Tuesday, February 28, 2012

More about PANDAS

"The central struggle of parenthood is to let our hopes for our children outweigh our fears." — Ellen Goodman

HERE'S ANOTHER ARTICLE about PANDAS. It appeared in October on the ABC News/Good Morning America website.


Oct. 5, 2011

Karli Bossman was a happy 5-year-old from Clayton, N.C., who loved going to kindergarten -- until one day in 2008, the easy-going child suddenly became obsessive and defiant. She ripped off her socks and underwear because they "hurt" and insisted on wearing pajamas. And Karli refused to get in the car because she was afraid it would run out of gas.

At first, her parents, Kevin and Kelly Bossman, thought the little girl was being bullied, but after checking with her teachers, that was not the case. What was so frightening was how quickly her behavior changed.

"All of a sudden she was crying and didn't want to go to school anymore," said her mother, 32-year-old Kelly Bossman. "Things got so bad we had to pull her out of the house hanging onto the doorknobs."

The little girl also had an irrational fear of elevators and was scared to go to bed at night for fear she would have a bad dream.

It took two years and 14 doctors to finally figure out what was wrong. Karli, who'd had at least 19 cases of strep throat in the last three years, had developed PANDAS. -- pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection.

Symptoms include obsessive compulsive disorder (OCD) -- general anxiety, emotional mood swings, rages and oppositional defiance behavior. Some children have learning disabilities and lose fine motor skills movement.

"It's not a rare disorder, it's just rarely diagnosed," said Dr. Denis Bouboulis, an immunologist from Darien, Conn., and one of the top experts on PANDAS. "There are a lot of children actually misdiagnosed as having a primary psychiatric symptoms, when, in fact they are autoimmune and organic."

The disorder was first described in the mid-1990s, but has only recently been recognized by the National Institute of Mental Health (NIMH). For years, medical experts thought the link between a strep throat and OCD was only coincidental.

But in 2009, a Columbia University study confirmed that a strep infection could cause PANDA symptoms like OCD behavior and Tourette syndrome tics in mice. According to that research, those psychiatric disorders affect 25 percent of adults and more than 3 percent of all children.

Strep throat bacteria are known to cause autoimmune disorders like Syndenham chorea -- characterized by fever and uncontrolled tics of the face or extremities -- in susceptible people. Scientists think that PANDAS and its quick onset use the same pathways as rheumatic fever, affecting the part of the brain that controls movement and behavior in a phenomenon known as molecular mimicry.

Karli's journey, which continues today as her family strives to find an effective treatment, involved many misdiagnoses, including the use of antipsychotic drugs that have side effects like tremors and weight gain.

Now, the mother of four wants to try intravenous immune globulin (IV IG) treatment that is offered by Bouboulis. That helped Lauren Johnson, the Chesapeake, Va., girl who sneezed 12,000 times a day because of an OCD tic. Her mother, Lynn Johnson, subsequently founded the PANDAS Resource Network, which put Bossman in touch with Bouboulis, who sits on the board of directors.

It took the Bossmans years to even get an initial diagnosis. When symptoms first began in 2008, "we kind of waited it out, wondering what it was," said her mother. But things got worse. In January 2009 thinking it was a behavioral issue, they took Karli to a local psychologist who gave them a book about OCD in adolescents and children.

"She told me to go home and read it and if I thought it was OCD, to call her back," said Kelly Bossman. The book mentioned PANDAS. "We'd had a long history of strep throats, and as I read the book, I thought, gosh, that's exactly what she has."

But none of the doctors -- a behavioral therapist and three pediatricians -- believed that was Karli's problem. "No one had heard of it and no one would listen," she said.

One even put the girl on the anti-psychotic drug Risperdal, and the 6-year-old gained 10 pounds in two weeks. But it helped calm down Karli's outbursts, especially toward her two younger sisters and brother.

"She was so upset, she would hit and kick and throw things," said her mother. "The drugs would make her to where she couldn't get mad and tone her down so you could work with her."

Months passed and eventually Bossman heard an ad on the radio for a study on children with OCD at Duke Medical Center with psychologist Chris Mauro. Karli was accepted and participated from February to June 2010.

"He asked us our medical history and I never mentioned PANDAS," she said. "We'd seen three pediatricians and they done blood tests and said she doesn't have it. We had given up on PANDAS."

Karli's condition waxed and waned, but in August of last year, she began second grade and the "high anxiety" started up again, according to her mother. She went back to Mauro, but this time as a patient.

"It was the first time we had been seen outside the study," she said. "He said he was so happy that now he could tell us what he thought, 'Karli has PANDAS.' Finally, a doctor was telling me I was right."

But Mauro cautions that a PANDAS diagnosis is controversial and treatments are "not a magic cure."

"The immune modulated therapy treatments with antibodies must be done early and young," he said. "And the science isn't clear on the approaches. PANDAS is very rare, and my big fear is that everyone who has OCD and a strep infection will think they have it," said Mauro. "The treatment of choice right now is cognitive behavior therapy, especially if you are working with the children and their families."

After finding support and resources online, she located Bouboulis, but had to wait months for an appointment. In the meantime, she found more mothers who had similar frustrations with getting the right diagnoses for their children with PANDAS.

One, Sara Davis Furr of Dunn, N.C., lived only 40 miles away. Her 8-year-old son ripped his clothes off at night because he saw snakes. Antibiotics had helped him, according to a story in the News Observer.

Dunn recommended a pediatrician closer to home who acknowledged the PANDAS and prescribed Keflex, an antibiotic. Karli miraculously got better.

"In 48 hours, 90 percent of the symptoms are gone," said Bossman, but within 10 days the OCD symptoms came back.

By February 2010, Bossman took Karli to her long-awaited appointment with Bouboulis. He did blood work and switched Karli's antibiotics and urged her to have all the three other children's tonsils out, to minimize Karli's exposure to strep. Karli improved for a while on new medication throughout the summer, but OCD symptoms started up again this year when school opened.

"She's back to not wanting socks and underwear, and her grades are going way down," said Bossman.

Karli has recently started to exhibit signs of depression. "She's crying that she's not good at this and that," said her mother.

When she appealed to immunologists at Duke to offer IV IG treatment, they refused, saying it was still "unproven," she said. Meanwhile, money has been tight and the monthly trips to Connecticut have been expensive with four children in tow. Karli didn't qualify for free treatment under the NIMH study, because she has had PANDAS for too long.

Bossman said she wants to tell her story to help others. "A lot of kids have it and parents don't know it," she said.

And for those who know, it's hard to find doctors because there are so few with expertise around the country.

"It's a disorder that's, in fact, very difficult to treat," said Bouboulis. "You need an expertise in four areas, neurology, psychiatry, immunology and infectious diseases."

"It's a very difficult entity to get a grasp on and the children and their families require a lot of attention," he said. "There are ups and downs in therapy, and most doctors shy away from getting involved."

But Bossman said she is hopeful that their insurance company with pay for the IV IG treatment and that it will work. "Other parents have seen good success," she said. "We are keeping our fingers crossed."

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Monday, February 27, 2012

27 (hundred) dresses

"Fashion changes, but style endures." ― Coco Chanel

DID YOU WATCH the Academy Awards? We did, of course. How romantic of Paul, having read my blog post which mentioned the menu for the Oscar night party-for-one that I have before I met and married Paul, to go to so much trouble to surprise me by recreating it. Told ya' he's generous. We ate ourselves silly; the shrimp from Waterfront was de-lish!

We were glad Christopher Plummer won for best supporting actor. At 82, he's the oldest actor or actress to ever win an Oscar. I thought he had the best line of the evening when he addressed the golden statuette he was holding during his acceptance speech by saying, “You’re only two years older than me darling. Where have you been all my life?”

I wish Viola Davis had won the award for best actress. On the other hand, it's hard to argue against Meryl Streep, and on the plus side Meryl managed to wear a dress that didn't look like she got it at the Salvation Army.

Speaking of dresses, which ones were your faves? Below are mine.

Worn by Penelope CruzThis is my number one pick.
Paul says that if it looks like something Grace Kelly 
would wear, it's a good dress. 

Milla Jovovich wore a dress that was
 old Hollywood with a modern twist. 

Coming at number three, Stacy Kiebler.

I'm glad Octavia Spencer won 
best supporting actress.

I thought Rose Byrne was stunning.

This was my second favorite, worn by Jessica Chastain.

Simple but classy, worn by Tina Fey.

I'm not a fan of Nina Garcia, but I like her dress.

Glenn Close exudes old Hollywood, 
va va voom glamour.

I'm also not much of a Cameron Diaz fan as a person 
or an actress, but she always chooses great runway dresses.
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Sunday, February 26, 2012

The Artist

"Don't accept your dog's admiration as conclusive evidence that you are wonderful." — Ann Landers

PAUL AND I and Paul's parent's went to see The Artist yesterday afternoon at the Fleur Cinema. We bumped into jazz pianist Jason Danielson and his wife on their date night and Rotary pal Tom Swartwood and his wife. Afterwards Jason said he thought it was the best movie he's ever seen, and Paul's mom said that cousin Pam felt the same way.

Jean Dujardin and Berenice Bejo

We all really liked it, but I have no idea what movie I'd say is the best I've ever seen. I'll have to think about that. I might give Jean Dujardin the best actor award this year, though. I also thought John Goodman was completely perfect as the movie studio mogul. 

They're not asking me, though, darn it. Of course I haven't seen The Descendants. Everyone seems to be raving about George Clooney's performance. I just don't feel like seeing something sad.

Paul is out buying the food for tonight's Oscars party at home. He just called from the store and told me that he's getting everything I used to have when there was still Elwell's, right down to the creamy garlic dressing and gigantic, breaded, deep fried shrimp (from Waterfront). Yum yum. He's really nice!!
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Saturday, February 25, 2012

Been there, seen that

"The only way to find the best actor would be to let everybody play Hamlet and let the best man win." — Humphrey Bogart, 1951 Academy Awards

ALTHOUGH WE'RE NOT going to have time to see all the movies nominated in the marquee categories for Academy Awards, Paul and I added Moneyball to our 'saw it' list a few nights back. We liked it. Both Brad Pitt and Jonah Hill give understated performances that ring true.

Brad Pitt, as if you didn't know.

Jonah Hill has lost weight.

Philip Seymour Hoffman is also in it. It took us a few minutes to recognize him. He's in everything lately, so it seems. I appreciate a movie made with enough intelligence that it doesn't need to resort to violence, sex, vulgarity or the ridiculous to keep viewers engaged. I'd give it awards just for that!

Philip Seymour Hoffman in Moneyball.

We're taking Paul's parents to see The Artist this afternoon, so one more before tomorrow's ceremony when we enjoy our Oscar picnic on the bed redux.
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Learn about PANDAS and PANS

"A problem is just a small part of a large person, so always keep your whole child in view." — Dr. Carl Pickhardt

I RAN ACROSS this article yesterday on MSNBC's/TODAY's website. It presents an answer to a medical mystery with such an unexpected cause and effect relationship that it sounds like a scriptwriter's idea for a 'possession' movie. 

It's science, though, not sci-fi. PANDAS (and now PANS) has been studied since the early 1990s when it was first identified by researchers at the National Institutes of Health. I'm glad to have this information just in case sharing it could someday help a family.

Sudden OCD in kids? Culprit may be strep throat, other infections

By JoNel Aleccia

For Kelly Wooldridge of St. Louis, the change in her son’s behavior was so abrupt, it was like someone flipped a switch. Overnight, Brendan, now 10, went from being an easy-going, “huggy-kissy” kid to a rageful child plagued with tics, compulsions and obsessions, she said.

“He would walk up and choke kids at school, or pick up a chair and throw it at them,” recalled Wooldridge, 37. Brendan developed facial tics, constant throat clearing, some humming. "He was just miserable in his own skin," his mother said.

The shift first occurred when Brendan was 3, just after several recurring bouts of strep throat. The disturbing behaviors lingered, seeming to wax and wane for the next few years with no clear cause or explanation. It wasn’t until last year that Wooldridge -- like a growing number of parents, pediatricians and researchers -- finally connected the dots between the common childhood infection and the sudden onset of some forms of mental illness.

“Last spring, we learned about PANDAS,” said Wooldridge. “I thought it sounded a little crazy, but it totally fit.”

PANDAS -- or Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections -- is the unusual diagnosis given to a group of children who abruptly develop Obsessive Compulsive Disorder or tic disorders such as Tourette’s Syndrome – but only after contracting infections such as scarlet fever or strep throat caused by Group A streptococcus bacteria.

“Parents describe it as a ‘possession’ or an ‘explosion’ of symptoms,” said Dr. Susan Swedo, a leading PANDAS expert and senior investigator in neuroscience at the National Institutes of Health.

PANDAS turned out to be the cause of non-stop sneezing for Lauren Johnson, a 12-year-old girl featured on NBC’s TODAY show, and it was linked for a time to outbursts of tics and twitches suffered by more than a dozen school-aged girls in LeRoy, N.Y. On Thursday, the International OCD Foundation, or IOCDF, warned that mental illnesses such as OCD can be triggered by infections in children.

“If a parent recognizes these symptoms developing seemingly overnight, along with a glaring change in their child’s personality and/or behavior, they should immediately have their child tested for strep,” agency officials said.

Quick treatment with antibiotics can be the key to reversing OCD, tics and other symptoms, said Swedo.

“If you treat it acutely with antibiotics, it will help quite quickly,” she said, noting that symptoms from the first episode eventually will subside. “But if a child gets another trigger, symptoms will return. If you have three episodes, the symptoms will become chronic.”

It’s not clear how many children may be affected by the disorder. About 1 percent of all children have OCD, but Swedo says there has been no research to determine the prevalence of sudden onset of the disorder preceded by strep or other infections. But both she and Dr. Michael Jenike, a Harvard Medical School psychiatrist who’s also been studying the problem, say in-progress research and the comments they hear from desperate parents every day indicate that PANDAS could be far more common than anyone suspects.

“It could be dozens of kids a day in this country,” said Jenike, who also chairs the IOCDF scientific advisory board.

Some children may have a genetic vulnerability to the disorder and parents of some sufferers believe that it may run in families. Now, new research suggests that the problem may extend beyond sudden OCD sparked by strep bacteria to include other infections, including Lyme disease, chicken pox -- even the flu.

This month, Swedo and other researchers have published a paper in the journal Pediatrics & Therapeutics that expands the definition of PANDAS to PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome, which encompasses more potential causes. The goal is to urge doctors and other clinicians to consider a full range of signals when they’re faced with abrupt changes in a child’s behavior or mental state.

“It’s clinically very, very distinct,” Swedo said. “Your only job is to find a treatable trigger.”

The trigger is believed to lie with the antibodies that are normally produced by the body to fight infection. Usually, in the case of a bacterial infection, the antibodies attack the invading bacteria and help elminate them from the body. But in the case of PANDAS, for instance, researchers believe patients mount an unusual immune response in which the antibodies may mistakenly attack the part of the brain that controls emotions, behaviors and physical movements.

Parents of children with PANDAS have been a galvanizing force for education and awareness, said Lynn Johnson, Lauren's mother, who founded the nonprofit PANDAS Resource Network after her family's experience. To such parents, there’s no question that strep and other infections are involved. Meghan Sherman, 15, of Plano, Texas, was diagnosed with PANDAS only recently, but she’s had OCD symptoms that rise and fall with infections since she was 7, says her mother, Jen Sherman.

“When we treated the strep, the symptoms would go away. I’ve seen it with Fifth disease and with flu and with other illnesses,” said Jen Sherman. Meghan now takes precautionary antibiotics during the winter cold and flu season to ward off infections -- and OCD.

When Kelly Wooldridge found out about PANDAS, she asked a doctor to test Brendan’s blood for strep, even though he didn’t seem sick. It came back positive. Now she’s taken his care a step further, opting for intravenous immunoglobulin or IVIG treatments that are thought to suppress harmful inflammation in the body. The change in her son, she says, is remarkable. He's no longer in trouble for behavior at school and he's been able to make friends.

"He’s had not one trip to the principal’s office,” she said. “The biggest thing now is that he’s happy.”

Not everyone agrees about the PANDAS diagnosis, which was first described in 1998. Parents who suspect their kids have the disorder say they're routinely discouraged by doctors who aren't aware of the diagnosis or who actively reject it. There has been considerable debate about the role of strep A infections in the development of the disorder. Some experts believe that PANDAS may be a version of a better-known related disorder, Sydenham's chorea, in which antibodies attack the part of the brain that controls movement. The American Academy of Pediatrics is wary of preventive administration of antibiotics for strep infections, advising treatment of active illness.

But Swedo said experts do agree that there is a subgroup of children who develop sudden, dramatic cases of OCD, accompanied by a wide range of neural and psychiatric symptoms.
The new PANS label will generate additional research, even as Swedo and other PANDAS researchers continue to focus on the effects of strep. She hopes the increased attention will only expand awareness of the disorder among reluctant doctors.

“You have a treatable and perhaps preventable form of mental illness,” she said. “While we’re debating, these kids could be being treated.”
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Friday, February 24, 2012


“'Meow' means 'woof' in cat." ― George Carlin

I DON'T GET why cats get such a bad rap. They're loyal, they're loving, they're funny. And they're smart — to varying degrees just like people. 

Here's a true story about a very smart cat who rescued his owner the same day he was adopted from a shelter. You'll love it.

By Laura T. Coffey
TODAY.com contributor
updated 2/23/2012 9:47:43 PM ET

Pudding the cat is big. He is orange. He is laid-back. And he’s a lifesaver.

Just ask Amy Jung. The 36-year-old Wisconsin resident credits 21-pound Pudding with saving her from the grip of diabetic seizure mere hours after she adopted him from a local animal shelter.

“If something or someone hadn’t pulled me out of that, I wouldn’t be here,” Jung told the Green Bay Press-Gazette newspaper.

Here’s what happened: On Feb. 8, Jung visited the Door County Humane Society with her son, Ethan. She had no intention of adopting a pet; she and her son just wanted to play with the cats, who are allowed to roam free at the no-kill shelter.

But, as can happen with felines and humans, Pudding and Jung felt a strong and immediate connection.

“He just gravitated to her,” Door County Humane Society Executive Director Carrie Counihan told TODAY.com.

Jung made an on-the-spot decision to bring Pudding home. Always a calm and relaxed guy, Pudding took to his new digs right away, displaying not a hint of skittishness on his first day there.

That evening Jung, who has been living with diabetes since the age of 4, went to bed at about 9:30 p.m. About 90 minutes later, she started to have a diabetic seizure. That’s when, according to the Green Bay Press-Gazette, “Pudding planted his weight on her chest and, when he could not wake her, began swatting her face and biting her nose.”

Jung came to her senses enough to yell out to her son for assistance. At that point, Pudding jumped up onto Ethan’s bed and startled him into action. He immediately rushed to get his mom the help she needed.

“Her doctor said she could have gone into a coma and not come out of it if much more time had gone by,” Counihan said. “The fact that Pudding did what he did without knowing her that well is just amazing to me.”

Since the scary Feb. 8 incident, Jung has followed her doctor’s advice to have Pudding registered as a therapy animal.

“I think he’s already made his first trip to Walmart,” Counihan said.
Pudding had been living at the shelter for about a month before Jung took him home. He arrived there in early January with another cat named Wimsy after their owner died. Jung adopted Wimsy, too, because she didn’t want to separate them.

This wasn’t Pudding’s first stint at the Door County Humane Society. In 2008, a family surrendered him to the shelter because their son was allergic to cats. His name at that time was Starbuck. His last owner, the woman who just passed away, decided to change his name to Pudding.

“Pudding is 8 1/2-ish now — not too old,” Counihan said. “And Wimsy is 3 years old. Maybe he’ll pick up some of Pudding’s powers.”
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Wednesday, February 22, 2012

Award-winning movies

"No good movie is too long and no bad movie is short enough." — Roger Ebert

THE ONLY OTHER movies Paul and I have seen from this year's crop of Oscar/Golden Globe/SAG award nominees are The Ides of March, nominated for Best Adapted Screenplay, and Bridesmaids from which Melissa McCarthy is nominated for Best Actress in a Supporting Role.

We rented the Ides of March on TIVO a couple of nights ago, and we both thought it was great. It was so suspenseful — which we weren't necessarily expecting. When it was over, we thought, "Wait, is it over?" not because it was left unfinished, but because it had us so engrossed that it hardly seemed like enough time had gone by for it to be done. Gosh, that Philip Seymour Hoffman is good; well, they all were. 

I'd like to see Albert Nobbs, Moneyball, The Artist, Tinker Tailor Soldier Spy, and maybe Hugo before Sunday, but obviously, that's not going to happen. We're not interested in seeing The Iron Lady, even though Meryl Streep is no doubt fabulous, because neither Paul nor I are attracted to the subject matter.

We're not Woody Allen fans ever since he married his daughter, so we'll skip Midnight in Paris. Neither one of us can take an animals-in-danger plot, so no War Horse for us, and we avoid really sad things so we'll take a pass on both Extremely Loud and Incredibly Close and The Descendants.

I have a method for dealing with on-screen violence (leaving the room if we're home or hiding my eyes, plugging my ears in a theater and singing I'm Looking Over a Four Leaf Clover), sexual violence is just much, much too upsetting for me to handle even with my patented aforementioned method. I literally have nightmares if I watch something that has that sort of content, so we won't see The Girl with the Dragon Tattoo.

Paul, Myron and I actually went to the theater to see TGWTDT (at that point I only knew that it was about a woman who kicks some serious ass) but when we saw the sign posted next to the ticket office window that said "extreme, prolonged, sexual violence," we changed our "other minds"— as Paul says — and went to see something and happy: We Bought a Zoo.

I used to try to see everything that got critical acclaim, even the most tragic ones, but about the time I met Paul, I decided that there are enough things IRL past and present to break my heart day on a daily basis, and cut myself some slack. Paul is good for me.

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Tuesday, February 21, 2012

A practice round

"If you're hung up on nostalgia, pretend today is yesterday and just go out and have one hell of a time." Art Buchwald

YEARS AND years ago there was a buffet a few blocks down the street called The Breese Inn. Owned and operated by the Breese family, people traveled miles to eat there. Then it stopped being a buffet and became a dinner restaurant; in northern Wisconsin, they would have called it a supper club. After that the Elwell family bought it, named it after themselves and changed the menu so that it featured primarily prime rib, steaks and seafood.

From the time I moved back to Ankeny to be with Grandpa for as long as Elwell's existed, I'd get the exact same meal to go on Oscar night — gigantic, deep-fried breaded prawns, a big, crisp salad with creamy garlic dressing, a side of spaghetti, the best Italian bread ever and a baked potato with butter and sour cream. I'd spread out a tablecloth on the bed and have my own little picnic party for one while I watched the Oscars.

Since the restaurant closed years ago, Paul and I make do with jumbo cocktail shrimp, brie and gluten-free crackers, raw crunchy vegetables and whatever else strikes our fancy. It's still a picnic, but now it's a party for two.

I got the date mixed up this year, though, and thought the Academy Awards was last Sunday night. Paul had already laid in the picnic supplies, so we went ahead and had it anyway and watched Downton Abbey. We'll just do it all again this Sunday when the Oscars are actually on.

PS: It's another SmartTalk offering tonight with Arianna Huffington doing the honors. I'll let you know how it goes. Blogs and kisses.
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Monday, February 20, 2012

Viola, Octavia and Jessica

"Sometimes you see how humanity can rise above any kind of cultural ills and hate, that a person's capacity to love and communicate and forgive can be bigger than anything else." — Viola Davis

I GOT MIXED up and thought that the Academy Awards were last night. I'm glad I was wrong so that Paul and I have a chance to watch one or two more of the nominated films.

We saw The Help a few weeks ago. Viola Davis is nominated for an Oscar for best actress for her role as Aibileen Clark. She's already won 20 other awards for that performance and been nominated for another nineOctavia Spencer and Jessica Chastain are also both nominated for Oscars for Best Supporting Actress. Octavia has already won 18 awards and been nominated for ten more, and Jessica has won 20 awards and been nominated for ten others all for their work in The Help.

Viola Davis as Aibileen Clark in The Help.

I thought Jessica was pitch-perfect in The Help, nailing the accent (which didn't come and go like Emma Stone's) and all in all creating a much more compelling and consistent character than Emma's Skeeter.

You know how some actors sound the same no matter what role they play? Paul and I always joke in a fake movie-trailer voice, "And Tommy Lee Jones as Tommy Lee Jones." Nicholas Cage and Keanu Reeves fit that same description in our opinion; we'll just say that none of them will ever be confused with Meryl Streep or Tracey Ullman, and don't mean because of the difference in gender.

Paul and I Tivoed Viola's interview with David Letterman because we wanted to learn a little about who she is as a person. IRL she doesn't sound even a tiny bit like her character, nor does Jessica.

Jessica Chastain as Celia Foote in The Help.

I got curious about the trajectories these three women's careers have taken. You can draw your own conclusions. Nah, just kidding. It wouldn't be like me not to help. We'll play the which-of-these-is-not-like-the-other game. The not-likes are in red.

Viola is 46. Octavia is 41. Jessica is 30.

Viola was born on her grandmother's farm which was part of a former plantation in St. Matthews, SC. Viola's mother was a maid and a factory worker, and her father was a horse trainer. Shortly after she was born, her family moved to Central Falls, RI where she grew up in what she described as "abject poverty and dysfunction" and was subjected to no small amount of racism. Octavia, whose mother was also a maid, was born and raised in Montgomery, AL. Jessica grew up in Sacramento, CA where her mother is a vegan chef, and her dad is a firefighter.

Octavia in character in the movie The Help.

Viola spent four years at the Julliard School, and then finished her degree at Rhode Island CollegeOctavia studied drama at Auburn Montgomery in Montgomery and then graduated with a bachelor's degree from Auburn University in Auburn. Jessica attended Sacramento City College for two years before going to Julliard on a scholarship provided by Robin Williams.

Viola graduated in 1988, but her professional acting credits didn't begin until eight years later. Her first part in a movie was called "nurse."

Octavia graduated in 1994, and although she had her first professional credit just two years later also as "nurse," she was still playing parts called "nurse 2", "nurse B", "baby nurse" and "waitress" (2000), "unemployment clerk" (2001), "check-in girl" and "waitress" (2002), "security guard" and "neighbor in alley" (2003), "woman" and "big customer" (2005), "landlady" (2006), "streetwalker" (2007), "nurse" (2008) until her award-winning role in The Help.

Octavia Spencer receiving her Golden Globe Award.

Jessica graduated from Juliiard in 2003, and her first professional acting credit was a large, named part in the TV movie Dark Shadows a year later.

Eight years after graduating, Viola appeared on Broadway for the first time and received rave reviews for it, earning both Tony and Drama Desk nominations as best featured actress in the play Seven Guitars(Octavia has not appeared on the stage.)

Jessica played opposite Al Pacino at the Wadsworth Theater in Los Angeles three years after graduation in the play, Salome, where "she was hailed for her brave and revealing performance" (an actual quote from an article written about her performance — she took her clothes off every night . . . all of them.)

Despite Viola's critically-acclaimed 1996 Broadway debut, despite being nominated again in 1999 for a Drama Desk award for Outstanding Featured Actress in a Play for her role in Everybody's Ruby; despite winning a Drama Desk Award for Outstanding Feature Actress in a Play and a Tony Award for Best Featured Actress in a Play in 2001 for her work in King Hedley II; despite being nominated once again for a Drama Desk Award for Outstanding Actress is a Play in 2004 for Initmate Apparel and winning both a Drama Desk Award for Outstanding Featured Actress in a Play and a Tony for Best Actress in a Play in 2010 for Fences — it took 20 years for Viola to get a major part in a big ticket movie. The film was Doubt for which she received 18 award nominations.

Viola Davis as herself.

It was 17 years after graduating with her drama degree before Octavia got a major part in a major movie. That movie was The Help.

Famous director Terrence Malick reportedly saw Jessica (um, literally) in Salome, and immediately cast her in The Tree of Life, a film headlined by Brad Pitt and Sean Penn that began production in 2007 — four years after graduation, and the following year she had not just a lead role, but the title role, in the 2008 film called Jolene.

Jessica Chastain as herself.

The same AskMen piece that called Jessica's performance in the play Salome "brave" and "revealing" also opined then that at almost 30 (she's 30 now) Jessica who had seven movies released in 2011 alone is "somewhat of a late-comer to the big ticket arena of big budget movies and Hollywood Oscar contenders." Really? Really?!!

Tell that to Viola and Octavia. All three are obviously so talented. I can't help thinking the arc of the three careers would have been different if the color of each woman's skin had been.

Footnote: Viola gave the acceptance speech at the SAG Awards when the cast of The Help won Outstanding Performance by a Cast in a Motion Picture. She said, "I just want to say that the stain of racism and sexism is not just for people of color or women. It's all of our burden. All of us. And we absolutely, I don't know, I don't care how ordinary you may feel, we, all of us can inspire change, every single one of us."