Health
N.S. woman who fought 4 years for cancer diagnosis urges others to be ‘persistent’
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For four years, doctors told Laura Landry-Rudolph the growing and painful rash on her inner thigh was “chafing” or perhaps “eczema.”
And for four years, Landry-Rudolph persisted something much more serious was going on.
In an emotional Facebook live video last month, the 32-year-old from Antigonish, N.S., shared what a dermatologist’s biopsy had finally revealed: cancer.
“The health-care system is f—ed,” she said through tears. “Why did it take my doctors four years, four years?! Thinking it was f—ing chafing in my inner thigh? And now it’s spread, and now I have to find out if it’s in my blood.”
Speaking to Global News, Landry-Rudolph said she wanted to share her story so that others know to speak out if they notice something wrong with their bodies.
“You know your body, you trust your gut. And my message, simply, is you have to advocate for yourself and be persistent in getting the answers that you deserve,” she said.
Her official diagnosis is cutaneous T-cell lymphoma, which is an uncommon type of non-Hodgkin lymphoma, according to the Canadian Cancer Society.
Landry-Rudolph’s symptoms began after she became pregnant with her first son. She said she noticed a reddish-purple rash and visited her family doctor, who prescribed her some creams.
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About a year and a half later, she noticed it had grown in size, had become painful and was leaking fluid,
“I was fearful that I had an infection. So I would visit (the ER), then again I was given antibiotics and no answers,” she recalled.
By the time she was pregnant with her second child, she noticed the rash had started to show up on the opposite side of her body on the left hip.
“Then I knew in my gut that something is not right,” she said.
Even then, she said she was seen by “multiple” physicians and told it was chafing or eczema. She was on a wait-list for a dermatology specialist for over a year, and when she asked the family doctor about the wait, she was advised to call and check on the wait-list herself.
That’s the day she calls a “miracle” because she called and they had a cancellation
“Hadn’t I made that call that day myself, I wouldn’t be in treatment right now,” she said.
“When I went up to see the specialist, he took one look at me and said, ‘This is not something we see every day.’ So in that moment, I was distraught. I had my mother with me. I was scared, I said, ‘I have babies. I’m a young mother, I’m 32 years old.”
It took three weeks for the biopsy results to come back, and in that time, a blood blister appeared on her hip. She saw a separate physician who had access to her biopsy results, and will never forget the way the news was presented to her.
“He said, ‘What you have is called cutaneous T-cell lymphoma.’ And I said, “Well, what is that?’ And the physician responded with, ‘I have no knowledge around this type of cancer, you can choose to Google it or choose not to. I’m so sorry that I had to deliver this news to you,’” she said.
“My world collapsed. I was left in the dark, I had to go pick up my kids from daycare thinking mummy might die. I don’t know what stage I’m at, I don’t know what type of cancer I have. All I know is I have a rare cancer that this physician has zero knowledge over.”
A photo of the rash on Laura Landry-Rudolph’s thigh taken in early 2023.
Provided/ Laura Landry-Rudolph
According to Landry-Rudolph, four years ago, only two per cent of her body was affected. Now, the cancer covers seven per cent of her body and requires her to travel to Halifax for treatment, which could last up to six months.
“If it wasn’t for me asking, I probably never would have gotten this diagnosis,” she said.
“My message here is not to belittle any physicians at all, whatsoever. But, if you notice something on your body, you listen to your gut and you push to get the answer.”
‘Effort to expedite people’s diagnosis’
Minister of Health Michelle Thompson told Global News the government has been working on ensuring Nova Scotians “getting better care, sooner.”
Part of that, she said, is looking at how people access primary care and looking at how to create “clearer pathways” for specialty service.
“Everything we’re doing in terms of the investments and the pilot projects that we’re trying is in an effort to expedite people’s diagnosis,” she said.
Premier Tim Houston campaigned on a platform to “fix” health care. Last month, he told attendees at the Progressive Conservative AGM he felt an urgency to get things done.
“None of this happened overnight and it will not be fixed overnight. But, I want you to mark my words. I may have inherited a broken system, but I will do everything in my power to fix it,” he said.
But critics have pointed out that the province’s system is in a crisis, highlighted by the recent emergency department deaths that have prompted investigations and a civil lawsuit against the province’s health authority.
So far this year, the province has initiated a pilot program that allows select pharmacies to provide more medical services and the College of Physicians and Surgeons of Nova Scotia has removed the requirement for doctors trained in the United States to write a certification exam.
The provincial government also announced $59 million for a new medical school at Cape Breton University, $37 million for a rural health-care institute at St. Francis Xavier University, as well as a new health-care data analytics and management program at Saint Mary’s University.
Health
'Pandora's Box': Doctors Warn of Rising Plant Fungus Infections in People After 'First of Its Kind' Case – VICE
A man in India is the first human known to be infected by a fungus called Chondrostereum purpureum, a pathogen that is most well-known for causing a disease called silver leaf in plants, reports a new study.
The patient, who was 61 at the time of the diagnosis, made a full recovery and has not experienced any recurrence of the infection after two years of follow-up observations. However, this “first of its kind” case study exemplifies the risks that fungal pathogens pose for humans, especially now that climate change and other human activities like rampant urbanization, have opened a “Pandora’s Box for newer fungal diseases” by contributing to their spread, according to the study.
Fungal pathogens are having a pop culture moment because they are the source of a fictional disease depicted in apocalyptic game The Last of Us, which was recently adapted into the acclaimed HBO series of the same name. But these microbes are also a real-life scourge that infect about 150 million people every year, resulting in about 1.7 million deaths.
Though millions of fungal species exist, only a very small fraction of them are able to infect animals, including humans, because our bodies present challenges to these invaders such as high temperatures and sophisticated immune systems.
Soma Dutta and Ujjwayini Ray, doctors at Apollo Multispecialty Hospitals in Kolkata, India, have now added one more fungus to that small list of human invaders with their unprecedented report of a C. purpureum infection. The patient, a plant mycologist, had suffered from cough, fatigue, anorexia, and a throat abscess for months before his hospital visit, and was probably exposed to the fungus as a result of his profession.
When conventional techniques failed to diagnose the disease, the pathogen was sent to a World Health Organization center based in India where it was finally identified using DNA sequencing. The case “highlights the potential of environmental plant fungi to cause disease in humans and stresses the importance of molecular techniques to identify the causative fungal species,” according to their recent study in the journal Medical Mycology Case Reports.
“This is a first of its kind of a case wherein this plant fungus caused disease in a human,” Dutta and Ray said in the study. “This case report demonstrates the crossover of plant pathogens into humans when working in close contact with plant fungi. The cross-kingdom pathogenicity demands much work to be done in order to explore insights of the mechanisms involved, thus leading to possible recommendations to control and contain these infections.”
C. purpureum can infect a variety of different plants with silver leaf disease, an often fatal condition that is named after the color that the pathogen induces on the leaves on the hosts. It is the latest in a growing number of fungal pathogens that have infected humans, which are buoyed on in part by human activities, such as urbanization, travel, and commerce.
Human-driven climate change is also accelerating the spread of infectious diseases, including fungal pathogens, by allowing microbes to adapt to higher temperatures (like those in mammal bodies), expand their range, and interact with new hosts in the aftermath of extreme weather events. And though fungal diseases have maintained a lower profile in epidemiology compared to other pathogens, they may be more dangerous than viruses or bacteria in some contexts.
“While viral and bacterial diseases receive most attention as the potential cause of plagues and pandemics, fungi can arguably pose equal or even greater threats,” according to a 2021 study in PLoS Pathogens. “There are no vaccines available yet for fungal pathogens, the arsenal of antifungal agents is extremely limited, and fungi can live saprotrophically, producing large quantities of infectious spores and do not require host-to-host contact to establish infection. Indeed, fungi seem to be uniquely capable of causing complete host extinction.”
In addition to avoiding the spread of new fungal pathogens that can directly infect humans, researchers also point to the damage these diseases can deal to crops and ecosystems that people depend on. For this reason, Dutta and Ray recommend more research into the nature of these infections and strategies to mitigate their spread.
“Cross-kingdom human pathogens, and their potential plant reservoirs, have important implications for the emergence of infectious diseases,” Dutta and Ray said. “Fungi are also responsible for various infections in plants that cause destruction of millions of plants and crops” and “produce toxins that contaminate food and cause acute toxicity.”
“Over the past several decades multiple new pathogenic fungi have emerged,” they concluded. “A notable emergence of the multidrug resistant fungus Candida auris has spread all over the world and has become a significant threat. The worsening of global warming and other civilization activities opens Pandora’s Box for newer fungal diseases.”
Health
Staff reassigned to children’s ICU in Winnipeg, some surgeries postponed: Shared Health – Global News
An influx of kids sick with respiratory illness at the children’s pediatric intensive care unit (PICU) in Winnipeg has forced a staff shakeup that may result in the postponement of some non-urgent surgeries, health officials say.
Shared Health says roughly 10 staff — including some from pediatric surgical and recovery units — are being temporarily reassigned to help at Health Sciences Centre Children’s ICU.
Read more:
Children’s ER seeing ‘unprecedented’ patient levels in Winnipeg as feds secure more pain medications
Officials say a resurgence in respiratory illness circulating in the province is to blame for an uptick in kids ending up in the hospital’s ICU.
There were 17 kids receiving intensive care in the PICU as of Thursday morning. The PICU’s normal baseline capacity is nine.
“A significant number of these patients were experiencing medically complex cases that were further complicated by respiratory illness, including infants and young children,” Shared Health said in an online statement.
There were 51 patients in the hospital’s neonatal ICU Thursday morning. The normal baseline capacity there is 50.
Meanwhile, Shared Health says the number of kids visiting the ER with influenza-like symptoms has increased from a low of 22 on March 18 to 47 on Wednesday.
Read more:
Children’s ER seeing ‘unprecedented’ patient levels in Winnipeg as feds secure more pain medications
Shared Health didn’t say how long it expects the latest staff reassignments will be in place.
While all urgent and life-threatening surgeries will continue to be performed, Shared Health said some non-urgent procedures will be postponed.
Families of affected patients will be contacted, officials said.
© 2023 Global News, a division of Corus Entertainment Inc.
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Toronto:
The numbers of babies born with syphilis in Canada are rising at a far faster rate than recorded in the United States or Europe, an increase public health experts said is driven by increased methamphetamine use and lack of access to the public health system for Indigenous people.
While syphilis has made a global resurgence over the last five years, Canada is an outlier among wealthy nations in its rate of increase: 13-fold over five years, according to Health Canada. The incidence of babies born with syphilis reached 26 per 100,000 live births in 2021, the most recent year available, up from 2 in 2017, according to the Health Canada data.
That total is on track to increase further in 2022, according to the preliminary government data obtained by Reuters.
Babies with congenital syphilis are at higher risk of low birthweight, bone malformations and sensory difficulties, according to the World Health Organization (WHO).
Syphilis in pregnancy is the second-leading cause of stillbirth worldwide, the WHO said.
Yet congenital syphilis is easily preventable if an infected person gets access to penicillin during their pregnancy.
Among the G7 group of wealthier nations for which data is available, only the United States had a higher incidence of syphilis at birth: 74 per 100,000 live births in 2021, triple the rate in 2017, according to preliminary figures from the U.S. Centers for Disease Control and Prevention (CDC).
There were 2,677 cases of congenital syphilis in the U.S. in 2021 for a population of 332 million, according to preliminary CDC data. Canada had 96 cases for a population of 38 million, according to Health Canada.
People experiencing poverty, homelessness and drug use, and those with inadequate access to the health system, are more likely to contract syphilis through unsafe sex and pass it to their babies, public health researchers said.
“In high-income countries you see it in pockets of disadvantaged populations,” said Teodora Elvira Wi, who works in the WHO’s HIV, Hepatitis and sexually transmitted infection program.
“It’s a marker of inequality. It’s a marker of low-quality prenatal care.”
What sets Canada apart are its Indigenous populations who experience discrimination and often have poor access to health and social services, said Sean Rourke, a scientist with the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto, who focuses on prevention of sexually transmitted disease.
“It’s just the whole system, and all the things that we’ve done in bad ways not to support Indigenous communities,” he said.
Health Canada told Reuters it has dispatched epidemiologists to help provinces contain the increase in congenital syphilis. Spokesperson Joshua Coke said the federal government is expanding testing and treatment access in Indigenous communities.
Tessa, an Indigenous 28-year-old woman who asked to be identified only by her middle name, said she had a years-long crystal meth addiction and was homeless when she got pregnant in Saskatoon, Saskatchewan.
“I would be walking down the street just crying: ‘Why am I living like this?'” she told Reuters.
She said she received no prenatal care until she went into labor in November, which is when she tested positive for HIV and syphilis during a routine test.
Her daughter was prescribed a 10-day course of antibiotics, administered by IV, and is now healthy, Tessa said. But she still thinks about the difficulties she experienced in accessing prenatal care.
“Having transportation, maybe, and a place to live, and being sober, probably would have helped, big time,” she said.
Susanne Nicolay, nurse lead at Wellness Wheel clinic in Regina, Saskatchewan, which serves Indigenous and vulnerable populations, said providers needed to do more to expand access to health care. “The system always talks about patients that are hard to reach. But I think it’s health providers that are hard to reach,” she said.
‘MULTIPLE FAILURES’
A lot needs to go wrong for a baby to be born with syphilis, said Jared Bullard, a Manitoba pediatrician who has been researching babies born with syphilis since 2021 in an ongoing study for the Public Health Agency of Canada.
“It’s pointing at multiple failures along the path,” he said.
In Canada, the rise in babies born with syphilis is concentrated in the three prairie provinces: Manitoba, Saskatchewan and Alberta.
Prairie provinces have higher crystal meth use and remote populations and Indigenous populations who may have trouble accessing health care, Bullard said.
Manitoba recorded the highest rate, with about 371 cases per 100,000 live births in 2021.
The province said in an emailed statement that it is expanding training for health care providers in addressing sexually transmitted infections, encouraging frequent testing and early treatment. It is digitizing its records of STI infections.
Saskatchewan has launched a public awareness campaign urging people to practice safe sex and get tested, said Dale Hunter, a spokesperson for the provincial health ministry. The province had an incidence of 185 cases of congenital syphilis per 100,00 live births in 2021.
Alberta said women aged 15-29 made up more than half of what it called a “significant increase” in syphilis rates. “The reasons for the increase are not fully known, but it is likely that a variety of factors have contributed to this rise,” Alberta Health Services spokesperson James Wood said.
In preliminary results of a study of 165 infants exposed to syphilis, Bullard and fellow pediatrician Carsten Krueger found at least two-thirds were born to women reporting a history of substance abuse.
About 45% of the women identified as Indigenous and another 40% had no ethnicity recorded. Indigenous people make up about 5% of the Canadian population, according to census data.
About a quarter of the people in the study did not get tested because they got no prenatal care; about one-fifth of those who tested positive did not get treated. Bullard said he has also seen people get treated early in pregnancy and then get re-infected.
Public health researchers and clinicians said the rates of congenital syphilis began increasing before the pandemic and worsened as public health agencies diverted resources to COVID-19 testing and other pandemic-related health measures.
“All of the social circumstances that contributed to this have just gotten worse over the pandemic,” said Ameeta Singh, an infectious diseases specialist with an HIV/STI practice in Edmonton, Alberta.
This month Health Canada approved a syphilis and HIV test that can provide results in less than a minute, allowing providers to begin treatment right away.
Some public health researchers and providers are urging the Canadian government to buy and distribute the tests.
“We probably need a million tests to get out there around the country,” Rourke said. “The solution’s right in front of us.”
Health Canada did not respond when asked about purchasing test kits.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
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