Category: medicine

A Medical Odyssey

ObFunny: We were in the grocery store conversing with the cashier when she asked how it was going I said it’s been a hell of an Odyssey over someones medical issues. She didn’t know what an Odyssey was so I explained it was an epic journey of sorts.

Well this medical odyssey – Someone (Not me) was having anal leakage all over the place. I’ve never cleaned up so much shit and blood in my life. A few days ago someone managed to get blood all over one of the bathrooms. A little bleach and water later and all cleaned up.

Two days later we present at the local Emergency Room – at 5:32PM. Final discharge time at 4:30AM. So eleven hours to find out he likely contracted a C. Diff infection when he was in the hospital a couple weeks ago. The treatment is cipro 500mg and metronidazole 500mg twice a day for seven days then probiotics to rebuild the wiped out gut microflora/microbiome.

But I feel bad for my guy – he’s been through a lot in the last eight months. I’m trying to be more patient about it, letting my sense of humor come out and play things like that. Event the initial doc we saw, well he was a student but still he was a good egg. So too the attending. I have to say the doctors at Emory Healthcare are good people. They don’t insult ones intelligence either. I appreciate that very much.

Now I know this will be about $4,000 for the visit. But I’m going to challenge it because as our good friends boyfriend said, they caused the infection, they should cover the ER visit. I tend to agree with him so when the bill comes I’m going to call and challenge it, saying their sloppy practices caused the issue and why should I have to pay for their fuck up. If they put up a fight I’ll get my attorney to call them. Because I’m a firm believe in if you broke it, you pay for it, not me.

3D Printed Organs

This is fucking fascinating. I knew it was coming but wasn’t sure when. Clinical in five years ok – that’s good. Think about it though. I’ve known for some time we’ve been able to 3D print the hollow organs like esophagus, bladder etc. But tissue with blood vessels has been the holy grail.

Not anymore. So with this technology we can print kidneys, livers, pancreas, lungs – and the heart may be next. And since they’re grown from a patients own cells there’s no risk of rejection. I’d say tech like this will tack 30 to 50 years of additional life to all of us.

In fact I’ve posted before on what extended lifetimes would mean. The pressure to have children when you’re young could potentially be pushed off until your in your 70’s. Imagine that.

Technology is catching up with the fiction. If you read any of the Heinlein books you know that Rejuvination Clinics are a common item in them. And they expect the market for this to jump from $23 Billion in 2015 to $94 Billion by 2020. This presents a good investment opportunity I’d say. And it will be a game changer for medicine. No more will we lose 4,000 or more people per year due to organ failure. That’s one I can think of off the cuff.

Just think what more could we 3D print? Arms? Legs? Eyes? The list is endless.

Had only this technology been available back in 1992 perhaps we could have saved my Uncle – he died from Cirrhosis of the Liver at age 42. So sad he’s gone but glad that in the future they can just grow a new liver for someone and it’ll save thousands of lives.

Interesting medical bit, a novel idea from the past

I remember house calls going out of vogue about the time I was 4 or 5 years old. Yes yes, I’m THAT old.

But now an old idea is new again.

A couple things jump out from the linked article. One is that the Missouri VA program for veteran care saw a drop in cost per patient of 62%! It went from $45,000 per year per patient down to $17,000. That’s no small feat.

The other little fact that really jumps out is that patients with multiple chronic conditions use up two thirds of Medicare money which approaches $500 Billion this year. If say we could realize the savings that the VA saw, we could chop that $500 Billion down to about $190 Billion. That’ where the savings multiply.

Another fact that jumps out about this new move, which by the way is included in the health care bills floating through congress. That is, patient outcomes IMPROVE when doctors make house calls.

The other little fact that really jumps out is that patients with multiple chronic conditions use up two thirds of Medicare money which approaches $500 Billion this year. If say we could realize the savings that the VA saw, we could chop that $500 Billion down to about $190 Billion. That’ where the savings multiply.

I’ve written about this before. If there’s one thing the U.S. is absolutely on top of it is emergency medicine. Education and technologies have evolved to the point that most every state has one or more Level 1 Trauma centers. The one near me is about 1.5 miles away. You can be shot, have a heart attack, stroke, etc. but the emergency folks can patch you up and keep you alive in most cases.

Where we absolutely fall down is on preventative medicine. And that is what doctors doing house calls would return to the equation.

But I think the reason we’re seeing such a fight over health care reform is because there are businesses out there that stand to loose a lot of money if we implement common sense ideas about medical care. Think about it, Medicare would save $310 Billion in costs. What could we do with an extra $310 Billion? Fix deteriorating infrastructure like roadways and schools? That’s just a start.

You have to look at who stands to lose when disruptive change like this occurs. The quick list I can think of is the hospitals, the insurance companies, the billing companies, the ambulance companies, cities (You think rescue runs are free?), and even states at some level.

The above is what I see as the prime opposition to true reform in health care. But we the people must let our legislators know that we know how disruptive this change will be, but we’re willing to work with them to see it passed.

Health Care Stories

This evening I attended a Spaghetti Dinner sponsored by Senator Sheldon Whitehouse (D-RI).

Met up with a couple of people on Sheldon’s staff that I had worked with when we were all at the RI Secretary of State’s office. Overall all about 130 people showed up for the event.

The event was MC’d by Providence Mayor David Ciciline:

Mayor Ciciline MCs Health Care Dinner
Mayor Ciciline MC's Health Care Dinner

And then Sheldon got up to say a few words before handing microphones out to the crowd:

Senator Sheldon Whitehouse
Senator Sheldon Whitehouse

It was a bit of a political who’s who, what with city councilmen John Lombardi (Ward, 13) , Nick Narducci (Ward 4), Peter Mancini (Ward 14), Terry Hasset (Ward 12), and Michael Solomon (Ward 5) and Rep. Grace Diaz. Also in attendance was Providence Police Chief Dean Esserman. One commonality among the politicians that attended, they all represent areas with a large number of elderly and economically disadvantaged.

There were some compelling stories. I didn’t tell mine but I’ve gone without treatment for this inner ear condition because I don’t even have coverage at this point. And the nerve sectioning in the inner ear won’t be cheap I’m sure. Other people were talking about the $15,000 for this, $7,000 for that, etc. The time and money wasted because we don’t have a viable public health care solution yet.

Sheldon did talk about a public insurance program. And he alluded to something that I should have asked but didn’t. He says that the public system will cause the private system to shape up. I suspect the public system would drain off the more expensive cases from the private insurers. In order to balance the system strong regulation would need to be put in place. Perhaps a fair system for those with expensive chronic conditions would be to create a pool of insurers including the public and assign people to those insurers by random lottery. This way all plans would share in the care for chronic conditions.

Sheldon did touch on efficiencies in health care delivery which is encouraging. But the idea of a for-profit insurer or a for-profit health provider runs counter to my beliefs. I don’t mean doctors and nurses should be taking a lower rate of pay, but that hospitals and insurers need to change the focus form providing for the shareholders to providing for the insured.

Interesting story on U.S. Healthcare

As one of those un-insured this makes my blood boil, especially when that Hunter bitch tries to sugar coat the industry position.

Part II

Part III

All this comes from a discussion thread about the California Nurses Association publishing a study that indicated expanding medicare could cover every single person in the U.S. and cost comparatively little.

You’ve heard me say this before, we need to knock down the insurance and billing companies first. They are the prime obstacle to having single payer, or universal, or what have you.

Profit and greed should NEVER, EVER override health.

Low birth weight and infant mortality in the U.S.

Found this interesting ranking of states for child birth weight and mortality statistics.

If you look at the map a couple of interesting bits of data become apparent:
Child Well Being Map of the United States

One of the scarier things that pop immediately into view is the fact that south and a column going up the midwest have the worst issues with child well being. In the case of the south, that’s the Bible belt, in the case of the midwest states, too much distance between advanced medical care and people.

Then look at the light pink areas. One of the things about those light pink areas is that there are many colleges and universities located within them, including many medical schools. In areas like that the quality and quantity of care tend to be greater and more accessible.

But what is the root cause of low birth weight babies? Is it the modern lifestyle? Or maybe all the chemical contamination in our environment. For example we now know that bisphenol-A is an endocrine disrupter. One of it’s effects on developing male babies is decrease in the anogenital distance and smaller penises In essence it mimics a feminizing hormone.

Other contaminants include heavy metals, radioactive isotopes, etc. We live in a very toxic environment and the effects aren’t just present in developing fetuses, but they affect children and adults too.

It’s really a shame that the Clean Air and Water act has been repeatedly attacked because we’re going to pay the price over and over again due to our lack of diligence.

More advances in treating brain cancer

Brain cancer, particularly glioblastoma multiforme (GM) is in the news again, this time Senator Kennedy is its latest victim. You may recall before that I found out about a vaccine that helped to prevent GM.

And now there’s more news. It appears that cancers have stem cells that live near blood vessels in order to gather an energy supply. They’ve now found that preventing the formation of new blood vessels may in fact starve many cancers, including brain cancers. Anti-angiogenesis drugs have been around for a while, but this is the first time they’ve been used in the treatment of brain cancers.

Brain Cancer Vaccine

I wouldn’t call this a vaccine per se, but it’s definitely very good news. From what I recall this is especially effective against glioblastoma’s which seem to be the majority of brain cancers. They’re also one of the nastier forms of cancer of the brain because there’s no known cure, only palliative measures.

I lost a good friend to that disease. I wish he was still alive to benefit from this.

Little by little we’re beginning to conquer diseases which for years eluded any curative measures. This is good news. It means human lifespans will now extend a bit more.

Why I prefer an old doctor

Over the past ten months we’ve been trying to figure out why the hearing in my left ear is about 60dB below normal, along with attendant ringing and at one point serious vertigo. The vertigo is gone now, my old noggin finally figured out that it was getting bunk information from the left side and so now I can ignore it. The human brain is a very cool system.

Anyhow during those ten months we’ve tried all sorts of things, antibiotics, diuretics, CNS depresants (for the veritgo), and high dosages of prednisone, we’re talking 60mg of the stuff. That seems to help me so now they think it might be auto-immune. I’ll know my next visit

So today I made my annual visit to my allergist. I’ve been seeing the same allergist since I was ten years old, so that would mean I’ve seen this guy every year for thirty-two years. In short, he’s a fossil but one I can comfortably talk with. His name is Dr. Jorge Sturam and he got his training at the National University of Cordoba in Argentina finishing in 1961. That would probably make him, oh, close to 75 years old.

So I mentioned the left ear problem to him and he responded that he remembered I had serious ear infections and strep infections as a kid. He then told me that you don’t recover without some effects from the infections, and that later in life they manifest themselves in hard to explain problems. Surprised the hell out of me that he’d remember all that, after all those years. And he actually gave his blessing to my killing my ENT. :)

So he looks in my left ear and tells me that the left eardrum is retracting. This would explain that the losses in the 60dB range are high frequency losses.

The guy is definitely a good doctor. I just hope he lives for at least another thirty or so years but I know that’s unrealistic. I estimate that by the time I’m fifty, I’ll have to find a new allergist. Oh well.

Serendipitous Inventions

The latest is something the pretty much kills all epithelial cancers (skin, digestive, etc.)

And to think, the researcher was annoyed that it was killing her test cancer cells.

Many things happen by accident. Nylon for example, or even the adhesive on a post-it. This is serendipity at its best.

I really think we’re on to a cure for cancer. And I really think we’re so close to eliminating HIV. We really might live into our hundreds and this is with common medical procedure, nothing so drastic as an overhaul of the human body though I don’t think that is all that far off either.

It is going to be an interesting future.