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Monthly Archives: November 2014

An Inspiring Story

The first two years of medical school are traditionally when students learn the scientific knowledge that serves as the basis of medical practice and research. Most students are more motivated to acquire this knowledge when they see how it connects to human health. Accordingly, many medical schools now teach at least some of their basic scientific concepts through illustrative clinical cases.

As part of a team helping to create the curriculum for the new UT Dell Medical School in Austin, I was recently given the assignment of writing about retinoblastoma. Since this is a cancer that occurs in childhood and I see exclusively adults in my practice, I do not have experience treating patients with retinoblastoma. When I set about researching actual cases of the disease, I came across the story of Ben Underwood. When Ben was two years old, his mother Aquanetta noticed that his right eye had a peculiar glow. After an examination by an ophthalmologist, Aquanetta was informed that Ben had a tumor called retinoblastoma in both of his eyes.

If left untreated, retinoblastoma will spread backward from the eye socket into the optic nerve, and then into the brain. Ben began chemotherapy, but after two months his right eye was consumed with cancer that it was removed. This was followed by an additional eight months of chemotherapy and then six weeks of radiation in attempt to save the left eye. When this treatment did not work, Aquanetta made the agonizing decision to have his left removed in order to save his life.

When Ben awoke from his second surgery, he said, “Mom, I can’t see anymore. Oh, Mom, I can’t see.” Aquanetta writes that “after praying for strength, I said, ‘Ben, Yes you can see’ and I took his little hands and put them on my face and said, ‘See me, you can see me with your hands,’ next, I put my hand to his nose and said, ‘Smell me, you can see me with your nose,’ then I said, ‘Hear me, you can see me with your ears, you can’t use your eyes anymore, but you have your hands, your nose, and your ears.’”

Ben’s mother and siblings worked hard to help him adjust to life without vision. Around age six, Ben began making clicking sounds with his tongue that enabled him to make sense of his surroundings by listening to the echoes bouncing off of objects. This process, known as human echolocation, is similar in principle to the sonar and animal echolocation employed by bats, dolphins, and toothed whales. Over time, Ben became so skilled at echolocation that he could accomplish such feats as playing basketball, riding a bicycle, rollerblading, and skateboarding. He was featured on the Ellen DeGeneres and Oprah Winfrey shows and was the subject of a program called The Boy Who Sees Without Eyes aired on the Discovery Channel.

I encourage you to watch the video I’m linking here. It’s a beautiful story of love, courage, hope, resilience, and faith.

Sadly, in 2007, a tumor developed in Ben’s sinus cavity and despite intensive treatment, he died two years later at age 16. This year, his mother Aquanetta released a book she wrote about Ben called Echoes of an Angel. It just arrived in the mail and I look forward to reading it.

 
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Posted by on November 29, 2014 in Uncategorized

 

Cholesterol and Heart Disease

I’m enjoying a brief lull between a number of demanding projects. So I thought I’d dust off the old blog and share some articles on medicine and health I find interesting. Here’s one on cholesterol and heart disease.

Back in 1995, a study was published showing the benefit of a cholesterol lowering-medication called pravastatin. Over a period of 5 years, 6,595 men aged 45-64 with high cholesterol who were either given a placebo or pravastatin. The study showed that treatment with 40 mg of pravastatin for 5 years significantly reduced the risk of having a heart attack or dying from cardiovascular causes by 31% compared with placebo. After the study was published, researchers followed the men for another 20 years. And at this year’s American Heart Association’s Scientific Meeting the results of that additional 20 years of study were presented. They showed that the risk of heart-related deaths was 27 percent lower among the men who took pravastatin for those first five years rather than dummy pills. They also found a 31 percent lower risk of heart failure and a 13% lower incidence of death in the group initially assigned to take pravastatin. Furthermore, no adverse effects from taking pravastatin, such as cancer, were detected. What’s interesting is that once the initial 5 year study ended, the men went back to their regular doctors, and about one-third of both groups kept or started taking a statin such as pravastatin. So any differences seen 20 years later were probably is due to whether the men took pravastatin during the initial five-year study.

Coronary heart disease is the leading cause of death in the U.S. and the world as a whole. So a study showing such an effective means of preventing and treating this condition is very good news. Yes, yes, I’m aware of the possible side-effects of statins like pravastatin. About 1 in 10 people get muscle aches. But these usually resolve quickly once the medication is stopped and may not occur at a lower dose or on an alternative statin. Statins tend to cause a slight increase in a person’s glucose level, but that is far outweighed by the decreased risk in heart disease these medications cause. There have been rare reports of people feeling less mentally sharp after taking a statin. But in these cases, such side effects quickly resolved upon discontinuing the medication. Furthermore, this kind of neuro-cognitive side effect seems to be quite rare. I’ve never observed it in my practice and a recent, comprehensive review of multiple studies failed to find evidence that statins cause memory loss. In fact, some studies suggest that statins may even have memory-protective effects. By the way, the medication pravastatin used in the study I’m citing is generic and very inexpensive.

Here are links to a couple of articles on the study.
http://www.medscape.com/viewarticle/789649
http://hosted.ap.org/dynamic/stories/U/US_MED_CHOLESTEROL_DRUGS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-11-19-15-20-07

 
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Posted by on November 27, 2014 in Uncategorized

 
 
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