July 31, 2014

Drug Studies MUST Include Seniors

I was pleased to see a recent op-ed piece in the New York Times -- "You’re Never Too Old to Be Studied" -- that made an important plea: Include seniors regularly in tests for drugs and medical devices.

How do we know that seniors are under-represented in clinical tests? In 2007, the Journal of the American Medical Association reviewed randomized controlled trials conducted between 1994 and 2006, and discovered that about 40 percent of those studies completely excluded people over 65 years of age.

The authors of the New York Times piece – Donna Zulman and Keith Humphreys – reminded readers that Americans 65 and up now represent about 13 percent of our population.  By 2030, that percentage will reach 20 – one in five Americans.

How can doctors confidently prescribe a course of action for such a big chunk of their patients when that group has essentially been excluded from the very tests designed to help healthcare professionals determine and recommend a medical plan?

Excluding seniors from these important tests has been a mistake… a misstep – thankfully – that can and should be corrected.

Women, Too
The same foolish under-representation has applied to women, too.  Only in 1993 – hard to believe, just 21 years ago --  did the National Institutes of Health (NIH) begin requiring studies to include women. Just two months ago, the NIH urged study leaders to include more female lab animals in their research… another step in the right direction.

As we’ve seen with women, seniors often need different treatments – and certainly reduced drug dosages – than the healthy younger patients who swell the study ranks. Like women, seniors usually weigh less than those younger study subjects. Seniors typically have reduced liver and kidney function, and therefore process medications differently. As a result, seniors are more likely to experience adverse reactions – dizziness, drowsiness, depression… or worse – than their younger cohorts.

In the past, study leaders have excluded seniors for some of those very reasons, citing the complex health issues they thought created ethical or practical problems for their studies.

But, as Zulman and Humphreys write, “Advanced age is not a reliable proxy for poor health.” Excluding any group of people from studies must not be based on age alone.

July 30, 2014

More Chronic Conditions = Fewer Years on Earth

Researchers from Johns Hopkins Bloomberg School of Public Health recently published this piece of news: the more chronic diseases you have, the shorter your life expectancy.

According to senior study author Gerard Anderson, a professor in the Department of Health Policy and Management at Johns Hopkins: "When you’re getting sicker and sicker, the body’s ability to handle illness deteriorates and that compounds. Once you have multiple conditions, your life expectancy becomes much shorter.”

By itself, that news isn’t all that surprising; people with a combination of illnesses are more likely to die before their healthy neighbors.

But here’s where the news gets more troubling. Compared to people in other developed countries, Americans already have a so-so life expectancy (#35 on the list, according to the World Health Organization's 2013 rankings, shown below). Now, those Hopkins researchers report that the life expectancy for Americans – which has been rising by about .1 years each year – is not maintaining that steady growth. Unlike citizens in other developed nations, Americans now have a decelerating life expectancy.

The Danger of Multiple Chronic Diseases
Why? Americans are developing more and more health problems. In fact, the Hopkins study reports that a whopping 80 percent of all Americans over 67 have multiple chronic illnesses. 

While we can boast about hospital quality here, the American healthcare system – by far the most expensive per capita in the world – doesn’t meaningfully serve the same high percentage of residents that we see in other developed countries. 

At the end of the day, it boils down to this: Americans don't choose wisely when it comes to the Holy Grail of wellness: diet and exercise.

The likely culprit in America is our obesity epidemic. Three of most common chronic diseases in America -- heart disease, high blood pressure, and diabetes – are all conditions that find accommodating hosts in obese people.

July 29, 2014

The Benefits of Saying "I Don't Know" in Business... and Medicine

A few months ago, a friend said he liked it when people answered questions with “I don’t know.” He thought the response was all too rare, that it showed strength – not weakness, that it showed wisdom – not ignorance, and that it encouraged dialogue, engagement, exploration. 

He said he feels like running for the hills when in the company of people who are sure about everything (even the big questions that don’t – and can’t -- have answers) and who rarely miss the opportunity to pontificate on their positions.

No, there’s nothing wrong with having clear, well-reasoned opinions on all the important topics of the day. Still, I understood my friend’s comments.

Soon after, I saw an article by ad man Curt Hanke on the business site Inc.com. The title? “The Power of ‘I Don’t Know.’”

Hanke began by citing a 2012 IBM study of companies’ chief marketing officers. When these executives were asked if they were prepared for all the unpredictable complexities and changes coming their way over the next five years, 52 percent of the CMOs said “no, I do not feel prepared.”

The author wasn’t surprised that so many executives acknowledged uncertainty about all the mysterious and unknowable developments that lay ahead for their industry. Instead, he was amazed that so many – 48 percent – felt prepared. Did they really feel prepared? Was their positive response driven by bravado – or the deadly fear of appearing weak – as much as anything else? Were they simply unable to say “I don’t know”?

In his essay, Hanke described four benefits that come to leaders when they say “I don’t know.”

July 28, 2014

Bergen, Norway: "It's Only a 10-Minute Walk." Yeah, Right.

In the past, I'd land in a new city and charge around trying to fill the day with as many new sights and experiences as possible. That was then.

My day last week in Bergen, Norway -- where the ship docked for ten hours -- showed me just how things have changed... and how this 85-year-old has adapted.

Avoiding my typical long list of must-do's, I narrowed the agenda this time to a stroll through the popular harbor Fish Market, and the funicular ride to the top of Fløyen mountain, one of Norway's most popular attractions. By 10:30am -- after a leisurely breakfast -- I was ready to go.

My two travel mates, concerned about my touring alone, said they'd be happy to accompany me, and at my own pace. I appreciated the offer, but knew I'd hold them back. I also knew I'd end up hurrying and pushing myself, not wanting to slow them down too much. It was a discussion we had quite a few times through the trip.

So, off I went on my own.

The First "Ten-Minute" Walk
Before I disembarked, I asked a ship staffer how long it would take to walk to the waterfront. The answer: "Just about ten minutes."

Here's the view as I left the ship and headed for town: shade on the left, sun on the right. I chose the the shady side of the street.

Why the shady side? Recently, when I've exerted myself in midday heat and humidity, I've often experienced a reaction not uncommon among Parkinsonians: orthostatic hypotension, a sudden drop in blood pressure typically caused by standing up. During these scary events, my systolic number often drops below 100.

July 25, 2014

Another Love: Helen Mirren

Dame Helen Mirren is certainly different from my last week's love, Billie Holiday. I was happy to see an interview with the actress in a recent edition of "AARP the Magazine."

Can you believe she's 68 years old?

During her 45-year career, she has portrayed three British queens in different films and television series: Elizabeth I in the television series Elizabeth I (2005), for which she received an Emmy and a Golden Globe Award for Best Actress; Elizabeth II in The Queen (2006), which won her an Oscar and the BAFTA Award for Best Actress; and Charlotte of Mecklenburg-Strelitz in The Madness of King George (1994), for which she earned an Academy Award nomination for Best Supporting Actress. She is the only actress to portray both Queens Elizabeth on the screen.

To be sure, she's one of the world's great actresses. But she is also a bright and fun dame who has been outspoken on many topics. Here are just a few examples:

Dame Mirren on Social Media
In her conversation with AARP the Magazine, the actress comes across as down-to-earth, sassy, self-deprecating and devilishly opinionated. Asked about the time-sucking quagmire that is social media, Mirren says:
It reminds me of a stinky old pub. In the corner would be this slightly disgusting old man who sits there all day, every day. If you went up and talked to him, you'd get the kind of grumpy, horrible, moldy, old meaningless crap that you read on Twitter.

July 24, 2014

Preaching to the Choir: Rudi Tanzi and Deepak Chopra Explain Why Meditation Works

This video is basically a promotion by Drs. Tanzi and Chopra for their best-selling book. But the clip explains -- simply and briefly -- why meditation works.

Tanzi has made several recent appearances on this blog. The Joseph P. and Rose F. Kennedy professor of Neurology at Harvard University, he also directs the Genetics and Aging Research Unit at Massachusetts General Hospital. With popular author and physician Deepak Chopra, Tanzi wrote Super Brain: Unleashing the Explosive Power of Your Mind to Maximize Health, Happiness, and Spiritual Well-Being.

The authors assert that the brain is capable of incredible healing and reshaping. Developing a new relationship with your brain can transform your life. The authors explain how using the brain -- instead of letting it use you -- can bring a host of positive reward, like:

  • Reduce the risks of aging. 
  • Promote happiness and well-being through the mind-body connection.
  • Access the enlightened brain, the gateway to freedom and bliss.
  • Overcome common challenges like memory loss, depression, anxiety, and obesity.

Yes, this line-up of benefits resembles the hype you hear from Dr. Oz and other TV hucksters, whose unscientific noise I usually ignore (and abhor). But Dr. Tanzi's credentials -- and his work -- are impressive.

I'm also sold on meditation.

Meditation and Me: The Latest
My own variety of meditation has become a treasured and important part of my days, clearly enhancing my sense of well-being. Here's the most recent "discovery."

July 23, 2014

Doctors’ Misdiagnoses: Why They Happen, How You Can Help Prevent Them

Estimates suggest that doctors make the wrong diagnosis during 10-15 percent of their patients’ office visits for new problems. So, if you’ve seen your doctor for about eight different issues in your lifetime, the odds are he’s misdiagnosed your problem at least once.

As reported in a recent Consumer Reports article, those misdiagnoses don’t involve uncommon or rare conditions… which might be understandable. According to a March 2013 study of 68 different cases in which doctors’ analyses were wrong, the issues they most often mis-identified -- or overlooked, or diagnosed late -- were these five common problems:
  1. Cancer (metastatic, or leukemia, lung, or pancreatic)
  2. Pneumonia
  3. Congestive heart failure
  4. Kidney failure
  5. Urinary tract infection
Doctors make those mistakes twice as often in their offices than in hospitals. But incorrect verdicts carry more severe consequences in hospital settings, since patients are already sick enough to be there.

Doctors at Johns Hopkins Hospital in Baltimore studied the problem of misdiagnoses, and their conclusions were published in the August 2013 issue of BMJ Quality and Safety in Health Care. Those doctors estimated that as many as 160,000 hospitalized patients die every year because healthcare professionals did one of these things:
  • Misdiagnosed a problem.
  • Made a late diagnosis.
  • Missed the problem altogether.
There are many reasons that contribute to faulty analyses by doctors, and those reasons typically occur in combination:

July 22, 2014

A Fabulous Fjord For Breakfast

Most likely, the highlight of the Norway cruise came as we headed for our first landing -- the village of Geiranger at the end of the Hellesylt-Geiranger fjord. The nine-mile waterway between these two towns is considered one of the world's most magnificent fjords.

How Fjords Are Formed
Fjords are waterway formed after glaciers ripped deep troughs into bedrock. Eventually, these glaciated valleys were filled by the incoming sea toward the end of the Ice Age.

Geiranger enjoys ice-free navigation year round, because the Gulf Stream carries its warm water north along the coast of Norway. Together, the warm water and cold air also create the region's typical cloudy mists, evident in these photos.

My Most Fabulous Breakfast Ever
As I stood in the ship's breakfast buffet line, the captain announced on the loudspeaker that we were entering part of the fjord where we could see the waterfalls named the "Seven Sisters" on the left and the "Bridal Veil" on the right.

I grabbed my cereal and coffee, and headed to the back deck. It was a cool, cloudy day with intermittent sprinkles, so not too many passengers joined me. I spent the next half hour saying to myself, "Life doesn't get any better than this."

July 21, 2014

Cinnamon for Parkinson's? A Promising Study, a Skeptical Review

The Journal of Neuroimmune Pharmacology recently reported an interesting study finding: eating cinnamon – yes, the common spice in apple pie and gooey Danish pastries – dramatically improved the health of mice with Parkinson’s disease by reversing changes – biochemical, cellular, and anatomical – that had been brought on by the disease.

Funded by the National Institutes of Health, the study was reported in the July 9 edition of the website of Science Daily, among other outlets.
OK, I don’t get too excited about rodent studies, since they certainly won’t translate into human treatments while I’m alive. But maybe they’ll lead to breakthroughs down the road for my younger fellow PWPs.

Cinnamon.... Like Curcumin, the Wonder Compound?
This study – with its simple spice component -- reminded me a little of the amazing findings for curcumin, the active ingredient in the Indian curry spice turmeric. About 500 studies studies have shown curcumin to be effective in treating a shockingly broad array of conditions and diseases, like Alzheimer's, Parkinson's, MS, cancer, diabetes, arthritis, cardiovascular disease, and depression. It's no wonder curcumin is called “the holy powder” on the Indian subcontinent. 

Will cinnamon, in time, generate similar research-based enthusiasm? 

Kalipada Pahan, PhD -- study lead researcher and professor of neurology at Chicago’s Rush University Medical Center -- touts cinnamon's promise: "Cinnamon has been used widely as a spice throughout the world for centuries. This could potentially be one of the safest approaches to halt disease progression in Parkinson’s patients."

July 18, 2014

"Lady Day at Emerson's Bar and Grill"

I've loved Billie Holiday ("Lady Day") since I first heard her recordings decades ago. But my wife hated her singing. So I listened to my Lady Day albums after my wife went to bed.

Hearing Billie Holiday's music late at night -- while I was half drunk -- only enhanced my love affair with her.

Holiday's difficult career exacted a painful price. She is as well known now for the grim travails of her short life -- she died at the age of 44, her voice spent, her body destroyed by addiction to alcohol and heroin -- as she is revered for the legacy of recordings she left behind.

Now Lady Day is being resurrected nightly at the Circle in the Square Theatre in New York City by five-time Tony Award winner Audra McDonald. The show -- Lady Day at Emerson's Bar and Grill -- is getting rave reviews.

July 16, 2014

"Difficulty Swallowing Can Be Fatal For People with Parkinson's"

Yesterday, I discovered that -- for people like me with Parkinson's -- swallowing difficulties can be fatal. I immediately searched for more information and found a good source on the National Parkinson's Foundation (NPF) website.

Difficulty swallowing, chewing, speaking and pushing food through the digestive system can all result from Parkinson's, since these functions depend on muscles that may be weakened due to changes in the brain.

Many people with Parkinson’s (PWPs) -- especially those in the later stages of the disease -- experience difficulty swallowing, or "dysphagia." The condition compromises quality of life, and cause life-threatening complications like aspiration pneumonia, malnutrition, and dehydration, according to Leslie Mahler, Ph.D., an assistant professor in the Department of Communicative Disorders at the University of Rhode Island. “The complication to be most concerned about is whether food is going down the right way,” she said.

According to the National Institutes of Health, the leading cause of death for PWPs is aspiration pneumonia, which occurs when food or liquids end up in the lungs -- not the stomach. That misdirection can inflame or infect the lungs and the passageways leading to them. PWPs are also at risk for asphyxiation and choking to death.

It is important to know the warning signs of a swallowing disorder, because some people may appear to be eating and drinking normally, but they are not, said Dr. Mahler. Early intervention and proper management of swallowing abnormalities are key to preventing major complications, she said.

Drooling and Coughing
One warning sign of dysphagia is drooling. The normal swallowing pattern slows, and -- as a consequence -- PWPs tend to drool as saliva accummulates in the mouth. The drooling is embarrassing and can cause a buildup of phlegm in the throat.

Coping in Copenhagen

Two points for starters:
  1. Note that the title reads coping in Copenhagen, not with Copenhagen. I loved Copenhagen. As usual, the problems were of my own making.
  2. I’m in the wheelchair only because I decided it would be quicker for us to tour the Tivoli Gardens. If I'd hobbled about on my cane, we wouldn’t have gotten very far. I brought my friends Terry and Prav over from London to push me around.
A Few Factoids on Copenhagen and Denmark
  • The Danes are the happiest people on the planet. According to the UN’s 2013 World Happiness Report, Denmark -- with a score of 7.6 -- beat every other country on a global happiness scale from zero to ten. Americans aren't especially happy; we landed in 17th place, between Mexico and Ireland. We talked with a Danish gal on the train who laughed scornfully when we asked about the Danes being the world’s happiest people. She was just back from a trip to the States and wished she could have stayed.
  • Copenhageners dine well. This small city boasts 15 Michelin stars. Noma, the “New Nordic” restaurant, has been named the World’s Best Restaurant three times. 
  •  Copenhagen rivals Amsterdam for the popularity of bikes. Half the people here pedal to work.
  •  Copenhageners are law abiding. It’s said that even at 3am on an icy cold night with no traffic in sight, they’ll wait for a green light at pedestrian crossings.
Our Weekend in Copenhagen
We arrived in Copenhagen early Friday morning. After settling in at our hotel – the excellent Babette Guildmeden – we got a nice introduction to the city on a canal tour. We had enough energy left to take a walk in the park across the street from the hotel.

July 15, 2014

The Scourge of Antipsychotics in Nursing Homes

Every day I wake up in my house, I count my lucky stars I’m still living here. Five years ago, when I first got my Parkinson’s disease diagnosis, I started planning to sell my house and move into a senior living facility. I suspected I’d experience a rapid decline, and that I’d need lots of help… and soon.

So I visited one particular place downtown I’d heard some good things about. It’s close to our excellent Metro system, to the Kennedy Center, fine restaurants, and the museums and theaters that make Washington such a great place to live. As I walked around, the residents there seemed pleasant, interesting, and active. The apartments I saw looked nice. I even thought, “OK, I could live here.”

Oh boy.

The past five years in my own home -- where I’ve lived for about half a century – have been wonderful. Mostly, I’ve enjoyed a long and fortunate Parkinson’s “honeymoon,” during which my symptoms have been manageable. I’ve enjoyed my garden like never before. And easing into a “new” life with Parkinson’s has been immeasurably more comfortable, more fun, and less worrisome for me because of my two young Nepali housemates. The peace of mind I feel because they live here is priceless. 

Life is good.

Over the past weeks, I’ve seen more and more evidence that, for seniors, staying in one’s own home  – as long as you’re safe, comfortable, and happy there – is an excellent predictor of continuing wellness.

For a while, I’ve thought of posting a few thoughts about the positive impact of staying in one’s home. Then a friend mailed me a copy of the July-August 2014 issue of the AARP Bulletin. One particular story caught my eye: “Prescription for Abuse: Antipsychotics in Nursing Homes.” When I finished the article, I breathed another sigh of relief – and gratitude – that I’ve eluded that grim nursing home fate. Who knows what the future holds, but I hope I’ll never have to see the inside of such a place.

Here are a few of the bullet points from that scary article.

July 14, 2014

Tourist Apartments: The Hotel Alternative -- Guest Post by Linda Fernandez

It's Sunday, July 13, in Copenhagen. I've just spent the weekend here, recovering from jet lag, having a reunion with two treasured friends who flew in from London, and seeing the sights (forget the mermaid -- take the train to the Louisiana Museum of Modern Art, sit on the grass and look across the water to Sweden).

Our hotel -- the Babette Guldsmeden -- is very nice and perfectly located for boarding our cruise ship tomorrow.

But in my recent travels, my favorite accommodations have been tourist apartments. My son, his partner, and I spent a week in a terrific apartment on the Île Saint-Louis in Paris last summer. I stayed in an incredible apartment in Buenos Aires this spring. I learned about the BA apartment from my friends Linda and Kurt Fernandez, who had rented an apartment in the same building when they lived in BA. The Paris apartment was also the result of a friend's recommendation.

I asked Linda to write this guest post because I'm looking for tips about finding and appraising these apartments. As you'll see, she's done a great job.

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Tourist Apartments: The Hotel Alternative
– by Linda Fernandez

When you’re staying at a hotel for more than two nights do you keep the do-not-disturb hangtag on the door so as not to be bothered by daily maid service? Do you rearrange the over-priced items in the mini-fridge so you can chill a bottle of wine and store some cheese and crackers? Do you gag at hotel internet connection fees? Would you love to wash your clothes while eating dinner?

If you answered yes to these questions, you ought to consider renting a short-term apartment as your next multi-night home away from home.

July 11, 2014

Let's Take a Break, Exercise, and Lose Some Weight

I'm taking a break from pontificating today because I'm scheduled to land in Copenhagen at about 8 o'clock this morning. Our cruise ship for touring the fjords of Norway will depart from here on Monday.

With all the dining possibilities ahead, I'll need constant reminders of the need for exercise -- to offset calories and to keep moving for better health in general.

I've not found better motivation than this now-classic whiteboard animation created by University of Toronto statistics professor Michael Evans. Using a variety of sources, he shows how to get the biggest health bang for your buck... or your effort. The video is fascinating and instructive:

After working that program for a while, we can move up to this one:

July 10, 2014

23andMe and the FDA: Spit and Genomes

The genetic testing company 23andMe is back in the news as it tries to repair its rift with the Food and Drug Administration. That battle has been framed by some as a struggle between individuals' rights to their own health information and the paternalism of the medical and government establishments. Others consider the FDA's action a necessary precaution as we begin to explore the exciting possibilities of genetic testing.

23andMe is an intriguing company with a fascinating history. It has used genetic testing technology to identify genetic markers associated with specific diseases and conditions. Its customers mailed a test tube containing their saliva to the company, which then analyzed their DNA. For $99, they received a report detailing risks for more than 240 health conditions. The idea was so revolutionary that in 2008 Time magazine named it "invention of the year."

The Start Up
The history of 23andMe revolves around Anne Wojcicki. As a young analyst on Wall Street, she had been frustrated that our wealthy country failed to provide its citizens even the most basic medical needs.

She became able to do something about it when she moved to California in 2006 to be with her boyfriend, Google co-founder Sergey Brin. She became convinced that Silicon Valley could help solve our health system's inability to really deal with diseases.

At a TED conference in 2006, she met Linda Avey, an acquaintance of Brin's and a longtime Biotech executive. The two hit it off and ended up pitching the idea of a DNA profiling company to Google, which invested $3.9 million in the start up. Genentech and other Valley firms signed on.

They dubbed the company "23andMe" for the number of pairs of chromosomes in a human cell. Wojcicki believed the widespread availability of the spit test would improve the relationship between health providers and patients -- giving consumers control over their own destinies like never before.

Wojcicki also thought that collecting genetic information from so many people would enable scientists to decipher DNA patterns and thus create cures for countless diseases.

A Fairy Tale Ends
Brin and Wojcicki were married in May 2007 and have a son and daughter. They've been viewed as the Silicon Valley's "golden couple."

Friends nicknamed them "the twins," because they seemed in sync about everything from the future of technology to their unconventional wedding -- a secret ceremony where the bride is said to have worn a white swimming suit and the groom a black one. They swam to a sandbar to exchange their vows.

Their fairy tale ended this year when the news leaked of Brin's affair with a colleague who was working on the Google Glass project with him. Here are Brin's lover, Wojcicki, and Brin -- all sporting the fancy eyewear:

Amanda Rosenberg (left), with Diane von Furstenberg and Sergey Brin at New York fashion week. The British lover of Google co-founder Sergey Brin started her affair with him after befriending his wife, it emerged yesterday
Correction: The woman in the middle is Diane von Furstenberg. Here's Brin and Wojcicki in happier days:

Brin, 40, pictured with his wife Anna Wojcicki, also 40, in 2008: One of the journalists who broke the story for U.S. technology website All Things D is the partner of a Google executive who is a close friend of Miss Wojcicki

July 9, 2014

Genetics: Preventive Medicine's Next New Frontier

"Right now, in this part of the century, the most exciting scientific and medical work is going on since the Enlightenment. And that is: we're setting the stage so that people can know where they stand genetically, to prevent the four big diseases that prevent you from being healthy after the age of 75." 

--Dr. Rudy Tanzi, Harvard Medical School, Massachusetts General Hospital

Today marks this blog's fourth appearance by Dr. Tanzi in the past few weeks. And it won't be the last. I've become fascinated with his work, and recently detailed his impressive credentials.

Before, I focused on his positive comments about the supplement ashwagandha, a recommendation that encouraged me to give it a try. But the main body of his work is much more significant. He's not another Dr. Oz touting new miracle pills or diets. Far from it.

Tanzi is pursuing genome research to identify genes associated with Alzheimer's disease and autism. The details of that work are too technical for me to fully grasp. Still, Dr. Tanzi has a unique talent for describing his work in a way a layman like me can understand.

You'll see an example of that talent if you click on the following link. You may have to cut and paste it into the URL bar if clicking doesn't work. It's well worth watching: http://on.fb.me/1zlc3JT

Personalized  Medicine
Dr. Tanzi talks about the exciting prospects for genetic research to bring about a new era in preventive medicine. Others describe it as "personalized medicine," the emerging practice of using individual genetic profiles to guide decisions about prevention, diagnosis, and treatment of a disease.

July 8, 2014

100 Doctors Identify the Top 10 Medical Innovations for 2014

One hundred top experts at the Cleveland Clinic – professionals who care for patients every day – answered this question: What medical innovations will reshape healthcare in 2014? As reported on the website What Doctors Know, here are their top ten answers.

#10:  Targeted Cancer Therapy
About 4,400 Americans die each year from lymphocytic leukemia (CLL). This year, doctors expect the FDA to approve ibrutinib, the first in-class oral drug available to treat CLL. Clinical trials were promising for the new drug, which targets cancerous cells without compromising a patient’s immune system.

#9:  Heart Risk Screened through the Gut
Researchers believe they have a new tool to predict risk for heart attack, stroke, and death: trimethylamine N-oxide (TMAO). When bacteria in the stomach digest choline -- a substance found in red meat, egg yolks, and dairy products  – the body produces TMAO. Choline is thought to promote hardening of the arteries. This means doctors have a new bio-marker to look for – TMAO – when assessing risk for heart attack, stroke, and death.   

#8:  Personal Sedation Station
Unless you choose to remain awake and alert during a colonoscopy, an anesthesiologist administers a drug like Propofol -- the one that Michael Jackson abused -- to put you under. Now there is new, personalized “sedation station” technology that enables healthcare pros OTHER than anesthesiologists to administer light sedation for life-saving colonoscopies. Here’s the main benefit: this new technology could reduce the national healthcare bill for this one important procedure by about $1 billion every year.

July 7, 2014

Two Takes on July Fourth -- One Dismal, One Joyful


"The Fourth of July was always a celebration of American exceptionalism. Now it's a commiseration of America's disappointment." Republican pollster Frank Lutz (one of the few statements on which Republicans and Democrats can agree these days.)

The Dismal Take on July 4, 2014
Twenty-five years ago, Arena Stage here in Washington presented a revival of On the Town, the 1944 Broadway musical about three sailors on leave in Manhattan during World War II. The show opened with the orchestra playing “The Star-Spangled Banner.” As the audience rose to its feet, I found myself in tears.

I remembered how we stood for the playing of the national anthem at the opening of every film at the movie house in Ithaca, New York -- my hometown. I was teary-eyed because I was remembering how united the country was then, and how divided we had become.

And that was 1989! If a revival opened in the same way today, I’d probably be convulsed on the floor, sobbing.

The Joyful Take
As I usually do these days, I'll disengage from the dismal big picture and focus instead at how happy my own world is. This fourth of July weekend was an example.

July 4, 2014

Ashwagandha: My Promising Trial Run

As I reported back in May, I saw an interesting interview with Dr. Rudy Tanzi, who was questioned about the claims that coconut oil and curcumin might cure Alzheimer's disease (AD). 

I hadn't heard about Dr. Tanzi, so I did some research. As a consequence, I've become fascinated by his work. First, I want to establish his impressive credentials.

Dr. Rudy Tanzi
Dr. Tanzi is a Professor of Neurology, and holder of the Joseph P. and Rose F. Kennedy endowed chair of Child Neurology and Mental Retardation at Harvard University. He also heads the Genetics and Aging Research Unit at Massachusetts General Hospital, which comprises eight laboratories investigating the genetic causes of Alzheimer's disease.

Dr. Tanzi has been investigating the molecular and genetic basis of neurological diseases since 1980, when he participated in the pioneering study that led to the location of the Huntington's disease gene, the first disease gene identified by genetic linkage analysis.

He spearheads the Alzheimer's Genome Project, which detected four new AD gene candidates. Time magazine heralded this achievement as one of the "Top 10 Medical Breakthroughs of 2008." 

Dr. Tanzi is one of the ten most-cited AD researchers, having co-authored over 450 research papers, including three of the ten most cited.

He co-authored the New York Times bestseller Super Brain with Deepak Chopra.  

I could go on, but you get the idea.

Dr. Tanzi and Ashwagandha
Here's the video interview with Dr. Tanzi about coconut oil and curcumin as Alzheimer's "cures." About three minutes into the tape, the interviewer asks Dr. Tanzi what he does to maintain his health and avoid Alzheimer's. Tanzi says the only supplement he takes is ashwagandha. Since there are many products, he recommends the version produced by Douglas Laboratories, but notes that a doctor's prescription is required for purchase. 

July 3, 2014

Stress: Its Damaging Effects on Our Bodies and Strategies to Reduce It

The negative impact of stress on human bodies and minds is a regular healthcare topic. It’s no wonder: stress can make us sick and even shorten our lives.

Stress is a big problems for millions of Americans. According to the WebMD website (one of my regular, trusty sources):
  • 43% of all adults suffer adverse health effects from stress.
  • 75-90% of all doctor’s office visits are for stress-related ailments and complaints.
  • The Occupational Safety and Health Organization (OSHA) declared stress a workplace hazard. Stress costs American industry more than $300B – yes, billion – every year.
  • 50% of emotional disorders last a lifetime, often due to chronic, untreated stress reactions. 
People frequently use tobacco, alcohol, and drugs to relieve stress. Unfortunately, those substances only exacerbate the problem by keeping the body in a stressed state.

Stress is normal -- the body’s reaction to any change that requires an adjustment or response. And stress can be good, too; it keeps us alert, motivates us to some action, and keeps us from harm.

But when stress-causing challenges and changes do not abate, when we cannot resolve them, and when there is no relief from them, the sufferer typically develops distress, a very negative stress reaction. Distress can cause a wide range of very real physical symptoms and problems.

July 2, 2014

Not All Gun Owners are Evil

I had another topic in mind for today’s post, but I just had a conversation about guns I found interesting. I was talking with a home contractor I’ve used for several years, and we've become friends.

He came to the house this morning so we could discuss several projects I had in mind. We hadn’t seen each other for awhile, so we spent some time catching up.

We were having a good chat, agreeing on many things. For instance, he said the GI Bill had completely turned his life around. He was able to get a college education and buy a house -- two things that wouldn't have happened without the government's help. We discussed how this huge federal welfare program had built the American middle class and helped create the post-war economic boom.

Then he mentioned he’d been feeling a bit bored lately and had decided to return to a hobby he really loved. He’s 60 years old. I’d written recently about studies that showed how being passionate about some pursuit was "a very robust predictor of health and wellness in old age.” So I wanted to hear more.

“What’s your hobby?” I asked.

“I’m a shooter and I like building guns,” he answered.

So much for our amicable conversation, I thought. But I decided to plunge ahead.

July 1, 2014

Google Glass in the Operating Room

In May, I wrote about the possible uses of the new wearable computer -- Google Glass -- for people with Parkinson's. Now – as reported in a recent New York Times blog post – the technology is entering the hospital operating room (OR).  It was inevitable.

A refresher: Google Glass is “smart eyewear” that provides voice-activated access to the internet and to any saved files. It also has a camera that can record or stream video. The wearer sees whatever he requests floating on a small screen projected on the lens above his right eye.

Many Potential Uses
Of course, there are many new ways that OR surgeons might use the new technology.

Info availibility.  Doctors and nurses can immediately access important info, like surgical checklists, patients’ vital signs, lab results, X-rays, CT scans, etc.

Video archive.  Doctors can record and archive operations on the video camera. If questions arise later, the doctor can consult the video to see exactly what happened.

Support from specialists during procedures.  Surgeons can live-stream operations so specialists anywhere in the world can observe and offer recommendations as the procedure takes place.

Training opportunities.  Doctors can use the video camera as a training device.  Said Dr. Selene Parekh, an orthopedic surgeon at Duke Medical Center: 
In India, foot and ankle surgery is about 40 years behind where we are in the U.S. So to be able to use Glass to broadcast this and have orthopedic surgeons around the world watch and learn from expert surgeons in the U.S. would be tremendous.

Focus on the patient:  Surgeons don’t need to turn away from patients to get information during delicate procedures. Dr. Pierre Theodore, a cardiothoracic surgeon at the University of California, San Francisco, uses the device to float X-rays and CT scans onto the small screen while he’s in the OR. He said:
In surgery, Google Glass is incredibly illuminating. It helps you pinpoint what you’re looking for, so you don’t have to shift your attention away from the operation to look at a monitor somewhere else.
He describes wearing Glass in the OR a “game changer."