Should over-the-counter medical abortion be available? | Daniel Grossman

The coat hanger – often with a red line through it – is a powerful feminist symbol. Conjuring images of women suffering unspeakable consequences of unsafe abortion, the coat hanger sends a foreboding message about a past we must not return to. The implications are clear: abortions women give themselves when they cannot access legal services are dangerous.

While the coat hanger rhetoric has been useful for the abortion rights movement, it has become problematic in the 21st century. Coat hangers are no longer the method of choice for women who want to end a pregnancy on their own. In my research in Texas, women much more commonly report using medications or herbs when they try to self-induce an abortion. Some of these medications are very safe and effective, while the problem with herbs is that they are often ineffective.

This representation of self-abortion as always dangerous is also problematic, because women may in fact be able to safely have an abortion on their own without medical supervision. Focusing solely on the coat hanger imagery also overshadows any conversation about women’s agency and self-determination when it comes to their healthcare.

Not all women who attempt to end a pregnancy on their own do so because they have no other option. Some prefer self-care and turn to herbs and supplements to manage most of their health needs, and some women see self-induction as less invasive and more natural than a clinic-based abortion. Others are just looking for a simple solution to a problem that our society has stigmatized and made difficult to solve.

Medication abortion could change the way our society perceives self-induced abortion. This option for pregnancy termination is available in many US clinics at up to 10 weeks gestation and allows women to take medications at home, where their experience is very similar to a natural miscarriage.

The most effective regimen involves the use of mifepristone, also known as RU-486, followed by misoprostol. Taken together, these drugs are more than 95% effective at causing a complete abortion. Misoprostol can also be used alone, but the efficacy of this method is closer to 85%.

A new article I co-authored in the British Journal of Obstetrics and Gynaecology turns the notion of self-abortion even further on its head by asking a simple question: do the drugs used in medication abortion meet the criteria of the US Food and Drug Administration (FDA) for over-the-counter sale? The answer is a qualified yes, although more research is needed.

Of course, at the moment, the idea of over-the-counter access to medication abortion in the United States sounds crazy. Currently American women in most states – unlike women in many other countries – are unable to buy even birth control pills without a prescription.

But in the same way that women around the globe are getting contraceptives on their own, many are obtaining medication abortion over the counter at pharmacies. The limited data so far suggests women are doing this safely – and there is no question that use of these medications has contributed to a reduction in abortion-related mortality worldwide.

The FDA has standardized criteria to decide if a medication is appropriate for over-the-counter sale. For medication abortion, the most critical remaining step is determining whether women can assess on their own if the method is appropriate for them – in particular, whether they are less than 10 weeks pregnant. Studies have shown that women are quite accurate at dating their pregnancies if they know when their last menstrual period was. Of course, women could also get an ultrasound, which might be easier to obtain – and more likely to be covered by insurance if they have it – than a clinic-based abortion.

Beyond dating the pregnancy, women must only answer a few health-related questions to determine their eligibility. One or two blood tests may also be required, although their utility is debatable. The rest of the medication abortion process already takes place at home, and women are told to seek care if they have unusual symptoms, such as fever or heavy bleeding. Women can also assess on their own whether the abortion was complete.

While all of these preliminary data are encouraging, more research is needed to clearly document whether the FDA’s criteria are met. We also need to know how much demand there is for over-the-counter medication abortion. It may be that most US women would prefer to meet with a doctor or nurse practitioner before beginning the abortion process, and clearly clinic-based support must remain an option for women.

From a purely medical perspective, it no longer makes sense to demonize women’s safe use of abortion medications at home – just as the abortion rights movement should no longer rely on rhetoric around returning to the days of coat-hanger abortions.

It may be a long time before these drugs are on the shelf of your neighborhood pharmacy, but in the meantime, there are other ways to improve access to this technology and help women obtain abortion care earlier in pregnancy.

Research has already demonstrated the safety of nurse practitioners providing medication abortion, as well as the use of telemedicine to expand access to this option. While we wait for more data on over-the-counter medication abortion, the time has come to start loosening restrictions on this abortion method and to help give women the type of care they want.

Should over-the-counter medical abortion be available? | Daniel Grossman

NHS and medical watchdog tried to suppress scandal over vaginal mesh implants

NHS bosses and the watchdog that oversees medical devices tried to limit public exposure of the scandal over vaginal mesh implants that have harmed hundreds of women.

Minutes of a meeting held in October 2016 show that NHS England and the Medicines and Healthcare Products Regulatory Agency agreed to “avoid media attention” over the implants, despite the fact they were seeking to encourage patients to report any complications.

The document, obtained by the Press Association, records an agreement to “take the press element out” of the “yellow card” campaign to record adverse reactions experienced by vaginal mesh patients, suggesting that it could be folded into a wider effort, “of which mesh is one element, to avoid media attention on mesh”.

The apparent cooperation between NHS England and the MHRA to minimise media focus on the debilitating problems increasingly associated with the implants appears to breach the NHS’s duty – reiterated regularly by health secretary Jeremy Hunt – to be open and transparent over patient safety failings.

NHS England and the Department of Health both refused to comment on the minutes of the meeting.

One possible reason for the NHS to want to limit exposure of the issuecould be to reduce the number of potential lawsuits faced by the health service.

More than 800 women are suing the NHS and the manufacturers of vaginal mesh implants after suffering serious complications, it emerged this week. Some women reported that implants had cut into their vaginas, with one woman saying she was left in so much pain that she considered suicide. Others have been left unable to walk or have sex, according to the BBC.

Vaginal mesh implants are used to treat incontinence after childbirth or pelvic organ prolapse, where the womb or bladder bulge against the walls of the vagina. Between 2006 and 2016, more than 11,000 women in England were given the implants to treat prolapse or incontinence, NHS data shows.

Around 11%-12% of users have reported problems, while lawsuits in the US have already seen around $ 2bn (£1.5bn) paid to affected women.

Campaigners say that hundreds more women have come forward after learning of the group planning to sue.

Kath Sansom, who runs the campaigning website and Facebook group Sling the Mesh, says the number of women contacting her has risen from a few people a day to more than 200 in the past 24 hours.

“It’s always the same story,” she said. “There are so many women who were told it was just them, that they were a one-off. They can’t believe there are others out there. So many people are told it’s back pain, endometriosis, gall bladder pain, scar tissue. And so many of them accept it, you trust medical professionals.”

Data from the MHRA, which has been looking at the issue since 2011 following complaints from women, shows more than 1,000 adverse incidents have been reported in the past five years.

Despite the problems that have emerged the MHRA insists that the best current evidence supports the continued use of the implants to resolve health conditions that could themselves cause serious distress to patients.

A report into the issue from a working party led by NHS England admits there is a huge lack of data on complications from the devices. Published studies on mesh implants do “not tell the whole story” and there are gaps in NHS knowledge about their safety, it added.

NHS and medical watchdog tried to suppress scandal over vaginal mesh implants

Could shared medical appointments help the NHS and patients?

In medicine, the private one-to-one consultation is sacrosanct.

Yet shared medical appointments have been used successfully for years at the Cleveland Clinic in the US. Patients appreciate them. They compare experiences with other patients, learn from their questions, gain more advice than they might otherwise, and improve their understanding of their symptoms.

For the hospital, the gains are seen in improved outcomes, higher patient satisfaction, dramatically reduced waiting times and lower costs.

Here, then, is an innovation that could help the NHS, caught between rising demand and squeezed budgets, which is leading to longer waiting lists and growing discontent. By sharing appointments, more patients could be treated more quickly, reducing waiting times, saving costs, yet raising standards of care.

They have been tried by GPs in Edinburgh, Sheffield and Newcastle, following the lead of doctors in the US and Australia. As a surgeon, I can see the potential benefits in bringing together patients undergoing the same procedure for pre- and post-surgical care.

Shared appointments are not appropriate for all patients or all conditions. They should always be offered, never imposed, and patients would always retain the option of a one-to-one consultation, if that was what they preferred. There might, however, be trade offs. Patients might be offered a one-to-one consultation in four weeks or a shared appointment in 48 hours.

They can yield real benefits in the routine care of chronic illnesses such as asthma, diabetes and heart disease, where patients can learn from and motivate each other. We already know the secret of Weight Watchers’ success lies in creating peer pressure among group members who compete to see who can shed most pounds. Alcoholics Anonymous similarly allows people to share a problem and begin to tackle it together. There are websites such as PatientsLikeMe which connect people to others with similar conditions.

However, shared medical appointments work differently from self-help groups. Each patient is examined by the doctor, diagnosed and prescribed treatment in exactly the same way as they would be in a one-to-one consultation. The benefit for the patients comes from observing how the other patients are managed, or manage themselves. In one example, a patient with heart disease was persuaded to get on an exercise bike by hearing about a teenager with a heart condition who had a passion for basketball.

The doctors are spared having to repeat the same information a dozen times a day, saving time and costs. Whereas a heart patient might require a half-hour appointment for a routine follow-up visit, with a shared appointment six or seven patients could be seen in 90 minutes.

In certain cases, only part of the appointment might be shared. For example, in a typical shared appointment for female patients at the Cleveland Clinic, the doctor performs breast and pelvic examinations and discusses test results in private, while the remainder of the appointment includes the other patients.

Given these benefits, it is surprising that shared appointments have not been taken up more widely. In an article in the New England Journal of Medicine, Professor Kamalini Ramdas of London Business School and I suggest there are four principal reasons: the lack of rigorous scientific evidence of their value, the absence of easy ways to pilot them, missing incentives and lack of awareness among both patients and clinicians.

There is another reason. Innovations in healthcare typically take 17 years to spread, from proof of principle to widespread uptake. And this is an average – some take decades.

We need smart ideas – and disruptive innovators to implement them – if we are to improve the outlook for patients and for the NHS. Shared appointments is an idea worth pursuing.

Lord Darzi is a surgeon and director of the Institute of Global Health Innovation at Imperial College London. He was a Labour health minister from 2007–09.

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Could shared medical appointments help the NHS and patients?

Medical couriers launch case challenging self-employed status

Couriers carrying emergency blood supplies to hospitals and samples to laboratories are to challenge their self-employed status in the first gig-economy test case to hit the healthcare sector.

The five cyclists, motorcyclists and van drivers, who all work for The Doctors Laboratory, a company which provides pathology services to the NHS, argue that they are employees and not independent contractors.

“I risked my life every day to get emergency blood to people, but the company won’t even recognise my basic employee rights without a fight,” one claimant, Ronnie De Andrade, said.

“I have been working for them for over five years and I don’t see my life progressing like this. I can’t get a mortgage, I have no pay when I go on holiday and I can’t get sick because I won’t get paid.”

TDL said it had not received formal notification of any employment tribunal claims brought by any of its couriers.

“We keep the working arrangements of our couriers under constant review to ensure that we comply with the latest standards and legal requirements,” a spokesperson said.

The couriers’ claim for employee status, which was filed on Tuesday at the London central employment tribunal, goes a step further than previous gig-economy cases – against taxi hailing app Uber and courier firm City Sprint – which both successfully argued drivers were officially “workers”.

Workers, who are employed under a contract in which they must always turn up for work even if they don’t want to, are entitled to employment rights including the national living wage, holiday pay and protection against discrimination, and may also miss out on other benefits including sick pay and maternity leave.

Employees have those additional rights guaranteed as well as protection against unfair dismissal, statutory redundancy pay and the right to request flexible working.

A self-employed person receives no entitlement to employment rights, beyond basic health and safety and anti-discrimination framework.

Jason Moyer-Lee, general secretary of the Independent Workers’ Union of Great Britain, said the TDL case was a “black and white example of bogus employment status”, as the couriers were required to work regular shifts dictated by the company, had to request time off and were not allowed to reject deliveries they were told to do. They are also not allowed to take outside employment while working for TDL.

The case has emerged as employment experts call on the government to tackle exploitation of the lower paid by abolishing different categories of worker after a string of scandals concerning the treatment of lower paid workers in the UK. The chancellor Philip Hammond is also expected to announce a consultation on the taxation of the self employed in Wednesday’s budget.

Speaking on Tuesday at the first hearing into the future world of work by the Commons business, energy and industrial strategy committee,

Hannah Reed, a senior policy officer at the Trades Union Congress, said: “There should be a floor of rights for all working people – a single worker definition.” Sue Tumblety, founder and managing director of the employment human resources consultancy HR Dept Ltd, added: “I would like the ‘worker’ category to go.”

Moyer-Lee said there was clarity between the different classes of worker but there needed to be better enforcement of the rules. He said: “I’m not in favour of eliminating worker status. I think there are are people who are in between an independent contractor and an employee.”

He added that getting rid of worker status might also make it harder for those currently classed as self-employed to win more rights from their employers – because the hurdle of proof was higher.

Medical couriers launch case challenging self-employed status

Britons "bumped off" EU medical research grant applications, MPs told

British medical researchers are being removed from applications for EU research grants by European colleagues because of Brexit, MPs have been told.

Prof David Lomas, representing UK university hospitals, told MPs that Britain’s position at the forefront of medial advancement was threatened were it no longer able to access the European Research Council, one of the world’s leading funders of scientific research.

“One big issue for most of hospital academics is applying for grant applications, and we’ve seen people bumped off grant applications to the EU,” he told the health select committee.

Applications to the ERC are usually made by consortiums of researchers from a variety of EU countries. Britain has a strong track record of taking the lead in these groupings.

“Previously having a British member would help you in your application to get funding … Nowyou are less than an asset, so we have had academics removed from grant applications,” Lomas said.

He said it was vital for patients that Britain continued to be part of leading edge research and was pressing the government to argue the case for continuing to contribute to the ERC on a pay-as-you-go system.

“If we don’t get the very best people we don’t drive the research and innovation where we punch above our weight. If we can’t attract the very best, we can’t lead in the innovations that will lead to patient benefits.”

Lomas said his own university, University College London, where he is vice-provost of health, and the University of Cambridge were huge beneficiaries of the ERC, as was the UK.

“We raised €760m [£642m] between 2007 and 2013 from the ERC. My own university and Cambridge are neck and neck for bringing more in to any university [than any other] in the EU,” he told the committee.

Brexit was also affecting recruitment of high-calibre staff in medical schools, with teaching hospitals in Leeds and Glasgow reporting people pulling out of job offers, he continued. “So we have lost stellar people who would have come otherwise.”

Concern over the right to live and work in the UK after Brexit was already affecting recruitment across the board, said Danny Mortimer, chief executive of NHS Employers.

Giving evidence before the select committee, he said the controversial application process for permanent residency cards involving an 85-page application form had proved counterproductive, and was deterring valuable healthworkers from planning to stay in the UK after Brexit.

Both men were speaking just weeks after the Nursing and Midwifery Council reported a sharp decline in registrations from Europe.

Just 101 nurses and midwives from the EU27 registered to work in the UK in December, down from 1,300 in July, the committee heard. About 5% of nurses and 10% of doctors in the NHS are EU nationals.

Mortimer said EU staff were critical to the smooth running of the the health service. “We cannot believe that the NHS can do without our EU national colleagues,” he said.

One area that could be more heavily impacted than hospitals is social care, with EU nationals plugging the gaps, particularly in rural areas where it was difficult to recruit British staff, MPs heard.

“Some areas it has been very difficult to recruit, rural areas are very difficult to recruit people in social care, so EU [nationals] have come into this area,” said Martin Green, chief executive of Care England.

Britons "bumped off" EU medical research grant applications, MPs told

NHS at breaking point, according to British Medical Association

The NHS is at “breaking point” with a decline in the number of hospital beds leading to delays and cancelled operations, the British Medical Association (BMA) has warned.

Analysis by the BMA found the number of overnight beds in English hospitals fell by a fifth between 2006-07 and 2015-16. The report found that in the first week of January this year, almost three-quarters of trusts had a bed occupancy rate of 95% on at least one day.

According to the analysis, in 2000 there were an average of 3.8 beds per 1,000 people, but this had dropped to 2.4 beds by 2015. The report said that in November 2016 14.8% of patients spent more than four hours waiting for a hospital bed, having been seen in an A&E department.

“The data demonstrates the increasing pressures on the system. It provides evidence of the underlying cracks within the NHS, such as funding constraints, changes and increases in demand, disjointed care and workforce pressures,” the BMA report said.

It noted that pressures on mental health services were particularly acute, with a 44% decrease in the number of mental health beds since 2000-01.

The document was seized on by opposition politicians, with Labour saying it was a “wake-up call [that] Theresa May must not ignore” and the Liberal Democrats warning the situation was becoming “intolerable”.

The BMA’s chairman, Mark Porter, said: “The UK already has the second lowest number of hospital beds per head in Europe and these figures paint an even bleaker picture of an NHS that is at breaking point.

“High bed occupancy is a symptom of wider pressure and demand on an overstretched and underfunded system. It causes delays in admissions, operations being cancelled and patients being unfairly and sometimes repeatedly let down.

“The delays that vulnerable patients are facing, particularly those with mental health issues, have almost become the norm and this is unacceptable. Failures within the social care system are also having a considerable knock-on effect on an already stretched and underfunded NHS.

“When social care isn’t available, patients experience delays in moving from hospital to appropriate social care settings, which damages patient care and places a significant strain on the NHS.

“In the short term we need to see bed plans that are workable and focused on the quality of care and patient experiences, rather than financial targets. But in the long term we need politicians to take their heads out of the sand and provide a sustainable solution to the funding and capacity challenges that are overwhelming the health service.”

Jonathan Ashworth, shadow health secretary, said: “Thanks to Tory mishandling of our NHS, patient numbers in hospitals are now routinely above the levels recommended for safety. The shameful reality is this overcrowding puts patients at risk and blows apart ministers’ claims to be prioritising safety.

“The number of overnight hospital beds has decreased by over a fifth and combined with Tory neglect and underfunding this has left nine out of 10 hospitals dangerously overcrowded this winter.

“Almost all hospitals have been running over the safe 85% mark for bed occupancy while 60 hospital trusts are over 95% this winter. The response from ministers is to blame others and bury their heads in the sand.

“This government’s mismanagement is failing our NHS and failing patients. The prime minister must wake up to this crisis and ensure that the NHS and social care have the funding and support needed in the budget next month.”

Norman Lamb, the Lib Dem spokesman and former health minister, said: “Chronic bed shortages should be the exception not the rule. The situation is getting intolerable, with more cancelled operations, longer delays and those with mental health issues being systematically let down.

“Ultimately we could reduce the need for hospital beds by improving preventive care. But cutting both preventive services and beds leads to disaster. That is what we are now witnessing.”

An NHS Improvement spokeswoman said: “The NHS has been under real pressure this winter, as it copes with a surge in demand for emergency services the knock-on effects are felt throughout our hospitals.

“Our hospitals are extremely busy but we are working tirelessly alongside providers to help them manage and to support more efficient use of the number of beds available.”

The BMA’s report is published before the NHS Improvement’s figures for the third quarter of 2016-17, which are expected to show the parlous state of trusts’ finances.

NHS Improvement’s chief, Jim Mackey, has acknowledged trusts will miss the £580m deficit “control target” and forecasters have predicted the combined black hole in their finances could reach nearly £1bn by the end of the year.

The Department of Health disputed the BMA’s analysis, insisting figures from before 2010-11 could not be compared with those afterwards; the earlier figures included NHS-provided residential care beds and were compiled on an annual basis, while the more recent figures were published quarterly and only included beds under the care of consultants.

A spokesman said: “This analysis is inaccurate, the figures come from two different time periods when the way of counting beds was different, and so they aren’t comparable.

“Our hospitals are busier than ever but thanks to the hard work of staff, our performances are still amongst the best in the world. We have backed the NHS’s own plan for the future with an extra £10bn by 2020.”

NHS at breaking point, according to British Medical Association

Ireland to legalise cannabis for specific medical conditions

Ireland is set to legalise the use of cannabis for treating specific medical conditions, after a report commissioned by the government said the drug could be given to some patients with certain illnesses.

The Irish health minister, Simon Harris, said he would support the use of medical cannabis “where patients have not responded to other treatments and there is some evidence that cannabis may be effective”.

The report said cannabis could be given to patients with a range of illnesses including multiple sclerosis and severe epilepsy, and to offset the effects of chemotherapy.

“I believe this report marks a significant milestone in developing policy in this area,” Harris said. “This is something I am eager to progress but I am also obligated to proceed on the basis of the best clinical advice.”

Last November, Harris asked Ireland’s Health Products Regulatory Authority (HPRA) to examine the latest evidence on cannabis for medical use and how schemes to facilitate this operate in other countries.

The study found “an absence of scientific data demonstrating the effectiveness of cannabis products” and warned of “insufficient information on [the drug’s] safety during long-term use for the treatment of chronic medical conditions”.

“The scientific evidence supporting the effectiveness of cannabis across a large range of medical conditions is in general poor, and often conflicting,” it added.

However, it added that any decision on legalising use of cannabis was ultimately for society and the government to make.

Harris said he wanted to set up a “a compassionate access programme for cannabis-based treatments” and was now considering any changes in the law needed for its operation.

The new medical cannabis scheme will run for five years and will be constantly monitored by Irish health service experts.

The big policy shift came in the same week that the Fine Gael-led coalition in Dublin backed the idea of a “safe injection” room for heroin addicts in Ireland’s capital.

The Temple Bar Company, which represents bars, clubs, restaurants and other businesses in the cultural-entertainment quarter on the south bank of the Liffey in Dublin, expressed opposition to locating any of the injection centres in or close to the tourist district.

The Temple Bar chief executive, Martin Harte, said businesses in the tourist centre collected 1,500 syringes from the streets around the area every year.

“We are bracing ourselves for an increase in the level of syringe disposals and related antisocial behaviour,” he said.

“Addiction centres make no provision for what happens outside of opening hours … The Temple Bar Company is not opposed to tackling issues with drugs in Ireland, but we are opposed to proposals that exacerbate and fuel an injecting epidemic in Dublin city.”

Last year, Aodhán Ó Ríordáin, the former Irish Labour party junior health minister, became the first politician to call publically for a safe injection centre for the more than 20,000 registered heroin addicts in Dublin alone.

Ó Ríordáin also said he favoured making the possession of heroin, cocaine or other opiates for personal use no longer an arrestable offence.

Although he is no longer in government, after last year’s election, Ó Ríordáin’s suggestion of partial decriminalisation of drugs among users won the backing of rank-and-file police officers in Ireland, who said it would free up resources.

Ireland to legalise cannabis for specific medical conditions

What Is Medical Identity Theft?

A recent study showed that the number of cases involved with medical identity theft have gone up more than 21% in the year prior to the release of the report. While identity theft in general has been on the rise for some time, these specific figures and their relation to the medical industry could be seen as shocking. What is medical identity fraud, and how does it differ from traditional identity theft? We’re going to take a look, along with how you can protect yourself.

What is medical identity theft?

The specifics of medical identity theft vary from case to case, but they obviously pertain in some way to your medical care, insurance or provisions. Examples of this specific type of fraud can include someone using your insurance for specialist care or to see a doctor, using your identity to obtain subscriptions for drugs they are not entitled, attempting to buy expensive medical equipment in your name or even make a false claim for compensation.

Medical identity theft is not just a financial problem, either. While someone using your identity for expensive goods could end up costly, it could also confuse your medical history. If someone visits a doctor pretending to be you, new information could be added to your medical history that obviously has nothing to do with you – this could be a problem when you really do visit the doctor as your files won’t be accurate and could lead to a misdiagnosis or mistake in care.

Medical identity theft is also unique because unlike some other types of similar fraud, you don’t need someone’s social security number to commit it. Because of the nature of some medical care, hospitals who are in a rush to provide treatment might not spot the fraud until much later.

How can you protect against it?

Everyone is entitled to a copy of their own medical billing records under HIPAA rules. It’s important to keep a copy and make sure you’re aware of how much you’re spending on average. Many people simply ignore such bulling data and are therefore unaware if there are any changes. This can be the first way to spot if you’re being overcharged or even defrauded.

Check your EOB (Explanation of Benefits) statement regularly to see if there have been any changes or if any provisions of care you haven’t received are listed. Be aware of your medical records and make sure you know if something is listed that has nothing to do with you.

Some medical providers might resist giving you your files, but you have a right to access them. More tips for preventing medical fraud can be found here.

As with all types of identity theft, there are some other simple measures you can take. Things like protecting passwords might not be as relevant here – but it’s still something you should be aware of. Some consumers choose to rely on identity theft protection services for an extra level of protection. Make sure you check all your mail regularly so you can spot any irregularities. You should also consider shredding your mail and other important documents as some fraudsters still rely on rummaging through trash.

While medical fraud is on the rise, if you know what you’re looking for – you should be more protected than most.

References:

http://medidfraud.org/wp-content/uploads/2015/02/2014_Medical_ID_Theft_Study1.pdf
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
https://www.consumer.ftc.gov/articles/0171-medical-identity-theft
http://noidentitytheft.com/

About the author

Peter Ellington has years of experience in the web security and fraud industry. He knows how important protecting your identity can be – that’s why he recommends identity theft protection.

What Is Medical Identity Theft?

What happens to your body when you use medical marijuana

Smoking marijuana, i.e. even the first puff, has an almost immediate effect on your brain, heart rate and sense of perception. Marijuana may have long-term effects on health as well, even though claimed otherwise by habitual users.

Marijuana, or cannabis, has an extensive history of traditional uses as a botanical medicine and an industrial material all throughout Europe, Asia, Africa, and America, and it has been used for at least 5,000 years.

What Is Medical Marijuana

Unlike “pot” (the recreationally used illegal drug), the term medical marijuana refers to the use of the whole, unprocessed marijuana plant along with its pure extracts, for the purpose of improving a symptom or treating a disease. For it to be effective, “it must be sourced from a medicinal-grade cannabis plant that has been meticulously grown without the use of toxic pesticides and fertilizers”.

Marijuana’s incredible healing properties can be attributed to its critical levels of medical terpenes and flavonoids as well as a very high cannabidiol (CBD) content. Even though marijuana has not yet been approved by the Food and Drug Administration (FDA) except in Colorado and Washington State, more and more physicians are prescribing it, swearing by its effectiveness and health benefits.

What are the Effects of Marijuana on the Body?

When marijuana smoke is inhaled into the lungs, the effect is immediate; marijuana is quickly released into the bloodstream, slowly reaching your brain and other organs. Smoking it is the most effective way for it to have a quick result; when drank or absorbed through food, it takes a little longer to take effect.

Here’s what happens to the body when marijuana is ingested:

Respiratory System

Marijuana smoke is made up of an assortment of toxic chemicals (including ammonia and hydrogen cyanide) which, much like tobacco smoke, may severely irritate your bronchial passages and lungs. Apart from wheezing, coughing and producing phlegm on a regular basis, you are looking at increased risk of bronchitis and lung infections. On top of that, marijuana has the potential to elevate your risk of developing lung cancer, as its smoke contains carcinogens. According to some studies, “marijuana may aggravate existing respiratory illnesses like asthma and cystic fibrosis”.

Circulatory System

Marijuana has a very serious effect on the circulatory system, as THC is carried throughout your body and it moves from your lungs straight into your bloodstream. Your heart rate may increase by 20 to 50 beats per minute within minutes, and this may continue for up to three hours. Still, marijuana can potentially stop the growth of blood vessels that feed cancerous tumors.

Bloodshot eyes are one of the telltale signs of recent marijuana use.

Central Nervous System

Once THC enters your circulatory system, it quickly enters your bloodstream and gets transported to your brain and the rest of your organs. The brain (under THC) releases large amounts of dopamine, which may not only make you feel good, but heighten your sensory perception, as well as your perception of time. THC changes the way information is processed in the hippocampus, leading to your judgment being impaired. New memories are rarely created when you’re high.

Your balance may also be upset due to the changes that take place in the cerebellum and basal ganglia, as can your coordination and reflex response. It is not uncommon for large doses of marijuana to cause hallucinations or delusions. In some people, marijuana can cause anxiety, while the symptoms of withdrawal are known to include insomnia, irritability and loss of appetite.

It is estimated that about nine percent of marijuana users develop an addiction, with young people whose brains are not fully developed facing a lasting impact on their thinking and memory skills.

Pregnant marijuana users will face additional issues, i.e. marijuana intake affects the brain development of your unborn baby. The child may be more prone to trouble with concentration, memory and problem-solving skills.

The pharmacologic effects of marijuana are thought to ease pain and inflammation. It may also be of use in controlling seizures and spasms.

Digestive System

Smoking marijuana often causes a burning in your mouth and throat. Taking THC orally is processed in your liver.

Using medical marijuana is recommended for people living with cancer or AIDS as it can help increase appetite. Also, marijuana can ease nausea and vomiting.

Immune System

Some research indicates that THC might damage the immune system, making you vulnerable to infections and illness. However, further research is needed.

What Diseases Can it Help Treat?

There’s still an ongoing research and debate on the effectiveness of medical marijuana. Those who swear by its effect claim that medical marijuana has an important role in many body processes, including immune functions, metabolic regulation, pain, cravings, anxiety and bone growth.

Common ailments being treated with medical marijuana include:

Degenerative neurological disorders such as dystonia

Mood disorders

Parkinson’s disease

Post-traumatic stress disorder (PTSD)

Multiple sclerosis

Seizures

Sunburn (with cannabis oil)

Potential side effects of medical cannabis are also numerous, and should be taken very seriously.

To everyone who is looking to use medical marijuana for curing an illness, it is advised they first consult with their appointed MD; while marijuana may potentially help ease or cure symptoms of one illness, it may potentially be the cause of another. If you are ill, don’t take it without having someone around, in case of a side-effect occurring.

What happens to your body when you use medical marijuana

Nipah: fearsome virus that caught the medical and scientific world off-guard

In 1998, with no explanation or signal of danger, a fearsome disease took off in Malaysia. Pigs died in large numbers and then men slaughtering infected animals also fell ill. They passed it to their families at home. Nearly half of those who got sick died.

It was not Ebola – it was a virus that became known as Nipah, after the Malaysian town of Kampung Sungai Nipah where it was first identified. But there are resemblances to Ebola in the way the disease suddenly emerged from the animal world and then spread between humans, causing a threat to life that caught the medical and scientific world off-guard.

The story of the outbreak of Nipah in Malaysia was told – and embellished – in the 2011 film Contagion, starring amongst others, Kate Winslet, Gwynneth Paltrow and Matt Damon. There, the disease became a global pandemic, killing 26 million people.

In reality, the death toll from Nipah in Malaysia and Singapore, where it had spread, was 105 out of 265 cases, but could have been much worse had it been more easily transmitted. It also caused the collapse of the $ 1bn pig industry. The disease seemed to come from nowhere, but as with other such viruses, the emergence and spread was caused by a cocktail of human behaviour and environmental change.

The virus is endemic in fruit bats – also known to carry Ebola virus. The bats were on the move, leaving rainforests where slash-and-burn logging was causing massive haze, shutting out sunlight and preventing the fruit they ate from growing. Drought caused by El Niño made things worse.

Large numbers of bats were later seen in the orchards around the pig farms of northwest Malaysia. The virus from their saliva was in the half-eaten fruit they dropped – which was devoured by the pigs.

The Malaysian outbreak was finally stopped by mass culling of pigs in May 1999. But since then there have been regular Nipah outbreaks in Bangladesh, where transmission occurs directly from fruit bats to humans.

“We know how it happens,” said Professor John Clemens, executive director of the International Centre for Diarrhoeal Disease Research, Bangladesh. “The fact that it has established itself as an endemic focus in Bangladesh with regular, albeit infrequent, transmission to man suggests that it could cause broader problems for humanity at large. I would add as well that similar to Ebola virus, people in intimate contact with Nipah patients can acquire the infection, human to human.

“I’m sure you see the parallels there with Ebola, except unlike Ebola, which has its traditional homeland in sub-Saharan Africa, Nipah is here in Asia.”

Nipah was at first misdiagnosed in Malaysia as Japanese encephalitis, because of the swelling of the brain that occurs.

“When it is transmitted to man, it can cause an extremely serious encephalitis, sometimes with pneumonia, and when people get sick with this, the case fatality rate is about 50%, with substantial serious neurological impairment of a fraction also who survive,” said Clemens.

In Bangladesh, the outbreaks occur because of the traditional drinking of palm wine, a delicacy made from date palm sap. Fruit bats like to hang upside down in the palm trees, with the result that their excretions – urine and saliva can find their way into the sap.

There should be ways to avoid this route of transmission – if not through persuading people to avoid palm wine, then by putting skirts on the trees to keep the bats away, said Clemens.

But that would not end the hidden risk. Changes in people’s behaviour or alterations we make to our environment can precipitate a small outbreak – perhaps with a different and unexpected route of transmission – that becomes something far more dangerous. It happened with Ebola, which spread from rural villages into the cities, where large numbers of people lived close together and were easily infected. That is also the danger with other zoonotic diseases, including Nipah, said Clemens.

Nipah: fearsome virus that caught the medical and scientific world off-guard

Another medical idiot abounds

On Wednesday, January 11, 2017, The Press of Atlantic City, in an article written by staff writer Nicole Leonard entitled. “NJ: Doctor gave bad vaccines knowingly”, elaborated about a NJ physician doing just that. Here’s the article:

The state says the doctor involved in the Ocean County case of faulty vaccines may (of course the door has to be left open in case a mistake in reporting was made) have knowingly given children compromised vaccines designed to protect against mumps, measles, chickenpox and other diseases.

New Jersey Attorney General Christopher S. Porrino submitted a complaint Monday to the state Board of Medical Examiners against Dr. Michael Bleiman of Southern Ocean Pediatrics and Family Medicine in Manahawkin, alleging he committed fraud, gross negligence and misconduct in administering child vaccinations.

A request for comment from Bleiman’s practice was not returned Tuesday (duh!).

The state Department of Health issued a warning Monday that 900 children were given possibly (keep that door open just in case) faulty vaccines at the practice between November 2014 and July 28, 2016, because they were stored at improper temperatures, reducing their effectiveness.

The affected vaccines were given through Vaccines for Children, a federally funded program that provides free or low-cost vaccines to eligible children in New Jersey.

Health inspectors on July 28th found Bleiman’s practice has 280 vaccines stored at incorrect temperatures.

Inspectors quarantined the vaccines at the Manahawkin practice and told Bleiman not to use them until they were proved effective, authorities said. The state alleges he gave patients the vaccines anyway (280 vaccines are too much profit to lose).

And the same day, Bleiman accepted a new shipment of an additional 335 doses (and the profits go up, up, up). Health officials advised the practice to store the new vaccines at acceptable temperature (at least we did our job by telling him).

Southern Ocean Pediatrics submitted temperature data to the state-run Vaccines for Children program that indicated they were still experiencing storage issues, authorities said.

From July 28 to Oct. 24, the state found Bleiman’s practice gave 38 children compromised vaccines, including the ones that were supposed to remain quarantined, authorities allege.

State VFC program staff removed all possibly compromised and ineffective vaccines from the office.

Privately purchased vaccines that were covered by insurance were kept in a separate storage unit, the Department of Health said. The department said Vaccines for Children health inspectors didn’t have access to those vaccines.

Meanwhile, Porrino’s complaint calls to suspend or revoke Bleiman’s medical license following a hearing. It also considered charging Bleiman with civil penalties, fees and restitution.

The possibly ineffective vaccines do not pose any health dangers to the children who received them, but health officials said those children might not be fully protected against vaccine-preventable diseases.

Not all children impacted by the faulty vaccines will need to be revaccinated, health officials said.

Children may be able to get blood tests called titers to determine whether the vaccines were effective, but tests are not available for all diseases. Some children may need to get new vaccines.

Department of Health officials said it is not recommending that affected children be excluded from school and will leave revaccination decisions to parents, guardians and their health care providers.

(Why can’t people realize that the body knows how to heal itself? Unfortunately, it all starts by putting unleaded fuel in the gas tank, but the large food companies, big pHarma, and the medical community want that kept a secret. Why? Because the thought of losing profits at the expense of keeping people healthy is a big no-no!)

Aloha!

To learn more about Hesh, listen to and read hundreds of health related radio shows and articles, and learn about how to stay healthy and reverse degenerative diseases through the use of organic sulfur crystals and the most incredible bee pollen ever, please visit www.healthtalkhawaii.com, or email me at heshgoldstein@gmail.com or call me at (808) 258-1177. Since going on the radio in 1981 these are the only products I began to sell because they work.
Oh yeah, going to www.asanediet.com will allow you to read various parts of my book – “A Sane Diet For An Insane World”, containing a wonderful comment by Mike Adams.
In Hawaii, the TV stations interview local authors about the books they write and the newspapers all do book reviews. Not one would touch “A Sane Diet For An Insane World”. Why? Because it goes against their

Another medical idiot abounds

NHS to trial medical advice smartphone app

An app that helps people get medical advice on their smartphones is to be trialled by NHS England, it has been announced.

The technology uses an algorithm to run a chat service that will search a database of symptoms, before advising whether to see a GP, go to hospital, visit a local pharmacy or stay at home.

NHS 111 is designed as an alternative to the NHS’s non-emergency 111 helpline, which has seen an increase in demand from two million calls a year to 15 million calls annually in four years.

But concerns have been expressed that the introduction of the app targets a symptom, rather than the cause, of the pressure on NHS services.

“Whilst it’s always important to maximise use of technology to empower patients and make efficient use of NHS resources, this initiative does not address the fundamental problem that we have a severe shortage of GPs and health professionals in community settings,” said Dr Chaand Nagpaul, the British Medical Association GP committee chairman.

He said that the app would rely “slavishly” on algorithms, rather than on clinical staff, which would leave no room for “clinical interpretation in certain instances”.

Nagpaul added: “This proposal does not address this fundamental limitation and may make the situation worse. What we should instead be doing is investing in having properly trained and appropriate clinical staff handling calls and requests from patients, complementing the use of new technologies.”

The six-month trial, beginning this month, will be available to north London residents in Barnet, Camden, Enfield, Haringey and Islington. Patients who choose to continue using the 111 helpline will still be able to do so.

Clinical commissioning groups have worked with technology firm Babylon to trial the app.

Adam Duncan, chief operating officer at GPs’ out-of-hours cooperative London Central and West, said the body was “happy to be working with NHS England and the other providers involved to ensure the piloting of the NHS 111 app is evaluated robustly”.

He said: “We aim to provide an alternative to using the NHS 111 telephone number for service users that would find it most convenient to their lifestyle. The use of the app could also reduce the demand on NHS 111 during the most busy periods, whilst retaining the high quality and accessible service.”

NHS to trial medical advice smartphone app

3 Reasons Medical Marijuana Should Be Our Anxiety Antidote

Approximately 40 million Americans suffer from anxiety— and I used to be one of them.

After being diagnosed with Hodgkin’s lymphoma in my mid-20s, I found myself facing a long road of treatment. I had no idea what to expect, and as you can imagine, I felt pretty darn anxious about the whole situation.

I started chemotherapy and was prescribed a cocktail of pills to help calm the side effects. On top of that, I was given anti-anxiety medication to help ease my mind.

Over time, however, after realizing all these pills were only causing even more side effects, I replaced a majority of them with self-prescribed medical marijuana, or MMJ.

Almost immediately, this so-called illicit drug began providing medicinal benefits I simply wasn’t seeing from my pharmaceuticals. I regained my appetite, my palms stopped sweating, I no longer had the hiccups all the time, and best of all, my anxiety melted away.

Take the Natural Route.

Marijuana is a very misunderstood plant — mainly because most of the research conducted about it pertains to its recreational use.

Those who use marijuana recreationally are looking to get high and have fun, not necessarily treat an illness. So, naturally, the plant is mostly recognized for its intoxicating effects and gets labeled as something that will only exacerbate our anxiety and make us feel paranoid.

Much of marijuana’s medicinal value is still flying under the radar. Not a whole lot of people realize it’s possible to ingest MMJ and not feel intoxicated at all yet still reap medicinal benefits. High-cannabidiol strains in particular are known for relieving pain, reducing anxiety, and inducing feelings of relaxation — all while allowing us to maintain our motor skills and not feel loopy.

When compared with pharmaceuticals, taking a natural path to anxiety relief brings clear benefits:

1. Fewer Side Effects.

Traditionally, anxiety is treated with quick-fix benzodiazepines like Xanax — which happens to be the most-prescribed psychiatric medication in the U.S. Patients can pop these pills on an as-needed basis, and within a few minutes, they begin masking the symptoms of anxiety.

Unfortunately, benzos cause side effects such as drowsiness, insomnia, memory problems, poor coordination, slurred speech and irritability. None of these extra issues is worth the couple of hours of relief.

MMJ causes far fewer side effects — and as illustrated by my story, it can actually help us overcome side effects we’re experiencing from other medications.

2. Less Addiction.


In addition to their many side effects, benzodiazepines pose a major addiction risk. MMJ, on the other hand, is not considered to be physically addictive. If a daily user were to suddenly stop taking his or her medicine, there would be no real noticeable withdrawal symptoms to speak of.

In fact, some doctors are even using MMJ to wean patients off deadly pharmaceuticals — and they’ve reported more than a 75 percent success rate.

3. Higher Quality of Life.


All aspects of life are more enjoyable when we can control our anxiety, especially though natural means.

A great thing about MMJ is that it’s highly versatile. Based on our personal preferences, we can choose to smoke, eat or topically apply our medicine. Further, many different strains and dosages are available to choose from, all with differing ratios of active ingredients that produce different effects.

Instead of numbing us to the outside world, MMJ opens our perception and brings levity to our daily functions. One study even found it lowers our responses to negative stimuli, which is an important step in fighting depression.

While all this information is great, it doesn’t mean we can just smoke a joint and forget all our problems. It’s important to work closely with a physician and MMJ dispensary to determine the right strains for us.

Those suffering from anxiety should also undergo regular cognitive behavioral therapy sessions that focus on identifying, challenging and neutralizing the unhelpful thoughts that underlie anxiety disorders. This two-pronged approach — natural medicine paired with therapy — will lead to the best results.

Tackling anxiety is no easy feat — and luckily, it doesn’t have to involve pesky side effects and dangerous addiction. Talk to your doctor today about replacing your pharmaceuticals with MMJ.

3 Reasons Medical Marijuana Should Be Our Anxiety Antidote

Medical trainers look to virtual reality tech

Surgeons are embracing technology’s cutting edge, using the latest in augmented, virtual and mixed reality, to transform medical training.

Among the devices the Royal College of Surgeons is planning to explore is the Microsoft HoloLens, a mixed reality headset, released to developers this year, which shows hovering 3D holograms.

The college said it was teaming up with education group Pearson, to harness immersive technologies for training students.

Mark Christian, global director of immersive learning at Pearson, said that with the HoloLens headset they could explore the possibility of creating realistic holograms to allow students to practise surgical procedures.

He said the approach could avoid traditional cadaver-based training. “You have schools like Case Western Reserve University that have that as their stated goal – within two years to do away with wet labs,” he said.

The potential for such technologies, he added, would be further boosted through the development of haptic technologies, which let wearers of the HoloLens and other devices, such as virtual reality headsets, experience other sensations, such as touch.

Impression of ‘augmented reality’ seen with a HoloLens device. Photograph: Microsoft/Rex

Immersive technologies could also prove a boon in the field of imaging; using the HoloLens doctors could explore entire brains, in images built up from MRI scans, floating in front of their eyes. “It’s there, [in] actual 3D,” he said.

Shafi Ahmed, council member of the Royal College of Surgeons, said the technologies were the future when it came to education. “[In the next five years] I think most people will be taught with this AR, VR, mixed reality,” he said. “Learning will change immeasurably.”

He added: “We are rebuilding [the college] for 2020. In that new classroom environment there will be no space for cadavers, it’ll be case-based anatomy, it’ll be teaching and learning using HoloLens and virtual reality – really disrupting 200 years worth of surgical training.”

But it might be some time before cadavers are completely replaced by technology. Andrew Reed, chief executive of the Royal College of Surgeons, noted the college would continue to offer cadaveric courseselsewhere in the UK in partnership with other faculties.

Ahmed, who is a cancer surgeon at Barts Health NHS trust and co-founder of Medical Realities, a company working with augmented and virtual reality, is a pioneering figure in the world of medical technology. In April 2014 he live-streamed an operation using the augmented reality device Google Glass, and in May this year he live-streamed the first 360-degree video of an operation.

He stressed that that approach was not a gimmick. His vision, he said, was to shake-up surgical training, and do away with traditional approaches whereby students in theatre barely caught a glimpse of procedures, while democratising access to training across the world. “Two-thirds of the population, five billion people out of seven billion do not have access to safe and affordable surgery,” he said.

Among other devices under development around the world are alternative approaches to hologram technology, such as that from the company Holoxica, which aims to project 3D holograms into a space without headsets.

And augmented reality is also finding its niche. Xpert Eye by Ama is based on smart glasses that allow doctors to remotely provide advice and support to those wearing the glasses, in what the creators dub a “see what I see solution”.

It was not only doctors that could benefit from the new wave of technology, said Ahmed, pointing out that immersive approaches could aid patients too.

“The real value of this stuff is already shown in patients with anxiety attacks, phobias, pain relief, and also in patient education,” said Ahmed, pointing out that VR headsets offered patients a chance to see what would happen to them during a procedure, or even watch their own surgery in retrospect.

Christian agreed, saying technologies like the HoloLens could offer patients a view of the inside of their own bodies. “I think people rationalise things more in a visual way,” said Christian. “We know that an informed patient [has] better outcomes.”

Medical trainers look to virtual reality tech

Sea Hero Quest is of huge benefit to medical researchers. So what’s the catch? | Emily Reynolds

In tech circles, alongside words such as “scaleable” and “the gig economy”, you often hear the phrase “tech for good” bandied around. Sometimes it’s a fairly innocuous but ultimately toothless concept, essentially denoting the idea that technology has the potential to be a driver for positive social change but not doing very much about it. Other times it can take on a more creepily utopian tone, suggesting that should the world more closely represent the shiny libertarian enclaves of Silicon Valley, the world’s problems would be solved. And sometimes – just sometimes – it does what it says on the tin.

A new game, designed to test spatial navigation, appears at first glance to do just that. Sea Hero Quest, which involves navigating a boat through choppy waters, contains a diagnostic test for the early signs of Alzheimer’s disease. The game has now been played by more than 2.4 million people – which the team behind the game say makes it the largest dementia study in history.

It’s now set to be adapted for use in a clinical setting – data could be fed back to clinicians, allowing for earlier diagnosis, better understanding of how medication is working for a particular patient and a more accurate and precise measurement of a patient’s decline. It could even be incorporated into NHS programmes.

This, it goes without saying, is initially incredibly attractive. Understanding and managing an illness or being alerted when you’re at risk simply through the daily use of an app sounds simple, easy and most of all useful. Could this not be a genuine use of tech for good, rather than the banal and empty proclamations often heard from CEOs and founders?

In theory, yes. In practice: maybe not.

More than 2.4 million people have downloaded Sea Hero Quest to their phones. Photograph: The Sea Hero Quest/PA

As with any health data-driven project, it comes with stipulations. A recent study in Lancet Psychiatry suggested that data gathered on Facebook could provide a “wealth of information” about mental health, with a series of language analysis and facial emotion recognition algorithms providing “insights into offline behaviours”. This, too, sounds great. Having your health monitored and managed through the passive use of technology you probably already use – what more could you want?

But there are a number of concerns here: primarily, the safety of private health data. The addition of a private company in the latter study may make it feel different: a towering behemoth such as Facebook obviously feels more threatening than something set up for and run by clinicians. But to not have the same reservations just because the data was being sent to scientists would be incredibly naive.

Science, much like technology, is often presented as objective, reasonable fact, without mentioning the very obvious caveat that it is conducted by human beings, who are often neither reasonable nor objective. Multiple studies about statistical analysis are useful to recall here – the results of such analyses may seem completely objective, but often reflect the preconceived biases of those conducting them. That’s not to say that would be the case with Sea Hero Quest, of course: just that the results of such research can be fallible.

And it’s also important to remember that, should the Conservative party have its way, the NHS may be in the hands of several, separately operated and privately owned companies before too long. This adds further complications: who would have access to our health data? How would they use it? How would data be efficiently and safely communicated across different companies? Would their data protection processes be cohesive? Would they be meticulous enough to protect our most private, personal data? The idea of having your phone feed data to a central NHS database sounds great in principle, but these questions would need to be answered before that could safely become a reality.

In an ideal world, tech would be utilised to help us to diagnose and treat illnesses: anything that can efficiently and effectively help people manage long-term or life-threatening conditions can only be a good thing. Similarly, the idea of a National Health Service that is genuinely innovative, that uses new ways to help people and that has a strong grasp on data security while it does so is incredibly appealing. Unfortunately, as with most utopian ideas, you’re left wondering whether it might just be too good to be true.

Sea Hero Quest is of huge benefit to medical researchers. So what’s the catch? | Emily Reynolds

My colleague"s suicide showed how vulnerable medical professionals can be

I stood in front of the ambulance bay door. My badge clutched in my hand, knuckles white, jaw clenched. I questioned my attempt at returning to work on this day. I stood in front of the doors grappling with a burning feeling in the pit of my stomach. I knew then, right there, that my career in the emergency department was over.

A quiet swollen presence of pain ran down every corridor. The night before, we lost a colleague to suicide. Some of us found the body. Some of us carried out the post mortem care. Some of us stood there as family filed in to the room. Some of us made the calls alerting fellow staff. Some of us, all of us, changed forever that night.

For some vocations, a bad day at the office means: “I dropped a carton of eggs” or “I broke the copier”. Some are more serious of course: “I really messed up a haircut” and the infamous “I crashed the company car”. In medicine, however, a bad day usually means, “We lost a toddler”; “A young family lost their baby”; “She will never walk again”; and “Time of death …”. The list could go on and on; the point is, the magnitude at which we affect the world of each individual person in healthcare is far different than most jobs. We take on the world, we attempt heroic measures, forgetting, we are indeed, so very human.

We study for years, sometimes decades, focusing our skill, perfecting it, to heal, to save, and to comfort. The team we do all these things with becomes a sort of family. You are all present on the worst days together. You share the sorrow, the shock, and the deep regret that everything you have dedicated your life to studying has failed you. You failed together. You failed in the worst way, but you have one another. You can share that dark humour, the memory of this fleeting moment. You can share together the memory of watching the doctor whisper something comforting, or that nurse hold the deceased family member’s hand. Each of you knows what it feels like, to pronounce a patient dead in one room, and in the very next room, moments later, help a three year old change into a hospital gown so that they can be evaluated thoroughly. You do all this with a smile on your face, never for a second letting on that in the next room, a tragedy they can’t imagine has just unfolded.

Eventually, it eats little holes in your soul. Sometimes there are nightmares, other times you stand in a quiet trauma room and feel the presence of every lost soul standing behind you as you scrub down a stretcher. Bigger and bigger it creeps, into you, never though are you afforded the right to go and lament to your friends over drinks, or weep at your place of worship. Never can you post on public media and share your sorrow. Never can you truly convey what it feels like to have dedicated your life to becoming an expert, but when you have a bad day, someone dies. You cannot ever make someone, who isn’t sunken knee deep into the profession, understand what that means.

The kinship you establish with those with whom you share this camaraderie cannot be duplicated. They are a family that knows all your secrets of trauma and sorrow. There is something indescribably comforting in having these people know you at your worst moments, exhausted, angry, and sad.

The secrets within the hospital walls bonding us together are the same web, that when one of us succumbs to the beast of depression, is torn apart forever. None of us knows what cost our colleague and dear friend their life, it was never made clear. But our family, if you will, was severed to the core, doing the thing we did well together, without them, to them.

I still practise, in a different forum. I think of emergency department life every day. Now I realise how human each of us really is, there are no superheroes among us. Now when my team is becoming saturated, I actively seek out ways to alleviate that pressure, for myself, and for my team. On good days someone gets to live another day, but this doesn’t make the really bad days any easier.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here. If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com. If you’re a healthcare professional affected by the issues raised in this article, help and support is available from Support 4 Doctors.
  

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

My colleague"s suicide showed how vulnerable medical professionals can be

After an expensive and lengthy medical degree, I won"t become a doctor

Breaking bad news is an essential skill taught to us at medical school, one that I had to employ when explaining to my friends and family that after seven tough years at university, I’m leaving the profession.

If I take a step back and look at where it all began, I see a 17-year-old with a supportive, medically-oriented family who were absolutely certain of their child becoming a doctor. My entire childhood was a subliminal path towards making this choice, from having Scrubs or House on TV daily, to admiring the respect with which everyone addressed my father at his clinics.

Despite having a clear inclination towards technology, and general geekiness, I chose to continue my medical degree for lack, or perhaps fear, of pursuing other options. It was, however, not long into my training before I started dabbling with non-medical opportunities while masking them as “CV-beefers” for my medical career. This included spending two weeks traveling across Sweden and the Netherlands with a group of like-minded and skilled individuals, helping to improve their healthcare systems using technology.

The pressure that comes from understanding the importance of the job you’re preparing for, life or death in the case of medicine, results in students wanting to study and perfect each topic to a point where other interests are boiled off. Eventually, I started reprioritising my interests over this urge for academic perfection.

Along the way, my drive to become a doctor has diminished by increasing disillusionment of working for the NHS. This is not to say the NHS isn’t a fantastic organisation and one we should be immensely proud of. My main gripe as someone with a strong entrepreneurial gene is that it isn’t an institution that embraces innovation. For me, the deal-breaker is that the NHS doesn’t treat its employees as individuals and isn’t open to new ideas. I feel I could have a bigger impact on healthcare working outside the NHS rather than for it – this is why I aim to pursue a career as a doctorpreneur, not a doctor.

Coming to this decision has led me back towards my passion for exploring technology and despite the demands placed on me by my full-time university course, I have launched a tech company called Synap, which is already having a big impact on the way thousands of students study for exams.

But while entrepreneurship is the right path for me and, I believe, many other medical students with a passion for innovation – it’s not right for everyone.

My family have come to terms with my decision to leave the profession because they know I am driven enough to succeed. Have they questioned the time and money spent on a degree I won’t be pursuing as a career? Of course, but they also believe that my time spent at Leeds University is an investment for the future. The medical skills and training I’ve learned and developed are transferable to so many areas of my life and I know they will make me a better businessman.

There’s a lot I love about medicine and the NHS, but being a doctorpreneur will provide me with an opportunity to help more people from the outside.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

After an expensive and lengthy medical degree, I won"t become a doctor

DIY doctors: New Zealand medical students "operating on themselves at home"

A number of medical students at New Zealand’s oldest university are practising invasive medical procedures on their own bodies, and the bodies of their fellow students.

A study published today in the New Zealand Medical Journal found 5% of medical students surveyed by researchers at Otago University medical school in Dunedin are practising in what is believed to give the aspiring medics stress-free conditions in which to hone their skills.

Procedures include inserting IVs, withdrawing blood and removing cysts on their own or other students bodies, some in their own homes using pilfered equipment.

The survey’s sample size was 284 students from a cohort of 800 in their fourth, fifth and sixth year of medical study.

Five percent – or 15 students – described practising on themselves or fellow students.

Co-author and deputy vice-chancellor Helen Nicholson said the findings were “very concerning” and warranted immediate further investigation.
“At the moment we don’t really know why the students are doing this, but anecdotally we have been told it is to practice their skills in a private and stress-free environment,” said Nicholson.

“It is pretty strange behaviour. We know some students were doing these procedures at home, with equipment they had taken from the hospital. So we do have serious concerns that this sort of behaviour is not displaying self-care or a professional attitude.”

Nicholson said while there were plenty of reports of doctors self-diagnosing and self-prescribing, to her knowledge this was the first study to identify students practicing medical procedures on themselves.

The most common practice the medical students tested on themselves was the insertion of an IV line into a vein, and the most common procedure students tested on each other was taking blood.

Nicholson said taking blood, removing a cyst or mole and inserting an IV were all particularly difficult procedures to perform on your own body, and all of them involved some degree of pain.

Professor Barry Taylor, dean of the Dunedin School of Medicine, said it was “pretty common” for students to practice a range of medical procedures on themselves such as using an ultrasound, examining inside each others ears or taking blood pressure.

But Prof Taylor said he drew the line at students practicing any surgical procedures on themselves or each other, and doing so in their own homes with no clinical supervision was dangerous.

“There is a broad philosophy in medicine that doctors shouldn’t promote what they haven’t experienced,” said Prof Taylor.

“And if you are practising on yourself you could argue that you are certainly getting informed consent. But the risks of something going wrong are similar to if you are treating a family member, which we discourage because you are not in a position to make unbiased or objective decisions.

“Taking blood and removing cysts are definitely on the margins of acceptable and could potentially be dangerous procedures if something goes wrong.”

DIY doctors: New Zealand medical students "operating on themselves at home"

Some medical treatments are pointless. But will patients want to know? | Fay Schopen

Imagine going to a doctor with a broken foot, say, or a bad back, or in a worst-case scenario, cancer, and being told that doing nothing would be the best course of action? Naught, zero, forget about it, go home – it hardly sounds like heartening advice.

But that could be the case. Senior doctors say that many procedures routinely carried out are in fact pointless. The Academy of Medical Royal Colleges, which represents 22 colleges, has published a list of 40 tests or treatments that they say have little to no effect on the patient, including x-rays for back pain and plaster casts for some small fractures.

The move is part of a campaign called Choosing Wisely, aimed at helping both medical professionals and patients to make informed decisions. A laudable goal of course, but as truth after sober truth unfurls on the website it feels like being repeatedly told that Father Christmas doesn’t exist. You know in your heart that this information is correct, but you don’t really want to hear it. Sure, you’ll come out the other side wiser and more mature, but also sadder; carrying with you the dull, adult ache of acceptance. The world is somehow a less joyful, more utilitarian place when you know that tap water is just as effective as cleaning cuts and grazes as sterile saline solution, or that hooking yourself up to a drip after an epic bender will not make you feel any better (although it does make for a great Instagram post).

Doing nothing when it comes to our health is not a palatable idea. We live in the age of intervention, when the most important thing in life is to do something, anything, everything – to have control over our own destiny. This way of thinking has spawned a million lifestyle bloggers, thousands of wellness apps, and more photographs of avocado on toast than could ever be necessary.

And there are some extremely serious – and uncomfortable – truths outlined by the academy. Palliative chemotherapy – sometimes used to shrink tumours or eliminate distressing symptoms – may not be the best course of action for terminal cancer patients, for example. Chemotherapy is toxic, and the academy says it may do more harm than good and can raise false hopes.

The truth is that many aspects of life are simply uncontrollable. Ageing, infertility, death and disease – even broken bones – are most often out of our hands. And hearing this news now, post-Brexit, when unemployment, housing and the economy are looking so precarious is an added kick in the teeth. When things are this bad, we want the illusion of control at least.

Who wants to tell a hopeful, expectant and possibly angry patient that ‘nothing’ is the answer?

I speak as someone who last week spent £70 on supplements in my local health food shop, in an almost certainly useless attempt to turn the clock back and coax my ovaries, ravaged by the chemotherapy I had five years ago, into spitting out one or two final, viable eggs. This was after being told by a consultant that I was extremely unlikely to be able to conceive. Did I accept the news stoically and quietly? Did I thank my lucky stars that at least I was alive, and feel grateful? Of course not. I whipped out my phone and began combing message boards and medical journals, downloading papers, buying books and noting down names of supplements I had never heard of. Doing nothing in the face of life’s black humour feels defeatist.

“You can’t put a price on health can you!” I said like a lunatic in the shop, embarrassed to be spending so much on what could be quite possibly be snake oil. Well, yes, you can: £70 in my case. It should also be noted that the consultant did not tell me to do nothing either. Despite the diminishing odds of IVF and my advancing age, there were “options”, she said. I didn’t ask what they were as I have a fair idea (donor eggs; surrogacy; Betty Blue-style madness) and I am not a millionaire. Infertility is a field ripe for doing something rather than nothing. A perfect convergence of the unbearable sadness of longing for a child, coupled with advances in technology and a faint ray of hope. It was a private clinic, and I felt like a walking wallet rather than a patient.

Choosing Wisely, however, addresses things that are more prosaic. It was launched in part to address the fact, revealed in a study carried out last year, that 83% of doctors said they had prescribed or carried out a treatment that they knew to be unnecessary. Well sure – they’re only human. Who wants to tell a hopeful, expectant and possibly angry patient that “nothing” is the answer?

Surely medical professionals have been merrily x-raying backs and putting feet in plaster casts and so on because on some level these things make patients feel good. Sometimes doing something, anything, is a placebo – and perhaps if this was recognised as such, the truth would be more palatable.

Some medical treatments are pointless. But will patients want to know? | Fay Schopen

Looking for non-invasive medical remedies; Try Naturopathic Medicines

Naturopathy is a holistic form of medicine that uses natural and non-toxic therapies to treat illnesses, prevent diseases and improve health. It presents a non-invasive and a complete form of treatment. Discovered in the 1800s naturopathic medicine borrows from a wide array of traditional healing practices; acupuncture, herbalism, botanical medicine and the use of nutritional supplements. Naturopathic medicine  encourages the self-healing process of the body using modern and traditional, empirical and scientific techniques. The treatment works by first finding the cause of the problem, unlike modern medicine that aims at treating the symptoms.

Naturopathic Physicians conduct lengthy interviews with patients focusing on their physical wellbeing, diet, lifestyle and emotional health. As such, they base their treatments on some beliefs:

· The self-healing nature of the body: the body has an innate self-healing ability, and naturopathy only facilitates this process by eliminating any obstacles.

· Use of gentle and non-invasive therapies.

· A holistic approach to treating patients: physicians identify any imbalances in the body and tailor the treatment to rectify it (depending on the symptoms presented).

· Symptoms denote an underlying internal imbalance caused by emotional, physical or mental problems.

· Focus is on proactive prevention: naturopathic physicians believe in preventing rather than treating diseases through an evaluation of subjective and objective information. As such, doctors can quickly decipher any future vulnerability in patients.

Naturopathic medicine is known to deal with all kinds of medical ailments the most common being; chronic pain, cancer, allergies, hormonal imbalances, fibromyalgia, fertility problems, menopause, respiratory conditions among others. In our discussion, we will look at 4-5 cures of using Naturopathic Medicine

1. Naturopathy to treat heart disease

Heart disease is also referred to as cardiovascular or coronary artery disease. Different medicines have been developed to treat the disease but most effective remedy requires diet changes. Naturopathic doctors recommend various natural ways of addressing the problem:

Mediterranean diet: it is a plant-based diet that is rich in fiber, fruits, whole grains and vegetables. It also emphasizes on monosaturated fats like olive oil and foods rich in Omega 3.

Supplements and herbs: they help fight atherosclerosis (the major cause of heart disease). Herbs like Coenzyme Q10 (an antioxidant that aids in energy production), Hawthorn (helps in the relaxation of blood vessels) and Taurine (protects and improves symptoms related to heart failure).

Meditation: it reduces physical, mental and emotional stress correlated with cardiac problems. Naturopathic doctors also recommend adding other forms of relaxation like listening to music, walking, dancing to your daily routine to reduce stress.

2. Naturopathy to treat fibromyalgia

Fibromyalgia is a health condition that causes chronic fatigue, chronic pain, depression, memory problems, irritable bowel syndrome, and headaches. It is a multi-casual health condition that requires a deep understanding of the body organs to treat the multiple factors that initiate the problem. If the multiple stressors occur over an extended period, they cause fibromyalgia, destroying the body’s natural healing ability. The condition requires an integrative approach of treatment i.e. through the use of conventional and alternative diagnostic techniques like naturopathy. Naturopathy physicians recommend the following therapies for patients suffering from fibromyalgia:

· Gentle exercises like yoga, dancing, Tai Chi, and walking.

· Eating foods rich in minerals like potassium citrate and magnesium maltase.

· Eating foods rich in anti-inflammatory and digestive enzymes.

· Foods that contain anti-oxidant vitamins like Beta-carotene, B-complex, C and E.

· Adding foods rich in fatty acids to your diet; fish oils, flaxseed oil, and primrose oil.

· Detoxification program that includes liver cleansing, mercury detoxification and amalgam removal.

3. Naturopathy to treat chronic pain

Chronic pain is pain that lasts longer than six months. The pain can be mild, excruciating or in the form of sporadic episodes. The most common causes of chronic pain include headaches, backaches, joint pain, and pain from an injury. Other kinds of chronic pain include pain affecting certain parts of the body such as the leg, neck, arm, shoulders, and the pelvis. It may also originate with an infection or initial trauma. Physicians recommend various medicines to treat/relieve chronic pain but most of them offer modest results and cause a host of side effects.

Naturopathy provides a more holistic alternative of treating chronic pain with or without cause by identifying imbalances in the body that irritate tissues, or nerves causing pain. For example if the pain occurs on both sides of the body, it indicates an underlying disorder; if it occurs on one location it is more likely to be caused by an injury. Naturopathic medicine provides various solutions for treating pain:

Acupuncture: it relieves pain by helping the body to release endorphins, reduce pain signals to the brain and stimulate the body’s healing ability.

An anti-inflammation diet: naturopathic physicians prescribe herbal medicines that reduce inflammation.

Hydrotherapy: here water is used to increase circulation, reduce inflammation and promote detoxification thus managing chronic pain.

Supplementation: natural supplements like curcumin, and fish oils reduce inflammation, muscle tension without causing adverse side effects.

4. Naturopathy to treat fertility problems

Infertility is a health problem affecting both men and women. Studies show 30% of infertility problems are caused by female factors, 30% due to male factors and 40% due to unknown causes. Modern medical diagnosis and remedies involve lots of invasive tests, surgery, drug therapy and now artificial conception technology.

Naturopathic therapy, on the other hand, provides a more holistic view of treating infertility problems. The couple is treated individually while addressing their emotional, spiritual and psychological aspects. Some naturopathic remedies used include herbalism, making nutritional adjustments, flower essences (helps relax the mind), osteopathy and homeopathy. The treatments enhance the body’s natural processes without the use of invasive surgical methods, artificial conception technologies or toxic drugs.

5. Naturopathy to treat allergies

An allergy is an aggressive immune response triggered by inhaling irritants like pollen or ingesting certain kinds of foods. People suffering from allergies are sensitive to mold, dust, spores, and pollen. Naturopathic medicine  associates allergies with weak immune and digestive functions thus naturopathic remedies help improve their function and eliminate the symptoms. Patients suffering from seasonal allergies should start the natural therapies a month or two before the season commences to minimize the severity of the symptoms. Other naturopathic remedies include:

· Herbal medicines like Dong Quai (has anti-inflammatory properties), eyebright (ideal for sneezing and itchy eyes), and the red clover (enhances the body’s resistance to allergies). Patients may make a tea of one or more herbs.

· Nutrition: include dark green, leafy veggies, deep yellow veggies, carrots, yams cabbage, ginger, onions and garlic.

· Hydrotherapy; hot foot baths, castor oil packs and placing a cold cloth on the forehead.

Sources

www.cancercenter.com

www.naturopathic.org

activebacktohealth.com

www.thehealthsite.com

Looking for non-invasive medical remedies; Try Naturopathic Medicines