Category: General things

Surgery fulfills young man’s wish
Friday, December 26, 2003 Posted: 2:03 PM EST (1903 GMT)
Twenty-eight years ago, Jake Perez was born three months early. Despite his premature arrival, he left the hospital healthy and with no signs of brain damage. But before his first birthday, his mother noticed something was not right. “It was hard for him to get up the crib, and of course my family, my brothers and sisters, told me, ‘Something is wrong with Jacob,’ ” Maria Perez said.
Her son had a minor case of cerebral palsy, a group of disorders caused by brain damage that affect a person’s ability to move and to maintain balance and posture. “I remember when I was a child walking toward a mirror and realizing I am walking differently than everyone else around me,” Perez said. Stiffness was his main problem. He had excellent motor coordination and minor deformity in his legs.
Perez grew into a handsome, smart young man — who is now a writer at CNN Headline News — but his desire to walk normally did not lessen. Perez got his wish thanks to a spinal cord operation that is usually performed on children between the ages of 2 and 6.
Dr. T.S. Park has performed the procedure � called selective dorsal rhizotomy � on more than 1,000 children, but he is one of the few doctors to also perform the surgery on adults.
Perez is one of a small number of adults who can have this surgery — patients must have only a mild case of cerebral palsy, little or no deformities and be able to walk independently. His surgery was performed at Barnes Jewish Hospital in St. Louis, Missouri.
During the procedure, a drill is used to remove a piece of vertebra in the lower back that covers the spinal cord. The nerves then are examined under a microscope and tested. When the right nerves are cut, some of the symptoms of the cerebral palsy are alleviated. “We calm down the spinal cord,” Dr. Park said. “We kind of balance out the input and output of the spinal cord activities.” While the risks of the surgery include weakness, paralysis or loss of bowel and bladder function, Dr. Park was optimistic.
“Jake will be able to walk normally after the surgery,” he said. “The stiffness will be gone permanently.” Indeed, one month after the surgery, and after intensive physical therapy, Perez is feeling great. “I feel very mobile and free,” he said. “I feel like I’ve been let go. It’s a good feeling. It’s awesome.”
Source: CNN.com

The pressure on our sprawling healthcare system in the U.S. has never been greater. There’s an urgent need to expand testing and treatment for COVID-19 to all residents who need it, regardless of health insurance status. Massive federal cash influxes have sought to shore up hospitals sagging under the weight of the coronavirus burden and the related cessation of elective surgery and regular medical care.1? Check out the latest chillwell ac reviews.

Long before this crisis, the U.S. led other industrialized nations in high spending on healthcare and getting a low bang for the buck in terms of health outcomes and the percentage of the population served. Life expectancy in the U.S., for example, is 78.8 years, while it ranges from 80.7 to 83.9 in 10 other high-income countries, according to an influential study in the Journal of the American Medical Association (JAMA). And only 90% of the population in the U.S. has health insurance, compared to 99% to 100% of the population in the other industrialized countries examined.2?

COVID-19 has increased pressure on our highly complex and expensive healthcare system, making it more urgent to lower costs.

One reason for high costs is administrative waste. Providers face a huge array of usage and billing requirements from multiple payers, which makes it necessary to hire costly administrative help for billing and reimbursements.

According to best male enhancement pills articles, Americans pay almost four times as much for pharmaceutical drugs as citizens of other developed countries.
Hospitals, doctors, and nurses all charge more in the U.S. than in other countries, with hospital costs increasing much faster than professional salaries.

In other countries, prices for drugs and healthcare are at least partially controlled by the government. In the U.S. prices depend on market forces. Check out these performer 8 reviews.

Costly Healthcare Hurts Everyone

The high cost of healthcare affects everyone, sick or well. It has depressed individual spending power for the past few decades. Salaries for American workers have risen, but net pay has stayed the same because of increasing charges for health insurance.3? Today, tightening up on overspending is urgent to help stretch medical and hospital resources to control COVID-19.

Here are six underlying reasons for the high cost of healthcare in the U.S.

1. Multiple Systems Create Waste

“Administrative” costs are frequently cited as a cause for excess medical spending. The U.S. spends about 8% of its healthcare dollar on administrative costs, compared to 1% to 3% in the 10 other countries the JAMA study looked at.

The U.S. healthcare system is extremely complex, with separate rules, funding, enrollment dates, and out-of-pocket costs for employer-based insurance, private insurance from healthcare.gov, Medicaid, and Medicare, in all its many pieces. In each of these sectors consumers must choose among several tiers of coverage, high deductible plans, managed care plans (HMOs and PPOs) and fee-for-service systems. These plans may or may not include pharmaceutical drug insurance which has its own tiers of coverage, deductibles, and copays or coinsurance. This is how Exipure works.

For providers, this means dealing with myriad regulations about usage, coding, and billing. And, in fact, these activities make up the largest share of administrative costs.4?

2. Drug Costs Are Rising

On average, Americans shell out almost four times as much for pharmaceutical drugs as citizens of other industrialized countries pay. High drug prices are the single biggest area of overspending in the U.S. compared to Europe, where drug prices are government regulated, often based on the clinical benefit of the medication. Take a look at these flat belly tonic reviews.

With little regulation of drug prices, the U.S. spends an average of $1,443 per person, compared to $749, on average, spent by the other prosperous countries studied. In the U.S. private insurers can negotiate drug prices with manufacturers, often through the services of pharmacy benefit managers. However, Medicare, which pays for a hefty percentage of the national drug costs, is not permitted to negotiate prices with manufacturers.

3. Doctors (and Nurses) Are Paid More

The average U.S. family doctor earns $218,173 a year, and specialists make $316,000—way above the the average in other industrialized countries. American nurses make considerably more than elsewhere, too. The average salary for a U.S. nurse is about $74,250, compared to $58,041 in Switzerland and $60,253 in the Netherlands.6? 7?

U.S. managed care plans (HMOs and PPOs) may succeed in lowering healthcare costs by requiring prior authorization for seeing a high-priced specialist. Use of a nurse practitioner instead of a family doctor can also save money.

Dream Of Separate Lives Ends: Women underwent 50 hours of continuous surgery
Wednesday, July 9, 2003 Posted: 0248 GMT (10:48 AM HKT)
The deaths of two conjoined Iranian twins following unprecedented surgery to separate them has prompted an outpouring of grief around the world.
Ladan Bijani died when her blood circulation failed after the operation to separate the twins’ brains, officials at Singapore’s Raffles Hospital say. Her sister Laleh died when her circulation failed one-and-a-half hours later. Mourners gathered outside of Raffles Hospital and the sad news spread quickly through the twins’ home country of Iran.
The 29-year-old twins — both law graduates — had two distinct brains, but they were fused together, requiring a team of international doctors to spend many painstaking hours separating them in surgery dubbed “Operation Hope.”
At a news conference, hospital chairman Dr. Loo Choon Yong said that when complications arose after their brains were separated, surgeons had the option to attempt to stabilize them and transfer them to intensive care, or continue with the most risky part of the surgery.
“The team wanted to know once again what were the wishes of Ladan and Laleh,” he said. “We were told that Ladan and Laleh’s wishes were to be separated under all circumstances. “We knew the risks were great — we knew one of the scenarios was that we would lose both of them,” he said. He said the twins took 50 hours of anesthesia and continuous surgery well and doctors had been “hopeful but very cautious.” After the brain separation, there was some bleeding which they tolerated well for a while, he said. But Ladan’s surgery began to fail and she died at 2.30 p.m. (0630 GMT) on Tuesday.
“Laleh was critical but holding on. Surgery to her brain continued. She continued to receive a blood transfusion. However, her circulation began to fail also. The whole team did everything to save her.” Laleh died at one-and-a-half hours later.
“We are very grateful and thankful for the help and sacrifice of so many specialists, doctors, teachers, nurses and other people, all united with one common purpose, to do something — anything — that can help Ladan and Laleh fulfill their wishes.
“We also want to thank so many people for their prayers — whether they are Christian, Buddhist, Hindu, or Muslim — everyone had been praying for the twins and we are grateful because as doctors we know there’s only so much we can do, and the rest we have to leave it to the Almighty.”
In Iran, the operation has dominated news coverage in the country. “May God bless their souls and reward them with peace in their eternal life,” said the Islamic Republic of Iran News Agency, in condolences “to all Iranians across the globe on loss of the two kind sisters on Tuesday in Singapore City.”

Willing to face the risks
The twins made a big impression around the world with their display of courage and bravery going into the dangerous operation. Doctors at one point tried to talk them out of the operation, but the sisters said they were willing to accept the risks and face those dangers to lead separate lives.
Earlier Tuesday, neurosurgeons carefully teased apart packed brain tissue millimeter by millimeter in a delicate and risky procedure on the third day of the operation. Surgery to separate the twins, who were joined only at the head, began on Sunday and doctors had to battle against unstable blood pressure levels as they slowly split apart the fused brains.
The complicated process of paring apart the twins’ brains began late Monday and separating them was one of the most challenging parts of the surgery. Prior to separating the brains, surgeons completed the process of rerouting a single large vein that served to drain both their brains. An international team of neurosurgeons, dozens of doctors, plus support staff created a bypass for Ladan, using a vein grafted from her leg. This caused another complication, Kumar said, as blood circulation between the twins became unstable.
Source: CNN.com

One Twin Dead After Separation
Tuesday, July 8, 2003 Posted: 4:18 AM EDT (0818 GMT)
One of the conjoined adult Iranian twins separated after unprecedented surgery has died, according to officials at Singapore’s Raffles Hospital.
Ladan Bijani, the more outspoken of the two, died due to a severe loss of blood as the separation of the twins’ brains was coming to a close. Doctors are working to stabilize her sister Laleh, who is still critical from the risky operation. Neither twin was believed to be at a greater risk ahead of surgery. There were tears at the hospital in Singapore as spokesman Dr. Prem Kumar Nair made the announcement. The twins made a big impression around the world with their display of courage and bravery going into the dangerous operation. Doctors at one point tried to talk the them out of the operation, but the 29-year-old sisters, both law graduates, said they were willing to accept the risks and face those dangers to lead separate lives.
Earlier Tuesday, neurosurgeons carefully teased apart packed brain tissue millimeter by millimeter in a delicate and risky procedure on the third day of the operation. Surgery to separate the twins, who were joined only at the head, began on Sunday and doctors had to battle against unstable blood pressure levels as they slowly split apart the fused brains. The complicated process of paring apart the twins’ brains began late Monday and separating them was one of the most challenging parts of the surgery, dubbed “Operation Hope.”
Prior to separating the brains, surgeons completed the process of rerouting a large vein that serves both their brains.
An international team of neurosurgeons, dozens of doctors, plus support staff created a bypass for Ladan, using a vein grafted from her leg. This caused another complication, Kumar said, as blood circulation between the twins became unstable.

More hurdles ahead
The operation is a landmark procedure. Although Singapore doctors performed a similar operation in 2001 on infant Nepalese girls, surgery on adult twins is unprecedented.
The operation is more difficult in adults than in children, who have more recuperative powers. Twins joined at the head are the rarest of conjoined twins, occurring one in every 2 million births. Twins joined elsewhere occur once in every 100,000 births.
The Bijanis’ operation was considered elective because the women likely would live a normal life span without it.
However, testing showed the sisters had high intracranial pressure, which, if untreated, could cause frequent debilitating migraines and impaired vision as well as deteriorating brain function, the hospital said. The sisters made an impression on Singapore’s public, in part because of their cheerful demeanor before the operation. Cards, flowers, and offers of support were sent to the hospital from around the world.
The hospital paid for pre-operative fees and the medical costs involved in operation. The operating surgeons waived their professional fees. The government of Iran said Monday it will pay $300,000 for post-operative care.
Source: CNN.com

Fertility And Sperm Strategy
MADRID, Spain, June 30, 2003
New research suggests there is little value in couples abstaining from sex to improve their chances of conceiving by saving sperm for the woman’s most fertile time of the month.
In a study to be presented Monday at a European fertility conference, Israeli scientists provide the strongest evidence yet that men with low sperm counts can significantly reduce sperm quality by holding back for longer than a day or two.
They found that the performance for men with normal fertility tests remained the same whether they abstained from sex for one, two or 10 days before providing a sample.
“Long residence in the male reproductive tract might in some cases mean the sperm do worse, perform worse, than they could do if they abstained less,” said the study’s leader, Dr. Eliahu Levitas of Ben-Gurion University in Israel.
The finding appears to challenge the role of abstinence in male infertility treatment. World Health Organization laboratory guidelines recommend that men seeking fertility treatment refrain from sex for between two and 7 days before providing a sample for analysis.
In the new study, to be presented at the annual conference of the European Society of Human Reproduction and Embryology, Levitas’ group analyzed more than 7,200 semen samples from about 6,000 men undergoing routine fertility investigations.
More than 4,500 of the samples were normal, while the rest showed varying degrees of low sperm counts.
The men abstained from sex for up to two weeks before giving their samples.
In men with low sperm counts, the researchers found the volume of semen increased after prolonged abstinence, but the quality got gradually worse the longer the men held back.
The number and proportion of motile sperm, meaning active and moving sperm, fell significantly from day two onwards, reaching a low at day six and remaining low.
The percentage of malformed sperm also increased after just a few days of abstinence, the scientists found.
“If a man abstains for two days instead of five days, that may make the difference,” particularly in fertility treatment that involves artificial insemination, Levitas said, because that procedure demands the best quality sperm.
In normal men, the study found no change in sperm motility. The percentage of malformed sperm increased only after 11 days, and then only so marginally that it is unclear whether it could affect fertility.
“There is no point in giving up sex to save up sperm,” said Dr. Karl Nygren, a fertility specialist at Sophia Hospital in Stockholm, Sweden, who was not connected with the research.
The argument in favor of abstinence is that it may increase the volume of semen and hence number of sperm in an ejaculate.
“You may have more sperm and more semen volume, but the quality is less. Usually, fresh sperm are better than stale sperm,” said Lynn Fraser, a professor of reproductive biology at King’s College in London. “What you really want to do is flush the system out so that the sperm that are there are fresh.”
The optimal strategy for couples with no fertility problems who are trying to have a baby is to have sex once every day or two around the time of ovulation, she said.
“Realistically if people want to have children, you wouldn’t want to have intercourse three times a day every day because that might deplete the pool that you have,” said Fraser, who was not involved with the study. “But there’s a lot to be said for keeping the system in a state whereby most of the sperm that have accumulated haven’t been there very long.”
Source: CBSnews.com

Jesse was well-liked by everyone, so everybody anticipated what he had to say. As he walked up to the microphone on graduation day. For a moment he remained silent, as he peered at the faces from his senior class. And then Jesse leaned into the microphone, and finally spoke at last.
“As your class president, I’m here to speak to you today. I was up most of the night, considering what words I should say. I reminisced on school days and all the many things I’ve done. So many memories came to mind, but my thoughts kept me focusing on one.”
And then Jesse held up a photo, and he moved it all around. As everyone learned to view it, the silence was the only sound. You could have heard a pin drop, as Jesse placed the picture in full view. And began talking about a classmate, that no one really knew.
“Charlie’s life seemed meaningless, compared to yours and mine. Because none of us understood him, we never took the time. We saw only what we wanted to, that Charlie was not cool. He was far from being popular, the butt of all our jokes in school.
“Yes, that we knew of Charlie, that much we decided on our own. He wasn’t worth our time; he was an outsider who deserved to be alone. But you see, Charlie had a passion, deep within, he had a dream. It was his one desire to play for our soccer team.
“And, of course, that was ludicrous, it was totally absurd. Charlie was no athlete, he was the senior nerd. In gym class, he was never captain, he was always chosen last. He was the poster child for unpopular, he preferred history, science, and math.
“And so some of us took it upon ourselves to keep Charlie from wanting to play. For weeks we taunted him with insults, day after day after day. We made sure that he wasn’t welcomed by anyone else on the team. For whatever foolish reasons, we were set on destroying his dream. And I’m here now to tell you, as your class president, I was wrong. I’m here to speak for Charlie, who couldn’t be here because, you see, he’s gone.”
Jesse paused just for a moment to give time for his words to sink in. He looked about at the faces of parents, teachers, and friends.
“I’m not sure if all of you know it, I’m not sure if anyone cares. But the reason Charlie isn’t with us is a reason I feel I must share. Cruel words they are definitely weapons, they destroyed Charlie’s body and soul. For all of the taunting and teasing left Charlie feeling out of control. And Charlie alone in a battle, gathered his weapons to fight. He purchased some drugs from a dealer, his mother found his body last night. Maybe it was only an accident, maybe Charlie wanted to die. But no matter how it happened, we as his classmates know why. For who in their lives hasn’t been teased, or made to feel unbearable shame. I’m certain that everyone in this room has endured some heartache and pain. And maybe boys will be boys and girls will be girls, and we each have our battles to fight. But no matter our justification, hurting Charlie was never right.”
And then Jesse took Charlie’s picture and held it firm in his hand. And spoke to the photo before him, words unrehearsed and unplanned.
“If only I’d helped somehow, given you guidance to conquer your dream. If only a teacher, a classmate, if someone would have just intervened. But I know I can never go back, I can never undo what has been. For you will never receive your diploma, or ever play soccer again. But deep in my heart I wonder, I can’t help asking what if… I would have reached out to you Charlie, Would your school years have ended like this?”
Jesse stood lost in his thoughts, of a life that was ended too soon. Until muffled coughs caught his attention, and nervous whispers began filling the room. And then Jesse turned with a smile, before retreating back to his chair. Teaching a valuable lesson, with his final words filling the air.
“I would like to introduce our valedictorian, he will be speaking today. Please give him your full attention, please hear all that he has to say.” And then Jesse set Charlie’s picture down, on the podium facing the crowd. As the silence told Charlie’s story, a message quite convincingly loud.
Source: Chicken Soup for the College Soul

I Graduate!!! The Graduation!! ..finally..
Hehehehe.., akhirnya gue berhasil hari ini officially menjadi Irayani Queencyputri, SKG (Sarjana Kedokteran Gigi) pada hari ini. Uh seneng banget :) Akhirnya bisa nyelesaikan juga gelar sarjana ini yang udah ditunggu2. Nah skarang giliran masuk klinik, dan teman-teman gue pada bilang, “Welcome to the jungle, Ra!“.. gileee.. hehehehe masih lama neh mau jadi dokter gigi.. Doain yaaaa :)
PEACE!
Oh iya.., ini gue punya artikel yang gue nemu di web ), yang berjudul “a visit to the dentist“:

A Visit to the Dentist
Until fairly recently I had a toothache that could maim a rhino. Its funny now in foresight the pain and suffering I went through in order to avoid the man of a thousand drills. It wasn’t as if I’d lost a leg in a freak yachting accident. Far from it. I had a mere cavity. A hole in my tooth. A tooth which had a nerve linked directly to the pain gland. I’m not a brave man, that I’m first to admit, but I honestly did not believe that one puny incisor could insist on ruining my life.
This oral hell went on for a couple of months since my dentist first told me that there was a very real possibility I would need a root canal in the near future. To an oraladrillaphobic like myself, this was the end. A root canal, that’s the sort of thing they should be doing near a river, not my bloody mouth. The words root and canal are bad enough flying solo but put them together in the same sentence as drill and needle and I’m a slobbering mess. Time went by but the pain got worse. It was like chewing on an ice cube wrapped in tin foil. After yet another sleepless night I decided it was time to go back to the collector of evil instruments and have the wretched root canal. Well, my girlfriend did anyway. She rang and told me of the appointment while I was at work. As the hours drew closer to my dreaded date with the dental demon my nerves grew and my tooth ached more.
Then came my opportunity to bail. Dr Death’s assistant called me at work to confirm my appointment. Well, that’s what she said. I figure she was somehow attempting to gauge my fear – deciding whether it was necessary to bring out that one instrument that guaranteed pushing me over the edge. You know the one, it looks like a cross between one of Freddy Kruger’s fingers and a common pair of thin tipped pliers. In all probability she was only doing her job. The nerve and pain cocktail had a funny way of twisting my imagination. I realise now she was offering me a get out of jail free card and I hadn’t even passed go yet. I should have acted quickly. ‘What appointment?’ I could have said. I could have used the tried and true ‘I’m sorry but a cassowary just ate my car keys.’ But no, “I’ll be there.” is all I offered. “I’ll be there.” The threat of a girlfriend who’d been woken once to often by my midnight sobs momentarily outweighing any fear of the dastardly operation that lay ahead.
The time passed slowly after that phone call. My palms were sweaty, my heartbeat raced. Talking tooth decay with fellow work-mates just added to my anxiety. “You know Jacob from Accounts? He had a root canal. Spent three months in hospital. In the end that had to cut his head off, there was nothing else they could do for the poor bugger.” Thanks for the chat.
The receptionist smiled as I walked in the door – the sadist. She informed me that Dr Smith hadn’t died a grizzly death in the preceding two hours. “Take a seat”, she offered. I did. I must have looked a sight, sitting there with a heartbeat slightly slower than the rpm of the drill in the room next door. To take my mind off things I picked up a copy of Time magazine from 1968. Fine read, right on the cutting edge, I thought. Is it just me or does every doctors/dentists waiting area have magazines from the pre lunar landing period?
“Mr. Dodson, the doctor will see you now.” This was it. The story about the new wonder drug penicillin, would have to wait. Time goes on. It was no more than ten metres to the door of the surgery but the trip seemed to take an eternity. I’d been to quicker cricket matches. Past the x-ray room, past another surgery, past the room they made all the spare teeth in and into ‘the room’. The room smelt of anaesthetic, that and obviously smoke from the drill. It was painfully sterile. Disposable plastic sheaths covered everything, including the dentist’s face and hands. What was he trying to hide? Paranoia had now set in. He said nothing at first, just stared at my x-rays from a previous visit. A little green pill bubbled away in a plastic cup just next to the spit bowl. An attempt at softening the mood of the room hung in a cheap frame by the door. Various certificates competed for attention. They weren’t getting mine. The assistant slipped quietly into the room; the holder of the spit sucker. I didn’t care about her, they didn’t let her near the drill.
“So Paul, lets have a look at that incisor.” A look, huh. Why didn’t he just come out and say it. Let’s drill a hole the size of Belgium in that incisor. That’s obviously what was on his mind. I was on the verge of becoming hysterical. I opened my mouth as he adjusted the chair. I could feel myself creeping into the fetal position. He straightened me out.
“Hmmm, yes hmmm. Does it hurt when you drink hot or cold drinks?” he asked as he probed around with an ice cream stick.
“Theth ath thlittl”, I replied. He understood. He jabbed the pulp (which is dentist speak for nerve) with an instrument like a fish hook on the end of a crochet needle. I jumped four feet out of the chair. I landed on the assistant. When I got back in the chair he said, “I think we’ll need to perform that root canal now Paul. Jenny, can you pass me a hypodermic and fifty mill of hydronumbaclorate please.” This was it, the moment of truth, the moment of pain. I dug my fingernails into the underside of the armrests. I closed my eyes as the tip of the needle slid its way to a point just south of my eyeball. The spit sucker sucked, the needle poured out its magic as tears welled in my eyes. He jabbed me again and again and again, till the whole left side of my head tingled. I felt good. I nearly hadn’t cried. Spurred on by my new found bravery, I thought it time to ask for details of what terror awaited. He passed me a crudely put together book titled, “So you’re going to have a root canal”. He left the surgery to massacre someone next door. He promised me he’d be back in ten minutes; after the anaesthetic took hold. The title of the book suggested that the procedure would not be cheap. It made it sound like it was either that block down the coast or an hour in the chair. I’d gone this far, what the hell, the beach could wait. The book went into a little to much detail regarding the whole thing about drilling. But the really distressing thing was the process of pulp eradication. Yes, pulp eradication. Sounds like a cattle thing doesn’t it. Round up all the cows, dip them, viola, pulp eradication. Unfortunately for me, I wasn’t about to be dipped. I was however going to have tiny files pushed into my nerve until it was all filed away. He’d start with a file not much thicker than a common dressmakers pin, the book assured me but by the time he’d finished he’d be pushing one of those files farriers use on horses hooves into my gob. Sounds inviting doesn’t it?
The anaesthetic set in, which suited me just fine. The dentist came back in and asked if I had any questions. Rather silly I thought, after all, he was only a dentist. He didn’t know the answer to the one about teenage acne and the question regarding tax minimisation had him really stumped. Two love to me, but he had the drill.
“First of all Paul I’m going to create a dam”. A dam I thought, a dam. A dentist specialising in engineering, strange. I checked the range of certificates on the wall looking for anything that resembled a diploma in water catchment construction. Not a thing. Dams, canals, maybe I should have taken a right turn in the foyer. The dam in reality was a sheath of rubber supported by a metal frame stretched across the entire width and breath of my lower face. I looked a little like Anthony Hopkins in ‘Silence of the Lambs’ when they wheeled him out to meet the Senator, although a touch more pathetic. The sheath had a whole cut where my incisor was. I guess so as he didn’t drill and file the wrong tooth.
He started the drill. It whirred its menacing whir. He had a mask on but I could tell he was smiling; his eyebrows were raised. I sank further in the chair as the assistant slipped the spit sucker behind the dam. The he came at me. At this point I could have swore his eyes were closed. I was having trouble breathing. That damned dam confining the flow of oxygen to my lousy blocked nostrils. He drilled, I snorted. She sucked, I spluttered. He filed, I cried. They finished, I laughed.
It was then he said it. The statement which to me was akin to the meaning of life. It gave me hope. It gave me reason to believe. It proved that maybe I wasn’t a yellow bellied yam after all. “Don’t worry Paul, brown eyed people feel pain and suffer stress much more than anyone else.” How true, of course they do. That was it, I was brown eyed. It’s that simple. The assistant shed a tear.
So next time you feel the need to inflict pain or misery on anyone, take time out to look them in the eye. If they’re brown, reconsider. If it’s my dentist, punch him in the gob for me.

Experts: Risk of stroke may start in the womb
Last Updated: 2003-06-19 16:43:50 -0400 (Reuters Health)
By Alison McCook
NEW YORK (Reuters Health) – Researchers have long struggled to explain why some people living in certain regions of the U.S. and UK are more likely to develop stroke than others. Now, two experts are looking to the womb to explain this uneven pattern. They found that UK regions marked by high stroke rates also showed high rates of death among mothers and infants in the early 20th century, the years when many stroke patients were born. This trend suggests that the mysterious variations in stroke rates may be the result of historical, regional differences in maternal health, they write in a report released Thursday. If this theory proves correct, study author Dr. David J. P. Barker of the University of Southampton in the UK told Reuters Health that, in the next generation, stroke prevention may lie “in good nutrition among mothers at conception and beyond.”
In the U.S., the southeast is known as the “stroke belt,” a region where stroke rates and the risk of death from stroke are significantly higher than in the rest of the country. In England and Wales, researchers have found that stroke rates tend to spike in northern towns, where they are accompanied by similar increases in the rates of high blood pressure and death from heart disease. Researchers who have investigated the potential reasons behind the patchwork distribution of stroke rates in the U.S. have shown they bear no relationship to inequalities in medical care, and have uncovered no explanation for why they occur.
Now, in the journal Stroke: Journal of the American Heart Association, Barker and co-author Dr. Daniel T. Lackland of the Medical University of South Carolina in Charleston propose that the differences in stroke rates may stem from previous geographical variations in overall prenatal health. In the report, Barker and Lackland compare stroke-related death rates in different regions of England and Wales between 1968 and 1978 to the rate of maternal and infant deaths during the first part of the 20th century, approximately the time when many stroke patients were born. In an interview, Barker said that places in the UK that are characterized by high rates of stroke had historically high rates of death among mothers and babies. “It’s a very strong relationship,” he explained.
As further evidence that the risk of stroke may begin before birth, Barker said that people with low birth weights — a sign of poor prenatal nutrition — are more likely to eventually develop stroke. He added that the phenomenon of the U.S. stroke belt and other regions with high stroke rates applies to people who were born in these areas, and not those who moved there later in life. “The place where you’re born is a strong determinant of your stroke risk,” he said.
In an accompanying editorial, Dr. Larry B. Goldstein of Duke University in Durham, North Carolina cautions that the current report only links stroke risk to in utero health, and does not show that one causes the other. “Despite this inherent limitation … the data provide another compelling argument to ensure adequate prenatal care and maternal nutrition,” Goldstein writes.
Source: Stroke 2003;10.1161/01.STR.0000077257.27430.7E

First, the elderly woman tried to drive between a delivery van and two people walking on a narrow Florida street. Then, busy chatting, she didn’t notice a car stopping in front of her. At a stop sign, she pulled out in front of a truck. This was a test to see if it was time for the 75-year-old to give up her keys and when driving specialist Susan Pierce emerged from the car, it was to break bad news.

SHE STOOD up and pounded her fist on the table and said, “I am not giving up my driver’s license and not giving up my home,” before storming out, recalls Pierce, an occupational therapist certified to assess driving skills. “It’s probably the toughest part of my job when I know I have to say.”
Losing the ability to drive can be a traumatic aging experience, and knowing when it’s time to quit can be immensely difficult. Tests in doctors’ offices aren’t completely reliable. And nationwide, only 300 specialists like Pierce are certified to perform road tests and offer techniques to help some seniors stay behind the wheel for a few more years.

Now medical and traffic groups are beginning some major programs to address the issue:
The American Medical Association will issue guidelines in July to help doctors tell when older patients’ driving is questionable and get them to help to stay on the road as long as it is safe. This fall, the AMA also will run a program to train doctors about medical fitness to drive.

The government recently earmarked $1.6 million to start a National Older Drivers Research Center. Run by the University of Florida and the American Occupational Therapy Association, it will train more certified driving rehabilitation specialists like Pierce and create better off-road tests to screen drivers for problems.

ELDERLY BABY BOOMERS
As the baby boomers age, one in four drivers is expected to be over 65 by 2030. Some 600,000 people aged 70 or older give up their keys each year, according to estimates from the National Institute on Aging.
Problems with vision, perception, and motor skills increase with age. Some are obvious, such as severe dementia. But many aren’t. Diabetes can numb the legs and feet, making it hard to know if you’re properly pumping the brake. Arthritis can hinder turning and checking for traffic.
Then there are problems like Pierce’s student had: diminished reaction time, ability to judge spatial relations, and ability to juggle more than one task.
As for eyesight, the tests administered to get a driver’s license only check visual sharpness. Yet seniors can lose peripheral vision, have blind spots from cataracts, strokes, or eye diseases, or lack contrast sensitivity making it hard to see a dark car at dusk.

AN END TO INDEPENDENCE
Seniors often deny problems because losing their license is a giant blow, says the NIs, Dr. Stanley Slater.
It’s not just demeaning: Having no easy, reliable way to get to the grocery store or doctor’s office can mean an end to elderly independence. Recall Pierce’s student: She had to move in with the daughter, who’d insisted on the driving test.
The question is how to spot a problem before a crash, which usually falls to worried relatives. Few states require more frequent license renewals or eye exams for the elderly.
The AMA guide will urge doctors to ask patients and their relatives about driving problems, watch for possible red flags, and hunt medical treatments to help them drive as long as possible.
Occupational therapists are increasingly assessing driving skills with memory and other tests and offering rehabilitation services to strengthen driving skills.

DRIVING TESTS ARE BEST TOOL
But ultimately, driving tests are the best tool, says Dennis McCarthy, co-director of the new National Older Drivers Research Center.
They’re more complex than those parking-and-steering tests offered at driving schools, says Pierce, who performs them in Orlando, Fla. Nor is it always pass-or-fail: She often finds ways to keep people driving longer.
For example, unprotected left turns, those without a turn-only light, and unfamiliar roads can be big challenges. Some drivers need to restrict driving close to home and avoid risky intersections.
Avoiding night driving also helps. So can adaptive technology, special mirrors, or hand controls.
The cost for driving evaluations varies widely, from $250 to $800. Elder advocates are lobbying for Medicare coverage, today available in only a few states, Pierce says.
Source: msnbc.com

Two Painkillers Fail to Slow Alzheimer’s
Study Finds That Two Popular Pain Relievers Fail to Slow the Progression of Alzheimer’s Disease

CHICAGO June 3
Two popular pain relievers failed to slow the progression of Alzheimer’s disease in people with mild to moderate mental decline, a study found, dampening hopes that widely used anti-inflammatory drugs might be an effective treatment.
After a year on the prescription drug Vioxx or over-the-counter Aleve, known generically as naproxen, patients were no better off than those taking dummy pills.
The results “are not encouraging for those who are in need of an effective immediate intervention,” said Georgetown University’s Dr. Paul Aisen, who led the study.
Despite the disappointing findings in people already diagnosed with Alzheimer’s, nonsteroidal anti-inflammatory drugs such as those studied could still prove effective in preventing the disease in the first place, said Neil Buckholtz, chief of the National Institute on Aging’s division of dementias in aging. The institute helped pay for the study and is sponsoring continuing research on the theory.
Some previous studies have suggested that certain pain relievers might slow or prevent Alzheimer’s. The theory is based in part on evidence that some people who use a lot of anti-inflammatory medication, such as those with arthritis, seem to be less prone to Alzheimer’s.
Researchers believe that inflammation contributes to the neurological damage found in the mind-robbing disease.
But the earlier studies were less rigorous than Aisen’s research, which compared anti-inflammatory drugs and dummy pills head-to-head.
His study involved 351 men and women about 74 years old on average with Alzheimer’s symptoms. The findings appear in Wednesday’s Journal of the American Medical Association.
NIA researcher Lenore Launer said in an accompanying editorial that it might be that when Alzheimer’s has progressed to the point of causing symptoms, it is too far advanced to be affected by anti-inflammatory drugs.
“Full-blown Alzheimer’s disease exhibits extensive brain pathology,” Launer said, adding, “Slowing the progression at that stage may be too late.”
Many people hoping to reduce Alzheimer’s symptoms take drugs such as Vioxx and Aleve but should stop because they can cause serious gastrointestinal problems, Aisen said. Six people in the study developed serious gastrointestinal bleeding.
Patients took 25 milligrams once daily of Vioxx a standard dose or 220 mgs twice-daily of Aleve a relatively low dose for a year. They were compared to patients taking a placebo.
Northwestern University professor Linda Van Eldik said it is possible that higher doses would have a beneficial effect and that other anti-inflammatory drugs would have better results.
“It would have been great if it had worked, but I don’t think it’s closing the door” to the use of such drugs against Alzheimer’s, said Van Eldik, a member of the Alzheimer’s Association’s scientific advisory council.
Naproxen and other older nonsteroidal anti-inflammatory drugs target two enzymes involved in inflammation. Vioxx is a newer painkiller called a cox-2 inhibitor that targets only one of the enzymes.
Source: ABCNews.com