Consider it America's other prescription drug epidemic.
For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders.
Unlike the overuse of opioid painkillers, the polypharmacy problem has attracted little attention, even though its hazards are well documented. But some doctors are working to reverse the trend.
At least 15 percent of seniors seeking care annually from doctors or hospitals have suffered a medication problem; in half of these cases, the problem is believed to be potentially preventable. Studies have linked polypharmacy to unnecessary death.Older patients, who have greater difficulty metabolizing medicines, are more likely to suffer dizziness, confusion and falls. And the side effects of drugs are frequently misinterpreted as a new problem, triggering more prescriptions, a process known as a prescribing cascade.
The glide path to overuse can be gradual: A patient taking a drug to lower blood pressure develops swollen ankles, so a doctor prescribes a diuretic. The diuretic causes a potassium deficiency, resulting in a medicine to treat low potassium. But that triggers nausea, which is treated with another drug, which causes confusion, which in turn is treated with more medication.
For many patients, problems arise when they are discharged from the hospital on a host of new medications, layered on top of old ones.
More ...
https://www.washingtonpost.com/national/health-science/the-other-big-drug-problem-older-people-taking-too-many-pills/2017/12/08/3cea5ca2-c30a-11e7-afe9-4f60b5a6c4a0_story.html?
Saturday, December 9, 2017
Monday, December 4, 2017
New Recognition for Chronic Fatigue - The New York Times
Having recently endured more than a month of post-concussion fatigue, I can't imagine how people with so-called chronic fatigue syndrome navigate through life with disabling fatigue that seemingly knows no end. Especially those who are erroneously told things like "It's all in your head," "Maybe you should see a psychiatrist," or "You'd have a lot more energy if only you'd get more exercise."
After years of treating the syndrome as a psychological disorder, leading health organizations now recognize that it is a serious, long-term illness possibly caused by a disruption in how the immune system responds to infection or stress. It shares many characteristics with autoimmune diseases like rheumatoid arthritis but without apparent signs of tissue damage.
Accordingly, doctors now typically refer to it as myalgic encephalomyelitis, meaning brain and spinal cord inflammation with muscle pain, and in scientific papers it is often written as ME/CFS. At the same time, a major shift is underway as far as how the medical profession is being advised to approach treatment.
The longstanding advice to "exercise your way out of it" is now recognized as not only ineffective but counterproductive. It usually only makes matters worse, as even the mildest activity, like brushing your teeth, can lead to a debilitating fatigue, the core symptom of the disease. Both the Centers for Disease Control and Prevention in the United States and the National Institute for Health and Care Excellence in Britain are formulating revised guidelines for managing an ailment characterized by six or more months — and sometimes years — of incapacitating fatigue, joint pain and cognitive problems.
More ...
https://www.nytimes.com/2017/11/27/well/new-recognition-for-chronic-fatigue.html?
After years of treating the syndrome as a psychological disorder, leading health organizations now recognize that it is a serious, long-term illness possibly caused by a disruption in how the immune system responds to infection or stress. It shares many characteristics with autoimmune diseases like rheumatoid arthritis but without apparent signs of tissue damage.
Accordingly, doctors now typically refer to it as myalgic encephalomyelitis, meaning brain and spinal cord inflammation with muscle pain, and in scientific papers it is often written as ME/CFS. At the same time, a major shift is underway as far as how the medical profession is being advised to approach treatment.
The longstanding advice to "exercise your way out of it" is now recognized as not only ineffective but counterproductive. It usually only makes matters worse, as even the mildest activity, like brushing your teeth, can lead to a debilitating fatigue, the core symptom of the disease. Both the Centers for Disease Control and Prevention in the United States and the National Institute for Health and Care Excellence in Britain are formulating revised guidelines for managing an ailment characterized by six or more months — and sometimes years — of incapacitating fatigue, joint pain and cognitive problems.
More ...
https://www.nytimes.com/2017/11/27/well/new-recognition-for-chronic-fatigue.html?
The Surgeon Who Wants to Connect You to the Internet with a Brain Implant - MIT Technology Review
It's the Monday morning following the opening weekend of the movie Blade Runner 2049, and Eric C. Leuthardt is standing in the center of a floodlit operating room clad in scrubs and a mask, hunched over an unconscious patient.
"I thought he was human, but I wasn't sure," Leuthardt says to the surgical resident standing next to him, as he draws a line on the area of the patient's shaved scalp where he intends to make his initial incisions for brain surgery. "Did you think he was a replicant?"
"I definitely thought he was a replicant," the resident responds, using the movie's term for the eerily realistic-looking bioengineered androids.
"What I think is so interesting is that the future is always flying cars," Leuthardt says, handing the resident his Sharpie and picking up a scalpel. "They captured the dystopian component: they talk about biology, the replicants. But they missed big chunks of the future. Where were the neural prosthetics?"
It's a topic that Leuthardt, a 44-year-old scientist and brain surgeon, has spent a lot of time imagining. In addition to his duties as a neurosurgeon at Washington University in St. Louis, he has published two novels and written an award-winning play aimed at "preparing society for the changes ahead." In his first novel, a techno-thriller called RedDevil 4, 90 percent of human beings have elected to get computer hardware implanted directly into their brains. This allows a seamless connection between people and computers, and a wide array of sensory experiences without leaving home. Leuthardt believes that in the next several decades such implants will be like plastic surgery or tattoos, undertaken with hardly a second thought.
More ...
https://www.technologyreview.com/s/609232/the-surgeon-who-wants-to-connect-you-to-the-internet-with-a-brain-implant/?
"I thought he was human, but I wasn't sure," Leuthardt says to the surgical resident standing next to him, as he draws a line on the area of the patient's shaved scalp where he intends to make his initial incisions for brain surgery. "Did you think he was a replicant?"
"I definitely thought he was a replicant," the resident responds, using the movie's term for the eerily realistic-looking bioengineered androids.
"What I think is so interesting is that the future is always flying cars," Leuthardt says, handing the resident his Sharpie and picking up a scalpel. "They captured the dystopian component: they talk about biology, the replicants. But they missed big chunks of the future. Where were the neural prosthetics?"
It's a topic that Leuthardt, a 44-year-old scientist and brain surgeon, has spent a lot of time imagining. In addition to his duties as a neurosurgeon at Washington University in St. Louis, he has published two novels and written an award-winning play aimed at "preparing society for the changes ahead." In his first novel, a techno-thriller called RedDevil 4, 90 percent of human beings have elected to get computer hardware implanted directly into their brains. This allows a seamless connection between people and computers, and a wide array of sensory experiences without leaving home. Leuthardt believes that in the next several decades such implants will be like plastic surgery or tattoos, undertaken with hardly a second thought.
More ...
https://www.technologyreview.com/s/609232/the-surgeon-who-wants-to-connect-you-to-the-internet-with-a-brain-implant/?
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