Gettysburg Medical News
The Clinical View
by P.E.  Hoffsten, MD
20 December 2006

OUR MANY, MANY BLESSINGS.

 HOLIDAY GREETINGS FROM THE MEDICAL COMMUNITY.

            There are many times during the past year when our problems seem overwhelming.  Watching an evening television newscast is depressing, maddening, annoying or all three.  It seems that we have little control over so many aspects of our lives.  The war in Iraq continues to put our loved ones in harms way and seemingly to no foreseeable purpose or exit.  Othorizations that get in the way of providing healthcare to patients.  They are frustrating but we can manage. 

            But this is the time of year when we should count blessings.  As I look back over the past year, the blessings are too many to count.  But I will list below ones that easily come to my mind in the past year.

            Very blessed today is the person that comes to the hospital with an acute gallbladder attack.  In the good old days they got a big incision in their side.  They were in the hospital for a week or more.  They had tubes down their throat for two or three days.  Recovery took six weeks.  Today, a laparoscopic cholecystectomy can be done and the person goes home the next day eating bacon and eggs for breakfast.  That is a blessing.

            I can remember being in medical school 40 years ago trying to take care of a lady with “dropsy”.  She had severe heart failure and her legs were swollen to the bursting point.  She was short of breath at rest and rest is all that she could do anyway.  Today, I take care of that same type of person in the hospital frequently and in several days her breathing is much improved.  The terrible swelling of her legs has gone down and she can go home using relatively simple medications with her heart failure treated.  That is a blessing.

            A previously well 24 year old man had a shaking chill on his way to work and came to the hospital with a lobar pneumonia that developed slowly but was found suddenly when he had the shaking chill.  It the 1930’s he would have died before Christmas.  Now he went home in three days feeling much better and cured of a pneumonia that would have been fatal in the past.  The antibiotics that let us do that are a blessing.

            A vigorous and energetic young man had an electrical abnormality in his heart that resulted in unpredictable, periodic collapse.  I recall trying to care for a person with such a problem in 1967 while still in training.  That person died at 22 years of age from a fatal heart rhythm.  Five years ago, a patient with a very similar condition had a “radio-ablation” procedure done on his heart which completely cured the condition and now he will live to a ripe old age cured of what was at one time a fatal disease.  That is not only a blessing, it is amazing that passing the little wire up to a person’s heart and “zapping” an abnormal fiber can be diagnosed, treated and completely curative. 

            Osteoporosis continues to result in many fractured hips each year.  But we have medications available that cut down the incidents of broken hips.  When hips do break, our orthopedists now have rapid surgical procedures that result in the person walking the next day.  That is a blessing.

            Heart attacks continue to claim approximately 600,000 people per year in the United States.  The most important step in dealing with these problems is prevention.  Fortunately, we have very effective medications that lower cholesterol, very effective medications that lower blood pressure, and improving medications that lower blood sugars in diabetics.  Through these three steps, many heart attacks are prevented.  For those individuals whose condition is far advanced, there are surgical procedures to reestablish circulation to compromised areas of the heart.  These procedures are life saving and a very special blessing.

            Six years ago, I helped care for a patient who had a condition called chronic myelogenous leukemia.  On average, this condition is fatal in 4-6 years.  The lady that I am referring to is alive, doing well and with no evidence of leukemia because of a new medication that virtually cures the disease.  To cure leukemia with a pill is a very special blessing.

            Many men develop cancer of the prostate.  Cancer of the prostate is the most common cancer in men and a significant cause of death from cancer.  Today, there is an injection that can be used every 4-6 months; in many men cancer of the prostate is virtually turned off.  That is a blessing.  The technological developments with mammography have cut the death rate from cancer of the breast in half.  Better surgical techniques have lead to less disfiguring surgery.  These preventions and treatments are a blessing.

            Cancer of the colon is a leading cause of death from cancer in our country but using colonoscopy to detect polyps before they ever turn into cancer will absolutely prevent a cancer from ever occurring.  It may sound strange to say, but believe it or not, colonoscopy is a blessing and I promise you is much less troublesome in the person’s life than having cancer of the colon.

            The many medications provided by our pharmaceutical industry have quite amazing and beneficial effects for the general society.  Indeed, one of the pharmaceutical industries motivations is monetary profit and so it seems that their efforts are tainted.  But to be sure, we are infinitively better off with the medications that they provide than without them.  Repeated studies have shown that individuals who adhere to a medication schedule prescribed by a healthcare provider do better than individuals who do not.  Complications and side effects not withstanding, our medications provided by our pharmaceutical industry are a blessing.

            Lastly, the greatest blessings of all are the many individuals in our healthcare system that provide the wonderful service that they do.  The laboratory technicians who do your analyses and draw your blood, the x-ray technicians who take care of the x-rays, our wonderful nurses who provide the bedside care, the physician assistants, the nurse practitioners, the primary healthcare physicians and the many specialists, the janitorial service of our hospitals and clinics, the plant maintenance individuals who make sure our telephones work and our clinics and hospitals are warm and dry, the receptionists and the administrative and clerical personnel are all an amazing blessing.  In spite of the problems that we seem to have in this world, our healthcare system is a wonderful blessing. 

            Merry Christmas to All and Best Wishes for a Healthy, Prosperous Year!