Friday, May 27, 2016

Parents, are your college kids slamming "study" drugs?

Back in the day, when we needed to pull an all-nighter to catch up before an exam, we downed some No-Doz--caffeine pills from the drug store that made you nauseated and jittery.

Now, according to Linda Begdache, research asst prof at Binghamton University, the "kids" are throwing down Adderall, Ritalin, Concerta, and Vyvanse.

These are what I call "big drugs." Basically, we are talking "speed." Brain stimulants.

These not only help with concentration, but induce pleasurable feelings from surging dopamine. Users feel alert, on top of it, brilliant even.

Seven years ago, Begdache says a student asked her about negative side efx of these drugs.

Good question.

She found that the users of these drugs were usually male--and had LOW GPAs.

The ADHD drugs carry a black box warning, meaning the FDA calls attention to serious or life-threatening risks.

But the kids buy them by the pill--they never see the original bottle or the warning. And many physicians prescribe them helterskelter.

The ADHD drugs rewire the brain the same way illicit drugs do. Abuse can result in addiction--the same way.

Brain changes can be permanent. They affect the "reward" centers of the brain, which affects the brain's self-correcting internal balance. This means the brain starts to want more and more.

These drugs can also "prime" the brain for other substances, such as alcohol, coke, or marijuana.

They can also bring about behavioral changes--aggression, mood swings, psychosis, abnormal libido and suicidal urges.

Some of this can also be handed down genetically to the user's offsrping, according to some researchers.

So...why not study as you go along? Be REALLY smart...taking a "big drug" when you don't need to is not smart.

Thursday, May 26, 2016

I like this idea--medical problemsolving

I have a friend who went for her first visit at a new primary physician with a cough--and he never even listened to her lungs. He didn't touch her at all. He said, "You said the cough was getting better--I might hear something, but it sounds like you are going in the right direction."

This is doctoring?

University of Nevada Las Vegas (UNLV) says their school of medicine is adopting a new approach. Instead of spending years memorizing anatomy, they will team up to treat "paper" patients--with symptoms that need unraveling.

For each paper patient, they will identify the condition and the needed treatment. They will determine what they know--and what they need to find out. Where will they get the needed info? In the course of all this, they will be learning anatomy, chemistry, biology.

This is called Problem-Based Learning--PBL.

The founding dean of the UNLV medical school, Barbara Atkinson, MD, first implemented this approach at the Drexel College of Medicine in Pennsylvania in 1990.

This approach also teaches doctors how to collaborate. It provides them lifelong networking friendships.

Faculty members in this system act as guides.They push the students' learning into necessary directions.

This is about thinking strategies--self-direct investigation, working as a team.

Honestly, this sounds pretty good to me. I have only had one doctor in my checkered past with physicians actually look something up and tell me about it. He had been thinking about ME outside the exam room. I was impressed.

He quit practicing, though--and went to teach.

Wednesday, May 25, 2016

Even those little kiddie pools can kill

Fun--but can be dangerous.
Big, deep swimming pools present a hazard to tots, of course, but they are often fenced by law.

What isn't fenced are the little inflatable kiddie pools. As my father used to say, you can drown in a cup of water. You can also drown in a mop bucket of water. And a toddler can easily dart out of the house and head for the kiddie pool before you know it.

More than 10% of child drownings occur in plastic wading pools or above-ground pools, according to Nina Shapiro, MD, professor of head and neck surgery and director of pediatric otolaryngology at UCLA.

More than half the drownings occur when this child is unsupervised or there is a lapse in supervision. The parent dozes off inside, goes in to answer the phone, or is just chatting with a friend.

The idea is to create layers of caution:

--Watch children vigilantly. They are fast--all it takes is a second for them to make a wrong move.

 --Have a phone by the pool in case you need to call 911.

--Install a gate at least four feet tall around large pools--make sure it's latched.

--Learn CPR.

--Drain little pools when not in use.

--Remove toys when the kids are not in the water..familiar objects can lure the little ones.

--Remember, life preservers are a safety device, not a toy. Wearing one might not be a bad idea for bold toddlers.

If something happens, you will bear the pain the rest of your life. High stakes.

Tuesday, May 24, 2016

Effort to get ready for unhealthy or frail old people

The Bipartisan Policy Center (bipartisanpolicy.org) did a year-long study on Healthy Aging: Integrating Health Care and Housing.

As thousands of Boomers a day retire and face mobility and health challenges, the United States will be facing a huge wave of issues.

This is truly bipartisan--despite the squabbling endemic to DC and especially to the campaign. Everyone knows or is related to someone older who will be facing decisions and problems.

The task force spearheading this year-long study consisted of Henry Cisneros, former Dem HUD secy, Allyson Y. Schwartz, former Dem House member, Mel Martinez, former Rep HUD secy and Senator, and Vin Weber, for Rep member of the House. Two Dems, two Reps.

On the premise that many older people prefer not to leave their homes, and also on the assumption, that it's a good thing to keep people as healthy as possible--on a plateau--in their homes, the task force looked at several areas:

--Relationship not only of one's health to what is needed in the home, but also the connection between what the home is like and health itself. In other words, an older person may need one-story, or grab bars, but the familiarity and comfort of home can also affect health conditions.

--The need for more affordable rentals for older people, not just "poor" people but also middle class (40% of Americans have $25,000 or less in the bank), who need to leave the home for a smaller rental. We need 6 million more affordable rentals in this country. Federal regulations add 25% to the cost of a new home--we need to cut or eliminate many of those. Also--tax incentives can encourage the private sector to build more suitable units and houses.

--Housing can, with planning and forethought, be suitable for a lifespan. You don't need to put in grab bars, but make the walls strong enough to take them when the time comes to install them. There are many other examples.

--Only 3.8% of all housing--now--is suitable for people with limited mobility. Communities also lack transportation (many older people can no longer drive).

--Falls increase health care costs by $34 billion a year. We need to retrofit premises or help people relocate to prevent falls--which would also cut the increase in Medicare.

--And more clinical services need to be brought into the home--rather than making frail older people with no transportation get out to doctors.

These are just a few things the group looked at. The report is due out May 23rd.

I attended this seminar--on the web. This was good because I am limited in my mobility and have no transportation.

Monday, May 23, 2016

Maybe your small town hospital is just fine

A new look-see shows that critical care hospitals in small towns may be superior for some operations--which is good because these are the hospitals closest to 20% of Americans.

The team, led by Univ of Michigan researchers, analzyed data from 1.6 million hospital stays for four operations: gallbladder removal, colon surgery, hernia repairs, and appendectomy.

In this sample:

--The risk of dying within 30 days of the operation were the same in small town hospitals and larger hospitals

--The risk of a complication (heart attack, pneumonia or kidney damage) was lower at critical access hospitals in rural areas

--Patients who had surgery at those hospitals cost Medicare an average of $1,400 less

--The patients in these small town areas were healthier going to surgery, which suggests surgeons may send sicker patients to larger hospitals

--But even after correcting for difference in pre-op health, outcomes were equal to or better than in larger hospitals

--Fewer than 5% of those in small town hospitals got transferred to larger hospitals--this was 25% for non-surgical patients

--Patients in critical care hospitals were less likely to need a skilled nursing facility after leaving the hospital

Hundreds of critical access hospitals are in danger of closing. Medicare pays them slightly more to keep them open and available to people in rural areas.

One researcher remarked that these hospitals are doing what they are supposed to. They are performing common operations in appropriately selected patients who are OK to get their care nearby.

Where we go from here could affect you.