Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Tuesday, June 23, 2015

Cognitive Chimps

I recently watched an interview in which John Stossel broached a very even-handed interview with Cavan Brunesden, DDS, representing the pro-fluoride water position and Paul Connett, representing the anti-fluoridation movement.  Stossel brought to mind a debate on the O’Reilly Factor between him and Bill O’Reilly on a more humorous vein: political correctness.  Somehow connecting the dots between PC, PETA and universities, I was reminded of an animal rights mission to find a home for laboratory chimpanzees at one of the major universities in Florida.

Their point was that the very reason for the chimp study was to demonstrate they had “cognitive powers” similar to humans, being able to make a preferential choice as to what foods tasted better after cooking.  Therefore they should be granted the dignity and deference given humans in similar studies.

Stossel brought O’Reilly a current list of politically correct terminology that went way beyond doing away with labels for Stewardesses or Chairmen and included one of my favorites: a dog-guardian.  O’Reilly opined that part of the problem inherent in that term was that guardians usually got paid for their service while pet owners are in the opposite camp.

One of my favorite jokes concerns a man, flying to a business meeting who hears a female voice saying, “Well, as we break through the clouds, feel free to push your seat back and relax.”

His reaction: “That’s all we need, a woman pilot in the cockpit!”

To which the flight attendant says, “You are correct sir, our Captain is female, as are the First Officer, the Purser and all three Flight attendants.  Oh, and we no longer call it a cockpit, it is the Flight Operations Center.”

I’m unsure of what that says about me, but JerrySeinfeld would say the pc-appropriate line has moved in too far. He told O’Reilly and Stossel that when his wife mentioned to their 14 year-old daughter that she might want to spend more time in the city, to meet boys, she said, “That is so sexist!”  Seinfeld believes college campuses as well as his daughter have become unable to see the humor in stereotypical behavior.

There is reason to agree with Seinfeld’s opinion.  A recent article in the WSJ traced the history that has resulted in Federal Funding for Title IX, which was designed to equal the opportunity playing field for women in college sports, to be diverted to Universities being, Judge, jury, investigative authority and court in cases of alleged sexual harassment.

A case in point being the University of Virginia, which responded to now-debunked allegations of fraternity house gang rape by closing the fraternity house, expelling at least two students, and defending the school’s policing of on and off-campus allegations of sexual misconduct.  All of this in response to seemingly innocuous “Dear Colleague” letters from federal education officials, which changed to ground rules of Title IX, creating a new standard that concluded women did not know what “sports” they were interested in and needed to be educated that they could compete in activities more classically defined at athletics.

Title IX funding has now been diverted from support for women athletes to defense of the university’s compliance with federal guidance and funds have been siphoned off to, no-so-surprising trial lawyers.  This seems particularly ironic when we see US Woman’s Soccer prominent on a world stage.

 Please plan to join me on my next Post, where I will explore that I see as the present and near future of Robots and Drones and how that future may affect us.

Tuesday, June 2, 2015

Heroin

For the last fourteen years the American Association of Maxilla-facial Oral Surgeons (AAMOS) has held meetings with interested stakeholders for their services in conjunction with a Dental Consultant’s Meeting I attend (AADC).

Lately, those meetings have been held on odd-years (pun recognized but not intended), this year outside of Albuquerque.  I was invited and indicated interest in recent proposed codes for sedation in conjunction with third-molar extractions.

That topic made the Agenda, but the surprising one to me was “How AAMOS plays a role in Heroin addiction.”

It shouldn’t have been that surprising.  NPR recently spent a week on the increase in Heroin addition, particularly in small towns and in conjunction with returning veterans.  A movie titled, “Heaven Knows What” is stirring interest prior to its release next week. And most of this coverage concluded that Heroin addiction was the consequence of addicts being unable to afford or obtain prescription opioids.

But is that accurate?  And if so, what is the easiest, cheapest, and most productive way to make inroads into the statistic?

Through the week, NPR looked at several different scenarios:  small or mid-sized towns in the Midwest, where unemployment and dead-end job prospects cause many of the young to lose heart and hope; urban and suburban areas where small-time players in Mexican drug distribution are finding a ready market for cheap heroin and an opportunity to pilfer 501 Levi Jeans from the local Walmart to take home to family and friends; some Veteran Hospitals where medicinal opioids are routinely prescribed over time to veterans who would otherwise require intensive care for their PTSD, and the over-prescription of opioids for chronic pain control.

This last was the focus of the Oral Surgeons at the AAMOS Meeting.  Most have a protocol of preventive pain abatement, namely, prescribing pain medication before the local anesthesia used to mask pain wears off.  This is nothing new, as I used the same regime when I was acting Oral Surgeon at the New London Dental Clinic.  I removed more than 1,000 wisdom teeth in about five months and routinely prescribed a three-day dose Vicodin.  How many of my patients actually needed this dose or how many actually used the entire prescription I could not say.

I do know that the potency of the medications has increased, as have the occasions for their prescription.  Mary and I are growing older and have more surgical procedures. In her case she had shoulder surgery and was prescribed oxycodone, partially because of its time-release feature makes compliance more predictable. I had Prostate surgery, and a hip replacement both of which resulted in some heavy medication prescription.  Neither of us are inclined to take medication without cause and consequently had large amounts of medications in our medicine cabinet.

Sometime past, a relative, who happens to be a pharmacist, noted oxycodone in our medicine cabinet and asked us, “Do you know the street value of that?, which we didn’t.  Interestingly when he mentioned that we noticed that about half the prescription had gone missing.  Our best guess is that the cabinet had been raided when our son had an unsupervised party.

And that was the explanation given by the AAMOS President, when asked what happens to those extra drugs?  He said many of them end up in Pharma Parties, although Wikipedia doubts the existence of those parties

Whether or not Pharma Parties exist is less significant to me than how do we get rid of those pills without polluting our waters or seeing them appear on the streets, and I asked the question, “Why do we make recycling as difficult as we do?”

The AAMOS Executive Director said that, while some pharmacies are allowed a fee to collect and render harmless medications, most Police and Fire Departments have a free drop-off, no-questions-asked program.

That may be true in her city near Chicago, but not so in my community.  The Fire Captain reminded me that my options are: pay the pharmacy, render the medications inert or poisonous and label them as such before placing them in as trash, or passing them off to the Hazardous Waste station.

Since I believe these are all unlikely to be normal for most households, I believe there should be a program to pay for turning in unused medications, much as we have programs that pay for turning in guns. BTW, this is the only approach that is quantifiable and affordable.  I hoped that this national problem gets some national support.

My next Post will be more light-hearted.  I’m calling it “Cognitive Chimps” and I think you will find it entertaining.  I hope to have you join me.