Babyproofing

[a while ago]
L: They told me to take like eight ibuprofen and have a friend drive me there. I was like "It can't possibly be that painful!" so I didn't take enough ibuprofen. I drove home in agony.

Mama: You know in Malaysia they banned IUDs for women who haven't been pregnant before?

[some time this afternoon...]
Me: I feel okay actually. That was less painful than I was afraid it would be based on what you told me and my friend's experience.
Gynaecology CPN: Good! We like it when it's not as bad as people expect.
Me: I have one more question. I normally use a menstrual cup for my periods; can I put it back in later or should I use something else? *
CPN: You should use pads for the rest of your period. We don't want to go sticking anything else up there for a while.

Good thing I decided to get this done well ahead of me and Potatoboy's wedding then...

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* Apparently you're supposed to go for IUD/IUS insertion when you're on your period because the cervix is somewhat open. It's more difficult and occasionally impossible to install them in nulliparas. I was tempted to giggle before the cramps kicked in because the sound of the metal tools clanking reminded me of myself repairing a bicycle [insert bad joke here].

Big Pharma is watching you

I'm pretty good at scaring myself, as you may have noticed if you've read some of my previous posts. I'm in the middle of a new book called "Our Daily Meds", which, as the title suggests, is about the massive amounts of medicines consumed by on a regular basis by Americans.

The book details how the industry that makes small-molecule drugs fell from its golden days in the 1930s - 1950s (antibiotics, corticosteroids) to the present mess. Now most "new" prescription drugs are often a) copycat "me-too" formulations of existing drugs, b) are less or only marginally more effective than generic versions, c) are "lifestyle" drugs sold to make people think that the common hiccups of a living body are diseases or d) all of the above. Real lifesavers are never discovered, or shoved in a drawer, because the markets for them are too small (rare diseases) or too poor (tropical diseases).

I kind of feel bad after reading this because I recently went to see a PA for a problem that's been bothering me all my life, but is relatively minor and doesn't affect my health which is otherwise great. She prescribed a brand-name anticholinergic. When I went to pick up the prescription, I found that it was $5 PER PILL = $150 per one-month supply. I also found out that it makes my mouth so dry that I can barely swallow when I wake up in the morning. Screw that.

I knew a guy in college who has ADD but stopped taking Ritalin because he hated what it did to him. Another guy with ADD has it bad enough that he needs his medication to function but also hates being dependent on it, as well as the insane price. In this day and age there is NO WAY synthesizing a small molecule drug should cost that much. My ex-boyfriend got antidepressants for a bout of depression that occurred when we were together (before you say anything, it wasn't my fault!), over two years ago, and I think he's still taking them.

My mum and dad are on statins to control their cholesterol levels but they are both healthy and active people, and our family has no history of heart disease. I wonder if maybe elevated cholesterol is just a function of age and doesn't really cause heart disease in people with healthy lifestyles? Or maybe it's a biomarker of some other underlying process that causes the heart disease it's associated with? And, I'm sure a lot of the middle-aged ladies I know are on hormone replacement therapy...

I'm certainly not against taking medicine - I will usually swallow a couple of paracetamol (a.k.a. acetaminophen - I had an argument with a doctor about this who insisted they were different things) on the first day of my menstrual period or antihistamines in the spring. As mentioned above, psychiatric drugs really do help a number of people too, but it's scary that there are huge numbers of people who take them for years or lifetimes.

A lot of the medicines you see in ads are expensive, brand-name versions of drugs where generics or over-the-counter drugs do basically the same thing. I'm really appalled that the US is one of only 2 countries in the world (the other is New Zealand) that allows prescription drugs to be marketed directly to laypersons, so that they're brainwashed into asking their doctors for the shiny pills they saw on TV. At the same time companies are also working on brainwashing and bribing the doctors - sometimes indirectly with souvenirs and fancy dinners, sometimes with direct cash payments for "consulting".

Maybe there should be a Foundation for Responsible Medicine (in the spirit of the UK's Sense About Science, but targeted at reducing overuse of conventional medicines) that has anti-marketing campaigns about useless or dangerous drugs that has ads like:

• Sanlu Infant Formula: Makes your children strong! have kidney failure!
• My Pikin: Soothes Kills your teething baby.
• Ritalin: Turns your children into little angels zombies.

Obviously I wouldn't be studying what I study if I didn't believe that science is an amazing tool that can save lives and help people in myriad other ways. A lot of people, seeing the hazards and corruption mentioned above, have mistakenly turned to "alternative" medicine in the belief that conventional medicine is all bad. The problem with the pharmaceutical industry is not a failure of science in and of itself. It's the failure of science to be stronger than capitalism.

Oh yeah, and I recently applied for a job at a research institute that's funded by one of the "Big Pharma" companies...at least it's not in the main company but is a not-for-profit arm. Round and round I go.

Epiphany

Papa had TB when he was a small boy. He was sick for a long time. They gave him streptomycin but it made him deaf in one ear.

Pa's secretary Mr. Roberts has a twisted foot that stands on its toes all the time, because that leg is shorter than the other. He had polio when he was small.

I am scared. They're taking us all out of class when there isn't a different class on the timetable. I am in Standard One and still don't feel comfortable in school, in this cage of dark blue pinafore, grey cement floor and wooden desks, trapped by my lack of language.

Teacher is taking us to the hall but instead of lining up two-by-two as we do for assemblies, we're lining up single file. I can hear girls crying.

There are people in all white who look like nurses. There is a needle in my arm that brings sharp, burning pain. I am told to open my mouth and given a drop of bittersweet liquid.

The taste of the liquid triggers a revelation: I know what it is. We have a book at home that has pictures of sick people. It tells you about all kinds of diseases and how to stop them. There is a picture of a boy who has polio with a twisted leg like Mr. Roberts, and a picture of a child taking a drop of liquid in his mouth.

And I think I'm the only kid in this whole class who knows: This needle and this drop are the magic potion of freedom.

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And that's how I became interested in vaccines at age six. It just took me 17 years to realize.

For the Tongkat Ali believers

This is the worst example I've seen recently of the mainstream media completely mangling scientific findings - not only exaggeration in this case but a complete reversal of the facts. You know I normally like theSun but which ever reporter wrote this story got it completely backwards:

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http://sun2surf.com/article.cfm?id=24775
Untreated erectile dysfunction can cause death, says urology specialist

KOTA BARU: Men suffering from erectile dysfunction must seek treatment fast as leaving the problem untreated for two years can be fatal.

Subang Jaya Medical Centre urology specialist Prof Datuk Dr Tan Hui Meng said a scientific study found that men with erectile dysfunction risk getting chronic heart diseases which can cause death in one or two years.

"Erectile dysfunction is closely linked to the health because it is the heart which does the pumping so that men get excited. Men who have difficulty keeping their partners sexually satisfied carry early symptoms of cardiovascular diseases," he told reporters at the 2nd Sexual Health Conference here today.

"Most men aged 40-45 years have this problem. It can only lead to death in two years if it is a continuous problem and left untreated," he said.

However, men aged 20-30 years-old need not worry as the erection problem is only temporary and not over a continuous period.

He urged men with sexually linked diseases to refer to doctors quickly to avoid more serious diseases.

Those suffering from diabetes and hypertension should control their food intake and seek treatment to prevent it from worsening as it can lead to erectile dysfunction. -- BERNAMA

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*bang head on table*
I have seen articles on the same topic from other news agencies in the past (can't be bothered to look them up right now). The REAL story that doctors are advising older men on is that HEART DISEASE can cause erectile dysfunction, not erectile dysfunction causes heart disease. This Dr Tan's comments are slightly unclear as quoted but it still completely boggles my mind as to how the reporter got it completely backward. This is a gold mine for anybody selling Tongkat Ali, fake Viagra, etc.

Anyway...I wrote to my dad about this...I dunno what his and my mum's sex life is like and I don't want to know but I thought I'd give him a heads-up since he's a pastor and people tend to forward a lot of silly stories to him, and sometimes he uses me for fact-checking.

Multidrug-resistant infections in Sultanah Aminah Hospital

This is absolutely appalling. (Scroll down to the second part of the story in the middle of the page.)

If you don't want to read it here's a quick summary. A woman whose 60-something diabetic father was in Sultanah Aminah Hospital in Johor complained because a consultant told him he urgently needed a wound debridement surgery, but he was subsequently left in the multidrug-resistant isolation ward for five days with only i.v. antibiotics. He has a multidrug-resistant Acinetobacter infection in the ulcer. A reporter from theSun went to visit them and found that:

• The door of the quarantine ward had a sign saying it should be closed, but it was left open
• another sign said that everyone going in must wear gloves, masks, and aprons, but there weren't any masks or aprons
• there was a pile of used gloves next to the glove box (yay cross-contamination!)
• visitors were ignoring the signs since the protective equipment wasn't there
• even worse, the reporter saw A NURSE AND A DOCTOR!!! walk in, attend to patients, and walk out without putting on the PPE or washing their hands (and the doctor's tudung wasn't tucked into her lab coat, which is effectively the same as a non-Muslim doctor having unbound long hair trailing all over).
• Another guy was there who had been in a road accident and acquired a multidrug-resistant infection from a metal implant in his leg. He's been there with a FRACTURED HAND for over a month. His fiancee said that the quarantined patients appear to have been "forgotten".

This hospital is apparently run by monkeys. Even if the patients weren't KNOWN to have an infectious disease, clinicians are still supposed to wash their hands between patients (I don't use the same gloves for different experiments in the lab).

Let me point out again for the sake of my American readers that Malaysia is not, in terms of technology, resources, or wealth, a backward country. I take every opportunity to smack down the ignoramuses who assume that "developing country" = "1990s Rwanda". We make computers, other electronics, drugs, all kinds of fine consumer products. We have so much. But brains? Who knows.