Archive for Ease and Disease

In the midst of sassafras

Which, come to think of it, you’re probably not:

You can still buy supposed sassafras concentrate. It doesn’t taste a bit like the stuff tasted when I was young. Good sassrass faded out gradually — I used to find short lengths of the root in simply-labeled cellophane packets at the grocer’s, Indiana-produced and presumably with most of the safrole steamed away. But I guess even that was too much for the drug warriors; you’ll look in vain for it now. Safrole, the stuff that gives sassafras a distinctive taste, was determined to be more bad for you than good and withdrawn from commercial use in 1960. By 1976, the DEA labelled it a drug precursor: it’s used in the manufacture of MDMA, “Ecstasy.” And not only is it illegal as can be, overuse of MDMA appears to be not at all good for you, either, and in several ways.

Fortunately, there are those who still tend the eternal flame:

The smoke shall rise again, to the place above where it began.

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Loud booze

You already know what I think about homeopathic remedies, typically diluted beyond any recognition and then dissolved in water. (Classic, for me anyway, quote: “[D]ump a teaspoon of the stuff into Lake Itasca, at the headwaters of the Mississippi River, and then wait for it to show up in New Orleans.”) CVS, though, is vending a homeopathic laxative that’s made of stronger stuff:

CVS might have stopped selling cigarettes, but you can still buy booze at the drugstore chain — without even getting carded. Just head over to the homeopathic medicine section and pick up some store-brand “constipation relief,” which just happens to be 40-proof.

In a piece for Slate on homeopathic medicine, chemist and blogger Yvette “Sci Babe” d’Entremont notes that this particular CVS product is 20% ethanol, meaning it contains more alcohol by volume than beer or wine.

So it may send you to the bathroom, but not for the reason you bought it.

In her video, Sci Babe downs six 1-ounce bottles of the stuff and gets, well, thoroughly hammered. At least your Wandering Drunks, or teenagers desperate for buzz, are unlikely to mess with something at $7.99 a shot.

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Mandating the inferior

About a decade ago, decongestants containing pseudoephedrine were barred from drugstore shelves and hidden behind the counter, lest some toothless jerkwad try to brew up some methamphetamine with the stuff. Desperate to appear au courant, or simply to appear, makers of OTC drugs hurried out new preparations containing phenylephrine, which doesn’t lend itself to meth production.

There’s just one hangup. Phenylephrine doesn’t work worth a flip:

In a new study of more than 500 adult allergy sufferers, researchers found that the common, over-the-counter (OTC) decongestant, phenylephrine, was no better at unclogging noses than placebo — even when given at higher doses than those currently approved. The study’s authors called on the Food and Drug Administration to strike phenylephrine from its list of effective nasal decongestants.

Were this a rational world, sufferers would be FedExing snot samples to Washington on a regular basis as payback. But no: it is deemed necessary to preserve all the defectives splashing around in the gene pool, because diversity or something.

Study particulars:
The Journal of Allergy and Clinical Immunology: In Practice, 2015.
DOI: 10.1016/j.jaip.2015.05.007.

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Unwellness of a sort

This is no way to start a week:

I retweeted this and received an answer: Panera Bread. Nearest might have been Beverly Hills, which for some inscrutable Beverly Hills-related reason closes fairly early, though not that early. And delivery? Perhaps it would have been better had she been in Louisville.

Anyway, there was no improvement the next day:

At least she’s sticking to serious remedies.

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Whatever this may mean

I have bloodwork done a minimum of three times a year, since some of the numbers derived thencefrom have occasionally been alarming. For the last decade or so, the blood has always been drawn from my left arm — or, when the veins are too embarrassed to show themselves, from my left hand.

For some reason this week — the only good reason I can think of is that they’d moved the furniture around — they drew from my right arm. And right there in the bend, for the first time in a decade, is a nasty bruise.

I’m not sure what to think of this. I mean, it’s not like I’m all of a sudden left-handed; I have always been a northpaw, and I thought that was why they drew from the left. And the left never bruises. (Used to the trauma, I suppose.) It will go away eventually, as bruises always do, or at least as mine always have. But it’s still strange.

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Least-surprising development

This is part of a press release, but it’s so much more:

Imprimis Pharmaceuticals, Inc. (NASDAQ: IMMY), a specialty pharmaceutical company focused on the development and commercialization of proprietary compounded drug therapies, today announced it has made available a customizable compounded formulation of pyrimethamine and leucovorin available for physicians to consider prescribing for their patients as a low cost alternative to Daraprim®.

Last month, Turing Pharmaceuticals LLC, the sole supplier of Daraprim, increased the price of this prescription drug from $13.50 per tablet to a reported $750.00 per tablet. The FDA-approved label for Daraprim indicates that it is prescribed for toxoplasmosis and other types of infections. Toxoplasmosis can be of major concern for patients with weakened immune systems such as patients with HIV/AIDS, pregnant women and children. According to the Centers for Disease Control and Prevention, pyrimethamine works to block folic acid synthesis in the parasite Toxoplasma gondii, the cause of toxoplasmosis, and leucovorin helps to reverse the negative effects on bone marrow caused by this mechanism of action.

Imprimis is now offering customizable compounded formulations of pyrimethamine and leucovorin in oral capsules starting as low as $99.00 for a 100 count bottle, or at a cost of under a dollar per capsule. Compounded medications may be appropriate for prescription when a commercially-available medicine does not meet the specific needs of a patient. For ordering information, please visit

There is, of course, a catch:

Imprimis’ finished compounded drug formulations do not have an FDA-approval label for recommended use. Imprimis compounded formulations are not FDA approved and may only be prescribed pursuant to a physician prescription for an individually identified patient consistent with federal and state laws governing compounded drug formulations.

This state has some fairly specific laws on the subject: a long list of “Good Compounding Practices” takes up six pages of the Pharmacy Lawbook [pdf]. Still, since Imprimis claims to distribute their compounds in all 50 states, one might assume that they’re in compliance with Oklahoma law.

And truth be told, it would almost be worth it to shell out $99 (plus, presumably, shipping) for a bottle of this stuff, purely as a way of saying “Screw you, Martin Shkreli.” That would, however, be, um, illegal, since I don’t actually have toxoplasmosis. I think.

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Preemptively clearing the lawn

There is, after all, such a thing as too much connectivity:

Recently there’s been a commercial on television for a drug / alcohol rehabilitation center that emphasizes that “you can bring your cell phone and laptop!” (I’m pretty sure it caters solely to the very well heeled.) The possibility that being continuously available and perpetually connected, via one’s cell phone and the Internet, might have something to do with one’s dependencies on drugs or booze should be of interest to the proprietors of such an establishment. I do hope they know what they’re doing.

I mention this because of a bit of knowledge that seems to me to fall into the “obvious / overlooked” category:

To the extent that one concentrates on worldly things, he neglects his own mental and spiritual health.

Just so. You must have time for yourself: for hobbies, for relaxation, for contemplation. Not having that time is genuinely Bad For You.

Having time each day merely to amuse oneself, or just to sit and think, greatly improves one’s life. Yet we’re practically taught to avoid such periods — to stay as busy as possible virtually all the time. The emphasis on work, on “multitasking” (which, as a former expert in the architecture of multitasking operating systems for embedded devices, I can assure you is always an illusion) and on achieving ever more per unit time is using us up in ways we don’t always perceive and even less often appreciate. You’d almost suspect that time spent in introspection had been deemed an offense against the social norms.

One of the reasons I’ve stayed in my particular job so long is simply that I can put it aside at 4:30; I don’t take work home with me, and seldom do I take calls from the office. I consider this practice absolutely essential to my mental health, and gradually, the powers that be are seeing it my way. Poor you if your particular set of TPTB doesn’t.

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Quote of the week

This is the opening to a Daily Beast article:

What Happens When You Survive Ebola

Memory loss. Irreversible skin and nerve damage. Hair thinning. Arthritis. The lingering effects of Ebola can last a lifetime.

Glenn Reynolds replies:

To be fair, when you don’t survive Ebola, the effects also last a lifetime.

Heh. Indeed. ™

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Physician, **** thyself

Prescriptions, so far anyway, are not actually mandatory, and Roberta X isn’t interested in the most recent one pushed in her direction:

… one of those stupid damn anti-depressants they hand out to fibromyalgia sufferers* and on the package insert, in at least 24-point type, it says, MAY MAKE YOU SUICIDAL. MAY WORSEN DEPRESSION. I’m not taking that stuff. I have, in the past, long ago, been almost that depressed and I’m not going back there. I’m not even taking a chance of going back there. Ibuprofen, acetaminophen and aspirin are sold at at every drug store, five-and-dime, grocery store, convenience store and corner gas station; it’s even free from the first-aid cabinet at work and if those drugs don’t make the pain go all the way away, they do well enough just about all of the time. And they don’t make you wake up wishing the planet could be improved by your absence.

I did my time on antidepressants. I still have one tablet on hand, probably expired, but it’s not here because I might need it; it’s here to remind me that I don’t.

Oh, that asterisk leads to a footnote in the original, and since her footnotes are always worth reading:

* I’m not saying that’s not a real thing — who am I to talk, after all, with my chronic pain with apparently no findable cause? — but people diagnosed with it are most certainly one of the favorite targets of those gawshawful drug-pushing ads on the TV, with twenty seconds of happy scenes and forty seconds of Dire Warnings read in a rapid monotone over still images of pastoral settings. Y’know, if the stuff was so wonderfully wonderful, M.D.s would be pushing it high, wide and mighty, ‘cos they are the kinds of people who are nagged by unsolved problems. Since they’re not — Ahem. The corollary should be obvious.

The most egregious failing of said drug-pushing ads, if you ask me, is this apparently invariable line: “Ask your doctor if [brand name of drug] is right for you.” If it then fails you, it’s your fault, because you asked for it. By name. Generics don’t advertise, which is one reason I got seven (!) prescriptions filled Friday afternoon for under $25. Meanwhile, the one brand-name drug I take is $2.50 per tab, $75 a month; the little puzzle box of Belsomra (suvorexant) is $99.99 for ten of ’em. You can buy a hell of a lot of Benadryl for a hundred bucks.

Some day, given the general trend of things, prescriptions likely will be mandatory. Remember THX 1138? The big crime was drug evasion, failing to take whatever meds were issued to you. I have to assume that Big Pharma is okay with this.

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Because you gotta have heart

This strikes me as almost certainly a Good Thing:

The National Basketball Players Association is working on a program that would fund cardiac screening and supplemental health insurance for its retired players, an initiative expedited by the recent sudden deaths of legends Darryl Dawkins and Moses Malone.

The joint effort between union executive director Michele Roberts and NBA commissioner Adam Silver — at a time when there still may be potentially acrimonious labor negotiations looming for their sides — is intended to ease the health concerns of its retired players.

And there are plenty of concerns:

The good-faith actions of current players were welcome news to retired veterans who have been rattled by the spate of cardiac-related deaths. Although there is no concrete data linking basketball players who are large in stature to early death from cardiac distress, the prevailing opinion among many former NBA stars is there has to be a correlation.

“It’s too close to home,” former star center Bob Lanier said. “It’s the topic nobody wants to address. How many people have we seen in our lifetime who are big and really tall and are 70-something years old? Not many. That’s because people [my size] don’t live that long.

“I know things are evolving. People are taking better care of themselves. They exercise, they watch their nutrition, they try to limit the stress in their lives. I do all of those things. But we’re still losing guys younger than we should.”

Lanier is 67; Kareem Abdul-Jabbar is 68. I’d hate to lose either of these guys any time soon.

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This I want

From Roger’s September Rambling #2:

From Donna: “Thinking of writing a bedtime book for grownups along the lines of Goodnight Moon. It will be titled Shutup Brain.”

Yes, yes, YES!

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Fark blurb of the week

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Life in Non-Drowsy Land

Saturday night, about five minutes before midnight, I extracted the little blue-green tablet from the card, and began my first test of Belsomra (suvorexant).

  • 12:00:  A book at bedtime.
  • 12:15:  A couple of yawns; I abandoned the book and turned off the light.
  • 1:45:  Still awake, and barely even drowsy.
  • 2:15:  Got up and cranked up the computer.
  • 4:00:  Went back to bed.
  • 4:45:  Last time I remember seeing the clock before sunrise.
  • 7:20:  Sunrise.
  • 7:25:  Discovered I’d pitched a pillow onto the floor.
  • 8:30:  Actually got around to retrieving the pillow.
  • 10:55:  Crawled out of bed.

Obviously I did get some small quantity of sleep, with various interruptions, out of this deal, but its onset was so long delayed from the time the pill was taken that I question whether it contributed anything.

Dosage: 10 mg. The prescribing information contains enough Scary Stuff to suggest that 10 would have been a heck of a lot safer than 20.

I will try again next weekend, perhaps on Friday night. I am not, however, particularly hopeful. The Holy Grail of sleep tabs — works in 15 minutes, disappears completely in six hours — has yet to be approached, let alone found. I will say this: it’s a wholly different dream function. Instead of the bad urban-fantasy stuff I find with Ambien, I got a bad memoir. Not really an improvement, but perhaps less frightening.

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All plop, no fizz

As usual this morning, I walked down the driveway toward the curb to fetch the newspaper. (I am one of those people who actually would prefer an afternoon paper, but the ten or twelve of us who still exist don’t count for much.) As usual, it was positioned on the section of concrete with the sharpest slant.

They say “Use your knees, not your back” to pick up stuff. If they had knees like mine, they never would have said such a thing. The Monday paper being generally smallish, I had a long way to go, and calculating the geometry of the matter, I spread my feet apart a few inches to buy some vertical. And then, having seized the paper, I unaccountably pitched forward, two, three steps, and wound up washing my face in the morning dew.

The fact that I was able to get up from this was heartening, or at least not leading to despondency. I dusted myself off and headed for the shop, figuring I can use the time at that traffic snarl around Penn Square to report that I wasn’t going to be in by 6:30.

No phone.

Evidently when I pulled myself off the ground, the little so-and-so stayed behind. I made a modestly mad dash in the opposite direction, retrieved the device, and started over. Okay, it was closer to 6:45. I can live with that. And they’re going to have to, you know?

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Not on your formulary

In fact, I don’t know how anybody affords this stuff at all:

A U.S. drug company is taking the Canadian government to court for its attempt to lower the price of what has been called the world’s most expensive drug.

Alexion Pharmaceuticals has filed a motion in Federal Court, arguing that Canada’s drug price watchdog has no authority to force the company to lower its price for Soliris.

The medication is approved to treat two rare blood diseases that affect about one in every one million people. A 12-month treatment costs about $700,000 in Canada, while in the U.S. it costs about $669,000.

Wikipedia contributes this little factoid:

Alexion tested the drug for rheumatoid arthritis, which afflicts 1 million Americans. The trials failed. But if it had worked for arthritis, Alexion would likely have had to charge a much a lower price for this use, as [it] would have to compete against drugs that cost a mere $20,000.

In other news, $20,000 a year is now considered “mere.”

I have been known to complain about a drug that costs me $75 a month. I don’t even want to imagine a drug that costs $75 an hour.

(Via Fark.)


Overnight insensation

The one characteristic that applies to all sleep medicines: if they work at all, eventually they stop working. Trying a new one, therefore, is fraught with peril:

It’d been a while since I’d tried anything new because, frankly, after a bunch of decades at this, you get USED to being exhausted and running on “dim” or, as I like to call it, “energy-saving mode.” True, I sometimes think, “I bet I would have cured cancer already, had I been able to get plenty of quality sleep every night, all during my life. And had I not gotten the D in chemistry and been at all interested in science.” My doctor has given me STERN warnings that I need to sleep because this will “kill” me. Ok doc then gimme some good drugs. Not drugs with butterflies. I need drugs with velociraptors.

Alas, butterflies are all you get:

The Lunesta … oh how I wish it had worked. It looked so promising. The marketing! See the pretty diaphanous butterfly? The website says it’s very “fast-acting” and warns that you shouldn’t even TAKE this pill unless you’re strapped into bed in your strait jacket and have hired a home nurse or Joe Don Baker to stand vigil. All this because you will be completely zonked out in a fucking minute, you skeptic you, and you will likely be trying to paint your home’s exterior overnight, ALONE, in your deeply restful dream state.

Pfft. No piñata confetti. Not so much as a plastic drink umbrella in the bedding this morning.

The doctor will be sending over a script for Belsomra (suvorexant), a totally new concept in sleeping pills, with a totally new level of TV-commercial creepiness:

If the little cloud creatures don’t scare you to death, the warnings will.

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Purell you say

Ramones Leave Home is one of those albums that got edited shortly after the original release, owing to serious pearl-clutching over track 5, “Carbona Not Glue,” the lyrics of which expressed a definite preference among major juvenile huffing substances. Certainly, though, none of these young punks would actually drink carbon tetrachloride.

But hand sanitizer? That’s different:

A new report is cautioning parents about the risks of seemingly harmless liquid hand sanitizer, after an increase in calls to poison control centers about children who’ve ingested enough of substance to make them dangerously drunk.

Since 2010, poison control center hotlines in the United States have seen almost a 400% increase in calls related to kids under 12 consuming hand sanitizer, CNN reports, citing new analysis by the Georgia Poison Center.

The high alcohol content in liquid hand sanitizer — ranging anywhere from 45% to 95% alcohol, compared to wine and beer at 12% and 5% alcohol — can easily cause alcohol poisoning with just two or three squirts, experts say. Children may become confused, vomit or experience drowsiness, and in extreme cases, a child might stop breathing.

Obviously the kids would be better off buying beer — even Oklahoma 3.2-percent quasi-near-beer. And it wasn’t that long ago I, a person of Obvious Age, got carded for purchasing a can of Krylon spray paint.

There needs to be a central database for all the stuff kids will attempt to ingest in a desperate attempt to get a buzz. I suggest they call it the Huffing (Some) Post.

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The impatient patient

The older you get, the slower you heal, and the more likely you are to respond this way:

The first 36 hours felt like Armageddon in my body, fever, chills, pain, nausea, weakness, the whole shebang. It would take me an hour to recover from the 10 minute drive to drop off the chicks at school. Takes longer in the afternoon because, apparently, sunshine and heat are not my friends.The bottle of antibiotics has two stickers on it: one tells me to drink lots of water, the other tells me to avoid prolonged exposure to direct sunlight. It would seem I’m now a fern.

All this started about two weeks ago.

(Via Bayou Renaissance Man.)


No sugar tonight

If this be blasphemy, I plan to make the most of it. Start here:

I’m also trying to clean up my diet. Oh, I eat pretty healthfully to begin with but I panic over these things and I actually wrote NO SUGAR! NO SUGAR AT ALL for the next week on the kitchen calendar. I worry, probably needlessly, about type II diabetes (and yes, I know: it’s how you eat all the time, not just in the week before bloodwork, but I want things to look their best). I think the tv ads I see for the million medications they have, some you have to inject, some with scary sounding side effects, that has the paranoid part of my brain convinced that probably everyone is actually diabetic and just doesn’t know it yet.

Fifty percent are there or close to it, say some of the alarmists.

But here’s the kicker: WHO issues a definition of Type 2 and it’s based entirely on readings. Oh, it says “with symptoms,” but everybody and his kid sister has symptoms of some sort. One arbitrary number applies to all seven billion humanoids, regardless of age, creed, color, national origin, metabolism, or astrological sign. This is convenient for those who compile statistics, and for nobody else.

It really does feel like everything is a moving target: you do, but you could do MORE. And it just wears me out. More exercise, more vegetables, less food that actually tastes pleasurable, less time spent just relaxing. (And I’ve seen several sites lately that remind us how awful sitting is for us, and we should, I guess, stand all the time, like horses or cattle…)

And I get that I’ll eventually not be able to outrun the Grim Reaper, it’s not that … it’s the whole fact that medicine in some sectors seems to be coming back to an idea not unlike the “you sinned, so you got sick” idea of the medieval era — “You sat too much on the job, now you have diabetes.” or “You relaxed when you could have exercised, now you have heart disease” and it feels to me like unless I keep pushing, pushing, more, more, more, eventually something terrible is going to happen and someone in the health-insurance office is gonna shrug and go, “You were insufficiently pure so you are on the hook for this financially, even if you can find a doctor willing to treat you.”

“Some sectors” eventually will be all sectors, because government.

I am resigned to not living forever. However, I reserve the right to sneer at the Reaper, that scythe-wielding son of a bitch, any time I please. And should some Deputy Associate Death Panel member object to this cavalier treatment of their true god — well, chuck you, Farley, this is why you get no respect from the population, while I’m having a bowl of ice cream in any flavor other than Pumpkin Spice.

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If this doesn’t make you smile, you have no face:

Directing a sci-fi blockbuster can be a rewarding experience for any movie maker. But when Guardians of the Galaxy director James Gunn found out that his character of few words — Groot — encouraged a child with a developmental coordination disorder to speak for the first time, he was astounded.

Josh Dunlap, a father to a child with dyspraxia, reached out to Gunn on Facebook to let him know how impactful Guardians of the Galaxy was on his son Sawyer… “When Guardians came out Sawyer could only say about three words and would communicate to his mother and I by other means,” Dunlap told Gunn on Facebook. “When he saw Groot, something clicked inside him and he connected with him on a level I haven’t seen.”

“He began to mimic him and he would use the word ‘Bah’ for a lot, but after he saw the film, he would change the tone in which he said it to convey a different meaning,” Dunlap added. “He would also start saying Groot for many things as well. Since that, he was finally able to go to a speech class and it has helped amazingly.”

I surmise that this probably wouldn’t have worked so well with Hodor.


The next-to-last nerve

The same Sudden Weakness that befell me Saturday afternoon at the supermarket hit me again at the office on Wednesday. It wasn’t quite so severe, but once again, it helped that I was near something to grab.

Normally I avoid seeking medical attention. I don’t think I’ll be able to this time. There’s no sensation that anything is ripped or torn: it’s just a pang, the muscles give way for a moment, and I do what I can to regain my composure.

The office, which does regular business with an occupational-health clinic, got me some chlorzoxazone, which relieves pain on a short-term basis. Clearly, though, there’s more here to deal with.

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Drop and give me $75

I was unloading groceries at the checkout stand this afternoon when something in my left thigh decided it wanted my attention and promptly knocked me to the ground, or at least several inches closer to it. If you’ve ever had anything that hurt like a son of a bitch, this is the son of a bitch it hurt like. For a moment I regretted not having bought a fresh bottle of Advil.

It can’t have been too severe: I was somehow able to walk, albeit haltingly, and I didn’t notice anything unusual-looking when I got home. Still, walking it off did not make it go away, and I may have to dip into my secret stash of Lortab if it doesn’t lighten up in the next couple of hours.

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Dear Addyi

If you were waiting on, for lack of a better term, “Viagra for women,” well, here it comes, kinda sorta:

Sprout Pharmaceuticals, Inc. (Sprout) announced today that the U.S. Food and Drug Administration (FDA) has granted approval of Addyi™ (flibanserin 100 mg) (pronounced “add-ee”), a once-daily, non-hormonal pill for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. Addyi is the first and only FDA-approved treatment for this condition, the most common form of female sexual dysfunction, affecting up to 1 in 10 women in the United States.

It has been a remarkable journey to get to this breakthrough moment. Today we celebrate what this approval means for all women who have long awaited a medical treatment option for this life impacting condition,” said Cindy Whitehead, chief executive officer of Sprout. “We applaud the FDA for putting the patient voice at the center of the conversation and for focusing on scientific evidence.”

The pink pill — Sprout’s toll-free number is 844-PINK-PILL — doesn’t precisely match up to its blue cousin:

Addyi is indicated for the treatment of premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD) as characterized by low sexual desire that causes marked distress or interpersonal difficulty and is NOT due to:
– A co-existing medical or psychiatric condition,
– Problems within the relationship, or
– The effects of a medication or other drug substance.

You definitely don’t want to use it while drinking. And where did they get that name?

Update, 20 August: Nancy Friedman reports: “The FDA official who announced the approval of the female-libido drug Addyi is named Woodcock.” But of course.


Forget about sleeping

Some nights I have to, and apparently by so doing I am setting myself up for something much, much worse:

[F]indings just published in the Journal of Neuroscience reveal that there’s an optimal sleeping position for brain health — and the good news is that this position is incredibly common.

According to the study, sleeping on your side, rather than your back or stomach is the most efficient way to help the brain discard toxic waste. The study examined rodents in three sleeping positions: lateral (side), prone (stomach) and supine (back). The researchers concluded that:

“The major finding of our study was that waste … removal was most efficient in the lateral position (compared with the prone position), which mimics the natural resting/sleeping position of rodents.”

Side-sleeping is thought to be the most common position, preferred by an estimated two out of three Americans.

And undiscarded toxic waste, particularly the protein fragments known as beta-amyloid, turns out to be implicated in Alzheimer’s disease, something I fear greatly. But there are going to be nights when every other fear in the catalog is going to be bidding for space in my brain, and behaving sensibly is completely out of the question.

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It’s the yeast they can do

People with pain, of which there are an abundance, swear by hydrocodone, an opioid obtained from poppies. Yes, those poppies. But what if you could make the stuff without having to go to the very same plants that support the heroin trade? It’s actually been done, on a small scale:

Over the past several months, scientists from around the world have published bits and pieces of a fascinating feat: In an effort to create pain medication components like hydrocodone — the main ingredient in the pain killer Vicodin — without the help of poppies, scientists have engineered simple baker’s yeast to synthesize these medicinal compounds from sugar. One by one, labs figured out how to get the yeast to turn A into B, and B into C, Y into Z, and so on and so forth.

Now, for the first time, researchers at Stanford University have done it from start to finish. In a paper published Thursday in Science, they report the successful synthesis of hydrocodone from sugar, thanks to genetically engineered yeast.

The abstract:

Opioids are the primary drugs used in Western medicine for pain management and palliative care. Farming of opium poppies remains the sole source of these essential medicines despite diverse market demands and uncertainty in crop yields due to weather, climate change, and pests. Here, we engineered yeast to produce the selected opioid compounds thebaine and hydrocodone starting from sugar. All work was conducted in a laboratory that is permitted and secured for work with controlled substances. We combined enzyme discovery, enzyme engineering, and pathway and strain optimization to realize full opiate biosynthesis in yeast. The resulting opioid biosynthesis strains required expression of 21 (thebaine) and 23 (hydrocodone) enzyme activities from plants, mammals, bacteria, and yeast itself. This is a proof-of-principle, and major hurdles remain before optimization and scale up could be achieved. Open discussions of options for governing this technology are also needed in order to responsibly realize alternative supplies for these medically relevant compounds.

I interpret that last sentence as “Those who wage the War On [Some] Drugs will have a coronary if this technology becomes widespread.” To them, Schedule II is the Voice of God.

Tangential: Apparently all five members of the research team — four are pictured at the WaPo link — are women.

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The glucose is clear

I’m not quite sure I understand this promotion:

Actually, that’s only half a gallon, but it still sounds a bit strange.

(Via Dawn Summers.)

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It costs how much?

What’s the single worst aspect of our current — and probably future — health-care system? If you ask me, it’s the fact that situations like this are possible:

[A] few months ago a doctor told me I should have a test, an angiogram, just to be safe. How much would it cost? The doctor had no idea. Nobody had any idea. If I wanted I could call up my insurance and be put on call waiting for half an hour to finally be told they had no idea. But, hey! Everybody wants to be safe, right?

Today I got the bill. Turns out it cost $7300. Who knew?

I’m not complaining that the test is too expensive. They had a big room with bright lights and computer monitors and machines going “ping!” Machines that go “ping!” cost money. I am complaining that I would have had to file a subpoena to get a ballpark figure for what it would cost. I was like, “Is it over $1000? Is it bigger than a breadbox?” Nobody knew.

How do they not know this stuff? Do they just make the numbers up afterwards?

Not enough people demand prices up front. Dr. Smith, who’s been there before, explains:

I’ve come to the conclusion that it’s the obligation of the seller to provide and display prices to the buyers. It’s not the obligation of the buyer to discover prices that are probably hidden. And in healthcare, most of the time they are. As a seller, if I say “here is what I am, here is what I do, and here is what I charge for it,” then the buyer can very deliberately determine whether that represents a value or not. They can comparison shop. And they can do it without revealing anything or providing any commitment whatsoever to me, the seller. This is present in every industry in the U.S. but it is largely absent in healthcare. Fortunately it is a growing phenomenon and more and more people are realizing that it is incumbent upon the seller to provide prices.

Worst-case scenario, which is actually the norm: prices are based on what the government will fork over.

[T]he government ultimately gets everything wrong. If they guess what my price should be, they’re either going to guess too low, which means I’m not going to provide the service, or they’re going to guess too high, which means resources are wasted.

Any attempt by anyone in a top-down central planning type of fashion to guess what the prices for services or products should be, is going to be wrong. Real prices emerge from competitive activity.

And avoiding competitive activity is at the very heart of American health care, a situation which the ACA does absolutely nothing to alleviate — but then, it was never intended to.

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March’s child is weak of heart

Or so this study would have you believe:

A new algorithm developed by scientists at Columbia University Medical Center (CUMC) supports previously reported associations between a person’s birth month and overall disease risk, including 16 new links that include nine types of heart disease. The study was published in the Journal of American Medical Informatics Association.

Prior studies have suggested a relationship between individual diseases (such as asthma and attention deficit hyperactivity disorder [ADHD]) and birth season, but this is the first large-scale study to compare rates of 1,688 diseases and the birth dates and medical histories of 1.7 million patients treated at New York-Presbyterian Hospital/CUMC from 1985–2013. More than 1,600 associations were eliminated and 39 previously reported links were confirmed, along with 16 new associations that included nine types of heart disease; risk of atrial fibrillation, congestive heart failure, and mitrial valve disorder was highest in those born in March. Previously, a study on Austrian and Danish patient records found that those born in months with higher heart disease rates (March through June) had earlier mortality rates.

You don’t think conception in the summertime (June through September) might have had something to do with it, do you?

Asthma risk was greatest among those born in July and October babies; this is consistent with an earlier Danish study in which the peak risk was in the months when Denmark’s sunlight levels are similar to New York’s in the July and October period (May and August). Data on ADHD matched those from a Swedish study suggesting that one in 675 ADHD diagnoses are for those born in November.

And if November children were more susceptible to ADHD, wouldn’t you expect at least one, or more, in twelve diagnoses? (Hey, look, a squirrel!)

Just the sheer number of potential ailments is enough to give Bill Quick reason to question the results:

The first red flag is the number of diseases used in the study — 1,688. I suspect that some correlations are inevitable with that large a number, whether there is any actual causal connection at all.

There’s always the astrological connection, and we all know how well that works.

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Ungentle benzo

Why all this screwing around with health-care coverage, or lack thereof, doesn’t really mean a damn thing in the long run:

A single dose of the anti-anxiety drug lorazepam — the generic version of Ativan — will run you about 14 cents at Safeway or Target.

At Good Samaritan Hospital in Los Angeles, the same pill goes for nearly $2,000.

At least that’s the impression Laurie Leigh came away with after being so overcome with grief when her 90-year-old father died at the hospital that she fainted at his bedside. She subsequently received a pill to soothe her nerves.

Leigh’s insurer, Blue Shield of California, covered about $200 of the bill, leaving her holding the bag for more than $1,700.

Of course, this doesn’t mean they charged her two grand for an Ativan; they also took her blood pressure and set her in a vacant bed in the ER for about an hour and a half. The tablet itself was a hair under $20. Still, you can buy thirty of them at Walmart for four bucks.

For the record, CFI Care — not its real initials — would have paid about $1360 had this happened to me, had I reached my annual deductible, which I think I’ve done twice in the last quarter-century.

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Bronco exhaust

Everybody’s seen the classic cuss jar. The Denver Broncos were alleged to have a fart jar:

Miller explained later:

Turns out Miller was pulling our finger chain, but I have to figure that this is probably more of an issue than anyone is letting on, inasmuch as if anyone smelt it, it may be safely assumed that someone dealt it.

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