tag:blogger.com,1999:blog-57579277275703423212024-03-15T12:35:15.073-07:00Beyond The PaleStoryteller . Survivor . Sightseer . Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.comBlogger215125tag:blogger.com,1999:blog-5757927727570342321.post-41841953096314435722024-03-15T10:08:00.000-07:002024-03-15T12:34:41.778-07:00The Irish Medical Times - Lack of HRT is cramping my style<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_fOjAbmQy6iQLvpdKYbvaGvddtHMwdxISa6vimRKRsnPCn2_WIw68U6eEgxzGNjly2P1KKHeScieWRFZ1JHipjxboOzixJe6m_-Zw4jVBhOO8cW0aYK1J7V5iEu5qgJTXbn_v2Qvg6PjEd9apRxaycThriRNFegOvzD1zQt_Aijwi8pCk1iHIvsvMqaU/s673/Screenshot%202024-03-15%2016.53.59.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="360" data-original-width="673" height="342" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_fOjAbmQy6iQLvpdKYbvaGvddtHMwdxISa6vimRKRsnPCn2_WIw68U6eEgxzGNjly2P1KKHeScieWRFZ1JHipjxboOzixJe6m_-Zw4jVBhOO8cW0aYK1J7V5iEu5qgJTXbn_v2Qvg6PjEd9apRxaycThriRNFegOvzD1zQt_Aijwi8pCk1iHIvsvMqaU/w640-h342/Screenshot%202024-03-15%2016.53.59.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqIsNojmjxWzKHqvBpGexjLcwzQyX0vusb3q2JXm7YSuSar5ghUkM7qOFqSeBJn-Ecx42xLE-e3A0ibYqklLW0fASJVL6N5OY_yvdoaSaC4IqycVZgBIc-C-BE8CRZ2jaHfXAnkQEVnT9iYZpccJBJyo-n7urs-X008HmsS30VDZpgQs8zrwb6g_behgE/s808/Screenshot%202024-03-15%2017.05.43.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="808" data-original-width="736" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqIsNojmjxWzKHqvBpGexjLcwzQyX0vusb3q2JXm7YSuSar5ghUkM7qOFqSeBJn-Ecx42xLE-e3A0ibYqklLW0fASJVL6N5OY_yvdoaSaC4IqycVZgBIc-C-BE8CRZ2jaHfXAnkQEVnT9iYZpccJBJyo-n7urs-X008HmsS30VDZpgQs8zrwb6g_behgE/w582-h640/Screenshot%202024-03-15%2017.05.43.png" width="582" /></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Read the rest of the story here - <a href="https://www.imt.ie/opinion/comment/lack-of-hrt-is-cramping-my-champagne-style-life-15-03-2024/">Lack of HRT is cramping my style</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2024/03/youtube-video-sheilaghs-nod-to-techies.html"><<PREVIOUS POST</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-86384843099875695422024-03-11T06:48:00.000-07:002024-03-15T12:33:25.253-07:00Youtube Video - Sheilagh's nod to the techies behind ehealth<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="352" src="https://www.youtube.com/embed/nhHitiUik-Y" width="480" youtube-src-id="nhHitiUik-Y"></iframe></div><p> </p><p><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222; font-size: small;">I have written manifold articles about telehealth from the patient perspective (some links below). </span><span face="Arial, Helvetica, sans-serif" style="background-color: white; color: #222222; font-size: small;">But I never took a moment to acknowledge the people who make the tech happen - the human intelligence </span><img alt="đ" aria-label="đ" class="an1" data-emoji="đ" loading="lazy" src="https://fonts.gstatic.com/s/e/notoemoji/15.0/1f64c/72.png" style="color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small; height: 1.2em; vertical-align: middle; width: 1.2em;" /></p><div dir="auto" style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small;">I was able to address this in a recent video I made with the HSE eHealth Ireland â</div><div dir="auto" style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small;"><br /></div><div dir="auto" style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small;">Links to my manifold articles (I just like saying the word 'manifold', it really doesn't get enough air time):</div><div dir="auto" style="background-color: white; color: #222222; font-family: Arial, Helvetica, sans-serif; font-size: small;"><br /><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/digital-healthcare-from-the-inside-out-12-02-2024/">The digital transformation of healthcare</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/telehealth-is-coming-are-you-ready-15-08-2023/">The advent of telehealth</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/dr-robot-ai4hf-to-you-is-coming-to-monitor-your-heart-12-11-2023/">Dr Robot</a></div><div dir="auto">- <a href="https://www.imt.ie/opinion/database-database-on-the-wall-who-is-the-sickest-of-them-all-27-08-2021/">The need for disease databases</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/wearing-your-heart-monitor-on-your-sleeve-are-wearables-helpful-or-harmful-10-12-2021/">The topic of trusting wearables</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/how-woke-is-artificial-intelligence-an-old-fashioned-approach-to-new-technology-06-09-2022/">How woke is medical AI</a> </div><div>- <a href="https://www.imt.ie/opinion/digital-health-its-virtually-here-or-there-14-01-2022/">Virtual health</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/the-gene-genie-is-about-to-come-out-of-the-bottle-09-11-2022/">The use of genomic information</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/ethical-shift-what-will-be-the-ethical-debates-of-the-future-18-01-2023/">Ethical shifts</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/foley-drones-on-about-flying-medicine-10-02-2023/">Drones in medicine</a> </div><div dir="auto">- <a href="https://www.imt.ie/opinion/sheilagh-foley/big-doc-will-it-be-the-next-to-fall-18-11-2022/">And doctoring on social media</a> <div dir="auto"><br /></div><div dir="auto"><a href="https://www.lettersfrombeyondthepale.com/2024/02/the-irish-medical-times-digital.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2024/03/the-irish-medical-times-lack-of-hrt-is.html">NEXT POST>></a></div><div dir="auto"><div dir="auto"><div dir="auto"><br /></div><div dir="auto"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><div dir="auto"><br /></div><div dir="auto"><br /></div><div dir="auto"><div dir="auto"><br /></div></div></div></div></div></div>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-163229859470615852024-02-13T11:08:00.000-08:002024-03-11T06:53:29.915-07:00The Irish Medical Times - Digital Healthcare from the Inside Out<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnfvBKgrdBbdXWsY9cZIv0Mcx3WJ4efWtWbi4zF7vr8EEuj8HG_cwT9JqN3nl24NV1DTKnPs8dabmmWQCIXacItjbisNDbdDSOVdF_TJNmvSHRgIFwMo-uebiBVfEy6fsp2rvQAq5Wwl1y6hr8zdIA_CWvc_Pu4EziRfYKXraIcF9GXb5Z2fiunzmj8jA/s678/Screenshot%202024-02-13%2019.10.26.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="380" data-original-width="678" height="358" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnfvBKgrdBbdXWsY9cZIv0Mcx3WJ4efWtWbi4zF7vr8EEuj8HG_cwT9JqN3nl24NV1DTKnPs8dabmmWQCIXacItjbisNDbdDSOVdF_TJNmvSHRgIFwMo-uebiBVfEy6fsp2rvQAq5Wwl1y6hr8zdIA_CWvc_Pu4EziRfYKXraIcF9GXb5Z2fiunzmj8jA/w640-h358/Screenshot%202024-02-13%2019.10.26.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieQBdLkvDWvOnAXjbzrSMiFWccD51cO20Mq9BbnIOLcIgl69r4Hec0rWkjN9dkihHCoPjoC5_NZgYJKbiCwI3cq_rbU4maj0KfRiiKRF3GsyfBhcUuvtBRoGp1mU0zPA8n0rfFYJtxlVN9McRalXclKkOlliR12SWdSs9kI-OB8QFhruNf_0trDPSecak/s819/Screenshot%202024-02-13%2019.11.26.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="819" data-original-width="729" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieQBdLkvDWvOnAXjbzrSMiFWccD51cO20Mq9BbnIOLcIgl69r4Hec0rWkjN9dkihHCoPjoC5_NZgYJKbiCwI3cq_rbU4maj0KfRiiKRF3GsyfBhcUuvtBRoGp1mU0zPA8n0rfFYJtxlVN9McRalXclKkOlliR12SWdSs9kI-OB8QFhruNf_0trDPSecak/w570-h640/Screenshot%202024-02-13%2019.11.26.png" width="570" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-f1b191ca-7fff-a9dd-50ab-abcc0a68f09b"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Virtual wards are already ramping up in University Hospital Limerick and St Vincent's Hospital Dublin. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I am an average person, I am a patient, I am a middle-aged mother (I prefer the term âgently usedâ). I am also one of the 91% of the global population that owns a smartphone. I am open to anything that can make my healthcare experience more seamless. I already use google maps, google calendar, phone reminders and pharmacy apps to try and keep on top of things. So it doesn't make sense to me that all the tech help stops as soon as I get to the door of the doctors. In fact, do I even need to go through the door?</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">In the same way we all got used to (dare I say, grew to prefer) booking our own flights online, we will get used to virtual wards, remote monitoring, online therapies, patient apps, patient portals and video/audio enabled care. There will be giving out, Joe Duffy will be very busy, but weâll get there, because the alternative is bleak. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There was a running theme throughout the conference speakers that we are approaching an inflection point of unsustainability, and we have to start leveraging digital technology. Patients and healthcare workers alike are tired of the legacy systems, the staff retention issue, the lack of connectivity and the poor access. It was refreshing to see that it's not just patients who are frustrated with the old way of doing things, the humans that make up the HSE want things to change.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">As a patient with multiple problems, one of my bugbears is how siloed our healthcare system is. So I enjoyed hearing about a new approach where teams integrate together to manage the full cycle of care alongside the patient using a National Shared Care Record. It was interesting to learn that there may even be a future potential for patients to add the information from their wearables as a data source. Although, like anything that touches on first party data the shared care record will have to jump through some hoops before we see it in action. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Iâm actually even more excited about the planned HSE patient app that will let us cancel and rebook appointments, store prescriptions, etc. It was described as âBringing all the information we have into our own data lakeâ. The next meeting invite I get I fully intend to reply with âMy apologies, I have gone phishing in my own data lake. For any urgent queries - ask Alexa.â</span><span style="font-family: Arial, sans-serif; font-size: 14pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"> </span><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"> </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Speaking of data there was a call to standardize terminology in order to map internationally. This alignment could allow for further leveraging of tech such as using AI to search all the standardized data with medical queries. Loretto Grogan, National Clinical Information Officer for Nursing and Midwifery (and conference organizer), made the astute point that information is at the core of healthcare delivery, so letâs put the supports in place to get the data right at capture. With standardisation we can achieve improved interoperability. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">With a flare of cross border camaraderie, colleagues from north of the border spoke about the lesson they learned introducing a digital health operating system in Northern Ireland. They trained 7,500 staff in 3 months. The audience listened with rapt attention, it was like we were teenagers and they were our cool older cousin telling us what life in university is really like. Iâm pretty sure I heard a few âNo wayâ, âWowâ, âThatâs crazyâ, âA 24 hour bar?â (maybe I misheard the last one). Some of their key takeaways included - teamwork, communication, and remaining agile. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">As we approached lunch and feet began to shuffle and throats cleared, a slide popped up on the screen - âThe Metaverse is Already Here!â. I think this is an important point to take in. These days most people are digitally empowered in their everyday lives, so, while there will still be very real and valid fears around telehealth from a patient perspective; there was an emphasis on getting there together. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The good news is that through different HSE digital initiatives dotted around the country, the journey has already begun.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I flitted around the conference centre talking to people, reading posters and dropping into hear speakers give the low down on their digital enterprises. The tech and results were impressive but most impressive of all was the passion and drive from the people behind it. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The new Children's Hospital in Dublin has adopted a âDigital Firstâ approach. Glancing at the presenters slide I counted at least 45 tasks that a staff member on a ward of the new hospital will be able to do digitally; from ordering tests and procedures, writing e-prescriptions, sending and receiving clinical comms, assigning patient information via a patient portal, through to requesting patient transport. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I learned about a Health Performance Visualisation Platform (HPVP) providing key performance values across acute hospitals. Showing data from EDs and bed management, to help manage flow. The up to date big picture of data can also be used to manage waiting lists for outpatients, surgery, radiology, etc. Itâs currently used in 28 hospitals and planned for more this year. I know this seems like an invaluable piece of tech that surely should have been already in use for the last 10 years. But platform tech is a relatively recent phenomenon, 10 years ago people were still using fax machines. I know there are many industries, including healthcare, that still use fax machines in 2024. Some old technologies will never die, like candles and pencils, but I am hoping the fax machine will slowly be pushed off a cliff. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Another stroke of efficiency, that can be used by the patient this time, is a new dashboard for Emergency Departments. This would be a real-time dashboard that would live on the HSE website. It would refresh every 10 minutes and show waiting times for patients in EDs based on triage categories. This invention was a suggestion straight from the HSE CEO after he himself paid a visit to an ED in Cork. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">This suggestion from the CEO reminded me that we are all patients ultimately. To me that is the standout difference between this HSE digital revolution and other initiatives in the past. Every human in Ireland has the potential to become a digital patient. The crazy thing about life is that weâre all one misstep away from calling an ambulance. The people at that conference that day, both speakers, organizers and spectators were all acting like major stakeholders, because in the truest sense, we all are. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">If you were ever going to sit up and pay attention to what the HSE is undertaking, now is the time. Communication around these changes will be key to its uptake and success. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">When I floated the idea of virtual wards recently to some fellow patients, there was some misapprehension that severely ill patients would be taxied off home with a thermometer in their gob and heart surgery would be offered across zoom, etc. The comments were obviously meant to highlight the ridiculous heights this could reach. The important point that needs to be communicated clearly is that patients monitored virtually are not the critically ill cohort. Virtual wards will be for those who are stable but still need some daily monitoring (that could be done from home), freeing up their hospital bed for a patient in worse shape who is currently hanging off a trolley in A&E. Itâs also optional, there is no compulsion to move to a virtual ward if you are not comfortable with that set up. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The HSE Social Inclusion team gave a really thought provoking example of how video enabled care (VEC) came to the rescue. Following the outbreak of war in the Ukraine, 1,300 migrants were arriving here a week. EDs began to notice that a large number of migrants were visiting the hospitals with non-emergency conditions. The HSE contacted 72 GPs, provided them with equipment, trained them up, put procedures in place, supplied access to interpreters and went live. 500 migrant people received GP VEC from Jan-Oct 2023. They are now looking into potential use of this in the homeless service. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I was the last speaker, with a lot to say. Like most Irish people I am most comfortable conversing in a story format sprinkled with references to disease/death/drama/eejits and so forth. I told the story of a fall I had during the year (drama) that resulted in a broken pelvis (eejit). I tried to get hold of a scan from hospital A to pass it to hospital B. When I rang I was passed from X-ray to Nuclear Medicine to the doctors secretary back to X-ray and so on. I was told âThe computer is brokenâ, âThe person in charge is having their breakfastâ, âWe donât give information to patients, because patients wouldnât understand itâ and my favourite âWhat is a CD?â</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The next day I got through to a lady called Michelle. Michelle told me that they had new technology in place called âBeamâ that could share scans between hospitals with the press of a button. While on the phone to me Michelle shared the scan with the hospital that needed it. Michelle made the point âAs a patient you have enough on your plate, you donât need to worry if the right person has the right information - thatâs our job.â We need more Michelles.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Patients have understandable fears around telehealth;</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">- The patient will be the last consideration</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">- We won't be able to do it physically or psychologically</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">- We'll lose the in-person benefits </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Throughout the conference there was an emphasis on the patient, on digital education, and on getting there together. Everybody was very enthusiastic and I personally learned a lot. There is a digital choo-choo train coming around the corner and we need to find a way to address patients' concerns, and offer reassurance through awareness, education and participation. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Afterall, digital healthcare is âourâ future.</span></p><br /></span></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">For the online article read here - <a href="https://www.imt.ie/opinion/sheilagh-foley/digital-healthcare-from-the-inside-out-12-02-2024/">Digital healthcare from the inside out</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2024/01/the-irish-medical-times-how-to-nip.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2024/03/youtube-video-sheilaghs-nod-to-techies.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-12621578793513150652024-01-20T10:18:00.000-08:002024-02-13T11:13:40.757-08:00The Irish Medical Times - How to nip smoking in the bud<p style="text-align: left;"> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJzyGsdnHL5ONtKm0IqJwK3IxiyIjwLngQy4cMrCBi8bE9rk1QXGEHe1Xh4LBO3UGuDmha1xY-nXXmCouYGzLYOGBLRby6Y2cBzwI_jfpzXd3Fq-QQPOADxtDumOcGFdPMkqWhN3ZXzwvbwl51reF448utRELrEvl0eaGTsW21Gx9xhjtMS9wGSHpdi54/s669/Screenshot%202024-01-20%2018.14.18.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="383" data-original-width="669" height="366" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJzyGsdnHL5ONtKm0IqJwK3IxiyIjwLngQy4cMrCBi8bE9rk1QXGEHe1Xh4LBO3UGuDmha1xY-nXXmCouYGzLYOGBLRby6Y2cBzwI_jfpzXd3Fq-QQPOADxtDumOcGFdPMkqWhN3ZXzwvbwl51reF448utRELrEvl0eaGTsW21Gx9xhjtMS9wGSHpdi54/w640-h366/Screenshot%202024-01-20%2018.14.18.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyV8sZ390Wg1HoqzsvxrbJzcSO5O15cK-MQljo36n96CN5HB9i7NWzWBbr6wewBGBJ-sa8CMvQb29YHZvcquOnRU4hrOaPuRgShHVJ0HGSknX9dnxMfuB9O2D4VkewPX5t2RppfVs0gXfVHhU9qXZ0vMbbAB5UnKm905Xc0E_L-tIZLEphFqhhXJN-T-U/s826/Screenshot%202024-01-20%2018.05.41.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="826" data-original-width="728" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyV8sZ390Wg1HoqzsvxrbJzcSO5O15cK-MQljo36n96CN5HB9i7NWzWBbr6wewBGBJ-sa8CMvQb29YHZvcquOnRU4hrOaPuRgShHVJ0HGSknX9dnxMfuB9O2D4VkewPX5t2RppfVs0gXfVHhU9qXZ0vMbbAB5UnKm905Xc0E_L-tIZLEphFqhhXJN-T-U/w564-h640/Screenshot%202024-01-20%2018.05.41.png" width="564" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-cdfee0f3-7fff-2788-f5e1-9bc01faf4ccc"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">On paper, it's a great idea. Funny thing about paper, it tends to go up in flames. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Vaping companies saw the dollar signs and started aiming their marketing at children. Using similar tactics learned from Big Tobacco many years ago - make it seem cool, use fashionable colours, pretend itâs all about independence, freedom, fun, rebellion, success, relaxation, friendship and sex appeal (FYI: fake e-smoke billowing out of your nose is not attractive - you look like the caterpillar from Alice in Wonderland). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">In fact, hereâs a Life Rule - Anything that comes out of someone's nose or mouth at high speed is never attractive. (coming out at slow speed is not a great look either). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There were some early celebrity endorsements of vaping, and of course the ever present social media influencers, who appear to be easy and willing enablers to sell on, letâs see, oh, anything. But who needs people these days, vaping and e-cigarettes have been promoted with popular animations and online gaming. They sell it in flavours like cotton candy and gummi bear - how can vaping executives look a person in the eye and say that is not aimed at children?!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Vapes can be made to look like everyday items for easy concealment, presumably from parents (as an adult you shouldn't have to conceal a legal passtime, unless you are heavily into axe throwing - might be advisable keep that one under wraps at the office party). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Recently, I have seen e-cigarettes discarded on the street, they look like highlighter pens. Addictive substances should not look like something you might have in your Pokemon pencil case. Their plasticity and disposability is also a concerning environmental issue that goes against the social conscience the young generation rightly boast. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Vaping exposes you to fewer toxic chemicals than traditional cigarettes but they still contain chemicals of concern and have been attributed to lung injuries including lung burns, breathlessness and death. There are links to chronic lung disease and asthma, and associations with cardiovascular disease, attention deficits and mood swings. Not to mention they are emerging products with problems we have yet to realize. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Letâs not forget that addictive nicotine is still part of the experience and provides a stronger hit than traditional cigarettes. Nicotine dependence can negatively impact the development of brain regions used for judgement and decision making. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">On to the most shocking point of all - vaping is proving to be a gateway to traditional cigarettes for the next generation (afterall, nicotine begets nicotine, in all its forms). </span></p><h1 dir="ltr" style="line-height: 1.38; margin-bottom: 6pt; margin-top: 20pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 400; vertical-align: baseline; white-space-collapse: preserve;">A 2021 study from the American National Library for Medicine entitled âReasons For Transition from Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Studentsâ was revealing. Reasons included the perception that cigarettes were cheaper, they required less maintenance, just open a pack and it's ready to go as opposed to charging it up or buying liquid pods, and students reported a heightened sensory pleasure from a ârealâ cigarette. </span></h1><h1 dir="ltr" style="line-height: 1.38; margin-bottom: 6pt; margin-top: 20pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 400; vertical-align: baseline; white-space-collapse: preserve;">Also, the reason why anyone in college does anything on a night out - peer pressure, and the cool factor (or in this case, lack thereof; e-cgis are considered something high school kids use, not super cool college kids who want to emulate the generations that went before them, and walk in their tobacco stained wake!). </span></h1><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">We have established that vaping is not the harm-reducer it aimed to be. In a similar âgood-idea-gone-badâ scenario, the man who invented plastic bags was a Swedish engineer named Sten Gustaf Thulin. He was concerned about the amount of trees being cut down to make paper bags, so in 1959 he invented the plastic bag. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Gustaf, Gustaf, Gustaf, you and Alfred Nobel have a lot to discuss (Alfred invented dynamite, became a pacifist and created the Nobel Prize to promote peace - look, weâve all done it). But donât fear, the world still has a conscience and alongside the global push to stop using single-use plastic, we need to collectively, as a community, stop smoking and vaping. We also need to do our best to prevent the next generation from falling into the nicotine trap.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Uk Prime Minister, Rishi Sunak, recently outlined proposals to raise the legal age of smoking annually by one year, each year. Children in Britain, now aged 14 or younger, would never be allowed to legally buy cigarettes. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There is no age restriction on the sale of e-cigarettes in Ireland. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">At a recent government Oireacthais Joint Committee on Health debate on the topic of âIssues related to cardiovascular health, stroke and heart attack - programme, services and preventionâ, the Irish Heart Foundation Director of Advocacy, Chris Macey, said âThe smoking rate among children is starting to rise for the first time in a generation.â</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Come on, Ireland! </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Remember in 2004 the world went into anaphylactic shock when Ireland (the island of big Leprechaun dancing booze hounds) became the first country in the world to implement legislation creating smoke-free workplaces that included bars and restaurants. Bars, lads! We stopped smoking in bars! </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">In 2002 we were the first country to introduce the plastic bag levy (sorry, Gustaf). In 1999 we were the best-in-class when it came to adopting the Euro (Punt? Leave it out!).</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">We can be the agents of change when people least expect it, thatâs our underdog superpower - if any political big swingers are reading this, we need to be decisive, catch up with the Brits, and focus our health policy on the burning issues. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Stop smoking and vaping - before it stops you. </span></p><br /></span></div><p style="text-align: left;">For the original article click here - <a href="https://www.imt.ie/opinion/time-for-a-non-smoking-generation-17-01-2024/">How to nip smoking in the bud</a></p><p style="text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/12/the-irish-medical-times-dont-wait-for.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2024/02/the-irish-medical-times-digital.html">NEXT POST>></a> </p><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p style="text-align: left;"></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-89999906063625800242023-12-11T03:51:00.000-08:002024-01-20T10:20:39.490-08:00The Irish Medical Times - Don't Wait for the Draft: Volunteer!<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8CuAtLLZRqcj6FjFUZRfsjIwnLXFIq9SADvUY_jOa44nvJXC6IfKYb3vlMOtyi_kSpZNzZjjZm9bLnvzVo0eDATUytunegPsFug_cBuloP74pg5toyICGUCL5PAdp1hxRBgHqPrtg_BmHiHYSfyzbrrGXMjHMwlfqhYksQaNahNt2S4C_QDmYrWwUiqE/s2048/IMG-20231117-WA0008.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1536" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8CuAtLLZRqcj6FjFUZRfsjIwnLXFIq9SADvUY_jOa44nvJXC6IfKYb3vlMOtyi_kSpZNzZjjZm9bLnvzVo0eDATUytunegPsFug_cBuloP74pg5toyICGUCL5PAdp1hxRBgHqPrtg_BmHiHYSfyzbrrGXMjHMwlfqhYksQaNahNt2S4C_QDmYrWwUiqE/w480-h640/IMG-20231117-WA0008.jpg" width="480" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2_mWnEpZ7lVlpkTz5zpw_XfpcV3wCeei6A3aOfe5k6sUlBKY_9FDigDcwytnAua2F8CdXQ8yXe2X12v9WkVUYUFWlSnKsLSKpnOjQ9jCJgIa2ocen5omldBApk4fj7ubMGy9ElGp-wwloV0xfa9_JNLKnJz-lxNVSsFRJ5U7OE8YNcb0NySaGVHpuoSk/s736/Screenshot%202023-12-10%2014.22.57.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="728" data-original-width="736" height="634" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2_mWnEpZ7lVlpkTz5zpw_XfpcV3wCeei6A3aOfe5k6sUlBKY_9FDigDcwytnAua2F8CdXQ8yXe2X12v9WkVUYUFWlSnKsLSKpnOjQ9jCJgIa2ocen5omldBApk4fj7ubMGy9ElGp-wwloV0xfa9_JNLKnJz-lxNVSsFRJ5U7OE8YNcb0NySaGVHpuoSk/w640-h634/Screenshot%202023-12-10%2014.22.57.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-b0a06a8b-7fff-f0f7-f361-acd49225fcc9"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">In my youth, I thought volunteering was something retired people did. During my time living in America I came to understand volunteering as a cultural norm. As part of their schooling, from a young age, some form of volunteering is expected from the students and the parents alike. As time goes on, it is definitely seen as a favourable trait when it comes to US college applications. Later, when Americans leave college and get a job, volunteering is part of the corporate scene with lots of options such as; outreach programs, painting community centres, fund raising, etc. Pretty much any way in which a corporation can invest its time and people into the local communities. </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"> </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">It was common among friends of mine in San Francisco to align themselves with local initiatives, joining boards of charities or non-profits. One of my friends, Shannon, was my social conscience, every so often she would rally a group of us together to go to the food bank in downtown San Francisco. One time she sent a text asking us to show up at a teenage homeless shelter to help put together treat-bags, which would be distributed later that night to kids sleeping on the streets. It was a hard text to say no to, the usual âSorry, Iâm getting my nails done. C U l8r gatorâ didnât seem appropriate. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">It was a bonding experience to pull together and spend time getting to know others, as we bent our heads, not in prayer, but working on something for someone more in need than us (which is its own sort of prayer). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Volunteering means different things to different people. And you certainly donât have to go to America to do it. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The Irish Heart Foundation held a Volunteer Conference recently and I was blown away by the types of volunteering and the people who volunteer. There were drivers and data miners, policy negotiators and administrators, every form of local champion was there. In fact, becoming a Patient Champion is a form of volunteering the IHF offers, with training provided in advocacy and communications (led by the legendary advocate and real live patient, Pauline OâShea, contact - ihfvolunteer@irishheart.ie)</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The age range of volunteers at the conference appeared to go from twenty-something up to eighty-something, with some folks skipping up to the stage and others taking to the ramp with their rollators. It was astonishing to hear peopleâs different contributions and how they all devote so much of themselves to helping others. One story that stuck in my head was about Paddy, an elderly dapper gentleman from Cork, who had been hosting a weekly over 65s charity talent show since 1977! The year I was born, I have a lot of catching up to do. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Whether you are into shaking buckets or shaking your tail feathers, there is something for everyone if you decide to volunteer. For a lot of us who go through a diagnosis or a life changing event and ultimately find a helping hand, we often feel an urge to give back. Some of us can no longer hold down the jobs we once had but we have an undiminished skill set still raring to go. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">That is how I found my path to âgiving backâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Patients are people too, we have skills just like everyone else. We might not be able to use the skills anymore as they were conventionally intended, but we can now repurpose them for the greater good. I worked for 20 years in Finance in portfolio construction and compliance. Since I could fit a pencil in my hand I have been writing. So give me data, information, regulations, policies, words, more words, projects, reports and a deadline - and I can whip things into shape. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I first joined the ranks of the IHF volunteers when we were fighting for heart failure patients' rights to higher priority for the Covid vaccine. A battle we made belated progress with and one we are still looking for answers and justice on (if anyone reading this is from NIAC or NPHET would like to respond on why heart failure patients are still not a priority, that engagement would be most welcomed). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Friendships were forged in those patient advocacy trenches that take on an extra significance. From that group of 8 soldiers, 2 of them are now dead. You are bonding with people that you know could fall ill and disappear - forever. If someone misses a meeting you donât assume they are on the sofa catching up on The Crown, you assume they are in hospital or⊠</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">After Covid, other issues came up for our band of warriors and more battles have since been waged. New troops have joined, new friendships forged, and we find ourselves in more alliances now than conflicts. Finding allies is our secret weapon and this we have done well. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Receiving a life altering diagnosis can feel like the beginning of the end, but it actually can be the start of something truly worthwhile. From this sense of worth comes a renewed purpose that can build your confidence back up. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Being a patient, or watching a loved one battle a disease, can feel disempowering. Stepping into a volunteering role can give you agency over the disease. Itâs a way of shifting the power balance in your favour. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">My âheart friendsâ (as I call them, to differentiate them from the rest of my friends who are heartless, Iâm kidding, the joke just wrote itself) come from all over the country. So it is rare to get us all physically in person in the one room. That was another reason why the IHF Conference felt exciting, all of us were able to sit down to lunch and converse like we hadnât a care in the world. It helped our sense of optimism that the conference was hosted by Meta so our surroundings were suitably cool and futuristic. A gigantic âthumbs upâ hung on the wall beside us as we ate, perhaps subliminally sending out a positive pressure. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The IHF very kindly acknowledged me at their conference for my contribution to the cause of heart failure patients. Not least of which was the space in this publication each month which affords me a platform to raise the patient's voice - thank you Ed!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">If you are looking to turn up the good in your life, try your hand at giving back through volunteering or donating to the cause that tugs on your heart. If you are looking to turn up the patient voice in your life - watch this space.</span></p><div><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span></div><p></p><p>Read original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/dont-wait-for-the-draft-volunteer-08-12-2023/">Don't wait for the draft - Volunteer!</a></p><p><a href="https://www.lettersfrombeyondthepale.com/2023/11/the-irish-medical-times-dr-robot.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2024/01/the-irish-medical-times-how-to-nip.html">NEXT POST>></a></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-40459000243533242792023-11-15T04:51:00.000-08:002023-12-11T03:54:22.586-08:00The Irish Medical Times - Dr Robot: Artificial Intelligence 4 Heart Failure<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZxaq7z178E4HMPUBtOilT-sI0Yp_dGeVV4O6u8_dnDM471y9KwxI20cKc34K6xBwpbm8uHlueU-Pi8YuT6By0NQUSUAq5vCSH9I2QIjfzo56LQXp00vJq8oUQ4XGAh2o-gB7JOP39MVtnBPN1DEiTIEhMXYBnUznSg_7nJoVSrvqcwZZEDy-jMvVSPok/s3425/PXL_20230915_092436522.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="3425" data-original-width="3072" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZxaq7z178E4HMPUBtOilT-sI0Yp_dGeVV4O6u8_dnDM471y9KwxI20cKc34K6xBwpbm8uHlueU-Pi8YuT6By0NQUSUAq5vCSH9I2QIjfzo56LQXp00vJq8oUQ4XGAh2o-gB7JOP39MVtnBPN1DEiTIEhMXYBnUznSg_7nJoVSrvqcwZZEDy-jMvVSPok/w574-h640/PXL_20230915_092436522.jpg" width="574" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9lNQxL2p6fnXWo2Vub6gtlICdlRnxmcOOnULOgZKbDzvPIEcL5So8JBjuzcVKsgHYOj0AHYmO5-aiFG-5IjpLN54gTENMyiS1565ni47htyaOwWxHUNemKxEW6GkDGqpu3bvbSvbKoI3a8ET24aaREkCbG1NZAwFLtdsgyM4TCVqSIImoIkokKrR5iaA/s829/Screenshot%202023-11-14%2013.18.45.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="829" data-original-width="733" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9lNQxL2p6fnXWo2Vub6gtlICdlRnxmcOOnULOgZKbDzvPIEcL5So8JBjuzcVKsgHYOj0AHYmO5-aiFG-5IjpLN54gTENMyiS1565ni47htyaOwWxHUNemKxEW6GkDGqpu3bvbSvbKoI3a8ET24aaREkCbG1NZAwFLtdsgyM4TCVqSIImoIkokKrR5iaA/w566-h640/Screenshot%202023-11-14%2013.18.45.png" width="566" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-810337ff-7fff-3789-12ef-990d60ad65a0"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Letâs think bigger - Imagine if you could tailor your own healthcare journey. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">If a trailblazer like Florence Nightingale was around today, she would get Google to turn on her trusty lamp, and sheâd start to explore how AI could personalize care for a patient. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Imagine if we could harness the power of AI to manage heart failure patients? The European Heart Network is on the case. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Iâm no Florence, but in September I was asked if I would like to attend a workshop in the European Cardiac Society HQ in Brussels, to discuss the future of AI in Heart Failure from a patient perspective (AI4HF). The event was arranged by the European Heart Network (EHN), the day would be about, with, and for patients. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Not accustomed to any developments in medicine starting with the patient, I kept expecting the email to be an early Halloween prank - halfway through reading it a ghoul would appear on my screen with a shrill scream that would be echoed by my own, followed swiftly by the sounds of my defibrillator going off. This, thankfully, did not happen. I managed to get to the end of the email without so much as the opening bars to the âMonster Mashâ playing. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I immediately launched into AI mode and checked the weather in Brussels, 31 degrees celsius, I looked out at the passive aggressive drizzling rain in Dublin, âYes, I am free on those datesâ I typed. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The night before the workshop a dinner in the heart of Brussels was hosted by the European Heart Networkâs CEO, Brigit Berger. The dinner attendees were strikingly similar to a Eurovision line up - Dutch, Flemish, German, Romanian, Spanish, Portuguese, Canadian (?!) and a healthy dose of Irish. There was a febrile feeling that at any moment someone might burst into Abba or Johnny Loganâs âHold Me Nowâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">What really struck me was the age group of the heart failure patients, we were all young (by young, I mean, everyone had most of their own teeth). Like many people with a shared trauma, we bonded over stories of broken hearts and were all set for the next dayâs workshop.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">From the minute we arrived at HQ, everyone was incredibly warm, welcoming and kind. They got straight down to business (after coffee and pastries, of course - this is continental Europe for Godâs sake, thereâs always time for an espresso). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">They talked to us about the aim of the AI4HF project - to co-design a trustworthy AI solution for supporting heart failure care and management. The organizers struck a great balance of keeping us on topic but also allowing the patients to express themselves in a safe non-judgmental space. Patients talked of how AI could be positive, such as a symptom tracker app and monitoring mental health. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">We moved on to the topic of what frustrated patients, we could have put the coffee pot back on and talked about that for a week. Two of the main frustrations that surfaced were patients feeling dismissed by doctors (even now, there is a doctor reading this thinking âThatâs not trueâ) and concerns around the lack of integrated care. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The project team was keen to ask us our thoughts on ethical issues around AI in heart failure. I was straight in with âbiasâ, this is a pet peeve of mine, I have written an article about this where I ask âHow Woke is Artificial Intelligence?â The AI4HF project felt assured that the big data they were working off was clean data. Another ethical point raised by a patient in the room was the accuracy of data. If a patient has to type in data, the potential for error is huge. Even the thoughts of moving to AI was flagged as intimidating for lots of patients (and clinicians). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There were very strong feelings from the patients that they should be in charge of their own information. Giving family members access is ambiguous, as they cannot contextualize the information the same way the patient themselves can, but where a family member is a caregiver perhaps it is beneficial that they understand where the patient is in their journey. Issuing health predictions to a patient, particularly bad outcomes, was felt by some to be off putting. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">What about a risk management tool? Now we were getting down to business. An app for symptoms of heart failure was discussed. We wondered if it could be captured in a wearable, to avoid having to input any data, let it all be seamlessly pulled as you went about your day. Thatâs the ideal situation, but unfortunately the technology doesnât seem to be there yet (one day!). An app seems like the most feasible option, and versions of this do exist in the private sector. We decided it should look at the acute risks facing patients including weight gain, fluid retention, palpitations, breathlessness, chest pain, blood pressure changes, etc. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Another idea floated was a shared decision making tool. The group envisioned a format with visual recommendations using colours, shapes, etc, not just reams of text. Decisions around medication, lifestyle and intervention could be presented in this visual interface to promote an immediate ease of understanding. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The conversation, like the ailment we all shared, was complex. Many ethical, legal and social issues will require further discussions, for example, data sharing. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">A poignant question was asked about reluctance within the medical community to onboard with AI. The long play theory is that it will become embedded in medical training and as time goes on the physicians who use AI will replace those who donât. What happens in the meantime feels like the painful part we call âchangeâ. I recently changed my milk from dairy to nut. It was an ordeal, not so much for me, but for my family who are refusing to onboard, I am currently interviewing for replacements. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">A salient point was made that patients probably use LLM more than doctors (large language models). I flagged what I had found in literature that LLM can be used to compare medications and highlight contraindications. A patient could even create a treatment plan using their own prompts, then ask the doctor to compare this AI plan to the current plan and see if any tweaks could be made to their care. There is evidence that the Chat bots make things up, but working in conjunction with a medical doctor, it could help save lives. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There was a strong desire to create a âtrustworthyâ AI4HF tool. One of the patientâs echoed the famous quote âTrust takes years to build and seconds to breakâ. People were at different points on the trust spectrum when it came to doctors. In our small group, most of us were ok with healthcare providers having access to our information via an app. Some patients were keen for medical information to be available from the app if suddenly needed e.g. a patient collapses. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">One of the patients reduced the room to laughter when she declared her absolute unwavering confidence in her own cardiologist when she proclaimed âIf he asked me to go out and fight a wolf, I would!â </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">This sparked a conversation where one of the patients shared that she had her cardiologist's personal number and could call him directly if needed. She said, very poetically, that he knew every crease in her embattled heart. This story was in contrast to other patients who wondered at times if their stretched to capacity cardiology team even knew their name!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">We left the experience on a high, with new friendships forged and all felt a little less alone in this heart failure journey. The project is ongoing with patient involvement a contingent part of the progress. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">There is also a very good chance we will join forces and enter the next Eurovision as its first ever AI contestant (first official one at least). </span></p><div><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Read original article here... <a href="https://www.imt.ie/opinion/sheilagh-foley/dr-robot-ai4hf-to-you-is-coming-to-monitor-your-heart-12-11-2023/">Dr Robot - Artificial Intelligence 4 Heart Failure</a></div><p><a href="https://www.lettersfrombeyondthepale.com/2023/10/the-irish-medical-times-invisibility-of.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/12/the-irish-medical-times-dont-wait-for.html">NEXT POST>></a></p><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-80924943739725317792023-10-11T08:12:00.004-07:002023-11-15T04:55:50.021-08:00The Irish Medical Times - The Invisibility of Heart Failure: Three Ways to be Seen<p style="text-align: center;"> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9pJ3SmcoN1f3S85zpnxgLy9t8JmKvO4V0aOzU6BajBxyEOc5OO6T6lKUSUT3JjrgMbeHDeVhw293bT1Mqh8omtyQcI4txyk9NlEqoyNeQv_hnZxKKef9Zo9_pWnnQT4SSrJ4xoyFEDmtBElaSsjdKaI99V1Ii98oModNDSEOhBY7Lqu1kXe0w-Xr8ZYw/s1600/IMG-20230627-WA0007.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="720" data-original-width="1600" height="288" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9pJ3SmcoN1f3S85zpnxgLy9t8JmKvO4V0aOzU6BajBxyEOc5OO6T6lKUSUT3JjrgMbeHDeVhw293bT1Mqh8omtyQcI4txyk9NlEqoyNeQv_hnZxKKef9Zo9_pWnnQT4SSrJ4xoyFEDmtBElaSsjdKaI99V1Ii98oModNDSEOhBY7Lqu1kXe0w-Xr8ZYw/w640-h288/IMG-20230627-WA0007.jpg" width="640" /></a></div><br /><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGcrKo-LtSrKfU5DR2ZJQoxeOcGwiQ0lvyPEJQln2kj3l8PGR-i8ZmSryV6AxG8PxI2Plpe_vjSpj1JdnOVqtoIm4JrUC4Rc0TAVNHJcBj-AdycxT7wyNNzLY2X5aKJWyZasUT4UMffFNQnWyXQc9dpGTSFIb1AA8wAvVfaI6CEde45uyH4QG7kFjObbo/s750/Screenshot%202023-10-11%2016.09.14.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="750" data-original-width="664" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGcrKo-LtSrKfU5DR2ZJQoxeOcGwiQ0lvyPEJQln2kj3l8PGR-i8ZmSryV6AxG8PxI2Plpe_vjSpj1JdnOVqtoIm4JrUC4Rc0TAVNHJcBj-AdycxT7wyNNzLY2X5aKJWyZasUT4UMffFNQnWyXQc9dpGTSFIb1AA8wAvVfaI6CEde45uyH4QG7kFjObbo/w566-h640/Screenshot%202023-10-11%2016.09.14.png" width="566" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-63094e8d-7fff-05eb-66f3-19fe2814cff1"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">However, with skillful medicating, surveillance, and lifestyle modifications patients can achieve periods of stability and live a version of their lives. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">But for most people there are frequent ups and downs, they are in and out of infirmaries, their life span is limited, and they have to spend a lot of time convincing people (including themselves) that just because they look ok, doesnât mean they are ok. It is a perfect example of an invisible disability. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">I know because I am one of the invisible. However, on that day in June I didnât feel alone. As the patients bunched together in the room, we were visible, if even for an afternoon. Some of the comments afterwards focused on how surprisingly young we were for heart failure patients. It is a condition heavily associated with the elderly, but revised figures are estimating as much as 43,000 Irish people under 70 are living with heart failure. To fully understand the gravity of that number - if we compress all of those diagnoses into a 12 month period, it would be akin to 120 young people being diagnosed with HF every day for a year! </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Ultimately, every sinner on this planet will die from a heart that fails. It might be preceded by cancer, a gunshot wound, or a cup of tea and the Late Late Show, but at the end of the day our hearts will stop beating. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Yet, heart patients are often overlooked and under-resourced. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Some consider it an inevitable problem that is too big to even begin to address. So, the IHF broke it down into a short list of fulfillable âAsksâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Heart Failure patients require three things from the Irish government:</span></p><ol style="margin-bottom: 0; margin-top: 0; padding-inline-start: 48px;"><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; list-style-type: decimal; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">Psychological supports</span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; list-style-type: decimal; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">Medical cards</span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; list-style-type: decimal; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">A Heart Failure register</span></p></li></ol><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The IHF would also like to see investment in community based support and access to cardiac rehab nationwide.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; vertical-align: baseline; white-space-collapse: preserve;">1. Psychological supports</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Distress, anxiety, fear, depression, trauma, are all common experiences in heart failure. Everyone in the Dȧil, heart patient or not, has experienced bad days and feral emotions, there was nodding and listening as this topic was discussed. IHF Advocacy Campaign Manager, Pauline, also a heart failure patient, captivated the room with her honest account of how harrowing HF can be. She spoke with a power and eloquence that only lived-experience and natural charisma can bestow. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Support is needed to understand and manage the condition of heart failure, to adjust to an impaired life, and to simply try and cope. When you are struggling mentally, physically or emotionally it can lead to maladaptive behaviour such as failure to take medication/exercise/nutrition. Psychological support for heart failure patients is a basic requirement and will help prevent costly relapses and readmissions. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Cardiac psychologists exist in Ireland but in very limited numbers and only attached to a smattering of hospitals. If patients receive counselling it is usually instigated and organized by the patient. There is no psychological safety net, there is no mental health check-in, when you are discharged you are in freefall until someone catches you or you hit rock bottom. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The knock on effects of a well adjusted patient will improve the lives of family members, friends, colleagues (not to mention healthcare professionals and caregivers) and will boost the countryâs Gross Domestic Happiness.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; vertical-align: baseline; white-space-collapse: preserve;">2. Medical cards</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The room was gently filling up with politicians of all hues as the case for medical cards for heart failure was explained. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Heart failure is an expensive illness with a daily laundry list of medications, frequent doctors visits, hospital excursions, scans, tests, device checks, blood tests and procedures - and thatâs before things start to become serious and the patient's other organs are compromised, their mobility is challenged, and their care becomes more intense and integrated. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">HF patients often have to modify or give up work mainly due to persistent fatigue, dips in heart function, and comorbidities, creating a shortfall in income to fund their hospital hobbies. For those that live more rurally their basic care is spread across their GP, their local hospital, and a consultant in a bigger hospital, usually a significant distance away. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">A patient may look normal in the early stages of heart failure or during periods of long stability, but they know they are dancing under Damocles sword. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">All of the patients in the Dȧil that day have had to give up the life they used to have. Remarkably, they are all a shining example of 'when life gives you lemons you make lemonade'. Except they didnât make lemonade, they made lemon meringue pie and left everyone wondering âhow did they do that!â. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">We can appear so able bodied and capable it is hard for those around us to remember we are not 'normal'. We have short bursts of energy but spend a lot of our days battling bone shaking fatigue, we have daily fluid restrictions so our lungs donât fill up with water and drown us, we canât run, or be who we once were. At times our heartbeat can vary from the infrequent dread-note of doom to the hyperactive thumping of electronic dance music. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">In order to provide fair and equitable care, to look after all disabilities, to ease the financial burden of the disease, and to just âdo the right thingâ, the government needs to provide medical cards to heart failure patients (with or without the lemons!). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; vertical-align: baseline; white-space-collapse: preserve;">3. Heart failure register</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Countries create databases of diseases as a way of managing the disease. A heart failure register would provide evidence for best practice, measure outcomes, provide feedback, improve the quality of care, and make sure heart failure patients are protected and prioritized. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The European Society of Cardiology has engaged a study to look into creating a general heart failure register for all of Europe. How awkward is it going to be when they ask Ireland for their list and the government has to scrabble around seeing if they can cog someone elseâs homework.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">A register will save time and money and benefit society as a whole.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Arguments for a HF register were put across in a more elegant manner in the Dȧil by the esteemed doctors from the Irish Heart Foundation. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">They were followed by impassioned impromptu stories from patients of their own real life struggles. The politicians had been snapping photos of the slides, jotting down notes, whispering and slipping amongst each other. Until the patients started to speak, and silence fell.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Fiona Meagher and Michael Madigan shared their traumatic heart failure experiences. Pointing out there were many influential people in the room who could assist in progressing our patient requests. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">When Esther OâShea, from the rebel county, stood up to give her impassioned plea from the benches, the crowd was brought to the edge of tears as she talked of her young family and how she was afraid to go to sleep at night in case she didnât wake in the morning. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">That is the harsh reality facing heart failure patients. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Making a difference is in the hands of the politicians. Please do the right thing - itâs as easy as 1, 2, 3. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">__</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; font-weight: 700; vertical-align: baseline; white-space-collapse: preserve;">SIDEBAR (Box)</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The IHF survey from 2022 findings:</span></p><ul style="margin-bottom: 0; margin-top: 0; padding-inline-start: 48px;"><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; list-style-type: disc; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">74% of HF patients had no (or inadequate) psychological support </span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; list-style-type: disc; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">60% of HF patients experienced a drop in income and an increase in living expenses </span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; list-style-type: disc; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">40% of working age HF patients had no medical card or GP visit card </span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; list-style-type: disc; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">96,000 people in Ireland have heart failure yet there is no register</span></p></li><li aria-level="1" dir="ltr" style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; list-style-type: disc; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; text-wrap: wrap; vertical-align: baseline;">1 in 4 HF patients felt abandoned after discharge from hospital</span></p></li></ul></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">Read original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/the-invisibility-of-heart-failure-three-ways-to-be-seen-and-feel-seen-10-10-2023/">The invisibility of heart failure: three ways to be seen</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/09/the-irish-medical-times-should-stem.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/11/the-irish-medical-times-dr-robot.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-49114332332251999532023-09-14T09:34:00.004-07:002023-10-11T08:17:18.704-07:00The Irish Medical Times - Should STEM education become STEAM innovation?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimQA2EsDNZ7vuRlw7Z9v5slQ1PVVEoeI7FyBhsQEzrCvJPG3LLC2frryGgs8kouFLhDXH7M0E3B2RavQLnivXB62kKbde0pKo1I_LtJgsMEJ_GNSA6OcXqXl6l1F4SQth3FsqniVE8dT4MWtti_vOfFP2c7mFUc3BCRka2Cy6qUwdof5LA-tIFIZ8x6kM/s611/Screenshot%202023-09-14%2018.30.28.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="348" data-original-width="611" height="364" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimQA2EsDNZ7vuRlw7Z9v5slQ1PVVEoeI7FyBhsQEzrCvJPG3LLC2frryGgs8kouFLhDXH7M0E3B2RavQLnivXB62kKbde0pKo1I_LtJgsMEJ_GNSA6OcXqXl6l1F4SQth3FsqniVE8dT4MWtti_vOfFP2c7mFUc3BCRka2Cy6qUwdof5LA-tIFIZ8x6kM/w640-h364/Screenshot%202023-09-14%2018.30.28.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggyeMgyW3BZipYXc_oGpsh9_knZkni3xmqedUsUi4UF48cQw3hvskiRAhdQAgt8pdUef0HVdWY_y3qFN2CWjevjwrnsHYohGJzRF4Tt_3qCWEOOO9KdPzJWR8MElRI2liEtbhi7Lg4sLVzINKHjvfbyS2oD7AsWq_X-twqZHYVYwBWziiGCQilK3rUmeU/s714/Screenshot%202023-09-14%2018.31.19.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="714" data-original-width="664" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggyeMgyW3BZipYXc_oGpsh9_knZkni3xmqedUsUi4UF48cQw3hvskiRAhdQAgt8pdUef0HVdWY_y3qFN2CWjevjwrnsHYohGJzRF4Tt_3qCWEOOO9KdPzJWR8MElRI2liEtbhi7Lg4sLVzINKHjvfbyS2oD7AsWq_X-twqZHYVYwBWziiGCQilK3rUmeU/w596-h640/Screenshot%202023-09-14%2018.31.19.png" width="596" /></a></div><div><br /></div><span id="docs-internal-guid-f85de286-7fff-6523-4c93-d354a1c2a161"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">A website of a famous university promotes progressing technology and continued innovation that may help address societal problems we have thus far struggled to contain. Iâm not sure exactly what societal problems or the forms of containment. So far, online peer pressure policing appears to have taken the unfortunate form of trolling and âcancel cultureâ. However, technology is indisputably the way forward and will continue to infuse our existence.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Learning STEM isnât just about knowing your way around a bunsen burner, building an app or a bridge, or getting really really good at sudoku. It can provide you with a sense of logic, a principle of validity, skilled reasoning, and problem solving ability. These attributes used to be requirements for the Galileo Galiliâs of this world, now everybody needs them just to turn on their phones. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Rooting STEM in the education policy and curricula is essential. But we are missing a vowel? When STEM becomes STEAM it includes Arts and Humanity classes alongside Science. This allows the left-brain logic thinkers (who go on to become engineers in tech companies) to learn how their algorithms will impact people on a personal level. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Technology has been a steep learning curve for us all, including its originators. Facebook, for example, was famously whistle blown for allegedly exploiting vulnerable people. Social media has the potential to be incredibly advantageous to humanity - to champion great causes on scale, to disseminate important information, encourage connectivity and give those that are not heard a voice. However, too often we are seeing methods to boost profits over people. Just because an algorithm works, that doesnât mean it's doing the right thing. I recently learned of the phrase âpurpose washingâ where a company purports to stand for an honourable purpose but in fact they are engaging in activity that is the antithesis to honourable. The fact this practice exists in such frequency that it has its own phraseology is disheartening. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">My heart, dissed or otherwise, is probably of no consequence to companies that purpose wash, but I am not alone in my dismay. Per the MIT Technology Review, more than one million users left Twitter when Elon Musk took over the company (now known as X). People vote with their feet.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">When I was younger that expression would conjure up images of people slipping into a voting booth, kicking off their shoes, grabbing the pencil between their big toe and second toe (whilst somehow keeping the pencil tied with string to the makeshift desk) and neatly tick the box of their favourite candidate (I was a kid, I didnât know what went on behind closed curtains!) </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The world's collective conscience is dangerously inflamed at this point, outrage is frequent and contagious. Tolerance is very low for mistakes let alone deliberate skullduggery. In this climate, corporate malfeasance is not just wrong, itâs bad business, and the market will reflect this. We need to start getting things right and infuse the engineering code with the emotions from the arts and humanity. Programmers and engineers are increasingly teaming up with artists to co-develop software, products and renderings for gaming, simulation and training tech. A knowledge of design, writing and history can help engineers problem-solve in more creative ways. The 3D printer is the end product of a STEAM project. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">The origins of modern tech was like the wild west. We are growing and learning as a global community. In a world where you can order your morning coffee in 68 different ways, interdisciplinary collaboration is the new normal. I believe by incorporating the arts and humanities into science, technology, engineering and mathematics, it will leverage both hard and soft skills to solve problems and create âconsiderateâ technology. Soft skills such as communication, collaboration, and consideration cannot be machine learned to the degree a human can apply them. So letâs be the only thing all of us can be - human.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Why stop at arts and humanity, many people are using STEM as its original Cambridge definition âsomething from which other parts can develop and growâ. There are now enhanced variations on STEM learning that include research, innovation, medicine, environment, entrepreneurship, social science, logic, robotics, multimedia, economics, agriculture, informatics and natural science, or as I like to call it STEAMRIMEESLRMEAIN. Stick that in your bunsen burner and smoke it!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;">Itâs hard to do everything and tick all the boxes (especially if you are using your feet) but I think adding some humanity to technology might be the appropriate next step in our co-evolution.</span></p><div><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; font-variant-position: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">For the original article read here - <a href="https://www.imt.ie/opinion/should-stem-education-become-steam-innovation-could-that-make-it-human-14-09-2023/">Should STEM education become STEAM innovation?</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/09/indianapolis-south-bend.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/10/the-irish-medical-times-invisibility-of.html">NEW POST>></a></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-83387453726417836302023-09-08T09:58:00.005-07:002023-09-14T09:35:44.630-07:00Indianapolis - South Bend<div class="separator"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinm1xYv4EM02hu1MIXYFOvnNs7uHGoxp46M94LEgci7PrMv2ki2jqJD8z_UU7QXwHYhovFE6XzaNwQcnZu-S8IL9AOdFOsv4U1qxUgrx-CwkO_-GPAtfxRDMTXY6yc_EpUDTa1EBY2oBsphAswZe5JwDLz0m1u14yVnEHcp3NasNqg33im83jU-sGk4TU/s4048/IMG_20170919_133636%20(1).jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="3036" data-original-width="4048" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinm1xYv4EM02hu1MIXYFOvnNs7uHGoxp46M94LEgci7PrMv2ki2jqJD8z_UU7QXwHYhovFE6XzaNwQcnZu-S8IL9AOdFOsv4U1qxUgrx-CwkO_-GPAtfxRDMTXY6yc_EpUDTa1EBY2oBsphAswZe5JwDLz0m1u14yVnEHcp3NasNqg33im83jU-sGk4TU/w640-h480/IMG_20170919_133636%20(1).jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Child of the corn</td></tr></tbody></table><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><b><u>INDIANA WANTS YOU</u></b><br /><br />This time 5 years ago we were rolling around Americaâs midwest. Hereâs what we were up toâŠ<br /><br />The Hoosier state, Indiana to you and me, might be the most underestimated and unassuming of all the states. It wrapped us up in its own warm MidWest embrace. I felt a closeness to it, maybe it's because Dom's great friend Patrick talks of his home state with fondness, maybe it's because a lot of Irish settled there over the decades, or maybe in a former life I was a Nascar Amish Notre Dame graduate. Whatever the reason, I strongly advise people to get off your iPhone, step away from the stress of the daily grind and go to a place where people still say 'hello' for the sheer hell of it!<br /><br />Side note, no one quite knows why people from Indiana are nicknamed "Hoosiers". My favourite theory is that the first settlers would answer a knock on their door with "Who's yer?" (whoâs yer/hoosier - get it). If you haven't already watched the classic Gene Hackman movie 'Hoosiers', cop yourself on and watch it - it's a classic!<br /><br />Speaking of Indiana movies of redemption, the night before we arrived in South Bend Indiana, I made Dom watch the movie Rudy. It's a true story of an underdog who dreamed of playing for the Notre Dame American football team. And whattayaknow, through guts, determination, against all the odds, with a ânever-quitâ attitude, the 5 ft nothinâ steelworker got his glory moment.<br /><br />You may start the movie obsessed by the thought âThey are pronouncing Notre Dame wrongâ, but by the end you'll be a rootinâ tootinâ Domer (ND alum nickname) cheering on the fighting Irish. A tear will come to your eye when Rudy is hoisted onto his teammates shoulders.<br /><br />We were pumped to visit this elite University. Dom had spent the week before on a 50 miler cycling adventure with his mates Patrick and Doug, both ND alumni. I just get a kick out of the fact the college's sports team is nickname is the Fighting Irish.<br /><br />We stayed on campus, and as soon as we dumped our bags we set off meandering. Everyone we encountered from students, to professors, to visiting parents were all so friendly and polite. Everytime we stopped to take a pic, people passing by would offer to take a family snap for us.<br /><br />The campus is stunning, beautifully kept lawns and concourses, buildings that wouldn't have been out of place at Hogwarts.<br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsIhwM7LkXZB3zUYm043hP2KZKsT9VRE0SGSAtjcIjNNzPfBcGXaBE2yzTAjHVTPXa-iUeBEo3H-Y8dkNfzmgYXieRxrFDZAMQQQ4QESWJx9q33jUKmhZ4TsdGhnnaFzIrGqy5evCopQD-bH3cC1hru2Or-chn58xK5PY5IxIXN83psq9HJsU19bt0dfQ/s1600/IMG-20170919-WA0033.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1600" data-original-width="1200" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsIhwM7LkXZB3zUYm043hP2KZKsT9VRE0SGSAtjcIjNNzPfBcGXaBE2yzTAjHVTPXa-iUeBEo3H-Y8dkNfzmgYXieRxrFDZAMQQQ4QESWJx9q33jUKmhZ4TsdGhnnaFzIrGqy5evCopQD-bH3cC1hru2Or-chn58xK5PY5IxIXN83psq9HJsU19bt0dfQ/w480-h640/IMG-20170919-WA0033.jpg" width="480" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Touchdown!</td></tr></tbody></table><br />We found the "Touchdown Jesus" a mosaic of Jesus raising his arms like a football umpire confirming a touchdown. I'm sure the intention is for Jesus to be praising God, but in Notre Dame football takes on a God-like reverence. Emblazoned on the entrance to the Basilica is "God, Country, Notre Dame".<br /><br />ND is a Catholic college with a blinged out neo-gothic basilica on campus. The church is exquisite with vibrant blue and gold ceilings depicting cherubs and angels. It's a visual gobsmacker.<br /><br />We crept around the corner to the grotto, a little cave beside a lake where people come to light candles and pray that their life works out and other hopeless wishes. I helped RĂłisĂn light a candle for world peace, and for dragons to be nice to unicorns.<br /><br />We snapped a pic of the Golden Dome, the most recognisable ND building. I bought RĂłisĂn a little girls "Fighting Irish" t -shirt and brainwashed her into announcing to strangers that she would go to university here. Say what you like about the American education system, they have "college" nailed. Ireland and England have been doing it longer but in the States college life is a full submergence experience, it's like moving to a different planet where you make a new family and often develop a lifelong love affair with your Alma mater. "Go Irish!".<br /><br />Interesting fact about South Bend, for all its perceived conservatism its mayor is Pete Buttigieg, a gay man. [It took me so long to post this story, Pete is no longer the mayor, but he, and his name, will not be forgotten].<div><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtJYmjuQuAb5QKqHbTYMNKdyyV3LQXmmiOqjwhNRB7BhDwnPUl9z7RExaJdxbwR-yZaQsDi2TXVnTWvMmevFkA2n6DJx3-tGVQ5TVtznCKKhHlS660zErGM3ZsoRoYCqZOPd7ezm6avyg1qYQrM2wRMGdvdOaxS__uY-mFGbBCTsbkowXoottluQUN1C8/s4048/IMG_20170919_130859.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="3036" data-original-width="4048" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtJYmjuQuAb5QKqHbTYMNKdyyV3LQXmmiOqjwhNRB7BhDwnPUl9z7RExaJdxbwR-yZaQsDi2TXVnTWvMmevFkA2n6DJx3-tGVQ5TVtznCKKhHlS660zErGM3ZsoRoYCqZOPd7ezm6avyg1qYQrM2wRMGdvdOaxS__uY-mFGbBCTsbkowXoottluQUN1C8/w640-h480/IMG_20170919_130859.jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Inside the American dream</td></tr></tbody></table><div><br />The next day we had the immense pleasure of being invited to visit our friend Patrick's parents who lived nearby. They lived in my American dream. Picture perfect houses nestled in woodlands, where people know their neighbors and start everyday with a smile.<br /><br />Betsy and Brian were the epitome of kind and friendly Midwest hospitality. They laid out a beautiful lunch and asked us all about our trips near and far. They are highly educated (ND grads) and well travelled themselves (both lived abroad), who would outstrip us in terms of life experiences but they kindly let us jibber jabber on as if we had invented the wheel. RĂłisĂn entertained with her 3 years old take on the Trump Presidency (according to her "Trump breaks rules", when Betsy asked âWhat rules?â, Roisin gave the considered answer of "The world's rules" ... from the mouth of babes).<br /><br />We waved goodbye full of great cheer and skipped off to check out our next stop, Amish Acres. Itâs a bit of an Amish fun land (possibly without the fun). The Amish donât actually live on the Acres anymore but they do work there, they sell their goods in the shops, they make the food in the restaurant and they transport tourists around in their horse and buggy.<br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIu60b3CZv9-sQ5ua6E529XlbmYswfnsH7bEKpsc3RNkiDi47nREetLQlmBN-4oUKMx1qwcgsB31PImZyvyl5lKQt6CG9uqlAca0NCIeTGpSVMeKgiXUXb66ug0mlZ3Waz0cF9Ll5cO4ZGlY8AV7T0fA-EyFh5vee1X2uEaQuY3yUOAtyCkHs1Uqe3Y0I/s4048/IMG_20170919_151237.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4048" data-original-width="3036" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIu60b3CZv9-sQ5ua6E529XlbmYswfnsH7bEKpsc3RNkiDi47nREetLQlmBN-4oUKMx1qwcgsB31PImZyvyl5lKQt6CG9uqlAca0NCIeTGpSVMeKgiXUXb66ug0mlZ3Waz0cF9Ll5cO4ZGlY8AV7T0fA-EyFh5vee1X2uEaQuY3yUOAtyCkHs1Uqe3Y0I/w480-h640/IMG_20170919_151237.jpg" width="480" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Keep it Simple Sweetheart</td></tr></tbody></table><br />I am a little obsessed with the Amish, the fact they choose to live like it's 1850 intrigues me. The reason the Amish came to America from Switzerland was because they were persecuted for their beliefs. The belief that separated them from other Christains was anabaptisim - they don't believe in baptism until you are an adult.<br /><br />The Amish follow the teachings of a man called Jakob Amman (hence "Amish"). He encouraged shunning and excommunication from the church for those who didn't follow the rules. Why do those who flee persecution often end up the persecutors themselves (I think a therapist would have had a field day with ole Jakob).<br /><br />As we sat in a school house on the property, the guide told us the Amish speak 3 languages; High German (their bibles are in this language), English (they learn this at school), Pennsylvania Deutsch (a mixture of German and English they speak at home). They start school at 6 and finish at 15.<br /><br />The guide brought us to an old Amish residence. Obviously they are self sufficient, they do clever things to avoid using modern conveniences like growing rows of flowers in-between vegetables to draw the insects away from the food. They use outdoor stoves to dry the fruit and veg so they can store and eat it during winter. They made their own soap from gathering the water that ran through the wooden ashes left by the stove (lye soap). They paint some rooms blue so birds won't nest in the rafters (because birds don't nest in the sky....it works!)<br /><br />The guide got on to my favourite topic, the outfits! The Amish don't have closets; they just hang their clothes in the hallway (considering they aren't the Kardashians, a few hooks in the hall works fine). The reason they still dress like farmers and nuns from the 1850 is apparently out of respect for the fact Jakob decreed it so over a 100 years ago.<br /><br />Vanity is not allowed in the Amish faith but one small mirror is permitted so the men can shave their moustaches off. It stems from the fact the army men 100 years ago wore moustaches and they were the group that persecuted the Amish, hence the âno moustacheâ rule.<br /><br />They don't allow electricity because they don't want the outside world of the "English" (anyone not Amish) coming in. They do seem to use gas a lot these days though with gas ovens and gas powered washing machines.<br /><br />5,000 Amish live in the area so you see them knocking about on horse drawn buggies with straw hats, long bears, girls with the bonnets, etc. They do not like people taking their photos because of the second commandment "Thou shalt not worship false idols" (for the same reason they don't have faces on their dolls). I refrained from taking pics (ok I may have taken one of the back of a buggy).<br /><br />I had to buy an Amish blanket (I already had a Mennonite one, for that story <a href="https://www.lettersfrombeyondthepale.com/2016/07/iowa-des-moines-pella-kalona.html">read here</a>).<br />The Amish girl who served me in the shop went into the back room and got straight on the computer... Was it gas powered?! Apparently there is some loophole that electricity and cars are ok if used for work (Wow, what if all the Amish signed up to be Uber drivers!!).<br /><br />From the Amish to a âbig cityâ, next stop Indianapolis.<span id="docs-internal-guid-3c6b1d0c-7fff-677d-e1d9-25260c44296d"><div><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div><div><span face="Arial, sans-serif" style="font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;"><a href="https://www.lettersfrombeyondthepale.com/2022/08/michigan-ann-arbor.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/09/the-irish-medical-times-should-stem.html">NEXT POST>></a></span></div><div><br /></div></span><div class="separator" style="clear: both; text-align: center;"></div></div></div>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0South Bend, IN, USA41.6763545 -86.2519897999999913.366120663821157 -121.40823979999999 69.986588336178841 -51.09573979999999tag:blogger.com,1999:blog-5757927727570342321.post-88839172271818237202023-08-15T05:24:00.001-07:002023-08-15T05:24:24.032-07:00The Irish Medical Times - Telehealth is coming, are you ready?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1MPRt9QPGED26tCELwMiZeYY1mgoE9WE_CBUg8asXaQfOwZnuijCU1PsjEPKKqN66RIr-WNb2G6O6PW4RNYcArP60lENNykik_9w5UXDoBAp5fLdTEr-5vAalwHV9eHyXf09RuxHqqnYzyZ-E4WnXuv-FoP-Z_wANXnTzfkZ7-_poiWIFs7u9M1L99RQ/s4080/PXL_20221114_151106702.PORTRAIT.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="4080" data-original-width="3072" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1MPRt9QPGED26tCELwMiZeYY1mgoE9WE_CBUg8asXaQfOwZnuijCU1PsjEPKKqN66RIr-WNb2G6O6PW4RNYcArP60lENNykik_9w5UXDoBAp5fLdTEr-5vAalwHV9eHyXf09RuxHqqnYzyZ-E4WnXuv-FoP-Z_wANXnTzfkZ7-_poiWIFs7u9M1L99RQ/w482-h640/PXL_20221114_151106702.PORTRAIT.jpg" width="482" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkib9hKfAtWhFFMU_eFc5umSfT2X5DI-KGmT6P-pojAp3hay0AUeRXO-S5bKdVYxOrtoQw2MZamF8RXItCFAmKqIWUtIiwUwSb-N8geHVk4AJXEAi5WHW_mYIvjSw0p5Wk4BcPL_0itvrlx8tUuCt7w_gG1eP_k7p5TbGINamFtyPHcl0mDwExHNZidJ4/s855/Screenshot%202023-08-15%2009.19.04.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="855" data-original-width="650" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkib9hKfAtWhFFMU_eFc5umSfT2X5DI-KGmT6P-pojAp3hay0AUeRXO-S5bKdVYxOrtoQw2MZamF8RXItCFAmKqIWUtIiwUwSb-N8geHVk4AJXEAi5WHW_mYIvjSw0p5Wk4BcPL_0itvrlx8tUuCt7w_gG1eP_k7p5TbGINamFtyPHcl0mDwExHNZidJ4/w486-h640/Screenshot%202023-08-15%2009.19.04.png" width="486" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">For the rest of the article read here - <a href="https://www.imt.ie/opinion/telehealth-is-coming-are-you-ready-15-08-2023/">Telehealth is coming, are you ready?</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/07/the-irish-medical-times-can-we-circle.html"><<PREVIOUS POST</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-59130043615373429342023-07-12T02:26:00.003-07:002023-08-15T05:27:19.897-07:00The Irish Medical Times - Can we circle back: the inevitability of parenting your own parents<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXg1kNQIrJZgvK2KUMG0SXWFCDdQIszDfa7gKenLo6gSpZ5M_jKuY2uQDfWmn72IJh3yU26vu33mlU9dJ3v3m9fGWEuToOvN3UyWeCUKSo8UuUuwvj1VHwuLAEMrMZPm-MSF4L51IDrtLMPmfLPFkVouEsL_FYx-kZsINI7WH5Wc3nwWZYAnB5L8qVDwA/s1080/Screenshot_20230712-120010.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1052" data-original-width="1080" height="624" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXg1kNQIrJZgvK2KUMG0SXWFCDdQIszDfa7gKenLo6gSpZ5M_jKuY2uQDfWmn72IJh3yU26vu33mlU9dJ3v3m9fGWEuToOvN3UyWeCUKSo8UuUuwvj1VHwuLAEMrMZPm-MSF4L51IDrtLMPmfLPFkVouEsL_FYx-kZsINI7WH5Wc3nwWZYAnB5L8qVDwA/w640-h624/Screenshot_20230712-120010.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGWN29ut7l7rFlHLIU0zRDafDjMmixYTgjjVOomozdvG7UtBoOlWTHWCD4Pb1xXKVl95bOjjSwh_4VsJu2thzaIxlgO68FmovcRceQZ4-CKwPnSNVsWUg3hS8VlYqNo7vbxN60ZLfU1TSjxaXjsv-nQlUGm6LeAb7v-XOHHNHJgB5voA4_hDSd4tdex7Q/s847/Screenshot%202023-07-12%2012.21.51.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="847" data-original-width="667" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGWN29ut7l7rFlHLIU0zRDafDjMmixYTgjjVOomozdvG7UtBoOlWTHWCD4Pb1xXKVl95bOjjSwh_4VsJu2thzaIxlgO68FmovcRceQZ4-CKwPnSNVsWUg3hS8VlYqNo7vbxN60ZLfU1TSjxaXjsv-nQlUGm6LeAb7v-XOHHNHJgB5voA4_hDSd4tdex7Q/w504-h640/Screenshot%202023-07-12%2012.21.51.png" width="504" /></a></div><br /><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-e646799b-7fff-1c5a-0734-c3f00ebcdc0b"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Infections can precipitate bouts of delirium but for the most part he had kept his wits about him. He wondered aloud if that was a blessing or a curse. He watched his body flounder and flail with great dis-ease and sadness. However, he was the source behind my dry sense of humour, and although a very quiet and proper man, we often exchanged knowing glances and wry observations that caught our shared thoughts on what was unfolding around us. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">He taught me how to tell a story, heâs from a Dublin lost to the ârare ole timesâ. His obsession was Irish history, in particular the stories, secrets and certitudes of his hometown. As a teenager I may on occasion have rolled my eyes back as far as nature would allow, when he would reminisce about taking trams, or point to where Nelsonâs Pillar once stood, often talking about how we are descended from the Tuatha DĂ© Dannan and how he could prove it! </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">When I visited him in the Nursing Home he asked the same questions; What time is it? What day is it? Had he missed Mass? One time he had me chase around the Home because he could âhear Massâ and was determined to find the source. He had me peering into residentâs rooms looking for God tucked inside their radio or streaming loudly from the Spirit Channel. He had me stop people in the corridor and ask them in hushed tones âYou know anything about a midweek Mass? Whoâs saying it? Is the Communion real? No handshakes? Iâm asking for a friend - This conversation never happened.â</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I knew with swelling sadness that heâd never set foot again in the heart of the town he loved so well, so I encouraged him to tell me about his life. His memories kept going back to his own father, a man I knew as âGranddaâ, a man who didnât say much. I feel my Dad was closer to him nearing the end, as if Grandda was somewhere nearby, waiting. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I curse the times I didnât pay a lick of attention in my eye-rolling youth, when every word out of my parentsâ mouth was a damning indictment of their dearth of coolness. Well, payback is a beast, my 9 year old often âshelvesâ me. Recently, at her own doctorâs appointment I went to speak on her behalf and her little hand reached out over mine, a sign to âbe quietâ that she stole from me, she looked at me, almost with pity and said âMom, I got thisâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I know how it feels to be infantilized, I wanted my Dad, and indeed my daughter, to speak for themselves. But sometimes, no matter how hard they try they canât get that boulder up the hill. They donât have to do it alone - when elderly patients are accompanied to their doctor appointments, it often improves the experience for all involved.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I spoke to a full time carer, who looks after both of her parents, about the challenges she faces. She pointed out that although largely her experience of doctors has been a supportive one, some doctors need to take certain things into account; an elderly person may be hard of hearing, find prolonged waiting very difficult, be overwhelmed by the appointment, or struggle greatly with speaking through a mask. Allowances and patience with patients is key. She made the powerful comment âThe elderly are still real people, itâs very easy to decide they are all alike. But </span><span style="background-color: white; color: #222222; font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I remember my dad once saying that he's still the same person inside as he ever was.â</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">My own fatherâs Geriatrician, Dr Graham Hughes, is a great example of a physician seeing the person behind the disease. He was exceedingly kind and patient, talked directly to my Dad but most importantly of all, he listened. He let my Dadâs thoughts wander and with light touches the doctor brought him back to the matter at hand. They both would look to me occasionally to contribute extra information, verification and be the voice my Dad couldnât find. At times it could get awkward and Iâd have to excuse myself (if I heard the word âwaterworksâ one more time I was going to ask the Head of Irish Water to take over my brief). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">There is support out there, lots of it, from public health nurses to HSE physiotherapists, dieticians, speech therapists, occupational therapists, social workers, carers, meals-on-wheels, social activities, support groups, home grants, carers allowance, mobility aids, drugs, rock nâ roll, etc. Like every public service there is never enough to go around but they are doing their best and if you get into the system, relief will come - granted, perhaps just a modicum. However, hopefully the government will learn from our Covid crisis, seeing how interconnected we all are, and pour more into the caring economy. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">A great fear seems to be losing independence, the irony is âsupportâ allows you to keep living in your world on your terms. I should say, everybody is different, some elderly folks have been untouched by serious illness or loneliness and live independent lives with little support. On the other hand, some young people have a fleet of support for every move they make, that they just canât shake - just ask Britney Spears. As people go, we are a variety of proof-of-concepts in the human experiment - no one support-stocking fits all, shop around!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Having an elderly parent with a serious illness was challenging but it was a journey that had its rewards. One of the strange quirks of my Dadâs Parkinsons was the changes in mood, at times he could start giggling out of the blue. His laughter reminded me of the humour we shared and within seconds I joined in - sometimes we laughed... until we cried.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Goodbye Dad. </span></p><div><span style="font-family: Arial, sans-serif; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Read the original article here - <a href="https://www.imt.ie/opinion/we-go-round-and-round-in-the-circle-game-and-end-up-being-parents-to-our-parents-11-07-2023/">Can we circle back: the inevitability of parenting your own parents</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/07/the-irish-medical-times-medical-power.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/08/the-irish-medical-times-telehealth-is.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-61342209397788477112023-07-07T04:05:00.005-07:002023-07-12T02:28:56.974-07:00The Irish Medical Times - The Medical Power Balance: Is it time for a change?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg97uf4EmyKv2dkO-ot5HIRSHPzyzMK8CbmUEHeYC91la2BtiUnVYyZ7ASkslYSvt8x4zI4vGfNm4a85Ac1EPDdj5oeMdYAALknZSyo68Ll8nMgW1mkwQDue0R7EglhxciYPZoBb0YO-pMSG1vrz1Vs9g_o3OcLbcH6h7IFgezbMknsx172p0DwbIr77pQ/s605/Screenshot%202023-07-07%2012.01.04.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="356" data-original-width="605" height="376" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg97uf4EmyKv2dkO-ot5HIRSHPzyzMK8CbmUEHeYC91la2BtiUnVYyZ7ASkslYSvt8x4zI4vGfNm4a85Ac1EPDdj5oeMdYAALknZSyo68Ll8nMgW1mkwQDue0R7EglhxciYPZoBb0YO-pMSG1vrz1Vs9g_o3OcLbcH6h7IFgezbMknsx172p0DwbIr77pQ/w640-h376/Screenshot%202023-07-07%2012.01.04.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheBNN9LazThxARTN8Uq5a7VvSUT_KMlSpArk6SQPA-QRTPSnX52V8dH1Uyiber-8zURmzos-hn3PnmF21Dz6-qACnB0kIR05gYl9Dg1NCpGyzMW_nx_PH0-Snq3F5v04588OcRjH1bYaFZPv7TWJFUWhM6C217oypnNJxZ4vnNU4jAkZMeb-0EotmoNO8/s836/Screenshot%202023-07-07%2011.49.34.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="836" data-original-width="665" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheBNN9LazThxARTN8Uq5a7VvSUT_KMlSpArk6SQPA-QRTPSnX52V8dH1Uyiber-8zURmzos-hn3PnmF21Dz6-qACnB0kIR05gYl9Dg1NCpGyzMW_nx_PH0-Snq3F5v04588OcRjH1bYaFZPv7TWJFUWhM6C217oypnNJxZ4vnNU4jAkZMeb-0EotmoNO8/w510-h640/Screenshot%202023-07-07%2011.49.34.png" width="510" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-cbc9bd1a-7fff-8a20-902f-00c1ed5e2ea0"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">They want to use those skills, meet their commitments, and help as many people as they can. At times, it can feel that in order to prioritize that talent, the hospitals can overlook the end-user. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">To improve the user experience, we need more consultants.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I think the old notion of a consultant ignoring a patient to play a round of golf is hackneyed and insulting (everybody knows they play pickleball nowadays). </span><span style="font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Being a consultant is a demanding job, from my perspective as a patient they work very hard, with a lot of responsibility. They are allowed very little room for error, they oversee a multitude of spinning plates, I imagine the pressure must be immense. Like everyone, they are allowed to have sick days and vacations (and play pickleball). </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">However, to flip the Spiderman quote, âwith great responsibility comes great powerâ. In my experience the system caters to this power the doctors unwittingly wield (some not so unwittingly). This can diminish the patientâs power, which is not very potent in the first place. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I recently had a family member with a serious chronic condition go in for a checkup. He was feeling very unwell. Two hours went by in the waiting room, no patient was called in to see the doctor. Eventually he managed to catch a passing nurse and found out the doctor was in fact not coming in today and the nurses and admin were concentrating on rearranging the doctor's schedule accordingly. They were so focused on re-establishing appointments, at a time the doctor would be available, they forgot to tell a waiting room full of patients to go home or seek help elsewhere. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">That was a mistake, an oversight, a lack of communication. They were trying their best to rebook patients, rehouse emergencies, help people, their intention was good. But unfortunately a lot of long-term patients have a story of being forgotten. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">In other service providing industries the customer isnât usually omitted from a change. For years I have brought my daughter to music classes, sports training, etc. I know things can get cancelled at the last minute, thatâs understandable (weather, acts of God, etc - weather doesnât influence music lessons, unless youâre blowing your panpipes down by the waterfalls). But as the person paying for the service I am usually notified as soon as the cancellation decision is made. I am very rarely left standing alone on the hockey pitch with the stick in my hand wondering whatâs going on. I will admit I have brought my daughter to the wrong pitch, at the wrong time, on the wrong day, but hey, Iâm not promising to deliver her a specific service, other than basic haphazard parenting.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Iâm sure there are an endless number of consultant doctors who feel very far removed from a âsuperstarâ status. There are probably a significant number of senior doctors who feel frustrated with decisions, or âthe systemâ, who feel their hands are tied, and their calls for resources, action, and need for change go unheard. However, as a patient, even though we are the customer/client, it is not uncommon to feel that the doctor's needs are catered for ahead of our own. For example, if a doctor can only work certain days, the system caters to this, the system doesnât cater to the patients needs, it works around the doctor - which makes sense because they are providing the service, but without patients there wouldnât be a service to provide. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">The NHS are starting to disrupt their own organisational model. They are starting to shift around responsibilities, a new initiative allows Pharmacists to prescribe for certain conditions including sore throats, earache, insect bites, shingles and UTIs. The aim is to help overstretched GPs. Another plan, yet to be approved, is to introduce apprentice doctorships (allowing school leavers to skip the traditional medical degree and start on-the-job training). Also, with the advent of AI, patients may be dealing more with bots and less with docs in the future.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">These are bold moves, I can feel a little stomach acid starting to roil at the mere thoughts of taking medical advice from anyone other than a fully fledged fleshy doctor, with the scars to prove it. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">But I believe introducing the concept of change may help crack the power imbalance in healthcare and increase the respect of everybodies valuable time. Even if some shockingly innovative ideas are ultimately rejected, having the conversation will move the dial in the direction of enhanced awareness of each other's struggles. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">I see you, I hear you, I wouldn't want to be you - it's time for change. </span></p><div><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">Read the original article here - <a href="https://www.imt.ie/opinion/the-medical-power-balance-is-weighed-in-favor-of-doctors-is-it-time-for-change-20-06-2023/">The medical power balance is weighed in favour of doctors: is it time for change?</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/05/the-irish-medical-times-gut-instinct.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/07/the-irish-medical-times-can-we-circle.html">NEXT POST>></a></div><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-48791922830542987872023-05-15T07:41:00.002-07:002023-07-07T04:08:17.691-07:00The Irish Medical Times - Gut Instinct: disease reversal and prevention through diet <p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeMoYgM8wbDkv2do1E5g2hYu9CYATQsm1cF8TbX1lzrNUZJL_9rzGojS7jGunQshVDb4LwSrorZ8o6LsJ9d3LmWkHp4R6A7AzPwX-oh58HpWj_D8eK5uKdp3ku3cCj9Gu8tDDfHDt-VS003ruYOE5wWq7biIyMqoAiHLg0rax_IH2XgRrTOhdFzMoM/s613/Screenshot%202023-05-15%2015.00.28.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="350" data-original-width="613" height="366" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjeMoYgM8wbDkv2do1E5g2hYu9CYATQsm1cF8TbX1lzrNUZJL_9rzGojS7jGunQshVDb4LwSrorZ8o6LsJ9d3LmWkHp4R6A7AzPwX-oh58HpWj_D8eK5uKdp3ku3cCj9Gu8tDDfHDt-VS003ruYOE5wWq7biIyMqoAiHLg0rax_IH2XgRrTOhdFzMoM/w640-h366/Screenshot%202023-05-15%2015.00.28.png" width="640" /></a></div><br /><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiE0Ej6-AgH7PGZa3ef8t1smwbs5ZqxusEF_laIpXmx8IF61g1hmzGDcuAdABjPKX40Pq6Ou5rIdEOZAYzriQ48nZW0xP6sB-oGZjhfgHrhadVWmv1Nlnp6yD3upujLI-_IieW2Ht2HmGpjPOApoBbTwR5y7ziKvhSkpil5KcVUPGCmdQWXUyCbccVw/s711/Screenshot%202023-05-15%2015.05.59.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="711" data-original-width="656" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiE0Ej6-AgH7PGZa3ef8t1smwbs5ZqxusEF_laIpXmx8IF61g1hmzGDcuAdABjPKX40Pq6Ou5rIdEOZAYzriQ48nZW0xP6sB-oGZjhfgHrhadVWmv1Nlnp6yD3upujLI-_IieW2Ht2HmGpjPOApoBbTwR5y7ziKvhSkpil5KcVUPGCmdQWXUyCbccVw/w590-h640/Screenshot%202023-05-15%2015.05.59.png" width="590" /></a></div><br /><div><span id="docs-internal-guid-bf074791-7fff-dae3-7be6-bf283d41ece3"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">âWhat are we going to do with that number?â I was hoping we were going to eat the number because American hospital jello is not a meal (itâs not even in a food group) and itâs probably contributing to the number on the board she was obsessed with. âWere going to bring that number down! Thatâs right, you got this!â</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">In reality I had no control over that number as I lay in my hospital bed. Developing diabetes after a distal pancreatectomy is a risk, one that was never discussed with me. But from my bed, thanks to my nurse, I felt I could influence it. I did everything the nurse asked me to do which was mostly these excruciatingly painful slow walks to the nurses station and back. âYou can do it!â sheâd cheer as I clutched on to my IV pole for dear life. When I wasnât pole walking, I was staring at the number on the whiteboard, visualising it getting smaller. And sure enough, through a natural rebalance of my insulin, but mostly because of my visualization, my blood sugars stabilised and I left the hospital diabetes free. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Two months later I was pregnant, and during my second trimester I tested positive for gestational diabetes. This time there was no whiteboard and a number I could play mind tricks with. I was given a glucometer, a food diary and assigned a dietician. As luck would have it my diet was already low in refined sugar and fats so I didnât have to overhaul my lifestyle. But I did have to start eating small meals more regularly and be far more conscious of food combinations and how quickly food released sugar. I piously ate porridge for breakfast every morning and thought this act alone would get me on the cover of Pregnancy Weekly (thatâs a zine that doesnât exist and hopefully never will). I used my glucometer to pinprick blood after every meal and note my blood sugar reading, thatâs how I found out my sanctimonious slurping of my stirabout every morning was sending my blood sugar through the roof!</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">My glucose reading is unique to me, itâs my metabolism interacting with my partial organs, other people may eat the same food and not have as high a reading. I still eat porridge to this day because I like it, itâs got nutrients, but I am now aware that it raises my blood sugar so I donât eat it every day, if I do eat it Iâll go for a walk or exercise in the hour afterwards to temper down the spike. Even a short walk at a slow pace will knock points off your blood sugar. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Having gestational diabetes was my first introduction to the concept of disease reversal and prevention through diet. This concept has now become an industry, there are podcasts devoted to gut health, TV shows dedicated to examining your poop, a plethora of doctors in functional medicine, apps that work out your macros (the macronutrient % of of carbohydrate, protein and fat in your diet) and of course celebrities and influencers who think theyâve cracked the code on how to eat best. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Recently, Gwyneth Paltrow, the famous actress and well-being guru, revealed her daily routine which involved skipping breakfast, having broth for lunch, and a vegetable paleo dinner. It was celebrated by some as a very health conscious nod to intermittent fasting, and an avoidance of processed food. It was seen by others as disordered eating. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">There is a path where a healthy approach can veer towards an eating disorder, especially in an environment where everybody with a phone and a platform is an âexpertâ. So we all have to be mindful of the path we follow. But this internal introspection of our bodyâs mechanics is throwing up some interesting information. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">An area that interests me is our gut health. Evidence shows if we can diversify our microbiome (the microorganisms that live in our gut) through eating a variety of fruit, vegetables, nuts, seeds, pulses, whole grains on a daily basis, we are almost (almost) guaranteed to have a stable healthy weight and see a reduction in inflammation, infection and age related diseases. I like this approach to diet because instead of restrictions it talks of incorporation and variety. According to a doctor I heard on a podcast/TV/poop show, ideally we should be eating at least 30 different plants a week, although if you are eating Busy Lizzies and hydrangeas for breakfast, no wonder you are full. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">By creating a healthy microbiome it can help you digest your food, regulate your immune system, influence your brain chemistries and enhance your metabolism overall. The gut microbes can tie back to diabetes as they influence your blood sugar peaks, how you digest fats and how quickly they are cleared. Which can influence inflammation, which can create disease, and weâre into another concentric circle. Blood sugar management, not just for diabetics, but for everyone, is an interesting proposal. One stat I found stated that your average American is eating 100 times more sugar today than they were 100 years ago. As Dr Casey Means neatly put it the ânormalâ American diet is a glucose rollercoaster.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Chronic inflammation can increase the risk of various diseases; diabetes, heart disease and even cancer. The man behind a lot of the gut research is Prof Tim Spector, a professor of genetic epidemiology in King's College London. He even believes microbes can affect peopleâs mental health with a diverse set of microbes staving off depression. He doesnât put any stock in calorie counting and gave the example that two people can eat an identical muffin, one person might have a mild sugar spike and no dip, whereas the other might have a large spike and dip, leaving them with a bigger calorie surplus for that day compared to their pal. He noticed people with better gut health tend to metabolize quicker and have less body fat. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">Ultimately, everyone is an individual, I would never tell someone what to eat (except my daughter - eat your greens!). Iâve long believed that we have our own unique reactions to food. I tried restricting carbs for a week and my body didnât like it at all. My endocrinologist told me I am not a candidate for intermittent fasting. There is no one diet that fits all, I predict the new approach that will pervade the diet/health industry is personalized nutrition, centred around disease reduction/avoidance. People are already sending online health companies their excrement and in turn paying for access to apps that provide them with tailored recipes, daily lessons, and a nutrition coach. So - you send me your s**t and Iâll send you mine?!</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;">As a patient, I want to eat in order to look and feel as healthy and strong as I possibly can be. Thatâs a much bigger goal than hitting a target weight or dropping a dress size. I donât think we all need to post off stool samples just yet, but if we started to change the way we think about food, from a foe to a friend, that would be a healthy start. </span></p><div><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space-collapse: preserve;"><br /></span></div></span></div><div><br /></div><div>Read the original article here: <a href="https://www.imt.ie/opinion/its-all-about-the-food-and-if-you-have-an-opinion-perhaps-youd-like-a-sample-12-05-2023/">Gut Instinct<span style="font-family: Arial; font-size: 11pt; font-weight: 700; white-space: pre-wrap;"> </span><span style="font-family: Arial; font-size: 11pt; white-space: pre-wrap;">- disease reversal and prevention through diet</span></a></div><div><br /></div><div><a href="https://www.lettersfrombeyondthepale.com/2023/04/the-irish-medical-times-peace-love-and.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/07/the-irish-medical-times-medical-power.html">NEXT POST>></a></div><div><br /></div>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-32391083433506481612023-04-24T10:28:00.004-07:002023-05-15T07:44:52.575-07:00The Irish Medical Times - Peace, Love and Understanding Dispensaries<p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFyBA0me_QQAVrlHajamnTXFmG7dH5DrtSeTILrrhRiSyJtQCzvtQVwk0uPugIMV7uzGfCf6Yow4bEqXXJmTYoShmWspWANnGyJOsOr6BDqWGI2mRFAmw0RVdrrBvL-IyXXT_1XNi-wYGPB69e80R50KIRHu7n3Nm3Bcj8pGDDkbehiNB23ITmts4R/s3840/DSC_2470.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2160" data-original-width="3840" height="360" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFyBA0me_QQAVrlHajamnTXFmG7dH5DrtSeTILrrhRiSyJtQCzvtQVwk0uPugIMV7uzGfCf6Yow4bEqXXJmTYoShmWspWANnGyJOsOr6BDqWGI2mRFAmw0RVdrrBvL-IyXXT_1XNi-wYGPB69e80R50KIRHu7n3Nm3Bcj8pGDDkbehiNB23ITmts4R/w640-h360/DSC_2470.JPG" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-73xv6wIlqcjBT9IRrEo2dmuMpsvPphBKBnzPrf70MaWlIaHC3snbKwdIxzVsbR7XdzH-KG7jKPQLVDt58JMuoa3frUnYZ_IlDPFxSP6jj1QcDMWP55jwcHueRpUbxYi0w511b-uFh6tGKJAWk9qGOCk4n7OqcrmsdBz9L6jOMmq4-3iVqnbIat8D/s902/Screenshot%202023-04-24%2018.16.40.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="902" data-original-width="665" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-73xv6wIlqcjBT9IRrEo2dmuMpsvPphBKBnzPrf70MaWlIaHC3snbKwdIxzVsbR7XdzH-KG7jKPQLVDt58JMuoa3frUnYZ_IlDPFxSP6jj1QcDMWP55jwcHueRpUbxYi0w511b-uFh6tGKJAWk9qGOCk4n7OqcrmsdBz9L6jOMmq4-3iVqnbIat8D/w472-h640/Screenshot%202023-04-24%2018.16.40.png" width="472" /></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-d10b6d41-7fff-922d-b528-a3f83afa5ede"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Nearing the end of my time living in San Francisco marijuana was legalized for recreational use. I remember going to a party where a very friendly lady, very high up (no pun) in a very big company, talked to me at great length about CBD versus THC. CBD, I learned, was cannabidiol, a compound found in marijuana, it had no psychoactive properties but was believed to have medicinal benefits. She told me this as she rubbed a CBD balm she kept in her purse onto my hands. It was San Francisco, Iâd been to weirder parties. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">THC, tetrahydrocannabinol, she explained, (as she scrolled through her phone checking for world events that might spark a call from her office), caused the high, the psychedelia, the euphoria, the good stuff. She enjoyed THC at weekends but had become a bit wary of some of her colleagues using it as a daily upper/downer. âIt keeps me focusedâ said one of her colleagues, while another justified the opposite âIt gives my mind a breakâ. An interesting admission to your boss during your work hours #onlyinsanfrancisco</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I returned to visit San Francisco last year and the dank headshops of old were gone, the dispensaries were explosions of colour, bright yellows and pink, welcoming people in. I honestly thought the new dispensary on the corner was part of the Body Shop franchise selling skincare and bath bombs. Then I realized that although the doors were open, the windows were still covered and instead of the burly bouncer there was a government mandated security guard, aka, the greeter. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Dispensaries are widespread in California, we took a road trip along the coast and almost every small town seemed to now have a dispensary alongside its Mom & Pop shops. Nowadays, given its State legality, it seems the majority of my middle aged friends in California would pop a gummy once and a while (or at least, have given it a go). No-one is daily micro-dosing, to my knowledge, just folks looking for a more mellow vibe than the loud, crashing, patio-furniture falling, mother-in-law insulting, flatulence farce that an alcohol steered evening can evoke. That said, nobody ever had a great sing-song or an impromptu ceilĂ after eating Bradâs special brownies. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">As I ambled up to a dispensary in San Francisco, my head was cocked and one eyeball was already across the line, just âhaving a lookâ. The doorman immediately asked for my ID. I am 45 and I look 45. I laughed, he laughed, I took a step forward, he stood up to his full height. We agreed if I wanted to enter it would be wise to comply with the law and provide a passport ID. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Once inside, my curiosity had turned to impulse buying. It wasnât my first rodeo, I had gone to college in the 1990s afterall. Unfortunate rounds of cancer in my 20s had left me abstemious, I hadnât touched a drop of alcohol in years. The only drugs on my rotation were placating my heart after chemo and radiation damaged it. I was probably the wrong person to start messing around with controlled substances, or was I the exact right person? No, I was probably the wrong person. Apparently the American government was letting me decide; me and âKylieâ, a smiley 19 year old with more tattoos than skin, who took me aside for my âconsultationâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Kylie listened to my medical history of multiple cancers and heart failure with nods of âSure, sure, sure, wait-what, ok, sure, sure, sureâ. I then explained I was hoping for help with my chronic pain and trouble sleeping. She asked if I wanted to smoke it, vape it, eat it, drink it, rub it, lick it, stick it, prick it, dab it, wear it or burn it? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Em, I tried to look contemplative as I checked for exits and wondered if I had told anyone where I was. I never felt more like a middle-aged Mum trying to be cool. I think Iâll eat it, I advised Kylie, Iâll eat it and Iâll drink it, and maybe the rub thing. I was now speaking in a whisper. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Kylie was on to her next question âWhat kind of high are you looking for?â I used my hand to indicate a level of wandering elevation I deemed appropriate for my station in life. She said she assumed I wanted to avoid couch-lock, paranoia, and the munchies. I replied - Did somebody tell you about the paranoia? She looked confused at my joke, her tattoos twisting into a question mark, âWait-what?â, was her stock reply. âI know, right?!â became mine - equally confusing. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Did I go through with the purchase? Weâll never know. Certainly my daughter will never know. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I will point out buying marijuana in a dispensary is not possible on a credit card, as it is still considered illegal in America on a Federal level. Itâs a cash only biz (you are also expected to tip your budtender). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Dispensaries donât just sell products with THC, the psychoactive ingredient that has been proven to help with anxiety, nausea, pain, depression, PTSD, MS, glaucoma, Parkinsons, etc. They also sell CBD, which does not alter your mental state, known to help with autoimmune disease and inflammation. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In my opinion, marijuana is a kinder product than alcohol in many ways. Kinder to those around you and your body. Itâs not without its negatives, it can cause your heart to race and the dreaded paranoia. Smoking it can lead to lung scarring, and becoming dependent on it (similarly with alcohol) can be a destructive lifelong issue. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">However, if you are a patient looking for relief, I believe marijuana should be an option. I am in favour of the medics helping a patient navigate it, but I donât agree with limiting the administration of the drug to the very small list of conditions that qualify patients for medical cannabis in Ireland. The dosage is important due to different peopleâs sizes, physiology, metabolism, underlyings, and mental health. Kylie was a great budtender but for someone like me with more medical problems than the boxset of Greyâs Anatomy, she was out of her depth. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I donât know if Ireland, even the âNew Irelandâ, is ready to follow Germany in proposing a full legalisation of cannabis. But we should at least address the overly conservative restricted list of illnesses allowed access to cannabis based products in Ireland.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Every single day, I take hard white pills the pharmacy compounded out of god-knows-what to stay alive. I live with life-limiting medical issues and medication side effects. If I could take government allowed medical cannabis to make my life even a little easier to bear, I would do it in a spliff second. </span></p><div><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: center;">Read the original article here - <a href="https://www.imt.ie/opinion/peace-love-understanding-dispensaries-14-04-2023/">Peace, Love & Understanding Dispensaries</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/03/the-irish-medical-times-generational.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/05/the-irish-medical-times-gut-instinct.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-39181827158260827392023-03-15T04:59:00.004-07:002023-04-24T10:31:34.184-07:00The Irish Medical Times - Generational trauma: can trauma leave a genetic impact on descedants?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOS80kBBNqf0qT-jqjWv3cStm2y1vW7bKIKb2xVPyF5iohe5pwVOv1NLKxHByJg8LImSAZPX_TXQqtm5eLM7TYXF7wWZZrROSfxFernRSN6TuJJFktQeplg8Wy0Zdawj1vm-gHC4GBW42ZdzjBnopFtA7uf55riRAJjEoh_dcvfvxdjkF2NeZdLcsU/s615/Screenshot%202023-03-15%2011.55.51.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="355" data-original-width="615" height="370" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOS80kBBNqf0qT-jqjWv3cStm2y1vW7bKIKb2xVPyF5iohe5pwVOv1NLKxHByJg8LImSAZPX_TXQqtm5eLM7TYXF7wWZZrROSfxFernRSN6TuJJFktQeplg8Wy0Zdawj1vm-gHC4GBW42ZdzjBnopFtA7uf55riRAJjEoh_dcvfvxdjkF2NeZdLcsU/w640-h370/Screenshot%202023-03-15%2011.55.51.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiXmX5wHs5ENRG1gcMZPAEZKSr8HErF-o3e5cygZNTp86kiEFI-nnTcDnyQXoqyulFM4ZQZCJYz9ZlH03Y-K1L05B6-PYNQnSNyKeqrvXDt2hqk_lUDde-LhyGZH0wtFy8bs45zFORXBD8v8fFdZInGphJoSacN26vC3m4Ca6-8_U4cVrAk392UXFS/s773/Screenshot%202023-03-15%2011.12.03.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="773" data-original-width="649" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiXmX5wHs5ENRG1gcMZPAEZKSr8HErF-o3e5cygZNTp86kiEFI-nnTcDnyQXoqyulFM4ZQZCJYz9ZlH03Y-K1L05B6-PYNQnSNyKeqrvXDt2hqk_lUDde-LhyGZH0wtFy8bs45zFORXBD8v8fFdZInGphJoSacN26vC3m4Ca6-8_U4cVrAk392UXFS/w538-h640/Screenshot%202023-03-15%2011.12.03.png" width="538" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-1bfda1ef-7fff-7632-2a90-64e3e1698b8e"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Epigenetics doesnât stop at the metabolism - if you cross a petite Shetland pony and a massive draft horse there can be a difference in appearance of the offspring based on the carrier. If you have a pony carrying the pregnancy the foal will be much smaller than cases where the horse is the surrogate. Through epigenetics the horse activates all the traits in the foetus that would make them most horse-like and vice versa. So, the next time you are in a bar and a horse walks in and the bartender says âWhy the long face?â, you can lean over and say âEpigeneticsâ. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">On the subject of surrogacy, Dr Michael Greger, author of the famous best seller, How Not to Die, believes there is some evidence that an embryo from a slim couple born to an obese surrogate mother could face an increased risk of obesity. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">According to Greger if you look at families where the mother had gastric bypass surgery and examine the children born before the surgery to those born after, (when the mother weighed say 100 lbs lighter), the children born to the lighter version of the Mom had lower rates of inflammation and metabolic derangements, and were three times less at risk of developing severe obesity themselves. He believes this research proves how important it is to prevent the generational legacy of obesity. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Given a female child is born with all her eggs already in her ovaries, is Greger saying the weight status of a pregnant woman could influence her grandchildrens propensity for obesity? Yes, thatâs exactly what heâs saying.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">To extrapolate that further, Greger is suggesting that one way to prevent childhood obesity is to avoid adding excess unnecessary weight during pregnancy (this is weight on top of the necessary natural weight gain). Who ever wants to give that speech to a room full of expectant mothers may also want to bear in mind the culture of fat shaming that women are exposed to on a daily basis, their fragile hormonal and mental state, the dissociation and trepidation they may already harbour about their changing body, and the general stress of pregnancy and just being a woman - with all that in mind, knock yourself out with the weight lecture. But maybe don't hang around for a standing ovation. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">That said, the passing down of generational problems should indeed be part of the education around pregnancy. Also the determinants behind obesity including emotional factors should be addressed.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The theory of inheriting metabolic memories from ancestors was studied in the Netherlands as many people have stayed in the same area for generations, therefore providing a good sample of a population that experienced scarcity to abundance. However, there are many examples of communities passing down molecular adaptations - an African slave brought to America starved and traumatized, could have descendants with diabetes today. People born primed to survive starvation are then raised in an environment that is front-loaded with sugar, rendering the epigenetic changes maladaptive. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Letâs not forget the Irish famine, could that explain to some degree our prevalence of celiac disease, perhaps also our penchant for sweet alcohol, our drift towards depression, and our sardonic slant on life. I also randomly attribute to the famine our ability to talk at great length yet say nothing of consequence (something had to fill the food gap), our inability to form a straight queue (famine walk), and our rugby sporting prowess (the ball is shaped kind of like a potato). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Itâs unclear just how far back a traumatic generational memory might originate. Perhaps a more nebulous example of generational trauma could be a modern day fear of dogs or cats, could this stem from a stone age ancestor who had a rough encounter with a wild animal? If our great granny (x400) took on a tiger in her youth, are we more likely to flinch when a poodle passes, or are we more likely to wrestle it in a familiar embrace? (Nobody wrestles poodles). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Itâs not just trauma that we can play âpass the perpetuating parcelâ with, experiencing love and incorporating that feeling into our physical code can genetically predispose a child to showing love. Of course, the essentials such as food and exercise are impacting how we look as a species. You are what you eat, processed food has changed the shape of humanity, literally. Our faces are smaller and our bodies bigger than our ancestors. But perhaps future humans may become physically smaller as we spend more time on screens and expend less energy. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">If we have a collective traumatic experience with say climate change and move in great numbers to Mars, our survival genes will kick in. Gravity is lower on Mars and the temperature colder, it's possible our limbs would start to lengthen and our body mass increase as the generations adapt. There is also an argument that green skin on Mars would fare better (probably due to the colour of the Martian sun favouring chlorophyll and the composition of the atmosphere on Mars, plus itâs just way cooler). To summarise - our great great great great alien grandchildren are all going to look like the hulk. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I am intrigued by this idea of memory genetics, people behaving, looking or eating in a certain way not purely because of learned modelled behaviour but due to a physical trait that was picked up along their family tree. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Living through a trauma could provide an innate resilience for your descendants.</span><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> I endured a number of cancers before my child was born. Maybe by simply surviving I have provided my daughter with a genetic durability that she will pass down the line. That and a penchant for bad jokes - my dad told me a joke about genetics, my daughter didnât get it, but I did. </span></p><div><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-alternates: normal; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">For the original article read here - <a href="https://www.imt.ie/opinion/sheilagh-foley/generational-trauma-can-trauma-leave-a-genetic-impact-on-descendants-14-03-2023/">Generational trauma - can trauma leave a genetic impact on descendants?</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/03/the-irish-medical-times-we-need-to-talk.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/04/the-irish-medical-times-peace-love-and.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-2399749038507003422023-03-05T02:30:00.006-08:002023-03-15T05:00:28.361-07:00The Irish Medical Times - We need to talk about Conor<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhilyFmIaFcu-s51LjijLDxuzlV8vqz_NBmMt0wJvBHDHHrUeJKSkJ6hDeAJPdoFx4bYXFfZaTNx9A0bdrrxip2ltgxjBF7rIvqscbVHr7Ri7pEk4P6vpAUODbPdOIY4MzMycv_1p2mZX3jWvfMF_BVRAyT-xad28LLJKs3RsnMwWCmBIFcYyouYS6I/s620/Screenshot%202023-03-05%2010.27.08.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="353" data-original-width="620" height="364" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhilyFmIaFcu-s51LjijLDxuzlV8vqz_NBmMt0wJvBHDHHrUeJKSkJ6hDeAJPdoFx4bYXFfZaTNx9A0bdrrxip2ltgxjBF7rIvqscbVHr7Ri7pEk4P6vpAUODbPdOIY4MzMycv_1p2mZX3jWvfMF_BVRAyT-xad28LLJKs3RsnMwWCmBIFcYyouYS6I/w640-h364/Screenshot%202023-03-05%2010.27.08.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfdtqYWDi9W1x6q2aity5eqXvjjcfYneh8qtc4C8YScuAgLiv7ucMBmvCqdSCoh0bxrE1IRG4udIxmDdmaupXb10k7ePRCufNJezUx4Q2K66rIbHEROuwiB-vKLYUgpScAZiXJynflV32IOsuU5GAWKU_MG8n9_cfwFuxnZp52lAy6npqfZTWQnkVu/s905/Screenshot%202023-03-05%2010.04.24.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="905" data-original-width="651" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfdtqYWDi9W1x6q2aity5eqXvjjcfYneh8qtc4C8YScuAgLiv7ucMBmvCqdSCoh0bxrE1IRG4udIxmDdmaupXb10k7ePRCufNJezUx4Q2K66rIbHEROuwiB-vKLYUgpScAZiXJynflV32IOsuU5GAWKU_MG8n9_cfwFuxnZp52lAy6npqfZTWQnkVu/w460-h640/Screenshot%202023-03-05%2010.04.24.png" width="460" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-42aaf93d-7fff-1162-818a-57c293eae32e"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In the interest of GDPR, respect for my friend, and fear I might accidentally voice activate a call to said friend (interrupting his busy work day with muffled magic that only the backseat of a Dublin taxi can provide) - I told the driver I had forgotten my friend's last name. Heâs my husband's friend, I mumbled as an excuse. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">With an air of disproportionate disappointment, the cabbie slumped back on his steering wheel. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Humans work best as a tribe (thinking 'we' not 'me'). Most of us listen to music other people make. We watch sports other people play and tense our muscles as they tense theirs. We stress about other peopleâs reaction to our work presentations, our public speeches, even what we are wearing or how we appear. Most of our daily energy is actually directed to others.</span><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Perhaps this collective tribe approach is making some of us see differences as unacceptable. Personalising pronouns as an affront to the common good. But the tribe is bigger than a set of established commonalities, we are ever evolving, there is new ground to break and new overlaps to be found. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">My enlightened cab driver clearly had the same thought as he decided to change tact from name to location. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">"Ah, yeah, Conor from the Southside, I know him". </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I reluctantly replied that Conor was a Northsider. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">"Ah, yeah, yeah, from out by Santry way, I know him. Short fella?" </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">No</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Silence hung low as we both accepted the deflating defeat. We had no overlap, no person in common. My driver didnât know Conor, no matter how much he wished he did. All was lost, there was no mutual acquaintance. Our tribes had never grazed on the same ground, we hunted in different packs and gathered different fruit. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">There was no way around this - I was approaching my destination, we slowed to a stop, I unbuckled my belt and leaned forward to say a quiet thank you and goodbye. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The driver's eyes were darting around with desperation, a single bead of sweat trickled from his grey roots. I could see him mouthing âConorâ in silent anguish. Then it hit him, a way out, an unfettered connection, he broke into a contagious smile and announced. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">"Well, I'll tell you something, Conor DEFINITELY knows me!" </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Delighted with ourselves, I waved my new friend off. Conor definitely didnât know him, but that didnât matter, we had cracked open the possibility that our tribes were friendly, âConorâ and himself had been on at least one fictitious bike ride together, this was progress. It didnât matter if we couldnât prove it, we could imagine our tribes blending and this could lead to anything - lawnmowers being lent, bowls of sugar exchanged, and kindness shown to someone you donât normally come across. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">We donât all know a Conor (well, we probably do) but we do all have commonalities. It can be very hard to recognize a familiarity in someone so directly opposed to what you hold to be true and fair. But we all overlap, we all share a Conor somewhere, somehow, and sometimes you just need to exert a smidgeon of creative thinking to find them. </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;">For original article read it here '<a href="https://www.imt.ie/opinion/we-need-to-talk-about-conor-03-03-2023/">We need to talk about Conor'</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2023/02/the-irish-medical-times-drones-in.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/03/the-irish-medical-times-generational.html">NEXT POST>></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-22409797886315746722023-02-12T01:53:00.002-08:002023-03-05T02:34:22.782-08:00The Irish Medical Times - Drones in medicine<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQtbGsrMGD1th_YhsSoFZkQOjtuCSy_11m0eeU1W7sxAAQ6yEI9ZQYbExe9rUi8fh3bh3_AdYWUywgQGCryqNcI0hzNdbctmqd3lg23QZKe2Js5GSugcs0maJVWpS29jjzNeUbWk3HIJ3O3dz1ZGZEoaxEhW-9ofaXrlSgyWtQE-3ShD0JvzQq4UeG/s611/Screenshot%202023-02-12%2009.45.04.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="339" data-original-width="611" height="356" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQtbGsrMGD1th_YhsSoFZkQOjtuCSy_11m0eeU1W7sxAAQ6yEI9ZQYbExe9rUi8fh3bh3_AdYWUywgQGCryqNcI0hzNdbctmqd3lg23QZKe2Js5GSugcs0maJVWpS29jjzNeUbWk3HIJ3O3dz1ZGZEoaxEhW-9ofaXrlSgyWtQE-3ShD0JvzQq4UeG/w640-h356/Screenshot%202023-02-12%2009.45.04.png" width="640" /></a></div><br /><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR4vrLBJlqJHKIvLPrs_-M2J2hw8M1B4a0BEQGCXoXtiRTHngONE-cZMR3ldYAMsSXWDpEZeWiNXOD5JwEaRIrqq5B7qsdClbiYhYlpcNVISeXfbv23u12PHTMkkfYDIwqHSBdREFA-TOrfTFq-a87xd7Ol3Md_Tq9kQoWZOr47qRTYwyc1_HLOGEd/s662/Screenshot%202023-02-12%2009.39.56.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="656" data-original-width="662" height="634" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiR4vrLBJlqJHKIvLPrs_-M2J2hw8M1B4a0BEQGCXoXtiRTHngONE-cZMR3ldYAMsSXWDpEZeWiNXOD5JwEaRIrqq5B7qsdClbiYhYlpcNVISeXfbv23u12PHTMkkfYDIwqHSBdREFA-TOrfTFq-a87xd7Ol3Md_Tq9kQoWZOr47qRTYwyc1_HLOGEd/w640-h634/Screenshot%202023-02-12%2009.39.56.png" width="640" /></a></div><span id="docs-internal-guid-62068413-7fff-b487-e381-0a473184ce51"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">This story is remarkable and a wonderful use of technology. I imagine the ambulance service, equipped with real live people, were also winging their way in the path of the drone. Weâre not all fortunate enough to have a doctor sauntering by as we collapse into our graves. If flying defibrillators become more commonplace perhaps it will be the forcing function society needs to encourage more people to learn basic First Aid. Not to mention, familiarizing folks with the appearance of a defibrillator to prevent the assumption the drone is merely swinging by with a late Christmas present. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Drones were used increasingly during the Covid pandemic to deliver medication, vaccines, bloods, and diagnostic kits. They continue to bring relief and urgent aid to hard to reach areas, including water and snake-bite serum. Weâre probably not far off routine medications being dropped to peopleâs doors, or bloods and organs transported between hospitals by drone. Although knowing the Irish health system, and given that we have no snakes in Ireland, I predict we will spend millions on a drone devoted solely to delivering snake-bite antidote. It will sit alone in a building formerly housing refugees and somebody will write a poem about it. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">On a more practical level, photographs or streaming video footage would allow the first responders/hospital to prepare more appropriately for incoming patients - particularly in the case of a disaster or major event. The drone could video its surroundings, covering as much area as required, it would allow for a tally of how many people are injured, how many look critical and where they are. Drones can find people in the dark through thermal sensors and night vision. </span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">A drone surveilling an incident could inform the emergency response and raise the warning if other areas/communities were at risk, such as a flood, fire, or gas leak. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">On the simplest of levels, drones can go where people canât. If a road is now blocked because of a disaster or accident, a 12 foot ambulance may have a tough time squeezing through.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">These flying robots arenât confined to the outdoors, there may be room in the future for drones to hum along hospital corridors dropping medications to patients, ferrying blood samples here and there. Drones could take over from meals-on-wheels and drop dinners to the elderly or infirm. They could âcheck-inâ on people living rurally, at risk of falls, or with dementia, especially during winter. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">There are even drones with small manipulator arms that could give a person a glass of water, bring them their medication, sort through laundry, clean the house, listen to complaints, and give the worldâs smallest hug (if it can make dinner, I think I found my soulmate). Apparently, the little manipulator arms also allow the drone to âclean a chandelierâ - if I am living alone rurally, on medication, probably elderly, possibly with dementia, presumably alone⊠am I concerned about the state of my chandelier? Of course, I am!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I read that in Japan and the UK there are drones placed in certain suicide hot spots areas. The drone monitors for potential jumpers by examining body movements (before they jump the person tightens and rocks their body in a certain way). The drone spots these people and a therapist talks to the person through the drone to try and help them. </span></p><br /><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">There are also drones that monitor situations where fights might break out, interestingly not necessarily used at football matches or places where emotions are high, but actually used by some schools in the UK where violence on school grounds is a problem. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">It opens up the possibility of many scenarios where monitoring a person's microexpressions or body language could predict something. Are people going to bring drones on dates with them and analyse the body language later? Will they be present in work meetings so people can replay conversions to catch looks and nonverbal cues that lead to decisions? Will we become like Philip Pullman's books with spirit animal daemons (the external physical manifestation of a personâs inner-self) - drones the size of a thumbnail hovering quietly over our shoulders capturing all that much needed âspontaneousâ footage for Tiktok etc - a step too far perhaps? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Many people have grave concerns about the use of drones and their interference with civil liberties. The intended use of the drone seems to be the main bone of contention. If a drone is mass surveilling an area to monitor traffic, that is largely deemed acceptable. If the same drone is used to see how many people in the same area have moustaches, that is considered a breach of privacy. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The rising generation are said to be less concerned with data privacy than their forebearers. They are growing up with social media, forever ticking âterms and conditionsâ and accepting cookies (files cached on your device to note your specific preferences and sign-in data). Perhaps they will be less worried about the varied purpose of the drones and use them for their own convenience. Amazon is purported to have already purchased many of the sky lanes (roads in the sky to allow the safe flying of automated delivery drones). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I imagine operating a drone will be a highly skillful job. The drone worker who will control and navigate the flight paths, including those inside a hospital, will surely be akin to an air traffic controller or pilot. It is very important that medical supplies are kept at certain temperatures and damage free. There may be a difficulty in balancing small and light weight payloads with high value medical contents. Not to mention the technology problem that still plagues all of our mobile phones - enough battery life to get us from A to B! </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I spoke to a commercial pilot with knowledge of the drone industry who felt the principal issue facing drone operators are the regulations. There are restrictions in place from aviation administrations, with particular limitations around night flights and operating in heavily populated areas. Sharing airspace with airlines is currently problematic and the potential for drones to be hijacked and reprogrammed. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">If we are all going to live in this augmented reality where drones are whizzing by our heads. Their flight path and landing zone would have to take into account their âcustomersâ head tilt, heart rate, blood pressure, expectations, reaction. So drone creators and operators will have to work with those versed in the physical and psychological impact of life with drones. Everybody from all backgrounds and all ages have to feel safe and comfortable with the drone. That said, we did all get our heads around the washing machine. Granted my washing machine doesnât fly around the room, much. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Drones gained fame in the military but are being picked up now by engineering, inspection, utility, mining, agriculture, real estate, infrastructure, wind farms, oil, gas, moviemaking, gaming, entertainment and retail, to name a few. Medicine, like all industries, will presumably embrace drones. To go where mankind cannot go, to do the impossible, to break barriers, save lives, and most likely to replace humans therefore reducing variability, cost and error. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: white; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In my opinion, as long as we definitely get the snake-bite drone, weâll be ok. </span></p></span> <div><br /><div>Read the original article here - <a href="https://www.imt.ie/opinion/foley-drones-on-about-flying-medicine-10-02-2023/">Drones in Medicine</a></div><div><br /></div><div><a href="https://www.lettersfrombeyondthepale.com/2023/01/the-irish-medical-times-ethical-shift.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/03/the-irish-medical-times-we-need-to-talk.html">NEXT POST>></a></div><div><br /></div></div>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-51530545815839055352023-01-18T10:11:00.004-08:002023-02-12T01:56:10.183-08:00The Irish Medical Times - Ethical shift: what will be the ethical debates of the future?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqxYFHq1gb97go20dB2LWSv7_n5ElwCi7cPxC83bBSfRrjPB8i4eTsX9ZrlXQdhiXnQDRPgT9XBL5dscbFgihe5SkNLlqDh4vixOfXq1RsR6-OQf9AkHNFmiBpcwGB5AEGs6DAkkKQxtDIiSPmHOHvvDzl4Fg0QnwjKMeODaFdEbjnUEuhnhG2kwtz/s617/Screenshot%202023-01-18%2018.11.41.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="352" data-original-width="617" height="366" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqxYFHq1gb97go20dB2LWSv7_n5ElwCi7cPxC83bBSfRrjPB8i4eTsX9ZrlXQdhiXnQDRPgT9XBL5dscbFgihe5SkNLlqDh4vixOfXq1RsR6-OQf9AkHNFmiBpcwGB5AEGs6DAkkKQxtDIiSPmHOHvvDzl4Fg0QnwjKMeODaFdEbjnUEuhnhG2kwtz/w640-h366/Screenshot%202023-01-18%2018.11.41.png" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkj-tsaDayMefKgBZ6DMGp1ZnTXAvFJ1oFT4wXmlAFxxxDEBXI6imh229GDkDsEQETnl7mctH1sAoKDWDz5fhut2_NfOsUQbKYVcDj5B60er_oyWx_-pvKd_9QjA72z4QuePTiPNg-bYFvPPjTwwblFmsmlGrsJfwXRvv-Rd3XXy03VqgAp8AoFyhF/s825/Screenshot%202023-01-18%2018.02.50.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="825" data-original-width="653" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkj-tsaDayMefKgBZ6DMGp1ZnTXAvFJ1oFT4wXmlAFxxxDEBXI6imh229GDkDsEQETnl7mctH1sAoKDWDz5fhut2_NfOsUQbKYVcDj5B60er_oyWx_-pvKd_9QjA72z4QuePTiPNg-bYFvPPjTwwblFmsmlGrsJfwXRvv-Rd3XXy03VqgAp8AoFyhF/w506-h640/Screenshot%202023-01-18%2018.02.50.png" width="506" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-4292a062-7fff-2561-8c4f-650c0f51a627"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">However, as people strain to sustain themselves and the environment, has meat had its day? Will eating meat become abhorrent, a peckish peccadillo for the depraved? If someone shared a photo of a BBQ or a butcher shop, would it be obscene?</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Another relatively recent swing is the strong push to lower emissions. We are not that far off from affordable clean energy. Once we are all comfortably in the green, will we look back at our fossil fuelling days with contempt and judgement? Arguably, thatâs already under way (not to say it's not warranted). </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Humans can become entrenched in their beliefs, a strong sense of right and wrong. At some point shortly after adolescence our neural models are formed, laying down the essence of who we are. If people strongly disagree or disapprove of our world (our neural models) we can have the same fight-or-flight response that a physical threat would evoke. Have you ever seen someone deliberately throw trash on the street, and you have that split second of moralising adrenaline when you think of picking up the trash and tearing down the street after the person, waving the crushed coke can in their face? Maybe thatâs just me. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">To avoid these can-waving moments we tend to surround ourselves with like minded people and bond with them. Therefore it can be very hard and painful to effect change. We literally need to crack open our minds and allow ourselves to debate, to evolve, to change our minds. So itâs not surprising that a lot of change comes from the younger generations who are less set in their neural ways. Their formative norms are not our norms. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Out of my daughter's friend group there are other children who are IVF babies. What will make their news headline? </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Maybe in the future all babies will have detrimental genes edited out - such as cancer causing BRCA. Right now we see gene editing as controversial, but will future generations look back and be confused by our hesitancy. If we only allow gene editing to remove risk and make someone a better version of themselves, what defines âbetterâ? Thatâs a slippery genetic slope, it will be interesting to see how generation alpha handles that one. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Sometimes economics will force a change in thinking. Every continent in the world engaged in slavery at one point (of every shape and shade of person), now most evolved countries see it as illegal. As abhorrent as it was, and however obvious the abolition of slavery seems now, it wasn't all to do with enlightened morals. It coincided with the harnessing of fossil fuels rendering droves of manpower less of a necessity. Technology can speed up our ethical frameworks. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">A conceivable method of reproduction in the future may include an artificial uterus, no human required (maybe I wasnât a million miles off the mark with my 11 year old understanding of a test tube baby). Right now, the idea of a baby growing in a sack in a lab may seem high risk. The foetus is missing maternal nurture, protection, bonding, placental benefits, not to mention the peri-genetic influence. However, in the future, society might see it as a safer option to whatever catastrophe is unravelling on earth. It would mean less exposure to incidental risk and disease than carrying the baby yourself. Perhaps pregnant people would be seen as primitive, (probably hanging out with meat-eaters). </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The ethical debates will reach into many fields, for example, how far will neuroscience go? Trauma is based on memories, what if in the future we could physically cut out the bad memories and implant good memories? We could cure PTSD, but should we?</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><br /></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I probably cannot fathom the ethical questions that future generations will tackle. But no doubt technology, environment, society and a group conscience will shift the conversations of right versus wrong. They say you should try and stay on the right side of history, but history is in the eye of the beholder. </span></p><div><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;">Read the original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/ethical-shift-what-will-be-the-ethical-debates-of-the-future-18-01-2023/">Ethical shift: what will be the ethical debates of the future</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2022/12/the-irish-times-im-syringe-half-full.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/02/the-irish-medical-times-drones-in.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-31339948002894077932022-12-16T13:41:00.004-08:002023-01-18T10:17:01.108-08:00The Irish Times - I'm a syringe half-full kinda girl<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNTJkzzvCf5bVJAqtCc4RjHS9cCJOKWTHDf5RHVYM3ZhvhbMYgJc0Mvk5_yyoG81mudCZEM-NaCOLNrtftgA1d18DT4XQXacTPrypMYESabjwy9h7yNv7tD-CpPSjEjq738xvLpmw8gg4FtXw2eSMD18g29crtGxyfeBbbLXWOwsI8fqoY_dmbU8dS/s1452/Screenshot%202022-12-13%2006.43.54.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="945" data-original-width="1452" height="416" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNTJkzzvCf5bVJAqtCc4RjHS9cCJOKWTHDf5RHVYM3ZhvhbMYgJc0Mvk5_yyoG81mudCZEM-NaCOLNrtftgA1d18DT4XQXacTPrypMYESabjwy9h7yNv7tD-CpPSjEjq738xvLpmw8gg4FtXw2eSMD18g29crtGxyfeBbbLXWOwsI8fqoY_dmbU8dS/w640-h416/Screenshot%202022-12-13%2006.43.54.jpg" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-e8949e64-7fff-5166-0f94-6c97d92aaf5d"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I want to talk about cancer, not about how harrowing and lonely a diagnosis can be, not a list of self checks that everyone should do but couldnât be bothered to. Iâm not even going to twist peoples arms to fundraise for helplines and hug centres (thereâs no such thing as a hug centre, I couldnât think of anything worse - I donât even like shaking peopleâs hands!). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I want to talk about the people who become perennial patients due to the late-effects of chemo and radiation, and how there is a distinct lack of infrastructure and clinics in place in Ireland to care for these survivors. I speak as one of those patients. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I am 45 years old, 22 years ago I was treated for Hodgkin's lymphoma with chemotherapy, radiotherapy, radiation boost, remission, recurrence, chemo again, overdose, high dosage chemo and a stem cell transplant. As a consequence of these treatments I have numerous problems, most notably I developed a second type of tumour, mouth cancer, from the radiation. I also went into heart failure from chemo toxicity enlarging my left ventricle. I now take a plethora of medications everyday to stay alive. Not to mention some embedded hardware to defibrillate my jippy heart. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">But hey, Iâm a âsyringe half-fullâ kinda girl. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Thanks to mantle radiation I am definitely due breast cancer and a decent chance of lung cancer, so thereâs that to look forward to. I have other persistent issues which include coughing up blood and eye strokes, they make Halloween a hoot! I have chronic pain from radiation fibrosis in my chest which is matched only by the chronic sternum pain Iâve had since my open heart surgery in my osteonecrotic breast bone. The only problem I had which hasnât yet been linked to my treatment was a random pre-cancerous tumour that appeared in my pancreas, it was removed along with my spleen. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">And to top it all off, Iâve developed an intolerance for avocado which is really burning a guacamole hole in my Taco Tuesdays. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Despite sounding like a 3D version of a Picasso painting, I am a healthy person, Iâve run half marathons and cycled 100 miles, I don't drink or smoke, Iâm a vegetarian - for-the-love-of-God!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The only explanation for the shambles that is my health is the life saving treatment I received aged 23. I am exceedingly grateful for the treatment and the kindness that was shown to me. If I didnât receive the treatment I would have died, that is beyond a shadow of a doubt. The approach was considered as progressive and safe as it could possibly be and still save my life. Life long damage was not a certainty but I was made aware going into things that my heart might take a knock and my chance of breast cancer would increase. I am not blaming anyone (not even those that made significant mistakes) as I know they were doing everything they could to help me. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">But if somebody pulls you from the water, saves you from drowning and breaks your ribs and punctures your lung in the process, wouldnât common decency dictate that they hang around to make sure you are ok? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">With cancer, the life saving gets underway with haste (for the lucky ones), the metaphorical broken ribs and punctured lungs come 20 years later. In my case the problems started 7 years later. I attend 10 consultants (at last count) across 6 hospitals and 2 countries. The hospital that saved my life when I was 23 removed me from their books a few years ago. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">They told me I wasnât a cancer patient anymore, I was a cancer survivor. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Being told you are not a patient, you are a survivor might be empowering to some ears, but not if you are still a patient. Yes, I survived, yes, I am in remission, yes, the therapy kept me alive, and now I have 10,000 problems, but apparently I am no longer </span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; font-weight: 700; vertical-align: baseline; white-space: pre-wrap;">your</span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> problem. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I donât necessarily expect to keep attending a clinic that treats active cancer patients, but I donât think a haematologist/oncologist gets to flick me off their books into the wilds of private hospitaltry via a phonecall from a nurse. I havenât had experience with every cancer on earth (although sometimes it feels like Iâm heading that way) and perhaps late-effects are not common place, therefore catering for such situations may be beyond the thought process of some doctors. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Also, it would be impractical and costly to expect every cancer patient to have their hand held until they are well into their dotage - playing checkers in an old folks home with one legged Peggy and her sister Maura (who keeps eating the checkers). But for patients who were treated for Hodgkins in the 1970s, 80s, 90s, early 00s, before targeted radiation and sophisticated chemo, late-effects commence on average 20 years after treatment and can be brutal and fatal. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">This is recognized in the UK and US where Late-effects and Survivorship Clinics exist. They monitor ongoing problems that cancer survivors face, they coordinate care amongst the patientâs specialists, they proactively think ahead to further problems this patient might face based on issues that have arisen for other patients, they provide screens, checks and maintenance care. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Itâs a hot topic right now because wide-field radiation therapy stopped in the late noughties so cancer patients treated with wide-fields prior to then (and are lucky enough to still be alive) are now hitting the 20+ year mark. We are seeing problems emerge such as second cancers, etc. For this specific patient cohort, hospitals should not be kicking them off their books after 20 years, they should be highlighting their names and calling them back in. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In a study from the Journal of the National Cancer Institute a 54 year old Hodgkinâs Lymphoma survivor has the same mortality as a 71 year old. Their future is compromised because of the late-effects therapy sequelae (a fancy medical word for consequences). The study went as far as to say these patients should not have a yearly physical and a âfriendly catch upâ, they require regular careful screenings for various risks. The National Academy of Medicine recommended that young adult cancer survivors be surveilled for life (apparently that memo didnât make it to my hospital). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">If you are a doctor reading this and you want to make your mark in medicine, set up a Late-effects Clinic in Ireland. You could transform and save lives. From what I understand there might be an odd doctor who will treat Late-effects of a specific subset of their own patients (meeting certain treatment criteria) but it's not an open door. It's more of a very small window, hermetically sealed. There may be one dedicated survivor nurse, a phone number if you need some reassurance or have a question. It's a start, but it's not close to enough for patients with therapy-induced, multivarious serious problems for the rest of their painful, fatigued and limited lives. It's not good enough!</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">If you are a Hodgkin's survivor, I won't hug you (there are centres for that) but I will direct you to an incredible patient resource where you can find Survivorship Care Plans providing a list of checks and specialists you will need - </span><a href="http://www.hodgkinsinternational.com" style="text-decoration-line: none;"><span style="color: #1155cc; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; text-decoration-line: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;">www.hodgkinsinternational.com</span></a><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">. If you live in Ireland, you will have to organise all of this yourself. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The pressure to manage someone like me canât fall to a GP, it is too niche, my visits to consultants are too frequent, a GP would not have the time to keep up. I became the keeper of my own history, my own health, my own progress. I study up, I read medical journals, articles, podcasts, webinars, I ask endless questions of doctors, I try to diagnose and make links between my problems. I ask questions beyond the remit of their discipline, or my presenting complaint, to see if it triggers something in them or if they can confirm or deny my own theories. But I shouldnât have to, I shouldnât have to wonder if I should have studied medicine just to stay alive. I wouldnât even get into med school, my thoughts are splintered - ever since chemo my brain is like a Pinterest board, full of unfinished ideas. </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Iâm not angry and looking to blame anyone or wallowing in self pity (some light paddling at best). Iâm not looking for anyone to throw me a parade because I survived (10 floats max, some face painting for the kids, Iâm not shaking hands, but Iâll sing âI will surviveâ). Iâm not hoping for indemnification, Iâve embraced radical acceptance (I even let my husband paint a David Bowie quote on our living room wall, trust me, Iâm zen). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Iâm just looking for a base. Some place, other than the calendar on my phone, that knows how many doctors I see, who they are, what they need to know about me, what they need to screen for, connect them to each other, answer questions they may have, tell them what works, what doesnât, and what to look out for next.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I donât expect a doctor to step up and carry my load for me, but someone could become the conductor that leads my orchestra of medics and optimises my care. I realistically donât see this happening for me (Iâve tried, hard) but maybe if my story resonates enough there will be some help in place for others who may emerge as part of this lost generation of patients. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Until then, I will keep this song and dance going, by myself. Not for me, but for everyone out there who survived, and most importantly - for everyone who didn't. </span></p><div><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;">Read the original article here - <a href="https://www.irishtimes.com/health/your-wellness/2022/12/13/im-a-syringe-half-full-kinda-girl/">I'm a syringe half-full kinda girl</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-big-doc-will-it.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2023/01/the-irish-medical-times-ethical-shift.html">NEXT POST>></a></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-88203762136681575922022-12-15T08:19:00.003-08:002022-12-20T08:27:14.528-08:00The Irish Medical Times - Can pets help you live longer?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_3isRrVELYD-dxwEbrzezn-QWWyOcBxXvrI0NZMLbEDZVzSbcXZQEB0tQu-a_P-egP4kOgVvmpj7fx5DMUH_oMsttsAOYnunxR4UI-6H4oRvA0DtlW20_9KFDy8wyXGCJR24GhCmlaRr2DuL8BaQjPtvnRBzR2KtkjnGwVXYdsaHEXEv8fmtuWWPz/s609/Screenshot%202022-12-20%2016.20.34.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="351" data-original-width="609" height="368" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_3isRrVELYD-dxwEbrzezn-QWWyOcBxXvrI0NZMLbEDZVzSbcXZQEB0tQu-a_P-egP4kOgVvmpj7fx5DMUH_oMsttsAOYnunxR4UI-6H4oRvA0DtlW20_9KFDy8wyXGCJR24GhCmlaRr2DuL8BaQjPtvnRBzR2KtkjnGwVXYdsaHEXEv8fmtuWWPz/w640-h368/Screenshot%202022-12-20%2016.20.34.png" width="640" /></a></div><br /><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcSo_E617fS_wV-VAB5cqsCZMqaon0CoQHnEP1sGCs01VZexLebALNckf7OeV50zqlVOI6iNdkfzsyA9d8l5C-CQZQsbOERzHhDTE9XQl-O9U2FuIDfAAh3ssIuYKGkaH9bvzFySWM8sDmU6YFJInFAWtTnm3edO6DNPzqJEIlRRsX0EWpwZjjhnMV/s889/Screenshot%202022-12-20%2016.21.55.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="889" data-original-width="658" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcSo_E617fS_wV-VAB5cqsCZMqaon0CoQHnEP1sGCs01VZexLebALNckf7OeV50zqlVOI6iNdkfzsyA9d8l5C-CQZQsbOERzHhDTE9XQl-O9U2FuIDfAAh3ssIuYKGkaH9bvzFySWM8sDmU6YFJInFAWtTnm3edO6DNPzqJEIlRRsX0EWpwZjjhnMV/w474-h640/Screenshot%202022-12-20%2016.21.55.png" width="474" /></a></div><div><br /></div>Read the rest of the article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/can-pets-help-you-live-longer-woof-course-07-12-2022/">Can pets help you live longer?</a><div><br /></div><div><a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-big-doc-will-it.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/12/the-irish-times-im-syringe-half-full.html">NEXT POST>></a><br /><p><br /></p></div>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-52437335908323133182022-11-24T08:35:00.003-08:002022-12-20T08:26:17.500-08:00The Irish Medical Times - Big Doc: will it be the next to fall?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWZbwHX7orOR385CF-dm0sVMDmQ1ShDGjlWnyTBAbC3PQqIiJYN7TlfQ64YJLAf2VS_zH4gFmopRFh_msP1XGYjFVgtPxCMfBHOZrnsFOPCGrUKjbKxDqDs_qNTnL7jPgMN8WzZ1xE_ooI4c-R9HlzNnZTRpdMwIRwf6mV5pHQtxw4daj_28OD6MBV/s1671/DSC_2355.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1331" data-original-width="1671" height="510" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWZbwHX7orOR385CF-dm0sVMDmQ1ShDGjlWnyTBAbC3PQqIiJYN7TlfQ64YJLAf2VS_zH4gFmopRFh_msP1XGYjFVgtPxCMfBHOZrnsFOPCGrUKjbKxDqDs_qNTnL7jPgMN8WzZ1xE_ooI4c-R9HlzNnZTRpdMwIRwf6mV5pHQtxw4daj_28OD6MBV/w640-h510/DSC_2355.JPG" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUQoNmy1_c0umPTcE09Q79XT4Tk1Ba4CfeLs-EPF6QzGt3m1QuF75Qt6n8zE4LCUxg6Jsxme6kh7zPxperNDE8k1WkCqwQ2ao8ejFF6C5g4qkKhozxFFDt9DecaVYIXAVrwkWYvYDvdTZIue4QbWHFNzdojQUm8faLOEbO0n6ss_ciLlNdp0nw4pbP/s850/Screenshot%202022-11-24%2016.27.13.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="850" data-original-width="654" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhUQoNmy1_c0umPTcE09Q79XT4Tk1Ba4CfeLs-EPF6QzGt3m1QuF75Qt6n8zE4LCUxg6Jsxme6kh7zPxperNDE8k1WkCqwQ2ao8ejFF6C5g4qkKhozxFFDt9DecaVYIXAVrwkWYvYDvdTZIue4QbWHFNzdojQUm8faLOEbO0n6ss_ciLlNdp0nw4pbP/w492-h640/Screenshot%202022-11-24%2016.27.13.png" width="492" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-abac90c5-7fff-4c71-670d-f29172a25066"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">But where do I stand on Dr Twitter? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I stand well away. My turnabout happened abruptly during one of the incarcerations in our homes, when I found myself spouting viral facts I couldnât substantiate, gleaned from one of the âHoly-Mother-of-Godâ twitter threads. I think the facts were from an epidemiologist, or was it an endodontist, weâll never know. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Did the explosion of medical personnel on social media increase our confidence in doctors or are we all over exposed and weary of yet another expert?</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I think the self appointed medical experts on social media fed the populous who were hungry for information. Some sparked debate, helped push through new protocols and highlighted the need for action. Stating facts, figures and likelihoods placated our fear of the unknown and managed our expectations, even through the horrors. Following some of these âexpertsâ gave me a sense that we were documenting where we couldnât control, and that had to count for something. Perhaps it also gave the authors a feeling of release and community. They may have strongly wanted to convey transparency, to cry for help, and importantly to call for action. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">However, were too many expert voices? Too many people vacating the contents of their heads into the collective consciousness? The downside of elucidating is the fear and arguments it can potentially cause. The misinformation, misinterpretation, repetition, sanctimony, the self-obsession on all sides. It can create a battlefield rife with ad hominem attacks; a bouncy castle of naive realism where you think everyone else is biased and only you see reality as it really is, others are idiots, liars or morally derelict (at least, thatâs how I personally like to start every social encounter). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">As one of my primary school teachers was prone to saying, just because you have a thought doesn't mean you have to share it. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">On the other hand, the sheer intensity and volume of medical opinions on social media allowed themes to emerge that had long been ignored such as drastic underfunding and dire working conditions. In order to manifest a modern movement, social media is clearly the bugle call. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The covid crisis was an unprecedented moment in modern history, we are entering a new phase now. As we know, Twitter is under new management and going through a change; Meta, Stripe and Amazon are also tightening their belts. I move in tech circles (donât we all) and word on the virtual street is that everyone is checking their email daily with one eye scrunched and a tight grip on their blue-ticks. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Cuts aside, whatâs the prognosis for Big Doc? Evidently, social media is not going away. Humans are hardwired to want to 'get on' with people and also 'get ahead' of them, we are obsessed with our perceived status. This is also reflected in the animal world, for example, ravens hang about and listen to other raven groups gossip, especially if that group has a raven who has had a reversal in status (a little birdie told me that). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">However, I am personally afraid of social media in its current form. I am genuinely concerned about my daughter delving into this superficial curated world where people can 'like' or 'cancelâ hundreds of people before breakfast. I've heard c-suite executives say regulation is strangulation. Let's all take a deep breath, start regulating, and see where that goes. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I predict (with my crystal ball) that Big Doc may become the parent we donât want to listen to. Our online existence will become more functional and less of a soapbox free-for-all. I think people will still use social media for information (medical and otherwise), entertainment, pontifications, celebrations, criticism, bragging and gossip (medical and otherwise) but I feel at this point we all looked behind the curtain and saw the wizard. Like covid, it will become part of life but hopefully not consume our lives. We may actually have to resort to looking each other in the face and scramble around to start the scaffolding of a conversation. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I imagine the extensive medical presence on social media will naturally remodel into a new form. This may start with an increase in âedutainingâ - short playful yet educational video reels on health. The shift will continue towards âmobile firstâ - health pages, devices, apps, websites are engineering content to prioritise mobile devices first and foremost, more visuals and less words. Of course, as Iâve said many times, first party data is the new oil, the depth of data will make the social media experience powerful and personalized, probably through your projector band or smart contact lens! This could allow for Augmented Reality (AR) in the online health space, AR could overlay a computer generated 3D image of a personâs body parts to demonstrate the working of their organs or the surgery they may require. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Social media will not be limited to a handful of apps on our smartphones, it will likely become part of the fabric of human existence, it will be in our clothes, appliances, architecture, transport, worklife, activities, hobbies, and our bodies. Like a fish who doesnât recognize that it swims in water, we'll probably be knee deep in our new online world before we realize weâre even there. [Glub-Glub]</span></p><div><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><div class="separator" style="clear: both; text-align: center;">Read the original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/big-doc-will-it-be-the-next-to-fall-18-11-2022/">Big Doc: will it be the next to fall?</a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-are-you-ready.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/12/the-irish-medical-times-can-pets-help.html">NEXT POST>></a><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-82319794295155818182022-11-19T02:03:00.002-08:002022-11-24T08:40:39.571-08:00The Irish Medical Times - Are you ready to share your genes?<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiy-Vqh1GfCPAKdmh3Y7mdFTtOpXj21P5RheXk1HNvu7Oho7dLSli8cQKGuCi-U-KSwO22HPUZAKjL5T7rs55hyHe_DQJHygNRAVqnZ4QRYQORneEt3cGwhdtShKmxroAHxsTvX59N8KTSCsBdNpKd3e4xAqY0IRZcKUmI2BqIwLSfpiJsV-5xjae_G/s613/Screenshot%202022-11-19%2009.58.46.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="339" data-original-width="613" height="354" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiy-Vqh1GfCPAKdmh3Y7mdFTtOpXj21P5RheXk1HNvu7Oho7dLSli8cQKGuCi-U-KSwO22HPUZAKjL5T7rs55hyHe_DQJHygNRAVqnZ4QRYQORneEt3cGwhdtShKmxroAHxsTvX59N8KTSCsBdNpKd3e4xAqY0IRZcKUmI2BqIwLSfpiJsV-5xjae_G/w640-h354/Screenshot%202022-11-19%2009.58.46.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja6KDO31FjsEdGU4P3lEh0Wv0lF3DEqhFXlEduPmZcUdjgxDleYDmAPJv5SsNum753YkuktXPsyxth8dJibp2d8wO6mZ4-AUfUMMs5MU2Fh67vnjBG7pBYk_ZI9EgBx56ZJUfqcaVIqDUVIHe0dA5_8yqzYG_a5iOxPVHehV95Qlru0GJvxwml2fGq/s892/Screenshot%202022-11-19%2010.00.31.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="892" data-original-width="655" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEja6KDO31FjsEdGU4P3lEh0Wv0lF3DEqhFXlEduPmZcUdjgxDleYDmAPJv5SsNum753YkuktXPsyxth8dJibp2d8wO6mZ4-AUfUMMs5MU2Fh67vnjBG7pBYk_ZI9EgBx56ZJUfqcaVIqDUVIHe0dA5_8yqzYG_a5iOxPVHehV95Qlru0GJvxwml2fGq/w470-h640/Screenshot%202022-11-19%2010.00.31.png" width="470" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-aac840b9-7fff-7a7e-77a8-d6fd08f38d35"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Nowadays researchers can search/sequence the genome (blueprint) looking for genetic mutations that can play a role in disease progression. If you have a database of genomes you can look for common variations that are frequently seen in say cancer cells. You donât have to wait for all the symptoms and until you are riddled with cancer to find out itâs coming your way. Genome based research can improve diagnostics, enhance therapies efficacy, and allow case specific decisions. Genetic data can also predict other major diseases such as Alzheimers and certain heart diseases.</span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; padding: 10pt 0pt 10pt 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">As a survivor of multiple cancers I have undergone nearly every genetic test available, much to the horror of my US medical insurance company. My genome appears to be spickety span without the hint of a defect. Given my cancerous history, I was told I may have a defect thatâs slipping through the net, one that I customised myself, something cute, homemade, and carcinogenic that I may pass down to my descendants. That said, and for my daughter who may read this, there is no evidence I have passed down any âcancer genesâ, everybody has a hobby, some people collect plates, I collect tumours. I may have a âbad luck geneâ but my husband says not to worry it will get overwhelmed by his genes for âawesomenessâ - so thereâs that to worry about. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt; padding: 0pt 0pt 10pt 0pt;"><span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The reason I did all the testing wasnât to find the mutation that I could hang all of my sorrows around (and put a centrepiece to the pity party I definitely would have thrown). I did the testing because knowledge is king. You canât fix a problem, until you know what the problem is. </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Aside from âwhatâ we are, much of âwhoâ we are is based on our genome, but saying "my genes made me do it" doesn't usually land well. Personalities are formed extremely early on, some scientists believe they are created in utero with some early childhood experiences thrown on top. They pretty much stick for life (major psychological traumas aside). What you see in the sandpit as toddlers is usually not far off what will play out in the boardroom later in life. There's the loud, the sheepish, the smilers, the aggressors, the silent, the confused, the mad, the peacemaker, the depressed, the delirious, the leader, the followers, the content, the unsure, the popular, the ignored, the manipulator, and the weirdo, to name a few (for the record, we are all weirdos, if you think you're not the weirdoâŠyou are the reigning President of Weirdopolis with a doctorate in peculiarity).</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Itâs great that we know so much about ourselves, some of us to a terrifying degree. But just because we live in an On Demand culture doesnât make everything automatically on demand. Even if you found your quirky gene, that doesnât mean the medication or therapy to manage that gene is ready, it could be 15 years away. Covid may have truncated clinical trials somewhat but they are still part of the process, and as we know, pharmaceuticals are a costly business. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In the UK they are considering whole genomic sequencing at birth to detect an array of diseases. The dataset would be so large it opens up the possibility of developing new therapies faster. Babies are pin pricked at birth already to detect a standard 9 diseases so the data needed to sequence the genome is already being collected. But itâs not a catch-all test, there are mutations we have yet to discover (as mentioned earlier, my body could be carving up my own DNA variation as we speak - no wonder Iâm tired all the time!). Obviously there is the cost, as of 2021 it would cost ÂŁ700m each year to sequence every baby born in the UK. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Privacy is big right now (shh, I canât tell you why, itâs classified information). Just the act of gathering and storing data can give people the heebie jeebies. Many people donât even like to reveal their full name on social occasions, for fear another dinner guest will perhaps steal their moniker and impersonate them in the post office picking up the socks they bought online. I canât get my daughter to tell me what the code is on her bike lock, itâs âa secretâ apparently. I saw an elderly woman in a doctorâs waiting room write on an official medical form that she was 21, to be then handed another sheet to fill in to confirm she wasnât pregnant - she was about 103! Yet, as a world we upload in the region of 5 billion photographs and videos to the internet everyday (thatâs an actual statistic). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">But the fear is real that employers, insurance firms, banks, companies and criminals will get hold of the very blueprint of who you are, profile you, and discriminate accordingly. First party data is the new oil and thereâs nothing more personal than the content of your cells. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">There is also the world of CRISPR (gene editing) that brings its own pros and cons. On one hand it could potentially save the world by creating genetically modified crops that withstand blight and inhospitable weather. On the other hand you could cut-and-shut your embryos to genetically engineer the âperfectâ child, add the new trend of invasive suppository-parenting where you inhabit the child's life - thatâs a pressured existence for the poor kid. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">But nobody wants to step away from genomic research, we canât turn back the clock. It can be done, so letâs be honest it WILL be done. Arguing against it is almost like saying we shouldnât use industrial looms for weaving because they will put people out of work, that thread has spun. If we at least try to regulate it, it may prevent some government sized tech firm (g-gov?) going all in - circa the year 2035 âWhat operating system do you run your body off? Iâm a gânome 6 myselfâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">However, in order to progress we have to take risks, and these risks can be mitigated. Circling back to the wise thoughts of the IPPOSI citizen jury, letâs do it, letâs build a database, but approach it ethically, lawfully and mindfully. There are techniques to try and safeguard data through de-identification, informed consent, cryptography, protection laws, access control, self regulation, and data perturbation (deliberately adding noise to a database to deter hackers). We can do this.</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Genome research raises hefty ethical questions, but as a chronically seriously ill person I hope to God I havenât passed a timebomb down to my daughter. If anyone builds the database Iâd happily throw my genes their way, and if they find the âawesomeâ gene, casually doing something amazing amidst the strands of my DNA, please let me know so I can inform my husband. </span></p><div><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><br /><div class="separator" style="clear: both; text-align: center;">For the original article read here - <a href="https://www.imt.ie/opinion/sheilagh-foley/the-gene-genie-is-about-to-come-out-of-the-bottle-09-11-2022/">Are you ready to share your genes?</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-united-against.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-big-doc-will-it.html">NEXT POST>></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><br /><p></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-47934378680930928592022-11-17T02:55:00.002-08:002022-11-19T02:12:07.831-08:00The Irish Medical Times - United against the odds<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwGSjrOta3ggA7Un0Jz7dtFS70hOudQprNUzXjFZKH-YpGmig2oJ8horkHjA25fVF1g6QK5PcWfSNIHji7RaBFs298s7ti-d8K1eAg2dJ_iQcYRMjfC-AhLXigqERjRL24LRft1p3z2xAQ99_1MVyJNT2fYkU5jeVCADmBGkyRigjA7vD0zB__1q9I/s646/Screenshot%202022-11-17%2010.50.04.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="377" data-original-width="646" height="374" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwGSjrOta3ggA7Un0Jz7dtFS70hOudQprNUzXjFZKH-YpGmig2oJ8horkHjA25fVF1g6QK5PcWfSNIHji7RaBFs298s7ti-d8K1eAg2dJ_iQcYRMjfC-AhLXigqERjRL24LRft1p3z2xAQ99_1MVyJNT2fYkU5jeVCADmBGkyRigjA7vD0zB__1q9I/w640-h374/Screenshot%202022-11-17%2010.50.04.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZRcb2bufv_taFyJb7lOZNfLXlNo5win4y9zKpxXDR_4k-WdwJzE1Pf5lhkLTZ3LzsyXcg-oBBUG5x46VsuWNy8ozpy5PdcB4xSeIBMQeIBWgqTVXsrMQWPgWlROza8xzamduqMoGMGeDuPvu0Eds0N__Qb3HPOIQX0pE1ul6yP-yUJwg4dbjoxoJV/s699/Screenshot%202022-11-17%2010.52.14.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="699" data-original-width="665" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZRcb2bufv_taFyJb7lOZNfLXlNo5win4y9zKpxXDR_4k-WdwJzE1Pf5lhkLTZ3LzsyXcg-oBBUG5x46VsuWNy8ozpy5PdcB4xSeIBMQeIBWgqTVXsrMQWPgWlROza8xzamduqMoGMGeDuPvu0Eds0N__Qb3HPOIQX0pE1ul6yP-yUJwg4dbjoxoJV/w608-h640/Screenshot%202022-11-17%2010.52.14.png" width="608" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-51cb6007-7fff-6ccd-0f93-1d49a1b23f57"><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Manners and âdoing the right thingâ play a large role in British society. People queued quietly for days to pay their respects to the Queen. Could such a thing happen anywhere else? Iâm not so sure, unless random violence, heavy drinking, loud singing and general pranking was allowed. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Could you imagine if the Irish equivalent of the Queen died? Although, forgive me, but Iâm at a loss as to who that would actually be, I want to say Gay Byrne?! But he has sadly passed (and anyone under 25 may not realize that is the name of a beloved national treasure). If we canât find a national figure whoâs imminent death we can all rally around, can we at least decide on one thing we all agree on. Apart from the fact that Club Milks taste different now than they did when we were kids - maybe thatâs just a me thing. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I suppose the vast majority of us on this island do enjoy a cup of tea. Thatâs not just an Irish thing though, as 100 million cups of tea a day are drunk by the British/Britons. Well, at least weâre not flailing around a political quagmire keeping our fingers crossed that a clown doesnât get into office. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Hm, maybe weâre more similar than we think. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I believe it was the writer Brendan Behan who once said âOther people have a nationality. The Irish have a psychosisâ. If we persist as victims of geography and canât unite across commonalities, perhaps we could unite against threats that donât care where we are from, what we believe, or who rules us. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The insightful academic futurist Nouriel Roubini has coined the term âmegathreatsâ to highlight impending problems that could change the face of the earth, and wipe that colour off your flag. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">According to Roubini, we are facing into the highest private and public debt ratios of all time, inflation is rising as a recession sets in, plus the ageing population threatens to crash our healthcare and pension systems. To put it concisely - we're screwed! Cheap money is dead in the septic water. Crypto and property bubbles are at bursting point. AI will likely lead to permanent unemployment in ever expanding fields. This landscape sets the scene for a rise in dangerous populist regimes. Aside from cyber wars we have an actual war in the Ukraine, and cold wars escalating between China-Taiwan and Iran-Israel, to name a few. The biggest megathreat is of course climate change (as discussed recently at COP27). </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">On one hand we might be heading irreversibly towards the dystopian future we thought only possible in movies, where a loaf of bread costs $1,000 and people live underground. Or perhaps people will stop talking and observing, and start working and progressing to switch courses. Roubini thinks a dystopian future is likely (cheery chap) - a moderate worry for us, a living nightmare for our grandchildren.</span></p><br /></span></div><br /><div class="separator" style="clear: both; text-align: center;">Read the original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/united-against-the-odds-11-11-2022/">United Against the Odds</a></div><br /><p></p><p><a href="https://www.lettersfrombeyondthepale.com/2022/10/the-irish-medical-times-what-patient-is.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-are-you-ready.html">NEXT POST>></a> </p><p><br /></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-58266559509487683152022-10-14T08:16:00.005-07:002022-11-17T02:56:50.116-08:00The Irish Medical Times - What a patient is thinking but won't say<p> </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-A2Cs5f6mC6CXJHrAxYqq8MbvVkPTk9ZM5dBimh2Ql3vehxrXUF5xCgMjc16NZAlRmVcajLhZCqNHl-Ie8MV8QGWa46Rt_iuXyqhsmASS32ZfH9Qnqz4Y3UbwMYAo21XnouEIuc1LFhSzebIQpmLT7AjpILKxc8ZwBoVRVf7PinkDyi_WgE-dDmBC/s4032/PXL_20210817_094755960.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-A2Cs5f6mC6CXJHrAxYqq8MbvVkPTk9ZM5dBimh2Ql3vehxrXUF5xCgMjc16NZAlRmVcajLhZCqNHl-Ie8MV8QGWa46Rt_iuXyqhsmASS32ZfH9Qnqz4Y3UbwMYAo21XnouEIuc1LFhSzebIQpmLT7AjpILKxc8ZwBoVRVf7PinkDyi_WgE-dDmBC/w480-h640/PXL_20210817_094755960.jpg" width="480" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Let's go-bag!<br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx8LLO-j7yrDr4qJd_mjqcMmr9b8vWSWOgGUFC1maYcr2mUFT9JhWJyBhSeiNhffxltqD1kL25As2aClSbkFP-PkdZY8bm-0KDpVO8o6Uui-wZFWnXSkYFj0hB8Io1D8UtWdzprfMfYsMoDj5DzlFRpK6zJCSig0ncaSoMDQEnHVzMzrY0f5666Iek/s750/Screenshot%202022-10-14%2015.49.52.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="750" data-original-width="655" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx8LLO-j7yrDr4qJd_mjqcMmr9b8vWSWOgGUFC1maYcr2mUFT9JhWJyBhSeiNhffxltqD1kL25As2aClSbkFP-PkdZY8bm-0KDpVO8o6Uui-wZFWnXSkYFj0hB8Io1D8UtWdzprfMfYsMoDj5DzlFRpK6zJCSig0ncaSoMDQEnHVzMzrY0f5666Iek/w558-h640/Screenshot%202022-10-14%2015.49.52.png" width="558" /></a></div><div class="separator" style="clear: both; text-align: left;"><span id="docs-internal-guid-3576fbca-7fff-cc40-c4e9-d6a60c27abbe"><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In reality, if you are badly injured your clothes may be cut from your body, nobody will be taking fashion or hygiene notes, although perhaps this act birthed that old Irish phrase âWould you look at the cut of your man?â, usually followed by âWho does he think he is?â. Once the man is within ear shot the speaker rounds it out with âWell, if it isnât yourself! Arenât you looking great altogether!â. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"> </p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">If you are injured/ill and mobile, you will likely be given privacy to change into a gorgeous hospital gĂșna, and if youâre really lucky and need some surgery youâll get your very own hospital issued disposable undies. Iâve worn various kinds, they are usually some form of latticed fishnet fiascos. Personally, I kind of like them. </span></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"> </p><ol style="margin-bottom: 0px; margin-top: 0px; padding-inline-start: 48px;"><li aria-level="1" dir="ltr" style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; list-style-type: decimal; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="background-color: transparent; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">What do I pack?</span></p></li></ol><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-left: 36pt; margin-top: 0pt;"> </p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">A friend recently told me she has a âgo bagâ ready in case anything happened and she ended up in hospital in a hurry. As a seasoned patient who has attended A&E many, many times, I have no âgo bagâ, I rely on my husband to bring me in, what can only be described as, detritus. Once he brought me in a woolly jumper, shorts, and a single hiking sock. After I gave him some âfeedbackâ, he brought in a suitcase so substantial the colourful porter commented âJaysus, you have me burninâ with jealousy, you look like youâre goinâ on your holibops to Ibiza!â. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">When I worked in a high-rise office building in downtown San Francisco one of the essential items every employee had under their desk was their emergency earthquake âgo bagâ. One day a Packing Party was announced, a euphemism for a table of bagels and cookies surrounded by baskets of survival paraphernalia. The idea was to lure workers to chew on bagels whilst making sure their bags were stocked up with the essentials, for me that was a mixture of asiago, plain and multigrain, definitely no onion bagels. Of course the bagels were the bait, Iâm sure the real essentials were the packets of dehydrated food, hand crank radios, flashlights, etc. It was a splendid idea, an appropriate reminder that The Big One was only a couple of richters away. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Perhaps the most shocking reveal at that Packing Party was the behavioural residue that seeped from our bags. Many years ago one lady had carefully packed into her bag a change of clothes which she assured us was the most important thing when emerging from rubble. I assumed she would pull out a pair of sneakers and a tracksuit, oh no, a pair of white stilettos and a denim mini skirt emerged. Another chap had been using his bag frequently as a gym bag until he abruptly stopped working out more than a year ago, his stagnant socks were their own emergency. Perhaps I was worst of all with a bag as light and empty as the cloud I assumed I would casually float away on if disaster struck. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Everybody should have a go bag ready to go. Top tip, pack it yourself, trust no one. </span></p><br /><ol start="2" style="margin-bottom: 0px; margin-top: 0px; padding-inline-start: 48px;"><li aria-level="1" dir="ltr" style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; list-style-type: decimal; vertical-align: baseline; white-space: pre;"><p dir="ltr" role="presentation" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">How do you tie a hospital gown?</span></p></li></ol><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I know how to tie a hospital gown, I just think they are badly designed. In my experience they have the same God awful get-up in hospitals everywhere. I actually prefer when they give you the paper ones with the little belt, you can at least pretend the whole thing isnât going to slip off your body as you walk from the bed to the bathroom (Iâve seen it happen, itâs not pleasant to witness). I know it's all about fast frequent access and quick release but have you seen the knots some people tie in them, you need to get a boy scout and a locksmith to get them out. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I never understood why you have to tie them at the back, I can tell you from personal visual assault that 80% of people are not doing that - at all. Why canât we tie them at the front with velcro or make it into a wrap dress. I suppose for emergencies that require the gown to be ripped from the body unhindered it would be awkward to then try and coax a patient's arms through the sleeves. The dance weâve all done putting a coat on our granny, trying to shimmy their osteoporotic bones around without dislocating their shoulders. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Doctors seem fine with the gowns, but they donât have to wear the contraptions, shouldnât patients have a say? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I also want to testify, due to the drafty conditions those gowns permit, I have been known to double-gown-it, tie one at the back, tie one in the front, nobodyâs getting me out of this burrito. I remember waking up in the hospital once with a paper gown as my base layer, then two to three cloth gowns on top. I thought I went to sleep in my pajamas! Did I go on a gown rampage? Like a demented Rose of Tralee contestant, ripping off peopleâs attire as they slept, âI must have ALL the gowns!â. Grabbing a porter as we swayed and sang âShe was lovely and fairâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I havenât even touched on other troubling questions that strike a patient such as: Is there wifi? Whatâs the story with a shower? Who do I have to bribe to get discharged early? Are you open to a few suggestions on how to improve the place? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">And the thought that crosses patients minds every few minutes - any update on what's happening to me? </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">As patients we know doctors and nurses are frantically busy, but similar to our medical minders - we are not mind readers. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">In between the cracks and crevices of confusion and miscommunication is the humour. I remember overhearing two conversations whilst in my bed in St Jamesâs Hospital between the man across from me, who described himself as âthe country fellaâ and the older lady beside him, who self deprecatingly introduced herself as âthe auld wan on the wardâ. </span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">The country fella was on the phone to his mate. At the same time the auld wan was on the phone to her sister. The cross conversation went as follows:</span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> *Country fella* : Well g'wan, were you playing cards last night? </span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> *Auld wan* : Sure I haven't got out of bed</span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> *Country fella* : Did you make much money? </span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> *Auld wan* : Absolutely! Don't ya know! </span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> *Country fella* : Ah, you can relax now, so. Put the feet up. Cheerio</span></p><br /><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">*Auld wan*: Okie, Dâokie</span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">I had to leave the ward, I was suppressing so much laughter I nearly went into cardiac arrest, no lie.</span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"> </span></p><p dir="ltr" style="line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;">Sometimes we don't need to articulate every thought or read peopleâs minds, the unspoken word just says it all. </span></p><div><span style="font-family: Arial; font-size: 11pt; font-variant-east-asian: normal; font-variant-numeric: normal; vertical-align: baseline; white-space: pre-wrap;"><br /></span></div></span></div><br />For the original article read here - <a href="https://www.imt.ie/opinion/sheilagh-foley/have-a-go-bag-ready-for-your-hospital-stay-cation-13-10-2022/">What a patient is thinking but won't say</a></td></tr></tbody></table><p></p><p dir="ltr" style="background-color: white; line-height: 1.38; margin-bottom: 0pt; margin-top: 0pt;"></p><div style="text-align: center;"><br /></div><div style="text-align: left;"><a href="https://www.lettersfrombeyondthepale.com/2022/09/the-irish-medical-times-how-woke-is.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/11/the-irish-medical-times-united-against.html">NEXT POST>></a></div><p><br /></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0tag:blogger.com,1999:blog-5757927727570342321.post-45388670293499076672022-09-09T03:27:00.006-07:002022-10-14T08:28:25.594-07:00The Irish Medical Times - How woke is Artificial Intelligence<p> </p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTpXXLHSD-M3_xMun7Ni-oAEphrFKFETajWKJ9rWZKoqJxKfWyVNfui0mI0LOHUpexbTZJaNMiPV06ltYDhuby_9kVn9NRaC33qfFDK296vtxXl94ku9qcqZCwvbQYKJ5Q4vN9bVzpN7q40jMVSlt1KFFcA2vBXHf6BID1jOK4m3VOXBqf_h6stJ3S/s4048/IMG_20170218_145936.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4048" data-original-width="1639" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgTpXXLHSD-M3_xMun7Ni-oAEphrFKFETajWKJ9rWZKoqJxKfWyVNfui0mI0LOHUpexbTZJaNMiPV06ltYDhuby_9kVn9NRaC33qfFDK296vtxXl94ku9qcqZCwvbQYKJ5Q4vN9bVzpN7q40jMVSlt1KFFcA2vBXHf6BID1jOK4m3VOXBqf_h6stJ3S/w260-h640/IMG_20170218_145936.jpg" width="260" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Let's do this!</td></tr></tbody></table><br /><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4xTydwRyLPYJebxucgErnxB9OojCehLH6KeCpN8a-aFMZRKGVgDyMa032YyrG955qqmJIZmqTs4D9D7XRKFZaiiGQqz5nVs08eDLoVY5q5npJbHmuv9RMYBZdPzwwZofCQuW6l8Yxh2CCFwCTcsIuR0iLGm3FFQsMvM6U5xpZCNvoSDi0oHts08Z6/s803/Screenshot%202022-09-09%2011.08.07.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="803" data-original-width="656" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4xTydwRyLPYJebxucgErnxB9OojCehLH6KeCpN8a-aFMZRKGVgDyMa032YyrG955qqmJIZmqTs4D9D7XRKFZaiiGQqz5nVs08eDLoVY5q5npJbHmuv9RMYBZdPzwwZofCQuW6l8Yxh2CCFwCTcsIuR0iLGm3FFQsMvM6U5xpZCNvoSDi0oHts08Z6/w522-h640/Screenshot%202022-09-09%2011.08.07.png" width="522" /></a></div><br />Now imagine a digital database of contacts was created by my neighbour of their friends and family, and those contacts were then migrated to my phone as the basis for my social and business circle. The information would be largely useless, yes I could invite their mother out to a motherâs day brunch and I could use their dentist if my tooth hurt (Iâm not suggesting their motherâs company would induce a pain in my face) but the experiences would not be quite the right fit for me. I need my own database of my own contacts or at least the contacts of someone who has had similar life experiences. <br /><br />There are deficits in the universal application of data results and the bifurcation points in medicine include gender/sex and race. Perhaps this may be a modern taboo, but scientists define male and female as different at a cellular level (thatâs not to say people shouldnât flip the script). It has been proven that women can metablolize drugs differently to men, women expereince different endocrine changes through puberty, pregnancy and menopause. Women also live longer than men and therefore experience more late-effects, Alzeimers, etc, some treatments including certain cancer protocols work better for women than men and vice versa, the differences go on. <br /><br />Some evangelists of this data gap point to big problems in health today due to the historical white male bias in medical trials; Heart disease and stroke are the leading cause of death and disability worldwide, however, in part due to messaging based on the male experience, it can be harder for a woman to recognise heart issues, and have them diagnosed and treated. Therefore, after a heart event or stroke women face a higher mortality and tend to endure longer hospitalisation. Cardiovascular disease can affect men and women differently in terms of symptoms, risk factors and outcomes. Yet, women have historically been underrepresented even excluded from cardiovascular clinical trials - it has only been mandatory to include them since 1993.<br /><br />Womenâs health decisions are often made on a narrow set of data, we need to be aware of the biometric data divide. But itâs not just a personâs sex that divides, itâs race too. A recent study in immunogenetics out of the University of California showed that different ethnicities have distinct genetic mutations that increase their risk for particular diseases and affect how they respond to medicine. It concluded that African American children neglected by research died from asthma at a rate 10 times higher than white children. <br /><br />While on the subject of disequilibrium, men are underrepresented in mental health research trials. Inclusivity and diversity across the board is needed, and thankfully, this is happening. <br /><br />Like a lot of young people my age, I enjoy using wearables (Iâm using âyoungâ in the diverse inclusive sense, aka âpeople with their own teethâ - most of them). As I have a heart condition I am particularly interested in keeping an eye on my heartrate. With the occasional ricochet between 50 and 180 bpms, I wasnât sure if it was capturing real life (or death), I believed my digital wrist necromancer was playing tricks on me. I opted for a chest monitor when exercising, which offered enhanced accuracy. I found it uncomfortable to wear with dubious readings, probably because of placement. I couldnât help but wonder if the device would be a more natural fit on a man. Was it originally designed with a male torso in mind? Probably. <br /><br />I wasnât the only person to wonder about a better fit for women as there are now smart bras entering the market (or in development). I have yet to try one, but my understanding is a smart bra is a wearable for women, a heart smart bra for example collects data on your cardiovascular health. An augmented comfortable garment using textile sensors around the torso and heart that picks up physiological data which connects with an app on your phone. It monitors heart rate and rhythm, ECGs, respiratory rate, temperature, posture and movement. Through the use of personalized biomarkers it looks for symptoms and triggers for heart issues. The information can be shared with your doctor for early detection and management of problems, and to track the efficacy of therapies. If enough women were to wear the smart bra, new datasets could emerge on female cardiovascular health. An alternative way to crowdsource information instead of the traditional formal invitation-only trials. There are also prototype smart bras to detect early breast cancer and stress. <br /><br />Inventive AI doesnât stop at ladies underwear, there are also smart toilets. Not to be indecorous, but these techno lavs monitor the products the patients leave in the bowl and test prostate health, blood sugars, intestinal issues and other ordurous matters. They are called âwellness toiletsâ. I imagine you could link your fancy toilet to your doctor or pharmacy to catch UTIs, etc, perhaps even before youâve finished in your water closet a script will have been sent to your phone. If we all join the posh privy parade collective problems could be identified at a micro community level such as poor nutrition, diabetes and pathogens (waste water monitoring has already proven to identify Covid hotspots before outbreaks occur). <br /><br />Lack of diversity in AI will impact us all. Some may see it as hysterics from woke wonk snowflakes, but any form of homogeneity will lead to skewed results and a clinical body of knowledge that is not applicable to swathes of the population. If you are well represented in clinical trials itâs likely you have a loved one who isnât. It is important for safety reasons that the person taking the drug or receiving the treatment has been sufficiently represented in the testing and analysis. If you throw the net wider there is also an increased chance of discovering a better treatment or approach for all patients. <br /><br />The lack of inclusion isnât only down to exclusion, there can also be a reticence to take part in the development stage from certain minority groups due to historical mistrust, which will take time to redress. <br /><br />I admit we all have our biases and it is not surprising that they have emerged in AI. Diversity and inclusion should enhance the tech, not make it so generic it loses its purpose. I think it will make for interesting learning curves as inventions created for certain populations are shared globally. For example, the Japanese government has a strategic plan that 4 out of 5 elderly people in need of care will have robot support. Healthcare robots can attend the bedside of a patient suffering from dementia, anxiety or depression and provide compassionate words when they detect tones of stress in the patient's voice. Iâm curious how that would translate to an Irish setting, I have visions of a robot bowling around St Jamesâs hospital in Dublinâs inner city skidding up to bedsides with a âAh jaysus, howayaâ, reporting back to the medical staff (in a robot voice) - The.Bleedin.State.Of.Your.One.In.Bed.5 - EXTERMINATE!<br /><br />I am clearly exposing a robot bias based on a childhood TV show about a doctor (of dubious doctorial credentials) travelling through time in a phone box chased by large angry pepper pots... although, Iâve seen stranger things in St Jamesâs. <p><br /></p><p>Read original article here - <a href="https://www.imt.ie/opinion/sheilagh-foley/how-woke-is-artificial-intelligence-an-old-fashioned-approach-to-new-technology-06-09-2022/">How woke is Artificial Intelligence</a></p><p><br /></p><p><a href="https://www.lettersfrombeyondthepale.com/2022/08/michigan-ann-arbor.html"><<PREVIOUS POST</a> <a href="https://www.lettersfrombeyondthepale.com/2022/10/the-irish-medical-times-what-patient-is.html">NEXT POST>></a></p>Letters From Beyond the Palehttp://www.blogger.com/profile/11613934814997415030noreply@blogger.com0