ABC News, in collaboration with MedPage Today, reached out to more More than 125 experts in various fields and specialties responded.
Their suggestions were then sent to the American Association for the History of Medicine, which narrowed the pool down to an authoritative list of 10 medical advances this decade that have had the most impact.
Source:
http://abcnews.go.com/Health/Decade/genome-hormones-top-10-medical-advances-decade/story?id=9356853
Pharmaceutical compounding helps doctors create customised medications for patients from all walks of life. While middle aged and elderly patients tend to rely more heavily on prescription medication, paediatric patients – especially babies and infants – benefit an enormous amount from the medications created by the modern compounding pharmacy. There are many fine examples of customised medications that have been developed for children and infants – more palatable flavours that make the medicine go down more easily is one – but it’s the solution that’s been crafted for reflux in infants that is perhaps the most intriguing. By examining how doctors and parents enjoy the benefits of compounding when it’s time to treat reflux in infants; it’s easy to see just how indispensable this process really is.
Reflux In Infants: What Is It?
Reflux is a very common condition and usually occurs in infants between ages zero to six months. It occurs when a baby brings back up the contends of their stomach after feeding. Sometimes, those contents are regurgitated and end up coming back out of the baby’s mouth. It is important to note, however, that regurgitation is entirely different from vomiting. Unlike vomiting, regurgitation involves no effort; food and other contents simply spill back out, but are not ejected or forcefully expelled from a baby’s mouth.
Managing Reflux
For the most part, reflux is not a serious or chronic condition. In fact, most babies outgrow it by the time they are sitting up regularly – usually around eight to ten months of age. During this time however, many parents become concerned with the effects of reflux and want to put and end to the regurgitation as well as the other associated issues. In turn, many paediatricians prescribe Losec. This is a very effective drug for treating reflux, but there is one major drawback: it is only produced in tablet form. Infants are obviously incapable of swallowing even small tablets. The thought of crushing them in not appealing – or advisable – to most parents.
Compounding Losec Into Omeprazole
When a mum or dad needs reflux medication for their infant, the paediatrician has an excellent option: Compounding Losec tablets into Omeprazole. Omeprazole is a compounded suspension form using the same active ingredient found in Losec tablets. This is administered to infants with a syringe and therefore provides an accurate dosage of medication and comes in two flavours – banana and
tutti-frutti. Compounding solutions can be a major rescue not only for the children who suffer from reflux on a regular basis, but also for their parents.
dailymail.co.uk reports:
A cancer sufferer has told how mistletoe saved her life after she shunned conventional treatments.
Joan van Holsteijn put her faith in the healing properties of the plant, which is more commonly associated with Yuletide romance.
She turned down potentially life-saving chemotherapy and instead had injections of mistletoe.
Amazingly, it has worked wonders: the tumours in her leg are now gone and she’s well on the road to recovery.
Also see the Hoxsey treatment here and here.
“I’ll chop you so low, you’ll have to look up to look down!” This was one of the lowest “chops” of all, that art of crafting an insult which was quite an intellectual skill amongst the wolfcubs when Silverwolf was in the fifth grade, at the Collectivist brainwashing center. The above “chop” was Silverwolf’s favorite, and would endlessly puzzle his mind, as he tried to imagine looking up to indeed look down. It seemed a daunting task, intellectually, to grasp this notion, just as it was equally to grasp the idea of “what is on the edge of the universe” or “is there anything beyond the universe?”
Fast forward a few score years to December 24, 2009, a day that will live in Libertarian infamy, as Silverwolf finally discovered what the meaning of “I’ll chop you so low, you’ll have to look up to look down!”
It’s the Healthcare Bill, for it is this piece of legislation that has extinguished the last spark of Libertarian Freedom residing on the face of the earth. Singapore may have lower income tax rates, but that is one of the few positives to say about that sewer of Human Values, a “country” that has executed a young Australian man by hanging for possessing a few pounds of cannabis. But from the standpoint of Freedom, it was almost certainly in America that there was still some glimmer of Libertarian Freedom, some still-flaming embers, as the income tax rate was lowered a score of years back from the usuriously immoral rates perpetrated by the Democrats during the dark days from Truman up to Kennedy (including Eisenhower, who, like Churchill, became a milktoast Socialist after defeating the National Socialism of Hitler and his numerous German fans).
But these embers of a dying Capitalism and Human Freedom have been extinguished by this immoral Health Care Bill, which gives the corporate Socialists everything they want, and destroys the last vestige of that Bill of Rights which Jefferson and the Founding Fathers so passionately saw the necessity of. America has been castrated by the feminized Socialism of Roosevelt through Clinton-Bush, and this Bill is the last nail in the coffin, for now, no longer is a Man Free in America, but he must now pay a corporate tithe every month just to exist as a Man, thus overthrowing the Creator-given Rights of Life, Liberty, and the Pursuit of Happiness, which the Men who wrote the Constitution had the vast intelligence to appreciate. Mental pygmies like Pelosi and Senator Reid have not one iota of that hyper-intelligence which reeks through the writings of Jefferson, Madison, and Paine, or the slightest love of Human Freedom. They are working for that Corporate-Socialist agenda which completely subjugates the Individual to the Collective, just as was done by the Criminals, Hitler, Stalin, and Mao, and they have virtually succeeded. The “reconciliation” of the Senate and House versions will be used to imply that real debate and give and take have gone on, but the real damage, the destruction of the Individual’s Self-Ownership, one of the axiomatic foundations of Libertarian insight, has already been achieved by the Moral Castrates of the Democratic Majority in the Senate.
However, Goliath was sure that he would slay David, and the punters of the day were laying the odds that way, but things didn’t turn out as expected. Judging from the anger of callers to Liberal- and Moderate-Democratic talk-show hosts last week in San Francisco, a very Liberal town, Silverwolf would say that the Democrats, in their self-righteous blindness which they invariably display towards the morality of what they are doing, especially when it is deeply immoral (witness Sen. Feinstein’s staunch support for Legalized Murder — oh, I mean, Capital Punishment), — these Democrats have finally slit their own wrists, metaphorically speaking, for they have not awoken to the fact that they are going to drive millions of Americans who either did not vote, or voted for them, believing the propaganda machine of Herr Obama, into a state of utter destitution when they suddenly have to use their food money to send off hundreds of dollars a month to a corporation that makes billions of dollars a year. This was the Clinton plan; this was the plan that Obama said he staunchly opposed when he lied during his campaign against Her Highness in Iowa, as he let go another trial-balloon lie. By now a dozen have rolled off his back, as effortlessly as they rolled off a teflon Reagan-duck. Birds of a feather study evasion together.
And as for lukewarm Republicans amongst that 31 million who will now be forced under threat of robbery — I mean, tax penalty, to make their monthly contributions to the insurance mafias, well, you can be sure they will be transformed in strident Republicans. With all those millions now forced to pay monthly tribute to the insurance companies, it’s small wonder that insurance execs with tons of their own stocks made a mint the other day, when final passage was in sight. No wonder insurance industry fan Buffett was so gungho on Barack. Qui bono? Who does it benefit? was the question that Professor Rothbard taught us to always pose when looking for the reasons for anti-Libertarian legislation. On this one, the answer is not difficult to determine.
When the half-of-Americans who are too indifferent to vote and the Obama-fans-no-longer who must now pay through the nose, without their beloved “public option”, are joined by angry Republicans, there will be a Libertarian coalition formed that will rival anything seen since the Founding Fathers wrested the Colonies from Georgy-Porgy Puddinghead-Pie the Third, or J. Bracken Lee ran for President in the 50s as a Libertarian. Impinging on the Freedom of Individuals can have a tonic effect on those who take the comparative Freedom of America and the Western European Democracies as a social given which has existed since time immemorial, instead of a brief respite in the long history of Totalitarianism, which is one group of gangsters trying to ride herd over a vast number of Human Freedoms. The requirement to pay out hundreds a month just to exist will produce a bile so galling that it will be tastable in the American political mouth, and the only way to spit that taste out will be for the public to vote out the Democrats, and vote in Libertarians and Ron Paul economic-Republicans. And they will.
“Heat not a fire for thy adversary so hot that it do singe yourself” advised Shakespeare, but that is a lesson the Democrats never learned.
Arise America, retake your Freedom at the polls, and vote the Collectivist Scoundrels out forever!
And that will be the best chop of all.
Hoooooooooooooooooooooowwwwwwwwwwww! — Silverwolf
“Work on your craft and don’t just focus on your career — your career has to have an underpinning of substance or your lack of knowledge will catch up to you.”
~ Barry Kennedy~
True lasting Success doesn’t simply happen overnight. Even our ‘instant starts’ from various Idol shows have sung for years, often in church choirs or bands before they were ‘discovered’.
Of course, lucky breaks can always play a part in Success, but watch one of the bajillion Texas Hold’em poker tournaments on TV and note that when the cards suck, experienced players know when to either bluff or fold and wait for the next hand, and that’s when we see the substance of their craft shine through.
So, work on your craft– hockey, medicine, financial analysis, music, politics, photography, parenting — and the experience base you build will give you the foundation your Success needs. And have patience. Time spent on your dreams is never wasted.
An excerpt from Stand Up & Succeed by Tim Reynolds from Cometcatcher Press.
Ciao for now,
Tim.
The Operation Medicine Cabinet which I blogged about recently has rounded up 60 pounds of unused prescription drugs in Oakland County.
The grand opening was Friday the 11th at the Royal Oak Police Department in partnership with the Oakland County Sheriff’s Office and Home Instead Senior Care, as well as other organizations. The residents were asked to bring their unused prescription drugs to the Police Department.
“It was a great success, and we’ve had dozens of people coming in since then, bringing their prescription drugs to our police station,” Police Chief Chris Jahnke said. ”Prescription drug abuse is on the rise, especially among teens, and that is one of our goals — to get narcotics out of the medicine cabinets and put them where they can be safely eliminated.”
This station in Royal Oak is now different than the situation at the Sheriff’s Office in Pontiac, as well as substations in Rochester Hills and Commerce Township. The new policy at the Royal Oak Police Department allows residents to drop off their prescriptions 24/7, while all the other stations are only on Wednesdays between 8 am and 4 pm.
Jahnke says that not only does this rid the streets of drugs, but it also has a green aspect; “Now the unused drugs won’t be going into the waterways and landfills,” he said.
These drugs will be disposed of in the same way that the police use to get rid of illegal drugs they have confiscated.
Bert Copple, general manager for Home Instead Senior Care in Birmingham, said disposing of drugs protects pets and children who spend more time at home.
“They’re around the house, and having prescription drugs in the medicine cabinet that aren’t being used, may open the door to experiment,” he said.
For healthcare professionals – especially doctors - it is challenging to be a good patient. As experts in health, we are sometimes considered to be role models for healthy living, so you’d think we would eat right, exercise as we recommend, see our own doctors regularly, and take medications always and only as prescribed. However, there are unique challenges for doctors to achieve health.We don’t always take care of ourselves, often feel guilty about taking time off to heal ourselves, and know too much about medicine.
1. We don’t take care of ourselves:
We work ridiculous hours, prioritizing paperwork over an after-clinic jog. If I’m on call on Monday night, when I usually play hockey, I have to miss my game. But do I do something instead to make up for the missed exercise? No. Sometimes, it’s more convenient to eat that deep-friend-who-knows-what in the hospital cafeteria than to plan ahead and pack a healthy lunch, even when you know better.
2. We don’t want to miss work:
If we are sick, we are reluctant to take a day off. Maybe it’s a sense of duty to care for our patients or maybe we have inflated egos and assume that the people depending on us will not make due without us. There’s also the fact that we will lose our fee-for-service income and some might reckon that our colleagues/staff/patients will think us less god-like if we bail out when it’s not a case of life or limb. I know. Sadistic. Doctors are – for lack of a more persuasive non-colloquialism -”hardcore.” What better job for type “A” OCDers? If we are contagious, our deep need to protect the vulnerable might persuade us to go home, but only after 7 nurses suggest that maybe it would be a good idea for the doctor to heal herself. I’m a little less self-destructive than the average doctor; with debilitating migraines on a regular basis, I’ve learned to make the sheepish call into the office when I just can’t shake one. There was a time when I tried to stay at work, but when a medical office assistant (MOA) told me “you look, uhm . . . green,” I started trying to take better care of my nauseated, photophobic self.
3. For a doctor to see their doctor, it’s like… I don’t know what it’s like. I haven’t been for a while.
Whether we take that sick day when we are acutely ill or not, we are loathe to see our doctors. We might not even have made the time to locate and meet a GP. If we have one, we might have a difficult time deciding when it’s appropriate to see him, not wanting to waste his time with trivial things, but not wanting to ignore something that could become serious. One would hate to be suffering as in the Man Flu:
Self-diagnoses is impossible to avoid. There is a phenomenon in medical school, in which students diagnose themselves with all sorts of ailments as they read them. Tired, cold, weight gain? Must be hypothyroidism! (Okay, actually, many medical students are sleep deprived and gain weight from not having time to exercise or eating hospital cafeteria food). Medical-studentitis is common. It can make you feel pathetic, though the condition, also known as medical student syndrome, doesn’t fully meet diagnostic criteria for hypochondria.
My right big toe was numb for several days. As in a tale of Oliver Sacks, I found it distressing to have this thing attached to me that didn’t fully seem to belong to me. The sensation was bothersome, but so was the confusion as to why it had occurred. I figured it would go away but a tiny part of me (perhaps a big toe’s worth!) was genuinely worried. I only half-jokingly informed my friend whose house I was staying at – “if I die, tell them I had a numb toe” – and continued on with my day. I knew it was probably nothing. But what if it was Guillain-Barre? Ischemia? Oh, it was nothing.
There ware other times where we might think “ahhhhh, it’s nothing, it’ll go away; if it we my patient, I’d reassure them and send them straight home without passing Pharmacy or collecting $200 dollars worth of treatments.” If we simply suck it up every time, we might miss the occasion in which things are serious.
4. We use medical language when we talk to our doctors
A patient’s choice of words distinctly shapes the way we approach their problem. Often patients in the office will hand their doctor the diagnosis on a silver platter. “Gee doc, I’ve had this terrible chest pain. It’s exactly like before when I had my heart attack . . . ” but we can also be lead astray. “I’ve got gout” doesn’t necessarily mean that you have positively birifringent uric acid crystals collecting in your joint capsule; you might mean that you have a red, swollen, and painful toe. If I had pain in my chest with deep breathing, coughing, and movement, I’d tell my doctor “it’s pleuritic.” My vocabulary is already tainted with the flavour of diagnosis. If what I say is very narrow, it can close my physician’s mind to wider possibilities.
5. We might be afraid to share, or we might think we know better
I’ve written before about the difficulty of finding a doctor for doctors. In a smaller community, your GP is also your colleague. It’s hard to reveal things to your doctor if you have to pass him in the hallway every morning on rounds; to tell him something that might in another context make one feel stigmatized, it can be an impossible thing, unless you have complete trust in his ability to keep it confidential and to not allow it to affect how he treats you as a colleague. In some cases, doctors do like to share their experiences with being on the other side of the scalpel or stethoscope. But, even if we are good at sharing, we might not trust the opinion of our doctor, thinking that our own is more valuable or accurate in some way. It is difficult to let go sometimes, but to be healed
It’s a whole different story when it comes to caring for an ill doctor or being a doctor and having an ill family member. For a start, check out What Do You Do When Your Loved One is Ill.
I’ve never had an egg donation planned around the Holiday season. My belief was that it would be too difficult and complicated. And the truth is … it takes some logistical juggling. I’m going to have to a) bring an 11 day supply of needles and medicine to my family’s place, b) remember to give myself injections at the same time everyday although I won’t be on any sort of real schedule, and c) hope my luggage doesn’t get lost.
December 26th marks the beginning of the necessary medical processes and three weeks (give or take a couple days) before the surgery. The medical processes required to donate occur very quickly and the first week or so consist of you giving yourself injections (for me 20 units of Lupron) and taking prenatal vitamins. During this time you aren’t required to go in for any blood work , although you are required prior to the start of injections. This is just to ensure that you are healthy and your hormone levels are normal.
After the week or so, you are required to be monitored consistently until your surgery. At first you will be monitored every other day, then it gets ramped up. About a week prior to the surgery you may be required to see the doctor everyday. Yes, even on the weekends. There have been many cases in which I have gone to the doctor for blood work and an ultrasound at 8:30 am and then rushed off to a soccer game at 9:45.
In reality, three weeks really isn’t that long, but the last week and a half will make you feel like you are Bill Maury in Groundhogs Day.
There. That title carries a whole different set of connotations than the anti-abortion media’s headlines: “Catholic nurse forced to participate in abortion, lawsuit filed” (Catholic News Agency) and “Nurse ‘Forced’ to Help Abort (the New York Post). Despite vigorous googling, I’m not finding much other reporting on this story at all, except from Jill at Feministe. You know your sources are thin when the Washington Times appears to give the most dispassionate and complete account:
Catherina Lorena Cenzon-DeCarlo, 35, a Filipina nurse who is a permanent U.S. resident and married to an American, says that Mount Sinai Hospital in Manhattan “blatantly” violated a 35-year-old federal law that protects health care workers with religious objections from having to assist in performing abortions.
The hospital performed a late-term abortion on a woman whose health was not at risk, she says. The nurse is asking for a jury trial that could strip the hospital of hundreds of millions of dollars in federal funding until it complies with the law….
According to the 26-page complaint filed in U.S. District Court for New York’s Eastern District, the lawsuit says when Mrs. DeCarlo was hired in August 2004, she told hospital officials outright that she would not participate in abortions. She is Catholic and her uncle is Bishop Carlito J. Cenzon, who leads the Roman Catholic diocese of Baguio in the northern Philippines.
The hospital did not object to this and gave her a form to complete that indicated her refusal to take part in the procedure. During the nearly five years from her hiring date until this May, the lawsuit said, the hospital had avoided asking her to assist on abortions, as it has a cadre of other nurses who have indicated their unwillingness to do so. …
But it was on May 24, a Sunday morning shift over Memorial Day weekend, when matters came to a head. The nurse said she was told she was assigned to help with a “D&C,” signifying “dilation and curettage,” a procedure to remove the remains of a miscarriage from a woman’s womb. But when she began preparing the operating room, she learned she had been assigned to help with aborting a 22-week pregnancy.
Dr. Noel Strong, the resident on duty, said the mother had preeclampsia, a medical complication involving hypertension and protein in the urine that is treatable with magnesium sulfate. Mrs. DeCarlo thought the preeclampsia not to be life-threatening and thus not an immediate cause for an emergency abortion. A flurry of calls then erupted between her and supervisors Fran Carpo and Ella Shapiro after Mrs. DeCarlo refused to take part in the procedure, the lawsuit says.
Ms. Carpo – on instructions from Ms. Shapiro – then forbade the nurse to try to find a substitute, adding that the doctor performing the abortion had called her, furious about the delay, the lawsuit charges. While Ms. Carpo said the patient was in mortal danger, Mrs. DeCarlo pointed out the patient was not even on magnesium therapy, the first step of treatment for the condition.
Ms. Carpo, the lawsuit said, was the manager on duty and could have easily stepped in as a replacement but instead threatened to charge Mrs. DeCarlo with “insubordination and patient abandonment,” charges that could have ended Mrs. DeCarlo’s career.
Mrs. DeCarlo broke down at this point and offered to get her priest on the phone to explain her point of view, says the lawsuit, but hospital officials were adamant that she participate. When she pointed out the abortion could be delayed until another nurse could be found to take part, she received more threats, the lawsuit says, until she finally capitulated, saying she would take part “under protest.”
When asked why she didn’t simply walk out of the building, one of her attorneys, Matt Bowman of the Alliance Defense Fund, said the plaintiff “strenuously protested to the point of tears. Employees should not be forced to choose between their jobs and their beliefs.”
The nurse said she was “forced to watch the doctor remove the bloody arms and legs of the child from its mother’s body with forceps” and carry those body parts in a cup to another area of the operating room.
Bear in mind that the only source of info for this story is the lawsuit filed. Everyone else is refusing comment. Of course the patient’s identity and history are being kept confidential, as well they should.
Jill and her commenters have done a fine job discussing the legal and moral obligations of hospitals and medical practitioners. I don’t want to rehash that here. I’ll just say that no nurse or doctor should be hired to work in the ER, as DeCarlo was, if they would withhold lifesaving treatment.
Instead, I want to look more closely at the medical issues. Preeclampsia is a fairly common complication of pregnancy, occurring in 5 to 10% of all pregnancies. It’s signaled by a rise in their blood pressure, protein in their urine, and (sometimes) edema, or swelling, especially of the extremities. Many women experience no overt symptoms and might not even know that they have it. Most women survive it just fine.
But in a small number of women – between 5 and 7 per 10,000 deliveries – preeclampsia progresses to full-blown eclampsia, which includes seizures sometimes followed by coma and death. It accounts for 17.6% of maternal deaths in the U.S and 15% of premature deliveries.
Just because preeclampsia is a fairly common condition doesn’t make it harmless. I know someone who died of it, a college classmate of mine. A former colleague of my husband’s lost his partner to it.
We don’t have many more tools to predict or control eclampsia than we did 100 years ago, although one major reason health officials tout prenatal care is that it can catch and monitor preeclampsia while it’s still mild. We also don’t understand its causative mechanisms, despite countless research studies. Magnesium sulfate can be given by IV to prevent seizures, and while it saves lives, it’s no miracle drug. The only definitive treatment is delivery of the fetus – and even then, the new mother remains at risk for a few days thereafter. Of the three major killers of expectant mothers 100 years ago – hemorrhage, infection, and eclampsia – we’ve only made great inroads against the first two, thanks to transfusions and antibiotics. Mortality from eclampsia remains significant.
So what was going on with the pregnant woman in DeCarlo’s case? Well, according to the Catholic News Agency, she wasn’t really in jeopardy at all:
Hospital officials told Cenzon-DeCarlo that the situation was an “emergency,” although evidence suggests that this was not the case. The hospital itself labeled the case as a “Category II,” meaning that the operation needed to take place within six hours. This would have allowed enough time to find another nurse without moral objections to assisting in the abortion, her lawyers said.
Matt Bowman, legal counsel for the ADF, explained that the hospital could not legally have required the nurse to participate in the abortion even if the case had been a “Category I,” meaning that the patient required “immediate surgical intervention for life or limb threatening conditions.” Federal statutes prohibit recipients of federal health funds from requiring employees to perform abortions, Bowman told CNA.
However, the evidence in the case suggested that the patient was not even at the “Category II” level, as the hospital had claimed. When the woman was brought into the room, Cenzon-DeCarlo observed no indications that the case was a medical emergency. The woman’s blood pressure was not at a crisis level, and standard procedures for patients in crisis [administration of magnesium sulfate] had not been taken. Yet the nurse was still required to aid in the abortion.
Since we don’t have any hard information, I’d like to put on my historian-of-childbirth hat and offer some informed speculation. Severe preeclampsia at 22 weeks’ pregnancy is not very common. However, it can occur, and there’s one variant that would demand immediate action: HELLP syndrome. Here’s how Reese at Feminist Mormon Housewives describes her experience with HELLP:
Earlier this year I had my first child. He was born at 28 weeks because my life was in danger. It turned out that I had HELLP syndrome, which is basically preeclampsia turned up to 11. My blood pressure was 186/110, my organs were failing, my red blood cells were disintegrating, and my platelet count was dropping making it so that my blood wouldn’t clot. If I could manage to function with my organs failing, and if I could have avoided having a stroke or heart attack, I would have bled to death in childbirth.
If the patient at Mt. Sinai was suffering from HELLP syndrome, the attending physician could have very reasonably determined that there was no way she could hold out for several more weeks, hoping for a viable but very premature fetus. Indeed, he judged her case serious enough to require intervention within the next several hours. This suggests either HELLP or another serious complication, such as a severe headache (indicating a high risk of seizure) or chest pain (possible embolism). If you’re going to go straight to delivery (in this case, abortion, because the fetus was still a couple weeks short of the very outer limit of viability), then you might start administering magnesium sulfate as seizure prophylaxis as part of pre-op procedures, but the main priority would be to get the operation underway. Ordinarily a nurse would start an IV. In this case, the assigned nurse was arguing with her supervisor instead of tending to the patient. Could that possibly have anything to do with why the patient wasn’t on magnesium sulfate?
The patient’s relatively normal blood pressure is a red herring, because as emedicine notes, HELLP can present differently than regular preeclampsia:
HELLP syndrome (hemolysis, elevated liver enzyme, low platelets) is a form of severe preeclampsia that has been associated with particularly high maternal and perinatal morbidity and mortality and may be present without hypertension or, in some occasions, without proteinuria. [my emphasis]
So we don’t know all the details, but certainly my speculations are a whole lot more believable than a scenario where mild preeclampsia was used as a pretext for elective abortion at 22 weeks. This was presumably a wanted fetus. On the off chance that it wasn’t, the woman could have sought elective abortion, which can still be carried out legally at 22 weeks. While it can be tough to find a provider for late-term terminations, last I knew New York City was one of the meccas for women needing such abortions. So there’d be absolutely reason to show up in the ER, hoping on spec that you could get an elective abortion. There’s also no reason why an ER doctor would prioritize a procedure if it weren’t urgent. Folks in the ER have a few other problems on their plate.
Just imagine you’re a woman hoping to bring a child into the world. Imagine you get sick with a condition in mid-pregnancy that you’d never even heard of. Imagine hearing the ER doctor – whom you’ve never met in you life – tell you that you need to abort in order to save your own life; otherwise, HELLP syndrome is liable to put you into liver failure, possibly complicated by kidney failure and blood that refuses to clot. And then imagine that your story of loss is plastered throughout the court system and the yellow press, trumpeted by pro-lifers as evil incarnate, and held out as an example of women’s and doctors’ supreme depravity.
No, we don’t know exactly what happened. But my speculative reading of the paltry facts is a whole lot more coherent and compelling than the tale DeCarlo tells in her court filings. Given that DeCarlo is the niece of a Catholic bishop, this whole thing stinks of a set-up. If it’s not, why she didn’t she just quit on the spot when her boss ordered her to aid in an act she considered murder? I’d like to think that I’d have that much moral courage. Instead, DeCarlo cooperated just enough to add drama to her lawsuit – after she’d gambled with a woman’s life.
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They say that the best way to learn something is to teach it, so that’s exactly what I’m going to do right now. But because you don’t want to know the boring stuff I’ll just tell you the interesting bits. The bits that will actually make you go aahhhh. Well, they made me go aahhhh, I don’t know about you. Perhaps if this kind of stuff interested you you’d actually be studying medicine. Perhaps you are, perhaps that’s why you’re here, you want to see life from a similar but different perspective.
Whatever, the fact is that you must be just about as bored as I am.
Okay, todays nugget of detail. Have you been watching flashforward? I’m up to episode 6 or something, then Demand Five kept cutting out on me so I had to stop, which was irritating in itself but anyway that’s not why I’m here. There was that one episode, where they diagnosed Addisons disease basied on the fact that in his flashforward the white man had somehow become black. Why does Addisons cause someone to become black?
Basically, Addisons is a disease caused by having too little cortisol. The secretion of cortisol is regulated by two things. When cortisol levels rise this is first detected in the hypothalamus in the brain, which releases CRH (corticotrophin releasing hormone). CRH goes on to stimulate the pituitary gland (which is also in the brain), causing it to secrete a substance called ACTH. The ACTH goes on to stimulate the secretion of cortisol from the adrenal cortex.
Anyway, in Addisons disease the adrenal cortex basically gets annhihalated by the body, i.e. in technical terms it is an autoimmune destruction of the body’s own cortex cells. As a result, the amount of cortisol it secretes decreases, which feeds back to the hypothalamus which releases more CRH, so the pituitary releases more ACTH. But due to the damaged adrenal gland, the amount of cortisol doesn’t rise up again, which means that moreand more ACTH is produced.
That’s all well and good, I can hear you crying, but how does it turn a white man black?
Well, when the ACTH is synthesised, it actually has within it a sequence of amino acids that is very similar to another protein called Melanocyte Stimulating Hormone (MSH). As a result, ACTH can, when it is in excess, bind to MSH receptors on melanocytes. And what melanocytes do is increase skin pigment, such that to wild excess, it could turn a white man black.
Coastweek — The Aga Khan Band preceded the walk while playing the National Anthem and entertaining the Mombasa crowd.
Coastweek — What a celebration it was for the inaugural A Walk for Life 2009, organised by the Aga Khan Council for Mombasa, created with the aim of assisting cancer sufferers who require financial support for medical care.
This prestigious event was held on Sunday 29 November 2009 at Butterfly Pavilion, Forest trails, Bamburi.
Read more at Coastweek
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My latest explanation of benefits from my Anthem offers a great illustration of how the current health care “system” discriminates against the uninsured. For the EMG I had in October, the doctor initially billed $1377. The “amount allowed” was $461.15. That’s the fee the doctor will actually collect. I’m responsible for just 10 percent of this as coinsurance ($46.11) since, as one of the people who’s driving up healthcare costs, I’d already met my deductible just four months into the fiscal year.
In other words, an uninsured Sungold would have had to pay $1377, or nearly thirty times what I actually paid. The doctor would have collected three times what she actually received.
And that’s just the doctor’s fee. On top of that, the hospital charges for use of its space, equipment, and resources. Anthem’s negotiated facility fee was $491.01 (with 10 percent of that again falling on me), versus $1,096 for my hypothetical uninsured twin.
To recap: I actually paid just over $100. The unfortunate uninsured Sungold would have paid nearly $2500.
Whoever dubbed economics the dismal science must have been thinking of the economics of health care.
I am currently reading the book, If I Get to Five: What Children Can Teach Us About Courage and Character by Fred Epstein, MD and Josh Horwitz.
The Book discusses Dr. Epstein’s Life. He was a pioneering pediatric neurosurgeon, now deceased, and the founder of the Institute for Neurology and Neurosurgery (INN) in NYC. The book talks of his life and growing up with dyslexia and possible ADD, at a time when both illnesses were “unknown” and children with these illnesses were labeled, mistakenly, as stupid. Fortunately, he had the help of a relative who taught him and the help of a teacher who gave him oral exams, instead of written ones.
Dr. Epstein was determined to become a doctor and to prove those who labeled him as “stupid,” wrong. The author mentions that he only got into one medical school with help. But, he became a pediatric neurosurgeon and went on to take cases that no one wanted and to pioneer different surgical techniques, such as for removing brainstem and spinal cord tumors. Additionally, he founded the INN as a place to not only medically treat patients, but to also care for them. Humanistic innovations included having a clown as part of the staff, having music therapy, and unlimited visiting hours in which parents could sleep over. The book goes into more details about Dr. Epstein’s life and his medical career.
As I continue reading the book, I am finding Dr. Epstein’s story to be truly remarkable, but the most touching sections of the book, are when he discusses his patients, including young children hoping to get to the age of five, and what the children taught Dr. Epstein about life. The young children savored the moments of their short lives and lived with tremendous courage.
As I continue to read this book, the stories of these amazing children are helping me to appreciate life more and to hopefully live more fully. To be grateful for what I have and how to overcome past disappointments.
I hope that no children have to go through what these brave children went through.
Here is an article with more information about Dr. Fred Epstein and his life and his work.
http://www.nysun.com/obituaries/fred-epstein-68-leading-pediatric-neurosurgeon/35920/
-Glenn 
founder,
www.GlennIsHere.com
www.GlennisGreen.com
Chicago – The people of the Dominican Republic live with staggering poverty, having very little access to any form of health care and no access to chiropractic care. Dr. Stephanie Maj has just returned from a chiropractic mission to help supply much needed health care and funds to the poorest of the poor in the Dominican Republic.
“I have vacationed in the Dominican Republic and although I knew it was a poor country, I saw first-hand how poverty can affect people,” Dr. Stephanie Maj said. “One community was living on the side of a trash dump, with poor Dominican kids wandering the trash heaps with no shoes. Their toys were old tires and bottle caps.”
In some ways, Dr. Maj notes, the people in the U.S. are more stressed out. The Dominican people lead a simpler life, free of the repetitive stresses such as sitting over a computer all day. Poverty and nutrition are the two biggest factors affecting the health of the Dominican people. The nutrition in the U.S. can be blamed as the biggest factor affecting health as well.
Maj adjusted 900 people in a three-day period. “I would say 75% of the people I helped were children. We would go to a school and adjust every kid in the school, as well as the teachers and staff.” That was for the children lucky enough to be able to attend school. Thousands of Dominican children are abandoned each year by parents who can’t afford to provide for them.
“One barrio we visited, Ponch Mateo, our guide was a teacher named Dumy. He runs a school named ‘Mano a Mano por el futuro’ (hand by hand for the future). Dumy showed us his one room school-house attached to his home. When I say home, I mean a wooden and tin shack with a dirt floor. He has no money to pay teachers and yet supplies a place to help kids get education as well as caring for orphans.”
Dr. Maj practices in the Lakeview neighborhood. She traveled to the Dominican Republic with a group of 30 doctors and 30 students intent on giving free chiropractic care to people. The group was organized by ChiroMission and as a group adjusted 35,000 people in a three-day period.
ChiroMission is the “Doctors without Borders” of Chiropractic. The idea is to teach less fortunate people in Third World countries how to take care of themselves so they’ll have a better shot at avoiding medical problems. ChiroMission has just expanded to Australia to take care of the Aborigines.
“I will never forget the children. Even with these tough conditions, there was joy in their eyes. All they wanted was to hold my hand and to hug me. For every one child I helped, they came back with 5 more. If I helped just one, I consider this trip a success.”
This group had their Chiropractic miracles as well. One man showed up with neurologic problem, a hand tremor like in Parkinson’s disease and drop foot. After being adjusted a couple of times in the morning, he hunted the doctors down at their next location. He walked up exclaiming in Spanish that not only had his tremor disappeared, he no longer had drop foot.
This trip changed Dr. Maj’s perception of poverty and life here in Chicago. “We think this economy is bad yet when you witness first-hand a different reality you realize things aren’t that bad. We need to be grateful for the abundance we have at our fingertips.”
Dr. Maj states, “The mission at Community Chiropractic is to check as many people as possible for hidden health problems and to save them from a life of drugs and surgery. We do this in Chicago everyday yet I realized after this trip that the world needs our help as well. I have been hit by a lightning bold and will never be the same.”
Dr. Stephanie Maj is the clinic director for Community Chiropractic, a full service wellness center offering family health care, acupuncture, massage, orthotics and nutritional counseling. Dr. Maj has been practicing in the Lakeview area for almost 14 years.
Scientists at Italy’s University Campus Bio-Medico of Rome recently announced an advance in thought-controlled biometric devices. A biometric hand was surgically attached to the patient’s nervous system via implanted electrodes. After the surgery in November 2008, it took the patient just days to start using the hand. During the one month trial, the patient was able to experience sensations when making the most complex movements ever documented by a biometric limb. Now, the challenge is to connect limbs for years, not months.
America’s pharmaceutical research and biotechnology companies are developing 34 medicines for diseases that disproportionately affect American women. The new report, Medicines in Development for Women, is presented by the Pharmaceutical Research and Manufacturers of America in cooperation with Prevent Blindness America and other national health organizations.
In addition to glaucoma and dry eye medicines in development, the report lists 155 medicines in development for diabetes, also a major cause of vision loss for women.
Treatment of age-related eye diseases, including glaucoma and diabetic eye disease, costs $51.4 billion annually.
For the full report, please visit www.phrma.org.
For more information on Prevent Blindness, please visit www.pbga.org.
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Here are excerpts from three articles about issues affecting nursing today. HIPAA is a biggie! Here is an article about what happens when you don’t follow the HIPAA regulations; violence in both the workplace and in the community affects nurses daily. Hospitals are historically located in low-income areas and crime is usually higher in and around those areas. Hospitals treat trauma and have drugs. Nurses work strange hours and come and go to cars parked in not-to-secure places. Violence toward healthcare workers is also on the rise and prevents some nurses from giving adequate care because they are afraid of assault.
Please read these articles at the source and let me know what you think we can do about these issues, won’t you?
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Houston hospital workers fired for HIPAA violationsBy Associated Press
Posted: November 26, 2009 – 1:30 pm EDTSixteen employees have been fired from the Harris County Hospital District in Houston, Texas, for alleged violations of patient privacy laws involving the records of a first-year resident, according to a district official.
The Houston Chronicle reports that the workers were fired late last week for looking at the medical records of a first-year Baylor College resident assigned to Ben Taub General Hospital. The doctor, Stephanie Wuest, became a patient at the hospital on Oct. 29, after she was shot in a grocery store parking lot. Her mother says she’s expected to recover.>>>read more
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The cost of murder Anti-violence groups, hospitals work to try and stop homicides, which have negative impacts on both the community and bottom linesBy Joe Carlson
Posted: November 30, 2009 – 5:59 am EDTJason was 8 years old the first time he came to the emergency department at 236-bed Children’s Hospital of Wisconsin in Milwaukee with alarming injuries, the results of being severely beaten on the playground.
Four years later, he returned to the ER with multiple stab wounds from scissors reportedly plunged into him by a classmate. The same nurse who cared for Jason the first time took care of him again, now concerned for his safety but powerless to do anything.
The last time Jason came to Children’s, he bypassed the emergency room and went directly to trauma, where surgeons tried to repair the damage of a gunshot wound to the chest. He was 16 years old, and he never left the hospital. For the third time in eight years, the same nurse was at his side and trying to reconcile her conscience as she tended to him on his deathbed.
“The nurse was saying, we have to do something for these kids. We’re just treating their wounds and not figuring out what is causing them and having them come back to us,” said Toni Rivera, recounting the story of the nurse, Jennifer Wincek, and the young patient, whose name was changed to protect his family’s identity. Rivera is today the manager of Project Ujima, one of the longest-running hospital-based violence prevention programs in the country.
Through education and community-outreach activities, Rivera said the program has decreased emergency-room recidivism—repeat trips to the ER within a year’s time—from the 18% seen in 1995 to 1% today among the 300 kids who take part in the program annually.
In 2009, 14 years after Project Ujima formed, it remains the only such program in Wisconsin. Officials with the Chicago-based organization CeaseFire, which partners with hospitals to help break the cycle of retaliatory street violence, estimates that 80 metropolitan areas are ripe for such programs judging by their per-capita rates of intentional violent injury.
“The hospital is absolutely a key partner in preventing violence,” said Sheila Regan, hospital response program specialist for CeaseFire. “On a daily basis, the hospital is a central partner.”
Proponents of the programs say many administrators whose trauma centers record high rates of violent intentional injuries are missing a crucial chance to save more lives and prevent costly admissions and readmissions. Although such programs can be expensive and operationally complex, all are based on the idea that the most efficient way to locate people most likely to be involved in the next violent incident is to meet them at the hospital in the aftermath of the latest trauma.
Supporters often compare the state of such programs to domestic-violence prevention programs in the 1970s. Just as it would be virtually unthinkable today to discharge a battered wife into an abusive home without offering help, proponents of community-violence prevention programs are hoping for the same kind of widespread acceptance of their ideas in hospitals someday. Although some evidence shows that community-violence programs save lives and cut healthcare and government costs, many of the existing projects are at risk of losing funding while money remains a major hurdle for prospective initiatives.
All such programs are founded on the belief that hospitals ought to be doing more for community violence victims than sewing up their wounds and handing them the phone number of some community agency. This new approach is known as the public health response, and employs epidemiological principals in the prevention of community violence.
“It’s very frustrating to you as a surgeon to see someone who you’ve spent three, four, five hours in their abdomen putting together their bowels … and then a year later, you see them come back to the hospital, this time for a gunshot wound to the head,” said Carnell Cooper, associate professor of surgery at 666-bed University of Maryland Medical Center in Baltimore, and executive director of the Violence Intervention Program in the hospital’s R. Adams Crowley Shock Trauma Center.
Anti-violence programs have been executed widely in large and small communities alike for decades, but the more recent idea of involving hospitals in the formula is based on three concepts. The first is that the most accurate predictor of a violent injury is if one person has already been violently injured, so that hospitals are seen as collection points for people who know where the next incident is going to happen, including not just victims but their families and friends. >>>read more
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Anti-violent beginnings Hospital-based programs among the optionsBy Joe Carlson
Posted: November 30, 2009 – 5:59 am EDTThe impetus to launch a hospital-based anti-violence program usually doesn’t come from CEOs concerned about their local communities or from an overworked social worker on the hospital staff.
In most cases, experts say, it starts with a trauma surgeon who is fed up with repeat trauma visits and sees that social norms in violent communities are essentially undermining the advances in medical science by returning ever-more victims for all those whose lives are saved on the operating table.
“I think the time is right for us to get even more involved as a profession,” said Robert Barraco, associate director of trauma at Lehigh Valley Hospital in Allentown, Pa., and chairman of the Injury Control & Violence Prevention Committee of the Eastern Association for the Surgery of Trauma. “We certainly have an ethical responsibility to participate in prevention efforts through our trauma services, and I look forward to more and more of these programs popping up across the country and becoming successful and producing more data.”
But violence prevention programs tend to be labor-intensive and difficult to classify in a hospital’s organizational chart. When deciding to start such a program, one of the earliest decisions to make is whether to implement a program that is hospital-based or hospital-linked.
In the former category, the caseworkers who make first contact with the victims receive paychecks from the hospitals and are part of the medical staff. One major advantage of this approach, observers say, is that employees don’t have to worry about violating the privacy rules in the Health Insurance Portability and Accountability Act of 1996. Hospital workers can walk around freely inside the facilities and don’t have to worry about getting consent forms signed before reviewing medical charts or talking with patients.
However, hospital employees may work regular business hours and can’t respond immediately during peak trauma times. Research from CeaseFire, an organization committed to reducing shootings and killing, shows that the most common time its workers respond to a violence victim is 2 a.m., and the most common day is Sunday.>>>read more
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Dr. Popper continued her explanation of the debate over mammograms…
“Today’s debate about health care reform involves delivery of and payment for ineffective and often unsafe tests and treatments, and the discussion is being led by lobbyists and special interests, including some well-meaning cancer survivors and other patients who are telling stories, not analyzing science.
At this time, medical services for which there is no evidence of efficacy consume 30% of all Medicare dollars¹. We must take the emotion out of our discussions about health care and focus on science, if anything is going to change for the better.
Health care is focused on doing more and more things, and offering them to more and more people. We pay for treatments and procedures; we don’t pay for results. Yet research shows that health is not improved by access to more care. The Dartmouth Atlas Project reported that in areas of the country where there were more doctors, more hospitals, more diagnostic equipment and more services and care offered, health outcomes were worse in spite of the fact that costs were an average of two times higher².
We must focus on doing the right things. We must insist on quality instead of quantity. We can’t just keep doing the same things and trying to pay less for each ineffective drug and procedure and expect that our health outcomes or our costs will change.”
The most important thing you can do for your health is to start eating a plant-based diet. Plant foods and not animal foods will build your immune system, prevent and/or reverse diseases like diabetes and heart disease, lower cholesterol and blood pressure, prevent cancers, give you more energy & longevity, and help you lose weight.
