Health Care for Aging Baby Boom Generation

I listened to the May 5th edition of Lizzie O'Leary's Marketplace Weekend (See this Link)

One of the segments went into detail about the current shortage of people willing and able to help care for older patients.  The segment described the relatively low pay and the sacrifices that healthcare workers need to make to do that job.  The problem is only going to get worse as the elderly population increases.  The sharp increase alzehimers patients is also overwhelming the healthcare system.  Over the past 20 years, the situation has been predicted by economists, public health professionals, and Governments.  It is clear that there will not be enough healthcare workers to handle the tsunami of the "baby boom" generation.  We are already having difficulty filling positions.  Even if wages for those jobs go up, it is unlikely that there will be enough workers. We have few alternatives:  Automation, import labor, or outsource the job.  Automation could really help. We could build and employ more robotic systems to do those jobs.  I believe patients could talk to robots, and robots could eventually perform a lot of the day-to-day care, such as feeding, bathing, and bathroom chores.  But it is unlikely that enough robots will be available during the next 10 years to handle this sharply increasing load of elderly patients.  We could issue "green cards" to caregivers from other countries such as Mexico, Philippines, India or South Africa. But those immigrants will want to bring their families and will need government services themselves.  Outsourcing seems like an improving option.  I think I might enjoy my final days if I could spend them at a nice, modern assisted living or nursing home located in Mexico, or the Philippines.  I believe may others would too!  If I had a large screen TV with internet capability, I could easily have "virtual visits" with my family.  My family could also keep track of my health progress by monitoring records via the internet.
The problem is that we don't have confidence that the care in other countries will be comparable to the US.  We also do not know if our US Government funded medical care will "cover" our care in those countries.  Taxpayers want to make sure there is no fraud involved in those expenditures.
We need our Federal Government to establish guidelines and negotiate agreements with other countries to enable companies in those countries to make investments in care facilities.  For example:

• International standards for design, construction, and operation of assisted living/nursing home facilities  -- not easy when we don't even have common standards among the US states.  

• An inspection and enforcement system to make sure that facilities not only meet the standards when they open, but also maintain the standards.

• International standards for professionals:  doctors, pharmacists, phlebotomists, nurses, nursing assistants etc.

• Tracking systems for bar-coded pharmaceuticals as they pass through the distribution system down to the patient

• Financial auditing system that provides Medicare and insurance companies with the assurance that funds are properly accounted for.

I believe the US needs to consider all three of these solutions.  We know the problem is coming, but it appears that our Government has done virtually nothing.  It is time to get started!

How the Sugar Industry Shifted Blame to Fats

From NY Times Article

The New York Times published on 9/12/2016 an article by Anahad O'Connor  titled:  "How the Sugar Industry Shifted Blame to Fats" which quoted a study in a publication of the Journal of the American Medical Association (JAMA-Internal Medicine).  The study done by Stanton Glantz of University of California San Francisco (UCSF) reported that in the1960s the Sugar Research Association paid three Harvard University scientists to publish a report in the New England Journal of Medicine that explained that dietary fats were more likely to be the cause of heart disease rather than sugars.  That study became a "turning point" in history and promoted significant changes in American's diets and triggered hundreds of studies looking into how fats contributed to heart disease.

Over the 50 year since that time, most of the types of dietary fats have been released from suspicion. However, it now appears that sugar is much more likely a cause of heart disease, obesity, diabetes, and tooth decay, and is a much more worrisome ingredient of our diet.
Who can we believe?  When scientists get backed overtly or covertly by industries with huge investments on the line, how can we protect ourselves from false claims of scientific evidence?  So for 50 years, which is most of my life, doctors, dieticians, and health professionals have been providing incorrect, or inaccurate advice about my diet!  How has that advice affected the total population of the US --and, in fact much of the world!   It is clear that we need to be more suspicious of revolutionary findings done by scientists, and now we do need to change our eating habits to reduce the amount of sugar in our diet.
This report also shows how influential a few, somewhat "rogue" scientists can be on matters of public policy.  Just a few scientists backed by the tobacco industry delayed restrictions on tobacco, very few scientists backed by the coal industry have seriously delayed the world's response to global warming.  How many more situations like that will we uncover?  

Zika Virus and Adult Brain -- Could similar virus have other effects on the brain?

I was always told that the "blood brain barrier" made it very difficult for any disease to get to the brain.  We have learned that many different virus can have an effect on brains.  Most recently, we've learned that the Zika Virus can have an effect on the brain.  See this article on Science Daily.  It is possible that Zika can affect the growth and reproduction of brain cells.
It is possible that Zika virus could have an even more severe effect on humans, if it ends up affecting our minds in some way--especially in old age.  I have been very disappointed that Congress has not appropriated adequate funding to get started on Zika research and prevention.
Now that we know that there are many different effects on the brain due to a wide variety of organisms, I think we need to look for the possibility that some of our diseases that affect brain and nervous systems may also be caused by outside organisms, such as virus.  For example, could Alzheimer's Disease be caused by a virus?  Could Parkinson's disease, or schizophrenia be caused by some sort of virus?

Acetaminophen No Help for Osteoarthritis

The San Diego Union Tribune had an article by Melissa Healy on March 20, 2016: Titled: "Study: Acetaminophen no Help for Osteoarthritis Pain"   So this means that very many people experiencing osteoarthritis who were taking acetaminophen were only possibly experiencing the placebo effect if they thought they felt better after taking the drug.  The study was done in Switzerland, and was published in the journal Lancet.  The same thing happened to me in the mid 1970s when I had severe neck pain, and was given ever larger doses of a drug called "Darvon"  (see on Wikipedia).  After 6 months of continuous pain, I finally went to a Chiropractor who "popped" my neck back into the correct position and the next day the pain went away.  The following year, I learned that Darvon was shown to not reduce the pain from back or neck pain.
I can't fault the drug industry, the doctors, or the FDA.  Everyone reacts differently to each drug, and since there probably aren't two sources of pain that are exactly identical, it is very difficult to test each medication against all sorts of pain.
It seems to me that everyone who is given a medicine should be given an application for their phone, which would remind them to take their pill, record when they do take the pills, and allow them to record any changes in their symptoms or pain in some regular, routine schedule.  Then, the drug manufacturer, the patient's doctor, and the FDA would have, in effect, "crowd sourced" information about how well the medication worked in each unique situation.
The study did show that diclofenac, naproxen, and ibuprofen did have some effect in reducing pain, but at recommended doses that sounded very high.   

Bleak outlook for Diabetes in the US

The San Diego Union Tribune had a column today titled "Researchers Offer Bleak Outlook on Diabetes Projections" by Soumya Karlamangla  that says that disease rates have increased 175% since 1980, and there is a huge population of people with prediabetes.  70% of the people with prediabetes will end up with the disease.
I know there is LOTs of effort to develop a cure.  There is a huge amount of advice written in newspapers and magazines for people to lose weight, exercise in order to reduce the chance of getting diabetes.  However, the results of the research so far do not seem like there will be a promising cure.  It appears there will only be methods of improving insulin control.  The approach of implanting cells in the body that will produce insulin sounds like it works, but I'm afraid it will be expensive and require significant follow up treatments and medication.
In the meantime, we need serious national leadership to set new standards for healthcare that will encourage citizens to enjoy a healthier lifestyle.  The cost of not doing it will be so high that combined with the alzheimer's care it could destroy the nation's budget.

Merkel Cell Cancer & Viral Cause

I just heard a podcast about Merkel Cell Skin Cancer on Australia Radio National's Health Report with Dr. Norman Swan..  I found that Wikipedia has an excellent description.  It is a tiny skin growth that can actually be a death warrant if not caught very quickly.  Take a look at this photo from Wikipedia:

That tiny little mark could be a type of cancer that can metastasize and spread through the body very quickly.  I seem to feel I've had similar marks like that on my body many times in my life --but they went away.   The real problem is that it doesn't appear to be anything dangerous, and most of us would ignore it and expect it to go away an a little while. What is also interesting is that it appears to affect white males between 60 to 80 more than women or other age groups. 

It also appears to be caused by virus discovered in 2008 (Merkel cell polyomavirus (MCPyV) )that many people appear to have immunity against.  People without immunity apparently are vulnerable to it. As we learn more about cancer we are finding that more and more of them are caused by viruses, or that viruses contribute in some way to the cancer.  

The rates of this type of cancer appears to be growing quickly.  Possibly due to the baby boom demographics, or is it due to more exposure to sun?  Or is the virus becoming more prevalent?  

It really seems to make it even more important for all of us, particularly in the age 60 to 80 year group, to have our skin checked professionally on a regular basis. There are specialists and support groups that can also help if we are diagnosed.  Here is one: http://www.merkelcell.org/   

Bacteriophages -- a new solution to antibiotic resistance?

Prevention magazine had an article by Koren Wetmore in the February 2015 edition that described "The Natural Superbug Cure" that no one is telling you about.  It is about Bacteriophages.  Discover Magazine also had a good article about it.  Phage Therapy is the use of specialized viruses to attack and kill disease-causing bacteria.
The use of bacteriophages to cure diseases was done a lot in Russia prior to the development of antibiotics.  Antibiotics were easier to use, and seemed safer at the time.  Since the introduction of the first antibiotics, many other antibiotics have been developed to target specific types of bacteria.  However the bacteria have developed resistance to many of the antibiotics.  It is clear that by developing more phage therapies, we can bypass that antibiotic resistance and cure some diseases that could not be cured by antibiotics.  Also, if we can hone the process and make it efficient enough, we could use phage therapy as a 'mainstream' form of fighting disease and prevent the bacteria from becoming resistant to the antibiotics.  Of course, there is also the possibility that bacteria can develop a resistance or "immunity" to the phage viruses as well.
From what I've read, I think the Government should put some significant resources into the development of phage therapy.  Others seem to think so too.   See this article in Frontiers  I see one of the problems with continuing the development of phage therapy is that it would be difficult to get a pharmaceutical company interested in developing the technology.  It could take hundreds of millions of dollars to develop, test, and get FDA approval for new types of phage therapies.  But the drug company would probably not be able to patent the idea, or get a reasonable return on the huge investment.  In situations like this, the only solution is to use public funds to develop the technology.  To be even more effective, it may require many countries to get together to share in the cost of development of the technology.