Monday, July 2, 2012

Things that make me grumpy

I say "epilepsy." What do you think of?

Did you think of someone drooling in a dimly lit institution? Or someone so sedated on their seizure medicines that they aren't capable of working?

Think again.

Yes, there are some patients who still fit that description. But they're rare. You want to know what most epilepsy patients look like? They look like YOU!

Yes, folks contrary to popular belief, epilepsy patients are out there living normal lives. And there's a lot of them. It's a disorder that affects 1% of humans. So imagine the Rose Bowl stadium in California. When sold out it holds roughly 90,000 football fans. And statistically speaking 900 of them have epilepsy. Some may even be playing on the field.

Current epilepsy patients in my practice include 7 teachers, 3 doctors, 5 nurses, 1 judge, 2 veterinarians, and a lot of other responsible professionals.

Very few diseases have been as maligned over time as this one has. The majority of early cultures attributed seizures to demonic possession. I'm sure many innocent epileptics were killed in horrible fashion because of this. Others saw it as an intentional punishment from the gods. The great Dr. Charcot, founder of modern neurology, reported that in 19th century France epilepsy patients were locked up in the same dark building used to house the criminally insane and mentally handicapped.


Detail from "Transfiguration" by Raphael (1516) showing a child possessed by demons. The boy's posture and eye deviation are typical of partial-complex epilepsy.


You don't have to look too far back in American history to find laws on the books that banned epilepsy patients from marrying or having children. In the mid-90's I even trained under a doctor who still believed that horseshit, and told young adults, just starting out in life, that they should never, ever marry or raise a family. That's a pretty damn devastating thing to do to someone.

Vilifying any person because of an illness is wrong, whether it's diabetes, hypertension, or cancer. But epilepsy is one in my specialty, and I'll make a stand for my patients.

I probably fight harder for the rights of my epilepsy patients than any other group. Several times a year I have to write a letter to a divorce attorney saying that a well-controlled seizure patient is perfectly capable of being a parent, because the ex is saying that it makes them a danger to kids. Or I have to reassure a family that a patient can drive, or work, or travel on a plane. Obviously, there are laws restricting some things, like driving, but the majority of patients follow them and are perfectly good drivers. Hell, they're likely a lot safer than many non-epileptic people behind the wheel.

So what brought on this rant?

Last week the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act (AKA Obamacare). Now this post is NOT about the PPACA. I know a lot of people feel strongly about it in both directions, and if you want to fight about it, go to a website where you can. Because it's not what I'm talking about, or giving an opinion on.

What pissed me off was the reaction of a radio talk show host (who's not a medical doctor).

U.S. Chief Justice John Roberts has epilepsy and (under treatment guidelines) is likely on medication for this (I'm not his doctor). Big deal. So are a lot of other people.

But, as usual, there are some who'd rather smear than respect an opinion. Conservative commentator Michael Savage went on record last week as blaming Roberts' vote on - surprise - his epilepsy treatment (!) saying his writings showed "cognitive dissociation." He noted that drugs used for epilepsy "can introduce mental slowing, forgetfulness, and other cognitive problems."

Yes, Mr. Savage, they can cause these problems. You can also find similar side effects listed for most blood pressure medications, statins, and many other drugs (which, given your age of 70, I suspect you take at least one of) yet I'm not going to say your comments are due to medications. The side effect list of any drug is HUGE. But that doesn't mean everyone who takes it gets them. Quite the opposite.

My point is this: You're certainly entitled to your opinion. But just because you disagree with a man, don't go blaming it on his medications or health. It's a step backwards for all the epilepsy patients out there trying to lead responsible lives in the face of biases like yours. And, I suspect, if he'd ruled the other way you'd never have made such comments.

Since you apparently don't feel people being treated for seizures are capable of making rational decisions or serving in a responsible capacity, I'm leaving you with a list of people who have (or are highly suspected to have had) epilepsy. Perhaps you've heard of some.

Tchaikovsky
James Madison
Napoleon Bonaparte
George Gershwin
Bud Abbott
Julius Caeser
Harriet Tubman
Vincent van Gogh
Neil Young
Lindsey Buckingham
Edward Lear
Prince
Alfred Nobel
Danny Glover
Socrates
Lord Byron
Hugo Weaving
Dostoevsky
Joan of Arc
Florence Griffith Joyner

Last, I should also mention former congressman Tony Coelho, who has the disorder. He was the primary sponsor of the Americans with Disabilities Act (1990). As a young man he wanted to be a priest, but was banned from such by his epilepsy. He also lost his driver's license and health insurance because of the diagnosis.

During his first run for congress (1978, which he won) his opponent tried to paint him with the same insulting brush, asking voters how they'd feel if their representative was at a White House meeting and had a seizure. Mr. Coelho responded, "I knew a lot of people who went to the White House and had fits. At least I’d have an excuse."


Sunday, July 1, 2012

Sugar: beats alcohol

Yes, yet another strange news item.


Thank you, Carol!

Saturday, June 30, 2012

Random Saturday Pictures

First off, we have this sign spotted at a Burger King. Even ignoring the grammar issues, it has to be the most unenthusiatic, uninviting, unappealing ad for a birthday party I've ever seen.

Just makes you want to yell "Sign me up!" huh?



Next is this fine beverage. Because what could be more enticing than a beer whose name translates to "Sudden Death"?

"Preferred 2-to-1 over Kool-Aid."



My reader Leigh recently got her water bill, and was horrified to find her city is spending tax dollars on a talking toilet mascot named "Leaky Loo McFlapper." They're claiming he's "world famous" (hell, I can't even find a FaceBook page for him) though at least he's not artisanal.

"Someday I hope to work up to McD's, when Grimace retires."





And, lastly, there's this technological breakthrough. Because what good is a $300 phone if you can't use it to open a beer?
Opening a beer? There's an app for that.


Friday, June 29, 2012

Care

I'm with a patient when Mary interrupts me. Dr. Intern is on the phone, and says it's urgent.

Dr. Grumpy: "This is Dr. Grumpy."

Dr. Intern: "HI! I just ran a Depakote level on Mrs. Seizure, and it's ZERO! I just spoke to her. She hasn't had any seizures, but I told her she needs to get in to see you ASAP!"

Dr. Grumpy: "Hang on... She isn't on Depakote. I changed her seizure meds in 2010, and she hasn't taken it since then. So I'd expect it to be zero."

Dr. Intern: "Why doesn't anyone tell me these things?"

Dr. Grumpy: "Well, it was noted in the letters I sent you. Don't you read them? Or check a medication list at each visit?"

Dr. Intern: "Who has time for that?"

Thursday, June 28, 2012

Gee, thanks

Dr. Grumpy: "What brings you in today, sir?"

Mr. Honest: "Dr. Asshat referred me. He said all the good neurologists couldn't get me in, and so I should see you instead."

Wednesday, June 27, 2012

Mary's desk

Mary: "Dr. Grumpy's office, this is Mary."

Mrs. Bekins: "Hi, I need to make an appointment with the doctor."

Mary: "Okay, what's your insurance?"

Mrs. Bekins: "Um... Gee, I really don't know. I'm in the process of relocating to Grumpyville, and don't have a job yet."

Mary: "All right... Would you like to call back when you know more?"

Mrs. Bekins: "No, I still want to set something up."

Mary: "Okay, when are you moving here?"

Mrs. Bekins: "I don't know yet. Could be anywhere from 3 months to a year."

Pause.

Mary: "I think it would be better if you call back when you know when you'll be here."

Mrs. Bekins: "You're probably right. What part of town are you in?"

Mary: "Do you know the areas of Grumpyville?"

Mrs. Bekins: "No. Can you send me a map? And recommend a realtor?"

Tuesday, June 26, 2012

Market share

In medicine there's a mysterious villain called "Big Pharma." This is a secret conglomeration of drug companies working to deprive you of both money and health as part of the New World Order. Depending on how far you buy into this bullshit, doctors are a part of this Medical-Pharma complex, along with (depending on your Haldol dose) any religion you hate, the United Nations, space aliens, homosexuals, and the Dead Milkmen.

Now, obviously, I don't believe this. The one grain of truth in the "Big Pharma" idea is that obviously companies that manufacture something want to sell it. This applies to medicines, car manufacturers, potato peelers, whatever.

Drug companies are required to do research to prove safety and efficacy of their stuff. But they also do smaller studies to try and prove they're at least better than a competitor. These studies, I must admit, tend to favor whoever sponsored them- but keep in mind they're trying to knock down competitors- NOT work with them.

A drug company sponsors a study that showed their drug worked. THE NERVE! Because, after all, no other industry would dare act like this...

So let's look at this article.

Basically (for those of you too lazy to click the link), it's a study that found "stone fruits" (those with large, singular, pits, like peaches) help with obesity and diabetes.

Some out there will claim this shows that Big Pharma is keeping "natural" secrets from them (because you'll otherwise NEVER hear that fruits & vegetables are better for you than a Big Mac). But let's read the disclaimer at the bottom of the article:

"The studies on the health benefits of stone fruit are funded by the California Tree Fruit Agreement, The California Plum Board, the California Grape and Tree Fruit League and the Texas Department of Agriculture."

Here's the bottom line: Everyone will pay for research to sell you their product. Whether it's Big Pharma or Big Farm.


Thank you, SMOD!

Monday, June 25, 2012

That's Amoré!

Mr. Fatherly: "It was really stressful 3 months ago, because my son and his fiancée moved in with me."

Dr. Grumpy: "How are things now?"

Mr. Fatherly: "Better, my son finally moved out last week."

Dr. Grumpy: "What about his fiancée?"

Mr. Fatherly: "I married her. That's why he moved out."

Sunday, June 24, 2012

Wanted: Students with partial amputations

Somehow I think this could have been worded better:


Thank you, Maridyth!

Saturday, June 23, 2012

OH, FOR HELL'S SAKE!!!


Thank you, WH!

Friday, June 22, 2012

Notes

Mrs. Flight: "I need a note, saying I'm too sick to travel to New York."

Dr. Grumpy: "Um... but you're not sick at all."

Mrs. Flight: "I know, but I'm trying to get out of this trip, and a note would help."

Dr. Grumpy: "I can't falsify a note for an airline."

Mrs. Flight: "No. It's for my sister. I don't want to go see her because she's a bitch."

Thursday, June 21, 2012

Airborn drug transference

Dr. Grumpy: "I'm going to start you on Coumadin."

Mr. Wisconsin: "But I'm already on it!"

Dr. Grumpy: "You are? I didn't see that in your chart..."

Mr. Wisconsin: "Well, I mean, I'm not on it myself, but my wife takes it. So wouldn't that cover me, too? Just from being near her a lot?"

Wednesday, June 20, 2012

WTF?

I've shown you guys some seriously strange drug company ads over the years.

After 15 years of reading journals I thought I'd seen every weird eye-catching trick an advertising agent can think up.

But, even I was taken aback by the sheer WTFness of a veterinary drug ad my esteemed colleague Webhill sent me yesterday:




 Thank you, Webhill!

Tuesday, June 19, 2012

Decimal fetish

Dr. Grumpy: "Any changes in your weight?"

Mr. Precise: "Yes." whips out iPhone "As of this morning, since January 1, 2012, I've gained 1.5873 pounds."
 
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