Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts

9.16.2009

NYC Considering A Smoking Ban in Public Parks

NYC is a small city, which means that Central Park is crowded - very crowded. Sheep's meadow at the base of the green rectangle looks more like Waikiki beach on summer weekends than it does its pastoral namesake.

In that context, I understand the proposed ban on smoking. Having someone light up 3 feet away there is not much different from having someone light up at the next table in a restaurant. It'd ruin the whole experience for me.

That said, Sheep's meadow is one place at one time. There are a few more select spots with this type of outdoor population density: Screen on the Green...the north (and now south) sections of the Great Lawn on Shabbat afternoon. In any other context, a smoking ban seems, well, needlessly paternalistic. Times Square is more crowded on a regular basis. Shouldn't we ban smoking there first? Same goes for most NY city streets at commuting hours and at lunch. Same deal? If the reasoning can't be applied consistently in city ordinances, I say drop it. Heck,the expense of putting up no smoking signs in all the parks is enough to sully the notion in my mind.

9.08.2009

Placebos Gaining Market Share

Wired has a great feature on the placebo effect. Pharma is paying more attention as more and more drugs are losing to the placebo. And it isn't because the drugs are less effective. They have the expected positive effect. Thing is, the placebo has recently started to have an increased positive effect to rival that of the drugs.

If that's the case, could doctors just make the judgment call to prescribe a placebo in some cases and see what happens? You have a tough-to-place pain in your arm. Doc tries a few things and then decides to prescribe Panaceanol(tm), a new Merck placebo that is just sugar. A week later, you feel fine. You've triggered your own body's ability to deal with the injury/illness, introduced fewer chemicals, and done so more cheaply. The cost was, in part, having to fool you into doing it. Is it worth it?

Most importantly, is there any way to permit Drs. to do while mitigating any chance for abuse?

4.08.2009

Smoking - in any form - Kills.

Just have to read it to believe it: http://news.bbc.co.uk/2/hi/health/6639461.stm.

Suddenly, I am lot more sympathetic to the argument that you may have a shorter life, but it will be worth living.

9.02.2008

High Stakes Poke Her

I respect Obama's statement that the Palins' family troubles are not a matter for the campaigns, but this is certainly a public discussion. Cast in relief is the wisdom and effectiveness of abstinence-only education.

Abstinence-only is a high stakes game. If you can't stick to that tenet, and clearly many/most can't, there is no backstop to pregnancy. When I was taught sex ed, we were repeatedly told that the only way to have safe sex was not to have sex. Abstinence-only advocates think that message is diluted by the rest of the education, which dispells the very real misconceptions teens have about conception and coitus and explains what the risks are and how to avoid them.

I don't know if education about condoms or other contraceptives would have helped in this situation, but wouldn't you have wanted this young woman to have the benefit of that education? (Actually, for all I know, she did have the benefit of it. I don't know what curiculum her school teaches).

And as an aside, I see hypocrisy in the right wing's embrace of Palin through this episode. This is precisely the situation they point to as evidence that abstinence education is necessary. If it were Barack Obama's daughter, they would decry it as the result of a morally bankrupt educational system. And if she decided to keep it, they'd ignore the pro-life angle and talk about the burden teen mothers place on our economy every year. Sure, perhaps McCain wouldn't, but the swift-boaters certainly would. What makes this any different? Palin can't keep her own house in order, why should we give her the spare keys to the White House?

5.29.2008

Orifice Politics

[ Warning - this content is a little more explicit than some other posts ]

Slate reports on an Adolscent Health Journal survey that shows that well over 3/4 of people who has lost their "vaginal virginity" have also lost their "oral virginity." Their what? How do you lose something I never even knew you had?

Also, this is a perversion (I know, isn't it delicious?) of the concept of virginity. Originally, virginity was determined by the rupture of the female's hymen. Apparently, the new conception of virginity isn't about piercing, and it isn't about entry either. Clearly things go in and out (in and out) of people's mouths all the time. What determines virginity now is not if but what is placed in an orifice or, more remotely still, for what purpose an orifice is employed.

Taking this idea to it's logical extreme, why not presume a virginity for every part of ourselves not yet sullied by the sex act. Mental virginity until the first sexual thought, sleep-away virginity until the first make-out session at camp, residential virginity - which really should be subdivided by the type of room in your house ... and we should probably include the car, the yard, motels, hotels, resorts, and the ocassional deserted-but-still-public place.

Or we could just go back to calling "oral virginity", "the first time they had oral sex."

5.15.2008

I Got To See Inside My Head This Morning

I got to see inside my head this morning because yesterday morning, at about the same time, I lay stomach-down on a bench and perched my chin on a pillow made of the same foam as a car bumper. From the four-foot diameter plastic doughnut before me came lasers in multiple cross hairs. The bench lifted me into the doughnut where I could see that the doughnut had rings that began to spin.

I got to see inside my head this morning because the doctor wanted a CT scan. Looking over it, we stepped back from my nose, through my eyes, into my brain, and out somewhere near the top-most edge of the spine. I could tell it was me because the first shot was a profile, and the flesh adorning my bones formed a very familiar silhouette. There were a lot of black spots. These, he explained, were my sinus cavities. I am already perturbed by the thought that we only consciously use 10% of our brains. Now I have learned that, in addition, about a quarter of my head is completely hollow.

I got to see inside my head this morning to point to a little grey deposit between the blank of my sinuses and the ghost-white of my bones. This is inflammation -- remnant of an infection. While there is still plenty of cavity around it, this is what makes it harder to breath. This is what motivates me to take the pills and puff the puffs for another two months. I don't have time to mull over the significance of the voids in my head. For now, I am their champion.

I got to see inside my head this morning and it convinced me to help make it a bit more hollow.

3.24.2008

Better Living Through Chemicals

Just a quick rundown of the drugs I have been on while trying to rid myself of a baterial infection or what-have-you:
  • Azithromycin (anti B)
  • Cefuroxime (anti B)
  • Gaufenesin (both with Codeine and OTC)
  • Advair
  • Tessalon Pearle
  • Sudafed
  • Levaquin (anti B)
  • Flonase and its new buddy Verqmyst
  • Prednisone
  • And an attempt at Nexium (ins. rejected, so I need to downgrade to Prilosec)

I am pretty sure I am forgetting some of these. Along with these came the cough drops and the lozenges and the tea and the smoothies and the staying off of my feet for several weeks and...well, you get the idea.

3.07.2008

Vitamins Contribute to Health?!

I have been saying it for years: Airborne and similar vitamin supplements that claim to be cold remedies etc. are a crock. Don't believe me? Well, Airborne itself has come around, settling a class action today for $23M. The claim: it don't do squat for colds.

If you bought the stuff recently and have the receipt for $6.99 - good god!- you can get a refund for up to six boxes.

And if you like taking vitamins before you get on to the recycled air environs of a plane, good for you and your immune system. The generic effervescent vitamins contain the exact same stuff as Airborne and sell for about $2.

Wii Blind


Instead of tapping a long, white stick, the blind could be using this nifty force feedback wand in the future. It will sense objects and buzz with an intensity relative to the size and proximity of the object. Awesome.

Two problems. First, how long will it take the blind who have been using the stick for years to learn this new sensation (I imagine good human factors engineering should solve this)? Second, those sticks let us seeing-eye humans know that there is a blind person around. Won't people walk into the blind a lot more if they use this incospicuous device?

3.05.2008

Pulmonology Redux

Hopping out of a cab in DC mid-March into a spring sunshine is elating. 244 Elm St. NW. That elation quickly disappeared when I called my doctor's office to find out why their eight story office complex was not readily apparent down this quaint, residential street near Howard University.



"For our address, please press four." Remove phone from ear. Press. Replace. "We are located at 2440 M," with a popping M-phasis, "street." Oh. That's about 24 blocks from 244 Elm St. and there aren't many cabs around.



Twenty minutes later, having paid double the cab fare for my error, I entered a pretty packed waiting room. My first impression was that people in their late twenties don't suffer many pulmonary disorders. Looking around the scene from a well-populated motel-lobby, I calculated I was the minority by about ten years.



If the decor was off-putting, the rest of my stay in purgatory wasn't. The forms were clear, bolding and underlining the quirks of the office so they pop out at you -- provide a CC number so we can charge that if you don't send a check to cover that which your insurance won't, and so on. All the while that I was printing, scrawling, and dating my name, nurses shuffled over to waiting patients. They knew their names. They spoke in a soft, familiar tone, and they genuinely hoped the elderly woman or the lightly wheezing man felt better between this and the next visit.



"Mister Cohen!" This would be the first of many sharp reports from deep within a Caribbean matron behind the desk. "C'mon back," pronounced "bock," and I was in.



I haven't disrobed for a doc since my physical, and that, at least, was expected, so when I was handed a gown and told to unbundle to the jimmies, I was put off. Exam rooms are stuffy with a minty, electric air anyway. This one was a little older, a little more used. The mintiness had gone stale. I obliged and draped my clothes on the chair, the scale, my shoes. Just as I finished the doc knocked. He is one of those people you don't really see as they wander by down the street. Not invisible, just unremarkable. Still, this was "Washington's best" pulmonologist of 2005. By the time I left, I counted at least seven lexan awards and several framed announcing the same peppered from room to room.



He took a history, jotted a bunch of notes, asked what seemed to be right questions, and, most important to my taste, didn't rush the experience. "Did the Advair work?" Kinda. "Like this, or like that?" More like the second thing. "Ah hmm." We ran through a test pattern of noises that I might have made. Yes, I hack. No, I don't snort or wheeze. My throat closed up when I ate spicy food. No, I don't have any symptoms of heart burn. Scratch, scratch, scratch. "Great. We'll get you a chest film and a breathing test."



"Mistah Cohen!" I donned my pants as instructed and headed for the x-Ray room. The only light in most of these rooms comes from the protective portal to the operators booth. That is, until they turn on the machines cross-hairs. This one stands up and looks like a robot about to give a mechanical hug. You lean into one of the arms. The other holds the xRay gun. You end up facing a wall two feet away that contains the developing machine, the power supply, and two heavy chemical resistant gloves. They look like hazmat gloves and the spray of brown fluid on the wall below them creates an unsettling combination. A Lysol spray-can completes the tableau. "Shoulders forward." A quiet instruction followed by the unease of cold metal. She steps into the booth. "Dip Breth!" The sharp report at four times the volume would make you gasp involuntarily anyway. The gurgling sound starts behind me and trails off a wet exhale. One more from the side and I am back putting on the rest of my clothes.

I thought going in that I might like the breathing test. I am a big fan of breathing and a big fan of computers. I figured doing one and seeing it plotted in real time on the other might be neat. Problem is, you don't go for a breathing test when you can breathe, you go when you can't. That, and the mechanical arm with a variety of hoses hanging off of it is reminiscent of the scream sucker from Monsters Inc. My Caribbean commandant tells me to sit and explains that when she stops cooing "nooormallll" and barks "Dip Breath!" I should suck and then blow until I am blue in the face and not stop until she instructs me to do so even though it feels like the last ounce of humanity is now seeping into the breathing tube.

It took me three or four tries. I took two breaks as I lost the ability to breath. Turns out that if you don't blow hard enough or long enough, the test parameters are no good.

More waiting. The doc comes back to get me. Chest films are clean. Breathing looks normal, perhaps slightly asthmatic, but this is most likely post nasal drip. He concludes that we take the Veramyst and Claritin D for three weeks and we'll see where we are. I ask if it is normal for a cough to last this long. He says it's possible. What about developing asthma in your late twenties. "It is not rare." Personally, I hope it's rare enough, but I guess we'll see in a month. Right now, I have drugs six and seven of my progression to get me through the day.

1.16.2008

Some Immuno-Comic Relief

Some of you know that I have been ill for the past week. A trip to the doctor confirms that this is in the enourmously broad category of "cold," rather than the equally cavernous bucket, "flu." Treatment: none. Patient has been instructed to "treat the symptoms." Patient lives in Washington D.C. and is well aware of-, and unsurprised by, this strategy.

This cold has launched me into such coughing and sneezing fits as I have rarely known. Yet, one stands above the rest. On my forehead is a bump, a result of a full torso-folding sneeze in the bathroom, followed immediately by a second-wave sneeze.

Ah-choo!, Ah-chooo! Ugh!

Dazed, patient looks up at the mirror to realize that he has hit his head on the faucet to the sink. Patient remarks to himself that this cannot be possible given that the faucet is one of those low-set modern types "way down there." Patient's new bump begs to differ.

Owie.

12.20.2007

Ooh, My Baseless Calorie Estimate is So High!

http://www.nytimes.com/2007/12/20/health/nutrition/20BEST.html?_r=1&oref=slogin

Anyone who has ever stepped on a piece of gym equipment knows that calorie counts are like guessing the number of jelly beans in a jar. To get an accurate count you'd need a chest strapped heart rate monitor, a realistic insert of your weight, your age, a machine regularly maintained so that tension readings were accurate....and the whopper -- a good sense for how your metabolic rate measured up with that of the average person with your height, weight, sex, and age.

Here's how I measure:
1. How much do I like doing that particular exercise? Hand-bike? Hate it. Not doing it.
2. How disgusting am I when I get off the machine? (Anyone who has played a sport with me knows that I do not sweat. I just degenerate into grades of gross.)
3. Over the course of a week or so, where do I notice I am losing some weight. Usually, I notice if I am growing a tummy or not.)
4. Run. Nothing, except perhaps rowing, is as strenuous.

9.06.2007

Fixin' to Perambulate

I'm out of my walking boot today!
I'm out of my walking boot today!
For those of you who give a hoot,
I just shed that stinkin' boot
And traded in the boot for Ankle Staaaaaaaaaaayyyyyy!

[ Thanks to Avenue Q and RSC ]

p.s. be afraid. be very afraid.

7.30.2007

For those wondering, it is broken.


My fifth metatarsal. 6 weeks in a walking cast + post-cast rehab. un-w00t.
Oh, and can someone please explain to me why insurance will cover a $300 fiberglass cast that must be replaced at least once, but will not cover a $150 walking cast that will last the term of my injury? My doctor and I were reminiscing about the days when he could prescribe what he thought was best for me simply because it was, y'know, the appropriate medical treatment. Ah, those were the days.

7.25.2007

The Line Between Stupidity and Genius is Blurred


You're looking at a cure for st-t-t-tutering. (That's probably unduly harsh. I have a few friends who stutter, so I know full well that it bears no relationship to intelligence -- just the impression thereof.)
What is so ingenious about this is its simplicity. It operates on the choral effect. It turns out that a stutterer will be able speak normally if speaking in harmony with others (a kind of "tag-along" effect). Solution: feed the stutterer's own words back into his/her ears via a hearing-aid-like device and modulate it so it sounds like a chorus of voices.
What amazes me is that nobody managed to come with this sooner. I mean, "duh!"

6.14.2007

Artificial Pinky. (Follow link for the video).

It appears that little biofeedback is needed. Rather, the mechanical contraption figures out the appropriate curl of the finger based on the angle of the remaining stub -- of course, as in all things, you have to keep your stub.

6.13.2007

TMJ - Temporomandibular Joint

Turns out we all have "TMJ." If you don't, you are missing something resembling the bottom half of your face -- a subject we will not take up here.

If you have what is commonly-known as "TMJ," you (like me as of this moment) suffer from a strain, inflammation, and consequent misalignment of that joint. How can you get this? I got it from a car accident and made it worse through basketball. The general answer, however, is: anything. You can do just about anything that causes trauma to the jaw and get it.

The solution: same as for a strained muscle. Rest, ice, and anti-inflammatories. Here we go...

5.10.2007

Healthier living through purses. Turns out the things are coated in germs and you ladies set them right down on eating surfaces. Honestly, I don't blame you -- I didn't give this a second thought until now.

Simple. Of course, that is what makes it genius. Now, if only we could figure out similarly simple and ingenious ways of effectively reducing our impact on the environment instead of vice versa.

5.09.2007

This public service announcement brought to you by generic Daypro:

If someone knows the number for Gregory House, please pass it along. For the rest of you, let's see if emulating the renowned TV diagnostician has armed you to deduce the cause of the following: jaw pain on the right side; not in the teeth, and just below the ear, occasionally pulling at the canal; bad enough to wake up the patient in the middle of the night and make for a generally irritable disposition during the day.

Possible causes:
1. Minor car accident in which the patient's head was tossed forward while the patient was looking 90 degrees to the left. Sound like whiplash? I thought so too.

2. Insufficient hygiene following fairly extensive dental work in the area not four months ago. Cavity? Good bet, even though the pain was not localized in the teeth. This theory went out the door when the pain started shifting from lower to upper jaw and back.

3. Stress: a history of teeth clenching and grinding. This is third on the list because it is a relatively recent recurrence of a childhood habit. The dentist originally caught it after the patient experienced pain on a business trip following a procedure. Altitude? Eh. Not enough to cause this type of pain.

Current most likely cause: Number 3, clenching. Turns out that having an abnormally strong bite can be downright excruciating when coupled with stress and a nasty unconscious habit.

Enter daypro: an anti-inflammatory that will at least make it all go away during the daylight hours. As for the stress that induces the clenching...well, there are always refills.

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