When we were kids, health issues were few. We’d skin our knees playing tag football in the streets or sprain a middle finger trying to stop an inbounds pass in basketball or get our asses kicked for hitting a homerun through Kate The Grouch’s kitchen window, but all those body parts would heal in a trice.
Eventually, everybody got chicken pox or measles or mumps---if you were unlucky, all three. Boring, but nothing to get excited about. Oh, and if you even so much as looked the wrong way, they snatched your appendix out. My sister, Alice (the Republican), had asthma, which turned her a funny color of Ironic Blue and necessitated occasional trips to the hospital, but all that did was make her more ornery. And then, of course, the devious Doctor Ainesworth showed up at my house one day, slapped an ether rag over my face and robbed me of my perfectly good tonsils on the kitchen table. Those tonsils were probably still viable for whatever secret acts tonsils may perform but the medical profession will always find a way to make a buck.
Our parents warned us about things like whooping cough, scarlet fever and polio, which you would definitely get from swimming in the Spicket River. We must have had powerful natural immunities because it never happened. Nobody much mentioned psychological diseases until little Timmy Finn jumped out a window in the first grade (don’t worry, we were on the bottom floor) and wasn’t allowed back in school for awhile. Everybody said Timmy was dropped on his head as a baby, so that pretty much explained that. We left it up to the adults to get the real illnesses, the hospital-requiring setbacks, the scary prognoses, the near-death experiences, never imagining the day we would morph into them. Well, guess what? It’s ambulance time, friends and neighbors. All those old half-heard radio ads for neuritis and neuralgia have become relevant. It’s like, you turn 65, a gong sounds, you open the door and a large truck outside dumps every ailment known to man onto your welcome rug. Hey, thanks for that, Cosmic Undoer.
Perfectly healthy citizens are suddenly transformed into coughing, wheezing goats, blind, lame and discombobulated. Suddenly, you have a cataract surgeon, a dermatologist, an ortho guy, an expert on cranky bowels and a medico certified in the treatment of yaws. You know everybody at the Walgreen’s pharmacy department by their first names. You search the internet for experts in acupuncture, fibrodysplasia ossificans and Alice in Wonderland syndrome. Life is no longer just a bowl of cherries. Life is a bowl of prunes. When will Superdoc arrive with a new lease on life? Is there hope for the future? If Trump steals my Medicare, will I have to report immediately to the Death Panels? Who put the bomp in the bomp bah bomp bah bomp, who put the ram in the rama lama ding dong? Keep reading. Mighty Mouse is on the way.
Ticker on the fritz? Low on the heart-replacement list? Considering a last-ditch trip to the healing waters of Lourdes? Have we got a product for you! The exciting Heart Mate III will sweep all your cares away. Once available only to patients circling the drain and ineligible for transplants, this little goodie--- approved by the hardass FDA---is implanted into the abdomen. As soon as it settles in, its fancy turbine engine the size of a D battery is turned on, steering oxygenated blood from the weakened heart through its turbine to the rest of the body. Eighty percent of patients tricked out with the Heartmate improve dramatically within six months of implantation and remain stable for at least two years, but some people get triple that. It’s not forever, but long enough for the next miracle to come along. Or at least to take that long-delayed trip to Bolivia.
Tired of those messy colonoscopies? Done with fasting, otherworldly cleansing solutions and scary anesthesia? Worried that Doctor Colon might be an early morning tippler who pokes a hole in your intestine, consigning you to that ole gospel ship? Well, fret no more with our newfangled Camera-Carrying Pill, a tiny goober which descends into your guts and sends back sparkling images to your doctor’s computer. Wow! No fuss, no muss. The pill is already used to view the esophagus and small intestine and now it’s ready for the big time. Shall we make you an appointment for next week?
Okay, everybody’s depressed, right? Coco the Clown is our deranged president and he’s drilling for oil everywhere, selling off the national parks, threatening nuclear war against California, and, worst of all, promising to bust marijuana dispensaries in states which have legalized pot. If there are any as yet unthought of bad ideas, Coco will discover them. It’s enough to make a grown man cry. OR to try Ketamine for a pepper-upper. Ketamine, a drug commonly used for anesthesia, was studied for its ability to target and inhibit the action of N-methyl-D-asparate (NMDA) receptors of nerve cells and the results were overwhelmingly favorable. Studies indicated that 70 percent of patients with treatment-resistant depression saw an improvement in symptoms within 24 hours of receiving the drug. For the first time, there was treatment for the severely depressed. Some of them even formed a sprightly kazoo band and they’re headed for Washington to serenade the White House.
No Doughnuts For You, Mr. Chubby!
Currently, half of those patients with Type 2 diabetes will die from complications of cardiovascular disease. By age 65, the odds go up to 70%, a chilly assessment. In 2016, however, two new medications began reducing the mortality rates considerably. Empagliflozin modifies the progression of heart disease by working with the kidney, while Liraglutide has a comprehensive effect on many organs. Given the positive results, experts predict a complete shift in the lineup of medicines prescribed for diabetes patients as well as a wave of research into new avenues targeting Type 2 diabetes and its comorbidities, whatever they are. And NO, diabetics, that does not mean you can return Dunkin’ Donuts to your Saturday shopping agenda.
By now, one of the first cellular immunotherapies for leukemia and non-Hodgkins lymphomas may have already hit the market. If not, it’s on the way to a supplier near you. Chimeric Antigen Receptor T-Cell Therapies are a type of immunotherapy in which a patient’s immune system T-cells are removed and genetically reprogrammed to seek and destroy tumor cells. Results of some studies have been impressive, particularly those focusing on acute lymphoblastic leukemia, where a remission rate of 90% has been reported. Cellular immunotherapy could one day replace chemotherapy and its lifetime of horrendous side effects, so light a candle.
Baby Steps
Don’t get pancreatic cancer. The literature advises that only 20% of patients survive a year past diagnosis and fewer than 10% make it to the 5-year mark. PC is pretty much a death sentence and there are no appeals courts. One of the problems is that pancreatic cancer presents no early signs and is usually well entrenched by the time it is discovered. Researchers recently reported in Science that chemotherapy drugs are ineffective because bacteria in pancreatic cancers actually breaks the drugs down. Thanks a lot for that, any good news? Perhaps. Researchers have found a link between new-onset diabetes and pancreatic cancer which could help with early detection. Apparently in some people, diabetes is caused by cancer growth in the pancreas. Soon, a more sensitive test to help determine the root cause of diabetes may reveal pancreatic cancer much earlier. Additionally, scientists at the Gastrointestinal Cancer Center at Dana-Ferber Cancer Institute discovered not only a genetic mutation that is present in more than 90% of pancreatic cancer patients but also variations that are associated with different outcomes. This has the potential to lead to novel, gene-based treatments.
Immunology has also shown promise as a treatment. A small Phase 1 study found that combining two immunology drugs may help some patients. “This is a glimmer of hope,” said Dr. Zev Wainberg, co-director of the GI Oncology Program at UCLA. “Until now, there have been no responses with any immunology drugs for pancreatic cancer.”
When we were kids, nobody had autism. Now, it affects about 3.5 million Americans, one in 68 children and gaining. No single cause has been identified, but students at the University of Southern California recently identified a hotspot for autism-related mutations in a single gene known as TRIO. The findings were published in the journal, Nature Communications. “I have never see this number of autism-related mutations in such a small area,” said the study’s corresponding author, Bruce Herring, PhD, a neurobiologist at USC’s Dornslife College of Letters, Arts and Sciences. “The likelihood that this number of mutations occurs by chance is 1 in 1.8 trillion. We’re pretty confident these mutations contribute to the development of autism-related disorders.” Herring expects that this major discovery will be the key to developing more effective strategies for treating autism spectrum disorders. I guess we’ll have to start rooting for the Trojans.
Happy Days Are Hair Again
Those little devils at USC have been busy. As if finding avenues into autism isn’t enough, the Southern Cal scientists are taking on a more universal problem---baldness. The SC Keck School of Medicine has released a new study that details a way to grow hair follicles from progenitor cells, which are broadly similar to stem cells but don’t have the ability to reproduce indefinitely.
Here’s how it works. The team found that these cells would form 3D conglomerations known as organoids, groups of cells that take on a structure similar to that of an organ. They then grouped themselves into the form of polarized cysts, which in turn gave way to layered skin. From there, they were able to produce skin bearing hair follicles which could be transplanted onto a mouse. The team observed that the follicles were able to produce hair once they had been transplanted onto the animal.
Hopefully, the same process could be used to treat humans suffering from balding. A patient’s own progenitor cells would be used to grow portions of skin with hair follicles in the lab, which would then be transplanted onto the scalp. This could provide relief for conditions ranging from alopecia to full-fledged baldness. The next step is human trials, for which there will be no shortage of volunteers. We have only one question to pose about the whole sordid affair. Where do we get on the next plane to LAX?
There’s A Man Goin’ ‘Round Takin’ Names
Just when we thought we were safely past the age of appendix worry, we were blasted from our seats by The Evil Trilogy. You know, that prehistoric notion that all catastrophic events arrive in three-packs. First, it happened to Margaret Lewis, senior princess of Unicoi, Tennessee, whose surly appendix had the unmitigated gall to explode all over her. Next, our neighbor, Greg Poe, had his innards doctor tell him things didn’t look copacetic in the neighborhood of his appendix, which was removed forthwith. And finally, our friend Richard Helms was afflicted with sharp pains over the holidays and rushed into surgery in Ocala. What the hell is going on here? It’s like a new horror movie, but instead of the aliens landing, it’s the appendix bombers. It’s enough to make a body rush to his local scan center for a quick peek.
Why do the little critters act up, anyway? Apparently, because they become blocked up by stool, a foreign body or cancer. Blockage also may occur from infection, since the appendix can swell in response to any infection in the body. Who knew? Will we miss our little pal once it’s gone? What will they put in that hole where the appendix used to be? Scientists tell us our little buddy acts as a safe house for good bacteria, which can be used to effectively reboot the gut following a bout of dysentery or cholera. Where will those good bacterias go after they’ve been evicted from the friendly confines? Is there someplace they can rent? Is there a possibility of homelessness? What do we do when the next wave of cholera sweeps across the nation? Is there an appendix farm somewhere I can get a backup? It’s a dilemma, but we’ll have to get back to you on all this. Seems our prunes have just arrived.
That’s all, folks….
