Sally Pacholok's Campaign to raise awareness of B12 Deficiency

Press Release

“Year of B12 Awareness”
September declared
“Vitamin B12 Awareness Month” in the United States
September 23 will be “Vitamin B12 Awareness Day”
Fall into Action by September 23

Fresno, CA- Masked behind misdiagnoses, B12 deficiency has slowly grown to become the most untreated and unrecognized nutritional disorder causing injury in the United States.
This crippler is a master of masquerade, striking different people in different ways. It afflicts one person with tremors, makes another depressed or psychotic, and causes agonizing leg and arm pains in still another. It can mimic Alzheimer’s disease, multiple sclerosis, early Parkinson's disease, diabetic neuropathy, or chronic fatigue syndrome. It can make men or women infertile or cause developmental disabilities in children. Other times it lurks silently, stealthily increasing its victim's risk of deadly diseases ranging from stroke and heart attacks to cancer.

Sally Pacholok, R.N. and Jeffrey Stuart, D.O. are spearheading a national effort to alert the public to the dangers of vitamin B12 deficiency—a public health care crisis costing state and federal agencies billions of dollars and costing millions of people their health.

Organizers chose spring to begin the campaign because it's a time when we're all thinking about getting out and moving around more—and healthy vitamin B12 levels are crucial for an independent and active life. They are calling on all health care institutions and assisted-living residences to learn about B12 deficiency by September 23—Vitamin B12 Awareness Day—and to include screening seniors for B12 deficiency in their fall-prevention programs.



Pacholok and Stuart point out that B12 deficiency is a world-wide problem and a hidden epidemic in the United States. B12 deficiency causes symptoms such as nerve pain or tingling, dementia, mental illness, tremor, difficulty walking, and frequent falls. It is commonly misdiagnosed as Alzheimer's disease, depression, peripheral neuropathy, vertigo, and mini-strokes. Major medical journals report that vitamin B12 deficiency occurs in up to 15 percent of the elderly—approximately 5.4 million seniors. Other studies report the prevalence to be 15 percent to 25 percent. What's more, these numbers only relate to persons 65 and older. They don't include the vast numbers of Americans under the age of 65—many of them infants, children or middle-aged adults—who become B12 deficient for a variety of reasons. In younger people B12 deficiency can mimic post-partum depression/psychosis and autistic-like symptoms in children.

Groups of people at high risk for B12 deficiency include vegans, vegetarians, alcoholics, people with eating disorders, celiac disease, Crohn's disease, those who have had gastric bypass surgery, and those who suffer from autoimmune diseases and AIDS. The use of certain drugs such as proton pump inhibitors, metformin, H-2 blockers and nitrous oxide can also cause B12 deficiency.

Did you know the following?
• Most patients who have B12 deficiency symptoms or are at risk for B12 deficiency never get tested.
• Even doctors who do order B12 tests miss many cases of B12 deficiency because they don't use an additional sensitive test (urinary methylmalonic acid).
• Misdiagnosis is common because B12 deficiency mimics other diseases.
• Many doctors rarely contemplate B12 deficiency unless red blood cell abnormalities or anemia—often late signs—are present.
• The elderly are easily misdiagnosed because doctors often blame their symptoms on coexisting medical problems.
• Treating B12 deficiency costs only a few dollars a month and symptoms are often completely reversible if people receive early treatment.
• If diagnosed too late, symptoms such as dementia, tremor, and nerve injury typically cannot be reversed.
• Multi-vitamin pills contain only small amounts of B12—far too little to correct a B12 deficiency or to prevent B12 deficiency in at-risk groups.

Pacholok and Stuart believe the hidden epidemic of B12 deficiency can be stopped in its tracks by educating the health care community and the public. "This is one of the most preventable, and most curable, of all medical scourges," they say, “but only if we choose to act." They urge the medical community to take steps including:

• Screening at-risk adults in assisted living residences, group homes, nursing homes, and hospitals.
• Incorporating screening for B12 deficiency into all fall prevention programs.
• Screening at-risk pregnant women and nursing mothers.
• Screening infants and children with developmental delays.
• Screening patients diagnosed with MS, mental illness, or dementia (including Alzheimer's).

Pacholok and Stuart are seasoned media interviewees and would be happy to answer your listeners' questions.

Sally Pacholok has been practicing emergency nursing for 22 years. Jeffrey Stuart, D.O. is board-certified in emergency medicine and has been practicing for 16 years. They coauthored the most comprehensive explanation of this problem, Could It Be B12?: An Epidemic of Misdiagnoses (Quill Driver Books). They have appeared as guests on CNN-Headline News, Seeking Solutions with Suzanne, KATV Channel 7 News in Little Rock, Arkansas, and numerous TV shows in southeastern Michigan. Additionally, they have been interviewed by dozens of radio stations including: KSTE Radio, Sacramento Wide World of Health, KHNR Honolulu Doctors Health Radio, KKCR BBS Radio, Dr. Ann West Show, CHOK Radio, Ontario Canada Live with Lee, Redbook, First Magazine, Bottom Line Health, Variety, Anchorage Times, Detroit Free Press, South Bend Tribune, Lockport Union-Sun and Journal, and Nursing 2007.

Possible Interview Questions:

Why is vitamin B12 important?
Why do we become deficient?
What are the signs and symptoms of B12 deficiency, and who is at risk?
Who should be tested?
Why are patients being misdiagnosed?
What are the names of the tests used to diagnose B12 deficiency?
What is the cost to patients and society regarding misdiagnosis?
What can we do to help raise awareness?

David Duncan Dundas, the 31st Chief of the Clan Dundas, taken at the 100th Dundas Clan/Family Reunion at Banner, Ontario

It has been said of the House of Dundas that "any Prime Minister can raise a man to the House of Lords but it takes seven centuries of Scottish history to make a Dundas of Dundas", the Dundases are certainly one of the oldest historical families in existence. Helias, son of Uctred who obtained the charter of lands of Dundas in west Lothian in the reign of Malcolm IV (1153-65) or a little later, is the first name recorded. From earliest times the Dundases played a prominant role in the affairs of Scotland, most remarkable was the legal dynasty beginning with Sir James, 1st Lord Arniston who died in 1679. His grandson Robert held the posts of Solicitor General, Lord Advocate and Lord President; he was succeeded by his son who, as Lord Arniston, was a judge. His son, like him called Robert, was a Solicitor General in 1784, Lord Advocate in 1789 and Chief Baron of the Exchequer in 1801. The statesman Henry Dundas was known as the "uncrowned King of Scotland" and " managed" Scotland for William Pitt. Through his offices, many estates forfeited after the 1745 rebellion were restored and the ban on the wearing of the tartan was lifted. Arniston House at Gorebridge is owned by the Dundas family. Dundas Castle near South Queensferry was built by James Dundas of that Ilk in 1424. In the 15th century the Dundas family garrisoned Inchgarvie Island in the Firth of Forth having been given special permission to do so by James IV. The present chief, David Duncan Dundas formerly of South Africa, now resides in England.

Information from www.electricscotland.com/webclans/dtog/dundas2.html

The statesman, Henry Dundas is the Dundas for whom Lord Simcoe, the first Lieutenant Governor of Upper Canada, now the province of Ontario, named a highway, Dundas Highway and the town of Dundas, Ontario. The city of Toronto has a Dundas Street, a subway stop called Dundas and a square called, Yonge Dundas Square. Many towns and cities in Ontario have a main street called Dundas Street.

Come one, come all ye Dundases of the Clan Dundas

In 1823, my gr.,gr.,...grandfather Moses Dundas, 9 generations ago, left County Fermanagh in Northern Ireland to immigrate to Canada. He settled in a small community called Cavan, Ontario near Peterborough. Not long after he was joined by his half-brother Gustavus Dundas. Gustavus was granted a parcel of crown land, near Cavan, for his service in the British Army, the last few years of which were spent on the Island of Elba, serving as a cook for the contingent of British soldiers who guarded Napoleon.

Two years later in 1825, cousins John and William Dundass left Northern Ireland for Canada. They settled in a small rural community called Banner, Ontario. Shortly after Gustavus and Moses left Cavan and along with their families joined the cousins, John and William in Banner.

In 1909, the Dundases got together for a family picnic/reunion on the Sunday closest to July 1st. That picnic/reunion continued each year and this year we celebrate the 100th Dundass/Dundas family picnic/reunion. At 11 o'clock in the morning on June 28th, Dundases will gather at the church in Banner where a piper will be waiting to pipe us (Dundases) into the small church for service. The same church that David Dundas, Moses son and my gr.gr. gr. etc. grandfather helped build.

Attending the service and the family picnic will be our Clan Chief, David Dundas who is attending from the UK. David Duncan Dundas, 31st Head of the Dundas Clan, is one of the oldest, continuous, hereditary Scottish chieftainships still in existence today.

I am looking forward to having a great time and meeting a lot of new relatives. Afterall we are all cousins.

Chicago..Pictures of Kim's first trip to Chicago set to the music of Elvis, "In the Ghetto"

From Movies

A scary morning...beginning with a telephone call

At 4:10 a.m. this morning, my telephone rang...Kim was on the line...Mom, she said, is it thundering at home, is it a weird kind of thunder? No, I replied, but if it is thundering there it will probably head our way because we have had thunderstorms every day for the last couple of weeks. Kim said she couldn't see any lightning but she said at 10 to 4 in the morning, her cat woke her up when all of sudden there was a loud boom and her apartment building shook and the windows rattled. She got up and the noise didn't stop, it was continuous boom, boom, boom. Ten minutes into the conversation we concluded that it wasn't thunder because there was still no lightning and there was no let up in the booms. I suggested she call the police admin number rather then 911 which she did but kept getting a busy. She called me back 15 minutes later and by that time I was awake enough to turn on the radio and found out that a large propane storage plant was on fire and blowing up a couple of miles to the north and west of her.

Kim and her sister live in Toronto which is about 43 miles west of me. Many thoughts ran through my mind, the first was to get dressed, drive in to their place and bring them back home along with their cats. By that time, however, the police had closed highway 401 in both directions and the only alternative would be to take city back streets to get to where they live. However, everyone was being warned to stay away from the area. I continued to monitor the radio and heard that an evacuation order was being released and thankfully the perimeters of that order ended about a mile from where Kim and her sister live.

At 5 a.m. I put the tv on to a 24 hour news channel and saw pictures of the fire and explosions...the first explosion at 3:50 a.m. looked like an atomic explosion, a huge mushroom shaped fire-red cloud..no wonder Kim and her sister felt their building shake..this propane storage facility is located in a residential area (the city of Toronto needs to have some answers ready), many residents were seen running down the street in their housecoats, some shoeless, some carrying their pets in their arms, houses with doors and windows blown out, just utter chaos. Residents were told if they didn't have a vehicle, then they had to walk, eastwards away from their homes and the scene of the fire. The first explosion Kim heard was at 10 to 4 in the morning, they were continuous, almost every minute until about 20 to 5 in the morning and then sporadic until about 6 a.m. Security alarms in buildings and on parked vehicles, some even in underground parking lots were activated...along with the sounds of the explosions, no wonder people thought a terroist attack had occurred.

As I write this the highway is still closed...it is difficult to get into or out of Toronto but at least the fire scene is a little bit more stablized. The concern is that there are 2 large railroad cars of propane on fire however, so far, the fire department has managed to cool the tanks off, keeping them from exploding. Unfortunately at the time of the explosions, there were workers at the plant. The latest news coverage says all but one are accounted for but the miracle is, so far there have been no fatalities.

Unlike the U.S. and Europe, Canada is very lax when it comes to where these propane fuel storage plants can be located. It is so unfortunate that it takes an accident like this to make our govenment wake up or at least I hope it will but I see an interesting time ahead this week with the City of Toronto trying to answer how this storage facility was allowed to locate in a built-up residential area 5 years ago.

...A story about pernicious anaemia being diagnosed too late and the resulting consequences

On October 9th last, the Pernicious Anaemia Society and the Pernicious Anaemia forum reached a milestone...Joshua joined as the youngest member of the PA society and of the forum.

Joshua is a 13 year old boy who was just recently diagnosed with Sub-Acute Combined Degeneration of the Spinal Cord, secondary to PA (SACDSC). He almost died before this diagnosis was made. Joshua (JJ) became ill in January of this year. During the time leading up to his diagnosis he saw many doctors and many hospitals. His paediatrician knew there was something wrong but again because of his age did not think to check for B12. JJ saw a liver specialist at Sick Childrens’ Hospital in Toronto. The liver specialist diagnosed him with Wilson’s Disease after a biopsy, but did not do a follow up even refusing to return calls from JJ’s mother. In the meantime, JJ's condition was getting worse. He was turning a nice shade of yellow that made his father think that JJ was in the early stages of liver failure. JJ’s paediatrician contacted the liver specialist at Sick Childrens’ Hospital and got no satisfaction from that doctor. The paediatrician believed that JJ’s illness was a problem with his blood and he contacted a haematologist at Sick Childrens’ Hospital whom he knew personally to ask him to see JJ. An appointment was set up but before that happened JJ collapsed and was unable to walk.

It was through the efforts of the paediatrician that the parents were able to get JJ admitted into Sick Childrens’ Hospital within a very short time. This hospital is located in Toronto, about a 50 minute drive by car from JJ's home. His father carried JJ out to the car and along with his mother, JJ was taken to Sick Childrens’ Hospital, his father carrying JJ into the hospital upon their arrival. It did not take very long for a team of doctors including a paediatrician and a haematologist to diagnose JJ’s illness...a B12 deficiency. JJ’s parents were told that JJ made history because his B12 level was the lowest recorded, a level of 0.

JJ remained in hospital for a week and a half with further tests being done. These tests confirmed PA and a later test confirmed SACDSC. And JJ is only 13. With the diagnosis of PA, Wilson's Disease was ruled out. JJ returned home, confined to a wheelchair. His parents were taught how to inject the B12 and JJ was on high loading doses of cyanocobalamin and folic acid. He was put on 40mg of folic daily (8 tablets of the 5mg prescribed) and will continue on this amount until Oct. 30th when he goes back to Toronto to see the doctor. The doctor explained the high amount of folic was needed because JJ was not absorbing vitamins at all. JJ is also on high amounts of calcium.

Martyn Hooper, the Chair of the PA Society has the same form of Pernicious Anaemia as JJ. Upon hearing JJ's story and the fact that JJ was confined to a wheelchair moved him deeply, consequently he grabbed a flight from his native Wales, traveling to Canada to meet with JJ on our Canadian Thanksgiving Day, October 8th. We met up with JJ at a neighbour's home close to me, the very same neighbour who had alerted me to what had happened with JJ. JJ is slowly improving, he had graduated from a wheelchair to a walker with wheels. Martyn was able to answer some of JJ's questions, particularly why JJ was having trouble with balance and walking.

Last week, his mom called me to tell me he was trying to use crutches. Good for JJ. He cannot go to school and the doctors think it may be January before he can go back. In the meantime, three schools have asked Martyn and I to go in and speak to them about Pernicious Anaemia. JJ’s school has asked for our help to let the students know what pernicious anaemia is and how they can help JJ when he returns. The other school is where JJ’s father is employed. What irks me most though is JJ needs a laptop, he is unable to hold a pen or pencil in his hand (an early sign of PA neurological damage is not being able to make a fist) and the school board is unwilling to provide him with one. Shame on them!!!

The haematologist and paediatrician at Sick Childrens’ Hospital who diagnosed JJ are writing a paper about JJ...they were astounded that, although Juevenile Pernicious Anaemia (JPA) is rare, a simple B12 test was not done.

I think everyone should have their B12 levels and Folate level checked on a yearly basis. This blood test could save your life or the life of your child.

Adoption:...finding my mother

Clayton Ruby, a well known and respected lawyer in Toronto is launching a court challenge to the Adoption Information Disclosure Act, 2005, which will come into effect late this fall in Ontario. Mr. Ruby believes that parents and children involved in adoption have the right of privacy and if they so wish, should have the right to restrict that information contained in their files so no one can access the personal information.

I so disagree with this. ( I will explain why I disagree in my father's story, the dundas side). Thank Gawd for Marilyn Churley who has led the fight to make Ontario open its adoption books. I am a foster child, I was never legally adopted. I was six months old when my maternal grandmother brought me to a farm in rural Whitby and left me with a family with the understanding that it would be for a short period of time. That short period stretched into 19 years. Now, I consider myself fortunate that I was never legally adopted. That means my birth certificate was never changed. What bit of information that was available to me was found quite by accident one day when, as a child of 12 years, I was rummaging through an old trunk in my foster parents' home and discovered a letter that had been written to my foster parents from my maternal grandmother. I had always known that I was "adopted" from an early age because my two older foster brothers would bring up that fact quite often when they wanted to be mean and nasty to me, in the sense that "you are adopted and you don't belong, you are not one of us".

I held on to that letter (it was never missed by my foster parents) because where I came from and how I was raised with this family, was never discussed. At a young age I knew not to ask my foster parents any of those kind of questions, knowing that I would not get an answer. Perhaps I was afraid that the answer would be what my foster brothers always said to me.."your mother did not want you so she gave you away".

When I was nineteen, I was no longer living with my foster family. It was 1959 and I was employed at Bell Telephone as an information and long distance operator. It was very easy for me to take the letter, written by my grandmother, and locate a telephone number for her. I did not think at the time about how shocked my grandmother would be when she got the telephone call from me. I have to give her credit though because not once did she scold me for calling or tell me that my mother would not want to hear from me, instead she asked me some information about myself, told me that I had a brother who was a year older than I and took my telephone number, promising me that she would give this information to my mother.

I left work that afternoon, going home to my apartment, waiting with a feeling of trepidation for the shrill ring of the telephone. The telephone did ring and on the other end was my mother. She began by asking me questions and then telling me why she had been unable to keep me. I discovered that my mother and father had been married, that my father was in the army and that my mother left him when I was a couple of weeks old because she said he had been physically abusive to her.

We agreed to meet the following Sunday and so with my boyfriend whom I had asked to accompany me for support, we drove to Cooksville, Ontario... to the restaurant where my mother and her common law husband were waiting..I walked into the restuarant, it was mid-afternoon but inside it was dark and gloomy (not a good sign). My mother saw us and immediately left the booth where she had been sitting and came up to me. I saw a stranger.

All those years of growing up, living with a family who were the complete opposite in looks to me...they were fair-skin, blonde-haired, blue-eyed, whilst I had jet-black hair, green eyes but I did have a fair skin (from my celtic ancestors, I later discovered). I looked at this stranger standing before me, looking for similarities but finding none, only in the shape of our body. My mother had a dark swarthy complexion, black hair and black eyes. This was not the mother of my childhood dreams.

We left the restaurant and followed my mother and her partner to a trailer park in Cooksville. They lived in a large trailer on a well-kept little street within the trailer park. Masses of climbing roses hung over the fence that bordered their corner lot and and competed for colour with scarlet geraniums that were planted in flower beds around the trailer.

My mother thought it best to have a talk first so she and I went into the trailer to the spare bedroom where we both sat down. I listened to what she had to say, again she placed all of the blame on my father, saying he used to beat her up all the time which was why she left him (I found my father 28 years later and my very first look at him convinced me that what my mother said was a lie, even thinking that just maybe it was the other way around, she beating my father). Now at 19, I was not that wise but I thought it very unfair of her to defame my father when he was not present to defend himself. I did not say this to her of course but that figured greatly in making me withdraw and not allowing myself to be open with her. It also prevented me from having any kind of deep feeling for her. She told me about my brother, a half-brother, named Larry who was one year older than me. She told me she was pregnant with Larry when his father was accidentally killed, racing a speed-boat on the Detroit River. She also told me she married my father to give my brother a legal name but then became pregnant with me right away.

We kept in fairly close contact from 1959 to 1972. I married in 1962 (the same boyfriend who accompanied me on my first visit to my mother), we had two daughters, born 1963 and 1966. My mother did visit quite often and our daughters called her nan. Our third child, a son, was born June 9th, 1970. He had a severe birth defect (a hole in his diaphragm) and lived only for three hours. From 1970 to 1971 we saw very little of my mother and in 1972 our second son was born on January 13th. I asked her to visit to see her grandson but she always put it off. In November of that year she sent me a birthday card, wishing me a happy birthday but said she thought it was best for her if she did not visit but did want to stay in contact by means of a yearly birthday card. I chose not to reply. I have not spoken to her or contacted her since that date.

I will admit the relationship was very one-sided. I tried to give more but could not, a hangover I think from being abandoned because that is and has always been the way I look at what both of my parents did to me, they equally abandoned their responsibility to me. Consequently, to this day, I am close only to my husband, my daughters and my son and his wife.

Finding my father (the Dundas side of that story) will follow.