Monday, March 19, 2012

LITTLE THINGS ARE A BIG THING

At my last eye exam my eyes were unchanged in spite of several years with Diabetes II, which was diagnosed by an eye exam. The life of my eye doctor, however has been turned upside down, not by medical conditions but by the health business. He has left the big clinic where he practiced for years, just as my previous eye doctor left that same clinic and then left the town. This is not unusual. I have only a dim understanding of what is going on, but I don’t think I’m far wrong. Being a physician is no longer a profession: it is a profit-making enterprise and the docs are being squeezed and managed with the rest of us.


Obamacare is beside the point. Doctors have made a devil’s bargain to get rid of the burden of paperwork and other management chores. They have lost their autonomy. Some have lost their morality. Whether they have lost their skill is irrelevant since that’s not what counts anymore. In fact, the nature of disease and the protocol for handling it is has changed, esp. in the case of something chronic like diabetes. One monitors with tests, notes the results, and runs one’s finger down the list of prescriptions indicated, and that’s it. No wonder people are disintermediating their doctors by simply going to the lab for the tests. If the doctors didn’t have control of the prescription pad, why would we need them?


The science of “omics,” which is the goofy name for the study of how operating genetics run the body, happened upon something very fortunate. Their main “lab rat” is a Ph.D. whose entire genome is recorded and studied. Not just that but also an integrative Personal "Omics" Profile, or iPOP. The word "omics" indicates the study of a body of information, such as the genome (which is all DNA in a cell), or the proteome (which is all the proteins). Michael Snyder's iPOP also included his metabolome (metabolites), his transcriptome (RNA transcripts) and autoantibody profiles, among other things. They saw that he had a vulnerability to diabetes though no one else in his family had ever been diagnosed with it.


Then one day he caught a virus and that actually GAVE him diabetes II. file:///Users/maryscriver/Desktop/omics%20&%20viruses ScienceDaily (Mar. 15, 2012) The team watched and learned.


When I was at seminary, one of my classmates (a woman in her twenties) caught the flu and then she had diabetes I. That meant injected insulin and constant monitoring. I’m happy to report that she’s maintained well and -- thirty years later -- serves a church happily. One does not have to die of diabetes IF one can maintain the protocol, which is rigorous.


I’ve only been diagnosed a few years but thanks to Internet contact, mostly Dave Lull (the cross-pollinating librarian) and Jenny Ruhl http://www.phlaunt.com/diabetes/bio.php I’m able to stay in control with one metformin a day plus food changes. Since I live alone, I cut my intake way back, lost fifty pounds, eliminated sugar, most carbs, white bread, corn fructose, processed food, and so on. I’ve always eaten a lot of veggies, salad and nuts. I read a newsletter about foods that convert to sugar slowly -- it comes out of Australia -- and another sort of rah-rah column about getting exercise. (I don’t do well on that one.) The point is that I’m in charge of myself, though it has meant major changes. This town is in a place where people interact through food: benefit barbecues, pie socials, candy on desks, coffee and cookies after church, and so on. Restaurant meals are high sugar, high process, big portions. But I’m a solitary anyway.


Most people who have lived here all their lives and who are diagnosed with diabetes, esp. on the rez, either become dependent on meds or simply sicken and die. Changing the way they eat, the way they cook, the way they interact with family and neighbors is too much. They find it impossible to lose weight. The ecology is changing too fast for them to evolve.


When I went for a refill on one of my two prescriptions (my high blood pressure med), the big Medicare website said I could not have any more until April 4. The local pharmacy records show one more set of meds was sent to me than I evidently received. We can’t figure out where the error is. I’m going to take advantage of this to run an experiment: I’ll not take any pills until April 4 and I’ll record my blood pressure every day. Today it’s 134/79. If it starts getting too high, I’ll buy enough pills out of my pocket to last until April 4. Assuming I have the money.


The point is not my blood pressure. The point is that our ailments have become very differently envisioned. Dr. Snyder’s diabetes onset involved 40,000 genes, all interacting in unique ways. A look at the names of the researchers reveals many countries of origin and the study itself was supported by Stanford University, the National Institutes of Health, the Spanish Ministry of Science and Innovation, the European Union, the European Research Council, the Korber Foundation, the Fundación Marcelino Botín and Fundación Lilly and the Breetwor Family Foundation. Snyder undoubtedly caught his trigger-virus from his small children who interact with the other children of the Stanford academic community, people who constantly travel and host other academics.


Many of us know and admire medicins sans frontieres. Now we have (we always did) diseases sans frontieres with frequent flier miles. Most are not dramatic. (Fatigue, malaise) Many are antibiotic tolerant. Some have been triggered by our constant invention and ingestion of peculiar molecules never seen in nature, much less in bodies. So far our water here is nearly pure, off the Rocky Mountains and traveling underground about thirty miles to our aquifer. That may not last since frakking means injected unnamed chemicals into the ground. Our wheat crops, which are grown right up to the town limits, are genomically altered to be Roundup Ready, meaning high levels of herbicide can be applied. The pigeons that hang around the granaries in town are all gone. No one will say how they were eliminated. Our cancer rates are high.


Years ago I used to have a poster in my kitchen that said, “Faithfulness in little things is a big thing.” It’s attributed to St. Francis, who advocated being as basic and interwoven with nature as possible. I wonder whether there’s a gene for that. It would probably take more than a few.

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