April 18, 2009

USS Stockdale Commissioning

Today marks a fitting honor for a true American hero.

The Navy will commission the newest Arleigh Burke class guided-missile destroyer, Stockdale, during an 11:00 a.m. PST ceremony on Saturday, April 18, 2009, in Port Hueneme, Calif.
Designated DDG 106, the new destroyer honors Medal of Honor recipient Vice Adm. James Bond Stockdale (1923-2005), the legendary leader of American prisoners of war (POWs) during the Vietnam War.
Stockdale was the highest-ranking naval officer ever held as a prisoner of war in North Vietnam. His plane was shot down Sept. 9, 1965, while flying combat missions over North Vietnam. Stockdale spent more than seven years in captivity at prisons in North Vietnam, including time at the infamous “Hanoi Hilton.” Four of those years were spent in solitary confinement. While imprisoned, Stockdale is credited with organizing a set of rules to govern the behavior of fellow prisoners of war and for helping to develop a code for prisoners to communicate with each other that included tapping on cell walls. In recognition of his leadership and sacrifice he was awarded the Medal of Honor in 1976.
Stockdale received 26 combat medals and awards, including two Distinguished Flying Crosses, three Distinguished Service Medals, two Purple Hearts and four Silver Stars. He was also named to the Aircraft Carrier Hall of Fame, National Aviation Hall of Fame, and was an honorary member of the Society of Experimental Test Pilots.

Admiral Stockdale was one of those men I was brought up to admire for the courage he showed during his years as a POW. He served this nation well, in both war and peace, in both military and civilian life. May the officers and crew of USS Stockdale be worthy of the superior naval officer for whom their ship is named.

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March 24, 2009

Gardasil Causing Lou GehrigÂ’s Disease?

I took a hardline stand against mandatory vaccination for young girls when Texas Gov. Rick Perry decided he wanted to play doctor with every sixth grade girl in the state of Texas, because I did not and do not see a sufficient nexus between school and an STD to justify the requirement. At the same time, I indicated that I would probably have my own daughter vaccinated if I had one. Others, though, raised issues of long-term (or even short-term) health consequences. It now appears there may be a rare one.

Phil Tetlock and Barbara Mellers were in a race against time to save their 15-year-old daughter, Jenny. As I reported last summer, Jenny developed a degenerative muscle disease nearly two years ago, soon after being vaccinated against the cervical-cancer-causing HPV. She became nearly completely paralyzed, though her mind was perfectly intact and she could still enjoy her pet parakeet, Hannah Montana, and Twilight.

I've been E-mailing Phil regularly over the past year, and up until our last E-mail, one week ago, he had been holding out hope that they would be able to find a cure for his daughter—or to at least determine if the human papillomavirus vaccine called Gardasil had caused his daughter's illness, most likely a juvenile form of amyotrophic lateral sclerosis (aka Lou Gehrig's disease). Sadly, the clock ran out last Sunday, and Jenny passed away.

Through their efforts to publicize Jenny's case on their blog, Jenny's parents have connected with two other sets of parents whose daughters developed what appears to be ALS after being injected with Gardasil. One was 22-year-old Whitney Baird, who died last August, just 13 months after receiving Gardasil. Another is Alicia Olund, a 12-year-old who began having trouble walking after getting her third shot last September. She now uses leg braces and a walker at home as her muscles continue to deteriorate. After ruling out other conditions, her specialists at the University of California-San Francisco Medical Center—who also treated Jenny—suspect that Alicia may have the same condition. "They don't know what she has," her mother, Barbara, tells me through tears, "but it's destroying her nerves and muscles, and none of the treatments they've given her are working. Before the vaccine, she was a perfectly healthy child, going for her brown belt in karate." (They're awaiting the results of the ALS test.)

Juvenile ALS is rare, with there being about 1 case for every 2 million teens. What’s more, there is no definitive link between the disease and Gardasil – but it appears suspicious that these three girls (among others) had the disease develop so soon after taking the HPV vaccine. The CDC is investigating to see if there is a link – and I now wonder if the risk of ALS outweighs the risk of cervical cancer. Frankly, I don’t know – but I do know the cancer can be treated and cured while the degenerative disease can’t be. What I do know is that I’m glad the Texas Legislature stepped in and ended Rick Perry’s foray into the unlicensed practice of medicine before even one girl could be endangered.

H/T Debbie Schlussel

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March 05, 2009

Expect This Fine Level Of Care If Obama Wins On Health Insurance

WeÂ’ve got a drug that can extend your life. You canÂ’t have it, though, because it will cost the government too much.

Thousands of patients with terminal cancer were dealt a blow last night after a decision was made to deny them life prolonging drugs.

The Government's rationing body said two drugs for advanced breast cancer and a rare form of stomach cancer were too expensive for the NHS.

The National Institute for Health and Clinical Excellence is expected to confirm guidance in the next few weeks that will effectively ban their use.

The move comes despite a pledge by Nice to be more flexible in giving life-extending drugs to terminally-ill cancer patients after a public outcry last year over 'death sentence' decisions.

Remember – it will be your responsibility to die before you become a burden on society under Obama’s medical plan.

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February 14, 2009

A Tattoo I May Choose To Get

Before Pearl Harbor, my mom's father worked in a shipyard as a skilled worker building ships. After Pearl Harbor, my grandfather was one of those recruited to help repair and/or salvage the vessels damaged and destroyed by the Japanese on December 7, 1941. One alcohol-fueled evening in Hawaii, he got a tattoo -- and he always urged us grandkids not to get one.

I'm not sure how many of the rest have adhered to his words, but I know I have. Indeed, my high school students (many of them already tatted up at 14 and 15) are rather surprised when I tell them I don't have a tattoo -- though they are quite respectful when I tell them why.

That may change, though, if these the inks in this article are ever approved for use, and if I can get the tattoo place in a sufficiently unobtrusive spot.

A tattoo for diabetics that changes colour depending on their glucose levels has been unveiled by scientists.

It is hoped the breakthrough could mean the end of painful daily blood tests for millions with the condition.

The tattoo contains tiny particles of "nano ink" that change colour depending on whether they come into contact with glucose molecules.

If levels are high, the ink appears yellow. If levels of the sugar are low, it turns purple. A healthy level shows up as orange.

There are currently more than 2.5million people with diabetes in Britain and more than half a million people who don't know they have it.

Diabetics need to test their glucose levels regularly and for most this means pricking their finger to draw blood.

The tattoo only has to be a few millimetres across.

The Massachusetts-based Draper Laboratories team accidentally discovered the ink while researching hydration in athletes.

While I can't see these tattoos completely eliminating the need for glucometers, I know that they would possibly cut down on the frequency of the finger sticks that go along with the use of a glucose meter. And I can't help but think that my grandfather would approve of such a tattoo, given the small size and the importance for maintaining good health.

It may, however, be two or more years before human testing trials would lead to approval by the government -- and who knows how long before insurance starts covering them.

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June 02, 2008

Victim Of Universal Health Care

Just remember -- this is what Hillary, Barack, and the rest of the Democrats are promising you when they promote their universal health care schemes.

A woman who was refused free NHS cancer treatment after she paid for extra drugs has died, reigniting the debate over whether patients should be allowed to "top up" their care.

Linda O'Boyle and her husband Brian, both retired health workers, decided to pay for treatment in addition to that available on the NHS in order to prolong her life.

Mrs O'Boyle was told that meant she was considered a private patient and so had to pay for all her treatment.

Government guidelines currently ban patients from mixing public and private care.

* * *

When Mrs O'Boyle, who had three children and four grandchildren, developed bowel cancer and began having chemotherapy, doctors said she could boost her chances of fighting the disease by adding the drug cetuximab.

It is not routinely funded by the NHS but she decided to use her savings to pay for it.Southend University Hospital NHS Foundation Trust then withdrew her free treatment, including the chemotherapy drug she was receiving.

In other words, because Mrs. O'Boyle affirmatively attempted to improve her health by seeking the best in medical care, she was denied access to even the minimal level of care provided by the government.

In my book, that is murder.

And now the Democrats want to bring such a medical rationing system here.

Don't tell them no -- tell them HELL NO!

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April 09, 2008

News Flash: Mumps Vaccine Not 100% Effective

I could have told you that.

Most of the college students who got the mumps in a big outbreak in 2006 had received the recommended two vaccine shots, according to a study that raises questions about whether a new vaccine or another booster shot is needed. The outbreak was the biggest in the U.S. since shortly before states began requiring a second shot for youngsters in 1990.

Nearly 6,600 people became sick with the mumps, mostly in eight Midwest states, and the hardest-hit group was college students ages 18 to 24. Of those in that group who knew whether they had been vaccinated, 84 percent had had two mumps shots, according to the study by the Centers for Disease Control and Prevention and state health departments.

That "two-dose vaccine failure" startled public health experts, who hadn't expected immunity to wane so soon — if at all.

Part of the problem was a new strain of the vaccine that these young people hadn't been vaccinated against.

But beyond that is the fact that the vaccine does not confer lifetime immunity.

And i speak from experience.

You see, i was one of the test subjects for the vaccine back in the 1960s. My family lived in Maryland at the time, and my brother and I were a part of one of the trials of the new vaccine.in late 1965 or early 1966. Several years later, around 1972 or 1973, I got mumps. Since we were now in northern Virginia, my parents took me back to the Naval Hospital at Bethesda -- and in the middle of the night I had a dozen doctors in lab coats standing around me, poking, prodding, and drawing blood. They were members of the original research team from NIH (also located in Bethesda), and having me on site let them check out how much immunity the vaccine conferred and whether it reduced the severity or durration of the disease. It didn't.

i don't know what changes were made over the years, but to hear that the immunity was not entirely effective sure doesn't surprise me.

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April 03, 2008

Do You Really Need That Water?

Probably not.

The idea that drinking eight glasses of water a day is good for your health has been dismissed as a myth.

Scientists say there is no evidence drinking large amounts of water is beneficial for the average healthy person, and do not even know how this widely held belief came about.

Specialists in kidney conditions in America reviewed research on claims eight 8oz glasses of water help flush toxins from the body, preventing weight gain and improving skin tone.

Dr Dan Negoianu and Dr Stanley Goldfarb, of the Renal, Electrolyte and Hypertension Division at the University of Pennsylvania, said no single study indicated average healthy people needed to drink this amount of water - a total of 3.3 pints - each day.

"Indeed, it is unclear where this recommendation came from," they say in a review in the Journal of the American Society of Nephrology.

In other words, drinking all that water does nothing for you – well, other than make you pee.

Will this impact bottled water sales, further fueling the recession?

And will Democrats blame George Bush?

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April 02, 2008

Genetic Link To Cancer, Smoking?

Having recently buried my mother-in-law following an extended illness caused by her smoking, this story interests me to no end.

Scientists say they have pinpointed a genetic link that makes people more likely to get hooked on tobacco, causing them to smoke more cigarettes, making it harder to quit, and leading more often to deadly lung cancer.

The discovery by three separate teams of scientists makes the strongest case so far for the biological underpinnings of the addiction of smoking and sheds light on how genetics and cigarettes join forces to cause cancer, experts said. The findings also lay the groundwork for more tailored quit-smoking treatments.

"This is kind of a double whammy gene,'' said Christopher Amos, a professor of epidemiology at the M.D. Anderson Cancer Center in Houston and author of one of the studies. "It also makes you more likely to be dependent on smoking and less likely to quit smoking.''

I lost my grandfather to such an illness four decades ago, and so avoided smoking out of fear that i would follow in my footsteps. A good move, in my eyes, as my mothers siblings who smoked were both dead before sixty -- while my mother is still going strong in great health in her mid-70s. had i started smoking, I'm sure I would already be gravely ill -- likely because of this gene. Fortunately, free will does come into play on the initial decision to smoke.

And I already see some of my teenage students smoking -- hooked on that nicotine -- in the tenth grade, which has made m wonder to what degree there was a genetic link rather than a social one. How many will die young because of the impact of this gene?

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April 01, 2008

Vytorin Study Raises Questions

This raises more questions than it answers.

The news keeps getting worse for two heavily promoted cholesterol drugs, Vytorin and Zetia. These drugs were supposed to offer a valuable alternative to the older cholesterol-lowering agents known as statins, a class that includes Lipitor, Zocor and other drugs that not only reduce cholesterol but also reduce the risk of heart attacks. In clinical trial results released this week, the newer drugs failed to reach their main goal: slowing the growth of artery-clogging plaques — a suggestion that they might not help ward off heart attacks.

* * *

In the clinical trial, 720 European patients with genes that cause abnormally high cholesterol levels were given either Vytorin, a combination pill that contains both Zetia and Zocor, or simply Zocor alone. As expected, the combination pill proved better than the statin alone at reducing the level of bad cholesterol. But to everyoneÂ’s surprise, Vytorin failed to slow the growth of fatty plaques in the arteries, and it may have even allowed greater growth than the statin did.

It seems clear that there is an issue with Zocor. But is Zetia as flawed a drug? I asked one doctor that question yesterday, only to be told that her reading of the study is that the problem is with Zocor itself, because of the lack of a sample with Zetia being given alone. And given that the drug is effective with its primary purpose, Zetia remains a good drug for those who have difficulties with the statin drugs.

I suspect we will hear more in the not terribly distant future about other studies. But one would have hoped that this would have been vetted during the approval process.

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December 04, 2007

I'll Agree With McDermott

You know, sometimes the regulations in place just do not account for reality.

In 1944, an Italian prisoner of war was found lynched following a night of rioting at Fort Lawton in Seattle.

Forty-three black soldiers were tried in one of the largest courts-martial of World War II. Of those, 28 were found guilty of rioting and sentenced to as many as 25 years in prison.

In late October, the Army's Board of Corrections of Military Records ruled the trial was ''fundamentally unfair and improper.'' It said the soldiers should be given honorable discharges and compensated. About a week ago, one of the men, Samuel Snow, got a check.

For $725.

The Army said that was the amount he would have been paid between the time he was convicted and the time he was released from prison about 15 months later.

The compensation, says Rep. Jim McDermott, is far less than Snow deserves. The amount -- based on Snow's wages at the time of $50 a month -- was not adjusted for inflation or to reflect any interest for the 63 years the Army withheld the money.

The regulations, of course, do not anticipate a situation like the one in this case. It rarely takes six decades to correct a miscarriage of justice like this one. But the Army has to follow the regulations in place, and so it acted properly -- as McDermott certainly knows.

Were, then, does justice lie? With McDermott and his congressional colleagues. I'm sure that special legislation can be written and passed to arrange for appropriate compensation in this matter -- as a matter of justice, not special favor.


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November 20, 2007

Guess We Don't Need Those Embryonic Stem Cells After All

Especially since not one significant medical advance has come through their use.

Researchers in Wisconsin and Japan have turned ordinary human skin cells into what are effectively embryonic stem cells without using embryos or women's eggs -- the two hitherto essential ingredients that have embroiled the medically promising field in a long political and ethical debate.

The unencumbered ability to turn adult cells into embryonic ones capable of morphing into virtually every kind of cell or tissue, described in two scientific journal articles released today, has been the ultimate goal of researchers for years. In theory, it would allow people to grow personalized replacement parts for their bodies from a few of their own skin cells, while giving researchers a uniquely powerful means of understanding and treating diseases.

Until now, only human egg cells and embryos, both difficult to obtain and laden with legal and ethical issues, had the mysterious power to turn ordinary cells into stem cells. And until this summer, the challenge of mimicking that process in the lab seemed almost insurmountable, leading many to wonder if stem cell research would ever wrest free of its political baggage.

As news of the success by two research teams spread by e-mail, scientists seemed almost giddy at the likelihood that their field, which for its entire life has been at the center of so much debate, may suddenly become like other areas of biomedical science: appreciated, eligible for federal funding and wide open for new waves of discovery.

"These are enormously important papers," said George Q. Daley, a stem cell researcher at Children's Hospital Boston, who was not involved in the work. Like others, he spoke with stunned elation reminiscent of scientists' reactions in 1997 to the cloning of Dolly the sheep from a skin cell, the first proof that adult mammal cells could have their genetic clocks turned back.

A couple of advantages come to mind.

1) There will no longer be a need o engage in morally dubious practices to get embryonic cells.

2) Unlimited and varied cell lines will be available for experimentation.

3) Cells used will match the recipient because they will be grown from the recipient's own cells, lowering the likelihood of rejection.

I'm curious – will liberals now agree that the wanton destruction of human life for purposes of medical experimentation is no longer morally appropriate when less repulsive methods are available, allowing for both scientific research and respect for the conscience of taxpayers?

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November 14, 2007

Avandia Health Warning

A quick FYI for my fellow diabetics.

The government slapped a prominent, though confusing, warning on the popular diabetes drug Avandia on Wednesday _ telling patients that it may, or may not, increase the risk of heart attacks.

The move is less stringent than steps Canada took last week to restrict the drug's use to hard-to-treat diabetics.

But the U.S. Food and Drug Administration concluded that studies are too contradictory to tell if Avandia really is riskier than other treatments for Type 2 diabetes.

So the FDA described the controversy in a black box on Avandia's label _ the most severe type of warning the agency can require _ pending further research. Unlike most black-box warnings that urge strong caution, Avandia's says, "The available data on the risk ... are inconclusive."

My doctor has switched all her patients off Avandia, from what she told me recently. I'd encourage anyone on the drug to seriously discuss the risks and benefits with their physician in order to make an informed decision.

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July 11, 2007

Students Complain About Loss Of Subsidized Birth Control

It seems that a change in Medicaid regulations is forcing up the cost of birth control for college students --from $10 a month to $35. From the wailing in this Houston Chronicle article, you'd think that it was "the end of the world as we know it."

Daisy Rios, a senior at UH, left the health center empty-handed after learning that her formerly $10-per-month pills now cost $35. Because of warnings from the clinic, she knew the increase was imminent, but she still felt sticker shock when it kicked in, she said.

"That was just a little too much to pay for at that time," said Rios, 22, who lives with her parents and holds a work-study job during the school year. She still had a two-week supply of pills left, she said, so she had some time to decide whether to purchase another pack.

At $35, oral contraceptives at UH still are cheaper than the same medication at most retail pharmacies for a woman without insurance. At a local Walgreens, for example, Ortho Tri-Cyclen Lo costs $54 per month. But generic pills are available there starting at $24, the same price as generics at UH.

Planned Parenthood sells brand-name and generic oral contraceptives for $31 per month, but some students can qualify for free medication.

Many students have switched to generic contraceptives because they're cheaper, said Mary Hoban, project director for the American College Health Association. But the price still isn't as low as that of the name brands that previously were offered at discounted rates, she said.

There also isn't a corresponding generic for every name-brand contraceptive, including Ortho Tri-Cyclen Lo. Nor is there one for the popular NuvaRing, a device that some women use as an alternative to pills.

"People are quick to say generics are the answer, but it's still twice the cost (as before) and it's not always available for the particular pill or product," Hoban said.

Now let's look at this. The increase is less than a bottle of water or soda a day. Indeed, a switch to generics is about the cost of three lunches at McDonalds a month. And we won't get into the question of abstinence, despite the fact that it would be the best choice for most of the students in question, since they are single and living on such a fixed income that they cannot afford even this token increase in the cost of birth control -- how could they possibly afford the child that a failure of the pill could bring about?

No, what we have here is an entitlement mentality run rampant, combined with a lack of morality.

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June 30, 2007

Diabetic Dumped By AMTRAK Crew

Shocking. Appalling. Disgusting.

A 65-year-old St. Louis man is missing after Amtrak personnel, mistaking his diabetic shock for drunk and disorderly behavior, kicked him off a train in the middle of a national forest, according to police in Williams, Ariz.

Police said Roosevelt Sims was headed to Los Angeles but was asked to leave the train shortly before 10 p.m. Sunday at a railroad crossing five miles outside Williams.

"He was let off in the middle of a national forest, which is about 800,000 acres of beautiful pine trees," Lt. Mike Graham said.

Police said there is no train station or running water at the crossing, which is about two miles from the nearest road, at an elevation of about 8,000 feet.

If he was truly "drunk and unruly", the correct approach is to restrain him as would be done on an airplane, not dump him in the middle of a forest. That this could happen is sufficient reason for this diabetic to steer well-clear of any AMTRAK train.

Fortunately, Williams has been found dazed and disoriented -- four days after being unceremoniously dumped from the train. Here's hoping for criminal charges and a lawsuit against AMTRAK and the employees as individuals.

H/T Texas Fred

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June 21, 2007

Stem Cell Veto

I am a diabetic. I'm regularly told that my condition could be cured by means of fetal stem cell research. So let me express my opinion clearly on President Bush's veto of the bill giving federal funding for such research.

GOOD FOR YOU, MR. PRESIDENT!

President Bush yesterday vetoed legislation to expand federally funded embryonic stem cell research, saying that scientific advances now allow researchers to pursue the potentially lifesaving work without destroying human embryos.

Bush followed his veto -- his third since becoming president -- with an executive order aimed at encouraging federal agencies to support research that offers the promise of creating medically useful stem cells without destroying human embryos.

This story, however, overlooks the more basic point -- nothing in current law makes it illegal to do research on fetal stem cells. There are a number of approved stem cell lines that can still be funded, and there is absolutely nothing to prohibit any fetal stem cell research using private money. What this veto does is simply prohibit the use of federal money to facilitate the taking of any more innocent lives for scientific research.

There are some points to consider -- some practical, some moral.

1) If fetal stem cell research is so promising, why isn't private industry funding it to the level that these breakthroughs will be made quickly. After all, a cure for diabetes of Parkinsons would be immensely profitable. Could it be that Big Pharmaceutical (the drug equivalent of Big Oil) is so unsure of the potential that it won't put up the money for research -- or that it simply feels that federal subsidies are its right?

2) Large numbers of Americans have moral objections to the methods for obtaining fetal stem cells. Is it appropriate to take their money to fund something that offends their values at such a fundamental level? Do their values and policy preferences matter less than those of researchers and (some of) those with medical conditions that could be cured by such research -- and why?

So I applaud the stand by the president in this case. Just because Dr. Mengele some research scientists seek government funding to destroy Jewish prisoners in a concentration camp embryos n a laboratory does not means that government should facilitate such work -- or that it is morally acceptable if they get such funding.

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June 18, 2007

Criminalizing The Practice Of Medicine

I've written on this subject before, so won't go into great details on my wife's health issues. Suffice it to say that she is able to function because of her pain management physician.

Not to worry, though -- the government is committed to make sure she is bedridden and in constant agony.

Ronald McIver is a prisoner in a medium-security federal compound in Butner, N.C. He is 63 years old, of medium height and overweight, with a white Santa Claus beard, white hair and a calm, direct and intelligent manner. He is serving 30 years for drug trafficking, and so will likely live there the rest of his life. McIver (pronounced mi-KEE-ver) has not been convicted of drug trafficking in the classic sense. He is a doctor who for years treated patients suffering from chronic pain. At the Pain Therapy Center, his small storefront office not far from Main Street in Greenwood, S.C., he cracked backs, gave trigger-point injections and put patients through physical therapy. He administered ultrasound and gravity-inversion therapy and devised exercise regimens. And he wrote prescriptions for high doses of opioid drugs like OxyContin.

McIver was a particularly aggressive pain doctor. Pain can be measured only by how patients say they feel: on a scale from 0 to 10, a report of 0 signifies the absence of pain; 10 is unbearable pain. Many pain doctors will try to reduce a patientÂ’s pain to the level of 5. McIver tried for a 2. He prescribed more, and sooner, than most doctors.

Some of his patients sold their pills. Some abused them. One man, Larry Shealy, died with high doses of opioids that McIver had prescribed him in his bloodstream. In April 2005, McIver was convicted in federal court of one count of conspiracy to distribute controlled substances and eight counts of distribution. (He was also acquitted of six counts of distribution.) The jury also found that Shealy was killed by the drugs McIver prescribed. McIver is serving concurrent sentences of 20 years for distribution and 30 years for dispensing drugs that resulted in ShealyÂ’s death. His appeals to the U.S. Court of Appeals for the Fourth Circuit and the Supreme Court were rejected.

McIver’s case is not simply the story of a narcotics conviction. It has enormous relevance to the lives of the one in five adult Americans who, according to a 2005 survey by Stanford University Medical Center, ABC News and USA Today, reported they suffered from chronic pain — pain lasting for several months or longer. According to a 2003 study in The Journal of the American Medical Association, pain costs American workers more than $61 billion a year in lost productive time — and that doesn’t include medical bills.

Contrary to the old saw, pain kills. A body in pain produces high levels of hormones that cause stress to the heart and lungs. Pain can cause blood pressure to spike, leading to heart attacks and strokes. Pain can also consume so much of the bodyÂ’s energy that the immune system degrades. Severe chronic pain sometimes leads to suicide. There are, of course, many ways to treat pain: some pain sufferers respond well to surgery, physical therapy, ultrasound, acupuncture, trigger-point injections, meditation or over-the-counter painkillers like Advil (ibuprofen) or Tylenol (acetaminophen). But for many people in severe chronic pain, an opioid (an opiumlike compound) like OxyContin, Dilaudid, Vicodin, Percocet, oxycodone, methadone or morphine is the only thing that allows them to get out of bed. Yet most doctors prescribe opioids conservatively, and many patients and their families are just as cautious as their doctors. Men, especially, will simply tough it out, reasoning that pain is better than addiction.

Are there unethical doctors who over-prescribe medication? Certainly. Are there patients who abuse and/or sell their medication? Without a doubt. However, most severe patients take their medication in accordance with their prescribed dosages, so that they can continue to have a life. But what that also means is that my wife and I are on a 30-day leash -- during certain times of the month we cannot leave town or make plans because the doctor will not give refills without an office visit. She once had to go to the office with pneumonia because she was nearly out of her pain medication and was told that she would get no more unless she was seen by the doctor -- despite a phone call from our family practice physician's office confirming her condition. Why? Because the pain management doctor, following the latest regulations from the state and the latest court decisions will not open himself up to any more legal jeopardy than necessary by giving refills without actually seeing the patient, even if their condition is irreversible and unchanged.

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June 14, 2007

Hospital Horror

As bad as my wife's last hospital stay in March was, at least we didn't have to deal with anything like this.

A woman who lay bleeding on the emergency room floor of a troubled inner-city hospital died after 911 dispatchers refused to contact paramedics or an ambulance to take her to another facility, newly released tapes of the emergency calls reveal.

Edith Isabel Rodriguez, 43, died of a perforated bowel on May 9 at Martin Luther King Jr.-Harbor Hospital. Her death was ruled accidental by the Los Angeles County coronerÂ’s office.

Relatives said Rodriguez was bleeding from the mouth and writhing in pain for 45 minutes while she was at a hospital waiting area. Experts have said she could have survived had she been treated early enough.

And I know just how bad any sort of bleed in the gastric system can be. Paula had one back in November, and received excellent care from the medical staff when we arrived at the ER on Thanksgiving morning. Indeed, it was a very close thing, with them telling me that even an hour's delay would have been fatal. That is why we have both shuddered as we have viewed news coverage of this horror -- Rodriguez could have and should have survived this emergency.

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June 09, 2007

I Believe There Are Vulcans Among Us!

Or at least some really strange medication side effects.

Doctors at Vancouver's St. Paul's Hospital came across something highly illogical when they tried to put an arterial line into a patient about to undergo surgery: his blood was dark green.

The green blood — reminiscent of the Vulcan blood found in Mr. Spock of Star Trek fame — came as a bit of a shock to Dr. Alana Flexman and her colleagues, who report on the unusual case in this week's issue of the journal The Lancet.

* * *

As surgical staff prepared the man for the middle-of-the-night emergency operation, Flexman and a colleague attempted to insert a line into a wrist artery.

Arterial lines are used to monitor blood pressure during an operation; any blood that flows when the line is inserted into the artery should be vivid red, the sign it has been oxygenated.

But in this case, which occurred in October 2005, it was not.

"During insertion, we normally see arterial blood come out. That's how we know we're in the right place. And normally that blood is bright red, as you would expect in an artery," Flexman said in an interview Thursday.

"But in his case, the blood kept coming back as dark green instead of bright red.

"It was sort of a green-black. Â… Like an avocado skin maybe."

The reaction in the room? "We were very concerned, obviously," said Flexman, who is training in anesthesia at the hospital.

Doctors suspect a reaction to the patient taking a larger than prescribed dose of a prescription medication.

Still, wouldn't you have loved to be a fly on the wall when the blood started flowing out green? The response of the medical team must have been priceless.

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May 31, 2007

A License To Ill?

This case certainly concerns me because of the public health issues it raises.

A man who may have exposed passengers and crew members on two trans-Atlantic flights earlier this month to a highly drug-resistant form of tuberculosis knew he was infected, and had been advised by health officials not to travel overseas.

The man flew to Paris from his home in Atlanta on May 12 for his wedding and honeymoon, even though health officials told him they “preferred” that he not get on the flight, he said in an interview published today in The Atlanta Journal-Constitution.

Days later, while he was in Italy, he was contacted by officials of the Centers for Disease Control and Prevention, and was told that he had a rare and potentially virulent form of the disease and should turn himself over to Italian health authorities immediately.

Officials of the centers said at a news conference today that they had begun to make arrangements with the Italian authorities to isolate and treat the man in Rome. But instead of cooperating with the plans, the man traveled to the Czech Republic and took a flight from Prague to Montreal.

He said in the published interview that he did that in the belief that he had been put on a no-fly list and would not be allowed to board a flight bound for the United States.

From Canada, he drove to the United States, and then turned himself in at a tuberculosis isolation hospital in New York City.

This is precisely the sort of entitlement-fueled arrogance that allowed the AIDS epidemic to spread -- the idea that the public does not have the right to be protected against highly communicable diseases because of the purported right of the plague carrier to be free of limitations on their freedom, the rest of society be damned. Knowing that he was ill and carrying the disease, we have a guy knowingly and intentionally exposing hundreds -- if not thousands -- of people to a didease that is drug-resistant and can kill its victims.

And the ACLU wants to make such a self-indulgent "license to ill" the law of the land in America. Just look at this suit.

A federal lawsuit filed Wednesday by the American Civil Liberties Union alleges that Maricopa County officials have violated the rights of a quarantined tuberculosis patient for months by treating him as a criminal.

The U.S. District Court complaint on behalf of Robert Daniels alleges health officials and the Maricopa County Sheriff's Office have violated numerous constitutional rights and the Americans with Disabilities Act.

The suit asks that Daniels be housed in appropriate accommodations, rather than the severe and "inhumane" jail conditions.

"It's good news for me," Daniels said Wednesday evening. "I finally have a chance to get out of this black hole."

Robert England, the county's tuberculosis control officer, declined comment. Other county health officials were not immediately available.

Daniels, 27, has been isolated in a jail ward at Maricopa Medical Center for 10 months under court order, although he was not convicted or charged with any crime.

Linda Cosme, an attorney for Daniels, said her client has been victimized by constitutional violations. "Robert is helpless," she added. "And he's at the mercy of Sheriff Joe Arpaio. He needs as much support as possible, and the ACLU is supplying that support."

Arpaio said Daniels is confined under court order, and must abide by security measures. "I run a safe jail, and he's going to be treated like anyone else," he said.

The problem is that the only facility equipped to handle such a severe health issue in that county is the secure ward. And while Daniels thinks it is good news for him that someone is trying to spring him from the most appropriate medical facility in the region, it is bad news for every person that Daniels will come in contact with in a less secure setting -- those who may die due to the disease that Daniels passes on to them.

If terrorists ever want to do a biological attack on the US, all they have to do is send in a dozen guys with Ebola. The ACLU will quickly file suit to ensure the attack is a success. After all, public health and public safety can't trump the freedom to pass on deadly diseases.


OPEN TRACKBACKING AT Right Pundits, Perri Nelson's Website, The Virtuous Republic, DeMediacratic Nation, Leaning Straight Up, The Amboy Times, Colloquium, Conservative Cat, Pursuing Holiness, Pet's Garden Blog, Diary of the Mad Pigeon, Wake Up America, stikNstein... has no mercy, Pirate's Cove, The Pink Flamingo, Gulf Coast Hurricane Tracker, High Desert Wanderer, Right Voices, and The Yankee Sailor, thanks to Linkfest Haven Deluxe.

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May 29, 2007

An Army Of Bloggers Against Cancer

You may notice that I've added a new blogroll on my site -- one devoted to fighting cancer. That issue is a very important one to me right now, given that my uncle will undergo cancer surgery beginning at 7:30 this morning, the time I've set for this post to appear on my site.

The originator of the blogroll, G.M. Roper (a fellow Munuvian) explains the goal this way.

Cancer is no respecter of race, religion, social status, income or profession. It is an insidious disease that robs people of a quality of life and too often, of life itself. This blog has one purpose, and one purpose only, to enroll as many bloggers in An Army Of Bloggers as possible and to encourage them to make an annual contribution to fighting cancer. The Rules for membership are simple, put the logo and blogroll on your blog, send a donation to a cancer program of any kind and post about it. It would be helpful if you write in the "memo field" of your check the following "Donated By The Army Of Bloggers." Help spread the word, help beat this s.o.b. into the ground. If you are a blogger, join the blogroll and make a donation. Leave a comment too if you would be so kind as to whom you donated to. Please leave the address and name of the charity in your comment (you don't need to name the amount). Please, if everyone helps this disease can eventually be whipped.

This Blog and accompanying Blogroll is dedicated Pamela Roper Clark, my beloved sister who passed away in 1990 from ovarian cancer. By putting the power of the blogosphere to work, we hope to make a citizens push to conquer this dread disease.

Who do I plan on supporting? The Siteman Cancer Center in St. Louis, which is a research partnership between Barnes-Jewish Hospital and Washington University School of Medicine. It is where my uncle is being treated, and where, with the help of the dedicated medical team and the grace of God, he will beat this disease.

To join, please information, please visit this link. Also contact G.M. Roper for inclusion.

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May 17, 2007

I'll Agree With The Democrats On This One

Our troops are chronically underpaid (even worse than cops, firefighters and teachers), and so i think they deserve any pay raise that Congress is willing to give them -- even if it exceeds teh one the administration has requested.

In the veto threat against the National Defense Authorization Act, the White House says they're opposed to two things: Increased survivor benefits of $40 a month to spouses of those who lost someone in military service, and a pay increase to all personnel, across the board, just half a percent higher than what the president endorsed.

There is plenty of good reason to veto the latest neo-Copperhead efforts to cut-&-run-&-surrender -- but this isn't it, because the proposal is not a budget-buster. Indeed, it is only common decency.

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May 09, 2007

More HPV News

I'd wondered about this, but never asked. But my intuition on the HPV matter has proved to be correct.

The sexually transmitted virus that causes cervical cancer also sharply increases the risk of certain types of throat cancer among people infected through oral sex, according to a study being published today.

The study, involving 100 people with throat cancer and 200 without it, found that those infected with the human papillomavirus were 32 times as likely to develop one form of oral cancer than those free of the virus. Although previous research had indicated HPV caused oral cancer, the new study is the first to definitively establish the link, researchers said.

"It makes it absolutely clear that oral HPV infection is a risk factor," said Maura L. Gillison, an assistant professor of oncology and epidemiology at the Johns Hopkins Medical Institutions in Baltimore, who led the study published in the New England Journal of Medicine.

The findings could help explain why rates of oral cancer have been increasing in recent years, particularly among younger people and those who are not smokers or heavy drinkers, which had long been the primary at-risk groups, experts said.

"There's been a kind of sea change in the last 10 years in who we're seeing with these cancers," Gillison said. "It makes sense with some changes we've seen in sexual behavior."

Maybe this will serve as notice to some of our young people that oral sex has consequences, too, and is not simply a safe way of having a good time -- or an entertaining form of party game.

But I'm also struck by the time frame of the change in throat cancer patients. What could have happened 10 years ago that would lead to such a change?

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April 30, 2007

Anotehr Gardasil Problem

It will either bankrupt doctors, cost parents an arm and a leg, or require unwarranted state intrusion into insurance.

When Merck launched a multimillion-dollar marketing campaign last year to promote Gardasil, its new vaccine to prevent cervical cancer, company officials probably did not anticipate that its signature phrase -- "one less" -- would apply not just to malignancies but also to physicians. Yet that slogan has come to symbolize the response of doctors locally and around the country.

Pincered by rising costs and eroding reimbursements, and resentful of what they regard as a long-standing and unfair financial burden, some doctors, especially pediatricians and gynecologists who are most likely to be asked for the vaccine, are refusing to buy it or restricting who receives the shots.

Discontent over the price of the vaccine -- the most expensive ever approved -- highlights a long-simmering dispute over reimbursement for immunizations, traditionally regarded as bedrock medicine. It is a dispute, experts say, with significant public health implications that has accelerated as the number of costly new vaccines has proliferated.

"This is a national issue that is affecting lots of people," said Benjamin Gitterman, president of the D.C. chapter of the American Academy of Pediatrics. "It's a matter of cash flow," Gitterman added. Some insurance companies are paying doctors $122 per shot -- just $2 more than the price doctors pay for a dose of Gardasil -- an amount not sufficient to cover the cost of stocking and administering the vaccine, doctors say. The problem is disproportionately affecting pediatricians, experts say, because they administer the majority of immunizations and are among the lowest-paid specialists.

"Some plans are saying I'll give you $90 -- and not

And yet too many folks want to force every girl to get the vaccine -- inflating corporate profits and costing someone -- and they never say who, but pobably the taxpayer -- a wad of money.

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April 26, 2007

Diabetes Breakthrough

And the more we know, the more we can do to find a cure.

Researchers said yesterday that they had identified seven new genes connected to the most common form of diabetes — the latest result of an intensifying race between university researchers and private companies to find genes linked to a range of diseases.

The findings, presented in three reports by university scientists and one by a private company, offer novel insights into the biology of a disease that affects 170 million people worldwide.

And the sudden spate of new results mark an acceleration, and perhaps a turning point, in the ability to find disease genes, the long-promised payoff from the human genome project that began in 1989.

YesterdayÂ’s reports bring the number of well-attested genes involved in adult-onset, or Type 2 diabetes up to 10, from the 3 known previously. The new genes do not immediately suggest any new therapy, but may point to a new biological basis for the disease, from which effective treatments could emerge in time.

And in the mean time, I'll just keep taking my pills.

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April 24, 2007

Free Hurwitz!

Practicing good medicine for chronic pain patients is not a crime!

William E. Hurwitz, the prominent doctor on trial here for drug trafficking, spent more than two days on the witness stand last week telling a jury why he had prescribed painkillers to patients who turned out to be drug dealers and addicts. But the clearest explanation of his actions — and of the problem facing patients who are in pain — came earlier in the trial.

The problem -- too many doctors don't want to give opioids to treat chronic pain, wven though they are often the most effective medications. The result is that patients suffer -- and are often incapacitate -- by pain that can be relieved. Indeed, chronic pain patients are often dismissed and given les effective treatments by doctors adhering to old ways of doing things or covering their butts out of fear of prosecution by over-zealous prosecutors.

Consider this testimony from defense experts (who testified for free, unlike the prosecution experts) about the standard of care given by Dr. Hurwitz.

Prescribing opioids was once taboo because of concerns over patientsÂ’ becoming addicted. But medical opinion gradually shifted over the past two decades as researchers concluded that high doses of opioids could sometimes be safer and more effective than alternatives like surgery or injections.

Two of the leading pain experts, Dr. Russell K. Portenoy of Beth-Israel Medical Center and Dr. James N. Campbell of Johns Hopkins University, testified without pay as experts for the defense. They said Dr. Hurwitz was widely known as a knowledgeable physician and passionate advocate of giving patients full pain relief, unlike many doctors who were reluctant to prescribe opioids because they feared legal repercussions, particularly when dealing with patients who sometimes used illegal drugs.

Such “problem patients” consumed so much time and energy that most doctors refused to treat them “regardless of what the consequences would be for the patient,” Dr. Campbell testified. He said that he had been initially skeptical of some of Dr. Hurwitz’s high-dose treatments, but was then impressed by the results in patients he sent to Dr. Hurwitz.

He said some doctors might argue that Dr. Hurwitz was guilty in some instances of negligence that would make him liable for damages in a civil case. But Dr. Campbell contradicted the prosecution’s experts by testifying that all the prescriptions were clearly within the “bounds of medical practice.”

But sadly, fear of prosecution is a real problem. One physician's office I was in recently had signs posted stating that "This office no longer prescribes Oxy-Contin, Lortab, or Darvocet" -- medications that are among the best out there for dealing with constant, debilitating pain. Good medicine? No -- good legal advice, after a visit from an inspector from medical regulators concerned about the number of his patients on pain medication. Another doctor I know insists upon a monthly visit from her patients seeking refills of pain medication they have been on for chronic conditions, after being asked by an insurance company to justify the number of pain pills she prescribes each month o its patients. And my wife's neurologist has had to document her case (as well as all his other patients) in excruciating detail to justify her level of pain medication -- to satisfy the demands of his lawyer, not best medical practices, so that he stays out of jail.

This prosecution is particularly troubling because Dr. Hurwitz was generally viewed as one of the leaders in his field. If they can go after him over disagreements on how to best manage the symptoms of chronic pain patients, how intimidated should every other doctor in the field feel? And if the level of risk becomes too high, what will be the fate of my wife, and hundreds of thousands of patients like her around the country?

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April 20, 2007

I’ll Pass On This Surgery

For practical reasons, if nothing else.

Doctors in New York have removed a woman’s gallbladder with instruments passed through her vagina, a technique they hope will cause less pain and scarring than the usual operation, and allow a quicker recovery. The technique can eliminate the need to cut through abdominal muscles, a major source of pain after surgery.

The operation was experimental, part of a study that is being done to find out whether people will fare better if abdominal surgery is performed through natural openings in the body rather than cuts in the belly. The surgery still requires cutting, through the wall of the vagina, stomach or colon, but doctors say it should hurt less because those tissues are far less sensitive than the abdominal muscles.

The notion of taking a different direction for to reach abdominal sites is a good one, though there are already options for gallbladder removal that involve only a tiny incision through the belly button.

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IÂ’ll Pass On This Surgery

For practical reasons, if nothing else.

Doctors in New York have removed a womanÂ’s gallbladder with instruments passed through her vagina, a technique they hope will cause less pain and scarring than the usual operation, and allow a quicker recovery. The technique can eliminate the need to cut through abdominal muscles, a major source of pain after surgery.

The operation was experimental, part of a study that is being done to find out whether people will fare better if abdominal surgery is performed through natural openings in the body rather than cuts in the belly. The surgery still requires cutting, through the wall of the vagina, stomach or colon, but doctors say it should hurt less because those tissues are far less sensitive than the abdominal muscles.

The notion of taking a different direction for to reach abdominal sites is a good one, though there are already options for gallbladder removal that involve only a tiny incision through the belly button.

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April 11, 2007

Buh-Bye-Mus!

MSNBC has fired Don Imus -- will CBS follow?

NBC News dropped Don Imus yesterday, canceling his talk show on its MSNBC cable news channel a week after Mr. Imus made racially disparaging remarks about the Rutgers University womenÂ’s basketball team.

The move came after several days of widening calls for Mr. Imus to lose his job both on MSNBC, which simulcasts the “Imus in the Morning” show, and CBS Radio, which originates the show.

CBS Radio, which is Mr. ImusÂ’s main employer, said in a statement last night that it would stick by the two-week suspension of the program, which begins Monday, that it and NBC news announced earlier.

But CBS said it would, in the interim, “continue to speak with all concerned parties and monitor the situation closely.”

The demands that Mr. Imus be fired had grown in intensity every day since last Wednesday when he made the comments, in which he labeled the women “nappy-headed hos.”

And ultimately, this is how things should work -- the market, not the government, has demanded the removal of Don Imus. He has the right to say as many stupid things as he wants, but no right to a privately-owned forum to spew them. The government can't punish you for your speech, but your employer can.

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Good News For Type 1 Diabetics

Stem-cells have been used to stop dependence on insulin by a group of Type 1 diabetics in a recent study.

Diabetics using stem-cell therapy have been able to stop taking insulin injections for the first time, after their bodies started to produce the hormone naturally again.

In a breakthrough trial, 15 young patients with newly diagnosed type 1 diabetes were given drugs to suppress their immune systems followed by transfusions of stem cells drawn from their own blood.

The results show that insulin-dependent diabetics can be freed from reliance on needles by an injection of their own stem cells. The therapy could signal a revolution in the treatment of the condition, which affects more than 300,000 Britons.

People with type 1 diabetes have to give themselves regular injections to control blood-sugar levels, as their ability to create the hormone naturally is destroyed by an immune disorder.

And please note – this is not embryonic stem-cell therapy. Rather it is a therapy using the [patient’s own stem-cells to stimulate production of insulin. We are still waiting for embryonic stem-cells to produce ANY therapies for ANY condition, while adult stem-cells are proving quite efficacious.

But as a Type 2 diabetic, IÂ’m waiting to see if this will translate over to my condition, freeing me from the need to take my medication.

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March 27, 2007

MRIs For Breast Cancer Screening -- Will The Funding Be There?

Well, that's my question in response to this new recommendation.

A major medical group is recommending for the first time that women at greatest risk of breast cancer undergo MRI exams every year to try to catch more tumors at their earliest, most treatable stages.

The American Cancer Society is issuing new guidelines today that urge annual MRIs for women at high risk because of a strong family history of the disease, a genetic predisposition or other reasons. As many as 1.6 million women in the United States fall into this high-risk category.

For these women, the recommendation adds the MRI (magnetic resonance imaging) exam to the standard tools that doctors should use routinely to detect breast cancer, marking the most significant change in the society's influential screening guidelines since doctors started recommending annual mammograms. The more sensitive MRI exams can pick up small tumors that mammograms frequently miss.

"The goal here is to do a better job of finding breast cancer early, when they are much more likely to be treated successfully," said Robert A. Smith, the society's director of screening.

The guidelines stop short of recommending annual MRI breast screening for all women, saying that there is insufficient evidence to support wider use of the relatively costly exams. But they say that women at a lesser, but still elevated, risk because, for example, they are breast cancer survivors or have a family history of the disease, should consult with their doctors about undergoing regular MRIs as well.

The guidelines stress that the exams should be done in addition to annual mammograms and regular physical exams in the hope of driving down the death toll from the common, widely feared malignancy.

Some question whether or not there is sufficient MRI capacity in the country to meet this call -- but I have no doubt that the machines can be manufactured and the operators trained in relatively short order. After all, look at the number of private imaging centers springing up around the country.

The issue is cash. Will insurance companies and government programs be prepared to regularly make the sort of payments this will require, as millions of new MRIs are done each year for cancer screening. After all, MRIs are around $500 a pop. This is out of reach of many patients without insurance help or other programs.

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February 28, 2007

CDC Doc – No Mandatory Gardasil

Well, now it is even a member of the panel that approved the drug coming out against mandating the Gardasil vaccine for all girls.

The chairman of the federal panel that recommended the new cervical-cancer vaccine for pre-teen girls says lawmakers should not make the inoculation mandatory, as the District and more than 20 states, including Virginia, are considering.

Dr. Jon Abramson, chairman of the Centers for Disease Control and Prevention's advisory committee on immunization practices (ACIP), also said he and panel members told Merck & Co., the drug Gardasil's maker, not to lobby state lawmakers to require the vaccine for school attendance.

"I told Merck my personal opinion that it shouldn't be mandated," Dr. Abramson told The Washington Times. "And they heard it from other committee members."

Dr. Abramson said he opposes mandating Gardasil, which prevents the cervical-cancer-causing human papillomavirus (HPV), because the sexually transmitted HPV is not a contagious disease like measles and he is not sure states can afford to inoculate all students.

"The vaccines out there now are for very communicable diseases. A child in school is not at an increased risk for HPV like he is measles," Dr. Abramson said.

Gee, that argument sounds familiar to me. Where have I heard it before? Oh, yeah – that is the same argument I made against the vaccines on day one, only to be told how wrong-headed my position was. Anybody want to reconsider that criticism now?

Oh, and there is this minor consideration as well.

Middle-school girls inoculated with the breakthrough vaccine will be no older than 18 when they pass Gardasil's five-year window of proven effectiveness -- more than a decade before the typical cancer patient contracts HPV, The Washington Times reported last week.

Infectious disease specialists and cancer pathologists say the incubation period for HPV becoming cancer is 10 to 15 years -- meaning the average cervical cancer patient, who is 47, contracted the virus in her 30s and would not be protected by Gardasil taken as a teen.

Dr. Abramson said the panel thinks the vaccine will last for at least 10 years. Even if it provides 10 years of protection, it would still leave girls given the inoculation in the sixth grade vulnerable during their late 20s and early 30s, when most cervical-cancer patients contract HPV. At that point, another round of Gardasil would be necessary.

So it seems to me that folks like Rick Perry and others seeking to play doctor with the little girls of the nation are not merely engaged in bad politics, but in bad medicine as well.

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CDC Doc – No Mandatory Gardasil

Well, now it is even a member of the panel that approved the drug coming out against mandating the Gardasil vaccine for all girls.

The chairman of the federal panel that recommended the new cervical-cancer vaccine for pre-teen girls says lawmakers should not make the inoculation mandatory, as the District and more than 20 states, including Virginia, are considering.

Dr. Jon Abramson, chairman of the Centers for Disease Control and Prevention's advisory committee on immunization practices (ACIP), also said he and panel members told Merck & Co., the drug Gardasil's maker, not to lobby state lawmakers to require the vaccine for school attendance.

"I told Merck my personal opinion that it shouldn't be mandated," Dr. Abramson told The Washington Times. "And they heard it from other committee members."

Dr. Abramson said he opposes mandating Gardasil, which prevents the cervical-cancer-causing human papillomavirus (HPV), because the sexually transmitted HPV is not a contagious disease like measles and he is not sure states can afford to inoculate all students.

"The vaccines out there now are for very communicable diseases. A child in school is not at an increased risk for HPV like he is measles," Dr. Abramson said.

Gee, that argument sounds familiar to me. Where have I heard it before? Oh, yeah – that is the same argument I made against the vaccines on day one, only to be told how wrong-headed my position was. Anybody want to reconsider that criticism now?

Oh, and there is this minor consideration as well.

Middle-school girls inoculated with the breakthrough vaccine will be no older than 18 when they pass Gardasil's five-year window of proven effectiveness -- more than a decade before the typical cancer patient contracts HPV, The Washington Times reported last week.

Infectious disease specialists and cancer pathologists say the incubation period for HPV becoming cancer is 10 to 15 years -- meaning the average cervical cancer patient, who is 47, contracted the virus in her 30s and would not be protected by Gardasil taken as a teen.

Dr. Abramson said the panel thinks the vaccine will last for at least 10 years. Even if it provides 10 years of protection, it would still leave girls given the inoculation in the sixth grade vulnerable during their late 20s and early 30s, when most cervical-cancer patients contract HPV. At that point, another round of Gardasil would be necessary.

So it seems to me that folks like Rick Perry and others seeking to play doctor with the little girls of the nation are not merely engaged in bad politics, but in bad medicine as well.

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February 17, 2007

A Note On The Gardasil Controversy

I just love it when the NY Times publishes an editorial disguised as an article and hides the contradictory information at the end. In this case, it is the really relevant information about why Rick Perry's Gardasil power-grab is opposed by so many people -- and it has nothing to do with promiscuous nine-year-olds

Groups on both sides of the debate appear to have been energized by the executive order of Gov. Rick Perry on Feb. 2 mandating vaccination. Opponents have pounced on Gov. PerryÂ’s ties to Merck and Women in Government. His former chief of staff is a lobbyist for Merck in the state and his wife, a nurse who has worked to promote health, once spoke at a Women in Government conference on cervical cancer.

“I looked at all of this and said, someone is playing politics,” said Cathie Adams, president of the Texas Eagle Forum, a branch of Phyllis Schlafly’s national Eagle Forum, a conservative group that calls itself “pro-family.”

Citing various reasons, the Texas Medical Association is not currently supporting mandatory vaccination.

Dr. Carol Baker, a professor of pediatrics at Baylor College of Medicine in Houston, said that two other vaccines for adolescents that were approved in recent years — against meningitis and whooping cough — have not yet been mandated in Texas. “To mandate just one, in my view, is a little odd,” she said.

The American Academy of Pediatrics is not advocating mandatory Gardasil vaccination, either. One source of opposition from pediatricians is cost. Buying enough H.P.V. vaccine for 100 girls would require a practice to lay out nearly $40,000 in advance. Many doctors say that the insurance reimbursement for giving the vaccine is not adequate to compensate them for administering it.

Dr. Bocchini of the American Academy of Pediatrics also said too much of the Gardasil focus was being placed on 11- and 12-year-olds, when legislatures should be focusing on trying to obtain funding to vaccinate girls and women in the 13-to-26 age group, many of whom are not covered by the federal vaccine programs aimed at children.

“A number of people are just not going to be able to get this vaccine,” he said.

Vaccines for serious illnesses that are more likely to be passed in classrooms are not required -- but Rick Perry is pushing the one that benefits his colleagues and contributors, and which his wife thinks is important. If he really gave a damn about public health, he would be trying to get the meningitis vaccine mandated through the legislative process. Instead, Perry is playing doctor with the little girls of Texas because of who it helps -- and I don't mean the little girls.

I will concede that I don't like the tactics and arguments of some of those on my side of this issue. Nor do I oppose the Gardasil vaccine, which I have repeatedly stated I would want any daughter of mine to have. But there is serious political corruption at work in Rick Perry's power grab, and there needs to be a greater discussion of the advisability of mandating this vaccine.

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February 15, 2007

Military Doctors Try Finger Regrowth Technique

This sounds like something out of science fiction, but may be on its way to becoming science fact.

Five soldiers at a military base in Texas are about to participate in a remarkable test to see whether they can regrow portions of fingers they lost in the war in Iraq.

Doctors plan to treat them with a fine powder called extracellular matrix, which is harvested from pig bladders. The material, found in all animals, is the scaffolding that cells latch onto as they divide and grow into tissue and body parts.

In the human body, it was long thought to be inert. But scientists have discovered that it appears to activate latent biological processes that spur healing and regenerate tissue.

Medical researchers have been making intriguing progress in the field of regenerative medicine. The pilot test, at the U.S. Army Institute of Surgical Research at Fort Sam Houston in San Antonio, shows how doctors are trying to apply their recent discoveries to a pressing challenge: helping thousands of Americans returning from Iraq to recover from wounds that would have killed soldiers a generation ago.

Now this is unlikely to result in the complete regrowth of entire digits, or even the bone in a segment – but it may enable some patients to have more complete use of hands after serious injury. That is great advance that will help people in both the military and civilian worlds.

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February 14, 2007

Another Reason To Reject Socialized Medicine

Some folks are just deemed unworthy of care under such systems.

Doctors in Britain regularly discriminate against older patients by denying them tests and treatments they offer to younger people, research shows today.

GPs, heart specialists and doctors who care for the elderly were all found to be influenced by a patient's age when making their recommendations -and older doctors were more likely to discriminate than younger doctors.

The study in Quality and Safety in Health Care, a specialist publication from the British Medical Journal, found that half of doctors in each of the professional groups treated elderly patients differently.

The researchers compared the responses of doctors to people aged under 65 and over 65. They pointed out that 65 was no longer regarded as being particularly old in British society.

Prof Ann Bowling, of the department of psychology, at University College London, led the study. She said: "Resources are limited and doctors have to make difficult decisions. Maybe they have run out of options and are using age as an excuse.

"When we spoke to the doctors they were quite ready to justify their reasons. They may see older people as less deserving," she said.

The truly alarming thing is that the referrals, tests, and procedures denied to these hypothetical patients are what we in country would consider to be routine care, not extraordinary measures – things like angiograms and angioplasty, or even cholesterol medications. Do we really wish to import such flaws into the best medical system in the world?

And on a related note, Dr. Walter Williams offers some other negatives about socialized medicine in his column today.

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February 13, 2007

A Practice That Must Change

I’m sorry, but there can and should be no patents on life – or on genes, the basic building-blocks of life. Yet for some strange reason, our government has allowed companies to patent parts of the human genetic code.

The results of this absurd practice is to make our own, naturally occurring genetic structure the property of someone else – an intolerable intrusion into our own fundamental right to own our own lives and to control our own bodies.

Gene patents are now used to halt research, prevent medical testing and keep vital information from you and your doctor. Gene patents slow the pace of medical advance on deadly diseases. And they raise costs exorbitantly: a test for breast cancer that could be done for $1,000 now costs $3,000.

Why? Because the holder of the gene patent can charge whatever he wants, and does. CouldnÂ’t somebody make a cheaper test? Sure, but the patent holder blocks any competitorÂ’s test. He owns the gene. Nobody else can test for it. In fact, you canÂ’t even donate your own breast cancer gene to another scientist without permission. The gene may exist in your body, but itÂ’s now private property.

This bizarre situation has come to pass because of a mistake by an underfinanced and understaffed government agency. The United States Patent Office misinterpreted previous Supreme Court rulings and some years ago began — to the surprise of everyone, including scientists decoding the genome — to issue patents on genes.

Humans share mostly the same genes. The same genes are found in other animals as well. Our genetic makeup represents the common heritage of all life on earth. You canÂ’t patent snow, eagles or gravity, and you shouldnÂ’t be able to patent genes, either. Yet by now one-fifth of the genes in your body are privately owned.

What this means, in a practical sense, is that private companies and researchers can control what information you can have about your own health, and they can also prevent scientific progress that will help improve the health of every man, woman, and child in the country (if not the world). The notion that private individuals have the right to control access to and study of a naturally occurring part of every human body is completely absurd – and morally indefensible.


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February 06, 2007

Doctors Oppose Perry's Gardasil Order

Last week, Texas Gov. Rick Perry decided he was going to play doctor with little girls across the Lone Star State by unilaterally ordering that they receive the Gardasil vaccine when they enter sixth grade. Many Texans, of all political stripes, are outraged by this naked power grab designed to bypass the legislative process. Others question the message that a mandatory vaccine for an STD sends to these children.

But there is one other group opposing Perry's practice of medicine without a license -- physicians.

From, among others, the Texas Medical Association and the American Academy of Pediatrics, many doctors are saying it's too early to mandate the vaccine, which was approved for use last June. It protects against four strains of the human papillomavirus that cause 70 percent of cervical cancers.

"We support physicians being able to provide the vaccine, but we don't support a state mandate at this time," said Dr. Bill Hinchey, a San Antonio pathologist and president-elect of the TMA, which represents 41,000 physicians. "There are issues, such as liability and cost, that need to be vetted first."

Other reasons cited by doctors in Texas and across the country include the vaccine's newness; supply and distribution considerations; the possibility opposition could snowball and lead to a reduction in other immunizations; the possibility it could lull women into not going for still-necessary cervical cancer screenings; gender-equity issues; and the tradition of vaccines starting as voluntary and becoming mandatory after a need is demonstrated.

Hinchey said that TMA leadership expressed their concerns to Perry on Tuesday. He said the TMA arrived at its position after debating the issue in committees in recent days.

A perry spokesperson indicates that the governor is "listening" -- but actually means he is digging in his heels and ignoring all opposition to his end-run around the 181 members of the Texas legislature and every parent in the state.

Commercials for Gardasil counsel consumers to "talk to your doctor to see if Gardasil is right for you." It appears that physicians are giving an answer that is unambiguous -- mandatory vaccination with Gardasil is wrong for Texas.

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January 21, 2007

Starving The Elderly

That seems to have become the way that many health care institutions in Great Britain are dealing with their old folks. And this is the universal health care model that the Democrats wish to follow in the United States?

A health minister made the shameful admission that elderly people are effectively being starved in care homes and hospitals.

Ivan Lewis said some are given just a single scoop of mash as a meal.

Other bedridden pensioners are 'tortured' with trays of food placed just out of their reach.

The minister's words are a stunning acknowledgement of how the care system still lets down the frail and elderly after nearly ten years of Labour rule.

They follow years of campaigning by charities and the Daily Mail to expose appalling deficiencies in the care of the over-65s.

Mr Lewis will launch an official campaign this week to improve the quality of food offered to thousands of vulnerable old people.

But his belated move drew a lukewarm response from campaigners. Help the Aged said: 'This is an issue we have been lobbying over for a long time and something the Government has known about for years. I hope it gets the proper attention and investment now.'

A spokesman for the charity Independent Age said: 'The Government has now finally realised, after years of campaigning, that it has a problem. Now it has to ensure its plans and initiatives are carried forward.'

See what happens when government subsidies remove the need to provide adequate care? Adequate care stops.

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January 02, 2007

A Great Piece On Gays In The Military

I cannot agree more with this column written by former Chairman of the Joint Chiefs of Staff John Shalikashvili -- and indeed believe that he does not go far enough in his support for a change of policy.

TWO weeks ago, President Bush called for a long-term plan to increase the size of the armed forces. As our leaders consider various options for carrying out Mr. Bush’s vision, one issue likely to generate fierce debate is “don’t ask, don’t tell,” the policy that bars openly gay service members from the military. Indeed, leaders in the new Congress are planning to re-introduce a bill to repeal the policy next year.

As was the case in 1993 — the last time the American people thoroughly debated the question of whether openly gay men and lesbians should serve in the military — the issue will give rise to passionate feelings on both sides. The debate must be conducted with sensitivity, but it must also consider the evidence that has emerged over the last 14 years.

We know that there are homosexuals int he military -- they are fighting and dying in Iraq. There are others who would gladly serve in our nation's military, if only they did not have to deny their sexuality. And ultimately, there is no legitimate reason for barring homosexuals from service.

But I think Shalikashvili does fall a little bit short.

But if America is ready for a military policy of nondiscrimination based on sexual orientation, the timing of the change should be carefully considered. As the 110th Congress opens for business, some of its most urgent priorities, like developing a more effective strategy in Iraq, share widespread support that spans political affiliations. Addressing such issues could help heal the divisions that cleave our country. Fighting early in this Congress to lift the ban on openly gay service members is not likely to add to that healing, and it risks alienating people whose support is needed to get this country on the right track.

By taking a measured, prudent approach to change, political and military leaders can focus on solving the nationÂ’s most pressing problems while remaining genuinely open to the eventual and inevitable lifting of the ban. When that day comes, gay men and lesbians will no longer have to conceal who they are, and the military will no longer need to sacrifice those whose service it cannot afford to lose.

Frankly, I believe that the American public and members of the armed forces would be less troubled by this change than the general suggests. Our society is more accepting of homosexual persons than it was 14 years ago, even though there is a line drawn at marriage. What is needed is an initiative as bold as that of Harry Truman when he desegregated the -- because now, like then, it is the right thing to do.

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December 16, 2006

A Diabetes Breakthrough

This should be of interest to all my fellow diabetics out there.

n a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body's nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians.

Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

"I couldn't believe it," said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists. "Mice with diabetes suddenly didn't have diabetes any more."

The researchers caution they have yet to confirm their findings in people, but say they expect results from human studies within a year or so. Any treatment that may emerge to help at least some patients would likely be years away from hitting the market.

This is great news -- but the "years away" part of the last sentence is frustrating. What we seem to have here is a cure for a life-threatening disease, one that may be confirmed very quickly -- but it will be much longer before regulators approve making those of us with diabetes healthy and able to live normal lives again without glucose meters, pills, insulin shots and highly regulated diets. Such delays seem cruel.

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