I think we should all be allowed to have an independent person in the OR while we are undergoing surgery if this is any indiciation:
"About half of all surgeries involve some kind of medication error or unintended drug side effects, if a study done at one of America’s most prestigious academic medical centers is any indication."
That is just plain scary. You go for surgery and then you have a 50% chance of medication error or unintended side effect. That is not good.
"“There is a substantial potential for medication-related harm and a number of opportunities to improve safety,” according to the study, published in the journal Anesthesiology. More than one-third of the observed errors led to some kind of harm to the patient."
But these numbers are pretty real. A recent study was done at Massachusetts General Hospital by observers. Previous studies showed much lower numbers but those were self reported by doctors.
"Drugs delivered during an operation don’t have the same safeguards other medication orders do. In most parts of a hospital, prescriptions are double-checked by pharmacists and nurses before they reach a patient. Operating wards are riskier. “In the operating room, things happen very rapidly, and patients’ conditions change quickly, so we don’t have time to go through that whole process, which can take hours,” Nanji said. While all the errors observed in the study had the potential to cause harm, only three were considered life-threatening, and no patients died because of mistakes, Nanji said. In some cases, the harm lay in a change in vital signs or an elevated risk of infection."
A few more thoughts:
"Not every mistake meant the patient got the wrong drug or an incorrect dose. For example, many errors had to do with properly labeling drugs when they’re drawn into syringes for delivery. Because most medications just look like clear liquids, having several prepared without labeling them poses a risk that the wrong one could be delivered. Those breaches in protocol were counted as errors. In about one-fifth of the problems, adverse drug reactions were considered unavoidable — for example, if a patient had a drug allergy that doctors didn’t know about ahead of time. The study found that some kind of error was made in about one in every 20 drug administrations. Several medications are typically used in each operation, from anesthesia to antibiotics, so that rate translated into some kind of error or adverse reaction in every other surgery. Operations that lasted more than six hours were more likely to involve an error than shorter procedures."
Okay, I'm good with no more surgeries, thanks.
Feb 5, 2018
Jan 29, 2018
I can tell its Pinktober
Yes I admit I can be a news junkie. I also like to follow information on my (many) ailments. I get daily Google Alerts for most of them so I can be one of the first to know about the latest treatment options.
I can tell its Pinktober. All my breast cancer news includes the words 'awareness', 'pink', the s-word, or other related terms. Yesterday's alert included these items:
"Harford observes breast cancer awareness month"
"Breast cancer survivor finds comfort in delivering flowers to other patients at Texas hospital"
"WATCH: 29 year old beats breast cancer, gets featured on Pink Ribbon Connection"
"Breast cancer awareness chili cookoff Saturday"
"Breast cancer survivors event"
This drives me crazy. Please stop spending money on pink and spend the money on more important things like research.
I can tell its Pinktober. All my breast cancer news includes the words 'awareness', 'pink', the s-word, or other related terms. Yesterday's alert included these items:
"Harford observes breast cancer awareness month"
"Breast cancer survivor finds comfort in delivering flowers to other patients at Texas hospital"
"WATCH: 29 year old beats breast cancer, gets featured on Pink Ribbon Connection"
"Breast cancer awareness chili cookoff Saturday"
"Breast cancer survivors event"
This drives me crazy. Please stop spending money on pink and spend the money on more important things like research.
Jan 22, 2018
Going for the big bucks instead of focusing on benefits to patients
Here's another thought that the pharmaceutical industry are going after the big bucks and not looking after the interests of the patients. A new study proposes that companies are focusing on developing late stage cancer drugs because the time to market (and financial return) is shorter than in developing preventive or early stage cancer drugs. I found this little tidbit online:
'Pharmaceutical companies are overlooking drugs to prevent cancer and treat early-stage tumors because they take longer and cost more to develop than drugs for late-stage cancers, according to a new MIT study.
“There’s dramatically more investments in the late-stage treatments than there is in stage one or stage two,” said Benjamin Roin, a professor at MIT and a co-author of the study. “There’s shockingly little investment in prevention.”
The study, published in American Economic Review, found that low investment in early-stage cancer drugs accounted for a loss of 890,000 life-years — additional years cancer patients would have lived — in just 2003.
The culprit, the authors say, is how regulators treat the vital exclusivity periods for new drugs. Because the exclusivity period begins when the patent is filed — not when it hits the market — drugs that take less time in clinical trials become more valuable, Roin said. Trials for cancer drugs targeting early-stage tumors and prevention can take significantly longer to show results, he said.
“It creates incentives to focus on the drugs you can get on the market quickly, as opposed to drugs that take longer to develop,” Roin said. “The patent system is penalizing companies if they take longer to develop stuff and providing bigger rewards if they develop stuff that gets to the market fast.”'
Perhaps they need to look at their business model instead of their shareholders. I mean aren't pharmaceutical companies supposed to be developing medications to help people stay alive and feel good? No wait, they must be out to make big bucks because if they wait for people to be sick and dependent on their meds, then they can rake in the billions. And they can charge more for these 'life extending' drugs. That way their shareholders will be happy. (I am really sick of shareholders after working for publicly traded companies.) Insert cynicism here please.
This is taken from the beginning of the study itself (Download pdf of study results here.):
"Over the last five years, eight new drugs have been approved to treat lung cancer, the leading cause of US cancer deaths.1 All eight drugs targeted patients with the most advanced form of lung cancer, and were approved on the basis of evidence that the drugs generated incremental improvements in survival. A well-known example is Genentech’s drug Avastin, which was estimated to extend the life of late-stage lung cancer patients from 10.3 months to 12.3 months.2 In contrast, no drug has ever been approved to prevent lung cancer, and only six drugs have ever been approved to prevent any type of cancer. While this pattern could solely reflect market demand or scientific challenges, in this paper we investigate an alternative hypothesis: private firms may invest more in late-stage cancer drugs—and too little in early-stage cancer and cancer prevention drugs—because late-stage cancer drugs can be brought to market comparatively quickly, whereas drugs to treat early-stage cancer and to prevent cancer require a much longer time to bring to market. More broadly stated, we investigate whether private firms differentially underinvest in long-term research, by which we mean technologies with long time lags between the initial spark of an idea and the availability of a commercially viable product. We document evidence that such underinvestment is quantitatively significant in an important context—treatments for cancer—and analyze potential policy responses."
'Pharmaceutical companies are overlooking drugs to prevent cancer and treat early-stage tumors because they take longer and cost more to develop than drugs for late-stage cancers, according to a new MIT study.
“There’s dramatically more investments in the late-stage treatments than there is in stage one or stage two,” said Benjamin Roin, a professor at MIT and a co-author of the study. “There’s shockingly little investment in prevention.”
The study, published in American Economic Review, found that low investment in early-stage cancer drugs accounted for a loss of 890,000 life-years — additional years cancer patients would have lived — in just 2003.
The culprit, the authors say, is how regulators treat the vital exclusivity periods for new drugs. Because the exclusivity period begins when the patent is filed — not when it hits the market — drugs that take less time in clinical trials become more valuable, Roin said. Trials for cancer drugs targeting early-stage tumors and prevention can take significantly longer to show results, he said.
“It creates incentives to focus on the drugs you can get on the market quickly, as opposed to drugs that take longer to develop,” Roin said. “The patent system is penalizing companies if they take longer to develop stuff and providing bigger rewards if they develop stuff that gets to the market fast.”'
Perhaps they need to look at their business model instead of their shareholders. I mean aren't pharmaceutical companies supposed to be developing medications to help people stay alive and feel good? No wait, they must be out to make big bucks because if they wait for people to be sick and dependent on their meds, then they can rake in the billions. And they can charge more for these 'life extending' drugs. That way their shareholders will be happy. (I am really sick of shareholders after working for publicly traded companies.) Insert cynicism here please.
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This is taken from the beginning of the study itself (Download pdf of study results here.):
"Over the last five years, eight new drugs have been approved to treat lung cancer, the leading cause of US cancer deaths.1 All eight drugs targeted patients with the most advanced form of lung cancer, and were approved on the basis of evidence that the drugs generated incremental improvements in survival. A well-known example is Genentech’s drug Avastin, which was estimated to extend the life of late-stage lung cancer patients from 10.3 months to 12.3 months.2 In contrast, no drug has ever been approved to prevent lung cancer, and only six drugs have ever been approved to prevent any type of cancer. While this pattern could solely reflect market demand or scientific challenges, in this paper we investigate an alternative hypothesis: private firms may invest more in late-stage cancer drugs—and too little in early-stage cancer and cancer prevention drugs—because late-stage cancer drugs can be brought to market comparatively quickly, whereas drugs to treat early-stage cancer and to prevent cancer require a much longer time to bring to market. More broadly stated, we investigate whether private firms differentially underinvest in long-term research, by which we mean technologies with long time lags between the initial spark of an idea and the availability of a commercially viable product. We document evidence that such underinvestment is quantitatively significant in an important context—treatments for cancer—and analyze potential policy responses."
Jan 15, 2018
Gym class
True confessions time: who failed gym in high school and went on to exercise regularly? I admit I failed gym in high school because I would 'forget' to go. I ended up taking a summer class to make up for it.
Yesterday I was at the gym talking to two women probably in their late 70s or early 80s. One said she flunked gym in high school and had to take it again in college. She wanted to take fencing (because it was like dancing) and was forced to take field hockey I think. She hated field hockey so she failed it.
I ended up telling them about the John F Kennedy physical fitness test. They did not know about it at all. I told them we had to run the 50 yard dash, the 600 yard run, and the standing broad jump. They were appalled. They never had to do anything like that.
We were all generally amused by our previous lack of interest in gym class and how we all go to the gym regularly. We never ended up talking about gym suits but I think their experiences with them were probably just as awful.
In elementary school, gym was fun. Except when I had to play soft ball because I could never hit the ball. Even when the gym teacher slow pitched to me over and over again. Today the gym at my elementary school is being dedicated to Jim Banks who was the best gym teacher ever.
So did you fail gym? Forced exercise was never fun.
Yesterday I was at the gym talking to two women probably in their late 70s or early 80s. One said she flunked gym in high school and had to take it again in college. She wanted to take fencing (because it was like dancing) and was forced to take field hockey I think. She hated field hockey so she failed it.
I ended up telling them about the John F Kennedy physical fitness test. They did not know about it at all. I told them we had to run the 50 yard dash, the 600 yard run, and the standing broad jump. They were appalled. They never had to do anything like that.
We were all generally amused by our previous lack of interest in gym class and how we all go to the gym regularly. We never ended up talking about gym suits but I think their experiences with them were probably just as awful.
In elementary school, gym was fun. Except when I had to play soft ball because I could never hit the ball. Even when the gym teacher slow pitched to me over and over again. Today the gym at my elementary school is being dedicated to Jim Banks who was the best gym teacher ever.
So did you fail gym? Forced exercise was never fun.
Jan 8, 2018
A Cancer Diagnosis is More Important
Today's Ask Amy column upset me and made me think. You can read it below or here as published in the Boston Globe.
I feel like if they want to talk about it or need my help, I will be there. It is understood by everyone in my family that we will help each other if asked.
My sister and I haven’t spoken for a week, and I found out from my other sister that my brother-in-law called me rude and not supportive because I didn’t offer to help.
I have two young children, and the younger one was constantly sick. I also work full time and am dealing with a dying father-in-law.
I don’t have the memory capacity or time to follow up on them all the time. Was I being rude?Hurt
Your sister and her husband also did not bring it up, but they knew you had an awareness of their situation and were no doubt expecting you to at least inquire.
You say you can’t be supportive because your sister’s cancer is trumped by other family issues. This is even more baffling, because if you have experience dealing with illness, surely you realize that the comfort doesn’t come from offers of “help,” but from having people at least acknowledge the challenging situation illness presents.
In the course of your messaging, what does it cost you to type: “Oh, Sis, I heard about your cancer. Thank goodness it was caught early. I’m thinking of you. . .”?
All of your reasons for not doing this come off as justifications after the fact. You should apologize and offer some sisterly support.
Obviously the letter writer is a bit self centered and she has a bit too much going on in her life to think of anyone else. But seriously? Your sister had cancer and you blew it off.
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Q. My sister (in her early 40s) was diagnosed with cancer. They caught it early, so it’s still at an early stage. We in the family all found out about this a few weeks ago.
I have messaged her and her husband a few times since then to chitchat, but never asked them about the cancer. I feel like if they want to talk about it or need my help, I will be there. It is understood by everyone in my family that we will help each other if asked.
My sister and I haven’t spoken for a week, and I found out from my other sister that my brother-in-law called me rude and not supportive because I didn’t offer to help.
I have two young children, and the younger one was constantly sick. I also work full time and am dealing with a dying father-in-law.
I don’t have the memory capacity or time to follow up on them all the time. Was I being rude?Hurt
A. You were being rude, and you ARE being rude.
Even if yours is a family that considers illness to be a private matter — your sister has cancer. It is incomprehensible that you would learn of this, initiate contact with your sister to “chitchat,” and then never mention it. Your sister and her husband also did not bring it up, but they knew you had an awareness of their situation and were no doubt expecting you to at least inquire.
You say you can’t be supportive because your sister’s cancer is trumped by other family issues. This is even more baffling, because if you have experience dealing with illness, surely you realize that the comfort doesn’t come from offers of “help,” but from having people at least acknowledge the challenging situation illness presents.
In the course of your messaging, what does it cost you to type: “Oh, Sis, I heard about your cancer. Thank goodness it was caught early. I’m thinking of you. . .”?
All of your reasons for not doing this come off as justifications after the fact. You should apologize and offer some sisterly support.
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I agree with Amy here. If someone is diagnosed with cancer, it should be recognized by family members. I have had too many people run for the hills at the word cancer. I never wanted to be buried in phone calls about my medical issues but it is nice if family members recognize it.Obviously the letter writer is a bit self centered and she has a bit too much going on in her life to think of anyone else. But seriously? Your sister had cancer and you blew it off.