Thursday, July 15, 2010

Hippocratic oath?

Most scientists agree that multiple sclerosis is a multifactorial disease. Everything from the environment, place of origin, having a predisposition to the disease, diet, vitamin D, including a unique genetic code have been proposed as a possible trigger the onset of MS.

If everyone agrees with this hypothesis why does it appears so difficult for the college of doctors and medicine to accept the possibility this disease may involve more than the central nervous system. It would seem logical to implicate professionals specializing in all hypothesis brought forth so that they could lend their expertise. Unfortunately It appears the reins of power are held by neurologists who for the most part appear unwilling to accept opinions from anyone regarding this disease, you almost get the sense that they enjoy the control the power they can exercise over a targeted patient group. From my perspective their emphasis for the most part appears centered on reducing the number of exacerbations a patient with MS will experience. Once the patient's disease progresses to the point where they are considered secondary progressive or if heaven forbid they are primary progressive casualties then treatment is generally limited to asymptomatic treatment which is about all they can offer. Pharmaceutical firms offer little to treat secondary progressive or primary progressive MS, a good portion of this population quite often cannot complete the necessary tasks to participate in a trial. Wouldn't it be a good idea to have a different set of tasks for those of us with secondary progressive or primary progressive MS and not to be simply written off once we have reached this threshold.

Isn't one of the first things you do when you receive a doctorate is to swear allegiance to uphold the Hippocratic oath? Given what medicine is today with so many specialists does it mean the oath applies to a portion of a patient's anatomy more specifically if you are a neurologist does the oath apply only to the central nervous system of that patient or is it all encompassing? If it is all encompassing as I suspect then wouldn't withholding treatment for an obvious abnormality or deficiency constitute a violation of this oath ?

Wouldn't isolating a specific group identifying them and preventing them from identifying the need for treatment constitute discrimination?

In the case of the liberation treatment proposed by Dr. Zamboni is it not possible that this is but one of the multifactorial conditions required in the development of MS? More importantly, can the patient obtain a benefit from correcting a malformation or stenosis?

From my experience it appears very few who have had the procedure have not noted some type of benefit thus facilitating their activities of daily living, isn't that what it's all about? My understanding is five locations in the United States will soon be providing this treatment, a few locations in Canada can be found yet one needs to do extensive research to uncover their locations. Why the secrecy, people suffering from kidney failure have this procedure done routinely it really is not that big of a deal, certainly there are risks every medical procedure carries risks therefore it becomes a risk benefit ratio and so far the benefits appear to far outweigh the risks involved.

I'm 53 and I doubt I will ever see the results from this study, I don't mean what we are doing now which is basically repeating what has been already been proven from the study in Buffalo and Georgetown no I mean results from an actual double blinded study.

We are already questioning the ethical issues surrounding the involvement of patients taking a placebo while participating on a trial, can you imagine if this trial involves surgery of any kind. Realistically I cannot see this happening at least not in Canada, what we will do is follow in other countries footsteps. Hey let's follow Australia, Italy and a number of other countries where this procedure is fully funded and regarded as a totally separate issue from MS, it's a vascular condition that when corrected just so happens to relieve MS symptoms.

A patient suffering from kidney failure is usually followed by a urologist, a vascular surgeon, a radiologist to name a few and this is a disease we can identify and treat why not implicate all of our resources for something we do not understand, it just doesn't make any sense to me whatsoever. I'm surprised that no lawyer has jumped on this to start a class-action lawsuit on the basis of discrimination, it may happen in the future and while unfortunate it may be the only means to get this issue resolved once and for all.

I will continue searching and if I come up empty-handed I may file a claim with the human rights commission, providing them with a lengthy petition would certainly not pose great difficulty.

And that's my two cents!

Tuesday, July 6, 2010

Depression Caused by Brain Atrophy in Multiple Sclerosis Patients

Received an article this morning which had me thinking, are the people who conduct these studies real? Seems to me they're missing the point, I certainly hope they did not spend thousands of our tax dollars in order to conduct this study.

Perhaps it would have been a novel approach to speak with people who have MS to find out the causes of depression.

You would think losing one's ability to walk, the constant numbing and tingling of extremities, the spasms, optic neuritis, incontinence could possibly contribute to cause depression?
                                                                                                                                                                                      I would think depression would be very likely to occur given these conditions.                                          For some it is quite possible depression begins the day they receive their diagnosis.
Come on folks, and this is for you scientists, please focus on the actual issue here the cause of MS and not some research which in my opinion provides little value.

You certainly don't require a PhD to understand that if your brain atrophies a host of cognitive issues may arise yet suggesting the atrophy causes depression in MS patients is akin tol putting the carriage in front of the horse don't you think?

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