August 3rd, 2007 by Dr. Val Jones in News
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An emergency medicine physician friend of mine sent me a link to a fascinating article about why cell phones aren’t good communication devices in major disasters like 9/11. When I was in NYC during 9/11 my cell phone didn’t work (the lines were all busy). Here’s what the article had to say:
“So why do text messages get through when phone calls can’t? For one,
SMS text messages are very short, so they require very little capacity
when they are transferred over the network. The second reason is that
text messaging works by allowing messages to be stored and sent through
the network.
If there is a delay in connecting to the network, the phone will
store the message in its memory and it will continue attempting to send
the message until it gets through. By contrast, voice is a
delay-sensitive application. If a sustained connection can’t be made,
the person on the other end won’t be able to understand what you are
saying. And so the call cannot be completed.
While it’s quite common for cell phone networks to get overloaded
during serious emergencies, there isn’t much that can be done to fix
the problem. The main reason is that it just isn’t economically viable
for carriers to build their networks to handle a tenfold increase in
capacity in every inch of their footprint.
“People have to remember that this is a commercial service,” Golvin
said. “It was never designed to be an emergency network. And it just
doesn’t make business sense for carriers to try to build it that way.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 31st, 2007 by Dr. Val Jones in Health Policy, News
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Two sad cases were reported lately – one by Medgadget in which a young child with Treacher Collins syndrome was denied a special bone-implanted hearing aid. Children with this genetic syndrome usually have normal intelligence, though their appearance reflects underdeveloped facial bones. Apparently her insurance company would pay for the procedure to install the hearing aid, but the $15K device was not covered in her parents’ insurance policy. Her parents could not afford the device, and the child has little hope of developing the ability to speak normally without the aid.
The second case was of Britain’s most elderly woman – a 108 year old who was told that she’d need to wait 18 months to receive a hearing aid from the National Health Service. Mrs. Beal is wheelchair bound, and unable to communicate without a hearing aid. Her favorite hobby is listening to music. Doctors say that she is unlikely to live long enough to receive the new hearing aid.
These two cases demonstrate that care is rationed in both a free market healthcare system, and a government run single payer system – and that rationing affects the disabled and the elderly first. This is the sad inevitability of limited resources, with only the independently wealthy enjoying the best of what healthcare can offer. Perhaps charity alone will hear the cries of these hearing impaired individuals?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 31st, 2007 by Dr. Val Jones in News
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Thanks to ED nurse Ian Miller who brought this research study to my attention: lidocaine jelly can substantially reduce the pain of having a Foley catheter inserted into the urethra – for both men and women. And yet the jelly is not always used for women. Many nurses, PAs and physicians erroneously believe that only men benefit from the numbing gel because they have longer urethras. But new research suggests that women benefit substantially from this pain reducing gel. What amazes me is that it took this long to research the issue – imagine all the women who could have had a more comfortable experience with this process. So ladies, if you (or your mom) need a bladder catheterization for any reason, be sure to ask for lidocaine jelly.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 30th, 2007 by Dr. Val Jones in Opinion
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You may remember the horrifying story of a young French woman who passed out after taking some sedatives, and her dog tried to wake her up by gnawing on her face. She was the first recipient of a face transplant, and is on immunosuppressant therapy to this day to prevent rejection of the donor tissue. This immunosuppression puts her at greater risk for cancer and infections and raises the issue of whether the benefits (a closer approximation of a normal appearance than reconstruction of her face from her own body tissue) outweigh the risks (a shortened lifespan and potential hospitalizations for infections, eventual tissue rejection, and perhaps cancer.)
Many people suffer severe facial disfigurement from accidents and burns every year. Face transplants could give them a chance at a relatively normal appearance – but American doctors are unwilling to put them at risk for what is in essence a cosmetic procedure. However, Harvard physicians are now offering face transplants to those who are already on immunosuppressants for organ transplants they’ve previously received. As you may imagine, the number of people who qualify for face transplants is rather small – as you’d have to have had an organ transplant and then coincidentally sustained severe trauma and tissue loss to the face.
The Boston Globe ran an interesting story on a man who was severely disfigured by facial burns and could have been eligible for a face transplant in France. He chose to undergo reconstruction from his own tissues, which requires no immunosuppression. He says that he is glad that his body is healthy, that he requires no medications, and that the risks of a face transplant are not worth the benefits, though he remains severely disfigured.
I think it’s interesting that the French took a different stand on this issue – allowing people to choose to have a cosmetic procedure at the expense of general health, longevity, and risk for life-threatening illness.
I have known patients who decline limb amputations for fear of disfigurement – even though the gangrene in the limb is sure to result in sepsis and eventual death. A person’s appearance and personal identity are sometimes inextricably linked – so that some would choose death over disfigurement (even of a limb). Is this choice pathological, or is it their right to choose? Given the choice between disfigurement or death, I’d choose disfigurement. I’d also not choose a face transplant over reconstruction from my own tissues, even if the aesthetic outcome is inferior. Still, I’m hesitant to say that those who’d rather live a shorter, less healthy life with a more natural face are unilaterally making the wrong choice for them. For the time being, though, people who wish to make that choice will need to do so outside of the US.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 24th, 2007 by Dr. Val Jones in Expert Interviews
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A new study in the journal Sociology of Education suggests that obese girls are only half as
likely to go to college as non-obese girls.
I interviewed the study’s author, Dr. Robert Crosnoe, to learn more
about the relationship of weight, self-esteem, and peer popularity to the
education of young women.
Dr. Val: What did your study reveal about the impact of
obesity on the education of young girls?
Dr. Crosnoe’s response – audio 1
Dr. Val: How does popularity figure into the equation?
Dr. Crosnoe’s response – audio 2
Dr. Val: How do you explain the gender gap – that obesity
didn’t seem to influence whether or not boys went on to college?
Dr. Crosnoe’s response – audio 3
Dr. Val: What should we do based on the study results?
Dr. Crosnoe’s response – audio 4
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
