September 30, 2014

New Blood Test for Depression: Farewell, Stigma

A new study suggests that a simple blood test can now accurately screen for depression and even identify the treatment therapy most likely to succeed.

For centuries, depression was a mysterious, unpredictable condition. Since there were no typical physical symptoms, and since it left no visible evidence on the body – no pockmarks, no bleeding, no coughing, no visible scars – people questioned its authenticity as a “disease.”

Through the years, people suffering with the mental illness would hear things like, “There's nothing wrong with you! Pull yourself up by the bootstraps and get on with your life.”

The End of Depression's "Stigma"? 
In addition to helping doctors identify and treat people with depression -- and even detect in advance those patients likely to experience depressive episodes in the future -- this new blood test provides evidence that depression is biologically very real -- like cancer, pneumonia, diabetes, Alzheimer’s, and Parkinson’s.

Now, as with other diseases, observable biological causes can be assigned to depression, and DNA test results may even suggest potential targeted treatments. The new blood test could help eliminate – once and for all -- the unfortunate “stigma” that has so long accompanied depression. That stigma has prevented countless sufferers from coming forward to seek help.

With her team, Dr. Eva Redei, a neuroscientist and professor at the Northwestern University Feinberg School of Medicine, took blood samples from 32 patients 21-79 years old who – through clinical interviews – had been diagnosed with depression. The researchers then compared those samples with blood from 32 people within that same age range without depression -- the control group.

September 29, 2014

My Levodopa/Carbidopa and 5-HTP: What I've Learned

What you see above are my two most important medications. The prescription drug carbidopa/levodopa is the most effective drug for treating the motor symptoms of Parkinson's disease (PD). The over-the-counter supplement 5-HTP has been a miracle drug for me in treating PD's non-motor symptoms.

As shown, I'm taking 16 carbidopa/levodopa pills each day (2 pills taken 8 times a day, at three-hour intervals). With 5-HTP, I'm taking half of a 50mg pill at bedtime and one quarter of a pill midday. I'm not happy with either dosage for reasons I'll explain.

Carbidopa-Levodopa for Parkinson's Motor Problems
Developed in the late 1960s, levodopa represents one of the most important breakthroughs in the history of medicine. You may remember the movie Awakening, based on the book by Oliver Sacks. It tells the story of using the newly-discovered levodopa on patients who contracted sleeping sickness during the great epidemic after World War I. That therapeutic connection happened about the same time researchers discovered that levodopa could also treat Parkinson's. Ironically, Robin Williams played the role of Oliver Sacks in the film. Seriously depressed, he committed suicide recently soon after learning that he had Parkinson's.

After 40 years of clinical experience, levodopa remains the gold standard treatment for Parkinson's. It's usually taken with carbidopa, which prevents levodopa from being converted into dopamine in the bloodstream, therefore allowing more of it to cross the barrier into the brain. Carbidopa enables Parkinson's patients to take about 80 percent less levodopa.

But this miracle drug has its downside. Like most others, it brings unwelcome side effects, some of them serious.

September 26, 2014

Three Old Rocking Chairs Have Got Me

I had planned today to write about my blood pressure crisis and my two most important meds: carbidopa-levodopa (my first line of defense against Parkinson's), and 5-HTP (my salvation in warding off the most threatening Parkinson's non-motor symptoms).

But I decided that post needed more research.

Fortunately, waiting in the wings was this piece I'd written just for fun. Much of my life is spent in one of these chairs.

I live in a split-level house, and the first two of these rockers are on the ground  level.

The Living Room Rocker . . .
Too bad the reflection from the window blemishes my grandson's self-portrait in the center of the picture. It's my all-time favorite Christmas present:

. . . and the View
Every window in the house offers a lovely view:

The Back Porch Rocker . . .
If the weather is at all decent, this is where I spend most of my time. The view behind this photo is OK, but . . .

. . .  This is My Favorite View:

September 25, 2014

How to Choose a Doctor

Over the past few years, I’ve chosen many new doctors and specialists. Most have been recommendations from other doctors I respect.

I’m 85. And in the weeks ahead, I expect to select a few more doctors.

In fact, the selection process never seems to end. It pops up again and again -- when we move to a new city, start a family, become disenchanted with doctors we have, care for an elderly parent, or develop new symptoms ourselves.

Our relationships with healthcare professionals end only when we die… unless we’re organ donors.

Have you chosen a new doctor or specialist recently? How did you make your decision?

I snooped around and found several lists of tips for finding and choosing new doctors.

September 24, 2014

My Healthcare Team and the Blood Pressure Crisis

This is the first installment of my report to my CEO (me) about lessons learned in resolving the labile blood pressure crisis. It reviews the performance of my healthcare team.
My General Practitioner
My GP seems to resent my eagerness to assume responsibility for my own welfare. I get the clear impression that this doctor wants to make decisions about my situation and my meds without partnering with me, the patient.

That approach just doesn’t cut it with me. From the start of my adventure with Parkinson’s five years ago, I’ve assumed a leadership role in managing my new medical reality. Doing so has made me feel more in control of what’s happening to me. I also know more about what's going on than my doctors do.

Just one example: For more than a year now, I've been dealing with an erratic blood pressure problem; the systolic (upper) numbers could vary as much as 100 points during a day. My GP takes my blood pressure, finds the systolic number is 170, and wants to prescribe a drug. An hour later, the number could have been 97. Who had the better information?

Even if I didn't have these issues with my GP, I'd still be looking for a doctor with a geriatric specialty. Very few of the studies underlying today's medical practice have included seniors, let alone the elderly. My current GP wasn't even aware of the current debate about whether people 80+ need to take blood pressure or cholesterol meds at all.

These days, I need my GP to be a good diagnostician, and I'm more likely to get what I need from someone with a focus on geriatrics. Specialists earn much more than GPs, which explains our growing shortage of general practitioners. Finding a GP with geriatric background is even harder.

Unless things change, the baby boomers can forget about finding a geriatrics-trained GP.

September 23, 2014

Here's How My Healthcare CEO and His Team Resolved My Blood Pressure Crisis.

Who is my healthcare CEO? Me of course.

Who's on the team? On call, depending on the nature of the problem, are my internist, a variety of doctor/specialists, my physical therapist, and my nearest and dearest, i.e. friends and family. A formidable group.

What's the crisis? "Crisis" may be a bit hyperbolic but, according to a study my son called to my attention, the problem I've been having for a year or more  is a key warning sign of a stroke.

I've been checking  my blood pressure with a wrist monitor for years, mainly because the 5-HTP pills that I take can have a side effect of causing a spike in blood pressure. I also keep a log of the readings.

Over a year ago I began noticing that at intervals throughout the day my blood pressure readings would spike upward and then subside.  As if this wasn't bad enough, I also was experiencing on occasion episodes in which I would come close to fainting and, when I was able to check, I found this coincided with systolic (the upper number) blood pressure readings below 100.

Often I recorded reading below 100 and over 200 in the same day. I provided more details about this in a recent post.

Clearly it was time to call in Team Schappi.

Two Issues, Two Solutions
When a problem comes up regarding my healthcare, the CEO (me) typically does the initial research for two reasons:.
  1. I'm the one who is most familiar with what's going on.
  2. I love doing research.
I was stymied at first because I couldn't find anything dealing with a  100-point spread in blood pressure readings. Then I realized that we might well be dealing with two separate problems, not one.

This is what clued me in:

Issue # 1: Why the High Blood Pressure?
In my blood pressure log, I record the reading and the time. I also note what pills I've taken during the day as well. Looking over the log, a clear pattern began to emerge. The spikes in blood pressure coincided with the "off" periods in my main Parkinson medication.

Carbidopa/levodopa is the drug of choice in  dealing with Parkinson's. Five years ago  when I started taking it, I took  1 pill (25mg of carbidopa and 100 mg to levodopa) every 6 hours. Today I'm taking two pills every 3 hours.

In the early years, my problem was that I'd forget to take a pill for hours since the timing of the pill didn't seem to make any difference in how I felt. Now I definitely can tell when the effectiveness of the last dose is wearing off and the new one hasn't kicked in.  This is referred to as an"off" period. My log showed that my blood pressure spikes were occurring during these "off" periods.

Time to call in the team.

September 22, 2014

Lower Blood Sugar = Better Memory Prospects

The lower your blood sugar, the less likely you are to develop memory problems. Even for healthy adults without glucose issues or diabetes, memory function increases as blood sugar levels decrease.

Those conclusions were published in the American Academy of Neurology’s journal Neurology.

On a less-is-more kick for some time now, I ditched the blood pressure meds months ago and then my statin meds for cholesterol just last week. Now, though my blood glucose numbers are pretty good, I’ll do my best to reinforce sugar’s place on my less-is-more list. (Clarification: As I'll report in a new post, I've gone  back to taking a blood pressure med now but to address a specific problem.)

With her team, Dr. Agnes Flöel from Charité University Medicine in Berlin, Germany, gathered 141 people who did not have diabetes or pre-diabetes (also called impaired glucose tolerance). These subjects – average age 63 – were not overweight, did not drink more than three-and-a-half servings of alcohol per day, and did not demonstrate any memory or cognitive impairment.

September 19, 2014

Here's an Example of How I Prefer Communicating with My Doctors

Not too long ago about the only way to communicate with your doctor was to call the doctor's office and make an appointment for a face-to-face meeting . . . or if it's more urgent "call 911" as the recorded message often tells you.

By working your way through a phone tree that seems endless, you might be able to leave a recorded message asking your doctor to call you.

But today a relatively small but increasing number of doctors will permit you to communicate by email. Usually this is done by giving you the email address of the doctor's assistant. Given the onerous amount of paperwork doctors are burdened with these days, it's understandable that most would not want to open the flood gates to direct one-on-one emails. But I have one on my team   with whom I'm able to exchange emails.

In communicating matters of substance that require clarity and accuracy, I know I'm better off using e written  communication rather than oral.

Here's an email I sent out Thursday to my neurologist and  the doctor who handles my blood pressure issues. It provides an example of how an email can provide important information completely and accurately and frees the doctor of the need to take notes.    It also provides an update on my No. health concern these days -- the erratic ups and downs in my blood pressure readings that I discussed last week.

Email Regarding Erratic Blood Pressure Readings
A week ago the two of you had given me these recommendations (Nos. 1 and 3 from Dr. B and No.2 from Dr. M.
  1. See if the peaks and valleys in the bp readings would be smoothed by  taking less carbidopa/levodopa at more frequent intervals, i.e. 1.5 tablets every 2.5 hours
  2. Try a low dose (10mg) of the bp medication nifedipine.
  3. Try a low dose of the Parkinson's disease (PD) medication dopamine agonist.
I decided to do a trial of each in turn starting with the pill-free option #1. But I also obtained a prescription for nifedipine.

Here's what's happened so far:
The first couple of days were much like what had gone before -- the peaks (above 150 systolic ) were the primary problem with a few lows (below 100). The peaks happened almost exclusively during carbidopa/levodopa off periods. The lows were more erratic.

I was mistaken in initially labeling the lows as orthostatic hypotension; they have no connection with moving from a seated to standing position. And I also was mistaken in thinking they only occurred in midday outings in hot humid weather.

Things began to change on Tuesday. I was getting readings above 150  on over half of the off periods. I decided late afternoon to begin taking the nifedipine.

Yesterday was a bummer. I got readings of 104/60 during my 3-4 a.m. quiet hour and the readings continued to drop. When the number hit 80/47 at  8 a.m., I decided I'd better take some salt.  I was so shaky that I had to prop myself up by hanging on to the walls in going to the kitchen. By 9 a.m. the reading was back up to 126/69.

The readings continued OK until 4 p.m. when it dropped to 89/52, but unlike the a.m. lows, I was feeling fine. 

Here's today thus far:

2:30 -- woke just to take c/l pill and go back to bed -- 152/79.
4:30 -- 116/62
Did my floor exercises
5:00 -- 91/49 and time for  my c/l pill.
I was feeling very wobbly but this time I was ready and had a salt container in my bedroom. I poured out a little, stuck a wetted finger in the pile of salt and then licked the finger. I had another low reading and did the salt routine again. The systolic number began to go up and by 6:30 the reading was 111/58.

I just now (1:30) took a reading --136/78.

Actually except for the 4 a.m. and p.m episodes, I'm feeling better than ever.

Other than that, Mrs. Lincoln, how did you enjoy the play?

I almost forgot: I may have complicated things by deciding two days ago to stop taking my statin. This was bad timing that unnecessarily tosses another issue into the pot.

So what do we do now?  I wouldn't mind continuing down this path through the weekend and check back with you on Monday.

Let me know.

P.S. Dr. M. -- As you predicted , I did tinker around a bit with 5-HTP at the start but I gave up on that and am limiting myself to  25 mg at bedtime.

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September 18, 2014

Bye-Bye to My Statins

I believe that "less is more." Back in April, I ditched my blood pressure pills. This weeks it's the statins I've been taking for decades to treat my elevated blood pressure. 

Here's what lead to that decision:

Are Statins Worth the Risk?
That question is increasingly being asked by doctors and medical authorities. Statins are one of the most commonly prescribed medications in the U.S. They are taken by an estimated 1 in 4 middle-aged adults.

They may become even more widely used. New cholesterol guidelines, introduced last November, could push that ratio to as many as 1 in 2 adults over age 40.

But for several years now there has been a simmering debate in medicine over statins."The prevailing dogma has been this statins are almost harmless and that they're a wonderful drug," says Tom Perry, MD, a pharmacologist and internist in Vancouver Canada. Caray is part of a team of doctors at the University of British Columbia that looks at the evidence for and against drugs.

September 17, 2014

Harvard Outlines Looming Housing Crisis for Seniors

On September 2, 2014, the Harvard Joint Center for Housing Studies & AARP Foundation released the results of a study that reports some troubling news: The USA faces a lack of affordable, physically accessible housing for seniors, particularly those with limited resources.

It’s a perfect storm in the making, as Baby Boomers – the nation’s largest-ever generation – speed into their senior years. They’re living longer, too, than any generation before them.

By 2030, 20 percent of all Americans will be 65+. By 2040, there will be an astonishing 28 million Americans 80+. That’s a lot of seniors.

“If things don’t change, low-income older people will be compromising their well-being in many respects. It’s an issue that will affect us all,” said Chris Herbert, acting managing director of the Harvard Joint Center for Housing Studies.

The study highlighted three particular issues.

1) The Cost of Renting or Owning a Home is Already High
Yes, housing costs are very high, and they will only increase. For millions of seniors, especially those on fixed incomes, just keeping pace with those rising costs isn't possible.

About 33% of Americans 50+ – and 37 percent of those 80+ – spend one third of their income on housing. That leaves little for all the other necessities, especially the most expensive ones – food and healthcare.

Seniors 80+ in financially-strapped households spend 59 percent less on healthcare every month than their counterparts who are fortunate enough to have affordable housing.

September 16, 2014

Treating Depression: Curcumin is Equal to Prosac and Better than Placebo

I continue to see positive reports about curcumin, the active ingredient in the Indian curry spice turmeric. This week, an Australian study reported that the supplement might relieve symptoms of major depression better than a placebo. 

First, to set the stage, here's a brief video about a 2013 study that compared curcumin to Prozac: 

Dr. Ajay Goel is director of epigenetics and cancer prevention at the Gastrointestinal Cancer Research Lab at Baylor University Medical Center in Dallas. He is now researching the prevention of gastrointestinal cancers using integrative and alternative approaches, including botanical products.

September 15, 2014

Remaining on the Job Helps Depressed Workers AND their Employers

A new Australian study shows that remaining on the job is better than taking time off from work, both for depressed individuals and their employers.

As soon as I read the September 10 press release from the University of Melbourne, I remembered an email I received many years ago from a friend who for months had been nearly incapacitated by depression. She finally took a simple retail job and – after getting through the stress of her training – started to feel better. In her note to me, she described “the healing power of work.”

After evaluating the records of Australians with depression, researchers at the University Of Melbourne and the Menzies Research Institute at the University of Tasmania tallied the costs based on several factors, including lost productivity, medications, health services, and the costs to replace absent workers.

Absenteeism and Presenteeism
According to lead researcher Fiona Cocker, Ph.D., the study provides more insight into the costs and consequences of both work absenteeism and “presenteeism.” She said that her group’s findings facilitate “more informed recommendations” that will benefit both employees and employers.

“We found that continuing to work while experiencing a depressive illness may offer employees certain health benefits, while depression-related absence from work offers no significant improvement in employee health outcomes or quality of life,” she said.

September 12, 2014

Blood Pressure Fluctuations = Increased Stroke Risk

A few days ago, I had dinner with my kids. Among other things, we discussed my current problem with blood pressure (bp): most days, my systolic (upper) numbers typically range from under 100 to over 200. We all agreed these wild fluctuations can't be good.

The next morning, my son sent me an email with a link to a report with this headline:
High blood pressure: New research suggests that see-sawing readings are the key danger sign for strokes.
Needless to say, that got my attention! I immediately opened on the link.

The report is based on work by Professor Peter Rothwell, director of the Oxford Stroke Prevention Research Unit in England.

What Matters are the Blood Pressure Variations
For years, experts thought consistently high bp created the greatest stroke risk. But evidence now suggests the real risk is more a function of dramatic blood pressure variations from hour to hour, day to day, week to week.

September 11, 2014

Alliance for Natural Health Lists "Best" Supplement Suppliers

Since I began this blog about five years ago, one clear trend has emerged: readers seem reliably interested in dietary supplements.

By far, the topic that has generated the most traffic here is coconut oil… particularly the (unproven) claims that coconut oil can treat Alzheimer’s, or retard the disease’s inexorable progression. I’ve devoted lots of ink in an effort to debunk that cruel, harmful mythology.

On September 9, I was interested to see an article – What Supplement Companies Do the Experts Swear By? -- published on the Alliance for Natural Health website.

I’ve never heard of most of these companies, and I’m certainly not endorsing any of them. I’m a firm believer that – in the realm of pills and most everything else – less is more.

My Favorite: Douglas Labs
But whenever I'm looking to replenish one of the supplements  I take (5-HTP,  curcumin, ashwaganda) I look to see if Douglas Laboratories is on the list. Here's why:

I've been impressed with the work being done by Dr. Rudy Tanzi.  He is a leading Alzheimer's researcher, having won the top AD awards. He also is  a neurology professor at Harvard, and director of the genetics and aging unit at Massachusetts General Hospital. I recently reported on an interview in which he was asked about his use of supplements and he responded:
The only supplement I take is called ashwagandha . . . Unfortunately, most of the ashwaganda you'll find online does not work. The best one comes from Douglas Labs.
The Alliance for Natural Health
Knowing the interest in supplements that exists out there, I wanted to share the ANH's list… if for no other reason than to see if readers have any reaction to it, one way or another.

September 10, 2014

Let's Take a Break and Relax with These Video Clips

Truth be told I need a break to delve into the continuing mystery of how my carbidopa/levodopa continues to produce blood pressure readings ranging from 69/47 to 191/103 -- and that's just this morning. It's now 11am and I'm typing this while wearing my wrist blood pressure monitor to remind me to take frequent readings to see if I can make any sense out of this craziness.

I'll report back on this in a few days.  Meanwhile . . .

Wonder how old you have to be enjoy watching this woman as she returns to work after 30 years:

Nice to see that a youngster has my problem with passwords:

Clever commercial for Depends:

Brazilian kids learn English by talking to lonely Chicago seniors:

#       #      #

While working on this post, I lost track of time and, as a result, I didn't take my 11am carbidopa/levodopa  until 11:45. This resulted in a blood pressure reading of 211/104!

Taking pill and meditating brought the reading down to 130/66 within an hour.

Go figure.

September 9, 2014

Do You Use Your Local CVS or Walmart Walk-In Clinic for Medical Services?

Are those clinics – the facilities you see at CVS, Walmart, Walgreens – a good idea?

If used wisely, yes.

Their very existence is an indication of American business ingenuity. These clinics also show just how inadequate the American healthcare system is at the moment.

As reported in a recent article in the Washington Post’s Health & Science section, the USA has the most alarming shortage of primary care physicians of any developed country in the world. Nearly three out of four Americans cannot readily access medical care at night, on weekends or holidays unless they go to an emergency room.

Enter the realm of quick-care medical services: those walk-in clinics at local pharmacies – typically staffed by nurse practitioners – or free-standing urgent care centers, where physicians are usually in charge.

No question: these places fill a need. In addition, the price is usually right, and the waiting time is almost always better than it is at the local hospital’s crowded emergency room. They also provide healthcare services to the millions of Americans who do not have their own primary care doctor. Nearly 40% of all visitors to these clinics do not have their own GPs.

Comparative Study Validates Clinic Use
In 2009, the Annals of Internal Medicine published a study that compared the care provided for urinary tract infections, sore throats, and ear infections at walk-in clinics, urgent care centers, and emergency rooms… all in Minnesota.

Using 14 generally accepted indicators of quality, the survey discovered that ratings were similar among clinics, centers, and doctors’ offices… but lower in hospital emergency rooms.

September 8, 2014

Proof Positive of Weather's Impact on My Health and My Meds

I love living in our nation's capital. But its one serious drawback becomes increasingly problematic as I deal with aging and Parkinson's -- the summer heat and humidity.

Each year, the swelter is harder for me to bear. Scientific studies confirm that the elderly are subject to greater heat stress than younger people.

The Centers for Disease Control report:
  • Elderly people do not adjust as well as younger people to sudden changes in temperature. 
  • Seniors are more likely to have chronic medical conditions that change normal body responses to heat. 
  • Seniors are more likely to take prescription medicines that impair the body's ability to regulate its temperature or that inhibit perspiration. 
An Exceptionally Nice Summer in DC, until Last Week
I've lived in Washington since 1955. I can't recall a summer as nice as this year's. Then again, I can't recall a lot of things.

But this past week brought us more typical summer weather: temperatures over 90 every day, with humidity -- dew point -- often above 70.This triggered a repeat of the strange experience I've been having for the past several years.

Mad Dogs and Englishmen and Me

September 5, 2014

On Books and Bookstores

My current read: Paul Johnson's Churchill
Churchill is one of the "Penguin Lives" short biographies in which famous authors profile famous people in 200 pages or less. Biographies and memoirs are my first choice in reading matter. But most of today's biographies are far too long for me.

I've read several of the Penquin Lives and been disappointed in some that seemed heavy on facts but light on the anecdotes and commentary that make biographies interesting. But Paul Johnson does an excellent job of combining narrative with critical appraisal and human interest stories.

The portrait above was done by Sir William Orpen, one of Britain's finest painters. He painted it at an especially low point of Churchill's life, Johnson points out -- during World War I when Churchill was First Lord of the Admiralty until the disastrous Gallipoli campaign precipitated his removal from government. 

The portrait is considered the best-ever of Churchill. When it was finished, Churchill sighed, "It's not the picture of a man. It is the picture of man's soul."

I'm thoroughly enjoying the book and  find Johnson's writing superb. I've considered rereading Johnson's Modern Times, but it's 880 pages long.

"So Many Books, So Little Time"
Currently on my bedside reading table is Doris Kearns Goodwin's The Bully Pulpit which runs 910 pages... 782 if you exclude notes and index. It's been sitting there for months, and I can predict it will disappear unopened in my next fit of downsizing. 

September 4, 2014

Dr. Newport Says Goodbye to Coconut-Oil-for-Alzheimer's Claims

For about five years, Florida neonatologist Dr. Mary Newport regularly described how eating several spoonfuls of coconut oil every day had created a miraculous turnaround for her Alzheimer's-afflicted husband Steve. Then, for about a year, she fell silent.

Last week, she re-emerged with a blog post  suggesting -- as far as coconut-oil-for-Alzheimer's was concerned -- that she was moving on.

But her story about husband Steve created a sensation. During my internet research, I was forever seeing links to the coconut oil video that showed the "new Steve" vacuuming their living room carpet. First aired on Pat Robertson's Christian Broadcast Network, the video was seen by more than 5 million viewers and became CBN's most popular show of 2012. As Dr. Newport continued to tell her miracle story, many other promoters jumped on the bandwagon.

Then all of a sudden... silence. At first, we heard that Steve had suffered a stroke. That story turned out to be wrong, but it was clear that Steve had experienced some kind of health setback

Dr. Newport Returns 
Last week, Dr. Newport posted on her blog for the first time in over a year.

In her comments (shown in full at the bottom of this post), Dr. Newport summarizes the results of Steve's use of coconut oil. Prior to starting on coconut oil in 2008, Steve had spent five years in declining health from Alzheimer's disease (AD). After the coconut oil regimen began, Steve had a few fairly good years. Then the decline resumed.

Dr. Newport reported that she has received over 400 testimonials from others about coconut oil and AD. These reports came from people who tried "coconut oil and/or MCT oil." (emphasis added). It was Dr. Newport who counted and interpreted these testimonials.

September 3, 2014

Novartis Announces "Game-Changing" Drug to Treat Heart Failure

The biggest medical news this past week – some might say in the past decade – was the announcement that a new drug has been shown to significantly improve the chances for the estimated 26 million people in the world living with heart failure.

This announcement underscored two important realities for me, one uplifting and the other sobering:
  1. Important medical breakthroughs – in any arena -- are indeed still possible.
  2. Unfortunately, those breakthroughs are possible only when Big Pharma stands to cash in.
In this most recent widely-heralded case, Swiss giant Novartis’s new still-unnamed drug (LCZ696) – when compared to the best treatment now available (enalapril) -- showed these impressive results:
  • reduced the risk of death from cardiovascular causes by 20%
  • reduced heart failure hospitalizations by 21%
  • reduced the risk of all-cause mortality by 16%
Novartis announced the study results on August 30, 2014 at the European Society of Cardiology Congress in Barcelona, Spain. The findings were published simultaneously in the New England Journal of Medicine.

Reaction from the medical community was swift and very enthusiastic.

"This is a new day" for patients, said Dr. Clyde Yancy, cardiology chief at Northwestern University in Chicago and a former American Heart Association president. He played no role in the study. "It's been at least a decade since we've had a breakthrough of this magnitude," he added.

“I think that when physicians see these data, they will find it compelling, and what we will see is a paradigm shift,” said Dr. Milton Packer, a professor of clinical sciences at the University of Texas Southwestern Medical Center in Dallas and one of the two principal investigators in the study.

Mariell Jessup -- a heart failure expert at the University of Pennsylvania -- wrote in the NEJM’s glowing editorial that LCZ969 “may well represent a new threshold of hope for patients with heart failure."

September 2, 2014

Curcumin Update: Promising New Vehicle to Cross the Blood/Brain Barrier

Curcumin -- the active ingredient in the Indian curry spice turmeric -- is the only botanical whose efficacy has been clearly demonstrated by science. Almost 5,000 peer-reviewed studies now exist to support its beneficial effects. Most of the studies were small, and many involved mice and rats, not humans. There's no question: we need more large-scale, peer-reviewed, clinical studies involving people, and a number of them are underway.

Curcumin has powerful antioxidant properties, so it can fight inflammation. Many diseases are accompanied by inflammation and -- according to some research -- are triggered by it. Curcumin also appears to combat ongoing cellular damage. These dual attributes -- combating inflammation and cellular damage -- could affect virtually all tissues in the body, including those in the brain.

What's especially exciting to me (and millions of others) is curcumin's potential to fight Alzheimer's, Parkinson's, and other neurological disorders related to inflammation.

Over a year ago, I set up a Google "curcumin" alert so I'd get the latest news. I usually hear about another promising new study every week. Here are the two most recent:
  • Discovery shows that curcumin blocks the metastasis of colon cancer by a new method.
  • Curcumin supplements may help with depression.
Most human studies of curcumin have focused on people with existing health problems. But one recent study looked at a group of healthy middle-aged people and concluded that a low dose of curcumin "can produce a variety of potentially health-promoting effects" for them.

Why aren't we all popping curcumin pills or eating lots of turmeric-heavy curries?