Naked Medicine

Let's Face It: Medicine is Business

Category: Society

Alli is Really Over The Counter Xenical

I was wondering about the rash of recent television ads for a product called “Alli”. It was obviously a diet product, but I wasn’t sure if it was an herbal supplement or prescription drug. The tone of the ad sounded more like an herbal supplement, and the multi-colored lettering on the bottle looked gimmicky.

Turns out that Alli is the over the counter (OTC) version of an old drug called Xenical.

Some side effects associated with Xenical: Oily Spotting, Flatus with Discharge, Fecal Urgency, Fatty/Oily Stool, Oily Evacuation, Increased Defecation, Fecal Incontinence. In layman’s terms: your butt “leaks” oil, you may expect to have sh*tty farts, you may expect to have the sh*ts (and when you do you’d better pray you’re near a bathroom because you may not have much time or control), you may expect to have oily sh*t, and you may expect to have trouble sh*tting all other times.

The ads could have just said that and saved us a lot of trouble figuring out what this product really is. But that would be too obvious, and the marketers are counting on consumers not knowing any better to buy into the hype so the drug company (GlaxoSmithKline) can make some money before people figure it out for themselves.

The Fine Print in Breast Cancer Support Products

Wall Street Journal published “How to Tell if a Pink-Ribbon Product Really Helps Breast-Cancer Efforts” by Tara Parker-Pope on October 10, 2006 addressing the commercialization of breast cancer and how consumers can determine how much of the sales go to breast cancer research or causes.

Consumers are warned to make sure the product supports a legitimate cause because “anybody can use the pink-ribbon” logo. Fine print usually discloses the actual percentage going to the cause. Be wary of merchants who only states that a portion of proceeds go to support research without actually disclosing how much is spent.

The article cites some purchases that donates a generous amount – examples included Karey Kyle Rose Quartz earrings (67% of purchase price goes to BreastCancer.org) and a Van Cleef & Arpels pendant (51% of the $1950 price goes to the Breast Cancer Research Foundation). (more…)

Commercializing Diseases and Impotent Symbols

Jeanne Sather is an assertive cancer patient who has a gagging reflex with pink ribbons. I thought I was one of the few XX chromosomal species who can’t stand the color pink, and I’m comforted to know that Jeanne passionately detests pink, especially the shade of pink that Jeanne associates with “girly, sexist expectations.”

Her article, “It’s October–Time to Gag Me With Those Pink Ribbons” makes an important point: gross commercialization of breast cancer may send the wrong message to women and concomitantly desensitize us to the seriousness of breast cancer. Furthermore, the pink ribbon is exclusionary: men get breast cancer too. If a man with breast cancer wears a pink ribbon, I bet 9 times out of 10 he’ll get asked whether his spouse or female relative has breast cancer.

A ribbon used to work when it was a symbol unto itself, attached only to the its original cause. Now I can’t remember if a black ribbon is an activist symbol against torture or melanoma or lung cancer (lung cancer ribbon is sheer with gold, but black could be a logical lung cancer color if you think about the color of a cancerous lung). (more…)

Truth in Healthcare Sits Between Extremes

A friend sent me an article called, “Drugged out of our minds“, written by Larry M. Jones, a retired Navy Commander and aviator in Texas. Mr. Jones thought the reasons given by drug companies for high drug costs smelled fishy and didn’t appreciate having to fight for a parking space or waiting room seat with pharmaceutical “reps waiting to peddle their wares to the physicians.” Mr. Jones said it was a shame that some American citizens had to skip or split pills because they could not afford their treatment.

I can’t argue with how this “stinks” and how nice it would be if we could get free or affordable medications. I have a chronic condition for which I need to take daily course of prescription strength medication and I have to consider the cost in my budget. I may also have some sympathy toward the pharmaceutical industry because I have worked in pharma companies for most of my professional life and I have some insight into how much research, development, and marketing costs.

Healthcare and medicine strike highly emotional cords in all of us. We – not just the seniors – are becoming victims of “poorly managed healthcare”. Working professionals are fighting a different battle in healthcare – employer healthcare coverage – than elderly or retired citizens, but we all eventually progress to the same question of affordability and healthcare cost. (more…)

Misleading Healthcare Ads and False Claims

Google has made astronomical profit from its advertisement programs, at least $900 million. Certainly, Google’s Adsense/Adwords services has benefitted both website publishers and businesses alike. Nakedmedicine.com takes advantage of Google’s Adsense service to display contextual (relevant) ads that Google serves up from advertisers, and when visitors click through to products and services that they are interested in, this website benefits by gaining a few cents in the “Website Operations and Maintenance” kitty. Google also serves up text-based, contextual ads next to key word search results.

When you mix free speech, lax advertising content policy enforcement, and opportunistic merchants, you come face to face with asking where the buck stops when consumers are barraged with misleading healthcare ads and false claims for miracle cures. (more…)

Is Common Sense Out of Touch for Society?

Shortly after Merck’s Gardasil garnered media spotlight for being an innovation against cervical cancer development, Forbes ran a story on “Condoms Protect Against Cervical Cancer.” The article concluded with an expert’s quote that our society have undoubtedly heard at least a few hundred times over the course of growing up:

“Use condoms and use them properly,” Wu said. “It’s the best form of protection against STDs [sexually transmitted diseases].”

Sounds like common sense. Condoms protect against sexually transmitted diseases, and without potential side effects from drugs. Barring allergy to latex, condoms would score high on the scale of risk-benefit ratio. (more…)

Benefits of Power Napping

By Deborah Serani, Psy.D.

I am the Queen of napping. I can nap anywhere, anytime.
It’s one of my many talents.

Most often, at around 2:30 everyday, I am at rest. I am Semi-conscious, not sound asleep but not fully awake. I can ease out of this wonderful place without a jarring effect. And when I emerge from my catnap, some 20 minutes later, I feel so good.

The benefits of napping have been well documented. Research has shown that a nap can promote physical well-being, improve mood and memory, sharpen senses and revitalize a person. The neurons in brain functioning get to rest and recuperate from the day’s stress. Intellectual performance improves from the boost a midday nap provides and accuracy in performance increases too. MRI’s of nappers show that brain activity stays high throughout the day with a nap. Without one, it declines as the day wears on.

Research also says that taking a nap of 30 minutes a day is better than sleeping 30 minutes later in the morning. And from another psychological perspective, falling into a light sleep can feel meditative (like my semi-conscious experience). As you nap, the dreams and streams of thoughts you experience may offer insights you may not be able to grasp at night when you are in a deep sleep.

When you sleep under normal circumstances, your brain cycles through several different stages of Delta, Theta, Alpha, Beta, and Gamma sleep waves. You drift from one stage of sleep to another – from light sleep to deeper sleep to REM sleep to wakefulness and so on. Delta and Theta sleep, also known as Sleep I and Sleep II stages, are light stages of sleep. So, the key to napping is to not fall into the deeper stages of sleep. That is why a 15 to 30 minute nap is recommended. Napping more than that, and you’ll find yourself waking up cranky or groggy. (more…)

Suicide and SSRI When Medical Legal Risk is High

By Robert Lamberts, M.D.

I had a tough situation in the office yesterday.

One of my patients is a 17-year old who went to the ER on Sunday for shortness of breath. They said she had a panic attack and should follow-up with me as soon as possible.

When I saw her, she was clearly distressed, but not to the point of needing to be hospitalized. I asked her what was up and she told me that she had been kicked out of school recently because she stabbed someone with a knife – apparently only after that person grabbed her forcibly. She lives with her mother and her father is a homeless alcoholic. Her mother tells her not to talk to him, but he calls regularly and tells her that she is all he has. He also says that he might kill himself. She knows that he shouldn’t say this kind of thing to her, but it puts her in a hard situation. On one hand, she knows that it tears her apart to talk with him. On the other hand, she fears that if she does not talk to him, he will kill himself.

I asked her if she ever thought of killing herself, and she said she had – especially after talking to her father – but was not at this time suicidal. She had a real good friend with her who was very supportive.

So I am stuck in a dilemma. On one hand, she is clearly depressed and needs both medication and psychological counseling. On the other hand, since there is a black-box warning for using SSRI’s in teens, putting her on one would put me at huge risk for a lawsuit should she follow-through and kill herself. I think she is at very high risk of doing that in the long-run, and don’t really have a longstanding relationship with her as her doctor. I did what I could to tell her to talk with either her friend or me if she should feel she is close to killing herself, but I don’t really know her that well. I am trying to reach one of the local child psychiatrists, but most of them are several months out for new patient visits. (more…)

Personal Perspective of Manic Depression

By Tom Pauken II

“A Personal Perspective of Manic Depression: This reporter gives a first-hand account about the bipolar disorder” reprinted with permission from Mr. Tom Pauken II.

Bipolar disorder, commonly known as manic depression, affects 0.3 percent to 3.7 percent of the world’s population. Fifty percent of them seriously considered or attempted suicide. Forty-five percent of Americans with bipolar disorder believe this sickness made a high negative impact on their lives. Seventy percent of those same respondents assume the public doesn’t understand their condition.

These statistics were compiled by a Global Survey for World Mental Health Day 2005 (Oct. 10) also posted on the upliftprogram.com Web site. Are these statistics important? Do you know somebody afflicted with manic depression? Well, I consider these statistics important because I suffer from this ailment.

I make this revelation not to grab attention for myself. I’m more passionate writing about geo-political issues of the East Asia-Pacific region. I shun diaries and anticipate never using first person voice in future articles.

Nevertheless, I feel an obligation to my readers. I want those suffering from mental illness to feel inspired during their moments of darkness because I might be manic depressive but I’ve taken great strides to overcome my difficulties. (more…)

What Open Medicine Is and Is Not

A benefit – and side effect – of Internet culture is an embrace toward access and openness. I can access an abundance of free information on the web. I’ve always embraced open source applications, like the one used to create this website, and will continue to do so as long as it’s available.

However, a potential misconception called “Open Medicine” is a side effect of the Internet culture. I do not believe most people who advocate for “Open Medicine” on the web actually understand what “Open Medicine” really means, and all the ramifications and responsibilities that come with the term. When most speak of “Open Medicine” they refer to the idea that medical information should be freely available, transparent, and credible.

I don’t argue with the concept of making healthcare information available, transparent, and credible. After all, I created www.NakedMedicine.com to provide Accessibility, Honesty, and Integrity in healthcare information.

What I oppose is the misconception built around Open Medicine. In my opinion, here is what Open Medicine is NOT:

Open Medicine is not a blogging network, even if the blogging network is composed of a team of doctors, nurses, scientists, other healthcare “experts”, or anyone who has a burning desire to voice an opinion about a particular healthcare trend or drug.

In considering what Open Medicine really is, we only need to look at the basic definition of “Open” as it relates to this Internet phenomenon:

The basic idea behind open source is very simple: When programmers can read, redistribute, and modify the source code for a piece of software, the software evolves. People improve it, people adapt it, people fix bugs. And this can happen at a speed that, if one is used to the slow pace of conventional software development, seems astonishing. Source: Open Source Initiative.

In other words, Open Medicine can work only when we are allowing access to what is considered proprietary information or intellectual property, for the expressed purpose to enable collaboration to improve and innovate upon this “open” information. (more…)

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