Archive for the ‘Health’ Category

Medicine & Religion: Is confession a potent balm against major diseases in RP?

February 16, 2009

Dr. Francisco Duque III, the secretary of the Department of Health (DOH) reportedly said a staggering 80% of Filipinos are suffering from non-communicable diseases (NCDs) “due to unhealthy lifestyle.” The doctor goes on to say that to combat cardiovascular illnesses, cancers, and diabetes, people have to go to church and make regular “confession.” I find his religious recommendation oddly misleading. It needs clarification.

“Among those considered as NCDs are cardiovascular diseases, cancer, and diabetes. Duque said the three are now among the major health problems in the country. Duque said one way to address this problem is for the people to go on regular confession.” I suggest that they go to church to pray and confess their sins because its one way of managing”— (02/16/09)

It isn’t unusual to blame stress as a cause of sickness. Though stress goes with almost all diseases, its role is often indirect, sometimes obscure, in many organic diseases. As far as science is concerned, most illnesses have underlying pathogenetic bases whose roles are generally far-reaching than the effects of stress.

Heart diseases are related to high fat diet, sedentary lifestyle, and smoking. Diabetes mellitus may have an autoimmune basis but can come with risk factors like obesity, lack of exercise, and genetics. Certain cancers are triggered by stepwise mutations (alterations in the DNA) that generate clones of abnormal cells that invade, metastasize, and eventually kill the body. In all these, stress plays a role, albeit less strongly than what is suggested by Dr. Duque.

The act of confession (reconciliation) taught by certain religions is not shared by all believers. Confessing sins to a priest by the Catholics has markedly dwindled in recent years. Dr. Duque may encounter criticism and opposition in recommending the holy sacrament to prevent non-communicable diseases. There are non-faith based treatments in medicine which are more predictable and efficacious.

Stress is part of the normal challenges of daily living. Not all people who go through significant emotionally disruptive situations get ill in the process. Sick and healthy individuals, suffer from harrowing conditions in varying degrees. As such the roles of stress in every illness are hard to quantify; their effects on the body aren’t uniformly the same.

I believe emotion plus the working of the mind, and the entire body equilibrium are influenced by stress more than it affects specific organs of the body. It is probably the reason why religion, spirituality, a belief in the supernatural, exercise, meditation, and relaxation regimens have some roles to play in disease management. The mechanisms behind their healing properties aren’t fully understood.

Yet, medical science offers credible explanations in disease causation and treatment. Illnesses can be attributed to causes like direct physical injuries, infections, cancers, immunologic conditions, hormonal swings, metabolic derangements, nutritional deficiencies, hereditary disorders, chemical, drug and radiation exposures, poisonings, among others.

Stress is only one among the long list. Therefore, “confession” as Dr. Duque suggested may help in being healthy, preventing sickness, and going through an illness and subsequent recuperation. But surely, we need to account for greater ways to fight diseases more than what have been recommended by the standard and complementary approaches of medicine. This is important in the holistic way of maintaining the health of the nation.(Photo Credits: denislpaul; sacerdotal) =0=


Octuplets spark debate on medical, socio-economic, & moral issues of assisted pregnancies

January 31, 2009

The birth of 8 babies to an unmarried California woman who already have 6 children and lives with her parents sparked controversies which cover medical, social, economic, moral and rearing issues. The unusual multiple births by caesarian section of octuplets by 33-year old Nadya Suleman didn’t come without the help of fertility treatments. This is according to Angela Suleman, the 31 week-old babies’ grandmother who said her daughter, the mother has been “obssessed” of having children. In spite of having delivered babies in the past, she chose in-vitro fertilization because of clogged fallopian tubes.

In-vitro fertilization (IVF) usually involves implanting fertilized embryo (blastocyst stage,) normally no greater than six, usually 2 or 3 in the womb. If more than two embryos take, the patient is given the choice by her physician to keep the babies or kill some of them in an abortion-induced reduction procedure. Many doctors focus on giving the best medical care and they feel it’s not their duty to dig on abortion issues (rights of the unborn) or prescribe how many children their patients must have. Suleman opted to keep all babies whose number was erroneously determined by ultrasound as 7.

Certain religious believers and anti-abortion advocates decry the practice of pregnancy reduction by doctors. Although Suleman rejected the offer to have any of her babies aborted after they were artificially set to develop in utero, there are strong objections on the medical and ethical judgment of implanting the 8 embryos on her who already have six children. There are those who believe the fertility doctor must be investigated and sanctioned for a breach of standard practice.

In 30 years of practice, “I have never provided fertility treatment to a woman with six children,” or ever heard of a similar case, said Dr. David Adamson, former president of the American Society of Reproductive Medicine and director of Fertility Physicians of Northern California.—Yahoo.News/ AP (01/31/09 Watkins, T; Neergaard, L)

There are strong doubts if the unmarried Suleman has the capacity to care for the 6 boys and 2 girls born premature along with 6 older children, ages 2 to 7. It is unclear whether she is employed, though she lives with her parents who are not financially stable. The parents filed bankruptcy last year with more than $900,000 liabilities. Records show Suleman kept a psychiatric techinician license in 1997 to 2002.

The premature octuplets who are currently cared for in a Kaiser Permanente hospital surely need specialized care. With skyrocketing medical costs in a state teetering towards financial insolvency, many critics fear Suleman may not be able to sustain the duties of a single mom— the physical, psychological, social, and economic demands of rearing 14 dependents. If she can’t keep up with the burden of motherhood, she may require public assistance and the effects on the children are hard to know. It is likely the cost of rearing them will be passed on to taxpayers and society in general. (Photo Credits: byaconnel73170; Ekem PD)=0=

UPDATE: February 2, 2009. Many critics believe the doctor didn’t make good ethical judgmentt in placing at least 8 embryos on Nadya Suleman whose mother Angela is critical of her daughter’s “obssession” to have babies.


Fecund birth and elderly parturition

December 19, 2008

The arrival of a baby is one of the happiest moments of a family. It is even happier for the Duggar family in Arkansas that welcomes Jordyn-Grace Makiya, a 7 pound, 3 ounces baby girl, the 18th member of the brood. Jim Bob Duggar and wife Michele who are devoted to parenting have now 10 sons and eight daughters. “The ultimate gift from God,” said the ecstatic father whose baby was born by caesarean section (CS) on Thursday, December 18, 2008 at Mercy Medical Center in Rogers, AK.

In India, a similarly happy couple celebrates the birth of their healthy daughter after a pregnancy that was made possible by fertility treatment. At 70 years old, two decades beyond the usual age of menopause, Rajo Devi delivered by CS at the National Fertility Center in Hisar, India, Monday, Dec. 8, 2008. She and husband Bala Ram, 72, had been trying to have a baby for about ten years in a community which bears stigma on childless couples.

Because of modern technology, changing cultural norms, and individual preferences, more couples like the Duggars and the Rams are able to decide on unusual choices of family size and age of childbearing. It is unclear what these choices will bring to their children of the future. (Photo Credit: AP/ Beth Hall; AP /Devendra Uppal) =0=


Top 10 leading causes of death: Philippines (2003) & USA (2005)

December 11, 2008

Ten Leading Causes of Mortality Philippines, 2003

1. Heart Diseases—————-38,677—29,019—–67,696–83.5–17.1
2. Vascular System Diseases–29,054—22,814—–51,868–64.0–13.1
3. Malignant Neoplasm———-20,634—18,664—–39,298–48.5–9.9
4. Accidents———————–27,720—6,246——33,966–41.9–8.6
5. Pneumonia———————15,831—16,224—–32,055–39.5–8.1
6. Tuberculosis, all forms——-18,367—8,404—– 26,771–33.0–6.8
7. Symptoms, signs and abnormal
clinical, laboratory findings,
8. Chronic lower resp. dis. —–12,998—5,907——18,905–23.3–4.8
9. Diabetes Mellitus————–6,823—-7,373——14,196–17.5–3.6
10. Certain conditions
originating in the
perinatal period——————-8,397—-5,725——14,122–17.4–3.6

Source: The 2003 Philippine Health Statistics
* Percent share from total deaths, all causes, Philippines
^ Rate per 100,000 population
Last Update: January 11, 2007

US Mortality 2005
—————————————–Number of Deaths————-% of all deaths
Heart Disease————————–652,091——————————26.6
Cerebrovascular Disease————143,579——————————-5.9
Chronic Lower Resp. Dis. ———–130,933——————————-5.3
Accidents (unintentional) ————117,809—————————–4.8
Diabetes mellitus———————–75,119——————————3.1
Alzheimer’s Disease ——————-71.599——————————2.9
Influenza & Pneumonia—————-63,001——————————2.6
Nephritis*——————————– 43,901—————————–1.8

*Includes Nephrotic Syndrome and Nephrosis

Source: US Mortality Data, 2005, National Center for Health Statistics, Center for Disease Control and Prevention, 2009

What is striking in these two tables is the primacy of heart diseases as the top cause of death in both the Philippines and USA. This includes congenital heart problems such as hereditary valvular and septal anomalies; acquired heart illnesses like ischemic, coronary, hypertensive, cardiomyopathic, and infectious conditions are included.

However, in a new report on Dec 10, 2008, cancer is noted to be on the rise. It is expected to top the list of disease killers by the year 2010. The main cause given is the unabated use of tobacco—resulting to an increasing incidence of lung and respiratory malignancies particularly in developing countries.

One notes the exceedingly high accident mortality rate in both countries—deaths that are basically preventable. The vehicular-injuries mortality in the Philippines is strikingly more than 4x in males, those who ply the streets as drivers and travellers.

Greater than 2,000 children are killed every day, or about 830,000 every year, from injuries sustained in preventable accidents, a United Nations’ report said.—PDI (12/11/08, Uy,V)

If #7 NEC in the Philippine data means necrotizing enterocolitis and #10 refers to perinatal diseases, they indicate high mortalities in newborns and children which isn’t reflected in the US data.

Tuberculosis, a treatable old chronic infectious disease still comes as #6 in the Philippines while in USA, Alzheimer’s disease, a degenerative illness of aging ranks high as the 7th leading cause of death.

The disparity of these data serves as a guide on the current healthcare planning and services respective countries must offer. Most of these top killers are preventable in which educational campaigns and proper medical care have significant roles. (Photo Credits: SterlingArtz; Poodle boi)=0=

RELATED BLOG: “The Death Clock and the Dangers of Smoking” Posted by mesiamd at 10/22/2008′ “Cancer races as the #1 disease killer in 2010” Posted by mesiamd at 12/11/2008

Cancer races to be #1 disease killer in 2010

December 10, 2008

The World Health Organization (WHO) recently reported that cancer will lord as the leading cause of death by 2010. The disclosure predicts that if trends continue, by 2030 new cancer diagnosis can reach 27 million, jacking up the number of sufferers to 75 million worldwide. A staggering 17 million of them are expected to die in that year surpassing the top killer: cardiac diseases.

It has been noted that cancer worldwide is on the rise, eclipsing the upward climb of infections and heart diseases. Countries like China, Russia, Indonesia, and India are known to have a huge smoking population. It is believed that tobacco-smoking in developing countries is the main reason for the increase in cancer cases, mostly in developing countries where at least 40% of smokers reside. Population growth and better disease recognition also add to fresh cancer diagnoses which are expected to reach 12 million this year.

Country/%/# of Smokers in Millions
Malaysia————2.90%——– —-3.65
ASEAN Countries–Total————- 125.8
Source: Southeast Asia Tobacco Control Alliance (SEATCA) Philstar (09/04/07, Crisostomo, S)

Cancer is one of the greatest untold health crises of the developing world…Few are aware that cancer already kills more people in poor countries than HIV, malaria, and tuberculosis combined. And if current smoking trends continue, the problem will get significantly worse,” said Dr. Douglas Blayney, president-elect of the American Society of Clinical Oncology.

“This is going to present an amazing problem at every level in every society worldwide,” added Peter Boyle, director of the WHO’s International Agency for Research on Cancer. —Reuters (12/10/08)

The concern for the cancer problem is real. Though it is potentially preventable and treatable among the major life-threatening chronic diseases, malignancies are blamed for 1 in 8 deaths worldwide. With the rising cost of medical services and the sharp increase of those who need care, treatment for cancer will over-burden the healthcare services.

Many countries worldwide aren’t prepared. The medical infrastructures needed to manage cancer patients are lacking or virtually non-existent. Governments are therefore urged to embark on aggressive cancer prevention programs, grassroots anti-smoking and anti-cervical cancer campaigns among others, to combat the emerging top killer. (Photo Credits: Andreia; Laura la Fataliste)=0=

RELATED BLOG: “The Death Clock and the Dangers of Smoking” Posted by mesiamd at 10/22/2008; “Cancer races to be #1 disease killer in 2010” Posted by mesiamd at 12/11/08.


More primary care MD’s needed for Obama’s promised healthcare reform

December 1, 2008

After a survey came out disclosing the frustration of primary care doctors who suffer in their job, the American College of Physicians (ACP) followed with a paper culled from more than 100 studies from the last 2 decades.

The report details the need for more primary care physicians whose number is dwindling. They are needed to improve healthcare and lower the cost of treatment.

If primary care physicians in a metropolitan area are increased by 15 %, researchers on health care utilization believe there will be beneficial cuts in the following services: emergency room 10.9%, surgeries 7.2%, inpatient admission 5.5% and out patient visits 5%.

In the last 10 years, US medical graduates entering family medicine and internal medicine have decreased to half its number. Many young doctors prefer high-paying specialties with less demand for time to see patients.

The developing doctor shortage crisis is a result of extended hours, low pay for primary care, and paperwork hassles associated with medicare, Medicaid, and private insurers. Sixty percent (60%) of surveyed MDs won’t recommend their profession. —American Medical News (12/08/08, O’ Reilly, Hedger, B)

The situation is best characterized by Ted Epperly, MD, president of the American Academy of Family Physicians (AAFP) when he said, “What remains unclear is how politicians’ promises to rescue primary care will play out in a likely fierce battle over health system reform. But raising awareness of the crisis is the start of finding a solution…. This won’t be turned around overnight. It will take a decade to get out from under this.“

A decade! That’s 10 years. 3,650 days!

A decade to correct the problem is incredibility long in the face of increasing health needs of Americans and rising cost of medical care. Obama has been served the notice. =0=

MDs plan to quit & its potential impact when 46 million uninsured Americans get their medical coverage

November 19, 2008

Before Pres. Barack Obama can assume office and work on his promised universal health care for Americans, primary care physicians in the United States are saying they are overworked.

Almost half of them plan to cut back on their practices or quit seeing patients. They are lobbying for rational reimbursements in their insurance claims particularly on Medicare and Medicaid patients.

In the survey by the Physician’s Foundation, 90% percent of doctors complain they devote too much time in paper work rather than take care of patients. Frustrated by the work environment, 60% of those surveyed is not recommending medicine as a career. Reuters (11/17/08, Fox, M; Wilson, C)

Experts say that there’ll be an increase in number of those who’ll need health care services. A rise of work load required for the aging Americans and the newly insured plus the upward climb in cost of treatment and medicines are likely to lead to a rationed medical care that Americans haven’t been used to.

Under the plan of Obama, 46 million uninsured will gain access to medical services. If not handled correctly, these may mean more triage of patients in the emergency rooms, longer lines in the doctor’s offices, greater cuts on tests, denials on procedures, and slowing of getting consultation appointments and treatments. The current health care isn’t ready to absorb the volume of work, much worse, if doctors scale down their practices or retire early from their jobs. (Photo Credits: by Julie70; Allsus)=0=

As nursing jobs become scarce, 88,750 brace for the next board examination

November 11, 2008

The nursing profession is often equated with tender loving care (TLC,) a trademark of compassionate service. In the Philippines those who are sick have reasons to be happy for they have more than the nurses they need. There is a surplus of nurses competing to take care of patients.

Nurses are desperate to grab employment in the nation’s crowded healthcare system. Four hundred thousand (400,000) are reported to be jobless; a wave of newly licensed professionals will join them after the next board exams. With the highest number of examinees in history, a total of 88,750 nurses will sit for the Philippine Regulations Commission (PRC)-administered licensure test on November 29 and 30, 2008.

Carmencita Abaquin and Marco Sto. Tomas of the Board of Nursing are happy about the advances in testing computerization. Having recovered from the cheating scandal in the June 2006 test, the exam administrators insist that the well-guarded computers will do the job. They promise that the conduct of the forthcoming licensure will be “leakage free.” Those who configure the computers aren’t expected to rig the reault. They assume the machines and testing materials are tamper-proof.

Yet, there’s a big problem that looms behind the effort to prevent cheating. Nurses are badly in need of work. Job recruitment has been slow. They can’t volunteer in hospitals because there is almost no vacancy even if many hands are willing to work for free. Having spent time, talent and treasure to become professionals, the nurses don’t have jobs mainly because of government indifference and neglect.

Four hundred thousand (400,000) unemployed young nurses translate into a disgusting waste of labor capital. The staggering number is a monumental setback to those who offer their career for the country’s most popular profession. In financial terms, this is a blow to the campaign to send workers abroad for more dollars intended to boost the local economy. The government seems disengaged, proudly slow to react to the problem.

As in the past, the blame and anger spread in all fronts, but nothing effective to correct the labor crisis has been done. The government’s labor allocation policy has failed. Unable to protect the nursing profession, Philippine lawmakers, labor planners, school administrators, and licensure officials haven’t acted to the satisfaction of the public.

Counted among the country’s reliable cash cows, the poor silent nurses are mercilessly brushed aside now that there’s little need for them inside and outside the country. The docile professionals, unable to vent their frustration, pathetically wait for the day when they’ll be able to find work. Sadly, the day isn’t coming anytime soon—for there’s hardly anyone to help them. Together with the unemployed, a fraction of the 88,750 board examinees is about to rush for jobs that aren’t there. (Photo Credits: glenmcbethlaw; uberdoog; allwaysNY) =0=

Bolante’s medical drama continues, but doctors say “telling the truth is therapeutic.”

November 8, 2008

When Jocelyn “Jocjoc” Bolante stepped out of the airport after he was deported back to the Philippines from USA, the former agricultural undersecretary went straight to the St. Luke’s Medical Center (SLMC) in an ambulance to start the tale of his illness. It is the familiar props of accused felons and shady characters which blur the distinctions between malingering and actual illness.

For sure, as I suggested in an old blog, Bolante is most likely suffering from health conditions that do not need a protracted “vacation” in a hospital suite. There are sicker patients out there who need his bed and people are tired of the drama which puts the medical profession’s credibility in a precarious balance.

In spite of the high-brow medical jargon SMLC’s Dr. Romeo Saavedra tells the press, Bolante appears in no immediate danger to die. His medical tests are long-drawn(running up to two weeks,) and sluggishly elaborate, belaboring the public to harbor doubts. One thing is sure though— Bolante needs to quickly come out of the hospital and answer the allegations surrounding the misuse of P232 million for fertilizer in 2003.

The murder of Marlene Esparat, the journalist-complainant of the case remains unsolved. And another scandal links Bolante to the P728 million misuse of money allegedly distributed to help Pres.Gloria M. Arroyo in her reelection. Think of the poor helpless farmers who have been adversely affected because government officials are neglectful and corrupt.

According to Senate Pres. Manuel Villar, Jr, Bolante is still under arrest and he sums up by saying “You know it is hard for us who are not doctors to talk about (Bolante’s condition) because even if he has no serious (health problem), we do not want to be blamed for whatever might happen to him.”

Rightfully, doctors of the Health Alliance for Democracy (HEAD) added Bolante could heal himself by telling the truth on the fertilizer fund scam. “Truth-telling is therapeutic,” says HEAD’s general secretary Dr. Geneve Rivera. Philstar (11/08/08, Punay, E.) Who will disagree? (Photo Credit: Icarusrising; mindmanifesting)=0=

RELATED BLOGS:Hospital: a vacation house or a sanctuary for malingerers?” Posted by mesiamd at 10/29/2008; “Accused of Plunder, Jocjoc Bolante, Returns from US a Deportee’ (10/29/08, Gimpaya, A)

UPDATE: After a long-drawn stay in the hospital (12 days confined in a suite as of November 10, 2008) doctors at St. Luke’s Medical Center released Jocelyn Bolante with a clean bill of health. This is what the public expects when the suspiciom is raised that felons and shady characters seek hospitals as vacation houses and malingerer’s sanctuary.

Hospital: a vacation house or a sanctuary for malingerers?

October 29, 2008

The spectacular show of Jocelyn (JocJoc) Bolante continued at the airport when an ambulance rushed him to St. Lukes’s Medical Center on his arrival on October 28, 2008. The deportee who lost his appeal for asylum in the United States allegedly complained of “chest pains” and hospital authorities are mum about his medical condition

“…as the then undersecretary for finance of the Department of Agriculture, Bolante was the architect of embezzlement of more than P3 Billion (around $64M), including P728M fertilizer fund, that were intended for farmers’ benefits…reports suggest that the fraud-tainted money was used as campaign fund of Gloria-Macapagal Arroyo in the 2004 presidential election.” UP “Accused of Plunder, Jocjoc Bolante, Returns from US a Deportee’ (10/29/08, Gimpaya, A)

Accused of stealing money from the Armed Forces of the Philippines (AFP,) Maj. Gen. Carlos F. Garcia committed a crime similar to that Bolante is charged of. Both needed some hospital stay. Garcia had himself confined in UST for alleged serious medical problems at the height of his trial only to be found guilty of corruption and acts unbecoming of a soldier.

Convicted child-rapist Romeo Jalosjos had been reported to have sought medical confinement for conditions like cough and high blood pressure that could well be managed on an out-patient basis.

Pres. Erap Estrada used the Veterans Memorial Medical Center as a private detention house until he was brought to Camp Capinpin in Tanay, Rizal. Later he was put under “rest house arrest” in his cozy villa across the camp on the bases of questionable medical reasons. His supporters were delighted, but the public couldn’t hide their scorn.

Yolanda Ricaforte, the bag woman in the Estrada plunder case also used some medical excuses. She pompously appeared in public in a wheelchair with a personal nurse during an investigation. With eyes shielded by dark sunglasses, she blamed hypertension for her “fragile” health. Her nurse in a white uniform plus a stethoscope on her neck stood by her side as though she could do something in case an emergency arise. After that appearance, Ricaforte surreptitiously rode a plane, skipped Manila to hide as a fugitive in America.

Filipinos understand that medical problems are used as props, distractions, and excuses during an inquiry or litigation. Lawyers exploit health reasons for their clients with the cooperation of their doctors. Not negating the need to stay in the hospital if there is true medical indication, the public is usually distrustful whenever people like Bolante goes straight to stay in a hospital suite (not the emergency room?) after his arrival in the airport. (Photo Credits: shashamane; suetortoise) =0=

UPDATE: GMA News reported on October 30, 2008 that Joc Joc Bolante is confined at St. Luke’s Medical Center for medical tests that will take 5 days—rather slow for a VIP. There is no apparent medical justification to keep him in bed in the hospital which can be better used by sicker patients. Many MDs suspect, with Bolante’s “stable” status, such tests on him are better done on out-patient (ambulatory) service.