WASHINGTON, DC,July 1, 2009  - The American Pharmacists Association (APhA)  announced the installation of its new Executive Vice President and Chief Executive Officer Thomas E. Menighan, BSPharm, MBA. In February 2009, Menighan was appointed as APhA’s Executive Vice President and CEO-Designate and began the transition into his new role. 
He is the 26th pharmacist to serve in this role and succeeds Dr. John A. Gans who served in the same capacity for the last 20 years.

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Undoubtedly, the most important headlines this week is the death of Michael Jackson. It was headlines news over all the newspapers, all over the world. On the 25th June 2009, Michael Jackson was pronounced dead at the University of California, Los Angeles Medical Center. He was said to have died from a cardiac arrest. That on its own, is not a proper cause of death. We are all anxiously waiting for the autopsy report. Well, what do the cardiac boys' say. It is common knowledge that MJ was under tremendous stress, with a 50 concerts due to start in about two weeks, he was to start an international tour to kick start his career again. He is USD400million in debt, he is 50years and have not performed for many years. He is high on drugs,including painkillers and occasional opiates. It is known that he was regularly on IV demerol, and also oxycontin. He was underweight when they did the autopsy, and allegedly quite emarciated.
What are the possible causes of a cardiac arrest? Or is it a cardiac arrest? His doctor, Dr Murray, was with in the house when he had the cardiac arrest. Dr Murray noted that he had a faint femoral pulse, when he arrived at the bedside. That would suggest that he may have been in respiratory failure, before the cardiac arrest. That raised the possibility of drug induced respiratory suppression as one would get with the opiates or other sedative group of drugs. IV Demerol could also cause hypotension, in someone dehydrated enough, to cause a hypotensive cardiac arrest. It is also interesting to note that MJ was under the care of a non-board certified cardiologist. Dr Murray is not board certified. Of course, Dr Murray tried to do CPR, but without opiate antagonist to reverse the opiate respiratory suppression ( if at all that is the cause ), and without endotracheal intubation, his CPR efforts would have been futile, as we now know it was. It was also alleged that Dr Murray performed the CPR without putting MJ on the hard floor. External cardiac massage would have been very ineffective, on the soft MJ bed.
Of course, he could have a cardiac arrest from other forms of drugs that he was taking. That is why we are awaiting the toxicology reports. With poor diet, and emarciated conditions, he may have been somewhat dehydrated, so that electrolyte imbalance and a cardiac arrest may have occurred.
It is also well know that MJ suffers from SLE. Lupus can also affect the heart, sometimes causing heart blocks, sometimes causing myocarditis and cardiac inflammation, thereby causing a cardiac arrest.
There is a distant possibility that at 50yrs, MJ could have had a heart attack, with that causing the cardiac arrest. MJ, though 50yrs old, never had a stress ECG? His cardiologist, Dr Murray felt that he looked well and so there was no need for a stress ECG, although all his concerts are heavily insured. Anyway it is important to note that a cardiac arrest is when the heart stops, either from ventricular fibrillation ( the heart fibrillating ) or complete heart block. A heart attack is when the patient has coronary artery disease ( maybe silent arteriosclerosis ) with atherosclerotic plaques on his coronary arteries. Should those plaque rupture, as it can do under severe stress, the resulting coronary thrombosis ( blood clot in the artery, blocking the artery ) causes the heart muscle cell death, we call a heart attack.
There is even a report that MJ may have committed suicide as his rehearsals were not going well. After not performing for so many years, and not being in perfect physical condition, he can hardly be expected to do the "moon walk ". Rather then face a flop on his comeback, he wanted to be remember for what he achieved earlier, not to mention the financial loss should the concerts flop. So he took his own life.
Whatever had happened, we would all have to await the whole autopsy report, including the toxicology report, before we can arrive at a definitive conclusion.
25th June has seen the death of an icon. May MJ rest in peace. His work on earth is done.

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By Andy Balaskovitz, abalaskovitz@gmail.com
Great Lakes Echo
July 1, 2009
On the west side of Michigan’s Okemos High School is Zach Trelstad’s favorite classroom. To the right of the greenhouse entrance is the sandy ground with desert-native plants. To the left is the tropical area filled with large overhanging leaves, ponds with amphibians and intricate vines on lattice. It’s about the same size as a regular classroom but filled with sunlight and plants instead of light bulbs and desks.
“When I whisper at them, the frogs will croak back pretty loudly,” said Trelstad whose independent study in this mid-Michigan school’s greenhouse is one of his favorite school experiences.
“I’m more into this class than any other one where I’ve sat inside and listened to the teacher,” he said.

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I thought you might like a glimpse into what my days are like. They are mostly filled with attempts to prevent or overcome the side effects of the radiation. Now I know why most cancer patients lose their hair - because they don't have the time to fuss with it after all of the things they need to do to survive chemo and radiation!

Morning:
1. The moment I wake up I am usually in pain so I take my pain medication right away.
2. My nose is also very stuffy and sore so first I do a saline rinse to clean out my sinuses.
3. Then with a Q-tip I rub Aquaphor in my nose to keep it as moist as possible. Right now it is very sore and irritated.
4. My eye is getting very dry and irritated so I place Liquid Tears eye drops in my eye.
5. I take my other medications: Zofran (nausea), Protonix (heartburn), Synthroid (for my hypothyrodism), Claritin, and stool softener to prevent constipation from all of the pain medications.
6. Apply Aloe to my face and neck to prevent skin deterioration.
7. Rinse my mouth with a salt and baking soda solution.
8. Rinse my mouth with a steroid solution to help the sores in my mouth. Yesterday the doctor said they were among the worst they have seen.
8. Attempt to eat something solid by mouth to keep my swallowing muscles active. This usually means yogurt or something soft.
9. Dump one can of Ensure Plus into my feeding tube.
10. Apply Lidocane to the sores in mouth to temporarily take away the pain.
11. Give myself a Lovenox (blood thinner) shot in my stomach.

Mid Morning:
1. Pain medication is starting to wear off so take another dose.
2. My nose is stuffy and sore again so I use a saline spray and try to clean out my nose as much as possible. Reapply the Aquaphor.
3. Dump another can of Ensure Plus into my feeding tube.

Lunch time:
1. Apply Lidocane to the sores in my mouth so that eating lunch will be a little easier.
2. Attempt to eat something solid again.
3. Use nasal saline spray and apply Aquaphor to my nose again.
4. Rinse with salt and soda solution again.
5. Rinse with steroid solution again.

Mid afternoon:
1. Take pain medication again.
2. Leave at 1:45 to go to radiation.
3. Get radiation therapy at 2:30
4. Arrive back home at 3:30
5. Dump another can of Ensure Plus into my feeding tube.
6. Take another dose of Zofran.

Dinner:
1. Rinse with salt and soda solution again.
2. Rinse with steroid solution again.
3. Apply Lidocane to mouth sores so that eating dinner will be easier.
4. Attempt to eat something solid by mouth.
5. Dump another can of Ensure Plus into my feeding tube.

Bedtime:
1. Take pain medication again.
2. Take another dose of Protonix, Zofran and stool softener.
3. Give myself another shot of Lovenox.
4. Do another sinus rinse.
5. Apply Aquaphor to the inside of my nose.
6. Do another salt and soda rinse.
7. Do another steroid rinse.
8. Brush my teeth and floss.
9. Brush with fluoride. (These two steps are important to protect my teeth. Patients going through radiation can easily get cavities)
10. Place Liquid Tears eye drops in my eye again.
11. Apply aloe to my skin again.

In addition to the above cares, I will now be giving myself IV fluids at home. It will start at 3 days a week and will eventually lead to every day IV fluids. It is getting harder and harder to keep drinking a lot of water. The nurse will be coming to day to show me how to do it.

Things have been going OK this week. It is getting tough to manage the sores in my mouth. The doctors have been giving me every possible solution they know of to help them heal but nothing seems to work. My Radiation Oncologist gave me the steroid rinse and I am hoping that will be an answer. Time will tell. Thank goodness for feeding tubes!

Please pray for the sores in my mouth to get better or to a level that is manageable.

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. Chronic bronchitis produces excess mucus and a productive cough on a daily basis for a long period of time; it is a long-term lung problem. Other symptoms of chronic bronchitis are breathlessness, chest pain, wheezing and sometimes coughing up blood.

People with compromised immune systems, the elderly, babies, people who are exposed to environmental pollutants and those who already suffering from a lung ailment are more prone to bronchitis and should see their doctor if bronchitis develops.

Symptoms may be relieved by drinking plenty of fluids and participating in steam inhalation with added menthol or eucalyptus. This will help to break up the mucus. Stopping smoking, cutting out mucus forming foods such as dairy products, eating plenty of immune boosting fruit and vegetables plus oily fish which contain anti-inflammatory properties will also be beneficial. Studies have shown that by breast feeding your baby, lung infections can be reduced throughout early childhood.

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