Saturday, January 16, 2010

Education Sentimentale

From the Urban Dictionary, submitted by Demon Phoenix 1347 on April 10, 2005:

Definition of TEABAG:

1) To insert one's nuts into the mouth of another (of either gender), usually while they are sleeping. Can either be a situation of laughter or of excruciating pain, depending on whether the victim is a biter. (verb)

EXAMPLE: Devon teabagged his girlfriend Veronica, then for shits and giggles he teabagged his friend Barton. And Barton bit Devon's left testicle off and beat the shit out of him.

2) When after being brutally killed in Halo 2, your opponent squats repeatedly on you, imitating the act of dipping his balls on you. Rather humiliating, especially when there's more than one of them doing it. (verb)

EXAMPLE: After I sniped five guys on a Multi-Flag CTF in Coagulation (including two in a Warthog) for a Kill Frenzy, two of them killed me with SMG fire and then simultaneously teabagged me.

3) A small bag of dried herbs, that magically makes tea when you add water and give it some time to steep. (noun)

EXAMPLE: I placed the teabag in the boiling water and gently stirred, five minutes later I had hot peppermint tea.

4) The scrotum of a man who has had his testicles removed. (noun)

EXAMPLE: Jenna broked up with her boyfriend Jacob because when she saw his equipment, she noticed he had a teabag.
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From the Twitter account of Andy Borowitz, "Comedian and Writer, New Yorker humorist, Creator of," January 15, 2010:

"The Teabaggers just found out what teabag means & freaked out. They're now calling themselves the Dirty Sanchezes."

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From the Wikipedia entry for Teabagging;

In 2009, Tea Party protests were formed to protest against United States government tax and spending policies. The use of the term "Tea Bagger" to describe these protesters has been used by several journalists, including Rachel Maddow, Keith Olbermann, Chris Matthews, and Anderson Cooper. Cooper later apologized, calling the term "silly" and stating that his use of it detracted from his serious reporting. The term's growth in the political arena earned attention by the Oxford American Dictionary, and the word "teabagger" achieved finalist status for the OAD Word of the Year.

Friday, January 15, 2010

Scott Reuben, Come on down! Let's Make a Deal!

Newsflash -- courtesy of WSJ Health Blog:

It looks like Scott Reuben, the Massachusetts anesthesiologist said to have used phony research data in 21 published papers, has reached a plea deal with
the feds.

Federal prosecutors accused Reuben of health-care fraud for allegedly
faking data that suggested after-surgery benefits from painkillers including
Merck’s Vioxx and Pfizer’s Bextra and Celebrex, the Justice Department said yesterday. The Justice announcement said he faces as much as a 10-year sentence and a $250,000 fine.

But the Associated Press said Reuben, the former chief of acute pain at Baystate Medical Center in Springfield, has agreed to plead guilty in exchange for prosecutors recommending a more lenient sentence. The sentence
would also reportedly include forfeiting assets of at least $50,000 that Reuben
received for the allegedly phony research. The Republican, a Springfield newspaper, said Reuben has signed a plea agreement under which he must pay $420,000 in restitution to pharmaceutical companies.

Reuben is accused with taking pharma money for doing research, then fabricating results and getting studies published in anesthesiology journals.The tale began to unravel last year as Baystate said it found Reuben had faked data and the Boston U.S. attorney began looking into the case. (For refreshers, see our posts here and here.)

Reuben’s attorney has said in the past his client cooperated with the hospital review and expressed regret. The lawyer didn’t immediately return a call for comment after Thursday’s federal complaint, the AP said.

Tuesday, January 12, 2010

Save the baby from the bath water!

The quote below was taken from the abstract for a study entitled Treatment of complex regional pain syndrome: a review of the evidence, by Tran DQ, Duong S, Bertini P, Finlayson RJ of the Department of Anesthesia, Montreal General Hospital, McGill University, Montreal, H3G 1A4, Quebec, Canada.

The study is published in the Canadian Journal of Anaesthesia, 7 Jan 2010.

"The available evidence does not support the use of calcitonin, vasodilators, or sympatholytic and neuromodulative intravenous regional blockade. Clear benefits have not been reported with stellate/lumbar sympathetic blocks, mannitol, gabapentin, and physical/occupational therapy."

This is probably one of those occasions when laypeople, like me, ought to refrain from commentary, as I am not trained in the statistical evaluation of a scientific study. Has this ever stopped me? Mwa ha ha!

It doesn't take much experience with CRPS studies to learn the pitfalls of the studies we hear cited so often: the sample populations are always too small, the conclusions as imprecise as the subjective measurements of pain. The exceptions are those efforts that detail some clinically measurable aspect of the disease. You know that already.

Nonetheless, I'd like to shout the [admittedly tenuous] conclusions above from the rooftops. Those treating CRPS, especially those treating newly diagnosed cases, need to heed the gathering warnings that the traditional Attack of the Blocks (do you hear the kaching:kaching of the procedurally-oriented anesthesiologist's cash register?) is no longer an acceptable response to nascent CRPS. Indwelling spinal catheters and neurostimulators also aren't turning out to be the longed for panacea. (For some reason, early on, I used to have dreams wherein I'd hear a baritone speaker talking about "bathing the spine in baclofen." I also once lobbied passionately for a spinal cord stimulator, until my compromised immune system rendered that impossible due to the infection risk.)

There are several studies that contradict this one about the influence of PT -- indeed, at least for children, extremely intense inpatient programs crammed full of entire days of PT have had near curative results. At the same time, most of us could testify to the terrible results we have when the physical therapist overprescribes or uses inappropriate modalities. I am still getting over the effects of having my entire right leg put into a machine that blew hay chaff round and round... Was desensitization the goal? I cannot even remember, so subsumed are my memories by the pain.

The subject of gabapentin is not one to address today. I tend to get overly worked up. If you don't know its sordid history, just plug "gabapentin fraud" into your favorite search engine. For me, its results will always be suspect. Yet, for many others, it has been helpful. Go figure.

It may be upsetting to see what you consider "tried-and-true" treatments declared invalid, or more correctly, insufficiently supported by research, but it is something that needs to be said, and faced, by both those who have CRPS and those working to find treatments for it.

Those of us with the disease tend to have a skewed point of view about the very meaning of effectiveness -- any relief at all, no matter how shortlived, has often come to be our goal. It is hard to entertain words like "cure" or "remission" (heck, even "treatment"!) when they no longer apply within our reality.

p.s. i am doing better. still pretty weak and tired, still doing more coughing than anything else -- but the emphasis is on *better*!