Scientific Inquiry Leads to Interesting Discovery: Galaxy Star is a Compulsive Tatter

Duplicate concepts are the bane of terminology editors everywhere. I was trying to tease out tattoo disorder. Is there such a thing? I never heard of it. Couldn't find any reference to it in the Medical Literature, so seeking the wisdom of the masses - Web 2.0 style - I Googled it. Lo and behold, I learned something. And if you don't know who this man is, you haven't done nothing.

Great thanks to Vikas, in Shimla, India writing at TattooBlog: Colors of Freedom. Vikas posts "Beckham Suffering from 'tattoo obsessive compulsive disorder'"Apparently, Mr. Beckham has admitted to having a problem with OCD. That's got to be rough for him, his family and his teammates. No word on whether or not he is in treatment or on medication for OCD. Vikas quotes Beckham as saying he is "addicted to the pain of the needles and tattoos...". I think that might be a different diagnosis.

Some of the literature out there indicates that extreme obsession with body art and tattoos may be a manifestation of Body Dysmorphic Disorder (BDD). A tragic sentence I found embedded in this link is that as many as 50% of patients undergoing plastic surgery may have BDD. It is unconscionable that surgeons are doing elective procedures on mentally ill people. It is down right predatory. It is time we call we for psychiatric screening prior to elective cosmetic surgery. Maybe we need to do the same for tattoos, especially in minors.

BDD has a high rate of comorbidity - it is usually seen with major depression, OCD or social phobia. Although it starts in late adolescence, it usually isn't diagnosed until people are in their 30's. I think body art is beautiful, but suffering is not, and profiting from the suffering of others is ugly. I doubt that if their patrons have a mental illness, tattoo artists have a clue, but cosmetic surgeons do.

Accepted forms of treatment are a combination of medications and psychotherapy. Extreme cases may require hospitalization. Untreated cases can result in suicide. The warning signs are obsession with appearance.








Thank you calmenda for use of beckham image.







Thank you to Middleton Tattoo Studios for use of image.

Labels: Beckham, blog, medical integrity, OCD, tatoo

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Darwin's Nightmare: Can Medicine 2.0 Save the World?

While thefounder, mentor and inspiration of thisMedicine 2.0 Blog Carnival was wilting in 42 degree C record breaking heat (107 F to the Yanks among us), I was sitting in my breezy San Francisco Bay side apartment, riveted by Darwin's Nightmare, apparently when I should have been getting this Carnival published.



I hope you will all bear with me for being late with this and help me wrap my brain around this issue. Here we are - pioneers on the new frontier of Medicine 2.0 - the marriage of new technology and health care. Yet a heat wave in Central and Southeastern Europe has claimed dozens of lives and has caused the air conditioning to be turned off in a Budapest hospital to save money on electricity bills. How can we talk about Medicine 2.0 when we don't have electricity, let alone electronics?

Then there's my film: Darwin's Nightmare, a 2004 documentary film by Hubert Sauper about a predatory fish that has invaded Lake Victoria. By the end of the movie one is not sure if the Nile Perch is the worst predator in the film. Exploring the economy and ecology of Lake Victoria, Tanzania, Sauper lets the children, the orphans, the prostitutes, the pilots who fly the fish out of the lake and the weapons of conflicts in, the guards, the AIDS victims, the business owners, the fish themselves tell the story of a world on the brink of disaster. This is our world. The homeless orphans and AIDS victims, the murdered and beaten prostitutes around Lake Victoria are our patients. How can we use Medicine 2.0 to save the world?

First up, bioinformaticist Michael Barton wants to save the world - How to Save the world and make everyone happy - one Power Point presentation at a time.

Ouch! davidrothman.net, whose very blog subtitle is too cool - Exploring Medical Librarianship and Web Geekery - really hits me where it hurts. He provides a link to Mayo Clinic Podcasts. Why isn't Healthline listening to me? Don't you all want to hear some podcasts from us? Help a sister out here...

MedSquod cuts me to the quick with Medical Podcasting Method #2: Write the Medical Blog Post First.

Alvaro Fernandez, CEO of Sharp Brains, a Brain Fitness Center or Gym for your Brain. Hey, we are going to need all the Sharp Brains we can get to solve our way out of these problems! He submitted some guidance for us all with the brain training games out there. Check out the link to the Alzheimer's Disease post: Nintendo Brain Age, Happy Neuron, Lumosity, and My BrainTrainer...

Lithuanian geneticist, Ramunas Janavicius, tells us that the Firefox based open source BioBar is like PowerBar: The Guide to Bio Databases.


Guys Like Gadgets
Steven Palter, MD of docinthemachine wants to transform medicine with tomorrow's technology. He reviews Microsoft Touch Screen - Surgery VR Potential.

Doctors Gadgets discusses using ePocrates on the iPhone.

Healthline's Joshua Schwimmer MD of Tech Medicine writes Medical Uses of the iPhone (Part 2). Readers are raising concerns about privacy compliance with battery issues.

John Sharp of eHealth writes PHR's on Cell Phones? Again with the battery issues!

Thank You!

medGadget for alerting us to Wellcome Trust Releases Images Collection Under Creative Common Licence. That's at least as exciting as a new Harry Potter book and movie. OMG!

Bertalan Mesko reports things have cooled all the way down to 37 degrees C and sends us Golden Links for Doctors. Non-doctor types (like moi) will find these resources indispensable as well!

PhD Biochemist Walter at Highlight Health offers The Highlight Health Web Directory
and explains the differences between web directories and search engines.


Survival of the Fittest
Health care attorney Bob Coffield writes MD Net Guide Article: Are Physician Blogs in a Legal and Ethical Twilight Zone?

My personal favorite submission: Jason Bobe works for the Personal Genome Project and asks all the right questions "... how are new technologies and the web going to redefine relationships between scientific communities and ...the general public...and the network of actors in between...His submission, Medical Ethics 2.0, gives us all plenty to think about while we melt in the heat.









Thank you kitakitts for use of photo thermo

Thank you Wellcome Trust for use of image of Lake Victoria, not so long ago...

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Insider Chatter says "Google Health at Risk"

Donna Bogatin of Inside Chatter interviewed Healthline's CEO West Shell last week for her blog post Google Health at Risk: Healthline Medical Search Snags Power Partners, and Money. The Big G has been taking some hits for its forays into health - whether it be complaints about its doctor dominated Advisory Group, Google Health's Architect Adam Bosworth,
but especially its position on Michael Moore's film Sicko.

"The search box is bad for your health!" Bogatin quotes Shell. Healthline has spent six years building the world's largest consumer health care database. Our navigation is medically sound - curated by clinicians - like me. When not sounding off about topics of interest, I work quietly with a team of other nurses, doctors, a pharmacist, microbiologist and geneticist to develop a rich, consumer friendly ontology, navigation tools and sophisticated products like Symptom Search. We will share more about our Clinical Team here in a future post. Google uses filters to eliminate unrelated content in search, but prevents users from connecting to the kind of information they might be looking for - related topics and resources. The Healthline search engine has a built-in scalable rules engine which allows for sophisticated search results manipulation beyond keyword basic filtering. Healthline technology ties terms together - like symptoms to diseases, and provides more nuance than rules based filtering.

Experiment for yourself with a few terms and see what results you get in the Big G search box vs. the Healthline search box: Try sex problem. What do you want your kids or your dad to search on? Never mind, your kids are going to look anyway. OK, try nervous. Last I checked, Wikipedia wasn't a reliable source for medical information. There are reasons why Google loves Wiki and so do I, but just not for health information. Try something more serious like Head trauma.

Healthline's clinical focus provides deep understanding of the complexities of health and wellness - from insurance billing codes to herbal treatments, to prevention and health promotion strategies and risk factors for disease. To get back to Bogatin's message - Healthline is now backed with strategic financing and partners to deliver what people want - health care information they can trust to help them make better decisions.

Thank you Larsz for use of photo.

Labels: Bogatin, Google, ontology, Search

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Healthline Hosts Medicine 2.0 Blog Carnival 7/24/07

Send me your submissions for all things about the confluence of Web 2.0 and healthcare. Hungarian medical student, genetics scientist, blogger and Wikipedia contributer Bertalan Mesko has been a pioneer in Medicine 2.0. It is his belief that the new generation of web services will change the way medicine is practiced and healthcare is delivered.

The main features of Web 2.0 that are applicable to the world of medicine are RSS feeds, podcasts and videocasts. Fellow Healthline blogger Joshua Schwimmer MD writes super-smart posts at Tech Medicine on all of these applications. Sadly, Healthline isn't up to speed yet in offering these state of the art Web 2.0 features. Maybe our new funding and partnerships will help us get there (?). Ten million adults read health blogs.

Mesko's slideshow provides instructions for subscribing to your favorite blog's RSS feed. Medical search engines are vertical search engines of peer reviewed content, in Healthline's case, using a unique consumer friendly medical taxonomy.

The Medicine 2.0 Blog Carnival is getting off to a slow start, but I have gotten some interesting submissions - thanks! I want more! I am especially interested in critical analysis of the limits of Web 2.0 and the applications to medicine. I wouldn't mind hearing from those quiet people in clinical informatics. What are you up to?

thanks unabonger, for use of image Mobile Podcast Recording Studio.

Labels: informatics, Medicine 2.0, Tech medicines, Web 2.0

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Healthline Secures Financing and Partnerships

Thanks to the wonders of technology (DVD's), this weekend I saw William Wylers' 1958 classic film, The Big Country. The days of settling a piece of land with 100 miles of fence and some ranch hands are gone, but the basics of a successful venture remain the same - we always need financial backing and reliable partnerships. In today's brave new world, we all need to figure out how we can work together to achieve common goals. Healthline Networks has built this website into a Top 10 health information website for consumers. Along the way, we have entered into technology distribution agreements with publishers, health plans, other search engines and online media companies.

Healthline combines powerful search technology with deep medical expertise to help people access reliable healthcare information. Judging from the feedback we get, we are making a difference. Securing strategic financing of $21 million will help us achieve our goal of being a global leader in health information services. New partnerships with GE/NBC, Aetna Ventures, Kaiser Permanente Ventures and our continued relationship with publishers Reed Elsevier, Mitsui & Co. and VantagePoint Venture Partners will allow us to step up our game and transform the way people get their healthcare information.

From our Board of Directors, Richard Carmona, MD, former US Surgeon General, says, "Healthline and its improved partner network are helping more families - here in America and across the globe - access health information that they can use to better manage their health." Healthline and its partners help to put power tools of knowledge and understanding about how to get healthy and stay healthy in your hands. Look for exciting new tools, content and products from us in the coming months, all reviewed by a team of clinicians who care about you!

Labels: Aetna, Dr. Carmona, Healthline, NBC

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Thank you, Dr. Smith at Aetiology for Grand Rounds 3.42!

Tara C. Smith, MD, professor of Epidemiology has one awesome blog at Aetiology. I just can't get enough of all things disgusting yet fascinating about medicine, and her blog has it all! She was kind enough to include my post Voices: Somalia Situation is so bad. Everyday Killin in this week's round-up of the usual suspects and then some. It's good reading and much more entertaining than reruns of Scrubs...

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Shot through the Heart: Dr. Carmona, Nation's Doctor

Dr. Richard Carmona, 17th US Surgeon General states he was "blocked at every turn" by the Executive Branch of the US government. His "travel was monitored" when he wanted to ride a bike with a disabled child - because he would be helping a "politically prominent family- the Kennedys". Guess what controversial event he wanted to attend? The Special Olympics! Eunice Kennedy Shriver, sister of Senator Ted Kennedy, founded them...Gee, he thought he was helping sick kids, Mr. President! Dr. Carmona, a former trauma surgeon, resigned from the office on July 31, 2006. Our nation has been without a doctor for a year. We are at war, make that two wars. With no trauma surgeon to triage the incoming.

Government scientists have been complaining for years that the Bush administration is trying to control and distort scientific evidence. Richard Carmona, MD, MPH, FACS testified before Congress that from 2002-2006, his speeches were edited and his learned opinions blocked on:

• stem-cell research
• dangers of secondhand smoke
• mental health
• emergency preparedness
• global health issues
• teen pregnancy prevention
• comprehensive sex education
• emergency contraception
  

Today's Wall Street Journal reports that while the US Surgeon General may have little formal power, the position is a "megaphone" on public-health issues.

We at Healthline are proud to have Dr. Carmona on our Board of Directors, and invite him to guest blog as a Health Expert on any subject he wants to, any time. We await his words of wisdom and applaud his heroism and his expertise. Thank you, Dr. Carmona, for fighting for all of us.

Photo courtesy of Google Images.

Labels: Dr. Carmona. Bush administration, trauma surgeon

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SICKO: An Industry Insider's View

I saw Sicko yesterday and have to admit, I laughed when MM commandeered boats to Guantanamo to seek care for sick 9/11 heros and cried when he took them to Havana Hospital. Now the US Treasury Department and Michael Moore are investigating each other over this alleged infraction of US laws, and the people who went on the trip have signed privacy agreements so they aren't talking. 47 million uninsured Americans is wrong and we need to fix it. But Moore's film isn't exactly fair and balanced.

The Sicko doctors in managed care who were disgraced worked in one aspect of insurance called Utilization Review. I worked in insurance for several years but always refused to work in UR for the very reasons cited - UR denies "payment, not care." I preferred being one of the people who advocated care. One of the secrets of saving money that Moore did not go in to is that by providing the best possible care, health care costs go down. This has been proven over and over again in countless studies, and why there is such a big push in the health care - and insurance industry to adopt Evidence Based Medicine Practices and integrate IT. Insurance companies were willing to pay me good money as a consultant and as an in-house nurse to advise them on the best possible plan of care for their insureds.

I only bring up the issue of race because it was brought up in the film: When a black worker for a utility company suffered a catastrophic spinal cord injury in an industrial accident, the Director of the large Worker's Compensation insurer company repeatedly instructed me to make sure Mr. S. had the best possible care. I was given complete latitude to find the best doctors, therapists, transportation companies, surgeons to provide his care. I was to spare no expense coordinating getting a car that he could drive outfitted for him, or accommodations made to his home. Both he and his wife knew they could call me and talk about any problems they were having and any issues they were dissatisfied with and I would do everything in my power to make it right. The doctors, therapists, injured worker and his family and the insurance company were all happy with my work for them. That is what I strove for every day - to create a win-win for everyone.

Because I am bilingual in Spanish, I am often called in to coordinate care for monolingual Spanish speaking (often illegal immigrants) from Mexico and Central America who were injured on the job. Before any of you go freaking out about illegals, let me tell you that the patrons, or bosses, go down to these countries seeking cheap labor and bring them back to this country. Oh, yes. I know a lot. They go down and recruit young men with second or third grade educations who are functionally illiterate. They bring them up here to the US and put them in high risk jobs. They get injured. Duh. Our great health care system puts them back together again. Our Workers Compensation pays for it. I'd love to tell you about Mr. J. -put back together again by the Stanford Trauma team- but there is just too much to tell. It's another blog posting. Let's just say Mr. J got the best of care and a new Cadillac Escalade. And he deserved every bit of it. He lost so much. More on that story later.

Michael Moore's movie would have a lot more impact if he narrowed his focus. If he had focused on the Kaiser Permanente story from Nixon to patient dumping, to the little girl who died. Or if he had focused on the 9/11 heroes from the time they volunteered through their treatment in Cuba. His story gets diluted when he throws everything into the pot. His story seems a bit strident when he tells only the side he wants to tell. See Barbarian Invasions
for another take on the Canadian healthcare system. Interview some nurses who have fled the NHS system in the UK. Unlike the doctor who lives in a million dollar home, they claim to be underpaid. Or go to Nepal and fracture your ankle while hiking in the mountains. See what you think of that healthcare system. If you don't want to travel so far, go to Mexico. And someone please get him a good editor! Michael - if you want a great follow-up story, someone should do a documentary on Michael Ruppert. Here is a case where lack of health insurance truly trumped First Amendment Rights!

Speaking of Mexico, I was blessed to receive great care from a Cuban doctor while on vacation in Tulum a few years ago. My daughter had an asthma attack and the doctor came to our hotel room/cabana, delivered medications and a nebulizer machine and gave her a steroid injection. Total cost of care? $15.


Photo courtesy of Google Images.

Labels: health care, insurance, Michael Moore, Sicko, Workers compensation

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Thanks Over! My! Med! Body! for Grand Rounds 3.41!

Anonymous! Med! Student!- somewhere here on the Left Coast! writes a savvy little blog Over! My! Med!Body! and hosted Grand Rounds 3.41 this week. Thanks to you Grahamazon for including my COMA: Interview with Liz Garbus post about the HBO documentary. There are a lot of other fascinating reads featured and some great commentary about the US healthcare system.

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Big Love Meets Managed Care: WellPoint's David C. Colby

Maybe money can buy you love. David C. Colby, CFO of the nation's largest health insurer, Wellpoint, had a total compensation package of $4, 253,859 and, in addition to two ex-wives, was juggling 16 girlfriends (that we know of), many of whom were or are employees of Wellpoint. Some of the women are now suing Wellpoint for sexual battery, breach of contract and infliction of emotional distress.

One of the women, Rita DiCarlo is a nurse who has already sold the rights to her side of the story to Silvercreek Entertainment and Larry Garrison. In February 2007, Larry Glasscock stepped down as CEO of Wellpoint succeeded by the only woman to head one of the top 50 US companies, Angela Braly. Colby was forced out three months later. Glasscock claims that concerns about Colby's ethics came to light "in recent days" but DiCarlo and others, represented by LA attorney Mark Hathaway state they brought concerns to the attention of company officials months ago.

The case of Sara Waugh vs. David Colby et al, BC373492, is filed in Los Angeles County Superior Court. Wellpoint shares have been falling since May,2007 on the NYSE. Somehow I can't help but feel it's the insured who are getting _____.

Thank you Google Images for use of photo.

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Dark Side of Disability: Fragile X and Chris Benoit

Pundits are speculating that the specter of leaving his 7-year old son an orphan may have been the motive for WWE Chris Benoit murdering his son last week. The child had Fragile X Syndrome, a poorly understood genetic disease. Males have only one X chromosome, inherited from the mother at conception, and Fragile X Syndrome is caused by a mutation of the gene called FMR-1.
This gene plays an important role in brain development but the mechanism is poorly understood. About 1 in 5,000 males have Fragile X syndrome. At birth they appear normal, but development is delayed. There is no cure for Fragile X, and management of the syndrome involves complex coordination of medical care, speech therapy, occupational therapy, physical therapy, psychologists and special education teachers.

As with many long term disabilities, families get torn apart. Support is hard to find. The issues are complex. Chris Benoit's actions were heinous. People who are suicidal are not thinking clearly. It is frighteningly common for suicides, especially males, not to want to leave anyone behind to mourn them. Call it the grandiosity that goes with the mental illness - they just can't conceive that their loved ones can go on living without them.

Fifteen years ago, psychiatrists called for standardized operational definitions, validated taxonomies, national and I would say international surveillance for this phenomenon. The most formidable foes any of us have to wrestle with are the ones in our own minds. There are warning signs that someone is going to blow. Are we doing enough to protect the innocent children who are all too often victims of murder-suicide ? It is parents who kill their own children - whether it be mothers suffering from post-partum depression or fathers who kill their wives in a jealous rage and take the kids so no one is left behind. None of us are paying enough attention, especially those of us in health care. We have already done too little too late.

Thank you Google Images for use of photo.

Labels: Chris Benoit, Fragile X, murder-suicide, wrestling, WWE

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