Archives For health

You don’t need to have credentials, medical training or even a good grasp of how science works to have an effect on pediatric care in the United States. All you need is good looks, a big smile and seem to be really, really passionate and caring. That’s the lesson in the fluff pieces we get about Jenny McCarthy who went from Indigo Mom to anti-vaccine crusader. Consider a snippet from Yahoo’s gossip site.

… For that, I adore Jenny McCarthy. And even though our opinions on vaccinations differ, I love the way she speaks her mind because she is — as Cookie also says — “wickedly funny” and hardcore and very real.

Now it’s great that she speaks her mind so well, but when her public assaults a pivotal form of defense against childhood diseases are being glossed over just because she has a pretty face, we’ve got a problem. Being attractive isn’t a skill. It’s the result of a genetic lottery. Her passion and a steady stream of fawning doled out by celebrity reporters are no substitute for real scientific knowledge and rather than be raised on a pedestal and admired for her activism, she should be questioned and put up against someone who actually went to med school rather than a DIY doctor like herself…

We’re the generation of parents who are saying, ‘Listen to us. We are the bosses of our children.’ I want parents to realize that, and not get pushed around by doctors who say, ‘Oh that’s 100 percent safe.’

Just being a parent doesn’t magically bestow a decade of training and practice upon you. Doctors should and will listen to your concerns but when you form a very strong opinion about things you know very little about, all you’re doing is complicating the expert’s job and endangering yourself and your kids. I can understand an anti-establishment attitude, but not when it comes to talking out of your depth. Doctors can’t say that any medicine or vaccine is 100% safe. However there are plenty of quacks who rush to administer unproven, New Age “treatments” for autism and make a fortune at it, and I noticed that this boss of her child hasn’t made a peep about these questionable methods. In fact, she wrote a book with a doctor who peddles them for a living.

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This post is going to be a little unusual for this blog. Typically, I don’t spend a lot of time on healthcare other than trying to debunk pseudoscientific claims of homeopaths and vehement anti-vaccination activists from a scientific standpoint. But for the last month or so, I haven’t been able to turn on the TV or look at a news site without hearing about some new uproar over a potentially major overhaul of the American healthcare system based on unfounded panic, astroturfing or stubbornly ideological grounds.

health cartoon

It really doesn’t seem to matter that no one has seen the full and complete bill which may be voted on in Congress. In fact, those who oppose it are using this opportunity to grossly misinform the public and insist that should any change to the system pass, random bureaucrats will butt in between you and your doctor to decide the level of care you’ll receive based on their schedule of costs, even though there’s no blueprint for how the plan will actually work other than wild speculation and rumors coming from random pundits.

Now here’s the really funny part about this threat. This is exactly what we have now. It’s just that instead of a government official, we have a clerk from an insurance company decide whether we can get what our doctors prescribe us and our quality of care depends on who we work for or how much we’re willing to pay. Let me give you a routine, real life example of how insurance companies interfere to prevent your treatment from exceeding how much they’re willing to spend on covering you. Or in this case, me.

Friday of last week I went to my doctor because I’ve been having a little trouble with my allergies. He examined me and wrote a prescription for a well known medication with a slight stimulant. In theory, I should be able to go to the pharmacy, have them fill the script and allow my doctor’s treatment plan do its thing, right? Actually, no. When I went to pick up my prescribed pills, the pharmacy says that the insurance company won’t cover the prescription. Instead, they want me to receive another version of this medicine and buy the mild stimulant it contains over the counter. I’m of course free to pay $185 for each month’s supply and take what my doctor prescribed me but they won’t do their job and try to cover my medical expenses because this medication is not as cheap as they’d like it to be.

All right, not a big deal. Happens all the time. I just need them to call the doctor who’ll confirm that I really do need the medication he prescribed. A few days later, I come back to the pharmacy and find that while the insurance company did authorize the medication and the doctor confirmed that there was a real medical reason he recommended the medication he did and he’s not just scribbling random expensive brand names on his prescription pad for the hell of it, it will only cover $40. Why? There’s a deductable on my plan and before they’ll cover 80% of my medication as they say they will in their list of benefits, they want me to pay the whole deductible. If I want the medication that badly, I have to pony up $250 first. Or I could just comply with their wishes and get the pills they want me to take.

Now, I realize that you’re going to say. I need a better insurance plan. And that may be true. However, to get the kind of plans offered by mid-size and large businesses for their full time employees, I’d need to pay upwards of $600 a month. If you’re single and do a lot of freelance and independent work, that’s an awful lot of money to shell out. Without a spouse with a full time job and a good insurance plan, you’re likely to end up with relatively sporadic coverage that gouges you for up to 50% of every procedure’s cost until they get their deductible out of you. When you ask what you can do to counter the charges, you’re politely told that it would be much more beneficial for you to get on a group plan or get a much more expensive one.

Here’s the bottom line. If a doctor prescribes a medication based on his or her evaluation of your health concerns, you should get that medication without being gouged or blocked by an insurance company that doesn’t want to pay for something they think is too expensive. The only real way to get what you need without hassling with insurance companies and their immensely complex rules is to pay for it out of your own pocket. If you can afford to spend thousands and thousands of dollars on everything from prescriptions to tests, you can get some of the most advanced medical treatment any place you go. If you can’t, you’re stuck playing the insurance companies’ game.

I’ve been told by health insurance experts that I just need to know how to work around the system, how to appeal decisions and with who to stubbornly fight to get my way. My response is that this complexity is totally unnecessary. You should be able to get the treatment you need when you need it and the way your doctor recommends you get it. You shouldn’t have to outline plans to fight insurance company clerks who penalize you for being too expensive for their tastes. And quite honestly, if we have a major overhaul of healthcare in the United States, the last thing I’m afraid of is some random paper pusher making decisions about the level of care that will be covered when I go to the doctor. I’m already dealing with that, even when it comes to simple allergy medication prescribed to millions of people every year.

Seems that the message of the groups opposing healthcare reform is that when the paper pusher in question is from the government, you’re as good as dead. However, when he represents a company that makes more money by denying you a slightly more expensive but necessary medication and forces you to pay out of pocket for it, that’s magically a-ok through the miracle of the almighty “free market.”

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Here’s another one of my BusinessWeek essays inspired by real events, an argument in favor of holding TV talk show hosts liable for promoting quack medicine and harming audience members. Yes I know, we should allow freedom of speech in all media formats rather than threaten people with lawsuits and trust the viewers to know that talk show hosts probably don’t have medical training and we should take all their advice not only with a grain of salt but an entire pound. But the fact remains that toying with people’s health is dangerous and there’s a good reason why we send people through a decade of rigorous training before they’re given the right to see patients and give them medical advice. And there’s a reason why we sometimes take that right away. I don’t see why people on TV should be exempt from those rules.

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You know that a new diet is now a trend when it appears on daytime talk shows. All the big diet fads got their start this way and now, following in their footsteps is something known as calorie restriction. It’s exactly what it sounds like. Practitioners will limit the nutritional value of what they eat on a daily basis to under 2,000 calories. Some go as extreme as 1,600 calories, about 80% of what humans are supposed to eat. And being on daytime television, calorie counters are making bold claims about what their diet can do for you.

nutrition label sandwich

Dr. Mehmet Oz, a staple of some of daytime’s biggest talk shows, recently made the claim that extreme calorie counting will let some people live to 120 and went as far as declaring that one particular practitioner of this diet trend, Joe Cordell, could live to see his 150th birthday. Don’t start wondering if you could get by on an apple a day just yet though. When it comes to getting your nutritional advice from talk shows, I have a simple suggestion. Don’t. Rather then dig into the details and discussing the pros and cons of the next fad to sell a gazillion diet books, these shows usually present what equates to an infomercial for whatever idea the thriving weight loss industry wants to embrace that month. But believe it or not, there actually have been studies on the concept of calorie restriction and serious academics have found a number of benefits, so much of the underlying science is solid. However, like all good things, calorie counting can be taken to very dangerous extremes and cause more harm than good.

Human bodies work best when we’re lean and have just enough food to provide us will all of the nutrients and vitamins we need to function. Anything more than that becomes excess calories and when coupled with a sedentary lifestyle, become excess fat. Being overweight carries many well known health problems such as high levels of low density lipoproteins, or LDL cholesterol. That’s the bad kind. The kind that clogs arteries and causes heart disease. Too much bulk also causes hypertension, can help trigger diabetes and reduces lifespan. By restricting yourself to a relatively small number of calories and carefully monitoring what you eat and how, you could avoid the causes of obesity, sidestep the problems with ingesting empty calories and put less stress on your body. The result is a prolonged lifespan. But by how much? Could anyone really live to 150 on 1,950 calories a day and is restricting yourself to 1,600 calories a potential time bomb? The most probable answers are no and yes, respectively.

According to our current understanding of medicine, if every disease were curable and we had some of the healthiest lives possible, we’d all be living somewhere around 120 years. However, not every disease is curable and one of the key processes behind aging is the drastic decline in our immune systems. People who live to be extremely old (95+) will actually die of frailty since their bodies are so deteriorated by the ravages of time, just about any serious stress would kill them. There’s no kill switch in nature, so frailty of old age serves as the finishing blow to a living thing and that’s something extremely difficult to counter with calorie restriction. And even the healthiest diet wouldn’t protect you from all cancers, especially if they’re hereditary. A far more realistic claim is to say that you might get an extra 10 to 15 years and your quality of live would improve drastically since your body would be lean, mean and healthy. Any more time on Earth than that would just be icing on the cake. Which you probably shouldn’t eat too much of.

And conversely, you don’t what to limit yourself too much. After all, cutting down calories to a drastic level means that you’re starting to cut into essential vitamins and nutrients which could affect how your body metabolizes its basic fuels. Hair and nails could grow slower, lacking the materials to regenerate themselves. Blood pressure could fall below normal and you could slip into the underweight category, starving your immune system of what it needs to effectively do its job. Being severely underweight would actually shorten your lifespan and come with its own set of complications. For example, while we tend to associate body fat with heart disease and a very high percentage of it is bad news, we do need at least some. Too little of it and fat soluble vitamins don’t get properly absorbed into our bodies. In effect, you could calorie restrict your way into semi-starvation and into an early grave, exactly the opposite of what you want to do. I know there are examples of people who only consume 1,600 calories for a day for a year and they seem just fine, but when we’re talking about life-extension studies, we really need to track them over many decades, not jus their first year or two.

So if you want to take on calorie restriction to help prolong your life, there’s some science that would support your decision and it probably will be good for you if you stick to it for years. But don’t get overzealous and starve yourself on just a few calories a day, expecting to live beyond the ripe old age of 150 by virtue of eating less.

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When the first cell phones went on sale, somebody, somewhere looked at those brick sized devices and said: “Holy crap, I bet this freaking thing gives you brain cancer!” So for the last few decades, doctors and scientists have been trying to figure out if that’s indeed the case and whether using your cell phone might just cost you a brain.

brain

A conclusive answer to this question would affect not only some 3 billion people or 45% of the world’s population, but the future of Third World countries where the lack of an infrastructure that could support business operations means that cell phones are fast becoming the de facto communication device. Who would invest in a country where the only cost effective method of staying in touch with anyone out of earshot is pumping carcinogenic radiation into an organ most people would consider rather important? Given the significance of the research and some two decades of studies and survey projects, we should’ve had a definitive answer as to whether cell phones are a health hazard or not by now.

But that’s easier said than done. A new generation of cell phones comes out every year. A brain tumor takes over a decade to develop. By the time you can put together a study to see how cell phones affect their users, the technology and the habits you’re studying are already outdated. On top of that, studying something over a decade means that most participants drop out long before your data collection is done and you’ll end up with too few people to make your survey meaningful on a macro scale. Of course just because it’s challenging to find a link between cell phones and cancer, doesn’t mean scientists stopped trying. Case in point, the biggest research project on the subject; the Interphone Study which worked with tens of thousands of people in fourteen countries since the late 1990s.

According to the group’s data, people who use their cell phones at least once a day for over ten years are facing a 50% increase in their chances of developing brain tumors. Quite a few of the cases would be malignant. But before you start wondering if you should get a hazmat suit next time you want to use your cell, you might want to keep in mind that the study’s data collection phase was conducted in 1998 and 1999 and the technology being linked to new cancer cases is long gone. On top of that, the Interphone Study is very limited in its scope and is very vague on the most important question. How exactly does the electromagnetic radiation from cell phones cause cancer? Causation is just as important as correlation.

Maybe rather than collecting extremely limited data sets and analyzing them for years on end, we should be studying the effects that cell phones have on living things more closely. After all, if we really want to find out whether our handsets are ticking time bombs, a research project that only studies talking on a phone with a GSM chip once a day or more and analyzes its data sets for almost a decade while the world leaps ahead, just doesn’t cut it.

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