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Fear of Flying, Journavx Pain Relief, and Health Misinformation in Canada · Morning Medical with Dr. Chow

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Hello and welcome to another episode of Morning Medical with Doctor Chow, where we dive into
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the latest medical and health news from around the globe.
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I'm Doctor Chi-Ming Chow, your host for today's journey into the world of health and wellness.
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As always, we're here to keep you informed and empowered with the most current information in
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the medical field.
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Today, we're focusing on a topic that affects millions of people worldwide: the fear of
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flying.
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Now, you might think that a fear of flying is just a minor inconvenience, but for more than
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25 million Americans, it's a debilitating phobia known as aerophobia or aviophobia.
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This fear can significantly limit one's life, preventing people from traveling for work or
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pleasure, and can even cause distress weeks before a planned flight.
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Doctor Gail Saltz, a clinical associate professor of psychiatry at Weill Cornell
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Medical College, explains that while many of us might feel a little anxious about flying, those
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with a phobia experience a range of symptoms.
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These can include a fast heartbeat, sweating, trembling, dizziness, and even nausea or
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vomiting.
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Some people might cancel flights or avoid traveling altogether just to avoid these
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distressing symptoms.
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Interestingly, the fear isn't always about the plane crashing.
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For some, it's about being in a confined space, a fear of heights, or even concerns about
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becoming motion sick or catching an illness.
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In fact, only a small number of flying phobias are actually about the fear of a crash.
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So, how can someone manage or overcome this fear?
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Doctor Saltz suggests exposure and response prevention therapy, where individuals gradually
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expose themselves to flying in a controlled way.
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This might include virtual reality therapy, where a therapist guides you through the
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experience of flying while teaching relaxation techniques such as meditation and deep
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breathing.
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For those concerned about the rare possibility of a plane accident, it's important to put
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things into perspective.
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Statistics show that you're far more likely to be involved in a car accident or get struck by
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lightning than to be in a plane crash.
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Everyday activities involve a certain level of risk, and flying is one of the safest modes of
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travel.
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Parents can also play a crucial role in managing their children's fears about flying.
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It's important to maintain a calm tone when discussing plane accidents and to reassure
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children about the rarity of such events.
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Keeping news and social media exposure limited can also prevent children from feeling
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overwhelmed by repeated coverage of the same event.
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Overcoming a fear of flying can take time, but with the right treatment, many people see
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significant improvements within eight to ten therapy sessions.
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For some, the phobia may persist longer, but the key is to have faith in the treatment
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process and trust that it can lead to recovery.
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Let's turn our attention to polio vaccines, a topic that has been in the spotlight recently
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due to political discussions surrounding vaccine skepticism.
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Robert F.
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Kennedy Junior, nominated to lead the United States Department of Health and Human Services,
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has been a vocal critic of vaccines in the past, although he's recently softened his
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stance during his Senate confirmation hearings.
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One vaccine he's questioned is the polio vaccine, which remains crucial in preventing a
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disease that was once a significant public health threat.
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Polio, or poliomyelitis, is a viral infection that can lead to severe complications.
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According to the World Health Organization, in its early stages, symptoms include fatigue,
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headaches, stiffness, and limb pain.
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In about one in two hundred infections, polio can cause paralysis, and in some cases, it can
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lead to death if the breathing muscles are affected.
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While polio primarily affects children under five, anyone unvaccinated is at risk if
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exposed.
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Historically, polio was one of the most feared diseases in the United States.
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The worst outbreak occurred in 1952, resulting in almost 58,000 paralytic cases and over 3,000
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deaths.
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However, thanks to vaccines, the disease was eliminated from the country by 1979.
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The first polio vaccine, an injectable form developed by Doctor Jonas Salk, was introduced
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in the early 1950s and approved for widespread use in 1955.
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Later, in the 1960s, Doctor Albert Sabin developed an oral vaccine that became the
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preferred choice for global immunization programs due to its ease of administration and
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cost-effectiveness.
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There are two primary types of polio vaccines: the inactivated polio vaccine, or IPV, and the
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oral polio vaccine, or OPV.
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The IPV, used exclusively in the United States since 2000, contains killed poliovirus strains
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and is administered via injection.
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It requires trained health workers and sterile equipment but carries no risk of
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vaccine-associated paralytic poliomyelitis, or VAPP.
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The OPV, on the other hand, contains weakened virus strains and is administered orally.
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It is more widely used globally, especially in developing countries, as it can be administered
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by volunteers and prevents transmission.
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However, there's a very small risk of VAPP associated with OPV, about one in 2.7 million
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doses.
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The impact of polio vaccines on global health cannot be overstated.
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Vaccines have played a pivotal role in eradicating the wild form of the disease in
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many regions, including the Americas, Europe, Southeast Asia, and Africa.
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The former Czechoslovakia was the first country to achieve nationwide eradication in 1960,
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thanks to a robust vaccination campaign.
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Despite these successes, wild poliovirus remains endemic in certain areas, such as
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Afghanistan and Pakistan.
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Without polio vaccines, the world would be a much different place.
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It's estimated that between 1960 and 2021, these vaccines prevented 29 million cases of
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paralytic polio.
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Expanding the scope to all vaccines, a study by the World Health Organization in May 2024 found
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that immunization programs have saved 154 million lives over the past fifty years,
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including 101 million infants.
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These numbers highlight the immense value of vaccines in preventing diseases and saving
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lives.
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The nomination of Robert F.
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Kennedy Junior has sparked debate, with some concerned about his historical stance on
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vaccines.
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Former Republican leader Senator Mitch McConnell, a polio survivor, emphasized the
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importance of the polio vaccine, stating that it has saved millions of lives and helped
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eradicate a terrible disease.
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Undermining public confidence in proven cures can be dangerous, and it's crucial for public
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figures to support evidence-based health measures.
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Today, we're exploring a significant development in the realm of pain management.
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The United States Food and Drug Administration has approved a new opioid-free pain medication
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called Journavx, also known by its generic name, suzetrigine.
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This groundbreaking medication is touted as the first and only approved non-opioid oral pain
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signal inhibitor, offering a non-addictive alternative for patients suffering from
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moderate to severe acute pain.
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Developed by Vertex Pharmaceuticals, a Massachusetts-based company, Journavx is
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designed to address the acute pain that often follows surgery, injury, or trauma.
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This is a critical advancement given that more than eighty million Americans experience acute
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pain annually, making it the most common reason for emergency room visits.
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Traditionally, such pain has been managed with opioid medications, which carry a risk of
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addiction.
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This new medication provides an alternative that eliminates these risks, marking a
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potential turning point in pain management.
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Julie Pilitsis, a neurosurgeon and chair of the Department of Neurosurgery at the University of
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Arizona College of Medicine, highlighted the importance of this development.
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She noted that for many patients, the introduction to opioids often occurs during the
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treatment of acute pain, leading some to become dependent or addicted.
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The availability of a non-opioid option like Journavx is especially exciting because it
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works differently from traditional pain relievers by inhibiting sodium channels outside
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the brain, rather than modifying brain receptors.
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The need for such non-opioid alternatives is underscored by data from the Centers for
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Disease Control and Prevention, which reports that in 2023, over five million Americans aged
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twelve and older had experienced a prescription use disorder within the past year.
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Furthermore, between 1999 and 2022, approximately two hundred ninety-four thousand
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people died from prescription opioid overdoses.
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Journavx has the potential to help manage acute pain more effectively, preventing it from
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developing into chronic pain and mitigating the risk of dependency.
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Jianguo Cheng, a pain management specialist at the Cleveland Clinic, described Journavx as
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meeting a 'major unmet need' in pain management.
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He emphasized that many current therapies rely heavily on opioids, thereby contributing to
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issues of dependency and misuse.
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With its novel mechanism, suzetrigine eliminates the risks of misuse, addiction, and
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respiratory depression, offering a safer alternative for acute pain management.
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In addition to its application for acute pain, suzetrigine may also have potential for
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treating neuropathic, or nerve pain.
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Further studies are needed to confirm its efficacy in this area, but the initial results
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are promising.
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Dr.
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Marc Siegel, a clinical professor of medicine at New York University Langone Health, praised
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the approval of suzetrigine, noting its lack of addictive properties makes it a vital new tool
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as we continue to combat the opioid epidemic.
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Journavx has been well-received in clinical trials, with a high percentage of patients
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reporting satisfactory pain relief.
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Dr.
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Siegel noted that the drug has been shown to decrease pain by about half, which he describes
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as excellent.
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However, as with any medication, there are potential side effects, including itching,
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muscle spasms, rash, and elevated levels of creatine phosphokinase in the blood, among
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others.
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It's important for patients to discuss these with their healthcare provider to ensure safe
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and effective use.
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Access to Journavx is expected to improve with the implementation of the Non-Opioids Prevent
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Addiction in the Nation Act, which will provide Medicare coverage for FDA-approved non-opioid
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pain therapies starting January 2025.
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This policy aims to enhance access and affordability, ensuring that patients can
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benefit from this new treatment while reducing reliance on opioids.
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As we look forward, the approval of Journavx represents a significant step forward in
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addressing acute pain without the risks associated with opioid use.
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Its development and approval underscore the ongoing efforts to provide safer, more
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effective pain management options, ultimately improving patient outcomes and quality of life.
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Today, we're delving into a pressing issue in the realm of education and its ripple effect on
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the workforce.
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Across Ontario, and indeed other provinces in Canada, colleges are slashing programs at an
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unprecedented rate, raising concerns about the diminishing choices available to students and
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the subsequent impact on the workforce.
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Vivian Eke, a student at Centennial College, finds herself in the midst of this upheaval.
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She's in the final term of her 3D animation studies, one of the many programs that the
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Toronto-area institution will suspend in the upcoming school year.
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The announcement sent shockwaves through the college community, with students and faculty
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alike grappling with the sudden changes.
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The root of these program cuts ties back to a reduction in international students, who have
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long been a financial lifeline for many post-secondary institutions.
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With higher tuition fees, international students have significantly bolstered college
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budgets, making their recent decline a financial blow to schools, particularly in
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Ontario.
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This province has been hit the hardest, with numerous colleges suspending or reviewing
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programs and even closing satellite campuses.
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Pari Johnston, president of Colleges and Institutes Canada, describes the current
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situation as 'unprecedented.' While it's normal for college programs to evolve based on labor
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market needs and enrollment numbers, the scale of these cuts is unlike anything seen before.
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For instance, St.
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Lawrence College in Kingston, Ontario, has suspended nearly 40 percent of its programs,
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affecting a diverse array from accounting to police foundations.
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The decision-making process for these cuts involves evaluating projected enrollment,
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financial sustainability, and labor market demand.
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However, even if a program meets one criterion, it might not fulfill the others, leading to its
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suspension.
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This has resulted in a projected student body reduction from 12,000 to 6,700 at St.
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Lawrence by next autumn, illustrating the profound impact on student populations.
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The broader implications of these cuts are concerning.
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Colleges are integral to local communities, providing education that aligns with regional
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labor market demands.
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The loss of programs could lead to a shortage of qualified graduates in essential sectors,
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affecting industries ranging from healthcare to trades.
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This is particularly troubling for rural areas, where colleges play a crucial role in training
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local workforces.
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Alex Usher, a post-secondary researcher and consultant, warns that the overall cuts could
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eliminate up to 1,000 programs across Ontario's public colleges.
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This is compounded by the fact that Ontario receives the lowest per-student funding among
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the provinces and has had a domestic tuition freeze for years.
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Consequently, colleges aggressively recruited international students, who now constitute
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about 70 percent of Canada's international college student population.
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The financial strain is palpable, with colleges facing short- and long-term consequences.
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These could include reduced class offerings, fewer elective choices, and cuts to student
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services.
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The situation is so dire that Usher predicts a national budget reduction of approximately $4
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billion for colleges.
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The impact extends beyond just the students and institutions to the broader community and
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economy.
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Colleges are vital in training the workforce, including builders, healthcare workers, and
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first responders.
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The reduction in available programs could lead to skill shortages, particularly in skilled
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trades and healthcare, sectors that are already experiencing high demand.
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Pari Johnston highlights the risk of these cuts, emphasizing that they could weaken
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Canada's public training capacity.
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As colleges face this 'pan-Canadian problem,' there's a real danger of undermining the
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training of essential workers that communities rely on.
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This situation calls for urgent attention to ensure that educational institutions can
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continue to meet the needs of both students and the labor market effectively.
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Historians and experts are raising significant concerns about a recent executive order signed
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by United States President Donald Trump, which declares that the United States will only
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recognize two sexes, male and female, and that these cannot be changed.
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This move has sparked fear and confusion among trans and non-binary individuals, as it
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seemingly disregards both biological and historical realities.
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According to historians, humans have never fit neatly into just two sexes or two genders.
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Mo Moulton, a history professor at the University of Birmingham in England, expressed
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dismay at the executive order.
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Moulton noted that there has been extensive effort throughout history to force individuals
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into a binary gender framework, which denies the complex realities of people's bodies,
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lives, and self-understandings.
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This executive order has sparked fear in trans people across the United States regarding their
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legal status, as it mandates trans women to be placed in male prisons and halts the issuance
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of passports with an "X" gender marker.
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Jules Gill-Peterson, an associate professor of history at Johns Hopkins University in
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Baltimore, stated that the practice of changing gender is not new and has been observed
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throughout United States history.
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The terminology and awareness around gender diversity may be recent, but the existence of
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diverse gender identities is not.
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For example, up to 1.7 percent of people are born with intersex traits, which include a
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combination of male and female biological characteristics.
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The introduction of the "X" gender marker on United States passports in 2021 was a
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significant step toward recognizing gender diversity.
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This change came after a legal battle by an intersex Colorado resident seeking a
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gender-neutral passport.
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However, with the new executive order, there are concerns about the future of such progress.
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In Canada, trans and non-binary individuals are voicing concerns about traveling to the United
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States due to the potential legal implications of the executive order.
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Canada has protections in place for transgender and gender-diverse people, such as Bill C-16,
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which was passed in 2017.
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This legislation added protections for these individuals under the Canadian Human Rights Act
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and Criminal Code.
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Experts emphasize that the concept of a gender binary was enforced by colonial powers and is
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not reflective of the diverse gender identities that have existed historically.
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For instance, Indigenous groups have had terms for various sexualities and genders beyond the
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binary classification of man and woman for generations.
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The term "two-spirit" was coined in Canada in the 1990s to encompass these identities.
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Benny Michaud, director of the Centre for Indigenous Initiatives at Carleton University
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and a citizen of the Metis Nation, criticized the notion of only two genders, stating that it
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is "ignorant" and a disservice to Canadians.
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Michaud, who identifies as tasta-ee-iniw, meaning "in-between" in Cree, highlighted the
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historical presence of LGBTQIA+ people and the harm caused by denying this reality.
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The executive order also overlooks the rich history of gender diversity in various
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cultures.
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For example, the hijras of British-controlled India were recognized as a third gender and
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were targeted for eradication in the mid-1800s by colonial forces, who saw the existence of a
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third gender as a threat to the social order they wanted to impose.
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Historical figures such as Dr.
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James Barry, Christine Jorgensen, and the Chevalier d'Eon exemplify how people have lived
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outside the gender binary long before modern terminology existed.
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These individuals and many others navigated societies that were often organized around
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strict gender binaries, yet they found ways to live authentically.
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The executive order's potential impact on incarcerated trans women is particularly
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concerning.
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Being forced into male prisons significantly increases the threat of sexual assault.
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Additionally, Trump's administration has moved to cut federal support for gender-affirming
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care for minors, despite medical consensus on its necessity.
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The Canadian government has advised passport holders with an "X" gender marker to be
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cautious when traveling to countries that do not recognize their gender.
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The uncertainty surrounding the executive order has led some Canadians to cancel trips to the
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United States out of fear of having their passports confiscated.
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The rollback of trans rights in the United States is alarming to many experts and
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advocates, who fear the psychological burden it places on trans individuals.
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Mo Moulton expressed concern for the safety of trans people, emphasizing the damaging effects
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of being told that their identities are invalid.
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Today, we're turning our attention to a growing concern in the health information landscape:
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the rise of health misinformation.
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A recent survey by the Canadian Medical Association reveals that more Canadians are
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encountering false or misleading health information, primarily through social media.
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This trend highlights the urgent need for media literacy to help individuals discern credible
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sources from misleading ones.
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The survey, which involved over 3,700 Canadians, found that 62 percent of respondents
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had come across health misinformation, reflecting an eight percent increase from the
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previous year.
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Notably, younger generations, such as Gen Z and millennials, are more reliant on social media
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for news, making them particularly susceptible to misinformation.
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Millennials were identified as the demographic most likely to encounter misleading health
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information.
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Misinformation expert Tim Caulfield expressed concern over this trend, noting that while
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misinformation might initially seem harmless, it poses a significant public health issue.
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Caulfield emphasized the importance of recognizing the difference between
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misinformation, which is shared unknowingly, and disinformation, which is shared with the
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intent to deceive.
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The survey also highlighted some common misconceptions, such as the belief that a
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healthy lifestyle alone can prevent cancer, held by 35 percent of respondents.
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Additionally, 21 percent believed that 5G technology causes cancer, despite scientific
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consensus that these frequencies are too low to cause DNA damage.
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Experts like Samantha Yammine, a science communicator, stress the importance of
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questioning information that triggers an immediate emotional response or makes confident
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claims without evidence.
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Yammine encourages a mindful approach to consuming information, suggesting a pause to
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consider the credibility of sources before sharing.
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The spread of misinformation is fueled by echo chambers in both online and offline
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communities, where individuals are surrounded by information that reinforces their
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pre-existing beliefs.
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This is compounded by a growing distrust in institutions, which can make people more
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susceptible to misinformation, especially if they belong to communities that have
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historically faced systemic discrimination.
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Despite these challenges, there is still a significant portion of the population that
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trusts scientific evidence.
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The survey found that 57 percent of respondents feel capable of finding accurate and unbiased
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information.
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However, there's a need for continued efforts in promoting media literacy to ensure that this
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trust is not eroded by misinformation.
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In conclusion, while misinformation presents a daunting challenge, it's crucial for
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individuals to engage critically with the information they encounter.
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By fostering media literacy and maintaining a skeptical eye, we can combat the spread of
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false information and protect public health.
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That brings us to the end of today's episode.
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Thank you for joining me on Morning Medical with Doctor Chow.
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Remember to stay informed and critical of the information you consume.
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Until next time, take care and stay healthy.