The Cost of Medical Treatment
Some research claims up to
one quarter of the entire government health budget is spent on hospital care
during the last 18 months of life.
Much of this care is given in the absence of any real prospects of extending overall survival or quality of life
The number of patients who need to be treated to save one life or prevent one serious event can be in the order of hundreds of thousands with sophisticated procedures such as some cardiac surgery, breast cancer screening and surgery for localised prostate cancer.
A claimed consequence of these enormous costs is
between 20% - 45% of eligible people miss out on effective treatments for common and serious conditions such as
cardiac problems and stroke.
The implication is a serious one. Rationing of medical treatment is on the way as no government can afford the cost of meeting patients’ over expectations of the value of modern technological medicine.
An ageing population is very threatening to health services.
The real questions are how will health care rationing be done and who will be responsible for that rationing.
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Diet and Cancer
Unfortunately there is
no evidence that dietary supplements or dietary modification alters the clinical course of cancer or pre-cancer.

The National Cancer Institute examined various diets and supplements including
vitamins, anti-oxidants, retinol and garlic and their effect on various cancers.
The conclusion was no benefit was seen. The study noted the large personal expenditure on supplements by some patients.
A healthy diet alone, or in combination with dietary supplements, weight loss or exercise
has no effect on all–cause mortality. Equally research showed no evidence of harm. A healthy diet is still strongly encouraged as many cancer patients live for many years and could die or be affected by other diet related illnesses.
Unfortunately this is another example of something like
dietary supplements, vitamins, anti oxidants etc sounding as though it should be helpful treatment but it simply is not.
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Drugs and Professional Cycling
You will have seen reports of alleged drug use in
Tour de France cyclists.
Unfortunately cycling is one of the sports with the worst drug use record
One top cyclist said it was not possible to make the top 50 ranking without drug use. Some claim up to
90% performance drug usage in professional cyclists
One champion cyclist spoke of injecting himself 12 to 13 times per day and taking a blood test to measure a certain blood parameter which indicates illegal drug use up to four times per day. He also took
Growth hormone, Folic Acid, Iron, blood transfusions & aspirin to prevent clotting caused by the drugs and on some days injected
cortisone and male hormones as well as a
drug co-factor.
In one year recently four professional cyclists died from heart attacks. The youngest was 23 the oldest 35.
About 100 cyclists have died prematurely over the last 20 years.
Amphetamine fuelled riders have fallen dead from their bikes in mid-race.
The use of performance enhancing drugs is now very sophisticated and often well ahead of drug testing methods. The rewards are so high many cyclists are tempted.
It is generally considered the problem is so large and profitable that control or elimination of drug use in cycling is unlikely.
Genetic performance enhancement has yet to become widespread . . .
and is thought to be almost undetectable !
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Exercise is good . . . but don't turn off the TV !!
Australians value their health but
many are not prepared to do anything to improve it
A recent survey of
1,000 people showed an impressive
86% believed
health was more important than a
high IQ or
wealth.
Sadly 74% would not turn off the TV or computer to become healthier and nearly 50% would not trade chocolate or dessert for good health.
About 60% had no idea of their blood pressure or cholesterol levels
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I think . . therefore I am . . .(or something like that)
This world famous Philosopher died in August 1900.
Who was he ? ? ?. . .and what did he die from ? ? ?
At age 24 he became a Professor of Philosophy in
Basle which was a remarkable achievement. He later served in the
Franco-Prussian war where it appears he contracted the disease which caused his disastrous medical problems and ultimately his death.
He returned to
Basle University but in 1878 his health became worse and by 1889 he had a breakdown. He collapsed in a street in
Turin,
was half blind, in almost unrelenting pain and wrote crazy notes to his friends.
He spent the
last 11 years in total mental darkness and was looked after first in an
asylum and then under the care of his
mother.
Imagine what ideas
Friedrich Nietzsche might have produced had he not suffered from
Tertiary Syphilitic Disease . . .
or . . .where some of his ideas produced because of the mental effects of
Syphilis ?
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Is anyone reading your promotional material ? ? ?
The
Australian Bureau of Statistics found almost half of the
15 -74 year group had
" poor " or
" very poor " literacy skills. These people had difficulties with many of life’s daily literacy demands.
A further 35% of those surveyed did not have a high level of literacy but were able to cope day to day.
Health literacy is defined as the
ability to read, understand and act on health information. Clearly much
Health Education material is simply
not being understood and so is ineffective. Many patients are simply
unable to understand treatment or the reason for tests and are unable to understand medication directions.
Almost certainly the same applies to
company promotional material and other written company material such as
instructions for use of a product.
IT information and the design of many of the
forms we have to fill out are significant culprits.
It also gives cause to wonder at the effectiveness of the Australian Education system
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Management of Adreno Cortical Insufficiency during Surgery. . .Wott ? ?
50 years ago an article with this topic appeared in a learned medical journal.
A sharp
eyed reader somehow put two and two together and was able to make a very significant revelation.
One of the three patients discussed was 37 years old and treated his
Addison's Disease with daily oral
cortisone as well as injections of
cortisone every three months.
He suffered from severe back pain with subsequent
bone fusions and a metal plate inserted.
This back problem was a football injury aggravated by World War II service. He had a well known stooped posture.
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Not surprisingly he also suffered from
chronic lethargy and weakness typical of
Addison's Disease. These symptoms were of considerable
public and political concern in
1960 and almost certainly affected his ability to work to his full potential. At least publicly,
his political career was not characterised by these symptoms.
He had a
" Moon Face " from the
cortisone. For pain relief he famously
used a rocking chair, took hot baths and
wore a very stiff corset.
It has been reasonable speculated that this corset held
President John F Kennedy upright long enough for
Lee Harvey Oswald's third shot to strike
President Kennedy with fatal consequences
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Holidays and Long Haul Flights and DVT
It's that time of the year again when families head off to distant fields for the school vacations.
Long flights are often involved with the associated stress, sleep deprivation, irritation and challenges of airports, marveling at the speed and discomfort of modern planes and the frustrations of keeping young children confined for hours at a time.
It is also that time when the risks of
Blood Clots (
Deep Venous Thrombosis - DVT) forming usually in the legs of long distance travelers….sometimes called "Economy Class Syndrome"….concern holiday makers. The risk of
DVT continues for about 2 weeks after the flight.
Remember a
DVT can form during any form of travel eg car, bus ,train where you are sitting in a cramped position for some time.
DVTs most commonly occur in hospital patients, post surgery.
A
DVT can affect anyone but risk Factors include:
* Age over 40 years
* Pregnancy
* People with or who have had cancer
* Anyone taking Oestrogen e.g. the contraceptive pill
* Smokers
* Obese people
* Dehydration
* Recovering from recent surgery
* Having an immobilised limb e.g. a leg in plaster
A
DVT is potentially a very serious problem, so take the following precautions when traveling to prevent
DVT:
* Exercise as much as possible
* Walk around the cabin
* Drink plenty of water
* Avoid excess coffee and alcohol
* Elasticised stockings may help
* Taking Aspirin pre flight might help a little
The overall risk of
DVT ? Not really known but
perhaps 1:50,000 travellers or
about one death per two million flights. Even lower risk with the above precautions.
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Flying and Radiation Exposure
A seven hour flight will expose a passenger to about the same radiation as a
standard
Chest X-Ray (0.04 units).
Each year people living near
Chernobyl Nuclear Reactor receive about
250 times the Chest X-Ray dose. . . with a consequent risk of developing
cancer of about
one in 1700.
An abdominal CT scan is equal to the radiation dose of about 400 Chest X-Rays
The message is clear: Avoid unnecessary X-Rays.
Radiation is not a potential danger from Ultrasound which uses sound waves and not X-Rays
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Melatonin –the arguments continue !
Melatonin is a
hormone produced by the
Pineal Gland which is a very small gland situated deep in the brain and very inaccessible.
Melatonin has an effect on the body clock with
hormone production being affected by daylight and darkness.
Melatonin has been available for some years over the counter.
Efforts to have such a potentially dangerous drug restricted to a prescription-only status as with other
hormones were unsuccessful as opponents to restriction successfully argued
Melatonin was a
" natural substance "
Melatonin has been widely promoted and used as the solution to
jet lag and to promote
sleep. Other bizarre uses include being used as a
" perpetual youth drug ".
A recent
meta-analysis of published research,
as opposed to hearsay and commercial promotion found
Melatonin in reality
did little to promote sleep or assist with sleep restriction as happens in
jet lag. Most claimed effects can be attributed to
placebo. In people with a sleep disorder from medical causes
Melatonin did increase the time asleep by about
10 minutes in eight hours sleep.
Melatonin has been poorly researched to date for all sorts of technical reasons. As well the quality of commercially available products is often very suspect and the recommended dosage varies widely between commercial products and between stores selling the product. Be aware
" natural " Melatonin may contain a
virus
Hormones are very potent body chemicals often with multiple target body organs eg the
hormones oestrogen and
thyroxine affect a wide range of physiological functions.
Would I take a hormone such as Melatonin with largely unknown effects on the body for such a simple, self limiting problem as sleep deprivation ? No way !!
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MEN should take more interest in their Health
Men: Visit their doctor less often
than women. Take fewer medicines than women. Use the Health System less often
than women. Have shorter life spans than women.
Many of the diseases that shorten men's lives are the so called
" Lifestyle Illnesses "resulting at least in part from the way they behave.
Smoking, excessive alcohol, lack of exercise, obesity, illicit drug use and
stress at work are all examples of a lifestyle that put men's health at risk.
Women have access to effective
breast cancer and
cervical cancer screening, but men have little in the way of effective cancer screening programs
For men regular
Blood Pressure, Weight and
Cholesterol checks are important. Do not ignore the other symptoms such as an alteration in usual bowel habit, blood in bowel motions and trouble passing urine.
These symptoms may indicate bowel or prostate cancer so check them out.
Men are prone to
emotional illness as well as women,
but men from a western culture may be less willing to acknowledge a problem. Anxiety and
Depression are usually easily managed.
It is easy to put
sleep disturbance, poor appetite, inability to concentrate and general irritability down to a
busy job but there may be more to it than that.
If you have any doubts about any of your symptoms, it would be useful and probably reassuring, to have a chat with your doctor
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Nicotine Dependence
While talking about good health, use this Quiz to check your
nicotine dependence:
1. How many cigarettes do you smoke per day? (More than 20/day indicates nicotine dependence).
2. Do you have your first cigarette within 30minutes of waking ?
3. Do you smoke when you are so sick you have to stay in bed?
For those answering yes then you have a problem (you already knew anyway!).
Nicotine patches to help quit smoking are not usually suggested for a
>10 cigarettes/day habit.
Nicotine patches are more useful in
>20/day habits
Check www.quit.org.au for more information
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Nicotine is safe . . . . . .what did you say ? ?
* Nicotine does not cause cancer
* Nicotine does not cause respiratory disease
* Nicotine is not directly responsible for tobacco & related diseases.
* It is the other components of tobacco which cause all of the problems
Nicotine only induces and maintains tobacco addiction
That means
Nicotine Replacement Therapy e.g. as
Nicotine Patches used to stop smoking,
is safe and does not cause the health problems associated with tobacco
Nicotine in these patches slowly reduces the
nicotine addiction while the psychological addiction or ritual of reaching for a cigarette, lighting the cigarette, repetitive hand to mouth etc is overcome.
Psychological dependence is a very difficult habit to eradicate
Just how addictive is smoking .jpg)
Recent U.K. research showed
smoking just one cigarette at age 11 doubles the risk of taking up the habit e.g. after three years of non-smoking
those who had smoked just one cigarette at age 11 years, were twice as likely to be smoking by age 14 years than those who had never smoked.
Anything else ? ? ? ?
Lots more about smoking !! . . . . . . .
Try this: Men who
smoke more than a packet of cigarettes per day have a
40% greater chance of being impotent than non smokers
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Hangover
Dr Richard 2007
Reviewed 10 April 2018