Medicine + YouTube = Medicine 2.0 ???

Do you have a question for Dr. Timothy Johnson regarding a recent health issue that you have been dealing with? Send your video question for Dr. Tim to answer on-air, or a text question using the form below.

I think that ABC is trying to capitalize on the popularity of YouTube (if you haven't heard of it yet, it recently got bought by Google for a cool $100 million...) by encouraging viewers to upload videos of their health questions. While this is not such a bad idea, these folks would be better of talking directly with their doctor. Should we call this Medicine 2.0?

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On Curing the Common Cold

For hundreds of years people thought the cold was caused by being cold. “You’ll catch your death out there,” people in 18th-century blizzards would say.

It was in the 1920s that we understood the cold to be a viral infection, a nasty little blighter that invades your body, multiplies and then causes you to sneeze so that millions of its brothers can shoot up the noses and through the eyes of everyone within 5ft.

Since then, we’ve been to the moon, invented the personal stereo, devised the speed camera and created the pot noodle. But still no one knows how to keep the cold virus at bay.

Aids came along and within about 10 minutes Elton John had set up his charity and was rattling the ivories from Pretoria to Pontefract so that now, while there’s no cure, there is a raft of drugs to keep the symptoms and effects at arm’s length. But the cold? Not a sausage.

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On the Regulations We Deal With

I shovel telomeres for a living. My friends in the computer industry are always asking me: “Why can’t you biotech guys cure cancer? Or aging? Or the common cold? What do you do with all those billions of government research dollars?”

Well, it’s time to confess: Biologists bought three stuffed mice and two petri dishes in 1974. These are recycled in staged publicity photos in such high-profile popular glossies as Proceedings of the National Academy of Sciences, Cell, and Eur J Gastroenterol Hepatol. Our much-hyped “gene sequencing,” “chromosome imaging,” etc. are all done on Photoshop by companies in Taipei . All the rest of the money goes to yachts, scuba equipment, and private islands in Fiji for all postdocs and research associates. That’s why medical researchers always look so tanned and vigorous.

OK, seriously: If the computer industry were running under the same conditions as biotech, this is how it would work:

There would be a Federal Data Administration (FDA). Every processor, peripheral, program, printer, and power cord made in or imported into the USA would have to obtain FDA approval. This would require an average of 19 years of safety testing on lab rats and clinical trials for effectiveness on nerd volunteers with informed consent, before prescription for general human use is allowed. Any change of any kind to any chip, ergonomic keyboard, or line of code would require re-approval of the entire system and any hardware or software that could in principle be connected to it via Internet, intranet, or hand-carried disk.

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My Least Favorite Nasogastric Tube

This may be a little different than my previous posts, but a question today prompted this. I was asked why we don't use these NGT's, even though we have a pile of them in the drawer. I'm confident that if you've spent anytime around a hospital, you're familiar with them as well.

First and foremost, for whatever reason, unlike other tubes, there is no radioopaque markings on the tube. This means that on an X-ray, there is absolutely no way to tell if this tube is in position, coiled in the esophagus, or (heaven forbid!) in a patient's lung. From a medicine standpoint I find this unacceptable; from a malpractice standpoint it is one big liability. Once in a while, for whatever reason, the tube is in place, but I have difficulty auscultating it. A simple X-ray can confirm placement, but not with this tube.

The second reason is that it is a single lumen tube. For feeding purposes this is ok, but for suction it is less than ideal. A tube with a sump will prevent the little holes from sucking onto the gastric mucosa and causing irritation, or worse.

The third reason is that these Levin tubes are very flexible, and are quite difficult to place. Even resorting to placing them on ice to stiffen them, they are still too flexible, and unless the patient is very cooperative, the placement is a chore.

Thankfully, with many other choices available, I don't use the Levin nasogastic tube anymore.

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