Artificial heart

The New York Times is reporting that the US Food and Drug Administration approved the sale of the first fully implantable artificial heart. Apparently, this device allows the patient to move about freely for up to two hours at a time.

The approval was given even though the grapefruit-size device was implanted in just 14 patients at four hospitals from 2001 to 2004. All of the patients, who agreed to receive the heart as an experimental device, were men, and all have died.

Two died from the implant operation. A third never regained consciousness, and the rest survived an average of five months. The longest survivor lived 512 days, when the mechanical heart failed.

Did I read that right? Fourteen patients in a four year period? All who received the device eventually died? If this was a medication, then it would be laughed out of the room instead of being approved.

The company is approved to sell 4,000 a year. But, in all likelihood will only be about 25-50. The cost? A cool $250,000. The company is not even sure if it will receive insurance coverage for the device yet.

For me, this is under the category of "just because we can do something, doesn't mean we have to do something." Granted, I realize that there are thousands of people who die each year waiting for a donor heart. The article also states that in the last six months of live, the slowing dying heart patient incurs an average of $1 million in ICU expense alone.

But, 14 patients in a four year period? Fourteen months ago, according to the article, the FDA voted to deny this same device because of concerns of complications like bleeding, strokes, and infection. Like the FDA is not embroiled in enough controversy with Plan B, Vioxx, Bextra, and other medications in the news.

In my opinion, these are just lawsuits waiting to happen. And, there are attorneys salivating out there just waiting for something to go wrong so that they can swoop in to defend these "victims" against the evil entrepreneur doctor who is seeking fame and fortune at the expense of a patient with a failing heart.

Update: I didn't realize the New York Times site only has limited access. Here's the article from The Washington Post. Hopefully, there are no access problems with this.

Stingray tape

The initial postmortem examination confirms that a stingray's venomous barb pierced Steve Irwin's heart causing his death, according to this article from National Geographic News.

It's not surprising to imagine that this entire incident was caught on tape. But, this article does confirm that there was video footage of the attack. This footage will now be examined by the coroner.

Irwin's friend, director, and producer, John Stainton, who was on Irwin's boat Croc One when the attack happened, says it is too early to release the footage of his friend's fatal encounter to the public.

What? Does anyone actually want to see this footage? I know that I don't. But, you know what will happen. The tape will be leaked out in some way and eventually end up on the internet and probably YouTube.Com as well. His family, friends, and fans are suffering enough. I hope this video is never released.

Update: Health Psych made this comment, "And the Steve Irwin backlash kicks off..." This article from the Guardian clearly exhibits this.

As a Melbourne boy, Irwin should have had a healthy respect for stingrays, which are actually commoner, and bigger, in southern waters than they are near Port Douglas, where he was killed. The film-makers maintain that the ray that took Irwin out was a "bull ray", or Dasyatis brevicaudata, but this is not usually found as far north as Port Douglas. Marine biologist Dr Meredith Peach has been quoted as saying, "It's really quite unusual for divers to be stung unless they are grappling with the animal and, knowing Steve Irwin, perhaps that may have been the case." Not much sympathy there then.

Blaming the guy who got killed? What the hell is that about? It's worse than kicking a guy when he's down. It's kicking a guy when he's dead. This really gets me upset. Of course, the next paragraph of the article mentions the controversial episode where he had his one month old son in one hand when visiting a crocodile in an Australian Zoo. The press just get me fired up sometimes.

Here's what I predict is going to happen. Politicians both in Austraila and in the US will use the hype generated by the press to pass laws preventing less direct contact between animals and people. The politicans will get a hold of the videotape from the Irwin episode and will broadcast it to make their point. The consequence of this will be significantly less wildlife/nature shows for television. And, television networks like Animal Planet will eventually become extinct. To be honest, I don't even watch nature shows. Am I overreacting to all of this?

Blogaholics Anonymous

Hello, I'm Dr. A, and I'm a blogaholic... Here's a question: Is it possible to tag yourself? (Insert joke here.) Anyway, in catching up on my bloglines, I was over at The Granola Rules and she got tagged by the latest meme to circulate the blogosphere. Title of the meme: What does blogging mean to me?

With everything going on lately (at least in my circle of bloggers), I figured, why not have a BA meeting and go through these questions! Now, BA meetings are only for those addicted to blogging (see my sidebar for details). If you're not, then this post is not for you - except if you're in denial of your blogging addiction - HA! Since, I'm hosting the meeting, I'll answer the questions first.

1) Are you happy/satisfied with your blog's content and look?
Uh, since day one of my blog, I've been obsessed with my sidebar and I have kept adding things to it. If people have cool sidebar stuff, please let me know (am I allowed to say that at a BA meeting?) As far as the content, I've been asked if I know any receipes and I can affirmatively say NO! (I'm not a cook, I only play one on TV) HA!

2) Does your family know about your blog?
Are you kidding? No way. Even if they did know, they wouldn't find it interesting. I don't talk a lot about my family in my blog. Not that I have a problem with talking about your family, I just choose not to.

3) Do you feel embarrassed to let your friends know about your blog? Do you consider it a private thing?
I presume this means your non-blog friends. I've been struggling with this question since I started. I guess I'm still of the mind set that it is a private thing. I've had some of my blog friends try to get me out of my shell to reveal myself, and I've been hesitant. Still thinking about my "semi"-anonymous status.

4) Did blogging cause positive changes in your thoughts?
I have no idea what this question even means. I'm glad I started blogging and I'm glad that I'm continuing. There were times when I considered stopping. But blogging definitely fills a need I have to express myself and connect with other people.

5) Do you only open the blogs of those who comment on your blog or do you love to go and discover more by yourself?
When I first started, I loved discovering blogs on my own - mainly by hitting the "Next Blog" button to see where I have ended up. Now, that my blogroll and my bloglines have increased, I've had less time to randomly stroll around the blogsosphere. I miss that.

6) What does a visitor counter mean to you? Do you like having one on your blog?
Great question. Yes, I do have a counter. I'm very competitive, and I have to admit that I'm jealous of those of you out there who have hundreds and hundreds of hits a day. I'm resigned to the fact that I will probably always be a Slimy Mollusc and will always be around 100000 on Technorati. But, I come back to telling myself that I do not blog for rankings or popularity. I blog for myself. If I lose sight of that, then that's the time for me to stop.

7) Did you try to imagine your fellow bloggers and give them real pictures?
I know fellow bloggers imagine me *waving at wolfbaby*. But, seriously, I have not given a real picture out, yet (see question 3 above)

8) Admit it. Do you think there is any real benefit in blogging?
Of course there is, or else none of us would be doing it. I tell people blogging is like putting a podium in the public square and speaking your thoughts. People can choose to listen, or not. People can choose to interact with you, or not. But, in a way, you feel like you're heard by someone, and that's comforting.

9) Do you think that blogger's society is isolated from the real world or interaction with events?
I think bloggers are part of the world in general. Do some bloggers choose to isolate themselves from current events? Yes, but some non-bloggers isolate themselves as well.

10) Does criticism annoy you or do you feel it's a normal thing?
I think I criticise myself more than anyone else. I don't know why, but I've gotten that feedback my entire life, "Don't be so hard on yourself." Criticism is normal and necessary. It just has to be constructive and not destructive.

11) Do you fear some political blogs and avoid them?
I don't fear political blogs, but I do avoid them. Especially now, politics is not about ideas and vision and leadership. Politics now is about total obliteration of a person's character and reputation. That's why the people who should be in politics to change things for the better - they avoid politics, and that's very sad.

12) Were you shocked by the arrest of some bloggers?
Technically, I was not arrested, I was only questioned. Just kidding. Were bloggers arrested? I did not hear of that.

13) What do you think will happen to your blog after you die?
I think it will be at the Library of Congress for future generations to study and learn from. Yeah right. I don't know what will happen to me tomorrow, let alone about my blog after I die.

14) What song do you like to hear? What song would you like to link to on your blog?
My Way but sung by Elvis Presley

15) The next "victims"?
I'm not going to tag anyone. This is a good set of questions. Blog about it if you like, or just comment on my answers. Thanks for stopping by!

Labor Day

If you ask any American what Labor Day is, you will probably get a variation of answers. It's not like Independence Day or Thanksgiving where there is a story that gets repeated every year. How did Labor Day start? When was the first Labor Day? I have no idea.

For most school kids in the US, Labor Day means the last weekend of summer. Most schools begin classes the day after Labor Day. One distinct memory I have of this holiday weekend is going to our local fair. This is a huge annual event around here. I never lived on a farm, but I had a lot of friends who did. Their entire summer was centered around this fair. Some had prized animals that would be shown and judged every summer (horses, cows, etc). Others helped their parents in the garden and had prized vegetables that would be shown every year. We have a diverse community and there would be a showcase of different ethnic foods, arts, dancing, etc, during fair week. Lots of great memories from back then. There are times I wish I could go back to those innocent days. The days when my biggest worry was whether my friends and I would have the same teacher for school the next day. Ahhhh, those were the days.

Another memory I have is watching the US Open tennis tournament every year with my parents. I still do this, and I'm planning to go over there today. In high school, I was really into tennis (when I was more athletic than I am now). And my friends and I would follow the tournaments all through the summer with the pinnacle being the US Open. Yesterday, one of my childhood heros played his last professional tennis match: Andre Agassi. I have watched this guy for the past 20 years, at different stages in his career and in his life. I'm always inspired by a superstar athlete who admits when things are not going well. I learned a lot about tennis and a lot about life. Thanks Andre.

The final memory that I'll mention is the annual Jerry Lewis Labor Day Telethon for the Muscular Dystrophy Association. Pk has had some very informative posts this weekend about muscular dystrophy. I encourage you to check them out. I had no idea what a telethon was until I started watching this as a child. I would ask my parents, "If the show goes on all day and all night, when do people sleep?" This was also one of my first introduction into fundraising as a child - not a bad thing, just a new concept that I learned as a youngster - the concept of philanthropy. I kept asking myself, "Why would people help other people that they don't even know?" I soon learned the answer to that one. Finally, it was one of my first introductions into medicine, or, at least, learning about a disease process. As a child, and even now, it was/is hard for me to imagine a child suffering for any debilitating disease.

Finally, I'm glad just to get August behind me. That was a very turbulent month on a lot of different levels. Thanks to May for giving me some closure and the ability to move forward. I'm ready to satisfy my blogging addiction again.

Break

On call today/tonight, and may start the holiday weekend early.
Back soon...

Here on gilligan's isle

"Just sit right back and you'll hear a tale, a tale of a fateful trip.
That started from this tropic port, aboard this tiny ship.
The mate was a mighty sailin' man, the skipper brave and sure.
Five passengers set sail that day, for a three hour tour..."

Do you know the rest of the words? No, I don't either. Did you know that for a mere $90,000 that you too can own the famed S.S. Minnow from the Gilligan's Island television series? Thanks to the person who sent me this link from CNN.Com talking about this story.

The twin-diesel, 36-foot (11-meter) mahogany Wheeler Express Cruiser hit a reef in Hecate Strait as the former owner was taking the vessel down the coast from Alaska. Scotty Taylor of Parksville said the owner sold the 46-year-old boat to him for salvage on condition that he promise to restore it.

Schultz, a boat broker, estimated Sunday that the work cost more than $180,000...

Taylor is selling the storied vessel because he is tired of it.

"He's going on 70 now and doesn't want to bother with it anymore," Schultz said. "It would make a great investment for a three-hour tour."

Likely story. I heard that this guy just got sick of all the Gilligan's Island jokes. Wouldn't you? I don't blame him. Give this guy some cider. I think that will definitely make him feel better.

Pain

When I first started exploring blogs, I was amazed by the amount of bloggers out there writing about pain. Pain that was difficult to diagnose. Pain that was/is difficult to treat. Pain that no one would believe -- except the blogosphere.

I read this interesting article from the Washington Post this morning talking about patients who have pain without a known cause -- meaning all testing that has been done is negative. The term somatization disorder is given to these individuals.

(Don't get me wrong, all the blogs that I read talking about pain do have a medical diagnosis and are receiving treatment. I want to be clear that I'm not labelling anyone that I read with the above term.)

I found the article interesting because it describes a treatment called "Cognitive Behavior Therapy," that teaches patients practical skills to help manage their symptoms.

The patients' ability to function, as measured by the number of stairs they could climb and the distance they could walk, was improved, and they reported being less troubled by 40 symptoms, including headaches, nausea, joint pain and difficulty swallowing.

The article goes on to say that those with this disorder may be more focused on their bodies than other people and have difficulty determining what is "normal" aches and pains - perhaps a "hypersensitive nervous system."

Arthur Barsky, a professor of psychiatry at Harvard Medical School and expert on medically unexplained symptoms, said he considers cognitive therapy essential.

"I focus on the way people think about their symptoms and try to decrease their hyper-vigilance," said Barsky, who has published studies of both somatization and hypochondria. He teaches patients to stop scrutinizing how fast their heart is beating, for example, to quit touching their neck to see if a lymph node is swollen, and to avoid searching the Internet for clues to their symptoms.

From my perspective, pain is a difficult thing to get a handle on. There has been a movement, especially in the medical community, to make an assessment of pain (during an office or hospital visit) as common as taking a blood pressure or obtaining other vital signs. I think this is a good thing, because I admit that docs probably don't address pain very well.

I definitely agree that there is a mind/body link. With that in mind, there has to be options for these individuals with somatization disorder. If cognitive therapy is proven to help is most cases, I'll definitely utilize this treatment option. I'll be closely watching the scientific/clinical studies as they further unfold.

Cider elixir

Those wild and crazy researchers at the University of Glasgow have really come up with something interesting. According to All Headline News, it all has to do with cider.

English cider apples are known to have a high quantity of phenolics - antioxidants that are associated with prevention of stroke, heart disease and cancer. Researchers are now looking into whether these same benefits could be observed in cider drinkers.

Researchers led by Serena Marks and funded by the Biotechnology and Biological Sciences Research Council (BBSRC) and the National Association of Cider Makers will be looking at the effect of drinking cider in 12 volunteers in the next few weeks. The purpose will be to study how phenolics are absorbed and metabolized by humans.

Hey! Over here! I'll be happy to volunteer my services for the sake of science. I'll even bring my own cider -- my favorite one is right here. *LOL*

Cell suicide

There's a story out today stating that scientists at the University of Illinois have found a way to make cancer cells "commit suicide" thereby "stopping [cancer] in its tracks." If this research can eventually made into some kind of medical treatment, other than side-effect-filled chemotherapy and radiation therapy, this is great news!

Here's a sample of the news coverage today --
Medical News Today: Making Cancer Cells Commit Suicide
Scientific American: New Compound Causes Cancer Cell Suicide
BBC News: Cancer Cell "Executioner" Found
New Scientist: Reawakened "Executioner" Makes Cancer Self-Destruct
MedIndia: A Synthetic Molecule Instigates Cancer Cells to Self-Harm

I'm probably the only one that finds this curious, but I was very surprised by the "non politically correct" language that was used in describing this news story. If a person committed suicide, would that be in the headline? Would the word "executioner" be used in a headline? Maybe I think about things too much. You're right, I should just get back to work.

Talk

"Thank you so much for inviting me to speak at your Alzheimer's Association support group this evening. I really appreciate this opportunity..."

I mentioned a few of weeks ago that I was going to do this talk. Thanks to all those who gave me comments and e-mail on this. This feedback helped me in my preparation.

I did a similar talk about 3-4 years ago at the hospital. There must have been 70-80 people there. When I showed up to the support group meeting, there were seven people. My reflex, at first, in a totally selfish thought was, "Only 7 people? I prepared a talk for only 7 people?"

After a few seconds of reflection, I knew I was being ridiculous and very selfish. I also knew that if there was only one person there, that one person took the time out of her/his schedule to hear a doctor talk about this mysterious disease.

What usually happens is that the question and answer session is better than anything that I prepare. So, I condensed a 60 minute presentation into about 20 minutes. "Are there any questions?" -- And, boy there were! A few of them were right along the lines of Moof's questions from earlier this month: How soon do you really want to know, Suicide: Acceptable in Alz, and If You Could Choose. Cathy has also posted about Alz before - namely devoting her blogfest to Alz Assoc, and this post called Skin Test.

Each person there shared her/his story about Alzheimer's. I couldn't help but feel helpless. With all the knowledge and training that I have, I knew that there is no cure for this disease, yet. One person there had concerns that her husband may have Alz. She was afraid to tell him that she was going to attend the meeting, and had questions "that only a doctor could answer." Unfortunately, I did not have a lot of answers, but I think she felt ok with what I said.

"In this day and age," one of the group members said, "older people would rather have cancer than Alzheimer's Disease." I have not stopped thinking about this statement since that night. Such a powerful statement, yet, I believe it's true.