Glia: all that and a bag of chips -- but what kind?

A fascinating study which further clarifies the role of those fascinating, complex, busy busy cells, the glia:

http://www.sciencedaily.com/releases/2011/12/111229131354.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

ScienceDaily (2011-12-29) -- New research indicates that glia cells are "the brain's supervisors." By regulating the synapses, they control the transfer of information between neurons, affecting how the brain processes information. This new finding could be critical for technologies based on brain networks, as well as provide a new avenue for research into disorders such as Alzheimer's disease and epilepsy.

This study indicates that glia regulate the speed of synaptic transmission, slowing or speeding up synaptic events according to what is needed. This means, for instance, that epileptic seizures, which are synaptic storms, relate to glial misbehavior.

The next question is, how? Why? What causes the glia to modulate a given transmission?

I'm looking forward to further studies on this.

CRPS, HPA axis, and a remarkable void in the science

I just went looking for scholarly articles linking chronic CRPS to the HPA axis damage that has been such a feature of my life. Though me, my cohorts and all my providers have been talking freely about this for years, there was nothing on PubMed and nothing of value in the Google search.

It's possible to chain together articles that make the point -- one on stress and adrenal function, one on stress and pituitary dysregulation, one on chronic neurogenic pain and hypothalamic oddness, one on constant pain as a causor of physiologic stress, and one on CRPS as a source of pain -- but academics get squirrelly when you make them link the logic. They don't want to think; it makes them feel exposed.

Nevertheless, me and my providers, me and my cohorts online, me and hundreds and thousands of people with chronic CRPS, have been taking it for granted all this time that there was a link -- because it is so bloody obvious that there is.

However, the studies don't exist.

The connection is obvious, but unwritten.

The data are sitting there, waiting to be captured.

The study subjects are right there for the recruiting.

It's like the topic is standing there with its pants down and its pockets full. An easy target -- and a rich one!

This is ridiculously obvious, and you know that all the subsequent work on CRPS and anything related to the adrenals, hypothalamus and pituitary would have to quote whoever documented it. Tenure, much?

Who wants to find the funding and put together a team? I would be happy to help. If I had the MD and the university contacts, I'd already be making calls. Please, whatever I can do to help, just let me know. Make it happen.

Scott Reuben and the poison in medicine's well

In a stunning piece of timing after yesterday's epiphany, this crossed my wire today:

"A Medical Madoff: Anesthesiologist Faked Data in 21 Studies" - Scientific American
http://www.scientificamerican.com/article.cfm?id=a-medical-madoff-anesthestesiologist-faked-data

"Beginning in 2000, Reuben, in his now-discredited research, attempted to convince orthopedic surgeons to shift from the first generation of nonsteroidal anti-inflammatory drugs (NSAIDs) to the newer, proprietary COX2 inhibitors, such as Vioxx, Celebrex, and Pfizer's Bextra (valdecoxib). He claimed that using such drugs in combination with the Pfizer anticonvulsant Neurontin (gabapentin), and later Lyrica (pregabalin), prior to and during surgery could be effective in decreasing postoperative pain and reduce the use of addictive painkillers, such as morphine, during recovery. A 2007 editorial in Anesthesia & Analgesia stated that Reuben had been at the "forefront of redesigning pain management protocols" through his "carefully planned" and "meticulously documented" studies."

More from the New York Times:
"Doctor’s Pain Studies Were Fabricated, Hospital Says"
http://www.nytimes.com/2009/03/11/health/research/11pain.html

And the Injury Board:
"The Fake Clinical Trials of Dr. Scott Reuben" http://cherryhill.injuryboard.com/fda-and-prescription-drugs/the-fake-clinical-trials-of-dr-scott-reuben.aspx?googleid=259290

It's hard to convey the total horror of the event described here. This physician scientist, who ran the pain clinic at one of my old hospitals, published research that became the cornerstone of pain treatment in the US and abroad. After 13 years of successful, peer-review-published, desperately important work, he recently admitted the following:

• Not one single patient was ever enrolled in key studies.
• There was absolutely no basis for the numbers he cited; he invented them.
• He was paid a great deal of money to come up with certain results, and that is exactly what he did.

The most influential part of his career was a fraud.

The countless studies founded on his widely-publicized fictions are therefore meaningless, under the rules of scientific evidence itself.

The degree to which we depend on medical science to save us when we really need it -- our helplessness at our times of greatest need -- require us to have some faith in the processes that deliver our care. This isn't just another massive fraud, it's a devastating blow to the cornerstone of healing in the modern age. How can educated patients ever continue to believe that our doctors have anything of value to offer us? How can honest physicians bear to let this situation exist?

He could not have chosen a worse field to work in. In medicine, sooner or later, every field has to rely on pain medicine, and he has fouled the well from which the widest number of patients must drink. Scientific American got it wrong: Madoff was a piker, next to this.

The science of pain control and pain management has depended heavily on garbage cooked by a liar, served by intellectual catamites and eaten by the brainwashed. From there, it was inserted into me and mine, who were assured that this was the best that medical science had to offer.

Too bad there was no actual medical science involved.

...I apologize for the strong language. Can you think of more precise and telling terms to use instead? I'd be happy to change them, if anyone can come up with something better.

There are administrative questions such as, whatever happened to peer-review? Who the hell was looking at his notebooks and other physical evidence of scientific work? Why did it take 13 years for a "routine check" at Baystate to break his cover? What on earth were the most important science editors in the world thinking? How many of them are still employed -- and why?

Those aren't trivial, but they are not what looms largest in my mind. I think of Debbie, and me these past few years, and other friends I can't name whose lives have been hopelessly distorted and sometimes horribly lost ... because modern pain research has been built on one psychopath's lies, which were funded and supported by a vast network of fellow liars, colluders, and the willfully blind.

It has sometimes occurred to me that the wrong people get sick.

Refocus on what works: In memoriam

Debbie died yesterday. She was a never-failing source of encouragement and intelligent support on one of my key online CRPS support groups.

She died on the table, while undergoing a medical procedure. I don't know exactly what it was, and given my respect for patient confidentiality, it's none of my business.

She's the first person to die of my disease, to whom I felt personally attached. Needless to say, it's sobering as hell.

I've written about the need to attribute deaths from this disease correctly. I'm preparing my own final papers. These thoughts are nothing new.

But today, they are biting deep.

I've recently become highly politicized over rights abuses and intolerable corporate stature in my country. I have privately -- and quietly -- become convinced that the US healthcare system is so completely predatory, so opposed to its own mandate, that it will never offer healing for anyone in my position.

Debbie's death has broken through my professional anxiety about appearing detached and scientifically sound. I have, at long last, become politicized about the most important subject in my life, after 25 years of personal and professional involvement up to my back teeth.

I have minimized my discussion here of what actually works. That dishonest omission has done us all a great disservice. I'm going to discuss what works, whether or not it's FDA approved, pharmaceutically profitable, or adequately studied.

Medical studies are a shining example of the fact that we inspect what we expect, not necessarily what we need. The fact that studies have not been done on most modalities, or not rigorously done in double-blind experiments, doesn't mean the modalities don't work.

It means the studies need to be done. Period.

Where I understand the mechanisms of action, I will explain them. Where studies don't exist, I'll detail what should probably be explored.

But I have had enough of silence. I will not die as Debbie did. I will not die on the table. I certainly will not die saturated with soul-destroying pharmaceutical-grade poisons, as so many of us do.

I will find a better way. I will find a way that works. I'll do my best to persuade others to study the modalities involved, and to fund the studies. My legislators will learn to recognize my name on sight, because their slavish debt to the pharmaceutical industry is absolutely intolerable and it's up to me, and others like me, to convince them of that.

I wish Debbie a painless and peaceful rest. I hope her extraordinary husband finds enough strength and comfort to manage life without her.

For myself, I want the intelligence, resources and strength to find a solid cure, make it happen, and spread the word.

No more silence. It's too much like consent or, worse, collusion.

I do not consent to the deaths of my friends.

With my eyes now open, I'll no longer collude.

Let's find a real way out.

Facial recognition is wholistic

This blog has been on hiatus as I've been dealing with a body-hostile healthcare system, insurance sociopaths and delusionally self-infatuated doctors, and I didn't want to take it out on the science.

This charming study turned up today and led me back here:

http://www.sciencedaily.com/releases/2011/12/111202155755.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

'ScienceDaily (2011-12-02) -- "Face recognition is an important social skill, but not all of us are equally good at it," says a cognitive psychologist. But what accounts for the difference? A new study provides the first experimental evidence that the inequality of abilities is rooted in the unique way in which the mind perceives faces.'

The brain uses a wholistic method for recognizing faces, whereas recognizing objects is more analytical -- meaning that the object is parsed out by the brain and assessed in chunks. Doesn't work well on faces, though.

One very pleasing, intelligent thing to note: these researchers concluded that the logical next step is to train people to use their brains more effectively -- not to look for yet another drug to fiddle with one part of a complex process and leave the patient more helpless than before.

My own facial recognition has plummeted with the evolution of CRPS, but it's a skill I acquired rather late in life. I'd always recognized people by the way they held themselves and moved -- a different region of the brain entirely. So I trained myself to recognize faces as such.

I'm not sure I could recapture that ability, but when a few other mental faculties are more predictable, I'm game to try.

Assumptions & memory: elders are sharper than we think

I'm intrigued by how much more capable the elderly are than we've been led to believe. Since only the luckiest and most sensible of us will even survive to be old, that makes a certain amount of sense.

CRPS, which typically attacks people in their "most productive" years (implicit assumption alert!), has shown us that many medications useful in CRPS, which have been given to the elderly like candy for decades (calcium channel blockers, antidepressants, benzodiazepines) have a serious effect on memory and cognition -- which was documented only because we don't expect 38-year-olds to suddenly lose their ability to track simple tasks.

But the elderly get no slack. If your whip-sharp grandad suddenly can't remember your kid's Little League scores, who's willing to relate it to the meds he just started for his heart?

And who cares enough about grandpa's brain to go to bat for him, and insist that the doc find another way to handle things? Hint: what you eat & what you do, do matter. Visits with nutritional consultants and PTs can be prescribed.

Back to this study:
http://www.sciencedaily.com/releases/2011/11/111104102129.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

These wonderfully sensible scientists framed an exact goal: they "set out to investigate how implicitly held negative stereotypes about aging could influence memory performance in older adults."

They specified "implicit" stereotypes, in other words, ones we're not aware that we're responding to. (The kind that patients and doctors hold about each other all the time.)

When the tests were run with the stereotypes laid in, the older people did worse on the memory tests. When the stereotypes were made irrelevant to the outcome, the elders did as well as the youngsters. On the same type of test.

Which should tell you just how pernicious and evil those assumptions we make about old people are. When grandma's memory starts playing up, ask her if she has started any medicine recently. Find out what it was for and how else that can be addressed. Ask if it's the smallest possible dose that's prescribed.

Give up the idea that pills solve problems freely, and recognize that each one imposes a tax on the body and brain.

If grandpa doesn't mind losing his mind but won't give up his risotto and vichyssoise, maybe the pills are fine, but if he simply assumes the doctor is offering the best deal without showing him alternatives, maybe it's time to talk about alternatives.

Because doctors default to doing what's easy and predictable -- just like the rest of us! That's not always what's best for a mentally or physically active person. They seem to deal with a lot of lazy idiots, and if you or your elders are neither, it takes a lot of effort to bust them out of their groove and get them to think things through.

Try taking it seriously, because nobody should be forced to lose their mind before they lose their pulse.

Preoccupation & CRPS-RAD

Last week, I was busy capturing files from FaceBook to save for a new website, http://crps-rad.ning.com/. It's very much in development, so please let us know what you think.

It will soon be at http://crps-rad.com but that's another story.

This is the real-world launch of a FaceBook group that became sufficiently important and popular that it had to get off those godawful training wheels and get a real site. It will shortly have the research and translations into plain English, the discussions and threads, and the ongoing evolution of prevention and management, of CRPS and its comorbidities that the FaceBook page has -- and, I hope, far more.

Now if only FaceBook were easier to work with. HAH.

Vascular growth and brain protection

"A nourishing protein that promotes the growth of neurons and blood vessels appears to stop the progression of a genetic disease that causes degeneration of the cerebellum, according to new preclinical research. The disease, spinocerebellar ataxia type 1, typically strikes people in the 30s and 40s and eventually causes death."

The key protein is called Vascular Endothelial Growth Factor, VEGF. It is known to stimulate the growth of healthy blood-vessel linings. We know for a fact that healthy blood vessels are important to maintaining healthy brains! Without them, we get strokes, not to mention this type of ataxia.

The funding-hungry researcher's first thought is, "How do we turn this into a drug?"

The smart clinician's first thought is, "How do we improve vasculation, oxygenation and circulation in safe, endogenous, sustainable ways from youth onwards?"

Don't need FDA approval for that. Just takes fresh food, fresh air, clean water, and safe activity.

Clinicians, if you're puzzled about how to get all that for your patients, call your legislators (use the link on the right to find them) and share your concerns. Those letters after your name are worth more than you might think.

SSRI can improve cognition after a stroke

This came out 2/2010, right in the middle of my being horribly overdosed on SSRI and SNRI medications:

http://www.sciencedaily.com/releases/2010/02/100201171523.htm

(This is where I give myself points for not being violently and irrationally opposed to the class of drugs that did me, personally, so much harm. It's important not to throw the baby out with the bathwater.)

129 patients were divided into roughly 3 groups, one of which got 5-10 mg Lexapro daily, another got placebo, and the third were assigned to "a problem-solving therapy program developed for treating patients with depression." (No idea what program that is and they weren't specific about it.)

The Lexapro group had the best neurocognitive scores after 12 weeks, though the author doesn't say by how much, or how they processed the data. These are both important issues in scientific studies, since some differences are significant and others are just curious, and how you arrived at those figures can have a considerable effect on how seriously your readers should take them.

"...reported changes in neuropsychological performance resulted in an improvement in related activities of daily living" -- which makes perfect sense. When all is said and done, healing of any kind is about what more you can DO afterwards! Doctors, patients, and significant others tend to lose sight of that, getting lost in the compelling drama of symptomatology, misery, and pain. It's not that that isn't important, but being able to take care of yourself -- or making it so your patient can do so -- is absolutely primal.

This study used low doses, which I suspect is key to unimpaired cognitive function -- not to mention avoiding the usual side effects of this class of drugs, as they did.

Warning: Starvation and alcoholism don't mix

The latest candidate for Dept. of the Blitheringly Obv.: Young people eating too little and drinking too much is worse than doing either alone. No, really??

Lasting damage to memory and thinking, more bad choices, and increased likelihood of developing chronic conditions later in life, are far more likely because the damage from each form of fashionable self-abuse compounds the other.

This idea is certainly high on the head-desk quotient, but the article is mostly clear and sensible:

http://www.sciencedaily.com/releases/2011/10/111017171506.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

They mention that the risks to women are higher ounce per ounce, but don't say why; that vagueness is annoying and wrong, and science is far enough along to know better.

The idea that real food might be good for you is kind of a shocking idea, to some. Encourage them to get used to it. Fresh salad, berries, roast chicken, apples, baked potatoes, butternut squash ... There are worse things. Like brain damage, cirrhosis, kidney failure, strokes, chronic fatigue, and HIV.

And looking really bad by 30.

New info on HIV in the central nervous system

My first nursing job was on an HIV/AIDS unti in 1991. I seem to remember learning, in the early '90s, that we knew that co-infection with different HIV strains meant the person would get sicker quicker and be harder to treat (but trying to get HIV positive people to use condoms etc. with other HIV positive people was practically impossible in those days), and that people with these co-infections had much higher rates of dementia and a more aggressive disease generally.

This study -- finally, and despite the facile title -- gets more specific about what happens with HIV in the CSF (cerebrospinal fluid):

"Distinct AIDS viruses found in cerebrospinal fluid of people with HIV dementia"

http://www.sciencedaily.com/releases/2011/10/111006173443.htm#.TpG92FJMVMI.mailto

By and large it's excellent work: the info on HIV in the macrophage is intriguing, as is the implied interplay between the seroactive HIV and the CSF-inhabiting HIV.

The implied determination to get more people on the horrifically aggressive HAART pharmaceutical regime is disappointing, for 2 important logical reasons:

1. This intensive regime, itself, has powerful and often irreversible effects on the following: mitochondrial survival, bone mineralization, memory & cognition, and digestion & absorption. That means teeth crumble and bones turn chalky, nutrition in food becomes unavailable so it's harder to maintain, and most of all, those of you who've read my work on mitochondria and on iatrogenic brain damage know how horrifying I find it to cavalierly trash those vital systems, most notably in the absence of any real efforts to support them in the face of iatrogenic -- let alone pathologic -- assaults.

2. The lack of any indication that the HAART drugs are any better at crossing the meninges (the covering over your spine & brain that forms the "blood-brain barrier") after this study, than they were before this study. That's an oversight that invokes a sardonic laugh. Heaven forbid the provider should actually pay attention to the patient and start the meds when needed, rather than assaulting the system maybe years before it's necessary in the hope of staying one month ahead of one strain's breakout. Bad math, you see?

It would be good to move away from the meme that drugs are the best, first, last, and finest answer. They're one part of it and they're easy to monitor, but we have to get a lot better at much more basic human care.

Good science. Stupid clinical take-away. But good science.

Re-myelination from stem cells

Scientists at Case Western Reserve have found a way to persuade pluripotent stem cells to become the specific type of cell that produces myelin and to re-myelinate living mice:

Mice stem cells guided into myelinating cells by the trillions

For once, I've got no logical criticisms to make. This is brilliant work which fills me with hope for those of us dealing with demyelination and all the havoc it causes. Here's hoping it translates well into human models, and soon.

Pain Manifesto

This came out of cold chronic CRPS type 1, a debilitating condition of intractable chronic pain, nervous system disruption, and multi-system dysregulation -- destroying the body's ability to manage heat/cold, blood sugar, immune defense, circulation, sensation, bone density, movement, vision, digestion, heart function, and ultimately survival.

"Standard" treatments don't work well for me; moreover, they involve invasive procedures too brutal to tolerate and medications I'm either outright allergic to, or that impair me so profoundly I can no longer function. At all.

So I took myself off my meds, thought things over, and came to the following conclusions.

MY CHRONIC PAIN MANIFESTO

Yes, it hurts.
It's going to anyway.

So should I hoard my days
And fast from life?
Comfort myself with poisons,
Blister-packed and FDA approved?

Some think it would be best all 'round.
I'd cure them if I could (heh!)
But I'm too tired for
Yet another pointless struggle.

The sunlight pours through trees like prosecco
And reminds me what it means to live:

Voices warm with love, the
Mouth-smack of good food,
The hug of hills and the
Rough snuggles of the sea.

Hoard my days? I'll spend each one
Like it's stuffed with jewels
Pouring through my hands like a miser's dream.

Feast on this:
The cost of life is much the same.
The difference lies in how you spend it.

How is this relevant to medical science? For one thing, it shows just how badly off base it is in vivo. Like any manifesto, it makes an explicit declaration: fundamental attitudes must change.

Policy determines what will be profitable, and profit opportunities determine what science gets funded. There is no profit in fully-functioning people, but there's plenty in people who are too sick to function but not sick enough to die ... for awhile.

Policy could allow my insurance to cover the things that do work (massage, reiki, homeopathy, yoga), especially given the detailed and vivid documentation I've provided of just how well they work. Nobody will fund science studies on these in any volume, because it is so much more profitable to drug people into silence.

Links between racial discrimination, stress and health

A fine candidate for the ever-popular Department of the Blitheringly Obvious: Being treated horribly because you were born at the melanin-rich end of the racial spectrum makes your health significantly worse.

Moreover, this study supports what sociologists have said for decades about the deep difference between discrimination against Blacks and discrimination against Whites -- it really is fundamentally different. Moreover, not all Blacks experience racial discrimination. So there's a couple of common assumptions blown apart by a few blood tests and a little science.

http://www.sciencedaily.com/releases/2011/09/110914122315.htm#.TnJi1Jxg-40.mailto

Living under indirect and direct threats to your autonomy and survival can damage your health? No, really??

I know, sarcasm is unbecoming. It's a little hard to resist, though, after so many decades of studies trying to "correct" for that and claim that Black people were just more poorly constructed and shouldn't eat all that chicken & grits. /tears hair/

I'm delighted that this study has hit the net, because we could do with more of this kind of, "Well, duh, of course!" information becoming part of the provider mindset.

As I learned when a guy tried to kill me for his prejudices on my 21st birthday, it doesn't matter if you belong to an oppressed group or not. (He thought killing Lesbians would be just fine, and since we didn't have a man around...)

We are all in this together, and if Black people are being shut down, I could be shut down next. After race, disabled middle-aged single women are about as close to the care "toilet" as you can get without flushing.

History is rich with examples of this kind of trajectory.

Let's keep our eyes wide open and our brains turned on. Especially when we're talking to those in different categories than ourselves.

Assessing live myelination -- and dead CRPS!

Fortunately, I'm bright enough to evaluate this extraordinary new method:

http://www.sciencedaily.com/releases/2011/09/110913103211.htm#.TnDL-iVvIQs.mailto

There are vague mentions in the literature of myelination in CRPS, but researchers are so busy trying to figure out how to pill CRPS -- a highly pillable disease -- that such mechanistic issues get surprisingly little play.

Myelin is the protective sheath of fat that keeps your neurons safe and warm, so they can do their work. Without myelin, your nerves can't fire properly -- or else they can't stop firing. They need the myelin sheath. Little kids need to take in a certain amount of cholesterol so their growing bodies can build good myelination. Demyelination, that is, the loss of that sheath, is most famously known for its role in Lou Gherig's disease.

I've long suspected that demyelination is both an important sign of disease progress and a powerful contributing factor to further degeneration of the peripheral, if not the central, nervous system in CRPS. However, there's not much in the literature, probably because it's a useless treatment marker in someone who's beyond treatment.

This brings us to the particularly delightful issue of finding corpses to study, since until now we could only check myelination after autopsy, and those who donate their bodies to science are filed under what took their lives.

People with CRPS develop heart disease, cardiovascular disease, bleeding disorders, organ failure, vision impairment, and staggering depression as a direct consequence of CRPS. However, when they drop dead, get struck by a bus they couldn't see, or take their own lives, we don't say "They died of CRPS." We say, "They died of heart disease, organ failure etc., traffic accident, or suicide" (-- if we're feeling kindly, "or depression.")

Thus, there's no way to identify the actual mortality rate of CRPS, although there unquestionably is one.

Diabetes, cancer, and AIDS get more dignity than this. I'd like to see our mortality rate properly attributed, not swept under the enormous rug of opportunistic conditions. This would contribute hugely to better medicine.

Doctors hate seeing patients hurt, but after awhile they can turn away from that, in order to drag themselves back to the office; they hate to see them die on their watch, and it makes them apply upward pressure on the reimbursement and legislative aspects of the care system.

There's nothing like a mortality rate among those in their "productive years" to make legislators sit up and take notice.

I started nursing within a decade of the first AIDS diagnosis; my first job was on an AIDS unit. I've seen it work.

Let's get our deaths properly attributed. It's one last gift we can give our compatriots as we head out the door. I'm going to put it in my will.

Full disclosure/reality check

I aim to post here at least once a week. Obviously, I've been slipping lately.

While CRPS has seriously (if episodically) affected my cognition, the great advantage of dealing with CRPS alone, over dealing with being overmedicated for CRPS, is this:

I know when I'm not that bright.

The ability to self-assess is key, and I'm grateful for it. (Small favors, I know.)

When I don't remember, I know I don't remember; when I need context, I know I need context; when I have the data in mind, I can tell you just how high my degree of certainty is.

My brain works sporadically, but I know when it's working. This is a big deal. The pharmaceuticals made it very very difficult to assess my own capacity, and that alone was functionally crippling.

Clinical takeaway: even subtle overdosing matters. Anything that acts on the central nervous system affects cognition to some degree. Boy, do I have articles about that!

As for now ... My brain has had no slack beyond what I need for coping with daily life. There are a couple of fascinating-looking articles I'd love to review, but they're going to have to wait until the pendulum swings back again.

Assuming it does, because let's face it, there are no guarantees. Nevertheless, I'll keep trying. Thinking and learning is what makes my life bearable, so I will definitely keep trying.

Creativity, "vomit," "poison" and "agony"

Here's a fascinating insight into why creative ideas get creamed so quickly, without regard for their merit:

http://www.sciencedaily.com/releases/2011/09/110903142411.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29#.TmOwKMTHEIo.mailto

It relates to our typically low tolerance for uncertainty. People would really rather suffer horribly with the devil they know, because the very idea of change fills them with such profound reflexive dread.

This is a useful datum for me to know in my ongoing inquiry into the intellectually indefensible aspects of medical science, as they affect my care. It's a ray of light.

Why? Because, on the one hand, I grew up with a higher than average level of variety in life, so it's not that scary to me; and on the other, my baseline state involves rather a lot of nausea, toxicity and pain, so the devil I know has serious competition. This reflexive gag-response to "thinking outside the box" has never made sense to me.

It has been clear to me for ages that people would rather suffer horribly and endlessly in their lives, rather than endure the mental discomfort of change. I'd like to know how to circumvent that, short of putting them through the same experiences as me. If those data surface, I'll be happy to share them.

Fundamental neurotransmission is not that simple

This is the kind of discovery that leads scientists to say, "What's happening is not a simple, monolithic process."

http://www.sciencedaily.com/releases/2011/08/110823154038.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29#.TlVjSrO9LIE.mailto

And when they say that, you know they're starting to pay attention. 

This fascinating discovery is a matter of function, not form. I gripe about the simplistic, even boneheaded science that seeks to uncover neurology by approaching it with a backhoe. This is one example of the more productive & telling approach, using the scientific equivalent of brushes and trowels. Good stuff, intelligent and apt. 

The radical new idea is this: the little blobs of neurotransmitters that sit between the nerve endings are not identical little blobs, but are in two separate sets of blobs. 

So what do they do?

The smaller group of blobs is the "recycling" set, called that because they get used and restocked each time the nerve fires. The larger group of blobs hangs back out of the way, and occasionally a blob takes off but not because the nerve just fired. Due to their relaxed attitude, these are called the "resting" set. 

In the article, the blobs are referred to as sacs (or "vesicles," in med-speak.) They're sacs in precisely the same way that the drop of water rolling across the hood of your car is a sac. The blobs have a sort of "skin" created by molecules gathering more densely at the surface, but nothing more. 

It's an important layer of molecules, though, since the detectable difference between the "resting" blobs/sacs and "recycling" sacs is the proteins that gather on their surfaces. 

Now, to discover what those proteins mean ... That's another study. I look forward to it. 

Scared of the wrong things: depressive chemistry and danger

Funny how the whole delicate neurological/neurochemical structure is so interwoven:

http://www.sciencedaily.com/releases/2011/08/110810133127.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29#.TkPZJ2TGXNQ.mailto

"...The researchers suggest that the strange defensive behavior exhibited by the enzyme-deficient mice may actually reflect a limited range of adaptive responses and lack of emotional flexibility -- the mice may only have one gear for fear."

We've all known people who make exaggerated choices around danger that make no sense to ourselves. (Having heard my mother and my sometime partner on the subject of my riding motorcycles, I'm pretty sure of that.) However, only at my most desperately depressed have I engaged in unsafe sex, which is the second stupidest risk I can think of (the first having nothing to do with motorcycles.) 

The role of MAO-A and depressive neurotransmitters, combined with the dopamine-deficient sense of hopelessness and diminished executive function, make that make sense: 

"Monoamine oxidase A is the main enzyme in the brain that breaks down serotonin, norepinephrine and dopamine..."

Which makes me think that it's possible, in humans in vivo, to be deficient in both MAO-A and in dopamine, serotonin, etc. It would explain a lot about certain mental states, even though it seems chemically tautological at first glance to be both Big 3-deficient and MAO-A deficient. As I've learned, though, deficiency and dysregulation do have additive effects, they don't cancel each other out. 

I'd like to see more studies which monitor serum and brain levels of these key chemicals together, preferably in humans. Science tends to take the simplest possible approach, which is rarely the most realistic and not necessarily the most telling. It does get funded and it does make it simpler to design the studies. 

I look forward to having more sophisticated thinkers (and funders) get into this branch of psychoneurology, since all these lively lovely tiny bits of info won't come together in a meaningful way until we can look at them in concert with a higher degree of exactitude and completeness. I suppose I'll have to be patient. And careful. 

Good medicine

Long silence. It's not that I've been uninspired by recent medical science.

I've been traveling, spending a lot of time with people I haven't seen in many years. They've turned out to be the kind of people who, as the body get more chewed up, the personality gets richer and smoother. Proud to love them. Delighted to be with them.

Now that's good medicine.

Mechanisms of the special neurologic destruction caused by blast injuries

This is absolutely thrilling:
"Bioengineers identify the cellular mechanisms of traumatic brain injury; New hope for treatment of TBI in veterans wounded by explosions"
http://www.sciencedaily.com/releases/2011/07/110722213427.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

These scientists discovered the answers to two frustrating questions that have been blocking effective treatment of blast-related head injuries (TBI, or Traumatic Brain Injuries.)

1. What happens to the brain's axons? Why do the vital communication-arms of the brain's nerve cells just disappear?

2. Why does TBI from explosions cause the brain's blood vessels to shut down and turn themselves off, even though the the injury doesn't seem that bad?

The horrific health cost to our soldiers on active duty has included being blasted by explosives. These cause profound and persistent brain injuries that seem too severe for the amount of shock experienced by the brain.

1. The axons are part of an interlocked structure that's woven together by cells and intracellular "glues." This structure is shaken apart by explosive shock. Axons have to release their connections and shrink, retreating into the body of the cell. This destroys the physical functional structure of the brain. The person instantly loses memories and processing power, as well as a pervasive host of brain tasks.

2. The vessels undergo a mechanical stretch caused by the explosive force pushing through the gelatinous mass of the brain, and then, as a result of that stretch, they become super-sensitive to the chemical messenger that tells them to snap shut and then stop acting like vessels at all.
Normally, #2 only happens in the case of severe hemorrhagic (that is, bleeding) stroke. However, we now know that it also happens in blast injuries that otherwise cause less apparent damage.
Clinical note: Blast injuries to the brain are uniquely insidious. They cause diffuse injury that's invisibly disabling and incredibly hard to manage, let alone recover from significantly. Behavioral issues and so forth are mechanically and chemically imposed on the soldier's brain; they are not wilful choices on the soldier's part.

A lot of fundamental retraining has to be done, because emotional, cognitive and social skills have to be significantly rebuilt and rewired. The wiring that the soldier has built on since childhood has been torn up on duty.

Thanks to our present understanding of neuroplasticity, there's hope and a path to develop, but it takes time. On top of psychological trauma and the damage that causes to the amygdala and sometimes the hippocampus, it's a hell of a lot for any layperson to grasp, let alone try to handle.

One of the truly thrilling things about these findings is the discovery of a process that keeps the axons from pulling back in the first place. At present, it works in a Petrie dish if given within 10 minutes of injury; hard to see how that could work in combat.

If it could be formulated to be used in a person, it would still have to be administered extremely fast. Maybe send each soldier out with an inhaler of the stuff? Or a nose spray? A 50-cent bottle apiece to save millions in treatment, lost wages, cost of care, incidental costs on the family, for each injured soldier. Seems like a bargain!

Chronic pain in homeless people not managed well

Today's very promising applicant for the Dept. of the Blitheringly Obvious: "Chronic pain in homeless people not managed well":
> http://www.sciencedaily.com/releases/2011/07/110721112613.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29
My cynical side is just delighted that people got paid to write that down in black and white. Smacken zie forehead.

For a change, I'm going to ignore the disingenuous and smug language putting inappropriate blame on the patient, because there's so much basic information missing.

As anyone who has been homeless or worked with the homeless knows, indigence involves the following facts of life:

- Assuming you can even get to treatment sites ...
- Doctors won't take you.
- Hospitals don't want you.
- Clinics can rarely fit you in.
- Pharmacies hate to see you -- a gaping well of need -- coming through the door.

And that's just the medical side. In regular life,

- There's no decent surface to lie down on.
- There's rarely a good way to get clean.
- The concept of "good food" is irrelevant. You have to eat what you can get, regardless of whether it triggers a flare or messes with your brain, and are expected to be grateful.
- If you're a woman or a kid alone, you're going to wake up with some guy on top of you. This is very bad for back and hip pain, among other things.

Facts you should know:

- Being homeless is a perfect recipe for mental ill-health.
- Disabled people are over 10x more likely to be homeless than their equally-educated & -skilled cohorts.
- Chronic pain is part of most disabling conditions.
- Because of the economy, and despite the masses of money floating around in the stratosphere, disability and indigence are hitting historic highs.

Clinical take-aways:

- Take note of the link on the right to contact your political representatives. Let them know how you'd like the situation to change.
- ALWAYS ask indigents about pain: what, where, when, exacerbates, what they do about it, & most importantly, what they'd like to be able to do about it. Answers to the last will surprise you, because most of these people aren't stupid. (Just weird.)
- Provide freebies, including toothbrushes and emesis basins. What they can't use, they can barter with.
- When prescribing, be as generous with free samples as your drug reps' handoffs permit. Your insured patients only need enough to get started; your impoverished patients need to get so used to feeling better that they'll prioritize accordingly (beg, borrow & steal for their scrip instead of their booze? It happens.)

Keep in mind that a few days' relief is just a break, but a few weeks' relief lets them start to function for a change. Some will abuse your kindness, but big deal.

The rest will take the opportunity of having their burden lifted a little, to move forward in a way they couldn't do before. And thus a good deed goes onward, invisible to you but not to those ahead.

Make it a habit. Eventually, you'll see it come back to you. The feeling when it does is indescribable.

News flash: the gut and brain are connected!

The obvious scatological humor will be left alone. Guys, you know what I mean. (Girls who were outnumbered by your brothers, you too.)

I started to blog this article because the forehead-smacking tone of the revelation that the gut might relate to the brain was a bit too much for me. On closer examination, it looks like the misplaced drama is the writer's, not the scientists'.

One of the places where serotonin is released is in the gut, where it helps digest proteins. That's the most obvious "duh" moment here. Moreover, as those of us who remember our embryology know, the inter-relationships and constant correspondence between neurology and gut, gut and immunity, immunity and endocrine system, endocrine and neurological system are all too intense and interlocked for words.

Most studies make brutally clear that these so-called systems are medically treated as separate and distinct, but our bodies never got that memo. It's all the same system, as far as the body is concerned.

Much of this researcher's recent work focuses on neurology of the gut -- enteric neurology. It's a real thing now. His prior work focused on the biological environment in the gut, or the intestinal microbiota.

// START Word geek goes wild:
Sometimes, I just love medical terminology for the way it rolls, hops, and bounces off the tongue. Enteric neurology. Intestinal microbiota. Hypothalamic-pituitary-adrenal axis.

Maybe that last one doesn't work so well.
// END Word geeking.

If you can stand the medical and chemical jargon, it's worth looking into some of his work. It's probably not a stretch to call it prescient, in that it is likely to lay the foundations for our emerging understanding of the gut as a more complex and self-managing, yet interlocked, set of systems than we've ever imagined before.

I can't find the original science article, just this unsatisfactory and superficial overview. It says that intestinal microbiota affect the person's mood and feelings, and that it's possible to deliver specific probiotics (like yogurt species, naturally-fermented cole slaw, certain cheeses and the like) in order to have a specific benefit to the neurological system.

If you were an empiricist, like me, it would sound like "eating good, living food leads to better mental health," which healers have been saying for millenia. But far be it from me to steal such well-researched thunder.


Link list:

Science Daily article:
A Gut-Full of Probiotics for Your Neurological Well-Being

Credentials of lead researcher, Prof. Lyte:
Mark Lyte, Ph.D., M.S., MT (ASCP)

Wikipedia's digest (sic) of the enteric nervous system (this seems basically congruent with the uber-geeky medical studies I looked at on the subject, so I accept it as a decent primer):
Enteric Nervous System

Couldn't find a good overview that didn't involve more dead rodents than I could, er, stomach.

Proportional monocytes and CRPS, translated

Today's translation from medspeak to English: Inflammatory white blood cells and inflammatory nerve cells, in relation to CRPS.

Elevated blood levels of inflammatory monocytes (CD14+ CD16+ ) in patients with complex regional pain syndrome

Here's what the jargon means.
// ed. note: my comments and clarifications are picked out by those two slashes and the contraction for "editorial notation."

One important factor in CRPS is inflammation that starts in the nerves. Microglia and astrocytes, which are the inflammatory and immune cells of the nervous system, get active enough to cause worse pain by themselves.

That's a sparking astrocyte. Pretty, eh?

// ed. note:  The inflammatory and immune responses are mixed blessings throughout the body.  An immune response is uncomfortable; think about the last time you had the flu -- sucked, huh?  An inflammatory response can cause pain due solely to the inflammation, like with some kinds of arthritis.  So, for the microglia and astrocytes to make pain worse is not a surprise, since that's what immune response and inflammation can do anywhere.

One type of immune cells normally floating in your blood, called monocytes, can get into the brain and spinal cord and turn themselves into the nervous system's immune cells, microglia. The added level of inflammatory/immune response leads to more pain.

// ed. note: Again, not as strange as it sounds.  The body's living cells all contain complete DNA, and they are designed to be both helpful and appropriate; heart cells transplanted into muscles become muscle cells, and muscle cells transplanted in the heart become very much like heart cells.  So, for this type of small white blood cells to turn into microglia is reasonable.

These are microglia in various active states.

// ed. note: The inflammatory response releases cytokines.  Cytokines are the chemical widgets, produced in inflammation, that serve as the chemical messengers running around the cells screaming that the sky is falling.  Some cytokines increase inflammatory pain, some cytokines reduce it.

This study looked for particular kinds of inflammatory monocytes in the blood, to test the assumption that higher levels of these particular types of monocytes (which can then turn into microglia, making the inflammation and pain worse, etc.) are related specifically to CRPS.

Now here's the fun part.  The basic blood-borne indicators of inflammation and illness were no different in those with CRPS than in normal people. That's why conventional lab results, like "complete" blood counts, come back normal for us.  However, the proportion of the particular types of monocytes associated with CRPS, were significantly higher in those with CRPS.  The type of cytokine that reduces inflammatory pain, was also significantly lower in people with CRPS.

That means the inflammatory process screws us coming and going, and screws specifically us, the people with CRPS, in ways that can be checked in a lab.

OK, GTK.

These are sensible scientists: they state that they don't know if the monocyte proportions changed before or after the onset of CRPS, or both before and after.  If before, it might indicate a predisposition to CRPS, in which case surgeries and accidents have to be handled with specific care for antioxidant therapy and aggressive pain control. If after, it might be relevant in figuring out how things are going and if what the doc is doing works.

Also, some drug company could make a staggering fortune off of new meds that mess with this process. They actually mention that at the end of the article, which means someone has to fund their work.

// ed. note: Be fair. We have a profit-based health care system driven by enormous corporations that are traded on the stock exchange, and the Sarbanes-Oxley laws mean that their first obligation is to their shareholders. Not patients. Not customers. But shareholders.

Conventional medicine has to come back to profitability.  There are more direct ways to address these immune and inflammatory issues by existing means, which could be further developed, but they don't sustain the pharma industry's usual annual returns of 20-40% -- a rate of stock profitability matched only by oil companies.

... On your pain.

If you have something to say about that, you can contact your political representatives here: http://www.usa.gov/Contact/Elected.shtml

Hemingway: How courage and depression go together

This article is well-intended, but egregiously judgmental and woefully ignorant:

http://www.npr.org/2011/07/02/137540700/after-50-years-remembering-hemingways-farewell

If it weren't for the inane babble puzzling over why Hemingway lived so intensely, this line would be the Winner of The Most Fatuous Statement award: 

"...in January 1961 he told his wife, Mary, that he could no longer write a single good sentence. And Hemingway would only settle for great ones."

It wasn't a question of settling for less than great, it was a question of how important it is to fulfill your purpose and dig some meaning out of life, even amid the unbearable. That purpose and meaning was taken from him, under the mistaken guise of treatment. 

Hemingway got electroshock therapy for his depression; a common side effect is to knock out your language abilities and cognition, sometimes for months and sometimes forever. The one thing that made his life endurable -- writing like himself -- was taken from him. 

Depressed people have more courage and determination than their non-depressed cohorts. Studies are finally being funded that verify this (which I'll dig up later. Feel free to nudge me with a comment.) 

Think about that next time you curl your lip over suicide. It's not about courage. It's about unbearable pain and a degree of mental crippling that puts a valid life out of reach. 

Waiting and working at it until things improve is a reasonable thing to do: Hemingway waited and worked at it for  40 years, though with so little real hope for treatment. Talk about courage! It's unthinkable how much courage he brought to bear on his life. His intensity and wild behavior were directly related to making his life bearable -- and his work more compelling. Check his quoted remarks on that subject. What's between the lines is breathtaking. 

The article's remark about suicidal lineage is true, but poorly understood. A suicide in the family has the powerful effect of making suicide less unthinkable. There is often a genetic tweak associated with it, but that's not all there is. The thing to know now is, we are not our predecessors; we can do more. Far more. 

Hemingway died before we developed SSRIs, SNRIs, and a tremendously improved understanding of neurochemistry, behavior, nutrition and psychodynamics. We have more options now. Lots more. Waiting and working at it is a real success path now. 

Be good to your depressed friends. You probably have no idea what they're capable of, when they can be well again. Help them persist. 

It's the most important thing to do: persist. A valid and bearable life is a reasonable thing to hold out for. Only death bars the door to healing. Things will change. 

Stem cell research is really whizzing along

Pluripotent stem cells (that is, the kind that could be turned into many different types of tissue) were successfully grown from urine:

http://f1000.com/11427957?key=khstst6kwbn437f

This is a little weird even for me, but intriguing as hell.

It's normal for a tiny number of cells from the draining parts of the urinary system to wash away in urine. Throwing off very many is not healthy. However, given a tiny number of healthy cells, they managed to tweak the epithelial cells (the cells that form the "skin" of a space) of the renal system into being able to turn into a variety of other cells, including nerve cells that could grow and connect to other nerve cells.

Caveat emptor: manufactured stem cells are not like Mother made. There is always something they do that's not in the original specification.

This article makes the point, at the end, that this is a starting point and that the stem cells it produces, and the differentiated (that is, specialized) cells that grow from them, really need to be evaluated before those of us who need new nerves (or kidneys, or whatevers) should start to cheer and break out the champagne.

Neuroscientists map a "new" target to wipe pain away

This article discusses the role of the peptide CDB3 in modulating the specific calcium channel signals that transmit chronic pain:

http://www.sciencedaily.com/releases/2011/06/110605132425.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

This article says it's a "novel" peptide, but last I heard, CDB3 was a cannabinoid, one of a couple hundred constituents derived from a medicinal plant cultivated for thousands of years, being researched by the likes of Prof. Robert Malamede in Colorado... For, among other things, specific & benign interference in calcium-channel signaling in pain pathways.

Let's keep our signals clear, even if we want to muddle pain's signals.

Why premature birth shouldn't be iatrogenic

I'm delighted to get my hands on an article about a study done by a nurse. Prof. Sullivan, RN and her team say, "Effects of premature birth can reach into adulthood."

http://www.sciencedaily.com/releases/2011/06/110615171408.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

Do you know why this is, logically, a candidate for the Department of the Blitheringly Obvious?

It has to do with fetal development. In a healthy pregnancy (that is, most of them), labor starts when the fetus's lungs -- the last thing to finish developing -- are done. Then the fetus signals the mother's body, and labor begins.

The neurological system and heart are getting the finishing touches in those last few weeks, too. The final stages of fetal development are extremely important, and ever more so as it gets harder and costlier to get care in this country.

Why does getting care matter? Aren't preemies a lot easier to deliver?

They pop out faster, yes. They also tend to need time in the neonatal ICU.

But wait, there's more.

This article goes on to say that premature babies tend to have lifelong problems with -- you guessed it -- heart, lungs, and neurology. Neurological issues that consistently show up relate to coordination; learning (especially math); memory; and, most worryingly, hypothalamic-pituitary adrenal (HPA) axis problems -- which messes up the body's ability to regulate weight, growth, anxiety, sleep, and mood; it's a major factor in CRPS, MS, and other constitutional illnesses.

These people are far more likely to require extra care and attention from parents, school, doctors, nurses, and therapists of both body and mind, _throughout_their_lives_ -- or at least, as Prof. Sullivan has shown, to the age of 21. More data to follow, as the study continues.

This is why I find "elective c-sections", which are often done at 37 weeks just to avoid the final stage of pregnancy, so appalling. They combine the drawbacks and long-term effects of prematurity with those of nonvaginal delivery and abdominal surgery. A full house, you might say.

Back to this article, which focuses on people who were born 21 years ago, when prematurity was not optional.

She states that these personalities tend to be more driven and success-oriented. On the one hand, that could be the cortisol talking (remember the lack of regulation? These people have higher than normal cortisol levels.) On the other, these are all people who have had a higher than average level of care, attention and structure in their young lives, and that tends to produce these characteristics anyway. When young people internalize the message that there are a lot of capable adults who really care what happens to them, they don't see failure as anything but learning how not to do it next time. And that's a setup for success.

Having explicated her stated finding, I have to say that she did not, nor did I read anything here about how she measured these personality characteristics. In short, it's possible she was looking for ways to make everyone feel better about the learning disabilities and systemic issues.

And that, frankly, is one of the common characteristics of nurse studies that tend to lessen the respect they otherwise deserve: nurses who achieve worldly success don't get there without being good at making decision-makers feel good.

I looked for the text of the study at her site, but no luck. I'll look on PubMed once I'm off this handheld. I'd like to clear up that last gratuitous silliness, if I can.

* Can't find it on PubMed. It was published very recently, so it might be worth checking back.

Acupuncture helps where conventional medicine can't even diagnose

A valid diagnosis is necessary to getting appropriate alopathic (that is, conventional Western) medical care. (This is why "House" is such a popular show: there's a lot of inherent drama in wrong diagnoses, because they can lead to chaos, suffering and hideous deaths.) Unfortunately, fully 20% of those who seek ongoing care don't get one.

No pressure.

The Chinese were developing diagnostic strategies before my British Isles ancestors were even sure how babies were made, so I view this intensely patronizing, very cagy terminology with a jaundiced eye, but the study itself looks pretty good:

http://www.sciencedaily.com/releases/2011/05/110530080513.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

As well as dramatic improvements in function and well-being, it's interesting to note that these patients made changes in their daily lives, because they felt their acupuncturists really cared (and probably because they knew what they were talking about.)

Do you have <i>any idea</i> how hard it is to persuade people to change the way they eat, move, sleep? Most people would rather put up with hideous suffering and tons of needless ill-health rather than change the pattern of their days. It's incredibly hard to make those changes, and speaking as someone who has had to change all that and more, I'm still not sure why it's so staggeringly hard.

But these practitioners of a well-structured form of acupuncture did it, and did it consistently.

-- Or rather, their patients did, given the combination of good info and perceptible support. Now THAT's a therapeutic relationship.

Curing the incurable: type 1 diabetes in mice, with 78% success rate

Next Big Future: Gene therapy reverses type 1 diabetes in mice with 78% success rate

Intriguing approach: providing gene therapy to both protect and rebuild the Islets of Langerhans, which means blocking the T cells from the islet cells without compromising them otherwise.

For an early trial of a complex therapy, this is rather brilliant and very promising. Of course, humans are not mice, but type 1 diabetes is generally type 1 diabetes - or something very similar.

Next up: a cure for CRPS, Alzheimer's, and AIDS. Hey, it could happen.

Thinking with your body, thinking with your mind

I'm too jetlagged to do this justice, but it's an intriguing look at the way we solve 3-D problems with, and without, using our hands to work out solutions.

http://www.sciencedaily.com/releases/2011/06/110602111448.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

News flash: Dementia is confusing & doctors should communicate

I can't resist candidates for the Dept. of the Blith. Obv.: Many geriatric patients receive an incorrect dementia diagnosis. 

http://www.sciencedaily.com/releases/2011/05/110531084629.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

The final diagnosis was determined by postmortem autopsies examining structures and changes in the brain, which are pretty definitive.

Most dementias are currently incurable, and only some can even be managed. So why does this matter?

Two reasons: the clinical and the academic -- which is ultimately clinical, too. 

Firstly -- and I'm speaking as someone who has skirted dementia myself -- if anything can be done to mitigate this hideous state, it should be done. Correct diagnosis improves your chances of getting appropriate care. 

Secondly, incorrect diagnoses screw up the data. How can we evolve our understanding, improve diagnostic criteria, develop more effective treatment, and work on actual cures, if we aren't clear about what we're working with and how it plays out?

What's lovely and touching about this is, the researchers truly believed that correct diagnoses were much more common, and that the communications between the neurology department and the geriatric psychiatry clinic were better than they were ... and that they changed their stance dramatically in response to their findings. 

Knowing how cautiously physician researchers normally phrase recommendations, and how neutral and respectful Swedes prefer to be, the researcher's closing remarks sound like a passionate cry from the heart. It's really moving. 

The key to growing old gracefully

Another candidate for the overpopular Department of the Blitheringly Obvious:

"Social life and mobility are keys to quality of life in old age"
http://www.sciencedaily.com/releases/2011/05/110528191542.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

The article goes on to say that old people go to great lengths to stay active and connected, and use their well-seasoned brains to problem-solve issues of daily living at a rate that makes most younger people look like pikers.

In this article, they actually used the term "extreme lengths" -- obviously they haven't considered what it's like to be old. You simply have to cope, in order to have a life worth living, and your friends help you figure it out. Doesn't that seem pretty self-explanatory?

Nurses could have told them all that, plus a bunch of gruesome stuff about skin care, but study scientists pay even less attention to nurses than they do to patients. I'm just glad someone FINALLY thought of asking the only people whose opinion on "quality of life for the elderly" really counts.

Numeric literacy, mental integrity, and fun with ferrets

Most people get confused when faced with an article about medicine, or any kind of complex science. Because people with extremely expensive educations wrote that stuff, then other people figure (at some level below common sense) that the study's authors must be fundamentally superior.

Education is not the same as intelligence.
Intelligence is not the same as sense.
Sense is not the same as integrity.

I come from a highly educated family. ('Nuff said.) Growing up in the context of good education really made it clear that people are people, regardless of the letters after their names. Degrees simply mean that someone can work hard on their own behalf; they're no guarantee of logic or brilliance. It's never wise to subvert common sense in favor of education.

So, if you're one of the majority who doesn't have alphabet soup after your name, give yourself some credit as you read these things.

There are a few simple principles that can help you dissect a study with reasonable confidence:

• Question assumptions (& listen to your eyebrows.)
  
• When the question makes no sense, you don't have to accept the answer.
  
• If it seems stupid, it probably is.
  
• Don't ignore the man behind the curtain.
  

A Furry Example of Fuzzy Logic
The article cited below is precious ... A delicious exercise in mental pretzel-ry designed to reduce the average brain to cottage cheese. It's easy to unravel if you hang onto your common sense and don't let go, because your brain is not average.
Ready? Here it is.

1. The title of the article linked below proclaims that researchers have proven that Topic A is bogus.
   
2. The researchers' summary says no such thing. It states that they've proven that your belief in Topic A should be much greater if you do believe in it or much less if you don't; doesn't matter which.
   
3. Then the researchers state that that finding, itself, doesn't matter, because they personally don't believe in Topic A, can't think of anything in its favor, and that you should agree with them -- regardless of their own findings -- simply because they said so.  (A fairly common conclusion.)
   

Let's pause to regroup, since this is enough to make most people tear their hair and gnaw the furniture. That tends to kill the punchline.

Backing up the train of thought to the beginning...


Pick something that there's some disagreement about. For the sake of clarity, choose something not too emotional, like, "Do ferrets make good pets?" Pretend that's Topic A.

You've already thought of ideas that support this and ideas that don't, and you probably already know whether you, personally, would like having a ferret as a pet.

Have you ever, in your most random moments, picked a percentage or a ratio to indicate how much you would, or wouldn't, like to have a ferret as a pet, with nothing to compare it to? I mean, is there any value to the idea of doing so? How odd is it to assume that people would?

TIP: Question assumptions. If your brain -- or the skin on your forehead -- starts to squirm, it's a good clue that there's an unexamined assumption waiting to jump up and trip you. Stop and check. 

Liking pet ferrets is simple: you either like them (a little or a lot), you don't like them (a little or a lot), or you decide you don't know enough to have an opinion. That last option isn't even available here, but it's very common.

If you have an opinion about ferrets as pets, doesn't its extent depend on external forces -- whether you've known pet ferrets, whether their owners were responsible, whether it was a nice ferret or a real brat?

And wouldn't the appeal of keeping/getting rid of a pet ferret depend on whether there's a pet store stocking ferrets and ferret supplies, what your lease says about pets, whether or not your housemate can ferret-sit while you're hiking the Camino de Santiago, whether your veterinarian can help you surrender an unwanted ferret? And don't these circumstances themselves change, from place to place and time to time?

So how can you assign an absolute percentage to your opinion about whether ferrets make good pets? How surprised would you be if anyone asked you to do so?

And, really... Why would you? Do you assign a percentage to how much you dis/like strawberries, the color blue, or Sarah Palin? Or don't you use value words instead -- love, like, can't stand?

Unless most (rather than very few) of you think of your preferences in numeric terms, then the very question the researchers are trying to answer is fantastical. Pure silliness.

TIP: You don't have to accept an answer, if the question itself makes no sense. 

Moreover, the way they processed the data doesn't change your answer; it indicates that your beliefs should be far stronger, whatever they are.

They're saying that, if you would like a ferret as a pet, you should be on your knees at the pet shop, weeping with longing -- or, if you already have one, should be emitting a constant stream of happy little noises as you snuggle your ferret at work, on the bus, everywhere, all the time.

If you would not like a pet ferret, you should be packing to move so you can stay as far away as possible from anything long and furry or even vaguely ferretlike -- or just blow up all the ferret-friendly pet shops where you live.

TIP: Just because someone with a very expensive education says it, doesn't necessarily make it so. If it seems stupid, it probably still is.

Contrary to the title of the article, the results tell you: don't change  your position, just become more extreme about it. That's their conclusion.

Isn't that helpful? Just what we need: debates that are even more shrill, spittle-flecked and unreasoning.

TIP: Repeat prior tip... Really stupid.
In light of the decisions that led up to this conclusion and the anti-intellectual nature of the outcome, do you think this makes sense? 

And, clearly following their own advice, the scientists themselves pick a side and pronounce that they don't like pet ferrets and that you shouldn't like them either.

Why?

Because they don't understand how anyone could like pet ferrets and BTW other scientists in vaguely pertinent fields don't know enough to prove how pet ferrets can possibly be desirable.

Therefore (stretching the metaphor), given this massive ignorance on the part of so many highly-educated people, ferrets are obviously terrible pets and all of them should be gassed.

...WHAT??...

SUMMARY:

This is not a terrible study and it was not done by stupid people. They just left their mental integrity in their other jeans, and that happens a lot.

Why on earth...? Because we all have assumptions and agendas.

Science aims to clear that out, but it's done by live humans with organs and mortgages, so their objectivity is pretty hit-and-miss.

When reading science articles, be open to hidden agendas while you look for the facts.  For better or worse, they go together. You might as well notice both.

Scientists are often very obvious about using big words to say silly things, and if you can step aside from feeling intimidated, it's surprising how obvious they are.

The problems here are common problems:

• Point 1. Article's title misrepresents the outcome of the study.
  I usually read an article at least twice before making up my mind.
  I read it through, then start again at the title.  How accurate is it?
  If the title isn't fairly accurate, I know someone's got an intrusive agenda.
  
  
• Point 2. Outcome doesn't make sense.
  It says you should believe either more than you do, or less than you do, but it doesn't matter which.  How to do so is not mentioned (for good reason.)
  I usually look over the details of an article three or four times, to give the facts time to sift together in my mind.
  When I feel my brow wiggling at something, I stop and look again. I trust my good sense more than I trust my education.
  Figuring out crappy data just requires you to assume you're not an idiot, even if you don't know the field. 
  Don't think badly of the scientists, just assume they have their own sets of human flaws.  It's a safe assumption!
  
  
• Point 3. Conclusion goes against the findings.
  In any case, DON'T believe in Topic A, because the researchers have made up their minds on the basis of their ignorance, and screw their data anyway.
  Continue to assume you're not an idiot, as you read the conclusion.  It's that simple.
  Then compare it, again, to the title and to the facts.
  If something doesn't add up, you know there's agenda going on.
  

These particular scientists intended to prove that their statistical method was better than existing methods. Given all the logical problems surrounding their efforts, I think they blew it, but I'm not a statistician.
CLUE:
The topic of this study was ESP.

As my relentlessly rational, very prescient Dad once said when I asked him whether his use of ESP was irrational, "It would be irrational to ignore the evidence of my own experience. It's highly consistent for me, even though most people can't do it, or can't do it very well. But just because they can't use this valuable tool, does that mean I shouldn't?  That wouldn't be very clever!"


Dad was very clever. (...And for the record, he did foresee his own end.)


Let's step over to another, less-emotional metaphor to think about studying this subject.
Imagine that most people are basically color blind, but a few can see some color.  Anyone who can see beyond the greyscale is not going to get much credit, but there are enough of them to make the rest wonder.


However, since the colorblind are looking for proof of color with instruments that see only luminance, but cannot see color even as tone or hue, they probably won't have much luck proving something that they don't understand, can't use, and don't believe in anyway. (...But they can sure get snarky, trying.)

TIP: Don't ignore the man behind the curtain. Think for yourself ... And try to remember, especially if you're in a position of respect, that you don't necessarily have the right to think for others. 

Today's unbelievably fatuous truism, which everyone always forgets anyway:  Other people are not you. Only you are. Honor that, and things go better.

THE POINT IS:
In the end, everyone has to pursue their own logic, account for their own experiences, and come to their own conclusions.


What science is supposed to offer is a crystalline view of measurable and provable data. It doesn't help if the scientists pick up a hammer and smash the crystal when presenting it to public view.


As I know all too well, education is not the same as intelligence; intelligence is not the same as sense; sense is not the same as integrity.


Read studies for yourself.  Practice makes perfect: the more you do it, the easier it gets, and the more accurate (and potentially shocking!) your understanding becomes.


Jump in here and comment on your own experiences. I'd love to hear from you about your adventures with this.

THE STUDY:

http://www.sciencedaily.com/releases/2011/05/110518080059.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

Digestive problems early in life may increase risk for depression, study suggests

http://www.sciencedaily.com/releases/2011/05/110512171517.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

This article states that gut disturbance in early infancy/lifelong gut disturbance (the language is kinda sloppy) can trigger lifelong depression and anxiety.

This doesn't surprise me, but most of the rest of the article does.

The rat-botherers who did the study presume it's all about the vagus nerve. Recently, a deliciously expensive procedure which stimulates the vagus has been found to alleviate some depression. It's good to know that.

It's good to keep a couple other things firmly in mind first, though:

- Serotonin is produced in the small intestine, as well as the brain. It helps to digest protein. It also plays a role in immune signaling. Think that could possibly be related, either to depression or to inflamed gut syndromes? H'mmm...

- My first thought: get right on top of infant digestive problems. That means getting serious about both prevention and cure.

Oddly, that idea wasn't even mentioned, even though prevention is infinitely better than trying to manage a lifelong downer like IBS or depression -- let alone both!

Prevention is simple in concept, but inexcusably difficult in our current system. With babies, it's easy: get dead-serious about breastfeeding. Where that's not possible, put aside formulas at the first sign of allergy. Don't switch between cow and soy milk, two of the most allergenic infant proteins on the planet; milk more goats and camels. Go to a breastmilk-bank. Find your local midwives because they are much better with the idea that birth is only the beginning of a much longer life, and they should know how to figure this out. If they don't, they can tell you who else to call.

And punctual treatment for troublesome insides -- with the least invasive meds. Interfere with their little regulatory systems as little as possible, but take care of the problem. For indigestion, chamomile and calcium carbonate are much better than h2-inhibitors (Zantac, Prilosec and the like.) Chamomile also soothes the mind and settles the emotions, so the kid can relax.

Try elimination diets to screen for allergies. Sadly, wheat, eggs, cow dairy, soy, and corn are common allergens which affect the developing gut -- and the developing skin and brain, because their little bodies never got the memo that all of these systems are supposed to be separate from each other.

Google those terms, discuss them with your midwife/pediatrician/nurse practitioner, and take care of the problem at its source.

You don't want more depressed people in the world. There are better things to do with infants than let their guts screw up a good life, handing them into the craps-shooting care of multiple pharmaceuticals and invasive procedures.

When I get on the CPU, I'll set up more links for my factual statements. This is it from the iPhone.

Bon appetit!