An earlier blog titled Our Doctors Can Do More To Help The People provoked heavy discussion from the BU family. BU came under heavy criticism by some who accused us of unjustly slurring that most noble profession, the medical doctor. We are therefore heartened by the feedback we have received which has been very supportive of our position.
We reiterate that Barbadians over the years have tended to focus on the rising food and petrol prices when echoing concerns about the cost of living. At the same time professional fees have been rising equally as fast e.g. doctors, lawyers, architects, surveyors, engineers to name a few. We have decided to AGAIN highlight the role doctors can play to help the PEOPLE more in the current bleak economic climate.
A BU family member who appears to be close to the medical profession has put forward the argument that doctors have to expend large sums of money to train, and expensive equipment is required to maintain an acceptable level of healthcare delivery in their private practices. Even if we accept this argument, how does one explain that we have several doctors in Barbados who own mature practices and are known to be very affluent, but do little or no pro bono work? These rich doctors continue to charge rates which show insensitivity to the current depressed economic conditions.
Against the background of a rising cost of living is it unreasonable to expect that some more than a few doctors should want to give a lot more back to the community? From the feedback we have gotten we know of a FEW doctors who charge pensioners $30-$40 for a consultation. We were even more surprise to learn of ONE doctor on the West Coast who does house calls! The reality however is that our research shows that the majority of our doctors are prepared to collude on the matter of fixing fees and gorge themselves on the fatted calf.
In light of the pressures on our healthcare system and the worsening economic climate, the Barbados Association of Medical Practitioners (BAMP) should want to mobilize some of the more affluent doctors to park their Mercedes and BMWs and commit to offering their services at reduced rates periodically. The public relations benefit pales in significance to the satisfaction of satisfying the moral law which is the underpinning of this most noble endeavour.
Have the affluent doctors in our society become so numb and insensitive to the ‘pain’ of their fellow citizens that they cannot see how their failure to do more to ease the economic ‘pain’ violates the medical profession’s moral code of First Do No Harm – Primum non nocere?
On behalf of the PEOPLE we are asking DOCTORS in Barbados to do more to help the PEOPLE, we know that you can do more.













126 responses so far ↓
J // January 23, 2009 at 12:18 AM
For ROK and Hopi and others who doubt the usefulness of universal vaccination, I heard that a little boy died from chicken pox last week and was buried today.
J // January 23, 2009 at 12:20 AM
There is a chicken pox vaccine, but it is not part of the Barbados formulary. Therefore parents who want to have the vaccine for their child have to pay about $180 for it and because it is preventative medicine the insurance companies do not reimburse.
ROK // January 23, 2009 at 1:26 AM
J
I want you to know that I believe in the usefulness of vaccines, but not the over-use of vaccinations.
I would consider vaccines as old technology. What David is aiming at here is how we can use the knowledge we have gained by modern technology, to our benefit.
Clearly, it is the domain of doctors to educate patients; they have the knowledge. It is also the domain of doctors to work with other medical services, production, research and practices; it can only make everybody better and more efficient.
I put it to you, David, that doctors should rely on their fees and not on selling drugs. They should consider that if they educate their patients, there would be less fear of doctors and actually more confidence in doctors if they impart lifetime lessons to people; they may see less patients but less stress too. The high fees would become worth it.
They should consider that to hold on to the opinion that people have to get sick for them to get rich, is inhumane. That is a myth. They may get richer if they educate the people.
This would be the effect of doctors pulling their weight:
1. Local farmers would benefit and the high demand for vegetables would fetch a better market price.
2. Our food bill would go down as more Bajans start to prize local fruits, vegetables and produce.
3. Fast food outlets would be forced to upgrade the quality of their food to meet the demand of a more conscious consumer.
4. Our health bill would be considerably reduced as we reduce importation of drugs.
5. Less loss of man hours because more people are healthy and more efficiency on the job and because they have more energy and feel less stressed; to help us raise the bar on standards of service.
Quite simply, there is a positive ripple effect that touches social cohesiveness, education performance in youth; and economic activity (more jobs and self-employment).
We can only conclude that a change in the role of doctors would lead to a whole new life, a shift in an old paradigm that still “captivates” us today.
JC // January 23, 2009 at 12:15 PM
Well said ROK……. well said!
me // January 23, 2009 at 12:48 PM
LOl…Im still waiting to hear who are these unfeeling rich doctors and who make up this majority of doctors that do no pro bono work…
I want to know how you know that they are unfeeling.
I want to know if they ( the expensive ones hide their fees then surprise you)
Id also like to know which doctors and how many dod not educate their patients. In addition how do you know that they dont?
Also explain to me why many people still insist on using Bayview instead of the ‘Free’ QEH?
J // January 23, 2009 at 1:28 PM
People use private hospitals instead of public ones for 3 reasons.
1. They need a thing done in a hurry, and the public waiting list is too long.
2. They have private (probably employer sponsored) health insurance and they like to use it up to get the thing done quickly.
3. They are poor great poppets who pay even though they can hardly afford it, but they want friends, relatives, colleagues, and especially enemies to think that they can afford the expense.
Georgie Porgie // January 23, 2009 at 1:53 PM
I agree with you.
But option #3 is certainly most fool hardy.
anon // January 23, 2009 at 1:54 PM
David what is a mature practice? And why should doctors do pro bono work? Who else does? Who else have you asked to do so?
In what way do rich doctors continue to charge rates which show insensitivity to the current depressed economic conditions? Why don’t the poor not then attend the polyclinics. Isnt it Bajan to cut your cloth to suit your size?.
Against the background of a rising cost of living why is it unreasonable to expect that some more than a few doctors should want to give a lot more back to the community? Who else is doing it? The carpenters and other artisans? The mechanics and wrought iron men?
Let the people live healthy lifestyles, and starve out the doctors man. Ask BT about how this can be done.
The majority of our doctors follow the tariffs, just as they do when they go to the airport and pay departure tax, or when they pay customs and excise taxes etc when they import a Benz or BMW.
David why are you against doctors who gorge themselves on the fatted calf? Is this not the major pastime of people in this age?.
Did the doctors cause the pressures on our healthcare system or the worsening economic climate? Don’t we pay the politicians well to deal with both of these issues?
Are you saying that the Barbados Association of Medical Practitioners (BAMP) mandate how its members should offer their services, when and for how much?
David, could you kindly explain the rhetoric below that you wrote? You have lost me completely.
The public relations benefit pales in significance to the satisfaction of satisfying the moral law which is the underpinning of this most noble endeavour.
David, could you kindly explain how the failure of the doctors to do “more” to ease the economic ‘pain’ of the populace violates the medical profession’s moral code of First Do No Harm? This is senseless rhethoric man!
Tell us what the doctors are supposed to do Sir!
Why do you envy the affluence of the doctors in our society? Have they not worked for their lifestyle? Unlike say the politicians?
Do you really think your harping on this theme will change anything?
You can preach like Peter, and Pray like Paul, but it aint going to happen!
antirok // January 23, 2009 at 1:56 PM
Rok
Your little essay reminds me of the drivel we used to write in English composition class at school.
You suggest that if the doctors would pull their weight according to your dogma, that local farmers would benefit and the high demand for vegetables would fetch a better market price. This is an obvious non secquitur. Who is to say that local farmers would plant the produce that is most desirable. Who is to say that the retail sector can not source the relevant food cheaper abroad? Would not the HIGH demand for vegetables fetch a better market price ONLY if supply is scarce according to basic Economics? You are of course familiar with the law of supply and demand right?
If the Ministry of Agriculture cannot successfully promote the prizing of local fruits, vegetables and produce, why do you think that doctors should spend time on this endeavor? Why do you think that they will be more successful than the MOA in helping to reduce the food bill in this way?
There is so much in popular magazines and on the internet for our populace to choose a healthier lifestyle as you put it. If folk are not availing themselves of such now, why do you think that doctors will change any thing? Do you think that because they are called doctors, that all doctors are effective teachers?
Explain succinctly how fast food outlets would be forced to upgrade the quality of their food to meet the demand of a more conscious consumer? We have been taught about AIDS since its “discovery” in 1981. Has teaching really made a dent in the incidence or prevalence of this disease on our shores. .
How do you know that our health bill would be considerably reduced as we reduce importation of drugs? Wont be then be spending the money on the latest preparations that the alternative practioneers peddle for antiaging, or wrinkled skin or whatever?.
You think that healthier folk will want to work more or play more?
Who told you that the youth are generally interested in education performance in youth?
Really! Really! Really Rok, the omniscient—and that is sarcasm OK? I don’t agree that your diatribe leads to the ONLY conclusion is that that a change in the role of doctors would lead to a whole new life.
Like David, your rhethoric is good, but your argument is bull shit.
ROK // January 23, 2009 at 2:54 PM
antirok
I don’t even know how to answer you. Please do some reading. I am making some assumptions… but I am going to respond to one.
First any good advice would be that fresh fruits and veg grown where you live is best. Getting your vitamins and minerals from a natural source is preferable to synthetic ones.
It flows from there. Good health = strong population = more productive = less drugs = less pressure on health services and the equals goes on.
Please!!!!!!
If vegetables become prized and demand is great and we could almost reach the level of a guaranteed market price, then more people would get into farming.
Wow! This is hard!
If more people stop buying and stop buying it for their children would not KFC and Chefette have to either review what they are selling or shut down?
You antirok? I think you anti Barbados. Who is you? CIA? MI5?
ROK // January 23, 2009 at 3:32 PM
Anon
You compartmentalising this issue. Like politicians, you are well paid. Unlike most of them, you are paid, not for a term or two, but a lifetime.
Please, don’t talk about pro bono work. Lots of people do it. Not a doctor ain’t come and help we in the C&W hearing nor in this one neither with BL&P. You going be making you money while we up there (I could hear you now) like idiots. Nobody ain’t send we to do that?
However, you may not need it but will more than likely reap the benefits… and I am sure that not one doctor will donate a sheet of paper and we have been crying for help.
antirok // January 23, 2009 at 3:55 PM
While you were at the C&W hearing etc the doctors were saving lives. Go figure! LOL.
Your cage has been rattled aint it Oh omniscient one.LOL.
Hopi // January 23, 2009 at 4:03 PM
@J….OMG!!!OMG! Where? when? how?why? You think I should run out and get some of that pus injected into my offsprings’ blood stream? Wha do you think?
Courtney // January 23, 2009 at 4:36 PM
J:
… because it is preventative medicine the insurance companies do not reimburse.
Haven’t it been said over and over that an ounce of prevention worth more than a pound of cure? The Insurance Company is partially responsible if they do not cover preventive medicine and proactive tests. With the new view of advanced medical imaging and screening devices one can maintain good health by having regular screening to detect disease early and treat it quickly, instead of waiting for symptoms of disease before visiting the doctor. If doctors see the same patients over and over, they are in a better position to help patients develop habits and behaviors that will prevent disease in the long run.
I am of the opinion that Health Insurance Companies feel that if there is no illness there is no need to pay; rather than thinking that it is better to catch an illness before it occurs or is in the early stages, such as high blood sugar levels, high cholesterol, hypertension, cardiovascular disease.
That being said, if doctors commit to preventive medicine and health promotion, I don’t see why the Insurance Companies would not want to join in the effort so that the chances of treatment will be greatly improved, and more importantly help to curtail the costs the Insurance Company would later pay out when the illness that could have been avoided becomes chronic.
Until there is collaboration among the Government, Health Insurance Companies, and the Private Sector, there will continue to be challenges beyond the control of the patient, and our citizens will continue to lack quality health care.
antirok // January 23, 2009 at 5:13 PM
Oh mighty ROK! Here you go again spouting drivel . Please do some reading? Really really really
As you make your assumptions…as usual, you seem to think that ONLY YOU CAN READ OR HAVE READ.
You write
If vegetables become prized and demand is great and we could almost reach the level of a guaranteed market price, then more people would get into farming.
This is another nonsequitur. Who tell you that folk want to farm? Who says that the guaranteed market price will be the optimum price to induce folk to farm?
You can not prove that local farmers would plant the produce that is most desirable.
You can not prove that the retail sector can not source the relevant food cheaper abroad.
You can not deny that a HIGH demand for vegetables would fetch a better market price ONLY if supply is scarce according to the law of supply and demand.
You can not prove that the doctors will be more successful than the Ministry of Agriculture in promoting the use of local fruits, vegetables and produce, nor can you prove that they do not do so now.
You can not prove that because they are called doctors, that all doctors are effective teachers? And that they can do the teaching you theorize they ought to do as the solution to all of our health ills.
You can not prove that healthier folk will want to work more rather than play more?
You have not entertained none of the reasonable issues raised, as you can only see your very very narrow view point.
DO YOU REALLY BELIEVE THAT ONLY YOU CAN READ OR HAVE READ.
DO YOU REALLY BELIEVE THAT ANY ONE THAT QUESTIONS YOUR DRIVEL IS ANTI BARBADOS? OR CIA? MI5?
The doctors will do as they wish, and niether you nor David can do anything about it. You can talk til the cows come home!
ROK // January 23, 2009 at 5:53 PM
antirok
I got you on ignore. You not any help to this situation even from your side of the fence. You think the minibus men out there want to drive minibuses? If so, why? Because they like driving?
Any activity that will bring in money people will do: Sell pig tails, sell nuts, bottle and sell seasoning, ketchup, mauby syrup, etc. People grow sugar cane to sell cane juice; all kinds of things if they perceive it profitable.
What drivel what? Who you trying to convince. Looks like you are one of those people who don’t like others to talk, that you could come with so much drivel. You don’t want your bubble burst? You in a comfort zone?
Incidentally, you ain’t out there saving lives free of cost; and you got people helpless and supporting the very drugs that killing people and if that was not happening, you would not have so much saving to do.
You would catch afire my house and then run and get your fire engine to out it and then tell me that you save my house?
I leave you to BU household.
bobbie // January 23, 2009 at 6:14 PM
Rok
The man running you ragged man. He has asked some good questions to counter your initial arguments, that are worth exploring. But you have been unable to rebut his counter points. Where are your debating skills? You act as though you must be allowed to say what you wish, and no one is to respond to what you say. It is your bubble that has been burst Rocky ma boy. It looks from here that it is YOU who are one of those people who don’t like others to talk Rocky ma boy. Examine yourself man.
How do you know that the man (woman) is even a doctor? Or in a comfort zone?
As you say Any activity that will bring in money people will do: including doctors selling medication or even samples LOL. As you say all kinds of things if they perceive it profitable. Why should doctors be different? LOL
Why should doctors save lives free of cost? How do doctors have people helpless? They have free medical services in Barbados. Not so? Free doctor, free medicine, free tests. What you complaining bout.
FYI before the advent of drugs as we know it today many lives were lost. Not so? Bet you didn’t know that?
It is drivel to say that “you got people helpless and supporting the very drugs that killing people and if that was not happening, you would not have so much saving to do.
You would catch afire my house and then run and get your fire engine to out it and then tell me that you save my house?” Examine yourself man. Examine yourself
Rocky ma boy the man give you a whipping today!
ROK // January 23, 2009 at 6:19 PM
Well bobbie. Can’t win all. I here honing my debating skills for next week.
David // January 23, 2009 at 8:00 PM
There is a reason why we have labeled the medical profession as ‘noble’. To whom much is given much is expected. We don’t accept that the ethos which permeates from the medical profession should be initiated in pure economics. If that is the case then there is no hope.
Some would use our comments about the medical profession to conclude that we are bashing. We know enough about the practices by some doctors in Barbados to be concerned.
Unfortunately Barbadians are so passive when standing up for their rights and being aggressive about their expectations. Having said that we must admire the unswerving defense of the profession by some members of the BU family who are obviously of that profession.
anon // January 23, 2009 at 8:22 PM
David
Take it from someone who knows. Having been in medicine for almost 35 years I can tell you that it is a myth that the medical profession is labeled as ‘noble’. What noble what? Some of the worse men I know are doctors. Becoming a doctor does not change the heart of a man, no more than changing one’s clothes does.
Doctors are human- mere men, just like other men, and they think like other men. At no time in their training are doctors taught that they are “noble” or superior to anyone else.
The maxim that “To whom much is given much is expected” applies to everyone- not only doctors. If the ethos which permeates from the medical profession should not be initiated in pure economics for doctors, then this should be so for everyone. Not only doctors.
The reason that there is no hope has nothing to do with the affluence of doctors in Barbados, but has to do with the heart of men in general. BU or ROK have no right to determine what doctors should charge, who they should charge or if they should work pro bono or otherwise.
You can bash as much as you like, or be concerned as much as you like about what you know about the practices by some doctors in Barbados, but you cant do a thing about it, because the fellas will always close ranks. So keep on admiring the unswerving defense of the profession. LOL
J // January 24, 2009 at 10:31 AM
Hopi wrote on January 23, 2009 at 4:03 pm
“OMG!!!OMG! Where? when? how?why? …you think I should run out and get some of that pus injected into my offsprings’ blood stream?
A 13 year old boy at Combermere school.
But you are living comfortably in the U.S. and there is no way that you would live in Barbados and give up access to some of the best medical care in the world so you can afford to make sport of us Bajans.
Your child did not die.
ROK // January 24, 2009 at 11:18 AM
J
Does one case of Chicken Pox where a child ends up dying be considered a national emergency. So many people I know had chicken pox and still alive today. What other complications were there?
How many people dying from asthma? You have a vaccine for that? What about diabetes and heart diseases, cancer. Please compare the statistics. If that one case can be of so much national concern what about the others? They gone past epidemic.
I really don’t understand the fear, panic and hysteria. I think it is a scare tactic on the part of a few die-hards in the medical profession.
Sapidillo // January 24, 2009 at 11:55 AM
The majority if not all of the professionals, be it doctors, lawyers, not to exclude our religious quacks, their first priority seems to be to get as much money out of our citizens as humanly possible by any means necessary.
To anon-
Could you tell me if ALL of our doctors in Bim were required to take the ENTIRE “Hippocratic Oath” or were they allowed to omit paragraphs such as:
1. “My professional judgment will be exercised as independently as possible and not be influenced by political pressures or by factors such as the social standing of the patient. I WILL NOT PUT PERSONAL PROFIT OR ADVANCEMENT ABOVE MY DUTY TO PATIENTS. ”
2. “I will ensure patients receive the information and support they want to make decisions about disease prevention and improvement of their health. I will answer as truthfully as I can and respect patients’ decisions unless that puts others at risk of harm. IF I CANNOT AGREE WITH THEIR REQUESTS, I WILL EXPLAIN WHY.”
I know for sure that the last sentence is NOT carried out.
Theses medical professionals whether it is the ones just entering practice or the old biddies, I would agree that their fees are somewhat high. They make the argument that the fees they charge pay for the loans towards their education costs and pay their insurance costs. There is nothing wrong with that. However, it is ironic that some general practitioners charge equally or very little less than the specialists.
Based on a culmination of factors which the citizens can’t seem to do anything about, I think it is a downright shame that the medical profession in Barbados is truly nothing to be proud of.
Hopi // January 24, 2009 at 12:41 PM
@J….But you are living comfortably…….’ No J. If you are aware of the ‘time of the day’ there’s no way you can be living comfortably anywhere. As far as ‘giving up some of the best medical care’ that’s not for me. My best medical care is PRE-EMPTIVE
Hopi // January 24, 2009 at 12:52 PM
Con’t @ J……I try to avoid doctors at all costs. Try to eat organically whenever possible, keep my rat-infested surroundings clean etc…etc…I do not trust/respect doctors, lawyers, so called professionals,and the list goes on…..they are too damn self-important.
Did this 13yr old die from chicken pox? Was he vaccinated against it?
Bonny Peppa // January 24, 2009 at 12:59 PM
Just ta add my two-cents worth, I understand that the little youngster died from ’shingles’, whatever that is. Someone told me that you contract chicken pox once in a lifetime and anything after that is called ’shingles’. Is there a doctor in de house? Please clarify.
Mawnin’ HOpi. Ya demon.
Anonymous // January 24, 2009 at 1:05 PM
Nowadays the doctors buying a simple machine to check your heart -ECG – then they buy a glacuometer to test your sugar, – next the cholestrol machine and everytime you visit them they want you to pay for a cholestrol test,a sugar test,,they push you to do an ECG,and before you know it that machine done get paid back for in 6 months yet they raking in money charging you high amounts for these tests – which sometimes are not always needed as often.
The younger doctors are the ones who seem to want to make money fast,while the older ones are like old relics because they would not go and do refresher courses and keep up to date.
I think of the case made by the former minister of health david estwick about dr brian charles.
Why would a doctor who is head of the medical services (brian charles) also want to be the representative for the insurance brookers covering the QEH.
Then the same doctor is the medical rep for CERO,and for the Prisons,and for the Defence Force.
I mean pleassee – isn’t that a clear case of trying to grab everything for yourself and not being able to offer anyone of the party quality service?
ROK // January 24, 2009 at 2:14 PM
I was invited by VOB to be on their call-in programme on Sunday (tomorrow). Topic is about the Legislation to ban Smoking in Public Places.
Hopi // January 24, 2009 at 2:17 PM
@Bonny Peppa. Good mawning yaself! I too would like to know what killed him.
David // January 24, 2009 at 2:21 PM
@ROK
What is there to discuss about that topic? Seems a no-brainer.
ROK // January 24, 2009 at 2:34 PM
@ anon
“BU or ROK have no right to determine what doctors should charge…”
That is so true. We decide how much we will pay, but those unfortunate who don’t think they have a choice, you can dictate to them.
This idea that people should fork out their hard earned money without question, is nothing short of inhumane and arrogant. You think you have the right to charge what you want and people must pay, without quantifying the value of what you are doing. Anything that you do is worth gold? Later for you. It is not worth it for me.
ROK // January 24, 2009 at 2:43 PM
David,
To some it is not. Certainly to some businesses it has an effect. I was just going through some statistics and it is showing a reluctance on the part of restaurants in the USA to impose the ban.
Surveys show these percentages in favour of banning smoking in restaurants and fast foods:
• Restaurants – 61 to 71 percent
• Fast-food Restaurants – 77 to 82 percent
In contrast, these are the figures that show action taken by these same owners:
• Restaurants – 25 to 45 percent
• Fast-food Restaurants – 52 to 72 percent
Hopi // January 24, 2009 at 2:48 PM
@ROK….I hope they have a rep from the parasite industries i.e, the medical mafia and the cigarette companies who make a killing from cigarettes and since you represent the people I hope you let em have it. As your supporting evidence, take along a few people who have been harmed by cigarettes directly/indirectly.
David // January 24, 2009 at 3:01 PM
With the high instance of Asthma in Barbados and the cost to our healthcare, why would we not want to contain unfiltered smoke in our tiny country?
ROK // January 24, 2009 at 3:12 PM
@Hopi,
I do not know any non-smoker who was harmed by cigarette smoke in Barbados. Please tell me about at least one. Not talking about asthma triggers. A host of things trigger asthma, including healthy foods.
Would dearly love these statistics otherwise there is a hole in the argument to ban in all public places, especially those that are not enclosed.
David // January 24, 2009 at 3:37 PM
Isn’t it ironic that the more intelligent we become simple decisions to make become so hard? Why should those of us who want to inhale fresh air have to accept polluted air from those who want to pollute the atmosphere?
The PEOPLE should always have the benefit of any doubt n’est pas?
ROK // January 24, 2009 at 3:42 PM
David,
I would like to stop having to inhale air with vehicle exhaust smoke in it. Let’s see how simple that is.
Anonymous // January 24, 2009 at 4:11 PM
That is a clear example of how full of crap VOB is.
With all this information of the doings of Lime we have that radio station devoting a whole Sunday to discuss a ban on smoking.
A whole Sunday to discuss that?
Who is the body dat does arrange these programmes?
Dey want locking up for operating under false pretences -that is,pretending to be intelligent whilst they obviously operating without a brain.
Hopi // January 24, 2009 at 4:34 PM
@ROK……And here I am ASSuming that you would support a non-polluted environment. Talk about ‘foot-in-the-mouth.’
ROK // January 24, 2009 at 4:40 PM
@Hopi
Your assumption is not wrong. However, I think that too much weight is being placed on cigarette smoking and not sufficient on the real culprits; vehicle exhausts and industrial smoke.
Time we get to solar.
anon // January 24, 2009 at 5:32 PM
Sapidillo
Can you indicate the parameters by which you will decide whether one should be proud of the medical profession in Barbados?
Certainly you can get to see a doctor easily in Bim. Its damn hard even in the USA even if you have insurance. Not always easy to get an appointment.
UWI doctors, as far as I know do not take the Oath of Hippocrates. They take a more relevant oath. Why should any one take such an out dated oath as printed below. After all old things are irrelevant today, such as for example the teachings of the Bible. You want one with out the other?
Here is the original Oath of Hippocrates
The full text from the “Harvard Classics” Translation.
I SWEAR by Apollo the physician and AEsculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation — to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.
Tell me Sappy where did you get your amendments to the oath which you quoted?
anon // January 24, 2009 at 5:33 PM
The omniscient ROK vomits faeculant material again
Does one case of Chicken Pox where a child ends up dying be considered a national emergency. So many people I know had chicken pox and still alive today. What other complications were there?
Questions
Since when was ROK a Public Health expert?
What is more important fool; the complications of a disease process or its cause?
Every case of infectious disease is of national significance fool!
The jackass vomits again
How many people dying from asthma? You have a vaccine for that? What about diabetes and heart diseases, cancer. Please compare the statistics. If that one case can be of so much national concern what about the others?
None of these diseases are infectious in nature, and so there are no vaccines for them idiot.
Your paranoia and envy of the profession and your ignorance is revealed by your vomitus thus
I really don’t understand the fear, panic and hysteria. I think it is a scare tactic on the part of a few die-hards in the medical profession.
Nobody has made an expression of either, panic or hysteria in any post on this thread except you.
Georgie Porgie // January 24, 2009 at 5:46 PM
@ Bonny Peppa
Shingles is a reactivation of the herpes zoster virus or varicella zoster virus, which is the same virus causes the childhood illness chickenpox. The chicken pox virus can remain in a dormant state in the body in the root of nerves that control sensation. When, after many years after the chickenpox infection the virus is reactivated , the virus travels along a sensory nerve into the skin causing a painful rash known as shingles.
This illness is called shingles to describe the distribution of the rash in a broad band- usually only on one side of the body that represents a dermatome—the area that a single sensory nerve supplies in the skin.
(The term “Shingles” is derived from the Latin and French words for belt or girdle. Anyone who has had the chickenpox infection or vaccine can get the herpes zoster virus that causes shingles. Older people and those with cancer, HIV, or organ transplants have a decreased ability to fight off infection and a greater chance of getting shingles. The majority of people with shingles, however, are healthy.
Shingles can be very very painfull!
Georgie Porgie // January 24, 2009 at 5:59 PM
Anonymous asked
Why would a doctor who is head of the medical services (brian charles) also want to be the representative for the insurance brookers covering the QEH.
Then the same doctor is the medical rep for CERO,and for the Prisons,and for the Defence Force.
I do not know how lucrative it is to be the representative for the insurance brookers covering the QEH or the medical rep for CERO, what ever that is but I do know that no one wants to work in the Prisons, and that to do one afternoon in prison is a very tiresome chore. I can also tell you that the pay is not great.
I can also tell you that do a “parade” at the Defence Force requires the doctor to travel to St Anns Fort by about 7-7;30 and see about 30-40 soldiers for a very small some of money.
To work as medical officer for Prisons and the Defence Force is not at all lucrative. Trust me. Any one who takes the time to do it is serving the country, and definitely not grabbing for them self. I suspect that working for CERO- another Government Agency is not lucrative either.
Hopi // January 24, 2009 at 6:04 PM
Straight from the horses mouth….’Anyone who has had chickenpox or vaccine can get herpes zoster virus that causes shingles.’
Georgie Porgie // January 24, 2009 at 6:14 PM
Anonymous.
You are quite funny.
I am glad to hear that our contemporary practitioners have invested in ECG machines, glucometer and cholesterol machines. The chap at Maas clinic has his machines too, and his tests are expensive and regular too, by the way.
If you don’t think that you need regular ECG’s, or have your glucose or cholesterol monitored, then refuse the tests or go to another doctor. EASY! How do you know how often the tests should be done?
I must be honest. I find this thread to be most hilarious as I read medical illiterates whine and complain, and comment about things they know very little, if anything about.
Now I was never myself one to indulge in much unneccesary lab tests, but I knew what I was doing. But for a layman to decide what tests are necessary or not is hilarious. Man in the states they do a whole battery of tests, and you pay for them all!
Why should doctors go for refresher courses when there is such good stuff on the internet, on every simple little topic? Guess how I know this? You are quite funny, Anonymous.
You have every right to opine, but I think you are quite funny
ROK // January 24, 2009 at 6:24 PM
anon
you are full of it. Obviously you are the omniscient one. Good thing that cancer, diabetes, etc. are not contageous. How much higher is the incidence of HIV/AIDS; or is it.
David // January 24, 2009 at 6:25 PM
@Dr. Porgie
We read somewhere last year under then Minister Jerome that doctors will be expected to do refreshers as part of the licensing process if we are not mistaken. As a doctor you should not resort to poking fun at the PEOPLE, if in their ignorance they leggo weak positions or arguments it is why you are the resident medical Czar, you have to enlighten man!
BTW we visited the BAMP websit to have a look at the tariffs but the link which we believe it is listed is a dead link, go figure. We have previously asked me to give us the list, we are still waiting.
Sapidillo // January 24, 2009 at 7:24 PM
anon // January 24, 2009 at 5:32 pm
Tell me Sappy where did you get your amendments to the oath which you quoted?
————————————————————————————————–
The following was sent to me by someone in the field. Here it is in part
UPDATE
The British Medical Association, in March 1997, published their first draft of a revised Hippocratic Oath to be considered by the World Medical Association.
“The Oath, a set of ethical principles derived from the writings of the ancient Greek physician Hippocrates, has been updated to put patients first. It aims to be a unifying force, superseding national, ethnic, religious and cultural boundaries by focusing on widely shared values.
The new wording can be adapted by nurses, paramedics and other health professionals.”
Commenting on the revised wording, Dr Sandy Macara, chairman of the BMA Council, said:
“It is as important now as ever it was for doctors to have an agreed statement of ethical principles. On qualifying, doctors need such a statement to make a public commitment to the professional responsibilities they are assuming. Thereafter these principles should provide guidance in the increasingly difficult ethical decisions they will make throughout their professional lives.
“The value of this update will be all the greater if it comes into use by every doctor qualifying from every medical school in the world.”
The BMA has been campaigning for the past five years for a revitalisation of the Hippocratic values. It has gathered examples of ethical codes from all over the world and common points from these have been integrated into the new wording.
The BMA has undertaken this work on behalf of the World Medical Association as the first stage of a revision of the current international code of medical ethics, the Geneva Declaration, which celebrates its 50th anniversary next year.
Appendix I
DRAFT REVISION OF THE HIPPOCRATIC OATH
The practice of medicine is a privilege which carries important responsibilities. All doctors should observe the core values of the profession which centre on the duty to help sick people and to avoid harm. I promise that my medical knowledge will be used to benefit people’s health. They are my first concern. I will listen to them and provide the best care I can. I will be honest, respectful and compassionate towards patients. In emergencies, I will do my best to help anyone in medical need.
I will make every effort to ensure that the rights of all patients are respected, including vulnerable groups who lack means of making their needs known, be it through immaturity, mental incapacity, imprisonment or detention or other circumstance.
My professional judgement will be exercised as independently as possible and not be influenced by political pressures nor by factors such as the social standing of the patient. I will not put personal profit or advancement above my duty to patients.
I will ensure patients receive the information and support they want to make decisions about disease prevention and improvement of their health. I will answer as truthfully as I can and respect patients’ decisions unless that puts others at risk of harm. If I cannot agree with their requests, I will explain why.
If my patients have limited mental awareness, I will still encourage them to participate in decisions as much as they feel able and willing to do so.
I will do my best to maintain confidentiality about all patients. If there are overriding reasons which prevent my keeping a patient’s confidentiality I will explain them.
Georgie Porgie // January 24, 2009 at 7:28 PM
@ David
I also heard that doctors will be expected to do refreshers as part of the licensing process. It would be interesting to see how that will be enforced.
As the resident medical Czar, as you call me, I do try to enlighten the forum, but that does not mean that it does not get funny sometimes. I also believe that one should not pontificate out of ones strong subject areas. They must be smart like you and ask questions, when they not sure.LOL
I didn’t even know BAMP had a website, as I have departed thence many moons ago, and have not followed up. As I said in the previous thread, I knew of the tariff way back in the early 80”s. I doubt that they will ever post it publically. You will have to get it from a medical friend, who does not see it as a precious secret
ROK // January 24, 2009 at 7:28 PM
I wonder where Hypocrates got that oath? I wonder if it was anything like the birth of the ten commandments?
Georgie Porgie // January 24, 2009 at 7:36 PM
Thanks for your revised oath Sappy.
You do realize that this oath is not yet in vogue?
Since our doctors are not now automatically accredited by the BMA or BMC why should they abide by thier will?
Are you suggesting that UWI change its oath?
And if they did, why do you think that folk will abide by such any more than they observe thier marriage vows for example?
J // January 24, 2009 at 7:56 PM
Georgie Porgie wrote “doctors will be expected to do refreshers as part of the licensing process. It would be interesting to see how that will be enforced.”
In Ontario refreshers (at least for nurses and maybe for doctors also) are tied to licensing. Licenses have to be renewed periodically.
No refresher.
No license.
It works every time.
David // January 24, 2009 at 8:51 PM
Doc Porgie
What do we do when doctors in Barbados charge patients for reading their pap smear and other test results? Is that ethically wrong? Do the patients complain to the medical council?
Georgie Porgie // January 24, 2009 at 10:05 PM
David
I guess they will tell you that they have charged you for a follow up visit, rather than for “reading” thier pap smear and other test results. Is that ethically wrong? I dont know who you would complain to for something like this.
Georgie Porgie // January 24, 2009 at 10:09 PM
David
I guess that your arguement may be based in 2 Cor 3. Should we deal with the letter or the spirit of the thing. I know doctors that will call you and report normal reasults to you, but call you in to explain seriously out of order results.
Bonny Peppa // January 24, 2009 at 10:20 PM
Georgie Porgie,
Is it you that kissed de girls and made them cry or you is de ‘calypsonian’?
You didn’t tell me if shingles can be fatal.
I enjoy your contributions and de sometimes friendly ‘rivalry with you and de bloggers. You can hold your own so I have no fear.
GEAR BOX,
Ya hiding or wah?
ahhhhhhhhhhhhhhhhhhhhhhhhhhh.
Georgie Porgie // January 24, 2009 at 10:33 PM
Bonny Peppa
Thanks for your kind remarks.
I am definitely not de ‘calypsonian’, nor am I the one that kissed de girls and made them cry. I will tell you now that I have not in my experience seen any girl crying when kissed. I made it a point that when my boys were growing up that they recited KISSED THE GIRLS AND MADE THEM HIGH!
Pain is usually the first symptom of shingles. For some, it can be intense, with just the slightest touch causing severe pain. Sometimes the pain can be mistaken for other problems or diseases, such as kidney stones, gallstones or appendicitis, depending on its location. Some people experience the pain without the rash, which makes diagnosing shingles more difficult. Although the shingles rash may resemble chickenpox, the virus typically causes more pain and less itching the second time around.
For about one in five people who develop shingles, the pain continues in the same spot long after the blisters have cleared. This condition is known as postherpetic neuralgia.
When you have postherpetic neuralgia, damaged nerve fibers send confused and exaggerated messages of pain from your skin to your brain. This leaves the affected area of skin sensitive to even the slightest touch. For some people, the brush of clothing or a breeze can be excruciatingly painful.
Shingles can also lead to other complications, including inflammation of the brain (encephalitis) and other neurological problems. If shingles occurs on your face, it can cause hearing problems and temporary or permanent blindness. Loss of facial movement (paralysis) is possible as well. If blisters aren’t properly treated, bacterial skin infections are another potential problem.
Encephalitis is indeed potentially fatal if not treated properly.
Bonny Peppa // January 24, 2009 at 10:57 PM
Georgie Porgie,
‘Kissed the girls and made them highhh? I would prefer ‘made them smile’.
Anyway, the info was enlightening about shingles. Scary as hell too. Bonny would be DEAD from what you said if I ever contracted shingles. I cannot bear pain at all. And yes, I have children so you could imagine what ‘labour’was like for me. I had dengue a few years ago and as there’s a God looking down, I wanted to take an overdose of sleeping pills but couldn’t get any. I actually asked my son to get some for me. Too much pain for one human man.Lord a mercyyy.
ROK // January 24, 2009 at 11:08 PM
GP
After all of that, are you saying that it is virtually impossible to die from Chicken pox/shingles? But from complications arising?
Georgie Porgie // January 24, 2009 at 11:47 PM
@ Bonny Peppa
‘made them smile’ don’t rhyme wid pudding and pie!
Shingles can be very painful. I once had a young patient with shingles before the rash erupted on her chest wall, and until the cardiac enzymes etc came back, we thought she had a heart attack! Of course not all cases are painful.
A good dose of dengue or break bone fever also occasions serious pain. Patients feel as though every bone in their body has been broken.
@ ROK
I certainly did not say that it is virtually impossible to die from Chicken pox/shingles, because the complications of a disease is a result of its causation. To die from the complications of herpes zoster viral infection is to die from an infection with herpes zoster virus. The HZV is the cause of death! Similarly to die from complications of the HIV/AIDS virus is to die from an infection with the HIV/AIDS virus.
If you dont get infected with the causative agent you really cant go on to get the complications associated with the disease that the pathogen causes.
However, death from the herpes zoster virus which causes chicken pox and shingles or its complications is not all that common. But as stated previously the herpes zoster virus can cause encephalitis and death.
ROK // January 25, 2009 at 12:37 AM
GP, thanks for the clarification.
Bonny Peppa // January 25, 2009 at 12:37 AM
Georgie Porgie,
“made them smile’,don’t rhyme wid pudding and pie.
Okay Porgie then we cud use smigh (new word for smile). Ya like um? Me too.
I probably had break bone fever along wid de dengue cause I’m telling you man, I felt like a dog had pissed in my face.
David // January 25, 2009 at 1:23 PM
@Doc Porgie et al
An unbelievable event is unfolding as we speak, ROK is on national radio expressing scepticism at the benefit of banning public smoking. He is not convinced that enough research has been done in Barbados to make legislation and laws relevant.
We are speechless ROK and must tell you that when you speak on health matters we may have to take it with a grain of salt:-). Not sure how the BU family will respond but if they do it will not be as passive an affair as you encountered on radio this morning…LOL.
Look stop the smoking man you don’t need empirical data when trending identifies smoking as a legitimate indicator for lung cancer and other ailments!
Anonymous // January 25, 2009 at 1:47 PM
Maybe,just maybe you all will now start to take some more of what ROK says with a pinch of salt.
I think on the whole he means well,but right now he is surprised and elated by the postive press he is getting here on BU,and so he spouts off authoratatively on every subject.
Like all who have gone this route before him, I think his 15 minutes of sunshine is about to end.
Georgie Porgie // January 25, 2009 at 2:30 PM
David
Probably ROK should read this article:
Smoking Linked to More Than Lung Cancer
Study Shows Tobacco Smoke May Be Linked to Non-Lung Cancers More Than Thought
By Caroline Wilbert
WebMD Health NewsReviewed by Louise Chang, MDJan. 22, 2009 — It is widely accepted that tobacco smoke causes most lung cancer deaths. A new study shows that tobacco smoke — including secondhand smoke — may also contribute to non-lung cancers more than previously thought.
Researchers used data from the National Center for Health Statistics and concluded that tobacco smoke may have led to more than 70% of cancer deaths among Massachusetts men in 2003.
“This study provides support for the growing understanding among researchers that smoking is a cause of many more cancer deaths besides lung cancer,” says researcher Bruce Leistikow, a University of California, Davis associate adjunct professor of public health sciences, in a news release. “The full impacts of tobacco smoke, including secondhand smoke, have been overlooked in the rush to examine such potential cancer factors as diet and environmental contaminants. As it turns out, much of the answer was probably smoking all along.”
Researchers compared death rates from lung cancer to death rates from other cancers from 1979 to 2003 among Massachusetts males. Their analysis revealed that the two rates changed in tandem year-by-year from 1979 to 2003.
The researchers conclude that the close relationship between the rates suggests that they have the same cause, which is tobacco smoke.
“The fact that lung and non-lung cancer death rates are almost perfectly associated means that smokers and nonsmokers alike should do what they can to avoid tobacco smoke,” Leistikow says in the news release. “It also suggests that increased attention should be paid to smoking prevention in health care reforms and health promotion campaigns.”
In the study, published online in BMC Cancer, the researchers called for increased tobacco control efforts.
anon // January 25, 2009 at 2:34 PM
I dun tell wunna already that when it comes to health matters ROK is a bull shitter of the highest order.
But I didnt think that he would embarass himself o national radio so.
antirok // January 25, 2009 at 2:39 PM
It is written: PRIDE GOETH BEFORE A FALL!
It seems that Rok’s “take” on the effects of cigarette smoking does not accord with the proven facts as recorded in the medical litterature.
Wuhloss! Murder!
ROK // January 25, 2009 at 3:06 PM
David
I hope the point I made is not missed. I do not see how my position is so negative. We all do something that is not good for us including over-eating.
First thing to note is that there was no dispute from me on the facts of smoking. All I am saying here is that we should not go down the road of scaremongering.
If I embarassed myself on national radio, then I did not feel it. According to the statistics, there are about 27,000 smokers in Barbados. I bet most smokers think that they should not force people to inhale their smoke. Most will out their cigarette first.
Can anybody tell me that I defended smoking and smokers. I agreed with the ban in public places, I have witnessed it first hand. I agreed with the position that cigarette smoke is harmful to the body. What I was not is a hypocrite.
But this is a wider issue. This is about giving the public an opportunity to make informed decisions, and not ones based on fear or within an agenda.
I certainly defended NGOs’ right and attempt to keep the information campaign up and not as David Ellis was suggesting that they keep their campaign at this pace in order to stay alive and get funds. That was certainly not a fair comment.
I may be a smoker and I have told myself that one should not regret anything they do, but live with it and accept the consequences, but at the same time, I have to wonder what came over me the day I picked up a cigarette.
I did not embarass myself. I called for more information. If you were embarassed, I can only say you should not be. We live in a democracy and that should mean that everybody has their story and should be able to tell it.
I am sure, David, that I have seen you battle against this hysteria, when an alternative view is put to those who have such a strong belief to the contrary that they refuse to hear or even understand the other side. Intolerance!
As for taking anything I say with a pinch of salt, again that is the hysteria of those pushing an agenda, so much so that in order to push their agenda they would attempt to discredit me personally. That is how we are as Bajans.
I want all of you that driving cars to put them down like I did. I walked to VOB and walked back, refusing lifts too. So I may be smoking but I am sure that by not driving, I have at least lessened the impact of dirty air on all of you. Let’s not get overheated on the few people who may inhale my tobacco smoke.
ROK // January 25, 2009 at 3:22 PM
GP
Even the researcher and David Ellis agreed with me openly that enough research has not gone into smoking and the effects of smoking in Barbados and indeed the tropics.
If you check the research, you will see that the biggest contributor is indoor smoking; offices, restaurants, discos, and especially in cars. Smoking in cars poses five times the risk… but you know what, they did not tell you that the risk is so high because the windows are turned up.
Now check with the Environmental Protection agency of USA. They tell you that ventillation drastically reduces the risk. Do we understand the risk when you live in a house or apartment in the cold, where the windows are never opened but people inside smoking?
We are not told these things so we go beserk at the ststistics and send people in a panic, when in truth and in fact, we have not made any consideration for our tropical environment.
Another thing for all you with new cars that get in them and turn on the air-conditioning. Well let me share this one with you:
Heat and Ultraviolet Light Trigger Pollution Inside Cars
However, on January 11, 2006, the Michigan-based Ecology Center released a report entitled: “Toxic at Any Speed: Chemicals in Cars and the Need for Safe Alternatives.” In this new report, researchers detail how heat and ultraviolet (UV) light can trigger the release inside cars of a number of chemicals linked to birth defects, premature births, impaired learning and liver toxicity, among other serious health problems.
Polybrominated diphenyl ethers (or PBDEs, often used as fire retardants) and phthalates (chemicals used to soften plastics) are the primary culprits. Part of the seat cushions, armrests, floor coverings and plastic parts in most car interiors, these chemicals are easily inhaled or ingested through contact with dust by drivers and passengers. The risks are greatest in summer, when car interiors can get as hot as 192º F.
How Can Drivers Reduce the Risks of Pollution Inside Cars
Motorists can lessen their risks by rolling down car windows, parking in the shade and using interior sun reflectors. But the Ecology Center is urging carmakers to stop using such chemicals in the first place. “We can no longer rely just on seatbelts and airbags to keep us safe in cars,” says Jeff Gearhart, the Ecology Center’s Clean Car Campaign Director and co-author of the report. “Our research shows that autos are chemical reactors, releasing toxins before we even turn on the ignition. There are safer alternatives to these chemicals, and innovative companies that develop them first will likely be rewarded by consumers.”
David // January 25, 2009 at 3:25 PM
@ROK
Relax man we are just ribbing you a little. Just that we had to chuckle when Ellis asked you why you tried to quit 3 times:-)
antirok // January 25, 2009 at 3:49 PM
After all of that
Rok YOU ARE NOT AN EXPERT ON HEALTH MATTERS!
ROK // January 25, 2009 at 3:58 PM
David,
I don’t mind the heckles, I hope the information shared was an eye opener. Other things in your car just as, or more dangerous than cigarette smoke.
ROK // January 25, 2009 at 4:06 PM
antirok
I never said I was an expert on health matters. I am not, but I ain’t stupid either. The question is, who guards the guards.
Information is essential, it is not enough to just say that we need vaccines, it should be researched and demonstrated within our context; and we should not just sit down and accept statistics that reflects a totally different environment to ours; natural and cultural.
Juris // January 25, 2009 at 4:46 PM
Why do we in Barbados seem to think we are unique?
ROK // January 25, 2009 at 4:53 PM
Juris, I hope you are not referring to the call for research. Note we have to deal with research in the tropics, as I am sure you will agree that living in the tropics is different from living in the cold.
Sargeant // January 25, 2009 at 4:58 PM
The province I live in has banned smoking in cars with children under the age of 16. I attended a viewing yesterday for a former colleague of my wife. This individual died as a result of lung cancer. According to my wife he wasn’t a smoker but had a second job as a bartender at an establishment where smoking was once allowed and there was lots of second hand smoke. Everyone has a right to make whatever decision they want affecting their health, however your right to smoke around me ends right at the time the smoke hits my nostrils.
http://www.theglobeandmail.com/servlet/story/LAC.20090121.SMOKE21/TPStory/?query=smoking+ban+in+cars
http://www.parentcentral.ca/parent/article/575274
antirok // January 25, 2009 at 5:05 PM
Ok ROK we will reinvent the wheel for you OK?
Juris // January 25, 2009 at 5:09 PM
Believe me, ROK, whether you are living in the tropics or in the cold, the effect of the carcinogens in cigarette smoke om the body is roughly the same. I endorse your call for tropical research in other areas, especially dengue and diabetes.
antirok // January 25, 2009 at 5:14 PM
@ Juris
So the the effect of the carcinogens in cigarette smoke on the body is roughly the same but in the tropics diabetes differs?
Do explain why you want all this reserch especially in dengue. What is it you want to find?
Are you another twit out of your league?
Juris // January 25, 2009 at 5:18 PM
No, antirok, I do not consider myself a twit. Certainly not like some others whose ambition, as judged by their pseudonym/name is solely to counter the view, whether valid or not, of another individual. It is simply that dengue is a tropical problem, and we seem in this region to have more than our fair share of diabetes incidence. That’s all.
anon // January 25, 2009 at 6:36 PM
Juris
I think that antirok is saying that the findings concerning the research on diabetes worldwide is relevant to Barbados, and there is no need to reinvent the wheel, since much research on diabetes has been done in both Barbados and at UWI.
What needs to be done is the application of the research by the people fool.
You are a medical illiterate. Like Rok , you are out of your league. So adjourn, and keep quiet and let those who know what they are talking about speak, so that you can learn a bit
Juris // January 25, 2009 at 6:44 PM
So are you saying anon, that you have to be medically literate, whatever that oxyMORON means, to put forward a view on what research is needed? And how come you are answering for antirok? Are you similarly benighted?
anon // January 25, 2009 at 6:55 PM
Quid dixi scripsique, dixi scripsique.
I repeat there is no need to reinvent the wheel, since much research on diabetes has been done in both Barbados and at UWI.
What needs to be done is the application of the research by the people
I am saying that IT IS VERY OBVIOUS that you do not know what you are talking about, and that like Rok you are shooting bull.
We dont need research on dengue, we need PRACTICAL STEPS TO DEAL WITH SANITATION AND KEEPING THE MOSQUITO POPULATION DOWN fool!
Instead of research we need to apply the information that has been gathered.
Any jackass can ask for research!
The Government via the Ministries of Health and Education has failed the people in the dissemination of the available information.
Both you and Rok know nothing about Public Health. Keep quiet and learn, and sto shooting bull!
Straight talk // January 25, 2009 at 6:58 PM
When the government takes upon itself the righteous will to legislate against Chefette’s saturated fat, the Transport Boards toxic diesel emissions and, god forbid, the sugar industries’ refinement of obesity that is the day I will accept their right to tell any individual how to live their lives.
Until that day keep these busybodies, and their underemployed UWI “experts” out of our private lives, unless they open up their own to public scrutiny.
Juris // January 25, 2009 at 7:14 PM
And in spite of this much research we are no better off than we were 40 years ago, anon/antirok. I trust you are not one of these UWI poseurs who are barely able to get 40% in an exam and then pretend that you know it all. But I doubt it. You are not smart enough. Do you really think that all the research that’s needed to be done has been done? By UWI? LOL!
Sargeant // January 25, 2009 at 7:26 PM
This debate getting hot. What with all the name calling and references to intelligence or lack of it. Truth be told ROK does spout a lot of nonsense on the blog, I remember he stated that democracy was alive and well in Cuba, I almost fell out of my chair at that one.
Straight talk // January 25, 2009 at 7:39 PM
At least in Cuba there is no pretence as to a credible opposition and the Cuban’s vote for their representative rather than a party.
Is our (or the USA’s) system really superior and able to offer a genuine alternative to the electorate.
Many would argue that the political class is so homogenous that it offers no real choice.
Different faces, but same outcome.
UWI poseur // January 25, 2009 at 7:56 PM
Juris
Can you cite the extent of your training in Public Health? And the school you attended?
Are you saying that the research that has been conducted on diabetes at UWI and worldwide is irrelevant to Barbados?
Are you saying that the findings of the available research on diabetes and dengue has been fully applied in Barbados, and so we need more research as the priority to deal with these problems?
Are you saying that there is adequate Public Health Education with respect to teaching our people about dengue and diabetes?
Are you saying that Ministries of Health and Education have done all they could/should in informing the people about what is known about dengue and diabetes?
Are you saying that practical steps to deal with sanitation and the reduction of the mosquito population is not necessary? And that is of paramount importance?
Are you saying that all that needs to be done is more research?
What do you have against UWI? What do you about the research done at the three centers over the course of the last 60 years? Have you heard of the discovery of veno-occlusive disease of the liver, or hypoglycin for example, or the work on sickle cell disease etc?
You asked “And in spite of this much research we are no better off than we were 40 years ago.” So are you saying that the answer is to then do more research? Instead of applying what is known?
You asked also “And in spite of this much research we are no better off than we were 40 years ago.” Yes we are. All of our public health indices have improved remarkably.
Have you ever managed a patient with diabetes in Barbados? Are you aware of the difficulties in so doing for both doctor and patient?
I think that both antirok and anon have made valuable points which you have been unable to refute. It is indeed true that, and I quote …..” the findings concerning the research on diabetes worldwide is relevant to Barbados, and there is no need to reinvent the wheel, since much research on diabetes has been done in both Barbados and at UWI.What needs to be done is the application of the research by the people.”
I think that you/we can benefit from this advice.
You may now address me as antirok/anon/ UWI poseur if you so desire. But can you answer any of the questions above or bring anything of relevance to the table ?
ROK // January 25, 2009 at 9:13 PM
OK Guys. Got the point. This comes down to policy and decision making. In particular the question of research-based policy and decision making.
In recent times we have been discussing (in national, regional and international fora) the impact of research on decision making and on policies and if the benefits of research are being passed on in legislation and policies; to the benefit of the people.
As a matter of fact, one of the planks upon which national participation by NGOs rests, is the impact of local knowledge on policy and decision making. Indeed, local knowledge is an important ingredient in gathering research data. It may be raw but it is at least an indicator.
I still think there are areas of research in which we need to indulge for ourselves if we are to make the most of our resources.
Just as an example, Let’s say we have the benefit of research about diabetes coming from a different environment. What have we done for ourselves in terms of helping people prevent the onset of diabetes? Diet, producing supplements from our own environment, etc?
You see, while there is research on the plants outside, we have none. So you will hear, for example, that artichokes good for this or that and rather than finding an alternative plant here, we start importing artichokes.
anon // January 25, 2009 at 10:53 PM
What have we done for ourselves in terms of helping people prevent the onset of diabetes?
EDUCATION is what we must do Rok. MORE PUBLIC HEALTH EDUCATION IS WHAT IS NEEDED !
Please kindly list the supplements and plants you propose to use in your treatment regimes.
ROK // January 26, 2009 at 9:03 AM
anon
“EDUCATION is what we must do Rok. MORE PUBLIC HEALTH EDUCATION IS WHAT IS NEEDED !”
Well! Well! Well! I wonder what you are saying different to me.
As to the plants I need, I await your recommendation. You are the expert. I am humbly depending on you. Let’s see how much more our doctors can do.
Sapidillo // January 26, 2009 at 11:24 AM
Those of us that keep close tabs on various health issues have noticed that HEALTH EDUCATION are TWO BAD WORDS in BIM. The Government, the Ministry of Health, the Medical Professionals have all failed our citizens miserably when it comes to disseminating information regarding health, be it about diabetes or other ailments. They want us to believe that they care about our well being but it is absolutely clear they don’t give sea crab sh**te about our health and other serious matters.
ROK // January 26, 2009 at 12:38 PM
Sapidillo/anon
One of the things I have found strange is the lack of access to local and regional research done by the UWI. I am not sure what is available to Government but certainly to the population there is a zero.
Yet, I could go on the internet and access a whole heap of research. Is ours worth gold?
As a result of this lack of access and people complain, all cries from the profession spew out criticisms. The research is done, so how the hell anybody is to know.
Same thing with Government. When the DLP shouted that there was no research done to come to a definition of poverty, up jumps the Government, trying to make people feel that the DLP does not know what they are talking about.
I call it ambush. There is need for information disclosure not only in Government but from other responsible institutions that are in the public interests. This kind of behaviour is un-becoming.
I can think about several organisations out there who can greatly assist with public education. The Cancer Society was headed by a doctor who had inside information and look at the job they did with tobacco.
Why not make this research and information available so that more NGOs can get on board?
anon // January 26, 2009 at 1:24 PM
Rok
Why you want all this acess to the research when you dont/cant use the little you all ready have effectively?
FYI regional medical research is discussed at annual symposia and the papers published in books- usually under the sponsorship of the drug houses. Try the library at the hospital or UWI library.
anon // January 26, 2009 at 1:25 PM
By the way you think that you or the public would understand the findings? LOl
Equity // January 26, 2009 at 2:49 PM
So what is the purpose of research? To be wriiten up in a language few understand to say that it has been done and how industrious our doctors are? In the USA and the UK there are journalists who write up the research findings for lay people. Aren’t our doctors capable?
anon // January 26, 2009 at 2:54 PM
Ah ha! In the USA and the UK there are journalists who write up the research findings for lay people.
Are they any such journalists in BIm?
anon // January 26, 2009 at 2:58 PM
Rok/Juris
Someone just sent me this in an email.
I would like to share this interesting discovery from a classmate’s son who has just recovered from dengue fever. Apparently, his son was in the critical stage at the ICU when his blood platelet count drops to 15 after 15 liters of blood transfusion.
His father was so worried that he seeks another friend’s recommendation and his son was saved. He confessed to me that he gave his son raw juice of the papaya leaves. From a platelet count of 45 after 20 liters of blood transfusion, and after drinking the raw papaya leaf juice, his platelet count jumps instantly to 135. Even the doctors and nurses were surprised. After the second day he was discharged. So he asked me to pass this good news around.
Accordingly it is raw papaya leaves, 2pcs just cleaned and pound and squeeze with filter cloth. You will only get one tablespoon per leaf. So two tablespoon per serving once a day. Do not boil or cook or rinse with hot water, it will loose its strength. Only the leafy part and no stem or sap. It is very bitter and you have to swallow it like “Won Low Kat”. But it works.
*Papaya Juice – Cure for Dengue*
You may have heard this elsewhere but if not I am glad to inform you that papaya juice is a natural cure for dengue fever. As dengue fever is rampant now, I think it’s good to share this with all.
A friend of mine had dengue last year. It was a very serious situation for her as her platelet count had dropped to 28,000 after 3 days in hospital and water has started to fill up her lung. She had difficulty in breathing. She was only 32-year old. Doctor says there’s no cure for dengue. We just have to wait for her body immune system to build up resistance against dengue and fight its own battle. She already had 2 blood transfusion and all of us were praying very hard as her platelet continued to drop since the first day she was admitted.
Fortunately her mother-in-law heard that papaya juice would help to reduce the fever and got some papaya leaves, pounded them and squeeze the juice out for her.. The next day, her platelet count started to increase, her fever subsided. We continued to feed her with papaya juice and she recovered after 3 days!!!
Amazing but it’s true. It’s believed one’s body would be overheated when one is down with dengue and that also caused the patient to have fever, papaya juice has cooling effect. Thus, it helps to reduce the level of heat in one’s body, thus the fever will go away. I found that it’s also good when one is having sore throat or suffering from heat.
Please spread the news about this as lately there are many dengue cases. It’s great if such natural cure could help to ease the sufferings of dengue patients.
Furthermore it’s so easily available.
Blend them and squeeze the juice! It’s simple and miraculously effective!!
Straight talk // January 26, 2009 at 3:50 PM
David:
Regarding the interesting papaya leaf post above, would it be possible to invite other “bush” remedies to be submitted, maybe in a separate section, hopefully building into a valuable first aid or back-up resource.
Hopi // January 26, 2009 at 3:51 PM
@anon…….If what you’ve just posted here is true you’ve made my day. I’m very happy to know that there are still people of the soil who have not lost their way. Happy to know that the Mother of All Nature is still working.
Hopi // January 26, 2009 at 4:06 PM
@David…… I 2nd ST’s idea. Just highlight your medical disclaimer…like ‘Please consult your physician….. since the info given here is not meant to cure, blah blah’ cause the vultures are sure to come out of the woodwork. But that’s an INVALUABLE idea.
anon // January 26, 2009 at 4:09 PM
Not so fast fellahs. Ya got to do research pun did thing first. Ask Juris & Rok!
Hopi // January 26, 2009 at 5:04 PM
@Anon……..What more research do we need? Here you have living proof (unless you just hoaxed us) and you still need to pay someone ridiculous fees to go in a lab just to tell you what you already know. Come on, where’s the commonsense? Death to STUPIDITY!
ROK // January 26, 2009 at 6:33 PM
anon
You underestimating NGOs and special interests groups. When you start to specialise, the information tends towards finity and not infinity. To study to be a doctor is a much taller order than repeating a task. It may take the doctor to set up the task but the point is he could train people to conduct the task and everything about doing it.
That is how an NGO will operate, as a specialist in carrying out a task. NGOs such as the diabetes association, the kidney foundation, Asthma association, Hope foundation, need an injection of research information and programmes which can be packaged and delivered to the communities.
ROK // January 26, 2009 at 6:37 PM
anon
here is where it is give back time. Yes you have symposia and papers published, but that is not what we want. We want you as a doctor or researcher to take the time to explain the importance of the information.
Also in terms of leadership, you should suggest programmes to combat problems. Help design and establish the programmes. Take a leaf out of Tony Gale’s book. What he established twenty years ago is still up and running and even improved. This is the effect of specialisation.
ROK // January 26, 2009 at 6:45 PM
anon
Come on man. Don’t pass the responsibility on to the journalists. They are not doctors who switched to journalism or do journalism part time.
Hey! you mean not even that? Well if none of you have to find ways of earning outside being a doctor it means wanna too comfortable. LOL!
All sport aside, no offence meant. Just couldn’t help… but those journalists in the international media are either doctors or have a fairly good science background; professors, etc. Check for yourself. They are authoritative and can either confirm or refute based on scientific theory and practical experience.
me // January 28, 2009 at 8:57 AM
Thought that this column was very on point….
http://www.nationnews.com/editorial/324794878596287.php
me // January 28, 2009 at 9:22 AM
I have been away but I am enjoying this thread…
LOL
another view // January 29, 2009 at 7:07 PM
Child Vaccines: Some Parents Ill at Ease
Does the private right of parents to not vaccinate their kids trump the greater public good?
By Neil Osterweil
WebMD Feature
Reviewed by Louise Chang, MD
Supreme Court Justice Oliver Wendell Holmes probably wasn’t thinking about child vaccines or parental rights when he said “the right to swing my fist ends where the other man’s nose begins.”
But the intersection of private rights and the public good addressed by Holmes is a subject much on the minds of parents, doctors, and public health experts these days, as a vocal and apparently growing minority of parents and alternative health care practitioners question the need for, or safety of, childhood immunizations.
“We are seeing in some states an increasing proportion of families who are choosing to delay or not immunize their children, and unfortunately, when this happens, we do see sporadic outbreaks of diseases like measles,” says Neal Halsey, MD, a director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
In February, 12 San Diego area children came down with measles. Eight of the children were eligible to be vaccinated against measles but hadn’t been, and three were infants too young to be immunized.
In Indiana in 2005, a measles outbreak infected 34 people ranging from 9 months to 49 years of age. Three of the 34 needed to be hospitalized, including one 34-year-old adult who had to be put on a ventilator for six days, and a 6-year-old child and 45-year-old adult who suffered from severe dehydration. Only two of the 34 were known to have been vaccinated against measles: one with one dose, which affords about 95% protection, and the other with the two recommended doses.
The Indiana outbreak was eventually traced to a 17-year-old girl who had not been vaccinated against measles, and had recently returned from volunteer work at an orphanage and hospital in Bucharest, Romania, where a wide-scale measles outbreak was later reported. She had apparently transmitted the infection to a 6-year-old girl while both were attending a church function in northwestern Indiana. The six-year-old was later hospitalized after she became ill while visiting relatives in Cincinnati, according to the CDC.Â
Measles Is Not Child’s Play
Some parents and critics of mandatory immunization dismiss measles as a “harmless” disease of childhood, like the common cold or earaches.
But according to the CDC:
• Up to 1 in 20 children with measles will get pneumonia
• About 1 in 1,000 children with measles will get encephalitis — an acute inflammation of the brain that can cause permanent nerve and/or brain damage
• 1 or 2 in 1,000 children who get measles will die from the disease.
“While measles is almost gone from the United States, it still kills about half a million people a year around the world,” a CDC fact sheet for parents points out. “Measles can also make a pregnant woman have a miscarriage or give birth prematurely.”
Before measles vaccines were developed, most children contracted the disease by the time they were 15, the CDC notes, resulting in:
• About 450 annual deaths
• 48,000 hospitalizations each year
• 7,000 cases of seizures, and
• 1,000 cases of permanent brain damage or deafness each year.
Yet some parents who object to childhood immunizations will host or bring their children to so-called “measles parties,” where the kids can get exposed to an infected child, get the disease, and develop immunity naturally. One such mother told the New York Times “I refuse to sacrifice my children for the greater good.”
“It would be a terrible mistake for a parent to deliberately expose their child to measles, or chickenpox, for that matter,” Halsey tells WebMD. “To deliberately give a child measles in this day and age is not only inappropriate, but it actually might be considered to be criminal, because it’s preventable.”
But that mother is no different from any other parent who wants what she thinks is best for her children, says Barbara Loe Fisher, president of the National Vaccine Information Center, a consumer-oriented vaccine safety watchdog group she co-founded. Fisher and NVIC co-founder Kathi William blame serious reactions to the diphtheria, pertussis, and tetanus (DPT) vaccination for their children’s learning disabilities and attention deficit disorder.
“I disagree that individual health and public health are two different things,” Fisher says in an interview with WebMD. “Individuals make up the community, and if you have a number of individuals who are suffering adverse effects to a medical intervention, a public health intervention, by extension that eventually becomes a matter of public health.”
Herd Immunity
Penelope H. Denehy, MD, professor of pediatrics at the Warren Alpert Medical School of Brown University in Providence, R.I., notes that in addition to protecting individual children against infectious diseases, universal vaccinations cover those children who for medical reasons cannot be vaccinated, a concept known as “herd immunity.”
“One of the things we know quite clearly is that if there are enough parents in an area who [refuse to vaccinate], there actually then becomes a large-enough group of non-immune kids to actually sustain outbreaks,” she tells WebMD. “There’s an area in Colorado where the rates of pertussis [whooping cough] were quite high because there was enough of a population who were not immunized to sustain the passage of pertussis around the community.”
In addition, even if an unvaccinated child is protected by herd immunity at home, if that child travels with her family, she runs a high risk of infection from a person from a part of the world with low vaccination rates, as happened in the case of the Indiana measles outbreak.
Vaccination for children entering school is mandatory in all 50 states, but all states allow exemptions for medical reasons.
“Even in a well-vaccinated population, there are going to be some children who can’t be vaccinated, either because they’re too young — for measles less than 12 months of age — or they may have cancer chemotherapy or some other compromising medical condition that makes it not possible to vaccinate them,” says Lance Rodewald, MD, director of the immunization services division at the CDC’s National Center for Immunization and Respiratory Diseases.
Rodewald notes that there is also a low but still significant failure rate for some vaccinations: “For example, with one dose of measles vaccine there’s a 4% to 5% failure rate, and with two doses of course it’s much smaller, but still there will be some susceptibles in the population,” he tells WebMD.
In addition to allowing medical exemptions for immunization, all states except Mississippi and West Virginia also allow exemptions from immunizations for deeply held religious beliefs, and 18 allow exemptions for “philosophical” objections, according to the NVIC.
In states where this is allowed, 2.54% of parents declined vaccines, according to a Johns Hopkins researcher.
Conscientious Objectors
One of the reasons for the rise in the number of parents requesting philosophical or religious exemptions from vaccination is that the standards for medical exemptions are so rigorous and that the exemption-granting authorities make it hard to claim them, Fisher says.
“It’s extremely difficult to get a medical exemption — it’s given out in all 50 states, but it is given out extremely rarely,” she says. “So what does a parent do in this country when they believe they have a child that has either been harmed or children who they believe are genetically risk? The only two exemptions they have are the religious or conscientious belief or philosophical belief exemptions.”
In a 2005 survey of vaccine-refusing parents published in the journal Archives of Pediatrics & Adolescent Medicine, more than two-thirds of respondents said their chief reason for rejecting vaccines was concern that they might be harmful, and nearly half said that vaccines “might overload the immune system.” The vaccine most often refused was against chickenpox (varicella), which was refused by slightly more than half of all vaccine objectors.
Some vaccine objectors say that they’re protecting their children from neurologic damage and that mainstream media are in cahoots with the medical establishment to downplay evidence linking vaccines and autism.
The Hannah Poling Case
Those who are convinced that there is a vaccine-autism connection point to the recently publicized case of Hannah Poling, who developed autism-like symptoms after receiving childhood vaccinations. The federal government recently agreed to award the Poling family compensation from a vaccine injury fund established to encourage vaccine research and development and protecting vaccine manufacturers from liability by offering an alternative to lawsuits.
But lost or buried in many of the news stories about the case was the fact that Hannah Poling also suffers from a mitochondrial dysfunction disorder, an extremely rare defect in the mitochondria or “power supplies” found in the nuclei of human cells. The disorder puts her at increased risk for side effects not just from immunization, but also from common infectious diseases, says Halsey of Johns Hopkins.
“That’s not a case of overwhelming the immune system, it’s oxidative stress associated with many infections, and children with these disorders can just get a mild cold at a certain time in their lives, and they will develop this neurologic deterioration, so just any stress will cause it in these children,” Halsey explains.
Denehy, who practices pediatrics at Hasbro Children’s Hospital in Providence, tells parents who worry about immune overload from vaccines that the simple bacterium that causes strep throat has hundreds of immune-system provoking antigens on its surface, whereas even when children receive multiple vaccinations, they receive only about 20 antibody-stimulating antigens.
“You’re immune system is going to be taxed much harder from things you’re being exposed to in the community than by vaccines, and your immune system has the potential to deal with many, many more challenges than any vaccination schedule presents to it,” she says.
Cherry-Picking Vaccines
The practice of inoculation — the attempt to induce natural immunity by exposing healthy people to small samples of a disease — goes back centuries. But it was Edward Jenner, a country doctor in rural England, who developed the first modern vaccination in 1796, after observing that dairy farmers who were exposed to the relatively mild disease cowpox never seemed to contract smallpox, a related but far more deadly disease. The word “vaccination” is derived from vaccinia, the Latin name for the cowpox virus.
Today, smallpox, once one of mankind’s most devastating diseases, has been wiped from the face of the earth and is known to exist only for investigational purposes in small quantities in tightly guarded laboratories.
Even the staunchest opponents of mandatory immunization acknowledge that the smallpox vaccination, and select others, such as the polio vaccine, have had incalculable benefits for mankind and that the theoretical risk of vaccinations against theses diseases are outweighed by the benefits.
But the NVIC and other groups question whether children get too many vaccines in too short a time and challenge the rationale for mandatory immunizations against less serious conditions such as chickenpox.
“Chickenpox is not smallpox, and hepatitis B is not polio,” the NVIC’s Fisher said in a November 2007 interview on CNN.
Fisher and like-minded parents, as well as some health care professionals trained in both conventional Western medicine and alternative therapies, feel that the potential risks of vaccines and the incidence of vaccine-related adverse events have been underreported, and that children are subjected to too many vaccines with too little proof of their and safety and effectiveness.
“We have been asking for almost three decades now for the basic science research to be done to identify those children who are biologically and genetically at higher risk than others for suffering vaccine injury and death,” she tells WebMD. “Those studies have not been done; the authorities refuse to do them.”
But to those parents who wish to “cherry pick” vaccinations for their children in the belief some vaccines are unnecessary, Denehy offers this cautionary advice:
“After you’ve been in practice for a while, you see children who are perfectly normal who are affected by these diseases, and 100 perfectly normal, healthy children a year died from chickenpox/varicella before we had the vaccine,” she says. “We had a child who died here in Rhode Island, whose mother didn’t believe in vaccines and took her to a chickenpox party — a perfectly normal 4-month-old who died.
“You can’t always assume that nothing bad is going to happen to your child.”
ROK // January 29, 2009 at 7:42 PM
another view
I could find a doctor who would speak about the same harmful effects of vaccinations too. What you can’t deny is that both the US Medical Council and the medical authorities in UK have been finding harmful effects from vaccinations and “victims” have been awarded damages in courts.
Now, in a lot of ways, much of the examples quoted are full of actions of those who are not aware. Public education is very necessary. Imagine taking a 4 month old baby to a chicken pox party?
That 17 yr old would have had to have contracted measles in an environment where people had measles, but she did nothing to protect herself because she was ignorant of the facts.
You also raising the issue of the level of responsibility of the citizen. The lesson I am seeing in the case of that 17 yr old is that if you travel you should always be aware of the environment in which you are traveling.
However, without a vast public education and the development of a health code for the population, it would be hard to speak of a civic responsibility as deep as that, for public health. As it is therefore, it can happen. Keep the people ignorant and make them pay through their noses; even if at the risk of untimely death or what could be called lawlessness; only if the person had known.
The bottom line is as Fisher said. There is a different way to deal with the problem to eliminate the risks both by the disease and the vaccinations; and research is necessary.
another view // January 29, 2009 at 8:08 PM
Rok
You are talking shite as usual. You do not know anything about Public Heath, and you display that fact everytime you open your mouth! Shut up and listen and learn for a change nuh!
ROK // January 29, 2009 at 8:53 PM
another view
you very sensitive? I ain’t see nothing so brown in what I saying… and the other thing is that I don’t have to shut up in order to learn.
As a matter of fact I learning now because I dared to open my mouth in the first place and I sure that I ain’t the only body learning.
Stop telling people to shut up. That is not nice and we here fighting against that same very thing.
another view // January 29, 2009 at 9:30 PM
ROK, the pontif
Lets hear your take on this article
High Blood Pressure Aftermath
Side effects to treating high blood pressure can be annoying, but they don’t have to ruin your life if you take charge.
By Leanna Skarnulis
WebMD Feature
Reviewed by Louise Chang, MD
Lying awake nights worrying if terrorists or bird flu will get you? Consider, instead, a threat that’s far closer to home, and one that you can control: high blood pressure.
One in three adults has high blood pressure, but only 61% are under treatment and roughly two-thirds do not have it under control, according to the American Heart Association (AHA) web site. In 2004, the disease killed more than 50,000 people in the U.S., yet the AHA says high blood pressure is easily detected and usually controllable.
Complications of blood pressure medications are one reason people never seek treatment (what if it makes me impotent?), abandon treatment (these swollen ankles look terrible), or cut back on their medication dosage (I’m tired of being tired).
WebMD talked with two cardiologists and a pharmacist about seven complications you should be aware of. Most importantly, they say that complications shouldn’t be a reason to abandon treatment or cut back on prescribed dosages. Instead, talk to your doctor or pharmacist. “We have 200 medications for treating high blood pressure,” says Thomas Giles, MD, who is professor of medicine at Louisiana State University School of Medicine in New Orleans. “We’ll keep on it till we find what will give you the best result and be least intrusive in your life. It’s no good to make people feel terrible, and we don’t have to do that.”
1. Fatigue and Dizziness
Dan Jones, MD, tells WebMD that when people begin taking blood pressure medication, the most common problem is fatigue. Jones is dean of the School of Medicine at the University of Mississippi in Jackson, and spokesman for the American Heart Association (AHA). “It’s especially true for older patients. If blood pressure has been elevated for a while, when the medication is taken and the blood pressure begins to come down, for a period of time there’s less circulation in some of the vessels, including those in the brain. It takes time for those constricted vessels to relax. There may be a perception that there’s less blood flow, which can produce fatigue or dizziness. If it’s mild, it can be worked through simply by staying with the medication.”
A patient who feels fatigued when on the medication may decide instead of taking it daily to take it every few days or so. “When they go off it, the blood pressure rises and they feel better,” says Jones. “If they continue this cycle, they never get past the fatigue, which typically will go away after two to six weeks of therapy.”
2. Cough
ACE inhibitors are a class of medication that can cause a persistent cough in 10% to 15% of patients. “Don’t continue the medication,” says Giles. “I tell patients that if they get a cough, let me know.” If the ACE inhibitor is stopped, it will need to be replaced with some other drug. Examples of ACE inhibitors include: Lotensin, Monopril, Prinivil, Zestril, Accupril, Altace, Vasotec, and Capoten.
3. Frequent Urination
No one wants to become famous for frequent bathroom breaks. Using diuretics successfully is a matter of timing. Try to take them in the beginning of your day. “I tell patients not to take the diuretic and drink a lot of water before they go to bed,” says Giles, who is president of the American Society of Hypertension. “And don’t take your pill before a one-hour taxi ride to my office. Wait till you get here to take it.” One of the most common diuretics used for high blood pressure is hydrochlorothiazide. It may be in its own pill on in combined formulations such as Hyzaar or Maxide.
4. Fluid Retention
Virtually any medication for hypertension that isn’t a diuretic can cause edema or fluid retention. Swelling of the ankles and legs can be more than a cosmetic problem. “Calcium channel blockers like amlodipine (also known as Norvasc) and nifedipine (also known as Procardia) are famous for causing swelling and pain in the legs,” says Sarah Ray, PharmD, BCPS. These drugs can also worsen underlying heart failure or other heart problems or reveal an unknown heart condition. “We’ve seen patients discover a heart problem only after starting on a calcium channel blocker.”
5. Sexual Dysfunction
Men may avoid getting treatment for high blood pressure because they fear it will cause erectile dysfunction (ED). Any medication that lowers blood pressure has the potential to cause impotence, says Ray, a pharmacist at Aurora Health Care in Milwaukee and spokeswoman for the American Pharmacists Association. “That scares people. It’s a matter of trial and error. Men who experience ED should talk to their doctor because for most people there are other options. Some patients could be candidates for Viagra if their hypertension isn’t accompanied by other heart problems.”
Vascular (blood vessel) disease, not medication, may be the underlying cause of ED, says Jones. “One reason they have ED is they’ve had high blood pressure for a number of years. The ED tends to be intermittent. Patients might blame it on the medication and stop taking it when the real cause may be the vascular disease from high blood pressure and they’re not taking their medication regularly.”
6. Heart Arrhythmia
Diuretics, which are commonly prescribed to lower blood pressure, can reduce potassium levels in the body and cause heart arrhythmia, or abnormal heart rhythm. Other medications may slow your heart rate too much. By all means, consult your doctor. “Prescribing lower doses of the diuretic and using medications in combination can get the desired result and offset side effects,” says Giles. “ACE inhibitors and angiotensin receptor blockers protect against potassium depletion, so if combined with a diuretic, you don’t have to worry about it.”
7. Allergic Reactions
A serious allergic reaction to blood pressure medications is rare but worth mentioning because it could be deadly. An allergy to ACE inhibitors or angiotensin receptor blockers can cause dangerous swelling of the face and of the throat that blocks airways, referred to as angioedema. “It’s a generalized, sudden swelling, usually beginning around the lips and face, sometimes with shortness of breath and wheezing,” says Jones. “It’s life threatening. The patient needs to get to the emergency room.”
Don’t Quit Medication Abruptly
The three experts told WebMD that quitting any medication abruptly could be dangerous. “If a beta- or alpha-blocker is stopped abruptly, there’s a withdrawal syndrome,” says Ray. “It causes a high increase in blood pressure and heart rate, which could be serious if you have underlying heart problems. It puts you at risk for stroke and heart attack.”
Treatment Adherence
High blood pressure is a chronic condition that requires lifelong treatment and monitoring. Untreated, it can lead to stroke, heart attack, heart failure, or kidney failure, making it a “silent killer,” says the AHA.
Yet patient adherence with prescribed treatment is not very good, says Ray. “There’s a certain percentage of patients who never fill the prescription, and a certain percentage who never get a refill.”
Jones says the key to managing the disease and complications of treatment is a healthy conversation between the patient and health care provider. “I’m fairly aggressive in talking to patients about what the side effects may be and reassuring them that I can respond if they feel like they’re having side effects. If it’s something that will go away with time, we’ll talk about it and make a decision together. If it’s something that won’t go away, like a cough, I pledge that I’ll stop the medication and use something that won’t bring that discomfort.”
another view // January 29, 2009 at 9:31 PM
herbs from the garden would lower blood pressure with out side effects. what you think? plus fresh fruits and vegetables
ROK // January 29, 2009 at 9:52 PM
another view
You looking to raise my blood pressure, nuh?
Man I don’t want to see that doctor at all. He want to treat for effects and then side effects too. Round and round in a circle, when will it stop?
You have the right recipe; fresh veg and fruits and if they come from your personal garden, so much the better.
another view // January 29, 2009 at 11:04 PM
So which fresh vegs and fruits from your personal garden to use to treat hypertension?
So the natural products that you think will treay hyperetension wont cause side effects?
So you mean that these perfect things will act only at certain receptor sites and no where else? O am I over your head here?
ROK // January 29, 2009 at 11:33 PM
Dread, shift to the bush medicine thread. All you want over there and if it ain’t there, put it up.
another view // February 1, 2009 at 7:47 PM
To those who denigrate our medical schools and thier accomplishments, here is our history.
ROK // February 4, 2009 at 9:16 PM
David,
I have to admit that I did not realise that world war III is on. The smokers putting up a fight worldwide. Some empty restaurants putting up signs too, “Non-Smokers where are you? We are going Broke.”
BTW Peter Wickham asked me to join him on his call-in programme tomorrow. Guess the topic? Smoking. Like I getting a reputation for being the lone smokers-rights advocate in Barbados, or maybe the Caribbean.
People, it is time to speak up. Smokers where are you? There are 27,000 smokers in Barbados. Wha happen? The statistics wrong?
David, don’t finish kill we. Give we a small break, man. This is the last one, just in case I start to become the next target for assassination. I planning a small revelation if he does call. It is supposed to be by phone.
David // February 4, 2009 at 9:55 PM
@ROK
Lol boy you better start charging some appearence fees because cigarettes gone up!
Tell Peter BU sends our regards and understand why he has to be a slave to the system. You can also feel free to give the BU family a shout out :-)
ROK // February 6, 2009 at 2:40 AM
Guys, I see that measles are on the rise in the UK. Found this BBC story and what caught my eyes was this part:
“The figures come as a report from the World Health Organization on a measles outbreak in Germany in 2006, in which two children died, found 80% of those who had caught the infection were unvaccinated.”
This report needs some clarification because if 80% were unvaccinated, it means that 20% vaccinated still got the disease. I would put down this 20% as those not getting the second shot. Could that be right?
Source: http://news.bbc.co.uk/2/hi/health/7872541.stm
David // February 7, 2009 at 5:08 PM
Should we find this article in today’s Nation interesting?
me // February 11, 2009 at 8:37 AM
http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece
for those gainst vaccinations please read the above…
Note that the increased incidence pf measles and death due to measles .
ROK // February 11, 2009 at 10:36 AM
@me
If you are referring to ROK then you have it wrong. The only thing I have against vaccinations is that they are frequently overused in the name of caution and secondly, they belong to an old technology which needs updating.
To tell you that I am against the use of anything that will improve the quality of life however small goes against my religion (conscience).
me // February 12, 2009 at 3:25 PM
now that the ‘link’ between autism and vaccines has been debunked….can we move forward!