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Blaming the Victims, Yet Again

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posted on Nov, 14 2006 @ 11:44 AM
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14 out of 24 patients who had heart surgery at Morristown Memorial Hospital experienced cognitive decline - they got stupider after surgery, because blood flow to the brain was obstructed during surgery. Numerous factors and events during surgery can interfere with blood flow to the brain, including other environmental factors, radiation exposure from tests and procedures, thrombosis, embolisms, and underlying vascular diseases. However, according to Dr. James P. Slater, a cardiac surgeon at Morristown Memorial Hospital, "Over the last decade, heart surgery itself has been implicated as the problem, and it's clear to us that patients bring their own risk to the table, and this risk is a behavioral risk."

 



health.msn.com
Among 24 patients who had undergone coronary artery bypass graft (CABG) surgery at Morristown Memorial Hospital in Morristown, N.J., 60 percent showed evidence of cognitive decline. Those with a history of smoking were more at risk. ...Why? ..."It probably has to do with the mechanisms of injury of smoking itself. Inhaling carbon monoxide over time is probably not good for the brain, and nicotine causes blood vessels to shrink and affects small vessels more than large vessels," said Dr. James P. Slater, a cardiac surgeon at Morristown Memorial Hospital. "During periods of stress, such as surgery, the vessels are not able to deliver as much blood, and therefore oxygen, to the brain."

"The injury may not be to the brain cells per se but to the microvasculature, or small blood vessels, in the brain," added Dr. Robert Bonow, past president of the AHA, chief of cardiology at Northwestern University Feinberg School of Medicine, and moderator of the news conference. ...The findings do throw new light on the impact of heart surgery on different patients.

"Over the last decade, heart surgery itself has been implicated as the problem, and it's clear to us that patients bring their own risk to the table, and this risk is a behavioral risk," Slater said. ...It's unclear how to remedy the problem, or even what to tell patients, especially if the risky behavior occurred two decades before, the doctors added.



Please visit the link provided for the complete story.



Smoking is bad. No doubt about it. And it probably does have long term effects - although "Quit Smoking" campaigns do say that quitting will restore the damage over time.

But blaming cognitive decline after surgery on a single behavioral risk? Making cognitive decline a personal responsibility in health?

I don't think so. Really, numerous factors and events during surgery can interfere with blood flow to the brain, including other environmental factors, radiation exposure from tests and procedures, thrombosis and embolisms, and underlying vascular diseases. This is common medical knowledge.

The goal here is to offload culpability onto patients - and make patients personally responsible for problems in surgery, even in the presence of factors they can't control.

Why?

Lots of reasons, but two stand out.

1. The risks associated with surgery are legion - ranging from infection with untreatable antibiotic-resistant bacteria to cognitive decline from surgery-related stroke and TIAs. Many post-surgery problems are linked to hospital acquired infections, missed diagnoses, and/or surgeons' incompetence - all of which involve liability. Blaming the victim is a way of avoiding liability.

2. Surgery is a dying profession - soon to be replaced by personalized medicine tailored to individual patients' needs, and maybe stem cell therapies. Surgeons are fighting to protect their turf, or carve out a new niche, and defending their livelihoods - by blaming their patients for a host of realities beyond anyone's control.

Smoking may be a factor in post-surgery cognitive decline - but even so, it is only one of numerous other factors. Why focus on patients' personal responsibility, blame the victims, and kick people who are already down?

For shame.







[edit on 14-11-2006 by soficrow]




posted on Nov, 14 2006 @ 01:15 PM
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"1. The risks associated with surgery are legion - ranging from infection with untreatable antibiotic-resistant bacteria to cognitive decline from surgery-related stroke and TIAs. Many post-surgery problems are linked to hospital acquired infections, missed diagnoses, and/or surgeons' incompetence - all of which involve liability. Blaming the victim is a way of avoiding liability.

2. Surgery is a dying profession - soon to be replaced by personalized medicine tailored to individual patients' needs, and maybe stem cell therapies. Surgeons are fighting to protect their turf, or carve out a new niche, and defending their livelihoods - by blaming their patients for a host of realities beyond anyone's control."


Im going to ask you - do you actually believe anything you have presented us thats in the above article? If you do.......



Where to start...... OK.... Surgery is a dying profession... You know what a CABG is? Coronary Artery Bypass Graft. Know what it does? The veins in your arm / leg are removed to be used as a BYPASS for the blocked coronary arteries. Blocked. This means your heart is actually dying as you are stood their. No blood, your dead. Hence the need for surgery. Their is NO OTHER TREATMENT FOR A BLOCKED CORONARY ARTERY. Surgery is the only way you will survive as it bypasses the block and keeps your heart tissue supplied with blood. No drugs, no nothing will help you if you have a blockage in your coronaries... they can aid you, but not treat it.


Smoking.

You want to die early, keep smoking. Its that simple. You raise your risks to such a high level that its amazing you actually keep on puffing away. Your wounds heal slower, your tissue recieves less oxygen because your inhailing poisons, your more likely to try to mobilise before you should because of your need for a fag... your not going to listen any way to any advice because you get all uppetty about it when people advise you to stop...your killing yourself. IT IS YOUR OWN FAULT.

You cannot underestimate the damage smoking does, and yet people hide behind any old excuse to carry on......

TIA's + Strokes.

Yes, surgery does run risks, its very true. Yes, a very small minority may suffer some affects from surgery, but not every body every time.

Lets have a look at your average CABG patient. They are fat, they are old, they are inactive, they smoke or did once, they lead life styles that will kill them and they know it, but do nothing any way. They may have other diseases / conditions ie diabetes that they do not comply to treatment plans, so are running way higher risks any way.... In short, they are fat, unhealthy and 90 times out of 100 its through their own choice. They have a raised risk any way for TIA's and strokes, which is just made worse by having life saving surgery.



OK, rant over.
But do yourself a favour, before laying the blame on the staff who fight day in day out to save lives through cardiac surgery, go work on a ward / observe for a while, and see just how soon these people would die without surgery any way. CABG surgery is complex, can be slightly dangerous for the patient involved, but hey, they have abused and destroyed thier own bodies to end up in a cardiac ward any how...... so whats a small surgical risk?

Don't blame the surgeons, don't blame the staff, blame the patients for self abuse.



posted on Nov, 14 2006 @ 02:16 PM
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I agrree whole-heartedly with the dark Knight. There has to be some level of personal responsibility on the patient for reaching the point for the need of said surgery. Every single surgery does not result in these issues every single time. Were that the case, then it would only imply that the body is not even supposed to be capable of going through such an operation after it has suffered a lifetime of irresponsible living. The meat and bones aint responsible for that way of living now, it falls soley on the individuals mind.

I would say then in response to this particular surgery, I suppose the problems are a result of the patients negelct for their own health.



posted on Nov, 14 2006 @ 02:40 PM
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whil i agree with you in form Drk knight i do feel i have to point out that he was right on one thing, surgery is a dying field, same thing with everyday normal medicne. As we get better and better at nanofabrication and indivdualised treatments the need for surgery has shrunk. We have already had one semi-succesful example of gene therapy Success albeit small . Granted only 2 out of 17 went into remission but its still proof of concept. As per your bypass thingie, with the advent of nanoscale machines blockages will no longer be a problem, take a shot and your bad cholesterol and blocked arteriers are no more.

There are some rapidly advancing technologies that will change the way we think about medicine and surgery.

here is a great site to help keep you up to date on the advances made in nanotech both medical and non-medical www.nanotechwire.com..." target="_blank" class="postlink" rel="nofollow"> Nanotech Wire

All that being said, while patients do have to take some responsibility before they go into surgery, it is also important to remmeber that surgeons will and do make mistakes, sometimes that means whomevers on the table dies. They will do and say whatever they have to/can to save thier own arses and carreers. Greed is the ULTIMATE motivator



posted on Nov, 14 2006 @ 03:30 PM
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I have surgery two times, and while they were my choices it was nothing that I could do to avoid them.

And I did extensive research before both procedures.

But when I went to surgery I put my life and my body into the hands of the surgeon and the staff.

If my surgeries has gone wrong I would want accountability for the fault, and no to be blamed for it as a patient.

Even when sofi refers to hart surgery still the people that have this surgeries are putting their lives in the hands of the surgeons.



posted on Nov, 14 2006 @ 05:03 PM
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that is true, and most cases come out just fine. The persons life is saved, unfortunately sometimes even after that some people do not care to change their lifestyle habits that put them in that position.



posted on Nov, 14 2006 @ 06:01 PM
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Originally posted by Elsenorpompom
All that being said, while patients do have to take some responsibility before they go into surgery, it is also important to remmeber that surgeons will and do make mistakes, sometimes that means whomevers on the table dies. They will do and say whatever they have to/can to save thier own arses and carreers. Greed is the ULTIMATE motivator


Yes surgeons make mistakes but that doesn't mean that they will all do whatever is neccessary to save their "arses". I don't think greed is the ultimate motivator either.


As far as the greed issue ... I don't begrudge a surgeon being a well paid individual. First off they must pay through the nose for malpractice insurance and secondly I want the person who's operating on me and my loved ones to be highly trained and well experienced, both things better obtained through recruiting people with good pay.

My son had several kidney surgeries as an infant (10 month to about 1 1/2 yrs). He had a couple week long hospital stays after said surgeries. I'll break down a typical 1 week hosptial stay/ 6 hour surgery bill. The hospital charges for a room, nurse care and medicine was $45,000 for a week ... the OR (not surgeon) charges for the 6 hours were about $7,500 ... the anethesiologist was $3,700 ... the Post-Op care $3,000 ... the surgeon (who actually did the 6 hour ... in my opionon, hardest work) $5,200.

I just don't see how the surgeon is "greedy" when out of over $250K of medical bills maybe $12k are his. Surgeons are skilled professionals who, for the most part, are doing they're job because they enjoy helping people and having a positive impact on patients lives.

Surgeons will make mistakes because they are humans ... no human is fallible ... some mistakes are understandable ... others are egregious and someone needs to pay through loss of license, etc.

In the case at hand on this thread the discussion is "blaming" patients for their loss of cognitive skills after complex heart surgery where this is limited blood flow to the brain. The article states a study showed that smokers were twice as likely to experience cognitive loss after such surgery as compared to non-smokers. I wouldn't call that "blaming" the patient ... it's a statement of facts ... smoking thins out the blood vessels further impacts the limited blood flow during surgery.

This surgery carries a danger of cognitive loss as a side effect ... said risk is further increased to smokers ... the choice of not having the surgery is probably worse than the cognitive loss. I can't find blame on the doctors/surgeons just because there are side effects. Can we find better ways to supply oxygen to the brain during such an intensive surgery? Maybe, and we should research those avenues but until then it's a risk that no one is really culpable for.



posted on Nov, 14 2006 @ 09:04 PM
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I look forward to nano scale machines un blocking arteries within the heart - But the matter still stands : Once tissue is dying / diseased, no amount of clever nano this nano thats gonna help you out - You will need to open up and let in the man with the hands so to speak. The surgeon.

However, if nano tech can stop this from happening in the first place by keeping us all unblocked and ticking over nice and smooth...well im 100% behind it, but, and a big but, you just know its gonna be expensive!

Change your life style, before it ends your life full stop.



posted on Nov, 14 2006 @ 09:37 PM
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Originally posted by D4rk Kn1ght

Change your life style, before it ends your life full stop.





There is a worldwide pandemic of chronic disease - with cancer, stroke, and heart disease heading the list.

At a molecular level, virtually all chronic disease involves the transdifferentiation of fibroblasts into aberrant myofibroblasts, with cell changes in connective tissue that result in "abnormal wound healing" and "tissue remodeling." All the evidence indicates an infectious component contributing to the molecular effects, most likely mutated beta-actin, a-smooth muscle actin and/or TGF-beta.

Certainly, the individual is not completely powerless - he does have some power - but he is not personally responsible for being exposed to repeated low-level contaminations in his food, water and air either.





Once tissue is dying / diseased, no amount of clever nano this nano thats gonna help you out - You will need to open up and let in the man with the hands so to speak. The surgeon.




Not at all true. Here's a quick and dirty overview of one alternative that does NOT require invasive surgery: tissue engineering.



Scientists visiting Harvard this month gave an audience of 180 a glimpse into the future of medicine - a world of implantable arteries, "bioartificial" organs, and replacement cells for failing hearts. ...Tissue engineering is a fast-moving interdisciplinary pursuit that combines medicine, cell biology, materials science, and nanotechnology. It promises to transform acute and chronic care and create a brave new world of engineered cells, microscopic drug delivery systems, implanted medical devices, and replacement organs.

Cutting-edge technology is emerging, he said, in engineered gene networks and cell networks - along with a few "bench-to-bedside" applications. "We're talking about products now," said Parker.

(For example) ...a biological pacemaker involves isolating a pacemaker gene found in the heart (HCN2), boosting its expression in heart cells grown from bone marrow, then injecting it into the left ventricle of the heart.

***

From the developing world:

Stem cell therapy can help cut down progression of cardiac disease to heart failure or treat existing heart failure, while up to 90 per cent success rate in stem cell surgery for cardiac patients has been recorded in “a very specific patient population”, latest research reveals.

Stem cell therapy helps the human body repair itself by utilising the stem cells, which are still at an early stage of development, and implanting them in other areas of the body in order to aid the body repair itself. Used in cardiac surgery, stem cells are directly injected into the heart muscle with a needle.

“There are many possible reasons why they work, from creating new muscle or blood vessels
, recruiting other cells or growth factors, or fusion with weakened cells making them stronger,” observes Patel. He feels the use of stem cells and tissue engineering can help India create an effective and efficient healthcare system for the future.


***

"Tissue engineering is very, very attractive because you can manufacture the valve exactly as you want to," said Dr. Valentin Fuster, director of the Cardiovascular Institute at Mount Sinai School of Medicine in New York City, president of the World Heart Federation, and past president of the American Heart Association.

***

Pitt Engineers Receive National Honors

Sacks' research focuses on quantifying and modeling the structure-mechanical properties of native and engineered soft tissues, particularly tissues of the cardiovascular and urological systems. Sacks directs the Engineered Tissue Mechanics Laboratory, and his team has concentrated on the mechanical behavior and function of heart valves and scaffold design, including the development of stress-strain models for these native and engineered tissues using a structural approach.

***

At Rensselaer, faculty and students in diverse academic and research disciplines are collaborating at the intersection of the life sciences, the physical sciences, and engineering to encourage discovery and innovation. Rensselaer's four biotechnology research constellations -- biocatalysis and metabolic engineering, functional tissue engineering and regenerative medicine, biocomputation and bioinformatics, and integrative systems biology -- engage a multidisciplinary mix of faculty and students focused on the application of engineering and physical and information sciences to the life sciences.




More:

Bio-Matrix Announces Construction and Installation of the Class 10,000 Stem Cell Cellular Tissue Processing Laboratory Completed

Advances in engineering heart tissue reported by MIT scientists


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posted on Nov, 14 2006 @ 09:52 PM
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Yes I heard about the new procedure of injecting stem cells into the patients I think that stem cells does hold a key to some treatments.

No wonder so many groups are against of it, if this treatments have positive results it can become a problem with the big pharmaceutical empire and their profits from alternative treatment.



posted on Nov, 14 2006 @ 10:47 PM
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Originally posted by marg6043

No wonder so many groups are against of it, if this treatments have positive results it can become a problem with the big pharmaceutical empire and their profits from alternative treatment.




New technologies are poised to completely revamp the medical industries - not just tissue engineering and stem cell therapies - and everyone's fighting for "market share."

...Not many are actually interested in patients welfare.

And half the hold-ups are political, designed to protect the status quo.





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