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Sunday, May 2, 2010

Medical wisdom continues to make life better

One of my favorite topics to write about is how much medical wisdom has improved just in my lifetime. Many of the ailments you and I suffer from today may not even be ailments in the future.

In fact, while I suffered from uncontrolled asthma as a child as well as did many other asthmatics, new wisdom has it so that it's very rare for anyone to have uncontrolled asthma in 2010. In fact, as I will write about in an upcoming article, asthma deaths and hospitalizations have significantly dropped since 1996 alone.

I recently dropped over at a fellow asthmatic's blog, Kerry, over at Hold Your Breath to Breathe, and she posted (see here) her medical records from when she was born a premature baby. I hope she doesn't swat me for linking to them here, yet I think having access to such records is a great reminder of how well we have it today, or at least how much better our children will have it than we do.

If nothing else, it's neat to look back and know why things are the way they are. I have the discharge papers from my stay in a hospital in 1981 for asthma (somewhere on this page), and the doctor wrote about how important it was for me to quit using my inhaled corticosteroid as soon as I was feeling better. Of course that was good wisdom back then. Today we know that you should never stop using your inhaled corticosteroid, especially when you are feeling well.

I see from Kerry's first ABG that her PO2 was 370, which by 1991 standards was acceptable. By 2010 standards, we know that's way to much oxygen, especially for a premature baby, and can lead to more harm than good -- such as ROP (I write about this here). In a class I attended just a few days ago, it is now common wisdom to allow a PO2 to remain as low as 40, which is the PO2 that a neonate's organs were developing inside the uterus before birth. That to shock those organs with a higher PO2 can lead to other problems right away and later in life, such as retinopathy of prematurity, which is a disease of the eyes.

Another neat thing to note is that new wisdom actually greatly diminished the risk for diseases such as hyline membrane disease and neonatal sepsis. So while in 1980 most sick premature babies died, by 1990 most survived. And, while many of those kids in 1990 may have been forced to live with certain illnesses such as ROP, new wisdom has greatly improved even those risks.

I imagine that 10 years down the road new wisdom will make things even better. As asthma experts have learned that prematurity can lead to asthma, perhaps there will be something that can be done to limit this risk. And, while experts have learned that lack of exposure to certain germs can lead to asthma in term kids with the asthma gene, perhaps there will be a germ vaccine some day to prevent asthma altogether.

Ironically, through the suffering of our fathers things are better for us today. Because kids suffered from asthma years ago, beta adrenergic medicine was invented, and ultimately lead to the rescue inhaler that I got to use as a kid. And while asthmatics like me had to use the rescue inhaler often as a kid, most kids today with asthma barely know they have the disease.

The same can be said of other diseases. Modern wisdom is making life better for us all. This is why we must never forget the past, for what we learn by the past will only make the future a better place.

4 comments:

Kerri said...

Hey Rick,
Thanks for the links! When I saw an RT/asthma educator back in March, she had many of the same thoughts as you do.
As you probably saw in the records, i do in fact have ROP (back when it was called RLF--retrolental fibroplasia).

I was really stoked to finally get these records (it took several months), mostly because, obviously, my parents don't remember everything! I've wanted to know more than they remember foreverrrr, and I still haven't finished going through all the sheets!

Rick Frea said...

I actually felt the same when I finally got my medical records from National Jewish. The only problem was after 20 years most of my records were shredded, and all I got was a summary. Still, it was better than nothing.

Kerri said...

Yep, exactly. When I realized that little fact that they only hold onto them so long, I jumped at getting them ASAP.

Kris said...

I think another thing that has improved health education is the internet...there is a wealth of information(as long of course you look in the right places!). So you can be as educated as possible, because sometimes doctors drop the ball. In March I was prescribed flovent and as the doctor walked out of the office I said, "wait! How long do I take this?" His reply was, "until the wheezing stops". When I pressed how long that should take he said, "oh, probably two weeks". Well of course, eventually the wheezing stopped. So I stopped my flovent and within a week I suffered a major flare...and thats when I went searching for info and came across you and Kerri. I'm so glad I did! If I hadn't gone searching the net, I wouldn't have even known about action plans, questions to ask or the options out there.

Kerri has given me more info than my GP. I think people are finally realizing their doctor's aren't God and they can be wrong. If you don't know any better you can't demand better and nothing ever changes.

Rick I laugh when I read about ventolin scrubbing bubbles...in 1994 I was hospitalized with pneumonia(that was missed for over a week because I had no rales) and I was given the ventolin treatments, though I was not wheezing, because I had mild asthma. Truth be told the only relief I got was simply because the hospital was insufferably hot and the mist from the mask was cool!