used, too, as may music without words such as drumming or playing another instrument.

erly egyptian death ritualDebra: When you re-interviewed the participants after they had completed their rituals, what did you find?

Christina: The results were even more positive than I had hoped. Many of the participants said they were surprised to find that the rituals gave them a sense of power and control that they had lacked since their sibling had died. Others felt they had begun to make progress in their healing process after years of being stuck. Still others said that the rituals provided them with a voice with which to express their grief.

Debra: It certainly sounds like natural rituals have much to offer people dealing with grief. Thank you, Christina, for doing this interview with me. I appreciate your time.

Christina: Thank you for your interest, Debra.

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Movie Review: “Collateral Beauty,” written by Allan Loeb

Loeb’s movie negatively portrays the grieving process as a problem that must be eliminated
Collateral Beauty Poster

Credit: collateralbeauty-movie.com

Sitting in the movie theater, I was excited. I had my leather seat reclined, a tub of popcorn on the armrest and my Kleenex tissues readily accessible. I had heard mixed reviews about “Collateral Beauty,” but I wanted to form my own opinion. And the fact that Will Smith was a member of the cast didn’t hurt. As the introductory credits began to roll, I glanced over at my friend and smiled. This was going to be good.

Fast-forward an hour and 37 minutes later, and I was thoroughly disappointed. The plot line was unnecessarily convoluted. Smith’s character was seriously stymied, and the movie itself was just one cruel trick after the next. Needless to say, I left the theater furious.

“Collateral Beauty” follows the story of Howard Inlet (Will Smith), a successful advertising executive reduced to a depressed recluse after his young daughter dies of cancer. Two years after his daughter’s death, Howard is still struggling to bounce back. His three business partners, Whit (Edward Norton), Claire (Kate Winslet) and Simon (Michael Pena) are trying to stay afloat without Howard. They have lost numerous high-profile clients and are on the verge of bankruptcy. Instead of consoling their partner, as good friends would, the three set up an elaborate plan to take full control of the company by tricking their boss into thinking Howard is unfit to work.

Howard and Whit

Whit (Edward Norton) and Howard (Will Smith)
Credit: www.vanityfair.com

They go about this plan by finding three letters that Howard wrote: one to Death, one to Love and one to Time. Hiring actors to play these roles, the partners film interactions between the actors and Howard and crop out the actors. They ultimately make Howard believe he is talking with imagined entities that no one else can see. As a result, Howard thinks he is experiencing hallucinations. What a way to help someone through loss!

Eventually, Howard is fired from the company, and the movie ends with the hope that he is on the road to recovery. But one question still remains: Were Howard’s partners justified in using deceit to get rid of him? I don’t think so.

To me, “Collateral Beauty” depicts the grieving process as a problem that must be overcome rather than a natural reaction to loss. While some critics might argue that Howard had more than enough time to come to terms with his daughter’s death, grief doesn’t have a time limit. Everyone grieves in their own way.

Besides, Howard did try to help himself. Early on in the movie, he attends a support group for parents who have lost their children, which spurs the beginning of his healing.

Howard and Death actress

Howard (Smith) with “Death” (Helen Mirren). 
Credit: www.inquisitr.com

Overall, I think “Collateral Beauty” failed to capture the beauty that can be found in loss, such as friendship, strength, truth and closure. The movie had so much potential to make a statement on how grief unites humanity. But in the end, it missed the mark.

Watch the movie trailer here.

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Electronic Health Records Fall Short at Critical Times

Information about end-of-life wishes is often hard to find in an emergency

Emergency room personnel not always aware of where to find information in electronic health recordsOver the last decade, the use of electronic health records — digital versions of the traditional medical chart — has become widespread in the United States. Incentivized by the passage in 2009 of the Health Information Technology for Economic and Clinical Health (HITECH) Act, a $30 billion federal program that sought to improve healthcare delivery by promoting standardized, electronic record keeping, clinics and hospitals across the country have rapidly adopted EHR technology since 2010. Today, about 96 percent of U.S. hospitals have electronic health records in place.

Depending on who you talk to, the conversion from paper charts to electronic health records has been a blessing or a curse. Certainly it simplified communication between care providers to some extent, and made critical patient information more accessible in an emergency. But, at least according to a recent article in the Minnesota Star Tribune, it has not made it easier for emergency room physicians to access information regarding patient wishes at the end of life. In fact, in a survey conducted in May 2016, less than a third of ER doctors said they felt confident that they could find this information quickly in electronic health records in an emergency.

The result? Far too often, patients are still receiving care they do not want.

The problem, according to Marian Grant, an associate professor at the University of Maryland School of Nursing, is a lack of consistency — something electronic health records are supposed to promote. “Weirdly, there is not a handy or consistent place to put these things in an electronic health record,” she said in an interview with the Star Tribune.

And Dr. Joshua Lakin of the Center for Palliative Care at Harvard Medical School, agrees. “We have had a challenge in that electronic medical records … are not really built to optimize finding plans about end-of-life wishes,” he said.

But some hospitals seem to be doing a better job than others in making the information accessible, Lakin added. One is Gundersen Lutheran Medical Center in La Crosse, Wisconsin. There, every page in the patient’s electronic health record has a tab that displays their wishes for end-of-life care. Other hospitals in the area are following suit, but progress is slow.

ED doctors don't always know where to look for information in electronic health records

Patients often get care they do not want in an emergency.
(Credit:gomerblog.com)

One tool that may help is a form known as POLST, or provider orders for life sustaining treatment. Unlike advance healthcare directives, which tend to be rather general, POLST gives first responders and emergency room personnel clear direction about treatment options such as cardiopulmonary resuscitation, artificial feeding and other life-sustaining care. Additionally, POLST is a binding medical order, which an advance directive is not. First responders and healthcare personnel must follow your wishes if you document them in a POLST. 

If they can find it, that is. When 67-year-old Beth Bedell, who has a brain tumor and debilitating chronic nerve pain, went to the emergency room at Regions Hospital in St. Paul, Minnesota last spring, her POLST was nowhere to be found. Bedell had already been resuscitated once against her wishes following a cardiac arrest two years ago. And though she says she’s grateful to be alive today, she created the POLST to ensure the same thing wouldn’t happen again.

“I was thinking, ‘Oh, come on guys, really? I’ve done all this work. I sat down with my doctor. I’ve gotten this notarized. I’m a HealthPartners patient, and this is a HealthPartners hospital,’” she said. “It was utter frustration and disbelief.”

What You Can Do

polst can be kept in electronic medical records

Physician orders for life-sustaining treatment form.
(Credit: medpass.com)

Unfortunately, emergencies are by their very nature unpredictable. And electronic health records are a useful tool, but they are far from foolproof. That’s why it’s so important to have end-of-life conversations with your doctor and your loved ones early on. Document your wishes in an advance healthcare directive, and make sure that you have designated a healthcare proxy. This person will make medical decisions for you if you can’t do so yourself, so make sure they know what you do and do not want.  

If you have a serious, life-limiting illness or are medically frail, you may also wish to talk with your doctor about creating a POLST. A POLST helps ensure that doctors honor your end-of-life wishes should you land in the emergency room. What’s more, discussing your wishes with your doctor can help you sort through what you may or may not want if you experience a life-threatening event. This discussion is an opportunity to ask questions too. For example, you may wish to ask your doctor what your chances are of returning home if you are resuscitated following a cardiac arrest.

Lastly, make sure to keep a copy of your advance healthcare directive and POLST form in a prominent place in your home. And always keep the phone number of your healthcare proxy in the same place.

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Our Monthly Tip: Bring Friends and Family to Your Loved One’s Favorite Place in Nature

Honor your loved one's memory by gathering in their favorite place outdoors

Our Tip of the Month:

Many people find comfort and peace in nature. Oftentimes a specific beach, forest, National Park or hiking trail is a person’s sanctuary during stressful times. After a loved one dies, bringing a group of family and friends to their most beloved outdoor place is a wonderful way to come together and remember them. Being outdoors  in nature has also been shown to reduce stress and improve overall well-being.View of a forest from afar

How-to-Suggestion:

If your loved one had a favorite beach, you can set a time and date that works for family and friends to come together for a day or two to remember them. It’s not necessary to hold a memorial at this place. It can just be a time to come together to remember your loved one’s life. Being in a place that they loved can, in turn, bring the important people in their life closer together. Another idea is to go camping for a weekend at your loved one’s favorite campsite. We can get a better sense of what a person held dear when we take part in activities that they enjoyed.

Group of people hikingGoing for a hike with family and friends on your loved one’s favorite hiking trail would be another wonderful way to honor them. By retracing steps they very well may have taken, you can remember them and share stories about their life. Hiking and conversation go hand in hand. Exercising outdoors in nature is also a wonderful method to deal with grief and sadness.

By bringing their friends and family together in a final ode to your loved one’s favorite place, you will be honoring both their love of nature and their life.

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