Mental impairment following bypass surgery

A study from Duke University, published in the New England Journal of Medicine in February, 2001, confirms what many doctors have suspected, but have been reluctant to discuss with their patients: A substantial proportion of patients after coronary artery bypass surgery experience measurable impairment in their mental capabilities.

...The impairment was not temporary, as many doctors have claimed (or at least hoped). The decrease in cognitive capacity persisted for 5 years.

-- from the article "Pump Head: Mental impairment after bypass surgery"

"Cheap safe drug kills most cancers"

I missed posting this when I first became aware of it. New Scientist wrote about a "cheap and simple drug that kialmost all cancers by switching off their 'immortality'."

All the drug does is change the metabolism of the cancer cell, which reactivates its normal self-destruct mechanism.

TheNew Scientist report from 2007 is here. I'll try to find follow information on how research is progressing.

Possibly lifesaving? Vitamin D and flu immunity

Americans suffer from an epidemic of vitamin D deficiency, especially in wintertime. Most people will be outdoors on a regular basis in the summertime -- possibly enough to make sufficient endogenous vitamin D. But what about next fall and winter?

J.J. Cannell describes his hospital days as a doctor in the midst of a flu breackout. His comments and subsequent research show that vitamin D may be vital as preventive and treatment for infections:

"As I am now a psychiatrist, and no longer a general practitioner, I was not directly involved in fighting the influenza epidemic in our hospital. However, our internal medicine specialists worked overtime as they diagnosed and treated a rapidly increasing number of stricken patients. Our Chief Medical Officer quarantined one ward after another as more and more patients were gripped with the chills, fever, cough, and severe body aches that typifies the clinical presentation of influenza A...

"I guess our hospital was under luckier stars as only about 12% of our patients were infected and no one died. However, as the epidemic progressed, I noticed something unusual. First, the ward below mine was infected, and then the ward on my right, left, and across the hall - but no patients on my ward became ill. My patients had intermingled with patients from infected wards before the quarantines. The nurses on my unit cross-covered on infected wards. Surely, my patients were exposed to the influenza A virus. How did my patients escape infection from what some think is the most infectious of all the respiratory viruses?

"...All of the patients on my ward had been taking 2,000 units of vitamin D every day for several months or longer. Could that be the reason none of my patients caught the flu? I then contacted professors Reinhold Vieth and Ed Giovannucci and told them of my observations. They immediately advised me to collect data from all the patients in the hospital on 2,000 units of vitamin D, not just the ones on my ward, to see if the results were statistically significant. It turns out that the observations on my ward alone were of borderline statistical significance and could have been due to chance alone. Administrators at our hospital agreed, and are still attempting to collect data from all the patients in the hospital on 2,000 or more units of vitamin D at the time of the epidemic."

Read more of his subsequent experience and research at Medical News Today.

"We have only recently learned how vitamin D increases production of antimicrobial peptides while simultaneously preventing the immune system from releasing too many inflammatory cells, called chemokines and cytokines, into infected lung tissue. "

In other words, vitamin D helps the body produce its own antibiotic, and it also helps protect against the body's excess inflammatory reaction against the flu virus -- a reaction that can be fatal. The effect of vitamin D on the new Mexican Flu virus (H1N1) has not been specifically studied, but there is no reason to think that vitamin D will not have the same effect on this flu as it has on other viruses and infections.

I am personally well-stocked on vitamin D. I think the easiest and least expensive way to take vitamin D supplements is Carlson Labs liquid Vitamin D drops. I will be buying these once I use up the pills I currently take. Three drops would provide the full 5000 IU wintertime physiological dose. For summer, depending on how much sun you get, you might not need any supplement at all. If any of us starts showing signs of flu, I will immediately start a 3-day course of 2000 IU/kilogram per day. Since I am approximately 60 kilos, that would be 60 x 2000 daily (sixty drops of the liquid). I am not a doctor, nor am I recommending this for anyone except my own family. Do your own research, make your own choices.

Vitamin D - annual supply for less than $12

The Mayo Clinic summarized the results of studies on the benefits of vitamin D supplementation on their medical news pages.

Recommended dose is around 1000 International Units of vitamin D-3 daily. Currently $8.88 will buy you 300 capsules, which is an annual cost of less than $12.

Carlson offers a higher potency, 2000 I.U., in a 360 size bottle, very nearly an annual supply (one daily) for $11.09.

The protection of vitamin D doesn't need to be expensive. It's especially important if you live in Northern climates where you may not get enough sun exposure in the wintertime.

Eat Fish, Prevent Stroke

From HealthGems Newsletter, Volume 11:

"Researchers reviewed data collected from 70,839 women who were free from diagnosed cardiovascular disease. The researchers found that higher consumption of omega-3 oils from fish was associated with decreased risk of total strokes, with a more protective decrease for thrombotic (blood clot) stroke. Women who ate fish 2 to 4 times a week compared to women with the lowest intake were 40% less likely to suffer from all types of stroke. Higher fish intake was not associated with an increased risk of hemmorrhagic (bleeding) stroke.
"Journal of the American Medical Association, 2001;285:304-12."

Your chance of benefitting from chemotherapy: 4%

From an investment-oriented newsletter, The Growth
Stock Wire, March 7 edition:

Chemotherapy is one of the most grueling treatments in modern medicine, one that causes nausea, hair loss, infertility, and more. Even so, most cancer patients willingly face such harsh side effects in hopes of getting better.

But what if your doctor told you the chances of you getting any benefit from subjecting your body to such chemical warfare was only 4%? I'd pass on the chemo and advise my family members to do the same...

Yet doctors have had no way to determine who would and would not respond to chemotherapy. So the thinking has been treat first, ask questions later. But now, for the first time, doctors can pre-screen patients that will respond to chemo based on the results of a new test that probes their cancer's molecular "fingerprint."

Tissue samples are run through a 16-gene test panel to identify the small percentage of patients that will actually derive a clinical benefit from the physically and mentally taxing chemotherapy regimen.

How much does a test like this cost? About $3,650 a pop.

That's worlds away from your standard $10 cholesterol test. But the information provided in the test is much more valuable, too. The doctor doesn't have to guess whether the patient will benefit. The patient understands the risks and payoffs of such a nasty treatment beforehand. And the insurance company would much rather cough up a few thousand bucks up-front for the test in order to skip out on a $20,000–$50,000 course of chemo.

Biostatistician Ulrich Abel studied chemotherapy many years ago, and concluded that chemotherapy was beneficial in only 1% of the cases it was used (monograph: "Chemotherapy of Advanced Epithelial Cancer"). He wrote, "A sober and unprejudiced analysis of the literature has rarely revealed any therapeutic success by the regimens in question in treating advanced epithelial cancer." (For more information, Google this phrase: "Ulrich Abel chemotherapy study")

Draw your own conclusions. My conclusion is that most of the time, the doctors KNOW it will not help. But they push it on patients anyway.

New technology could save tens of thousands of lives, if doctors would use it

This amazing technology of which I speak is the paper and pencil, used to make a checklist.

This New Yorker piece describes how intensive care was improved, revolutionized, in the state of Michigan, by the use of checklists to make sure doctors performed certain procedures correctly in the course of treating the most desperately sick patients.

About five million Americans will be in ICU this year at some time. The most dangerous thing that can happen in an ICU is an infection developing in one of the tubes ("lines") the doctors put into the body to deliver medicine, transfer blood in and out, or for drainage. "I.C.U.s put five million lines into patients each year, and national statistics show that, after ten days, four per cent of those lines become infected. Line infections occur in eighty thousand people a year in the United States, and are fatal between five and twenty-eight per cent of the time, depending on how sick one is at the start."

Yet, when doctors are routinely required to follow a strict checklist to ensure clean hands, proper disinfectants used on the body, the body draped fully during installation of the line -- at Johns Hopkins, line infection rates went from 11% to zero! In a single hospital, eight lives and 2 million dollars in costs were saved from the simple use of a checklist.

Next, checklists for installing lines and two other procedures done in ICU's were instituted as standard policy in all hospitals in Michigan. "Within the first three months of the project, the infection rate in Michigan’s I.C.U.s decreased by sixty-six per cent. The typical I.C.U.—including the ones at Sinai-Grace Hospital—cut its quarterly infection rate to zero. Michigan’s infection rates fell so low that its average I.C.U. outperformed ninety per cent of I.C.U.s nationwide. In the Keystone Initiative’s first eighteen months, the hospitals saved an estimated hundred and seventy-five million dollars in costs and more than fifteen hundred lives." This is for a single state.

Other states are not rushing to follow Michigan's example. Why? Does this remind anybody else of Semmelweiss?

Instead of using these virtually costless techniques that could save tens of thousands of lives annually, millions are spent on research that will save a fraction of that number, even if a drug or new medical gizmo proves successful. I am increasingly convinced that for-profit health care works at cross purposes to the desired endpoint of better health.

Vitamin E supplement for better absorption

Certain health conditions, including cystic fibrosis, can impede the absorption of fat-soluble vitamins, including Vitamin E. Such individuals are often deficient in those vitamins (Vitamin A, Vitamin D, and Vitamin E, primarily).

A new liquid formulation that contains the whole family of Vitamin E compounds has been introduced by Douglas Laboratories. Because the vitamin E is surrounded by a water-solutble shell, the vitamin is absorbed more easily. The data sheet is here.

This liquid supplement would also be a benefit to those who have trouble swallowing capsules and tablets.

The goal is to reduce deaths, not cholesterol

The NY Times reports today that unreleased data on the cholesterol-lowering drug Zetia, which earns $5 billion each year for its makers Merck and Schering, raises the possibility of liver damage, especially when the drug is taken in combination with a statin drug for lowering cholesterol.

New evidence shows that the drug makers Merck and Schering-Plough have conducted several studies of their popular cholesterol medicine Zetia that raise questions about its risks to the liver, but the companies have never published those
results.

Partial results of the studies, alluded to in documents on the Food and Drug Administration's Web site, raise questions about whether Zetia can cause liver damage when used long term with other cholesterol drugs called statins.

Most of the millions of people who use Zetia take it along with a statin like Lipitor, Crestor, or Zocor. Or they take it in a single pill, Vytorin, that combines Zetia with Zocor...

All drugs have potential risks and side effects, of course, and doctors and patients must weigh those against a drug’s medical benefits. But in the case of Zetia, despite its widespread use, there is no evidence proving that Zetia can reduce heart attacks and strokes, as cholesterol drugs are meant to do. There is extensive medical evidence showing that Lipitor and other statins provide such
protection...

One expert, Dr. Beatrice Golomb of UC San Diego, suggests that doctors are missing the purpose of prescribing cholesterol drugs. The goal should be about reducing deaths from heart attack and stroke, not merely lowering the cholesterol number on a drug test. And there is not sufficient evidence that Zetia can actually prevent heart attacks. The company even says so in their television ads for Zetia! Their online advertising states clearly, " Unlike some statins, ZETIA has not been shown to prevent heart disease or heart attacks. "

Why suffer the risk of liver damage without proven benefits? Why not look to one of the many non-toxic ways of lowering cholesterol that actually do reduce cardiac deaths, like fish oils, for example?

Vitamin D deficiency may intensify chronic pain

"Of the [chronic pain] patients tested, 26 percent had vitamin D inadequacy. Among these patients, the morphine dose was nearly twice that of the group with adequate vitamin D levels. In addition, the vitamin D inadequacy group used morphine for an average of 71.1 months versus 43.8 months. The vitamin D deficient group also reported lower levels of physical functioning and had a poorer view of their overall health. "

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