Originally published on: http://themedicalblog.net/2014/11/06/dr-samori-swygert-mental-illness-may-lead-to-mass-disarmament-of-americans/

Would you feel safe and comfortable sitting next to a person that is in possession of a firearm, and diagnosed with a mental disorder?

Would you feel safe and comfortable with your kids playing in the household or within close proximity of an individual in possession of a firearm and diagnosed with a mental disorder?

Depression, major depression, anxiety, ADHD, bipolar-schizophrenia, PTSD, obsessive compulsive disorder, dissociative identity disorder, and Munchausen syndrome, are all classified as mental illnesses.

The topic of mental health is one of the prominent issues that American society and politics is currently wrestling with.  Many citizens are trying to find out why there has been such a surge and proliferation of mental illness on a national level.

Two valid questions about mental health:

1. Has mental illness always been this prevalent, and we just ignored and under diagnosed some of the disorders?

                                                         OR

2. Have associations, boards, and committees designed the diagnostic criteria to the most minute detail, characteristics, signs and symptoms, that the average citizen would be diagnosed with a mental disorder at some point throughout their daily routine?

The seriousness of mental illness

If we were to tabulate the total number of mental disorder diagnoses from the various kinds of mental disorders, we would be looking at tens of millions of Americans.  The issue hits homes in several ways.  First and foremost, people love their family and friends and hate to see them suffer from debilitating conditions.

Secondly, there is a social stigma attached to people with mental disorders.  Who wants to be called or hear someone they love being called loony, crazy, nut, psycho, off their rocker, etc.?

Third, this is an expensive burden on families and individuals.  Medication is expensive, and individuals require routine checkups,  evaluations, counseling, and in some cases, hospitalization.

Fourth, this can be an impediment to family, social, professional, and educational progression.  Some of these disorders make it difficult for some patients to engage in some routine life activities.

Lastly,  we’ve seen the impact of mental illness manifested in countless mass murders, homicides, and suicides.  We’ve seen some of the most gruesome, heinous, and unimaginable events like Colombine, The Colorado Movie Theater Shooting, and Virginia Tech.

Gun legislation and mental illness- ta ying it all together

It’s only logical that discussions on gun legislation and policy are conducted on a national level when you do the statistical analysis of mental illness diagnoses and gun violence.

However, with any legislation, you must specifically address the issue at hand without infringing on the rights of citizens.

What is the New York State Safe Act?

The S.A.F.E. Act is a New York State legislation. The acronym stands for: Secure Ammunition and Firearms Enforcement act.

This was designed with the specific intent to reduce and prevent irresponsible and illegal use of firearms.  The legislation encompasses domestic violence, gun safety tips, school violence, gun violence, hunting, and more.

A subsection of the New York State Safe Act is called MHL 9.46.  This corresponds to the subsection 9.46 of the act on Mental Health.

This portion of the act requires psychologists, psychiatrists, registered nurses, and licensed clinical social workers to forward the diagnoses and evaluations of patients that are diagnosed with mental disorders to the Director of Community Services.

This is especially mandatory if practitioners consider a patient to be a harmful risk to themselves or others.  This report is then cross checked against New York State gun license registry.  Individuals diagnosed and considered a threat to themselves or the community with a gun and gun permit  must have their firearms confiscated, and gun permit voided.

This sounds good theoretically, especially if you ask the questions I posed at the opening of this article. However, will this lead to the mass disarmament of millions of Americans?

What are the future ramifications of policies like this? We must consider children are being diagnosed with disorders in the 1st grade. Theoretically  speaking, millions of future adults (who are children right now) can be ruled unfit to possess a firearm before they even reach the age to legally purchase a gun.

This is crucial because two things in this controversial topic are subjective:

1. The writers, authors, and framers of the diagnostic criteria of the DSM-V have made the diagnostic criteria so expansive that any American can have a mental disorder.

ALSO

2. The subjective judgment and interpretation of the psychiatrist, psychologist, licensed clinical social worker, and registered nurse can permanently brand a person for life.  How do you account for bias and/or lack of professional experience of the individuals assessing and diagnosing people?

Are they distinguishing between some temporary moods from a bad day,  bad break up, death of a loved one, or financial crisis, from something more permanent like chemical imbalances and neural abnormalities?

Since 2012, New York State has put 34,500 New York residents on its “NO GUN LIST.”

What are your thoughts?

Hit me on Twitter: @docswagg06

Sources: 1, 2

$1,000 pill may cure Hepatitis C but leave you bankrupt

By: Dr. Samori Swygert

How will Obama Care manage this medical conundrum? A new Hepatitis C medication has hit the market. The name of the drug is called Sovaldi (Sofosbuvir). The cost is $1,000 per pill. Yes, I said $1,000 per pill, and the prescribed regimen is for 12 weeks.¹ This yields an astronomical medical expense of $90,000. However, clinical trials have noted that it cures 9 in 10 Hepatitis C patients. Gilead Sciences is the drug company that manufactures the medication.

The final prognosis of Hepatitis C results in liver transplantation, this usually occurs after severe decompensated Cirrhosis of the liver and treatment failure. The liver can’t be salvaged once this disease progresses to a certain point. Liver transplants cost as much as $577,000 according to an article published by WTOP (a reputable news source for Washington DC).³ Secondly, Hepatitis C has a 95% recurrence rate after liver transplantation. The public should also note that there are different genotypes of Hepatitis C, some more extensive and severe.

Hepatitis C is transmitted by blood, and sexual intercourse. The Infectious Disease Society of America (the leading medical authority on infectious disease) furnished their epidemiological estimates. The society estimates that approximately 3 to 4 million Americans are infected by Hepatitis C.²

There are other conventional therapeutic regimens that include medications like Ribavirin, Interferon, Simprevir, and more. However, many of the traditional regimens come with more undesirable side effects, and don’t produce the cure rate of Sovaldi.

This is critically important, because the Infectious Disease Society of America has actually updated their clinical guidelines for Hepatitis C. The update has made Sovaldi the first line treatment.

According to an article in Forbes Magazine, this same drug only costs $ 900 to complete the whole regimen in Egypt. You must ask yourself, “how does the manufacturer calculate their drug price?”. Many times drug manufacturers have to recoup all the expenses in research, drug development, marketing, and etc. However, this is a kind of precedent setting, and especially when you consider how cheap it is in another country but 100 times more expensive domestically.

This is going to throw so many curveballs and monkey wrenches in the Affordable Care Act and Medicare/Medicaid. How will states and insurance companies decide who is worthy of this drug?

The state of Oregon has already initiated discussion on how to limit access to this expensive medication to low income individuals. This is a social joust between ethics and economics. This manifests the true meaning of “the cost of living”. This also accentuates the argument of wealth disparities. A clear and distinct argument can be made about health versus wealth. A 1%’er with Hepatitis C wouldn’t flinch at the cost of this medication, however this budget item could dismantle an entire family that’s struggling in today’s economy. This makes you question the “AFFORDABILITY”, in the Affordable Care Act.

Lastly, this emphasizes the importance of responsibility in lifestyle, and creating wealth base. When individuals participate in risky behaviors such as unprotected sex, and IV drug use, you increase your susceptibility to disabling diseases such as Hepatitis C. The disease itself is physiologically crippling, and so is the burden of expense from pharmaceutical therapy.

We must understand that the interests of pharmaceutical lobbyists reside in maximization of profit for drug manufacturers, and not necessarily the patient in all instances. If the concern for patients were top priority, the government and the manufacturers would devise a more economically affordable strategy to increase accessibility to all infected patients, independent of costs.

What are your thoughts?? Is this a form of medical gentrification? Should the government intervene and regulate drug pricing?

Sources:

1. http://www.forbes.com/sites/theapothecary/2014/06/17/the-sovaldi-tax-gilead-cant-justify-the-price-its-asking-americans-to-pay/

2. http://www.hcvguidelines.org/

3. http://www.wtop.com/628/3644354/1000-a-pill-Sovaldi-jolts-US-health-care-system

Medicine in the Matrix- the future of healthcare: Part 1 (the Red Pill)

By: Dr. Samori Swygert

The future of medicine will undergo a revolutionary transformation.  I purchased a copy of U.S. News & World Report 2014 January-May edition.  I also read a captivating article in the Wall Street Journal: How digital medicine will soon save your life, by Robin Cook and Eric Topol.  When I finished reading this article and magazine expose, I said to myself “welcome to the Medicine Matrix”.

First, the goals in future medical practice are centered on everyone having a fully sequenced genome.  This means that your full DNA is completely mapped out, and analyzed.  This will reveal any and all genetic defects, or variances in certain genes.  This will supposedly allow for more precise dosing of drugs, and more specific drug selection.  Drug selection is important because some individuals have enzymes in their liver that breakdown drugs faster in some people, but slower in others.  This can lead to toxicity or ineffective treatments.  Furthermore, some individuals may produce more or less receptors for drugs to bind to, and that affects overall therapy.

Secondly, the main focus of these two pieces of literature is prevention.  Prominent researchers, institutions, and biotech companies have collaborated expertise to create an anticipatory and prevention based arsenal of therapies.  For instance, if an individual has their genome sequenced, and carries the gene that codes for Cystic Fibrosis, the CFTR gene, a drug designed by Vertex Pharmaceuticals will target that specific mutation and alter it.  Some patients that take the drug Abacavir to manage HIV, but maybe predisposed to a fatal drug reaction.  Thus, a genetic test would be conducted to see if Abacavir is appropriate for this patient before administration. Lastly, cancer patients can see what drugs will and won’t work based on the gene mutation they may possess.  This will allow physicians to tailor and streamline drug regimens.

Let’s talk technology

Everybody’s cellphone will become their medical watchdog.  The tech industry and medical community have created apps and programs that will be installed on your smartphone.  Individuals will have nanobots dispersed into their bloodstream that will conduct internal surveillance of EVERYTHING inside your body.  A nanobot is a small digital device that is 10^-9 in size (like a millimeter is 10^-3), this is extremely small.  However, these nanobots will detect your body’s: pH, blood count, signs of infection, temperature, glucose levels, drug levels, serum protein, HCG hormone (detect pregnancy), testosterone and estrogen levels, change in blood chemistry before a heart attack, pre-cancerous signals, microorganisms, and more.  All of this data will be transmitted to your doctor and your phone.

In addition to the nanobots in your bloodstream, our smartphones will be able to read your ECG and tell your physician if a heart attack is impending.  The nanobot-smartphone alliance will also serve as a sentinel to monitor patients that have been recently discharged from the hospital or clinic and cut length of stay, while still allowing physicians to monitor their progress.

The FDA has approved a “smart watch” called, Visi.  The watch measures breathing rate, blood pressure, oxygen levels, and the electrical conductivity of your heart.

Telepresence will be another medical biggie.  A motorized physician avatar will be suited with GPS, monitors, microphones, speakers, and sensors.  This high tech apparatus will have travel around the hospital from unit to unit, and room to room, but here’s the catch, a real-time screen with the physician is attached.  Physicians can check on their patients from a remote location like their home, or while on a trip. A high definition, high resolution camera will allow doctors to zoom in and out for surface exams.  The doctor can conduct real-time conversations and interviews with patients and staff.  The robot avatars can also consult with other doctor avatars, so you may see 2-5 robots “huddling” as they think about care plans for a patient.  The telepresence aspect has also been touted as an advantage for underserved or rural areas that lack adequate physician access.

The abundance and ever burgeoning amount of medical data can be overwhelming to many practitioners.  I can vouch for that as a critical care hospital pharmacist.  Every other month new drugs are hitting the market, and you must learn these drugs, or at least understand the use, dosing, side effects, and contraindications.  This also applies to physicians because they have to prescribe the drugs, understand the diseases and conditions patients have.

Well IBM developed, “Watson”, yes the computer that humans played against in jeopardy.  This will be integrated in healthcare systems around the country.  Volumes upon volumes of research, textbooks, guidelines, case studies, and etc will be installed in this device to help healthcare practitioners arrive at faster, accurate, and more well informed decisions.  Technology experts predict that by 2020, Watson will contain the equivalent of 500 billion four-drawer file cabinets worth of medical information.

Dr. Showme Da Money

Lastly, to finish off this part, I have included direct excerpts from the U.S. News and World Report expose.  We must discuss financial and economic aspect of this digitized upgrade.  Healthcare is big business.  This past January the Federal Communications Commission reported that it has allocated $400 million annually for creating broadband networks to facilitate communication between rural areas and “urban medical hubs”.  BCC research has predicted a doubling of the telehealth market from $11.6 billion to $27.3 billion in 2016.

AT&T has invested $1 million in funding to help develop the telehealth market.  The NIH estimates the cost of sequencing a person’s genome at approximately $5,700, so multiply that by the number of individuals that are to receive medical care and all the babies to be born!  President Obama proposed $100 million for brain research. The Icahn School of Medicine at Mount Sinai in New York already invested $3 million for their genomic supercomputer.   There is much more to discuss but far too lengthy for a blog post.

Stay tuned for part 2 as we go more in depth to this digital medical revolution.

Source

1. http://online.wsj.com/news/articles/SB10001424052702303973704579351080028045594

2. http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/11/05/telemedicine-vast-potential-increased-efficiency

3. http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/11/05/the-push-to-personalize-medicine

Harvard Study details cognitive risks of fluoride in water

by: Doc Swagg

Routinely, I’m fascinated with the amount of pollutants and toxics that inundate our food and water supply.  Each week it seems like new statistics on cancer and other conditions emerge within the news media.  2012 Harvard University published their findings on the effects of fluoride in drinking water.

Please check this out and share with your friends and family.

http://www.hsph.harvard.edu/news/features/fluoride-childrens-health-grandjean-choi/

8.7 MILLION POUNDS OF U.S. MEAT RECALLED

by:Doc Swagg

A meat processing company, Rancho Feeding Corp, has been implicated in the distribution of over 8.7 million pounds of “diseased & unsound” meat.  A CLASS 1 LEVEL recall has been issued for the following meat designations: USDA mark of inspection “EST.527”, and production dates from January 1st through January 7th of 2014.

4 states have been noted to have received the distribution of beef carcasses that bypassed inspection.  The following states are being reviewed: California, Florida, Illinois, and Texas.  A Class 1 level recall is listed as being the most serious recall classification, and noted to have the capability to cause serious adverse health consequences and even death.

Thoughts

It’s imperative that we try our best to begin sourcing our own food, growing our food, and paying meticulous attention to the meat and produce we are purchasing.  Routine recalls and negligent processing and inspection practices are putting us at various health risks.

We are feeding our kids, and elders this food, and they may not have the immune system to combat food borne illnesses that can lurk in the meat we purchase and are more vulnerable to death or severe sickness.

The fact that more than 8.7 million pounds of meat can bypass thorough inspection is a signal of the breakdown in the processing and distribution chain.  We eat to live and maintain optimal physical performance on a daily basis, but it appears that our very own consumption is killing us because of a lack of due diligence.

This is the news release for the Department of Agriculture’s Food Safety and Inspection Service division:  http://www.fsis.usda.gov/wps/portal/fsis/topics/recalls-and-public-health-alerts/recall-case-archive/archive/2014/recall-013-2014-release

Uncle Ben’s Infused rice recall: who’s inspecting?

By: Doc Swagg

The Mars company is the parent company of Uncle Ben’s Mexican Style, and other INFUSED RICE that has been implicated in a series of  “allergic-like” reactions that several school children have succumbed to recently.

According to news sources, children in 3 Texas schools are suffering from bouts of rashes and flushing.  Mars food company is requesting all distributors of this particular brand of Uncle Bens rice immediately return them in efforts to track and detect the source and distribution of the rice.

Currently, they have not identified the causative agent responsible for these symptoms.  The company is on record for saying that this is not consistent with all other styles of rice that they manufacture through various supermarkets, and other retail outlets.

Thoughts on this

Once again, we are witnessing a failure in the safeguarding of our food supply.  Persistent compromise of our nutritional and dietary sources have almost become routine and “habit-like”.

Where is the accountability when it comes to maintaining quality assured food production?  What happened to good manufacturing practices?  A lack of integrity, the cutting of corners, and failure of adequate inspection are just the beginning of possible reasons for this surge in FOOD RECALLS.  Last week there was a recall on approximately 8.7 million pounds of meat in four states.

We are seeing a failure in oversight, and these cases of food borne illnesses, recalls, and selling of poisoned meat are only indicators of poor food inspection standards.  The Department of Agriculture could obviously higher and train more employees to conduct thorough inspections in all states.  This is one way to reinforce the safety of our foods, and decrease the unemployment rate!  What are your thoughts on this???

Source Links

1.   http://www.cnn.com/2014/02/10/health/uncle-bens-infused-rice-recall/index.html

2.  http://www.usatoday.com/story/news/nation/2014/02/10/uncle-bens-infused-rice-recall-children-sick/5362573/