💊 Safe and Effective … Or Perhaps Not

As I work, between other tasks, to clear out the news chum, here’s a collection of articles related to health, medicine, and drugs:

  • Co-Pay Accumulators. One of the big problems with our medical system in the US today is how we pay for drugs, and a large part of that are the games insurers make us play. Consider co-pay accumulators. These impact use of those coupons drug manufacturer’s provide to make their drugs affordable. Copay accumulators mean that coupons no longer will be counted toward patients’ deductibles. When you use the coupons, you pay a fixed amount. The drugs manufacturer takes care of the difference between that fixed amount and what the drug company charges (or what insurance would pay). More importantly, the coupons are often applied to the insurance deductible (especially for injectable drugs ), speeding up the point where your out-of-pocket max is met. Co-pay accumulators, on the other hand, allow insurers to double dip: They get their full co-pays and they get to extend the duration of patients’ deductibles. The article is an interesting read for the exploration of the pros and cons.
  • Anticholinergic drugs and Depression. Recent studies are showing that some classes of anticholinergic drugs — particularly those used to treat depression, Parkinson’s and urinary incontinence — carry a higher risk of cognition problems or dementia. The concern is those anticholinergics used for depression (e.g. amitriptyline), urinary incontinence (e.g. oxybutynin) and Parkinson’s disease (e.g. procyclidine) were associated with around a 30% increased risk of developing dementia. Amitryiptyline is of interest to me, as it is a common drug used for migraines as well.
  • Depression Drugs and SuicideMore than a third of American adults use medications that list depression as a risk, and a quarter use drugs that increase the risk of suicide. The 203 drugs researchers identified aren’t obscure; they include some of the most commonly prescribed medications around — like birth control, beta blockers for high blood pressure, and proton pump inhibitors for acid reflux. Many are drugs used for migraines. The researchers from the University of Illinois and Columbia University discovered people using these drugs had an elevated risk of depression compared to the general population. And the more medications with depression as a side effect people took, the more their risk of the disease increased. It is certainly something to be aware of. [And while I’m ending a sentence with a preposition, here’s why that is considered bad.]
  • Yogurt and Chronic Inflammation. A recent study provides new evidence that yogurt may help dampen chronic inflammation. The study explored the hypothesis that yogurt may help reduce inflammation by improving the integrity of the intestinal lining, thus preventing endotoxins — pro-inflammatory molecules produced by gut microbes — from crossing into the blood stream. While anti-inflammatory medications like aspirin, naproxen, hydrocortisone and prednisone can help mitigate the effects of chronic inflammation, each comes with its own risks and side effects. There is a need for additional options — particularly safe, gentle, long-term treatments. Researchers have been exploring dairy products as a potential dietary treatment for more than two decades. Findings have been mixed, setting up a scientific debate about whether dairy products are pro-inflammatory or anti-inflammatory.
  • Baking Soda and Auto-Immune Disease. Here’s another interesting study, this time concerning baking soda (the most effective antacid, in my book). It appears that a daily dose of baking soda may help reduce the destructive inflammation of autoimmune diseases like rheumatoid arthritis. The study is some of the first evidence of how the cheap, over-the-counter antacid can encourage our spleen to promote instead an anti-inflammatory environment that could be therapeutic in the face of inflammatory disease, Medical College of Georgia scientists report in The Journal of Immunology.
  • Dealing with Chronic Pain. We’re all hearing about the opiod epidemic. Yet for those with chronic pain, they are often the only choice. What if they weren’t, and I’m not talking CBD as an alternative. Pain often has a psychological cause or at least a psychological component. There are 100 million Americans who suffer from chronic pain, and an unknown number of them with back pain, neck pain, fibromyalgia symptoms, or other forms of pain that have no diagnosed physical cause. There have been numerous studies showing the benefit of placebos — in other words, belief that something will work — and belief is a large component of why prayer works for some. The problem is  the psychological component is often dismissed or never acknowledged. Cognitive behavioral therapy, meanwhile, shows meaningful benefits on chronic pain — both for psychogenic pain, and for pain with a physical cause — according to systematic reviewsof the research. There’s also promising research around mindfulness-based stress reduction and therapies inspired by it.

🗳️ Respect, Tolerance, and Being the Example

Yesterday, over on Facebook, I shared a meme from the group No Labels, a movement for people who are fed up with the dysfunction in Washington, and will no longer put up with a government that does not represent the interests of most Americans. The meme consisted of four lines:

  1. I put my country first.
  2. I vote for the person, not the party.
  3. I respect everyone’s opinion, even if I do not agree.
  4. That’s what it means to be an American.

Hoo, boy! You should have seen the responses. Yes, it wasn’t worded exactly correct (which memes are); in particular, line 3 should have been “I respect individuals, and I tolerate everyone’s opinion, even if I do not agree”. But still, it made me realize that I have a number of progressive readers that, while they profess tolerance of a wide variety of dimensions — religion, skin color, orientation, size, etc. — they don’t extend that tolerance to the political or idological realm. If you are a Conservative, if you are a Trump support, especially if you are on the far right of Trump supporters, they won’t tolerate you. They feel obligated, in some ways, to belittle and insult, to scream yell and fight. I’ll note that I haven’t heard much on this from my few Conservative readers — I don’t know if they are the same way for the folks on the far left. I’d expect they are.

This baffles and bothers me no end. I have always been taught that repentance is always possible. One can turn away from evil ideologies and make restitution. There have been numerous cases of White Supremacists doing exactly that, and turning around and working against the ideology. This has happened because they found people that accepted them as people, and convinced them of the errors of their ideology. They were treated with respect and not dismissed.

I believe there is a large undercurrent of Trump supporters that support him not because they necessarily agree with all he says, but because they are pissed at how Liberals have treated the Conservatives. They see us dissing and disrespecting them, so why should they listen to us at all? I’ve seen people who have voted for Trump, or for similar politicians, for the reason that it would piss off the Liberals, not because they like the politician. Why do many Liberals behave this way? Because the Conservatives behaved that way when Obama was President, dissing and disrespecting the Liberals. And they did it because of how the Liberals behaved when Bush was President. And the Liberals behaved that way because of how the Conservatives behaved when Clinton was President. See the pattern. We’ve got to break it.

There were some good articles of late relating to this. In an opinion piece about Robert DeNiro’s “Fuck Trump” at the Tony’s and how that turns off voters, the author wrote:

You’re right that Donald Trump is a dangerous and deeply offensive man, and that restraining and containing him are urgent business. You’re wrong about how to go about doing that, or at least you’re letting your emotions get the better of you.

When you answer name-calling with name-calling and tantrums with tantrums, you’re not resisting him. You’re mirroring him. You’re not diminishing him. You’re demeaning yourselves. Many voters don’t hear your arguments or the facts, which are on your side. They just wince at the din.

You permit them to see you as you see Trump: deranged. Why would they choose a different path if it goes to another ugly destination?

In an interview with Trevor Noah in the LA Times, when asked about his most important on-the-job lesson, he said:

Many of the people you deal with in politics are doing what they think is right, according to their point of view. There are a few disingenuous bad actors who know how they’re contorting facts or reality or issues to mobilize people in the direction they desire. But it’s really, really hard, and it took me a while to realize, that many people genuinely are pursuing the direction they believe is correct. So I had to learn how to deal with those people in an empathetic way as opposed to in a condescending way. I don’t have to agree with you; I don’t have to think that you are right. But I will do my utmost to treat you as the human being I hope you would treat me as.

I want to emphasize that ending: ” I don’t have to agree with you; I don’t have to think that you are right. But I will do my utmost to treat you as the human being I hope you would treat me as.” We can disagree and argue about ideas and behaviors. We can insist that those are wrong. But the underlying person — whether brown, black, white or green; whether MS13 or Phi Betta Kappa; whether Conservative or Liberal — is worth respecting, for if you dismiss them out of hand, you have no chance of turning them around. Respect doesn’t mean agreement. It means listening to what they say, showing that you have heard what they said, and then based on what they said convincing them of a different viewpoint. It is the exact same respect you have been taught to show for your spouse.

If we want to have any chance of changing the administration to something that approaches something somewhat normal (and remember, when compared to Trump, even  such past bad examples as Nixon and Bush 43 look good), we can’t have people voting out of spite. That’s true whether the person is a Trump-ista, a Bernie-crat, or a Hillary supporter. We need to listen, we need to understand their concerns (which are often multifaceted, and not just a particular bad ideology). We need to accept the person, even as we reject the ideas. If we do that, we may be able to move that person (or people observing the discussion) between the partisan divide based on labels alone, and get them to see how close to the brink we have gotten.

Going along with this should be the notion of consistency: If something was wrong for one side, it is wrong for all sides. If, for a given behavior, it was unacceptable for Obama to do it, it should be equally unacceptable for Trump to do it. The “rightness” or “wrongness” of an action doesn’t change “because it’s our guy”. There are numerous examples of this that I’m sure you can think of. Private email servers. Unsecured phones. Attempts by Communist governments to interfere in our elections. Working with dictators and those that impinge on human rights. We need to be consistent on what actions are acceptable and what is not. That also goes for our behavior. If you are behaving in a way that you would have criticized if your political opposite did it, then don’t do it. Did you get upset when Conservatives made fun of Obama’s looks. Then don’t do it for Trump. Be consistent. Consistent approaches as to what is the correct behavior, independent of whether you politcally agree with the person you are criticizing, is another form of respect.

OK. I think this rant is done.