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Another FDA approved drug is recalled. “Approved” does not mean fully tested.

The weight loss drug Belvique has been withdrawn from the market by its producer, Esai Pharmaceuticals After post-marketing studies revealed an increased risk of cancer.

The FDA approved the drug for routine prescription, but only if the maker conducted “post-marketing” study of a potential cancer risk identified in preliminary research. That five year follow up study revealed an increased risk of cancer among those taking the approved drug. This is another example of why “approved” does not mean fully tested.

All medical decisions should be made with your full collaboration and understanding of the benefits, risks, alternatives, and unknowns of the treatment being prescribed.

If you would like to learn more about how we can help educate you about medical facts, or coach you to collaborate better with your doctor regarding your medical decisions, email us or call 203-692-4422 for a free introductory consultation.

When the prescribed cure is the actually the cause of an epidemic, the real cure is collaborative critical analysis.

Imagine going to your doctor with a problem, and getting a prescription that not only worsened it, but has a one in ten chance of actually killing you instead.  
The dramatic cognitive error that led medical experts to overlook an accepted medication as the cause of a serious epidemic is not rare. This essay from Massive Science  details how this kind of medical error has happened more than a few times in modern medical history.  We’ve witnessed many of those kinds of episodes over our 42 years in the healthcare field.
The cognitive bias built into the medical paradigm of treating diseases with poisons or clever devices designed to control biological functions (all medications poison some part of the biological system) often leads doctors to fail to distinguish the cure from the disease.  
Only robust doctor-patient collaboration to relentlessly analyze the benefits, risks, alternatives and unknowns of medical decisions can mitigate this powerful limitation of medical science and culture.
The essay vividly illustrates 2 critical problems that impede such shared health care decisions.  
First, the frequency of unknown effects of many treatments after they are approved for use but not adequately tested for all adverse effects.  
Second, the cultural blindness many experts and doctors have to those unknown possibilities.
The essay reviews some deadly illnesses that were attributed to diseases rather than to the side effects of their treatment that were causing those illnesses.  It reveals the cognitive biases built into the medical paradigm of treating diseases with approved medications but not considering the unknown possibilities of the adverse effects of the treatment on the patient.
It also reveals how difficult it is for even the best doctors to avoid that trap.  We at Operam have witnessed the effect over our long careers in healthcare, and we are dedicated to helping you ask your doctors the kinds of questions that can help them avoid the trap as they make medical decisions with you for your care.  
If you would like to learn more about how we can educate and coach you to better collaborate with your doctors, call us at 203-662-4422, or email ajc@operamhealthcare.com for a free introductory consultation

For the New Year, resolve to exercise your way to health and to healthy collaboration.

Over our long careers, we at Operam Healthcare have promoted sensible weight training and cardiovascular exercise as one of the most fundamental self-management practices for staying healthy and preventing a multitude of illnesses and their complications.
And so as we all collectively celebrate the symbolic end of one run around the sun and set off on a new adventure in orbit, we would like to share this Joyful report from NPR describing the benefits of exercise, and providing some simple, sensible advice on how to engage in it.
We would add one thought, which is to take every opportunity to lift, push, and pull some weight around in your everyday life; gardening, yard work, taking stairs, carrying groceries, doing some cleaning chores, hiking up and down hills, and even working small weights at your desk can engage those muscles that will keep your mind-body strong and in a healthy and harmonious biological rhythm.

Then, when you visit your doctor, be sure to review how exercise fits into any treatment plan they have for you. That will often change the balance of your medical decisions.  It is a powerful way to collaborate with your doctor for your health.

And so Happy New Year.  Let’s hope it’s a good one.

If you would like to learn more about how to take charge of your health and healthcare, e-mail ajc@operamhealthcare.com, or call 203-692-4422 for a free introductory consultation.

Critical reading skills for media reports needed to remain informed and make good decisions

A recent dangerously misleading headline and report on NPR does not accurately reflect the content of the story, and reinforces the need for critically reading media reports to skillfully taking charge of your own healthcare.  Don’t let the media mislead you.

The report is about a conference on how blood sugar metabolism in the brain might predispose people to Alzheimer’s disease.  The headline claims that controlling blood sugar could prevent Alzheimer’s disease. But it could be very DANGEROUS to try to lower your blood sugars without using great caution in how you do it.  

And simply lowering blood sugars using current methods, even just lifestyle change, has not been proven to help reduce your risk of Alzheimer’s disease.

Though the participants in the conference did discuss how “keeping your blood sugar in check could lower your Alzheimer’s risk.”, the key conclusion was that while their findings advanced the science of brain glucose metabolism, and found potential links between how the brain metabolizes glucose and how it could develop Alzheimer’s disease, no clear causal conclusions could be drawn.

Importantly, the current methods of controlling blood sugar were not tested for their safety and efficacy in preventing the development of Alzheimer’s disease.

A key disconnect in the data not mentioned in the report was that while Alzheimer’s disease only affects one percent of people in the US, there are many more diabetics than that who have poorly controlled blood sugars.  

Much work needs to be done before the interesting findings presented by these scientists can be translated into a safe and effective plan for treating diabetes to prevent it from causing  Alzheimer’s disease.

An important caveat was stated clearly in the article; Low blood sugar could cause problems that lead to Alzheimer’s disease.  That means exerting caution in how patients control their blood sugar to avoid low, as well as high levels.

Also of note, the apoE enzyme mentioned that normalized brain sugar metabolism and brain cell function in rats worked in rats with high blood sugars.  That suggests that the blood sugar itself is not the problem, but rather that how the brain cells handle blood sugar causes trouble.

We repeat, do not try to change your diabetes treatment plan without first talking to your doctor.  But by all means talk to your doctor about doing the best you can to keep your weight safely down and your blood sugar safely controlled.  As the report does mention, there are lots of reasons to do those things for yourself.

At Operam we help you learn how to ask and answer important questions about your health, and work well with your doctors to make the best decisions about your health care and disease management.  Call us at 203-692-4422, or email us at ajc@operamhealthcare.com for a free consultation.

Personal preparation for the time when advanced care can be as harmful as it can be helpful.

The critical importance of strong advanced care planning:

Our recent experience with a personal family illness revealed how easy it is for even seasoned professionals to become hesitant at a time when decisions must be made at a critical moment. Even a full understanding of benefits, risks, alternatives and unknowns wilts under the pressure of knowing how you or your loved one wants to live their life when living it will be under a compromise between quality and quantity.

It’s easy to personally value “quality” over quantity, but understanding the details of what that means for different levels of compromise can be overwhelming when there are many variables and unknowns to consider.

Don’t let medical technology overwhelm your personal identity, needs and and values when a health exigency or crisis occurs.

Doctors often make decisions that seem right based on expert guidelines or recommendations, but don’t account for your own personal needs, values or goals.

While individual diagnostic or treatment plans are often difficult to comprehend or integrate, the most important time for making fully shared decisions is when medical science and technology don’t offer easy solutions or certainty.

It is critical to be prepared for that time by having carefully examined and fully communicated your own or your loved one’s goals and values. When a crisis occurs for you or your loved ones you can then more effectively collaborate with your doctors or other caregivers. It is all too easy to become overwhelmed with the complex medical decision making that must occur in the chaotic environment of a medical crisis.

If you would like more information, education, coaching or advocacy to prepare for the time when medical technology cannot give you or your loved ones’ life back, but can take away your opportunity to live a dignified and peaceful life as life’s end approaches, check our website and email or or call for an introductory consultation about advanced care planning.

Navigating the unknowns of medical science requires strong collaboration

A teacher and mentor of mine once confided, “I want you to know that half of what I teach you is wrong. Unfortunately, I don’t know which half.”

We often write about the incomplete nature of medical science. New findings and recommendations about the use of aspirin to prevent heart disease reveal how difficult navigating such incomplete science is.

The authors of the study quote an expert who states, “Our findings show a tremendous need for health care practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease,” 

The expert is referring to those same healthcare practitioners who just recently routinely recommended using aspirin to prevent heart disease.

What is missing from all of these recommendations is a healthy recognition of the unknowns in medical science. A deep understanding and consideration of those unknowns is critical to making a medical decision that matches your own goals and values.

We can help you to navigate the unknowns by educating you on particular topics and coaching you on how to use your knowledge to better collaborate with your doctors.

Email us at ajc@operamhealthcare.com, or cal 203-692-4422 for a free introductory consultation.