Oct 302016
 

It is almost the end of October, and I only added one blog entry so far this month. One reason is that we had a minor health scare: when my wife traveled to Hungary last month, she landed in a hospital on arrival, as she had an unexplained seizure during her flight.

She is doing well, thankfully. She returned home safely, with no lasting effects. There will still be a few more tests to be sure, but the scare is largely over.

This unfortunate incident, however, allowed us to experience first-hand the state of the health care system in Hungary, about which we read so much in recent years. Yes, as it is well known, the system is badly underfunded: salaries are miserably low, and sometimes, even basic supplies are lacking.

But we cannot utter a bad word about the health care professionals that my wife encountered. They were impeccably professional and helpful, going out of their way to assist us, even beyond the call of duty. When my wife’s cell phone was acting up, one nurse volunteered to help fix it with my assistance. When I explained to a doctor that I cannot visit her in person because I happen to be a continent away, he handed the phone to my wife, allowing us to have a conversation (finally!) using a hospital line for a few minutes. They helped with insurance matters, too, and they issued a very thorough discharge report, complete with a CD-ROM containing the results of a CT scan.

All in all, we have nothing but praise for these overworked and underpaid health care workers, some minor mishaps notwithstanding. They were kind, they were helpful, and every one of them that I spoke with was ready to assist, forthcoming, and flawlessly polite. Thank you for your kind care. Köszönjük szépen.

 Posted by at 10:15 am
Jun 072016
 

Alexander Fleming discovered Penicillin in 1928. He received the Nobel prize for his discovery in 1945.

A Facebook friend shared his Nobel lecture. Particularly, the following quote:

The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant. Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the streptococci are now resistant to penicillin the treatment fails. Mrs. X dies. Who is primarily responsible for Mrs. X’s death? Why Mr. X whose negligent use of penicillin changed the nature of the microbe. Moral: If you use penicillin, use enough.

Fleming thus foresaw the dangers of emerging antibiotic resistance. Too bad the world failed to listen. Now, a growing number of people die from once treatable (e.g., post-operative) infections because the evolution of bacteria outpaced our ability to develop new antibiotics.

 Posted by at 11:07 am
Aug 072015
 

Frances Kathleen Oldham Kelsey died this morning. She was 101 years old.

Dr. Kelsey’s name is the subject of legend among thalidomide sufferers. Born in Canada, Dr. Kelsey moved to the United States, where eventually she became an employee of the Food and Drug Administration in 1960. The first file on her desk was about thalidomide, a drug that is now known to have caused many thousands of birth defects worldwide.

Concerned about the drug’s suspected side effects, Dr. Kelsey refused to approve it without full clinical trials. She was vindicated when the numerous birth defects caused by thalidomide came to light. The USA was thus spared a scourge that was inflicted by thalidomide on many other countries, including Canada.

Eventually, Dr. Kelsey was even recognized by the president of the United States, John F. Kennedy.

Dr. Kelsey’s Canadian recognition came much later. In 2015, she was finally awarded the Order of Canada. Her family asked that the award ceremony be moved up as her health was in rapid decline. Accordingly, Elizabeth Dowdeswell, Ontario’s Lieutenant-Governor, visited the Kelsey home yesterday. Dr. Kelsey was reportedly aware and was thrilled.

Frances Kathleen Oldham Kelsey died less than 24 hours later. But what an amazing life she lived.

 Posted by at 12:17 pm
Feb 142015
 

Vaccinations are not without risk, some say. Why should the evil government compel me to expose my child to a known risk, they ask. Why is it my problem if someone else’s child is not vaccinated, they argue.

Well… it boils down to simple math, really. Suppose that once infected, a person remains infectious for a period of time denoted by \(\delta t\). The virulence of the disease is measured by the number of people that a single patient can infect during this period of time. It is called the basic reproduction number, denoted by \(R_0\). If this number is greater than one, we have the potential for an epidemic.

So then, after some time \(t\) has elapsed, the number \(N(t)\) of people who are infectious at that moment \(N(t)=N_0R_0^{t/\delta t}\), if \(N_0\) was the number of infected people at \(t=0\). At least this will be the correct number during the early stages of the epidemic; later, infection rates slow down as a growing number of people will have already caught the disease and the survivors will have developed immunity to it.

But we are interested in the early stages indeed, because the idea is to prevent an epidemic in the first place. So this simple model is adequate.

Now what happens when you vaccinate people? Even if everyone gets vaccinated, vaccines are not 100% effective. If the efficiency of a vaccine is given by \(\epsilon\) (a number between 0 and 1, with 1 meaning 100% efficiency), the aforementioned formula is modified: \(N(t)=[(1-\epsilon)R_0]^{t/\delta t}\). If \((1-\epsilon)R_0<1\), we win: an epidemic is avoided.

But what happens when not everyone gets vaccinated? Some people obviously cannot be: very young babies, people with compromised immune systems, etc. Let’s say the vaccination rate is given by \(\rho\). Once again, the formula for \(N(t)\) needs to be revised: \(N(t)=[(1-\epsilon\rho)R_0]^{t/\delta t}\).

And this is where the problem lies: if \((1-\epsilon\rho)R_0>1\), the potential for an epidemic exists.

measles

Take the case of measles, for which \(R_0=12…18\). Even if we take the lower limit of the given range, \(R_0=12\), it is one of the most virulent contagious diseases out there. The measles vaccine is supposedly 95% effective: \(\epsilon=0.95\). So then, \((1-\epsilon)R_0=0.6\), and we are good: in a fully vaccinated population, measles would disappear in short order. This is indeed what happened when measles vaccinations became common in much of the world starting in the 1970s.

But now, let us think about \(\rho\). The math is easy: If \(\rho<0.965\) (that is, if more than 3.5% of the population are unvaccinated), \((1-\epsilon\rho)R_0>1\). Herd immunity is lost: the disease spreads.

And lest we forget, measles is a very deadly disease. Parents who play Russian roulette with their children on the basis of unsubstantiated fears concerning the vaccine’s effectiveness and side effects forget that often the only reason their child survives the infection is because they have access to first-world health care… the same health care that would have prevented the illness in the first place, if not for the parents’ arrogant stupidity.

These parents should be reminded that in poorer parts of the world, their counterparts often risk their lives to get their children vaccinated. Like parents in Somalia who, defying a ban on polio vaccination by al-Shabaab, smuggle their children to government-controlled areas to get the life-saving vaccine. Obviously these Somali parents are a lot smarter, a lot wiser than first-world anti-vaxxers, be it new age parents who prefer “happy thoughts” (or whatever) over medically approved methods, or nutty right-wingers who distrust the government on everything.

In short, if your political or religious views, or your scientific illiteracy compel you to be as stupid as a doorknob, please find a way to express your stupidity without endangering the health and lives of others.

 Posted by at 3:42 pm
Jul 232014
 

In recent years, I’ve been struggling a little bit with my eyesight.

I’ve been nearsighted all my life, just like my Mom. I remember I once told my Mom when I was a child that at least as we get older, while other people get farsighted, for us the two will cancel out; and who knows, we may not even need glasses after a while.

Alas, that’s not how things work.

Myopia and presbyopia are not mutually exclusive. Just because you are nearsighted does not mean that your eye cannot lose its ability to focus. So you remain myopic, in need of glasses to see things that are afar; but the same glasses are no longer useful when you are staring at things up close.

So like many others at my age, I ended up with graduated prescription glasses: the top of the lens is meant to see far, whereas a lesser diopter is used at the bottom to help see things up close. Of course it also means that like many others in their fifties, I end up adopting that strange posture of holding my head up while reading a book in my hands, just to make sure that I look at the book through the appropriate part of the eyeglass lens.

And, I found, graduated glasses are by no means a perfect solution when it comes to staring at a computer screen. I found that I kept having to change the angle at which I kept my head, as I looked at different parts of the screen. It was frustrating and inconvenient, and indeed, it was interfering with my productivity.

Recently, I got a new pair of graduated glasses, in the hope that they will fix the problem, but they really didn’t.

So then, I decided to take matters into my own hands. I’ve known about a site, clearlycontacts.ca, for some time; they offer prescription glasses at a fraction of the cost you pay at a retail eye-wear store. So I ordered a new pair of “reading” glasses from them. Except that instead of giving them the “correct” prescription (+2 diopters for reading on both eyes relative to the baseline value for my myopia) I specified a smaller correction, halfway between the “reading” and the farsighted values.

The new pair of eyeglasses arrived Monday morning. As I opened the box, I was trying to tame my expectations; after all, you’re not supposed to play eye doctor with your prescription. I opened the box, took out the new glasses, put them on, and… WOW. I can finally see my entire screen clearly, without having to hold my head at unnatural angles. And the eyeglasses are almost good enough for reading, and not too bad for far vision either; my vision is a bit blurry with them, but I can still read, e.g., roadside signs, so these new glasses might even be safe for use while driving, at least in an emergency.

But for the computer screen, they are just perfect. And I already noticed a significant increase in my productivity, simply because my eyes and my neck don’t tire out as I work.

And the price of this little eyeglass adventure? A grand total of 58 dollars and 95 cents. Less than 60 bucks. And that price actually included scratch-resistant lenses.

Needless to say, I am very pleased. Indeed I am sufficiently pleased to provide clearlycontacts.ca free advertising in the form of this blog post. I am sure they don’t mind.

 Posted by at 10:35 pm
Nov 142013
 

Our cat Szürke remains gravely ill and I don’t know if he will make it.

About two years ago, he was diagnosed with hyperthyroidism, a not altogether uncommon disease among older cats. At the time, we opted to treat his condition with medication (Tapazole); the alternative would have been radiological treatment, which works well but would have required him to spend a long time (couple of weeks, we were told at the time) in quarantine.

Szürke has been doing well although lately, he has been losing weight.

Then, on Sunday October 6, he started vomiting. Occasionally throwing up a furball is not exactly a problem with most cats. Vomiting a clear, foamy liquid eight times in an hour is.

The next day, we took Szürke to our local vet who diagnosed him with renal failure, noted that he was dehydrated, and his T4 level was also very low. We discontinued the Tapazole. Even more alarmingly, he was becoming a little anaemic, with a PCV level of 20 (normal, I believe, is between 30 and 50).

We brought Szürke home. He was doing okay, though his appetite was not great. A week later, on October 16, we went back to the vet for a recheck. The vet became very alarmed when Szürke’s PCV level was measured at 15. She immediately recommended that we take him to Alta Vista Animal Hospital, where he would get a transfusion.

Szürke spent two days at Alta Vista. When we brought him home, the diagnosis was still largely unchanged: the anaemia was believed to have been caused by advanced renal failure. The only thing odd was that his renal values were really not that bad. On the other hand, an ultrasound examination showed no other abnormalities that could have been responsible for his condition.

We brought Szürke home on Friday, October 18, with a prescription for Eprex, a subcutaneous injection that was supposed to stimulate his bone marrow and help him produce red blood cells. Szürke got his first injection on Saturday, but we never got to the second two days later, as by that time, Szürke stopped eating altogether. So instead of injecting him, I took him back to Alta Vista.

This time around, Szürke spent four days at the hospital. He received two more transfusions, as his PCV levels dropped to alarmingly low levels (the lowest, I believe, was 7.) On Tuesday, October 22, we actually visited him late at night, thinking that this was probably good-bye.

By this time, however, the diagnosis was different. For starters, a detailed blood test showed that his anaemia is likely regenerative: his reticulocyte count was higher than normal, in fact. I actually viewed this as both a ray of hope and as a message of sorts: if his little body has not yet given up fighting, how can I give up on him?

So the question then, was this: is his regenerative anaemia anemia due to a haemorrhage or haemolysis?

There were no obvious signs of haemorrhage. There was no blood in his vomit or his stool (though my wife and I noticed, and brought to the vet’s attention, that his stools were significantly darker than normal.) So the doctor’s first bet was that the anaemia is haemolytic, due either to an infection or an autoimmune condition. A biopsy was non-conclusive but it indicated a possible minor gastrointestinal infection. Still, the doctors were leaning towards an autoimmune condition as a more likely explanation.

I brought Szürke home on the 25th of October, with prescriptions for Prednisone, Omeprazole, potassium gluconate, Metronidazole and Sulcrate. He was also back on Tapazole, albeit at a much reduced dose. His PCV level after his last transfusion was 17. Yet three days later, when I took him back for a recheck appointment, his PCV was down to 12. At this time, after discussions with the doctor, we opted to discontinue to the Tapazole altogether, betting on the possibility that the autoimmune response was due to sensitivity to this medication. The Sulcrate was also discontinued (he responded very badly to my attempts to administer this liquid medication.) On the other hand, he began receiving cyclosporine in liquid form.

Nonetheless the next day, his PCV levels were further down, to 10, and he was vomiting, so I took him back to Alta Vista for his fourth transfusion. With his PCV back at 13, I brought him home. Two days later, on October 31, we went for a recheck and, surprise: his PCV was up to 17! Finally, some real hope, we thought. Also at this time, the liquid cyclosporin was discontinued in favor of a capsule, which was much easier to administer.

We were okay for a few days. The next visit was on Friday, November 4. By then, Szürke’s PCV was up to 20! However, his T4 levels were going through the roof, due to his untreated thyroid condition. On the vet’s advice, we began to give him an appetite stimulant (Mirtazapine) in the hope that this will be sufficient to make him eat a special, low-iodine diet (Hill’s Y/D) which would allow us to control his thyroid without medication.

For a few days, all seemed to go well but then his appetite dropped, despite the Mirtazapine. On November 11, I took Szürke to our local vet, who checked his PCV: a disastrous 11. I immediately discontinued the Y/D diet and started giving him whatever he liked… the thinking was that if these were to be his last few days on Earth, I won’t try to starve him with food he wouldn’t eat, and if there is still hope, the thyorid is a long-term concern, whereas the anaemia can kill him in days.

The next day, I discussed all this with the vet at Alta Vista who suggested another possible treatment: Chlorambucil (medication so dangerous, I’m advised to wear rubber gloves when handling the capsules. Scary.) The vet also reluctantly recommend another transfusion. By the time we got to Alta Vista, Szürke’s PCV was down to 9. When I brought him home very late at night, it was back to 12 as a result of the transfusion.

That was two days ago. Szürke is home today, and seemingly doing well. But that has always been the case; even when he was weak as a kitten, his happy disposition never changed, he never ceased being playful, never even stopped grooming himself.

He is eating moderately well. He is interested in the world around him. He is still accepting his medications without too much trouble.

But we still don’t really know what on Earth is wrong with him in the first place. So we are left with taking things one day at a time. I have no idea what tomorrow will bring.

 Posted by at 6:55 pm
Jul 242013
 

I grumbled once in this blog already about the incessant Marineland commercials on most Canadian channels this time of the year.

I still hate (desperately hate! As in, hate more than the sound of a hundred piecees of chalk screeching on a hundred chalkboards) the song, but I was hesitant to give them more publicity in my blog.

Until I came across a story from last August about animal suffering at the park.

Not exactly unexpected, to be honest, though even the singer who sings that horrendous jingle found the accusations shocking. She’d now prefer to see the jingle’s tag line replaced with “All the whales haaaate Marineland!”.

And I do, too, now for more than one reason.

 Posted by at 8:20 am
Jul 212013
 

dementia-villageI was watching a report this morning by Sanjay Gupta on CNN about a unique Dutch facility caring for dementia patients.

Unofficially dubbed “dementia village“, the facility aims to provide a life for its residents that is as close to “normal” as possible.

Yet there is something creepy about a place that only has one way in and one way out, and it is locked and under surveillance. A place where freedom is illusory. Even Gupta could not resist making a comparison with The Truman Show: that the normalcy in “dementia village” is a fake, a deception.

True, it’s a deception that serves a noble purpose. Yet it reminded me of another fictitious facility: The Unit, as depicted in the eponymous novel by Swedish author Ninni Holmqvist, where people live out the last days of their lives while waiting to become organ donors.

 Posted by at 9:25 am
Nov 082012
 

Rudy Giuliani made an interesting comment on CNN yesterday. He ridiculed his own party by pointing out that they are all for states’ rights… except when they are not, such as when they are pushing to amend the federal constitution to define marriage. He pointed out that a conservative party that stays out of both people’s pocketbooks and their bedrooms would be a winning combination. I couldn’t agree more.

So how come I am in favor of Obamacare? Well… I also like highways. Some libertarians may argue that by building a highway, government restricts your freedom to drive where you want and forces you onto a narrow strip of asphalt. Technically true, but I still prefer to live in a place with a well-developed national infrastructure. These days, I consider a universal health care system just as important a part of that national infrastructure as highways, schools, or electrical networks.

 Posted by at 9:44 am
Jun 282012
 

The first American president who made a serious effort to introduce universal health care was Teddy Roosevelt, almost exactly 100 years ago. Teddy Roosevelt is of course also famous for the eponymous bear.

And now we have ObamaCare, upheld by the United States Supreme Court in a surprise decision, with conservative justice Roberts being the “swing vote”.

You put bear and care together and what you you have? A care bear, of course. Maybe supporters of ObamaCare will celebrate by sending plush care bear toys to the White House…

 Posted by at 1:02 pm
Jun 282012
 

I was watching CNN this morning. At around 10:08 AM, they announced that the United States Supreme Court struck down the key “individual mandate” provision of Obama’s health care reform law.

A few minutes later, it dawned on them that the justices’ comments relating to the Commerce Clause were not the end of the story. They still weren’t sure of themselves but they corrected the headline.

Finally, after an additional several minutes, it became clear: the law has been upheld.

I am sure I will hear more about this “save” on CNN’s Reliable Sources this Sunday…

 Posted by at 12:57 pm
Jul 192011
 

I found out that I am less squeamish than I thought.

I went out for a walk this morning, and in the middle of a sidewalk, I suddenly spotted a mouse. First I thought it was a small furry mouse toy, as it looked like a perfect little mouse, completely motionless. But then I realized it was the real thing, probably dead… but no, wait, it was still kicking. When I touched it with the toe of my shoe, it squeaked loudly and tried to crawl away… but even though I was trying to steer it towards the grass with my shoe, it didn’t get very far. I think it was badly injured, probably a broken leg or something. Eventually, fears of hantavirus and whatnot notwithstanding, I just grabbed it by the tail (loud squeaks followed) and threw it in the grass.

I mean, what was I supposed to do, step on the poor thing? Yes, I know, too much empathy is bad for your health, but apart from their size, mice are not that different from other mammals… they have hearts, lungs, a sizable brain, and the ability to feel fear and pain. In all likelihood, this poor critter has since been found by a cat, but at least it’s not expiring in the middle of a sidewalk half crushed to death when someone steps on it.

Yes, I avoided touching my face afterwards and washed my hands as soon as I got back home.

 Posted by at 1:36 pm
Jun 122011
 

Gabrielle Giffords is on the mend. It is inspiring. I’d not wish what she had to go through even on my worst enemy. I hope it’s not just morbid curiosity on my part when I wonder, to what extent will she be able to recover in the end? Is her personality, are her mental abilities intact? I hope so, but there are limits to what medical science can do when a lead slug rips through a large chunk of your brain.

 Posted by at 11:18 am
Jun 022011
 

After all the hype and insanity, it is reassuring finally to hear a lone voice of sanity in the debate, reignited by the WHO’s idiotic report, about cell phones and cancer.

OK, maybe “idiotic” is too strong a word… how about “irresponsible”? Everything is “possibly carcinogenic” of course. For instance, all cancer cells contain a significant amount of a chemical known as oxygen dihydride. This evil chemical can kill in many different ways, cancer is just one of them… it can also cause asphyxiation.

But back to cell phones. Unlike X-rays or UV, low frequency electromagnetic radiation does not cause chemical changes. The heat generated as a result of brain tissue absorbing a fraction of the phone’s transmitted power (a few hundred mW at most) is minuscule, a tiny fraction of the heat generated by the brain itself as it operates. Furthermore, we are routinely exposed to much stronger low-frequency EM fields generated by things like the electrical wiring in our houses, electric motors, CRT televisions, overhead power lines, other radio transmitters… or, for that matter, heat from a stove, which is also electromagnetic radiation, surprise, surprise (but of course “radiation” sounds a lot scarier than “heat” or “waves”). There is no convincing mechanism, no conclusive evidence either, and plenty of well-established reasons to believe that these cell phone concerns are pure nonsense… so how can a body like the WHO scare people like this? It is reprehensible.

 Posted by at 3:21 am
Jan 192011
 

There is a very icky treatment out there for a very difficult infection: it’s called fecal transplant, and apparently, it can be used to defeat an otherwise deadly, difficult infection.

Not good enough for the health bureaucrats in British Columbia, who, according to news reports, are barring physicians from applying this treatment, because according to them, the treatment is experimental and its safety cannot yet be ascertained.

Commendably cautious, you might say… but wait a cotton-picking minute, aren’t these the same health bureaucrats who spend public money to fund acupuncture and other forms of “alternative medicine”?

Tricky trumps icky, it seems.

 Posted by at 1:38 pm
Jan 062011
 

I am reading the articles from the British Medical Journal about the Andrew Wakefield case. Wakefield was the British physician who published a fraudulent study in 1998 linking vaccines to autism, causing a worldwide scare which may have resulted in the deaths of many unvaccinated children over the years.

What I didn’t know was that Wakefield wasn’t merely incompetent: he was a fraudster. According to the BMJ, he deliberately and fraudulently falsified data while being paid by a legal firm that was planning to sue the vaccine manufacturer.

I also do scientific research. My research (thankfully) has nothing to do with people, vaccines, or diseases; it’s about things like historical spacecraft or obscure aspects of gravity theory. Even so, I find the idea of altering or “massaging” my data, be it for fame or for profit, totally unthinkable and abhorrent. To do so when people’s lives are at stake… The likes of Wakefield not only undermine the credibility of the entire scientific community, they also put people’s lives at risk for monetary gain.

I wonder if Wakefield will ever face criminal charges. Perhaps he should.

 Posted by at 5:11 am
Apr 252010
 

So a few days ago, I wrote a blog entry about Ontario’s new grade school curriculum. The one that has since been withdrawn due to objections by conservative groups. I have to concede: they may have a point. I used no words in my blog post that were not used in the curriculum itself, yet the result was apparently too strong for Facebook; their automated software did not pick up and paste the entry onto my Facebook page.

Still, I stand by what I said: after I looked at the actual curriculum (as opposed to the sensationalized headlines about it) there really was nothing in it that a sane person could possibly object to. It’s not about sanity, of course, it’s about politics, which is why Ontario Liberals decided to abandon the updated curriculum after all. They can only fight one battle at a time, they say, according to the Toronto Star. I just wish that the battle they chose to keep fighting was this one, as opposed to the astonishingly braindead idea of messing up pharmacies by blocking payments to them by generic drug companies. Or the HST… which would have been a good idea back when the GST was introduced, but now, it’s just a badly disguised tax grab.

 Posted by at 11:36 am
Feb 102010
 

About ten years ago, my gall bladder was removed. (To anyone who never had gall bladder cramps: you don’t want to know.) I knew that no surgery is trivial, and that even famous people, like Russian rocket designer Korolyov, may have been killed by botched gall bladder surgery, but hey, we live in modern times, and laparoscopic surgery isn’t quite the same as it used to be in the old days when they cut your abdominal cavity open with a machete. Indeed, six hours (!) after I was rolled into the operating room, I was sitting in my own chair at home, and I haven’t had a complaint since.

Congressman John Murtha, a leading opponent of the war in Iraq, had the same surgery a few days ago. Unfortunately, he was returned to the hospital two days later, and was pronounced dead not long thereafter… apparently a result of botched surgery, as they may have cut one of his intestines, resulting in a deadly infection.

I’m glad I didn’t know such things can happen back when I was going under the knife! Sometimes, ignorance is bliss.

 Posted by at 1:41 pm