Showing posts with label Medicine. Show all posts
Showing posts with label Medicine. Show all posts
Changing the guidelines of mammography may increase breast cancer mortality
The US Preventive Task Force, a panel of experts, none of whom are oncologists, has recommended the following which has stirred much confusion and controversy:
1. Raise the age of first mammogram from 40 to 50 years old
2. Mammogram will be done every two years instead of every year
3. Stopping mammogram when a woman reaches 74 years
4. Patients and doctors may not do breast examinations
Mammography has been recognized as a vital tool in breast cancer detection. I believe a delay of 10 years before the first mammogram will miss cancer at an early stage when it is treatable with the best chance of survival. The panel thinks greater morbidity and mortality can be avoided if patients talk to their MDs on the cost-benefit assessment of the procedure. It is doubtful if this is true.
Those who advocated raising the age of taking mammograms ignored the successes in the fight of breast cancer which were achieved in last 10 to 20 years. About 15% of women in their 40’s are diagnosed with breast cancer from routine mammogram screenings. Since the use of mammograms in the early 90s there had been a 30% drop in mortality, about a third of which were women with ages 40 to 50. The procedure had been mainstay to early cancer diagnosis and treatment in this age group.
The change from a yearly mammogram to every two years will miss breast cancers at an early age. And halting the procedure after 74 years (at a time when longevity is getting longer,) can lead to more women dying of mammary tumors in their old age. The panel rules the number of patients falling in these categories is negligible and therefore can be ignored. Yet, in truth, looking at these "negligible" patients as expendable groups (not as individuals) is unfair and inhumane. What if it is you, your wife, mom, or sister who has the risk of having the disease?
Not recognizing the utility of breast examination to diagnose cancer goes against the grain of experience in medical practice. There are instances when during breast exams, patients are alerted of tumors that turned out to be cancers. Therefore, breast examination still plays a role in cancer detection.
I believe the lowering of the frequency of mammograms and the delay of conducting the routine procedure for women will adversely affect the gains in the fight against breast cancer. Women in ages 40-50 are the most productive and to preserve their life, they deserve a the best medical care.
Obviously, the new guidelines that are recommended are flawed. They come at a time when the pressure to lower the cost of medical services is among the hardest to tackle in the healthcare reform. Many doctors don’t agree with the recommendation of the US Preventive Task Force. Even the American Cancer Society and the American College of Obstetrics and Gynecology voice their objections to the proposed guidelines. =0=
==============================================================
Cosmetic surgeon loses license resulting from sex-tape scandal
Dr. Hayden Kho, the infamous cosmetic surgeon of the Belo Medical Group involved in the blistering sex scandal with movie starlet Katrina Halili, Dr. Vicki Belo, and other women was stripped of his license to practice medicine on November 20, 2009 by the Professional Regulations Commission (PRC).
The basis for the license revocation stemmed from the young doctor's poor judgment of videotaping his sexual relation with Halili and showing the intimate footage in You Tube for the public to see. The PRC ruled that Kho’s action was immoral and dishonorable.
The medical license revocation prompted Kho’s legal counsel to file for a motion of reconsideration before the decision to prevent him from practicing his profession becomes final. Representing her client, lawyer Lorna Kapunan said the surgeon’s punishment was “too harsh and unfair.”
Obviously, the PRC's decision on Kho's case reflects the standard of morality of the professional regulating body. The humiliation which comes from this sex scandal is a shameful example from which doctors and other professionals can learn from. (Photo Credit: Philstar) =0=
RELATED BLOGS: "As the Kho-Halili sex scandal is investigated, obscene video sells briskly in the sidewalk " Posted by mesiamd at 5/29/2009; "Dr. Vicki Belo: a lesson on cosmetic surgery, sex, & "quackery"?" Posted by mesiamd at 11/07/2009
===============================================================
Sen. Sarah Palin stirs the healthcare debate with her warning of the “death panel”
If Alaska Sen. Sarah Palin is dumb as her detractors have portrayed her all along, how come, in spite of her resignation from her governorship, she has been getting attention from the American public? In her recent indictment of the healthcare overhaul proposal of Pres. Barack Obama, she speaks of a “death panel” that looms when it is approved.
Sen. Palin refers to the effect of rationing that has to be done to rein over the cost of medical care. Rationing is almost inevitable in Obama’s healthcare reform for it plans to cover 47 million uninsured people including illegal aliens. There will be sharp need for doctors and nurses for the expected rise in the demand of medical services. Long waiting times may occur. Quality of care will suffer. Delays in diagnostics and treatments like what happens in Canada and other countries are likely. All these can result to an overall rise in the price of the whole healthcare services. And it can lead to the decline in the preeminence of US medical care which attracts patients worldwide.
There are sectors in society who boldly sell their judgment on who is worthy to avail of the resources of the government. If there will be any cost-cutting measures, the elderly, the disabled, the very young and handicapped are threatened to be denied of services in favor of the young and productive.
Healthcare Discrimination
Dr. Ezekiel Emanuel, the brother of the White House chief of staff, a radical adviser of Barack Obama believes that the life of Americans 15 to 50 years are more valuable and therefore deserving of services more than the old, the chronically ill, and the dying. Put in a compromising stance, Emanuel disavowed his previous support on rationing. Disguised as humanitarian, his scary point of view is an extension of the old debate that supposes that the unborn in the womb is expendable and it’s OK to abort them. Obama is pro-abortion.
After reversing the pro-life policy of Pres. George W. Bush, Obama has already started funding of abortion at taxpayers’ expense not only in the United States, but outside the country. One can see why the debate on “death panel” raised by Palin has morphed into a human rights and moral issue that casts doubt on the Obama plan. The selection on who may live may shift from fetuses in utero to those who are old and unproductive in society.
My Personal Experience
Sen. Palin knows so well because of Trig, her son born with disabling Down’s Syndrome. I can just sympathize with her because I too am handicapped with an unrelenting rare blood disorder. Under Medicare, I have been denied of diagnostic tests and treatments, an aftermath of cost-cutting and government rules interfering with my doctor’s medical judgment.
My doctor and I have to be contented with a medical regimen that is second in line (and probably less effective than what was originally planned.) Such insurance-mandated treatments may shorten my survival and that of other patients who are prevented to get the first line medical intervention.
I have to buy additional coverage from private insurances to help when my primary insurance falters. Speaking from experiene, by responsibly planning one's medical needs and spending for them, one can avoid devastating mistakes. Despite the imperfections of my coverage, my gut tells me problems in healthcare will worsen with what Obama is proposing.
End of Life Issues & Medical Reimbursement
In a push to “popularize” end of life decisions, a group of Obama supporters have inserted in the healthcare bill an end of life provision that will give reimbursements to doctors who discuss to their patients on how to decide on death issues. The provision somehow validates Palin’s “death panel” fears. It is a step closer to the door of euthanasia or something more sinisterly evil. Though optional, the proposed money incentive creates a pressure to direct a patient to decide. To avoid problems ahead, the congressmen decided to drop the provision.
Sarah’s liberal detractors labeled her assertions as “false rumors” and "alarmist" but the intent of the Medicare reimbursements are ominously suggestive. The provision they dropped has hints of selective triage on who deserves to live. That’s not unexpected for there those who won’t stop at anything---at a cost on trampling on age-old moral values---just to cut down the expense of healthcare.
The old and the very young and those with diseases requiring expensive treatments are vulnerable in these cost-saving measures. If they think certain persons are socially expendable, they want to throw the sanctity of life out of the window. Assurances to the contrary is offered by Obama, but will they hold when the right time comes?
Healthcare Intrusion to Private Lives
Plans are in the offing for a group of health experts in government to oversee the decision on who can avail of standard medical care and who will avail of them with what kind of doctor and where. The experts will have access to information of patients when electronic records are set up. Those who fall outside their regulations may be denied or be challenged to go on appeal, delaying treatment, without assurance of success. So we know why the healthcare debate has heated up all over America.
Bureaucrats are inching their way to ram into the throats of the public a social plan that tends to devalue the life of a certain segment of society. The town meetings across America are airing the voice of the angry opposition. Trying to snuff off dissent, those who want to push the healthcare reform have accused these meetings as disruptive handiworks of the mob. Obama blamed the media for paying attention to the protesters.
Foiling Effective Dialogue
Sen. Nancy Pelosi of California (D,) among other partisans, called protesters of the heathcare bill anti-American and pro-Nazi. Such immature accusations by a government official frustrates meaningful discussions to resolve the complex issues of the problem.
The healthcare proposal is promised to be cheap. But the calculations of expenses have run into trillions of dollars that compromise taxpayers’ money. The huge spending and debts scare ordinary Americans who believe it will be hard to come out solvent in this ambitious plan. There are so many promises to digest from Pres. Barack Obama and his self-avowed cognoscentis. Tempers rise. Frustration and confusion take over.
What Can be Done?
Reining on healthcare expenses can start with limiting bureaucracy and fraud in Medicare and Medicaid. Electronic records will bring savings. Personal healthcare accounts and aavings for expected medical needs must be encouraged. Give the people medical choice (not the single public payer which give the government too much control) to allow market forces to work with competing companies.
Implement tort reform in mediicine to discourage frivolous lawsuits that jack-up the overhead expenses of health professionals. Disease prevention must be emphasized to avoid expensive treatment when people get sick. Limit government intrusion on the freedom of doctors to treat their patients.
Palin as Victim of Media bias
Amazing! Sarah Palin whom the arrogant liberals and the biased media have demonized, cajoled, underestimated and labeled as dumbed now stands in the forefront of “activism." In her straightforward way, the victim of hate and scorn helps make the public aware of the other side of Obama’s healthcare proposal. She asks people to weigh on crucial issues that our health system, comprising a 1/6th of the US economy.
Sarah may be more informed than some of her political counterparts. Many lawmakers and their constituents don’t know the intricacies of the healthcare bill which comes in more than a 1,000 pages. Majority of lawmakers don’t know what is in the book. They haven’t read it. But Obama wants it approved in a snap of a hand, just like the $787 billion bailout that is hyped as the panacea of America’s financial problems. In bated breath, America is waiting with trepidation. (Photo Credit: infacinatorin; healthcare4every1) =0=
============================================================
Pres Arroyo slashes price of 5 common drugs
On July 27, 2009, Pres. Gloria M. Arroyo signed Executive Order (EO) 821 to reduce the price of 5 common medicines which manufacturers resisted to put down. The essential drugs include anti-cholesterol drug atorvastatin, anti-hypertensive amiodipine, antibiotic/antibacterial drug azith-romycin, anti-neoplastics/anticancer drugs cytarabine and doxorubicin.
“Last week, pharmaceutical companies acceded to government pressure to cut in half the prices of the 16 other essential medicines which the health department found to be exorbitant.
These are medicines for hypertension, diabetes, common bacterial infections, amoebiasis (a leading cause of diarrhea) and cancers (such as leukemia, the top killer pediatric cancer). But the drug companies refused to give in to the appeal of the Department of Health (DoH) for a 50-percent price cut for the five other medicines on the list."---Inquirer (07/27/09, Pazzibugan, D; Esguerra, CV.)
A welcome respite to the poor and supported by the Department of Health (DOH,) the implementation of Arroyo's drug plan starts on August 15, 2009. However, it remains to be seen if this rule will be followed. High cost of drugs are among the reasons why Filipinos are unable to maintain their medicatons leading to longer patient morbidities and premature deaths.
The maximum retail price (MRP) of drugs has been a source of contention between the manufacturers and the consumers. The Pharmaceutical and Healthcare Association of the Philippines (PHAP), composed of drug companies promised they will support the new price regulation but believes it would have been better if free market---competition dictates the price of the medicines.. (Photo Credit: Techfever) =0=
==============================================================
WHO declares H1N1 flu a pandemic; RP’s cases rise to 92
After weeks of weighing in the right time to declare a pandemic, the World Health Organization (WHO) finally ruled on Thursday, June 11, 2009 that the swine flu which caused illness and death to 27,737 and 141 people respectively, had reached pandemic level. It’s the first pandemic to be categorized in more than 40 years.
The new viral infection which has spread to 74 countries usually manifests as a mild illness and uncommonly cause death. Health authorities however emphasize the need for prevention and more caution. The virus is highly transmissible and quite unpredictable. It has a potential to transform and grow in virulence as it affects different populations of the world.
The decision to raise the disease to level 6 underscores the need for vigilance, prevention and control by various governments. The pandemic will spur the production of vaccines and drugs to fight the disease. It will require more money to keep the illness under control.
The raising the alert to the highest level coincides with the increase of cases in the Philippines to about 100, the highest number of those sickened so far by the swine infection in Southeast Asia. With the unpredictability the infection, one can just hope that the effort by the health authorities will lessen the incidence, mortality and morbidity of the pandemic in the country.
What is a pandemic?
A pandemic is a new infectious disease that spreads around the world.
The best recent example of a pandemic is AIDS, caused by a virus new to humans: HIV.
Seasonal flu viruses spread around the globe and cause 250,000 to 500,000 deaths each year -- including some 36,000 annual deaths in the U.S. But seasonal flu isn't considered a pandemic, even though the viruses that cause them change a little from season to season.
One of the seasonal flu viruses is a type A H1N1 virus. But the type H1N1 swine flu virus that appeared in 2009 is an entirely different virus. It carries genes from swine flu viruses from North America and Eurasia as well as genes from human and bird flu viruses.
Humans have never before been infected with this virus. That means that nobody is immune, although some people born before 1957 may have been exposed to an ancestor virus that could possibly give them a small degree of protection.
Because the vast majority of people are vulnerable to the 2009 H1N1 swine flu virus, because it spreads easily from person to person, and because the virus is spreading in communities in different parts of the world, the current swine flu has reached pandemic proportions.
Flu pandemics occur regularly. That's because there are many kinds of flu viruses in animals (mostly birds), but so far only a few have evolved the ability to infect humans. There were three flu pandemics in the 20th century: in 1918, in 1957, and in 1968. Source: WebMD (06/11/09, Daniel J. DeNoon; Louise Chang, MD)
What is WHO doing to respond?
"WHO continues to help all countries respond to the situation. The world cannot let down its guard and WHO must help the world remain and become better prepared.
WHO's support to countries takes three main forms: technical guidance, materials support, and training of health care system personnel.
WHO's primary concern is to strengthen and support health systems in countries with less resources. Health systems need to be able to prevent, detect, treat and mitigate cases of illness associated with this virus.
WHO is also working to make stocks of medicines (such as antivirals and antibiotics) and an eventual pandemic vaccine more accessible and affordable to developing countries.
Both antivirals and vaccines have important roles in treatment and prevention respectively. However, existing stocks of antivirals are unlikely to meet the demand. And vaccines may be developed, but it will some months.
Therefore, rational use of the limited resources will be essential. And medicines are only part of the response. WHO is also deploying diagnostic kits, medicines and masks and gloves for health care settings, teams of scientific experts, and medical technicians so countries in need can respond to local epidemics.
A pandemic sets national authorities in motion to implement preparedness plans, identify cases as efficiently as possible, and minimize serious illness and deaths with proper treatment.
The goal is to reduce the impact of the pandemic on society."---Source: www.who.int (Photo Credit: Amanda Ruth) =0=
RELATED BLOG: "Mitigation versus containment in the fight against the H1N1 flu" Posted by mesiamd at 6/09/2009
UDATE: June 14, 2009. Surveillance of H1n1 cases in the Philippines added more cases to the previous count---now totalling to 111 cases after a few grade school students in Nueva Ecija tested positive to the swine flu infection. =0=
==============================================================
Favoring alternative medicine, mom and child from Minnesota reject cancer treatment
To protect the best interest of a child suffering from cancer, the court in Minnesota ordered the mother to bring her son to the doctor for additional tests and treatment. But 13 year-old David Hauser is nowhere to be found after her mother Colleen told the court that she wanted alternative cancer treatment for her son instead of the state-of-the-art medical treatment offered in the hospital.
The teenager suffers from a life-threatening lymph node malignancy called Hodgkin’s lymphoma which when medically treated has a high chance of being cured. He and his family were ordered by the court to come on May 19, 2009 for a hearing to determine if its in the boy’s advantage that he goes for chemotherapy and/or radiation instead of taking the nebulous alternative treatment of herbals and vitamin supplements that the mother learned from the internet.
After having a course of chemotherapy, the boy and his mother who are believed to be hiding in California, decided against further treatment, invoking on religious beliefs as the reason for their change of heart.
“Daniel's father, Anthony Hauser, said in an interview Wednesday at the family's farm near Sleepy Eye, a town of 3,500 people about 80 miles from Minneapolis, that his wife and son left without telling him their plans, and that he hadn't heard from them... In Minnesota, district judge John Rodenberg ruled last week that the Hausers were neglecting their son, and ordered them to consult doctors. He cited a state law requiring parents to provide necessary medical care for a child." ----AP (05/20/09, Forliti, A; Condon,P, Kamowski, S)
The boy who obviously doesn’t fully understand the prognostic ramifications of his disease is in bigger danger of dying if he is not promptly treated medically. Daniel’s case brings to focus the clash between standard medical treatment and alternative medicine when patients are faced with difficult illnesses.
Because of the mother and child’s decision to dodge conventional medical remedies, the government is in an awkward position to pursue protection for the boy against the mother’s conviction of what is best for her child. The decision is probably easier if the sick person is an adult and mature enough to decide for himself. (Photo Credit: CBS) =0=
============================================================
Quarantine of 3 possible Swine flu sufferers in Cebu
It’s a waiting game for three individuals who were quarantined in Cebu on suspicion that they harbor the H1N1 flu virus. A Filipino who was detected to be running fever by thermal scan at Cebu Airpot was isolated together with his wife after they arrived from their trip which brought them to Ireland, Hongkong then to Cebu via Cathay Pacific Fight.
They were sequestered in quarantine rooms at the Vicente Sotto Memorial Medical Center pending the results of their laboratory tests crucial in determining if they have the pig flu. With them was an Englishwoman who voluntarily came to the hospital on May 4, 2009 to complain of cough and colds after visiting Mexico and Hongkong, places where the swine virus had been reported.
Renan Cimafranca, the head of the Regional Epidemiology Surveillance Unit said that the public will be notified of the laboratory tests sent to the DOH’s Research Institute of Tropical Medicine (RITM )in Alabang on the three individuals as soon as they are available. Although the swine influenza seems to behave like the seasonal flu, caution and vigilance are advised because the behavior of the new flu strain isn’t completely known.
Since no swine flu has so far been detected in the Philippines, the Department of Education (DePEd) has no plan to interrupt the schedule of opening of classes in June. Health authorities in Cebu are confident of their readiness to tackle the H1N1 virus infection after learning from their experience in controlling Severe Acure Repiratory Syndrome (SARS) in 2002-2003. (Photo Credit: AP/ Gregory Bull) =0=
Pig flu spreads to Italy
While the temptation to be complacent is there to stifle the fight against the swine influenza, the first case of infection is reported in Italy.
The Italian who traveled from Mexico was hospitalized in Massa near Florence after coming down with flu on April 23, 2009. With treatment, he apparently recovered. Anti-viral medications were given to his relatives as disease prevention.
Raising the alert level to 5 which indicates that a pandemic is likely, the viral illness cause fear in all corners of the globe. The World Health Organization (WHO) has closely monitored the spread of the disease which is present in at least 15 countries. In USA, 143 cases are confirmed in 20 states. In Mexico, the total number of persons infected has jumped to 443, including several deaths. (Photo Credit: shhexycorin) =0=
===========================================================
A story of hope from a Bilibid prison inmate
by Josephine R. Bundoc, M.D.
Christopher Solis is a 21 year-old spinal cord injury patient with paralysis from the hips and below. He regrets till this day the very one mistake in his life ---- succumbing to the restlessness of youth, he took the dare his friends made by staking a hold-up ---- landing him 2 gunshot wounds on the abdomen and thigh by a police officer.
Now on his 4th year as inmate at the National Bilibid Prison, because of excellent behavior and conduct, he is due for parole on June 2009, cutting his prison sentence by 3 years.
Life outside the prison though will be no different for him because he has been wheelchair bound, could not control his bowel movement and urination and has a pressure ulcer over his insensate buttocks. Worse, he could barely move his legs.
We admitted him at the UP-PGH ward and fabricated orthopedic prosthesis for both of his lower extremities that would render his hips, knees and feet stable for balance yet allow enough mobility to walk. After 2 weeks of training ---- he could stand and walk with crutches --- a big help indeed because his pressure ulcer started to heal as he is off his butt more; his bowel movement has improved because he is more mobile --- and it has greatly facilitated his voiding because he can now go to the toilet to void and have some privacy.
Best of all --- he is out of depression and is now looking forward to his parole and going back to school. To start saving money for his future schooling, he rediscovered his talent for painting--- a very good one at that!
"Hope is the thing with feathers
That perches in the soul.
And sings the tune
Without the words,
and never stops at all."
Emily Dickinson (1830 - 1886)
==========================================================
Christopher Solis is a 21 year-old spinal cord injury patient with paralysis from the hips and below. He regrets till this day the very one mistake in his life ---- succumbing to the restlessness of youth, he took the dare his friends made by staking a hold-up ---- landing him 2 gunshot wounds on the abdomen and thigh by a police officer.
Now on his 4th year as inmate at the National Bilibid Prison, because of excellent behavior and conduct, he is due for parole on June 2009, cutting his prison sentence by 3 years.
Life outside the prison though will be no different for him because he has been wheelchair bound, could not control his bowel movement and urination and has a pressure ulcer over his insensate buttocks. Worse, he could barely move his legs.
We admitted him at the UP-PGH ward and fabricated orthopedic prosthesis for both of his lower extremities that would render his hips, knees and feet stable for balance yet allow enough mobility to walk. After 2 weeks of training ---- he could stand and walk with crutches --- a big help indeed because his pressure ulcer started to heal as he is off his butt more; his bowel movement has improved because he is more mobile --- and it has greatly facilitated his voiding because he can now go to the toilet to void and have some privacy.
Best of all --- he is out of depression and is now looking forward to his parole and going back to school. To start saving money for his future schooling, he rediscovered his talent for painting--- a very good one at that!
"Hope is the thing with feathers
That perches in the soul.
And sings the tune
Without the words,
and never stops at all."
Emily Dickinson (1830 - 1886)
==========================================================
The march of the pig virus
Across the borders of Mexico the fast-moving virus has proven its efficiency of causing alarm across the globe. The World Health Organization (WHO) raised its level of vigilance to level 4 indicating that the disease is highly transmissible among human beings.
The United States declared a public health emergency to coordinate the Department of Homeland Security’s response to the changing health threat. Russia, Hong Kong and Taiwan said they would isolate travelers showing symptoms of the virus. Europe urged people to forgo non-essential travel especially in the disease epicenter.
CDC recommendations on Prevention
1. Wash your hands regularly with soap and water, especially after coughing or sneezing. Or use an alcohol-based hand cleaner.
2. Avoid close contact with sick people.
3. Avoid touching your mouth, nose, or eyes.
With the uncertainty of where the march of the disease will go, countries like the Philippines banned the import of pork from Mexico and the United States. Asian countries such as Singapore, Thailand, Japan, Indonesia and the Philippines started active screening of with flu-like symptoms travelers in their respective airports.
To date, there are at least 6 countries with the pig flu infection----Mexico, USA, Canada, New Zealand, Spain, and Israel. It is likely more places will confirm swine infections. There are about 2,000 downed by the illness with about 150 deaths. From extrapolations from past pandemics, in a worst case scenario, a large-scale illness can overwhelm care-givers and hospitals and cause the death of 2% of those affected, perhaps 2 million in USA alone.
The spread of the flu had negatively affected business and the economy. The world market fell yesterday amid threats of a pandemic and instability of the financial markets. Mexico had so far the most number of flu victims and it suffered the aftermaths of a faltering economy, drug wars, and a recent earthquake. Its major dollar earner, the tourism industry, slowed for lack of visitors.
There are those who ask why the US-Mexican border has not been closed---the disease adding to the problem of illegal aliens in the United States taxing the healthcare system. The active surveillance of suspected carriers seen in Asia is absent in America. The Obama government has no plan to halt school, ban large gatherings in public places considered mixbowls of infection.
Top level positions in the CDC and Department of Health and Human Services (HHS) still need people to decide on encompassing health decisions especially if the situation deteriorates. With the illness out of the box people criticized Mexico for not doing enough in controlling the disease at the onset. (Photo Credit: National Terror Alert; AFP/ Luis Acosta; AFP/ Null; Reuters/ Chaiwat Subprasom/ Thailand Animals Health) =0=
============================================================
Mexico’s new swine-avian-human flu worries health experts of global pandemic
Mexico closed down schools, museums and movie houses on Friday, April 24, 2009 as nearly a thousand suspected cases of influenza were reported to sicken people and at least 61 died. The disease which may be transmitted from animals (zoonotic infection) has worried Mexican authorities for its killing power and its adverse effects on tourism, a major source of revenue for the country struck by economic downturn, drug wars, and narcotics trade.
“Mexico's Health Secretary, Jose Cordova, said only 16 of the deaths have been confirmed to have been caused by the new strain, through testing at government laboratories. Samples from 44 other people who died were still being tested. The health department put the total number of people sickened by the virus at around 943 nationwide.” ----AP/ Philstar (04/24/09)
To contain the spread of the disease, the Mexican government urged the public to shun large crowds and avoid close contacts with people. Those with fever, cough, a sore throat, muscle and joint pains are advised to see a doctor and stay at home. The people responded with certain fear and confusion.
“Most of Mexico’s dead were young, healthy adults, and none were over 60 or under 3 years old, the World Health Organization said. That alarms health officials because seasonal flus cause most of their deaths among infants and bedridden elderly people, but pandemic flus — like the 1918 Spanish flu, and the 1957 and 1968 pandemics — often strike young, healthy people the hardest.”--- New York Times (04/24/09, Lacey, M.; McNeil, D. Jr.)
Eight (8) non-fatal flu similar to those caused by this new Mexican strain were diagnosed in the southwest United States prompting health authorities to sound an alarm. It is unknown how many more will go down with the disease.
According to Center for Disease Control (CDC,) which monitors the disease, the new strain of flu contains a combination of gene sequences of pig, bird, and human influenza.
“Given how quickly flu can spread around the globe, if these are the first signs of a pandemic, then there are probably cases incubating around the world already, said Dr. Michael Osterholm at the University of Minnesota.” ----Newsnet5.com / AP (04/42/09, Stevenson, M)
It is said the flu seems responsive to the two drugs available: Tamiflu and Relenza. The medicines need to be taken early during the illness to get the best benefit.
Health authorities scramble to control the disease which has the potential to spread as a pandemic. It isn't known if the vaccination given last fall and winter confers protection from this new viral strain which is transmissible from person to person. Neither is it understood how the genetic mixture of the virus came to be. Frequent hand washing and covering one’s mouth during a sneeze or cough are among the common precautions to prevent the spread of the disease. (Photo Credit: Opiado)
=========================================================
Filipino doctors in USA, 2nd to India among IMGs
We are quick to assert that among the international medical graduates (IMGs) in the United States, Filipinos are 2nd to doctors from India as the most represented ethnic group in the profession. This is a very good record for our country who has distinguished itself as one of the most prolific doctor suppliers of America. About ¼ of doctors in USA are IMGs.
Top Ten Countries of Medical Education for IMG Physicians
2007
India------------------------------------ 19.99%----------------------47,581
Philippines------------------------------8.7%-------------------------20,861
Mexico----------------------------------5.8%-------------------------13,929
Pakistan---------------------------------4.8%-------------------------11,330
Dominican Republic------------------3.3%--------------------------7,892
Russia----------------------------------2.5%------------------------- 6,039
Grenada---------------------------------2.4%--------------------------5,708
Egypt------------------------------------2.2%--------------------------5,202
Korea------------------------------------2,1%--------------------------4,982
Italy--------------------------------------2.1%--------------------------4,741
Source: American Medical Association (AMA) Masterfile 2007
2008
India-------------------------------------21%--------------------------41,247
Philippines------------------------------ 9%---------------------------21,081
Mexico---------------------------------- 6%---------------------------13,980
Pakistan----------------------------------5%---------------------------11,901
Dominican Republic-------------------3.7%---------------------------8,618
Russia------------------------------------2.7%---------------------------6,293
Grenada----------------------------------2.7%---------------------------6,299
Egypt-------------------------------------2.2%---------------------------5,301
Korea-------------------------------------2.1%---------------------------5,031
China-------------------------------------2.1%---------------------------5,087
Source: American Medical Association (AMA) Masterfile 2008
The 2008 American Medical Association (AMA) IMG record shows the Filipino doctors rank second to India in number----9% and 21% respectively of the total number of foreign medics who train in the United States. That’s a total of 21,081 Filipinos vs. 41,247 Indians. Because of the sharp difference (double) in numbers between the two groups, Filipino physicians in USA looks scarcer compared to the Indians.
The current distribution of Filipino doctors will probably stay for a while since the boom of the nursing profession in the Philippines has lured more doctors to come to USA as nurses. Former Sec of Health Dr. Jaime Galvez Tan confirmed this trend when he revealed in 2007, "My latest study, there are 9,000 doctors who have become nurses. Six thousand of them (6,000) have left the Philippines mainly for the U.S. to work as nurses." Majority of these MD-nurses come from government hospitals, keeping the pool of United States Medical Licensure Examination (USMLE) takers and residency seekers from new graduates relatively intact.
A coincident fall of medical student enrollment, as much as 40% in some schools, has caused the lack of physicians in the Philippines, but not so much in USA since it remains to be a favored job destination of Filipino health professionals for more than 50 years. What is astounding is even if Filipino IMGs are second to the Indians, their number is small---less than half of the latter.(Photo Credit: Jandentonchua) =0=
=========================================================
Lucid interval in acute brain injuries: a crucial lesson on Natasha Richardson’s death
The death of Broadway star and movie actress Natasha Richardson illustrates the necessity for quick trauma management in cases of acute brain injuries. In hindsight, Richardson didn’t go to the hospital immediately after she banged her head during a ski accident in Mont Tremblant, a luxury resort in Quebec, Canada.
She had a lucid interval and a feeling of wellness not unusual in some victims of head injury. At that crucial time, blood seeped from a torn blood vessel between the brain and skull creating an epidural hematoma, an enlarging blood clot that was big enough to cause her demise. The New York medical examiner confirmed the epidural bleeding from blunt trauma that caused her death.
Richardson, the daughter of famed actress Vanessa Redgrave was conscious and well soon after the ski accident. She refused early on to be brought to the nearest hospital, hence a delay of about 4 hours before life-saving treatment was instituted. Only when she experienced headache, a sign of rising pressure within the enclosed cranium that she decided to go for the doctors’ aid.
There are questions whether an early medical intervention could have saved her life. Perhaps yes. There is a short golden period in those suffering from acute epidural bleed when doctors can still save a life. From Canada, she was flown to Lenox Hill Hospital in New York City where she passed on a day later.
The coffin bearing the remains of the talented celebrity was taken out of the Greenwich Funeral Home in Manhattan. Lights of Broadway were dimmed to pay tribute to Miss Richardson, a Tony award winner and a member of a family of distinguished movie and theatre thespians. (Photo Credit: Mickey Strikes; Reuters/ Eric Thayer)=0=
RELATED BLOG: "Broadway star Natasha Richardson died of brain injuries in a ski accident" Posted by mesiamd at 3/19/2009
=========================================================
Obama’s stem cell research policy: the use of embryonic cells from helpless unborn sparks religious debate
As a sign of the moral dilemma and political divide rocking the United States, Pres. Barack Obama reverses the Bush-era stem cell policy that protects the embryo from being used as a tool in finding treatments and cures for illnesses. It is one of the many secularist liberal thrusts of the new administration.
The contentious decision is a triumph for those who want effective treatments against diverse illnesses like cancer, stroke, heart attack, and Parkinson's disease. However, it is a set-back for the outspoken anti-abortion groups and pro-lifers who believe that life starts at conception and therefore the unborn is deserving of social protection.
“Embryonic stem cells are master cells that can morph into any cell of the body. Scientists hope to harness them so they can create replacement tissues to treat a variety of diseases — such as new insulin-producing cells for diabetics, cells that could help those with Parkinson's disease or maybe even Alzheimer's, or new nerve connections to restore movement after spinal injury. But they come with criticism. "I believe it is unethical to use human life, even young embryonic life, to advance science," said Tony Perkins, president of the Family Research Council, a conservative organization that opposes the move.”:----Yahoo News/ AP (03/08/09, Eliot, J)
Obama is criticized by conservatives for approving the use of embryos in stem cell research to be funded by tax payers’ dollars. But his supporters believe curing sickness and allaying suffering take precedence over the welfare of the embryo. The advocates of the new policy are part of the rising number of Americans who believe that life without maladies is possible. They hope the words "incurable" and "terminal" may one day be banished from the vocabulary.
"This action is morally wrong because it encourages the destruction of innocent human life, treating vulnerable human beings as mere products to be harvested," said Cardinal Justin Rigali, the Archbishop of Philadelphia and Chairman of the U.S. Conference of Catholic Bishops' Committee on Pro-Life Activities"----Yahoo News/ AP (03/09/09, Gorski, E)
There are those who believe that the public funding of embryonic stem research is a paradoxical prelude to setting up of a healthcare policy which will use less costly medical services to the aged and the severely ill----a radical triage plan which favors more care for people who are young and productive over those who are old, and disabled.
Despite the advance of modern science and temptations to hasten social engineering, life must be respected at the start of conception. Having seen abortion and selective pregnancies done in the America first hand, I don’t concur with Obama’s stance to use the cells of developing embryos in research investigations.
Though I may well benefit from embyronic stem cells because of my illness and disability, on ethical and religious grounds, I believe researches must find a way to spare the embryo. Life in its early form has been redefined, used and abused to suit certain socio-political agenda. The growing embryo deserves equality, dignity, and protection from society just like any human being.
“Princeton University politics professor Robert George, a Catholic and another member of the Bush-era Council on Bioethics, said the moral argument over embryonic stem cell research is not rooted in religion but in ethics and equality. He said research shows that an embryo is a human being in its earliest form of development, so we have to ask ourselves whether all human life should be treated equally, with dignity and respect. “----Yahoo News/ AP (03/09/09, Gorski, E)
Convenience, easing suffering, prologation of life, and escaping mortality must not be done at the expense of others in society. From the vantage of science, embyronic stem cell research is not the only way to find cures against life-threatening and debilitating illness.
It’s my belief that individuals and governments have no ethical right to use cells of helpless embryos to advance the conveniences of the strong even if the need is pressing. Though cures from stem cells may one day be realized with the use of the conceptus, humanity can’t escape the changes that go with something as natural as sickness and ageing---all that leads to dying and demise. (Photo Credits: California Institute for Regenerative Medicine x 2)=0=
=======================================================
The Ebola-Reston virus scare in the Philippines
Ebola Hemorrhagic Fever
There was panic and alarm when Ebola virus first emerged as a fatal bleeding disease in Congo (Zaire) in 1978. Similar outbreaks in neighboring countries in Africa occured. Transmitted mainly by body fluids, the acute infection (aka Ebola hemorrhagic fever, EHF) of the Filoviridae family of RNA viruses presented like a typical viral infection--- fever, headache, joint and muscle pain, sore throat, and weakness after an incubation of 2 to 21 days. Some manifested with a skin rash, conjunctival injection, diarrhea, vomiting, stomach pain, internal and external bleeding.
There were those who survived and spontaneously recovered, but many with severe infections showed signs of hemorrhage, fluid loss, shock, and eventual death. EHF is feared because it is highly transmissible and carries a high mortality rate.
Reported cases of EHF have been zoonotic infections (animal borne.) A potential agent of bioterrorism, Ebola can present as a nosocomial infection, a disease contracted in hospitals and medical facilities during an outbreak. The exact origin, location, and natural habitat (known as the "natural reservoir") of Ebola virus aren't fully known. This makes containment of the infection difficult.
The first 4 of the 5 subtypes of Ebola is known to cause disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The virulence and lethality of these viral strains are suggested by World Health Organizations's (WHO) containment recommendations below. EHF has no known vaccine nor specific cure.
WHO's containment of Ebola
•Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented.
•Tracing and following up people who may have been exposed to Ebola through close contact with patients are essential.
•All hospital staff should be briefed on the nature of the disease and its transmission routes. Particular emphasis should be placed on ensuring that invasive procedures such as the placing of intravenous lines and the handling of blood, secretions, catheters and suction devices are carried out under strict barrier nursing conditions (biohazard.) Hospital staff should have individual gowns, gloves, masks and goggles. Non-disposable protective equipment must not be reused unless they have been properly disinfected.
•Infection may also spread through contact with the soiled clothing or bed linens from a patient with Ebola. Disinfection is therefore required before handling these items.
•Communities affected by Ebola should make efforts to ensure that the population is well informed, both about the nature of the disease itself and about necessary outbreak containment measures, including burial of the deceased. People who have died from Ebola should be promptly and safely buried. --- World Health Organization (WHO)
WHO's therapy and treatment of Ebola
• Severe cases require intensive supportive care, as patients are frequently dehydrated and in need of intravenous fluids or oral rehydration with solutions containing electrolytes.
• No specific treatment or vaccine is yet available for Ebola haemorrhagic fever. Several potential vaccines are being tested but it could be several years before any is available. A new drug therapy has shown some promise in laboratory studies and is currently being evaluated. But this too will take several years.
• Experimental studies using hyper-immune sera on animals have shown no protection against the disease. ---World Health Organization (WHO)
Ebola Reston virus in the Philippines
"In 1989, Reston, an Ebola virus subtype, was isolated in quarantined laboratory cynomolgus monkeys (Macacca fascicularis) in Reston, Virginia, USA. From 1989 to 1996, several outbreaks caused by the Ebola Reston subtype occurred in monkeys imported from the Philippines to the USA (Reston in Virginia, Alice in Texas and Pennsylvania) and to Italy. Investigations traced the source of all Ebola Reston outbreaks to one export facility near Manila in the Philippines, but the mode of contamination of this facility was not determined. Several monkeys died, and at least four people were infected, although none of them suffered clinical illness."---World Health Organization (WHO)
The Ebola-Reston (ERV,) the fifth subtype of the virus was first found in Philippine monkeys. It has caused disease in primates, but not in humans. Mainly because this that local health authorities seem to be “in control” over the simmering Ebola outbreak that has infected pigs in Pandi, Bulacan.
To make sure the ERV doesn't spread to the general population, the Philippine government in coordination with the World Health Organization (WHO) is on the process of slaughtering 6,000 infected pigs. So far no person has been reported to have fallen ill of the disease, but there are 6 farm workers and butchers who turned positive for Ebola antibodies. This is surely a cause of concern.
In spite the Department of Health's (DOH) effort to contain the disease, nobody knows the extent ERV has spread in the country at this time. It is unclear which other animal species harbor the disease agent and need isolation or killing. Philippine health authorities can only speak of what they know---that a number of pigs and some individuals were proven to be positive for antibodies--- which means they encountered the virus without suffering signs of illness.
With the potential to mutate and acquire virulence, Ebola-Reston can be transmitted to susceptible hosts and become infective to more animals and humans. Though ERV doesn’t cause disease in healthy individuals, it’s unclear what happens if the virus infects people with weak immunity or those sick of debilitating illnesses. That’s why to avoid epidemics, isolation or euthanasia of infected animals (like in the Avian Flu infection) are high in the list of priorities.
Awareness of the disease is enhanced through step-up public health education. Cleanliness is important. There is heightened watch over the sale of “double-dead” meat that may carry the disease agent. As a precaution, testing for ERV is expanded and export of porcine meat to other countries has been halted.
The strategies to combat ERV is complex and tedious. Despite DOH’s monitoring and vigilance, medical workers have to deal with the challenges of a serious health threat whose outcome is just starting to unravel. The danger of Ebola doesn't only rest on the Philippines, but on the entire world as well. It's a global effort that this disease is nipped on the bud. (Photo Credit: [][][][][]/ www.bio.davidson.edu /KeeAun)=0=
==========================================================
Medicine & Religion: Is confession a potent balm against major diseases in RP?
Dr. Francisco Duque III, the secretary of the Department of Health (DOH) reportedly said a staggering 80% of Filipinos are suffering from non-communicable diseases (NCDs) “due to unhealthy lifestyle.” The doctor goes on to say that to combat cardiovascular illnesses, cancers, and diabetes, people have to go to church and make regular “confession.” I find his religious recommendation oddly misleading. It needs clarification.
“Among those considered as NCDs are cardiovascular diseases, cancer, and diabetes. Duque said the three are now among the major health problems in the country. Duque said one way to address this problem is for the people to go on regular confession." I suggest that they go to church to pray and confess their sins because its one way of managing”----GMANewTV.net (02/16/09)
It isn’t unusual to blame stress as a cause of sickness. Though stress goes with almost all diseases, its role is often indirect, sometimes obscure, in many organic diseases. As far as science is concerned, most illnesses have underlying pathogenetic bases whose roles are generally far-reaching than the effects of stress.
Heart diseases are related to high fat diet, sedentary lifestyle, and smoking. Diabetes mellitus may have an autoimmune basis but can come with risk factors like obesity, lack of exercise, and genetics. Certain cancers are triggered by stepwise mutations (alterations in the DNA) that generate clones of abnormal cells that invade, metastasize, and eventually kill the body. In all these, stress plays a role, albeit less strongly than what is suggested by Dr. Duque.
The act of confession (reconciliation) taught by certain religions is not shared by all believers. Confessing sins to a priest by the Catholics has markedly dwindled in recent years. Dr. Duque may encounter criticism and opposition in recommending the holy sacrament to prevent non-communicable diseases. There are non-faith based treatments in medicine which are more predictable and efficacious.
Stress is part of the normal challenges of daily living. Not all people who go through significant emotionally disruptive situations get ill in the process. Sick and healthy individuals, suffer from harrowing conditions in varying degrees. As such the roles of stress in every illness are hard to quantify; their effects on the body aren’t uniformly the same.
I believe emotion plus the working of the mind, and the entire body equilibrium are influenced by stress more than it affects specific organs of the body. It is probably the reason why religion, spirituality, a belief in the supernatural, exercise, meditation, and relaxation regimens have some roles to play in disease management. The mechanisms behind their healing properties aren't fully understood.
Yet, medical science offers credible explanations in disease causation and treatment. Illnesses can be attributed to causes like direct physical injuries, infections, cancers, immunologic conditions, hormonal swings, metabolic derangements, nutritional deficiencies, hereditary disorders, chemical, drug and radiation exposures, poisonings, among others.
Stress is only one among the long list. Therefore, “confession” as Dr. Duque suggested may help in being healthy, preventing sickness, and going through an illness and subsequent recuperation. But surely, we need to account for greater ways to fight diseases more than what have been recommended by the standard and complementary approaches of medicine. This is important in the holistic way of maintaining the health of the nation.(Photo Credits: denislpaul; sacerdotal) =0=
===========================================================
Nepalese MD’s to train and render service in Bicol Medical Center
As a result of the drop in the number of medical school graduates and the exodus of local doctors to foreign countries, the Bicol Medical Center (BMC) in Naga City has resorted to bringing in 40 doctors from Nepal. From the remote country close to Mount Everest, Nepalese foreign medical graduates will be in the city to train and render service.
"The Bicol Medical Center (BMC) in Concepcion Peque̱a, Naga City is a 500-bed government tertiary hospital under the direct supervision of Department of Health Center for Health Development РBicol, Legazpi City. It is a non-profit institution and one of the 13 medical centers under the National Government." http://doh.gov.ph/bmc (Photo Credit: bmc)
The presence of imported healers in Naga is expected to beef up the medical personnel of the government hospital which has suffered the lack of MDs for the last 5 years. There have been fewer applicants to fill in the 28 doctor-vacancies in BMC. Therefore, the coming of the international physicians appears to be a boon to the hospital service in the city. But is it?
Without inciting any nativist sentiment against the foreign professionals, I think it is justified to ask if the Nepalese doctors’ schooling is comparable to those of the local physicians. The adherence to standard medical training (i.e. in the tradition of Western allopathic medicine) is important before they are allowed to handle patients. Their medical background must be adequate to meet the peculiar health needs of the community. To ascertain competency and avoid compromising the health of patients, they must be tested for basic communication and clinical skills.
Though the Department of Health (DOH) approves of these foreign doctors, does the government have guidelines that define the scope of medical duties and accountability? Are the professional regulations in place to protect the doctors, their patients and the hospitals where they work? Will the presence of these trainee-MDs not interfere with the training and oversight of local doctors, nurses, and other paramedical professionals? Are there enough senior MDs to supervise and teach them? Are they not in violation with the rules of the Professional Regulations Commission (PRC) which regulates physician licensure and practice? Has there been discussions on the effects of foreign doctors on the healthcare of the nation? Their presence may distract the government from pursuing the programs which will make local doctors stay and serve the community instead of going abroad.
In a blog I posted on August 27, 2008, I wrote:
According to Philippine Medical Association (PMA) president Reynaldo Santos, M.D. the arrival of these foreign medical trainees attests to the high quality of education in the country. But this is doubted in the wake of a sharp decline of the number of hospitals, a marked rise in patient load for doctors and nurses, a low passing rate of Filipinos in the United States Medical Licensure Examination (USMLE,) an over-crowding of patients and trainees, lack of budget, equipment upgrade, and medical facilities in many hospitals.
I hope Bicol Medical Center has ironed out the important issues cited above. Otherwise, sending in the Nepalese doctors will solve some of the current healthcare problems of Naga City, but it can also spawn fresh and bigger challenges that haven’t been given enough attention and consideration.=0=
RELATED BLOG: "RP’s 40% drop in med school enrollment & the foreign doctors" Posted by mesiamd at 8/27/2008
==========================================================
"Chronic Fatigue Syndrome” and Sen. Miriam D. Santiago’s tiredness
I hope Sen. Juan Ponce Enrile was correct when he said that Sen. Miriam D. Santiago needed an indefinite leave from her legislative work because of chronic fatigue syndrome (CFS.) I don't know if what he meant coincided with what we know of the disease.
Chronic Fatigue Syndrome is a nebulous medical condition with unknown cause whose manifestations run from physical to the psychological. As such CFS comes as a diagnosis only after careful and thorough health investigation which considers a plethora of possibilities----hormonal problems (i.e. thyroid disease, diabetes,) chronic infections (TB, malaria,) exogenous drugs (substance abuse), malignancies, organ dysfunctions, nutritional, immunologic, and metabolic derangements (malnutrition, poisonings, autoimmune diseases) and psychiatric problems (bipolar disorder, depression, schizophrenia) among others.
CFS is a hard diagnosis to make because there are no specific tests or laboratory markers to pinpoint the ailment; many illnesses have fatigue as among their prominent symptoms and a good fraction of patients looks well. The manifestations of CFS vary in severity and its course is characterized by periods of remissions and exacerbations.
A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms may include:
• cognitive dysfunction, including impaired memory or concentration
• malaise or exhaustion lasting > 24 hours after physical or mental exercise
• unrestful sleep
• joint pain without signs of inflammation
• persistent musculo-skeletal pain
• depression
• mood swings
• headaches
• tender cervical or axillary lymph nodes
• sore throat
• cardiac and respiratory symptoms
According to the Center of Disease Control (CDC) between 1 and 4 million Americans suffer from Chronic Fatigue Syndrome (CFS), an illness which presents with overrid ing tiredness. A fraction of patients are seriously impaired; at least a quarter are unemployed or on disability. About 50% of those affected come to their doctors and 40% of them have previously unrecognized medical or psychiatric condition.---Source: Center for Disease Control (CDC) at www.cdc.gov/ncidod/diseases/cfs
What CDC tells us is just the tip of the iceberg. From the medical perspective, one can however surmise if Sen. Miriam D. Santiago really suffers from a serious disease. Is she really sick? Does she have CFS or is she plainly tired. Let her doctor investigate so she can be treated.
The flamboyant senator who is known for her “intelligence and tartness” just wrapped up her investigation on the scandalous World Bank (WB) allegations that top-ranked officials in government colluded in rigging of project deals by contractors. She must really be tired as the Filipinos--- for nothing of great significance came out of a senate probe of this nature. The investigation only broke open the unhealing wounds of corruption that has left the country mired in shame. (Photo Credits: St.ChristopherLucky; diong) =0=
===========================================================
Octuplet mom mulls on what lies ahead for her babies
Nadya Suleman, the unmarried woman who had 6 children born through in-vitro fertilization (IVF) prior to having a set of premature octuplets, also by IVF, had been getting extra attention. People couldn’t help but be curious of what was going on for the 33-year old mother who had been the most talked about parturient on earth.
With no means to support 14 children, Nadya had a fertility doctor sustain her “obsession” of having 8 babies in one pregnancy---far more than what had been considered permissible in the practice of assisted pregnancy and multiple births. According to Nadya, her desire to have many children arose from her “loneliness” of being an only child. She admitted having to battle bouts of depression.
Nadya shares a modest three-bedroom home in California owned by her mother and father who are experiencing financial difficulty. Last year, the parents applied for bankruptcy. Nadya was on disability when she gave birth to her first 6 children. Having suffered back injuries while working in a psychiatric facility, she was awarded benefits for a handicap---- $165,000 between 2002 and 2008 as she complained of headaches and vertebral pain.
Now, she is trying to market her story for an undetermined sum---perhaps a book deal, TV appearance, interview, and display of her children. Her supporters and critics are stunned.
Businesses which traditionally give assistance to mothers with unusual multiple births aren’t offering freebies. Many are dismayed by this woman whose psychological health and competency to be a responsible mother is uncertain. Confined in the hospital with her 8 babies, her astounding medical bills are growing.
With her premature octuplets (6 girls and 2 boys,) Nadya and the people around her mull on what lies ahead for her 14 children who are likely to be social charges. They live in California, a state that is in real danger of being bankrupt at this time when the economy isn’t good. (Photo Credit: Aconnel173170)=0=
============================================================
Octuplets spark debate on medical, socio-economic, & moral issues of assisted pregnancies
The birth of 8 babies to an unmarried California woman who already have 6 children and lives with her parents sparked controversies which cover medical, social, economic, moral and rearing issues. The unusual multiple births by caesarian section of octuplets by 33-year old Nadya Suleman didn’t come without the help of fertility treatments. This is according to Angela Suleman, the 31 week-old babies’ grandmother who said her daughter, the mother has been "obssessed" of having children. In spite of having delivered babies in the past, she chose in-vitro fertilization because of clogged fallopian tubes.
In-vitro fertilization (IVF) usually involves implanting fertilized embryo (blastocyst stage,) normally no greater than six, usually 2 or 3 in the womb. If more than two embryos take, the patient is given the choice by her physician to keep the babies or kill some of them in an abortion-induced reduction procedure. Many doctors focus on giving the best medical care and they feel it's not their duty to dig on abortion issues (rights of the unborn) or prescribe how many children their patients must have. Suleman opted to keep all babies whose number was erroneously determined by ultrasound as 7.
Certain religious believers and anti-abortion advocates decry the practice of pregnancy reduction by doctors. Although Suleman rejected the offer to have any of her babies aborted after they were artificially set to develop in utero, there are strong objections on the medical and ethical judgment of implanting the 8 embryos on her who already have six children. There are those who believe the fertility doctor must be investigated and sanctioned for a breach of standard practice.
In 30 years of practice, "I have never provided fertility treatment to a woman with six children," or ever heard of a similar case, said Dr. David Adamson, former president of the American Society of Reproductive Medicine and director of Fertility Physicians of Northern California.---Yahoo.News/ AP (01/31/09 Watkins, T; Neergaard, L)
There are strong doubts if the unmarried Suleman has the capacity to care for the 6 boys and 2 girls born premature along with 6 older children, ages 2 to 7. It is unclear whether she is employed, though she lives with her parents who are not financially stable. The parents filed bankruptcy last year with more than $900,000 liabilities. Records show Suleman kept a psychiatric techinician license in 1997 to 2002.
The premature octuplets who are currently cared for in a Kaiser Permanente hospital surely need specialized care. With skyrocketing medical costs in a state teetering towards financial insolvency, many critics fear Suleman may not be able to sustain the duties of a single mom--- the physical, psychological, social, and economic demands of rearing 14 dependents. If she can’t keep up with the burden of motherhood, she may require public assistance and the effects on the children are hard to know. It is likely the cost of rearing them will be passed on to taxpayers and society in general. (Photo Credits: byaconnel73170; Ekem PD)=0=
UPDATE: February 2, 2009. Many critics believe the doctor didn't make good ethical judgmentt in placing at least 8 embryos on Nadya Suleman whose mother Angela is critical of her daughter's "obssession" to have babies.
=============================================================
Subscribe to:
Posts (Atom)
