52 replies to this topic

[stocks]

How Choose to Doctors Die

It’s Not Like the Rest of Us, But It Should Be

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”


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[stocks]

Do Not Resuscitate -- Do you wish to be resuscitated if your heart stops?

Television has done an excellent job of distorting true medicine, including the resuscitation of dying patients.

Resuscitation isn’t as clean and gentle as they portray on television. The chest must be compressed hard and deep enough to pump the blood out of the heart. This can lead to broken ribs, punctured lungs and possibly an injured heart. Paramedics move beyond the gentle mouth-to-mouth breathing and insert a breathing tube into the patient’s throat. Electrical shocks may have to be delivered to attempt to shock the heart back into a normal rhythm. An intravenous line (IV) would be started, so potent medications could be delivered through it. The patient is transported to the hospital, and if they aren’t already pronounced dead, they may be instantly hooked up to life support machines, without consulting with family.

What are the chances that all of this will work? The statistics, while not highly accurate due to variances in reporting methods, show that survival after resuscitation is 6 to 15% for patients already in a hospital, 1 to 2% for patients in nursing homes and between 4 to 38% for patients who were resuscitated in non-health care settings. The statistics are the worst for patients who have chronic illnesses, cancer or dementia. Since most people who are on palliative care or hospice care have one or more of these conditions, their survival would most closely resemble that of nursing home residents -- 1 to 2%. It’s important to note that the 1 to 2% of patients often have some kind of damage to the brain or heart.

The question now becomes, “Is it worth it to put myself or my loved one through the traumatic process of resuscitation for a 1 to 2% chance of survival?”


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[stocks]

The last sixty years have produced a mountain of anti-tonsillectomy evidence that doctors seem to ignore

If you search "tonsillectomy/adverse effects" on PubMed, you will get more than 1000 references:

including polio, weight gain, vomiting (many articles), taste distortion (here, here, here), Hodgkin's disease (here, here, here, here, here, but here is evidence that disputes the association), Creutzfeld-Jacob disease (e.g., here, here), inflammatory bowel disease and Crohn's disease, rheumatoid arthritis, severe spine infection, neck infection (here, here), speech problems (here, here), hearing loss, ear pain, visual loss (here, here), depression, several other serious problems, and immunological abnormalities (e.g., here, here, here).

Also tonsillectomy "is associated with a relatively high risk of postoperative complications" and that "the actual post-tonsillectomy haemorrhage rate is much higher than that recorded in hospital statistics."

Overtreatment -- wasteful and harmful medicine -- is an enormous problem. It is the subject of two recent books (Overtreated and Overdiagnosed) and a Newsweek article. Tonsillectomies are an example.


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[melonseed]

Stocks, the message you drive can be offensive to some but true in many ways. I, am grateful to medical science for my mother's survival. Severe pancreatitis with multiple organ failure. I truely believe in the work of nature that the body play the major part in healing itself, but medical science has allowed an environment supporting the process. I for one do not seek any medical attention unless it is totally unbearable or I think i am dying and it's worth a shot. I know there are some doctors here. You are honoured for improving lives without a doubt. But also the misdeeds of medical science cannot be denied. Which includes unethical promotion to public seeking treatment with main objective id to drive medical related product sales. Wild theories practiced over decades and only till date proven it's a mistake, drug companies conveniently ignore. End of the day, we give healthcare workers the due respect as they are the masses option to live better. Medical abuse might be on the rising trend, along with every other evil due to "globalisation". Can't fight the world, live with it. Don't read too much into everything. You'll just get depressed. It's a far from perfect world.

[stocks]

In cancer science, many "discoveries" don't hold up

During a decade as head of global cancer research at Amgen, C. Glenn Begley identified 53 "landmark" publications -- papers in top journals, from reputable labs -- for his team to reproduce. Begley sought to double-check the findings before trying to build on them for drug development.
Result: 47 of the 53 could not be replicated. He described his findings in a commentary piece published on Wednesday in the journal Nature.

Some authors required the Amgen scientists sign a confidentiality agreement barring them from disclosing data at odds with the original findings. "The world will never know" which 47 studies -- many of them highly cited -- are apparently wrong, Begley said.

Part way through his project to reproduce promising studies, Begley met for breakfast at a cancer conference with the lead scientist of one of the problematic studies.
"We went through the paper line by line, figure by figure," said Begley. "I explained that we re-did their experiment 50 times and never got their result. He said they'd done it six times and got this result once, but put it in the paper because it made the best story. It's very disillusioning."


http://www.reuters.c...E82R12P20120328

[stocks]

What Causes Disease?

For humans, as large complex animals, invasion and colonisation by infectious parasitic agents is the basic problem in life

For example, it is likely that the mid-twentieth century epidemic of heart disease was caused by some infectious agent - not known;

As well as the damage from micro-organisms and parasites, there are problems with the body's 'immune' reactions to these invaders - and these probably cause another whole set of 'autoimmune' diseases; which may include eczema, asthma, rheumatoid arthritis

What about Diet?

It seems that humans can live a full lifespan on a huge range of diets, so long as the food does not contain too much poisonous or infectious stuff.

The most striking thing about diet is how little dietary components matter to life expectancy, so long as there is enough food.


http://charltonteach...s-of-thing.html

[stocks]

Hospitals, doctors offer cash discounts for medical bills

A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.
Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.

Snyder said she went back to work last year at a hair salon in Seal Beach, partly to help pay her insurance premiums of $700 a month.
"It kills me that I'm paying that much in premiums," she said, "and it's better to pay cash out of my own pocket."

(Los Alamitos Medical Center lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.
When The Times called for a cash price, the hospital said it was $250.)

Health-policy experts say the growing awareness of cash prices should accelerate the trend toward increased disclosure of all types of medical costs. But entrenched interests are likely to resist.

"The insiders in the healthcare industry don't want to lose control over this information," Keckley said. "But price transparency is inevitable."


http://www.latimes.c...2049,full.story

Edited by stocks, 29 May 2012 - 08:41 AM.

[Rogerdodger]

My wife got a self-pay colonoscopy. Price was 1/2 and the doctor was paid immediately WIN-WIN! But maybe it was a half-@ssed procedure...

Edited by Rogerdodger, 29 May 2012 - 10:45 AM.

[stocks]

Hospitals, doctors offer cash discounts for medical bills

Doctor Explains Shocking and Irresponsible Healthcare Costs

Watch this amazing Video

Forget everything you ever thought you knew about healthcare costs! In this video (as well as the website) I expose many of the deceptions that are occurring in healthcare now.

For example:
-Most generic medication cost less if you don't use your insurance to buy them.
-Most doctors have no idea what they get paid for an office visit.
-Hospitals routinely bill TEN times what they expect to be paid.
-Most diagnostic tests are very inexpensive to run
-Insurance companies deliberately bargain in bad faith when it's your money.


http://www.youtube.c...ture=plpp_video

[stocks]

AARP -- 4 Surgeries to Avoid

1. Stents for Stable Angina

Despite stents' ineffectiveness, close to 500,000 are implanted each year for stable chest pain, says Sanjay Kaul, M.D., a cardiologist at Cedars-Sinai Heart Institute in Los Angeles

2. Complex Spinal Fusion for Stenosis

Deyo recently studied the records of more than 30,000 Medicare patients who underwent surgery for stenosis of the lower back and found that complex fusion procedures (in which surgeons place bone grafts between multiple vertebrae) had increased an astounding 1,400 percent between 2002 and 2007.

The risks are significant: Those who underwent complex fusion were nearly three times more likely to suffer life-threatening complications than those who underwent less invasive surgery. Previous studies have also found that most fusion patients experience no more relief from their chronic back pain than those who had physical and behavioral therapy.

3. Hysterectomy for Uterine Fibroids

Each year approximately 600,000 American women have hysterectomies, or removal of the uterus, and studies show that the vast majority are unnecessary.

4. Knee Arthroscopy for Osteoarthritis

With this procedure a surgeon places a tiny camera in the knee, then inserts small instruments through other incisions to repair torn or aging cartilage. Studies show the operation works well when patients have in fact torn their meniscal tissue, but it is no more successful than noninvasive remedies in treating osteoarthritis of the knee



http://www.aarp.org/...to-avoid.1.html