31.5.05

"Med-Mal"?

"Med-Mal fears have doctors on the defensive, study says"

Forgive me, please, but this headline from the Pittsburgh Business Times makes me wonder who funded a study to point out the obvious. Of course you're going to be defensive... In this country, doctors have become the equivalent of wounded antelope in a land populated heavily by hyenas. (<--- i won't dignify that breed of self-serving "human" by calling them lions) Innocent doctors are preyed upon by opportunistic parasites.

Of course there are doctors who deserve to be strung up by their thumbs. In my opinion, though, healthcare professionals need to do a better job of policing their own-- how can judges and juries of totally uneducated people be expected to make fair decisions in these cases?

Our society is all together too litigious- People act as though medical malpractice suits are a unique crisis, when in fact there are many other groups facing similar crises. Private citizens, real-estate and property owners, landlords, even branches of the government. This litigiousness is symptomatic of societal decay. We are drowning by inches in Narcissus' pool.






Oh, and...... Where I come from, it's just called CYA medicine, not what the Pittsburgh writer gently terms as "defensive medicine".

25.5.05

ten things

Dreaming Again has tagged me to share 10 things I've never done. I am going to take a little bit of a different approach to it, though, to make it more fun. (at least for me, that is. ;)

So it'll be more like... 10 (possibly obscure) things I've never done, but would like to do.

1...I have never walked the Camino de Santiago (de Campostela), an ancient European pilgrimage route. The majority of modern pilgrims begin their journey in the Pyrenees, at Saint-Jean-Pied-de-Port, or at Roncesvalles. Some Europeans even set out from their homes. They walk (other means of transportation are used, but generally not considered legit) across northern Spain, about 425-450 miles, to Finisterra: the end of the earth.

2...I have never taught my cat how to use the toilet. Link to an article about a soon-to-be-marketed toilet-training system for felines, thanks to an inventive woman in Australia.

3...I have never seen a bluebird. They do not typically venture into my part of the world, and I've never been lucky enough to see one elsewhere.

my brain is too tired to finish this tonight, but i feel the need to post something, so here is my pathetic, unfinished attempt. i shall edit and complete it soon.

23.5.05

the good idea

My father's hands began to shake a number of years ago. [He attributes it to CO poisoning from his VW Beetle, which could be true given what CO does to the basal ganglia.] At first it was just a little tremor, a minor shaking in his hands. Over the past handful of years, the tremor has become more severe and much more noticeable. He has difficulty writing, and it's not just his hands now- His arms tremble constantly, even when he is at rest. He worries quietly sometimes that it will go beyond his arms.

The only other health problem Dad has is mild hypertension. About a year ago, he became dissatisfied with the medication he was on to control his blood pressure... Knowing that he planned to see his rather uncreative physician about some alternatives, I armed myself with information and sprung an "attack" on Dad.

Me: So you're going to see Dr. Doe about your BP, huh?
Dad: Mm-hm.
Me: Have you ever talked to him about your tremor?
Dad: Oh, sort of. He doesn't have much to say.
Me: Welll, as long as you're going in maybe you could show him this article from the NEJM. It's about treating essential tremor with propranolol, which also happens to be a BP med. Maybe you could kill two birds with one stone? Wouldn't that be cool, to actually do something about the tremor? Since you need a BP med anyway?

Dad was intrigued and hopeful at the idea, took the article to his doctor, and started taking generic propranolol. It helped lower his BP and also significantly improved the tremor. After a while, though, he noted that the benefits of the propranolol began to wear off as the day went on. His doctor shrugged it off... So I suggested before his next appointment that he ask about taking Inderal LA, which is a sustained release form of propranolol. So he asked, and Dr. Doe wrote a new prescription for Inderal LA.

The tremor is still there, and still bothersome, but the propranolol makes a noticeable difference. You might say it "takes the edge off" the tremor. [Obviously a tremor is minor in comparison to, say, a ballooning aneurysm- But it is an embarassing and frustrating ailment, too often trivialized by those who don't take the time to consider its far-reaching ramifications...]

Cool story, right? I am telling it not for my role in it, however, but because of a bigger issue- I often wonder what would happen to someone else in the same situation. What if a poor immigrant who spoke little English and had little medical knowledge had gone to Dr. Doe with the same problems as my father? Would the immigrant have received treatment for his tremor? Would my father, even, have gotten treatment had I not been involved?

Why wasn't my father's MD coming up with this idea himself? Why was he so willing to ignore a tremor when there are fairly safe, inexpensive ways of treating it? And then so complacent about his failure later.

How many patients, every day, are losing out simply because they don't know what to ask for?(NOT as in asking for a pill just because they saw the TV ad... which is another rant all by itself) Of course, the patient bears a responsibility to participate in their care, insofar as they are capable. It is the physician's responsibility to make up for the gap created by the differing capabilities of patients to participate in their own care. Why do they so frequently, as in my father's case, fall short? [My intent is not at all to villainize physicians- I owe my life to the medical profession- These are merely my thoughts, raw. I hope they come across as intended.]

One would like to think that all patients are treated equally, but in reality my father's story illustrates what I see as a looming cloud over the medical profession; a lack of quality-control, if you will. How do we remedy such a situation? Where are the legions of patients and doctors who should be willing to improve the situation, at a time when physicians seem to be a threatened breed? Perhaps if we could recognize and respect each others' roles, our healthcare system would not be nearing (or already in) crisis in so many ways.

i'll have to edit later... you know it's time to quit staring at the computer when your eyes start crossing from exhaustion.

18.5.05

"baby" names



My new kitty cat, Eéva. (finnish pronunciation :)
Adopted from the local animal shelter, Eéva was a stray. She's only about 8 or 12 months old, but bears all the signs of recently having had kittens. She's a bit traumatized-- first she was separated from her kittens and stuck in a tiny cage at the pound. Then she went to the vet to be spayed and get some vaccinations. She had an allergic reaction to one of the medications she was given...

She finally came home with me yesterday, and seems to be doing okay physically. Unfortunately she's terrified of the dog, Hershey, but I am hoping that will change over time. For now I am just keeping them apart. ([The dog is curious, not at all hostile, but it will take a while for Eéva to realize that. Hershey is 1/2 black lab, 1/2 golden retriever, 8 years old, and wouldn't hurt a fly.])



Some of the names I considered for my new friend:

Ronat (means seal in Welsh)
Indra (after the rain god)
Portia (think Shakespeare)
Astrid

Guess I could still change it... but Eéva seems best thus far.

mandatory naptime, feline and human, right now!

5.5.05

good weed?



Medical marijuana (link to Wikipedia) is such a complicated and huge topic, it's difficult to know where to begin. For starters: marijuana refers to any of the several Cannabis species, and some of their hybrids.

The marijuana plant contains many chemicals which are possibly psychoactive. Scientific knowledge of many of these cannabinoids is somewhat lacking, however. The principle active chemical in marijuana is delta-9-tetrahydrocannabinol, usually called THC. Cannabidiol, or CBD, has also been shown to play a role in the "high" associated with cannabis use.

In the United States, synthetic THC is available as the prescription drug Marinol. This is generally prescribed to quell severe nausea in cancer patients on chemotherapy, and to treat the "wasting syndrome" associated with AIDS.
One might wonder why, if we have Marinol, anyone would fight for the right to use marijuana. But Marinol contains only one of the hundreds of chemicals found in marijuana - A point often raised by supporters of medical marijuana. Many argue that THC alone is not as effective as the whole plant. Unfortunately, federal policies in the U.S. make it difficult to research the efficacy of marijuana versus THC alone.

A new drug, Sativex, an extract of Cannabis sativa, was recently approved in Canada for treatment of neuropathic pain associated with multiple sclerosis-- an approval that has provoked intense reactions on both sides of the medical marijuana debate.
For years, many MS sufferers have resorted to smoking marijuana when prescription medicines are inadequate. The introduction of Sativex provides a legal, regulated alternative to the harsh smoke.

I decided to write this entry after hearing a very short segment of a popular Conservative radio show yesterday... Michael Savage was, in his usual venomous tone, airing his ignorance. He claimed, among other things, that there are no legitimate uses for marijuana. He also said that those who fight for the right to use marijuana for medical purposes are really just looking to get high.

He was so hate-filled and malicious that I couldn't stand to listen to his vitriol for long. I know, without a shadow of a doubt, that there are people out there who truly can benefit from the use of marijuana. To attack them and undermine their cause is despicable.

Was Peter McWilliams "only" looking to get high? This courageous, intelligent man stood up for a cause, and was mowed down by a federal judge. Mr. McWilliams had AIDS and cancer... For some time, he was unable to keep down his medications due to extreme nausea. Marinol and other anti-emetics didn't do the trick. Mr. McWilliams lived in California, where state law (Prop. 215) permits the use of medical marijuana. So he tried it, and it worked. He was able to keep down his AIDS medications, and his viral load plummeted. He was able to live a much more normal life, until the feds got involved. The charges brought against McWilliams were a farce, and many believe his prosecution was politically motivated. He was forced to plead guilty to the charges in order to avoid a mandatory sentence of 10 years' jail time. His mother and sister put up their homes as bond for him-- While out on parole, he was forced to submit to a urine test every couple of days. If he were to test positive for marijuana, his mother and sister would lose their homes.

Peter McWilliams died June 14, 2000. He was found at home in an upstairs bathroom, having choked to death on his own vomit. He was 50 years old. His crime, apparently, was that of fighting to stay alive.



This entry is only the tip of the iceberg, unfortunately. There is so much more to the issue than what I've presented here. I urge you, if you haven't already, to educate yourself on this. Sorry if the entry is a bit choppy/ not cohesive.. My brain doesn't always work quite the way I'd like it to. :)