Medical Whack-A-Mole

Recently I learned that one of my band mates had died, apparently quite suddenly. None of us knew he was seriously ill. It occurred to me that with all the health issues I’ve been dealing with over the past few years, my demise would hardly come as a surprise. More likely friends would wonder: “Which ailment was it that finally got her?”

 

The more I thought about it, the more I realized that I’ve been playing Medical Whack-A-Mole. When I finally get one illness under control, another one pops up to take its place. Many times, it was the treatment for the first that caused the next one. Let’s start with my lung cancer, which was diagnosed about two and a half years ago. I entered a clinical trial through Yale, in which I received regular infusions of three drugs: two chemo therapy and an immunotherapy, plus study pills that might have been a placebo.

 

The program was to last two years, but one year into it, I developed pneumonitis, a severe inflammation of the lung. My oncologist and my pulmonologist agreed that the likely cause was one of the drugs I was getting. There was no simple way to know which one. Pulling any of them would take me out of the study in any case, so we stopped my cancer therapy completely.

 

Mercifully, it appeared that the year of treatment had halted the cancer before the pneumonitis popped up like a mole. We whacked that sucker back down with a heavy course of Prednisone. For those of you not familiar with it, Prednisone is a steroid. I was on it for weeks, but it cleared up most of the lung inflammation. It’s a go-to treatment for many ailments.  I’ve concluded that it’s one of three things every household needs on hand, along with duct tape and WD-40.

 

But true to my Whack-A-Mole analogy, the Prednisone gave me a major face rash and I blew up like the Pillsbury Doughboy. I also developed edema in my feet and lower legs. An ultrasound made sure the fluid retention wasn’t due to vein leakage and that I had no blood clots. The edema was just another mole that popped up when we used the steroids to whack something else.

 

An online search led me to taking high supplements of magnesium to reduce water retention. Sadly that whack led to a pop up mole of severe diarrhea. Needless to say, I decided to live with the fluid build up. Fortunately, shortly after the course of steroids was completed, that problem disappeared. Unfortunately, it did not mean I was headed for clear sailing with my health.

 

Even with the pneumonitis under control, I was increasingly short of breath. Tests performed by my pulmonologist turned up two new “moles” to whack. Turns out I have a paralyzed right diaphragm muscle, usually caused by an injury. In my case, there’s no clue why and it might never be normal again. A few weeks of physical therapy could help. More on that later.

 

The other “mole” was pleural effusion, a build up of fluid around the lung. That was drained via a thoracentesis procedure. My breathing improved immediately. Nevertheless, my pulmonologist prescribed a steroidal inhaler to keep my airways clear. The mole from that turned out to be a side effect of some hoarseness, but I can live with that. Back to the pulmonary rehab, which I had two afternoons a week.

 

The rehab included education and light stretching, leg and arm exercises, followed by time on a treadmill. At each session, the treadmill speed and time were increased, but never to anything too stressful. The morning after what would be my last session, I woke up with horrific neck and back pain. Plus I also had a partly paralyzed right hand. I assumed I had slept crooked and pinched a nerve, or something like that.

 

When the pain persisted for days, I made several appointments with specialists. The last was with a neurologist, who has ordered several tests. He also prescribed Gabapentin to address the nerve pain. It has serious mole-like side effects. You can get tired and dizzy, so I take it only late at night.

 

I feel like I’m in a fairy tale. If I stopped dying my hair, I’d be Snow White, but I’m already most of the Seven Dwarfs. Allergy season has me Sneezy. Though I’m certainly never Bashful, much of today’s news leaves me feeling Dopey. I ask so many questions of my physicians that I might as well be a Doc. Gabapentin leaves me Snoozy and Dizzy. Despite spending most of my time playing Medical Whack-A-Mole, I’m rarely Grumpy and I’m usually Happy. I won’t ask for more than that.

 

Copyright 2023 Business Theatre Unlimited

Retirement Tools — Pills That Tattle

This week’s health news should have all of us sitting up and taking notice, especially if we’re not very good at sitting down and taking meds. Proteus Digital Health issued a press release that was covered by media outlets from network news to CNN Money to PC World. And with good reason.

Proteus announced FDA approval for an invention that combines technology, healthcare and perhaps even social media. It’s a device about the size of a grain of sand that contains an 'ingestible sensor.' That chip is imbedded into a pill; you swallow the pill and your stomach fluids activate the sensor. It then transmits data (including 'heart rate, body position and activity') to a patch stuck on your skin. The patch, in turn, transmits to an application you’ve downloaded to a mobile device.

The first wave of product in the US will have the sensors embedded into placebo pills that must be taken at the same time as the patient’s meds. Eventually, the chips will be put into actual pills. You don’t need batteries and you won’t have antennae sticking out of your head, but you must replace the stick-on transmission patches every seven days.

It’s expected that this invention will be especially useful for seniors who are prone to forget to take their meds. Exciting as this news is, I see some problems with the design. I’m judging based on my own increasingly limited attention span.

First, consider the initial test phase with the separate placebo. Seniors who have trouble remembering to take their actual medication may take the meds and forget the placebo. Or worse, take the placebo and forget the meds. Under the first scenario, the mobile app will have caretakers calling to prompt pill-taking that will result in overdose. Under the second, folks will be celebrating proper medication when all the addle-brained patient took was a sugar pill with a fancy chip in it.

Then there’s that patch. Do they really think someone who has trouble remembering to take his pills will remember to stick on a patch? Or to replace it every seven days? Good luck with that. I’m at the point where I’m thrilled to remember to change my underwear every day. (OK. Not really.)

Next, there’s that mobile app that reads the data sent to the patch. Hello! Mobile app? What percentage of seniors have a mobile device onto which they've downloaded even one app? I have a cell phone, but I’ve never used it to take a picture and I don’t text. (Both too expensive under my frugal, emergencies-only plan.) Needless to say, I have no apps and wouldn’t know how to get one, much less how to use it. And I’m no Luddite.

Finally, for those on multiple meds, I envision them taking placebo A with pill B and vice versa. (Remember, each chip is programmed to match a particular medication and schedule.) Have fun sorting that out.

Now that I’ve raised all these red flags, I’m sure Proteus will come up with additional technology to address these problems. I’ll therefore assume that this device becomes a huge success and moves on to expanded applications. For instance…

In collaboration with my GP, my husband will embed these microchips into the cookie portion of the ice cream sandwiches on which I snack. If I eat too many of them, or too close together, my stomach will tattle on me. Proteus will have devised a way to hide the transmission patches in those cute magnets we all have stuck on the outside of the fridge. The icemaker will have a hidden mobile device with the necessary app to send out a binge alert.

But wait. It gets worse. Remember that social media part I mentioned up front? The intention was for the pill taker to have Internet access to secure applications that could report their personal medical data. They could also link to information on health topics related to their specific meds.

My nightmare scenario has social media running amok. My ice cream ingestion is instantly posted to my Facebook wall. 'Elaine just ate two ice cream sandwiches in the space of a half hour, and she was lying down the entire time!' (And they don’t even mention they were the mini-sandwiches.) I’m forced to wear the shame of my lack of self-control like a scarlet letter A. Oh, the ignominy!

In the realm of 'Thank the Lord for small favors,' at least they can’t put those microchips into wine. So, I won’t have to worry about anyone keeping track of how many glasses of my favorite vino I have and in what timespan. On that note… I raise my glass. Salute!