A Heart Attack in the Medicine Cabinet

People don’t like pain, even in small amounts. Look in any medicine cabinet in America and you are likely to find multiple medications for pain. Among the most common and most effective are anti-inflammatory medications such as Motrin, Advil and Aleve. Millions of people take these medications on a daily basis to treat headaches, muscle pain and arthritis. New evidence now suggests this may be dangerous.

While doctors have known for a while that there was a slight increase in heart attack risk in patients taking anti-inflammatory medications the risk was considered to be negligible. We knew about it but we didn’t talk about it. We are in the business of making people feel better and when patients are in pain we want to do something about it. Non-steroidal anti-inflammatory medications (NSAIDs) make people feel better. They are inexpensive and available over-the-counter in low doses or by prescription at higher doses and the benefits of decreased pain and improved function seemed to greatly outweigh any concerns. 

It seems we were wrong.

Recent studies have demonstrated that the risk of heart attack and death was significantly increased. The strongest evidence came from an analysis of several studies totaling over 120,000 patients. The analysis revealed an average of 3 more heart attacks over 10 years for every 100 patients. As the patients in the study averaged an age of 61 and were not typically at high risk for heart disease the results are particularly concerning.

One expert, Dr. Peter Wilson of Emery University is quoted in the NY Times,-

“The over-the-counter medications, which have the lowest doses, probably increased risk by about 10 percent, he said. Low-dose prescription medications were likely to increase the risk by about 20 percent and higher-level dose prescription medications by about 50 percent”

Interpreting these numbers requires an understanding of a patient’s baseline risk. Using myself as an example, as a 54 year old man with normal blood pressure and high cholesterol treated with medication my risk of having a heart attack in the next 10 years is about 4%. If Dr. Wilson is correct, over-the-counter medications cause a net increase of 0.4%, low dose prescription medications 0.8% and higher dose NSAIDs have a risk increase of 2%.

For men like me this translates into one more heart attack for every 250 patients for OTC use, one of 125 patients for low dose prescriptions and one in 50 for high dose medications! If I had diabetes and was treated for high blood pressure those numbers would double. When I realized that the medication I was taking every day to manage my arthritis pain had a 1/50 chance of leading to a heart attack in the next 10 years I decided my pain wasn’t as bad as I thought it was! 

While younger people at very low risk for heart attack can take these medications with little concern and occasional use for headache and back strains is not likely to have much of an impact for anyone, the reality is that a large number of older patients have been taking these medications on a daily basis. This new data will require us to reevaluate our approach to arthritis pain.

Here are some of the approaches I am considering-

1-      I am having individual conversations with all of my patients who are on daily NSAID medications

2-     I am encouraging my patients to consider acetaminophen as first line treatment for pain

3-     I am revisiting the lifestyle changes that can help ease arthritis pain. Obesity is an important factor that patients typically do not want to address. It can no longer be ignored.

4-     I am becoming more willing to tolerate mild to moderate pain. I stopped my daily medications 2 weeks ago. My pain has increased significantly, but it is not unbearable.

5-     I will consider prescribing more medications that are pain modifiers and not pain relievers such as certain anti-depressants (duloxetine is a common medication for this) and seizure medications (such as gabapentin)

6-     When necessary I will be more willing to consider narcotic pain medications

Medicine is changing. Treatments we once thought to be safe weren’t. Doctors will need to individualize approaches to the management of pain and patients will need to be willing to consider new options. It is not hyperbole to say that lives are at stake.

Bart

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One of Christianity's Biggest Lies

We like formulas. We want to know that when we follow the appropriate steps in the correct order that a positive outcome is guaranteed. To this end we buy books that promise such things as 6 Steps to a Happy Marriage, 8 Principles for Success in Business, and 7 keys to Getting into The College of Your Dreams. Falling for these fantastic promises in our personal lives is sad. Falling for such false promises in our spiritual lives is a tragedy.

The idea that God blesses us because of what we do is one of the biggest lies in Christianity. Too many of us fall for it.

Blessing in this life is not guaranteed by following any formula or set of rules. God’s blessings are based on His character and not our performance. While many Christians will profess this truth our lives can say otherwise. When we follow God we expect him to bless us and give us what we desire. When it doesn’t happen we find ourselves disillusioned, disappointed and depressed.

This is where I found myself in 1993. I had just started my first “real” doctor job and life was going well. Lisa and I were both teaching Sunday School and regularly attending Bible Study. We were giving more to the church than we ever had before in both time and finances and we were checking all of the spiritual boxes. Everything was going well except for the area of fertility.

We had struggled to conceive for years. Our son appeared to be a fluke, as in the three years after his birth Lisa had not conceived in spite of our not using any contraception. A miscarriage in June was disappointing but it at least confirmed that conception was possible. We were certain that God would soon bless us with another child.

In November our prayers were seemingly answered. It all made sense to us. We were faithfully serving God and He had blessed us with another pregnancy. A few weeks later the bleeding started and an ultrasound confirmed another miscarriage. We were devastated. We found ourselves wondering what had happened. We had actually thought, at least to some degree, that our faithful service would result in God answering our prayers. We were wrong.

The broken thinking that led us to believe that we had a part to play in God’s blessing us, that there was an element of earning blessings, caused our grief to be greater than it would have otherwise been. In the loss of that pregnancy we were taught the truth that God blesses in His time, for His purposes, to those that He chooses, for His reasons. We don’t earn anything.

It is only when we understand the truth of God's grace that we can break free from the lie of earned blessing. Sadly for me, it took the sorrow of loss for me to learn the lesson.

- Bart

I share more details of our heartbreak and the lessons learned in the 4th part of the series I taught on Broken Thinking. All four parts are available on my vimeo page at www.vimeo.com/bartbarrett. This particular lesson can be viewed by clicking here.

Planned Parenthood and Selling Body Parts, a Christian Doctor Responds

Baby parts are on sale. We just didn’t know it. The release of the Planned Parenthood videos revealed repulsive secrets about the organization and our society.

Many people reacted with shock and disgust to the hidden camera footage of a Planned Parenthood physician callously discussing getting reimbursed for the organs of aborted babies. In the conversations I have had and in the articles I have read there has been a common question, “How could they do such a thing?”

My answer has caught people by surprise- “Why wouldn’t they?”

The Planned Parenthood policy of selling aborted baby organs is the natural and expected outcome of the worldview and mindset of the organization. Planned Parenthood believes that unborn life has no inherent value apart from that given it by the mother. Regardless of the stage of pregnancy or level of development, it is only a “fetus”, just a blob of tissue until the mother declares it otherwise. Life is only life when it is wanted.

While Planned Parenthood denies the value or sanctity of unborn life it proudly proclaims its support for adult life. (The “rights of the woman” are its guiding value) If unborn life is not at all life and adult life is of supreme value, why wouldn’t you collect the end products of a medical procedure so they could be used for medical research? And since your work is noble and valuable, why not make a little profit while you were at it?

If Planned Parenthood gave any credence to the opinions of those disturbed by the revelation of their tissue procurement policies they wouldn’t be in the abortion business to begin with. Arguments about the dignity of life or the morality of the policy were dismissed long ago. In the minds of Planned Parenthood those who make such arguments are anti-women, anti-science, simple-minded religious fanatics. Planned Parenthood knows what they are doing is right, they know the tissue they are dealing with is not a baby and not yet human. They have to believe this in order to continue in business. Like so many monsters in history their evil deeds are justified by their determination of what is fully human and what is not.

When something or someone is determined to be less than human then it is not entitled to the legal protection or respect accorded to other human beings. The Jews under Nazi rule, slaves in early America and Christians in many Muslim nations all attest to the atrocities that come when men determine that other men are not fully man.

We have allowed Planned Parenthood to determine what and who is human and who is not. The videos reveal the natural outcome of their determination. As shameful as their practices are, the greater shame is that we have allowed these practices for so long. As a society we have ignored the truth about the atrocities of the abortion industry and pretended that barbaric providers were rare. We turned the other way when Kermit Gosnell preyed on poor women, we ignored the fact that abortion clinics are disproportionately located in minority neighborhoods, and we lied to ourselves and pretended that abortions after the first trimester were rare and in the best interests of the mother. Worst of all, we lied and said it was “just a fetus” or a lump of cells.

It is a sad reflection on the nature of man that when we deign to decide what is and is not human we do so in a way that elevates ourselves and devalues other life. A true and correct definition of life can only come from the God who gives it. 

- Bart

The drawing in the post is of a baby at 18 weeks of pregnancy. The first video released shows the Planned Parenthood doctor describe selectively crushing a child like this in order to harvest intact organs. 

UPDATE: I have received some appropriate questions which have correctly pointed out the legality of Planned Parenthood's actions and that the fees charged for the tissue were not all that great and profits were nominal. Objections were focused on the term "selling baby parts", if money is exchanged for the intact liver of a baby of 18 weeks gestation the term is every bit as accurate as the euphemistic "reimbursement for collection of fetal liver tissue." 

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Why Do People Do Stupid Things?

A man jumps 180 feet from a crane into an air bag. A woman dons a fire suit, climbs into a car and blows it up. Another man splits 45 watermelons open in less than 60 seconds, with his head. Watching this on television two questions repeated in my mind. Why would anyone do this? And, why am I watching this?

The first question is something I have considered for years. Several possible answers have come to mind from boredom to adrenaline addiction, but I think the true answer is more basic. People have a desire to be recognized, to receive attention, to be special. They want to be somebody. It is as if their greatest fear is insignificance. The desire for adulation and recognition is so overpowering that people will risk life and limb for a moment of praise.

It is easy to look at these seemingly insane daredevils and say, "I would never do That!"  But is not totally true. We all do things to get recognized, many of which are silly and some of which are downright foolish. Simple expressions of this desire include those who have too many clothes or too much makeup and those non-stop talkers who always need to be the center of attention. The desire to be recognized, when not appropriately checked, can lead to harmful behaviors such as sexual indiscretions, risky investments, or the dangerous behaviors we see on reality TV. Being ordinary, just one of the crowd, doesn’t satisfy.

The root of all this dates back to the nature of all mankind. The Genesis account describes the initial sin of Adam and Eve and the deception that led to it. They were created to live lives in submission to God, but that was not enough. They were tempted by the thought that they could be more, that they could be like God. The desire to be Godlike, to be above others, has plagued us ever since. We want to be recognized as greater and more special than we are. Contentment is an elusive virtue.

The solution to this problem is not to do more and achieve more, as this is a desire that can never be satisfied. The solution is to see ourselves as God sees us, to remind ourselves that our value comes from Him and what He sees in us and not in the praise of others. This is a simple statement but it is amazingly difficult to realize! It is nevertheless worth the effort for it is the secret to a life of contentment and peace.

-              Bart

As for the second question, I watch this on TV for the same reason I watch most programs. It was what was on at the time!

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Bill Cosby, Ben Affleck and Others Who Were Not What They Seemed to Be

People we considered our heroes are turning out to be anything but. How could we be fooled so badly?

Bill Cosby was America’s Dad. Not only did he play a loving, intelligent and supportive father on his television sitcom, he was a tireless advocate for education and personal responsibility. I was one of the millions who looked up to him and considered him a role model. Little did I know that he was a sexual deviant who preyed on women. Any claim he may have had to innocence evaporated these last few weeks when the transcript of a 2005 deposition was released in which he admitted under oath giving a woman a powerful sleeping pill in order to have sex with her. America’s Dad was in reality America’s Pervert.

Ben Affleck and Jennifer Garner were America’s Couple. Talented, beautiful and seemingly in love, they built a family together in the public eye. In the midst of the dysfunction of Hollywood they put on a façade of normalcy. There recent divorce announcement revealed the truth about their marriage. It was in reality dysfunctional and unhealthy. Careers came before kids, and the extended absences common with the acting profession contributed to the end of their marriage.

Leland Yee was an American success story. Born in China, he came to America at the age of 3. He graduated from UC Berkeley, one of the top schools in the nation, then went on to obtain a doctorate in Child Psychology. He worked as a child therapist for years before entering politics in 1988. He was a member of the school board in San Francisco, a county supervisor, and a member of the State Assembly in California before winning a seat in the California State Senate in 2006. He gained a reputation as a staunch advocate for gun safety and sponsored numerous bills restricting access to guns in California. In 2012 he announced his candidacy for the office of California Secretary of State. Mr. Lee was respected member of the Asian community and honored by gun control groups. He was also a crook and a gun runner. He pleaded guilty to federal racketeering charges July 1, 2015.

The list of similarly admired people who are not at all admirable is seemingly endless. Sports heroes, celebrities and even pastors are placed on pedestals for public adoration only to later be found completely unworthy of respect. I am left wondering how it is that we idolize losers with such regularity.

I have come to the conclusion that it is human nature to want heroes. We want to have someone to look up to, someone who can help us believe that amazing things are possible. What we do not want to recognize is the truth that all people are all messed up, that no person is perfect, near perfect or even good at heart.

We choose distant people as heroes, people we do not know well, because we can overlook or deny their imperfections. When we know someone well we tend to know their faults and failures and all of the ways in which they are not heroic at all. We tend to focus on their imperfections and cast them aside as potential role models.

In my life I am learning to look up to a different kind of person. I am learning to admire those who work hard at being the best they can be outside of the public eye, people who are far from perfect, who know their flaws and do not hide them but instead work to overcome them every day. I believe it is these people, who labor in the shadows and whose accomplishments are overlooked by others, who are the greatest role models in our world.

When the day comes that we all stand before God and give account for our actions it will not be the Afflecks, Garners, Cosby’s and Lee’s who are recognized. The greatest honor will not be reserved for the Obamas, Bushes, Clintons or Romneys of the world, the movers and shakers and the most powerful. It will be for those individuals who honored God in their daily lives, who faithfully loved and served God outside of the eyes of the world.

May we all seek to be and to honor these kind of heroes.

Bart

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