Almost a week ago, I ran a marathon. I am hard pressed to remember anything that I wanted more than to finish that run. I stayed high for days. I hope to run one again, but more importantly I hope to keep up the distance running in the meantime (not 26 mile runs but in the high teens). I am grateful that I accomplished my goal.
Strange Police: Just yesterday evening a story caught my eye. I saw that a class action suit was being brought against a drug company. This was not about someone getting diabetes because they took Zyprexa or a widow suing over a heart attack caused by Vioxx. It was shareholders suing because the company misled them about a drug in development. The drug had not proved effective and certain individuals had adverse health effects during the trial. The company did not mention any of this and the stock price went up and people bought the stock and then at a health industry meeting, the truth about the drug trials was revealed and of course, the price of the stock crashed. Well, if the FDA isn’t equipped for due diligence it is nice to see that Wall Street is. (yeah I know…)
Department of Justice: Another odd source for a law suit and yet here it is. Recall that drug companies themselves cannot market a drug or device for a use that it was not intended for but a clinician on his own, can prescribe something off label. In the news these days, Johnson and Johnson’s congestive heart failure drug, Natrecor. The company is accused of encouraging doctors to use the drug for less serious heart problems and in those instances the drug did not improve health and exposed persons to significant adverse outcomes. The DOJ comes in because Medicare paid for some of this off label IV drug treatment. Here is where I want to remind you of the provision in the stimulus bill about effectiveness research. It is exactly the two examples that I just provided that make that a worthwhile clause.
Genetic Testing: Here is a different spin on genetic testing. For the record and to reiterate, I am not a proponent of the testing in regards to seeing if one has for instance, a predisposition to heart disease or even breast cancer. In my mind, for those specific illnesses knowing family history and risk factors is enough to guide one in making lifestyle choices that might protect against the illness. If one has a gene say that is related to heart disease incidence, the recommendation will be the same as if they don’t…. exercise daily, avoid high fat foods and eat an abundance of certain fruits and vegetables. In a new twist however, genetic testing is being studied to determine if ones body is going to get any or a sufficient benefit from certain drug treatments. The latest study regards using ones genetic profile to determine appropriate warfarin or coumadin dose (a blood thinner). Other medications have been tested in this way and recommendations have followed. This seems to fall into the line of best treatment. At this time however, the cost benefit is still being considered. The genetic tests can cost 400 dollars. Still, I see more reasons to use genetic testing this way than to see if one might be at risk for a disease.. we are ALL at risk for disease and have tremendous power over what we choose to do to protect ourselves.
Flu Vaccine: Each year there are questions regarding whether or not the flu vaccine that is available is going to protect us against the actual flu we are exposed to. I have never taken the vaccine… this week a comedian, Bill Maher (sp), referred to the flu vaccine as a scam. I don’t know about that… but I do wonder about the fear that the government evokes in people and the waste of vaccines every year.
Colon Cancer Screening: Here it is again, that ugly little life saving test that I keep hoping is going to get better before I have to endure it. No news on the less invasive option this week, but on the sedation option. I am certainly against full sedation in general and cautious on anesthesia as it has short and long term cognitive consequences. In much the same way that I tell the dentist to use the least amount of Novocain possible, others are recommending little or no sedation for colonoscopies. It is safer and one is not rendered useless for the 24 hours post test. A Wall St. Journal reporter tells us that she went this route last year and had only mild discomfort and some cramping. She also talks about watching the little video camera make its way through her intestines on a little TV monitor. In other words, she is not normal. Just kidding. The non sedation or little sedation option is not very common in the USA and is a matter of debate for physicians. There is concern that the patient will stop the procedure because of the discomfort. I do not think that I can handle this without sedation and seriously pray for the virtual colonoscopy to gain acceptance for effectiveness before I turn 50.
Colon Cancer: I was going to end with the above and thought better of it. So you know, there are things that you can do to lower your risk of this cancer. This includes limiting red meat and processed meats while enjoying a diet high in certain fruits and vegetables as well as whole grains and you know, fiber. A healthy bowel is a healthy bowel. Note to self: don’t increase your fiber intake without being mindful of your water intake J
Happy Weekend!
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