medicine Archive

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Maybe I was simply full of shit when I was a kid

By
Trevor Macomber
– March 6, 2012

I’m only vaguely embarrassed to admit that I wet the bed until a ripe old age when I was younger. I don’t think the condition survived into double digits, but if it didn’t, it came pretty damn close. So after reading today’s…let’s call it “fecally frank” article about bed-wetting in Slate, I had to wonder: maybe my parents were right. Maybe I really was just full of crap at that age.

Our culture has two reactions to potty problems: Either these problems represent a parental failure, or they are not actually problems but rather a normal (if bothersome) part of growing up. Parents are led to believe that kids are kids—they get busy playing and forget to go potty. They wet the bed, but that’s normal for their age.

In reality, potty-trained kids should not have accidents any more often than you or I do. And while overnight dryness often happens well after a child is toilet trained, bedwetting at age 6 should not be dismissed with, “You’re a deep sleeper. Be patient—you’ll grow out of it.”

Accidents and bed-wetting have the same root cause: chronically holding poop or pee or both. A rectal poop mass squishes the bladder and messes with its nerves; holding pee thickens the bladder wall, shrinking the bladder’s capacity to hold urine and triggering hiccuplike contractions. The upshot: wet undies and bed sheets.

[...]

Here’s the interesting part: [pediatric kidney specialist Sean] O’Regan noted in his papers that the parents of his patients had no inkling their children were backed up. Yet these kids were so clogged that they could not feel, in their rectums, the presence of balloons inflated to the size of a small cantaloupe.

O’Regan’s research tells you why constipation is so easily missed. Often, the rectum simply expands to compensate, like a squirrel’s cheeks or a snake’s belly. So much poop builds up that even though the child may still poop regularly, she never completely empties. Many severely clogged kids poop two or three times a day. Parents and doctors are fooled into thinking all is well.

Ummm, it goes on. Fascinating, in a gross sort of way.

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The Huffington Post is a Shitty Website

By
Tom OHare
– October 24, 2011

HERE IS YOUR MEDICAL WOO FOR THE DAY, BROUGHT TO YOU BY THE HUFFINGTON POST, WHERE HOMEOPATHY AND ACUPUNCTURE CURE AIDS AND CANCER!!!

In order to establish a system that is truly focused on health care, we need to expose some “myths” that will allow us to unlock the door to creating a more efficient and successful healthcare delivery system.

Myth #1- Technology has improved healthcare

Palm, meet face. Amanda Marcotte pretty much has this whole thing covered for you, in case you want to read a thorough takedown. Here’s a nice little graph to ponder in the context of Dr. Bob Kornfeld’s first “myth” (of six!):

Curious. What this table demonstrates is that, from the baseline of medical competence called “Not Killing Your Fucking Patients,” technology does seem to have improved healthcare — at least to the extent that people are no longer dying at 49.2 years old as a matter of course. But whatevs! It’s still a myth! What else does the good doctor have to say?

Myth #4 – Medications improve health

We are, in this country, the most heavily medicated society on the planet. People are taking medications to control the symptoms of countless diseases. These medications are either prescribed by their physicians or purchased over the counter by the patient. I have seen, in my practice, thousands of elderly patients taking upward of 10 prescription medications as well as a few over-the-counter ones. If you ask the average senior how they are feeling, most will say that they feel awful in spite of their medications. How could this be? If the medications are supposedly “keeping them healthy,” how come they feel so bad?

All those people living with AIDS by downing a cocktail of pills every day? THEY’D BE HEALTHIER IF THEY WERE DEAD!

And of course, he’s an anti-vaccination nutter, too (because the HuffPo looovvesss the woo):

Myth #5 – Childhood immunizations protect us from serious disease

It’s a foregone conclusion that upon the birth of your new baby, immunizations will start as soon as possible to protect your child from many serious childhood illnesses that can devastate his/her health. Pediatricians set up important immunization schedules to be adhered to so that the baby is not left unprotected. In years gone by, many children were afflicted with polio, measles, mumps, Rubella, influenza, small pox, diphtheria, whooping cough and others. Of course, the majority of these children recovered without incident (other than polio, which caused permanent nerve damage most of the time), but there were some children who had serious sequelae and even some who died from these diseases. Modern science discovered a way to confer immunity on these children so that they would never become afflicted with these diseases, and for the most part, it has been successful. The question is, at what price?

AUTISM, ADHD, ALLERGIES, EVIL FAIRIES, BEAR ATTACKS, AND GLOBAL COOLING, THAT’S WHAT PRICE, PAL!

The saddest part is that about half of the HuffPo’s commenters seem to agree with the quack doctor and his quack medical advice. Our planet is doomed.

 

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Life sucks: in perspective

By
Trevor Macomber
– October 24, 2011

"Wesley Warren Jr., who suffers from a condition called scrotal lymphedema, rests his 100-pound scrotum on a pillow and milk crate while waiting for a bus at the Bonneville Transit Center. JEFF SCHEID/LAS VEGAS REVIEW-JOURNAL"

In anticipation of a shitty week — both professionally and, as a result, bloggingly — please do not enjoy this story about 47-year-old Las Vegan, Wesley Warren Jr, and his 100-lb ball sack.

The article’s got the seriously painful details if you want them, but suffice it to say, dude could use a break:

In hopes of getting the money for a possible corrective procedure that physicians have told him can cost about $1 million, Warren swallowed his pride by outing himself recently on shock jock Howard Stern’s national satellite radio and cable TV freak segment.

But he used the pseudonym “Johnathan from Las Vegas” to let people know that his penis is so buried in his scrotal tissue that he can’t direct his urination and often sprays the area around him.

He also told — to more laughter on the set — of how he can’t sit down for a bowel movement and must catch it in the same kind of pail used in casinos for coins.

“I don’t like being a freak, who would?” Warren said. “But I figured that the Stern show is listened to by millions of people and they might want to help me. I hope some millionaire or billionaire will want to help me.”

Many people have reached him through his benefitballsack@yahoo.com email address, he said.

Of course, even if that million comes down from on high, Warren won’t necessarily be sitting pretty (as it were):

Urologist Kassahun informed Warren that a team of urologists and plastic surgeons would be needed to cut away the excess tissue and to perform the reconstructive surgery that would include skin grafts. Every attempt would be made to save and reconstruct Warren’s penis and testicles, but it was possible that they would have to be completely excised.

“I told him that if there was major bleeding we might not be able to save them,” Kassahun said.

That news shook Warren.

“Basically, he was telling me there was a good chance that I would be castrated and have to go to the bathroom through a tube for the rest of my life,” he said. “I really would like to have a relationship with a woman. I should be in the prime of my life right now.”

If you need me, I’ll be over there in the corner, curled into the fetal position and rocking back and forth while whispering incoherently to myself.

Jesus, somebody help this dude out. (Not Jesus specifically, mind you, because any deity who would visit such maladies on his flock is a deity whose further help you can probably do without, thank you very much.)

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Antioxidants are bad for you but I still hold that coffee is good

By
Ben Nolan
– September 19, 2011

Whaaaaa…? Kent Sepkowitz in Slate (like a month ago, but I missed it then, so sue me):

As it turns out, we have no evidence that antioxidants are beneficial in humans. (Though if you’re a Sprague-Dawley rat, there’s hope.) In fact, as Emily Anthes wrote last year in Slate, the best available data demonstrate that antioxidants are bad for you—so long as you count an increased risk of death as “bad.”

[snip]

As noted by Anthes, and Michael Specter in his book Denialism, the first clear crack in the façade was the 2007 revelation in JAMA that antioxidant vitamins were not merely useless but harmful. Building on this clinical observation, a German group has developed a plausible scientific explanation of the increased risk. The title of the group’s most recent publication, “Extending life span by increasing oxidative stress,” pretty much sums up their view: The human cell should toughen up. It can benefit from enduring something harsh like the insult caused by free radicals. This way, the organism is more prepared to fend off the inevitable Big One, be it cancer or a toxic fume or perhaps a bout of cholera. Practice makes perfect.

That it’s packed with anti-oxidants (higher density than blueberries) was one of the cornerstones for my argument that drinking copious coffee is healthy. Guess I’m going to have to go back to the drawing board…

WebMD:

“It has not really been shown that coffee drinking leads to an increase in antioxidants in the body,” Lane tells WebMD. “We know that there are antioxidants in large quantities in coffee itself, especially when it’s freshly brewed, but we don’t know whether those antioxidants appear in the bloodstream and in the body when the person drinks it. Those studies have not been done.”

Nice! Although highly provisional.

According to the same article, coffee can substantially lower your probability of contracting type 2 diabetes –

Australian researchers looked at 18 studies of nearly 458,000 people. They found a 7% drop in the odds of having type 2 diabetes for every additional cup of coffee drunk daily.

– as well as improve your odds of avoiding liver cancer, Parkinson’s disease and dementia (*shudder*) –

A 2009 study from Finland and Sweden showed that, out of 1,400 people followed for about 20 years, those who reported drinking 3-5 cups of coffee daily were 65% less likely to develop dementia and Alzheimer’s disease, compared with nondrinkers or occasional coffee drinkers.

So those are pluses.

And while it increases your odds of high blood pressure, it also mitigates several risk factors for heart problems and stroke.

In a study of about 130,000 Kaiser Permanente health plan members, people who reported drinking 1-3 cups of coffee per day were 20% less likely to be hospitalized for abnormal heart rhythms (arrhythmias) than nondrinkers, regardless of other risk factors.

And, for women, coffee may mean a lower risk of stroke.

In 2009, a study of 83,700 nurses enrolled in the long-term Nurses’ Health Study showed a 20% lower risk of stroke in those who reported drinking two or more cups of coffee daily, compared to women who drank less coffee or none at all. That pattern held regardless of whether the women had high blood pressure, high cholesterol levels, and type 2 diabetes.

Giving to the devil what is his, it’s unambiguous that it can make heartburn worse.

So obvs you should make a judgment call, and maybe take a second to think if you’re already someone who suffers from pretty bad heartburn.

Anyway.

I raise my excessive, I’ll grant you, quad-shot Americano to your health!

(Not actually me and, by the looks of it, not actually an Americano)

On a personal note: Shout-out to Fahrenheit Coffee, which just shuttered its location just an elevator ride from my office on Friday. Consistently the best espresso I’ve ever head.

Samir: Best of luck finding a new location soon (preferably, again, close to the old one OR in High Park / the Junction). May you flourish there. I already miss the crap out of you guys.

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I am saved!!!!!!!!!111one!

By
Tom OHare
– September 12, 2011

Viva la revolucion!

From the island nation known for the quality of its cigars comes some pretty big news today: Xinhua reports that Cuban medical authorities have released the first therapeutic vaccine for lung cancer. CimaVax-EGF is the result of a 25-year research project at Havana’s Center for Molecular Immunology, and it could make a life or death difference for those facing late-stage lung cancers, researchers there say.

CimaVax-EGF isn’t a vaccine in the preventative sense–that is, it doesn’t prevent lung cancer from taking hold in new patients. It’s based on a protein related to uncontrolled cell proliferation–that is, it doesn’t prevent cancer from existing in the first place but attacks the mechanism by which it does harm.

As such it can turn aggressive later-stage lung cancer into a manageable chronic disease by creating antibodies that do battle with the proteins that cause uncontrolled cell proliferation, researchers say. Chemotherapy and radiotherapy are still recommended as a primary means of destroying cancerous tissue, but for those showing no improvement the new vaccine could be a literal lifesaver.

Granted, there’s heart disease and emphysema and asthma and lung butter and chronic bronchitis and strokes and shit to worry about, but as a smoker I find myself rather cheered by today’s medical news. The next pack of Pall Mall Red 100s will be purchased with considerably less guilt than usual. Thanks, Cuba!

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A fully equipped gynecological operating theater has been discovered underneath Tripoli’s Fateh University

By
Trevor Macomber
– September 9, 2011

Highly disturbing news from BBC Africa:

A fully equipped gynaecological operating theatre, bedroom and jacuzzi have been discovered underneath Tripoli’s Fateh University.

The rooms were discovered beneath the Green Theatre which was used to teach about the revolution and the Green Book which contained Col Muammar Gaddafi’s thoughts and solutions to the country’s social, political and economic problems.

From The Daily Beast: "Tripoli University Dean Faisal Krekshi shows the press gynecological equipment in an examination room at the school., Credit: Babak Dehghanpisheh"

 
Yikes. Just…yikes.

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Well, This is Somewhat Horrible

By
Tom OHare
– August 24, 2011

Be it proposed:

Wherein: If you are a doctor, and you are ordered to chop off a man’s foreskin, and you chop off his entire penis because you “found cancer” and just, you know, “didn’t bother to seek a second opinion, man…”

Wherein: “Because, I mean, c’mon guys, wouldn’t YOU want your dick chopped off if some doctor discovered cancer in it while giving you a circumcision?? I mean, seriously…”

Wherein: “Who wouldn’t just up and decide that the patient would be cool with it? IT’S CANCER. Because. You know. I mean.”

Wherein: “Would you bother to wake someone up over that? Would you? I wouldn’t. IT’S CANCER AND DICKS GROW BACK, SILLY! DICKS ARE LIKE STARFISH, AND STARFISH NEVER DIE, WHICH MEANS NEITHER DO DICKS!!!”

Be it resolved that: You shall not be allowed to practice medicine anymore. Ever. Ever, ever. Ever, ever, ever with cherries on top.

Furthermore: If you are on a jury in a case such as this and fail to award the plaintiff a monetary settlement for his, shall we say, “troubles,”

Be it resolved that: You shall be stricken with a sexual dysfunction of a severe sort in short order.

Srsly, c’mon dudes. The doctor cut the dude’s DICK off. WITHOUT ASKING FIRST! And you didn’t give him a penny. Shameful. Shameful, shameful shit.

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Guardian Headline Worth Reproducing In Full: “Scientists credited on ghostwritten articles ‘should be charged with fraud’”

By
Ben Nolan
– August 3, 2011

Yes they should.

Juicy bits:

Writing in the journal, PLoS Medicine, Simon Stern and Trudo Lemmens, who are law professors at the University of Toronto, warn that measures brought in by publishers and professional bodies to curb guest authorship and ghostwriting have so far failed to tackle the problem. They call for more severe sanctions against those involved, even when the articles are scientifically accurate.

“It’s a prostitution of their academic standing. And it undermines the integrity of the entire academic publication system,” Lemmens said.

“A guest author’s claim for credit of an article written by someone else constitutes legal fraud, and may give rise to claims that could be pursued in a class action,” the authors write. The same offence could also support claims of “fraud on court” when drugs companies rely on ghostwritten articles in court cases. Stern and Lemmens argue that pharmaceutical companies and the medical writers they sponsor may also incur liability for soliciting and facilitating fraud.

Recycling a relevant post from a couple months ago:

…drug companies hire publication planning agencies to launder PR through medical journals!

In the early 2000s, court documents released through litigation over controversial drugs – such as Vioxx and the hormone replacement therapy Prempro – showed pharmaceutical companies frequently hiring medical communication agencies to ghostwrite articles and place them in influential medical journals under the “authorship” of well-known academics paid thousands of pounds for their endorsement.

…

But without the window of court documents to show how publication planning is being carried out today, the public simply cannot know if reforms the industry says it has made are genuine.

Dr Leemon McHenry, a medical ethicist at California State University, says nothing has changed. “They’ve just found more clever ways of concealing their activities. There’s a whole army of hidden scribes. It’s an epistemological morass where you can’t trust anything.”

NUMBERS!

There are now at least 250 different companies engaged in the business of planning clinical publications for the pharmaceutical industry, according to the International Society for Medical Publication Professionals, which said it has over 1000 individual members.

Many firms are based in the UK and the east coast of the United States in traditional “pharma” centres like Pennsylvania and New Jersey.

Precise figures are hard to pin down because publication planning is widely dispersed and is only beginning to be recognized as something like a discrete profession. These numbers are higher than any previous estimate, yet in truth the industry is likely to be bigger still.

Odds any fraud charges along these lines will be successfully prosecuted?

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How could you not click on an article with this headline?

By
Trevor Macomber
– July 26, 2011

Risky pelvic mesh highlights worries about FDA process. Not only do the first three words make for an amazing band name, the whole thing is just so bizarre that you can’t help but want to learn more.

Unfortunately, what you learn can’t be unlearned.

LEARN:

Janet Holt figured she simply had an infection “down there.”

But instead of a prescription, her doctor told her she’d need a procedure. Her bladder had slipped out of place, creating an uncomfortable condition known as pelvic organ prolapse, which affects many women as they age.

Her doctor said he could fix it, building a kind of nest or cradle to prop up her insides…

Four years later, however, the medical device that was supposed to fix Holt’s problem has caused a host of new ones, sparking constant pain and requiring seven more operations as other surgeons tried to remove the mesh, which had eroded into her vagina, bit by bit.

Which had eroded into her vagina, bit by bit. If I’ve read a more a more awful sentence this year, please, God, don’t let me remember it.

More insanity:

Holt has become a poster child for growing concerns about the government process that allows devices such as surgical mesh — made of the same material as Rubbermaid storage containers — to be used with no testing on patients before they’re allowed on the market.

[...]

Unlike prescription drugs, which must be proven safe and effective before they’re marketed, most medical devices have no such requirement. [emphasis my own] Only about 10 percent of devices, those deemed the riskiest, such as breast implants and implantable pacemakers, fall into that category. Surgical mesh, used to support organs that have slipped over time, does not.

Jesus jumpin’ Junior Mints. What the hell is the FDA doing if it’s not testing synthetic materials that are being permanently inserted into the human body?

Oh, it’s going after the walnut industry for making true health claims about their products? Well then, carry on!

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Healthcare < Guns

By
Trevor Macomber
– April 29, 2011

Earlier this week, The Daily Show with Jon Stewart once again played the role of our collective conscience by calling out Congressman Cliff Stearns’ proposal (and the rest of congress’s discussion-free acceptance of said) to vet 9/11 first responders against the terrorist watch list before providing them with the health care assistance due to them under the only recently enacted Zadroga bill — which took a mere 10 years to pass in the first place. (death + taxes has a characteristically sensible review of the episode and subject matter.)

Now fast forward to today and the AP’s sadly unshocking report that “More than 200 people suspected of ties to terrorism bought guns in the U.S. last year legally, FBI figures show.”

And how is that possible? Well, obviously because “It is not illegal for people listed on the government’s terror watch list to buy weapons.”

So to recap: 9/11 first responders who rushed into burning, collapsing skyscrapers and/or spent months and years of their life at ground zero inhaling poisons and other biologically destructive elements in an effort to find bodies and remove rubble are still dying or bankrupting themselves without a scintilla of assistance from the federal government, but if they want to go out and buy a handgun to, say, hold up a liquor store to pay for their chemo or simply to blow their brains out before their life comes to a slow, painful end? Well, have at it sirs and madams! And by the way: you’re welcome.

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