Category Archives: Medicine

Let’s Stop Fixin’ Stuff and Create Some New Systems

It’s Bill Maher, so you know he’s going to be using some crude language. But this is worth watching in spite of it.

I really wish he wouldn’t use the kind of language he uses, because I like him very much otherwise. But we live in a free country. (Well, at least in theory.) So he can say whatever he wants to on his own show.

My problem is that I have to decide whether a particular video is important enough to post it on MY BLOG in spite of the language. Usually it’s not, but I think this one is.

Bill Maher is exactly right when commenting on the state of our country.

Skeptical, Evidence Based Thinking

Be skeptical, not cynical

According to George Hrab, being skeptical — as opposed to being cynical or denialist — is a good thing. Doubts and reservations are the backbone of science and reason and have led to some of humanity’s greatest achievements.

He is a musician, a comedian, a storyteller, and a skeptic. He has written and produced seven independent CDs and one concert DVD; published two books; recorded hundreds of episodes of an award winning podcast; and has emceed numerous international science conferences, all while being the drummer for The Philadelphia Funk Authority. He’s travelled to four continents promoting critical thinking, science, and skepticism through story and song.

He says he is considered one of the preeminent skeptic/science/atheist/geek-culture music icons currently living in his apartment. (Whaaaat? Yup, that’s what he says.)

For about the first four minutes of this talk, he discusses Jenny McArthy and the anti-vaccine movement she helped to found. She popularized a fraudulent 1998 study that claimed to link the MMR vaccines most children are required to get with autism.

Jenny McCarthy - not very skeptical
Photo by planetc1

She even claimed her own son got autism from the shots, but Hrab points out that what he actually had was something else with no connection to the shots and that he is doing well now, a few years later.

The study was later withdrawn by the scientific journal that published it and the researcher lost his right to practice medicine, because of his fraudulent and unethical methodologies. Many studies done since have shown no link between the vaccinations and autism, but it is difficult to undo the harm that was done by believing bad science non skeptically.

He points out that Jenny McCarthy is not a bad person. She just isn’t very skeptical, so she drew wrong, harmful conclusions.

  • He advocates evidence based thinking and embracing your doubt.
  • When you hear a new piece of information, say, “Whaaaaat?”
  • “Every time you look on the Web,” he says, “Every time you receive a piece of email … pretend it’s April 1st.” April Fool’s Day. You don’t want to be the fool. Don’t assume everything is wrong; just check the evidence. If there’s no evidence, then don’t hesitate to doubt. Be skeptical.
  • Don’t be afraid to doubt. Doubt drives the engine of science.

Everybody should be skeptical

“Everyone is susceptible,” he says. Sir Arthur Conan Doyle, who wrote Sherlock Holmes, believed in fairies in the garden. Little flying girls with butterfly wings. The only way to avoid believing a lot of nonsense is to be skeptical.

“Most important,” he says, “Don’t take my word for it.”


Sources”

Pain Pump Posting Hiatus

Synchromed pain pumpI apologize for the hiatus in posting. I can only blame it on the minor surgery I had Monday, November 2. All went well, as expected; but I haven’t been able to bring myself to do much useful work yet.

I’ve mentioned my chronic pain before, but I’m not sure if I’ve mentioned my “pain pump” or not.

I have chronic pain in several forms, and I’ve had it for more than 60 years. The two worst causes right now are my severe psoriatic arthritis and my sometimes excruciating peripheral neuropathy. In addition, I still have an occasional migraine, although I seem to have mostly “outgrown” those in my mid-40s. Before that, I had suffered migraine headaches every day for more than 20 years and less often even before that. The first one I remember, I was five years old; and I thought the left side of my face was rotting off for two days!

Since there is no known cure for either psoriatic arthritis or neuropathy, I use a variety of methods to control the pain. Probably the most effective way is by using a “pain pump” implanted under the skin of my lower right back. It pumps a tiny — but constant — amount of opioid liquid to my spinal fluid 24 hours a day, and can be adjusted by using a magnetic controller in my doctor’s office.

The pump holds up to 40 ml (about an ounce and a half) of a dilute liquid, which lasts for several months. When it runs low, it can be refilled over and over again by sticking a needle through my skin and into a diaphragm in the pump. About every five years, when the battery runs low, the entire unit is replaced.

No big deal. Really.

I got to the hospital about 8 am. Something caused the doctor to run late, but that was no problem to me. I was prepared. I spent the time reading a good science book on my iPhone. An anesthesiologist came for me about 11:00. He slipped a mask over my face and told me, “Just relax now and breathe deeply.” I remember taking about three breaths. The next thing I knew, I was in another room on another table, and somebody was telling me to wake up. By about 1:00 pm, I was on my way home.

While I was asleep, they rolled me over on my stomach, made a small incision in my skin, removed the cigarette-box-sized-but-round old pump, inserted a new pump just like it into the same spot, hooked it up to the tubes already in place from last time, made sure it was working, and glued my skin back together. I had a strip of clear, waterproof tape for a bandage.

I’ve had no increased pain from the surgery, and I’ve needed no additional help at home. It was by far the easiest operation I’ve ever had. So maybe it’s just making excuses to blame the posting hiatus on that. I dunno, but I’m gonna do it anyway. Wouldn’t you?

I’ve written this not only to make excuses, but also to inform others who might be suffering. Chronic pain is a terrible and very common problem among older people, and even among many younger ones. Pain is supposed to serve a purpose, but chronic pain serves none. It just hurts and hurts and hurts and it seems like there’s nothing you can do about it and sometimes you almost want to die.

Almost.

My medicine doesn’t take all the pain away, but it helps. It takes the edge off  and makes the remaining pain bearable. Sometimes, it almost goes away for a while.

My first pain pump 12 years ago

I resisted getting a pain pump for many years, until one of the best doctors I have ever known told me there was nothing else he could do for me. He had recommended a pain pump before, and he recommended a pain pump again. I saw two different “pain doctors,” and they both recommended installing a pain pump. So I had a pain pump installed. The relief was both quick and wonderful. For a long time, I told people I hurt less than I had hurt for 50 years.

It has never done the whole job. I still have to take pills. And I still hurt sometimes. But it helps so much I only wish I had gotten my first pain pump many years earlier.

I’m not a doctor, and I certainly don’t give medical advice. I only post this here in the hope that it will provide information that might help somebody else.


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Black Death Still Lives

Two new “black death” patients.

Black rat, Rattus rattusFor the second time this summer, health officials in California are investigating a case of plague that a camper most likely contracted while visiting Yosemite National Park.

The Centers for Disease Control and Prevention is testing a visitor from Georgia who camped at Yosemite, the Sierra National Forest and the surrounding areas in early August. Two campgrounds were closed after another case was announced two weeks ago. Since then the authorities have been warning visitors of possible plague risks.

New York Times
August 19,2015

Plague, also known as “bubonic plague,”  “black plague,” “black death,” and several other appellations, wiped out at least a third of the population of Europe in the 14th century — some historians estimate as high as two thirds — and also very large numbers of people several other times and places. Before entering Europe this time, it had ravaged China, India, and areas along the trade routes of the East.

The same germ had also been responsible for the Plague of Justinian that killed an estimated 25 million people in Europe in 541–542 A.D. and maybe that many more over the next two centuries. It came to Europe and spread there in the blood of the ironically named black rat (pictured above).

The Black Death arrived in Europe by sea in October 1347 when 12 Genoese trading ships docked at the Sicilian port of Messina after a long journey through the Black Sea. The people who gathered on the docks to greet the ships were met with a horrifying surprise: Most of the sailors aboard the ships were dead, and those who were still alive were gravely ill. They were overcome with fever, unable to keep food down and delirious from pain. Strangest of all, they were covered in mysterious black boils that oozed blood and pus and gave their illness its name: the “Black Death.” The Sicilian authorities hastily ordered the fleet of “death ships” out of the harbor, but it was too late: Over the next five years, the mysterious Black Death would kill more than 20 million people in Europe–almost one-third of the continent’s population.

History.com

It’s rare among humans now, but it survives in rodent populations in the southwestern United States and elsewhere. The rodents are generally immune to it, but their fleas are not. Fleas ingest the bacteria and become infected when they drink the blood of an infected animal. The bacteria actually multiply in the flea’s gut until they clog up its digestive system and make it vomit when it bites another animal and tries to feed again. It regurgitates infected saliva and blood into the new animal, passing the infection to it. Occasionally, humans gets infected this way.

Yersinia pestis bacterium causes black death.

The disease is caused by the Yersinia pestis bacterium, which can also cause “pneumonic plague” or “septicemic plague.” The difference between the three forms depends only where the infection exists in the body, but that difference is important.

Pneumonic plague, a severe type of lung infection, is one of three main forms of plague, all of which are caused by the bacterium Yersinia pestis. It is more virulent and rarer than bubonic plague. The difference between the versions of plague is simply the location of the infection in the body; the bubonic plague is an infection of the lymphatic system, the pneumonic plague is an infection of the respiratory system, and the septicemic plague is an infection in the blood stream.

Wikipedia

Three forms of the disease

An untreated Yersinia pestis infection in the lymph nodes, the bubonic form, may be fatal in humans around 30% of the time.  An untreated infection in the lungs, the pneumonic form, is not only more likely to be fatal, but is also more contagious; it is spread through the air when the patient coughs, like the flu is. The untreated septicemic form, in the blood, is fatal in 99% to 100% of patients. However, this form is rare.

The bubonic form is usually caught from the bite of an infected flea. Only rarely does this become one of the other forms. However, in those rare cases when the infection does settle in the lungs (possibly because of a prior lung infection), then it becomes pneumonic and spreads through the air to the lungs of other people. In this form, it can wipe out a whole family in a week.

“In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.” Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms–fever, chills, vomiting, diarrhea, terrible aches and pains–and then, in short order, death.

History.com

Patients with all forms of this disease usually recover if treated soon enough with antibiotics. Probably the worst danger from black death now is that it’s so rare it’s not always identified in time for treatment to work.

There are a series of short videos on the subject here, where you can learn more than you ever wanted to know about the black death in about 26 minutes total. But be warned, they are gruesome.

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MERS Virus

MERS virus in camel cellA few days ago, I posted a picture of a bunch of MERS viruses–more specifically known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV)–attacking a monkey cell. Here’s a similar picture from the current Science News of MERS viruses attacking a cluster of camel cells. To my untrained eyes, it looks like a much lighter infection.

When I posted the previous picture, I mentioned that South Korea had closed schools and canceled public events to stop the outbreak there from becoming a pandemic. At that time, 30 people were known to be infected including one who had travelled to China. 1,369 people were under quarantine in South Korea.

As of July 27, there have been 186 known infections between South Korea and China, and 36 patients have died.

This is another viral disease, like ebola and AIDS and flu and colds. Like the other viral diseases, it does not respond to antibiotics. There is no known cure for it and no vaccine to prevent it. It apparently travels through the air on tiny droplets of spittle when somebody coughs or sneezes, the same way flu and cold viruses do.

All that currently can be done for patients is to treat the symptoms and hope their immune systems eventually defeat the infections. It works in about 60% to 70% of patients. The other 30% to 40% die.

In May of this year, two healthcare workers arrived in the United States from different cities in Saudi Arabia. Both had travelled through England. Within days after arrival in the US, they were both sick with MERS, apparently having been infected in Saudi Arabia. Both were hospitalized and treated and released a few days later. No other cases of MERS have been found in the United States….yet.

The good news now is that a protein has been found in the blood of a recovered patient that seems to latch onto the virus and prevent it from infecting cells. In mice, it has dramatically reduced infection in as little as three days. It will take time, but this protein may become the basis for a vaccine to prevent the disease or a treatment for people who get it. Maybe both.

But the pharmaceutical industry works slowly, as it must. Development and testing take a long time. Such a vaccine or drug will not become available in time to help with this current outbreak.

A free 2-page information sheet about MERS is available from the Center for Disease Control and Prevention here.

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Sophia Tabors: 10-year-old Science Fair Hero

Sophia TaborsWhen smart kids speak, pay attention. Sophia Tabors’ mother did.

Ten-year-old Sophia Tabors saw her grandpa drop a bag of apples and asked him if he was OK. He said something, but she couldn’t understand it. Then she noticed one side of his face was sagging, and she knew. Her grandpa was having a stroke!

How did this fourth-grade girl know what was happening to her grandpa?

“My other grandpa had a stroke and during that stroke I’m like, ‘Well it’d be interesting to find out why strokes happen and what causes them,’” she said. So she did. Sophia learned all she could about strokes and turned what she learned into a prize-winning science fair project. Even though one teacher told her this wasn’t a good subject for a science fair, she took a second-place ribbon anyway.

It was only two months later that she was at the grocery store with her mother and her other grandpa, and she realized this grandfather was also having a stroke. “He dropped a bag of apples,” she said. “He was staring at it and I was trying to ask him if he was okay. He was saying something, but I didn’t get it and his face was droopy on one side…I told my mom what was happening and she called 911.”

Her grandfather’s doctor credits her with saving his life, as well as physical abilities. “I have no doubt she saved a lot of his functions and probably his life too,” Dr. Alshekhlee said.

Sophia’s grandpa is recovering well now, largely because she was prepared and alert.

Well done, Sophia. Very well done indeed. We are all proud of you. The report says you love reading and learning and science. I hope you’ll keep on reading and learning all you can. People say “curiosity killed the cat,” but that’s nonsense. Curiosity is good. Very few things are as satisfying as learning, and you never know when something you’ve learned will save somebody’s life again. Or be useful in some other way.

You referred to yourself as a bookworm. This is great! Be sure to finish your education, but also learn all you can on your own. Good books, science magazines, and the internet make this easier than it has ever been before.

Since you’re interested, think about studying some branch of science.  You’d make a great scientist!

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D. medinensis: Dragon Worms in Your Body

I have to agree with this one. Some extinctions might be OK. The extinction of Dracunculus medinensis, the “dragon worm,” also known as the guinea worm, is one example.

D. medinensis is almost extinct now.

Unlike smallpox, which the UN World Health Organization wiped out in 1977, the Guinea worm (D. medinensis) has been driven almost to extinction by the efforts of former President Carter and his Carter Center. The Carter Center is a non-governmental organization.

The disease is caused by the female which, at up to 800 mm (31 in) in length, is among the longest nematodes infecting humans. In contrast, the longest recorded male Guinea worm is only 40 mm (1.6 in).

Wikipedia

The Dracunculus medinensis life cycle starts when somebody drinks water contaminated with tiny, almost invisible crustaceans known as copepods–Anna Rothschild called them “water fleas”–that have been infected with larval guinea worms. Once swallowed by a human, the copepod is digested, but the larval worms inside it live on and infect the human.

D. medinensis larvae
D. medinensis larvae

After the D. medinensis larvae are released, they migrate through the intestinal wall into the abdominal cavity, where they mature and mate. No wonder people get sick, with playful 31-inch worms crawling around inside their bellies.

When the appropriate time comes, the pregnant female worm eats her way through subcutaneous tissues, usually until she reaches an ankle, where she releases just a few larvae at first. These produce a blister on the skin that itches so badly that people usually put their feet in water to relieve the itching, whereupon she releases the rest of them into  the water to infect the resident copepods and start the cycle all over again.

The female guinea worm slowly starts to come out a little way from the host’s skin after the blister ruptures, and patients keep their feet under water to encourage her to emerge enough so they can very gently get hold of her and begin winding her around a piece of gauze, if available. More commonly, they use a small stick. They wind her very gently, so as not to break her. If they break part of her body off, the rest will stay inside and die and rot and cause serious infection. Complete extraction usually takes several days.

Winding the worm around the stick this way is thought by some to be the source of the Rod of Asclepius, the symbol of medicine.

Ex-President Jimmy Carter and his Carter Center, working with the US Centers for Disease Control and Prevention and the UN World Health Organization, began a program in the 1980s to eradicate D. medinensis. In 1986, 20 countries were affected by the worms.

The program included educating people in the affected areas to know that the disease was caused by drinking contaminated water, isolating and supporting sufferers, distributing filters for drinking water, and educating people about using them.

As of this year, D. medinensis has been reported to be almost extinct.

This is surely a very good thing, and I admire President Carter and his Carter Center tremendously for their work.

A caution

Nevertheless, this is tampering with nature. I wonder whether or not anybody knows what the effects will be? Have there been environmental studies? Do we know what water creatures may prey on the larvae that we may starve into extinction by robbing them of their food? We know the copepods do, and they may not be the only thing. Besides, what eats the copepods that may also starve if we starve the copepods? All I’m saying is that it’s complicated. Everything in nature is, and somebody probably ought to look at it. Maybe somebody did and I’m just not finding it.

On the other hand, it seems like very minor tampering compared to what we do all the time. I’m not suggesting we stop preventing infections. I’m just suggesting that next time we start to deliberately drive an organism extinct, maybe we ought to do a study while we’re getting started. Just in case.

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Note: August 21, 2015 – I just heard President Carter say (on a video) that when he started his eradication program, there were 3.6 million cases of guinea worm and now we are down to 11 cases. He has recently had a cancer removed from his liver and he still has four melanomas in his brain, but he hopes the last guinea worm will die before he does. The video is here.

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Jerry Coyne on Faith Healing

Denying children vaccines just one part of the problem

Jerry Coyne at The Amazing Meeting 2013
Jerry Coyne at The Amazing Meeting 2013

But denying children potentially life-saving vaccines is just one part of the problem; I’d like to eliminate even more exemptions: those now enshrined in many laws permitting religious parents to withhold scientific medical care from their children in favor of faith healing.

Professor Jerry Coyne

A couple of days ago I discussed briefly Dr. Jerry Coyne’s new book Faith vs Fact. Yesterday he published an article in Slate, in which he made the statement above. I very strongly agree with it.

As you can guess from his picture, Coyne is an outspoken man. As a biologist, he is intimately familiar with both health and disease. He promotes vaccines to prevent diseases. He believes American children should be required to have their vaccines before starting to school, with no exception except for medical reasons. Personal philosophy or religion, he says, should not be an excuse for endangering the public health.

Jerry Coyne says it’s time to eliminate religious exemptions from medical care for children

Forty-eight states—all except West Virginia and Mississippi—allow religious exemptions from vaccination. (California would be the third exception if its bill becomes law.) A similar deference to religion applies to all medical care for children. As the National District Attorneys Association reports, 43 states give some kind of criminal or civil immunity to parents who injure their children by withholding medical care on religious grounds.

According to Coyne,

Some states allow religious exemptions from required testing of newborns for metabolic disorders, such as the inability to break down fats or amino acids, that can kill an untreated child but are perfectly treatable if caught early.

To illustrate his point, Dr. Coyne tells of a teenage girl who needed medical help for “fainting spells.” Her father refused to get her to a doctor, so she asked teachers for help. Apparently getting no help from her teachers either, she ran away from home; but she was found and returned to her father. Three days later she died from a ruptured appendix.

Many of the same states also allow exemptions from giving newborns hearing tests, eye drops to prevent blindness from herpes infections, testing children for lead levels in their blood, and even “learning about disease in school.”

In perhaps the most bizarre and potentially dangerous law, public school teachers in California can legally refuse to be tested for tuberculosis on religious grounds.

Christian scientists, Scientologists, faith healers, and little fundamentalist cults scattered all over the place are protected by these laws, while their children sometime die in agony. This is not right, and should not be permitted in any civilized country.

Infants and people who cannot have vaccinations because of medical reasons are put at risk by those who refuse to have them (or let their children have them) because of their superstitions, both religious and otherwise. Coyne discusses these problems at length in his new book.

Vaccinations should be required in all states; and children should be protected from parents who refuse them necessary medical treatment on ANY grounds and let them die or suffer from untreated cancer, diabetes, or other disease.

Parents do not own their children, and parental rights are not infinite. A parent may make his or her own decisions about healthcare, but he or she must not be permitted to make such decisions for a child and let the child suffer or die without effective medical treatment because of the parent’s religion or philosophy. Evening cases where a child himself refuses medical treatment for religious reasons, it must be remembered that a child cannot make mature decisions; and a court should determine whether or not the treatments continued. Religion or other superstitions should not be a factor.

See also Dr. Coyne’s recent article in The Scientist.

Source: http://www.the-scientist.com/?articles.view/articleNo/42938/title/Opinion–Science—Religion–A-Centuries-old-War-Rages-On/http://www.slate.com/articles/health_and_science/medical_examiner/2015/05/religious_exemptions_from_medical_care_faith_healing_kills_children.html

Long Overdue Marijuana Bill

Marijuana
Marijuana

Senators Kirsten Gillibrand, Cory Booker, and Rand Paul announce a new medical marijuana bill at the US Capitol on March 10, 2015 in Washington, D.C. This is a step that is long overdue.

For decades federal law has simply declared that Marijuana is a medically useless and dangerous plant and sought to eradicate it, even where it grows wild. Medical researchers have been all but forbidden to even check to see if it has any true medicinal properties.

In recent years, several states have legalized the plant for medical purposes, but users there were still in danger of arrest and prosecution by federal authorities. Even this semi-legal medical use relies mostly on anecdote, rather than research to determine need, dosage, etc.because the federal government and many states have hindered research.

Senators Kirsten Gillibrand, Cory Booker (L), and Rand Paul
Senators Kirsten Gillibrand, Cory Booker (L), and Rand Paul

This bill needs to be passed so people with glaucoma, cancer, chronic pain, and many other diseases and conditions can safely benefit from the drug. If it were legal, I myself would have tried it long ago in an attempt to seek relief from my own chronic pain. Because of federal and state laws, I never have been able to.

Of course, even if this becomes federal law, state law here in Texas may still prevent my trying it.

Get Your Vaccines

Only vaccines wiped out smallpox, the terrible disease that previously killed so many millions of people every year.

Only vaccines have more recently wiped out polio — that horrible, crippling, maiming, killing disease from my own childhood that put thousands of Americans in “iron lungs” because they couldn’t even breathe — from the United States and most of the rest of the world. (Only fear of the vaccinations has permitted polio to still exist in about half-a-dozen third-world countries. And, of course, fear of the vaccines permits the disease to spread back into the rest of the world from time to time. So, for now, we still have to vaccinate against a disease that should have been extinct for more than a decade.)

Some other diseases — like flu, for example — we’ll probably never be able to eradicate. But annual flu vaccines can prevent most of the 26,000 flu-related deaths that occur in the United States alone every year.

I know I’ve said it before, but it’s important. Get your vaccines.

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