Category: MATURE MATTERS (C)

PACK RATS AND SAVERS – CLUTTERERS ADDICTION

 

http://californiawithkids.com/tag/does-anybody-even-read-tags/ Have you ever wondered why you saved something?  You find the dust accumulation, like fresh snow on the sidewalk, on the old book or stack of papers.  You can’t live without it, or them, or the files, or the boxes of the papers or files or smaller boxes.  You absolutely know, beyond any shadow of a doubt – that you, yes you, will indeed, one day, not soon, but some day – require that item to be whole.  Wow….

blog link Why do the savers do this?  I remember walking into an office of a professor once.  Little did I remember of our conversation.  Overwhelming amazement and disbelief warped my mind as the mountains of papers sat from the floor to the ceiling.  Not only papers, but also the books, the binders, the boxes of books, and the boxes of binders.  Why would he need a conference syllabus from 1979? 

That little seashell gift from your Auntie is still valuable and taking up space not only on the mantle, but also in your brain.  She gave that to you in 1960!

Clutter is intimate.  Clutter represents the untapped resource of the final idea.  Clutter is the soul of what can become.  All those articles neatly filed, catalogued, scanned into a progression of finding it someday.  All the unread, partially read, outdated books that may become part of your next book, or writing, or an editorial. 

Possibly the worst offending clutterers?  Certainly teachers hit the top of the list, at all levels.  Hobbiest are great clutterers, never know when you need that spool or dried up glue.  Some of that remaining blue yarn could become the hair of that unique doll for the grandchildren.  But everyone is a clutterer. 

Your next dinner party, social engagement, or backyard barbe will prove my point.  Just look around.  Why is the broken golf ornament still on his desk?  Big Bird finger puppet – thought he went out years ago?  What’s behind that door?

Offices, garages, and closets make great hideaways for the clutterer’s calmness.  But overall the problem rests somewhere between poverty, obsessive-compulsive disorder, ADD, and depression, all mixed for normality to hypomania.  Within all of this, is creativity.  Clutterers are creative, like the addictive mind.  They find the place, the time, the hidden capacity to make the world around them in the mirror look normal.  But the reflection from the mirror tells a different truth and perspective.

Now, not all clutterers, savers, and pack rats deserve such painful insight.  But as the time train continues the “eternal project” remains incomplete for another day. 

The rules:

1.  Experiment with throwing something away.  Calculate in advance how you will feel, then, in a day or so, compare your reality with what you calculated.  Pain or gain?

2.  Start clearing by starting with smaller boxes of items, a drawer, a desk, a closet.  Can’t eat the elephant with one bite.

3.  Feel good about donating to others who might use it, like Goodwill or other charitable agencies.

4.  With the modern day video cameras, photograph the things that represent memories and get rid of the junk.   It is the memory we clutch to, not really the item.

5.  Talk with your family, friends, colleagues.  They do it too.  Every family has one !

6.  A nice compromise for families that distress over the junk…make a memory box.

7.  Remember, only the feelings are real, the uncompleted task is still part of the soul. 

8.  Professional counseling is required to break the grip of this strange yet sometimes funny process of the human spirit.

 

Well, today, I was going to go find a cheap storage unit.  Which stack of paper was that ad in?  Which box?   Which room?  Oh, ya, in the bathroom…oh, it was at work…….

 

 

(adapted from The Magazine, 2007 Jan. with significant commentary by CastMD)

STROKE – BRAIN ATTACK – MRI OR CTSCAN

When it comes to having a stroke, with a sudden loss of movement, speech, thought processes, or consciousness – the quick response to get to 911 and get the patient to the hospital is paramount.  Once in the hospital, sometimes a "clot buster" drug can be used, just like in heart attacks, to restore function.  There are very strict timeline and symptom criteria for use of such "clot busters" in the setting of an acute stroke – "cerebrovascular accident" or CVA.

 *****

Stroke is a medical emergency. Know these warning signs of stroke and teach them to others. Every second counts:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

Call 9-1-1 immediately if you experience symptoms!
Time lost is brain lost!

***** 

But how does the doctor know if a stroke has happened and where is the stroke?  New modalities of computerized tomography of the brain (CT) and magnetic resonance imaging (MRI) and other imaging techniques tell the doctors more information about the stroke.

Some strokes are not the "clot or blocking artery" type – as some are bleeding types and yet others are "embolic" types, or clots that have travelled from some other area of the body.

The National Institute of Neurological Disorders and Stroke (NINDS), part of NIH has conducted the largest study of these patients to determine which imaging study might be best to see the stroke in the brain.

A non-dye MRI showed five times the sensitivity compared to and twice the accuracy of a non-dye CT scan.  Both MRI and CT not using dye again, were about equal in seeing the bleeding type of stroke.

Independent neuroradiologists read the studies and both studies were conducted on each patient in the study. Of the 356 patients with suspected stroke, the MRI showed superior for diagnosis.

If you or anyone you know, develops sudden loss of speech, motor control in an arm or leg, loss of consciousness, or confusion – call 911 immediately.  Time is so important in this disease.  Just as in a heart attack, let your doctor know of any concerns you have with regard to stroke.

 

GOING GREEN – AN ESSAY – THE WASTE BY THE PHARMA INDUSTRY AND ADVERTISING COMPANIES – WHERE IS AL GORE ON THIS?

Did you ever get a sample or starter pak of medicine from your doctor?  Usually, the pak will have one or two pills in a blister, nuclearbomb proof wrap, and then boxed with some expensive advertising.  When is enough, enough !  To top it off, the little pill in the blister pak in the little box is one of five or six other little highly advertised little boxes in a yet bigger box.  Then comes the literature that is mandated by the FDA to be put in each box or on the blister pak itself.  Then, with the leaving of the little boxes in the bigger boxes, pages and pages of highly detailed literature is presented and left with the doctor.  Only God or Buddha would actually know how much of this stuff ends up in the garbage.

 

And now, with the internet, WebMD, CastMD, Mayo Clinic, and other portals of Net-formation, why is all this waste appealing to the advertisers, the pharma companies, and the FDA subcommittees? 

If the waste would stop, more medicines could be used by clinics to help offset the high costs to patients for starter paks, courses of medicines, or to give to those without drug benefits…a rising number !  How about just a 5-10 point update on the med instead of pages of infitessimal fine print squished on multi-folded paper…What do you think FDA? 

Well, I hope Al and his Green friends read my essay today.  Maybe he could trade some of those "Green CO2 impression stamps" he bought to offset his private jet and give them to the FDA and the Pharma companies.  That way, the universe would be in drug balance, and we don't have to worry about trees, water, air, and the uninsured and underinsured.  ZZZZOOOOOOOMMMMMM, I hear his jet now………

SUICIDE AND THE ELDERLY – A “MATURE MATTERS” ESSAY

Our “mature matters” group of the boomers increasing into their late 60’s, 70’s, and onward into their 80’s and 90’s represent a new volume of potential depressed individuals and suicidal risk candidates.

It is fairly simple for depression in the elderly to go unrecognized or missed.  Many times the depressed mood is masked by drugs such as anti-parkinson meds, narcotics, pain relievers, and heart and blood pressure meds.  Many co-morbid conditions of parkinson’s, early dementia, diabetes, mini-strokes, heart disease, neurological disorders can also mask symptoms of elderly depression and potential suicidal risk.  Depression in the elderly can suddenly change, manifesting itself as agitation, confusion, new dreams or hallucinations, but even can be a change toward new apathy or diminished or unusual caring.  Certainly, with any of these, the constant is a change from the baseline of the elderly person. 

Males suicides rates are alarming.  Rates continue to rise as men age, with a peak in the mid-80’s of age.  Meanwhile, females suicide rates peak in middle age, then decrease again in older years.

Elderly men in their 80’s have greater success in suicide attempts when compared to their younger male counterparts.  Younger men generally have more attempts, but generally are less apt to completion.  Many times planning specifics are detailed and even some have been to their doctor recently.

Elderly men typically will have a diagnosis of depression, while younger individuals will have a history of affective disorders (mood) or substance abuse disorders.  Additional risk to the elderly potential suicide victim is a group of problems including loss of spouse, loss of home, previous suicidal discussion, alcoholism, or new diagnosis of a chronic condition. 

 

Families and caregivers must be alert for any change in attitude, mood, eating habits, sleeping habits, or conversation or discussions of suicide – or discussion of would be better, less burdensome to their family, or hopelessness.

 

Elderly patients need a close eye and open ear to their concerns, wishes, demands, and needs.  A hopeful and loving family with caring friends, with professional consultation, can be literally elderly life saving…and that shows that “Mature Matters.”

BIOPHARMACEUTICALS AND GENERIC DRUG POLICY – GENERIC SAFETY EFFICACY PURITY – LEGISLATING WHEN A GENERIC IS A GENERIC?

 

Biopharmaceutical “generics” controversy continues on Capitol Hill.  Manufacturers say that the biopharmaceuticals cannot be guaranteed of safety, potency, and purity in the generic sense, since they are proteins and other biological type medications.  This is quite different from the many generic forms of other drugs, such as aspirin, penicillin, and other chemical drugs. 

Why is this such a big deal? 

Biopharm prices are considerable higher than chemical drugs.  Of the $252 billion dollars spent on prescription medicines in 2005, $33 billion was biotech-biopharm types of medicines. All med sales grow about 5-6 % per year, whereas the biopharm group grows about 3 times that rate. The top three selling biopharm meds were neupogen, epogen, and intron A – with costs at about 15, 20, and 22 thousand dollars per patient per year. Imiglucerase, an enzyme drug, will cost about 200,000 dollars per patient per year.  

Large carriers such as Kaiser and others are seeing astronomical increases in these drug costs.    Medicare estimates for drug plans estimated at 395 billion, now is over 650 billion over the ten years initial estimates. 

 In the generic marketplace, drug costs have been reduced about 50-70 percent in general.  However, this truly sensical process may be difficult to add to generic follow-through biotech group of biopharmaceuticals. How will the abbreviated new drug application be changed to allow “generic” or “follow-through” biotech biopharmaceuticals to progress faster to FDA approval?  Certainly, the savings for guaranteeing the purity, safety, and efficacy of the biopharmaceuticals may not be as great.  The big issue still remains whether the profits from “open season” on the off patent biopharmaceuticals will allow for continued research and development for newer and unique and orphan type biotech drugs that will save patients and save money.   

The baby boomers are passing through the biopharmaceutical turnstile now, and with growing numbers. 

How the 1984 Hatch-Waxman Act (Drug Competition and Patent Term Restoration Act) will change and what effect any change will have is to be determined as of yet.  This law allowed rapid development and approval of chemical drugs for generic distribution after patents expired on known brand name drugs. 

 

(Commentary by castMD with adaptation from:  Fuhr & Blackstone's article in Biotechnology Healthcare)  

 

BLURKER ADDICTION AND BLOGGER BEHAVIOR BLURKER ANONYMOUS SCREENING AND CONFIRMATION – NEED A PROFESSIONAL?

BLURKER ANONYMOUS SCREENING (CAGE)

  • Have you ever thought you ought to Cut down on your blog entries or blurking?
  • Do you feel Annoyed at criticism of your blog writing or blurking?
  • Do you feel Guilty about your blog writing or blurking?
  • Do you ever take an Early-morning look (eye-opener) at your latest blog favorite or use blogging or blurking upon awakening  (“a little hair of the dog that bit you”) to start the day or to feel better?

IF YOU ANSWERED ONE OR MORE “YES” TO THE  ABOVE SCREENING TEST – CONTINUE TO THIS CONFIRMATORY EVALUATION . 

BLURKER ADDICTION CONFIRMATION SYSTEM ®

Eating meals alone while blurking or blogging

Rereading your blog or your latest entries

Rereading your favorite blogs

Trying to stop reading blogs

Considering group meetings for bloggers

Realizing your world is centered on your favorite blogs

Wondering repeatedly what writing an entry would be like

Time with family and friends are limited

Sneaking away to check your favorite blogs

Do you check your blog stats over once per day

Do you wonder in moments of calm who might be seeing your blog

Not owning up to the problem of the continuous blurker

Family members want to call a “confrontation” meeting

Limited showers and shaving while eating at the computer

Occasional outbursts of solo-laughter discussed by others in your life

Anxiety and panic arrive when you cannot blurk

Anxiety and panic arrive when you cannot hit “submit”

Anxiety and panic heightens when reading the submit “verify code” letters

Computer failure makes you go to the public library to “check out a book”

Computer server failure makes you just sit in disbelief

Now realizing you have blogger-buddies, you want a festive gathering to touch and appreciate them  

Your children ask your spouse or significant other who the stranger is while looking at you

Your complete social circle has changed

And your only means of conversation must be in blog format. 

GRADING SYSTEM 

0 – 2                             LOW RISK

3 – 5                             MOD RISK

6 – 10                           HIGH RISH

11 – 15                         EXTREME RISK

> 15                         COUNSEL/INPATIENT  
         

www.blurkeranonymous.com

FIELD BURNING REVISITED – ILLEGAL ON APPEAL * EPA TO STEP IN – AGAIN – WILL THE CDA TRIBE and THE ELECTED OFFICIALS STEP UP TO THE ENVIRONMENTAL “PATIENT ADVOCACY” PLATE?

The U.S. 9th Circuit Court of Appeals declared that the field burning practice since 1993 has been illegal.  The unanimous decision by the Court forces a reconsideration of events that allowed the practice to continue despite widespread opposition. The EPA federal laws overpower the lobbyist-generated state laws.  An environmental plea must go out to the owners of the lands where field burning is conducted.  www.castMD.com has been writing about this issue for months – where has the EPA been?  Where have the protectors of the land, water, and air been?  To lease or rent, knowingly for the practice, is like knowlingly leasing a house for meth making or meth distribution.  All the parties know that this practice pollutes.  All the parties know that this practice is unsafe for patients.  All the parties know this is harmful to the people of the earth.  Isn't it time for leadership by the elders, officials, elected few, and, as "Country Attorney" Jerry Spence would say:  "Faceless corporations?"   Which leaders will be strong, bold, and sincere to tell the truth AND do the right thing? It is time to "walk the environmental talk."

 

SEE PREVIOUS ENTRIES:

http://www.castmd.com/?p=53

http://www.castmd.com/?p=47

http://www.castmd.com/?p=46

http://www.castmd.com/?p=48

http://www.castmd.com/?p=24

http://www.castmd.com/?p=8

SUBLIMINAL EVIL LURKS IN BLOGOSPERE WWW.CASTMD COMES TO THE IMMEDIATE RESCUE “CAUTION: ENTERING THIS UN-SPUN ZONE”

 

Bloggers beware.

 

Bloggers beware

Of pen’s fiery flare.

Bloggers beware

Of hateful glare.

 

Bloggers beware

Of gifts they bear.

Bloggers beware

Of tempting dare.

 

 

Bloggers beware

Of laughter’s stare.

Bloggers beware

Of limited care.

 

Bloggers beware

Of  legal snare.

Bloggers beware

Of snake-eye pair.

 

Bloggers beware.

 

quit smoking – cessation by drug – nicotine blocker chantix – how good is it? side effects and risks?

 

The latest news on this new nicotine receptor blocker to assist you to quit smoking is good but not the great breakthrough. Research is getting hotter.  And we can help patients "shock" that habit with this new drug at a brain receptor level.

What castMD has been told is a reality of about 25 % of patients on this medicine (lest we forget…risks of medicine exist here also) continue to be smoke-free at about 3 months, and about 45 % are smoke-free at about 6 months.  This is the latest scoop on this as compared to previous numbers below.  As with all new drugs, the love affair of the honeymoon settles in to reveal the subsequent anniversaries and the baseline love still there.  Thus, as with new drugs…but this addiction research is approaching marvelous breakthroughs with the MRI, PET, 3D scanners and high tech computer software in the brain research world. 

Many patients have success with the gum, patch, or control device.  Yet many simply quit cold turkey…but often this is after "an event" such as a heart attack, stroke, pneumonia, emphysema attack…landing that patient in the hospital.

The "click of the heels" and make a wish still remains hard work, commitment, and desire to stop smoking.  Moral, family, and friend support must be involved to a level that they all qualify for an "Oscar" for best supporting role!

 

 

Journal of the AMA published an article in July, 2006 on the Chantix nicotine receptor blocker and its goal of stopping smoking:

44% of those on Chantix were not smoking at 12 weeks 
29.5%% of those on Zyban were not smoking at 12 weeks 
18% of those on a placebo were not smoking at 12 weeks 
22% of those on Chantix did not smoke from week 9 to 52 
16% of those on Zyban did not smoke from week 9 to 52 
8.4% of those on a placebo did not smoke from week 9 to 52

*****

The U.S. Food and Drug Administration (FDA) announced approval of Chantix (varenicline tartrate) tablets, to help cigarette smokers stop smoking. The active ingredient in Chantix, varenicline tartrate, is a new molecular entity that received a priority FDA review because of its significant potential benefit to public health.

Chantix acts at sites in the brain affected by nicotine and may help those who wish to give up smoking in two ways: by providing some nicotine effects to ease the withdrawal symptoms and by blocking the effects of nicotine from cigarettes if they resume smoking.

"Tobacco use, particularly cigarette smoking, is the single most preventable cause of death in the United States and is responsible for a growing list of cancers as well as chronic diseases including those of the lung and heart," said Scott Gottlieb, MD, Deputy Commissioner for Medical and Scientific Affairs. "The agency is committed to helping facilitate the development of products to help people quit smoking and improve their overall quality of life."

According to the Centers for Disease Control and Prevention (CDC), an estimated 44.5 million adults in the United States smoke cigarettes and more than 8.6 million of them have at least one serious illness caused by smoking.

"Cigarette smoking is a very difficult habit to break due in large part to nicotine dependence or addiction" said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research. "Chantix therapy has proven to be effective in smokers motivated to quit and will provide another tool for physicians to use for the millions of smokers who want to quit."

The effectiveness of Chantix in smoking cessation was demonstrated in six clinical trials, which included a total of 3659 chronic cigarette smokers who were treated with varenicline. Five of the six studies were randomized, controlled clinical trials in which Chantix was shown to be superior to placebo in helping people quit smoking.

The approved course of Chantix treatment is 12 weeks. Patients who successfully quit smoking during Chantix treatment may continue with an additional 12 weeks of Chantix treatment to further increase the likelihood of long-term smoking cessation.

In clinical trials, the most common adverse effects of Chantix were nausea, headache, vomiting, flatulence (gas), insomnia, abnormal dreams, and dysgeusia (change in taste perception).

Chantix is manufactured and distributed by Pfizer, Inc., New York, NY.

(adapted from FDA-AMA sources)

CYANIDE ANTIDOTE – FDA APPROVED RECENTLY – WILL IMPROVE FIRE AND POISONED VICTIMS’ CHANCES OF SURVIVAL WITH EARLY EMS AND KEY TO BIOTERRORISM MONITORING *** CYANOKIT (C)

Fire victims, EMS providers, methlab remediation teams, and firefighters will be greatly served by this medical advancement in the United States.  This cyanide antidote replaces the "lilly kit" that had been used for years, which used early, was lifesaving but medically cumbersome at best.  Three medicines quickly had to be given to these severely critical patients – and the antidote itself had poisoning problems itself.  This new antidote uses an extremely novel idea.  Vitamin B12, hydroxycobalamin, likes cyanide.  With a little molecular twist, the new antidote drug, hydroxocobalamin, simply exchanges a part of the drug and binds the cyanide with impressive results.  Dr. Steve Borron, well know to some of us, and definitely an international leader in this arena, has done significant and life changing research on this new antidote to get the approval through the FDA.  This antidote has been used in Europe for over a decade with great success.  Others like Dr. Hall in Denver has done work on the FDA project years ago.  Many have contributed to this landmark success of getting this drug in a workable form into the United States.  Congrats to all of them!

 

FDA News

FOR IMMEDIATE RELEASE
P06-205
December 15, 2006

Media Inquiries:
Press Office, 301-827-6242
Consumer Inquiries:
888-INFO-FDA

FDA Approves Drug to Treat Cyanide Poisoning

The Food and Drug Administration (FDA) today approved Cyanokit (containing the drug hydroxocobalamin, intravenous tubing and a sterile spike for reconstituting the drug product with saline) for the treatment of known or suspected cyanide poisoning.  The approval, which is based on evidence of the drug's effectiveness when tested in animals, improves the nation's ability to respond to emergencies, including a potential attack by terrorists.

"Cyanide is a potent poison and one of the substances that could be used in a chemical attack," said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research.  "Today's approval is yet another measure to counter the threat of terrorism, which is a critical component of FDA's public health mission."

Cyanokit received a priority review and was approved under the Animal Efficacy Rule, which  allows use of animal data for evidence of a drug's effectiveness for certain conditions when the drug cannot be ethically or feasibly tested in humans. 

In a controlled study in cyanide-poisoned adult dogs, the use of Cyanokit reduced whole blood cyanide concentration by approximately 55% by the end of the infusion, and significantly improved survival of the Cyanokit-treated dogs compared with dogs receiving placebo.

The safety, metabolism and excretion of Cyanokit were evaluated in 136 healthy adult humans.  At the proposed starting dose of 5 grams, the drug was found to be generally well tolerated with side effects that were mild to moderate.  The drug exits the body unchanged in the urine.  In the presence of cyanide, Cyanokit's active drug takes up the cyanide and becomes a form of vitamin B12.

The most frequently reported adverse reactions in the trial were red urine, skin redness (both from the drug's coloration itself), a temporary increase in blood pressure, headache, nausea and injection site reactions.  Allergic reactions were observed in a small number of individuals but were relatively mild and responded quickly to treatment.

Cyanokit is manufactured for EMD Pharmaceuticals, Inc by Merck Sante s.a.s. in Semoy, France and packaged by Dey Laboratories of Napa, California.

More information about FDA's efforts to counteract bioterrorism is available on FDA's website at http://www.fda.gov/oc/opacom/hottopics/bioterrorism.html.

 

(photos courtesy: google images)