Maggie's Farm

How many of you fellows out there are on statin medicines, like Lipitor or the others? Raise your hands.

Well, it's a good idea to take them. It may turn out to be a good idea even if your cholesterol and triglyceride levels are in the normal range.

Why? Because the way they seem to reduce arterial disease leading to heart attack and stroke may not be just - or even mainly - so much by altering cholesterol and triglyceride blood levels, but by stabilizing the endothelium (inner lining) of arteries. Here's a technical paper on the subject. One quote: 

Several clinical trials including Heart Protection Study (HPS), Collaborative Atorvastatin Diabetes Study (CARDS) and Treating to New Targets (TNT) Study have suggested that statins can offer protection to patients with normal lipid levels through various nonlipid-lowering effects.

The inflammation, clots, and plaque on arteries are the main cause of terrible events. American males already have visible arterial disease in their 20s. I saw it and touched it when doing autopsies in medical school, in young people who died of other causes.

Everybody dies. Statistically, if you reach maturity and don't die in a car crash, the odds are that half die of cancer and half of heart/arterial disease. So, if you can postpone that arterial disease, you get to die from a cancer.

That's today's cheery medical news.

I have no problem whatsoever with physicians easing terminal peoples' path out of life with merciful doses of morphine, but I have great problems with the Brave New World of government rationing of medical care, and the hustling of people into death to save money as they seem inclined to do in the UK, Canada...and in Oregon.

Dr. Bob discusses. One quote:

We have, at last, arrived. The destination was never much in doubt — once the threshold of medical manslaughter had been breached, wrapped as always in comforting words of compassion and dignity, it was only a matter of time before our pragmatism trumped our principles. Once the absolute that physicians should be healers not hangmen was heaved overboard, it was inevitable that the relentless march of relativism would reach its logical port of call.

In my view, easy abortion was the first big step in the direction of removing the annoying inconvenience of a human life. Perhaps it would be most expedient - or utilitarian - to do us in the minute we stop paying income taxes...assuming our function is to serve the "common good." Or at the moment of our birth, because it is certain that we will become expensively ill someday.

And when it comes to medical treatment in general, I like TigerHawk's idea much better than any governmental idea. WallMart! Just as long as I have my own doc who knows me and cares about me first.

Addendum: Father of Canada's medical system rejects what he created. "Woops. I goofed. So terribly sorry."

We have posted in the past about the role of natural Vit D - and the role of Vit D supplement, in cancer prevention.

Here's a piece at Pajamas on the subject. The take-home message is, I believe, get tan but not burned.

It's good news, because those of us who are pasty-white Anglos look better with some healthy color.

Columbia's Brain and Mind Symposium has archived (on online video) a wonderful and relatively non-technical series of lectures by the world's greatest neuroscientists.

These talks were presented in 2004 as a part of Columbia University's 250th Anniversary. (h/t, Neurophilosophy)

We said this a month ago. Will you believe it if it comes from Instapundit?

MORE VITAMIN D NEWS: "New research shows that people who regularly use sunscreen and avoiding sunlight may be sacrificing important vitamin D, which is made by the skin when it's exposed to sunlight. Now, the recommendation is to get 15 minutes of sun at the peak of the day three times a week to help avoid a vitamin D deficiency. . . . For years, Americans have been taught that as summer approaches, they should reach for sunscreen to protect themselves from a scorching burn - and the skin cancer it might trigger. But new research shows that by covering up, they may be sacrificing important vitamin D, which is made by the skin when it's exposed to sunlight. . . . Vitamin D deficiency is associated with reduced bone strength and risk of fracture; a twofold increased risk of some cancers such as colon, breast and prostate; an increased risk of both Type 1 and Type 2 diabetes; worse control of diabetes for those who have it; decreased immune function; and possibly also heart disease."

Which do you believe? Last year's expertise, or this year's? I am inclined to trust this year's, or God would have put sunscreen on our skin.

I know that it is trite to tout exercise, but it is worth mentioning that we keep learning more about its health benefits. I recently attended a talk on breast cancer in which daily exercise compared favorably with several widely-used chemotherapy protocols.

Humans were not designed to sit on their butts all day watching TV or reading ephemeral stuff on the Internets.

You name it, and exercise helps it, in the NYT by Jane Brody.

Thought I might share the data from a meeting tonight about vitamins, health, and cancer. The short version:

- Do not take folate-containing supplements unless you are bearing babies. (Unfortunately, the government in its infinite wisdom mandated its addtion to bread and other foods for the benefit of child-bearing women who eat terrible diets.)
- Adults should not bother with vitamin supplements, except...
- it's probably a good idea for most people to take 2000 iu of Vit D3 daily (which is actually a hormone, not a vitamin) even if you spend time outdoors, and...
- 20 minutes of daily exercise is a good thing.

That's just one researcher's opinion, of course.

Up to 2 billion people on the planet are infected with tuberculosis - one third of the earth's population. That doesn't mean that they have contagious pulmonary TB, just that they contain the bug which has the capacity to attack them viciously at any time, especially if something weakens them, such as HIV, other illness, or malnutrition.

Most of the cases are in Africa and Asia - the so-called TB Belt which, in Africa, overlaps with the HIV Belt. (The combination of HIV and TB is termed "the perfect storm" of infectious disease.) However, over a million Americans are infected with TB.

I learned during my Yale Continuing Medical Education series this weekend that most HIV in the Northeast is transmitted by sharing needles, not via homosexual activity. I also learned that man-to-woman HIV is on the rise in the US. Woman-to-man transmission remains essentially impossible, apparently. I have been told that the rare reported cases were probably guys lying about their IV drug use or their homosexual activities.

In our New England cities, drug addiction, mental illness, HIV and TB is a common mix and a huge challenge to the dedicated docs who try to take care of these people, not only because of the medical difficulties but because these people are not reliable patients. Throw in a pregnancy too and you have a case that could take up half your time taking care of just one of these poor souls, who usually have few-to-no social supports in their lives but who also avoid, or will not cooperate with, government help.

Often, these folks break appointments as often as they make them because their lives are out of control, and nobody has the power to fix that. You send a visiting nurse, and they have moved out. "Lost to follow-up," until they reappear feeling desperately ill again.

During one of the talks, a famous clinical researcher on infectious disease just could not resist gratuitously throwing in a snarky Power Point slide mocking George Bush's intelligence (implicitly comparing it to his own, and "ours"). It always bothers me when these Ivy types (of which I happen to be one, along with Bush with his Yale BA and Harvard MBA) just assume that everyone in their audience has the same view of things...because we are, of course, the elite bien pensant folks, aren't we, all thinking alike?

Speaking of Moonbats, that reminds me of an email from a medical friend attending a medical conference and giving a talk in San Fran last week. He said that a young and lovely California doc approached him after his talk and said "I just needed to tell you that you have a special, beautiful aura."

I emailed back and asked "Was she hitting on you?"

He replied "I don't think so. I think it's just that California is a different planet."

I said "Guess so, because I think your aura is rather ordinary."

Photo: Robert Koch,  the great man of infectious disease and historic benefactor of mankind, who discovered the TB, Anthrax and Cholera bugs, and created "Koch's Postulates" which made possible the conquest of most of the diseases that ravaged man through history.

It's the same game, whether played from the right or from the left. Scare you into herding yourself into a malleable collectivist mass.

Well, maybe from the Conservatives a bit when they weaken, but the power-greedy Left in America rarely misses an opportunity to declare "market failure", followed by a grandiose plan to expand the power of the Federal state. FDR wrote the playbook, with Lenin's help.

Whether it's oil profits, climate, medical treatment, schools, risky mortgages, income differences, etc, there's always a "plan" for a grab for money and power.

That is why I am always highly skeptical about manufactured and trumped-up crises.

Medical insurance is a case in point. TigerHawk has a solid piece on the subject, in response to a piece by Ezra Klein which tries to convince the reader that American medical care is terrible, and the NYT piece by Mankiw that we linked yesterday. All worth a read.

And one more comment, re the "fully-socialized VA system." I have worked in a VA hospital attached to a major teaching center, and it worked just fine as long as you worked within the decreed limits. That's beside the point. VA patients have the choice of where to go for medical treatment, and they use those choices because the VA only offers clinic-style medicine, much like the charity clinics most kindly hospitals provide to their communities.

The Post Office works pretty well too (except for the USSR-style lines at the window), but we also have UPS, FedEx, etc as welcome alternatives to a government-controlled, lazy-bureaucrat-operated, arrogant monopoly which has no incentive - and no heart - to give a damn about you.