Today is now. Now is current. It is what is. Yesterday is a trail of previous now. Tomorrow is a feeling of now coming to be, but it is not. Now is the moment. Worry less by focusing on now. Now is the mind not thinking but of the now. Remember as in an emergency, only the focus is the emergency. All past and future stop. Focus is now. Time leaves as focus intensifies to the now. Less anxiety happens when focus is on the now moment. Now…
So much of our world is drug oriented. We understand overall, that without drugs, even chemicals, our world would be full of disease, food sources would be lessened, and conveniences would be limited. As this thesis is written, the touch is embracing plastic keys, rubberized mouse pads, vinyl coated wiring – my elbows pushing steadily on laminate. The rubber tips of my work tools include rubber ear tips on my stethoscope, rubberized tubing to the metal plated bell to listen to patients’ hearts with a plastic cover shield to clean off.
So what is the deal with the lead in the toys? The recent recall included over 405,000 lead contaminate toys from the Chinese manufacturers. Some of the toys recalled were “Duck Family,” Robot 2000, Big Red Wagons, Winnie-the-Pooh spinning products.
To my knowledge, no child has been severely poisoned with these toys, nor injured in a poisoning sense with these lead toys. The greatest majority of lead cases these days are from old paints…pre-1976…when lead was taken out of the USA marketplace of paints. So old paint chips that children eat or ate, especially in older home and apartment buildings renovations, was and are the source. But the biggest reduction in lead overall in the USA was the reduction of lead in gasoline. This essentially stopped the big problem. More discussion of lead poisoning was when under Clinton’s administration, the lead limits were reduced to an absolute low level despite little or no data to support the new change. But even with this new limit in children, few ever have had disease.
Nicotine in itself is a drug, a chemical that has been used obviously in smoking addiction, but in itself is not a bad thing. It has been used in industry in a variety of compounds. Nicotine, however, is the buzz in smoking. Just good old craziness allowed the U.S. to create multi-millionaire attorneys fighting for “our rights” and for those who “didn’t know” cigarettes were bad, yet the USA funds tobacco, the tribes sell tobaccos at reduced prices to entice smoking, and the CDC funds research to explore “the nicotine drug cure,” and it is all still legal. At a recent American Heart Association meeting, research on the new nicotine vaccine has made some promising head roads. One year and five shots later, the vaccine doubled the number of “stopped” addicted smokers from about 6% to 15% over the year. The problem still exists that less than 10%, some say lower, smokers of cigarettes ever stop that consistently try to stop. How many smokers? About 46-50 million in the U.S. and about half of them will try to stop sometime. The vaccine is a potentially great drug to help. The nicotine blocker med which castMD has written on before still helps to, but so far is not necessarily more effective than the patch or the gum. Stopping smoking takes good old will power.
And then there is the date-rape drugged toys. Most of this happened if not all was with the “Aqua Dots” toys. It seems that one of the chemicals in the surrounding coating changes or gets metabolized in the body when eaten. This is an extremely unique and interesting mass-market finding. It is really quite amazing that it was found. The GHB that was found is extremely difficult to measure generally. Many times in the ER, labs can not find it. It is metabolized quickly. Some of the previous day’s internet drug providers (illicit) sold chemicals that would convert to GHB. Some of these chemicals are still passed around and used at “rave parties” and other parties. GHB is a dangerous drug. It is illicit. It can kill you or make you unable to defend, protect, or interact. Thusly, called the date-rate drug. However, it was a prescription drug known as Rohypnol that was one of the original date rape drugs. It is also now illegal in the U.S., but probably can be found in the international markets illegally…not sure of legally however. Always open your own beverage and never leave one sitting around…especially in the club scene.
Did Bonds do it or not? Will the “asterisked” marked Hall of Fame baseball be delegated a fraud by another drug story? Not just another drug related story in recent and past news. Maybe all steroids should just be allowed in all athletics. Tell the athletes the risk, the wrestlers, the baseball players, and the Olympians. All these steroid abuse stories have hit the news just in the past months.
But the problem with that is…this story…
Doping in sports is a problem. But would you give or have someone else give your daughter or son steroids for performance enhancement? Watching little league and junior to senior sports makes me wonder. How far would a parent or caregiver go?
From the 1976 Olympians of East German come the latest stories of abuse, which is being called in a new documentary “The Great Olympic Drug Scandal: Revealed.” The sports “theme plan” developed relied on anabolic steroids. That year, 40 gold medals were placed over East Germany’s team members with a heavy emphasis on women’s swimming events winning all the golds in nearly all the events. Children were given oral tablets and injections, even on the day of competition in the Olympics, untraceable at that time. Coaches were rewarded by success, despite the unethical mark. Some athletes recruited prior to teenage were started on performance enhancement drugs. Doctors were required to sign confidentiality agreements despite the unethical mark.
Some of the athletes had sexual identity and self-worth problems while growing up. Many had obvious gynecological irregularities. In later life, sexual identity was explored and some even had sex changes. But many have been left out of the story lines…How has their lives been altered? How many have died unknown, changed forever by the decay of human value, gross ethical breaches of doctors, and limitless greed of self-flagellating coaches.
Systematic. Documented in abusive performance. Involuntary. Organized to destroy human life. Sidelined by death. Welcome to professional sports and Olympian sports.
Welcome to Beijing anyone?
Welcome to the Drugs’ Hall of Shame! It is NOT about performance…
Workplace drug tests recently have shown a decrease in cocaine positives during the first half of 2007. The positive tests for cocaine dropped 16% as the overall rate was 0.58 percent. This rate is the lowest since tracking the information back in 1997 by one lab. The lowest rate of decline was in the Midwest while the highest rate of decline was in the New England areas. The total tests counted for this tracking included about four and one-half million urine drug tests, which all included testing for cocaine and other drugs of abuse. Some believe the shortage of cocaine and higher costs are driving the decline, while European cocaine abuse is becoming increasingly popular, adding to world-wide demand. As a Medical Review Officer for Work-Place Drug Testing, cocaine remains popular.
In another report on drugs of abuse, marijuana recently was highlighted. It is apparent that reefing the great weed is about 5 times more harmful than one cigarette. The apparent problem is a greater intensity of airway obstruction. This effect may be caused by an increased “holding” of the smoke which is a longer time of interaction with the lung tissue. Another concept is that the smoke is literally hotter, creating a deeper thermal injury to the lung tissue itself. Interestingly, when compared to regular smokers, the marijuana smokers had less emphysema changes.
DAWN, or the Drug Abuse Warning Network, continues to focus on hydrocodone. This narcotic goes with the brand names of Norco, Lortab, Vicodin – but is generic in many prescriptions. Sales of hydrocodone and oxycodone have dramatically increased over the past years. The Pharma industry spends over 3 times as much on advertising as it did a decade ago.
www.castMD.com has written on this plague and the advertising push to addiction by the Pharma industry in past postings.
Despite the pressure to put these dangerous and addictive drugs on a higher schedule of restriction of prescribing, Schedule II, the FDA and DEA has been lobbied heavily to not do so.
With all the Pharma advertising, a push toward better pain management, and the abuse of narcotics, hydrocodone based drugs and combo drugs ranked number 2 in 2006 just behind the cholesterol lowering brand name, Lipitor. From 2001 to 2006, hydrocodone prescriptions rose by 2/3rds.
Hydrocodone is the number one drug in its category to arrive at the Emergency Department. It is also the number one drug of its category reported to the National Forensic Lab Info System.
www.castMD.com says, “Ban hydrocodone or elevate the Schedule.” It is a considerable concern of abuse in junior high kids, high school kids, and patients.” Should it be banned?
DRUGS IN WORKPLACE – ARE YOU TRYING TO SKIRT THE ISSUE?
A month or so ago the Feds released their workplace data regarding use of drugs while on duty in various jobs and employments. These are the newest data compared to previous studies in mid-nineties.
Industries that continue to have high rates of on the job drug use and use of drugs are those industries in general that continue to have high job turnover rates.
Illicit drug usage among the 18-64 year olds working full-time was the highest in food service and accommodation industry, construction work, entertainment and arts, information services, and management support companies.
The highest rate was 16.9 percent of the food and accommodation employees used illicit drugs in the last month, in the survey.
Construction workers and miners had the highest heavy use alcohol rates at 17.8 percent. Even CEO’s rate was at 8 percent for heavy alcohol usage.
Marijuana continues to lead the pack on illicit drug use for these surveys.
Over 12 percent of the illicit drug users had three or more employers in the past year! Current drug users had twice the rate of missing one or more days in the last month.
Increased rates of illicit drug use were seen in men and lesser paid jobs.
About half of the full-time workers report that their company does pre-placement drug testing. Protective services had the highest rate (76%) of this type of testing, while legal occupations had the lowest (14%) reported in the study.
Only one-third of the workers reported random drug testing policies by their employers.
ONLY one-third of the workers reported they would be less likely to work for companies with random testing programs in place.
According to D.A.W.N. which stands for Drug Abuse Warning Network the top ten Emergency Department visits were surprising. Although this list is published openly, it does run about 1-2 years behind.
ECSTASY (mdma)……………..ALMOST 11,000
This data is from a reporting system in the United States. Many times, GHB for instance, is gone from detection upon arrival to an Emergency Room. Many inhalants cause death, therefore do not show up in the Emergency Room, but rather the Coroner’s venue. Many times the data is also regionally directed, for instance, in high methamphetamine areas, illicit use might be seen higher in the corresponding Emergency Departments.
To round out this medical commentary today, the United States still has these top ten killers.
This data is from the 2004 National Center for Health Statistics, the latest full database. Prevention is the key in almost all of these killers. With the severe childhood obesity concern in the United States, these data may get thrown in the air, with new issues on top. For instance, diabetes and asthma may replace the first and second positions due to the issues of childhood health management in general.
CHRONIC LOWER RESPIRATORY DISEASES…………5.1%
INFLUENZA AND PNEUMONIA……2.5%
As part of my background in pharmacy, emergency medicine, and toxicology, my eye is geared toward new illicit “marketing styles.” One of the latest, yet as usual, older than you think, is “cheese” heroin. This “starter pack” of heroin is REALLY heroin…the DEADLY kind of heroin…the good old toxic illicit heroin.
The difference is in the making of it. The manufacturers of the illicit drug geared for the teens is the mixture of heroin and Tylenol PM©. This multi-drug cocktail of acetaminophen, diphenhydramine (better know as brand name benadryl © and other companies brands) and of course heroin creates a deadly risk. Each item in this mix can be deadly.
As the famed Paracelsus, an earlier father of poisoning stated, “It is not the agent, but rather the dose of the agent. And everything therefore is a poison.”
Acetaminophen remains one of the most toxic poisons if taken in overdose and is the lead cause of death for many years in Europe, while diphenhydramine is again a unique poison in overdose. The anticholinergic side-effects of the drug in overdose creates elevated deathly temperature rise, hallucinations, cardiac instability, agitation, and even death. Heroin for years now continues to plague not only the U.S., but nations around the world. It has enormous addictive potential and leads to severe toxicity, criminality, and occasional deaths on the streets.
Say “Cheese” is a deadly form of a multi-drug extravaganza geared to entice, to addict, and to control your kids. Already in the last 1-2 years, especially in the Texas market, over 20 deaths have occurred. The product appears like Parmesan cheese in structure, yet kills with a vengeance.
Say “Cheese” is usually snorted. Why do drug abusers snort? It is because the absorption rate is good. But I have seen those individuals with chronic cocaine abuse, literally rot the nasal septum out…”look Mom, no septum!”
Post-mortem toxicology tests will reveal the deadly three drugs in this mixture…heroin, diphenhydramine, and acetaminophen.
“Cheese” is not a starter-kit for drug use. “Cheese” is a start-kit for deadly teenager activity.
SAY “CHEESE” MAY BE THE LAST PICTURE TAKEN……..
HUG YOUR KIDS TODAY!
All my daughter’s friends were over for their little party.
These eight or so girls, all about 7 years old were playing crazily. You see wintertime had broken in Minnesota, and the summer was near. But it was one of those days you live for there, vibrant blue sky, gentle breeze, and life’s passions greening up.
Well, the little girls had played on the playground equipment for quite awhile, and in the sand making “things.” They were drawing chalk style hopscotch boards on the sidewalks, and had jumped rope without any bruises. Such a great day, such harmony in family and friends with nature watching.
My daughter and her little friends decided it was time to play “hide n’ go seek." No one better to hide than dad. Their collective eyes leaked with sincerity of request. How could any father turn such princesses and angels down for this next fun event, on such a great day, in such prime weather, in Minnesota ?
The "search and rescue" group of small girls began to count.
Meanwhile, my scurrying about reminded me to tell them to, “Count Loud” and “NO peeking." They, in unison, guaranteed this with giggles and laughter.
My eye scanned the topography. Where to hide? How long would it be to hide quickly, yet stealth like? Scanning the local yard’s horizon, a brilliant idea now could become reality. Ha ha ha. Those little ones will never see me there.
Quickly, quietly, and with ease my legs jumped up into the tree. This tree was strong. It could hold an adult, even a hidden stealthy adult. Lots of those huge Minnesota leaves that would cover all the color of the “hide n’ go seek” secret agent. So covert.
SIX, SEVEN, EIGHT.
Hurriedly my arms pulled my body into location, in the tree. Knowing how to quickly judge and climb a tree was like riding a bicycle or swimming to me. All those hours building huge tree houses in the skies of tall ash or elm trees now would pay off. All those limb evaluations of size versus strength and caliber were emblazoned in this climber. This was a confident spot.
As my arms lifted me into position, with my sitting spot almost prepared, the little girls were starting to rustle. Shifting my seat gently as not to be heard by doing a pull-up on the branch above, suddenly my stealthy world changed.
As my pull-up ended, my line of sight was slightly diagonally upward. A loud noise, a squeal. Then heard of buffalo, a covey of quail, and a wild horse stampede came right at me! My ears were frozen on the word, “TEN” that the little princesses had yelled. My eyes were beyond frozen to see eye to eye with it.
Squirrel attack !!!
Yes, man to female animal, face to face, and eye to eye there it was. No time for a counterattack. It was cold. It was heartless. The attack of the mother squirrel was like no other. Brutally shown teeth, larger than a shark – claws drawn, sharper than the griz. Lightening speed, out of no where. An ICBM loaded and launched at the intruder. No early warning system for the unprepared “hide n’ go seeker.” BAM. The war was on. Knowing my face had been hit, a cover was needed. No where to hide now. Too far up to jump, as a youth might attempt. Age and wisdom prevented that action quickly. Swiping away the blood, my fight was limitless but so ill directed. Not once was there a hit on the enemy despite readjusting my coordinates while in the leaves. Retreat was the only option. Cut the losses. Sooner, not later. This mother wasn’t retreating from the nest she had so preciously prepared for the family.
The gaggle of girls was coming down the sidewalk. They too had heard the noisy breach of the stealthy sacred safe place. It was over…almost.
The “hide n’ go seeker” now did what all attacked, retreating, and severely mentally and physically injured “hide n’ go seekers” do. Swing out of the tree. With two great leaps of caliber-calculating swings, my feet hit terra firma. Solid. Looking around quickly, the attack was over.
All the faithful players of the “hide n’ go seek” family game came running. My position was still of a prepared martial arts stance, ready to counter strike as if a secondary push might occur.
“We see you,” they all yelled. The girls approached quickly to prove they had seen me. But as they received their victory in game, they realized what was different. Suddenly, they all began screaming at the top of their choral lungs, high pitched in fear, yelling and running away faster and faster. My daughter said, "Daddy, you have blood,” and she ran away too, to the safety of the flock. Reaching up to my face, it was warm, and slippery. Looking at my hand, realizing my sweat from the environmental battle was not red – it was blood. Wiping away the blood from my hand to my pants, the flow of blood continued. A painted warrior of sorts.
My wife came outside to see how things were going with the “hide n’ go seek” game. She had come around a corner just as the girls were approaching. “My goodness,” she said, “Why did you fly out of that tree…to scare the girls…They were yelling so loud…And YOU looked like a gorilla flying out of the tree… AND you are bleeding!” “What happened?”
As my eyes close yet to this day, that mother squirrel is in my view forever. Everyone survived. A family moment. A father-daughter memory forever. And now you know why my 20 something daughter sends reminders once in a while, and why she sent me a shirt with a squirrel on it that states the rules: “ADVICE FROM A SQUIRREL.”
The Herald – Everett, Wash. – www.HeraldNet.com
Published: Saturday, April 28, 2007
Toxic drug at Portland clinic causes three deaths
PORTLAND, Ore. – Three people in the Pacific Northwest have died after receiving a drug that was erroneously made 10 times more potent than intended, the Oregon State Medical Examiner’s Office said Friday.
ApotheCure Inc., a drug-compounding pharmacy company in Texas, said an employee made a weighing error in the creation of the drug colchicine, which lead to the deaths. Colchicine is commonly used to treat gout, but in these cases it was being given intravenously to treat back pain.
The drug was sent to the Center for Integrative Medicine in Portland, where three people received injections of the defective batch of the drug this spring. All three people, two from Portland and one from Yakima, died between the end of March and beginning of April from the toxic levels of the drug.
The defective doses were sent only to the Portland clinic, ApotheCure said.
The Food and Drug Administration said it is investigating the case but believes the problem has been contained.
The Center for Integrative Medicine has since closed, and representatives from the organization could not be reached.
Colchicine works by stopping cells from dividing, which reduces inflammation in conditions such as gout, said Dr. Rob Hendrickson, associate medical director for the Oregon Poison Center. But in excess doses, the drug stops all cells from dividing – eventually leading to organ failure and death.
The medication is not commonly used anymore and the use as a back pain treatment is less common than for gout.
Gary Osborn, a pharmacist and certified clinical nutritionist for ApotheCure, said the situation could have been contained earlier, but the clinic did not contact ApotheCure until nearly two weeks after the first death. He said the second death occurred before the company was able to complete recalling the batch and sending them a new lot. He said this is ApotheCure’s first incident of this sort.
“We are kind of the leaders in the industry,” Osborn said. “But you know what people say, stuff happens.
The Daily Herald Co.
ALL RIGHTS RESERVED.
This is the time of year when lawn chemicals, yard cleanups, and neighborhood events start to be exposed and available to little hands. Certainly many chemicals, including pesticides, herbicides, fuels, and cleaning agents are ubiquitous in homes and garages. But beware. Many of these chemicals are poisonous and dangerous with regard to flammability, explosiveness, and chemical burns.
Each dollar invested in poison centers saves about seven dollars in expenses not needed if the patients go into their doctor, their clinics, or their hospitals. This is a great public health service.
Over the years since the early 60's, the poison centers have become an integral part of the healthcare network. Now with the terrorism issues, the poison centers have become an integral monitoring source of information, as many times calls come to the poison centers early and often, thereby making a grid of what is happening and where it is happening.
For instance, when the bad botulism toxin product that was being used by spas and clinics that were trying to save money by not buying and using the approved botulinum toxin brand, the poison centers were seeing a problem early. Patients across the country, in pockets, were being paralyzed – not just the muscles of the eyebrow, forehead, and other smaller muscles.
The poison centers across the USA now have a single number. Depending on your area code, your call will be forwarded to the center in your area, or the one contracted by your state officials. For instance, Idaho calls go to Denver's poison center. Alaska's poison calls go to Oregon. Washington's poison center gets all of Washington State's calls. This year that number will be around 150,000 calls! Poison calls are answered by an expert group of pharmacists, nurses, Pharm Ds and have backup by physicians specializing in toxicology and poisonings. It is the number that the experts in all fields, from dermatologists to kidney specialists, call when the patient has been poisoned, or is toxic from unknown sources, or when the patient doesn't act or change based upon "normal" disease states.
The goal of Poison Prevention Week is to reduce illnesses, injuries, and deaths due to poisonings; build safer communities; and reduce unnecessary health care costs for everyone.
Here are some ways to be poison cautious:
Obtain syrup of ipecac and keep it in your home – but use it ONLY if instructed to do so by a poison center or physician
Use child-resistant containers and remember, they are not childproof
Keep products in their original containers
Never call medicine candy or take it in the dark
Return products to storage areas immediately after use
Teach children about Mr. Yuk
Put Mr. Yuk stickers on all poisonous products
Call the Poison Center for a free information packet and Mr. Yuk stickers
Keep emergency numbers next to your phone:
What is National Poison Prevention Week?
Public Law 87-319 authorizes the President to designate annually the third week in March as National Poison Prevention Week. This act of Congress was signed into law on September 16, 1961, by President Kennedy, after which the Poison Prevention Week Council was organized to coordinate this annual event. Congress intended this event as a means for local communities to raise awareness of the dangers of unintentional poisonings and to take such preventive measures as the dangers warrant.
(PC week and listing adapted from WAPC.org website with commentary from castMD.com)
EATING DISORDERS OR DISORDERED EATING is a reflection of SELF-PERCEPTION and A SERIOUS CALL FOR HELP !
Significant focus lately has been on the “models” around the world and their associated “thin” look. American Idol, the next Super Model, and others show the associated forces of “thinness.” Also, many articles and news reports have been on the obesity problem in the world, especially the United States.
Challenges have come so forefront with this terrific medical problem for our young women and some men, that even the modeling companies, worldwide, have taken newer roles of healthy expectations to limit the “skin on bones” starved look of current models.
Medically, the disordered eating individual includes new changes in diet in teens, especially if going from “normal” family eating habits to vegetarian, isolation during meals, or dieting. Many time friends know of problems, but do not want to “rat” on their friend. A sudden change in baggier “hiding” clothes may be a clue to a weight losing teen, unable to stop the spiral of destructive behavior.
These eating disorders or better stated, disordered eating patients represent a body dysmorphism – an unhappiness of self – yet usually a symptom of feelings –sometimes brought on by the patient’s world. Many are perfectionist personalities doing well in personal growth, school, friends, and even family.
What is anorexia nervosa?
Anorexia nervosa is an illness that usually occurs in teenage girls, but it can also occur in teenage boys, and adult women and men. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia isn't just a problem with food or weight. It's an attempt to use food and weight to deal with emotional problems. This problem demands professional help.
People with anorexia starve themselves, avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating, or take laxatives or diuretics (water pills) to keep from gaining weight. People with bulimia don't usually lose as much weight as people with anorexia.
Why do people get anorexia?
Warning signs of anorexia
The reason some people get anorexia isn't known. People with anorexia may believe they would be happier and more successful if they were thin. They want everything in their lives to be perfect. People who have this disorder are usually good students. They are involved in many school and community activities. They blame themselves if they don't get perfect grades, or if other things in life are not perfect.
Girls with anorexia usually stop having menstrual periods. People with anorexia have dry skin and thinning hair on the head. They may have a growth of fine hair all over their body. They may feel cold all the time, and they may get sick often. People with anorexia are often in a bad mood. They have a hard time concentrating and are always thinking about food. It is not true that anorexics are never hungry. Actually, they are always hungr
y. Feeling hunger gives them a feeling of control over their lives and their bodies. It makes them feel like they are good at something–they are good at losing weight. People with severe anorexia may be at risk of death from starvation. As dying continues, heart rates drop, kidney damage and liver damage can occur. Odd changes can occur, such as high cholesterol and other heart disease.
Treatment of anorexia is difficult, because people with anorexia believe there is nothing wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a small amount of weight loss) may be successfully treated without having to be admitted to the hospital. But for successful treatment, patients must want to change and must have family and friends to help them.
People with more serious anorexia need care in the hospital, usually in a special unit for people with anorexia and bulimia. Treatment involves more than changing the person's eating habits. Anorexic patients often need counseling for a year or more so they can work on changing the feelings that are causing their eating problems. These feelings may be about their weight, their family problems or their problems with self-esteem. Some anorexic patients are helped by taking medicine that makes them feel less depressed. These medicines are prescribed by a doctor and are used along with counseling.
The most important thing that family and friends can do to help a person with anorexia is to love them. People with anorexia feel safe, secure and comfortable with their illness. Their biggest fear is gaining weight, and gaining weight is seen as loss of control. They may deny they have a problem. People with anorexia will beg and lie to avoid eating and gaining weight, which is like giving up the illness. Family and friends should not enable to an eating disorder patient’s demands. Group therapy for the family, and even the friends can be very helpful, and much more informative for a consolidated unified front to help save the life of a disordered patient.
Some books that castMD would recommend are:
The Body Betrayed
Dying To Be Thin
Starving For Attention
(Caveat: some discussion is extremely serious, and adult oriented but may be used with proper counseling and medical assistance.)
adapted from: FamPhys with commentary by castMD