The body is still such a mysterious device. It's so frustrating that we still can't figure out diseases like ALS. The greatest invention would be a body debugger.
Imaging + Genome Sequencing + Blood Tests
Still pretty barbaric compared to what we'll see in the future, but useful while we drag ourselves forward.
Anecdote: I was bit by a tick about 2 weeks ago. To get a lyme disease/meningitis test done, I had to pay my copay ($30) at my primary doctor (for him to approve the tests) and then had to make another appointment to have my blood drawn and tested by Lab Corp (~$200). I then had to wait for my doctor to call my back because Lab Corp would not provide my results directly to me (!!!).
Like I said. Barbaric.
Because where I come from, if I was bitten by a tick I could book my primary doctor's appointment online, get the blood test done the same day at a walk in clinic without an appointment, and then phone the doctor's surgery two days later to get my test results...without paying anything.
I almost thought that once, but it's really easy to run through the facts:
1. Since the primary purchasers of health insurance are companies, the insurance companies grossly tilt their plans in the direction of companies. Individual plans are lackluster. The individual plans where I live don't even cover mental health services. Not even one.
2. Since companies are fallible, we cannot depend on them to honestly offer insurance to every worker who deserves it. For example, in Massachusetts, there is a mandate for companies with full time employees to provide a health insurance plan: http://www.rawstory.com/rs/2013/03/29/companies-cut-hours-of... naturally, companies schedule for .1 less hours and leave you in the dust.
It seems that this is a total mess. Companies cannot be put in the crossfire of the health insurance debate with these unimplementable laws.
The only reasonable solution is to pay for it with the federal income tax. Competition and free markets are good, but not in this space. Would you like to find out the free market price for an ambulance after you were involuntarily hit by a bus and woke up in an ICU?
We live in a strange land of "freedom"
Pay out of property tax. Follow the money and keep the money loop as small as possible to maximize return on investment and minimize accounting losses.
99% of your lifetime medical expenses are going to be at the hospital closest to your home, most likely. Makes closing the loop simple and obvious.
If for political reasons you have to go county sales tax to pay for the county hospital, that works too.
Much like the most effective way to fund a local school system seems to be local prop tax rather than the feds or the UN or something.
"Companies cannot be put in the crossfire of ... with these unimplementable laws."
Its never slowed down any other regulation for any other reason in the past, ever, so may as well not start slowing down with health care.
If that happens my new home is going to have to figure out their property tax situation, though (NH property tax is one of the highest)
It's an empty word at this point. Freedom from what?
Unfortunately, because the Conservative party have frozen NHS funding, you'd have trouble getting that doctor's appointment, and the walk-in clinic would potentially bugger up your blood test, forget to put your NHS number on the sample, then call your doctor who would contact you a week later to tell you to go in again and have it re-done.
There's no good reason why we shouldn't be spending more to make sure that the service works properly, just right-wing ideology.
directly.
Whether it's better/cheaper to pay directly or indirectly is a separate issue worthy of its own debate, but either way TNSTAAFL.
This is the most important lesson of the whole discussion, having gone thru this. There's a direct analogy with rabies, if you know the animal is uninfected you can save yourself quite a bit of time, pain, and money. If you know its infected, well, treatment usually is wiser than waiting for death.
Bit by a dog? Eh, make it let go, and then walk away, no need to check for a rabies vaccination tag. After all, what are the odds? LOL
I don't know where you live but it is pretty standard to get a few vaccines (rabies included) when bitten by an unknown dog as a precaution.
Same reason people get tetanus shots with puncture wounds.
There's still a chance of having it even after the antibiotics. The chances of getting it even after taking a prophylaxis go down from around 3% to perhaps a little under 1%, but there's still a chance. And there are also other tick diseases that doxycycline doesn't work for. The most likely case is that mine was only attached for a little under 24 hours, which reduces the chances even further, but considering that if not treated right away it's basically as bad as AIDs it's still kind of alarming.
Do you see a doctor after every time you get into a car? Because that is far more likely to kill you than just about anything you can think of.
> If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.
Why do they even test for it? Don't they just start antibiotic treatment for it?
To a crude first approximation, a new antibiotic gets a fixed number of uses in the environment before it becomes ineffective in the environment. Its bad medicine to "waste" a valuable use of a fixed supply of an expensive product. You can save 50 million lives of actually sick people, or just provide 50 million placebos.
Also most dr. have a huge aversion to making people sick, and there are very few antibiotics indeed (none?) that don't have a measurable chance of killing the user or making them sick. Amoxocilian makes me pretty sick. Doing a course of it "for fun" would be incredibly unwise. Of course if it were "take the amoxocilian and get sick, or the infected leg has to be chopped off" well maybe that's worth some puking and fever.
So if your odds of infection are 0.5% but the odds of horrendous digestive system meltdown are 5% and death is a 0.1% likelihood, you're better off getting tested.
This is like the old "why not remove everyone's appendix?" question. Because removing everyone's would kill more people than appendicitis currently kills for a net negative.
Except when you get bitten by a tick and have stage-1 Lyme disease symptoms like a huge swollen bulls eye, your odds of infection are more like 99.9%. If someone is getting tested for getting bit by a tick, they most likely have some sort of symptoms.
> You've just defined the recipe for developing antibiotic resistant "other things". Doxocycline-resistent... donno UTI or STD or gum disease or whatever. That would suck if STDs became resistant, now incurable.
I thought that was more likely from the hundreds of millions of pounds of antibiotics used in factory farming, not preventative medicine.
When a bunch of us were exposed to a person who 48-hours later came down with severe meningitis (coma), they dosed us all with cow pills of antibiotics. I'm sure they could have waited until we all got 105F fevers by the time the tests came back, but they took the risk of antibiotic resistance and pre-treated us all.
Labor and materials cost money. Someone has to pay.
LabCorp is not staffed with people trained to divulge and discuss your potentially serious diagnosis.
All but the smallest independent medical clinics have phlebotomists on site. If you want faster medical service, move to a more dense/develeped town. Most of us live in cities, for reasons quite like this.
A blood test is not useful for a recent tick bite. It takes 4-6 weeks for the antibodies to be present in detectable quantities. For Lyme, you observe the possible site of infection for a few days, if it is swelling or reddening (with or without the characteristic "bulls-eye" pattern), then you get antibiotics. Doxycycline is popular, but it's a long (21-day) course, so a good doc will not prescribe it casually.
Meningitis is either bacterial or viral. The true test is analysis of spinal fluid (this one goes to 11!), but it's a very fast-moving and dangerous infection. Regardless, a blood test is unlikely to be conclusive.
You can save the tick and send it off to a local lab for analysis. That'll tell you with a high degree of certainty if the tick had the spirochette. In some parts of the country, most do. It won't tell you if it has been transmitted to you, of course.
Disease transmission typically happens after the tick has been attached for 36-72 hrs.
Those of you who haven't lived in deer tick country might not realize how tiny the things are this time of year. Pinhead sized or smaller. Easy to miss even if you're diligent. No solution for it except to be more diligent, however.
Good luck with the doxycycline. I don't understand why your PCP ordered a blood test, but the meds make sense.
http://en.wikipedia.org/wiki/Gross_world_product
It's probably just a matter of figuring out how to funnel enough money and people on the problem. Smartphone advances, for example, will be incredible over the next decade. Much better graphics, CPU, batteries, etc. That's because there's a huge market for them. Another example is 4k TV's, which are out of reach. Within 5 years, they'll be cheap, and a lot better.
Figure out a way to have consumers directly spend more money on medical research/technology and great things will happen.
The dramatic advances in consumer electronics aren't just about spending. We spend a similar amount on cars, but a new car today isn't much different from a new car ten years ago. Forty years after we landed on the moon, we don't have day trips there. Consumer electronics change fast largely we've been able to make increasingly tiny patterns in silicon, but most of our other technology develops much slower.
LASIK is younger than I am, and new technologies tend to develop faster. Looking at the Wikipedia article on breast implants, the pace of development there doesn't seem remarkable: it says the latest generation date from the mid 1990s, and that seems to be mostly an incremental safety improvement. There have been more significant advances in non-consumer healthcare in that time, e.g. Radioimmunotherapy.
And again, cars: widespread consumer technology, lots of money in the industry, but mostly incremental improvements. Though Google's self-driving cars are interesting.
Do you think medical devices are closer to cars or computers? We spent $100 billion dollars forty years ago to go to the moon and stopped. Nothing really changed until SpaceX (i.e. private enterprise) got involved to drive down the cost.