Hypertension and Pit Vipers

Yesterday I read a fascinating (to me, anyway) article about the history of the development of drugs to treat hypertension (high blood pressure).  The topic is interesting to me because a couple of months ago, my blood pressure inexplicably went from “Too high” to “Be prepared to die”.  For just over a month now, I’ve been seeing the doctor often, sometimes as often as twice a week.  He added a medication to the one I was already taking, desperately trying to get the BP back down.  As of the last visit two weeks ago, it’s back down to “Too high”.  We still aren’t finished experimenting–he may add a third drug, or a combination of a different two drugs.  The silver lining to this is twofold:  first, he’s very positive and says it CAN be done.  Second, he’s paying attention, which is an increasingly hard quality to find in a doctor. 

So with my own personal troubles, it’s no wonder I was interested in an article in the New York Times that came out on Thanksgiving Day, called The Evidence Gap:  A Big Hypertension Study and Its Minimal Impact.  http://www.nytimes.com/2008/11/28/business/28govtest.html?pagewanted=1&_r=1&hp The study in question purportedly showed that the very cheapest (and first discovered) drugs to treat hypertension–namely, diuretics–were as good or better than some of the more recent, more expensive, and seriously hyped-by-the-drug-companies drugs.  So in one corner you have a government study whose noble goal is to save people money, and in the other corner you have the greedy drug companies with millions of dollars at their disposal to influence doctors and advertise to the general public.  Not so fast.  Money and politics influenced the outcome, according to people on both sides.  (Surprise!)  Everybody had an agenda.  And perhaps out of character, I’m on the side of the drug companies on this one.  Diuretics alone may do a lot of good for a large number of people, especially in the case of people who don’t have insurance, but they’re going to leave a lot of people in the dust–as the government absolutely has to know.  The newer drugs have many additional benefits, but the issue here for the government, in my opinion, was more about allocation of resources, not about saving individual lives.  No wonder this article was in the Business section rather than the Health section. 

So I decided to do a little more research and found this truly fascinating article (The NYT article does not qualify as “fascinating”).  http://www.fasebj.org/cgi/content/full/18/3/421e  This article talks about the history of the development of drugs to treat hypertension and among the many interesting factoids:  There were no treatments for hypertension until the 1950’s.  As I mentioned earlier, diuretics were the first.  Then came ACE inhibitors.  The process of developing ACE inhibitors began when someone discovered that Brazilian pit viper bites were killing workers in the banana groves of South America by causing a drastic drop in blood pressure.  Someone said, Hmmm…maybe we can use this to our advantage. 

It seems the discovery of new drugs is often like this.  It happens by accident, sort of.  After the discovery of the effect, researchers then have to figure out the how.  Then figure out how to make it into a drug.  In its experimental stage, scientists were injecting people with pit viper venom.  These days, ACE inhibitors are made synthetically, which, sadly, means that a lot of Brazilian pit vipers will now live long and healthy lives.

Live Football Blog

Shhh.  Don’t tell anybody, but I don’t like sports.  It isn’t that I hate sports, I’m just not interested.  However, today, I’m watching my obligatory semi-annual football game.  (Semi-annual:  at least one college game, plus the Superbowl.)

I do have to at least pretend, to an extent, because I live in Tallahassee.  I think that if you live here and admit you aren’t interested in football, they make you move somewhere else.  So today I’m watching the Florida/Florida State game.  It’s pouring down rain, and that can’t be good, especially for the team that’s worse–namely, Florida State.  Florida State may be counting on the weather being a problem for Florida. On the other hand, if the weather was better, Florida State could be losing faster. 

Still, the thing I do like about sports is the human dimension.  (Shhh, don’t tell anybody.) You have a guy like Tim Tebow playing, Heisman Trophy winner and seemingly all-around nice guy.  Watching him makes me think of back in the day when I used to love watching Joe Montana.  Not quite the same…watching Montana was like watching ballet.  Tebow is more of a power player.  On the FSU side, you have Myron Rolle.  A handsome but big scary-looking guy who last week was named a Rhodes scholar.  All you people with negative attitudes about athletes…go eat dirt. 

Now so far it seems to me that one of the announcers is highly prejudiced toward Florida.  That’s fine, but don’t be so obvious.  I don’t know if it was him who said it or not, but so far, the best quote of the first half was referring to the Florida RB Demps:  “He’s faster than a rabbit in love.”

Stay tuned for observations from the second half.

When Racism Kills

It could be argued that racism always kills some people eventually, one way or another. 

But it’s taken me until today to be able to comment on an article in Tuesday’s New York Times, which had me so stunned and upset that well…it took me until today. 

The article reported on a Harvard study that showed that the South African government’s position on AIDS treatment has cost 330,000 adult South Africans their lives along with another 35,000 babies.  All together, 3.8 million years of life.  Those numbers are about as easy to wrap your mind around as if you tried to count the number of stars in the sky in a single night. 

And why did the South African government deny its own people the treatment they needed?  Because the prevailing view was that the drugs, and I quote, were “peddling centuries-old white racist beliefs that depicted Africans as sexually rapacious.

“Yes, we are sex crazy!” the document’s [a document crafted by A.N.C. leaders] authors bitterly exclaimed. “Yes, we are diseased! Yes, we spread the deadly H.I. virus through our uncontrolled heterosexual sex!””

In other words, it was a white racist plot.  The Presidency of South Africa changed hands two months ago, and the new President immediately took steps to remove the Health Minister who suggested treating AIDS with garlic, lemon juice, and beetroot. 

So under any other circumstances, we would call this genocide, and that’s what I call it.  The former President ignored science, because it was white science.  Wouldn’t provide drugs, because they were white people’s drugs.  It isn’t mentioned in the article, but there is that rumor that white people created AIDS to begin with as a way to wipe out black people.  Now white people are providing toxic drugs to those people who managed to survive, just as a way to make sure they go ahead and die. 

It’s ignorance, but it’s also racism.  The idea that nothing good can come from white people.  And that idea kills. 

Here’s the full article:  http://www.nytimes.com/2008/11/26/world/africa/26aids.html?pagewanted=1&_r=1&hp

Shopping Insanity

Last night while watching my two Thursday TV programs–Jeopardy! and CSI–I saw numerous ads for retailers who were opening early today, with special extra discounts along with the already advertised discounts, for those arriving early.  One (Kohl’s), was opening at 4:00 A.M.  Two (Sears and Circuit City) were opening at 5:00 A.M.  My first thought was, I’m glad I don’t work in retail. 

Then when the 11:00 news came on, they reported that people were actually camping out at one of these stores (though I never heard which one).  I simply could not fathom this.  I can sort of understand people camping out to be the first to get tickets for a concert or a movie, but even then it’s a stretch for me to grasp it.  However, I think the waiting in line part turns into a sort of festival of its own, and there’s nothing wrong with that.  But shopping? 

Of course, as I’ve said before, I pretty much hate shopping (well, not counting shopping for food).  I don’t shop for pleasure, only for necessity.  There are exceptions, such as last week when Fakesister visited and we checked out two stores I’d never been to that I wanted to see. 

I realize that some people consider shopping a sport, and apparently a competitive sport at that.  So just now I heard on NPR that a 34-year-old man, an employee of Wal-Mart, was trampled to death in Long Island, New York at about 6:00 A.M. this morning.  The store opened at 5:00 A.M., but I guess things weren’t moving fast enough for the crowd (mob) outside, so they broke down the doors. 

I’m sure no one there planned to kill anyone today.  But the reality is, once it starts, there’s no getting out of the mob.  It’s like a living organism until the foremost members of the organism reach an impenetrable object (the legendary “brick wall”).  When the forward motion stops, it relieves the pressure on those behind.  I would never have believed this could happen, that you could get caught up in a crowd and be unable to retreat if it hadn’t happened to me personally. 

The occasion was Jazzfest in New Orleans–the first and last time I ever attended.  Jazzfest attracts hundreds of thousands of people and it’s held in a very small space.  They have many different stages going on all at once, and the year I went, Jimmy Buffett was playing on the main stage.  I’d come with two friends, but we’d become separated, so I was drifting around on my own (me and my water bottle, it was blazingly hot) and headed for the main stage.  By the time I realized I wanted out, it was too late.  I kept trying to turn around, and couldn’t.  The pressure behind me and to either side was relentless, and I had no choice but to keep moving forward.  I started saying to myself, Don’t trip, don’t fall down, Don’t trip, don’t fall down.  Then I remembered to pray that no one in front of me tripped and fell down either, because I would have had no choice but to walk over them.  At last the forward motion eased, I presume because the head of the beast ran into the walls of the stage.  It’s a wonder that the people in front of the stage weren’t crushed.  Which has happened. 

People die from being crushed, trampled, and suffocated.  There are so many famous examples.  The long ago Rolling Stones concert.  Soccer games.  Pilgrims at Mecca.  All it takes is one spark of panic.  I’m not sure how panicked the people around me at Jazzfest were; at least overtly we were all staying calm, but there is no way they didn’t feel the same sense of helplessness I did. 

This is a preventable situation.  Namely, don’t let yourself get in a crowd like this.  And to do it all for saving a few dollars at Wal-Mart?  To some extent I think this shows the level of anxiety people are feeling about the economic situation.  That in order to buy presents for Christmas, you have to get the best deals and be there first.  But there are those who, as I said, view it as a competitive sport.  Anybody who gets in front of you, smack ‘em down.  I blame them, but I also blame the retailers.  They set this up. 

But mostly my heart breaks for this poor guy who went to work this morning and never made it home.

Thanksgiving Thoughts

Today I resolved to be thankful, and I’ve spent the day making a list of things to be thankful for.  My main problem is, I don’t know who to thank for the things I’m thankful for.  Sure, I know we’re supposed to be grateful to God, Whatever that is.  Already I guess you can see my problem. 

I decided not to let that stop me.  I’ll be thankful, and let God, Fate, the Universe, Accidents of Birth and Genetics sort it all out amongst themselves and decide who gets credit for what. 

First on my list is, I’m glad I’m not a turkey.  If I were, I’d be giving thanks that I’m not a turkey from Alaska.  Otherwise, I’m giving thanks that…

…it’s Clementine season!  Yesterday was the first time I saw them for sale, and I’d forgotten that besides having a fire in the fireplace, Clementines are another great thing about winter. 

…that I have two eyes and can see out of both of them.  That I can walk.  That I have a job. That I have a house to have a fireplace in.  That I have a wonderful sister and special friends, and the companionship of four very special animals (aka “Fakefamily”).  I’m thankful I’m alive to be thankful. 

There are probably fifty other things I could name, but I find there’s only so much thankfulness I can manage in one day.  Plus, I think it’s best to keep things simple. 

However you spent your day, I hope that you were thankful for it.

Weekend Wrapup: Dateline Sunday, 11-23-08

Alas.  The Staycation is at an end, and I didn’t even get around to blogging about all the fun stuff that happened.  Besides attending the concert by the Trans-Siberian Orchestra and visiting the St. Marks National Wildlife Refuge, there was some shopping involved.  Precious little, I might add, because I hate shopping.  But everywhere Fakesister and I went, I found some little something for less than $10. 

At World Market, I found Mocha Java coffee (once again, thanks to Anarchist for the tip) for maybe $8.  However, it should be said that any savings there were nullified by having to buy a grinder ($11) at Publix.  At the Museum Shop, I bought a set of “Knowledge Cards” for $5.  These particular cards are called “Howling at the Moon–A Quiz Deck on Animal Communication”.  Sample question:  Do wolves really howl at the moon?  Fakesister and I are big on trivia and are using them as a daily braintease.  That $5 was 50% off, because the Museum Shop is going out of business.  Another small business bites the dust.  These days I’d say that if you aren’t selling necessities, your future is bleak. 

At Tallahassee Nurseries, I bought a $4.99 bottle of Tupelo honey in their Christmas store for my friend Judith, who I observed was using cheapo honey from Publix in her hot tea.  At Kohl’s department store, I bought a pair of slippers (Isotoners, even!) for $11, and a hat/scarf/glove combo for $15–both 50% off.    Deals like these don’t really count unless it’s something you need–I mean I could buy a Ferrari for half-price, but how smart would I feel about it?  The slippers were an absolute necessity, since Tallahassee has decided to pretend it’s January instead of November, and it’s so cold that the flip-flops weren’t working for me any more as early-morning attire.  Ditto the hat/scarf/glove set.  I doubt I’ll ever wear the gloves, and I’ll wear the scarf only when I have an urge to look fashionable (almost never), but as far as I’m concerned you can never have too many toboggan-type hats.  I simply cannot function with cold toes and ears. 

There was also a lot of food involved, capped off by dinner Wednesday night at The Melting Pot, a chain fondue restaurant that is so overpriced and over-ambienced they charge you for opening up the menu.  Well, not really.  And yet…I love it!  Still, you know you’re about to get hosed when a glass of their cheapest Pinot Grigio costs almost as much as a bottle of the same brand at Publix.  We had their cheddar cheese fondue, which comes with bread, apples, and veggies (cauliflower, celery, and carrots).  Note:  no meat.  Then we had chocolate fondue for dessert. 

On the nature front, we also paid a visit to Maclay Gardens, which is a state park smack in the middle of urban Tallahassee.  It was once the winter home of a gentleman from New York named Alfred Maclay; at his death, his family gave the house and grounds to the State of Florida.  Just as it was a bit late to catch the Monarch butterflies at St. Marks, it was too early to catch the spectacular display of camellias at the gardens, though a tiny few were blooming.  By January, the camellias will be in full bloom, and the best part?  A month later, it will be Spring!  I leave you with an image of one of them to look forward to.  Meanwhile, keep your toes and ears warm!

Don’t That Beat All

For those of you who aren’t from the South, this is a time-honored phrase meaning “What the fuck were they thinking?” We are prohibited from saying this out loud, due to the if-you-can’t-say-anything-nice rule. 

The occasion for this post is that today I learned that sometime in the past week, my hometown newspaper, the Tallahassee Democrat, held a “Blogger’s Luncheon.”  Apparently my invitation was lost in the mail. 

The luncheon was organized by a reader, and took place in the Democrat headquarters, where attendees wore name tags with their screen names on them.  The food consisted of sandwiches from the Dem’s cafeteria, plus whatever the attendees brought with them.  What?  This is a church supper?  They should have invited me–I make a mean coleslaw. 

I have to work hard at not being too cynical, but in this case, I’m failing miserably.  This is the last gasp of a dying newspaper. 

Don’t that just beat all?

Staycation Highlight: The St. Marks National Wildlife Refuge

One of the really nice things about living in Florida is that you’re never far from places of relatively unspoiled beauty–well that is, until the developers complete their mission of paving over the entire state, at which point all of Florida will look like Miami Beach.  Tell me that doesn’t scare you.  But even in Miami Beach, you’re just a stone’s throw away from the Everglades and Everglades National Park, which is truly one of the most astonishing places on earth. 

This past week, even though it was frigid. my sister and I took the one-hour or so drive to the St. Marks National Wildlife Refuge in hopes that we would see some straggling Monarch butterflies.  St. Marks is one of the oldest wildlife refuges in the country, and was established to provide a safe habitat for migratory birds.  http://www.fws.gov/saintmarks/  St. Marks is also on the Monarch butterfly flyway; from there they fly across the Gulf of Mexico to their wintering grounds in Mexico.  We saw a few butterflies, a couple were possibly Monarchs, but for sure there were Gulf Fritilarys:

And Cloudless Sulphurs:

Are those great names for butterflies, or what?  We also saw a magnificent Wood Stork, who took flight as we passed by:

The prickly pear cacti were fruiting along the nature walk by the lighthouse:

And speaking of the lighthouse, I never see it without thinking of the wonderful ballad “The Lighthouse’s Tale”, by Nickel Creek.  http://www.youtube.com/watch?v=jTAyMt3ldSU  Like the lighthouse in the song, the St. Marks lighthouse looks lonely.  From what I can tell, it last had a keeper in 1942.  It was automated in 1960 and is maintained by the Coast Guard.  But its house is empty, and I wonder about the tales it could tell. 

I believe that wherever you live in the country there are marvelous sights just around the corner.  Well, unless you live in Nebraska.  Actually, I really should quit picking on Nebraska, since I don’t know enough about it.  I have been to Omaha and it is quite a spectacular sight, perched on a bluff high over the Missouri River.  I think it’s important to get out and see the marvelous things in your very own neck of the woods, even if they’re somewhat kitschy.  For example, I lived in Memphis for 25 years and never went to Graceland.  I regret that now.

Don’t You Just Hate It When…

…you live in Florida and it’s 26 degrees when you get up in the morning?  And that’s Fahrenheit.  That’s roughly, um, minus two Centigrade.  I realize this is NORTH Florida, but shouldn’t there be some difference between here and NORTH Dakota?  I mean, even the Cayman Islands have a “north”. 

…when you can’t remember the exact formula for turning Fahrenheit into Centigrade and vice versa?  Which is either 9/5 or 5/9 of one or the other, plus or minus 32?  And your engineer sister can?

…when you’re forced to drive through a road construction area on a daily basis, but at night the road trolls have sneaked out and moved all the orange barrels from one lane to another, so that the lane your brain is programmed to drive in today is forbidden territory tomorrow?  I can’t tell you how many times this week my Camaro has attempted to mate with a traffic barrel. 

…when you finally find Mocha Java coffee beans (thanks for the tip, Anarchist!), and then can’t remember what you did with either of the two grinders you own? 

…when the dog eats the cat’s catnip mouse? 

…when Sarah Palin stops talking?  Oh wait.  That hasn’t happened.  The video of her pardoning a turkey, while turkeys are being slaughtered in the background is truly priceless.  But, I mean, what’s the big deal?  She made it clear she was only pardoning ONE of them.  Goshdarnit, get over yourselves People!  Anybody who criticizes her for this is a sexist.

Whining About the Government

This is a somewhat misleading title, since I really plan to whine about people who whine about the government.  In my last post, I mentioned that the Bureau of Land Management was planning to cull the western wild horse herds by killing 6,000 of them.  The BLM already has 30,000 animals confined in pens awaiting adoption, and it seems fairly clear that euthanasia is an unavoidable next step.  Or at least it was, until Madeleine Pickens offered to take all 30,000 of the horses off the BLM’s hands and place them in a new, one-million acre sanctuary.  Before we all get up in arms about the heartless cruelty of the BLM, it seems obvious to me that they are out of space and money.  Mostly money.  Can you even imagine how much it costs to feed 30,000 horses?  I suspect the BLM is between a rock and a hard place.

But today’s target is not the BLM, but the FDA.  I’ve been thinking a lot about the FDA recently, because in the last month I’ve been prescribed two drugs “off-label”, meaning, “not approved by the FDA for that use”.  The first is a drug called Avastin.  This is a cancer treatment drug–though not even approved for all cancers–which prevents the formation of new blood vessels, in an effort to starve tumors which cleverly create their own new blood supply.  Opthamologists have been using it for years to stop bleeding in the retina.  The company that makes Avastin, Astrazeneca, came up with a modified form of the drug and called it Lucentin, which is presumably more suitable for injection, and Voila!  The FDA approved it, just like Astrazeneca wanted them to.  At that point, Astrazeneca tried to withdraw Avastin for use by opthamologists, and the doctors went into revolt.  Why?  Avastin is $300 per dose;  Lucentin is $2,000 per dose.  Can you say, profit motive?  And the FDA was complicit. 

The second drug is Crestor, a drug to treat high cholesterol, even though my cholesterol is normal.  Just days after I started taking it, an article in the New York Times reported that a new study shows that Crestor, in particular, cuts the risk of heart attack by more than 50%, and the risk of stroke by slightly less than 50% even in people with normal cholesterol levels.  If I already hadn’t started taking it, I would have been asking where to sign up.  On the other hand, the study, like 99.9% of all such studies, was funded by the drug company which makes it.  Three guesses which drug company that is?  Close your eyes and guess, and no fair peeking.  You got it–Astrazeneca.  Hmmmn.  I wonder what this study will do for sales of Crestor?

But after whining a bit myself, I did a reality check and here is the reality:  the FDA does not have the money to do its own studies.  It reviews the data and makes a decision to approve or not approve based on the data it gets from studies commissioned in most cases by the drug companies.  And there is a certain level of trust that has to be there; the thinking being that it would not be in a drug company’s best interest to release a drug that kills a bunch of people.  (And see how well that worked with the FDA approved drug Vioxx, which killed a bunch of people.  At least it was made by Merck.)  But if that level of trust were not there, it would take eons for every drug to be approved, if we had to wait for the FDA to verify every single study. 

In short, there is no future in whining.  If you don’t give the government the resources it needs to do the job properly, then you can’t blame them when things go wrong.  The sad part is that rather than acknowledge that we aren’t funding the FDA sufficiently, if something really bad happens (one case of mad cow disease in the U.S. is all it would take) there are people who will be pointing fingers at the FDA and wondering why they didn’t do more with less.  Because the government is funded by that evil four-letter word:  taxes.  The deregulation, government-is-the-problem, let-the-market-handle-it crowd will be howling for the head of the FDA on a platter if there is a true disaster–and there have already been mini-disasters. 

What we need is to refocus our priorities.  If it were up to me, I’d be throwing a lot more money at the FDA.