Well, anyone who has followed my love affair with mobile health apps will understand that, when I come across a pack of apps (with the priciest one running $1.99–and the ones I picked out, well, free), that claims, as does the iPad app “Medical Abbreviations Glossary,” to “reveal all [the] mystery [when] looking [at] abbreviations from medical records, prescriptions or expert advices” [sic] (apparently these experts have a lot of advice), I jump right in to assess the situation.

Of course, sometimes ‘assess’ is merely a synonym for ‘buy.’ [It's all just a business expense, isn't it?] So for the iPhone I “bought” (and the length of the name is worth the price alone) “AbbStore-Lite – Free Medical Abbreviations, Eponyms & Acronyms.”  There’s a name with authority.

This one got rated as “an excellent app with marvelous character,” and any app with character is a friend of mine. In these callow days, how often do your apps have character?  I’m looking at my Compass–and Google Maps, which I really love, since I can’t find my way out of a paper bag, even one that’s on my driveway, with the mouth open to my house–and then there’s Adobe Reader, a fine app, to be sure, . . .but I’m still thinking even with those, all-told, I’m a little short, app-wise, on character. So I was a bit intrigued.

In the app reviews I also found, “Don’t waste ur money!!,” which I didn’t find highly complimentary, but, given that it cost nothing, I didn’t sweat it.

Now, before I go on, we should just briefly review that I’m clearly not a doctor–although (in the interest of full disclosure) I was briefly pre-med in college (it was a short-lived experience). Nor am I a trained (or even an untrained) psychologist, nor a nurse, social worker–or even a volunteer at a nursing home. These apps are just of interest to me.

But they’re more than that to those who see patients–much, much more.

In fact, if the BBC is to be believed (and, really, when isn’t it?), the mis-reading of doctors’ abbreviations puts lives at risk. The UK’s Medical Defence pointed out that  difficulties arise because some abbreviations have more than one meaning. Here’s a good one: my ”AbbStore-Lite – Free Medical Abbreviations, Eponyms & Acronyms” had two offerings for BID, which I imagine you, like me, thought was just a lazy way of telling you to take your meds twice a day (the abbreviation, clarifies the app, is short for the Latin bis in die, which should shock no one to learn means twice a day.)

But actually, turns out BID is also commonly used in medical parlance to mean (and this is a good one), brought in dead–so you could see how some confusion could arise if you were one of the people in the ER in charge of reading patient charts–particularly if you did not have the patient in front of you–that might clarify the situation. [It's also a well-known abbreviation for the Billing and Invoice Department, but neither these apps nor I can worry about that today.]

The BBC went on to report that:

• A 2008 study in the US of study of 30,000 medication errors , some fatal, indicated that 5% of the mistakes were as a result of a misunderstanding of abbreviations in doctors’ notes; and for those who were lucky enough to live through the abbreviation crisis, some:
• had the wrong limb removed or operated on, and
• others were given wrong–and deadly– doses of drugs.

So let’s afford a little more healthy respect to these apps than we might otherwise–although, after utilizing them, I find that a bit of a challenge.

A point for their side–they themselves are respectful, and that should earn some respect back. Although I’ve been exposed to some medical acronyms in my life that are–how can one put it?–less than highly respectful, when I checked both these apps for DAAD (dead as a doornail), BND  (bloody near dead), and TSTL (too stupid to live), I drew up blanks, leading me to believe: a) that the apps might refuse to truck in some of the more sickly humorous acronyms that keep medical residents going; and b) the applications instead probably spent their time focusing on collecting a greater selection of more relevant abbreviations. You’ll just have to turn to Google if you find ABITHAD in your notes. (I liked this one a lot, even if it wasn’t in my app–It’s “Another blithering idiot – thinks he’s a doctor.”) Right? If you’re the guy who really wants to hear that FLK stands for funny looking kid--these aren’t the apps for you.

BUT. . . if you’ve just always wanted to know what KVO, VEB, or  ZIFT stood for–your day has arrived! Just follow my link (I’m going to recommend the first app over the second–I’ll come back to the latter app in the next paragraph), and you’ll find all sorts of information like that (and just so you don’t have to be kept waiting and hitting hyperlinks, your answers here are: keep vein open [with slow infusion], ventricular ectopic beat, zygote intrafallopian transfer). Now you know.

In terms of the iPhone app–well, you pretty much get what you pay for (bubkis). You have to know the acronym or abbreviation you’re looking for first. First you put it in–and the app does respond with the full answer–in fact, with white font on a lovely shade of blue.  It just seems to me to take a lot of initiative to actually know what you want to know–but I bet some people are up for it. I tried to put  in DQA, which my ‘other sources’ had told me was a drama queen alert-but wouldn’t you know, it wouldn’t even let me enter those letters (talk about controlling).  The app insisted on a DQF entry–not at all what I had planned, but which, in fairness, is more serious, and which, ultimately, a seriously serious field deserves.  So, having been forced away from drama queens, DQF, I am now officially informed, stands for double quantum filters. I’d like to say I’m glad I know, but. . .

The excitement just goes on.

Also for the iPhone ( $.99) is “MedAbbreviations: Medical Abbreviations Reference.” It insists you must be over 17 to download this app, which makes me wonder what in the world I’m missing–the excitement eludes me.

This had a real plus and a real minus–which might be the meaning of life in general.

The plus–it was amazing how many phrases it pulled out of its pocket for PDR (this is just representative; it has a whole host of offerings for many entries), which, having a father as a doctor–and having actually seen doctors through my life–I know as the Physicians’ Desk Reference.

But for this app the fun is just beginning. PDR might also be:

• pigmentary disorder, reticulate, with systemic manifestations (pretty heavy, huh?), or
• post delivery recovery, or
• powder (not very impressive, is it?), OR
• proliferative diabetic retinopathy.

A fairly  impressive display of acronym agility, I thought.  It would be worth $.99 to just to be sure you were getting the most bang for your abbreviation buck.

Or at least I think so.

To be truthful, I’m not sure you’re feeling the love about these apps the way I am. Maybe you’re not. Okay. But let’s just say, you’re a middle-aged man with a heart condition who finds himself in situations where doctors’ notes appear all too frequently–on instructions she’s written for you, on prescriptions, in your chart. Wouldn’t  you love to know what your doctor was meant when he wrote AGA in your chart, which you caught a glimpse of when his nurse left it lying next to you on the examining table?

While your goofy friends insist she means you had an acute gravity attack (like you fell over your feet and didn’t notice), what if you  had one of these apps to assure you what it meant? Then you could look it up and put your mind at ease?

You could whip out your iPad or iPhone, and find out it really stands for appropriate for your gestational age.

Just think how that could put your mind at ease.

The DCP just provided a wipe-out of the major psychiatric diagnoses, to wit

“[I]t should be noted that functional psychiatric diagnoses such as schizophrenia, bipolar disorder, personality disorder, attention deficit hyperactivity disorder, conduct disorders and so on, due to their limited reliability and questionable, validity, provide a flawed basis for evidence-based practice, research, intervention guidelines and the various administrative and non-clinical uses of diagnosis.”

Well, you know, it’s quite true I don’t belong to the DCP, or to the American Psychological Association or APA or the, Canadian Council of Professional Psychology Programs (think it’s the CCPPP?), or any other acronymed association, for many reasons, but mostly because I don’t have the qualifications.  But I’ve been around some mentally ill, and have a good idea that, sometimes a person really does suffer from a psychiatric diagnosis, as unfortunate as that is.

Yesterday I received an email, asking me one small thing.  Here it is, in full:

“I am Veronica and I’ve been a follower of your blog for quite some time. I really appreciate the unique thoughts and the kind of efforts you have put in managing such a great blog.

I was wondering if you can have a look on the infographic “Schizophrenia: The Broken Mind” (http://www.bestmedicaldegrees.com/schizophrenia/), which we have posted on our site. This is somehow relevant to your blog content. If you also think so, then, please consider it for sharing with your blog audience.

Feel free to let me know if anything I can do for you. Thanks a lot for your time!

Best,
XX”

So I was going through life, not vigilant, for sure, but ‘alert’ (another synonym)-at least most of the time–until I ran into the 2013 Health Observance and Recognition Calendar Days. Look–I already provided you the link–you really must go take a look. Because you may have thought that you were ‘watchful,’ but I bet for years you’ve failed to notice Root Canal Awareness Week (May 17-23), Medical Transcriptionist Week (May 19-25), Health Care Recruiter Recognition Day–anyone?–June 4; I bet few have properly been mindful of School Backpack Awareness Day (September 18) and I’m pretty skeptical that an appropriate number of people have been vigilant when it comes to  a personal favorite in our household, what’s known as Time Out Day, June 12, which–I am not making this up–”emphasizes the importance of surgical teams taking a “time out” to confirm vital patient information before beginning every invasive procedure.”  That’s right–I’m all for a day that encourages surgeons to find out if I’m actually the one who’s supposed to be in surgery or if it is my 87-year-old roommate, to determine if I’m keeping my uterus–or finally throwing in the towel on the thing, to make absolutely certain that it’s the right side that’s problematic–so they should probably do their business there.

Be that all as it may, there were two weeks asking for my attention that I felt I really should summon up mindfulness for, and, if you haven’t spent all your intentness elsewhere, perhaps you’d join me.  It’s a bit of a challenge, because they’re both the same week, May 12-18, but I think we should all give it a try.

National Anxiety and Depression Awareness Week

When it comes to anxiety and depression, there are a few things it’s definitely worth being mindful of.

• Anxiety disorders are the most common mental illness in the U.S., and they affect nearly 40 million adults in the United States age 18 and older (18% of U.S. population) (Anxiety & Depression Association of America).
• Anxiety disorders are highly treatable, yet only about one-third of those suffering receive treatment.
• Anxiety disorders cost the U.S. more than $42 billion a year, almost one-third of the country’s $148 billion total mental health bill, according to “The Economic Burden of Anxiety Disorders,” a study commissioned by ADAA (The Journal of Clinical Psychiatry,60(7), July 1999).

According to the National Institute of Mental Health:

• Major depressive disorder is the leading cause of disability in the U.S. for ages 15-44.
  
• Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.
• Of course it can develop at any age–but the median age of onset is 32.
• The National Alliance for the Mentally Ill tells us that depression affects more than 6.5 million of the 35 million Americans aged 65 years or older.

• The New York Times, which always teaches me something, made me cognizant of the fact that researchers report nearly 60 percent of the people in treatment do not receive adequate care.
• Breaking down the stats reveals in any given one-year period, 13 million to 14 million people, about 6.6 percent of the nation, experience the illness.
• I further learned that, although I was quite interested in stats on ECT, no one keeps them.  ECT.org attempts to clarify the situation with this obfuscating information: “Only a handful of US states require reporting, and many other countries either do not collect data at all, or do so partially.” Illuminating.

Note that you won’t find any such lack of knowledge when it comes to Awareness Day # 2  You ready? It really doesn’t take much vigilance at all–I’ll walk you through.

National Women’s Health Week

My source (which I’ve now shared with you) explains the week, coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health, “brings together communities, businesses, government, health organizations, and other groups in an effort to promote women’s health.. . .[It] empowers women to make their health a priority. It also encourages them to take steps to improve their physical and mental health and lower their risks of certain diseases.”

You’re ready to be aware about this one, too [although I notice the word 'aware' does not appear here, so maybe the bar is lower for women], but not quite sure where to start?

Interestingly, in a Web search, I couldn’t find a whole lot of practical information about how women were supposed to take those steps to improve their health and lower their risks.

What to do.

Well, one way is just becoming. . .well, aware of women’s health status as it is–and, given that there’s little I love more than an infographic that expresses what I need to know in picture form, you could just hit the link to this infographic, entitled “The Affordable Care Act: Addressing the Unique Health Needs of Women.”  Done in pink (where’s my 3-year-old-neice when you need her?), it’s got a truly odd assortment of facts (did you know only 16% of moms exclusively breastfeed at 6 months?).  I wasn’t aware of them before, and now I am, so there’s getting on the bandwagon for you.

Another is being sure you know all the preventive services women are supposed to have (even though it’s overwhelming, and some are rather on the unpleasant side).  The U.S. Department of Health and Human Services’ Health Resources and Services Administration put out a table entitled, “Women’s Preventive Services: Required Health Plan Coverage Guidelines Supported by the Health Resources and Services Administration,” which, obviously, doesn’t just list what you need–but assures you that it’s covered, too. There are services there you might never have known were covered, such as Breastfeeding support, supplies, and counseling, and Screening and counseling for interpersonal and domestic violence.

Finally, womenshealth.gov, a project of the U.S. Department of Health and Human Services Office on Women’s Health, really runs the show, so you really want to get yourself and your attentiveness over there. They’ve got an interactive chart about preventive screenings, offer a free on-line publication entitled Women’s Mental Health: What It Means to You, have a link to a Statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius,

And, best of all, the site concludes with 5 things women can do to celebrate the week (example: Discussing with their health care professionals which screenings and tests are right for them and when and how often they should have them).

Not one of them is hard, although of them take some level of consciousness.

But if you read an info graphic, or contact your doctor or find out about preventative services covered by your health plan, you should be pretty proud of yourself.  You have celebrated Women’s Health Week with full awareness. Way to go.

I mean, I think I ate solid foods on time and all that – but when it came to riding a bike, four, five, and six passed me by before there was any success on a two-wheeler.

The lovely sound of ‘teen’ at the end of my age was long gone by the time I got myself to college.  And I did finish – but the mid- 20s had crept by, and I completed grad school while inching toward 30.

But the point really is that I did do all those things – I still ride my bike all the time, I have my college degree (in English, which is of course a degree which has immediately usefulness and which employers salivate at when they see it on a resume) and–believe it or not–I do I have a Master’s degree.

This is all by way of explanation of why this post is being published on 8 May. Like I said, I’m a slow starter – but I do get there And I’ve gotten us to the publication of a post on an extremely important topic–and hopefully I even have a few helpful things to say on it.

Mental  Health Awareness Month (watch that name carefully – it’s about to change on you ) has actually been around since Congress created it, way back in 1949.  It’s hard for me to say, but, from my perspective, it has not exactly made a  radical difference in the lives of the mentally ill–but it was nice of all those Senators and Congressman to make an effort anyway.

But then 8 days ago, things got really exciting on the Mental Health Awareness Month front. Decades after Congress played its part, President Obama took the stage and, making a (what other kind?) presidential proclamation, which you can read the whole of here, he proclaimed that May would now be (here’s the name switcheroo, in case you forgot to pay attention) National Mental Health Awareness Month.

As if that isn’t enough excitement in itself, three other Awareness weeks are embedded into this one:

• May 5-May 11 is National Children’s Mental Health Week. The theme this year is “Out of the Shadows: Exposing Stigma.”  Check it out at National Federation of Families for Children’s Mental Health.

• May 19-May 25 is Older American’s Mental Health Week.  I really like the message this week carries, which is that mental illness is not part of the aging process. Just as a tidbit for you: the second highest suicide rate in this country is currently among those 85 and older. Something to think about.
• May 20-May 27 is Schizophrenia Awareness Week. One out of every 100 people suffers from schizophrenia. The focus of the week this year is on the physical health of those with the illness–a source of real concern.  Research has shown that those with schizophrenia die, on average, 25 years earlier than the general population. For more information on schizophrenia, the website Schizophrenia and Related Disorders Alliance of America  offers a lot.

Well, that’s a lot of awareness you now have, but I feel I’d be remiss if I didn’t leave you with some ways to celebrate the month–the general part of it–I have to think more for each of the individual weeks–and make it matter (even if we are starting 8 days late).

Ways to Celebrate National Mental Health Awareness Month

1. Mobile App Challenge:   I must admit, with my interest in mobile health, this one’s a personal favorite, so I gave it prime real estate. For this one, you pick and install a mental health mobile app on your smartphone or tablet–and then actually use it for the month (or 3 weeks, in our case).  That’s really  it.  The writers of the article ask that you report back to their Facebook page, but it’s a T2 page, so that really only applies if you use a T2 mental health app, which are good–but there are many others to explore.

2. Mental Health America: Someone always comes up with this as an activity in an awareness month, and, if you’re just not up for breaking your teeth on something new, this is the way to go–it’s the ubiquitous Fact Sheet. You can download and read it–and you’ve probably more actively celebrated National Mental Health Awareness Month than 74.5% of the population. [It's also particularly appealing: Under "Your Pathway to Wellness" two of the 'pathways' are 'a day at the spa' and 'playing with your pet.' I'd like to start my pathway to wellness immediately.]

3. SAMHSA (Substance Abuse and Mental Health Services Administration) has community events planned in 28 states (if I counted correctly) and DC (although how West Virginia got included while New Jersey got the boot is beyond me), all on children’s mental health. It’s worth taking a look and seeing if you’re included (South Dakota in, Wisconsin out), as they address how to shatter the stigma of mental illness, and how to use art to help children express themselves.

4. Suggestions too techy? Take too much energy? Just not your thing?  Then I direct you to psychologist Nicole Connolly, Ph.D., who has some ideas for celebrating National (thank you, Mr. President) Mental Health Awareness Month that just might fit your bill. As a hint, they start with taking a walk, and end with talk to someone–and in between you get to meditate. I think it just might be your thing.

So make the most out of National Mental Health Awareness Month. I can assure you–even if you’re starting late, you can still finish strong.

And so we come to the “Resolved” part, and this is what the House has to say, “Resolved, That the House of Representatives supports the goals and ideals of Borderline Personality Disorder Awareness Month.”

And here’s where I felt like I got left out in the cold–because I couldn’t find “the goals and ideals of BPD (forgive me–I have a sore elbow from typing) Awareness Month.”

And really, there are bigger people than I taking charge of this, so you might just want to head yourself over to the heavily-initialed NEABPD, otherwise known as the National Education Alliance Borderline Personality Disorder, who clearly are where it’s at. They even have an Awareness Poster you can download. Can you beat that?

I really can’t–not a poster, for sure, and I’m pretty positive I’d come up on the losing end of a House Resolution, too, so the best I can offer is some thoughts for BPD Awareness Month that I think it’s worth–well it’s worth people being aware of, when they may not have been.

For example, unlike ‘depression,’ which came into use (mainly replacing ‘melancholia’) in the late 1800s, or ‘schizophrenia,’ mostly in use since 1908, it was not until 1938 that the term ‘borderline’ was coined. It was done so by one New York psychoanalyst (one Adolf Stern, if you’re into details), and he used the term–and no one likes this, but it’s just the facts–because people believed the illness existed on the “border” between neurosis and psychosis.

Although BPD is hardly related to the vast majority of psychotic disorders, apparently it just had staying power, as here we are, over a decade later–still on the border.

Sometimes what is written about those with BPD in the popular press is astonishing. Time magazine, perhaps, not the single most erudite magazine to grace this planet, but certainly a reliable, steady source of news, published the following harsh piece  on June 8, 2009,  innocuously titled “The Mystery  of Borderline Personality Disorder.”

Borderlines are the patients psychologists fear most. As many as 75% hurt themselves, and approximately 10% commit suicide — an extraordinarily high suicide rate (by comparison, the suicide rate for mood disorders is about 6%). Borderline patients seem to have no internal governor; they are capable of deep love and profound rage almost simultaneously. They are powerfully connected to the people close to them and terrified by the possibility of losing them — yet attack those people so unexpectedly that they often ensure the very abandonment they fear. When they want to hold, they claw instead. . . .Many therapists have no clue how to treat borderlines.

Well. Just go ahead and say what you think about borderlines–don’t hold back, there.

But their point about therapists not being able to manage patients with BPD is interesting, and perhaps we should leave with a response , as long as it’s awareness month.

Let me introduce Dr. George Eman Valliant, an American psychiatrist, professor at Harvard Medical School, and Director of Research for the Department of Psychiatry, Brigham and Women’s Hospital. He has dedicated his life to researching mental illnesses, among them personality disorders.

Dr. Valliant had something to say about all those doctors who struggled with patients, and, finding them ‘impossible,’ called them borderlines, and all those clinicians who, as Scientific American Mind writes, in their superlative January 4, 2012, article, “Diagnosis of Borderline Personality Disorder Is Often Flawed,” “presum[ed] that patients who do not respond well to treatment or who are resistant to therapists’ suggestions are frequently ‘borderlines.’”

Enter the Valliant. In 1992 Sir Valliant wrote: ”I believe that almost always the diagnosis ‘borderline’ is a reflection more of the therapists’ affected rather than their intellectual response to their personality – disordered patients.”

You tell ‘em, George, especially during Awareness month. And, special for Awareness month, I share with you–and leave you with–the title of Dr. Valliant’s article in which he shared this belief:

“The Beginning of Wisdom is Never Calling a Patient Borderline.”

I’m so attached to my Apple products because I think they can do just about anything–predict the weather, remind me to take my medicine, show me the way when I’m terrifically lost–if I speak nicely to Siri.

But it turns out they can do more than that–a whole heck of a lot more, and that, with their easy-to-learn accessibility, their apps, and their developers working hand-in-hand with physicians and nurses to make what they need. . . .well, they’ve changed the face of healthcare as we know it.

I read  an article worth passing along–”How Apple Accidentally Revolutionized Health Care“ by Keith Speights–and I feel like telling you all the good parts, like that in 2011, 75% of physicians interviewed owned an Apple product, or in April, 2012, there were over 13,600 apps in the App Store [and--just in case you were worried--I have plenty to say about some of these mobile health apps]–but then I’d be stealing all of Mr. Speights’ thunder, and would that really be fair?

I’ll keep myself quiet and busy by going to check my lab results in my “MyChart” app–it’s always exciting seeing how high my white blood count can go.

Happy reading.

And she suffers from bipolar disorder–badly. It has ravaged her life.

But she has come back to talk about it in a fresh and inspiring way–and to ask the question: In all the lithium and locked doors and loneliness. . .what happens to the self?

It’s worth a read, from Friday’s New York Times, ”The Problem With How We Treat Bipolar Disorder.”

I spent a good amount of time trying to think of a way to put it that involved less brutal honesty, perhaps some more word craft–a bit of extra verbiage that might distract from such an unplesant truth.

But, ‘sometimes I worry’ was definitely a bit shy of the whole truth, ‘how I imagine certain things will turn out is a bit concerning’ didn’t really cover it, and  ’it’s happened that I think in advance about things in a non-positive way’ was fairly inelegant.

So okay, there you have it. I can be anxious. It’s not a crime.

But it seems like each time I turn around there’s some unpleasant truth I’m finding out about states of emotion. If it isn’t that the seriously mentally ill die an average of 25 years early (that is seriously unpleasant), then it’s that children who suffer emotional abuse at the hands of their parents respond less well to skin cancer treatments, or that even people with sub-clinicial levels of depression have higher rates of cancer and cardiovascular disease.

And sure enough, it just isn’t safe anymore to be anxious.

With the catchy title, “Chronic Anxiety Speeds Aging,” MedPage Today blithelely informed me that those with the most severe forms of anxiety present on the cellular level as 6 years older than their ‘devil-may-care’ counterparts.

For real.

Which is wonderful to for anxious people to know, since it gives them something else to  about.

In fact, I’m off to dwell on the fact that a 2005 study in the journal Circulation found that (warning–if you, too, are anxious, there’s really no need to read on.  Your heart will get you whether you worry about it for years ahead of time or not) women with, as quoted by Harvard Health Publications, “the highest levels of phobic anxiety were 59% more likely to have a heart attack, and 31% more likely to die from one, than women with the lowest anxiety levels.”

That ought to keep me busy for a while.

If you, too, are anxious, and fear you can’t find anything in the media to really put the fear of God into you at the moment–drop me a line. I’m anxious–and attuned. What a winning combination.

What more could there be, what hidden potential is just lying behind drugs we thought we knew?

Look at well-known cancer drug Avastin.  It has been used to treat late-stage colon, breast, and long cancers–and it’s recently been found to treat age-related macular degeneration. Not as glamorous as erectile disfunction or date rape drugs, but important nonetheless.

In 2006 Lucentis was approved for age-related macular degeneration, with claims that it could stop the disease’s progression–and maybe even reverse it. But recently doctors have argued that Avastin is successful in producing the same results–at a fraction of the cost. With Lucentis at around $2,0000 per treatment, and Avastin $150 per treatment, its advantage is clear. However, Avastin is not FDA-approved for AMD, and Genentech, the company that markets both drugs, has stopped sales of Avastin to the pharmacies that cut them into the proper doses for AMD.  Its future as a treatment remains to be seen.

But Avastin doesn’t ist around waiting. Just this past year, a team of researchers at Massachusetts General decided to try Avastin on neurofibromatosis type 2, a rare or orphan disease typified by the growth of noncancerous tumors in the nervous system. Found in about 1 in 25,000 people, the tumors can often impact the auditory nerve,  resulting in deafness. Traditionally, treatment has consisted of surgery or radiation, but both have negative effects. Operations on those with tumors the size of small plums almost always yield deafness, and radiation can actually lead to cancer.  Of the 10 patients in the  study, the tumors of six shrank by 20% or more;  of the seven patients who had hearing loss before the treatment, the hearing of six improved or remained the same, rather than deteriorating further as would commonly occur in the disease.

We’re up to 5 new uses here as well.

Every year in the U.S. 100,000 people are diagnosed with kidney failure, the final stage of chronic kidney disease (CKD).  Diabetes is the most common cause of kidney failure, making up 44% of all cases.  At the end stages of the illness, people will have to undergo dialysis or transplantation. But, in a surprise finding, ACE inhibitors which treat high blood pressure and weak heart muscles turn out to also slow the progress of kidney disease significantly.

Other illnesses are managed by surprising medications, as well. For example, enuresis, or persistent bed-wetting past the age of 5, found in 15% of 5-year-olds, is treated by. . . .tricyclic antidepressants and desmopressin nasal spray. Scout’s honor.

And then just this year, in a surprise to those familiar with heart disease, a study of chelation therapy, which involves infusing agents that remove metals from the blood stream, found that it reduced the rate of death and heart-related problems in a clinical trial sponsored by the National Institutes of Health.

In the very old wine in new bottles category, take acetylsalicylic acid, better known as aspirin, used for ages to alleviate pain.  The U.S. took the formula from the German Bayer as spoils of World War I.  And it was a wise little gift we handed ourselves, the gift that keeps on giving. Besides anti-platelet action,  75 mg a day of aspirin a day reduces incidence of colorectal cancer, providing cardiovascular protection at the same time. Aspirin is in the rare category of drugs that cost little and can effectively replace others that are expensive.

Given that it takes approximately $1 billion to develop a new drug, companies are thrilled when they discover one of their medications can treat an apparently unrelated disorder. The research studies can bypass the first few steps–finding the molecule, preparing it for medical use  and testing for toxicity.

Just to leave you with a few more: Astemizole,used to treat allergic rhinitis, has been found to treat malaria; Evista for osteoporosis has now been found helpful in breast cancer, and Rheumatatrex and methotrexate, both used to treat cancer, help treat rheumatoid arthritis and other immune disorders. Provigil originally treated narcolepsy, and is now used to manage chronic depression; Inderal for high blood pressure blood pressure also manages migraines.

Let’s hope researchers continue this lucky streak. The autoimmune-cancer link has produced a number of cross-overs. Surprise uses for old drug save lives and save millions, if not billions, of dollars.  It’s really recycling at its best.

In The Slumbering Masses” Wolf-Meyer looks at the recent history of sleeping patterns. Before electric lighting, folks went to bed shortly after sunset for Part I or the night. Four to five hours later, they awoke (like me, surprisingly) and enjoyed other activities. Ben Franklin supposedly used the middle of the night to read naked in a chair.  Eventually, they returned to bed for Part II, the “second sleep.”

The theory is that capitalism forced people to go to work at dawn and stay there til night, a schedule gradually modified to 9-5. With that external pressure, we obsess any time we’re awake in the night hours that we’ll be tired at work.  Sleep problems are, Wolf-Meyer thinks, the result of being forced to sleep when we’re not naturally designed to do so.

A second, related explanation of the origin of insomnia nation comes from Rill Roennenber’s “Internal Time: Chronotypes, Social Jet Lag, and Why You’re So Tired.”  Our chronotype is our internal clock,  People tend to be either larks and owls. Larks, who naturally rise early, are well suited to a work schedule, while owls, the reverse, do well socializing at night. Each bird feels fatigued when engaging in activities at the opposite end of its wakefulness cycle.

Infants are natural larks, exhausting their parents, while teens are owls, likewise exhausting their parents.  Proposals for later starts to the high school day make inherent sense but have not been instituted.

These 2 theories help explain our insomnia but don’t make it disappear.  They may, however,  ease the fear of not sleeping by reframing the problem as situational rather than a disease.