Sunday, September 17, 2017

A QUOTE I WILL KEEP - MIDNIGHT SPECIAL



Engineer, Air Force brigadier general, and surgeon: Michael Yaszemski, M.D., Ph.D., re time after last rites as he awaited surgery:

“I flipped a coin and it stayed up on the living side,”



 Mayo Clinic Discovory's Edge This week



Saturday, September 16, 2017

COLD MEDICINE - what's in it, good or not so good - COFFEE BREAK

On twitter this morning:  on a site Compound Interest

A picture chart (whatever they call them now) on what's in cold medicine and how does it work by Andy Brunning

You can see the picture on..... click this:







http://cen.acs.org/articles/93/i45/Periodic-Graphics-Chemistry-Cold-Medicines.html

I wish you health

Friday, September 8, 2017

TODAY'S COFFEE BREAK QUOTE:


"If you’re paid by the test, you’ll conduct more tests."

A little thought for our coloring books of what's wrong with our health system


https://www.forbes.com/sites/glennllopis/2017/09/06/value-based-healthcare-models-demand-inclusion-and-individuality/amp/

Thursday, September 7, 2017

NHS RATIONING TREATMENT THAT STALLS BREAST CANCER?

 A couple of women on Twitter drew attention the past week to this September 1 article in Telegraph by Laura Donnelly.

NHS rationing bodies refuse to fund treatment which stalls breast cancer 

According to the article, The National Institute of Health and Care Excellence said there was a lack of evidence to prove that the drug called fulvestrant extended lives.   

Studies that said fulvestrant "stalls the cancer’s growth by around three months" were seen as weak on research. 

Also NHS  feel it is too expensive compared to other available drugs. So over a thousand women will apparently not get the drug until it is studied further. 

The article says Fulvestrant is "licensed for women with oestrogen-receptor positive cancer, who have not already had other forms of hormonal treatment."  (my bolding)

Right there I began to find different takes on the drug as used in the states.

 Medline Plus for instance seems to find different rules on who is eligible here for the drug:  

"Fulvestrant is used to treat hormone receptor positive breast cancer (breast cancer that depends on hormones such as estrogen to grow) in women who have experienced menopause (change of life; end of monthly menstrual periods) " and whose breast cancer has worsened after they were treated with antiestrogen medications such as tamoxifen (Nolvadex). (Bolding mine.)
   
Fulvestrant is also used in combination with palbociclib (Ibrance®) to treat hormone receptor positive breast cancer in women whose breast cancer has worsened after they were treated with antiestrogen medications such as tamoxifen (Nolvadex)."

Also "Fulvestrant is in a class of medications called estrogen receptor antagonists. It works by blocking the action of estrogen on cancer cells. This can slow or stop the growth of some breast tumors that need estrogen to grow."

More specifics from cancer.gov:
https://www.cancer.gov/about-cancer/treatment/drugs/fulvestrant:
"Fulvestrant is approved to treat:  Breast cancer in postmenopausal women. It is used in patients with estrogen receptor positive breast cancer that has metastasized (spread to other parts of the body) after treatment with other antiestrogens."   There it is again!  Not for use here as a woman's first antiestrogen. 
So  who should get it as the first antiestrogen, and who should not.
Aside from who should get it, I found notes on what it does from   
https://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet

On this site, Tamoxifen, which I take, is explained  as a SERM -  drugs that bind to estrogen receptors, keeping estrogen from binding with them.  Serms are also versatile, acting as estrogen agonists in other parts of the body.  
BUT Faslodex/fulvestrant is presented as a different substance entirely:  "However, unlike SERMs, fulvestrant has no estrogen agonist effects. It is a pure antiestrogen.
 In addition, when fulvestrant binds to the estrogen receptor, the receptor is targeted for destruction."    (my bolding)

Those last three powerful words from an American site might be interpreted as hope or ammunition for argument by the women who are protesting the refusal to use fulvestrant without more testing.  

Who is right?  How could we ever know?  

Wednesday, August 23, 2017

THIS TIME

When Rik was dying, we were neighbors.  I could hold her hand for hours if she wanted.

Judy is far away.  Can  you send a holding hand by mail?

Maybe she has more time
     at least this time...

Monday, August 21, 2017

MAKE YOUR OWN MEDICAL RECORDS - Before the doctor's office...


Recently I had the mother of all sinus allergy attacks.  I was actually coughing and sneezing too hard to drive.  It taught me that a tissue in each hand can make me forget all I need to say.  Things like what to tell the doctor and what to ask the doctor.  And showed me how careless I’ve been.  Even with my rules:

Keep meds list updated
I update my grocery list daily. But Meds list - the really important one - not very well.   
Mine didn’t have my new eye meds on it.  And it was too complicated. Need to simplify.  Since I’m absentminded, I leave on it some meds I no longer take (with a line through them.)  Just in case somebody wants to give me an Rx that once caused me trouble. Or one I’m really allergic to.

Take your meds list everywhere including to the doctor’s office and drugstore.
The doctor and the med assistant may need to scan it (It’s amazing how office computers eat half or all of my file including pills & meds (like the ones I don’t dare take.) If you drive, a current meds list in your glove box might be worth doing - might copy mine & put it in today. And keep a current one in whatever bag you take with you for a hospital test, especially  outpatient surgery.
 .
Take a list of the questions you should ask (especially if I’m too sick to pay good attention)
Questions like:
What’s wrong with me?

Why do I need this test.    How much will it cost?
 (I asked why a chest Xray, should have mentioned I’ve had a five-year pneumonia shot.)

What medicine(s) are you giving me?    Is it expensive?
Is it a pill. Or pills?  How do I take it (some pills I can’t take) He explained.  (More on that later.)
What does it look like?  He showed me the little packs
Is it a steroid?   Since I took them, I’ve had reasons to wish I had asked that question!!

Write down what he says
If you’re as old as I am, you may hate having your daughter go in with you to see him, but my daughter’s writing is readable, MINE? NOT SO MUCH.  And she asks intelligent questions.  (If your doctor looks AT AND TALKS TO your daughter instead of to you, you can ask plainly to be spoken to directly. (Some doctors have not learned that.)

It’s hard to make myself ask these questions.  But I know asking could save me.   Drugstores, and busy doctors, even mine, are not perfect .)

In the past I have been sent home with the wrong labels on pills. (Luckily I knew what they should look like).
I have also been sent home with wrong, incomplete or missing instructions.  Some pill bottles are so small that instructions are on a sticky flap that falls off way too soon. You may have had that experience.

Yes, people even a lot younger than I am, take off glasses or contacts, and just think they know which bottle is which.  And yes, some people can’t afford the glasses they need to read microscopic drug store label print. A friend bought a 4-inch flat magnifier for those occasions.

 I don’t want to take the wrong pill, or take any pill four times a day instead of one time.

 I have a shiny red folder for each doctor for all this stuff.  It cost almost nothing.  Do it.



Thursday, August 17, 2017

Breast Cells discovery on Twitter


"Researchers Identify Estrogen Receptor Stem Cells In The Mammary Gland"