Saw this at a doctors office in one of the patient rooms.
At first I wasn’t even sure what it was.
Looks like a stomach.
What are those globs?
Oy, they represent malignant tumors (from what I understood reading the fine print).
Really makes it hit home when you see it in front of you on display like that.
So much suffering from illnesses like cancer.
G-d should have mercy.
We really need to find “the cure!”
Imagine what a day that will be. 😉
If you have a pulse and have been to the stores or even shopping online lately (hey, it’s the holidays so of course you have), you know that prices are on the rise.
And this is amazing, because–
Major factors point to pricing that should be driven down:
– Commodities–which are the basic raw materials from agriculture to oil and gas and metals and mining–are at a more than 16-year low!
– Manufacturing has moved to low cost sourcing countries (China, India, Vietnam, Africa, etc.)
– Technology continues to benefit us in terms of cost-efficiencies from the transformation to robotics and automation.
Yet, we keep on seeing prices move ever higher:
Just a few examples…
– “Housing market is on fire” with existing home prices exceeding the pre-recession peak!
– “Car prices at records highs – and rising“
– “Food prices are sky high“–it’s not your imagination.
– Fashion “prices rising so fast“
– Health care spending is “again accelerating”
– “College costs are so high and rising.“
Forget the B.S. of the basket of inflation stats your being feed…you know that your bills are going up, while your income is stagnant.
The real question is why is the middle class always getting milked–whose interest does it serve? 😉
So the new Apple Watch promises to monitor our every virtual health status as technology and person blend to become one.
However, the question raised in the New York Times is whether this level of continuous monitoring is really all that necessary?
“One central rule of doctoring is that you only gather data that will affect your treatment?”
But how can more data hurt you?
– Change in measurements are often normal: For example, “blood pressure jumps up and down in response to thoughts, hydration, and stress.”
– Data sometimes outstrips our ability to understand it: So collecting more and more data may actually end up concealing the needle in the haystack, rather than culling the crucial piece of evidence we need for a diagnosis and treatment.
– Data can sometimes belie the underlying truth: “Some patients die with ‘Harvard numbers, [and in others] test results can can look bad even when the patient is fine.”
– Obsessive-compulsive monitoring may actually stress us out: “If you were dieting would stepping on the scale 1,000 times a day help you lose weight?” Perhaps, the stress of monitoring every stat we generate may actually make us sick from fear and worry.
The point is that as they say, “there can be too much of a good thing”–monitoring and checking is helpful, but not every minute of every day without some intelligent filtering and analysis.
Perhaps, the technology will evolve to wear the monitoring is unobtrusive and where the artificial intelligence is there to more or less accurately decipher true warning signs from run of the mill changes in bodily functions, and where data is aggregated to get a holistic picture and diagnosis of the person rather than a snapshot of individual functions.
No one can live under a microscope and making ourselves sick with an endless stream of health tracking and worries is not helpful.
However, in time, the technology will most certainly evolve to where it will be discreet, accurate, and truly lifesaving. 😉
(Source Photo: Andy Blumenthal)
My wife took this photo today at The Drupal for Government Conference at NIH.
The man in the photo was not only participating in the conference, but also taking notes on his Apple Macbook Air.
It is incredible how technology is helping us do our jobs and be ever more productive.
This is the vision of technology taking us beyond the natural limits we all have and face.
I remember a few years ago when I was in the hospital for something and feeling bad about myself, and my wife brought me a laptop and said “Write!”–it was liberating and I believe helped me heal and recuperate.
I wonder if hospitals in the future will regularly provide computers and access to patients to not only keep them connected with their loved ones, but also let them have more options for entertainment, creativity, and even productivity, to the extent they can, while getting well.
Kudos to this gentleman–he is truly a role model and inspiration for us all.
(Source Photo: Dannielle Blumenthal)
Usually when we talk about the dangers of cyber attacks, we are concerned with the dangers of someone stealing, spying, or systematically corrupting our information systems.
But Barnaby Jack who died last week at age 35 brought us awareness of another, more personal and perhaps dangerous hack…that of hacking medical devices.
Barnaby, a director at computer security firm IOActive, became known first in 2010 for being able to hack at cash machine and have it dispense money.
In 2012, he drew attention to a flaw in insulin pumps whereby someone could cause it to administer a fatal dose to its unknowing victim.
This week, Barnaby was going to demonstrate how heart implants could be hacked, killing a man from 30 feet away.
With advances in the miniaturization and battery life of personal medical devices and implants for monitoring and managing patients health, more and more people could be exposed to malicious or murderous cyber attacks on their body.
With the potential for RFID embedded chips for managing our personal identities to bionics for replacing or enhancing human body parts with electronic and mechanical implants, the opportunity for someone seriously messing with our physical person grows each day.
If dangerous vulnerabilities are discovered and exploited in these devices, an enemy could go from the traditional attack on our information systems to potentially sickening, disabling, or even killing millions at the stroke of some keys.
Imagine people keeling over in the streets as if from a surprise attack by a superior alien race or the release of a deadly chemical weapon, only it’s not extraterrestrial or kinetic, but instead a malevolent cyber attack by a hostile nation or cyber terrorist group taking aim at us in a whole new and horrible way.
(Source Photo: here with attribution to Bhakua)
This is awesome–the iKnife (“Intelligent” knife) for cutting away cancer, can also detect the cancerous cells.
I had previously heard about dogs being able to sniff cancers such as lung, ovarian, and skin–but never a surgical knife doing this.
With the iKnife, a surgeon can use a electrosurgical knife to cut/burn away cancerous tissue, but even better yet, this knife sucks away the smoke containing the vaporized tissue to a mass spectrometer that analyzes the particles and is said to be 100% accurate (so far) in detecting cancerous tissue (from those that are normal).
This is critical because it can be life saving in guiding surgeons not to miss any of the cancer (and therefore also helps avoid repeat surgeries) as well as not removing unnecessary tissue that is not cancerous.
Dogs can help alert us to hidden cancers within and the iKnife can help remove them with greater precision and success.
Hopefully, with G-d’s help, one day we won’t need either anymore. 😉
Watching my parents age over the years has been hard–and very painful.
They are good people–they’ve worked hard all their lives (nothing was just given to them), they are devoted to serving G-d, and they are loved by their family, friends, and community.
They have lived a good life and we are grateful for every day.
Yet as they are getting older, the body like anything physical, starts to get sick and break down.
Both my parents have serious illnesses, and in the last two years my mom has become almost totally disabled and is moving from a rehab center to a nursing home this coming week.
I read this week in the Wall Street Journal, what I’ve been watching with my own eyes…we are living “longer, but not healthier lives.”
Over the last 2 decades, life expectancy has risen 3 years to 78 years, but unfortunately only 68 of those, on average, are in good health–meaning that people suffer for about ten years with various disabilities.
What is amazing is that people are being pressed to retire later in life with an increase in age to receive full social security benefits to 67 by 2022–giving the average person a healthy retirement to enjoy of just 1 year!
With the average working household having less the $3,000 in retirement savings, things are not looking too good for Americans to retire young and enjoy their healthy years either.
Additionally, despite longer living, in the last 2 decades, the U.S. fell from 20th place to 27th place in 34 member nations of the Organization for Economic Co-operation and Development (OECD) for life expectancy and quality of life.
The leading causes of death remain heart disease, cancer, and stroke. And disabilities are being driven by back, muscle, nerve, and joint disorders.
Seeing with my own parents, the deteriorating quality of life and true suffering as they age, I am left questioning the real wisdom of keeping people alive, when the quality of life has so deteriorated as to leave them in pain and misery.
While no one wants to lose their loved ones–the emptiness is devastating–at the same time, watching them endlessly and needlessly suffer is worse.
I see my mom clutching her wheelchair, always in various states of discomfort and pain, and less and less able to help herself, in almost any way–it is tragic.
So I ask myself is it also unnecessary and wrong?
I call it forcing people alive. We keep people going not only with extraordinary measures, but also with day-to-day medicines and care that keeps their hearts pumping, their lungs breathing, and their brains somewhat aware.
The patients are alive, but are in a sense dying a long and painful death, rather than a quick and painless one.
I love my parents and mom who is suffering so much now, and I don’t want to lose her, by does really caring for her mean, at some point, letting her go.
I tell my dad, “I just want mom to have peace”–no more suffering!
For the average person, 68 years of health is too short, but 10 years of disability and suffering may be too long.
We use advances in technology and medical breakthroughs to keep people alive. But what is the cost in pain and disability, and even in cold hard dollar terms for a nation being gobbled up by deficits, longevity, and miserable disease and disability?
People are living longer but at a significant painful price!
Is this real compassion and empathy or a senseless fight with the Angel of Death?
(Source Photo: here with attribution to wwwupertal)
How many of you heard the phrase as a child, “Cleanliness is next to G-dliness”?
Over the years, we’ve learned that germs and associated illnesses are frequently transmitted by touch and through the air.
And so we’ve become sensitized to the importance of things like regularly washing our hands, using antibacterial soap, and generally keeping our homes and offices as clean as they can be. (Okay, some people I know aren’t so good about this–yes, you know who you are!)
The problem is that even with regular cleaning, corners, cracks, and surfaces are missed and harmful germs survive.
You can imagine that this can be especially true in places like hospitals and nursing facilities where unfortunately, there are already a lot of sick people.
Xenex Healthcare has invented an amazing robot that takes care of the problem–no, I am not taking about euthanasia (just kidding).
But really, this robot is wheeled into a room–generally after a manual cleaning that according to Bloomberg BusinessWeek (25 February 2013) often leaves 50% of the room still infected–and these germs can survive up to six months.
The Xenex robot generates a pulsing ultraviolet (UV) light from its extending head that zaps viruses and bacteria–destroying their DNA–and leaving a room 20 times cleaner!
There are 20 million hospital infection a years in America, killing about 100,000 people, and costing about $30,000 per infection, so the Xenex robot that kills up to 95% of many deadly infections and superbugs is significant.
The robot costs around $125,000 or it can be rented for $3,700 per month–but it can disinfect dozens of rooms a day.
I’d like to see a Xenex robot for every home and office–that should do wonders for improved health care in this country.
Oh and it makes a great gift for Howie Mandel. 😉
Yesterday, I read in the Wall Street Journal (7-8 July 2012) about end of life decisions.
With healthcare costs spiraling out of control, driven especially by the care given to those in their final year of life, as a society we are confronted with horrible decisions.
When do you do “everything possible” for the patient’s survival and when do you make the call to “pull the plug.”
The article was about one man specifically–age 41, I think–who needed a heart transplant–which was expensive but successful, but then infection and complications set in over the course of the year and resulted in doctors removing part of his lung, his left leg above the knee, his gallbladder, and with the patient eventually living off of a ventilator.
The medical staff described the patients wincing in pain and the horrific image of at times with the tube down his throat, his screaming with no sounds coming out.
Doctors and the hospital’s ethical counselors spoke with the parents of the man (as his wife had divorced him prior) about discontinuing care.
Part of the conversation was about the practically futile attempts to keep the man alive, the pain of the patient, but subtly there was also the notion about the high cost of care and the patient having reached Medicare limits.
When the father was told that the nurses were having ethical questions about treating the man, the father wanting to keep his son alive at virtually all costs said, (rather than his son being taken off of the medical care he was receiving) maybe these nurses who had an issue with it shouldn’t be working on his ward!
The patient died within the year and at a cost of something like $2.7 million dollars (and the man leaving behind a 9 year old son himself).
There is no question that we want to provide the best care for our families and loved ones–they mean everything to us.
But when does the greater cost to society (i.e. the greater good) outweigh the benefits to the individual?
Yes, can we come up with hard and cold actuarial calculations about what a person contributes into the system, how much value they bring the world, what the anticipated cost is to keep them alive, and what are the chances of success–and then we can draw a line of what as a society we are willing or able to spend to save this person.
That is very matter-of-fact–objective, but practically devoid of feeling, compassion, and hope.
What if the calculation is wrong and the person could’ve been saved, lived longer, at lower cost, and/or would’ve been a great contributor to society–how do we know how to really figure individual life and death decisions.
And what of the cost–the meaning–to the family that relies and loves this person and needs him/her–the cost is priceless to them.
But what about others who don’t, can’t, or won’t receive proper care because others ended up taking more than their “fair” share–aren’t they also human beings deserving as well of proper care–and to their families are they not also invaluable?
From an ethical standpoint, this is one of those horrible dilemas that plague our consciousness and to which answers do not come easy.
An almost insane question– but can we be, in a sense, too giving to an individual, too generous societally, and with some things trying too hard to be ethical?
Like we are seeing now with the financial decline of the European Union and the frightening fiscal challenges ahead for America–how do maintain the traditional “safety net” (Medicare, Medicaid, Social Security, and more) without bankrupting the system and underlying society itself?
In essence, what happens when in our effort to be humane to people and give them a basic standard of living and care, keep our country safe, drive research and innovation, and secure human rights and democracy around the world–we overextend ourselves.
Like many a great society before us that flourished and then declined and even disappeared–do we get overconfident, overly ambitious, and ultimately become self-defeating?
No one–a family member, a compassionate and caring human being, and especially an elected politician wants to say “no” when these decisions hang over us.
But the reality is we will soon be faced not only with the life and death decisions of today, but also generations of built-up overspending and borrowing to finance generous, and yes even corrupt, spending habits.
This will affect present and future generations requiring harder and longer work lives to get a lower standard of living and care, and could even result in our noble society’s decline.
The result is we not only face individual life and death decisions every day, but we also are facing a potential existential threat to our way of life.
Expect gut-wrenching decisions over the next decade(s) and prepare for life to change in painful ways for all of us–on and off the deathbed.
While no one wants to face these questions and make the hard decisions, this is exactly what will need to happen–sooner or later.
Fiscally-speaking, there is no longer one way to freedom, but through a collective fight to secure our nation’s future.
(Source Photo: Andy Blumenthal)
The best article I have seen on the subject of Electronic Health Records (EHR) was in Bloomberg BusinessWeek (21 June 2012) called “This machine saves lives so why don’t more hospitals use it.”
What I liked about this article was how straightforward it explained the marketplace, the benefits, the resistance, and the trends.
Some basic statistics on the subject of EHR:
The healthcare industry is $2.7 trillion annually or ~18% of GDP.
Yet we continue to be quite inefficient with only about half of hospitals and doctors projected to be using EHR by end of 2012.
Annual spending on EHR is expected to reach $3.8 billion by 2015.
Basically, EHR is the digitization of our medical records and automation of medical services so that we can:
– Schedule medical appointments online
– Check medical records including lab and test results
– Communicate with our doctors by secure messaging/email
– Send prescriptions into the pharmacy electronically
– Automatically keep track of dosage and refills
– Get alerts as to side effects or interactions of medication
– Analyze symptoms and suggest diagnosis
– Receive prompts as to the latest medical treatments
– Recognize trends like flu outbreaks or epidemics
– File and speed claim processing
So why do many doctor’s seem to resist moving to EHR?
– Cost of conversion in terms of both money and time
– Concern that it can be used against them in medical malpractice suits
– Potential lose of patient privacy
– Lack of interoperability between existing systems (currently, “there are 551 certified medical information software companies in the U.S. selling 1,137 software programs”–the largest of which are from GE and Epic.)
The government is incentivizing the health care industry to make the conversion:
– Hitech Act (2009) “provides $27 billion in financial incentives” including $44K from Medicare and $63K from Medicaid over 5 years for outpatient physicians that can demonstrate “that they are using the technology to improve care.”
– Patient Protection and Affordable Care Act (2010)–a.k.a. Obamacare–calls for “accountable care organizations” to receive extra money from Medicare and Medicaid for keeping patients healthy, rather than by procedure–“they are expected to do so using computers.”
The big loophole in EHR right now seems to be:
– The lack of standards for EHR systems from different vendors to be compatible, so they can “talk” to each other.
– Without interoperability, we risk having silos of physicians, hospitals, labs, and so on that cannot share patient and disease information.
So, we need to get standards or regulations in place in order to ensure that EHR is effective on a national, and then even a global level.
A number of months ago, I went to a specialist for something and saw him a few times; what he didn’t tell me when I started seeing him what that he was retiring within only a few months.
Aside from being annoyed at having to find another doctor and change over, I felt that the doctor was not too ethical in not disclosing his near-term intentions to close up shop and giving me the choice of whether I wanted to still see him.
But what made matters worse is that I got a letter in mail with the notification–not even in person–along with a form to fill out to request a copy of my medical records at a cost per page, so that I could transfer them–hardcopy–elsewhere.
Of course, this was also the doctor who hand wrote prescriptions still and wasn’t able to get test results online.
To me, seeing someone with a great amount of experience was really important, but the flip side was that in terms of organization, he was still in the “dark ages” when it came to technology.
I look forward to the day when we can have both–senior medical professionals who also have the latest technology tools at their disposal for serving the patients.
In the meantime, the medical profession still seems to have some serious catching up to do with the times technologically.
Let’s hope we get there soon so that we not only have the conveniences of modern technology, but also the diagnostic benefits and safeguards.
(Source Photo: Andy Blumenthal)
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