The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.
In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.
Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing. It’s just a matter of time that they become our main caregiver.
But will patients be pleased?
Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency. Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.
Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being. Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.
Many patients cite seeing a medical provider and not being examined or asked to undress before an exam. Time constraints, or avoidance of being accused of wrongdoing, have caused some providers to refer out for heart, gynecological, and rectal examinations. Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.
We use Google, Wikipedia and Siri to answer our health questions currently. No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.
However, and this is the kicker……
There is no way to replicate the sixth sense humans have when it comes to something being wrong with you. Artificial intelligence cannot provide a “gut feeling.”
Let’s take a urinary tract infection, for example. I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine. A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection. But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecologic tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.
One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea. Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine. While observing her for a few minutes, post injection, she began to have shortness of breath. We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.
Would a robot have picked up on that? Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.
Another case I had as an urgent care physician was the following:
A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before. Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died. So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right. Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.
So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do. Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless. Too bad cost gets in the way of real medicine.
The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States. Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.
This occurs “within 12 hours of the onset of extremely dangerous heat conditions”. This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than three hours a day for at least two days in a row and the night-time temperatures will not drop below 75 degrees. Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times. Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.
At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. It's important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.
If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.
Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.
Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.
The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.
Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.
Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.
Avoid excessive exercise when outdoors and make sure to make use of shady areas.
The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….
Thursday morning Hawaii’s Kilauea shot ash and smoke into the air and blew a volcanic cloud that could reach 30,000 feet into the sky. The volcano has been spewing lava for weeks, prompting thousands of nearby residents to evacuate. Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels. Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.
Let’s break these health risks down:
Volcanic ash can irritate the respiratory passages causing the following symptoms:
Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)
Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult. Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.
Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.
During a volcanic eruption, smoke plumes not only change the air quality but also visibility. During times of day when there is less light, road visibility obscures pedestrians and nearby cars. Drivers are urged to avoid the road during these smoky times.
Water quality can become affected by the ash or pH changes if supply becomes contaminated. Moreover, water use increases for cleanup so shortages may ensue.
Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages. Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.
May is Skin Cancer Awareness Month as 5 million cases of skin cancer are diagnosed each year in the United States. This week, Consumer Reports released its 2018 Annual Sunscreen Guide on the best sunscreens to offer protection against UV (ultraviolet) rays. They looked at 73 various sunscreen lotions, sprays and sticks, which touted 80 minutes water resistance and an SPF of 30.
The top 5 sunscreens reported are:
La Roche-Posay Anthelios 60 Melt-In Sunscreen Milk, $36 (lotion)
Equate (Walmart) Sport Lotion SPF 50, $5.00 (lotion)
BullFrog Land Sport Quik Gel SPF 50, $8.50 (lotion)
Coppertone WaterBabies SPF 50 Lotion, $9 (lotion)
Trader Joe’s SPF 50+, $6 (spray)
Sunscreens use chemicals to disperse or absorb UV rays. Inorganic compounds in sunscreen such a titanium dioxide or zinc oxide attempt to scatter the UV rays. Organic compounds such as PABA and oxybenzone attempt to absorb UV rays so they can’t damage the skin.
UVA rays penetrate deeply into both the epidermis and dermis. They can cause premature aging of the skin, wrinkles, and skin cancer.
UVB rays are shorter and primarily affect the epidermis. They are responsible for causing sunburns as well as skin cancer.
SPF stands for Sun Protection Factor. The higher the SPF, the less sun photons enter the skin and cause damage. SPF primarily measures the protection against UVB rays. We multiply the SPF factor by how long it takes one’s skin to burn by the SPF number to determine the protection factor.
In theory, an SPF of 30 suggests your skin, if it burns within 10 minutes without protection, will not burn until 300 minutes has lapsed (30 times 10). However, we find this isn’t always the case. People sweat or swim and the sunscreen dissipates. Moreover many don’t put on the proper amounts (see below.)
So instead we use SPF as a grade to how much protection the product can offer.
An SPF of 15 blocks 93% of UVB rays
An SPF of 30 blocks 97% of UVB rays
An SPF of 50 blocks 98% of UVB rays
As we see, the relationship is not linear, however the higher the SPF, the more protection we have against UV rays.
Although the SPF alludes to protection against burning, hence UVB rays, a sunscreen may still protect against both UVA rays and UVB rays if it’s a broad spectrum sunscreen.
At least one in three adults has high blood pressure and strokes are the 5th leading cause of death in the United States.
In May we raise awareness of both these conditions during American Stroke Monthand National High Blood Pressure Education Month.
Every 40 seconds, someone in the United States suffers a stroke. And high blood pressure puts one at risk of a stroke, as well as heart disease.
Here are your questions answered.
The top number, or systolic pressure, is the pressure the heart exudes during a beat or pumping of the blood.
Diastolic pressure is the pressure in your arteries between beats while the heart is “filling.”
Both numbers are equally important as elevation of either can increase one’s risk of cardiovascular disease.
High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg. Last year it was guestimated that 42% of Americans would soon be considered “hypertensive.”
Chronic high blood pressure can be dangerous. It may cause:
The stages of blood pressure are defined in the chart above. At the elevated or early stages of high blood pressure the following lifestyle changes will be recommended:
As a family physician I would also screen for diabetes, high cholesterol, low thyroid, kidney disease and sleep apnea.
If blood pressure cannot be controlled and continues to rise, medications may be prescribed to decrease blood volume, or lower the heart rate, or relax the blood vessels.
A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke: ischemic and hemorrhagic.
Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain. 80% of all strokes fall under ischemic. It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients. Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.
Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels. The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells. The bleeds could occur from high blood pressure or aneurysms that rupture.
What are the signs of a stroke?
Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side. We can also see central effects. The symptoms of stroke include the following:
If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot. Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA). These clots can also be surgically removed and arteries widened to bring blood flow to the brain.
With a hemorrhagic stroke, we need to stop the bleed and improve flow to the brain. Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.
Time is of the essence, so it's crucial to identify the warning signs and call 911 immediately. The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911). The sooner a stroke victim receives medical attention the better the prognosis.
The following put us at risk of having a stroke.
Avoid the following:
When my realtor handed over the keys to my first home in late September, I didn’t feel like I had realized the American Dream. I even had a car in the lot (well, on the street) and a chicken in the pot. But there was still something missing.
I felt closer to realizing the American Dream while doing drugs with friends in the Escalante National Monument. That national treasure in Utah is being gutted to exploit energy sources by Secretary of the Interior Ryan Zinke and President Donald Trump, but they can’t touch the memories I have of that place or the feelings they invoke.
As we pulled away from a National Park Ranger checkpoint with so much drugs and alcohol the four of us couldn’t finish it all in a week, I watched as unlucky hippies leaned against cop cars on the side of the road with their hands cuffed behind them. It made us all realize how lucky we were. Hell, I wasn’t even supposed to be out of the county without my probation officer’s permission, so staying my ass out of federal prison and going on to have the time of my life made it feel like the new American Dream was to do drugs in beautiful places with lovely people and not get caught. But that’s just part of the new American Dream. The new American Dream is to do all those drugs and then recover from whatever addictions you acquire.
It wasn’t until I quit drinking that I felt I had realized the American Dream. I’ve tried just about everything when it comes to stimulants and depressants, but it was alcohol that brought me the most trouble in my life. Sure I was on probation for possessing a pound or so of pot, but I spent more days in jail during that probation because of alcohol than I did for using cannabis, and I still managed to use cannabis pretty regularly. But I drank daily.
First I decided I’d “slow down” for my body’s sake. You know, drink fewer days during the week. And I did, too. I had just become really intrigued by body chemistry and nutrition, so when I started counting my calories, I got a good look at my problem. I drank less often, sure, but did I ever make up for it on the weekends.
When I found it difficult to meet my caloric goals because of my drinking, I drank faster so I could drink less, or I did more exercise so I could drink more. My weekly cheat day became my opportunity to get super drunk.
When I visited my hometown in Eastern Montana and was assaulted while drunk for saying I was a Socialist, I realized I was incapable of drinking responsibly. I drank for more than 12 hours that day and blacked out en route to a house party. The only thing I remember is saying “I’m a Socialist” and someone immediately suplexing me. Sure, it was a hate crime, but since I couldn’t remember a name, face or much of anything, I wasn’t about to make a big deal of it. I figure those people living with themselves has to be punishment enough.
It took a few more weeks before I actually quit alcohol for good. It was October 3rd, and the Minnesota Twins had lost to the Yankees in the playoffs, again. I drunkenly rode my bike home from O’Donovan’s Pub, where a bartender informed me that Twins’ third baseman Miguel Sano frequented the place, and one time, drank “16 beers” with his arms wrapped around two women while on the disabled list with a stress fracture in his leg. (Just under three months later, Sano was alleged to have committed sexual assault.)
I haven’t had a drink since I heard that story. The next day hurt worse than any hangover I’ve had, including the morning after the Socialist suplexing. I stayed home from work and chased Ibuprofen with soup and water. I had no alcohol in the house because I had finished it all when I got home the night before. Usually I would have handled that hangover with a Bloody Mary or Screwdriver, but I just couldn’t bring myself to leave the house to get alcohol. When I checked my receipts (apparently after I had closed my tab I opened another) and found I had spent $70 -- my average monthly booze budget -- in one night, I knew I was done drinking. I didn’t need an intervention or treatment to stop drinking because I knew if I drank again, I could drink myself to death.
That doesn’t mean alcoholics don’t need help. In fact, 95 percent of alcoholics who need treatment don’t think they need it. Maybe I’m just a member of that majority, and it’ll take a relapse for me to realize it. At least I could get treatment if I wanted it, and my insurance would even cover it. That’s not the case for every addict.
A 2016 report by the U.S. Surgeon General found that one in seven Americans will face some sort of substance addiction. The economic impact of those collective addictions amounts to $442 billion each year, which rises as healthcare premiums rise. And America has the highest drug-death rate in the world.
Worse yet, we’re not even addressing the problem properly. Instead of providing the treatment addicts need, money is funneled by politicians to for-profit prisons instead of treatment facilities, leaving addicts without the treatment and supportive community necessary to keep them clean. The number of substance abuse treatment facilities in the U.S., which focus on drug and alcohol abuse, was reported to be 13,873 in 2014, a decrease from the 14,152 facilities reported in the previous year.
“Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose,” according to a 2012 study published in Addiction Science & Clinical Practice. Of the more than 21 million addicts in America, only 10 percent receive treatment, mostly due to a lack of healthcare coverage or lack of treatment centers in their area. According to the Journal of the American Medical Association, 80 percent of opioid addicts don’t get treatment, and a similar 2015 study found a million opioid addicts couldn’t get treatment for their addictions if they wanted it.
That leaves a lot of Americans on our own to struggle through our addictions. I’ve resisted to commit to Alcoholics Anonymous or the 12-Step Program because I wasn’t convinced I had a problem. Now that I am convinced, I realize the importance of having a community to support you and your decision, but I still haven’t attended an AA meeting because the 12-Step Program utilized by AA most often relies on a commitment to religion. Giving oneself up to “a higher power” is the first step, and it wasn’t until I read Russell Brand’s Recovery: Freedom from Our Addictions that I found a non-religious means to put the 12-Step Program to work for me, an atheist.
Since publicly announcing my problem with alcohol on Facebook on Oct. 12, 2017, I found I did have a community in place to help me through my problem with alcohol. Friends of mine who’ve long been out of touch and also quit drinking offered their support, as did my family. Not every alcoholic has friends and family with experience overcoming addiction, however. I guess I’m lucky to have excessively drunk alcohol and done drugs with people willing and capable of realizing and accepting their powerlessness over substances.
Prisoners aren’t leaving prisons with that community in place. They’re reentering communities where they’ll be tempted around every corner. So until we stop putting nonviolent, drug offenders behind bars and instead put them in treatment centers to get the help they truly need, we’ll be inching ever closer to making the new American Dream overcoming addiction.
If you like this, you might like these Genesis Communications Network talk shows: America’s Healthcare Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, Dr. Coldwell Opinion Radio, Good Day Health, Health Hunters, Herb Talk
Experts report allergy season will worsen each year due to environmental changes.
Allergy season usually begins in March with the start of Spring and can extend to the Fall even leading to new Fall allergies.
Each year we find allergy season starting a few weeks earlier as temperature changes prompt early blooms.
Tree pollens start first in January and then taper off in April. Grass pollen starts to rise in February and March. Finally weed pollens join the party by the Spring and extends through the Summer and Fall.
Dr. Jeffrey Demain, Board Certified Allergist and Immunologist reported at the March meeting of the American Academy of Allergy, Asthma and Immunology the following, “We have higher temperatures and expanding levels of carbon dioxide.
“When you look at a pollen grain, there are certain proteins that cause the allergy, they are the allergenic peptides,” he said. “It’s been shown that in rising carbon dioxide, the allergenic peptide of each pollen grain goes up.”
Plants utilize carbon dioxide for respiration as humans use oxygen. The higher carbon dioxide levels, the higher the pollen counts and proteins in pollens that contribute to allergies.
The increase in storms may contribute to allergy season as well as moisture in the air causes pollen to swell and “explode” into multiple little pollen particles, smaller and easier to breathe in.
Moreover stagnant flood water may cause fungi, mold and spores to grow, also leading to allergies.
The Allergy Capitals Spring 2018 report found many cities are worse off this year than they were in previous seasons. McAllen, TX , Louisville, KY, Jackson, MS, Memphis, TN and San Antonio, TX ranked in the top 5 in “Most Challenging Places to Live With Spring Allergies.” The copy of the report is below:
Let’s review allergies…..
Allergies are the result of the immune response to a foreign particulate that our body senses. One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder. Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body. IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood. When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.
Symptoms of allergies could include any or a combination of the following:
Colds may have very similar symptoms to allergies. However they are different. The common cold is caused by a virus. When one gets infected by the virus they may feel malaise, fever, and achy. This does not occur with allergies. Moreover, nasal secretions from allergies are usually clear. In a cold, the mucous could be thicker and with color. The same holds true with sputum. During an allergy the cough may have little to no mucous and if so, be light colored. Thick mucus could be a sign of an infection. An allergic sore throat will seem more dry and scratchy. A sore throat from a cold is more uncomfortable and less easy to soothe. Allergies may persist or be cyclical. Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.
Yes and no. Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over. Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.
As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack. Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.
Avoiding, or decreasing exposure to the allergen is key. We suggest the following:
Local tree, ragweed and grass pollen counts can be obtained here.
A study out of Harvard’s TH Chan School of Public Health finds 5 simple lifestyle changes that can add 1-2 decades onto one’s life.
Researchers looked at lifestyle and diet of over 100,000 men and women apart of the Nurses’ Health Study and the Health Professionals Follow-up Study. They found sticking to these lifestyle changes at the age of 50 could give the average woman 14 extra years of life and the average man, 12.
Since cancer and heart disease contribute to hundreds of thousands of deaths a year, study authors suggest the following:
Since smoking has been long linked to early death, due to increase risk of arteriosclerosis and multiple types of cancer, avoiding tobacco products have been found to increase life expectancy.
Researchers encourage a healthy body weight, more specifically a BMI of 18.5 to 24.9 kg/m2.
Obesity has been linked to diabetes, heart disease and multiple cancers, so a healthy diet is paramount.
Diets rich in vegetables, low sugar fruits, whole grains, fish and healthy fish oils have been found to decrease risk of diabetes, obesity, heart issues and various cancers.
Avoiding excess salt, sugar, and saturated fats are key.
30 minutes a day of moderate to vigorous activity daily has been recommended by multiple medical associations. I would encourage making sure one’s medical provider evaluates heart health before engaging in vigorous activity. But walking, swimming, household chores, dancing, and many other activities fall under “moderate activity” that can be safe and provide multiple health benefits.
Moderate drinking is defined as no more than one drink a day for women, two drinks a day for men.
Image above from CDC
However, the health benefits of alcohol consumption are controversial, as many studies have linked alcohol consumption to cancer. Moreover, the sugar levels in alcohol can contribute to diabetes and obesity.
The recreational drug scene has changed immensely in the last decade, with hundreds of new psychoactive substances (NPS) being introduced in the last 10 years. They’re commonly known as “designer drugs” and some can be herbal substances referred to as “legal highs.” A lot of these substances are legal because they’re just being discovered and researched, and it takes time to pass legislation outlawing them.
Dahlia Wachs, MD, FAAFP, of The Dr. Dahlia Show, says people are gravitating to harder drugs that are more likely to be cut with new psychoactive substances because tolerances have increased so much.
“What’s happening is drugs aren’t strong enough anymore … people are trying to gravitate to heavier and heavier things to get high,” she said. "That’s why heroin is so crazy right now.”
The Drug Enforcement Administration (DEA) issues a quarterly report identifying drugs that are emerging threats to public health and safety, but drug dealers are having no problem finding a market for these new drugs because drug users often don’t know they’re consuming them.
A new study by New York University shows an increase in the use of new psychoactive substances. Over a quarter of 80 hair samples provided by people frequenting New York City music festivals and nightclubs tested positive for new psychoactive substances. The most common substance was butylone, and other new drugs detected were methylone and methoxetamine.
The drug most commonly mixed with new psychoactive substances is ecstasy, or MDMA. Since being marketed as Molly, the use of ecstasy has exploded at music festivals and nightclubs, but MDMA users are rarely getting MDMA. A similar NYU study showed 40 percent of music festival and nightclub goers tested positive for “bath salts” despite reporting no intentional use.
Wachs said drug education at an early age is one way to assure children are aware of new psychoactive substances’ effects. She recommended showing images of people under the influence of “bath salts” so children would be less likely to consume a drug that could have easily been cut with new psychoactive substances. She also thought children should know that people who die from drug use aren’t always drug users.
“We’ve got to start in grade school and high school … There has to be some really good campaigning that somebody could put something in your drink … like you never take a drink from someone,” she said. “You buy your own drink. I have two teenagers, and I tell them to never take a drink from anyone.”
Regardless of legality, these substances will continue to be created and consumed, which makes the work of Erowid even more important. The Erowid database provides information on psychoactive substances from alcohol to tobacco and even Bufo toads. That’s right, psychoactive toad venom. The point of the website is to provide information so drug users can consume drugs safely, and with the rise in NPS creation and consumption, drug users knowing what they’re potentially putting in their bodies is more valuable than ever.
Erowid provides information that helps drug users identify drugs and avoid an overdose, including what not to mix and a proper dosage given your size and sex. It gives you a rundown of what you can expect from your trip, when it will kick in, when it will be most intense and when it will likely end. The legality of the drug is broken down by individual countries, and there’s chemical information for you drug geeks out there. You can even get a “Drug Geek” t-shirt for donating $45 to fund the purchase of their new, private server, which protects you, the user.
Whether you are a drug user or not, the availability of this information is healthy and essential. Drug users won’t be stopped, so at least allow them to be informed.
If you like this, you might like these Genesis Communications Network talk shows: America’s Healthcare Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, Dr. Coldwell Opinion Radio, Drew Pearson Live, Good Day Health, Health Hunters, Herb Talk, Free Talk Live
The controversial and often ridiculous “gaming leads to violence” argument rears it’s ugly head once again. Multiple sources report that the World Health Organization proposed a revision to their International Classification of Diseases (ICD-11) to classify gaming behaviors as a mental disorder, labeling it a “disorder due to addictive behaviors,” and later a “hazardous gaming” section. Responding to the classification, dozens of game savvy scholars paused their Xbox One to immediately pen an open letter to the W.H.O., which saves me the trouble of doing so.
The authors of said letter have more expertise than me, ranging from the obvious “video games, internet and social media” to broad categories like “children’s rights in a digital age” to the slightly obscure “epidemiology of healthy and unhealthy use of new media” and more. Their letter, "Gaming Disorder in ICD-11: Letter of concern" states, “Concerns about problematic gaming behaviors deserve our full attention. Some gamers do experience serious problems as a consequence of the time spent playing video games. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder, and the empirical basis for such a proposal suffers from several fundamental issues.”
Included within the letter are their main concerns:
“The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents…”
Well, the CD-11 proposal doesn’t discuss violence, but yes, inevitably a conversation about video games eventually leads to a discussion about the violence within video games. A typical argument of, “this video game will turn your sweet, perfect child who never does anything wrong (ever!) into a chaotic evil homicidal lunatic!” is nothing new, sadly .
Back in the early 1990s, the hardest game to find (ever!) was Night Trap, an interactive movie/video game developed for the Sega/Mega-CD and released in late 1992. The game is 90+ minutes of full motion video sequences. The player switches the point of view between various hidden cameras monitoring the interior of a house and then can activate traps to capture intruding vampire creatures (called Augers) in hopes to prevent the house women (one of which is played by Dana Plato of Diff'rent Strokes) from having their blood drained.
The game was instantly notorious for “adult themes,” a violent, blood-draining “mechanic,” and a controversial “nightgown scene,” which led to the game being pulled from the market. Today this game would be considered laughably tame.
This all came to a head in 1993 with the Senate Committee Hearings on Violence in Video Games. I don’t know if Night Trap was solely responsible for the hearings, but I’m certain it was a factor, as the committee often mentions the game citing it as "shameful," "ultra-violent," "sick," "disgusting," and claims it encourages an "effort to trap and kill women.”
Wait. What? An “effort to trap and kill women?” Huh?
The documentary Dangerous Games, included in the PC version of Night Trap, allows producers and cast members to defend the plot and clear up that fact the gameplay is designed to, obviously, prevent the harm of the women in the house. In addition, “the blood draining device is intended to look very unrealistic to therefore mitigate the violence.” Despite scenes in which the girls are grabbed or pulled by enemies, “no nudity or extreme acts of violence were ever filmed or incorporated into the game.” As is usually the case, no one on the committee had ever played Night Trap and the whole hearing views on YouTube like a posturing mess of out-of-touch, old, white men.
Night Trap is not the only game that has been under fire over the years. Controversy follows video games like bees to honey. Games such as Doom (violence), Mortal Kombat (violence), The Grand Theft Auto Series (adult themes, trigger warnings, violence, violence against women), hell, even Leisure Suit Larry was controversial (obscenities and mature themes) in it’s time, the list goes on and on. Some games clearly deserve the controversy more than others.
Kind of. The crux of the issues with the W.H.O. classification of “Gaming Behavior” doesn’t revolve around violence, but since the two are often intermingled I wanted to bring it up but don’t want to go too far down that rabbit hole.
I will say that, of all the games I am aware, GTA is the most problematic, as it’s a game that, arguably, glorifies violence against women up to and including sexual assault and murder. Much has been written about the moral bankruptcy of the game. I’ll let an excellent article in polygon continue the GTA discussion but then I have to move on: Regarding GTA 5 - It’s Misogyny Can No Longer Be Ignored.
The focus of the W.H.O. classification is clearly on the words “obsession” and “addiction,” linking both to symptoms of mental disorders. Which, to be honest, does seem a bit fair.
The most famous case of obsessive gaming is the 1991 “EverQuest suicide” of Shawn Woolley, a Wisconsin kid that struggled with learning disabilities and emotional problems. When he was twenty one years old he found a new job and moved into a new apartment. Less than a year later, while he sat at his computer desk, he shot himself. The online game, EverQuest, was on the monitor in front of him.
His mother, Elizabeth, has since blamed EverQuest for significantly contributing to Shawn’s suicide. She told multiple sources that Shawn, “...in mid 1991...stopped working, stopped cleaning his apartment and stopped seeing his family. He wouldn’t let anyone come in and all he did was sit at home and play EverQuest. That was the beginning of the end.” Her view of online games is that they are designed to include addictive qualities that are unhealthy to the gamer.
After Shawn’s death Liz created the website On-Line Gamers Anonymous or the OLG-Anon. Elizabeth founded the site in 1992 in order to, “...share our experience, strengths and hope to help each other recover and heal from problems caused by excessive game playing, whether it be computer, video, console, or on-line.” OLG-Anon continues to operate today.
Shawn’s story is tragic, but I suspect you are thinking exactly what I am thinking. Elizabeth describes Shawn as someone who struggled with, “learning disabilities and emotional problems.” I’m inclined to believe, “emotional problems” more so than obsessive online gaming, were the root of Shawn’s sad end. That being said, I 100-percent agree that too much gaming can be unhealthy. Of course, I believe that too much of any one thing can be bad for you. Even drinking too much water can be unhealthy!
I’ve seen obsession similar to Shawn’s. A former roommate spent anywhere from eight to 10 to maybe 16 hours a day playing World of Warcraft online. He would pause for sleep, restroom breaks and meals (which he would eat in front of his computer). He would not clean his room, the interior of his car was a disaster, he would not do dishes, and he certainly couldn’t be bothered to remove empty bottles, cans or pizza boxes from on or around his computer desk.
You will be shocked to learn said roommate was notoriously underemployed and pretty damn dateless for the three (or four?) years he was glued to WoW. But then he got over it. So while I agree gaming can be unhealthy, I have yet to read one legitimate study to convince me that even the unhealthiest of gaming choices is a gateway to violence or violent behaviors.
As for “gaming behavior as a mental disorder?” Well, I don’t know. My gut instinct is, “Gaming can’t be classified as a mental disorder ... because that would be silly.” On the other hand, there are some really silly mental disorders already out there: triskaidekaphobia, explosive head syndrome, the Jumping Frenchmen (of Maine) syndrome. If gaming can become SO obsessive and SO addictive … then maybe it deserves a place in the mental disorder hall of fame along with those listed greats.
But probably not. Referring back to the open letter:
“The healthy majority of gamers will be affected by stigma and perhaps even changes in policy. We expect that inclusion of gaming disorder in ICD-11 will cause significant stigma to the millions of children and adolescents who play video games as part of a normal, healthy life … In brief, including this diagnosis in ICD-11 will cause signiﬁcantly more harm than good. Given the immaturity of the existing evidence base, it will negatively impact the lives of millions of healthy video gamers while being unlikely to provide valid identification of true problem cases.”
There is a mountain of anecdotal evidence to suggest gaming can be unhealthy. There is an equally colossal volume of peer reviewed actual evidence to suggest gaming has a host of positive benefits (especially for kids) including (but not limited to): helping them learn to follow directions … engaging in problem-solving to find solutions …. learning strategy and anticipation, understanding management of resources, reading, multitasking and quick thinking. The lists just go on and on.
I’m not going to link every study I’ve read because, trust me, they are real easy to find on your own. And the reason they are real easy to find is because there is a crushing amount of studies suggesting there are many healthy, and some unhealthy, things about gaming (SPOILER ALERT: But the healthy benefits seem to far outweigh the potential unhealthy aspects). So, don’t take my word for it. Get to that Googling.
Now, if you’ll excuse me I have to Rage Quit Darkest Dungeon before I can move onto XCOM2. Then I will finally have time for that glorious month long Mass Effect: Andromeda binge!
Non-steroidal, anti-inflammatory drugs (NSAIDs) include ibuprofen and diclofenac. These medications are seen in products under the brand name Motrin and Voltaren, respectively. This class of medications is one of the most popular as they help consumers treat a variety of ailments including helping to relieve pain, inflammation and lower fever. Moreover they are inexpensive and many do not require a prescription at the lower doses.
However, their chronic use has been linked to serious medical complications such as ulcers, kidney failure and cardiac issues. This week, a study published in the March issue of European Heart Journal – Cardiovascular Pharmacotherapy found NSAID use (specifically Ibuprofen and diclofenac) to increase the chance of cardiac arrest.
The researchers from the Copenhagen University Hospital Gentofte in Denmark reviewed close to 30,000 cases of people who suffered cardiac arrest out of the hospital during the years 2001 and 2010 and found NSAID use. Diclofenac, specifically, carried a 50 percent increased risk of cardiac arrest.
COX-2 selective inhibitors, such as Celebrex and Naproxen (Aleve) were NOT associated with increased risk in this particular study.
According to the study author, Professor Gunnar H. Gislason, professor of cardiology, “the findings are a stark reminder that NSAIDs are not harmless. “Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.”
He continued by saying, “Naproxen is probably the safest NSAID and we can take up to 500 mg a day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population. Safer drugs are available that have similar painkilling effects so there is no reason to use diclofenac.” He suggested no more than 1,200 mg of ibuprofen per day.
This is not the first study that has demonstrated Naproxen to have lower cardiovascular risk. In fact the FDA was asked to remove the warning from its label, yet its panel voted to keep the NSAID related cardiovascular risk warning, with committee member, Donald Miller, chair of the pharmacy practice department at North Dakota State University in Fargo, saying “there is certainly a lot of evidence that naproxen is safer than other [NSAIDs] in terms of causing heart attack and stroke, but being safer doesn’t mean it is perfectly safe. I think that is the big issue.”
NSAID use has risen exponentially as more people are living longer and feeling the effects of aging in their joints and back. Moreover, narcotics are becoming less accessible and providers are offering these non-addictive substitutes instead; however, because these are non-narcotic, and many are available over the counter, those who self-medicate may inadvertently take too much since “it wouldn’t be over the counter if it wasn’t safe."
One theory is the medication may cause suppression of prostacyclin, a cardioprotective lipid (prostaglandin), that inhibits platelet activation and vasoldilation (relaxation of the blood vessels). NSAIDS have also been known to raise blood pressure, possibly by this inhibition of vasodialation. This type of stress on a heart, especially if its vulnerable to abnormal heart rhythms or heart disease, can cause cardiac arrest.
But we don’t want to be fearful that taking anti-inflammatories will stop our hearts. Being proactive with our heart health is paramount, and this study reminds us to use caution with over the counter medications.
Firstly, we must know our risk factors. These include:
As you can see, many of us can be at risk for heart disease. Therefore, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.
Reduce your risk by doing the following:
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