How the ‘ordinary’ can effect change
An implant designed by an engineer to prevent his aorta enlarging has been fitted to 200 patients
The origins of several significant therapies can be traced to the astute observation by patients that a drug prescribed for one purpose had inadvertently alleviated the symptoms of some other quite unrelated condition. Hence the discovery of the value of beta blockers for those with essential tremor and in reducing the severity of migraine attacks; that the Parkinson’s drug ropinirole abolishes restless leg syndrome; and others.
This recognition of how patients might contribute to medical progress has recently been put on a more formal basis. Back in 2014, Prof Pedro Oliveira of Copenhagen’s Business School established the Patient Innovation website, encouraging people to propose novel solutions based on personal experience. There are now 850 ingenious and imaginative submissions, including the thermal bra designed by a woman following reconstructive surgery for breast cancer to combat the common and distressing problem of the intense coldness of her reconstructed breasts due to the loss of heat-generating tissue.
Louis Plante, an electrician and cystic fibrosis sufferer, noted that,
when attending a concert, the vibrations produced by the speakers helped clear the sticky secretions from his lungs, and he pioneered a sound wave-generating machine that boosts mucus flow. Digital whizz Stephen Bourke has developed the software for an app promoting compliance with complex drug regimes that now has 40,000 users in Britain. And most impressive of all, chartered engineer Tal Golesworthy designed an implant to prevent the enlargement of his aorta that has subsequently been inserted into 200 patients similarly afflicted.
The potential for “ordinary people” to make a significant contribution to medical progress is thus clearly considerable. It would be interesting to hear from readers of similar insights that might be worth exploring.
Ablation v medication
The merits of the procedure of catheter ablation compared to long-term therapy for the many with atrial fibrillation, as recently considered in this column, has predictably generated much interest. Ablation certainly improves the quality of life and reduces the risk of recurrence in those with fibrillation induced fatigue and breathlessness.
The question arises, however, as to whether it should also be the preferred option for those whose symptoms are already well controlled on medication. The prospect that it might obviate the need for continued drug treatment is obviously attractive especially when associated with adverse side effects.
Still, the procedure’s success cannot be guaranteed and there is admittedly the very small risk of complications such as haemorrhage or stroke. The relevant arguments are considered in some detail in a recent editorial in the Journal of the American Medical Association.
Meanwhile, retired cardiologist Alex Morris, who has himself been troubled by AF in the past, points out that for some the abnormal rhythm can be induced or exacerbated by excess consumption of alcohol and caffeine. Further, it may be the only manifestation of an overactive thyroid (hyperthyroidism) that needs to be tested for, as its treatment can be curative.
Divine intervention
Finally, further to the recent comments on the physical and spiritual benefits of pilgrimage, my thanks to a reader for passing on her experience of the miraculous power of prayer. When recently the intrusion of a neighbour’s dog into her garden caused her free-range hens to flee into a nearby wood, she spent several hours seeking them out and cajoling them to return. “I realised I had to get them all back before dusk or the fox would get them,” she writes. When all except her favourite golden hen had been retrieved, she requested divine intervention for which she vowed, in exchange, to sacrifice her craving for chocolate. Soon after, she saw the missing hen reunited with her companions – and has not craved chocolate since. Perhaps, she suggests, others wishing to give up on their cravings might consider doing a similar deal with the Almighty.